statewide access to safe and appropriate placements governor’s action group for safe children...
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Statewide Access to Safe and Statewide Access to Safe and Appropriate PlacementsAppropriate Placements
Governor’s Action Group for Safe Children
Draft Recommendations for Discussion
Governor’s Action Group for Safe ChildrenGovernor’s Action Group for Safe ChildrenWork Group # 2: Statewide Access to Safe Work Group # 2: Statewide Access to Safe
and Appropriate Placementsand Appropriate Placements
• Inventory existing placement options• Use existing data and best practice to
define gaps in continuum of placement options
• Consider existing child profile data to prioritize highest system need for placement options
Inventory of Placement OptionsInventory of Placement Options&&
Priorities ofPriorities ofHighest System NeedsHighest System Needs
Priority #1: Quality Foster Priority #1: Quality Foster Care, including family- and Care, including family- and
group-based caregroup-based care
Priority #1: Quality Foster Priority #1: Quality Foster Care, including family- and Care, including family- and
group-based caregroup-based care
• Address process issues – Image, Marketing, Support, Per Diem, Community Involvement
Foster Homes: Current Number of Homes by DHR Regions/DJJ Districts
397 284
1023
240
245
265
191
312
184
325
223 219Source: Department of
Juvenile Justice, Division of Family and Children
Services, Office of Regulatory Services; May
2002
1 397
2 284
3 1023
4 245
5 240
6 265
7 191
8 312
9 184
10 223
11 219
12 325
Total 3908
Group Homes: Capacity by DHR Regions/DJJ Districts
79 153
812
123
165
247
16
41
224
198
52 44
Source: GA Department of Juvenile Justice,
GAHSC Database; May 2002
1 79
2 153
3 812
4 165
5 123
6 247
7 16
8 41
9 224
10 52
11 44
12 198
Total 2154
Elements ofElements ofQuality Foster CareQuality Foster Care
• Foster homes with higher standards
• Sibling placements
• Therapeutic foster homes
• Kinship care
Determining Need for Quality Determining Need for Quality Foster Care, includingFoster Care, including
family- and group-based carefamily- and group-based care
• According to DFCS: • In FY 1999 Georgia had 5,000 Foster Homes • In FY 2000, Georgia had 4,000 Foster Homes• In FY 2001, Georgia had 3,800 Foster Home
• The number of children in foster care has increased from 12,693 in FY 1999 to 13,965 in FY 2001.
• This decrease in the number of Foster Homes and the increase in the number of children in foster care has created significant pressure on current foster homes due to overcrowding and shortage of appropriate foster home placements.
Determining Need for Quality Determining Need for Quality Foster Care, includingFoster Care, including
family- and group-based carefamily- and group-based care
Priority #1: Quality Foster Priority #1: Quality Foster Care, including family- and Care, including family- and
group-based caregroup-based care
• At least 1,200 additional quality foster homes needed statewide
Priority #2: Priority #2: Therapeutic Placements – Therapeutic Placements – Intermediate and Intensive, Intermediate and Intensive, including family, group and including family, group and
residential settingsresidential settings
Alcohol & Drug/Substance Abuse Residential: Capacity by DHR Regions/DJJ Districts
54
15
1515
15
15
15
Source: GA. Division of MHMRSA and GAHSC
Database. May 2002
1 15
2 0
3 54
4 15
5 0
6 0
7 0
8 15
9 15
10 15
11 0
12 15
Total 144
Outdoor Therapeutic Programs: Capacity by DHR Regions/DJJ Districts
60
85
25
50
50
30
30
30
Source: GAHSC DatabaseMay 2002
1 85
2 110
3 0
4 75
5 0
6 0
7 0
8 0
9 60
10 30
11 0
12 0
Total 360
Therapeutic Foster Care: Capacity by DHR Regions/DJJ Districts
6
48
7862
19
8
8
12
7
19
12
1
9
Source: GAHSC DatabaseMay 2002
1 60
2 19
3 154
4 0
5 0
6 0
7 26
8 12
9 0
10 1
11 0
12 17
Total 289
Therapeutic Group Homes: Capacity by DHR Regions/DJJ Districts
12
?
246
68
48
10
6
52
12
6
50
150
4010
Source: GAHSC DatabaseMay 2002
1 48+
2 0
3 116
4 50
5 0
6 150
7 6
8 62
9 0
10 52
11 10
12 0
Total 494+
Long-Term Psychiatric Hospitals: Capacity by DHR Regions/DJJ Districts 104
100
100
12561
6020
21
Source: GAHSC DatabaseMay 2002
1 121
2 0
3 390
4 0
5 0
6 0
7 0
8 80
9 0
10 0
11 0
12 0
Total 591
Elements of Needed Elements of Needed Therapeutic PlacementsTherapeutic Placements
• Acute Emergency Placements • Emergency Shelter Placements• Facilities for dually diagnosed kids
MR/SED• Substance Abuse Programs• Mental Illness with Chronic Violent
Behavior• Sex Offenders’ programs and programs
for victims of sexual abuse
More Elements of Needed More Elements of Needed Therapeutic PlacementsTherapeutic Placements
• Facilities and placements for medically fragile (HIV+)
Placement alternative for kids under 12 – otherwise committed to DJJ
• Therapeutic transitional living programs for DJJ and DFCS children served by MATCH
Determining Need for Therapeutic Determining Need for Therapeutic PlacementsPlacements
• Children currently on state MATCH waiting list 282
• Amy Hale, MATCH Team, DFCS
• Need for MATCH level therapeutic emergency placements 95
• Dianne Sacks, MATCH Team, DFCS
• Estimate of county MATCH, not referred to state level 300
• Amy Hale, MATCH Team, DFCS
• DJJ need for long-term therapeutic placements[1] 100
Cheryl Dresser, Assistant Deputy Commissioner, DJJ
[1] Based on DJJ database, number of youth scoring high on mental health
needs minus youth currently in intermediate and intensive placements.
• DJJ need for emergency therapeutic placements[2] 50
Cheryl Dresser, Assistant Deputy Commissioner, DJJ
• Level of care children (20% of 998 total approved) not able to be placed appropriately because placement is not available 200
2] Based on number of referrals to the State DJJ Behavioral Health
committee - youth in RYDCs and YDCs needing immediate mental health residential placements.
• At least 1,450 additional therapeutic placements needed statewide
Priority #2: Priority #2: Therapeutic Placements – Therapeutic Placements – Intermediate and Intensive, Intermediate and Intensive, including family, group and including family, group and
residential settingsresidential settings
Priority # 3 Priority # 3 Transitional/Independent Living Transitional/Independent Living
ProgramsPrograms
Descriptors of Needed Descriptors of Needed Transitional/Independent Living Transitional/Independent Living
ProgramsPrograms
• Placement options for pregnant teens and teen moms with kids
• Transitional living with vocational/educational supports for state supported children and youth adults
Maternity Homes: Capacity by DHR Regions/DJJ Districts
15
?
8
6
Source: GAHSC DatabaseMay 2002
1 0
2 0
3 15+
4 6
5 0
6 8
7 0
8 0
9 0
10 0
11 0
12 0
Total 29+
Second Chance Homes:Capacity by DHR Regions/DJJ Districts
14
8
12
12
12
Source: GA Office of Regulatory Services. May 2002
1 12
2 14
3 8
4 12
5 0
6 0
7 0
8 12
9 0
10 0
11 0
12 0
Total 58
Determining Need for Transitional/Independent Living
Placements
• # in DJJ (non-MATCH) who need transitional living programs [1] 120 Cheryl Dresser, Assistant Deputy Commissioner, DJJ
[1] Based on number of DJJ committed youth scoring high on residential support needs and age 17 or older
Priority # 3 Priority # 3 Transitional/Independent Living Transitional/Independent Living
ProgramsPrograms
• At least 120 transitional living placements needed statewide
Priority # 4:Priority # 4:Emergency Placements, including Emergency Placements, including
family- andfamily- andgroup-based caregroup-based care
Emergency Shelters: Capacity by DHR Regions/DJJ Districts
2287
13
32 67
20
20 12
10
20
52
Source: GAHSC Database. May 2002
1 45
2 12
3 228
4 0
5 22
6 0
7 0
8 10
9 0
10 8
11 20
12 52
Total 397
10
12
8
12
Determining Need for Emergency Placements
• Emergency placements for DJJ “low-“ and “medium-risk” 146 children[1] Cheryl Dresser, Assistant Deputy Commissioner, DJJ
[1] Based on 5% of the total number of youth in FY02 scoring
low or medium on the detention risk assessment instrument (11,689) and turnover every 90 days) The 5% is an estimate of the number that may need emergency shelter care.
• Emergency placements for DFCS “at-risk” children 100
Dianne Sacks, MATCH Team, DFCS
There are currently no available emergency placements in Regions 4,6,7,9, and 10.
Priority # 4:Priority # 4:Emergency Placements, including Emergency Placements, including
family- and group-based carefamily- and group-based care
• At least 246 emergency placements needed statewide
Summary of Georgia’s Placement Summary of Georgia’s Placement Need Priorities for Year OneNeed Priorities for Year One
1. At least 1,200 additional quality foster care homes statewide
2. At least 1,450 additional therapeutic placements statewide
3. At least 120 additional transitional living placements statewide
4. At least 246 additional emergency placements statewide
YDC:Capacity by DHR Regions/DJJ Districts
410
168
150
244
150
150 349
120
80
Source: GA Department of Juvenile Justice. May 2002
1 0
2 0
3 0
4 0
5 0
6 560
7 394
8 150
9 517
10 120
11 0
12 80
Total 1821
RYDC: Capacity by DHR Regions/DJJ Districts
30
30
100
80
60
64200
49
30
26
40
30
30
30
3030
3030
30
30
100
Source: GA Department of Juvenile Justice. May 2002
1 160
2 80
3 423
4 30
5 26
6 40
7 60
8 30
9 60
10 90
11 30
12 100
Total 1129
50
How do we Change the How do we Change the System??System??
Filling the gaps doesn’t solve the problem
Filling the gaps doesn’t solve the problem
YourHealthPlan
Where Do I Go for HelpHelp?Your
MHPlan
Your
DJJ
Plan
YourDFCSPlan
YourEducationPlan
Multiple Case PlansMultiple Case PlansEducation
??
PublicHealth
MentalHealthDJJ
DFCS
One Case PlanOne Case Plan
MH/MR/SAEducationBehaviorPhysical HealthFamily Support/PreservationPlacement
Services Services AsAs Needed Needed
Services Services WhereWhere Needed Needed
HomeFosterCare
Group Home
InstitutionTherapeutic Foster Care
Therapeutic Residential Placement
Guiding FrameworkGuiding Framework
Case ManagementCase Management
Investigate the optimum case Investigate the optimum case management system that has the management system that has the
following attributes:following attributes: a. Accessibility for all Concerned Parties
b. Accessibility Without Stigma
c. Coordination
d. Research Based
e. Accountability
Investigate the optimum case Investigate the optimum case management system that has the management system that has the
following attributes:following attributes: f. Multi-Agency Assessment- Single Case
Plan
g. Case Load
h. Interactive Data Systems
i. Community or School Based
j. Judicial Actions
Investigate the optimum case Investigate the optimum case management system that has the management system that has the
following attributes:following attributes:
k. Funding
l. Competent, Customer/Family Case Managers
m. Involvement
n. Authority for Juvenile Court
o. Community Planning
Investigate the optimum case Investigate the optimum case management system that has the management system that has the
following attributes:following attributes:
p. Experienced, Educated, Trained and Motivated Case Mangers
q. CWLA Standards
r. Treatment Plans and Outcome Reviews
s. Outcome Measures
t. Responsibility
RecommendationRecommendation
Investigate and develop a case management system with the essential elements by
December 2002.
Governor’s Action Group for Safe ChildrenGovernor’s Action Group for Safe ChildrenWork Group # 2: Statewide Access to Safe and Work Group # 2: Statewide Access to Safe and
Appropriate PlacementsAppropriate Placements
• Inventory existing placement options• Use existing data and best practice to
define gaps in continuum of placement options
• Consider existing child profile data to prioritize highest system need for placement options
Identifiable BarriersIdentifiable Barriers
Legal/Policy Legal/Policy
• All laws, regulations, policies, etc. that define the age of a “child” for the various child serving agencies to determine eligibility for services should reflect a consistent definition and should allow for the provision of services until age 23. This does not intend to initiate services for adults over the age of 18, but rather to guarantee the continuation of services to youth aging out of systems and moving to independent living.
Legal/Policy Legal/Policy
• To assure that disposition is reasonably related to the needs of the child, children who are at risk for out of home placement must have adequate, well-trained legal representation.
• Statutory authority to assess and share information on all children at risk of out-of-home placement will be established.
LicensureLicensure • An independent Office of Regulatory Services,
separate and distinct from the structure, will be authorized to license all public and private residential and in-home service providers. The separation will legitimize the independence of the licensing authority and require the public agencies and well as private providers operating out-of-home placement facilities to meet the same rigorous standards. The Office of Regulatory Services will also be responsible for all waivers and will maintain current and accurate data on all waivers.
LicensureLicensure
• Licensure will require the timely and accurate support of the placement database.
• State incentives to communities should be created that allow group homes of up to 12 children to be established in areas zoned residential or agricultural.
EducationEducation
• Public education will be responsible for providing all education services to all children regardless of special needs or jurisdictional agency.
Mental Health Mental Health
• Georgia needs a comprehensive system of care for mental health, mental retardation and substance abuse.
• Services need to be available to families in their home and in their community based upon assessed risk factors, not on labels.
• Services must also be available to children immediately upon removal from their homes.
StructureStructure
Investigate the creation of a Structure focused on children’s issues. One such structure might be a Children’s Agency that coordinates all programs and services for children and families with children (families with children include guardian, grandparents and other extended families). The structure will address the following:
StructureStructure
a. Case Management – The coordination of all services to children, regardless of the agency delivering the service
b. Mental Health – All outpatient and inpatient services for children
c. Juvenile Justice – All residential and non-residential programs and services
StructureStructure
d. Child Welfare (Child Protective Services/Foster Care/Adoption/Child Support)
e. Family Support/Preservation
f. Substance Abuse – Services for children only with a link to services for adults with children
StructureStructure
g. Public Health – Child and Adolescent medicine
h. Nutrition – Cutting across education, family support, juvenile justice, etc.
i. Expectant Mother – for minor females and females who have not transitioned to independent living
StructureStructure
j. Developmental Disabilities
k. Education Partnership
l. Coordination/maximization of other services (e.g. Peachcare, Title IV-E, etc.)