November 15, 2013
Agenda Item
Person
Responsible
to Lead
Discussion
Introductions
and Welcome
Ron Scroggy
DFCS Director
Comments
Sharon Hill
DHS
Commissioner
Comments &
Discussion with
Providers
Commissioner
Horton
[DFCS/PROVIDER
LEADERSHIP MEETING]
Notes
Submitted by C. Dresser, Georgia Alliance of Therapeutic Services (GATS)
In attendance: DHS Commissioner Keith Horton; DFCS Director Sharon Hill; Mike Angstadt, Twin
Cedars; Amber Black, Jesse’s House; John Blend, Goshen Valley; Susan Boatwright, DFCS; Roxanne
Cade, DFCS; Lori Campbell, MENTOR; Cheryl Dresser, GATS; Brooke Ford, RCC; Charles Hampton,
AGAPE; Karen Hardy, DFCS; Camille Harvin, DFCS; Jill Holder, A Friend’s House; Bruce Johnson, DFCS;
Shaun Johnson, DFCS; Dianne Kelly (Yearby), DFCS; Scott Merritt, KidsPeace; Melody Meyer, RCC;
Richard O’Neill, DFCS; Alieizoria Redd, FFTA/Lutheran Services; Heather Rowles, MAAC; Ron Scroggy,
Together Georgia; Cindy Simpson, CHRIS Kids; Gwen Skinner, Devereux; Floyd Sloan, DFCS; Michael
Stiles, DFCS; David Teubl, DFCS; Carol Winstead, RCC
1. Discussed media coverage of issues – story will be broadcast tonight (11.15.13) on Channel 11
regarding Cobb & Gwinnett cases. DFCS has received phone calls and e-mails of support from other
states’ agencies.
2. DFCS will involve provider community in planning – providers were given the opportunity to express
interest in working/planning groups with DFCS at the Practice Matters meeting; those work and
planning groups will be developed over the next few weeks. For providers who were unable to attend
Practice Matters, they will be given the opportunity to declare areas of interest through response to
GA Score notification
1. Commissioner stated his intent that the agency must be a better partner with providers. He
attended a recent meeting with Mary Margaret Oliver and Chairman Willard regarding a foster care
youth who stayed in jail over 52 days for a simple violation. DFCS is in process of drafting a memo
regarding providers calling law enforcement requesting that providers notify DFCS when they call law
enforcement and/or a youth is incarcerated. There is a joint DFCS/Provider workgroup that is
reviewing provider practices and situations, and will be developing recommendations for protocols.
The possibility of expanding the curriculum of Crisis Intervention Team (CIT)
(http://www.nami.org/template.cfm?section=cit2 to include how to respond to DFCS youth was
discussed. CIT training is currently available in Georgia under the auspices of DBHDD and NAMI.
2. Commissioner Horton requested the provider community to work in partnership with DFCS to
reduce the amount of “hoteling” that occurs because providers will not admit certain DFCS youth into
their programs. There was substantial discussion around this issue, including the lack of information
available to provider for DFCS youth when emergency placements need to be made (late Friday nights,
weekends); the wariness of providers admitting high risk youth and resultant RCC findings if an
incident occurs.
3. Commissioner presented the idea of a certification program for provider direct care staff. There has
been discussion about this over the years, and programs in England and Chapel Hill had been reviewed.
Discussion included the recommendation that DFCS review the DBHDD Developmental
Disabilities/Technical College partnership model that was created some years ago. DFCS is in process
of reviewing MWO direct care staff, collecting information on certification, orientation training, and
training plans and will develop a survey for response by MWO providers. KidsPeace has a model in
which salary is based on training; they will provide the model to DFCS for information.
4. DFCS is working with DJJ, DBHDD, and DCH to address the new Children in Need of Services (CHINS)
requirements. DFCS created a draft MOU for juvenile court judges that is being reviewed by DBHDD,
DJJ, DCH, and calling DOE today. The MOU will be shared with providers. There will be a pilot project
with Judges Tilley and Harrison for CHINS problem solving court to determine how best to engage
parents and hold them accountable. Providers shared the following information: Forsyth County has
opened a reporting center and is using aggression replacement training which includes a family
component; Cobb County Juvenile Court is using the curriculum Thinking for a Change; Troup County is
utilizing Functional Family Therapy. DFCS is in process of doing an inventory of all community
resources available in each county; suggested that they review United Way’s inventory.
November 15, 2013
Common
Referral
Cindy Simpson
Medicaid
Redesign/
Amerigroup
All
Group Homes –
Holding Beds
Gwen Skinner
Lt. Governor’s
Foster Care
Initiative Work
Group
All
ILP Work Group
Update
Cindy Simpson
[DFCS/PROVIDER
LEADERSHIP MEETING]
5. DFCS is opening a dialogue with school social workers and counselors. Several education issues
were discussed: home schooling (Mary Margaret Oliver may pose legislation for better regulation);
principals taking mandated reports and not sending them out; the need for relevant reports.
6. Commissioner asked providers “what can DHS/DFCS do better?” Providers listed the following:
 Concerned about Amerigroup’s rates and service authorization
 WellCare is in process of slashing services
 SHINES and billing issues – discussion regarding the requirement by DFCS case manager to
enter information into SHINES for respite (CPAs) and providers not receiving payment due to
lack of data entry. Some barriers were identified: children moved without notification to the
Placement Unit; glitches in SHINES; DFCS not notified until billing becomes an issue; case
workers not trained to enter respite data
 Gaps in payment
 RCC/OPM duplicative processes
 Providers wary of admitting youth at high risk of behavioral issues due to RCC repercussions
 Difficulty of getting necessary information from DFCS for emergency admissions; fear that
CHINS will exacerbate the problem
7. ACTION STEPS
 Charles Hampton will provide billing issues/data to DFCS
 Diane Kelly will head up workgroup to look into billing and training issues that will include
Dave Teubl and Data Integrity Specialists; and will provide an update at the next
DFCS/Provider Leadership Meeting on December 20, 2013
 Use Practice Matters forum to discuss maltreatment in care and RCC issues – providers will
collect descriptions of RCC standards/responses that cause them to be leery of admitting high
risk youth – which may exacerbate the hoteling problem
 DFCS will review hotel expenditures, lengths of stay, and placements following hotel stays
 DFCS is creating a joint provider/DFCS planning committee to provide solutions and
recommendations to DFCS for hard to place youth
The final draft Common Referral was introduced at Practice Matters with instructions that it be used
between then and end of December as a practice exercise; then used January through March with
workers and providers submitting feedback to OPM, with expectation of full implementation May 1. It
was noted that the draft does not include DJJ and there needs to be follow-up on DJJ’s inclusion.
Providers voiced concern regarding possible decrease in rates. Providers also voiced concern regarding
DFCS readiness to place children after very short lengths of stay in PRTF – Amerigroup is unlikely to
authorize lengths of stay equal to current APS practice.
Issue – when youth abscond and bed is held open, providers can get penalized in SHINES for not
providing services while the youth is not in residence. Beds may be held for up to ten (10) days
Depending upon the frequency of required services the rate of penalization increases.
ACTION STEPS:
 Providers will e-mail examples/issues to Diane Kelly
 Diane will discuss with Care Solution to determine a resolution
Providers voiced concern that DFCS was not in attendance. First meeting was largely presentations by
FaithBridge. Other providers will be speaking at the next meeting and the group plans to review other
states/entities such as Wisconsin, New York, and New York City.
First meeting was attended by six providers, reaching out to others to join the discussion. Intent of the
work group is to develop recommendations to DFCS such as moving from measuring “participation” to
measuring “competency”
ACTION STEPS:
 Cindy will provide meeting notes from the first meeting to Diane Kelly
 Second meeting will be scheduled and notification sent out
November 15, 2013
Per Diem
Reimbursement
Work Group
John Blend
TraumaInformed
Statewide
Rollout
All
State ID Cards
Roxanne Cade
CPA Measures
Diane Kelly
Next Meeting
[DFCS/PROVIDER
LEADERSHIP MEETING]
DFCS – Rich O’Neill provided data that the work group is using to make recommendations for
developing new costs based on a more sustainable business model, considering the unfunded
mandates over the last several years
Providers want to insure they are aligned with DFCS expectations regarding trauma-informed care and
are looking at DFCS for guidance. DFCS stated they do not have a current project plan, but a plan does
need to be included for report to the Feds. DFCS is grappling with how to move the conversation from
an academic perspective to welfare practice. CHRIS Kids is using the ARC model
(http://alamedacountytraumainformedcare.org/attachment-self-regulation-and-competencyarc-acomprehensive-framework-for-intervention-with-complexly-traumatized-youth/
The National Association for Children’s Behavioral Health is promoting trauma-informed care at its
December conference (http://www.nacbh.org/PubDocs/TechnicalMeeting2013_ProgramMaterials.pdf
DFCS is in the process of negotiating a MOU with DDS to expedite the process of obtaining ID cards for
foster care youth. DFCS is also looking into a waiver process to waive the requirement for certain
documents and determining what kind of information foster care youth do have easily available. DFCS
is considering a pilot with satellite sites to be identified. Providers are currently responsible for the
$30.00 fee. DFCS has engaged the legal department to look into inconsistencies across the counties
ACTION STEP:
 Roxanne will ask DDS if they are willing to waive the fee
Some adjustments to CPA measures will be announced soon and there will be discussion to get CPAs’
input about last year’s performance
December 20, 2013, 10:00 AM, 2 Peachtree, 29th floor, Boardroom