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New Provider Residential Services Orientation. Introduction. Presented By: Together Georgia (GAHSC) Department of Human Services (DHS) - Residential Child Care (RCC) - Office of Provider Management (OPM) Department of Juvenile Justice (DJJ). Who Should Attend.

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New provider residential services orientation

New ProviderResidential Services Orientation


Introduction

Introduction

Presented By:

Together Georgia (GAHSC)

Department of Human Services (DHS)

- Residential Child Care (RCC)

- Office of Provider Management (OPM)

Department of Juvenile Justice (DJJ)


Who should attend

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)


Who should not attend

Who Should NOT Attend

Day Care Center Operators

Foster Parent wantabe’s

Adult Personal Care Home Applicants

Psychiatric Hospital Applicants


New provider residential services orientation

1. Organizational Capacity and Needs Assessments

2. Licensure

3. Contracting with the State

4. Referrals and Payments

Steps to Provision of ServicesPresentation Organization


Www gahsc org office@gahsc org 404 572 6170

www.gahsc.org ♦ [email protected] ♦ 404.572.6170

Organizational Capacity and Assessment of Needs


Perspective how children youth come into care

Perspective:How Children/Youth Come into Care


Perspective characteristics of children in care

Perspective: Characteristics of Children in Care

DFCS Room Board and Watchful Oversight

Base / Traditional care

Base with Additional Watchful Oversight

Base with Maximum Watchful Oversight

Specialty Base Watchful Oversight

Specialty Maximum Watchful Oversight

Specialty Medically Fragile Watchful Oversight

https://www.gascore.com/content/page.cfm/12/out_of_home_care


Perspective georgia s priorities

Perspective: Georgia’s Priorities


Perspective georgia s preferred out of home placement hierarchy

Perspective: Georgia’s Preferred Out-of-Home Placement Hierarchy

In-Home with Bio Family

Relative Kinship Care

Foster Care

Group Homes


Perspective federal review oversight

Perspective: Federal Review Oversight

  • Permanency

  • Safety

  • Well-being


Research service needs

Research Service Needs

Licensure does not ensure a contract or placement of children

https://www.gascore.com/content/sitemap.cfm


Matching needs with services

Matching Needs with Services

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


Matching needs with services1

Matching Needs with Services

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.

Per Diem determined by level (basic to therapeutic) Generally lowest paid per day per child rates.


Matching needs with services2

Matching Needs with Services

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.

Only 14% of all foster children are placed in these facilities.


Matching needs with services3

Matching Needs with Services

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.


Matching needs with services what license should i pursue

Matching Needs with ServicesWhat License should I pursue?

Child Placing Agency (CPA)(Foster Care)

Private Family centered Child Care

Few Capital Costs

Higher Reimbursement to Cost ratio

Higher Percentage of children entering care

Required to be “not-for-profit”

Child Caring Institution (CCI)

(Group Homes)

Campus focused Child Care

High Capital Costs

Lower Reimbursement to Cost ratio

Lower percentage of children entering care

No requirement for “not-for-profit.”


Develop the business plan

Develop the “BUSINESS PLAN”

The Plan versus Good Intentions

-Board -Facilities

-Budgets -Legal Issues

-Constituency-Policies & Procedures

Is there a need for the service you are wanting to provide in the geographical area you are wanting to operate?


Board development not for profit only

Board Development(Not-for-Profit Only)

Should you be a Not-for-Profit (501 c 3)?


Board development those who are accountable for the organization

Board Development(Those who are accountable for the organization)

Truism - An organization is as strong as its Board.

Choose people who can provide expertise in a variety of areas (finance, marketing, social services).

Go beyond friends and family

(choose people who will provide open and honest feedback)

Valued stakeholder in community


Not for profit organization nearly all are 501 c 3

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


Executive director one who manages the organization

Executive Director(One who manages the organization)

Choose person of experience, integrity, responsibility and history

Balance of vision-focus and business

Remember he/she will represent your organization

They will be held accountable to carry out your policies and procedures


Staff personnel your most valuable asset liability

Staff & Personnel (Your most valuable asset/liability)

Truism - Your program is as good as your weakest link.

A thorough background check is essential.

“Would you let these folks care for your child?”


Budgets and budgeting budget development

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


Budgets and budgeting

Budgets and Budgeting

Medical Care Covered by Medicaid –

Nearly all children in residential care qualify for Medicaid.


Budgeting rate setting

Budgeting/Rate Setting

Placement providers are paid a per diem for Room and Board and Watchful Oversight (RBWO)

CCIs - Group Homes

Base$104.87

AWO$132.85

MWO$187.30

Maternity home$104.87

*Second Chance$104.87

Teen Development $111.46*plus $62.97 for the infant, total of $167.69


Budgeting rate setting1

Budgeting/Rate Setting

Placement providers are paid a per diem for Room and Board and Watchful Oversight (RBWO)

CPAs – Child Placing Agencies (Fixed Payment to Agency – excludes payment to foster parent)

Traditional$22.08

Base WO$29.89

Max WO$41.27

SBWO$46.35

SMWO$71.07

SMFWO$83.43


Budgeting rate setting2

Budgeting/Rate Setting

Placement providers are paid a per diem for Room and Board and Watchful Oversight (RBWO)

CPAs – Child Placing Agencies (Payment to Foster Parent based on age of child)

0-5 years of age$15.04

6-12 years of age$17.00

13+ years of age$19.36


Budgeting rate setting3

Budgeting/Rate Setting

Truism – Quality care resulting in good outcomes will be your best option for success

Securing adequate funding remains one of the top priorities for any administrator.

Without money, services can not happen.

The State is usually your #1 customer/payer

In Georgia there are only a handful of For-Profit agencies


Fundraising

Fundraising

Grants for Startup

Very few

Often only to Existing Groups

Need 501(c)(3) status – Not-for-Profit

Anticipate 18 months for start up support

Build constituency


Policies procedures provides the why and how of the organization

Policies & Procedures(Provides the why and how of the organization)

Develop P&P around licensing and contract rules and regulations.

Consult someone who has successfully done residential child care.

They should make sense to all who must operationalize them.

Train on them.

Follow your P&P in all ways at all times.

Keep them current.


Your facilities cci

Your Facilities (CCI)

Fire Inspection - # 1 Problem Area

Most Expensive to Correct

State Regulations,

County Interpretations

and Enforcement


Your facilities cci1

Your Facilities (CCI)

Community Support - # 2 Problem Area

Build Support Carefully

If negative, hard to overcome

Use community leaders to lead

Truism- Work hard to overcome “not in my backyard” mindset


Your facilities cci2

Your Facilities (CCI)

Zoning – The “Tip Off”

to the Community -- Required before Licensing-- Zone for “a licensed childcare institution for six or more unrelated children”-- Key Stakeholder of community can help with this


Reporting requirements

Reporting Requirements

Child Abuse Reporting Requirements

Stuff will happen - Self-report

The law requires you to report abuse and neglect

Always report, even if not certain of issue.

Preserve your relationship with State by dealing with integrity


Additional consideration to delivery of services

Additional Considerationto Delivery of Services

Performance Based Placement

Deliverables and Outcomes

Data Management, Documentation and Reporting

Competition

Experience

Accreditation


New provider residential services orientation

Oversight

Residential Child Care (licensing)

Office of Provider Management (DFCS contract)

PEAS

Kenny A (Fulton and DeKalb Counties)

Working with the State


New provider residential services orientation

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.

Working with the State


New provider residential services orientation

Departments & Divisions of State Agencies


Step two licensure

Step Two - Licensure

Steps to Provision of Services:


New provider residential services orientation

New Provider Orientation

Presenter: Rhonda James, DHS—Office of the Inspector General, Residential Child Care Unit

Presentation to: GAHSC New Provider Orientation

Date: Quarterly (2nd Tuesday of the Month)

Georgia Department of Human Services


Vision mission and core values

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.


Dhs office of residential child care services

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.


Applying for licensure

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 @ https://dhs.georgia.gov/forms-and-applications

  • 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.


Staff qualifications for cci

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.


Physical plant for cci

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.


Physical plant for cci cont

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.


Staff qualifications for a cpa

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.


Staff qualifications for ctcc

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.


Staff qualifications for ctcc cont

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.


Physical plant for cctc

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.


Physical plant for cctc cont

Physical Plant for CCTC (cont.)

  • Staff may not enter into a resident bedroom to access the bathroom.

  • All centers serving residents dependent on a wheelchair or other device for mobility shall have:

    --At least two exits, remote from each other, accessible

    to child with easily negotiable ramps.

    --All doorways and halls shall accommodate

    wheelchairs.

    --At least one bathroom of sufficient size to

    accommodate a wheelchair and assisting staff.


Maternity home basic and second chance services

Maternity Home (Basic and Second Chance Services)

  • Maternity home--is an agency providing care within any six-month period, to more than one (1) pregnant woman, either before, during or within two (2) weeks after childbirth. Providing care to pregnant youths through 21 years of age. Services are limited to eight weeks of services…unless providing Second Chance Home Services.

  • Second chance home--means a licensed maternity home that provides full-time residential care, support and supervision to pregnant and parenting youth through 21 years of age and their child(ren) that is expected to last for more than an eight (8) week period following delivery. Program services include parenting skills, such as child development, education, job training, transitioning to independent living, family budgeting, health and nutrition, and other skills to promote residents’ long-term independence and the well-being of their child(ren).


Maternity home basic and second chance services1

Maternity Home (Basic and Second Chance Services)

  • The director must possess a Masters or RN Degree and two years of related experience or a Bachelor’s Degree and four years of related experience.

  • The Human Services Professional (HSP) Must possess a Master’s Degree in social work, psychology, childhood education, education counseling and psychology, nursing or healthcare, or a related field or a bachelor's degree and either have two (2) years experience in a field related to the type of residents served or be supervised by another human service professional with a master's degree in one(1) of the above disciplines.

  • There shall be at least one HSP for every 16 residents in care including the infants.


Maternity home physical plant

Maternity Home (Physical Plant)

  • The sleeping room shall not be less than 75 square feet per resident in single rooms, and not less than 63 square feet per resident in multiple rooms

  • There shall be at least one (1) lavatory with hot and cold water, one (1) toilet and a bathtub and/or shower for every four residents.

  • A nursery is not required by these rules, however, maternity homes that include nurseries must meet the following additional requirements:

    The nursery shall be large enough to allow a minimum of 30 square feet of floor space and 300 cubic feet of air space per infant.

  • There shall be separate toilet and bath facilities for the residents and staff.


Runaway and homeless youth programs

Runaway and Homeless Youth Programs

Effective July 1, 2011, RCC is also authorized by law to register Runaway and Homeless Youth Programs (RHYP)

(O.C.G.A. § 49-5-160 et. seq.)

  • Runaway and Homeless Youth Programs (RHYP) - currently licensed child welfare agencies or 501(c)(3) organizations that serve children under 18 years old who have run away and/or are homeless.


Runaway and homeless youth programs1

Runaway and Homeless Youth Programs

  • The agency must submit a description of the range of services provided, the manner in which those services are provided to youth and a statement that the Services that are provided to youth, are limited to 72 hours.

  • The agency must submit operational policies and procedures.

  • Must have at least one staff member who is licensed.

  • There is an annual registration fee of $25.


Criminal records check law

Criminal Records Check Law

  • The director and owner of each license type must both document a satisfactory criminal records check (fingerprints—live scan)

  • All other employees must be in compliance with the law.

  • If any employee’s check reveals any crime, person cannot be hired until resolved and cleared through the Office of Inspector General’s.

  • Any person acting in the absence of the director must meet the qualifications of the director and document a satisfactory CRC.


Waivers variances

Waivers & Variances

  • The department at its discretion may grant a waiver or variance of specific rules upon application being filed.

  • A variance may be granted upon the applicant showing that a particular rule or regulation would cause an undue hardship.

  • A waiver may dispense entirely with the enforcement of a rule or regulation upon showing that the purpose of the rule or regulation is met through equivalent standards.


Licensure process

Licensure Process

  • Self Assess for rule compliance and completed application materials.

  • Submit application with all necessary local approvals if required. (zoning, fire inspection, CO, etc.)

  • Initial on-site Inspection scheduled—an office conference for a CPA. If approved, a Temporary License is issued for 12 months.

  • Annual re-licensing inspections

  • Follow-up Inspections

  • Complaints/ Self-reported incidents


Licensure

LICENSURE

  • Obtaining a license through the Office of

    Residential Child Care does NOT guarantee a

    contract with other state agencies or departments

    to serve children and adolescents.


B r e a k

B r e a k


Step three contractual process for providers

Step Three - Contractual Process for Providers

Steps to Provision of Services:


New provider residential services orientation

New Provider Orientation

Presenter: DFCS, Office of Provider Management

Presentation to: GAHSC New Provider Orientation

Date: October 8, 2013

Georgia Department of Human Services


Vision mission and core values1

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.


Becoming a new rbwo provider

Becoming a New RBWO Provider

  • The RBWO Provider process is handled through the Department of Families and Children Services (DFCS) Office of Provider Management (OPM)

  • The process applies to agencies seeking to obtain a RBWO Provider contract as a Child Placing Agency (CPA) or Child Caring Institution (CCI)

  • Agencies seeking a RBWO Provider contract with DFCS must have an applicable CCI or CPA license from the Residential Child Care


New rbwo contract deadlines and effective dates

New RBWO Contract Deadlines and Effective Dates

  • As of April 2013, the start of FY2013, The Office of Provider Management established new contract deadlines and effective dates.

    • There are two (2) contract lifecycles within a fiscal year:

      • July 1st

      • October 1st


How to become a rbwo provider

How To Become A RBWO Provider?

www.gascore.com


How to become a rbwo provider1

How To Become A RBWO Provider?


Provider information sheet

Provider Information Sheet

  • Interested providers should review the applicable New Provider Information Sheet.

    • New CCI Provider Information Sheet

    • New CPA Provider Information Sheet


3 ring binder

3 Ring Binder

  • RBWO Application

  • RCC License

  • Agency’s Policies & Procedures

  • Agency’s Training Plan

  • Organizational Chart

  • Budget

  • W-9

  • Evidence of Criminal Records Check

  • Vendor Form (along with voided check)

  • Insurance ($1 million per occurrence/$3 million aggregate policy limits)*Exception

    • Malpractice/Professional Liability

    • Commercial General Liability

    • Commercial Umbrella Policy

    • Workers Compensation Insurance (if plans are to employ 3 or more employees)

    • Business Auto Policy (*$1million per occurrence/$1 million aggregate policy limits)


Available resources

Available Resources

  • RBWO Provider Service Needs List

  • FY2014 RBWO Minimum Standards for CPAs and CCIs

  • DHS Map of Counties by Region

  • RBWO Contract Deadlines and Effective Dates Memo

  • Previous Trainings and Upcoming Trainings


Contact information

Contact Information

After reviewing the Becoming a New Provider

Information online,

interested providers with questions

should contact:

The Office of Provider Management

via email [email protected]


Questions answers

Questions & Answers


New provider residential services orientation

Department of Juvenile Justice

Division of Community Services

Serves to Protect the Citizens of Georgia by Providing Prevention Services, Court Services and Supervision, Treatment and Rehabilitation of Youthful Offenders.


Department of juvenile justice

DEPARTMENT OF JUVENILE JUSTICE

Avery D. Niles, Commissioner


New provider residential services orientation

MISSION:

Our Mission is to protect and serve the citizens of Georgia by holding young offenders accountable for their actions through the delivery of services and sanctions in appropriate settings and by supporting youth in their communities to become productive and law-abiding citizens.

VISION:

OFFER HOPE AND YOUTH CHANGE.DJJ will lead the nation in preparing young people in its care to develop and sustain productive lives.


New provider residential services orientation

Division of Community Services

4 DJJ Regions – NW, NE, SW, SE

Regional Placement Specialists: Direct Oversight of all Contracted Residential Providers licensed as Child Caring Institutions & Child Placing Agencies

NW – Margaret Cawood SW – Archie Herman

NE – Victor Roberts SE – Jeffery Alligood

http://www.djj.state.ga.us/FacilitiesPrograms/fpDistrictsMain.shtml


New provider residential services orientation

Average Age - 13 (range is from 10-22)

Mostly Males

Most Common Offenses - Property & Status

Oppositional - Lack Impulse Control

Common Mental Health Diagnoses - Conduct Disorder, Depression, PTSD

Substance Abuse Issues

Characteristics of Children in DJJ’s Care


New provider residential services orientation

During FY 2010 – 44,502 and FY 2011 - 40,226 youth were served by the Department of Juvenile Justice.

Services to Children in DJJ’s Care


Www gahsc org office@gahsc org 404 572 61701

www.gahsc.org♦ [email protected] 404.572.6170

Private Placements


New provider residential services orientation

Agency determines what services to sell (or give away) to the private individual or corporation

(usually another state.)

The nature of these services is determined on the ability to provide those services within the Licensing framework and approved levels of care.

Services Purchased


New provider residential services orientation

Determined by agency’s mission and ability to care for the child.

And Agency’s ability to serve

Characteristics of Children in Private Placement


New provider residential services orientation

Client Application Process-- Licensing allows an agency to provide out-of-home services. Within the rules of Licensing, each agency develops their own application process.

Contract Approval Process -- There is no approval process save Licensure.

Approval Process of Vendors and Marketing


New provider residential services orientation

Referrals - Referrals are made by private individuals or agencies or another state. This referral network is determined by the agency.

Payments - Payments are negotiated with each referring party.

Private PlacementsReferrals and Payments


New provider residential services orientation

Private Placements usually include:

a charity basis

another State

Insurance

private pay

Referrals and Payments


New provider residential services orientation

1. Organizational Capacity and Needs Assessments2. Licensure

3. State Approval Process for Vendors

4.Marketing to Referral Sources,

DFCS, DJJ, Private Sector

In Conclusion:Steps to Provision of Services


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