State of the State - Drivers of Change June 14, 2011 Normer Adams Executive Director Georgia Association of Homes and Services for Children In 2009, I wrote, “The changes occurring in foster care and group home care are unprecedented. Fewer children are entering foster care, even fewer are cared for in congregate care. More families are being supported by home and community based services.” This remains true.

Drivers of Change Change is mandated by: –Federal and State Public Policy –National Advocacy Groups –Lawsuits –Evidence Based Practice

Opportunity New Leadership – Background not in Child Welfare Experienced with working with community-based providers Willing to partner and listen Georgia Turned Corner – Family Centered Practice here to stay Performance Based Management is norm Evidence Based Care the Standard

Status of Care 7000 children in foster care and holding 1/3 cared for by group home providers Half cared for by private sector State is being held accountable for its behavioral health services Community based care is preferred option All providers must have Family Engagement skills

Status of Oversight GAHSC has advocated for reasonable and balanced oversight ORCC is in transition--LaMarva Ivory is interim Director and probably will be in that position for the foreseeable future OPM will continue to monitor for contract compliance Negotiations around sharing of oversight responsibilities

Challenges Increased acuity of care –Children are older –Children have more issues –Children have been in more placements and in care longer –Residential care will continue to be last option.

Challenges Business Models Stressed –State will always gravitate to the providers with best outcomes, lowest cost, and most convenient business model –Small agencies will have most difficulties –Managed Care will continue in behavioral health and be expanded

Challenges Threat of Continued Recession –Sluggish economy is in fourth year –Every agency in government poised for rebound –Reimbursement keeping up with cost of providing services

Opportunities More Privatization –Foster care –Behavioral Health Services –Transitional Living More Collaboration –Systems of Care –Family Team Meetings –Children’s Cabinet –Training Consortium

Opportunities Demonstrated Impact –Performance-Based Contracting and measurement norm –Less Competition

Conclusion Move from an Art to an Science Professionalization of Child Welfare Fewer Providers Less Specialization and more Networks More Managed Care