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UPDATE OUR COMMUNITY OUR KIDS OCOK Innovation in Community Based Care Continues to Drive Improvement in Region 3b

LAUNCH OF CASE MANAGEMENT In March 2020 OCOK assumed responsibility for case management entering Stage II of its contract STAGE II RESP O NSIBILITIES Court and legal case management Provision of services for biological families Responsibility for achieving permanency Oversight of kinship care OCOK set an ambitious goal to reduce caseload sizes to 14 children per worker within the first year AVERAGE CASELOAD SIZE EXPERIENCED WORKERS Despite the challenges associated with onboarding the workforce filling vacancies and the simultaneous COVID outbreak OCOK has been successful at reducing the average caseload size to 14 5 in the first 12 months 19 8 18 9 18 8 18 4 16 8 16 5 16 8 16 4 16 8 16 5 16 1 14 5 TARGET 14 MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 2020 JAN FEB 2021 WORKERS WITH MORE THAN 17 CHILDREN Although the average is 14 some workers continue to have caseloads higher than 17 children due to real world constraints In its first year OCOK cut in half the percentage of workers with high caseloads from 53 to 26 OCOK s goal is to reduce this metric to a resting level of 0 53 55 46 41 43 44 41 44 42 37 39 26 MAR APR MAY JUN JUL AUG 2020 SEP OCT NOV DEC JAN FEB 2021 As caseloads come down OCOK is shifting its strategic focus toward improving permanency outcomes and increasing utilization of kinship care

COMMUNITY CAPACITY FOR ALL KIDS OCOK s long term vision for a full continuum of care in Region 3b came to maturity in 2020 but suffered a set back due to COVID N E W TH ER APEUTIC C APACIT Y Expansion of therapeutic foster care and professional home based care Residential treatment within the region Integrated behavioral health services In the transformed system children with therapeutic needs are now much more likely to live in a family setting For example children in the clinical group identified to be at risk for suicide or self harm now spend 57 of their days of care in a family setting compared with around 40 in the old system This capacity growth occurred in 2018 and 2019 during the expansion of therapeutic foster care CARE DAYS IN FAMILY SETTING CHILDREN AT RISK FOR SUICIDE SELF HARM PERIOD OF SUSTAINED GROWTH 41 43 35 42 43 40 46 51 55 56 57 54 56 57 57 57 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 17 17 17 17 18 18 18 18 19 19 19 19 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 FY FY FY FY FY FY FY FY FY FY FY FY FY FY FY FY More recently growth in professional home based care programs has succeeded in diverting the highest needs group of children those with Autism and other developmental disabilities who require complex care from residential to family settings In 2020 children in this clinical group spent 63 5 of their care days in a family setting compared with around 36 previously COMPLEX AUTISM DEVELOPMENTAL NEEDS 63 5 46 3 35 5 35 9 2017 2018 2019 2020 Similar gains were evident across all clinical groups of children except one ADHD group Each child is assigned to one of 20 groups based on their specific combination of needs using a machine learning algorithm For more information see OCOK s report Clinical Populations in Paid Foster Care

As a result of the increased local capacity children with therapeutic needs are now far more likely to be placed in their home community BRIN GIN G K IDS H OM E PHASE 1 2015 2016 In the first two years of its contract OCOK focused on local capacity growth in foster family homes 20 increase in foster home capacity Increased foster home placements within 50 miles month after month until it reached 90 Sustained higher performance as the new normal BRIN GIN G K IDS H OM E PHASE 2 2019 2020 More recently OCOK has developed new therapeutic treatment capacity in the region Approximately half of all children in residential treatment are now placed locally PLACEMENTS WITHIN 50 MILES OF HOME 100 75 BRINGING KIDS HOME PHASE 1 BRINGING KIDS HOME PHASE 2 50 25 0 2015 2016 FOSTER HOMES 2017 2018 2019 2020 RESIDENTIAL TREATMENT Percentage of children placed within 50 miles of home on the last day of each month January 2015 September 2020 EFFECTS OF COVID 19 PANDEMIC Although the data from 2020 prove the effectiveness of the new therapeutic capacity the COVID 19 outbreak stopped the expansion of professional home based care in Region 3b and most of the gains of early 2020 were lost by the end of the year Much work remains to restore this capacity in 2021 as our community recovers from the pandemic The pandemic also delayed permanency and slowed recruitment and training of foster and adoptive homes creating new capacity challenges at the same time as referrals to foster care are trending upward OCOK anticipates demand for foster care in 2021 will stretch our community s capacity significantly

SMARTER USE OF DATA OCOK s advanced analytics tools are rolling out to other CBC regions in 2021 Over the past several years OCOK has developed innovative tools to improve oversight of foster care OCOK is partnering with Five Points Technology Group to deploy these innovations from the laboratory to the field CLINICAL CLASSIFICATION Automatic classification into one of 20 clinical groups based on their specific combination of needs Identify risk groups project outcomes and costs Measure performance by matched population AUTOMATED OUTCOME TRACKING CONTRACTOR PERFORMANCE MANAGEMENT FOSTER PARENT SCORING Up to date outcomes calculated automatically No more waiting weeks or months for results Easily compare trends for contractors homes counties etc Detailed performance scorecards for each contractor on demand Compare performance for similar children to control for differences in case mix Rank foster parents based on their past performance Identify high performing or low performing families PREDICTIVE MATCHING Match children with placement options based on historical performance and predicted best outcomes for the individual child COMPREHENSIVE RISK MANAGEMENT Track daily risk for adverse events in one place measuring risk of safety incidents placement disruptions running away psychiatric hospitalization etc Identify factors associated with reduced or increased risk INTEGRATED GEOGRAPHIC DATA Neighborhood level census data related to child demographics and socioeconomics tied to outcomes County and zip code drill downs

COMING SOON IN REGION 3B OCOK is partnering with A Second Chance Inc national experts in kinship care to bring a proven approach for expanding quality kinship placements in 2022 New sub acute psychiatric care options are being developed to provide a further resource for stabilizing youth with the highest needs OCOK is developing plans to work closely with local CASAs on collaborative family engagement to further advance kinship placement opportunities PROTECTING CHILDREN PRESERVING FAMILIES SINCE 1915 With over a century of experience ACH Child and Family Services a Fort Worth based nonprofit agency provides 17 programs and services to children and families struggling with life s challenges In 2014 ACH created the Our Community Our Kids OCOK division to pioneer Community Based Care CBC in Texas In 2020 OCOK became the first Single Source Continuum Contractor in Texas to enter Stage II of CBC ACH has been accredited every year since 2003 by the Council on Accreditation and in 2018 Our Community Our Kids also became nationally accredited For more information contact Courtney Leaverton JD 817 502 1325 oc ok org 4 21