Childrens Rights Settlement Agreement Overview

House Committee on Oversight November 17, 2021

Childrens Rights Settlement Agreement

Childrens Rights Settlement: Agreement Children s Rights Inc. and the State of Rhode Island settled their case (Andrew C., et al. v. Raimondo) in May 2018. Agreement focuses on ensuring appropriateness of placement, recruitment of foster families, quality of parent-child visits and sibling visits, timely and complete service plans, and timely and complete child protective service response to child abuse and neglect complaints. How the Agreement Works How the Agreement Works The Department is responsible for meeting a series of benchmarks that are overseen by a monitoring team comprised of an independent data validator and the RI Office of the Child Advocate. Each reporting period is 6 months, and data reports are due to the data validator 30 days after the end of each reporting period. The requirements for any commitments that are met for two consecutive 6-month reporting periods allow for DCYF to exit from the requirements of that commitment. Conversely, if any commitments in the settlement are not met for two consecutive 6-month reporting periods, then DCYF must develop a corrective action plan. 3

Childrens Rights Settlement: Reporting Periods CRI Reporting Periods CRI Reporting Periods Monitoring Report Release Date Monitoring Report Release Date Reporting Period 1 (July 1, 2018 to December 31, 2018) June 30, 2019 (amendments received on 12/31/2019 and 2/9/2021) Reporting Period 2 (January 1, 2019 to June 30, 2019) Reporting Period 3 (July 1, 2019 to December 31, 2019) Reporting Period 4 (January 1, 2020 to June 30, 2020) Reporting Period 5 (July 1, 2020 to December 31, 2020) Reporting Period 6 (January 1, 2021 to June 30, 2021) Reporting Period 7 (July 1, 2021 to December 31, 2021) December 31, 2019 (amendment received on 2/9/2021) December 3, 2020 February 9, 2021 July 13, 2021 Monitoring report expected early 2022 Reporting Period in progress 4

Childrens Rights Settlement: Sections of Compliance RP1 (Ended RP1 (Ended 12/31/18) 12/31/18) 89.13% 100.00% 100.00% 100.00% RP2 (Ended RP2 (Ended 6/30/19) 6/30/19) 89.08% 100.00% 100.00% 100.00% RP3 (Ended RP3 (Ended 12/31/19) 12/31/19) 91.24% 96.88% 100.00% 100.00% RP4 (Ended RP4 (Ended 6/30/20) 6/30/20) 91.40% 100.00% 100.00% 100.00% RP5 (Ended RP5 (Ended 12/31/20) 12/31/20) 95.52% Exited Exited Exited Section Section Measure Measure Compliance Compliance 1.0 1.0 2.2 2.2 2.3a 2.3a 2.3b 2.3b Assessments Assessment & Stabilization - Initial Assessment & Stabilization - 14 Day Assessment & Stabilization - 60 Day Congregate Care - Initial Determination Congregate Care - Placement Review 85% 100% 90% 95% 3.1 3.1 90% 95.56% 100.00% 65.88% 79.01% Exited 3.2 3.2 90% 94.67% 95.19% 98.20% 95.87% Exited Sections 2, 3 and 9 Sections 2, 3 and 9 District Court Judge approved the joint Notice of Exit from these sections of the Settlement Agreement on March 26, 2021. Section 1 Section 1 The Monitoring Team recommends and will support the Department s filing of a Notice of Exit from Section 1. Section 11 Section 11 Annual Maltreatment Reports. Annual Maltreatment Reports. DCYF is complying. Reports were published in January 2019, March 2020, and March 2021. (www.dcyf.ri.gov/data-evaluation/safety-data-reports.php) Section 12 Section 12 Foster Care Recruitment Plan. Foster Care Recruitment Plan. DCYF published a plan in 2019, 2020 and 2021. 5

Childrens Rights Settlement: Sections for Improvement RP1 (Ended RP1 (Ended 12/31/18) 12/31/18) 73.33% 94.13% 16.76% 3.28% RP2 (Ended RP2 (Ended 6/30/19) 6/30/19) 69.64% 95.31% 14.67% 0.00% RP3 (Ended RP3 (Ended 12/31/19) 12/31/19) 68.75% 96.48% 6.63% 6.03% RP4 (Ended RP4 (Ended 6/30/20) 6/30/20) 66.07% 96.14% 43.42% 26.71% RP5 (Ended RP5 (Ended 12/31/20) 12/31/20) 92.44% 97.00% 17.07% 25.78% Section Section Measure Measure Compliance Compliance Sibling Placement (QR)* Caseworker Visits - Frequency Caseworker Visits - Quality (QR) Sibling Visitation (QR) Parent-Child Visitation - Frequency (QR) Non-Kinship Placement w/o License Background Check prior to Placement Kinship Licensing in 6 Months License Renewal - FP and Home Study CPS Report Screen In CPS Investigation Response Time CPS Investigation Completion Case Plan Timeliness Case Plan Elements (QR) * (QR) = Qualitative Review. 4.1 4.1 6.1 6.1 6.2 6.2 6.3 6.3 80% 95% 85% 85% 6.4b 6.4b 85% 12.62% 10.20% 10.53% 42.52% 34.99% 7.1 7.1 7.2 7.2 7.3 7.3 7.4 7.4 8.1 8.1 8.2 8.2 8.3 8.3 10.2 10.2 10.3 10.3 100% 100% 95% 85% 90% 90% 85% 80% 80% 100.00% 70.83% 45.00% 23.29% 96.48% 77.76% 84.35% 12.86% 4.74% 100.00% 69.60% 11.39% 55.10% 95.26% 90.89% 87.13% 31.26% 11.11% 99.73% 90.29% 46.46% 38.17% 96.64% 86.26% 69.29% 49.34% 0.00% 96.50% 93.37% 64.58% 37.01% 93.68% 81.78% 65.83% 43.40% 36.77% 96.55% 94.10% 40.60% 47.75% 96.92% 91.65% 85.71% 70.10% 20.80% Sections 4, 6, 7, 8 and 10 Sections 4, 6, 7, 8 and 10 Corrective Action Plans have been developed for these sections. Section 5 Section 5 -- -- FSU Workload Study. FSU Workload Study. DCYF issued a competitive bid and is evaluating vendor proposals. 6

Childrens Rights Settlement: Corrective Action Plans Corrective strategies have been developed for each item in Sections 4, 6, 7, 8 and 10. CRI Settlement measures are monitored and reviewed monthly. Division leaders (CPS, FSU, Resource Families) are responsible for developing and updating action plans. Overarching Strategies Overarching Strategies Procedural Improvements Technology Supports Caseload Reduction Supervision Documentation 7

Accreditation

Council on Accreditation (COA) RIGL 42-72-5.3 required DCYF to submit a plan no later than October 1, 2020, to pursue national human services accreditation through the Council on Accreditation (COA). Based on that report, the General Assembly approved $9.4M in general revenues for all accreditation costs, including $8.8M for the 75 positions the Department identified as necessary to become accredited. It also included $600K for other identified costs, including accreditation fees. The 75 positions are in addition to the 16 new frontline positions that were already included in the Governor s budget recommendation. Home | Council on Accreditation 9

COA Process Application & Agreement Stakeholder Survey Self Study Site Visit Commission The agency applies to COA. COA reviews the agency s eligibility and generates and accreditation agreement that the agency reviews and signs. The agency reviews its policies, practices and procedures against COA s Standards and shares evidence of implementation with COA. The agency administers a survey developed by COA to agency stakeholders. COA Peer Reviewers (Review Team) conduct an on-site visit to assess the agency s implementation of the standards and share feedback with COA. COA will use the feedback provided by the Review Team to make an accreditation decision and share feedback to the agency via a report. Agreement signed 11/1. Intake/Kickoff 12/6. COA estimates a 3-year process, including time for the Department to increase its staffing. 10

COA Progress to Date Major Activities Major Activities June 25 June 25 July 8 July 8 July 29 July 29 July 29 July 29 August 17 August 17 August 24 August 24 September 20 September 20 Re-engaged with COA Set up an online portal with COA Updated COA fee estimate Finalized Phase One Hiring Plan Began recruitment and selection process Submitted the COA application Met with COA to scope standards; standards available at coanet.org/public-standards Administrative and Management Service Delivery Administration Child and Family Services Negotiated terms of contract agreement Held meeting with Missouri s accreditation team Held meeting with Tennessee s accreditation team Signed COA contract agreement September 22 September 22 September 24 September 24 October 22 October 22 November 1 November 1 11

Phase One Hiring Plan The Department created a Phase One hiring plan in July that includes 52 staff. This first phase is focused on immediate increases in frontline and supervisory positions as well as infrastructure positions that will help support both the large increase in staff and the accreditation process. Fifty-one (51) of these staff are union, and none are administrators. Forty-eight (48) of these staff were approved by the DOA to begin recruitment on August 17, 2021. Phase One Hiring Progress to Date Phase One Hiring Progress to Date 7 FTEs began working at the Department prior to Nov. 1: 7 FTEs began working at the Department prior to Nov. 1: o 4 FSU Supervisors (10/24/21) o 1 Paralegal Aide (9/26/21) o 1 Implementation Aide (10/24/21) o 1 Human Services Business Officer (10/24/21) 7 FTEs will begin working with the Department on 7 FTEs will begin working with the Department on 11/21/21 o 3 Social Caseworker IIs (FSU) o 2 Child Protective Investigators o 1 Senior Human Services Policy and Systems Specialist o 1 Social Caseworker II (Community Services & Behavioral Health) 11/21/21: : 29 FTEs began working at the Department on 29 FTEs began working at the Department on 11/7/21 o 17 Social Caseworker IIs (FSU) o 8 Child Protective Investigators o 2 Clinical Training Specialists o 1 Social Caseworker II (Voluntary Extension of Care) o 1 Casework Supervisor II (Voluntary Extension of Care) 11/7/21: : 9 FTEs 9 FTEs are currently being recruited: are currently being recruited: o 4 Child Support Technicians o 3 CPS Supervisors o 1 Office Manager (Legal) o 1 Economic and Policy Analyst I 12

COA Next Steps Goals for the next 60 days Goals for the next 60 days 1. Conduct Intake (Kickoff) Meeting with COA. This meeting is scheduled for December 6. 2. Pay to COA the accreditation engagement fee in full ($195,477). 3. Issue an RFP to contract with a project manager who has subject matter expertise in supporting states in achieving human services accreditation. If the proposals submitted render suitable project management resources, then the Department will enter into a contract for the services. 4. Develop the Phase Two Hiring Plan. This phase will include 39 new staff with a focus on additional frontline staff as well as quality improvement and quality assurance staff. The Department expects to begin the recruitment and selection process for Phase Two in January 2022. 13

Psychiatric Residential Treatment Capacity

Initiative to Increase In-State Psychiatric Residential Treatment Capacity Budget includes $1.0M in general revenue ($3.5M all funds) to expand Psychiatric Residential Treatment Facility Budget includes $1.0M in general revenue ($3.5M all funds) to expand Psychiatric Residential Treatment Facility (PRTF) capacity in (PRTF) capacity in- -state. This will help to: state. This will help to: Reduce the number of youth with complex behavioral health needs who are ready to leave a psychiatric hospital but no appropriate treatment stepdown program is available. Reduce the number of female and male adolescents who need to be placed at out-of-state facilities at which maintaining family connections and delivering necessary holistic family therapy is more difficult. Develop intensive residential treatment options for female adolescents who are the victims of severe trauma and active sex trafficking and who may be self-injurious, assaultive and/or at risk for elopement. 15

Initiative to Increase In-State Psychiatric Residential Treatment Capacity Progress to Date Progress to Date DCYF and EOHHS Medicaid updated PRTF certification standards and developed a rate-setting methodology that EOHHS submitted to the Centers for Medicare & Medicaid Services (CMS) on 6/29/21, for approval. CMS issued an official Request for Additional Information (RAI) on 9/21/21. DCYF works closely with EOHHS Medicaid to provide all information and answer questions regarding the request for the State plan amendment. CMS has informed EOHHS verbally that RIDOH will serve as the designated state agency to survey and certify compliance with the federal PRTF requirements. DCYF will continue to perform oversight and enforcement for state PRTF requirements and perform current licensing functions. DCYF and RIDOH have executed CMS-required Interagency Service Agreements, which incorporate federal and state certification, survey and billing functions to support the federal approval process. CMS has requested that RIDOH that DCYF and RIDOH complete all federal certification requirements with regard to St. Mary s Home for Children and to enter information into the CMS IT system (ASPEN Automated Survey Process Environment). 16

Interim Steps to Bolster Placement Capacity DCYF has published a request for proposals (RFP) to solicit vendors who can develop an intensive residential treatment program for eight to sixteen adolescent females (ages 14-19 years old). Vendors must submit proposals by November 18. DCYF has amended its contract with Family Service of Rhode Island to reopen an enhanced behavioral health group home at Wilson House for adolescent female youth between the ages of 18-20. The Department has initiated discussions with community providers to reopen assessment and stabilization centers for adolescent males and females. DCYF has provided foster care families and contract providers premium stipends and created a list of foster parents who are willing to take emergency placements of children. The Department has also reinforced its efforts to identify suitable kinship homes for children and/or in need of interim placements. Gov. McKee has submitted a State Fiscal Recovery Fund proposal for provider wage stabilization ($12.5M for SFY22). This funding would provide supplemental wage payments to provider personnel and incentivize retention and recruitment. 17