EEC RESIDENTIAL AND PLACEMENT UNIT OVERVIEW

Board of Early Education and Care May 12, 2009

Foundation

102 CMR 3.00 is adopted in accordance with M.G.L. c. 28A, particularly §§ 9 through 13, which states the policy of state government to assure every child "a fair and full opportunity to reach his/her full potential." In order to fulfill its mandate as the agency responsible for licensing residential programs, the Office has developed specific standards for residential programs to provide this opportunity to the residents they serve.

The nature and scope of 102 CMR 3.00 are based on the belief that every aspect of a program's operation affects the residents in its care. The philosophy, administrative policies, staff, physical facility and clinical, recreational, and educational services all contribute to a resident's everyday living environment, and should maintain a level of quality that promotes healthy development.

Rationale for Licensure

3.02(1): Definitions:

Child. Any person under the age of 18 for part or all of a calendar year or under 22 with special needs.

Child with special needs. A child who, because of a disability consisting of a developmental delay or an intellectual, sensory, neurological, emotional, communication, physical, specific learning or health impairment or combination thereof, is or would be unable to progress effectively in a regular school program. This may include, but not be limited to, a school age child with special needs as determined by an evaluation conducted pursuant to M.G.L. c. 71B, § 3, and as defined by the Department of Education in 603 CMR 28.00.

Residential and Placement Unit Organizational Chart

Commissioner Sherri Killins

Northeast Region Licensor

Michael Curran

Kelly Buckley, Residential and

Placement Supervisor

Dave McGrath, Deputy

Commissioner of Field Operations

Western Region Licensors

Christine BurnettDavid Micka

Central Region Licensors

Michael GinettiRichard Mucci

Tim Keane, Residential and

Placement Supervisor

Southeast Region Licensors

Miguel OrtegaKathy Perry

Metro Boston RegionLicensors

Kerry Murphy McCallKara Adams

406 Group Care LicensesGroup Care Program: A program or facility that provides care and custody forone or more children by anyone other than a relative by blood, marriage oradoption on a regular 24-hour a day, residential basis.

65 Temporary Shelter LicensesTemporary Shelter: Care and services (as appropriate to the needs of the child)provided to a child on a regular 24 hour a day basis for a period not to exceed45 days or in the case of placement in a secure detention facility, not to exceed90 days.

51 Adoption LicensesAdoption: The establishment of the legal relationship of parent and child in accordance with the provisions of M.G.L. c. 210 et seq.

83 Foster Care LicensesFoster Parent: An individual who provides temporary substitute parental care for a child or children under an agreement with a licensed or approved placement agency.

Licensor Caseloads/Responsibilities

2008 Calendar Year Unit Statistics

Averages Per Licensor:

Responsible for 70 providers/programs each Conducted over 31 licensing renewals each Opened 3 new and closed 4 licensed programs each Conducted over 80 complaint investigations each 46 investigations per licensor required follow up activity due

to regulatory violations Reviewed quarterly restraint data and assured reporting

compliance for 46 programs each Reviewed quarterly foster care suspected abuse/neglect data

and assured reporting compliance for 9 programs each

R and P Unit Licensing Functions

1. Licensure of New Programs In person/phone consultation with perspective applicant Application submitted with 40 policies and procedures Licensor reviews 40 documents assuring compliance with regulations Written response/in person meeting relaying outstanding policy/procedure issues Schedule physical plant inspection Issue 6 month Provisional license Conduct 3 month monitoring visit Issue 2nd six month Provisional license

2. Licensure of Current Programs 3 months prior to expiration, licensor sets up renewal visit and requests

application Receive/Review application inclusive of updated policies, procedures and

inspections Conduct visit to the facility (one to six days depending on the size/scope of

services) Conduct Exit review/meeting Write and send review Review corrective action from program License renewal or other action taken

Licensing Functions Continued

3. Investigations Mandatory incidents and complaints

(837 in 2008) Intake, collaborate, investigate and assure compliance (411 investigations resulted in citations)

4. Enforcement Follow-up on all complaint citations Monitoring visits Legal referrals Enforcement meetings

5. Technical Assistance Developing policy and TA papers Provide training and assistance to programs

Examples of Technical Assistance

Licensors provide consultation and training on:

The creation of behavior management policy and procedure

Background Record Check policy and procedure

Home Study development

Internal investigations

Program development

Other Responsibilities Include

Conduct trainings for programs

Attend and present to provider organizations

Evaluate and produce feedback for the need for policy, procedure and regulation change

Interagency meetings

Internal meetings

Internal/external committee involvement

Regional duties and operations meetings

Collateral Work

Residential CarePopulation Served

Includes but is not limited to:

Learning disabled

Autism and pervasive developmental disorders

Behavioral disorders

Eating disorders

Sex offender/sexually reactive

Criminal offender/adjudicated youth

Severely physically disabled with limited life expectancy

Schools for the deaf/hard of hearing, blind, etc.

Spectrum of Services

Range from educational services for learning disabled children, through independent living skills for teen parents, to acute clinical and behavioral treatment for severely troubled children.

Most of the children in residential facilities are there for treatment of emotional and behavioral issues that may include sexual and physical abuse and self-injurious behavior.

Challenge

To build regulations in a meaningful way that support changes in:

Spectrum of care

Length of placement

Diversity of program model

Melmark School

Hillcrest Educational Centers

AdoptionPopulation Served

Children birth to 18 Domestic Infant International Special Needs/Waiting Child

Adoptive parents

Birth parents

Spectrum of Services

Domestic Infant: potential expectant parents make an adoption plan and choose a

prospective adoptive family for their childInternational: prospective adoptive families are approved via a home study process and

then enter an agency program where they are matched with a childSpecial Needs/Waiting Child: prospective adoptive families are matched with a child currently in foster

care within a state system such as DCF

Hague Adoption Convention Multilateral international treaty designed to protect children, birth families

and adoptive families from unscrupulous practices, including hidden fees, bribery and child abduction

Central authority is the US Department of State All US agencies working in international adoption must now be accredited

through the Council on Accreditation 14 Massachusetts agencies have accreditation, 4 have full accreditation

status.

Challenges

Challenges Implementation of Hague has resulted in fewer infant

adoptions and an increase in adoption of older, special needs children

Adoption has become much more complicated, more expensive and a longer process for families and children

Adoption practice and law is complex and largely unregulated in other states. Many Massachusetts adoptions are multi-state in process   

Impact and Change

EEC has recently revised their home study policy to be more congruent with the time frames required by Hague and BCIS 

Adoption Advisory Group has met quarterly for over 5 years and consists of two supervisors, two licensors, two attorneys and 15 adoption agency directors

Focus of the group is to identify tangible areas that need revision in the regulations, discuss trends in adoption and best practice concerns in Massachusetts

Foster CarePopulation Served

Foster care agencies serve kids from birth up until the age of 22

Kids can have similar issues as those placed in residential program, but they require a less restrictive setting

Many kids in foster care have been removed from their homes due to abuse/neglect issues

Foster CareSpectrum of Services

The agencies hold EEC licensure not individual homes

Homes are directly overseen and supervised by foster care agencies such as DCF, Mentor and Dare

Ensures that agencies are in compliance with regulations regarding the supervision and oversight of their homes

Oversight of the administrative operations of foster care agencies

Challenges

Regulations need to be updated to reflect current practice

Lack of potential foster homes/parents 

Although there is one set of regulations for both foster care and adoption, they could be broken into sections for easier understanding

DARE Family Services

Current Challenges

Economy Professional development of work force in

facilities and foster homes Restraint reduction Technological advances

great for time management and supervision In the wrong hands can be used neglectfully

Staying current with ever changing adoption law/practice

Impact of vacant/ positions Detecting areas of overlap with other agencies Regulation revision

Regulation Revision for Residential and Placement Services

Residential Current regulations lack the flexibility to

withstand changes is program design Assessment of restraint regulations with eye

toward early detection training to avoid restraint Cross walk with other agencies to assure

alignment and minimize duplication

Placement Address regulatory inconsistency with Federal

Hague Adoption Convention Improve regulatory language relative to adoption

related expenses/fees

Questions?

Thank You