1. California’s Child Welfare Continuum of Care Reform (CCR) Overview California Department of Social Services January 2016

2. * Senate Bill 1013 (Chapter 35, Statutes of 2012)
Background
Legislative mandate*:
Reform Group Homes and Foster Family Agencies with robust and diverse stakeholder input
Legislative report with recommendations
Builds on previous reform efforts: SB 933, RBS Reform
Continuum of Care Reform:
A comprehensive framework that supports children, youth and families across placement settings (from relatives to congregate care) in achieving permanency. Includes:
Increased engagement with children, youth and families
Increased capacity for home-based family care
Limited use of congregate care
Systemic and infrastructure changes: rates, training, accreditation, accountability & performance, mental health services
* Senate Bill 1013 (Chapter 35, Statutes of 2012)

3. Vision
All children live with a committed, permanent and nurturing family
Individualized and coordinated services and supports
Focus on permanent family and preparation for successful adulthood
When needed, congregate care is a short-term, high quality, intensive intervention that is just one part of a continuum of care available for children, youth and young adults

4. Guiding Principles
The child, youth and family’s experience is valued in:
Assessment
Service planning
Placement decisions
Children shouldn’t change placements to get services
Cross system and cross-agency collaboration to improve access to services and outcomes
Recognizing the differences in the probation system and among other groups of youth

5. State/County Implementation Team
Proposed CCR Implementation Framework
DRAFT
State/County Implementation Team
CDSS, DHCS, CWDA, CPOC, CBHDA, CSAC
County Representatives
Stakeholder
Implementation
Advisory Committee
Providers, Youth, Caregivers, Tribes, Advocates, Counties, Legislative Staff and others
CCR Implementation Workgroups
Therapeutic Residential Services Settings/FFA Program & Licensing
Rate Structures
Accountability
Framework
RFA Implementation
Training
Deliverables
Program Instructions
Regulations
ACLs/CFLs
Forms
Capacity Building Activities
Outreach Activities
Communication Materials
Training Curricula
Mental Health Certification
Accountability & Oversight Framework
Accreditation Process
Application review process
Provider Performance measures
Consumer Survey
Rate Structure
New Therapeutic Residential Services Settings & FFA rates and rate structures

6. Therapeutic Residential Services Settings
The “Paradigm Shift”
Group Home
Therapeutic Residential Services Settings
(aka STRTC)
Children who cannot be safely placed in a family can receive short-term, residential care with specific care plans and intensive therapeutic interventions and services to support transition to a family.

7. Foster Families Resource Families
Resource Family
Relative Caregiver
Foster Family
Adoptive
Family
Resource Family Approval:
Related and non-related families
Training for all families
Resource Families still choose the role they play in the system: temporary or permanent
Prepared for permanency-no additional approvals necessary
RFA Process:
Single, unified RFA process will be used for all caregiver families: kin, NREFM, county foster families, FFA foster families
Avoids need for adoption home study and second, more in-depth background check; once approved, families can adopt or become kin- guardians

8. The Goal: Children in Resource Families Children in Congregate Care
Permanent
Family

9. Increased Engagement Child & Family Team(CFT)
Up-front and continuing assessment along common domains
Aligns with the California Child Welfare Core Practice Model (Statewide Practice Model) & Pathways to Wellness (Katie A. settlement)

10. Building Family Care Capacity
Existing efforts to improve and increase the capacity of home-based family care:
Quality Parenting Initiative
Resource Family Approval Process
Approved Relative Caregiver (ARC) Funding Option Program (2014: $30 million investment)
Tribally-approved homes/Tribal access to background information

11. Increasing Capacity for Home-Based Family Care
Resource family approval by counties, Foster Family Agencies (FFAs) and Therapeutic Residential Services Settings
Funding for support, retention, recruitment and training of resource families & relatives
Foster Family Agencies provide Core Services:
Trauma Informed
Culturally relevant
Accreditation through COA, CARF & JCAHO
May provide core services to children in county approved families and relatives
Updated and expanded training requirements across provider and caregiver categories

12. Limited Use of Congregate Care
Transition County Shelter  Temporary Shelter Care Facility
Group Home  Therapeutic Residential Services Settings that provide Core Services:
Trauma Informed
Culturally relevant
Capacity to transition to children to family care by approving resource families

13. Meeting the needs of Probation Youth:
Collaboration and coordination will be necessary in order for CCR to be successful for Probation Youth.
Identify the training and supports families need to parent probation youth in FFAs and for Therapeutic Residential Services Settings to develop programs targeted at probation youth.
Programs developed and/or maintained for probation youth who are in need of substance use disorder treatment, sex offender treatment and behavior modification programming.
After-care services as a central component to ensuring a youth’s successful and sustaining transition back into his/her family home.

14. Meeting the needs of Probation Youth:
Extensions for Probation Youth are linked to the progress tied to specific benchmarks. In the year ahead the CDSS will be:
Engaging FFAs and other community based organizations to develop strategies to recruit and support specialized foster homes.
Defining outcome measures to be collected and analyzed to assess implementation of CCR and the impact on Probation.
Working with Providers, Courts and County Probation Departments to develop capacity for home-based family care.
Working with Therapeutic Residential Services Settings to address treatment needs of specific Probation populations.

15. Core Services
FFAs and Therapeutic Residential Services Settings make available core services either directly or through formal agreements:
Access to specialty mental health services
Transitional support services for placement changes, permanency; aftercare
Education, physical, behavioral and mental health supports
Activities to support youth achieving a successful adulthood
Services to achieve permanency & maintain/establish family connections
Active efforts for ICWA-Eligible children

16. Oversight, Accountability & Provider Performance Measures
National Accreditation
Cross Departmental Oversight Framework
Evaluate provider performance along common domains
Youth, caregiver and stakeholder satisfaction surveys
Public transparency of provider performance

17. Accreditation: FFAs and Therapeutic Residential Services Settings
Accreditation will be accepted from:
Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
Commission on Accreditation of Rehabilitation Facilities (CARF)
Accreditation through Council on Accreditation (COA)
CDSS is engaging with agencies and will continue to address specific needs of the State, Counties, and Providers regarding accreditation and CCR requirements.

18. New Provider Rate Structure
Sunset RCL system (1-14)
*A single Therapeutic Residential Services Settings rate (IV-E)
*A tiered resource family care rate structure based on level of need for the resource family and resource family agency
*Therapeutic Residential Services Settings rate will not be blended with Title XIX (rates for mental health services is status quo)
*Therapeutic Foster Care Rate (Katie A)
Multi-year implementation:
New requirements take effect 1/1/2017
Provisions for extensions up to two years
Additional extensions for providers and longer for those serving probation youth
Therapeutic Residential Services Settings and FFA may be public or private.
Design a new program audit that aligns with required program and treatment competencies and accreditation standards; coordinates program, fiscal, and health & safety reviews (DHCS, CCLD, CDSS).

19. The Work Ahead… 1-1-17 Will take “a village”!
CCR Report
AB 403
Preparation
Policies
Rates
Outreach
Orientations
Tools
Training
Accountability
Recruitment
Performance measures
Pre-Implementation
Applications
Reviews
Licenses
Mental Health Certification
Data testing
Training & TA
Will take “a village”!
CDSS will be collaborating with a wide array of stakeholders in the implementation work
Implementation:
Children & families
served differently!
Extensions
Data collection
Monitoring
Technical Assistance
Policy Revision

20. Provider Licensing
CDSS Community Care Licensing (CCL) will review applications for group homes transitioning to “STRTCs”.
Applications for licensing will include the Plan Of Operation/Program Statements and licensing forms that need to be updated.
Provisional licensure may be issued in order to secure accreditation.
Providers will submit an application with revisions of the updated Plan Of Operation/Program Statement to their local CCL Regional Office.

21. Questions and Contact Info
Questions can be sent to:
Additional information on the CDSS website at: