Providence Service Corporation

• Founded in 1996• Fletcher McCusker, Mary Shea, and Boyd Dover• Human Services Without Walls• NASDQ traded public company (PRSC)• Sarbanes-Oxley compliant• 44 States and Canada• Organic Growth and Acquisitions (Maple Star of

Washington)• Outcome driven

– Contextualized Feedback System-CFS (Vanderbilt and University of Arizona)

– Evidence Based Practices– Corporate University– E-Learning (ethics and confidentiality)

Providence Services • Home and Community Based Counseling

– Intensive home based counseling– Substance abuse treatment services– School based support services – Tutoring– Correctional services– Workforce development– Foster care and adoption services– Case Management (Behavioral Health, Child Welfare, Senior Care)– Developmentally disabled and autism spectrum services– Mentoring

• Not-for-profit services• NET Services• Social Services Network Management • Arizona, New Mexico, Florida, NET models

– Providence experience and success.

Maple Star• Incorporated in 1998 as a non-profit child caring

agency serving youth in Bend, OR• Services began in the Portland Metro area in 2001,

the Salem Metro area in 2003 and the Southern Willamette Valley in 2004

• Maple Star became affiliated with Providence Service Corporation in 2005.

• 2008, Maple Star became the largest Specialized Foster Care Agency in the state of Oregon.

Principles of Service and Partnership

• Open and continuous Communication• Data and factual based decision making• Shared decision making through Partnership Council and

Community Committee• Transparency• Accountability• Urgency/Intensity• Innovation and flexibility• Focus on outcomes and performance• EBP and Quality care• Respect for providers and consumers/clients as well as

other stakeholders• Inclusive model, all that have compassion for this work

are welcomed• Fiscal responsibility• Advocacy

Master Contractor • System of Care Design

– Seamless system– No wrong door– Gap analysis– Integrated services

• Linkages to other systems (Health, Education, SA, MH, DV, DD, Workforce, Housing, Faith Based, Community Supports, etc.)

• Partnership with Tribes

– Focus on community based, in-home delivery– Intensive/Rapid Service Delivery

• 24/7 response and crisis response system

• Legal Requirements– State Statutes and SB 2106– Braam Settlement Agreement– Indian Child Welfare Act– Federal Requirements (Chaffee Act, Title IV-E, Title IV-B,

CAPTA, CFRS, etc.)

Master Contractor• Local Management and Decision Making

– Partnership Advisory Council (decision making )– Community oversight (accountability)– Data driven decision making– Transparency

• Administrative Services Model– Master Contractor not a provider– Create an environment for success– Emphasize provider strengths– No competition with providers for fund raising, grants, etc.

• Maximize Use of Technology– Electronic records– Mobile Tools– Data System– Communication

Master Contractor• Provider Network

– Inclusive, we want a robust network of providers• Strong Coordination and Communication

– Full Service Array (adoptions, foster care, relative care, reunification, SA/MH, DV, visitation, child care, relative search, reunification, education, independent living, etc.)

– Credentialing– Training and Support– Accountability

• Corrective Action Plans• Incentives

• Contract with Department– Role Definition (Case Coordination vs CA social worker duties)– Compliance– Reporting – Performance/QA/Monitoring– Advocacy– Federal Funding

Performance Based Contracting

• Quality Assurance– Data reports and tracking– External Reviews– Case review (internal and external)– Accreditation– Consumer/client satisfaction

• Every child is unique and must have a plan that fits

– CFS (contextualized feedback system)

• Utilization management– Hub of service access, availability, and level of care– Right service, at the right time, in the right amount– Support providers in locating/accessing services– Care Coordination

• Risk Management– Programmatic Risk (QA, Incident reports, Assessments, Face to

Face, supervision, documentation, identify high risk cases, etc.)

– Financial Risk (cash flow, utilization, reimbursement/payment structure, real cost, audits/monitoring, etc.)

Payment for Services• Department documentation Requirements• Data system and collection of information on

clients and services– FamLink connectivity– Outcome tracking– Service Plan tracking– Encounter tracking

• Methods of payment– Case Rate (CA to pay MC)

• Global population vs specific clients needing services• Fixed amount of funding for each client served

– Cost reimbursement• Direct reimbursement for allowable costs, requires prior

approval of budget– Fixed Price

• Fixed monthly payment for a specific level of capacity and service delivery

Service System• Clients to be served (Families and Children)

– In-home– Out of Home– Intensive treatment – Adolescents out of home

• Referral Process (new cases, legacy cases)1. CA Social Worker (any CASW)2. Master contractor 3. Conduct FGM ( time frames) and determine service plan,

tasks, responsible parties, partners, time lines.4. Provider engages family for service delivery

• Solution Based Casework– Services planned with the family– Services focused on the safety of the child and specifically

preventing the circumstances that lead to the abuse– Services focused on intervening and addressing everyday

events and stress points that threaten the safety of the child– Situation specific relapse prevention skills

Service System• Wraparound

– Family Voice and Choice – Team Based – Natural Support for the family – Collaboration – Community Based – Culturally Competent– Individualized – Strengths Based – Unconditional and persistent – Outcome Based

• Family Group Meetings (MC/Provider lead)– Family Members– Community Supports– Faith based– Teachers– Employers– Provider and CA team

Service Array• Evidence Based Practices

– Family Functional Therapy (FFT)– Incredible Years– Homebuilders– Multi-Dimensional Treatment Foster Care– Nurse Family Partnership– Parent Child Interaction Therapy– Project SafeCare– Triple P-Positive Parenting Program

• Adverse Childhood Experiences• Safety Services

– Emergent Response– Supervision and observation (risk assessment)– Concrete Funds and Services– Transportation – Housing Assistance– Basic Home and Safety management

Service Array• Family Support Services

– Therapeutic Services– Parent Education and Support– Referral Services and Efforts– Evaluation

• Child Focused Services– Intensive Treatment Services (BRS)– Sexually Aggressive Youth (SAY) Services– Adolescent Services– Medically Complex Services

• Placement Support Services– Placement Resources– Permanency Supports– Out of Home Caregiver Support– Services to Support Child Well Being– Visitation Services

• Expansion of Services

Outcomes• System Performance Indicators

– Services within 2 hours for emergent referral– FGM held within 24 hours (emergent referral) and 72 hours

(non-emergent referral)– Services will be coordinated and initiated within 24 hours of

Service plan or revision– Service Plans reviewed/updated at least monthly (quarterly

for Out of Home)…..FGMs– Children and Families will be satisfied with services– Culturally relevant services delivered– Tribes are satisfied with Services

• Child and family Safety and Well being Outcomes– Child Safe in their Home– Child safe with their family 6 months after services end– Decrease LOS in BRS– Youth level of functioning improves– Youth in ILS complete secondary education and have

transition plan– Youth in Transitional Services will have viable income