Adult Foster Licensing 2013 ANNUAL REPORT 2013 PRESENTED BY ELLEN TURNER NICOLE DUCHELLE Licensing of Foster Care in Olmsted County COMMUNITY RESIDENTAL SETTINGS: Olmsted County licenses foster homes in several different ways, but are typically under the umbrellas of Community Residential Settings or Family homes. Case Managers are tasked to match client needs to the type of foster care provided so that individuals are not over or under served. Community Residential Settings (CRS) are defined by the owner/provider NOT living in the home. They come in two varieties: Highlights of FY 2013 Operational Excellence 1) Shift staffed group homes, typically our larger corporate providers. 2) A hybrid, which is a live-in type model with additional shift staffing provided as needed based on the needs of the individuals living in the home. This type of home is uncommon. Family Foster Homes are defined by the owner/provider living in the home. These homes may do foster care only or they may take more difficult clients who have waivered services. In January of 2014 there was additional licensing requirements for all waivered service providers (245D), which will limit the number of providers for this model. There are currently 23 homes licensed for 245D. AFC support group is well attended in its third year of operation Staff knowledge and longevity: Ellen 21 years, Nicole 6 years Excellent training opportunities offered to providers Strengths Foster Care licensing team is broadly experienced High degree of collaboration between placing social workers and the licensing team Strong partnerships with Mayo Clinic, Olmsted Hospital, Nursing Homes and Assisted Living facilities We do our work with a team approach Some images this report courtesy of FreeDigitalPhotos.net
AFS Licensing Logic Model & Program Flow ADULT LICENSING 2013 Managing for Results (M 4R) - O lm sted County s Strategic Management System Adult Foster Care Strategy Map Mission: Partnering to Provide Education, Access, Choice, and Support Vision: An accepting community with a Vision path to advocacy, options, and achievement C o m m u n ity S e rv ice s B u ild in g a sa fe, th r iv in g a n d in clu siv e co m m u n ity A d u lt Values: a n d F a m Respect, ily S er v iceinnovation, s Pa r tn e rin g Collaboration, to p r o v id e a cceand ss, ch Accountability o ic e a n d su p p o r t P rovide A ccess a nd Ch o ices Build the Com m unity C u ltiv a te safe an d affo rd ab le livin g environm e nts M a n a ge th e Resources M ax im ize a ll potential revenues Dem onstrate Sou nd Fiscal M anagem ent Why? 1 Run the Business How? Enhance partnerships and c o lla b or at ive practices Prom ote inno vation through best and evidence base practices Develop the Em ployees S u p p o r t s t a f f s k il ls and know ledge development M4R Component RUN THE BUSINESS Annual Foster Care Banquet The Adult Licensing program holds an annual meeting of providers to improve partnerships and collaborations. Each year, Foster families gather together at the annual Adult Foster Care Appreciation Banquet. Foster families are recognized for the service they provide to Olmsted County residents. Speakers share stories to provide lessons learned and encouragement. Entertainment events from comedy hour to casino nights reward foster families. This year s was held at the Clarion Inn in Rochester on May 9th. Over 100 providers and workers were in attendance. PAGE 2
M4R Component MANAGE THE RESOURCES ADULT LICENSING 2013 Foster Care Licensing Census at a Glance CRS Clients & Homes Family Adult Foster Care Clients & Home 344 350 350 239 231 242 5 2 1 104 106 107 2 6 11 4 9 10 106 103 104 New Licenses Total Homes Number of Clients Served 2011 2012 2013 New Licenses Closed Homes Total Homes Number of Clients Served 2011 2012 2013 2013 marked a milestone in Family Care; total clients hit an all-time high at 242! Adult Foster Care Licensing oversees two types of service for clients; 1. Community Residential Settings with paid staff, set up exclusively to provide adult foster care 2. Family Foster Care family homes run and staffed by the homeowner. M4R Component BUILD THE COMMUNITY Foster Care Residents Safe From Harm Adult Licensing staff regularly visit and respond to complaints at Foster Care homes. Those visits most often result in no action. On occasion, a violation is noted and recorded. If the violation is minor, such as a tag not displayed on a fire extinguisher, a correction order is issued and the home must make a correction within a set time frame. More serious infractions result in homes being placed on probationary status. Most serious infractions result in immediate revocation of foster care licenses. 2013 Budget 83% 2013 Revenues 11% 6% Service Revenues Grants Tax Levy/Reserves Expenses: Program Expenses: Salaries/Benefits 171,433 Indirect Costs 11,944 Direct Client Costs 35,350 Contracted Services 0 Total Program Expenses 218,727 Administrative Expenses 35,788 Total Program and Administrative Expenses $ 254,515 Revenues: Service Revenues 28,500 Grants 15,938 Total Revenues 44,438 Tax Levy/Reserves 210,077 Total Revenues and Tax Levy/Reserves $ 254,515 PAGE 3
ADULT LICENSING 2013 M4R Component DEVELOP THE EMPLOYEES Licensing Training The licensing team takes advantage of all trainings provided by DHS for licensing workers Licensing staff attend a variety of pertinent training topics on different practices, disabilities, etc; and then bring their knowledge back to the County and coordinate training opportunities for licensed providers. 245d: a new statute went in to effect on Jan 1, 2014 that impacted CFC homes and family homes that provide waivered services (other than Elderly Waiver) as well as Foster Fare. All homes formally known as Corporate Foster Care (CFC) Homes became Community Residential Settings (CRS). Needs and Strategic Solutions Increased supports for foster parents due to an increasing 18-21 year old foster care population More specialized AFC homes for individuals with specific needs: Severe and Persistent Mental Illness (SPMI), cognitive deficits, behavioral supports, etc. Need more accessible homes staff actively recruits new providers and is pursuing all available grant opportunities Historically, the elderly have been the largest population in FFC homes. This is shifting to individuals with SPMI. Additional support and training for providers in needed to best serve these clients Problem: increased referrals of individuals for foster care who have extensive criminal history. This does not typically fit with family foster care Increasing numbers of private pay individuals are being referred for foster care. These clients are assessed by Adult Licensing staff and if they require ongoing case management, that will also be provided by the two Licensing staff. More persons who have experienced homelessness require foster care PAGE 4
ADULT FOSTER LICENSING 2013 Next Steps 245d is now the licensing authority for all service through disability waivers, which is a huge change for our CRS providers, causing much additional work for them. Likewise, Family providers wishing to accept Waiver clients must first complete the paperwork and pay the fees for 245d licensing. The effects of 245d are addition of work and expense for providers and limitations on the homes that can accept waiver clients. About 25% of our family homes are 245d providers Disability Waiver Rate Management System (DWRMS) now sets the waiver rate for all waivered services, including foster care. In some cases these rates are dramatically different than those determined by our old system for the same service Region 10 Quality Assurance System no longer has authority in Olmsted County due to the inception of 245d. This was a waiver to our former Consolidated Licensing Standards and not allowed currently under 245d. We have worked together proactively for many years to ensure quality and address concerns, so this is a loss to Olmsted County We are working hard to help all the providers but especially the family providers, understand and meet the new 245D requirements. In 2013 we helped our providers navigate the application process for 245D through several trainings. We continue to create and offer trainings that reflect the needs of the providers and adjust the trainings to fit the level of knowledge the providers have. This is an ongoing effort. Although QA is no longer a licensing authority, the relationship that QA has allowed us to build with the providers continues. We work very closely with providers on issues that arise and work to help problem solve areas of concern. Conclusion We do a lot with a little. AFS has 200 homes that serve well over 500 individuals in those homes. Being the hub of SE MN, we get many out-of-county referrals. All of this work is done with two part time staff who, fortunately, rock! We greatly appreciate CSSAB s continued generous support of levy funds. Those levy funds provide: 1. Training opportunities for providers 2. Much needed relief/respite dollars so our providers can get a break PAGE 5