State of Maryland Executive Department
GOVERNOR'S OFFICE FOR CHILDREN, YOUTH AND FAMILIES
ROBERT L. EHRLICH, JR. Governor MICHAEL S. STEELE Lieutenant Governor M. TERESA GARLAND Special Secretary
Report on HB 416Children’s Group HomesUse of SubCabinet Resources Directory for Notification and Identification October 1, 2004
House Bill 416 required the Governor’s Office for Children, Youth and Families, in coordination with the Department of Health and Mental Hygiene, the Department of Human Resources, and the Department of Juvenile Services, to conduct an analysis and make recommendations on how the SubCabinet Resources Directory may be used (1) to notify State and local elected officials about children’s group homes newly licensed in the official’s jurisdiction, and (2) by State and local elected officials, law enforcement agents, and other appropriate individuals to quickly identify both the owner and the agency that licenses a group home at a particular location. Background on the SubCabinet Resources Directory The SubCabinet Resources Directory (SRD) is one module of the SubCabinet for Children, Youth and Families Information System (SCYFIS). SCYFIS is a web-based, electronic database designed to help frontline staff organize their case records for a number of interagency case management programs. The SRD, under further development, will contain a wide range of resources that frontline staff may access to assist their clients. These resources range from non-residential to residential services. Group home placements, which are the focus of this legislation, are for children in out-of-home placements who are unable to remain in their
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homes for a range of reasons. The information contained in the SRD includes basic information on the parent organization that owns the group home, the State licensing agency, and the specific site. Addressing HB 416 In June 2004, Special Secretary Garland convened a workgroup at the Governor’s Office for Children, Youth and Families (GOCYF) to address HB 416, HB 1146, and SB 711. These bills are all interrelated and address issues affecting children in out-of-home placement across the State of Maryland. Over the summer, the workgroup expanded to include representatives from other SubCabinet Agencies, including the Department of Health and Mental Hygiene (DHMH), the Department of Human Resources (DHR), and the Department of Juvenile Services (DJS). This membership list can be found at the end of this report (Appendix A). Additionally, members of the workgroup attended meetings of the Resource Development and Licensing Committee (RDLC) and met individually with the licensing coordinators at DHMHDevelopmental Disabilities Administration (DDA), DHMH-Mental Hygiene Administration (MHA), DHR, and DJS, as well as individuals from the Interagency Rates Committee (IRC). The workgroup agreed that, the SRD must be updated to meet the requirements of HB 416, and also to facilitate the work required by SB 711 and HB 1146. Specifically, the SRD will assist in conducting the needs assessment of children in out-of-home care required by SB 711 and in developing the system of outcomes evaluation required by HB 1146. The improvements required by HB 416 dovetail with the SubCabinet’s decision in June 2003 to have the SRD serve as a repository of information for caseworkers throughout the State. Prior to commencing work on the substantive requirements of the bills, the workgroup identified the need to develop a “common language” for referring to various types of out-of-
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home placement. The workgroup developed a placement categories worksheet to provide a comprehensive list of all placement types and categories used by various agencies for a range of purposes. This worksheet contained definitions from the Core Regulations found in COMAR, as well as definitions used by the Interagency Rates Committee and Single Point of Entry. A subcommittee on the placement categories met and was able to streamline the list of placement categories into four larger groups: Family Foster Care, Community-Based Residential Programs, Non-Community-Based Residential Programs, and Hospitalization. These four categories will serve as the main categories of residential placements within SRD, with the second tier of out-ofhome placement types (community-based residential programs) being the focus of the work on HB 416 as this category captures the “group home” placement type. This revised list of out-ofhome placement types can be found at the end of this report (Appendix B). The Plan for HB 416—Notification of Officials and Identification of Group Home Owners The plan designed to meet the objectives of HB 416 reflects the current licensing process. It is also dependent, however, on integrating the licensing process with the SRD. The foundation for providing the most accurate data to the individuals named in this bill is contingent upon connecting the SRD to the licensing process at each agency. Agency licensing coordinators, rate-setting individuals, and people responsible for administering contracts have participated in identifying the ways in which the SRD will become an integral part of the licensing process. See Appendix C for a detailed explanation. The licensing process begins when a potential group home provider submits a proposal to the Single Point of Entry (SPE) located at the Governor’s Office for Children, Youth and Families (GOCYF). SPE reviews the proposal and, if acceptable, forwards it to the appropriate licensing agency (DHMH-DDA, DHMH-MHA, DHR, or DJS). The licensing agency, based on
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its protocol, works with the potential group home provider to determine whether a license will be issued. If the licensing agency issues a license then (1) the group home provider will complete the SubCabinet Provider Profile within the SRD, (2) the licensing agency will enter license information into the SRD, and (3) within 30 days of the licensing date, the SRD will issue an email or letter (depending on the individual’s preference) to State and local elected officials (State Senators, State Delegates, County Executives and the Mayor of Baltimore City). See Appendix D for a sample notification. It should be noted that, at this point in the licensing process, neither a State rate nor State contracts have been established for the group home provider. Once a rate has been set for the site, the rate-setting agency will notify the group home provider, the SPE, and the State licensing agency, and will enter the rate information within the SRD. Finally, once a contract has been entered, the contracting agency will input the specifics of the contract into the SRD. The SRD will provide electronic notification about newly licensed group homes. In order to view contact and license information about existing group homes, State and local elected officials, law enforcement agents, and other appropriate individuals will be provided with a specific level of access to the SRD in order to quickly identify the group home owner and State agency that licenses the group home. These individuals will be able to view this information about a group home by logging onto the SRD or having the option to contact GOCYF staff to obtain the information needed, including the status of the group home’s license. For example, law enforcement will then be able to see if a group home has a current license, or if the license has been suspended, revoked, or not renewed.
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Implementation of the Plan GOCYF, DHMH, DHR, DJS, and the IRC have agreed to follow the plan that was developed to ensure that the proper notification may occur and appropriate officials have access to information about the owner and licensing agency for a given group home. It was further agreed that, in order to update the database and be responsive to inquiries, all SubCabinet agencies would coordinate existing staff resources to maintain the SRD. Maintenance responsibilities include data entry, assisting group home providers and State licensing staff with data entry, and providing support and assistance to State and local elected officials to access the information requested. In order to comply with HB 416, a number of modifications to the SubCabinet Resources Directory are needed. Most of these changes are already covered in a budgeted plan for the SubCabinet for Children, Youth and Families Information System (SCYFIS) intended to improve the SRD. The passage of HB 416 spurred clarification on how the SRD will be finetuned so that it becomes an integral part of the licensing process. Additionally, the bill has generated the need for a set of functions specifically geared to provide notification of group home licensure and access to State and local elected officials. Notification can most efficiently and cost-effectively be handled through e-mail. When a group home provider enters data about its group home for licensing purposes, the provider will be required to enter the address, jurisdiction, and legislative district where it is located. GOCYF staff will assist with data entry to ensure that all group homes issued a license are correctly coded, and, when the e-mail notification is sent out, the appropriate State and local elected officials receive the e-mail.
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Access to the SRD by State and local elected officials will be handled in two ways to assure quick and easy access. As the SRD is a secure site, the first option is to issue log-on accounts to State and local elected officials who would then have access to the SRD information about group homes. Alternatively, State and local elected officials would have the option to contact GOCYF directly and obtain information about a group home, during regular business hours. In order to implement the plan outlined here, funds available from the budgeted plan to modify SCYFIS (referenced above) must be expended by the end of FY2005. Through collaboration among the SubCabinet agencies and utilization of staff designated at these agencies, it will be possible to reach agreement on how to manage the SRD. It is anticipated, therefore, that the recommendations contained in this report can be implemented fully by the fall of 2005. The Special Secretary and the SubCabinet for Children, Youth and Families are committed to building the capacity to track out-of-home placements for Maryland’s children. This commitment has been clarified and can be seen through the SubCabinet’s response to HB 416, as well as to SB 711 (requires needs analysis of out-of-home placements) and to HB 1146 (requires a plan for the development of an outcome evaluation system). The Governor’s Office for Children, Youth and Families, as directed by the General Assembly, will continue to coordinate the work required by these bills with the assistance of the SubCabinet Agencies.
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A. Membership Roster B. Placement Categories List C. Detailed Explanation of Licensing Process and Plan for HB 416 D. Sample E-Mail Notification to State and local elected officials
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APPENDIX A Membership Roster: SubCabinet Response to Out-of-Home Placement Legislation Lead Contact: Deborah Harburger, Governor’s Office for Children, Youth and Families Department of Budget and Management: Marc Nicole Department of Health and Mental Hygiene: Marcia Andersen, Barbara DiPietro, Alycia Steinberg, Connie Urquhart, Al Zachik Department of Human Resources: Tammy Bresnahan, Charlotte Giles, Sharon Hargrove, Philip King, Bill Lee, Rosemarie D. Satyshur, Elizabeth Seale, Grace Turner, Jim Witherspoon Department of Juvenile Services: John Irvine, Janice Marquez, Mary Louise Orth, Denise Sulzbach Governor’s Office of Crime Control and Prevention: Andrea Alexander, Greg Leyko, Dilip Paliath Governor’s Office for Children, Youth and Families: David Ayer, Cynthia Mather, Brother Frank O’Donnell, Ralph Thomas, Susan Russell Walters, Deborah C. Wilder Maryland State Department of Education: Linda Bluth, Rosemary King Johnston, Steve Sorin, Renee Spence Maryland Department of Disabilities: Lynell Otto Office of the Attorney General JoAnn Goedert
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APPENDIX B Placement Categories The following out-of-home placement categories have been created as part of the SubCabinet Response to HB416, HB1146 and SB711. It should be noted that specific placements may focus on serving children based on age, gender and other client characteristics. I. Family Foster Care A. Kinship Care B. Regular Family Foster Care C. Treatment Foster Care D. Individual Family Care Home II. Community Based Residential Programs A. Independent Living B. General Service Group Home C. General Service Group Home Serving Special Characteristics: 1. Aggressiveness 2. Sex Offending 3. Fire Starting 4. Runaway 5. Medically Fragile 6. Teen Mother/Pregnant/Mother-Infant 7. Substance Abuse Treatment D. Group Home with Specialized License: 1. Therapeutic Group Home 2. Shelter Care 3. Respite Care 4. Program for Children with Developmental Disabilities (including Alternative Living Unit) III. Non-Community Based Residential Programs A. Residential Treatment Center (including RICA) B. Residential Education Facility (public and non-public) C. Intermediate Care Facility for the Mentally Retarded (incl. State Residential Center) D. Psychiatric Respite Program E. Juvenile Detention Facility F. Wilderness Program G. Juvenile Commitment Facility H. Long-Term Care Facility – Substance Abuse Treatment Program IV. Hospitalization A. Acute Somatic B. Psychiatric 1. Free-Standing 2. General Hospital Psychiatric Unit C. Intermediate Care Facility – Substance Abuse Treatment Program
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APPENDIX C Detailed Explanation of Licensing Process and Plan for HB 416 The chart below illustrates the licensing process, detailing the policy level at which the actions occur, details about actions taken and who would be notified, the information to be entered into SCYFIS, and the person responsible for the data entry. Each of the steps is described below. Level of Policy
Single Pointof-Entry (Within GOCYF) Licensing (DHR, DHMH, or DJS)
Provider Applies to SPE. SPE notifies Licensing Agency Issue License and Notify IRC and SPE electronically. General Assembly/local officials notified electronically within 30 days with caveat that neither rate nor contract have been set. Set rate for given Fiscal Year; and Notify Licensing Agency and SPE electronically.
Information Entered into SCYFIS
NO DATA ENTRY AT THIS STAGE
Person Responsible for Data Entry
Provider profile is entered, revised and verified as part of licensing process.
Contract(s) entered by Licensing Agency and/or other MD Agencies with verification of provider profile, at the option of State agencies and upon approval by the Board of Public Works (when applicable).
Enters information for providers with new/modified rates (renewal updates to be handled electronically) to include Preferred/ NonPreferred, Fiscal Year, and dollar amount. Revisions under certain circumstances.
Providers enter provider profile using Excel or SCYFIS (SCYFIS can import Excel version). Licensing Agency checks provider profile for accuracy. IRC/Rate-Setting Agency
During the first step of the process, a potential provider submits a proposal for review by the Single Point-of-Entry (SPE) within GOCYF. After SPE reviews the proposal and works with the provider, the proposal will be forwarded to the appropriate licensing agency-either DHR,
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DHMH, or DJS. At step two, the licensing agency works with the provider to create a provider profile that contains basic contact information, as well as characteristics and levels of intensity of the children served and services provided. The provider would be required to complete the profile in an electronic format—directly into SCYFIS for those with Internet access and sufficient knowledge of database systems or into an Excel spreadsheet for others. GOCYF staff would provide assistance to providers as they complete the profiles. The licensing agency will verify the profile for accuracy before posting it for other State agencies to view. Once the licensing agency has issued a license to the provider for a particular site, the licensing agency will enter information into SCYFIS. This will trigger an electronic notification or written letter (depending on the individual’s preference) to State and local elected officials (State Senators, Delegates, County Executives and the Mayor of Baltimore City) within 30 days of issuance that a new group home has been licensed, with the caveat that neither a rate nor a contract has been set. This caveat is necessary, because, even though a group home provider has obtained a license from DHR, DJS, or DHMH for its site, the provider is not yet able to accept children committed to the custody of the State for placement. The provider will need to obtain both a rate and a contract before it can accept children from the State. As soon as they are licensed, however, the providers have the right to accept children into their group homes if they are from out-of-state or remain in the custody of their parents and are being paid for through private insurance. This represents a small proportion of the children who are placed into Maryland-licensed group homes statewide. Therefore, it must be understood that notification to State and local officials upon issuance of a new group home license does not mean that the group home may accept children in State custody. Only when a rate is established and a
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State agency contract is issued, a process that can take up to several months, can children in State custody can be placed in the newly licensed group home. Step three in the process occurs after a license has been issued. The Interagency Rates Committee (IRC) analyzes the group home information and issues a rate for the current fiscal year, as well as a determination of whether or not the provider has a “preferred” or a “nonpreferred” status. For all new providers and providers receiving a modified rate, the rate-setting agency would go into SCYFIS and enter the rate that has been assigned and the preferred/nonpreferred status. This would trigger notification back to the licensing agency, and the group home would be ready for the contracting process. At the start of each fiscal year, the IRC will send GOCYF an electronic database of rates for all providers. Staff will modify the SRD to reflect any cost-of-living or other rate increases. The contracting agencies (child-placing agencies) would, at step four, be able to negotiate a contract based on the rate assigned and the terms from their particular agency. The contract then goes through the Department of Budget and Management and the Board of Public Works (when applicable) for formal approval. Once a contract has been issued, the contracting agency would enter the relevant contract information—number of beds, gender of children—into the SRD. It is at this point that the group home’s information would be available to frontline workers. The information will not become available to frontline staff prior to this time to ensure that children in State custody are not inappropriately placed. Upon establishment of a contract with an Agency, the information contained in the provider profile, as well as the rates and whether the group home has a preferred or non-preferred status, will be made available to frontline staff. Over time, any revisions to the provider profile will be made by the provider and approved by the appropriate contracting and/or licensing agencies.
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State and local elected officials, law enforcement agents, and other appropriate individuals will have a different level of access than frontline workers to be able to quickly identify the owner and agency that licenses a group home at a particular location. These officials and agents will be able to view information about the group home as soon as it has a license, by either logging onto the SRD or contacting GOCYF staff to obtain the information needed. Additionally, these individuals will be able to continue accessing information on the group home even if there is no longer a contract or a license is suspended, revoked, or not renewed. The workgroup felt that this was an important component of the modifications to the SRD because it will allow law enforcement agents and others to determine if a home is a group home in good standing and whether children should be placed there.
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APPENDIX D Sample E-Mail Notification to State and Local Elected Officials The SubCabinet Resource Directory (SRD) will generate an email message and send it to the State and local elected officials from the jurisdiction where the newly licensed group home is located, within 30 days of the license date. The information about the group home contained in this email will also be the information available for State and local officials and appropriate individuals issued an SRD log-in account to access information about existing group homes. TO: FROM: RE: DATE: State and Local Elected Official The SubCabinet Resource Directory Newly Licensed Group Home: Sunnyside Group Home September 28, 2005
This email is to notify you of a newly licensed group home in your jurisdiction. Once licensed, group home providers have the right to accept children from out-of-state or who remain in the custody of their parents and are being paid for through private insurance. Children in State custody can be placed in the newly licensed group home only after a rate is established and a State agency contract is entered.
Name of Group Home: Address:
Sunnyside Group Home 123 Pine Avenue Randallstown, MD 21201
Name of Parent Organization: Contact Person: Contact Phone:
ABC Agency, Inc. John Anderson 410-555-1212
Licensing Agency: Coordinator: Coordinator Phone:
Department of Human Resources Bill Lee 410-767-1212
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