New Provider
Residential Services
Orientation
StateOrientation
of Georgia
1
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)
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)
Orientation
3
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
Orientation
4
Overview
Normer Adams
Executive Director
Georgia Association of Homes
& Services for Children
www.gahsc.org
normer@gahsc.org
404 572 6170
Steps to Provision of Services
Presentation Organization
1. Organizational Capacity and Needs Assessments
2. Licensure
3. Contracting with the State
4. Referrals and Payments
Steps to Provision of Services
Step one - Organizational
Capacity and Needs
Assessments
FIRST PRIORITY
Develop the
“BUSINESS PLAN”
The Plan vs. Good Intentions
-Board
-Budgets
-Constituency
-Facilities
-Legal Issues
-Policies & Procedures
Organizational Capacity Assessment
FIRST PRIORITY
THE BUSINESS PLAN (continued)
• Research
– The Need
– The Competition
• Interviews
• Field Trips
Needs Assessment
FIRST PRIORITY
What will I be When I grow Up?
Child Placing Agency– 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
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
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
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
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-forProfit”
Needs Assessment
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-forprofit.”
Board Development
(Not-for-Profit Only)
Should you be a Not-for-Profit (501 c 3)?
For-Profit
•Personal profit and benefit
•Personal management
•Ownership of assets
•Risk of own resources
Not-for-Profit
•Community ownership
and control
•Community support
though contributions
•Risk of community
resources
Organizational Capacity Assessment
Georgia’s Priority of Placement
1.
2.
3.
4.
5.
6.
7.
Family
Relative
Friend
Adoption
Foster Care – public sector
Private sector foster care
Private sector group homes
Organizational Capacity Assessment
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
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
Budgets and Budgeting
Budget Development
Expenses
Income
• Staff--Base Pay
• Benefits
• Insurance--Property,
Casualty, & Liability
• Food
• Clothing
• Transportation
• Other
• State Fees
• Contributions-nonprofit
only
Organizational Capacity Assessment
– Charity gifts
– Grants
– Endowments
Budgets and Budgeting
Medical Care Covered by
Medicaid –
Nearly all children in
residential care qualify
for Medicaid.
Organizational Capacity Assessment
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
Fundraising
Grants for Startup
All Foundations and Charities:
1.
2.
3.
Organizational Capacity Assessment
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
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
Your Facilities
• Fire Inspection - # 1 Problem Area
– Most Expensive to Correct
– State Regulations, County Interpretations and
enforcement
Organizational Capacity Assessment
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
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
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
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
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
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
Working with the State
• Some Steer
The State is our partner in
caring for children. Their role is
regulatory and contractual.
Respect it.
• Others Row
Our role is providing services to
children. Together we work to
provide the best care for
children.
Organizational Capacity Assessment
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
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
Budgeting/Rate Setting
Placement providers are paid a per diem for Room
and Board and Watchful Oversight.
CCIs - Group Homes
Base
AWO
MWO
2nd Chance
Teen Development
Maternity home
$101.82
$128.98
$181.84
$162.91
$108.21
$101.82
Organizational Capacity Assessment
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
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
6-12 years of age
13+ years of age
$14.60
$16.50
$18.80
Organizational Capacity Assessment
Departments & Divisions
of State Agencies
DHS Office of Residential
Child Care
Child Care Licensing
Rhonda James (rjames@dhr.state.ga.us)
2 Peachtree Street, Atlanta, GA 30303
404-657-5589
http://ors.dhr.georgia.gov/portal/site/DHR-ORS
Steps to Provision of Services
Step Two - Licensure
DHR Office of Regulatory Services
Child Care Licensing
•
License Categories:
– CPA – Child Placing Agency - Placement of children in foster and or
adoptive homes; domestic and international placement
and home Study Services.
– CCI – Child Caring Institutions or group homes 6 or more residents 6-18
years old.
– CTCC-Children’s Transition Care Center—medically fragile children.
Short-Term (1-14 days); Long-Term (90-days)
– OCCP – Outdoor Child Caring Program - Wilderness Camps
– Maternity Homes (MATH)—home for pregnant mothers.
– Determine which type of program you want to be.
Licensure
How to Apply for Licensure
1. All CCIs & CTCCs MATH must obtain local
zoning and fire approval before submitting an
application
2. Download the licensure application package
3. Familiarize yourself with ORS rules and
regulations--develop a working knowledge of
the meaning and intent of these rules and
regulations
4. Develop policies and procedures to address
each rule
5. Prepare your agency for compliance with the
Licensure
regulations
Staff Qualifications
for CCI
• Director: Masters/2 years related experience or
Bachelors/4 Years related experience
• Human Services Professional (Social Services):
Bachelors/2 Years Experience or
supervised by Masters
• Child Care Worker: 21 Years Old/ High
School or GED
• Director and owner both must document a
satisfactory criminal records check.
Licensure
Staff Qualifications
for CPA
• Director: Bachelors/2 Years related
experience unless doing clinical
supervision of staff
• Case Work Supervisor (Social Services):
Qualified Masters/2 Years CPA
experience
• Case Worker: Bachelors degree
• Director and Owner must document a
satisfactory criminal records check
Licensure
Staff Qualifications
for CTCC
• Director: Master’s Degree or Higher in
Nursing, Social Work or other Health Related
field plus two years of experience working
with medically fragile children; or
• A licensed registered nurse, physician, other
licensed health care professional with at least
five years of experience working with
medically fragile children.
Licensure
Staff Qualifications
for CTCC (cont.)
• Human Services Professional:
Bachelors Degree in social work with
two years experience or a master’s
degree or be a licensed LPN or
registered nurse.
•There shall be one awake RN or other
staff on duty at all times when children
are present who is trained in first aid and
has a current CPR certificate.
Licensure
Criminal Records Check Law
• Must be in compliance with Criminal
Records Checks Law.
• If employee’s check reveals any crime,
person cannot be hired until resolved.
• Must submit Live Scan and application
to Office of Investigative Services
for clearance.
Licensure
Physical Plant for CCI
1. Water/Sewage
2. Bedrooms:63 Square Feet per resident
(double occupancy). 75 Square Feet (Single)
3. Bedrooms – must document space capacity to
serve at least six residents. Not to exceed 16
4. Bathrooms – one sink/toilet per 8 kids, 1
shower per 10 kids.
5. Separate bathroom for staff.
6. Staff may not enter into a resident bedroom to
access the bathroom.
7. SAFETY FIRST--Inside and Outside
Licensure
Physical Plant for CCTC
1. Water/Sewage
2. Bedrooms: 63 Square Feet per resident
(double occupancy). 75 Square Feet
(Single)
3. Bedrooms – must document space
capacity to serve at least six residents
4. Bathrooms – one sink/toilet per 6 kids.
5. 1 shower per 6 residents.
6. Separate bathroom for staff.
7. Staff may not enter into a resident bedroom
to access the bathroom.
Licensure
PHYSICAL PLANT CCTC (CONT)
• All centers serving a child or children dependent
on a wheel chair 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
wheelchair access.
• At least one bathroom of sufficient size to
accommodate a wheelchair and assisting staff.
Licensure
Behavior Management
• Develop behavior management
policies and procedures.
• Policies should address behavior
management techniques for type of
children served.
• A behavior management plan must
be documented in the resident’s
service plan.
Licensure
Behavior Management (cont’d)
•
•
•
Develop policies and procedures on
emergency safety interventions
Emergency safety means those behavioral
interventions techniques that are authorized
under and an approved emergency safety
intervention
ESI’s are to only be utilized by properly trained
staff in an urgent situation to prevent a child
from doing immediate harm to self or others.
Licensure
Waivers & Variances
• The department at its discretion may grant
a waiver or variance of specific rules upon
application being filed.
• Variance may be granted by upon showing
by the applicant that a particular rule or
regulation would cause 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
Regulatory Process
• Self-Assess for Rule Compliance and
Completed Application Materials
• Submit Application with all local approvals
if required
• Initial On-Site Inspection – Office
Conference for CPA’s: Temporary License
(12 Months)
• Annual Re-Licensing Inspections
• Follow-Up Inspections
• Complaints/Self-Reported Incidents
Licensure
LICENSURE
• Obtaining a license throught the office of
Residential Child Care does NOT
guarantee a contract with other state
departments to serve children and
adolescents.
Licensure
Break
Steps to Provision of Services
Step Three - Contractual
Process for Providers
Division of Family
& Children’s Services
DFCS
The Office of Provider Management
404-657-3572
http://www.dfcs.dhr.georgia.gov/portal/site/DHR-DFCS/
New RBWO Provider Application Process
 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
Office of Residential Child Care
Services Purchased
New RBWO Provider
Application Process
As of 7/1/11, the start of FY2012, The Office
of Provider Management has revamped the
provider application process
 Revised provider applications are closely aligned
with the FY2012 RBWO Minimum Standards
 The revised application process now includes an
online New provider Self-Assessment
 New Provider application requests will be based
on specific services and locations identified on the
Current RBWO Provider Service Needs List
Services Purchased
New RBWO Provider
Application Process
Information about the application process
is now available online at
www.gascore.com
Once on the home page of the website,
click on the New RBWO Provider
Application Infolrmation – FY12 icon
(the third posting listed in the News and
Events section on the left side of the home
page)
Services Purchased
New RBWO Provider
Application Process
 Interested providers should review the
applicable New Provider Information
Sheet, which outline the process step-by
step
 New CCI Provider Information Sheet
 New CPA Provider Information Sheet
Services Purchased
New RBWO Provider
Application Process
 The New RBWO Provider Application Information FY12
icon also includes helpful reference resources for
review and downloading
 All documents reference on the CCI and CPA New
provider Information Sheets are available online:
 FY2012 RBWO Provider Service Needs List
 FY2012 RBWO Minimum Standards for CPAs and
CCIs
 DHS Map of Counties by Region
Services Purchased
New RBWO Provider Application
Process
After reviewing the New Provider
Application Process
Information online, interested providers
with questions
should contact:
The Office of Provider Management
Main Office
(404) 657-3572
Services Purchased
DJJ
Department of Juvenile Justice
DIVISION OF COMMUNITY
Services and Intake
Community Services and Intake (404)-508-6500
Patricia Lavalais (404) 508-5087
www.djj.state.ga.us
Department of Juvenile Justice
Division of Community Programs
Serves to Protect the Citizens of Georgia by
Providing Prevention Services, Court Services
and Supervision, Treatment and Rehabilitation of
Youthful Offenders.
Approval Process of Vendors
DJJ Contract Application Process
· Upon Obtaining Licensure, Contact the Residential
Placement Specialist (RPS) in the District in which Your
Facility is Located
· Potential Provider requests application package from the
Residential Placement Specialist.
· Completed Application is submitted to the Residential
Placement Specialist.
· Application is reviewed by Residential Placement
Specialist and supervisor.
Approval Process of Vendors
DJJ Districts and Regions
Residential Placement Specialists
4 DJJ Regions
NW, NE, SW, SE
Regional Placement
Specialists
1. Richard Fox (NW)
2. Kim Settles and Curtis
Washington (NE)
3. Jeffrey Bright and
Ayrica Rhodes (NW)
4. Carl Harrison (SW)
Approval Process of Vendors 5. Sue Riner (SE)
DJJ Contract Approval Process
• Residential Placement Specialist (RPS)
Conducts Site Visit
• Assesses Willingness and Ability to
Service Delinquent Youth
– School Issues
– Supervision
• Contract Process Initiated
Approval Process of Vendors
Characteristics of Children in
DJJ’s Care
•
•
•
•
•
Average Age - 13 (range is from 8-17)
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
Services to Children
in DJJ’s Care
• During FY 2004 - 59,000 and FY 2009 54,753 youth were served by the
Department of Juvenile Justice.
Services Purchased
Private Placements
Normer Adams, GAHSC
Private Placements
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
Characteristics of Children in
Private Placement
• Determined by agency’s mission and ability to
care for the child.
• And Agency’s ability to serve
Characteristics of Children
Private Placements
• 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
Private Placements
Referrals and Payments
• 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.
Referrals and Payments
Private Placements
Referrals and Payments
Most Private Placements are done on a
charity basis unless the placement is done
by another State.
Referrals and Payments
In Conclusion:
Steps to Provision of Services
1. Organizational Capacity and Needs Assessments
2. Licensure
3. State Approval Process for Vendors
4. Marketing to Referral Sources, DFCS, DJJ, Private
Sector