Georgia

1. Georgia Georgia’s Lead Agency Plan

2. KVC Behavioral Healthcare The lead agency in the North East Region of Kansas and Metro Kansas City, Kansas since 1996: New lead agency in Omaha and Southeast Regions of Nebraska; Child Welfare provider in West Virginia Responsibilities Include: KVC has a 24/7 Intake with centralized support and MIS data entry & reporting KVC provides all quality assurance of the lead agency network KVC provides private fund raising from their service areas 2

3. KVC Behavioral Healthcare Responsibilities Include: Case management for both child and family to achieve permanency through reunification or placement in an adoptive home or Other Planned Permanency Living Arrangement (OPPLA) Foster Care placement, Foster Parent recruitment, retention and training Adoption services including recruitment, and support achieving 1000 adoptions in 1000 days as the lead agency 3

4. Eckerd Community Alternatives The lead agency serving Pinellas and Pasco Counties for the past 1 ½ years Provides community engagement, oversight of children and families protection and well-being System accountability, network development and subcontract oversight Community development using indigenous resources Collaborative leadership with stakeholders 4

5. Florida’s entire system of care is privatized and heavily based in the concept of local community involvement and responsibility for the outcomes for the children System implemented for over 10 years and ECA is the 3rd Lead Agency in the Clearwater, FL area. Preceding two failed Florida DCF or the local sheriff’s office provides the initial protective service investigation and refers children to ECA for out of home placement. Eckerd Community Alternatives 5

6. KVC and ECA Similarities Intake and placement of children in out of home settings Foster home recruitment, retention and recommendation for licensing for all foster and adoptive homes Full case management designed to achieve permanency including reporting to the court and making recommendations Independent Living Services 6

7. KVC and ECA Similarities Adoption Services Aftercare and transitional services Subcontractor network development and monitoring Quality management and oversight of their internal operations and those of their subcontractors Annualizes the System Of Care performance and recommendations for improvement 7

8. Systems Role of the Public Agency Monitors Lead Agency contract through a variety of monthly, quarterly and annual reports to evaluate performance outcomes and financial accountability Provides technical assistance and training to Lead Agency staff Maintains the relationship with the federal government 8

9. Systems Role of the Public Agency • Maintains the protective services investigation and decision to place out of home • Maintains the child welfare legal system (legal representation for children)

10. Conclusion and Recommendations A lead agency would best benefit Georgia’s children and the Division of Family and Children's Services creating the following: Reduction in the number of contracts for DFCS to monitor and maintain Creating a procurement environment of positive competition between providers Potentially budget neutral by using current purchase of service contracts 10

11. Conclusion and Recommendations Clarifying roles between public and private community creating greater efficiency “By spreading the whirlwinds around” this allows DFCS staff to focus on the development of new programs, evaluation of trends and monitoring outcome and quality DFCS will be able to hold lead agencies and providers more accountable for outcomes in support of CFSR, Kenny A and Fostering Connections 11

12. Conclusion and Recommendations Lead Agencies would receive incentives to achieve reunification or permanency through a capitated payment mechanism Eliminates artificial levels of care by focusing accountability of an outcome to one private agency Lead Agency will be able to be more flexible in requiring their staff to work the hours and days to “do what it takes” to deescalate crisis and avoid a higher level of placement 12

13. Recommended DFCS Lead Agency Model To begin pilot with Two-Four lead agencies (Lead Agencies could serve in more than one region) Goal: Step children & their families through the continuum of services for the purpose of achieving three primary outcomes: Increased Safety Permanency Well being Lead Agency contract will be performance-based with outcomes consistent with Kenny A, CFSR and Fostering Connections 13

14. Recommended DFCS Lead Agency Model Lead Agency Payment Mechanism: Payment will be a capitated rate based upon a case rate or Per Child Per Month Incentive payments for safe permanency will include the following: Child must remain in permanency for 12 mos. Re-entry before 12 mos. will result in reduced payment Mandatory 12 month aftercare 14

15. Lead Agency Model Lead agency will work in conjunction with DFCS case manager in providing enhanced services Lead agency will incorporate the following outcomes: Promote the safety of children Decrease the time it takes to achieve permanency for all children Enhance the DFCS system’s capacity and accountability 15

16. Lead Agency Functions Point of contact for placement and intake including referrals 24/7 resulting from investigations Evaluation based upon the North Carolina Family Assessment Survey to determine strengths and challenges to reunification and permanency Partnership with DFCS worker to diligently search relatives and other family significant for placement 16

17. Lead Agency Functions Conduct Utilization Management reviews Develop a System of Care for the region with sub-contracted providers and indigenous resources Develop a quality assurance plan for the region to include a continuous quality improvement process Lead Agency will be required to meet minimum financial standards to assure stability and the ability to manage financial risk of capitated payment mechanism 17

18. Lead Agency Functions Develop Independent Living Plan for children over the age of 14 Provide Training & Technical Assistance to subcontractors to achieve system goals 18

19. Lead Agency Responsibilities Utilize the Georgia Family Centered Case Practice Model and Principles to deliver all levels of practice using the following: Consider child’s safety and health paramount Provide relevant services with respect for and understanding of children’s needs and children’s and families’ culture 19

20. Lead Agency Responsibilities “No eject, no reject” therefore all children and families will have access to needed service or placement regardless of race, ethnicity, sexual orientation, physical or emotional handicap, religion, or special language needs Provide family with services needed to keep the child at home and safe Foster care will be temporary 20

21. Lead Agency Responsibilities Reunify children in out-of-home placements with their families within 12 months If child cannot be reunified within established timeframes set by federal and state law, DFCS will find a permanent home 21

22. Lead Agency Responsibilities Ensure children in out-of-home placement have the following: Stable placements that promote the continuity of critical relationships (i.e. parents, siblings and other relatives) Least restrictive placement settings to meet individual needs Long-term decision making for the child’s needs consistent with federal and state timelines 22

23. Next Steps What we would like to do: • Get your blessing to draft RFP • Plan release of RFP March 2010 • Plan a selection of lead agencies no later than May 1, 2010 • Start up and Implement no later than October 2010 • Extend current contracts to October 2010