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Georgia’s Lead Georgia’s Lead Agency PlanAgency Plan

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KVC Behavioral Healthcare• The lead agency in the North East Region of Kansas

and Metro Kansas City, Kansas since 1996: New lead agency in Omaha and Southeast Regions of Nebraska; Child Welfare provider in West Virginia

Responsibilities Include:

• KVC has a 24/7 Intake with centralized support and MIS data entry & reporting

• KVC provides all quality assurance of the lead agency network

• KVC provides private fund raising from their service areas

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KVC Behavioral HealthcareResponsibilities Include:

• Case management for both child and family to achieve permanency through reunification or placement in an adoptive home or Other Planned Permanency Living Arrangement (OPPLA)

• Foster Care placement, Foster Parent recruitment, retention and training

• Adoption services including recruitment, and support achieving 1000 adoptions in 1000 days as the lead agency

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Eckerd Community Alternatives• The lead agency serving Pinellas and Pasco

Counties for the past 1 ½ years

• Provides community engagement, oversight of children and families protection and well-being

• System accountability, network development and subcontract oversight

• Community development using indigenous resources

• Collaborative leadership with stakeholders

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• Florida’s entire system of care is privatized and heavily based in the concept of local community involvement and responsibility for the outcomes for the children

• System implemented for over 10 years and ECA is the 3rd Lead Agency in the Clearwater, FL area.

– Preceding two failed

• Florida DCF or the local sheriff’s office provides the initial protective service investigation and refers children to ECA for out of home placement.

Eckerd Community Alternatives

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KVC and ECA Similarities

• Intake and placement of children in out of home settings

• Foster home recruitment, retention and recommendation for licensing for all foster and adoptive homes

• Full case management designed to achieve permanency including reporting to the court and making recommendations

• Independent Living Services

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KVC and ECA Similarities

• Adoption Services

• Aftercare and transitional services

• Subcontractor network development and monitoring

• Quality management and oversight of their internal operations and those of their subcontractors

• Annualizes the System Of Care performance and recommendations for improvement

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Systems Role of the Public Agency

• Monitors Lead Agency contract through a variety of monthly, quarterly and annual reports to evaluate performance outcomes and financial accountability

• Provides technical assistance and training to Lead Agency staff

• Maintains the relationship with the federal government

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Systems Role of the Public Agency

• Maintains the protective services investigation and decision to place out of home

• Maintains the child welfare legal system

(legal representation for children)

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Conclusion and Recommendations

A lead agency would best benefit Georgia’s children and

the Division of Family and Children's Services creating

the following:• Reduction in the number of contracts for DFCS to monitor and

maintain

• Creating a procurement environment of positive competition between providers

• Potentially budget neutral by using current purchase of service contracts

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Conclusion and Recommendations

• Clarifying roles between public and private community creating greater efficiency

• “By spreading the whirlwinds around” this allows DFCS staff to focus on the development of new programs, evaluation of trends and monitoring outcome and quality

• DFCS will be able to hold lead agencies and providers more accountable for outcomes in support of CFSR, Kenny A and Fostering Connections

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Conclusion and Recommendations

• Lead Agencies would receive incentives to achieve reunification or permanency through a capitated payment mechanism

• Eliminates artificial levels of care by focusing accountability of an outcome to one private agency

• Lead Agency will be able to be more flexible in requiring their staff to work the hours and days to “do what it takes” to deescalate crisis and avoid a higher level of placement

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Recommended DFCS Lead Agency Model

• To begin pilot with Two-Four lead agencies (Lead Agencies could serve in more than one region)

• Goal: Step children & their families through the continuum of services for the purpose of achieving three primary outcomes:– Increased Safety– Permanency– Well being

• Lead Agency contract will be performance-based with outcomes consistent with Kenny A, CFSR and Fostering Connections

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Recommended DFCS Lead Agency Model

Lead Agency Payment Mechanism:

• Payment will be a capitated rate based upon a case rate or Per Child Per Month

• Incentive payments for safe permanency will include the following:

– Child must remain in permanency for 12 mos.

– Re-entry before 12 mos. will result in reduced payment

– Mandatory 12 month aftercare

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Lead Agency Model• Lead agency will work in conjunction with DFCS

case manager in providing enhanced services

• Lead agency will incorporate the following outcomes:

– Promote the safety of children

– Decrease the time it takes to achieve permanency for all children

– Enhance the DFCS system’s capacity and accountability

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Lead Agency Functions

• Point of contact for placement and intake including referrals 24/7 resulting from investigations

• Evaluation based upon the North Carolina Family Assessment Survey to determine strengths and challenges to reunification and permanency

• Partnership with DFCS worker to diligently search relatives and other family significant for placement

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Lead Agency Functions• Conduct Utilization Management reviews

• Develop a System of Care for the region with sub-contracted providers and indigenous resources

• Develop a quality assurance plan for the region to include a continuous quality improvement process

• Lead Agency will be required to meet minimum financial standards to assure stability and the ability to manage financial risk of capitated payment mechanism

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Lead Agency Functions• Develop Independent Living Plan for children over

the age of 14

• Provide Training & Technical Assistance to subcontractors to achieve system goals

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Lead Agency Responsibilities

• Utilize the Georgia Family Centered Case Practice Model and Principles to deliver all levels of practice using the following:

– Consider child’s safety and health paramount

– Provide relevant services with respect for and understanding of children’s needs and children’s and families’ culture

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Lead Agency Responsibilities

• “No eject, no reject” therefore all children and families will have access to needed service or placement regardless of race, ethnicity, sexual orientation, physical or emotional handicap, religion, or special language needs

• Provide family with services needed to keep the child at home and safe

• Foster care will be temporary

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Lead Agency Responsibilities

• Reunify children in out-of-home placements with their families within 12 months

• If child cannot be reunified within established timeframes set by federal and state law, DFCS will find a permanent home

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Lead Agency Responsibilities

• Ensure children in out-of-home placement have the following:

– Stable placements that promote the continuity of critical relationships (i.e. parents, siblings and other relatives)

– Least restrictive placement settings to meet individual needs

– Long-term decision making for the child’s needs consistent with federal and state timelines

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Next StepsWhat we would like to do: • Get your blessing to draft RFP

• Plan release of RFP March 2010

• Plan a selection of lead agencies no later than

May 1, 2010

• Start up and Implement no later than October 2010

• Extend current contracts to October 2010