New Provider Residential Services Orientation

1. New ProviderResidential Services Orientation State of Georgia

2. Introduction What We Will Do - Educate Presented By: Georgia Association of Homes & Services for Children (GAHSC) Department of Human Services (DHS) - Office of Residential Child Care (ORCC) - Office of Provider Management (OPM) Department of Juvenile Justice (DJJ)

3. Who Should Attend Applicants for the Licensing of: Child Caring Institution – (Group Homes) Outdoor Child Caring Programs Child Placing Agency (Foster Care, Adoptions) Children Transition Care Centers (CTCC)

4. Who Should NOT Attend Day Care Center Operators Foster Parent wantabe’s Adult Personal Care Home Applicants Psychiatric Hospital Applicants Maternity Homes Applicants Insect Exterminators Applicants Beauty Shop Operators Applicants Road Contractors Applicants

5. Overview Normer Adams Executive Director Georgia Association of Homes & Services for Children www.gahsc.org normer@gahsc.org 404.572.6170

6. 1. Organizational Capacity and Needs Assessments 2. Licensure 3. Contracting with the State 4. Referrals and Payments Steps to Provision of ServicesPresentation Organization

7. Step one - Organizational Capacity and Needs Assessments Steps to Provision of Services

8. FIRST PRIORITY Develop the “BUSINESS PLAN” The Plan vs. Good Intentions -Board -Facilities -Budgets -Legal Issues -Constituency -Policies & Procedures Organizational Capacity Assessment

9. FIRST PRIORITY THE BUSINESS PLAN (continued) Research The Need The Competition Interviews Field Trips Needs Assessment

10. FIRST PRIORITY What will I be When I grow Up? Child PlacingAgency– An agency that recruits, supports and places children in foster homes Child Caring Institution – Group home or other congregate care environment where facilities are built for the placement and care of children. Outdoor Child Caring Programs – Programs using a wilderness model for care and treatment of children. Needs Assessment

11. FIRST PRIORITY What will I be When I grow Up? Child Placing – An agency that recruits, supports and places children in foster homes First placement priority for state. 75% of all foster children go into this placement. Lowest cost per day per child Regulations require that they be not-for-profit. You can not own them, profit from them or sell them. Needs Assessment

12. FIRST PRIORITY What will I be When I grow Up? Child Caring Institution – Group home or other congregate care environment where facilities are built for the placement and care of children. This is last placement choice for children with basic needs. DFCS is not issuing any new contracts for this service Only 14% of all foster children are placed in these facilities. Needs Assessment

13. FIRST PRIORITY What will I be When I grow Up? Outdoor Child Caring Programs – Programs using a wilderness model for care and treatment of children. These are wilderness programs for children. Most are considered treatment facilities. Few of these facilities are being used for placement. Requires over 500 acres in land. State very reluctant to contract with new providers. Needs Assessment

14. FIRST PRIORITY What License should I get? Child Placing/ Foster Care Private Family centered Child Care Few Capital Costs Labor Cost follow Labor needs Higher Reimbursement to Cost ratio Higher Percentage of children entering care Required to be “Not-for-Profit” Child Caring Institution / Group Homes Campus focused Child Care High Capital Costs Labor cost do not follow labor needs Lower Reimbursement to Cost ratio Lower percentage of children entering care No requirement for “not-for-profit.” Needs Assessment

15. Board Development(Not-for-Profit Only) Should you be a Not-for-Profit (501 c 3)? Organizational Capacity Assessment

16. Georgia’s Priority of Placement Organizational Capacity Assessment

17. Board Development(Those who are accountable for the organization) Truism - An organization is as strong as its Board. Choose people who can help you Go beyond friends and family Movers and Shakers of community make good Board Members Organizational Capacity Assessment

18. Executive Director(He/She who manages the organization) Choose person of experience, integrity, responsibility and history He/She will represent your organization He/She will carry out your policies and procedures Organizational Capacity Assessment

19. Budgets and BudgetingBudget Development Expenses Staff--Base Pay Benefits Insurance--Property, Casualty, & Liability Food Clothing Transportation Other Income State Fees Contributions-nonprofit only Charity gifts Grants Endowments Organizational Capacity Assessment

20. Budgets and Budgeting Medical Care Covered by Medicaid – Nearly all children in residential care qualify for Medicaid. Organizational Capacity Assessment

21. Fundraising Grants for Startup List of all the Foundations and Charities that give to new organizations starting children homes and group homes. Organizational Capacity Assessment

22. Fundraising Grants for Startup All Foundations and Charities: 1. 2.3. Organizational Capacity Assessment

23. Fundraising Grants for Startup Very Few Only to Existing Groups Need 501(c)(3) status – Not-for-Profit Anticipate 18 months for startup support Build constituency Organizational Capacity Assessment

24. Not-for-profit Organization(Nearly all are 501(c)3) Internal Revenue Service (IRS) Regulations for securing tax deductible contributions Takes at least 1 year to secure A knowledgeable person can do it without lawyer Organizational Capacity Assessment

25. Your Facilities Fire Inspection - # 1 Problem Area Most Expensive to Correct State Regulations, County Interpretations and enforcement Organizational Capacity Assessment

26. Your Facilities Truism- If Community Support starts off negative, walk away. It will never turn positive. Community Support - # 2 Problem Area Build Support Carefully If negative, hard to overcome Use community leaders to lead Organizational Capacity Assessment

27. Your Facilities Zoning – The “Tip Off” to the Community -- Required before Licensing-- Zone for “a licensed childcare institution for six or more unrelated children”-- Movers and Shakers of community can help with this Organizational Capacity Assessment

28. Policies & Procedures(Provides the why and how of the organization) Truism – If your director can not explain them, they should not be your director. Get a person who has done residential child care to prepare your policies and procedures These are your rule books for operations You will live and die by them They become your Bible for operation Organizational Capacity Assessment

29. Technical & Clinical Assistance(Gut instinct is not enough.) Truism – Education and Experience is more valuable than gut instinct. A compliant child may be a depressed child. An attentive, indulgent staff may be a pedophile. Money in your pocket may not mean money in the bank. Your High School Joe might like your facility as coed, but you won’t. Organizational Capacity Assessment

30. Staff & Personnel Issues(They make or break your organization) Truism - Your program is as good as your worst staff. A thorough background check is essential. “Would you let these folks care for your child?” Organizational Capacity Assessment

31. Reporting Requirements Truism – God Forgives but the State never Forgets Child Abuse Reporting Requirements Stuff will happen! Self-report. The law requires you to report abuse and neglect. Do not even THINK of not reporting. Preserve your relationship with State by dealing with integrity. Organizational Capacity Assessment

32. Working with the State Some SteerThe State is our partner in caring for children. Their role is regulatory and contractual. Respect it. Others RowOur role is providing services to children. Together we work to provide the best care for children. Organizational Capacity Assessment

33. Budgeting/Rate Setting Truism – Child Welfare programming makes for a bad business investment. Georgia’s regulations prohibit any organization from making money. Your daily per diem will be the lesser of your costs or the maximum rate. Organizational Capacity Assessment

34. Budgeting/Rate Setting Truism – If you are doing it for the kids, then the money will come. Funding remains the top priority for any administrator! Without money, nothing happens. The State is your number # 1 customer, and quite often, your only customer! In Georgia, there are only a hand full of For-Profit agencies. (There is a reason for this. There is no profit in child welfare!) Organizational Capacity Assessment

35. Budgeting/Rate Setting Placement providers are paid a per diem for Room and Board and Watchful Oversight. CCIs - Group Homes Base $101.82 AWO $128.98 MWO $181.84 2nd Chance $162.91 Teen Development $108.21 Maternity home $101.82 Organizational Capacity Assessment

36. Budgeting/Rate Setting Placement providers are paid a per diem for Room and Board and Watchful Oversight. CPAs – Child Placing Agencies (Fixed Payment to Agency) Traditional $21.44 Base WO $29.02 Max WO $40.07 SBWO $45.00 SMWO $69.00 SMFWO $81.00 Organizational Capacity Assessment

37. Budgeting/Rate Setting Placement providers are paid a per diem for Room and Board and Watchful Oversight. CPAs – Child Placing Agencies (Payment to Foster Parent based on age of child) 0-5 years of age $14.60 6-12 years of age $16.50 13+ years of age $18.80 Organizational Capacity Assessment

38. Departments & Divisions of State Agencies

39. Step Two - Licensure Steps to Provision of Services

40. New Provider Orientation Presenter: Rhonda James, DHS—Office of Residential Child Care Presentation to: GAHSC New Provider Orientation Date: Quarterly (2nd Tuesday of the Month) Georgia Department of Human Services

41. Vision, Mission and Core Values Vision Stronger Families for a Stronger Georgia. Mission Strengthen Georgia by providing Individuals and Families access to services that promote self-sufficiency, independence, and protect Georgia's vulnerable children and adults. Core Values Provide access to resources that offer support and empower Georgians and their families. Deliver services professionally and treat all clients with dignity and respect. Manage business operations effectively and efficiently by aligning resources across the agency. Promote accountability, transparency and quality in all services we deliver and programs we administer. Develop our employees at all levels of the agency.

42. DHS Office of Residential Child Care Services LICENSE CATEGORIES CCI--Child Care Institution also known as a group home. CPA--Child Placing Agency…foster care services and adoption (both domestic and international)…Home study Only CTCC--Children Transition Care Center—medically fragile children. OCCP--Outdoor Child Caring Program—Wilderness Camp…requires 10acres of land per child. Maternity Homes/Second Chance Homes—home for pregnant mothers and mothers and babies. Runaway and Homeless Youth Programs(RHYP)—a registered program. DETERMINE WHICH TYPE OF PROGRAM YOU WANT TO BE.

43. Applying for Licensure • All CCI’s, CTCC’S. OCCP’S & MATH, RHYP—must obtain local zoning and fire approval before submitting an application. • Download the application package @ www.ors.dhr.georgia.gov • Familiarize yourself with ORS rules and regulations and develop a working knowledge of the meaning and intent of the rules. • Develop policies and procedures to address each rule. • Prepare your agency for compliance with the rules and regulations.

44. STAFF QUALIFICATIONS FOR CCI • Director—master’s 2-years of related experience or Bachelor’s degree and 4-years of related experience. • Human Services Professional—provides the case management…bachelor’s degree approved field and 2-years of experience or a master’s degree in approved field of study. • Child Care Worker—must be at least 21 years of age and have a HS Diploma or a GED.

45. PHYSICAL PLANT FOR CCI • Water/Sewage…If the home operates on a septic tank must submit Environmental Health Inspection or copy of city water bill. • Bedrooms--63 sq.ft. per resident for double occupancy and 75 sq.ft. for single occupancy. • Must document space capacity to serve at least six residents not to exceed 16. • Must document a food service permit if providing care for thirteen(13) or more residents.

46. PHYSICAL PLANT FOR CCI (cont.) • Bathrooms--one sink/toilet per 8 residents and 1 shower per 10 residents. • There must be a separate bathroom for staff. • A staff member may not enter into a resident bedroom to access the bathroom • An initial on-site inspection is completed and observed for SAFETY FIRST—INSIDE AND OUTSIDE.

47. STAFF QUALIFICATIONS FOR A CPA • Director--must have a bachelor’s degree and 2-years of related experience unless they are providing the clinical case supervision. • Case Worker Supervisor (Social Service) Master’s Degree and 2-years of related experience in a CPA. • Case Worker—Bachelor’s degree • There are no physical plant requirements for a CPA.

48. STAFF QUALIFICATIONS FOR CTCC • Director--Master’s degree or higher in nursing; social work or other health related fields and two years of experience working with medically fragile children. • A licensed registered nurse, physician, other licensed health care professional with at least five years of experience working with medically fragile children.

49. Staff Qualifications for CTCC cont. • Human Services Professional—bachelor’s degree in social work with two years experience or a master’s degree. • There shall be sufficient staff members on duty at all times to assure each child proper care according to his/her needs. When children are present at the center, there shall be at least one awake RN on duty.

50. Physical Plant for CCTC • Water/Sewage…If home operates on a septic tank must submit Environmental Health Inspection or copy of city water bill. • Bedrooms--63 sq.ft. per resident for double occupancy and 75 sq.ft. for single occupancy. • Bathrooms--one sink/toilet per 6 residents. • One shower per 6 residents. • Separate bathroom for staff.