la audit-secure transitions foster family agency contract review (may 2011)

8/3/2019 LA Audit-Secure Transitions Foster Family Agency Contract Review (May 2011)

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C O U N T Y OF L O S A N G E L E SDEPARTMENT OF AUDITOR-CONTROLLERKENNETH HAHN HALL OF ADMINISTRATION500 WEST TEMPLE STREET, ROOM 525LOS ANGELES, CALIFORNIA 90012-3873PHONE: (213) 974-8301 FAX: (213) 626-5427

WENDY L. WATANABEAUDITOR-CONTROLLERASST. AUDITOR-CONTROLLERS

ROBERTA. DAVISJOHN NAlMOJUDI E. THOMAS

May 12,20 11

TO: Supervisor Michael. Antonovich, Mayo rSupervisor Gloria MolinaSupervisor Mark Ridley-Thoma sSupervisor Zev YaroslavskySupervisor Don KnabeFROM: Wendy. WatanabeAuditor-ControllerSUBJECT: SECURE TRANSITIONS FOSTER FAMIREVIEW - A DEPARTM ENT OF CHILDREN AND FAMIPROVIDERW e have completed a contract compliance review Agency (Secure Transitions or Agency ), a Departm(DCFS) provider. The purposef our review was to determine whetherTransitions was providinghe services outlinedn their Program StatementCounty contract.e completed our review during October 2008nd conducted follow-up review in March 2010.DCFS contracts with Secure Transitions, a privateorganization to recruit, train andertify foster parentsor supervising childrenplaces in foster care. Once thegency places ahild, it is required to monitoplacement until thehild is discha rged fromhe program. Secure Transition26 certified foster homesn which 32 DCFS children were placed review. Secure Transitionss located in the Second District.CFS paid SecureTransitions approximately $662,000 and $656,0002009-10, respectively.

Results of ReviewSecure Transitions didot always ensu re that the foster homes , casetaffcomplied with theounty contract and California Departmen t of SociaTitle 22 regulations. In addition,uring our follow-up reviewn 2010, Secure Tra

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Board of SupervisorsMay 12,2011Page 2

still had not resolved many of the issueshat existed during our 2008 review. Forexample:Two (40%) of the five Needs and Services Plans (NSPs) n 2008 containedinaccurate information and did not include a tn emancipationreadiness issues. In addition,our (80%) ofhe five NSPsid not have goals were specific, measurabler time-limited and some of theoals were notge-appropriate. This issue waslso noted in our Secure Transitions report issued on April 24, 2007.During our follow-up review in 2010, all three additSPs reviewed hadappropriate goals.owever, one (33%) ofhe NSPs had conflicting information.Secure Transitions' attached response indicatese viewall NSPs to ensure accuracy and that they include apoals.One (50%) of thewo NSPs reviewedn 2008 for children taking pmedication didot include a discussion onhe children's usef the medication required. This issue was also noted in our report issued on April 24, 200During our follow-up reviewn 2010, one (33%) of thehree additional NSreviewed for children taking psychotropic medication nclude a discussion the children's use ofhe medication. In addition,ll three children's case othave required documentation of monthly evaluaty the prescribing pand didot have up-to-date medication logs. However,he foster parents and thechildren indicatedhat they were taking their medication andere seen monthlyythe prescribing physician.Secure Transitions' attached response indicatesnsure NSPs includea discussion on the children'sse of psychotropic medication.Three (60%) of theive case files reviewedn 2008 didot have documentationhatthe children's DCFS social workers were provided withonthly updates on thechildren's progress.During our follow-up reviewn 2010, all five additional caseiles reviewed didothave documentation that the children'sCFS social workers were monthly updates.or three children, theast documented update was five montold and for two children, the last documented update wo months old.Secure Transitions' attached response indicatesill ensure their workers contact DCFS monthly with updates on the children'srogress.Two (40%) of the five children reviewedn 2008 exceededhe maximum age (17years old) for services and the Agency did not have


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Board ofupervisorsMay 12,2011Page 3from CDSS Com munity Care Licensing (CCL) as required. This issue was alsonoted in our report issued on April 24, 2007.

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During our follow-up review in 2010, two (67% ) ofhe three additional childrenreviewed exceeded the maximum age and the Agency did not have documentationof an exception from CCL.Secure Transitions' attached response indicates that they will ensure that all childrenmeet the age criteria.Two (40%) of the five children reviewed in 2008 received initial den talxaminations51 and 84 days late, respectively. This issue waslso noted in our repo rt issued onApril 24, 2007.During our follow-up review in 2010, two (67%) of the three additional childrenreviewed both received initial dental examinations 13 days late.Secure Transitions' attached response indicates that they will remind foster parentsof medical and dental examination due dates to ensure children receiveexaminations timely.

Details ofur review, along with recommendations for corrective action, are a ttached.Review of Report

We discussed our report with Secure Transitions on January 18, 201 1. In theirttachedresponse (Attachment I), Secure Transitions management indicates the actions theAgency has taken to implement the recommendations. We also notified DCFS of theresults of our initial and follow-up reviews. In theiresponse (Attachment II), DCFSindicates that, due to the repeated findings, they will assess the Agency for fullimplementation of our recomm endations within six mon ths and determine if progressiveaction isarranted.We thank Secure Transitions management for theirooperation and assistance duringour review. Please call me if you have any questions or your staff may contact DonChadwick at (213) 253-0301

Attachmentsc: William T Fujioka, Chief Executive OfficerJackie Contreras, Ph.D, Interim Director,DCFSLinda Lakso, Board of Directors Chair, Secure TransitionsDr. Melvin Moore, Executive Director, Secure TransitionsJean Chen, Community Care LicensingPublic Information OfficeAudit Committee


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FOS TER FAMILY AGENCY PROGRAMSECURE TRANSITIONS FOSTER FAMILFISCAL YEARS 2008-09ND 2009-1 0BACKGROUND

The Departme nt of Children and Fam ily ServicesFoster Family AgencySecure Transitions orgency) a negotiated monthly child placement, establishedy the California Departme nt of SoCDSS)Foster Care Rates Bureau. Basedn the child's age, thegency receives betwee$1,430 and $1,679 per m onth, per child.CFS paid Secure Transitions $662,000 and $656,000 during Fiscal Years (FY) 2008-09nd 2009-10, respectively.PURPOSEIMETHODOLOGY

The purposef our reviewas to determine whether Secure Trathe services outlinedn their Program Statement and the Coue reviewedcertified foster paren t files, children's case files, heAgency's staff. We also visited a numbe rf certified foster homesnd interviewed thechildren and foster parents.e completed our review during ndconducted a follow-up reviewn March 201 0.

BILLED SERVICESObiectiveDetermine whether Secure Transitions provided n accordance their County contract and CD SS Title 22 regulations.VerificationWe visited three of the 26 Los Angeles County certified foster Transitions billed DCF Snd interviewed three foster parentsnd five foster childplaced in the three homes .n addition, we reviewed the case files parents and five childrennd we reviewed the Agency 's monitoring March 2010, we visited two foster homesnd reviewed additional fosterchildren's case files.ResultsDuring our 2008 review,ecu re Transitions did not always compcontract requirements andDS S Title 22 regulations. For example, the Agencyid notensu re that foster paren t certification files, children 's nd ServicesPlans (NSPs)nd Quarterly Reportsad all the required information. did not ensure children's initial dental examinationsnd Quarterly Reportscompleted timely, NS Psere accurate and approved byCFS social workers,

A U D I T O R - C O N T R O L L E RC O U N T Y O F L O S A N G E L E S


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Secure Transitions Fosteramily Agency Page 2DCFS social workers were provided with monthly updates on the children'srogress. Inaddition, Secure Transitions did not renew exceptions obtained from CDSS CommunityCare Licensing (CCL) before billing DCFS for children that exceeded the maximum agefor services. During our follow-up review in 2010, Secure Transitions still had notresolved many ofhe conditions that exkted during our 2008 review. Specifically, wenoted the following:Foster Parent Certification

One (33%) ofhe three foster homes reviewed in 2008 was not assessed by SecureTransitions tonsure the foster parents could care for more than two children. Atthe time of our review, three children were placed in the home. This issue was alsonoted in our Secure Transitions contract review report issued on April 24, 2007.During our follow up-review in 2010, we confirmed that theome from our 2008review and two additional homes reviewed were appropriately assessed.Two (67%) ofhe three foster parents reviewed in 2008 did not complete therequired 15 hours of annual continuing education training. At the time of our review,the two foster parents had completed five and 12 hours of training, respectively.This issueas also noted in our report issued on April 24, 2007.During our follow-up review in 2010, the four additional foster parents reviewedcompleted the required training.One (33%) of the three foster parent files reviewed in 2008 did not include a currentdriver's license and proof of auto insurance. This issue was also noted in our reportissued on April 24, 2007. In addition, the foster parent's CPR certificate had expired.Subsequent to our review, the Agency provided documentation of a current driver'slicense and proof of auto insurance. In addition, the foster parent completed therequired CPR training.During our follow-up review in 2010, the foster parent's proof of auto insurance wasno longerurrent. In addition, one (33%) of the three additional foster parents' filesreviewed did not have a current CPR certificate.

Needs and Services Plans and Children's Case FilesFour (80%) ofhe five NSPs reviewed in 2008 were not approved by the DCFSsocial workers as required. This issue was also noted in oureport issued on April24, 2007.During our follow-up review in 2010, all three additional NSPs reviewed were notapproved by theCFS social workers.



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Secure Transitions Fosteramily Agency Pane 3Two (40%) of the five NSPs reviewedn 2008 contained inaccurateSpecifically, theSPs indicated the childrenere under 14 years old, were tooyoung for emancipation services and were unemployedere 19 year-old young adults and were employed. In additionhe two NSPs didot include athorough discussionn emancipation readiness issues.During our follow-up reviewn 2010, one (33%) of the three areviewed had conflicting information. Specifically, thhat FamilyReunification services were completedut later indicates that Familyservices wereot yet completed.Four (80%)f the five NSPs reviewedn 2008 didot have goals that were measurable or time-limited. In addition, some of the goals in the NSPsere notage-appropriate. This issue was also noted in eport issued on April 24, 2007.During our follow-up reviewn 2010, all three additional NSPs reviethat were specific, measurable and time-limited.One (50%)f the two NSPs reviewedn 2008 for children taking psycmedication didot include a discussion on the children's required. This issueas also notedn our report issued on April4, 2007.During our follow-up reviewn 2010, one (33%) of the three areviewed for children taking psychotropic medicatithe children's usef the medication. In addition, all three children's case othave required documentation of monthly evaluatiy the prescribing physiand did not have up-to-date medication logs.owever, the foster parentsnd thechildren indicatedhat they were taking their medication athe prescribing physician.One (20%) of the five Quarterlyeports reviewed in 2008 was preparedmonths late. Thisssue was also noted in our reportssued on April 24,007.During our follow-up reviewn 2010, three (75%)f the four additional QReports reviewedere prepared late.wo of the reports were preparedapproximately one month late and one was prep

* Two (40%) of the five Quarterlyeports reviewed in 2008 did not include the children's progressn their goalss required. This issue waslso noted in ourreport issued onpril 24, 2007.During our follow-up reviewn 2010, two (50%) of the four additioReports reviewed didot include details of the children's pro

0 Two (40%) of the five Quarterlyeports reviewed in 2008 did nohechildren's report cards as required.A U D I T O R - C O N T R O L L E R

C O U N T Y O F L O S A N G E L E S


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Secure Transitions Foster Familv Anencv Pane 4During our follow-up reviewn 2010, one (25%) of the four additional QuarterlyReports reviewed did not include the children's report cards.Three (60%) of the five case files reviewed in 2008 did not have documentation the children's DCFS social workerstwererovided with monthly updates on thechildren's progress.During our follow-up review in 2010, all five additional case files reviewed did nothave documentation that the children's DCFS social workers were provided withmonthly updates. For three children, the last documented update was five monthsold and for two children, the last documented update was two months old.One (20%) of the fivease files reviewed in 2008id not have documentation the children or theirCFS social workers were informed of the children's personalrights and the Agency's policies and procedures as required. This issue was alsonoted in our report issued onpril 24, 2007.During our follow-up review in010, all four additional case files revieweddocumented that the children or their social workers were appropriately informed.Two (40%) of theive children reviewed in 2008 exceeded the maximum age (17years old) for services and the Agency did not have documentation of an exceptionfrom CDSS CCL as required. This issue was also noted in our report issued on April24, 2007.During our follow-up review in010, two (67%) of the three additional childrenreviewed exceeded the maximum age and the Agency did not have documentationof an exception from CCL.Two (40%) of the five children reviewed in 2008 received initial dental examinations51 and 84 days late, respectively. This issue was also noted in our report issued onApril 24, 2007.During our follow-up review in010, two (67%) of the three additional childrenreviewed both received initial dental examinations 13 days late.

RecommendationsSecure Transitions management ensure:1. Assessments are completed for homes where more than two childrenare placed.2. Foster parent certificationiles have all the required informationincluding documentation ofraining hours, CPR certificates, dlicenses, and proof of automobile insurance.



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Secure Transitions Foster Family Agency Page 53. NSPs are accurate and approved by the DCFS social workers.4. NSPs include goals thatre specific, measurable and time-limited.5. NSPs for children taking psychotropic m

discussion on the children's usef the medication.6. Quarterly Reports are prepared timelynd include the children'sprogress toward achieving goals.7. Quarterly Reports include children's report cards.8. DCFS social workersre updated monthly regardinghe children'sprogress.9. Children meet the age criteria fo r services.10. Children and the DCFS social workers are informed ofhe Agency'spolicies and procedures.I .Children's initial dental examinations are conducted timely.

CLIENT VERIFICATIONObiectiveDetermine whether the program participantseceived the services that STransitions billedo DCFS.VerificationWe interviewed five children placedn three of Secure Transitions' homes and three foster parents to confirmhe services thegency billed to DCFS.

The foster children indicated they enjoyediving with their foster parentsnd the fosterparents indicated that the serviceshey received from the Agencyexpectations.RecommendationNone.

A U D I T O R - C O N T R O L L E RC O U N T Y OF L O S A N G E L E S


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Secure Trans itions Foster Family Agency Page 6STAFFINGICASELOAD LEVELS

ObjectiveVerify that Secure Transitions social wockers' caseloads do not exceed 15 placementsand that the supervising social worker does notupervise more than six social workersas required by the County contract and CDSS Title 22 regulations.VerificationWe interviewed Secure Transitions' administrator and reviewed caseload statistics andpayroll records for the Agency's social workers and supervising social worker.ResultsAt the time of our008 review, Secure Transitions' three social workers carried anaverage caseload of 12ases and the Agency's supervising social worker supervisedthree social workers. However, Secure Transitions has a part-time contract socialworker that didot sign a declaration stating that their combined caseload at allagencies will not exceed 15 children as required. This issue was also noted in ourreport issued on April 24,2007.During our follow-up review in 2010, Secure Transitions did not have any contractedsocial workers.

Recommendation12. Secure Transitions management ensure that contract social workerssign declarations stating that their combined caseload at allgencieswill not exceed 15 children.

STAFFING QUA LIFICATIONSObiectiveDetermine whether Secure Transitions' staff possess the education and workexperience qualifications required by their County contract and CDSS Title 22regulations. In addition, determine whether the Agency conducted hiring clearancesprior to hiring their staff and provided ongoing training to staff.VerificationWe interviewed Secure Transitions' administrator and reviewed each staffs personnelfile forocumentation to confirm their educationnd work experience qualifications,hiring clearances and ongoing training.



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Secure Transitions Fosteramilv Agency Page 7ResultsSecure Transitions'taff possessed the required educationnd work experience the Agency conducted hiring clearancesnd provided ongoing training on the County contract.

RecommendationNone.

PRIOR YEAR FOLLOW-UPObiectiveDetermine the status of the recommendations reportedn the prior Auditor-Controllermonitoring review.VerificationWe verified whetherhe outstanding recommendations fromhe FY 2005-06 monitorireview were implemented. The reportas issued onpril 24, 2007.ResultsOur April 24, 2007 monitoring reportad 17 recommendations.he Agencyas fullyimplemented ten recommendationsnd partially implemented one However, the Agency has not implementedix recommendations primarilassessing foster homes, certifying that foster he children forservices, dental exam timeliness, completing andSPs, and contract worker caseloads.

Recommendation13. Secure Transitions managementmplem ent the outstandingrecommendations from the April 24, 2007onitoring report.



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Attachment IPage 1 of 9


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SECURE TRANSI"T1ONS FOSTER FAlrJIlkY AGENCY CONTRACT REV IW

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la audit-secure transitions foster family agency contract review (may 2011)

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