Georgi
a2
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
Georgi
a3
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
Georgi
a4
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
Georgi
a5
• 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
Georgi
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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
Georgi
a7
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
Georgi
a8
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
Georgi
a
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)
Georgi
a10
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
Georgi
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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
Georgi
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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
Georgi
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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
Georgi
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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
Georgi
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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
Georgi
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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
Georgi
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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
Georgi
a18
Lead Agency Functions• Develop Independent Living Plan for children over
the age of 14
• Provide Training & Technical Assistance to subcontractors to achieve system goals
Georgi
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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
Georgi
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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
Georgi
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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
Georgi
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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