Daily Update August 27, 2014
1723 Study Committee Meeting Aug 25
1723 Study Committee Meeting
August 25, 2014
Rep. Andy Welch, Chair
Rep. Joyce Chandler
Rep. Penny Houston
Rep. Mary Margaret Oliver
Rep. Kevin Tanner
Rep. Tom Weldon (teleconference)
Rep. Wendell Willard
The August 25
meeting was designed to be informational to hear from agencies.
Those presenting included:
Department of Public Health
Department of Human Services
(RCC and DFCS)
Department of Juvenile
DHS Power Point -
DJJ Power Point -
Sept 8 10:00 CLOB 606
1723 Study Committee Meeting
August 25, 2014
Department of Public Health
Director of Environmental Health
presentation was delivered by DPH. Chris reviewed the requirements
and process noting that DPH requires food service permits from the
local departments for residential care with 13 or more children.
Providers will average two inspections per year based on the type of
facility and risk, i.e. coffee shop would be risk 1; risk 2 –
cooking and cooling processes (2 inspections/year); type 3 high risk
goes beyond the scope of rules (3 inspections/year). They may add
inspections as needed.
380 staff work with local health departments to standardized rules
and implementation. The inspection process is the same as with
restaurant grading. Violations are based on risk – higher risk
carries a higher point reduction. DPH scoring does not get factored
with the overall scoring with DHS.
inquired about doing inspections in tandem with others and
inspections of family model agencies. Chris responded that
inspections are unannounced in order to get an accurate picture.
When they announce visits it takes away from seeing activities
during the busiest time, therefore they do not see accurate picture
of day-to-day activities. It was stressed that agencies have to be
prepared at all times. Based on inspection history, DPH can reduce
the number of inspections. It was noted that in the family model,
most are only licensed up to 12, so this is not a problem.
Every department posts inspection scores on a website. Generally,
DPH posts the last five inspections. Once the program is initially
permitted, a follow up routine inspection is completed within the
first 60 days. If the score is Unsatisfactory there is a follow up
inspection is within 10 days. If risk is present, the provider is
required to make correction with inspectors on site. In the second
year, follow up inspections might be optional based on the score of
the first annual inspection. Rep Welch noted it will be helpful to
see the full number of inspections.
Ashley Fielding, Legislative Liaison
Residential Child Care - Carol Winstead
Office of Provider Management – Dianne Kelly and Catrecia Stokes
was noted that the process has allowed DHS to be introspective in
how they can remove some of the burden. They reviewed roles for
each of these groups.
minimum standards. Licensing is required to care for six or more
children. The initial licensing visit is announced. Providers are
issued a preliminary license and RCC revisits in 6 months. The
provider receives an assessment the end of the first year and review
of citations, if any. RCC gives citations a scope and severity
level. An agency can receive a second temporary license if needed.
The maximum they can give is two temporary licenses. After one
year, if approved, the provider receives a continuing license.
Annual visits are unscheduled and completed within one month of the
previous year’s visit. Other visits are on an as-needed basis.
RCC sets the
licensing standards and OPM sets contractual requirements, which
might be in addition to RCC requirements. A list of statutes that
guide the work was provided to the committee.
provided further review of the RCC process noting that they inspect
and require a plan of correction for deficiencies. It was noted that
they have a triage unit that addresses complaints received through
RCC reports mailbox (self reported or outside). They evaluate
whether or not the complaint needs investigation – only 30% are
usually investigated. Clarification was provided noting the
difference between a complaint versus incident - an incident is
reviewed a list of proposals to reduce oversight.
It was reported
that there are 300 licensed facilities in the state. RCC sets the
licensing standards; OMP holds the contract and may set additional
requirements. OPM responds to complaints based on severity.
asked a number of questions asking of the 300 facilities, how many
are used by DJJ or other (Mental Health). RCC does not maintain this
number. RCC is the only licensing authority and they regulate all
the same. DJJ investigates complaints. Rep Oliver further asked of
the 470 CPS complaints from 300 facilities, how many are child on
child versus child on adult. How many confirmed/substantiated? She
expressed interest in incident of arrest of children in foster care
and asked what happens, i.e. is there programmatical protection.
It was noted
that RCC inspects (unannounced) 5% of foster homes or 10 per
licensing agencies, which ever is greater. Providers are down to two
CCIs that have foster care. It was reported that 45% of children in
foster care are placed with private providers – of this number, 30%
are in family foster homes (approx 1,300 CPA foster families). The
remainder 55% of foster children are in DFCS homes or with relative
placements. Group home placements account for 18% of DFCS
children. It was stressed that PRTFs are hospitalizations, not
inquired about the 55% of DFCS placements asking if the case manager
approves relative placements. It was noted that the county office
handles approval of foster homes – the same list is used that
private agencies use to approve homes.
expressed in the level of care needed. It was noted that in
therapeutic foster homes, foster parents are supported to a level
that they can take a child with high level need. An estimate was
provided noting there are approx. 150-200 children in Maximum
A review was
provided of the ranking system. Dianne Kelly explained base program
designations noting the staff to child ratios differ based on
children coming into DFCS
BWO – Base 1:15
AWO – Additional
MWO – Maximum
Specialty; additional training and supports to foster parents.
Rep Houston expressed interest in the normalcy issue raising
questions about use of shampoo. DHS reiterated the issue with
keeping hazardous materials away from children. It was reported that
this was cited five times in past 1.5 year. They are looking more
closely to see if it was appropriately cited and/or if there is
another way to look at this. Products that do not have, “keep out of
reach of children” do not have to be secured.
responded to questions about refutation and the appeals processes.
A provider may
refute inconsistencies with a surveyor’s citation that is without
validity. Carol noted that approx. 10 years ago they evaluated and
put into place the refutation process. A surveyor should conduct an
exit interview so the provider can correct errors on site. A plan
of correction is required within 10 days for citations rated B or
higher. A provider can refute and reference the rule they are
refuting and include additional information in the Plan of
Correction. RCC will then review and delete, revise, or uphold. It
was noted that this is a voluntary process put into place by RCC.
Carol noted that they can evaluate patterns around rules and
process is a right of the provider when enforcement action is
taken. They have the right to appeal. RCC offers a settlement
conference with the provider. Rep. Willard asked if an appropriate
due process is in place. It was noted that if the provider appeals,
it goes to an administrative law judge. If appealed, they can go to
General Counsel for RCC provided information. She acknowledge they
the concern around the appeals process. It was stressed that
Georgia’s process is in line with other states. The Office of
Administrative Hearings issues an initial decision; either party has
opportunity to seek an appeal review decision by someone who does
not have contact with the case and is appointed by the DHS
Commissioner - they issue an opinion. There is not a right to the
settlement conference – RCC offers this. It was reported that in
the last five calendar years there has not been a request for a
judicial review. After the administrative decision, providers did
not seek additional review.
It was noted
that there is an independent APA review. It was further noted that
not all citations rise to an adverse action - APA only applies to
sanctions [adverse action]. The provider has 10 days to request a
hearing only if there is an adverse action. It was noted that there
have been 33 adverse actions out of more than 2,000 citations.
Representatives clarified that providers do not have the right to
appeal a citation that does not have sanctions, although citations
are published. It was noted that this is an internal process. Rep.
Tanner expressed concern with the adverse action posted on the
website and requested that they think about a way that they can have
a good process to clear these up.
When asked what
numbers by law judge were brought to review by the Commissioner are
changed, it was noted that of three appeals requests one was
overturned in favor of RCC and another appeal was won. A question
was raised asking why go through LJ (law judge) if reviewed
internally. The LJ decision is not considered final. [Can go to
Superior Court after opinion]
PPT from DFCS
Office of Provider Management (OPM)
reported that there are currently 179 CCIs and 71 CPAs. She
referenced the RBWO minimum standards, management of risk and
education of providers. It was noted that the Performance Based
Placement scoring requires a score of 70 or above out of 100 to
ensure placements of children.
are unannounced based on the number of children placed.
The QFH Study
Review is looking at safety and foster home study.
The Ga Score
system was explained noting that it is used by providers to enter
data. The system was created for providers to use. It was stressed
that the SHINES system is specific to the child.
Rep Welch asked
who reported into the score card. Those with RBWO contract report.
RCC reports part of the survey and they are part of the
comprehensive review score. The goal is for OPM to use the score
card to determine which contracts will be issued/reissued. Some
providers have needed more technical support. Termination of
providers is rare - more often they suspend placements, limit
numbers, or change approval level to lower level children. DJJ can
also utilize Ga Score - it could be helpful to have information from
expressed interest in the education achievement criteria and asked
if they check to see that every child has a surrogate appointed and
ensure IEP is being followed. This is the responsibility of the
county case manager. They try to use the birth parent as surrogate
or foster parent.
was noted that RCC and OPM are two different oversight entities.
Rep Oliver asked
how to consolidate requirement of criminal background checks
stressing we would like to see this happen. Reference was made to
legal issues and Rep Oliver challenged this and requested that they
seek help with a solution.
It was agreed
that it is possible for the Divisions to combine annual
inspections. OPM goes out once per year and could propose every two
years. They can further look at inspection schedule based on
performance. OPM and RCC are in conversation about how to decrease
visits with foster homes.
raised the suggestion that the Departments look at software and data
base for intra-agency communication. Rep. Houston also noted that we
are not using technical data enough. It was noted that the
Department has internal monthly meetings and have talked about a
calendar system for all to enter information to cross check visits.
It was noted that yes, inspection forms overlay with OPM and RCC.
OPM is looking from safety perspective.
A question was
posed asking if there is an appeal process for termination of a
contract. It depends on why the contract is terminated. The
Department can give 30 day notice – there is not an appeal to this.
A suggestion was
made to look at the PCP scoring to correspond with what RCC is
suggested the use of advisory panels that are the regulated bodies
and have providers give information from advisory group to review.
Recognize those who need to get out of the business.
was provided on the response time to providers. Policy is that RCC
has 30 days from exit date to get the report to the provider.
Rep. Welch asked
if we have looked at other states for interagency data sharing. It
was noted we are working on enhancements with Ga Score (contract
management system.) and allowing RCC and DJJ to be part of the
system. RCC emails every adverse action to OPM. Dianne Kelly
reported that DFCS leadership meets monthly with the provider leader
associations. Also, Practice Matters meetings are offered to every
contracted RBWO provider to talk about child welfare practice.
Rep. Welch asked
how many children are transferred to privately funded homes like
WinShape and Eagle Ranch. It was noted there are none because OPM
does not have a contract with them. Rep. Welch stressed that we want
to incentivize those who have funding and asked, how do we
incentivize. Can we look at monitory or tax incentives?
reported that the Department is also looking at predictive analytics
starting with CPS when a report comes in, noting previous risk
factors - this could create a system of red flags.
John Smith, Racquel Watson and Carl Brown
An overview was
provided of the Department and its oversight. There are:
residential facilities for CCI and CPA
are shared with DFCS
facilities contract with DJJ and DFCS
13 DJJ only
oversight include four regional treatment specialists and six
residential placement specialists. There are three planned site
visits per calendar year – one announced and two unannounced. It
was announced that they will team together a calendar with other
departments. Some standards that they have to oversee are DJJ
specific based on safety and security as an agency. DJJ reports
back to facilities within 72 hours. They are addressing an appeals
Timelines for a corrective action plan depends on the deficiency:
A question was
raised about YDC and RYDC, RBWO youth – there are 800 hard beds.
30 - Base
70 - AWO
221 – MWO
Rep Oliver asked
about cross over children and the federal law/ payments through IV-E
asked about the joint working relationship and what is done
differently from DFCS. Racquel noted this is addressed in the Power
Point, i.e. a PREA (Prison Rape Elimination Act) incident has to be
immediately addressed which is outside of how we as agencies address
joint audits. It was suggested that consideration be given to inter
governmental agreement for regular annual regular visits. Carl Brown
noted they can discuss this.
suggested consideration for interagency operations allowing OPM to
oversee the contracts and inspections associated with the contracts.
It was noted that DJJ has a substantial contracting department and
focus solely on residential contracts would not result in
cautioned that the reasons kids are in [DJJ] custody are different
from reasons they are in DFCS custody. He encouraged consideration
of ways to do inspections at the same time. It was noted that DFCS
inspectors do not have the same expertise as DJJ inspectors – they
are not there for the same reasons. Rep. Welch asked if we could we
cross train. It was noted that DJJ has to look at the most critical
needs, i.e. sexual offenders. DJJ is charged with safety, security
of child and community. If DFCS takes on inspections and they do
not receive information until 7-10 days later, this creates issues.
asked for a report out of the 470 – where they come from and what
they reflect. Reference was made to the RCC Power Point slide on
complaints of abuse and neglect Rep Oliver asked how many are DJJ.
How many in DJJ or DFCS are arrested from facility and sent to
jail? She asked if this happens, should your facility post bond.
provided closing remarks stressing that they want more concrete
identified code statuary provision that need to be addressed, i.e.
assignment, duties to streamline this and rules/regulations. He
asked for ways to incentivize privately funded providers.
Sept 8 at 10:00am, CLOB 606
TOGETHER GEORGIA is the new name of
our state’s most venerable organization for child and family
services providers: the Georgia Association of Homes and Services
for Children (GAHSC). Since its inception 50 years ago, GAHSC has
been a tireless champion of children all across the Peach State.
While we’re proud of what GAHSC has accomplished over its long
history, we’ve redesigned the organization from the ground up to add
even more value to the hard-working providers serving Georgia’s
children and families. Find out more by being our guest at a
meeting, talking with our friendly members and leadership team, and
by visiting our website at
An email newsletter as a public service