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					   EEC RESIDENTIAL AND
PLACEMENT UNIT OVERVIEW


Board of Early Education and Care
May 12, 2009
Foundation


   102 CMR 3.00 is adopted in accordance with M.G.L. c.
    28A, particularly §§ 9 through 13, which states the
    policy of state government to assure every child "a
    fair and full opportunity to reach his/her full
    potential." In order to fulfill its mandate as the agency
    responsible for licensing residential programs, the
    Office has developed specific standards for residential
    programs to provide this opportunity to the residents
    they serve.

   The nature and scope of 102 CMR 3.00 are based on
    the belief that every aspect of a program's operation
    affects the residents in its care. The philosophy,
    administrative policies, staff, physical facility and
    clinical, recreational, and educational services all
    contribute to a resident's everyday living environment,
    and should maintain a level of quality that promotes
    healthy development.
Rationale for Licensure


3.02(1): Definitions:

   Child. Any person under the age of 18 for part or all
    of a calendar year or under 22 with special needs.

   Child with special needs. A child who, because of a
    disability consisting of a developmental delay or an
    intellectual, sensory, neurological, emotional,
    communication, physical, specific learning or health
    impairment or combination thereof, is or would be
    unable to progress effectively in a regular school
    program. This may include, but not be limited to, a
    school age child with special needs as determined by
    an evaluation conducted pursuant to M.G.L. c. 71B, §
    3, and as defined by the Department of Education in
    603 CMR 28.00.
             Residential and Placement Unit
                  Organizational Chart

                                      Commissioner
                                       Sherri Killins



                                       Dave McGrath,
                                           Deputy
                                      Commissioner of
                                      Field Operations

                       Kelly Buckley,             Tim Keane,
                       Residential and           Residential and
                         Placement                 Placement
                         Supervisor                Supervisor

Western Region      Central Region         Northeast Region        Southeast Region   Metro Boston Region
  Licensors           Licensors                Licensor               Licensors            Licensors

Christine Burnett   Michael Ginetti         Michael Curran          Miguel Ortega     Kerry Murphy McCall
 David Micka        Richard Mucci                                    Kathy Perry          Kara Adams
406 Group Care Licenses
Group Care Program: A program or facility that provides care and custody for
one or more children by anyone other than a relative by blood, marriage or
adoption on a regular 24-hour a day, residential basis.
65 Temporary Shelter Licenses
Temporary Shelter: Care and services (as appropriate to the needs of the child)
provided to a child on a regular 24 hour a day basis for a period not to exceed
45 days or in the case of placement in a secure detention facility, not to exceed
90 days.
51 Adoption Licenses
Adoption: The establishment of the legal relationship of parent and child in
accordance with the provisions of M.G.L. c. 210 et seq.
83 Foster Care Licenses
Foster Parent: An individual who provides temporary substitute parental care for a
child or children under an agreement with a licensed or approved placement
agency.
Licensor Caseloads/Responsibilities

              2008 Calendar Year Unit Statistics

Averages Per Licensor:

   Responsible for 70 providers/programs each
   Conducted over 31 licensing renewals each
   Opened 3 new and closed 4 licensed programs each
   Conducted over 80 complaint investigations each
   46 investigations per licensor required follow up activity due
    to regulatory violations
   Reviewed quarterly restraint data and assured reporting
    compliance for 46 programs each
   Reviewed quarterly foster care suspected abuse/neglect data
    and assured reporting compliance for 9 programs each
R and P Unit Licensing Functions
1. Licensure of New Programs
   In person/phone consultation with perspective applicant
   Application submitted with 40 policies and procedures
   Licensor reviews 40 documents assuring compliance with regulations
   Written response/in person meeting relaying outstanding
    policy/procedure issues
   Schedule physical plant inspection
   Issue 6 month Provisional license
   Conduct 3 month monitoring visit
   Issue 2nd six month Provisional license

2. Licensure of Current Programs
   3 months prior to expiration, licensor sets up renewal visit and
    requests application
   Receive/Review application inclusive of updated policies, procedures
    and inspections
   Conduct visit to the facility (one to six days depending on the
    size/scope of services)
   Conduct Exit review/meeting
   Write and send review
   Review corrective action from program
   License renewal or other action taken
 Licensing Functions
 Continued

3. Investigations
 Mandatory incidents and complaints
    (837 in 2008)
 Intake, collaborate, investigate and assure compliance
    (411 investigations resulted in citations)

4. Enforcement
 Follow-up on all complaint citations
 Monitoring visits
 Legal referrals
 Enforcement meetings

5. Technical Assistance
 Developing policy and TA papers
 Provide training and assistance to programs
Examples of Technical Assistance


    Licensors provide consultation and
    training on:

   The creation of behavior management
    policy and procedure

   Background Record Check policy and
    procedure

   Home Study development

   Internal investigations

   Program development
Other Responsibilities Include

   Conduct trainings for programs

   Attend and present to provider organizations

   Evaluate and produce feedback for the need for
    policy, procedure and regulation change

   Interagency meetings

   Internal meetings

   Internal/external committee involvement

   Regional duties and operations meetings
Collateral Work
Residential Care
Population Served

Includes but is not limited to:


   Learning disabled

   Autism and pervasive developmental disorders

   Behavioral disorders

   Eating disorders

   Sex offender/sexually reactive

   Criminal offender/adjudicated youth

   Severely physically disabled with limited life expectancy

   Schools for the deaf/hard of hearing, blind, etc.
Spectrum of Services


   Range from educational services for
    learning disabled children, through
    independent living skills for teen
    parents, to acute clinical and behavioral
    treatment for severely troubled children.

   Most of the children in residential
    facilities are there for treatment of
    emotional and behavioral issues that
    may include sexual and physical abuse
    and self-injurious behavior.
Challenge


   To build regulations in a meaningful way
    that support changes in:
       Spectrum of care

       Length of placement

       Diversity of program model
Melmark School
Hillcrest Educational
       Centers
Adoption
Population Served


   Children birth to 18
       Domestic Infant
       International
       Special Needs/Waiting Child


   Adoptive parents

   Birth parents
Spectrum of Services
Domestic Infant:
   potential expectant parents make an adoption plan and choose a
    prospective adoptive family for their child
International:
   prospective adoptive families are approved via a home study process and
    then enter an agency program where they are matched with a child
Special Needs/Waiting Child:
   prospective adoptive families are matched with a child currently in foster
    care within a state system such as DCF


Hague Adoption Convention
   Multilateral international treaty designed to protect children, birth families
    and adoptive families from unscrupulous practices, including hidden fees,
    bribery and child abduction
   Central authority is the US Department of State
   All US agencies working in international adoption must now be accredited
    through the Council on Accreditation
   14 Massachusetts agencies have accreditation, 4 have full accreditation
    status.
Challenges

Challenges
 Implementation of Hague has resulted in fewer infant
  adoptions and an increase in adoption of older, special needs
  children
 Adoption has become much more complicated, more
  expensive and a longer process for families and children
 Adoption practice and law is complex and largely unregulated
  in other states. Many Massachusetts adoptions are multi-
  state in process

Impact and Change
 EEC has recently revised their home study policy to be more
  congruent with the time frames required by Hague and BCIS
 Adoption Advisory Group has met quarterly for over 5 years
  and consists of two supervisors, two licensors, two attorneys
  and 15 adoption agency directors
 Focus of the group is to identify tangible areas that need
  revision in the regulations, discuss trends in adoption and
  best practice concerns in Massachusetts
Foster Care
Population Served

   Foster care agencies serve kids from
    birth up until the age of 22

   Kids can have similar issues as those
    placed in residential program, but they
    require a less restrictive setting

   Many kids in foster care have been
    removed from their homes due to
    abuse/neglect issues
    Foster Care
    Spectrum of Services


   The agencies hold EEC licensure not individual
    homes
   Homes are directly overseen and supervised
    by foster care agencies such as DCF, Mentor
    and Dare
   Ensures that agencies are in compliance with
    regulations regarding the supervision and
    oversight of their homes
   Oversight of the administrative operations of
    foster care agencies
Challenges

   Regulations need to be updated to reflect
    current practice
   Lack of potential foster homes/parents
   Although there is one set of regulations for
    both foster care and adoption, they could be
    broken into sections for easier understanding
DARE Family Services
Current Challenges

   Economy
   Professional development of work force in
    facilities and foster homes
   Restraint reduction
   Technological advances
      great for time management and supervision
      In the wrong hands can be used neglectfully
   Staying current with ever changing adoption
    law/practice
   Impact of vacant/ positions
   Detecting areas of overlap with other agencies
   Regulation revision
Regulation Revision for Residential
and Placement Services

Residential
   Current regulations lack the flexibility to
    withstand changes is program design
   Assessment of restraint regulations with eye
    toward early detection training to avoid restraint
   Cross walk with other agencies to assure
    alignment and minimize duplication


Placement
   Address regulatory inconsistency with Federal
    Hague Adoption Convention
   Improve regulatory language relative to adoption
    related expenses/fees
Questions?




         Thank You

				
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