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OCOK Feb 2019 Update on CBC(2)

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Community based care Bringing Kids HOME The momentum continues with greater capacity and more kids living closer to home who benefit from a family setting Status Report February 2019 The Akins Family with foster adopted children advocates for community based care

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Our Community Our Kids continues to drive results in community based care As the Single Source Continuum Contractor SSCC serving Region 3b Our Community Our Kids OCOK is responsible for finding placement and monitoring care for children in paid foster care After 4 years OCOK continues to pave new ground for CBC in Texas while also working in collaboration with other SSCCs as they begin serving children OCOK is delivering better outcomes for kids in foster care Placement stability keeps getting better Foster Home Disruption Rate Cumulative Disruptions per 1000 care days 1 55 1 5 1 45 1 4 1 35 1 3 1 25 Source OCOK data A disruption is defined as a move from a foster family home to another placement excluding moves that result in sibling reunification Foster Home Placements Within 50 Miles 95 85 80 All kids 75 High Needs 70 65 OCOK s converging strategies are working to minimize unnecessary moves from foster homes Therapeutic foster care programs Matching algorithm Wraparound behavioral health Crisis respite Disruption mitigation procedures Provider performance reviews This improvement translates to an estimated 250 placement disruptions prevented to date 90 Percent Placed within 50 miles on last day Community based care CBC is a performance based way of approaching the challenges of foster care that gives local communities the flexibility and authority to improve the system FY2015 FY2015 FY2016 FY2016 FY2016 FY2016 FY2017 FY2017 FY2017 FY2017 FY2018 FY2018 FY2018 FY2018 FY2019 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 OCOK has been successful at improving stability for children in foster homes but not for children in residential treatment Source OCOK data A high needs child is defined as a child who ever required a therapeutic level of care More kids are living close to home OCOK s targeted capacity development efforts are paying off More homes in rural areas means more kids are placed closer to their homes The development of therapeutic foster care means more kids with complex needs can be served closer to home 90 of foster home placements are now within 50 miles of the child s home of removal up from 87 in Q4 75 of all Region 3b kids including those in residential settings are placed within 50 miles compared to 63 of youth statewide Improvement will continue as local RTC capacity comes online

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Local capacity building is the key to community based care OCOK has focused on expanding capacity in rural areas where it was needed most OVERALL GROWTH 36 286 100 120 December 2015 688 HOMES 300 TO December 2018 26 19 175 938 HOMES Source OCOK data Capacity is counted as the number of active licensed foster homes on December 1 of each year Percentages represent change from 2015 to 2018 OCOK is filling gaps in the region s continuum of care Prior to community based care there was no residential treatment center in the region for teens Region 3b teens who needed residential treatment had to be sent out of the region to have their needs met Residential Treatment Bed Capacity for Teens in Region 3b 44 OCOK has developed new capacity with three facilities now coming online This increases regional bed capacity from 0 to 44 The recent rollout of Professional HomeBased Care enhances the local continuum of care Provides a step between residential treatment and therapeutic foster care A comprehensive continuum of care is beginning to take shape in Region 3b Outcomes will continue to improve as the system develops 13 0 Dec 2017 Dec 2018 Dec 2019 Source OCOK data Current 13 beds associated with VisionQuest RTC The additional beds projected for 2019 represent two additional facilities at ACH Child and Family Services and Gladney currently under contract and starting up Gladney plans to operate under a GRO license

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OCOK s strategic approach is yielding continuous long term improvements to foster care More kids are living in family settings High Needs Kids in Family Settings 64 New therapeutic foster care capacity is starting to move the needle High needs children are spending more time living with families instead of in group settings 63 0 Percent of Days in Foster Family Home 63 62 60 61 0 60 5 60 5 61 61 0 OCOK expects this trend to continue as its new Professional Home Based Care PHBC programs scale up 59 4 59 For all kids standard and high needs 80 of all care days are now in family settings 58 57 56 Source OCOK data A high needs child is defined as a child who ever required a therapeutic level of care 55 54 FY2017 Q4 FY2018 Q1 FY2018 Q2 FY2018 Q3 FY2018 Q4 FY2019 Q1 3 000 and spending less time in institutional settings RTC Utilization Care Days Shelter Utilization Care Days 13 000 3 500 2 892 12 000 2 500 11 000 2 000 10 000 11 626 11 550 10 858 10 143 1 699 1 604 1 500 1 290 1 236 9 000 1 000 8 000 500 7 000 The recent growth of therapeutic foster care is reducing the region s reliance on emergency shelters and residential treatment centers 6 000 FY2018 Q1 FY2018 Q2 FY2018 Q3 FY2018 Q4 FY2019 Q1 FY2018 Q1 68 0 66 8 67 0 66 0 65 0 9 592 65 0 64 0 64 0 FY2018 Q4 FY2019 Q1 Source OCOK data Less time in institutions means more sibling groups can be together With the recent wave of high needs kids entering the system the percentage of sibling groups together had been trending downward 63 0 60 9 61 0 FY2018 Q3 The number 1 reason sibling groups are separated is because one of the siblings is in a residential setting 63 4 62 0 FY2018 Q2 But therapeutic foster care has helped turn this trend around 67 of sibling groups are all together compared to 67 of non CBC sibling groups 60 0 59 0 58 0 57 0 FY2018 Q1 FY2018 Q2 FY2018 Q3 FY2018 Q4 FY2019 Q1 82 of sibling groups have no sibling placed alone Source DFPS data

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Continuing the momentum of caring for kids Coordinating services at the local level helps CBC better leverage resources and services for children Important examples include Targeted recruitment campaign created by Leadership Fort Worth for use by all network Child Placing Agencies Launched Collaborative Family Engagement CFE with 100 participation from five local CASA agencies Launched Professional Home Based Care PHBC the first program of its kind in Texas PHBC is designed to serve the highest needs kids in a family setting and is being delivered by CK Family Services RISE and The Bair Foundation Partnered with three Behavioral health providers CK Tarrant County MHMR Pecan Valley MHMR for in home visits throughout the seven counties Collaborate with Tarrant County Bar Association to develop and deliver Court 101 to over 900 foster families Cook Children s Fostering Health Program increased medical clinic visits from nine in Oct 2017 to 170 per month in Dec 2018 Hope Fort Worth a faith based recruiting initiative held six adoption events highlighting over 100 children seeking adoptive families Created the first annual Quality Parenting Summit with over 125 Foster Parents attending to learn about the resources in the system Safe Babies Court Hope Fort Worth TCU Purvis Institute TBRI Training Cook Children s Fostering Health Professional Home Based Praesidium Care Quality Safety Parenting Equation Summit NITY OUR COM U M MU M N CO Our Kids Court Training for Foster Families R COMMUNITY OU Behavioral Health Services Recruitment Campaign ITY CASA Collaborative Family Engagement Y OUR C O UNIT MM MM U N CO R COMMUNITY U OU O Provider R Network ITY Gateway Our community is working together for our kids O U R

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Community based care Success despite significant challenges Since 2014 Region 3b has experienced significant increase in kids with more challenging behavioral needs Case rate funding shortages have created challenges funding costs of care Shortages of residential treatment capacity challenged placement of teenagers Lack of interoperable data systems The numbers are key but what s really important are the children The youth I represent is benefitting tremendously from the PHBC model It is truly different from a traditional foster home placement in many ways and allows youth who have intensive therapeutic needs to be in the least restrictive setting This youth would be moving from foster home to foster home with a combination of RTC placements if he did not have access to the PHBC model Since Charles has been in a PHBC home for the last six months he has improved coping skills reduced serious incidents and is learning how to communicate and advocate for himself in healthy ways We at the Department have felt supported through this process as there isn t an impending threat of discharge and placement change We especially love the individual attention that Charles receives as the only youth in the home and having one stay at home parent has allowed for quick responses to needs for education medical therapy etc Attorney Ad Litem Sustaining this progress requires DFPS Supervisor A rate methodology which more closely aligns with legacy system funding Interoperable data systems Continued expansion of the CBC model in Texas For more information contact Dr Linda Garcia 817 502 1325 www oc ok org