2. Statewide Access to Safe and Appropriate Placements Governor’s Action Group for Safe Children Draft Recommendations for Discussion

3. Governor’s Action Group for Safe Children Work Group # 2: Statewide Access to Safe and Appropriate Placements Inventory existing placement options Use existing data and best practice to define gaps in continuum of placement options Consider existing child profile data to prioritize highest system need for placement options

4. Inventory of Placement Options & Priorities of Highest System Needs

5. Priority #1: Quality Foster Care, including family- and group-based care

6. Address process issues – Image, Marketing, Support, Per Diem, Community Involvement

7. Foster Homes: Current Number of Homes by DHR Regions/DJJ Districts 397 284 1023 240 245 265 191 312 184 325 223 219 Source: Department of Juvenile Justice, Division of Family and Children Services, Office of Regulatory Services; May 2002 1397 2284 31023 4245 5240 6265 7191 8312 9184 10223 11219 12325 Total 3908

8. Group Homes: Capacity by DHR Regions/DJJ Districts 79 153 812 123 165 247 16 41 224 198 52 44 Source: GA Department of Juvenile Justice, GAHSC Database; May 2002 179 2153 3812 4165 5123 6247 716 841 9224 1052 1144 12198 Total 2154

9. Elements of Quality Foster Care Foster homes with higher standards Sibling placements Therapeutic foster homes Kinship care

10. Determining Need for Quality Foster Care, including family- and group-based care According to DFCS: In FY 1999 Georgia had 5,000 Foster Homes In FY 2000, Georgia had 4,000 Foster Homes In FY 2001, Georgia had 3,800 Foster Home The number of children in foster care has increased from 12,693 in FY 1999 to 13,965 in FY 2001.

11. This decrease in the number of Foster Homes and the increase in the number of children in foster care has created significant pressure on current foster homes due to overcrowding and shortage of appropriate foster home placements. Determining Need for Quality Foster Care, including family- and group-based care

12. Priority #1: Quality Foster Care, including family- and group-based care At least 1,200 additional quality foster homes needed statewide

13. Priority #2: Therapeutic Placements – Intermediate and Intensive, including family, group and residential settings

14. Alcohol & Drug/Substance Abuse Residential: Capacity by DHR Regions/DJJ Districts 54 15 Source: GA. Division of MHMRSA and GAHSC Database. May 2002 115 20 354 415 50 60 70 815 915 1015 110 1215 Total 144

15. Outdoor Therapeutic Programs: Capacity by DHR Regions/DJJ Districts 60 85 25 50 30 Source: GAHSC Database May 2002 185 2110 30 475 50 60 70 80 960 1030 110 120 Total 360

16. Therapeutic Foster Care: Capacity by DHR Regions/DJJ Districts 6 48 78 62 19 8 8 12 7 19 12 1 9 Source: GAHSC Database May 2002 160 219 3154 40 50 60 726 812 90 101 110 1217 Total 289

17. Therapeutic Group Homes: Capacity by DHR Regions/DJJ Districts 12 ? 24 6 68 48 10 6 52 12 6 50 150 40 10 Source: GAHSC Database May 2002 148+ 20 3116 450 50 6150 76 862 90 1052 1110 120 Total 494+

18. Long-Term Psychiatric Hospitals: Capacity by DHR Regions/DJJ Districts 104 100 125 61 60 20 21 Source: GAHSC Database May 2002 1121 20 3390 40 50 60 70 880 90 100 110 120 Total 591

19. Elements of Needed Therapeutic Placements Acute Emergency Placements Emergency Shelter Placements Facilities for dually diagnosed kids MR/SED Substance Abuse Programs Mental Illness with Chronic Violent Behavior Sex Offenders’ programs and programs for victims of sexual abuse

20. More Elements of Needed Therapeutic Placements Facilities and placements for medically fragile (HIV+)  Placement alternative for kids under 12 – otherwise committed to DJJ Therapeutic transitional living programs for DJJ and DFCS children served by MATCH

21. Determining Need for Therapeutic Placements Children currently on state MATCH waiting list 282 Amy Hale, MATCH Team, DFCS Need for MATCH level therapeutic emergency placements95 Dianne Sacks, MATCH Team, DFCS Estimate of county MATCH, not referred to state level300 Amy Hale, MATCH Team, DFCS

22. DJJ need for long-term therapeutic placements[1] 100[1] Cheryl Dresser, Assistant Deputy Commissioner, DJJ [1] Based on DJJ database, number of youth scoring high on mental health needs minus youth currently in intermediate and intensive placements. [1]

23. DJJ need for emergency therapeutic placements[2] 50[2] Cheryl Dresser, Assistant Deputy Commissioner, DJJ Level of care children (20% of 998 total approved) not able to be placed appropriately because placement is not available 200 2] Based on number of referrals to the State DJJ Behavioral Health committee - youth in RYDCs and YDCs needing immediate mental health residential placements. 2]

24. At least 1,450 additional therapeutic placements needed statewide Priority #2: Therapeutic Placements – Intermediate and Intensive, including family, group and residential settings

25. Priority # 3 Transitional/Independent Living Programs

26. Descriptors of Needed Transitional/Independent Living Programs Placement options for pregnant teens and teen moms with kids Transitional living with vocational/educational supports for state supported children and youth adults

27. Maternity Homes: Capacity by DHR Regions/DJJ Districts 15 ? 8 6 Source: GAHSC Database May 2002 10 20 315+ 46 50 68 70 80 90 100 110 120 Total 29+

28. Second Chance Homes:Capacity by DHR Regions/DJJ Districts 14 8 12 Source: GA Office of Regulatory Services. May 2002 112 214 38 412 50 60 70 812 90 100 110 120 Total 58

29. Determining Need for Transitional/Independent Living Placements # in DJJ (non-MATCH) who need transitional living programs[1]120 Cheryl Dresser, Assistant Deputy Commissioner, DJJ[1] [1] Based on number of DJJ committed youth scoring high on residential support needs and age 17 or older

30. Priority # 3 Transitional/Independent Living Programs At least 120 transitional living placements needed statewide

31. Priority # 4: Emergency Placements, including family- and group-based care

32. Emergency Shelters: Capacity by DHR Regions/DJJ Districts 22 87 13 32 67 20 12 10 20 52 Source: GAHSC Database. May 2002 145 212 3228 40 522 60 70 810 90 108 1120 1252 Total 397 10 12 8

33. Determining Need for Emergency Placements Emergency placements for DJJ “low-“ and “medium-risk” 146 children[1] Cheryl Dresser, Assistant Deputy Commissioner, DJJ[1] [ 1] Based on 5% of the total number of youth in FY02 scoring low or medium on the detention risk assessment instrument (11,689) and turnover every 90 days) The 5% is an estimate of the number that may need emergency shelter care.[ 1]

34. Emergency placements for DFCS “at-risk” children100 Dianne Sacks, MATCH Team, DFCS There are currently no available emergency placements in Regions 4,6,7,9, and 10.

35. Priority # 4: Emergency Placements, including family- and group-based care At least 246 emergency placements needed statewide

36. Summary of Georgia’s Placement Need Priorities for Year One 1. At least 1,200 additional quality foster care homes statewide 2. At least 1,450 additional therapeutic placements statewide 3. At least 120 additional transitional living placements statewide 4. At least 246 additional emergency placements statewide

37. YDC:Capacity by DHR Regions/DJJ Districts 410 168 150 244 150 349 120 80 Source: GA Department of Juvenile Justice. May 2002 10 20 30 40 50 6560 7394 8150 9517 10120 110 1280 Total 1821

38. RYDC: Capacity by DHR Regions/DJJ Districts 30 100 80 60 64 200 49 30 26 40 30 100 Source: GA Department of Juvenile Justice. May 2002 1160 280 3423 430 526 640 760 830 960 1090 1130 12100 Total 1129 50

39. How do we Change the System?? Filling the gaps doesn’t solve the problem

40. Your Health Plan Help Where Do I Go for Help? Your MH Plan Your DJJ Plan Your DFCS Plan Your Education Plan

41. Multiple Case Plans Education ?? Public Health Mental Health DJJ DFCS

42. One Case Plan MH/MR/SA Education Behavior Physical Health Family Support/Preservation Placement

43. Services As Needed

44. Services Where Needed Home Foster Care Group Home Institution Therapeutic Foster Care Therapeutic Residential Placement

45. Guiding Framework

46. Case Management

47. Investigate the optimum case management system that has the following attributes: a. Accessibility for all Concerned Parties b. Accessibility Without Stigma c. Coordination d. Research Based e. Accountability

48. Investigate the optimum case management system that has the following attributes: f. Multi-Agency Assessment- Single Case Plan g. Case Load h. Interactive Data Systems i. Community or School Based j. Judicial Actions

49. Investigate the optimum case management system that has the following attributes: k. Funding l. Competent, Customer/Family Case Managers m. Involvement n. Authority for Juvenile Court o. Community Planning

50. Investigate the optimum case management system that has the following attributes: p. Experienced, Educated, Trained and Motivated Case Mangers q. CWLA Standards r. Treatment Plans and Outcome Reviews s. Outcome Measures t. Responsibility

51. Recommendation Investigate and develop a case management system with the essential elements by December 2002.

52. Governor’s Action Group for Safe Children Work Group # 2: Statewide Access to Safe and Appropriate Placements Inventory existing placement options Use existing data and best practice to define gaps in continuum of placement options Consider existing child profile data to prioritize highest system need for placement options

53. Identifiable Barriers

54. Legal/Policy All laws, regulations, policies, etc. that define the age of a “child” for the various child serving agencies to determine eligibility for services should reflect a consistent definition and should allow for the provision of services until age 23. This does not intend to initiate services for adults over the age of 18, but rather to guarantee the continuation of services to youth aging out of systems and moving to independent living.

55. Legal/Policy To assure that disposition is reasonably related to the needs of the child, children who are at risk for out of home placement must have adequate, well- trained legal representation. Statutory authority to assess and share information on all children at risk of out- of-home placement will be established.

56. Licensure An independent Office of Regulatory Services, separate and distinct from the structure, will be authorized to license all public and private residential and in-home service providers. The separation will legitimize the independence of the licensing authority and require the public agencies and well as private providers operating out-of- home placement facilities to meet the same rigorous standards. The Office of Regulatory Services will also be responsible for all waivers and will maintain current and accurate data on all waivers.

57. Licensure Licensure will require the timely and accurate support of the placement database. State incentives to communities should be created that allow group homes of up to 12 children to be established in areas zoned residential or agricultural.

58. Education Public education will be responsible for providing all education services to all children regardless of special needs or jurisdictional agency.

59. Mental Health Georgia needs a comprehensive system of care for mental health, mental retardation and substance abuse. Services need to be available to families in their home and in their community based upon assessed risk factors, not on labels. Services must also be available to children immediately upon removal from their homes.

60. Structure Investigate the creation of a Structure focused on children’s issues. One such structure might be a Children’s Agency that coordinates all programs and services for children and families with children (families with children include guardian, grandparents and other extended families). The structure will address the following:

61. Structure a. Case Management – The coordination of all services to children, regardless of the agency delivering the service b. Mental Health – All outpatient and inpatient services for children c. Juvenile Justice – All residential and non-residential programs and services

62. Structure d. Child Welfare (Child Protective Services/Foster Care/Adoption/Child Support) e. Family Support/Preservation f. Substance Abuse – Services for children only with a link to services for adults with children

63. Structure g. Public Health – Child and Adolescent medicine h. Nutrition – Cutting across education, family support, juvenile justice, etc. i. Expectant Mother – for minor females and females who have not transitioned to independent living

64. Structure j. Developmental Disabilities k. Education Partnership l. Coordination/maximization of other services (e.g. Peachcare, Title IV-E, etc.)