2 CBC NEGOTIATION SESSION FLORIDA DEPARTMENT OF … · cbc negotiation session florida department...

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American Court Reporting407.896.1813

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CBC NEGOTIATION SESSIONFLORIDA DEPARTMENT OF CHILDREN AND FAMILIES

FAMILY SERVICES OF METRO ORLANDO

OCTOBER 5, 2010

LOCATION:400 WEST ROBINSON STREETSOUTH TOWER, TENTH FLOORCONFERENCE ROOM 1006ORLANDO, FLORIDA

REPORTED BY:HEATHER K. HOWARDCOURT REPORTER

NOTARY PUBLIC - STATE OF FLORIDA

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* * * * * *P R O C E E D I N G S

October 5, 2010 9:05 a.m.MR. SACHS: We're about to get started here

this morning. I have -- well, it really doesn'tmatter what time we start because you have allday. I don't have anybody new on my side of thetable, Greg, I think we're all the same. Anynew players on your team?

MR. KURTH: We just have on our side WendyWolfswinkel here today, who is our chieffinancial officer. We are going to have,Walter, a few other folks join us from our stafflater on today.

MR. SACHS: Wendy, we've all got names infront of us, so hopefully you'll be able toconnect the dots when we are talking. Just someground rules again today, be sure to identifyyourself before you talk so our court reportercan have a good recording of the session.

As you know, this meeting is not held inthe sunshine, so we'll control access to theroom for our folks. Greg, be sure to payattention to the door. If anyone walks in thatyou don't know, raise your hand and let us know.

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Jan is here to support Chrissy, and Ibelieve John may or may not be joining us today.He's on a regional directors call, but Nickshould be on.

MR. COX: I'm committed to this process.MR. SACHS: -- issues on the call this

morning was a 15 percent cut exercise, I want tobe on that call.

MR. COX: I don't want to be on that call.MR. SACHS: I'd like to hear what they're

saying. So anyway I think that's it. Yes,Grant.

MR. LACERTE: Just real quick, I have toleave at 11 o'clock. I have a conflict, but I'mglad to be here.

MR. SACHS: Okay. Today's agenda is 9 to12 and then 1:30 to 4:30. If we are at noonishand we have a half hour left or 45 minutes left,then our desire would be just to fly rightthrough and not take the hour and a half breakand come back for 30 minutes. And if we have alot of agenda left, then obviously will take alunch break and come back.

As we sort of structure the day as we getthrough it, at the very end I'll do, like I did

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last week for our Seminole team, and that iseach of the negotiation members will be asked ifthey have any additional questions. And thenyou'll be allowed to do some sort of a closingstatement or whatever, at the end of the thing.And then we'll talk about next steps.

We are at the level of recognizing theagenda. On item 1C, resource development, youguys went through that at length last week. Ithink that snuck on the agenda by mistake, sowe've already lined through it on ours. If youtouch on resource development, that's fine, butwe won't expect it as a separate agenda item.

So we are ready to get started.MR. KURTH: Thank you, Walter. Good

morning, everybody. We're going to go ahead --last week, Walter, we kind of got into about 6minutes of this, so we're going to just start atthe beginning again about the concept of a leanand efficient model which was on the agenda.

Really we wanted to cover five things withyou this morning about this issue. We arecertainly going to talk a little bit about howwe're efficient from the administrativeperspective. Talk a little bit about added

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value from a revenue maximization perspective.We will, Walter, touch base again on resourcedevelopment and kind of clarify some things thatcame up last week.

Then we want to talk a little bit about ourconcept of having service centers that arebasically shared services for both counties.And then we're going to get into someorganizational structures following the processof giving you our -- I think you asked for agraphic of our system of care. So we'll havethat as part of this component as well.

Last week we very briefly got into this.If you go to the next slide, Melinda, we talkeda little bit about administrative efficiencies.One of the things that we're going to hand outis a statement of functional expenses. Wetalked briefly last week about our indirectrate. Our finance committee has finance expertson it. We take the issue of looking at ourindirect rates very seriously. These are someother indirect rates around the state, and wehave consistently maintained under the statewideaverage for OPAGA.

One of the things that's coming around

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right now is an analysis of our indirect rates-- the 4.36, by the way, is the indirect ratefor our DCF portion of our dollars. When weinclude some of our other dollars in grants andwhatnot, the indirect rate actually drops down.

So what I wanted to do was just to haveWendy very briefly as a CFO and her team whohave constructed a statement of functionalexpenses to really just briefly refer to that.I know it's coming around as we speak.

MS. WOLFSWINKEL: Okay. As Greg mentioned,both of these reports were generated directlyfrom our Solomon accounting system that flowright from our chart of accounts. We have costcenters and general ledger codes for everyprogram down to the OCA in our accountingsoftware.

So this one that says 4.36 indirect is inthe format of our DCF invoice, and it is for theentire fiscal year ended June 30, 2010. So itshows an indirect which is automaticallycomputed all the way from, you know, when billsare paid to the 4.36. Now, the statement offunctional expenses is our overall agencystatement of functional expenses which will flow

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directly to our form 990 when it's filed withthe IRS.

This as well is for our entire last fiscalyear. As you see we have program servicesbroken out at 95.91 percent, management ingeneral at 3.95 percent and fundraising at .14percent.

MR. SACHS: On other noncash DCF income,271,529, what is that revenue source?

MS. WOLFSWINKEL: Other non-DCF cashincome?

MR. SACHS: Noncash DCF income.MS. WOLFSWINKEL: That is in-kind

contributions, I believe. No, that's downbelow.

MR. COX: That's down below.MS. WOLFSWINKEL: Yeah.MR. SACHS: I wasn't aware of any income

you get from us that's not cash.MS. WOLFSWINKEL: Yeah, you know, that's a

good question. I'm going to have to check withMike and Rich and get back with you.

MR. SACHS: That's a nice healthy number.MS. WOLFSWINKEL: Yeah.MR. SACHS: We like that you're getting at,

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but I would love to know what it is.UNIDENTIFIED SPEAKER: Your wisdom has a

high value.MS. WOLFSWINKEL: I'm sorry I can't answer

that right now. I'll find out and let the groupknow.

MR. SACHS: Thank you.MS. WOLFSWINKEL: Thank you.MS. SCOTT: I have a question. Lesley

Scott. What do you consider direct services andindirect services?

MR. KURTH: I'll go ahead and have Wendyanswer that.

MS. WOLFSWINKEL: Well direct services aredirectly associated with our programs, so ifit's, you know, adoptions or foster care,independent living, those are all direct.Indirect is like Greg is the CEO, the accountingstaff, insurance costs. We break out everythingaccording to program from salaries, everyone'ssalaries, they are coded to cost centersdepending on what they do there. And then webreak out all of our lease costs and everythingaccording to FTEs, you know, so it's more justthe administrative functions.

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MR. DEBOARD: So it's not services flowingfrom your contractual relationships down to yourdirect care providers, it's non-direct services?

MS. WOLFSWINKEL: Correct.MR. DEBOARD: It's your administrative

overhead.MS. WOLFSWINKEL: Yes.MR. DEBOARD: Nothing to do with direct

services, those contracts.MS. WOLFSWINKEL: That's correct.MR. DEBOARD: And just so --MR. SACHS: This is Walt. Just so our team

knows, the Department issues a cost allocationmodeling that the lead agencies all use, and inthat model we've defined what sort of theprinciples around what gets charged indirectversus direct. So the lead agencies kind ofdefine indirect the same way.

So when you look at a chart like this, itis very apples to apples. We do as muchnormalizing as we can. There are strategiesthat some lead agencies use to call somethingindirect versus direct. We've tried tonormalize that playing field to make this chartmore of a comparable chart than ever. It used

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to be not comparable at all.MS. WOLFSWINKEL: Right. Two years ago I

was actually on a statewide workgroup along withElwood, Mackelhaney (ph) and the CFO ofHillsborough kids, Karen Maziar (ph), and wereally went through what's direct and what'sindirect as a whole system of care so we couldbe more consistent on a statewide basis.

MR. SACHS: This is Walter again. Aspecific question about this first page, and Idon't know how easy this is going to be toanswer, but it's sort of a current question inthe game. With the vibe that's out there aboutindependent living being so underfunded, isthere a way to tell from the upper section,section A, how much family services puts oftheir green of money toward independent living?I can't derive it from the words that are outthere, but maybe a CFO can't tell me.

MS. WOLFSWINKEL: Well, I don't know fromthis form that you could get that, but we spendabout 1.2 million of green money --

MR. KURTH: It's going to be -- yeah, itwill be in excess of $1 million for independentliving which is really coming from, Walter,

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section A, where we are dipping into the othercase management funding.

MR. SACHS: So somewhere up in the probablythe dependency case management line there isabout 1.2 million of that that's pushed intoindependent living?

MR. KURTH: That's correct.MS. WOLFSWINKEL: Right.MR. SACHS: Okay.MR. KURTH: So independent living down here

in section C when we look at services andwhatnot and some of the admin components, we'respending about a million to 1.2 million aboveand beyond --

MR. SACHS: Right.MR. KURTH: -- it's pretty consistent with

a lot of the CBCs around the state that haveincreasing and then shortfalls in their mail.

MR. SACHS: The other question I hadregarding expenditures and potentially gettingon administrative efficiencies, Barney Ray (ph),who does an analysis of the year-end surplus,put out a chart a couple weeks back about whichlead agencies were generating surpluses andwhich ones weren't, and FSMO, Family Services

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was the only agency not generating a surplus.You spent all your money, and you also I thinkdipped into your last year surpluses and spentall of that. So at the end of the year you arebasically even.

There is a mind set afoot in lead agencyworld that I've heard, talked to thelegislature, you can't do this business without(unintelligible). You know, you have to havethe (unintelligible) authority. You have tohave surplus funds. You can't end the year atzero and just start up again, you have to havefluff. We all were able to end the year atzero, you didn't need to roll forward, you keptrolling, and I see --

UNIDENTIFIED SPEAKER: We had a surplus atthe end --

MR. SACHS: And I see 53.9 million inrevenue versus 51 that you get in your checksfrom us, so you are generating a ton of grantrevenue that's coming in. Obviously, there'sprobably more green money in that revenue thanour money that we give you. But I am interestedin the discussion about your corporatephilosophy on a roll forward, and what your mind

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is telling you that if it took not only what wegive you plus the $3 million in surplus lastyear plus potentially some of your grant fundsto run Family Services of Metro Orlando during'09/'10, what does that tell you about '10/'11,and your forecast for how successful you'regoing to be at running it this year at the samerevenue string?

MR. KURTH: Well, I think roll forward whatit does is it allows us to have a system of careand to take into account bumps and increases,decreases and various spending outside of justlooking at the fiscal year. So a lot of theissues that we had last year with respect toroll forward being predominately used, a lot ofit had to do with the fact that our out of carecosts have been going up. We did do a lot ofone-time investments particularly in casemanagement last year, and then of course we havesomeone doing increases in independent living.

We know this year we do have to bring downspending and are going to have to make somereductions across the board, both staff and somecontract components. And we have to also getour out-of-home care expenses back down a little

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bit. So our out-of-home care was as high as48,000 when we first started, and went down toas low as about 29,000, and now it's back intothe mid to upper 30s.

I think in many respects, Walter, the issueof roll forward, if anything, it's really aboutgiving us flexibility to kind of even out theprocess. So like last year if we didn't haveroll forward, we would have had a big problemthis last year. Now we're at the point thatwe've got a good system, our caseload ratios arelow, we can make some changes and whatnot andkind of make some reductions for the rest of theyear. But we do have to get that back down.

MR. SACHS: When you mentioned changes,could you be more specific about strategies thatyour company is, you know, we are three monthsinto the year, getting into our fourth month,what strategies are you using to drive the costdown or change your revenue profile?

MR. KURTH: First off on out-of-home carewe are in the process of doing the placementredesign whereby we are going to have a betterhandle really on our out-of-home care costs.It's not that we didn't in the past, but I think

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we didn't necessarily manage the processes ascentralized and as tightly as we would haveliked. And the foster parent community hasreally asked us to be more involved without aswell. So in many respects, I think that's goingto be a significant contributing factor.

The other component is that our existingcase management contracts both for CMOs andindependent living expire at the end ofDecember, and so we have the ability to enterinto new contracts beginning January 1.Internally, we've already talked about someefficiencies that we can achieve both on theindependent living side and case managementside. We do have to make some reductionsoverall, but by combining some of the ILfunctions with case management that's going tobe an opportunity as well.

And we certainly are looking at minor staffreductions as well, we'll talk a little bitabout that later on. Our payroll will go downat least 55 percent on an annualized basis.

MR. LACERTE: This is Grant. I would liketo chime in on that last point. Staff is goinginto its second year, you know, on a wage and

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salary freeze, and I think that's consistentwith the entire board's and organizations'philosophy that we do believe that we need to belight. We represent that we are utilizingpredominantly taxpayer funds to provide theseservices, so we have to take that responsibilityseriously.

And we have to -- we certainly hope thatthings will improve because we are concernedwith all of our staff, work so hard, but in suchlong hours, midnight phone calls, that at somepoint we can give back to rewarding theirservice financially. But right now we are inthe middle of a freeze and it's a reflection ofthe fact that the community is in dire economicstraits.

SERGEANT GLACIER: Grant, what's your totalemployee count right now?

MR. KURTH: Right now it's at 95 employees.SERGEANT GLACIER: You've had two years of

a pay freeze?MR. KURTH: Correct.MS. WOLFSWINKEL: This is Wendy. If I

could just mention from a risk managementstandpoint and a business philosophy about the

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roll forward, from an accounting standpoint, Imean, this is such a risky business model with,you know, us not having the control of childrencoming into our care of system, that it's justreally a very good prudent business decision toallow CBCs to have that buffer. I mean, Iwouldn't call it fluff, you know, because to be,you know, we were projecting our roll forward tobe 660,000 and it was 80. I mean, we didn'tintend to land almost even, it just happenedthat way. So I just wanted to bring that out.

MR. SACHS: Thank you. Walter again.Nick, I'll let you jump in after me. Greg, youmentioned having the ability to renegotiate yourcase management contracts beginning in theJanuary cycle.

MR. KURTH: Right.MR. SACHS: I think last week we talked

about incentivizing case management for theright things and moving them philosophicallytoward lower caseloads, drive, quality,permanency goals, all that good stuff, yourstructure of your contracts today, do they allowfor performance bonuses and if not, will thestructure of tomorrow's contracts allow for

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performance bonuses and if so, how is thatbudgeted with the idea that you are restrictingyour employees from getting performance bonuses?

MR. KURTH: On the first issue in terms ofhow we are structured right now, we do have ourcontract incentives. And we had variousincentives particularly around some legacyadoptions. We had some incentives around birthparent contact. Those were earned in additionto the actual contract amount from our casemanagement organizations.

We guarantee their fixed payment whichcovers all of their indirect and their variousprogrammatic negotiable components. And then wehave a process in place, a unit of care for lackof a better term, that's tied to the actualpositions that are filled. So it's kind of athree-tiered process. Cover their fixed, covertheir FTEs as they are filled and provide anyincentives on a bonus basis.

Going forward what we would like to do, andwe've looked at the Duval contract as one goodmodel for example, is let's look at the conceptof having them for example perhaps havewithholds, give those dollars up front, but have

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them earn up to the actual contract amount. Andif they don't earn up to that amount, then wewithhold that. It's not a penalty in the senseof we try to get those resources up in front, sothat would be a little bit more fixed in manyrespects and really gives those CMOs more of anincentive to say, okay, I'm going to earn up tomy reunification goal because it's in mycontract, if I don't, then I will have a portionof that withheld.

So that's our thought process goingforward.

MR. SACHS: So more of a -- I've got themodel in my head. I'm trying to imagine if youdo withhold the funds, then what are those fundsused for?

MR. KURTH: Well, we could depending onwhere we are at at the end of the year. I mean,if we are able to take some of those withholdfunds which hopefully won't be all thatsignificant, I would hope that folks would beable to earn, but we would hopefully have thatbe utilized as potential contributions to therollover process. And if those dollars aresignificant, we can always look at some

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discussions with case management on some otherreinvestment activities. You know, it could be-- maybe we want to do another incentive forexample with that or maybe we would want to dosomething within the system that can help directit back to somewhere else.

MR. COX: Nick Cox here. I can't get thelawyer out of me, so I got to ask these. I waslooking at your legal expenses, you are around$90,000 for legal. I don't know what thatrepresents, and I'm not necessarily asking that.I guess I'm wondering two things. First of all,I'm assuming that you all don't have in-housecounsel, you have someone that you contract withoutside which (unintelligible) represents?

MR. KURTH: We don't have an in-houselawyer.

MR. COX: Okay. I don't think anybodydoes. My other question is -- well, HKI has alawyer that works for them, but anyway,regardless. The other question that I have --and maybe Shane can pipe in on this and help usout, too, is that in my region I have a part ofmy region that you're probably familiar with whois getting hammered right now with litigation --

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some of it not appropriate in my opinion -- buthave you all seen much litigation, and I'm notsaying that if you have, it's a negative,because I see a lot of this litigation --

UNIDENTIFIED SPEAKER: You're going to seeit.

MR. COX: -- is not appropriate, but Imean, have you all seen a lot of it, andsecondly how have you all, I mean, has therebeen any particular strategies -- and I lookedat Grant too because you're the lawyer on theboard, one of the lawyers -- do you all have anythoughts or strategies about how to deal withthat in the future?

Because I know in my region a lot of theconcerns from one of my CBCs is that insurance-- I don't want to get in an insurancediscussion -- but insurance is becoming more andmore of a concern in terms of, I mean, for thisone CBC it's really become a serious concern.

Have you all given any thought to that?MR. KURTH: We have been lucky, Nick, we

have not had any claim payouts and whatnot. Wedo have one litigation right now that's sort ofoutstanding, but that's really it. I mean, we

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have not had, for six years, we have not had anylitigation. Knock on wood.

MR. COX: I'm with you.MR. KURTH: And I would say our response to

that comment, Nick, it really comes down to goodquality management and risk management. And oneof the things that -- I don't want to get intoquality and whatnot -- but from a riskmanagement perspective, we do have some qualitycomponents within our case managementorganizations as well. And we really do a nicejob I think overall on risk management. I thinka lot of practices and systems we started fiveor six years ago, you know, again knock on wood,has really helped us to not have issues which iskind of unusual for being a large urban area.

I know HKI has had some very significantissues. And we have been, you know, in thepast, very aggressive. In fact, we wereprobably one of the first lead agencies -- wewere really a model to get all the additionalinsurer certificates from our subcontractors toname us as additional insured. That practice issomething that we actually did even before theDepartment was really requiring it because our

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insurance folks -- in fact, we have Arthur J.Gallagher in Tampa as our broker -- really saidthis is a best practice. And so we were workingwith our insurance broker really more as apartner several years ago on some of theseissues with respect to risk management.

MR. COX: I didn't want to talk aboutadditional insurers. Let me be real clear.

MR. KING: As I sit on the board andbecause I sit on the finance committee as well,one of the past jobs that I had was always riskmanagement --

UNIDENTIFIED SPEAKER: She needs to seeyour name.

MR. KING: Randall King. So that's one ofthe things that I tend to always want to bringup and ensure that we are looking at -- we knowif we are spending money or going to somethingelse or renegotiating contracts for personnel.The first thing that always pops into my head ishow is this going to (unintelligible). So if itdoesn't make any sense to me on that side ofthings, then I'm out in (unintelligible).

MR. COX: I agree. I asked the questionbecause you mentioned HKI, and I think that some

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of the litigation that comes there has not been-- I'll just say well-founded, I mean, I thinkeverybody --

MR. LACERTE: I share your philosophy,Nick. I'm very grateful for the fact that wehave only one case outstanding. I think that'sremarkable. And I do think staff deserves --the organization deserves some credit for doingthe right things to try to keep risk as low asreasonably possible, but I'm not going to turnaround and bash staff if we get hit withsomething tomorrow because I think there is alot of unfounded litigation out there. That'smy philosophical view as an attorney.

MR. COX: I'm with you.MR. LACERTE: There is a lot -- in these

economic times lawyers are suffering too andthey're looking for cases. And so I think theway to handle that is kind of what Randall wassaying is to have a very aggressive riskmanagement -- approach to risk management.Don't assume the best all the time. Haveadequate reserves of insurance to respond andutilize outside counsel when you have to.

And I've noticed that staff is very willing

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to rely on outside counsel, not recklessly, notoutside of budgetary parameters, but if you havea question, don't just guess. And don't justask me, because I don't represent FamilyServices. I'm a board member, get outsidecounsel's opinion. We've got to do this, gettheir opinion. I think the staff is verywilling to do that, and that's important.

MR. COX: I will question. I apologize. Ihad one other question and it's not going tosurprise you that I'm going to ask this, but Iwas looking in section B on the DCF invoice, andI -- as you know I've expressed my concern aboutgroup care and I'm wondering what the plans are?Because you've got over double of your spendingin licensed care and residential group, and Iguess we've kind of touched on it already, butthat to me is troubling. I guess we've touchedon it a little bit, but do you have anythingmore that you can tell me to assuage my --

MR. KURTH: Nick, I would say this is gray.It really comes down to we have to really expandour foster care capacity. We've talked a greatdeal here about recruitment and really our goalto expand foster homes.

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The other component I want to add here isthat, you know, it's not unusual for us to havesome kids that cost as much as 3 or $350 a day.We could have 10 kids and cost up to a milliondollars a year. And we have had over the lastsix months particularly an increase in olderyouth coming into care which some of those kidsare not going to do real well with a foster homeplacement.

So I absolutely want to bring that down aswell. I think that the challenge is that inmany respects when we look at the kids and incare and whatnot, we're a little bit less thansome other CBCs around the state when we look atper capita of out-of-home care, but the types ofkids that we do have are a little bit morechallenging and we had a little bit more of ashift to the upper end in terms of age wise.

MR. COX: Do these dollars , the 7 millionper residential group, do these include SIPkids?

MR. KURTH: SIP?MR. COX: SIP, the kids in --MR. KURTH: Yes. If we have to pay for a

kid at Devereux, it would be included in that.

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If we have to pay some kind of dollars outsideof the Medicaid component, we have some kids ina DD situation where they are on the wait list,but not necessarily on the waiver, we are payingfor those kids.

MR. COX: Do you know offhand, and this maynot be fair to ask, what kind of numbers you arelooking at from your CBC in terms of SIP and DDkids? Because I mean that's a significantamount of money, I recognize that.

MS. LEWIS: Right now -- we have right nowfor children that are in a SIP placement that isbeing funded by SIP. We have six kids that arein our TC that are being funded by us. Of thosefour -- of those six kids that are being fundedby us, they are all DD. All of those are DDkids. And then there are -- in our top 15, 10of those kids are developmentally delayed. Theyare on the wait list, and they are in either inthe right facility or they are in a facilitywhere they are getting the right kinds ofservices until we can find the right facilitywhich would be Viera, which is a block facility.And that hasn't changed, Nick. That hasn'tchanged.

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Our top 15 have always had the majority.Have always been developmentally delayedchildren. And even if they are in a group homethat is an APD approved group home we are stillpaying the res hab and we are still paying theroom and board and that's going to be 200 to$400 a day depending on the needs of that child.We work very closely with APD to make sure thatwe are paying the right rates, and if there are14, that's a lot of money.

MR. LACERTE: And the board shares yourconcerns and desires to expand the foster carecapacity to reduce the number of kids in grouphomes. That's why we have our board memberNancy Ellis taking charge of the foster parentinitiative in Osceola County because we have areal shortage there.

MR. SACHS: This is Walt. You have a chartup there called administrative efficiencies.One of the things I mentioned last week that Iwanted to hear more about is what are thehazards of a too lean organization? Where doyou think you are too lean it? And whatstrategies do you have in place to deal withthat or do you think that you're correctly

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modeled now and don't have any weaknesses inthat environment?

MR. KURTH: I don't think we have anyparticular weaknesses -- this is Greg. I don'tthink we have any weaknesses, Walter, in theadministrative components. I think we have beenwoefully understaffed and under resourced in ITfor example, we have one IT guy.

We obviously would have liked to have hadthe ability to develop a software system severalyears ago. We have done that over the lastyear. We'll talk about that a little bit later.I'd say that's by far the most significant underresourced area. Otherwise, I think we arerelatively okay. Folks work very, very hard.We've brought our insurance costs down over thelast couple of years, knock on wood, and havealways looked at other ways to be a little bitleaner as much as we can.

We're not at the point where we can'treally do anything less.

MR. SACHS: I just want to continue thisline of questioning real quick. Walt, again.Do you have strategies in place were successionplanning where you are one deep? This state

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government is running into that heavily rightnow. We are getting one deep in a lot ofplaces. And when that person wins the lotteryor happens to leave because of being recruitedelsewhere, the talent falls off the table. Sothe recovery is huge.

So what strategies are you using as acompany for succession planning or distributingknowledge so that you don't have a crisis whenyou're one-deep person wins the lottery?

MR. KURTH: This is Greg.MR. SACHS: We used to say hit by a bus.MR. KURTH: We do have --MR. COX: That's why we are so careful with

Walt. We have no one that can fill his shoes.MR. KURTH: On a very high level, Walt,

with respect to succession, the board this lastyear did approve a succession plan at a highlevel with respect to the CPO.(Unintelligible.)

UNIDENTIFIED SPEAKER: Replacing you.UNIDENTIFIED SPEAKER: We can replace Greg.MR. KURTH: I'm okay, but I think the rest

is (unintelligible). I will say this that whatespecially in finance and quality and certainly

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in operations, there is a lot of cross trainingthat is going on. And sometimes when yourleaner what happens is that everyone does haveto figure out a way to really work together thatmuch more on a cross fertilization basis andwhatnot. So like between contracts and financefor example, we have folks that might be in onedepartment, but they are working very closelywith somebody in the other department.

So there's a lot of folks in quality thatknow a little bit about contracts, and there'sfolks in finance who know a little bit aboutcontracts. So I think we definitely have a lotof folks who have done a lot of cross trainingtogether. And ironically, FSFN, the new FSFN,especially going in to 2C, has really requiredthat programs and finance really meaningfullyget together in a manner that we've never reallydone together before, and it has really forcedus to say, hey, we really need to understand theworkflow of how we do our business.

SERGEANT GLACIER: This is Scott Glacier.Greg, I've listened to what you have to sayabout your leaner and efficient model. I'mlooking at your 990s from '07, '08, for the

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grace of God I can't get '09 to come up throughGuideStar here in public records. I've gotstaff that work for FSMO that from '07 to '08got upwards of a 12 percent pay increase.You've got a number of your staff that went from-- one went from 80 grand a year to 83 grand ayear. You've got another one that went from --God it was pretty significant, let me see here-- went from 70 up to 81 grand a year. You,your self, went from 139 two 148,000 -- I'm notcriticizing your salary because I know that DCFultimately has a model to facilitate where yousit, am I accurate?

MR. SACHS: Not necessarily a model, but wedo watch closely.

SERGEANT GLACIER: Fair enough. Pleasedon't take this as some sort of castigation asanother elephant in the room that is, you know,this $1.6 million figure that ultimately equatesto roughly, what, you got 15 staff according toyour 990, I think it was in '08, that make over50 grand a year plus the six people here thatmake upwards of 60, 70, 80 grand a year.

So it's one of those things whereultimately a privatization was brought in to do

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this better and do this cheaper, and I'm notsitting here with a Holy Grail of oh my God weare governmental employees and we've had tostare at cutbacks and so forth, but it justseems that in this economic climate thatcutbacks would be on the table whether it's cutsin staffing, whether it's reduction in pay,because Lord knows there is a vast number ofpeople out there who would be happy just to havea job that could probably do some of these jobsthat I'm looking at for probably perhaps abetter job for less money. That would save youmoney. And then I learned this morning that youburnt through $3 million from previous rollforward, and burnt through all your money thisyear.

I look at it from myself as an employee ofthe government as to how we go about savingmoney, so that we don't have to cut people. Asthe Sheriff has told me and told other staffmembers, cutting people is the last thing he'llever do. But when I look at your 990 it seemsthat you are more slanted towards getting 10 and12 percent pay increases when other institutionsare in the same industry are taking their funds

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and operating below that allotment, and rollingthose funds forward.

So I'm having a hard time wrapping my headaround lean and efficient while at the same timeseeing these salaries that are being paid out,and I need to know that as you move forward inthis economic climate, because again, the mediapays attention -- you're over here like where'sthe question in all of this, right? Exactly.That ultimately, you know, vendors are beingtaken to somehow justify this elephant in theroom that is your payroll because you said thatyou're saving money on insurance, I think itwas. I just need to know that something isbeing done in the future to somehow shore thesecosts down because, ultimately, maybe to a pointthat you're just --

MR. LACERTE: Let me jump in here for asecond because I signed those 990s. First ofall, your raise -- how long had you gone withouta raise before we gave you your raise?

SERGEANT GLACIER: It was for a couple ofyears.

MR. LACERTE: Yeah, okay. He hadn't --Greg hadn't received a raise for a couple of

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years --MR. KING: Five and a half. Let me chime

in because I'm one of the guys that sits overthat 990. The reason why they got raises onthose years is because none of them had receivedany raise, any pay scale raises, for a number ofyears. So we sat, myself and Wendy and Sherrod,had sat and thought about whether or not theseexecutives -- because when you look at the 990,it's only the executives -- this is Randall King-- the executives are the only ones that are puton the 990. If you are not seeing the wholepayroll.

SERGEANT GLACIER: I know that becauseyou've got 100 and something, 195 people that --

MR. KING: I understand, but your commentwas payroll so when I'm hearing that theautomatic assumption is you think that is thewhole payroll, and I just want to make sure weare putting it on record because that's not thewhole payroll, it's just the executive staff.All people that make over a certain dollaramount.

We made a decision at that time becausethey hadn't received any kind of pay increases,

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they hadn't received ample compensation over thenumber of years prior to that, that we would dothat. That was the reason why we did that.

MR. LACERTE: And then I would also like tochime in and just reiterate that we are in themiddle of a wage and salary freeze. Our folksgot those raises, and they were deserved at thetime, but since then, the economy's imploded andthey are having to provide all of this, thiswork, without added compensation, without addedfinancial incentive. So I think that my biggestconcern, and I think we have no choice on that,but my concern with the Sheriff's Department andwith our own agency, my own employer is in themiddle of a wage freeze, is morale, and theability to get out there. These are toughservices that we are in.

A lot of our folks -- they love the kids,and they are dedicated to the children andthat's why they do it, but there's no way, inany shape or form, an easy job. And I lookforward to the day when we can start giving themappropriate financial reward for the hard workthey do.

SERGEANT GLACIER: I guess -- give me one

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second. I don't know if pay cuts have beenconsidered because -- Grant, you make a validpoint. Morale is always an issue, but what itcomes down to is that the job needs to be donefor a higher calling, more than money, it's --by Greg's own statement a moment ago, you'repaying upwards of 350 a kid, and realistically,you cost more than that a day. Is what it boilsdown to.

I'm not trying to bicker about importancehere, but when I've got somebody who is gettingpaid more than the governor of the great stateof Florida, clearly making a very big decision,I need to know that in this climate that you'vegot staff that is willing to accept pay cuts.

That ultimately for altruistic reasons, arewilling to give back to their $11,000 pay raisethey received in one year. Whether they hadn'tgotten raises or not, there's members of otheragencies, other institutions, other privatecorporations, that would gladly give money backin order to stay employed and to garner thebenefits and ultimately the goodwill of helpingkids out. So it begins to boggle my mind as toperhaps where the mission is. I don't know if

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that's something that you've considered as partof taking a pay cut, because again, you've burntthrough a lot of money.

MR. KURTH: The money that we(unintelligible).

(CROSSTALK.)MR. KING: (Unintelligible) increases in

out-of-home care, so it wasn't so much of aburden. Circumstances of the current economicsituation, we just had a huge increase -- you'remaking it sound like we are burning through asif we've negligently spent money arbitrarily,but that's not what happened. We had a hugeincrease. We had no choice. We had, correct meif I'm wrong, Greg, at one point we had 10children that cost us 1.2 million because oftheir psychotropic drugs. That's a lot ofmoney. That was unexpected.

So it's not like we've burnt through itarbitrarily, we had to take care of the kidsthat were in care and we had no choice.

MS. WOLFSWINKEL: Scott, this is Wendy. Iwant to just mention that over the last severalyears, we have formalized an administrative -- apay schedule, and looked at, very importantly,

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comparing salaries in the field, in thecommunity. We've taken it very seriously thatpeople are paid right for what they do, and it'scontinually looked at. So I just wanted to notethat.

MR. LACERTE: That's a good point, Wendy.And I'd like to add that we are getting,eventually, I'll probably be gone when we getthere because I have to leave at 11, but we aregetting to our new model, our new organizationalmodel, and there will be savings in that. Therewill be positions that are eliminated. So interms of cuts, there are cuts coming. In termsof salary or wage cuts, I can tell you from my-- and this is just one board member -- I'mworried about driving people who work hard anddo a good job for us out. I am.

SERGEANT GLACIER: It's 2010. There's lotsof people that are unemployed that probably havethe same or better skill sets for less money.

MR. LACERTE: I just --MR. KING: I can look at at least five

executive staff. Wendy, for example, she's aCFO, and she and I have the same credentials.And I can tell you from my -- the last CFO job

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that I had, I made twice as much money as shedid. So quite honestly we are getting hercheap. We are really getting her cheap.

MR. LACERTE: I agree.MR. KING: And in addition to not only

getting paid twice as much, I got incentivebonuses. So I think the last year that I wasthe CFO of that particular company I made$375,000. She's getting a fraction of that.And having to deal with a lot of risks. I hearwhat you're saying, but I have to take somehomage on that.

MR. LACERTE: There are positions beingcut.

MR. SACHS: (Unintelligible) where you aregoing, (unintelligible).

(CROSSTALK.)UNIDENTIFIED SPEAKER: (Unintelligible.)MR. KURTH: Just one last thing. On

executive administration, I want you to knowthat for the 990 requirements going forward, theboard must approve the CEO's salary and part ofthat process to do a third-party review of allthe other CBC lead agency salaries. We're goingto come to market, and our board has definitely

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done it for the last couple of years.MS. WOLFSWINKEL: Very diligently.MR. KURTH: So we are actually out about

average despite being a little on the biggerside as a CBC lead agency. And then the feeadministration policy is a rational systemwhereby we do have a process of how do we reallyvalue positions and whatnot. We do have a lotof various specialized positions in our system,so there's a lot of components that are notnecessarily easily replaceable. But we do havea lot of methodology in terms of how we do payon that. But I definitely do take your commentssincerely in the sense of where can we look atpossible situations to make reductions, and wehave done pay reductions for folks. We haveactually reassigned folks and put people intodifferent types of positions and had done a payreduction as a result of that.

SERGEANT GLACIER: Fair enough.MR. KURTH: So moving on. That was a good

quick discussion. I think that I do want toemphasize that we are one of the lowest --

MS. KOGUT-LOWELL: Greg, I'm sorry. Thisis Mary. I've been wanting to ask a question on

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the previous slide, and it's very quick Ipromise you. This source at the bottom thatsaid CBC report, could you specify what CBCreport that is?

MR. KURTH: That came from the CBCsthemselves. That was actually self-reported bythem based on their actual expenditures --

MS. WOLFSWINKEL: (Unintelligible)expenditure report. Yeah.

MS. KOGUT-LOWELL: Okay. Thanks.MR. KURTH: We are going to continue to

move forward. I think if we could, you know, Iwant to emphasize that we are the only CBC inthe central region that was eligible for equityfunding this last year, and that we were $6million underfunded. And our indirect ratewould actually be a little bit less if we wereactually at the fair share allocation.

So going to the next slide, one of thethings that I did want to highlight, and this isprior to getting a little bit of equity dollars,we really appreciate Secretary Sheldonadvocating. We were able to get a million and ahalf equity dollars in this last legislativesession, but there are significant differences

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in the region relative to who's underfunded andwho's over funded with respect to equity.

This is the Department's fair shareallocation. Walt, I know you're more of anexpert on this, but in a nutshell it looks atpoverty, kids in care and certainly child abuseand neglect reports. And this is a challengefor us, so I mean when we look at where we areat, we are operating significantly less thansome other comparable lead agencies within theregion.

MR. COOPER: Greg, you bring up a point,but you know, Walter mentioned the $3 millionspent fiscal year '09/'10 roll forward of theprevious year, so on top of that we also spent1.5 million in equity money. So ultimately,four and a half million dollars was spent morethis past fiscal year than the previous fiscalyear. Out-of-home care only went up a milliondollars.

So where is the other three and a halfmillion spent in the fiscal year?

MR. KURTH: The equity was not last year.MR. COOPER: I'm sorry. It was for this

year.

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UNIDENTIFIED SPEAKER: Yeah.MR. COOPER: Okay. So again, I'll rephrase

the question. So the additional 2 million,where was that spent?

MR. KURTH: Really in two areas,independent living increases. Particularly wehad a significant new investment in theindependent living program beginning in 2008 andthen also we made some significant investmentsin case management as well. So those areroughly the two major areas that we did somework, and the other component is a lot of newprevention dollars particularly in OsceolaCounty with the capacity there.

MR. SACHS: This is Walt. What is theincreases in case management? What does thatmean? Buying more case managers?

MR. KURTH: Not necessarily case managers,Walt. It was really an area we built somecapacity with Family Finders this last year,family team conferencing, some additionaldollars for what are called clinical carecoordinators.

MR. SACHS: Right.MS. NORTON: We also funded case management

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-- one supervisor to five case manager ratioversus the one to six which was the prior model,and we funded case management -- the caseloadratios as a performance incentive for our bestperforming CMOs. We funded them at 15 tocontinue the good work, and the rest of thesystem we funded at 1 to 16. So we brought thecaseload down through funding more case managersand having (unintelligible).

MR. SACHS: This is Walt again. This sortof goes back to my earlier question, those typesof changes seem to be ongoing changes that willhit in the future as well. They are notone-time ups that you will then not have anaccelerated cost the next year. So now we havea year where we had surplus, where we were ableto do that. Yeah we got a 1.5 equity out ofthis year, but that's half of what your spendingwas last year. So now you have a 1.5 hole thisyear and those the systemic changes that youmade are happening again.

So the strategy around that doesn't makeany sense to me. Because the idea of usingsurplus in its original mind set, were thingsthat would be enhancements, but not cost you

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downstream. Because you should never count on asystem generating surpluses every year.

MS. NORTON: Well, what we see for examplelike doing the funding methodology that we hadwith the case management supports, we've seen areduction, a big reduction, in our largest CMOfrom, I think they were funded around 800, 840,possibly, a year ago and now they are down tolike 640, 650. So we see significant changesrelative to how staff are able to managecaseloads. So those providers has significantincreases.

Then when we look at the system we are ablethen to move resources around where we need towhen we see an emerging trend, we are able toactually address it because we, you know,achieve some savings relative to theseinvestments this year, you know, becauseremember it's all systemic. So everything isable then to be moved to what the need is.

I certainly understand your point, but it'svery fluid. And some of the supports that wehave in place, particularly in Osceola County,we definitely -- DD, housing, those types ofthings, we think are going to be hugely

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impactful relative to some of the challengesthat we have (unintelligible). So we willcontinue to look and evaluate that.

One of the things that we didn't speakabout was, you know, independent living and theGreat Oaks Village issue, we didn't reallyanticipate that we would have such a largeholdback this year. Three years ago -- twoyears ago, we were actually funded at about 1.6,1.7. The district then decided that FamilyServices, Seminole and Brevard, would beabsolved from the GOV holdback and all of thosedollars then it came out of our contract, andour utilization really has not been, you know,at that level. Even though we typically get thefunds back, last year we didn't get all of themback. So that was simply another issue.

Then of course we did have a significant,not a significant -- we had about $350,000 cutthat we hadn't anticipated. So that's half amillion dollars that we left on the table withGreat Oaks Village, which was several casemanagement positions and then the cutback.

MR. COX: Also -- this is Nick. Also I'dbe as defensive of Seminole as I would be of

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them. I mean, a lot of the stuff you mentionedthat has caused this has been stuff that's beenpushed out of Tallahassee, some of it verysuddenly. And we felt it in our agency as well,so I mean, I think a lot of that from whatyou're saying, my reaction, and I don't know ifJohn could tell us, but a lot of that is kind ofbeing reactive to I think a lot of programs andissues that are being pushed very hard out ofTally.

MR. KURTH: I think the other thing, Walt,just to kind of continue to sort of emphasize totry to address your question, out-of-home careover the last year definitely has gone up higherthan we anticipated. So our goal is to reallyget that cost 4 to $5000 less a day which rightthere that's a million and a half dollars.

MR. SACHS: This is Walt. Because youmentioned out-of-home care, John I apologize,but you get to go next. I have always heardthat everybody likes to put their kids inOrlando because there's so many residentialhomes here and CBCs are sending kids here andyou can do the old courtesy supervision stuff.Does that hit your budget at a level that's not

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anticipated thing or is that manageable and isnot a cost accelerator because of the volume(unintelligible)?

MR. KURTH: It's not a big cost issue. Itis an issue in the sense that for every in thatcomes here in Orlando, is much greater than theouts that we have. So we are doing excessivemore courtesy than other places around thestate.

MR. SACHS: But not excessive budget wise?MR. KURTH: It's not necessarily what I

would say a huge budget impact per se.MR. SACHS: John?MR. COOPER: This is John. Greg, the past

fiscal year you spent almost 2 million inprevention services, how much of that was anincrease from the previous fiscal year?

MR. KURTH: I don't know off the top of myhead.

MS. WOLFSWINKEL: We can get that number.MR. KURTH: In terms of '09, John, versus

'10 -- I mean '10 versus '09?MR. COOPER: Right.MR. KURTH: Okay.MR. COX: This is Nick. Are we maximizing

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use of 4E dollars you feel like in Circuit 9?MS. LIS: Yeah. And we're going to get to

that -- it's in the PowerPoint.MR. COX: Then I'll wait. Thanks.MR. KURTH: We are going to go ahead and

move on. I just think that the equity issue iscertainly something that is significant, butwe've done what we could with respect to thatbudget.

When we talk about maximizing revenue, Ithink that these are a number of added valuesthat we want to emphasize. One is that we havenearly a quarter of our kids who are on SSI orSSA, and that's very significant in the sensethat we can actually have many of these kids, ifthey age out, are going to have that SSIbenefit. It's really also a system in helpingkids go home in many respects.

We are really proud of the fact that one ofour Medicaid people on staff is a one-timeformer DCF access professional, and we've donereally a terrific job in getting our relativecaregiver grant programs really streamlined.I'm really proud of the fact that we've beenable to double the RCG component. And we are

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also one of the first lead agencies to haveaccess to the Florida system and reallystreamline that.

The others aspect is that we really haveconcentrated a great deal on getting our kidsenrolled on Medicaid, and it is prettycomplicated in many respects with respect tocaregivers, but we've really done our besteffort with respect to leveraging that. And Ithink the other component is we certainly havetalked about ongoing leveraging of public andprivate dollars as much as we can. Thecommunity service center merger that we talked alittle bit about was one such opportunity to dothat.

The other big thing I want to mention here,and going back to you Nick and your question, goback one, Bart, we had the lowest -- one of theworst 4E rates in the state in 2004 and five.In right before the waiver we were actuallyalmost double that, we went up to the high 50sin many respects. And I want to emphasize thatwas another 4 million to the entire state, notjust to our local circuit.

So we always had a very significant 4E

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issue, Great Oaks Village is not a 4E eligiblefacility. So before the waiver, placing kidsthere meant a loss of Title 4E. If we ever losethe waiver, we have a significant challenge inthe sense that Great Oaks Village is noteligible to receive such federal funding. It'sa moot point because we now have the waiver, butI want to highlight that a significant amount ofmoney on an annualized basis that we were ableto generate for the state prior to the waiver.

What I want to do now is last week wetalked a little bit about resource development,and I think it's really important for us toreally talk as much as we can about added valueof all the various relationships, contacts,opportunities, cash, in-kind and whatnot. So weare going to hand out something right now thatreally talks a little bit about those componentsthat have really created added value.

John, to answer your question if Karen --we just did a little bit of math here and I'lllet Karen from a contract perspective answeryour question.

MS. NORTON: For additional -- this is veryrough, additional placement (unintelligible)

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about 700,000 -- prevention I'm sorry -- about$700,000 over the previous year.

MR. COOPER: Yeah. I thought it was anincrease. I just wanted to know how much. Ithought it was pretty significant. Okay.

MS. NORTON: So that's just a really --MR. COOPER: So not quite double, but

almost.MR. KURTH: And there were some

annualization issues because we built someadditional capacity actually towards the latterpart of the previous fiscal year. If youannualized it, it puts it (unintelligible).

I'm going to go ahead and have Bart justreview this. On the back sheet or on thebackside of your analysis here is our best withrespect to talking about added value. Bart,I'll just let you kind of walk through this.

MR. MAWOUSSI: I wanted to present to youhow we look at added value in the communitybecause really that's the essential component ofwhat we do. It's one of the basic principles ofcommunity based care going back to thebeginning. You know, we do that a number ofways including the traditional resource

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development kind of things, cash, in-kind,grant, revenue, and you see that in the list onthe other side as well as in the pie chart.

But we also generate a significant amountof value to the community in terms of generatingvolunteer support services. Inspire the peopleto really support children that is in ourcommunity. We do that through a number ofdifferent programs. We have a general volunteerservices that people who support us at ourevents and support the services, in general, ourmission through our AmeriCorps programs, bothVista and Public Allies.

And you know, volunteer services fromfoster parents. I don't think anyone woulddispute the fact that the foster parents are notreimbursed fully for the important service thatthey provide to kids in their care.

MR. LOVE: Excuse me. Your fading out alittle bit. Could you speak up?

MR. MAWOUSSI: Yes, I'll try to speak up.And we look at revenue to the community that wehave been able to generate. We already talkedabout the increase in 4E, revenue to the statebased on our increase in eligibility back from

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2004, 2006. That's a 4.3, 4.5 million dollarincrease in revenue to the state each year. Sothat's amounted to about twenty years since the4E waiver -- 20 million dollars since the waiverbegan.

And we have savings in utilizationmanagement as Greg mentioned. The daily cost ofcare for children in foster care has decreasedfrom $48,000 a day in the beginning to a low ofabout 29,000 a day, and then back up a littlebit. But we also have very significant DJJservices, liaison services, that we provide thatyou'll hear about later that have reallyimpacted the system in a big way in terms ofdiverting children from the formal involvementin the child welfare system. So it's part ofour family preservation and preventionactivities.

So total we actually generate value to thecommunity of about 40 cents on every dollar,every DCF dollar, that's invested in us. So youcan see that both in graphical format here onthis page in the list and it shows basically ourassumptions as we arrived at that figure.

Yes, Mary.

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MS. KOGUT-LOWELL: One comment on thisgoodwill. You have on here are $98,000.Explain what you mean there.

MR. MAWOUSSI: Goodwill for a for-profitorganization is typically the value of itsclient list. For a nonprofit it's typically thevalue of its donor list. There are a lot ofdifferent ways to measure that, we picked onethat was recommended by an organization thatdeals in nonprofits called Convio (ph) whichreally values each individual on the donor listat a particular dollar amount that's arrived atthrough their research.

MS. KOGUT-LOWELL: So you are looking atdonors when you come up with the goodwillfigure?

MR. MAWOUSSI: That's correct.MR. SACHS: Bart, this is Walt. So I

understand this correctly, you are valuing thenon-expenditure of dollars, 5.4 million, asadded value to the community?

MR. MAWOUSSI: That's correct.MR. SACHS: The money which you used to

give to people to run their business, which youare no longer giving to them because you are

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more efficient, is a value to the community?Connect that dot for me.

MR. MAWOUSSI: The efficiency is in thereinvestment of those dollars, as John wassuggesting, just in one year a 7 percentincrease --

MR. SACHS: That 5.4 million is in the 50million, right? That used to be part of the 50million.

MR. MAWOUSSI: Correct.MR. SACHS: Now it's not, it's being spent

on something else.MR. MAWOUSSI: Now it's being spent --MR. SACHS: So are we double counting it?

I mean, I don't want to over critique the chart,but that's a glorious number. The payments partto me works -- are big in my head. Stateemployees always stand up and say, look at theamount of money we didn't spend. Give me athousand dollars to pay for everything I didn'tspend. Well, if you didn't spend it, woo-hoo,you know, you've got to spend it on somethingelse. Let's not double it. So I can't connectthat dot. Help me.

MR. MAWOUSSI: Walt, the fact is that we

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actually did spend the money. You don't see adifference in the bottom line. We spent $50million, but we invest that money in services toprevent kids from ever being abused andneglected in the first place thereby reducingcosts of formal involvement in the child welfaresystem later and impacting our community thatmuch more.

So it's really about reinvesting thosedollars in higher impact areas, and that's wherethe true cost savings comes from.

MR. DEBOARD: I've got a question. You'vegot volunteer services foster parents that's thedifference between the board rate of pay tofoster parents and the cost to raise a child aspublished by whatever that USDA is. I guessevery CBC can tout several million dollars thatis based. I guess I don't --

MR. MAWOUSSI: And they should.MR. DEBOARD: I guess I don't see that as a

-- I don't know. I mean, I don't know what itcost me to raise my kids, but it's probably --

UNIDENTIFIED SPEAKER: It's a lot.MR. DEBOARD: Yeah. All my money.MR. SACHS: (Unintelligible.)

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(CROSSTALK.)MR. DEBOARD: All my money, you know, but I

guess I'm trying to see -- I'm trying to figureout what makes you special here, Bart, is myquestion. I'm looking at these things and I'mlooking at what other folks do, probably similartype activities, but that's the one that stoodout to me. It's like well, I guess every CBCcan say that.

MR. MAWOUSSI: Shane, there's nothingspecial about claiming the volunteer servicesfor foster parents. You know, if there's been areduction in out-of-home care costs over time, Ithink it's completely fair to claim thosevolunteer services and foster parents. And weare not unique in that respect. Where I thinkit's important is in that we recognize theimportance, the critical importance, of thefoster parents to our system.

When we are talking about where we mightwant to invest funds in the future, if fundswere to be allocated for this from the state'sperspective, boy, we really need to narrow thatgap. I'd actually like to present a few yearsfrom now a list that shows volunteer services by

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foster parents, zero, because we've paid themwhat they actually deserve for the service thatthey provide.

MR. DEBOARD: Let's talk about one of thesethat I can get my head around because that one Ijust can't. Revenue to the community,calculated based upon the funds made availablethrough FSMO's activities such as Title 4E, SSI,FEFL eligibility, determinations. I'm guessing-- that's when you went back to the other slidewhere I can get my brain around, which was okay,we worked really hard to get kids on SSI thatdeserve it. We worked really hard to make sureMedicaid or whatever, I'm guessing that 4E orwhatever it is, that represents a lot of thatslide, correct?

MR. MAWOUSSI: That's correct.MR. DEBOARD: That's $6 million?MR. MAWOUSSI: Correct.MR. DEBOARD: Okay. So are you saying that

you can show where in past years you have that$6 million less coming in to help take care ofthose kids as compared to now where we've reallyincreased that and you've got that somewhere ona bottom line, you know, that a bean counter

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would come up with on one of your spreadsheets?MR. MAWOUSSI: Uh-huh.MR. DEBOARD: Yes or no?MR. MAWOUSSI: There's actually been an

increase in the eligibility for SSI. Weincreased eligibility for Title 4E. Soabsolutely, yes.

MR. SACHS: I'll just remind everyone tospeak loudly because Rod is on the phone andunfortunately the speakers for the phone areonly right here. So please enunciate thisdirection.

MR. LOVE: Thanks, Walt.MR. SACHS: No problem.MR. KURTH: This is Greg. Just a point of

clarification, Shane, I just want to emphasizethese are dollars that we're creating. Theydon't necessarily flow into our budget per se,like additional Title 4E dollars would flow intothe entire state. SSI eligibility dollars thatwe've been able to increase have been able tooffset the cost of care for those kids, but thatflows directly to the state since the state isthe only entity that can get those dollars.

MR. DEBOARD: Okay. Let's talk about the

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ones that flow directly into your budget thatyou've got the discretion to spend the money inways that you think are going to help impactyour system of care. Because really to methat's what we're talking about here is yourorganizational structure. How are the thingsthat you've done are going to help you do thatbetter in the future? So which one of theseamounts --

MR. KURTH: Certainly --MR. DEBOARD: That's what I'm interested

in.MR. KURTH: Okay. Cash and in-kind -- in

terms of hard dollars cash and in-kindcomponent, grant revenue based on what we havecurrently in the pipeline, Shane, is what we'vebeen able to bring into the system. We'vetalked a little bit about Public Allies in thepast that -- that's the overall value each year.About a quarter of that is flowing to usdirectly. And that would be -- those that wouldactually be harder components that we wouldactually see in our balance sheet.

MR. DEBOARD: So cash and in-kind, grantrevenue, what was the other one?

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UNIDENTIFIED SPEAKER: Resource anddevelopment.

MR. KURTH: Public Allies.MR. DEBOARD: Okay. So those are the guys

that work hard to really bring in on anannualized basis? You're looking upwards ofclose to $4 million, over $4 million here,right?

MR. KURTH: Uh-huh.MR. DEBOARD: Okay. So annually that's

what you are hitting it hard to bring in thatmoney?

MR. KURTH: Correct.MR. DEBOARD: Okay. That's what I'm trying

to figure out.MR. KURTH: We really wanted to show the

other added value components as well outside of--

MR. DEBOARD: I understand that. I getyou, but some of the things I just can't get myhead around. Especially the $3 million, youknow, thing right there. My question is whatmakes you special? That doesn't make youspecial because everybody's got that. Okay?

MR. KURTH: I agree.

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MR. DEBOARD: Okay.MR. SACHS: Moving on.MR. KURTH: We're going to move on --MS. WOLFSWINKEL: Excuse me, Greg. This is

Wendy. Before we move on, just real quickly,the other noncash DCF income from the statementof functional expenses -- now I know why Iforgot it, because I didn't want to record it.But it's the RDC, remote data capture computers,that we own, but our case managementorganizations have. So they --

MR. SACHS: The influx of the computer(unintelligible).

UNIDENTIFIED SPEAKER: Do you did give us a(unintelligible) contribution.

(CROSSTALK.)MS. WOLFSWINKEL: Yes.MR. SACHS: (Unintelligible.)MS. WOLFSWINKEL: The balance sheet

(unintelligible) we'll get our income statement.MR. SACHS: Right. It won't be as revenue,

but it'll show in depreciated value orsomething.

MS. WOLFSWINKEL: Right. Thank you.MR. SACHS: Thank you.

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MR. KURTH: Thanks a lot.MR. SACHS: We don't need to forget

(unintelligible).UNIDENTIFIED SPEAKER: (Unintelligible.)MR. KURTH: Okay. Moving on. As far as

the lean and efficient model, we want to talknow -- we want to move into what we're going topropose as a shared service center model foreach respective county. Over the last five,four, five, six years we have had co-location attimes with the Department. The Departmentchanged the way it did some of its officelocation. We started out doing a lot ofco-location legal and PI, and the Departmentovertime changed the way it was doing itsbusiness.

So we in turn now really have to change theway that we are doing our business with respectto facilities, and one of the things that wewant to propose to you all is looking at theissue of establishing a common facility in bothcounties whereby we share office space with casemanagement organizations. And especially inOsceola County, looking at the option of havingwhat we would call some hoteling space with some

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of the providers that don't necessarily havetheir own office space.

So we're giving you an analysis right nowthat getting in year two would have anannualized savings of over $1 million a year.Craig Castor who is our executive advisory boardmember who is also involved in commercial realestate has provided a lot of free consultationon this process. What we have done here iswe've looked at all of our various current leasearrangements within our case managementorganizations that we pay in our contract aspart of the fixed expenses. We in turn havelooked at some other, you know, one time costthat we would have in terms of moving, IT wiringand taking that into account.

And then the other component is that whenwe look at other indirect admin rates that arebeing paid around the state to look at acorresponding reduction in indirect admin thatwould be paid (unintelligible) case managementorganizations which would be offset by the factthat we would be taking on facility expenses androles and what not.

So this is being presented to you all.

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This is not something that will be doneovernight, obviously. This would be at least athree-year process. Going into year two, wewould certainly look at some beginning savings,but we would have some upfront costs. There isa lot of leases that we have that we have totrue up together, and the square footage ratethat we have presented before you is somethingthat's really based on the current marketsituation. That's not to say it couldn't bepossibly lower and whatnot.

But this is our process of becoming evenmore efficient with respect to facilities andalso creating more of an opportunity to brandbetter in partnership with our CMOs in bothrespective counties.

MR. SACHS: Greg, this is Walt. When theallocation of position FTEs across the counties,353 to 384, you mentioned the reductions instaffing of Family Services so that shows anincrease obviously I believe that that wouldthen be not in Family Services staff, but incase management staff or other work staff.

Can you give us an idea on the 266 and the118 what the distribution of Family Services

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staff would be in those proposed shared spaceslocations?

MS. WOLFSWINKEL: This is Wendy. I canspeak to that. In addition to the CMOs in thisanalysis, is also considering prevention anddiversion partners as well as a visitationcenter. Of the total Family Services staff it's73.

MR. SACHS: 73 distributed in both?MS. WOLFSWINKEL: Well, right now we have

Family Services staff of 73 in our facility. Wehave some staff that are housed in with the CMOsso we kind of took the Family Services staffwith the CMOs, looked at the total currentstructure, but of the current 353 -- well, that73 of Family Services I would have to find outhow many of family services staff was consideredin the CMO numbers.

MR. SACHS: Part of our interest becauseyou do want -- part of this -- I like the ideaof rebranding. I have another idea, that youguys keep using the words "Family Services," andI love it, but Metro Orlando to me is a killerfor you all. And it just sends a corporatemessage in your name that I think you all could

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change tomorrow, if you chose to, but --UNIDENTIFIED SPEAKER: Osceola would

probably (unintelligible).MR. SACHS: Well, I'm just saying there's

this -- it's not even rural Orlando, it's MetroOrlando. So one of our ideas that we keeptalking about is Osceola presence, but I can'ttell from this chart what the Family ServicesOsceola presence is. Is there a way to derivethat?

MR. KURTH: We didn't break it outspecifically like that, Walt. We could do that.

MR. SACHS: Has there been discussion orthoughts about that?

MR. KURTH: Yes. And that gets into --MR. SACHS: Is there a round number that

you know in your head that you don't have tolook up?

MS. WOLFSWINKEL: Well, it's comingactually.

MR. SACHS: It's coming.MS. WOLFSWINKEL: Well, it's kind of

coming. Everybody, all of our staff, are inthese spots.

MR. SACHS: Right. Right. Right. I'm

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just wondering, is it 10 or is it 40? You'vegot what, 95?

MR. KURTH: A little bit less than that.MR. SACHS: 90?MS. NORTON: We actually have --MR. SACHS: It's not 45, 45, I'm sure.MS. NORTON: (Unintelligible) to tell you

that 10 percent of our workforce that's funded,is not DCF funded, so we do have some positionsthat are not funded by DCF.

MR. SACHS: If it's coming, great. If it'snot coming, I'd like to know.

MR. KURTH: It is. Yeah. It's in the orgchart, and I apologize that I didn't count upeverything. And it is a little bit in the sensefluid because we do have some opportunities toput more staff in Osceola County. We've hadsuch tight situations and spaces. I think theimportant thing also in Osceola County is wewant more hoteling space with our providers. Weneed more training space. We need more -- thebiggest priority is more conference room spacedoing level of care staffings and whatnot.

But I think the intent, Walter, is to havea solid presence in both counties relative to

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the impact and the work that we are doing inboth counties.

MS. WOLFSWINKEL: This is Wendy. This iswhy we have allocated 186 square feet per FTE inOsceola as opposed to 162 square feet per FTE tohave some space for community folks and to havemore of an integration there.

MR. LACERTE: I can tell you that theOsceola members of the board, and I think theOrange County members of the board as well,expect to see our presence in Orange andOsceola. I mean it's already very, veryvisible, but we need to do more.

MR. COOPER: This is John. Greg, this iswelcomed. You know, Greg and I have hadconversations for years about this model many,many times, and '04, '05 during the transitionyears, we went from having three or four servicecenters in Orange County to eight. You know,communication, collaboration, co-location, youknow, and with the attorneys and CLS, CPI andthe CMOs it just went from being fragmented toseverely fragmented in one county.

Quite frankly, I don't blame some of theCMOs because some of the space we had in

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transition was pitiful. But, you know, leaseswere expiring at the time of our transition, soa lot of them took the opportunity to, bam, moveout on their own into new locations. So we wentfrom three or four locations in one county toeight. It was kind of crazy.

I'd like to see us get back to a smallerlocation to get that collaboration backespecially with the PIs, the attorneys and thecaseworkers.

MR. KURTH: And we are committed to doingthat. Going into the next slide I think I wantto mention Osceola County in particular, thereare certainly -- well, we haven't taken intoaccount our other opportunities to partner witheven other partners. You know, the Osceola, theHelp Now home from 1930 has about 4,000 squarefeet, and it's about ready to fall apart.

So we've even expressed to them maybe wecould co-locate with them, center for drug-freeliving is right next to Family Alternativeswhich is --

MR. COOPER: (Unintelligible) Help Now?MR. KURTH: We talked to Help Now, yeah.

Maybe we could have --

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MR. COOPER: I painted that place lastFriday.

MR. KURTH: You painted it?MR. COOPER: Yeah.MR. KURTH: If you did the plumbing and the

heating, he'd have a different opinion.MR. SACHS: That's why they're moving.

They saw the paint job.MR. KURTH: There's other opportunities

here. Visitation centers, the other thingthat's kind of inefficient. We are paying fortwo separate visitation centers outside of theco-location with our CMOs, and things weinherited at transition. We want to bring thatprocess into play as well, so that we can haveon site visitation and really co-locate as muchas possible.

Obviously, we are talking about a prettygood sized building in Osceola County, at least25, possibly bigger than that. So what we'vedone overnight, but we are throwing this out inthe sense that, and not just from a savingsperspective, but it really helps everyone toco-brand and work well together, and havesomething that's a benefit to the community.

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So if there aren't any comments about this,we are going to continue to move on. We aregoing to go ahead now and hand out ourorganizational -- not our organizational chartyet, but we are going to hand out -- I think youhad asked for a graphical chart for our systemof care. So we're handing that out as we speak,and we want to give you all an opportunity tolook at that.

MR. SACHS: This is Walt. Grant, in caseyou have to document the volunteer hours withJohn, he's billed at $13 an hour.

UNIDENTIFIED SPEAKER: Good. We'll putthat down right now.

MR. SACHS: Just a little bit of anadjustment.

UNIDENTIFIED SPEAKER: It was part of theUnited Way.

MR. COX: If you saw his paint, youwouldn't think it was operational.

MR. SACHS: Rod, you are missing out onsomething very shiny.

MR. LOVE: Really shiny, huh?MR. SACHS: Yep. It's pretty.MR. COX: It slips out of my hands, it's so

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shiny. Slippery. This is pretty paper.MR. KURTH: You don't know what it's like

to print one of these things.Well this is our graphical presentation of

what we do with it, much of this was alreadypresented at the Regis Little Task Force. Whenwe talked about crossover (unintelligible) withall various departments, they wanted to see allthe various entities that we interface with.

UNIDENTIFIED SPEAKER: But it was smallerand not the same quality of paper.

UNIDENTIFIED SPEAKER: It was too the samequality of paper.

MR. KURTH: It was the same quality paper.MR. SACHS: Come on now.UNIDENTIFIED SPEAKER: I'm pulling out the

original.MR. SACHS: Let's move forward.MR. KURTH: So really this -- I just want

to -- and obviously the Department folksunderstand the components here, but I think it'sreally important to show from a system of careperspective how we interface with APD, DJJ,certainly that of the Department. How weinterface with APD. The AHCA Magellan component

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is the managed care approach. When kids getdeeper into the system, they go into thatprogram. Looking at the advisory componentsthat we have in place, along with their variousfunders and most importantly some of oursignificant partners and programs.

So I'll let everyone kind of digest this.MR. SACHS: Greg, if you are looking at

this chart, the place my eyes should go to firstis where an arrow would start. Am I looking inthe middle? Am I looking at upper left?

MR. KURTH: Upper left with respect to --MR. SACHS: The hotline calls come in

through DCF, there's some community referralsand then it hits Family Services?

MR. KURTH: Correct.MR. SACHS: Okay. And then some stuff is

screened out, some stuff is unsubstantiated andthen as Family Services hits it -- I see theloop in from DJJ probation, I don't see the loopout to DJJ. Where are you interacting with DJJas opposed to DJJ interacting with you? Is thatarrow supposed to go both ways or is it justintentionally only going one way?

MR. KURTH: Well, it really is both ways.

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We are going to -- this afternoon when BurneyVaughn is here we're going to talk about therole and the work that he does with respect toDJJ. It really is both ways. I will tell you,not to take away from Bernie's presentation, butit does appear more one way at times because hegets up to 80 calls a month from JPOs asking forsome type of assistance for some kids who arecoming out of commitment and need some kind ofdischarge planning. But it definitely goes theother way as well in terms of collaboration. Wework very well with them locally here.

And Burney does have a whole, full-blownpresentation on the role that he does as the DJJliaison.

MR. SACHS: This is -- folks on our panelwho are interested, this is something that wehave encouraged each lead agency to do, but veryfew of them have been able to graphicallyillustrate their system of care. Heartlandstarted this model of graphical illustrationwhen they adopted the system of care method ofcontracting, and I thought Marcy Villamonte (ph)did a really good job of sort of laying out howthat system works. And you could really see how

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a kid could kind of progress through the system.Unfortunately, when we asked other lead agenciesto do it, it's been very hard to replicate.

So I appreciate the design. It's very easyto digest, and by representing all of theserelationships, you really show the depth of thesystem of care.

MR. KURTH: Correct.MR. SACHS: You don't just show FSMO, you

show all of the stuff that FSMO makes happen.MR. KURTH: That's correct.MR. SACHS: So that's as much Family

Services -- sorry -- using your current title.UNIDENTIFIED SPEAKER: Make people put a

quarter on the till for saying FSMO.MR. SACHS: Really?UNIDENTIFIED SPEAKER: Yeah. Unrestricted

donations.MR. SACHS: If you'd change your name, I'd

never say it.(CROSSTALK.)MR. KURTH: (Unintelligible.)MR. SACHS: That's Family Services of Metro

Orlando.UNIDENTIFIED SPEAKER: (Unintelligible.)

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UNIDENTIFIED SPEAKER: Yeah.MR. WOODLEY: Excuse me. I have a

question. This is Arto. Greg, where is yourprevention programs or your prevention processillustrated on your process.

MS. DANO: That would be the diversionprevention services, and even --

UNIDENTIFIED SPEAKER: The(unintelligible).

MR. WOODLEY: Under family preservation andadvocacy programs?

UNIDENTIFIED SPEAKER: There's a little "I"that has a circle.

MR. WOODLEY: I see the "I." Okay.MS. DANO: And then community service

center supports that as well as well as our postadoption services.

MR. WOODLEY: So what -- I know whatcommunity service center is. I understand yourpost adoption services. Diversion andprevention services, what does that entail?

MS. DANO: We have a whole presentation onthat, but we have staff dedicated --

MR. WOODLEY: Later on.UNIDENTIFIED SPEAKER: Yeah.

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MS. DANO: Yeah.MR. WOODLEY: We'll wait.MR. KURTH: So one of the things, kind of

moving on, we're going to get into theorganizational structure now, Walter. Let's goahead and hand that out.

I think what is important I want tohighlight the fact that we have some kind ofcomponent within our organizational structure tofacilitate all of these various relationships.And when we talk about arrows going back andforth to our dedicated staff from a specialtyperspective or assigned for those variouscomponents. So it's not just these are all thepeople we work with. There are meaningfulroadmaps and whatnot going back and forththroughout the system.

MR. LACERTE: And I can tell the committeethat the executive committee of our board whilewe are certainly not micromanaging this process,we have -- Greg has brought this to us. We havelooked at it, we are very comfortable and agreewith this. We think that it addresses a numberof issues, but two of the biggest issues, Ithink, for us going forward is enhancing our

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collaboration with our case managementorganization partners. And also as much aspossible, integrating our county specificapproaches, and letting the folks in thosecounties know better that we're doing that.

MR. KURTH: Well, if I can move into theorganizational realignment components, it's veryimportant for us to be very sensitive to how dowe adapt our leadership to the ongoing changingcapacity that we have developed over the lastcouple of years? And with a shared servicecenter approach, with the org chart that we havehanded out, it's also very imperative to figureout what do we need to do differently from aleadership perspective.

What we want to present to you today is theidea --

MR. SACHS: Greg -- I apologize. I see alot of people getting up and roaming around.It's right at 10:30 and it would be -- youprobably want to do this for 20 or 30 minutes.There will be a lot of questions, a lot ofdetail in it, so I think it's a good publichealth break. I apologize for not keeping upwith the time. It's 10:29, let's come back at

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10:40.(A break was had.)MR. SACHS: It's about 10:40. We are

ready. Greg, go ahead. Your floor.MR. KURTH: Thank you, Walter.MR. SACHS: Rod, are you back with us?MR. LOVE: I'm with you.MR. SACHS: All right.MR. KURTH: All right. We've gone ahead

and presented you all with a new org chart, andone of the things that we want to particularlyemphasize is that within a, moving towards ashort service center component, and feedback wereceived from the community and our own casemanagement folks, is we want to have analignment that's really going to be much morecounty specific in terms of how we provideleadership out in the field.

We really want to integrate everything fromprevention to permanency, specifically, at thatcounty-based level. Ongoing placement supportas part of our placement redesign component andcertainly ongoing integration of performance andquality. And particularly a new emphasis for meis really in light of the fact that we have a

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very large provider network. It's veryimportant for us to look at how we do networkmanagement within a streamline communicationprocess going forward.

So on the org chart, one of the things thatwe want to particularly highlight is the fact,and if we go to the next slide, is the idea ofhaving two directors. One in each respectivecounty that would oversee all of the day-to-dayoperations. One of the things that weparticularly want to emphasize is the importanceof having this director be the point of contactfor the Department, for the courts, for our CMOsand for other providers as a point of contact inthat particular county.

In addition to that, is looking at the ideaof having, again, greater placement andutilization supports especially with respect towhat we're doing with our foster parents withthe quality parenting initiative. We've alreadytalked a little bit about the concept ofcentralizing placement.

The other component here with respect toongoing changes, going to the next slide, isthat with respect to quality and performance is

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really, in light of the fact that we are nowdoing the initial licensing process and doingthe actual training for both our frontline staffand that of foster parents, is reallyintegrating that stronger with respect toquality. We think that there's even moreefficiencies down the road. We really want tolook at some opportunities to partner with theUniversity of Central Florida where we've hadsome discussions of having them do some preservice training and continuing thosediscussions and dialogue.

Then there's the aspect of what I reallywant to talk about and that is the concept ofestablishing a network development director.And I think it's important that, you know, weknow we've built a lot of capacity, and yet whatwe have to do is adapt better to what we havedone in building that capacity. So the idea isto have, under the auspices of the CEO, anetwork management component that's not justabout overseeing contracts, but most importantlyabout overseeing all of the collaborationactivities, streamline communication andmanaging that on a little bit of a tighter basis

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going forward.One of the things that we would absolutely

want to do is really ensure that within thischart, and I've kind of color coded it a littlebit, is that we are looking at a staff reductionof at least a 5 percent on an annualized basis.When you look at our annualized June payroll andwhen you look at what this would cost on anannualized basis going forward, it's at least 5percent less.

What we are adding on here though are acouple of things that we currently don't evenhave that obviously looks at some otherefficiencies. One is that having ourselves takeon a little bit more oversight of the ongoingplanning for independent living both from aneligibility perspective and a coordinationperspective. So we only have a couple of peoplethat we are adding to the org chart from thatperspective.

Then IL redesign is going to be somethingthat we're looking at and partnering with ourcase management organizations --

UNIDENTIFIED SPEAKER: Which one of thesetabled organizations are we looking at here?

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UNIDENTIFIED SPEAKER: That's the new one.UNIDENTIFIED SPEAKER: Okay. Were talking

about --MR. KURTH: (Unintelligible.)UNIDENTIFIED SPEAKER: -- the second page?

I mean, I'm just -- because I'm not followingyou here.

MR. KURTH: I'm sorry. I'm just talkingabout this right now, getting away from theslide a little bit.

UNIDENTIFIED SPEAKER: Thank you.MR. COOPER: Greg, on the -- this is John.

You're talking about the IL, eligibilitycoordinator and the specialist as new positions.You have two under the CO, would you considerputting one of those each under each countydirector?

MR. KURTH: We could. Yeah. I mean, rightnow we would look at having a coordinator -- thecoordinator would be really system wide for allof the life skills components, and then we wouldhave an eligibility individual who would handlethe RTI component and whatnot.

MS. DANO: Which we could also incorporateunder our Medicaid management because that's

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what they do. They do eligibility, and that'swhat they do. They take that portion ofcriteria, making sure that the criteria is metand it's not just considering where the kid's ator what their needs might be, but they are goingto take the I guess the emotion out of makingsure that they are eligible. They're not makingan entitlement. They're making sure they meetthe criteria.

MR. KURTH: We have added on here, ofsignificance, is we've really had a lot ofrequests from PIs, especially in Osceola County,to have another family preservation specialist.We currently have three right now that includesone lead, but we want to have another one thatwould help provide additional backup because itis a challenge right now. These are folks thatare constantly on the phone and are providing alot of support services to families and to PIs.

Then the other component that we talkedabout is the addition of a relative advocatethat would be included in here as well.

What I want to emphasize is that in theend, we are looking at a little bit over 83 1/2DCF funded positions including all the indirect

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and direct components that would be funded bythe contract. Actually, a little bit over 10percent of the staff would actually be eitherpartially funded by the Department or fundedelsewhere with respect to contracts and grantsthat we have.

All of the components that are in purplewould be absolutely brand-new positions thatwould require folks to apply for thesepositions. They would be new job descriptions.Everything in blue are some current positionsthat we have, but we would have to augment thosejob descriptions and whatnot going forward.

Then obviously on the very, very back thereare certainly a number of positions that wewould eliminate as it relates to creating newpositions and whatnot on this perspective orgchart. This is something that we would want tocertainly get additional feedback from everybodyabout.

I think going back to your questionearlier, Walt, is obviously everythingunderneath the Osceola director would be placedwithin Osceola County. And then there areopportunities in licensing and training and even

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eligibility to actually look at some of thoseother positions to be placed within OsceolaCounty as well, even though they may notnecessarily report to that particular countydirector.

MS. MURRAY: This is Dawn. Greg, can youclarify on the second page UM specialist and UMcoordinator, it says gray is not funded by DCF.Who funds those positions?

MR. KURTH: That's the administrativedollars that we get as part of the partnershipthat we have with a child welfare behavioralpartnership.

MS. KOGUT-LOWELL: This is Mary. I have aquestion and maybe I missed this one when Iwalked in, is this pretty much, I mean, I knowyou said you are open to feedback, but is thispretty much a done deal and has the boardapproved it?

MR. KURTH: The executive committee hasbeen involved in providing feedback to me withrespect to ideas around the organizationalchart. The board doesn't necessarily have toapprove the org chart per se. They do approvethe overall budget and whatnot, but I certainly

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consult the VIP executive committee on that.But it is not a done deal in the sense thatwe've rolled this out to staff yet. Obviously,we certainly have some abilities to get somefeedback and whatnot.

MR. LACERTE: And the board will be fullyinformed. That's a very good question. Theboard will be fully informed.

MR. SACHS: Is the board supportive of theredesign?

MR. LACERTE: Yes.MR. SACHS: Okay. Just on the general

(unintelligible).MR. KING: This is Randall King. You did

mention one thing that I wanted to look at is Iwanted to get a complete org chart and I wantedto compare that with the job descriptions to seeif the eliminations and mergers of positionsdidn't heighten any risks.

MR. SACHS: Nothing fall through thecracks.

MR. KING: Right. So that's what they aredoing for me, so as soon as I get that and I cancompare that with the risk, then I can kind ofsay okay, I'm good. We've already made the

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decision that these are something that need toget done going forward. This is just a matterof doing it so that we don't have(unintelligible).

MR. LACERTE: And we discussed this atlength in our Friday, October 1 board meeting.

MR. SACHS: This is Walt again. On page 2,Orange County director, Osceola County director,can we walk through the variances between thetwo models? And where there is norepresentation in Osceola County for somethingin Orange, why? And where there is norepresentation in Orange for something inOsceola, why? And if you can just go through itas it's listed, that would help me.

I see two program specialists boxes, I havean issue with that. That's a size issue.

MR. KURTH: Right.MR. SACHS: But I see a school services

coordinator, part-time, then later an educationliaison, education liaison being in both -- thisis mainly for Rod who can't see this -- but noschool services coordinator. Is that part of aneducational liaison or a completely differentrole that has no purpose in Osceola?

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MR. KURTH: Well, in Osceola County --well, let me back up. In Orange County wecurrently do fund two educational liaisonpositions right now. We added one last year inOsceola County after we piloted in Orange. Theidea of the school services coordinator, thatwas partially funded in the past by a grant thatwas through the United Way. And we are lookingat converting components of that person'sposition into an educational liaison function.

So we'll probably not quite have fully twoeducational liaison components within Orange,but we will have one in Osceola County.

MR. SACHS: So those educational liaisonsare not new?

MR. KURTH: They are not new. I'm sorry.They are new. On our org chart they are not newin the sense that they are currently fundedwithin the current contract.

MS. DANO: The school services coordinatoractually falls under the community servicecenter and provides school-based angermanagement services currently.

MR. SACHS: Completely different thaneducational liaison --

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MS. DANO: Right.MR. SACHS: -- they don't have any real

relationship with each other?UNIDENTIFIED SPEAKER: Yes. As part of the

community service center in south Orlando.MR. SACHS: Okay. So then let's go down to

CSC manager, coordinator, receptionist andpublic ally.

MR. KURTH: The community service centermanager, that's the community service centerthat is located on south Orange. We do supportOsceola families though. The receptionist isobviously there to help maintain the building,and the direct assistant specialist is there tohelp with the emergency assistance funds that ispredominantly funded through the United Way.

Again, we do have available dollars forboth Orange and Osceola Counties. They justhappen to be located in Orange County. Then thepublic ally is really the entity that is goingto help with the mentoring. We talked aboutpublic allies last week. We are going to havetwo of those allies. One is going to helpoversee the mentoring. That person is locatedat the community service center, but we do have

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mentoring that they are overseeing in both GreatOaks Village and Sunnyside.

MR. SACHS: And if that project werereplicated in Osceola County funded partially byyou guys and part by the CSC, then you couldhave a similar model in Osceola County?

MR. KURTH: Right.MR. SACHS: Even though the current model

serves both?MR. KURTH: Right.MR. SACHS: The other green in the Orange

County is the direct assistance specialist?This is something that you partially funded?

MR. KURTH: That's correct.MR. SACHS: What is its purpose, and why is

it not also replicated in Osceola?MR. KURTH: The direct assistance

specialist, part of that is, again, that is partof the United Way dollars that help fund thatposition to help manage United Way emergencyassistance funds. And then there are some otherfunds that are made available to us that don'tnecessarily flow through our income statementthat the United Way makes available.

Again, those dollars are available to

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Osceola residents, but that direct assistanceperson just happens to be housed on south OrangeAvenue.

MR. SACHS: Okay. And then the otherquestion is on the Osceola model you have afoster parent assistant and no foster parentassistant in Orange.

MR. KURTH: We have a foster parent liaisonfor the whole system which is just a little bitabove, Walt, reporting to the COO. What we havedone is we want to make sure that we had aparticular assistant just for the Osceola folks,and going forward we are going to have a publically devoted just to foster care recruitment aswell in Osceola County.

MR. SACHS: So that foster parent assistantrelates to this foster parent liaison?

MR. KURTH: Yes.MR. SACHS: Up top?MR. KURTH: Yes, sir.MR. SACHS: And there is some relationship

to recruitment?MR. KURTH: Yes.MR. SACHS: In the uber chart? Is that the

same director of quality? Where is recruiting?

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MR. KURTH: Recruiting is right now isembedded under quality and licensing. Going topage 3, we have a community advocate who is amarketing person. One of the things that we gotfeedback around from quality parentinginitiative, was the idea of getting more of amarketing person to assist in that process.Right now she has done everything from adoptionrecruitment, supporting the Heart Gallery, isout there managing ongoing recruitment, takesall the phone calls and will be overseeing anally who will be housed in Osceola County.

MR. SACHS: So if you're problem today isfoster homes in Osceola County, it's recruitingand retention, I don't understand why thereisn't a motivated part of your org chart that'sdealing with that. It looks like it's -- itlooks like you're giving it a little ofattention by a putting an assistant over there.I've got some people to work with, and we hopethat Osceola gets better.

It really doesn't look like a motivated,concentrated, ongoing problem design solution asfar as your org chart goes. Maybe I am undervisioning what your vision is, but I can't see

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it from the people that are dedicated to it.MR. KURTH: Okay.MR. SACHS: And maybe I'm just not seeing

it.MR. LACERTE: I would add that we are

dedicating board and community resources to thatproblem as well. (Unintelligible.)

MR. DEBOARD: You are dedicating what,Grant?

MR. LACERTE: Board -- board resources anddrumming community involvement and --

MR. DEBOARD: What does dedicating boardresources mean? I've heard that two or threetimes today.

MR. LACERTE: Nancy Ellis is a member ofour board of directors and she's chairman of theOsceola County foster parent initiative. We'vealready had at least one or two events torecruit foster parents to raise awareness of theissue, and she's taking this very seriously.And we are going to have more events through herleadership.

MR. DEBOARD: Thank you, Grant.MS. LIS: If I can just add to that too.

This is Melinda. I mean, the best recruitment

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is really foster parents themselves or adoptiveparents. We've really hooked in tightly withthe association, they are not here today, butthey are very committed to that. And that'sreally, I mean the staff people who go out andrecruit, they can do some, and it's importantyou have to have that, but really your bestrecruitment tools are going to be the peoplethat are on the ground who have done it, and arewilling to go out. And we have that commitmentin Osceola, and we have this reunification --this group that's been working, they've mettwice now, to really drum up the community, thechurches, everyone there to really get into howdo we get more people in this county to reallywant to step up to the plate.

MR. LACERTE: But if I understand Walt'sconcern, okay, what staff resources are youdedicating?

MR. SACHS: Yeah. I think it ought to bepart of the next three years mission statement.You know, because -- I mean, Nick has addressedthis now five times at least.

MR. COX: Not doing it again.MR. SACHS: This dependence on residential

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group care is specifically related to the lackof foster homes in Osceola County. The heavycritique we hear is that Osceola kids are beingplaced outside of the county. Solution, getmore foster parents in Osceola County.

MR. KURTH: Absolutely.MR. SACHS: Where is the org chart driving

that? Where is the -- maybe I'm just not seeingit, and I apologize.

MR. KURTH: One would be the communityadvocate component, Walter. Two, the fosterparent liaison is heavily involved in supportingthat process. We're dedicating a public ally tothat entire process. What you also don't see onhere is a public ally that's also a FloridaUnited Methodist Children's Home. It's alsodedicated solely for Osceola County.

So it's kind of like -- I can see whereyour concern might be. It's in little differentbits and pieces, but in terms of our processthere is a coming together with respect to whatwe are overseeing.

MR. LACERTE: You mentioned our missionstatement. This is a part, a critical componentof the boards strategic plan for the upcoming

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years. We have to solve this.MS. NORTON: From just a higher level, you

know, when you look at the quality departmentwhich has quality management, trainingresources, adoption and licensing as well asrecruitment, then all these resources reallyjust through organizational structure of thisdepartment are available to assist with that,determining what the need is. I mean, many ofthe initiatives that we've talked about andwe'll talk about later today, have come out oftaking a look at what the current practices andwhether or not children's needs are met.Whether or not they are satisfied in theirfoster home. With the rate of placement in thecounty is. Those are the things that come outof quality and performance.

And then in terms of training, trainingfoster parents, opportunities for efficienciesamong our training staff and those folks withinthe licensing entity that provide thepre-service training for foster parents andadoptive parents. The crossover of licensingand adoption within one organizational setting.To recruit for adoption is to recruit for foster

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care and vice versa. Many people come to usthinking they want to do one thing and end updoing something very different. So there arespecific resources in place within the structureto support adoptions, very specific targetedadoption recruitment and a specific public allyspecifically for Osceola County who reports tosomeone who on a broader scale on a systematic.You know, looking at the whole system is reallygenerating -- that community advocate is theperson at the front door, the person chargedwith hooking foster parents, supporting them,meeting their needs, giving them information andsupport they need so that they'll continue onand hear a little bit more about what fosteringand adoption is going to be.

So it's just a whole loop from what weneed, how are we going to get there, how are wegoing to do it? Let's train them and then let'smeet their needs. So it all happens within thisone structure.

MR. DEBOARD: I've got a question. I'dlike to get away from foster parent recruitmentbecause I think we covered that already. Here'smy question on your table of organization and

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how it relates to dollars and cents, services inthe community for both Orange and Osceola.Based upon your current organizationalstructure, what percentage of your current staff-- how many current staff do you have at FamilyServices right now?

MS. NORTON: 90 (unintelligible).MR. DEBOARD: 90. How many -- what is the

percentage of those 90 staff that are going tobe placed directly into the community providingdirect services so to speak as opposed toadministrative services with what they providenow? You know, how many is that? Is it five ofthose people? Is it six of those people?

And do you see that as creating moneyactually going into direct services as opposedto administrative overhead which is kind of theway I view it at this point in time? In otherwords, you know, you've got 95 staff in your newtable of organization, how many of those peopleare going to be in, you know, providing directservices to the community? Like, you know, yourcounty directors are, obviously, that's directservices in the community and supporting what'sgoing on with your CMOs, so on and so forth.

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So what's the percentage of staff that'sgoing to be down in the community and what doesthat equate to on an annualized basis? If youfigured that out yet.

MR. KURTH: One of the things, Shane, Iwould say that we are not proposing reallyanything different in our fiscal administrativeindirect components and whatnot. We are addingadditional services here with respect to thecounty manager. We talked a little bit about anadditional family preservation specialist, butreally the vast majority of this is out in thefield in some capacity.

Right now we have about 65 or 70 staff atthe main office. We want to have some folks,especially like some folks in licensing, if wehave enough space in Osceola County to have twolicensing folks there, we'll put them there.Right now we have five allocated positions doingthat, so we want to split out based on who canfocus on what county and do what we can tohousing in that respective county.

MS. NORTON: In fact, those folks are outthere. You know, training doesn't happen in theoffice. It happens in Osceola County. It

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happens at locations in Orange County(unintelligible). Training, under the trainingdepartment that happens, you know, we dopre-service training of staff, but we have fieldinstructors. These folks also are in theservice centers providing field instruction tostaff within the service center. So thosepeople would be assigned to CMOs within theservice centers. Which they actually are now.

MR. DEBOARD: Right. I'm just trying toidentify it because this is one of the thingsthat I brought up with the other providerthat's, you know, competing for the contract andI just want to be fair and ask the same questionof you guys.

MR. KURTH: Yeah. I think -- we didn't getdown to actually every position which is in whatcounty, Shane. I think -- we know we can giveyou that specifics, but right now we're givingyou at least of the process of what those actualpositions are. But we can definitely give youwhat we believe will be located in each county,then also what's indirect in terms ofcentralization.

MR. SACHS: There's no doubt that these

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seven would be in Osceola, these listed underOrange would be in Orange.

MR. KURTH: Correct.MR. SACHS: There may be others staff

co-located in those service centers to come, butthey are not there yet. That's a three-yearproject that come out of your quality units,that come out of your leadership unit, but theCFO staff would stay at the headquarters level.

MR. KURTH: Right.MR. SACHS: The admin that is known today

as admin would be admin. What is known tomorrowas service delivery would be more distributedbetween Osceola and Orange (unintelligible).

MR. LACERTE: That's exactly right. Andunfortunately -- I'm sorry to interrupt. Thisis Grant. I have to go and I'm not going to getto see the rest of you, at least in thissetting, and I'd be remiss if I didn't thankyou, each and everyone of you for yourdedication to our children and your dedicationto the community. And if we're fortunate enoughto be awarded this contract, I know this processwill have made us a much better organization.Thank you very much.

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MR. KURTH: Thank you, Grant.MR. COX: Thank you, Grant. Good seeing

you.MR. WOODLEY: Greg, I have a quick

question. This is Arto. In terms of yourcounty directors, how will they manage -- I seeyou have a person reporting directly to you forstakeholders and committees, but how will theymanage relationships in a separate counties?Will that happen through your office or willthey have someone within their organizationalstructure that would have the communityrelations and development, resource development?

MR. KURTH: Most of the relationshipmanagement in terms of working with ourstakeholders on a field basis, would be handledby the county directors. We would want theminvolved in corporate relations, but we wouldcertainly want to have a way for us toadequately support them and whatnot. So to theextent that we can look at a community relationsor corporate relations person that we can havein each respective county, we would look atthat. We don't have that right now because ofjust the fact that we only have a couple of

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folks doing that, but we would definitelysupport them being involved in networkrelations, in being the county contact, beingthe face of the community for the community andreceiving some support and whatnot.

Let's be realistic about how much corporaterelations stuff they can do because we look atthem really predominately driving performanceand being the liaison with core and othersignificant stakeholders out in the field.

MR. WOODLEY: It's the same question that Iasked the other provider whose bidding for thecontract. That's a big job, just doing therelationship piece in the community outside ofthe work with the children is really twoseparate jobs. So I just encourage you that youlook at it. They are both independentlyimportant, but you have to think that throughbecause part of the challenge that you are goingto get is how people relate to you and how didthey engage, but also how do you serve. Sothat's very important if you want to maintainand build your relationships in Osceola andOrange to really think that piece through.

MS. SCOTT: I have a question. I know you

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talked about the public ally being placed inOsceola County for foster care recruitment, butisn't that just a 10 month job?

MR. KURTH: It is a 10 monthapprenticeship, yes.

MS. SCOTT: Okay.MR. KURTH: And then we would look towards

continuing that every year.MS. SCOTT: But it would be then a

different person --MR. KURTH: Yeah. Well, what we could do

and part of it would also be is if we could lookat leveraging and going into a full-timeposition down the road as well. But yeah, itwould be a different person next year. Itdefinitely is a 10 month apprenticeship and itcould be, I think, there's an opportunity torenew for one year.

MR. MAWOUSSI: Yeah.MR. KURTH: So they could possibly do it

for two years based on the program allowances.MR. SACHS: Greg, this is Walt. On the

last page, you have a listing of closed andrepurposed positions. The two that kind of jumpout at me, and there probably should be more,

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adoptions subsidy eligibility specialist and DDspecialist. Are those repurposed into likepositions elsewhere doing the same job and justnot called that anymore?

MR. KURTH: Yes. On the DD specialist wehave somebody right now who is mainly both theliaison with APD. We'd like to have thatposition be a little bit broader. We arecalling it an out-of-home care specialist, butthe main focus would not be lost with respect toAPD.

MR. SACHS: And adoption subsidyeligibility?

MR. KURTH: Adoption subsidy eligibility wewould like to repurpose that into the ILeligibility. We think that we can -- we do havean adoption specialty -- I'm sorry. We do havean adoption eligibility specialist that we wouldmaintain in-house, but we have two positionsright now. We would look at converting one intothe IL component.

MR. SACHS: And the other question with thechart is I know that your model of a proposedco-located system is a three year developmentmodel.

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MR. KURTH: Correct.MR. SACHS: With board approval, how

quickly would this table of organization beimplemented?

MR. KURTH: Great question, Walter. Mygoal would be -- I think it would be a littleambitious to do it by January 1, but we woulddefinitely look towards by February 1. Somepositions we know we really want to do somethingfirst in Osceola County with respect to theOsceola director. But in terms of getting jobdescriptions in place, posted and then lookingat internal and even some external candidates, Ithink we could get everything in place by theend of January. That's taking into accountholidays and some other things.

MR. SACHS: Sure. Thank you.MR. KURTH: I do want to emphasize this is

something that we would love to continue toreceive some feedback on, so these aresituations that we are absolutely open to getsome feedback on.

MS. KOGUT-LOWELL: Greg, one question.This is Mary. The Osceola director and theOrange County director, I mean, I know these are

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new positions, I'm just curious, I mean, howwould you envision -- what process would you gothrough to fill those? How would you look forthose folks? And I'm certainly not asking youto name names or anything, but --

MR. KURTH: Sure. In terms of recruitingand whatnot?

MS. KOGUT-LOWELL: Right.MR. KURTH: I think it's very important to

look at somebody who has actually done fieldworkbefore and overseen a program. These are folksthat have to understand the court system. Theyhave to understand child welfare. They have tounderstand CFSR. Certainly having somecredibility within the county. Understandingthe way the courts work, would be terrific.Understanding how to really work incollaboration with our case management partners.

Those folks are really going to be zeroedin on those CFSR components. It's going to be ahuge component of their job description andwhatnot. So looking at them as prettysignificant, high-powered child welfareprofessionals.

MS. MURRAY: Greg, this is Dawn. Question

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on your CO. First of all, this gray one is thatyour current CO? Okay this is your proposed?

MR. KURTH: That is correct.MS. MURRAY: Could you give us a crosswalk

-- I know you probably don't have it today, butcould you give us a crosswalk of the compositionfirst as your converting into your new positionsbecause it's a little confusing following who iscurrently doing it, who will be doing it nexttime or is it something that's going to go away?

MR. KURTH: Are you talking the position orthe person?

MS. MURRAY: The position.MR. KURTH: Okay.MS. MURRAY: Compare the person itself, but

the position in the duty that's being done now.Like for example, you talk about the(unintelligible) one person would be going away.

MR. KURTH: Correct.MS. MURRAY: Well, who's going to be doing

that on your proposed chart? Could you sendthat to us?

MR. KURTH: Okay. Yeah. Okay.MR. KING: (Unintelligible.)MR. KURTH: Yes.

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MS. MURRAY: That would be helpful in thisprocess because looking at this, it just lookslike that duty, that job duty, is going away.And I'm sure that's not the case --

MS. NORTON: That is not the case.MS. MURRAY: -- but we need to know that.MR. KING: This is Randall. This is why I

asked why. And I wanted to know what was goingto go away and how it was going to transition soI could physically see if there was going to beany mitigated risk that was going to go up orthe position is going to be filled, are theservices still going to be provided or are kidsgoing to be gapped out. That's the part that Iasked that you give to me, and Greg has giventwo weeks to be able to give that to me so Icould look at it, so that I could becomfortable.

MS. MURRAY: And I understand that, but wereally don't have two weeks.

MR. KURTH: We can get something to you inthe next day or two. I mean, much of it ishere, Dawn, in the sense of we do know wherethese activities are going to be fulfilled withrespect to the org chart, so we can do that.

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MS. MURRAY: Okay. Great.MR. KURTH: These are these eliminated

positions, and then I'll go ahead and crossreference the actual new positions. And then wecan try to put a little description of what'sgoing to be (unintelligible).

MS. MURRAY: These positions areeliminated. They do A, B and C, but now thisnew position will be doing their duties.

MR. KURTH: Okay.MS. MURRAY: So we know the job isn't going

away. Someone is still doing the job.MR. KURTH: Yeah. Some jobs are going

away, some components are going away.MS. MURRAY: Okay.MR. KURTH: But then we're going to be

looking at creating some new components goingforward. Like the new family preservationspecialist, that's a new position.

MS. MURRAY: Okay.MS. SCOTT: I see that the director of

clinical services is going away. How is that,you know, when we talk about doing MPTs, LOCs,those types of stuff that are usually run by youall. Where does that fall?

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MR. KURTH: That would be under thedirector of placement and UM, Lesley.

MS. SCOTT: Okay. Is there a -- I don'treally see like a clinical person there, maybeI'm --

MS. LEWIS: Well, the person that would bein that position would have a clinicalbackground. And then we've also made sure thatthe CMOs have a clinical component with ourclinical coordinators, and the meetings withthem will continue weekly. So they are verymuch aware and attend the placementstabilization, the MPTs, LOCs.

SERGEANT GLACIER: Greg, this is Scott.Greg, what was the catalyst for thisreorganization?

MR. KURTH: The catalyst for theorganization?

SERGEANT GLACIER: The reorganization.MR. KURTH: I think probably beginning

about a year ago as we really got strongfeedback from our foster parents. They reallywanted us to take in placement in-house. Ithink that as we also had some discussions withcase management organizations, they gave us some

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perspectives of definitely saying hey, we reallywant to be much more involved relative tocollaborative planning.

And we did not necessarily have thestructural process in place to really facilitatethat. And I think certainly with the idea of --particularly with the idea creating a greaterbranding presence in both counties that's beenpart of our strategic planning process, reallylooking towards how do we do that in line withthe shared service center model.

MR. KURTH: Okay. Moving forward. I justwant to very quickly last week I think you hadasked this, Walt, about what kind of thingscould we do if we had a little bit of additionalequity. We'll go to the next slide here. We'dlove to get rate increases to our fosterparents, a lot more additional supports thanwhat we have right now. We certainly would loveto have a lot more early engagement activitieswith investigators.

We are going to talk to you a lot about DJJand wraparound a little bit later on, but theseare certainly areas we'd love to take you in toanother level. And certainly the enhancements

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that we would like to propose in our softwaredevelopment system called IRIS. We'll talk toyou about that a little bit later on. Andobviously looking at any other feedback from thecommunity of what's most important.

MR. SACHS: You might actually staff IT upa little bit.

MR. KURTH: Staff IT up a little bit.Any other questions?MS. DUNCAN: This is Carolann. I asked

last time about the percentage of administrativecosts on your total budget. How will thisreorganization -- well, I don't know, you weregoing to get back with us on that?

MR. KURTH: On the indirect admin?MS. DUNCAN: Just on the admin.MR. KURTH: It's really not going to have

an impact, much of an impact at all in terms ofa percentage basis because we're not looking atany major or significant staff changes on theadministrative side. It's really driven byoperational changes and whatnot.

Okay. Were going to go ahead and move on,Walt, and I know we are a little bit behind.I'm going to try to speed it up a little bit,

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and let's get into the whole case transferprocess right now with respect toinvestigations.

MS. LEWIS: Okay. This is Beth speaking.I'm going to go through this rather quickly. Ithink this is one of our strengths. So if wecan go to the next slide. The case transferprocess, a PI makes a decision to either removethe child or leave the child for in-homeservices, and basically call Family Services toschedule staffing.

We send out a calendar of the staffing toall of the appropriate parties. Then theresource specialist which is a Family Servicesemployee picks up the packet and reviews itprior to the staffing. At the case transfer orthe ICC staffing is facilitated by the resourcespecialist between the case managementorganization and the PI.

One of the strengths is that the resourcespecialist can make referrals at the time ofstaffing or immediately following, and then wehave worked out a process with the Departmentwhere we track the same documents if the PIdoesn't have everything and they work directly

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with the resource specialist to ensure that thattakes place to the case management organization.

Are there any questions on the process?MR. SACHS: This is Walt. PI doesn't have

everything in the packet, embarrassingly low,what is your philosophical decision point?

MS. LEWIS: There are certain things thatwe've worked out with the Department thatabsolutely have to be there, but they may nothave --

MR. SACHS: Give me an example of somethingthat absolutely has to be there.

MS. LEWIS: That absolutely has to bethere. The case has to be built in FSFN.

MR. SACHS: Okay. If it's not, whathappens?

MS. LEWIS: Then we re-staff the case, butthat is checked prior to the staffing. So mostof the time they don't ever get to the staffingwith that happening.

MR. SACHS: Okay. So give me an example ofsomething that happens.

MS. LEWIS: A CBHA referral.MR. SACHS: That is critically important.MS. LEWIS: That is critically important?

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MR. SACHS: Something that you have tohave, and it occasionally happens, and you haveto deal with it.

MS. LEWIS: A relative home setting notbeing done.

MR. SACHS: So what happens then?MS. LEWIS: We follow up on it. If the

child is already placed and the PI has alreadyplaced the child, we will follow up on it. Andthey are good.

MR. SACHS: Would you accept the case, andmove forward.

MS. LEWIS: Generally we do. Generally wedo.

MR. SACHS: I hate that I got to deal withthe equivocation. What does "generally" mean?When do you not and why? You've experienced itbefore obviously, you said generally you acceptall cases.

MS. LEWIS: I can't give you an exactexample. The thing that we push back the moston are when the cases are not built in FSFN. Wewon't staff the case, and everybody's on thesame page.

MR. SACHS: Then you guys pretty much know

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that before the staffing, right?MS. LEWIS: We know that --MR. SACHS: You can tell, right?MS. LEWIS: Yes.MR. SACHS: So you're not wasting the

energy of driving to it and sitting down andsaying wait a minute. It's not built in FSFN.You know that before?

MS. LEWIS: Right. There have beenconversations at the staffing where FamilyServices is pushing back, and that has been aproblem. And we have addressed that with thestate because my staff are -- if the PI has madethe decision to remove, then they can not pushback. They need to go ahead and staff that. Sowe've had to work with the Department on that,but generally those are our issues. So when Isay we push back, it's been because we've pushedback inappropriately.

MR. SACHS: Okay. So what I'm hearing isFamily Services is there to make sure thecontinuity of case management occurs?

MS. LEWIS: Yes.MR. SACHS: And that even though there are

some issues in play, that as opposed to being

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the line of "no," you are how do we get to"yes"?

MS. LEWIS: Yes. That's what we try to do.MR. SACHS: Okay.MS. LEWIS: So that's why with the missing

documents, we wanted to be able to follow up onthem. Sometimes the PI just can't get them, andit's staffed right away. So we want to trackthat and make sure that that transfer takesplace without impeding services getting to thefamily.

MR. SACHS: Thank you.MS. LEWIS: These are our strengths and

strong working relationships. We can makeimmediate referrals that the resource specialistcan do. I think there is strong communicationbetween the resource specialist and diversionspecialist and the PIs and the ability to divertcases. Sometimes, not always, but sometimeswhen it gets to a staffing things have changedwithin whatever was going on when the PI madethe decision, and we would put that case in aprevention, diversion model rather than(unintelligible) out-of-home. That's rare, butsometimes that happens.

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Any questions?MS. KOGUT-LOWELL: I have a question. This

is Mary. Let's talk in terms of generalities,how soon after shelters does the case transfertake place?

MS. LEWIS: We like to do it within fivedays, sometimes it can be as many as eight. Andthat's for cases that are in out-of-homeparticularly cases that are paid license care inout-of-home. Other cases, the in-home cases,again, it can go up to 30 days depending on thePI working the case and when they decide it'sgoing to become an in-home case or not.

MS. KOGUT-LOWELL: Okay.MS. LEWIS: We track all of that.MS. KOGUT-LOWELL: The reason I ask, I know

at the dependency summit at the breakout sessionthere was some discussion about having atransfer much earlier on.

MS. LEWIS: We are going to get to that.MS. KOGUT-LOWELL: Oh, you're getting to

that.MS. LEWIS: Yeah. I'm going to get to

that.MS. KOGUT-LOWELL: Okay.

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MS. LEWIS: So these are the strengths thatwe currently have. Given that you just saw whatwe were proposing as far as reorganization, sothe enhancements, and I think this will answeryour question, Mary, is the county managerswould have the authority to adjust the ICCstaffing, the initial transfer of services fromthe PI to services to meet the county specificneeds. So that would be between whatever theCLS, the PIs, the case management organizations,the county manager, we would work that out sothat it would make the most sense for thatparticular service center, for that particularcounty.

We have always invited, and this actuallyhas increased, since our inception we've alwaysinvited the families and we would like to seemore of that happening at the initial casetransfer. We like to have some family teamconferencing and wrapping the families tighter,particularly when they are going into relativeplacement. Make sure there's relatives have thesupport that they need. We believe that havingthe families there and having these additionalsupports will build a solid base for our case

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plan as we work towards that.We track all of the data, but our database,

IRIS, that we have has all of that informationin it as far as the missing documents, the kindsof cases that are coming in, the different --all of the information -- it takes all of theinformation from FSFN as well as informationthat we have at the front end staffing. We canpull reports and it will help us analyze what'sgoing on, and will also show trends and thingslike that which we are really excited about.And that is IRIS, our Integrated ResourceInformation System.

So are there any questions? This is -- weare really excited about -- this particularmodel will, I think, address many of theconcerns regarding being able to staff the casesmore quickly.

MS. MURRAY: Beth I have a question.MS. LEWIS: Yes.MS. MURRAY: This is Dawn. Do you have

increased parent participation at the ICCstaffings, how do you propose to do that?

MS. LEWIS: Well, the PIs have beeninviting them, but I think if we were working

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together in the community with the countymanagers, working together with them, that theresources we would be able to -- we would beable to do that. Right now they are in theservice centers. It's more complicated. I'mnot sure that -- I'm not sure that having themin the county would make a difference, but Ithink -- they weren't coming at all, and I thinkit's at 25 percent in Osceola. I would reallylike to see an increase in Osceola, and I wasjust thinking that with the county managersbeing there and the PIs being available to makethe staffing more frequent as needed, that wewould see an increase in families being able tobe there. Right now it's two days a week.

MS. MURRAY: So your proposal of increasingparent participation is because you have moredays? Is that what you're saying?

MS. LEWIS: I think that might help, yes.MS. MURRAY: I'm just trying to figure out

how you're going to do it. That's my question.MR. SACHS: This is Walt. Is there any

models in the state where they have incentivizedparent participation that you've looked at andseen any opportunities for that?

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MS. LEWIS: I don't know that.MR. SACHS: Are there other resources that

could be made available to the parent at thestaffing that might encourage them to come? I'mjust thinking how far outside the box have youthought about this.

MS. LEWIS: I haven't thought aboutincentivizing the parents. I haven't thought ofthat.

MS. LIS: Transportation is always a bigissue.

MS. LEWIS: That is a concern.MS. LIS: That's one of the biggest issues.MS. LEWIS: And we were going to add more

transporters in Osceola County, so that could besomething that we would look at. Again, itwould be a shared approach toward the ICC,having the families there, obviously, having thefamilies there, it's not going to make anydifference. We can't do the family teamconferencing or the wrapping of services, if wedon't have the voice from the family.

So we had thought about the increase intransporters particularly in Osceola because Ithink our participation in Orange County is at

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50 percent or higher.MR. SACHS: This is Walt. It seems to me

that if you're going to make that level ofenergy to do this the way that you want to doit, that you would put a lot of resources behindgetting the parents there because it sort offalls apart if the parent isn't there. So thereought to be motivation for your staff to helpthe PI or whatever. Whoever is trying to managethe parent participation, that's where theresources need to be directed to incentivizethat incentive.

I don't know how to send the message, butyou know what I'm saying. And if it all fallsapart because they are not there, then we oughtto be putting a whole lot of effort into gettingthem there.

MS. LEWIS: And I didn't want to say, but Igo back to the transporters. I didn't want tosay to Dawn we will go get them because I don'twant to make that decision for the countymanagers, but the ability to make thosedecisions would be within the county managersjurisdiction. And they would be able to addressthose kinds of things.

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MR. KURTH: One thing that we've talkedabout is having what we call our parentadvocates who could go out to those parents andsay, hey, you know, I've been in your shoesbefore. I understand what this is all about andlooking at them to engage those parents and helpthem. Some of these parents might not want toget transported by one of our workers, but theymight feel a little bit more comfortable with aparent advocate.

We talked a little bit about the relativeadvocate, but those are some areas that we candefinitely look into with respect to a parentadvocate.

MR. COX: Isn't it sad that we have to sithere and talk about incentivizing parents?

UNIDENTIFIED SPEAKER: Yeah.MR. COX: Has nothing to do with it, I'm

sorry.MR. SACHS: (Unintelligible.) This is Walt

again. The relationship with the PI, sheriffs,would you advocate for, against or are youneutral on Osceola and/or Orange County sheriffstaking over PI?

MS. LEWIS: If you're asking me

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specifically, I'm neutral on it.MR. SACHS: You are neutral on it.MS. LEWIS: I am.MR. SACHS: What about family services in

general?MR. KURTH: We've never discussed it. I

know in the past a lot of sheriffs departmentshave gotten a lot of new money in terms oftaking over from previous investigations fromthe Department. I mean, I would like us to lookat how do we have those dollars also be sure ofthe services as well. So I mean, I personallyam neutral on it. I think it's really importantto focus on the relationship in terms of what'sgoing on.

MS. NORTON: Has Osceola County(unintelligible)?

SERGEANT GLACIER: We have spoke about itat great length. To go temporally it goes allthe way back to Mike Watkins, and then we'veactually sat down with Karen Hansel anddiscussed it at great length and it's one ofthose issues that I think will continually be onthe table. It's never something that has beencompletely pushed off the stove so to speak.

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MR. COX: It gets sidelined with theeconomy and the budget, right? That's how it iswith my other sheriffs.

MS. NORTON: Generally, it's a little bit-- in Seminole, when Seminole took over forexample, and they cost the sheriff's officethree times as much to deliver the services tothe DCF. So I think probably finances is goingto play a huge role.

MR. SACHS: It cost them that much --MS. NORTON: Yes.MR. SACHS: -- or they were funded that

much?MS. NORTON: They -- okay. Thank you.MR. SACHS: That's a whole different

perspective.MR. KURTH: Oh, yeah.MR. SACHS: Unless (unintelligible) gives

you three times as much money, it doesn't costthree times as much, they spent three times asmuch.

UNIDENTIFIED SPEAKER: It cost the state --MR. COX: As the home of four sheriffs, I

love my sheriffs.MR. SACHS: I agree.

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MR. COX: I love my sheriffs.MR. SACHS: Again, it goes back to the

argument of community based care. If we hadn'tdone this, we would still be putting $400million into child welfare. We are now putting$700 million into child welfare. That's a goodthing.

UNIDENTIFIED SPEAKER: Well I think it's adifferent --

MR. SACHS: If we have now triple fundedsheriffs, we're putting triple funding towardPI. Let's all celebrate. What my concern isthat if it's true cost, then that's a realissue. If it's not really cost but we actuallycan now do more in PI than we ever did before,that's a good thing.

MS. NORTON: I think it's the model. Youknow, because this model is very different fromwhat an investigator --

MR. SACHS: And the perspective I'm gettingfrom Family Services is that you all are neutralon the issue? If the issue comes up, youwouldn't wiggle either way?

MR. KURTH: We would want to be engaged inthe process. We absolutely want to sit down

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with Family Services and talk about that. Wejust don't have the experience of working withthe sheriffs, I'm sorry, so we don't have aperspective one way or the other.

MS. LEWIS: And then finally, just toclarify in regards to the parents, because wewant to do FTC, because we want to do wraparoundand having the parents at the table, we wouldwant to share that responsibility and engage ourCMOs to have them have that vision as wellbecause it's going to start at the verybeginning. It's going to start with engagingthem from the very beginning and getting theminvolved with the process.

MS. BALL: Are we ready to move intoenhancing Osceola provider network?

Family Services has increased the focus onenhancing the Osceola provider network certainlyover the last couple of years. I think, youknow, we've had a lot of discussion in thesemeetings even about Osceola County and I thinkeveryone is already aware of the particularissues, and it is a challenge within OsceolaCounty (unintelligible).

What I'm really proud to say is that we

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have some extraordinarily dedicated staff withinOsceola County who've worked really hard withour case management organizations, the providersout in Osceola County and stakeholders out inOsceola County. It's just an extraordinarilydedicated group of people who have advocated forOsceola needs being met, and I think we've gonea long ways towards that. I think obviouslythere's more to be done. What I'm going to betalking about are some of the things that wehave done and some things that are in process.Many of these things we've actually alreadytalked about, so I will do my best to not boreyou going into great detail on things we'vealready spoken about. If there's something thatneeds clarification, you can ask.

We have spoken a lot about the highinstances of domestic violence within OsceolaCounty, so obviously there's a need for expandeddomestic violence support. Some of the thingswe've done are expanding our funding to Help Nowwhich is a domestic violence shelter.

Within Osceola County where we fund a childadvocate, and then we've added also a positionwhere we are funding a domestic violence expert

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who we've spoken about before. She providesconsultation and expertise to our casemanagement, protective investigators, sheattends the ICC staffing when there is domesticviolence involved. She actually sits in on thestaff things to provide expertise to actuallystart working with families if they are there.

One of the things that she is going to befinalizing that we've spoken about before is aparenting program specifically for battererswhich we do not currently have, so there is aneed for that.

And we've also spoken about before theprogram we are in the process of developing withDepartment of Children and Families, Help Nowand Gulf Coast who is our current preventiondiversion program on specializing in domesticviolence, specifically those families whereperhaps the batterer and the victim are going tobe staying together. They may not currently beliving together, but their plan is to get backtogether. So we are working on incorporatingthat with the safety together model.

The Homemaker and ICCP programs for thosewho maybe don't know ICCP is the Intensive

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Crisis Counseling Program which has been aroundfor years. They work with families where thechildren are in imminent risk of removal. Andthen Homemaker is more of a peer professionalwho goes out into the homes to work on thingslike budgeting and housekeeping and in-home careand that type of thing.

These programs had actually gone away inour system of care for a while and we broughtthem back a couple years ago in both Orange andOsceola. We currently find two homemakers andan ICCP counselor within Osceola. And one ofthe things that we will be looking at is we workwith our provider in this coming year on thecontract is how we can expand the ICCP. It'ssomething that we've struggled with because weknow that there is a need for more than one ICCPcounselor position. It's more like one and ahalf. So we've tried that with other providersin the past, but I think with our currentprovider, given their structure, we have theability to make some changes with that so thatwe can have some more ICCP counseling withinOsceola.

We've talked about the increased

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transportation supports to Osceola County wherewe fund a greater ratio of transporters withinthe CMOs in Osceola County. We currently fund10 transporters.

We've talked about the expanded housingsupports where we fund a case manager withOsceola County, you know, Osceola County wasable to get a grant. It draws down, you know,federal money to assist with housing needs forfamilies, and then we fund a case manager whohelps to draw those funds down and gets themdirected to our families, you know, before theycome into the system as well as those whoactually enter the child welfare system. She'salso working on developing resources. Shelocates low income housing for families, sothat's been a new addition this past year that Iknow has been an asset to Osceola.

Development of network providers. This iswhere, again, I feel really proud of the workthat we've done, and I'm going to ask Stacey topass these out. I can't recall how much we'vetalked about our purchases service system, butwe do have a network of providers that we'vedeveloped. What Stacey is handing out now is

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our approved behavioral panel of providers.Specifically, this is just for Osceola County,so these are folks who actually deliver thoseservices in Osceola County whether it's in-homeor whether they come, you know, some of themhave offices located in Osceola, but some ofthem do not. That has been one of the strugglesthat we've had.

For example, you know, Lesley, I know youare aware that we have had, you know, for a yearwe had basically one psychologist, you know,providing psych evals in Osceola County. And westruggle to find providers who could actuallycome out to Osceola to deliver that service, andBeth and her staff really worked diligently withDr. Tressler (ph) who is that one provider toget other psychologists trained. And then wehave gone out and located -- we now have five.If you look at that list, you'll see that thereare five psychologists who come out to OsceolaCounty to deliver the service, and it includesbilingual folks because we know that is a bigissue.

So what you are looking at is not only ourcontracts that are in Osceola County, but are

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purchases service providers. What you don't seethere is the other relationships and providersthat have been developed to meet other needs,and we'll talk later about, you know, more aboutthe resource specialist and the work thatthey've done to really enhance providers inOrange and Osceola Counties, but they've done asignificant amount of work to ensure that thereare providers available to, you know, to meetthe needs of families.

MS. MURRAY: One question. This is Dawn.On the list that Stacey just passed out, thissays Osceola County, a lot of these addressesare not Osceola County. Does that mean thatthey come to Osceola to deliver the services orwhat does that mean?

MS. BALL: Right. It means that they areeither providing in-home services, a lot ofthem, you know, counseling and parenting. A lotof them are providing in-home services or insome instances especially with the psychologistwhat happens is, let's say YFA has a case thatthey are scheduling a psychological for. Theywould arrange for space, so like thepsychologist who comes from, you know, the Miami

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area, they arrange a space for him when he comesout here and he provides the service here.

So everybody on there except for, Ibelieve, Dr. Parnell (ph), she's currently theexpert listed on there related to Munchausen.So far she has not traveled to Osceola, andfortunately, we don't have -- that's not thetype of case that you get a lot of. If thatneed increased, we could try to work with her tocome to Osceola County.

So everyone else that you are looking atare folks, even though they have addresses ofdifferent locations, they actually come out toOsceola whether it's in-home or in the officesdown there.

MR. KURTH: This is Greg. Dawn, kind of onthat point, it's one of the reasons for theshared service center for Osceola County wherewe are having a higher per square foot in termsof allocated positions that we have right nowbecause we want to create opportunities forhoteling to those providers that cannot afford aspace in Osceola County, but kind of need tohave a place to hang their hat and do something.

So those are some of the things we want to

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do on a shared planning perspective in thecommunity.

MS. BALL: So you see that up there, thatis one of the enhancements that we talked about,and I won't go into any more because we'vetalked about it quite a bit now. Expanding thefoster home capacity is something that Melindatalked about last week and, you know, we'vetalked about it quite a bit. We recognize it'sa need, even though we have doubled the numberof foster homes, obviously, there is a greaterneed. And we've talked quite a bit about that,so I'm not going to go into that again.

Increasing residential group care capacity.Currently we have one residential group carefacility in Osceola County. There are some ofyou here who know that we had some challengeswith that facility, and we actually worked withthem very closely over the last couple of monthsand provided some additional, you know,resources to them to help them develop theirprogram. We were having some significantchallenges -- they didn't really have a programplan, it's a mental health facility who runs thegroup care, not really your typical child

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welfare facility. And they didn't have a goodprogram plan in terms of from one shift toanother, you know, a consistent parenting.

So we put in some resources to help themdevelop and structure a program. And ourcurrent residential care specialist went outthere recently to check in with them, and shesaid it was really amazing that just thecultural difference. First of all, there was alot of property destruction. So just going outphysically to this facility, you know, she wasable to see a big change. You can now tell thedifference between the staff and the childrenthere.

So that's one of the things that I thinkwe've done to help, you know, to enhance --

MR. KURTH: I just kind of want to throwout a -- I know Nick isn't allowed to say thisanymore, right?

MR. COX: I promise to keep my mouth shut.MR. KURTH: What I really want to say is

that -- I really want to make sure that weclarify, were not talking about increasedresidential capacity in the system but ratherthose kids who do need residential support to

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keep them in Osceola County. I want to makesure we're not just going to go out and buildnew beds.

We only have one residential provider inOsceola County, so if we lost them, and we had alot of work to do over the last year, thatwould've been a stretch for us. So we want tomake sure that we talk about the sense thatthere are some kids we do place out of countyresidentially. We are talking with the providerright now for about six to eight beds. Very,very much a group home, parent kind of modelwhereby they can actually take some youth andwhatnot. So I just want to clarify the rest.It's not just going to beds, but wanting tofocus on keeping the kids in the county from aresidential perspective.

MS. BALL: Over the last three years andreally this is Greg and Karen particularly haveworked to develop a very strong relationshipwith the University of Central Florida. One ofthe things that you'll hear Karen talking aboutlater is how much Family Services values socialwork as an educational background for the folksthat we have working in the field.

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And through that partnership, I know it'sbeen something of a long process, but we arevery excited that just this last month theUniversity of Central Florida which is locatedout here in east Orlando, has now developed asatellite office in Osceola County with a Masterin social work program. So we have folks, Ithink there's 30 some folks, who now have signedup for that, and we have folks from Departmentof Children and Families, from our casemanagement organizations, you know, variousother organizations down there with their staff.They are now able to go through this program.And that's something I know from our casemanagement organizations that something that wehear from them, particularly the ones fromOsceola County, they talk about how challengingit is for them to get qualified staff in OsceolaCounty. So we think this is really going tohave some very long reaching impact as this goeson. They just started up in September.

We currently have one of our CMOs that's aCAC, but that's a very recent thing thatoccurred last year. The Osceola County CAC washaving some financial struggles, and for those

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of you who have been out there, they have thisreally fabulous facility. They are locatedon-site with a counsel on aging, but they werehaving some pretty significant financialconcerns. And it was possible they were goingto have to close their doors.

So we had worked with one of our casemanagement organizations to develop so that theycould actually move into the facility, you know,so they are paying rent to the CAC. It's ableto stay functioning, and then the CMO was veryhappy. It really is a very nice facility. Soit was really kind of a nice match where we wereable to, you know, maintain a very importantorganization within the Osceola network throughthat partnership.

And then last week Lashawnda had talkedabout the court liaisons, and one of the thingsthat we did to enhance the network in Osceolathis last year was to go from a half-time courtliaison to a full-time court liaison in OsceolaCounty.

Then one of the things is an ongoing thingto work within the Osceola network is thebimonthly dependency workgroup meetings. It

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involves family services, the guardian ad litem,children's legal services, the judges, you know,a variety of folks who get together every month-- every other month to really work on issuesimpacting on dependency within Osceola County.So it's an action planning group always workingtowards, you know, what are the needs, and howcan we address them?

Then -- Actually I'm going to let Greg talkabout the partnership with neighborhoodstabilization fund.

MR. KURTH: The neighborhood stabilizationfund, I briefly mentioned this last time, we arehaving some discussions with the county. Wehave $3.9 million in neighborhood stabilizationfunds. We were looking at buying distressedhomes and making that available to nonprofits.

So we've talked about the idea of havinghomes donated to either us or another entity tohelp out particularly with sibling foster care.We've talked about the six to eight group homewith friends possibly looking at having a homedonated to them as well. So I'm actually havingdiscussions with the county tomorrow about thatissue.

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MS. BALL: I can't remember if we talkedabout this previously or not, but I don't knowit's been maybe a couple years ago thatDepartment of Children and Families talked aboutthe economic downturns and the need to bring insome of the leases. We had folks at differentplaces, and I know for the Department ofChildren and Families, they had to downsize.And children's legal services was co-locatedwith one of our CMOs in Osceola County, butbecause of this downsizing DCF was going to haveto move them to another facility.

And our case management organization feltvery strongly, and we concurred, that it doesprovide great benefit having CLS and casemanagement there together. So one of the thingsthat we did is to fund CLS being able to remainin that facility with the case managementorganization. So that's been what, two yearsnow, something like that?

And then the last thing I'm going to talkabout is, again, something we talked a littlebit about and that is the public allies. Wecurrently have, I believe, eight public allieswho are going to be funded through six

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organizations. Am I saying that right, Bart?MR. MAWOUSSI: Yes.MS. BALL: And they are going to be doing a

variety of things that will impact the Osceolanetwork. You know, we've talked about themsomewhat, you know, the recruitment. We willhave not only someone who is going to be workingon Osceola recruitment, but Florida UnitedMethodist Children's Home has someone. It's --I don't know, Bart, do you want to say who thedifferent organizations are?

MR. MAWOUSSI: Yeah. Help Now, Habitat forHumanity. As you said Florida United MethodistChildren's Home, and I'm sure there's going tobe someone that I'm going to forget to say.

MS. BALL: Yeah. Sunnyside.MR. MAWOUSSI: CAC and Sunnyside.MS. BALL: Yeah. And Sunnyside, they are

going to be utilizing it for a recreationdirector that will really help, you know, withthe programming there.

MR. SACHS: This is Walt. ICCP, youmentioned one and a half is kind of a target, doyou have other intensive crisis or rapidresponse type resources in Osceola County

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besides the ICC program?MR. KURTH: Not necessarily on a

contractual basis. Our family preservationspecialists are there --

MR. SACHS: But are they on 24/7availability and can go into a home at two inthe morning?

MR. KURTH: No.MS. BALL: The one that comes immediately

to mind is our youth advocate program, and thatis, I think we talked about that a little bit,is on the front end and on the back end, but onthe front end is more of an immediate at leastwithin 12 hours is what we put in. That's whatwe wanted them to be able to respond. Andthat's for those families -- usually they areinvolved with the Department of Juvenile Justiceand we are trying to prevent, you know, kidsfrom actually coming into the system.

MS. MURRAY: But do they go in 24/7? Likewe can call them at two o'clock in the morningand asked them to come out?

MS. BALL: Well, it's a 12 hour response.So we could call them and it would probably notbe in the middle of the night that they would go

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out.MS. MURRAY: Okay. And so it's not a rapid

response like Walt was talking about?MR. SACHS: So as far as an immediate

response, like critical issue, need them therein an hour, there's only the one person?

MS. DANO: I supervise the diversionprevention specialist which Greg is calling thefamily preservation specialist because we arelooking at changing the name to follow, but justlast week or a couple weeks ago PI called adiversion prevention specialist in the middle ofthe night and said, hey, I have a homelessfamily, you know, what can I do with them? Shehas networked and built such relationships inthat community, she was able to pick up thephone and call America Best in and say, hey, Ihave this family that needs shelter. Because ofher relationship she didn't have to signanything, she didn't have to provide a creditcard or anything --

MR. SACHS: I appreciate that. I'm gettingat a very specific issue where a family is incrisis at an odd hour of the evening or night ormorning, and someone in the home, doing crisis

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counseling keeps that child from being removed.Is that one person in Osceola County with a goalof one and a half or is it bigger? I can'timagine that this solves that problem. To methat is hugely under resourcing a piece of yoursystem that will prevent your kids from cominginto care and repair families for a very longtime by having crisis solutions available.

Have you all thought through that? Is thatsomething bigger on your plate or are you okaywith one and a half?

MR. KURTH: Well, I don't know if we'vegotten a lot of feedback from PIs that mostly --mostly the feedback has been --

UNIDENTIFIED SPEAKER: (Unintelligible.)MR. KURTH: I'm sorry?MR. SACHS: Just wanted to see if I was

asking the wrong question.MR. KURTH: No. No. I think it's a great

question. I mean, we haven't gotten real strongfeedback to say that we need more of that crisisin the middle of the night. What we've gottenfeedback from, Walt, is we need more help withmore diversion specialist from PIs. That's oneof the things that we have.

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We can always look at augmenting ourcurrent family preservation contract throughGulf Coast that does ICCP. We can alwaysconvert that because they do ICCP and theregular diversion, which I know were notsupposed to say anymore, we can easily convertthat into more of a rapid response if we need todo that.

Some of the feedback in Osceola County hasbeen folks have said to us from the PI side weprobably don't need as much Homemaker, forexample. While again, Gulf Coast does that aswell. So we can always shift out betweenHomemaker, ICCP and regular sort of diversionprogramming based on what we want to do.

MS. MURRAY: Just to clarify, I think wehave voiced a concern regards to ICCP slots.That there is a need for more because there'salways a waiting list --

UNIDENTIFIED SPEAKER: (Unintelligible.)MS. MURRAY: -- so staff has said that if

you have someone go out there quickly, it wouldreally help them.

MR. SACHS: And it's not Family Builders,it's ICCP.

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UNIDENTIFIED SPEAKER: (Unintelligible.)MS. MURRAY: Family crisis. Yeah, that's

what we've asked for more for someone to get outthere. Because intensive crisis counselingprogram will go out there, you know, within acouple of hours. They will meet us out there atfour or five o'clock in the morning wherehomemakers is great, but that's not who's goingto do that intensive focus.

MR. KURTH: We can do that, Dawn, becausewe are working with the same provider in thatcomponent. We can augment their focus. We candefinitely do that.

MS. MURRAY: Well, Orange County is adifferent provider.

UNIDENTIFIED SPEAKER: Right.MR. KURTH: (Unintelligible) talking about

Osceola County.MS. MURRAY: Osceola is not the need, it's

Orange.MR. KURTH: Oh, okay. I thought --MS. BALL: Okay. That's where -- I'm

sorry, Dawn. I just wanted to clarify thatbecause I have heard in the past actually wasthat there was a need more for Osceola. I

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hadn't -- to be honest, I hadn't heard of theneed in Orange County.

MS. MURRAY: I think it's the oppositebecause in Osceola they're saying they don'tneed the ICCP slot that's why they are talkingabout changing them to the domestic violence --

MS. BALL: That was Homemaker.MS. MURRAY: -- and all of that.MS. BALL: Yeah. They were saying that

about Homemaker.MR. KURTH: Okay. I'm sorry, Walter. I

thought you were asking about --MR. SACHS: Actually I was. I didn't -- I

was specifically asking about Osceola. Iunderstand Osceola isn't a problem, so one and ahalf probably is appropriate.

MR. KURTH: Okay.MR. SACHS: The other comment I had is that

with your relationship with UCF and sort of thatlong standing partnership that you built and nowthe Masters program in Osceola County, do youthink there is an opportunity there to work withtheir school of communication or media ormarketing to work on foster parent recruitmentin Osceola County via some UCF grad students or

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something doing some -- you know, they gotpeople looking for projects all the time, and ifthey have a face in Osceola County, then theycould enhance their face by sponsoringleadership type activities.

MR. MAWOUSSI: Maybe I can respond to that.We actually have had some conversations with notonly UCF, but also Full Sail and Orlandovocational technical schools about leveragingsome of their resources including their studentsand their space and their technology to supportour recruitment efforts. We actually do utilizeinterns from UCF to support our communicationsprograms which in turn greatly supports ourrecruitment initiatives.

So absolutely, there are thoseopportunities.

MR. KURTH: And I think that's a greatpoint, Walt. We can definitely do a whole lotmore in many respects. And we do a lot of UCFinterns with our post adoption support programand whatnot. So we can certainly look at evengreater opportunities.

MS. LEWIS: Okay. We're going to talk alittle bit about family preservation and

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prevention programs. Family centered practice,it really -- the family is the center of thiswhether if you're looking at wraparound inOrange County preservation and prevention orchild welfare. When we're looking at wraparoundin Orange it's really exciting what's happeningout there because they are taking a number ofsystems of care and integrating all of thesesystems of care into one. We are talking aboutfamily preservation preventions -- actuallyStacey Dano, the director of operations, isgoing to be talking about our familypreservation program. But I also wanted tomention that Burney Vaughn who is our DJJliaison is going to spend some time talkingabout the crossover use that he deals with andour relationship with DJJ. We are really proudof that.

And then Selena Norman who is our postadoption specialist is going to be talking aboutwe were the first CBC in the state of Florida todevelop a post adoption program. And that's inlarge part due to Selena, and the amazing workthat she's done working with the families andkeeping children from coming back in on the back

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end.When we are looking at child welfare, we're

going to be talking about the integration ofsubstance abuse and mental health, and thecapacity that we've built within our CMOsregarding family team conferencing and familyengagement and the family center practice. Andthen Greg is going to --

MR. KURTH: One of the things that I justwant to emphasize and we really want to makesure that we are also consistent with theframework on a statewide basis (unintelligible)prevention plan and really these five factorshere are also incorporated on a statewide basis.When you look at the center of social policy andwe look at families with similar circumstances,why are some families not abusing or neglectingtheir kids compared to other folks with the samesort of demographic profile?

And it really comes down to these fivecomponents in terms of what they have, andthat's the commitment, the nurturing and theattachment, knowledge of the basic childdevelopment, their own resilience, their andsocial connections in the community which

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includes a lot of informal supports and thenongoing concrete supports for parents.

So much of our family preservation programis really based on these five core principles.

MR. SACHS: Just for Rod's benefit, Gregdidn't intentionally skipped this, but knowledgeof parenting is on the slide too as opposed tojust knowledge of child development.

MR. KURTH: Thank you.MR. SACHS: Because that's a big issue.

Some of it's true parenting skills.MR. LOVE: Thanks a lot, Walt.MS. DANO: I'm Stacey Dano director of

operations. In talking about prevention andfamily preservation, we really need to definethe different levels of prevention and what itmeans to our system of care. We have primaryprevention events where we go out to, you know,we mentioned before all the events that weattend, we not only are involved with thoseevents, we do prevention walks. We doeducational information out in the community,but we also join many task force and areinvolved in task force such as the child abusedeath reviews. We're a part of that team

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locally, so that we can glean information as toprecursors to child death and target preventionevents around that.

We have investigators coming to us, ourdiversion prevention specialists, and say, wehave a family here that are co-sleeping andthere's no crib for the family. We make surethat we get cribs for that family and providethat to hopefully prevent any child deaths.

Secondary prevention really targetsfamilies with multiple risk factors with thegoal of preventing child abuse before it occurs,and our community service center really is greatwith this model because they do provide thoseconcrete care, we have financial assistance. Wehave a cloths closet. We have -- it's an accesssite. We have a food pantry there, so it meetsthose concrete needs.

Tertiary prevention, it's for thosefamilies that are already involved in the systemwhether or not the findings of a report aresubstantiated or not or whether or not they needcourt intervention, and our in-home supports dothat.

I know we talked about different contracts

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and these are the main ones that do supportprevention and family preservation, and I'm notgoing to go through all of them. I know we'vespoken in regards to some of these. I do wantto highlight a couple. We have BethanyChristian Services that provide a safe familiesprogram. They cross the gamut of prevention aswell as family preservation. They providerespite for families that are in crisis, keepingtheir families and their children out of thesystem. As they do recruitment, they are outthere in the community providing preventioninformation so that it hits that primary piece,but they also take referrals from communityfamilies. Law enforcement, if they run across afamily that is in need, they can call them andhelp them provide support. They have mentorfamilies to help families in a specific area ofneed. And also we do take referrals frominvestigations as well.

Healthy families. Healthy families as youwell know there have been budget cuts across thestate. We do provide funding to support thatparticular program. And certainly they wouldnot have been able to provide as many services

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as they have without our funding.Gulf Coast Family Prevention and Diversion

Program, that's our main family preservationprogram for our area. The only referrals theyare able to receive are directly from theinvestigators, and they do go through thediversion prevention specialist.

Family services positions and programs thatsupport family preservation. Really in lookingat this, you know, we see different specialistsand they do work as a team because they do runacross different needs and specialities. TheAPD/CMS specialist's main focus is certainly thechildren in licensed care with special needs,but because of that expertise she is able tohelp and provide resource information to thediversion prevention specialist and DJJ liaisonand our adoption support specialist.

If you note I did kind of put in italicsover there that the diversion preventionspecialist will become the family preservationspecialist.

The diversion prevention specialists, I'mgoing to get a little bit more into detail as towhat services they provide, and I would like to

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note that in 2006 they were known as theresource specialist at the time. USF didrecognize them as the best practice model. Wehad several CBCs around the state duplicate thatmodel.

MR. WOODLEY: I have a quick question. Twoslides back, you talked about your secondarylevel CSC who is part of the Family Services.They are under your umbrella. They are yourprimary partner in your secondary prevention?

MS. DANO: They are actually a division ofFamily Services. They are part of it. Theyenhance what we do. I mean, we are able toaccess emergency assistance, funding. We'reable to be an access site. There's a computerroom so that they can go job hunting ifnecessary. And really they are also a meetingsite for different agencies. They have AAmeetings there. They have Jewish familyservices (unintelligible) classes there as wellas Harbor House is located there.

MR. WOODLEY: How do you identify thosefamilies who have those risk factors that couldpotentially be in the system? Do they just walkup to CSC or how do you --

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MS. DANO: Well, I have a slide on CSC, andyou'll notice that I have a slide and they aretalking about the volume of calls that theyreceive. Just generally, they receive about10,000 phone calls looking for assistance,families, from December 2009 to June 2010.

MR. WOODLEY: So that's how you -- okay.MS. DANO: Yeah. They find us.MR. WOODLEY: Okay.MR. SACHS: This is Walt. The presentation

you are doing right now has a lot to do withwhere we are going to be defending the future.51, $52 million or whatever, the simple argumentout there is the numbers are down, you shouldn'tbe getting that much money any more. Hey guys,you're wrong. We need that much money stillbecause we've got to plow it into this stuff.

How do you quantify the successes that youare having in primary, and secondary, tertiaryprevention programs so that the laymanunderstands that the front door is closing andthat your back door is not reopening?

MS. DANO: Right. We actually, you knowagain, we have some future slides, but we haveserved about approximately 6,000 children and

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families outside of the normal child welfaresystem.

MR. SACHS: Are you able to connect thatthough to when we weren't doing it, the frontdoor looked like this. Now that we are doingit, the front door looks like this. Have yougot quantifiable evidence of success or are youjust saying here's how many we are serving?

MR. KURTH: Well, when we talk about --particularly when we get into the DJJdiscussions, I think clearly with the impactwe've had on the number of kids that we servedthat come to us directly from DJJ, a significantnumber of those kids would definitely come intocare had it not been for the work that we'redoing and some of the other supports.

MR. SACHS: The reduction of risk exposureis huge, and that has a benefit. We talkedearlier about look at how much we've saved fromthe community impact on out-of-home care costsby having this good UM thing on top of all ofthis. Well there's got to be the sameconnective literature on what is happening withall of this investment, and that's got to beable to make sense to people who don't know

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child welfare. But when it just screams thathow can you need so much money when the kidnumber isn't what it used to be.

Let me talk about where we are because it's11:59. And I see some folks arriving, and youmentioned that we have speakers who will betalking about other issues in the front. Atnine o'clock I mentioned that if we have 30 or45 minutes duration, we would just plow rightthrough it. If we have two or three hours, wewant to take lunch and come back. Where are we?

MR. KURTH: We have a ways to go.MR. SACHS: Okay.MR. KURTH: Where are we at, Michelle, on

the agenda? We kind of gave you an estimate ofwhat we had.

UNIDENTIFIED SPEAKER: Right. We haveallocated a good three hours. So we have thispresentation on family preservation and thenSelena and the ones that are here for the postadoption part of prevention and familypreservation and the DJJ also is a part of that.

MR. SACHS: Okay. And I want to respectyour having the ability to tell us everything weneed to hear about the value of your company. I

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have asked my team to be diligent aboutquestioning so that we are not -- we're onlydoing value added type exchanges, so we will beeven more diligent with this this afternoon tomake sure we get through the agenda.

Do we need to do anything to wrap up onyour current discussion -- sorry --

UNIDENTIFIED SPEAKER: That's okay.MR. SACHS: -- current discussion or can we

start --MS. DANO: We can start --MR. SACHS: -- right here after lunch?MS. DANO: Not a problem.MR. SACHS: So we are adjourned, and we

will meet back at 1:30.(A lunch break was had at 12:15 p.m.)MR. SACHS: Okay. We are going to pick up

where we left off. Greg, you might want to dous a favor and introduce the folks that havecome in new.

Just a reminder, if you are talking, pleaseidentify yourself before you talk so the courtreporter can capture the information correctlyto the record.

MR. KURTH: I want to introduce to my left,

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Burney Vaughn who is our DJJ liaison. He'sgoing to talk about DJJ outreach and partnershiptoday. I also want to introduce Theresa Burtwho is our wraparound specialist to talk abouther role. And this is Selena Norman who isgoing to talk about post adoption support alongwith her (unintelligible).

What I want to do, Walt, just a couple ofthings -- oh, I forgot Cheri Williams. CheriWilliams who is back from her recent birth ofthe twins.

MR. SACHS: Yea.MR. KURTH: She's rejoined us, so she's

going to be part of our quality presentation aswell. I think I have everybody.

A couple of things, Walter, I wanted to leteverybody know we just gave you, and we didn'tpass this out earlier, but we did what is calledan Osceola investment newsletter, and we wantedto make this part of the presentation earlierfor some of the provider capacity in OsceolaCounty. Also back to the org chart issue, if Icould just kind of be clear on one of the -- wekind of talked about two days to give you somedetail on that, and I wanted to make sure that

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was okay.We heard a little bit of feedback about

some challenges from you all about looking atclarity around where is the foster parentoutreach and recruitment in Osceola County?What does that really look like on the orgchart? We'd like to make a minor modificationto make that clearer to you, otherwise, theother components will be relatively the same andwe are always looking for opportunities to getany other feedback on that.

MR. SACHS: Thank you, Greg. This is Walt.I think the thing that I would like the team toknow if you could do it before we leave today,have somebody analyze it and figured it out, ifyou can figure out distribution between Osceolaand Orange of your staff, Family Services staff.If we have that number and we are aware of it,because we know it's going to be bigger thanseven, we just don't know how big it is. And ifit's eight, its eight. If it's 18, that'sdifferent.

MR. KURTH: You want us to give you thatnumber today?

MR. SACHS: If you could. I don't think --

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because we're sort of ending today, we may nothave this opportunity to exchange informationafter today.

MR. KURTH: Okay.MR. SACHS: And I want to be respectful of

the process not to have an open ended exchangeof materials after today.

MR. KURTH: Okay. Maybe at the break I'lldo a quick and down and dirty kind of positionanalysis.

MR. SACHS: Perfect.MR. KURTH: Okay. Great. All right we're

going to go ahead and get back to the diversionwhich is now family preservation, and I'll goahead and turn it back over to Stacey Dano.

MS. DANO: I've already talked about thefour specialist positions that supportprevention and family preservation services.I'm going to go into a little more detailrelated to the diversion prevention specialistwhich Greg has been referring to as our familypreservation specialist.

I just have to say these are some really,really amazing staff. They support ourinvestigators. They are co-located, and more so

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they really partner with the investigators inhelping them provide assistance to the familiesthat come in the front end.

Not only that, they are available tocommunity families. If the hospital has theirname, they provide our diversion preventionspecialist -- our specialists names to familiesin need, and they work directly with ourcommunity families. They have a workingrelationship with DCF client relations, so asthey deal with community families, they do someoutreach to our diversion prevention specialistsas well. And we assist those families coming inthrough that channel as well.

They do make joint visits of course. Therealm of services they provide, they do provideinformation, referral information, but they alsomake joint visits with the CPIs on more complexcases, and their range and facilitate wraparoundservices for families.

And I would just like to provide oneexample. One of our diversion preventionspecialists had an investigator come to her andsay, Hope, I have this family and there is noabuse or neglect, but this family has two very

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young small children, and I don't know what todo. I may have to remove these kids. And thePI proceeded to tell Hope a little bit aboutthis family.

They were traveling from Tampa to Orlando,and there was a fatal car accident where thegrandmother had passed away. The mother wasseverely injured and in the hospital for fourweeks, and there were two small children underthe age of five. At that point Hope said, don'tremove them. Let's go out. Let's see what wecan do.

Thankfully there was an aunt that waswilling to give up her job in Tampa to come carefor these children. And Hope did whatever shecould to help this family stay intact. Shearranged for 4C. She arranged for in-homenursing for the mother who was severely injuredand disabled. She helped them go through thatprocess of getting disability, freed up theaunt's time so she could seek employment, griefcounseling because they lost a integral part oftheir family. And moreover, she went to talk tothe landlord and said this is the situation, andshe arranged for three months worth of emergency

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assistance to give them a leg up.I mean, these kids were severely

traumatized too. She brought in car seats, newcar seats for these children, and these kidsjust kind of fell apart. So to think what couldhave happened if these kids were removed and howthat would have affected them. This is the typeof service they provide out in the field. Youknow, they are just simply amazing.

So they do work with community families,and I mentioned earlier they do great communityoutreach. They are on a multitude of task forcewith the domestic violence task force. DVfatality review, the child-abuse death review,the central Florida drowning prevention, theOsceola child-abuse prevention, and we are alsoinvolved with the local planning team, theCircuit 9 local planning team.

And really this is how our program isintegrated into the community. We've talkedabout community prevention events. Thecommunity service center, the multitude of taskforce that we are involved in, and for theCircuit 9 local planning team, I recentlyaccepted to take the chair position of that.

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I'm going to co-facilitate that planning teamalong with Joy Chuba (ph) of the Osceolachildren's -- Child Advocacy Center.

Again, not only are the diversionpreventions co-located with the investigators,they really do partner with them. We havecollaboration with Orange and Osceolagovernment. We provide contract servicesthrough our ICCP, Homemakers. We know thatthere is a great need for homeless prevention inOsceola, so we have provided funding to supportthat advocacy position. And we have a multitudeof other service providers that we work with.

Now I know that this chart is hard to seeand I think that Michelle is handing out a factsheet which provides details as to the differentcontracts and programs that we work with. Theblue lines represent the children served for thefiscal year 2009/2010 in Orange County. And thered line indicates the children served for thesame fiscal year in Osceola County.

The large number you see towards the leftof the screen, that's the children served by thediversion prevention specialists. Right now weonly have three positions, and I know they serve

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at least 120 PIs, I believe it is Dawn.MS. MURRAY: 135.MS. DANO: Okay. So we have three

positions right now serving 135 PIs, and like Isaid services they provide run the gamut of thearray. There were at least 128 children inSeminole County that they helped as well. It'slike whoever calls them, they help. They don'tdistinguish. And altogether that's about 6,000children served through our different programsabove and beyond.

Future enhancements and strategies. Again,we know that three positions aren't going toserve 135 well. There is so much more we cando, so we are adding an additional position tosupport investigations. Also, you know, we'retalking about added value. I know that we needto do more about looking at is the work they'redoing making an impact? And IRIS will help usdo that. That's our Integrated ResourceInformation System, our new data system that'scoming out. We'll be able to pull, you know,more comprehensive reports, and we have theability to look at maltreatment types ZIP codesso we can focus our prevention activities that

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way.We are also seeking a great opportunity

with Planned Parenthood on teen pregnancyprevention, and we will always continuecollaboration and participation with communityprevention events.

Now the community service center, I knowthat we have already touched a little bit on thecommunity service center and the concrete needs,and the merger happened in December of 2009.Again, it's really just complemented things thatwe've already been doing. We have the foodpantry, clothes closet. We have parentingclasses, the Hero program.

I just have to briefly mention thecommunity service center. This is their seventhannual -- they just had their seventh annual.Ron Blocker, the superintendent of Orange Countyschools always attends. It's an amazingprogram. They really celebrate children thathave been acts of kindness, reported dangerousactivities on school campus and reallyempowering these kids and celebrating them forstepping up and speaking out.

You know, one little first grader had saved

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up all her money, she heard about Haiti. Shesaved up her money and her birthday money andprovided it all to the Haiti Relief Fund. It'sjust, you know, we want to celebrate those kindacts. I've already mentioned meeting spaces forproviders and the youth advisory board.

Now here is a chart illustrating the numberof calls that the community service centerreceives for assistance. This reallydemonstrates the need out there. I mean, weknow the economic times are tough, and thisclearly demonstrates it. From December 2009 toJune 2010, there was approximately 10,000 callsreceived at the center for assistance, and mostof them were related to rent, mortgage paymentsand utility payments. Unfortunately, we weren'table to serve 10,000 clients, but the need isthere. We will always be looking for resources.

The United Way provides us 126,000 a yearof funding, but we are also able to access otherfunding through the United Way family emergencyfunds. Federal funds, the emergency Feed theChildren Program, we get funding through OrlandoSentinel, Publix. So there are other funds thatwe can access.

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MR. SACHS: I have a question on thecommunity service center. You do fund part ofits work?

MS. DANO: Uh-huh.MR. SACHS: Is there some money from Family

Services that goes into it?MS. DANO: Towards the positions, yes.MR. SACHS: Does any of it go for this

stuff, what people are calling for help with,rent, mortgage, utilities, other?

MS. DANO: That's the funding that wereceive through the United Way, but I --

MR. SACHS: Right. Any of your contracteddollars go out through this?

MS. DANO: A goes towards the positionssupport.

MR. SACHS: Just the position support. Soyou're United Way money though can help themwith this kind of a --

MS. DANO: Right. The United Way moneygoes directly to emergency assistance funding toassist these families.

MR. SACHS: Do you have any involvementwith triaging, who gets what and how much theyget?

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MS. DANO: Our direct service assistance --there some criteria that they go through makingsure that the need is there, and some of thefunding has caps to it. Like the familyemergency fund, the most they can get is 750 forrent, and there are some fees that way. Sothere is certain criteria.

But I would also like to say the diversionprevention specialists also know that there is aneed for additional funding, so they are alwaysbrainstorming and thinking outside the box.They've held yard sales and garage sales to usesome items and get some additional resources forprevention to help these families that may notbenefit from this type of funding.

And right now they are also coming up witha concept of having a baby shower kind ofconcept so that when people bring donated items,we can give them donation receipts to meet theneeds of young children. So they are alwaysthinking and trying out new things.

MS. MURRAY: This is Dawn. Of those 10,000calls, do you know what percentage are likefamily safety cases? Because I know communityservices serves the community as a whole, so you

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don't necessarily have to be a family or aparent. Do you know what percentage of those10,000 calls are families that we would haveserved?

MS. DANO: We serve 433 children, so thatwould be specific to Family Services. And also,you know, we do have a limited amount offunding. We run out, and we have additionalneeds for families in our system. We will lookat using temporary assistance for needy familiesso that they have funding.

So future enhancements, of course, is weare going to continually look for resources,support the families to meet their needs andfamily preservation. And we'd like to utilizeand expand the center to help our independentliving youth as well.

And you did ask the question as related tothe family preservation protocol. How does itintegrate? How are we integrating it. And I dohave to say that, you know, we've always had avery strong front end system, and we did cometogether with the stakeholders. We had DCF andinvestigations, child legal services, our familypreservation provider through Gulf Coast at the

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table and myself at Family Services, and really,and Dawn led this, and we appreciate herefforts. What we really had to do is justlayout what we were already doing. We alreadyhad a strong system in place. We just had tomake a few tweaks to close that communicationgap. So, I mean, it's already been integrated.

Do you agree with that, Dawn?MS. MURRAY: Yes.MS. DANO: Okay. Thank you.MS. NORTON: I'm just going to talk briefly

about in-home supports and parenting supportbecause you've heard about those two already.ICCP we've already talked about that within bothcounties, and the Homemaker program, we offerthat in both counties. The only thing I wouldlike to add to that is within Orange County wehave a large Creole population which we servethrough a Creole (unintelligible) serviceagency. We transitioned those dollars to OrangeCounty government and they have two Creolehomemakers to assist with some of the needs ofthe other agencies.

The youth advocate program we've talkedabout that on the front end and at the back end

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as a way to promote in-home supports to youthkids intact and also to transition those kidswho are, especially the older youth and the DJJtypes of cases, to transition those kids fromthe system back home so that we have actualsupport in the home.

The nurturing parent program, that's ourprimary parenting program that we fund, and wefund that in a group setting through the twovisitation centers. There's one in each countythat works primarily with out-of-home carecases, and then we fund that through theHomemaker program and have those servicesdelivered individually in the home for in-homecases. So that's primarily what we do relativeto the parenting of --

MS. BALL: Can I just add -- I'm sorry.This is Michelle. I just want to add on thenurturing parent, we do have those programs thatspecifically use that, but we've also brought intrainers to fund the systemwide. We've got ourcase management organizations, other communityproviders who come in and benefited from thattraining so they can deliver the curriculum witha larger array of folks. And that was our -- we

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trained our family preservation program, GulfCoast and also some of the case managementorganizations.

MS. NORTON: We are working as one of ourimprovements going forward with incorporating a-- expanding a safe and together model toinclude a parenting program for batterersseparate from -- this program is obviously noteffective. And as we looked at to furtherenhance this type of program, we are looking atdeveloping, you know, through a qualityimprovement effort, a needs assessment relativeto the type of parenting program that best meetsthe needs of those families, and then evaluatingwhere we are and what we need to do to bridgethe gaps.

You've heard about a vast array of servicesthrough our (unintelligible) services system andthrough the funding that we provide to all ofour case management organizations as a part of afixed-price contract. And those you can breakdown to behavioral support, therapeutic support,immediate needs types of services that are justavailable to in-home and out-of-home care cases.

The DV support you've heard about, you've

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heard about emergency financial assistance.You've heard us speak about access, and how, assoon as kids are removed, we get the children onMedicaid, every child we have, unless they arean illegal alien, is on Medicaid. We providesupports to not just families within our system,but to the community in general.

And we are able because of ourrelationships with the access program office tofacilitate the application process for them, tolet parents and caregivers know where they arein the process and what they need to do to getthrough it. We hold Medicaid support groups.We provide an awful lot of information tofamilies, in-home families, out-of-homefamilies, case managers, PIs, everyone withinour system of care relative to this.

So that's a brief overview of our in-homeservices.

MR. KURTH: We're going to -- I know withRod on the phone, we wanted to go ahead and moveinto the DJJ portion of what we do, and BurneyVaughn, I've asked him to be here today. He isour liaison, and I'm going to go ahead and turnit over to Burney.

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MR. VAUGHN: My name is Burney Vaughn.MR. SACHS: Let me just -- Rod, are you

there?MR. LOVE: Yes. I can hear him.MR. SACHS: All right. Good.MR. VAUGHN: All right. My name is Burney

Vaughn. I am the DJJ support liaison for Orangeand Osceola County. My main focus is dealingwith lockout cases. Kids that are locked out ofjuvenile system basic care, failing to pick upthe kids basically.

On a monthly basis I probably see anywherefrom 80 calls on lockout cases in Orange andOsceola County and even my neighboring countieslike Seminole, Brevard and wherever else,out-of-state, whatever, most of the time dealingwith our kids going back and forth. I supportthe courts. I support government agencies. Isupport family preservation, and any outsideagencies that need to be supported.

On this slide you see up here, basically,I'm the first responder with all these partners.These different partners basically help supportme when it comes to lockout cases. Withoutthese partners, I couldn't do my job because

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these are the providers that actually are ableto put in the home, provide support to keep kidsin their homes, out of the system.

Since 2005 we have served over 728 kids inthe family preservation program. These childrenare at high risk of coming into the dependencysystem. 75 percent of these have(unintelligible) through the dependency system,and it was $6 million of that was saved inannual reinvestment for these kids that are notcoming into the dependency system.

These primary duties are my duties that Ideal with. I deal with court. I deal with bothcourt systems, with delinquency and dependencycourts. I provide community-based interventionwith families, referrals to families to be ableto take care of their kids, provide services fortheir kids in their home other than the fostercare system. The local (unintelligible) teamwhich is our LRT team consists of a lot of ourpartner agencies like APD, CMS, DCF, DJJ, AHCA,Family Services, SAM office and child legalservices. And me and Dawn Murray serve jointlyon that committee, and strongly without hersupport I wouldn't be able to do what I need to

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do.Interface with the JPLs. I want to say

probably within the last -- between '05 and '06,I spent a lot of -- most of my two yearsbuilding relationships with the JPO, DJJ, thepartnership between DJJ and DCF. I like to knowthe person. There's always been that link --there was like a gap between them, now withinthe last few years I was able to bring these twoentities together on just being able tocommunicate with case management organizations.

JPLs know what the family case managers aredoing. Family case managers know what JPO isdoing. So that's a big, big process. I thinkthat -- that's a big hurdle that we got over.

MR. LOVE: This is Rod love. In years goneback, we found ourselves -- thank goodness forthe champions agreement now, but it seems likeit never failed to happen, 4:30, five o'clock ona Friday, we've got a kid that's being releasedfrom the detention center. It's a lockoutsituation because nobody wants to come get thatkid. We can't hold them. And it used to bethat we found ourselves in a situation where DJJwould be saying, DCF, you need to do something

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because this is a dependency case. DCF wouldsay wait, this kid's still under yourjurisdiction.

We've improved underneath the championsagreement, but have you -- between Orange andOsceola I know, if you know, we used to havethat situation more prevalent in Orange thanOsceola, but what's the prevalence of that now?

MR. VAUGHN: Well I think communication isreal good about that now. Me and -- well, I'mon call 24 hours a day seven days a week,basically, handling this kind of stuff. Soalong with support from Dawn Murray with the PIsand along with the support with DJJ andMr. Hightower and a lot of your local hereadministrators and your supervisors, Mr. Love,that we are able to pretty much step that up andget the kid out and placed somewhere. We arebasically -- get information that we canbasically get that kid either home or contactparents, so we don't have -- we're not havingthat gap too much now, but we basically are --quit responding to that now, so we don't have alot of kids places staying overnight and gettingheld illegal, what you want to say illegal, in

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detention center at the time.MS. MURRAY: This is Dawn. Just to say

from Burney's side here, he's wonderful. Wehaven't had the issues before, a lot of thetimes previously DCF would basically get stuck.We would pick them up. Now with the programsthat they were talking about earlier the YAP andwith Burney, we are able to put services in thehome to help the parent instead of us justshuffling the child to shelter. The parent isgetting the service they need and that is thanksto Burney.

MR. VAUGHN: That's thanks to Dawn toobecause I couldn't do it without her.

MR. LOVE: The money must be passing backand forth.

MS. MURRAY: With lots of love in the room.(CROSSTALK.)MR. VAUGHN: It's just (unintelligible).MR. SACHS: You're the only love

(unintelligible), Rod.MR. VAUGHN: To answer your question,

Mr. Love, that's basically just thecommunication in the joint partnership that wehave established in Orange and Osceola County

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with all of our partners, even DJJ, that I havea good relationship with the Deputy ChiefHightower which is a good support to me too.

MR. LOVE: Good. Thanks a lot. DeputyHightower still isn't getting a raise.

MR. VAUGHN: On the attending commitmentstaffings. Commitment staffings, as you alreadyknow, that these kids are coming out ofcommitment programs, high-level kids. They'd becoming out as sex offenders and a lot of timesthey can't go home. They really can't go homebecause a lot of times the victim's in the home,and usually what I'm going to do six -- not evensix days out, do the transitional staffings, DJJwill let me know. They involve me with anytransition staffing because what happens is thatgives me a heads up to make a determinationwithin two months or three months for alternateplacement, and we can actually prevent this kidfrom coming into foster care. Now some kidshave to come into foster care, but we will atleast have enough notice where we can makeproper arrangements for this kid before cominginto foster care. That's where the transition-- and that's a big support and that's a joint

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commitment from DJJ that they have with me,notify me on cases like that.

UNIDENTIFIED SPEAKER: Is that in writing?MR. VAUGHN: No it's not. It's not in

writing, it's just basically --MS. MURRAY: We have that draft --MR. VAUGHN: Draft.MS. MURRAY: -- we haven't had it signed by

DJJ yet, but we do have that draft.UNIDENTIFIED SPEAKER: If Nick approaches

you after the meeting, ignore him.MR. COX: Tampa is a nice place to live.

Are you aware -- this is Nick Cox -- are youaware, is this something that FSMO came up with,his position, or is this something that'shappening around the state? Because I don'tthink it's happening in my region.

MR. KURTH: This is Greg. We created thisseveral years ago, and I do want to add, I thinkthree years ago Burney was the circuit awardwinner here at the dependency court improvementsummit. And we did identify the issue of DJJ asa major concern early on when we started, and wewanted to make sure that we had a resource forboth DJJ, DCF and ourselves, and Burney kind of

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came --MR. COX: If he came to Suncoast region, he

would be region award winner. Not that I'mtrying to -- Rod, go get me one of these.

MR. LOVE: I wish.MS. KOGUT-LOWELL: This is Mary. I just

wanted to add as well because I've had someinteraction with this whole process and it issomething that has gone very well. I thinkwe've had a great success in our dealings withDJJ --

UNIDENTIFIED SPEAKER: (Unintelligible).MS. KOGUT-LOWELL: -- yeah. We've had some

great successes and it's been good to see.MR. VAUGHN: Okay. On the strength

programs, this is -- I do a wide diversionservices to families to help keep kids in thehome. I wanted to add, this is the system ofyouth and family care and involved in DJJ, andbasically what I do here is basically keep thekids from --

UNIDENTIFIED SPEAKER: (Unintelligible).MR. VAUGHN: Sorry. I skipped that one.

Sharing the data systems with JJIS, I would saythanks to DJJ and support from my contract

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manager here which is Christine Boggery (ph), Iwas privileged to have access to JJIS which is abig integration system with DJJ. I am able toaccess every criminal history on every childthat I get a hit on that could possibly becoming my way. This allows me to focus on whattype of child I'm dealing with and how I need toapproach the family when I make that first pointof contact with the family on why didn't youpick up the child.

This is actually a support system that Ican use also to support my case managementorganizations with all my CMOs because I'm theirsupport too. When there is a kid that wealready have in foster care, they are runningcommittees, charges and everything like that,they call me, Burney, you know, this kidcommitted charges. Can you help me get DJJ tosee what we can do about getting this kidcommitted or getting this kid right back infront of the judge. I make my contacts and wecan get that stuff processed, I can get ameeting started, I can get staffing started.And I support CMOs. I support anybody thatcomes to me, school systems, anybody. I'm open

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to anybody.MR. COX: Suncoast region?(CROSSTALK.)UNIDENTIFIED SPEAKER: (Unintelligible)

Suncoast region, he's only for Orange.MR. COX: What happened to one DCF?MR. VAUGHN: And supporting other CBCs such

as Seminole County. I have worked on a fewcases with them. Brevard County, CBC Brevard,worked on a few cases with them. Because wehave kids placed all over the district.

UNIDENTIFIED SPEAKER: Is that part of theregion?

MR. VAUGHN: Part of the region.MR. SACHS: This is Walt. Thank you.

That's some deep work. Do you see anopportunity for your work or do you touch theindependent living kids who are aging out whoare in jeopardy of introducing themselves to anadult system and they've had no experience withthe juvenile system?

MR. VAUGHN: I have had --MR. SACHS: The homeless center or the

adult jails sometimes is where kids landunfortunately. And I wondered if you have

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interactions or the ability to communicate withindependent living kids about the path theydon't need to go down?

MR. VAUGHN: Walt, usually when I -- well,yes, yes I have. Stacey kind of oversees thatindependent living program. There's severalcalls that I'm involved with to support theindependent living program, a lot of our kidsare in independent living process are still in acommitment program. They're basically aging outof foster care and into an adult systembasically. Hopefully not into the adult system,but to be honest with you, by the time that Iget involved with the case, they are usuallyalready in foster care, already committed thecharges by then. These kids have already beenin care (unintelligible). If I can get to them,I wish there was some way I could say -- do allcalls and say basically hey, before you gettingtrouble, call me before you get in trouble. Butthat don't work in the system.

MR. SACHS: This is Walt again. The thingI was connecting to is earlier I asked Gregabout this chart, the one you have over therewhere it shows the arrow coming in to Family

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Services, and when does the arrow go out? Andpart of I think you're reaching out to some ofthe stuff you've talked about here working withCMOs and working with the JPOs where you don'talways have to be a responder, you could be areacher. And I thought that on the reach sideyou can also reach into the independent livingkids and do some education or something that wayto show them the trail they don't need to godown.

MR. VAUGHN: I'd be glad --MR. SACHS: That is a scared straight

program every now and then.UNIDENTIFIED SPEAKER: That's a great

suggestion.MR. VAUGHN: These are my two strong

providers. I've got Mentor Motivating Youthunder the direction of Stan Morris (ph). When Ihave a parent that's basically on the edge ofcoming out of JDC, they are kind of basically(unintelligible) taking the kids back into thehome, I also try to -- I utilize the mentoringprogram just to put into home -- just to makesure that the parents have that support becausethey want somebody new in the home at that time

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of removal, and I can usually get this providerout there within an hour. I make a phone call,they're out there within an hour.

The gentleman that runs this program isactually a mentor to the Orange County JDC rightnow. So all the kids know him -- that come outof that program already know him. So he's agood source. He does a lot of placementstabilization with us. Strong background inworking with kids with a criminal history, andhis monthly services time is two to six months.We utilize him a lot.

MR. ATKINS: Is that a 24/7 situation also?When you call them, I mean, regardless of whenit's happening --

MR. VAUGHN: I can call him directly and hewill have somebody out there on the weekends orwhatever. And he also supports -- not only doeshe support my lockout cases, he also supports mykids that are in foster care that he might needto use the placement stabilization. Weekendcalls, (unintelligible), he'll be out there --he has staff that will be out there.

MR. BEUTLER: This is Dean. Do thoseproviders serve both Osceola and Orange County?

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MR. VAUGHN: Yes they do. And outside ofOrange and Osceola County, we have some that arein Seminole County.

The youth advocate program which is knownas the YAP program, this is a fairly new programthat we just implemented about six or sevenmonths ago. It's a new program, but it's a goodprogram. The difference between both programsis that the youth advocate program is moreintensive. They do a lot of wraparound supportthat deals with kids with mental health issues,just basically to be able to hold that parentshand and say hey we'll walk you through theprocess. Basically make sure that you are thehaving support that you need to keep your childsecure in your home.

MR. COOPER: This is John. You may want totalk about YAP as a reunification strategy also.

MR. KURTH: Yeah. The youth advocateprogram, I mean, this is really -- somebodymight be a little bit familiar withmulti-systemic therapy which is a very, veryexpensive model. This model is, for lack of abetter term, on the cheaper side, and we arehousing them right now at the community service

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center. But instead of having professionalsworking with actual parents in the home andwhatnot, they have what are called advocates whowill go into the home, and they will actually goand stay overnight sometimes in those familysituations.

So we have been able to figure out a way --it's still kind of a -- well, I shouldn't sayit's new, but it's now full, but the opportunityis to also look at some youth, maybe olderyouth, who are looking to step down and go backhome, figure out a way to get one of thoseadvocates into the program and ultimately workwith that family. So we've done a little bit ofboth, on the front end as well as facilitating alittle bit of reunification. And I think thatin terms of the way that it has been working,this would be one of these programs that wecould scale up even more. I think we only have10 slots right now, but it's one of these thingswhen we look at out-of-home care dollars, if weinvest in this program, scale it up, and there'sgoing to be an offset on the out-of-home careside.

MR. VAUGHN: Go back to MMYA, Mentor

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Motivating Youth, Mentor Motivating Youth since2008 has served more than 450 kids that they areserving -- actually, have provided referralservices to them. They have a 95 success ratekeeping kids in their home. They are real goodabout keeping kids in their home.

This chart here is basically kind of like aratio of children diverted and the childrenentering into care. The number of childrendiverted from dependency care has increaseddramatically over the last five years. And wehave diverted more delinquent kids from fostercare than probably any -- I can imagine, any CBCacross the state of Florida. (Unintelligible.)That's the out-of-home operation basically.

I want to add that basically withoutMr. Love and Dawn Murray and DJJ and DCF, theymake my job more -- very easy because withouttheir support, I couldn't do what I do.

MR. SACHS: This is Walt. I want to makesure I understand that chart correctly becauseit was atmospheric in these numbers. It appearsto me that for every kid that enters care, 1,200kids are diverted to DJJ --

UNIDENTIFIED SPEAKER: Percentage.

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MR. SACHS: Yeah, but a 1,200 percentincrease, is that 12 kids is that how you'regoing to write 12, 1 to 12, for every kid 12 getdiverted?

UNIDENTIFIED SPEAKER: (Unintelligible.)MR. SACHS: 1 to 12. Okay. I get confused

over 1,200 percent. Okay, I get 100 percent,but 1,200 percent -- okay. Now I got it. Soevery kid that comes in, 12 are diverted.

UNIDENTIFIED SPEAKER: Yes.MR. SACHS: All right. I got the math.MR. KURTH: And I really -- I think what I

-- and when we talk about leveraging and returnon invest -- this is Greg -- I want to emphasizethese are kids where Burney has been asked toget involved because we really know there's areal issue of these kids possibly coming intocare unless we do something.

So JPOs are reaching out to him for reason.Other folks are reaching out to him, and I thinkthat's rather significant from our perspective.

MR. SACHS: Did Burney start in '09?MR. KURTH: Burney started in '05, '06 --

'04, '05.MR. SACHS: Come on, Burney, what were you

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doing for five years? What -- if you had to tieit to something, '09, bang, '10, bang, '11,there's huge increases. You went from four kidsto averaging two over five years --

MR. COX: Twelve.UNIDENTIFIED SPEAKER: (Unintelligible).MR. VAUGHN: Well, the champion agreement,

that's part of the MMYA, Mentor Motivating Youthprogram and without those agencies, that's whatmade the differences.

UNIDENTIFIED SPEAKER: And he was alsobuilding those relationships in 2005, 2006 --

MR. SACHS: And your kids entering thefront door is going down.

UNIDENTIFIED SPEAKER: Uh-huh.MR. SACHS: So it's a --MR. KURTH: I want to emphasize also going

back four years ago Burney was involved in whatwas called case assignment as a regularcounselor, so this wasn't his own job. When welooked at what he was able to do in terms of theDJJ referrals, because he was actually on call,we figured out it would be best just to continueto have him begin really in '07 to really beginthis process on a full-time basis. I think that

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also helped us break down this wall.MS. SCOTT: On the 2011, I'm a little

confused. We're not there yet, but --UNIDENTIFIED SPEAKER: It's the fiscal year

ending (unintelligible).UNIDENTIFIED SPEAKER: So it's based on

three or four months so far (unintelligible).UNIDENTIFIED SPEAKER: Yes.UNIDENTIFIED SPEAKER: Okay. Did you and

Scott say something?UNIDENTIFIED SPEAKER: No. I was going to

ask a similar question. We were looking in thefuture.

MR. KURTH: I was thinking Bernie's prettyprophetic.

UNIDENTIFIED SPEAKER: Yeah.MR. SACHS: Rod, did you have any other

questions regarding the DJJ, DCF crossover kids?MR. LOVE: No, I'm good. Thank you.MR. SACHS: Okay.MR. KURTH: Thank you, Walt. We're going

to continue to move on. And I'm really proud ofthe fact that I'm here to introduce SelenaNorman. We are very proud of the fact that wewere the first lead agency really in terms of

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post adoption support program, and the first totrack and develop a manual that we are going tohand out, and I really want to kind of turn thisover to Selena.

MS. NORMAN: Good afternoon, everybody.I'm Selena. I'm here to talk to you about ourpost adoption services program, and how itintegrates with our diversion, prevention andin-home services. This past fiscal year we'veserved about 300 adopted children just in fiscalyear '09/2010. Since 2007 when I started, it'sbeen about 570 to 600 kids in Orange and OsceolaCounty.

We work with families in Orange and OsceolaCounty, but we also work with families in arange of counties, families who live here andmay have moved out of county or out of state.We work with is out-of-state families becausethey originated from here. We work withfamilies in neighboring counties who may nothave access to post adoption services. We havequite a few families from Seminole County thataccess services for post adoption.

We work with families who have adoptedprivately, families who adopted internationally,

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and this is because those families also haverisk of staying intact based on numerous issuesof trauma. So we work with those families aswell, and they are very receptive to that.

MR. COOPER: This is John. Just a quickquestion, we were actually having a discussionthis morning, but do we have numbers locally, ifnot statewide, the number of disruptedinternational adoptions? I know we had a couplein the last couple of years, but are we trackingthat in anyway? Or anecdotally do you have anumber?

MS. NORMAN: Internationally I would sayprobably just based on the ones that we've seenon our end only a few. A few that we've beenable to capture. Statewide I know that's been achallenge as well of capturing that informationbecause it would depend on the family disclosingthe adoption at the shelter hearing, and if thatdoesn't happen, then there's no real way ofknowing that as of yet.

So we work with our resource specialistswhen they attend ICC staffings and say look, youknow, if you hear that this family has adoptedand we don't pick up on it because it wasn't a

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local adoption, you know, let me know so we canstart tracking that. So that's a newdevelopment.

MR. COOPER: Is that international?MS. NORMAN: I mean, the international

lines are few, but they -- I would say it's verysignificantly low. But they do -- they arereaching out for supports for support groups andthings.

MR. COOPER: Right. I hear that it'sbecoming a challenge, but I'm not sure that wecan actually defend that because we don't havethe data that supports it?

MS. NORMAN: Yeah.UNIDENTIFIED SPEAKER: We could have a

whole training on it.UNIDENTIFIED SPEAKER: We are actually

going to look at -- were going to look atdisruption (unintelligible).

MS. NORMAN: Speaking to our post adoptionprogram goals, is to keep families intact and toreduce trauma to children and to the siblings ofthose children and the parents. To minimizeadoptions to solutions by supporting andeducating families.

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As Greg had mentioned, we've developedFlorida's first adoptive parent handbook andpost adoption resource guide. It was inspiredby a Seminole adoptive parent actually whoreally was just looking for answers to questionsshe could not find, and so we went through andfigured out what her questions were and wentthrough and answer them and developed themanual. The manual was very successful. JimCallender's (ph) office requested a copy and Ibelieve they now have a statewide manual. So weare very proud of that.

We also -- one of our main goals is todevelop provider capacity for post-adoptivefamilies, and providers primarily focusing onmental health counselors that have an adoptioncompetency level, but other providers as well.In May of 2008 Family Services hosted the firstadoption competency training in Orlando. Weinvited providers from all over the state. Wehad about 35 providers that came to that. Thetrainer who was there as our trainer was apublished adoption competency expert whodeveloped her own adoption competency curriculumin New York.

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Speaking to our continuum of services topost adoption in Orange and Osceola County, weprovide resource information and referral,counseling referrals and service referrals,targeted case management referrals. Speaking totargeted case management, it's a huge support topost adoption services. When I started, Ithought I would be doing tons of direct casemanagement, and to be one person serving over2,000 children that are adopted in Orange andOsceola County, it seemed kind of -- I neededmore partners. So we worked with our targetedcase management organization real well, makinglots of referrals all covered by Medicaid andthey worked very well with the parents.

I provide support with our coordination ofSIP applications for adopted children that hassevere mental health issues, working with theSAM office, with Ingrid in Orange and OsceolaCounty as well as Cheryl Lyons in Brevard andSeminole County.

We provide educational support. I've satin on IEP meetings and referred families for oureducational liaisons when needed as well as someof my interns. We provide support to our -- we

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provide a children's, teen and parent supportgroup which just started out small and has justgrown into an enormous support for adoptivefamilies.

We also provide emergency financialassistance when necessary. We start withreferrals to the community service center sincethat is their forte, they do a wonderful jobworking with our families. I'll also work withour diversion prevention specialist, also workwith Burney because sometimes we have youth thatmaybe their adopted at three and four years old,maybe they had substance abuse exposure asbabies or some severe trauma early on. And theygrow into teenagers who need a lot of services,so some of our families have the same dynamicsas any family in our community. So we will workwith Burney on YAP services and utilizingMentoring and Motivating Youth.

Speaking about mental health and adoption,nationally 25 to 30 percent of adopted childrenhave a diagnosed mental health disorder as wellas 10 to 15 percent of children in residentialtreatment centers are adopted children. InFlorida we think it's a little higher. I gave

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that statistic to one of our local group homes,and they said wow, our population of kids it's alittle higher than that of adopted youth.

So one of the things we encourage with ouradoption professionals are that parents are morelikely to access those services when they aresupported by their adoption professionals. So Iwork very closely with our adoption unit, withMs. Juanita on educating our CMO staff about theservices after adoption.

Another thing to touch on, our specializedproviders do not accept -- well, some of ourspecialized providers do not take Medicaid. Wealways look to refer families to counselors whoaccept Medicaid as a first line of service, butsometimes after six months or a year ofcounseling and it's not moving along as well asthe family would like or let's say Medicaidservices are capped because that happens sofrequently, we will supplement assistance to thefamilies to pay for the specialized providerswho may be EMDR certified therapists or atherapist who specializes in attachment andbonding issues.

The counseling services for adoptive

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families, it started -- when I started and wedid the adoption competency training, it reallygave us an opportunity to meet a lot of thetherapists who are specialized working with ourkids are passionate about adoption and to reallybuild a base of providers for that.

At the state level I know the Department ofChildren and Families has a sponsored adoptioncompetency certification process now, and a lotof those providers we were already working with,went ahead and got certified in that adoptioncompetency sponsored by DCF. It was throughRutgers University adoption competency training.

The focus of a lot of the therapy for thefamilies is very family centered, familyfocused, therapeutic approach. We reallyencourage therapists to use that approach asopposed to just individual counseling for thechild because we want the parents to be able tohave those coping strategies when working withour children. The therapists do a great jobeducating families about brain development andtrauma. I know we are working on that on thefront end as well in training with adoptivefamilies. In the new TAPP curriculum there's a

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lot on brain development and trauma.Service and therapy referrals are unique to

each family. We try not to do cookie-cutterservices. We really try to make sure thatwhatever the family dynamics are and whatever isgoing on with them, that we meet the specificneeds. The therapists are wonderful. They do agreat job educating and supporting familiesthrough treatment. I know now a lot of ourpost-adoptive counselors are working onpre-adoption counseling as well to make it moreseamless and make the process more streamlinedfor families, so they don't feel that after anadoption finalizes, they are kind of leftwithout support. So they are really feelingsupported.

MS. WHITE: This is Juanita. Another thingwe have the therapists do in working with thekids to prepare them for adoption because wefeel that working with the kids in conjunctionwith their therapists would ensure a more stableplacement for us to move forward towardspermanency.

MS. NORMAN: Our adoption support groups,they meet monthly in each county. We have one

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usually the second or third Thursday of themonth in Orange County at Family Services. Andwe have one in Osceola County which is usuallythe fourth Thursday of the month at thechildren's advocacy center. They are verygenerous, Joy Chuba over there, to donate theirspace for that.

Our Osceola County families can meet -- thegroup has really grown into quite a structuredgroup. It originally started with just a parentgroup which was meant to be psychoeducational,an educational group and also a mutual sharinggroup. So they have the opportunity to learnfrom each other.

What we found was some parents wanted tocome but couldn't because they did not havechild care, so we started with utilizing stafffrom Family Services volunteers who would stayafter and watch the youth while the parents metfor the meeting. What it grew into though is wehave a partnership with UCF and their Masters insocial work interns, and they developed a kidscurriculum and a teens curriculum and we wereable to turn the kids group into a therapeuticgroup as well for the kids to do family

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activities while their parents meet.The parents enjoy it. The kids enjoy it.

In January we started a teen group which wassupposed to be a temporary group. However, theteens really wanted to keep coming back. If wecould have the teen group every week, they wouldcome. But we have that monthly as well inconjunction with the parent group. And we haveregulars now, we have an average of fourteenagers to seven or eight teenagers that cometo this support group now every month, and theyencourage their other friends to come.

It's been a year now. We've looked atdoing more research into the stabilization ofour support group families, but we have somefamilies that have now developed relationshipswith each other where they do weekend activitiestogether and have really proved to be a supportin stabilizing some of those adoptions.

The topics of the support group changemonthly. We do -- it was based on a survey wesent out in the subsidy checks two years back onwhat kind of topics you want to hear about?What are the things you want to learn about? Sothe topics range for mental health issues and

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adoption, open and close adoption, braindevelopment, bonding and attachment and loss arebig. Adoption Medicaid which is a recycledtopic, we are doing that one again this month.We have our Medicaid specialist coming out,sitting down with the families and answering anyquestions they might have. Birth families is abig topic that actually comes up even when it'snot on topic night. But these are just some ofthe things we do at the support group meetings.

Speaking to enhancements to post adoptionservices, we look to enhance the strategies inthe Florida child abuse and prevention plan.That's a big -- I know there's a big push forthe child abuse and prevention plan at the statelevel. And looking at the six strategies thatare listed in the child abuse and preventionplan, we are meeting each of those strategies.

One is information to adoptive familieswhich we provide extensively adoption competencycertified therapists, which we are on trackwith. Providing a post adoption servicescounselor, which is why I'm here I guess.Support groups which we have full onencompassing support groups now. And then our

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faith-based efforts which I know we have ourfaith-based counsel moving forward withsupporting all families at Family Services.

We look to expand our adoptive familysupport group, and we can do this by adding afew contracted hours for our co-facilitators. Ididn't mention this before, but I don't run thesupport group by myself. We have a contractedprovider who is an adoption therapist, licensedclinical social worker and an adoptive parent.We really got a bang for our contractedprovider.

She co-facilitates the group with myself,and the beauty of that, the greatness in that,you have your resource person at the meeting,but you also have a person who has some clinicalexperience and has walked the walk. They'readoptive parents, so they really understand thedynamics of what's going on. So we look toexpand those hours to provide additionalmeetings as well as expanding our relationshipwith the colleges and obtaining more clinicalinternship opportunities so that those internscan work with the children and the teens and theparents.

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We look at holding semi-annualpost-adoptive parent training and workshops.The state does this about once a year. They'llhave a conference statewide and have parentscome and get some training. So we look to dosomething localize for local families so theycan all come. We're looking at having, similarto our support group structure, having a teencomponent, having a kids component, so that thewhole family can come and learn about some ofthe challenges and issues they're having withtheir adoption. They can learn from mentalhealth professionals. We'll have someexperienced adoptive parents there as well assome breakout sessions where they cantroubleshoot with each other which has been areal effective tool for the support groups.

Another enhancement is enhancingutilization over a total post adoption database.We are the only CBC and the state that's reallytracking the services we provide, and we arelooking to put some of that into FSFN as well astailoring it to IRIS. I use IRIS as well forpurchase of services for their supplementalservices.

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MS. SCOTT: I have a question. Onoutreach, you know, because I adopted a childthat had been in foster care for four years whenshe was eight and now she is 14 and the outreachof previous adoptive parents, can you talk alittle bit about that? I know like -- I do haveto say that what you get in the flyer with thesubsidy check every month is, you know, look atit and, okay, I don't need it this month, butyou know, so I think that's great.

A month might come along and I think that'sgreat, but how do you -- like if you have reachout to other previous adoptive parents,especially if they have direct deposit of theirsubsidy check.

MS. NORMAN: Well, they still get the EFTstatements, just like you would get your directcheck, they would get the EFT statements, sothey get those flyers as well. I mean, there isa challenge because we do have families who haveadopted from other parts of the state who movedto Orange and Osceola County, so of course theirsubsidy check is not going to have myinformation in it.

But we do have a list of providers

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throughout the state that do post adoption work.And so every chance I get, I send those otherstatewide CBCs and CMOs our local information soif they have a family in need that calls them,they can contact us. At a statewide level,Tallahassee has a list of post adoptioncounselors and adoption unit contacts, so we tryto network with each other to catch thosefamilies as well. So I hope that answers yourquestion.

And then speaking to families that just areunder the radar because they adopted somewhereelse, aren't in contact, it's really -- thoseare the, I think, the most challenging to reachfamilies, but we still get them. We still getthe families that, you know, moved here fromLouisiana and are looking for services, but it'susually through working -- at that point theyare usually going to call through the hotlineand the diversion prevention specialist contactsme right away saying are you working with thisfamily. And then we kind of wrap that familyaround with as many services as we can.

MS. SCOTT: I just think it's importantthat you keep putting it out there --

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MS. NORMAN: Oh, yeah. I know the parentsare spreading the word, the ones that come tothe meetings. Another thing that we do too onthe case management level is if we have anannual -- well, when we have trainings for casemanagement about adoptions, I'll come out tothose trainings and say don't forget, you know,we have post adoption services out there. Don'tforget to give the families information.

And our handbook actually goes to everyfamily that finalizes now. When they come in tosign their subsidy agreement and get all oftheir information, they get a copy of thehandbook, and they are gone over all of thebenefits of adoption now.

MR. DEBOARD: Excuse me. This is Shane.I've got a question. I know some -- a certainpercentage of I guess adoptions are going todisrupt and dissolve, do you have a comparisonto know here is FSMO's percentage of disruptedand dissolved adoptions that you actually didover the last few years compared to thestatewide average? Do you know that or do weeven track that? I don't know if we track thatas a state or not.

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MS. NORMAN: The state is starting to trackthat. I don't have the states exact number. Ido have some of our numbers, and our actualfamilies that have dissolved that are ouradoptions are at about 3 to 5 percent.Nationally, I know that it's about 10 to 20percent. And then there are those adoptionsthat dissolve that are from other places. Thefamilies kind of --

MR. DEBOARD: Right. I'm just talking --it seems like you got a really great program andyou've put a lot of effort into it to try tomaintain the families that do adoptions which isgreat, and I'm just curious, you know, I hate toboil it down to numbers, but you know, if we hadthe numbers, we'd like to see the differencebetween hey we've got a great program, you know,we have a very low dissolution rate as comparedto the state on average. You know, becausemaybe you don't have such great programs otherplaces. That was the reason for the question.

UNIDENTIFIED SPEAKER: I did provide that-- someone, I think Dawn asked aboutdissolution, and so we've looked at dissolutionsover, I can't remember, it was like 600

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adoptions.MR. DEBOARD: Okay.UNIDENTIFIED SPEAKER: 21 dissolutions of

which of those 21 dissolutions in the sameperiod, nine of them were children that we hadactually placed, and the other kids were fromother areas or even private adoptions, nationaladoptions. So our dissolution rate was 1.4, andhistorically the disruption rate for adoptionsjust in general is about 15 percent?

UNIDENTIFIED SPEAKER: Yeah.UNIDENTIFIED SPEAKER: And that includes

infant adoptions all the way through specialneeds adoptions.

MR. SACHS: Significantly low.MR. DEBOARD: Yeah. That's what I was

trying to get out. Thank you.MR. KURTH: If I can make and add to that,

Shane, a lot of the other components is that thebest recruiters are adoptive parents themselves--

MR. DEBOARD: Sure.MR. KURTH: -- adoptive parents, so we

really think that there's some -- we haven'tcollected this data, but there's a lot of

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anecdotal information out there from parents whogot post adoption services who said, try thisout because you won't be forgotten afterfinalization. So we think there are somebenefits on the recruitment side as well.

MR. DEBOARD: Right. Okay.MS. NORMAN: Some of the future

enhancements of our post adoption services isour respite program. The biggest gap nationwidein post adoption is the availability of respitecare for adoptive families that really need it.We were fortunate this year, we are veryexcited, we obtained a seed funding grant fromAdopt Those Kids, for $5,000, to start up apilot respite program. There were only 34awarded in the country.

In conjunction with that we received anadditional $8,000 in funding from one of ourlocal faith-based groups in Osceola County, theJMJ Life Center, and that's exclusive forOsceola County families for respite care. Itwill be based on a voucher-based system. Ourco-facilitator of our support group willcoordinate a lot of this service. She ran avoucher-based system in Illinois for special

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needs adoptive families. It will be based on aneeds assessment completed by our clinicalinterns. It will be gauged on participation insupport groups, so we expect our families whomeet the respite care to reach out as well andbe participants in the support group.

And we look to develop a network of respitefamilies, and that network of respite familieswe are going to reach out to our new adoptivefamilies who are just certified -- or justapproved to be adoptive parents. There are somany pros to this. They're background screenedand TAPP trained, they've got the parentingtraining, they are looking for that hands-onparenting experience. They'll get that workingwith adoptive families that are already out inthe community. And it creates a greatmentorship, partnership between our adoptivefamilies that are experienced families and thenew families who may not be matched with a childyet.

MR. BEUTLER: Dean Beutler. Let me askabout that. You said you are planning to dothat?

MS. NORMAN: Yes. This is in the works.

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MR. BEUTLER: When do you anticipate?MS. NORMAN: Well, I mean, the Adopt Those

Kids grant was -- the training was last week forus to come and get the configurations of howthey want their program to run. Our reportingsystem -- because it is federal dollars, so wehave to report back to them. So we are lookingat -- we just sent out a respite needsassessment through the subsidy checks today.

So we will be looking at the mentorshipopportunity within the next month or tworeaching out to our TAPP training. Now I'm surethat's not going to accumulate in a one-monthtime, but I would say in the next six months weare looking to really develop that network foradoptive parents.

MR. BEUTLER: Are you aware of thisoccurring anywhere else in the state or in thecountry?

MS. NORMAN: No. Jacksonville last yearwas awarded the same grant, they structuredtheir program differently and unfortunately itdid not work out for them. So we are the onlyone.

MR. BEUTLER: Thank you.

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MS. NORMAN: The lifecycle of adoption hasseveral different dynamics than a biological orbirth family which require additional support,diversion prevention services, so it takes acommunity family system and providers workingtogether to support adoptive families throughoutthe lifecycle of adoption.

MR. SACHS: This is Walt. I have a coupleof questions. Dental services, how is thatgoing? I didn't see anything in the resourceguide regarding it, and you didn't talk aboutit. So what's happening in the world of dental?

MS. NORMAN: Well, Medicaid is provided toall families that adopt through foster care, soprimarily -- which there is a five page sectionthere about adoption Medicaid with the help ofSherry Beck (ph), our Medicaid specialist -- sodental services, whatever is not covered byMedicaid which happens sometimes with oralsurgeries and things, there are situations wherefamilies cannot afford that assistance. Then wewill look at that situation on a case-by-casebasis to support families through that.Orthodontics is one.

MR. SACHS: Are there available providers

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in Orange, Osceola who are available to thesystem and support adoptive families that arepartners or --

MS. NORMAN: Well, there are some communityresources, which I don't have at my fingertipsright now, but we do have a couple medical homesor dental providers, like Threshold (ph)provides a dental program. We have a Medicaidprovider list that is the AHCA Medipass providerlist, and every chance we have, we provide thatlisted to adoptive families. They can always --one of the services I didn't have on the slidewas I do help families troubleshoot withMedicaid issues. If I can't answer it, I referthem to our Medicaid specialist, but 9 times outof 10 they call, I'll provide them resourceinformation regarding Medicaid or locating aMedicaid provider if they are having a hard timewith that.

MR. SACHS: UCF doesn't have a dentalprogram does it?

MS. NORTON: No.UNIDENTIFIED SPEAKER: We just put our

dental panel together actually.(Unintelligible) panel for behavioral health.

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We just did the same thing for dental, so that'salmost hot off the presses.

MR. SACHS: Second question is in our 2009version of our template, we asked the leadagency to develop a protocol on when you shareinformation with the adoptive parent prior tothe adoption, and when does that occur and whatis the process used to do that disclosure? Howfar prior to the adoption event does the parentknow about the child's entire history? So canyou talk a little bit about your protocol forthat?

MS. WHITE: This is Juanita White. If it'sa relative or foster parent of course we aretalking to them all along in terms of, you know,the history of the child when the child cameinto this system and et cetera. We have a fulldisclosure staffing and it's usually between 2to 4 weeks before the finalization because wewant families to come in, you know, we have toget services in place or, you know, if we haveto assist them in any other way, we want to doit before we get to the point of finalization.

At the full disclosure we advise -- we askthe parent to come. I have also asked that the

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foster parent -- because I've started sitting inon the full disclosure staffing and if this isan adoption only, I would like to see the fosterparents also in attendance because who knowsthat child better than the person that hasparented that child (unintelligible) and anytherapies involved with the child.

If it's necessary or, you know, to ask aschool administrator, a counselor who has beeninvolved with that child, I feel that it's ourresponsibility to provide parents with --

MR. SACHS: Same for group homes, if it's agroup home residency, do you have the group homeprovider come?

MS. WHITE: Yes.MS. MURRAY: This is Dawn. You said that

was held before finalization, what informationis shared before placement if it's an adoptiveparent not a foster parent?

MS. WHITE: If it's an adoptive parent andits an adopt only, we also provide thatinformation to make sure that the therapists orthe case managers, whoever is involved with thechild, I'll provide as much information aspossible. As much as we know, they know.

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We also have developed -- and this has beenreally cool, you know, within the agency. We'vedeveloped a pre-adopt support group where wehave families to come in who do not haveidentified placements, so they come to a grouponce a month, and we have therapists who come into talk about different issues that childrenmight have within the system whether it's issuesdealing with (unintelligible), issues dealingwith separation, behavior issues, whatever, inorder to prepare these families so once they getto the point of having a child placed with themor are considered for placement, then thefoundation or the pipeline information in termsof, you know, what kids -- in terms of movementor have been removed from a home and at thepoint of finalization, they will already have agood idea.

MR. SACHS: One other question. Thisrelates to money. We've talked about that thismorning as it relates to adoption services.Greg, I need you to pull this out if you stillhave it, because I'm looking at a line on the, Iguess it was your schedule of funds AS000adoption services, $12,500 and then there are

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subsidies down in section C.Your contract specifically says that you

are limited, you know, your risk is limitedbecause of the legislative funding of adoptionsubsidies. The first question is do youanticipate that the volume of adoptions and theprogressive nature of the subsidy requirementover time, that you are going to have to dealwith that at some point as a risk issue wherethe subsidy numbers are going to get too bigversus what you're getting? Or do you find theDepartment's way of sort of reallocating thesubsidy at the end of the year to make it allmakes sense is working?

MR. KURTH: This is Greg. Walter, I'd saythe latter part is definitely working. We getan idea as to what that line item will be. Itall depends on the timing issues as to whenadoptions are going to hit. We used to have awhole lot of adoptions sort of at the end of theyear, and now it's actually smoothed out quite abit. I don't know where we're at this year.Juanita, in terms of finalization so far, it'sabout --

MS. WHITE: We've had to date, I think, 57

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and we're looking at, hopefully by December 31,100 finalization's --

MR. SACHS: So 50 a quarter?MR. KURTH: It's about 50 a quarter and

that's much more smoothed out.MR. SACHS: As opposed to 50 and then 200.MR. KURTH: Well, we used to -- we used to

do a lot on National Adoption Day, and we stillwill and whatnot, but it's a little bit smootherthroughout the entire year. But I like theprocess that the Department does to look at itas a way to look at adoption subsidies for poolstatewide and then figure out a way to makethose adjustments at the end.

MR. SACHS: Then with the specific line upabove, 12,500, publicly is that number what youput in green money toward adoption services oris there --

MR. KURTH: It's a lot more than that.MR. SACHS: -- or is there a whole bunch of

other money buried elsewhere and we just see, ifI'm an adoptive parent and I get this piece ofpaper, I'm all pissed off because all I see isadoption services 12 grand and that's all youdo, 12 grand out of whatever million? I know

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that's not real.MR. KURTH: Correct.MR. SACHS: I just wondered how you -- how

you would talk about that if you wereapproached.

MR. KURTH: I can -- yeah, I mean, I wouldjust say that because of the flexibility that wehave in our budget where we are pulling indollars or some PSSF money as well that we areusing for adoption supports. We are using thosedollars and whatnot. We are also pulling somedollars elsewhere even out of other casemanagement as well. And then of course asSelena has noted, we have gone out and got somegrants Adopt US Kids, JMJ Counseling and whatnotto help support the rest of the respite portionof the program.

But we really always looked at ourselvessupporting Selena's position which we know isabove and beyond the actual allocation just forthat particular post adoption activity.

MS. LEWIS: This is a pictorial ofwraparound. I would like to introduce TheresaBurt, she is our wraparound specialist. She hasbeen intimately involved in developing the POS

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system, our Purchase of Service from IRIS. Sheattends many of the LRT staffings, NBTstaffings, level of care staffings, and we havesome very intense in-home cases. I'm going toturn this over to Theresa so that she can tellyou about some of the things that she has donespecifically with wraparound.

MS. BURT: I'm Theresa Burt. I'm thewraparound specialist at Family Services. Iquite often get asked what is wraparound? Soit's basically a very comprehensive way ofcustomizing services, resources and supports forthose families specifically that have those justreally intense needs, and we are talking aboutfamilies that probably touch multiple systemsover time and it's a way to go in and reallycomprehensively, in a family driven way, likesit with that family. Really find out what'sgoing on, and find out what they need and justwrap the services around them so that they canbe successful and happy.

Just one example of how we have done thatis we had a child who was being served by ourcase management organization and they were justkind of stuck. The mom had touched several

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systems across the county trying to get servicesfor her son who was developmentally delayed. Hehas autism, mental health services. They hadleft a domestic violence situation severalmonths prior, and they were just trying to geton their feet. The mom was trying to figure outhow to do this, provide for her son, trying tojust navigate all of that.

So I was asked to go in with the casemanagement organization to help support them andsee what we could do. The biggest thing thatthe mom was trying to do at that time was getAgency for Persons With Disabilities on board towork with her son, and she was just having ahard time navigating the system and things likethat. The mom was Haitian, so she was runninginto some cultural barriers along the way too,like trying to navigate services.

So basically what we did is we went in andwe sat down with mom that first -- the first daythat I sat down with mom and the case manager,and when we looked at all of her needs, likejust sat and listened to her what was going on,she had so many needs from basic needs down.She was having utility issues. She was having

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rent issues, childcare issues, just a multiplearray of issues, and they had worked very hardtrying to get things in place and then just runinto a lot of barriers.

So what we did is we began to build a teamwith mom. Find out, you know, who do you feellike you need, what do you need, and as thefacilitator of this process I began to pull inthose people. We pulled in -- the child was notenrolled in school at the time, so we got OrangeCounty Public Schools on board. We were able toget a behavioral analysts who was Haitianthrough adopt behavioral services. The teacheridentified, through Orange County Public Schoolsas well, they were able to identify Haitianteachers to start working with this child athome initially.

We worked with the YAP program who has beena huge support to mom, and they kind of servedas like a family partner to mom and reallyhelped her navigate systems like child support,Medicaid, food stamps, all of those things. Theadvocate was also able to go -- mom wascurrently in school, trying to get someeducation so that she could better herself. So

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she was also able to go to the mom's school andwork on some of those relationships and issuesaround mom's childcare issues and support her inthat so that she could be successful and get onher feet in that way.

We also worked -- we reached out to Agencyfor Persons With Disabilities and began thatprocess. We started with the application. Theydid eventually get on the med waiver for APD.At that point we helped her do the crisis toolwhich went up to Tallahassee, came back and heis now on the med waiver and is able to get thesupport and services that he needs through themwhich was a huge journey that we took with herthrough that process and supported her through.

She identified her sister, her brother andher mom that lived locally who were supports toher. So we pulled them in and they have beenkey in some childcare issues and things likethat. They've also provided a lot of emotionalsupport for mom. And they have also providedsome economic help throughout this wholeprocess.

What we did was we had ongoing teammeetings. We brought everybody to the table,

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and everybody just sat with mom and just brokedown what were the barriers? And they as a teamjust sat and found out what their challengeswere, ways that they could collaborate moretogether. One of the unique things was when weleft the meeting, Orange County Public Schoolsand ADAPT exchanged phone numbers. They wouldtalk outside of the meetings and they would meettogether sometimes at mom's home to helpimplement certain behavior strategies that momwas needing help with. So it was really just agreat way that they collaborated and workedtogether as a team.

At the last Orange County Public Schoolmeeting that we had, they actually -- they weresaying that this was one of the bestcollaborations that they had ever seen becausepeople had really put their heads together andhad to think outside the box. And OrangeCounty, specifically, they recognized that theydidn't have a specific program that this childfit into anywhere in the county.

So we sat at the table and they said, youknow what? We've got to look at what this kidneeds and fit the services to meet his needs.

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And they really worked hard to make that happenfor this child. So currently the child when wefirst got involved which was back in December,was really at risk of coming into care becauseall of these issues that were going on. Todate, they have all of these supports andservices in place, and the child has not comeinto care. He has stayed with his mom.

And the strength that we identified withmom is that she was very committed to workingwith her child and meeting her child's needs.At no time was she wanting her child to comeinto care. So we really, really try to supporther in that and provide her what she neededthrough the wraparound process to make thathappen.

So that was just a specific case that weimplemented this, and then like he said I dowork with LRT and different -- so I'm alwayslooking for ways that we use these principles ofwraparound to reach out to our families and makeit family driven, strength-based, culturallycompetent and make it tailored to what our kidsneed to be successful.

Then the other part of what I've been doing

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recently is I've been a part of the wraparoundOrange project. This is a grant from substanceabuse and mental health administration thatOrange County has received, and actually FamilyServices was a part of this at the verybeginning stages. They helped write a part ofthe grant, and then Greg has been a part of themanagement team and the governing committee andthe finance and sustainability committee.

I've had the privilege to be on theclinical committee and subcommittee forwraparound Orange. I've got to work withCarolann on that. What we've done is we'veworked to help build the model for wraparoundOrange, the service delivery, implementation andbecause of the experience that I've had inwraparound in the participation and planning,moving forward I'm going to be the leadfacilitator for the project, the wraparoundOrange under Family Services of Metro Orlando.

MS. DUNCAN: I just wanted to say -- thisis Carolann -- she's a star. She's done such agreat job. I feel like she's worked for merecently. I feel like I worked for wraparoundand she worked for me.

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MR. COX: Are you interested in moving toTampa?

MR. ATKINS: This is René. I was sittinghere listening to you going through yourprogram, and it really sounds very impressive.Are you the only staff member that's deliveringthese services? I mean, it just seems as if,you know, it's just so much for one person.

MS. BURT: I'm the wraparound specialist atFamily Services, but we do have staff throughoutthe county that are housed at -- part of ourcase management organizations who have beentrained in family team conferencing which issimilar, it's a similar way to work withfamilies, and we are definitely -- we've beentalking about moving forward and ways that wecan add this process or this way of working withfamilies throughout our system of care.

One of those is placement stabilization.We've been talking about ways that we can liketurn those into more of a wraparound process andthat the youth at the center of that especiallyones like in our group homes and things likethat. And really sit down and talk with them.Find out what are they wanting? What are they

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feeling? And just kind of make it more youthdriven so that we can help stabilize them. Sothat's just one example of ways that we want toutilize this process and train more of our staffeven in just using this process and working withfamilies.

MS. LEWIS: Okay. And we'll talk moreabout that in a few minutes, René. This is anintegrated substance abuse and mental health,and just so you have a feel for this slide, theblue are the Family Services employees. Thegreen is the provider panel that Karen hasreferenced a number of times. They may or maynot accept Medicaid, but they are specialtyproviders that can deal with the intense needsand the special services that may be required ofour families. The yellow is the behavioralpediatric network, and Greg mentioned that wherewe brought our psychiatrists together and it's aproject through CMS for children withpsychotropic medications can go through that.Then the mental health and substance abuse thatincludes the SAM office as well as a communitymental health center and other providers thatmay not be part of the provider panel.

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The clinical coordinators are new thisyear. This is something that Family Servicesfunded the CMOs to have. When we startedlooking at the number of children on sexualsafety plans, the number of children that hadpsychotropic medications and the intense needsthat these kids were coming into care with, werealized that we needed some additional clinicalexpertise in the CMOs.

And our two CMOs -- we have four CMOs, butthe two smaller ones, YFA and OHU, theirclinical coordinators are involved in everysingle one of these. They attend all of themeetings that I mentioned that Theresa goes to.They are intimately involved in placement. Theyare available for any kind of -- the GAL maycall or we may call, they have all of theinformation. They write the safety plans forthe children, and they input all of themedications into FSFN.

They have been very, very helpful for us.They can make direct referrals and many of themdo make direct referrals. They attend the ICCstaffings. We have found that we wanted toreally embed this clinical overlay into all the

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different things, so they will pull peopletogether. They also are involved with theMagellan telephone calls as we are making phonecalls and getting the authorizations, they willbe a part of that as well. So they have beeninvaluable to us in making decisions.

And this is -- we have taken -- we haveused the CANS tool to help drive placement fromthe very beginning as to how that child matchesup with where we are going. And as I mentionedearlier, we are going to be doing surveys forthe foster parents, and the clinicalcoordinators are going to be involved with this.We meet with them every week to find out some ofthe issues and challenges that they areexperiencing.

And -- I wanted to say something else, butI don't remember. No, I guess that's it. Ithink that's it. So they have been veryinvolved.

The next slide shows all of the differentthings that the clinical coordinators do, sothey have been very helpful as far as providingclinical oversight. They are wonderful for thefamily case managers, and they also, especially

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the two smaller CMOs, but across the board theywill review the CBHAs and make sure that theappropriate services are made by the family casemanagers, and they work closely with Theresa orthe resource specialist within the CMO to makethe services available.

Melinda is going to talk about familyengagement.

MR. SACHS: This is Walt. I have asubstance, mental health issue, question. I mayhave missed it or you are calling it somethingdifferent, but the family interventionspecialist in the SAM program, how is thatworking? How is that not working?

MS. LEWIS: You're talking about FIS?MR. SACHS: Yeah.MS. LEWIS: They were under the -- in the

orange under substance abuse and mental health,and they are available to the resourcespecialist that are housed within the CMOs. Theclinical coordinators also work with them, andthe referrals are made generally right there.But if they have a known substance abuse issue,we don't have to go through them. We can makereferrals directly to our providers to take care

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of that. But if there's a question obviously weuse them, and they have been wonderful.

We do have a waiting list I think. It goesback and forth.

MR. SACHS: But there is an awareness,commitment? There is participation?

MS. LEWIS: Yes.MR. SACHS: It's working?MS. LEWIS: And we meet monthly with -- no

I think it's quarterly. We meet quarterly withthem to talk about different issues, but theyare available and they are wonderful.

MR. SACHS: There are parts of the statewhere it's not.

MS. LEWIS: No, it's --MR. SACHS: So I just wanted to --MS. LEWIS: We met years ago to work that

out, and it hasn't been an issue. And if we'veever had a conflict, we call the SAM office.And I wanted to also go back and say that westill work with the SAM office when we havechildren that we need to admit into an RTC, andwe have the suitability, but they -- but theyare too far down the wait list and we reallyneed to get them in. Again, we work very well

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and they will direct us as to how -- where weare supposed to go. But there are not anyissues with that program.

MR. COX: This is Nick. Did I hear you saythey are in Orange? Do you have --

MS. LEWIS: They're in both.MR. COX: Oh, okay. I thought you said --MS. LEWIS: I was saying there is a waiting

list and it goes back and forth. We try to keepthat -- it doesn't happen very often, but onoccasion right now with the economy -- I'm notsure what it is, Nick, but we have seen anincrease in substance abuse and an increase inDV.

MR. COX: So have we.MR. KURTH: This is Greg. It's really been

on prescription drugs, on the prescription side.UNIDENTIFIED SPEAKER: Is there a problem

there?MR. KURTH: (Unintelligible) stuff is

easier, but --MR. BEUTLER: (Unintelligible) where are

they under the new proposed reward?MS. LEWIS: No, they are actually in --

they belong to the CMOs. We fund it, but they

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belong to the CMOs. They meet with us everyweek. They meet with the person that runs theMagellan portion, the UM coordinator and theymeet with me.

MR. BEUTLER: Okay.MS. LEWIS: Every week. It's been

wonderful.MS. MURRAY: This is Dawn. On the clinical

coordinators, what is their background?MS. LEWIS: All three -- there is four of

them. CHS, even though they are in twocounties, they only have one. We ask that theybe licensed. That they have some kind of mentalhealth licensure, but one gal who works with CHSand worked in the open door program forever, sheunderstood the system, she worked closely withthe doctors, they asked for -- to be able tohire her. So we went ahead and did that becauseshe was familiar with the children and theissues that we were dealing with.

The other three are licensed, andinterestingly enough none of them come out ofthe child welfare system. Some of them havemanaged care background. One of them -- two ofthem came out of -- one of them came out of

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state and the other one came from DJJ. But whenthe new one came on, she is shadowing the othersso that she can figure out what they're doingand how they bring best practices from eachother within their own CMOs.

MR. SACHS: As anxious as I am to get tofamily engagement, we need to take a break.It's 3:06, so let's take 10 minutes.

(A break was had.)MR. SACHS: Okay. Let's take our seats.

Let's have our seats and get started.Greg will be here shortly. I have no

problem with that. Rod, are you back? Rod willbe here in a minute. If we can get quietplease, we'll get started, and will turn it overto family engagement practices.

MS. LIS: Family engagement practices isreally part of everything that we do, so I thinkyou've heard from Selena and Burney and Theresaabout how we engage families and Stacey on theprevention side. So when were talking aboutfamily engagement here, we are really going tofocus on children that are in the system.That's where I think it's really crucial.Everywhere else we are definitely doing it

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because we have to do it.We have done several major initiatives

which I'm going to highlight super quick inlight of time. The first one is family teamconferencing. It's a national model. It'ssomething we invested in back around 2008. Webrought down a group of experts to come down anddo some training. Really started looking intothis. We then proceeded to do a pilot at KidsHope United where we were doing family teamconferencing with cases that were close toreunification. We felt like it was workingreally well.

We then decided that we were going toinstill it across all of our CMOs, and so now wefund for the CMOs to actually have a full-timefamily team conferencing manager within theirown service center. These professionals arethere to really engage the families. I mean, tome it's kind of like social work 101 from yearsago that we moved away from, but it's engagingthe families, having the families present,having them be part of the service delivery,making decisions along with the case and reallygetting them involved at the outset. So we

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built a lot of capacity within the CMOs toreally look at this.

In addition because it's a model thatreally everyone should instill, not just childwelfare case managers, but the whole system, weinvested in training. So we've done lots oftrainings across the system. We trained over100 people. That's ongoing, and that's going tocontinue. We are utilizing it now both at thefront end, meaning kids that are first cominginto care and having that family team conferenceengage them, and the back end when they arelooking at reunification.

Kind of hand in hand with that, is FamilyFinders. That's another national model. Webrought in experts to do some training on that.We have kind of our own internal expert inFamily Services on the Family Finders. That'sreally looking at making connections for kids,particularly legacy kids which means kids thathave been in the system a long time, and theyneed to have some connections. So there is kindof a skill that goes behind family finding, andthere's also software that accompanies this.

So we've invested in that as well. So we

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build capacity on the CMO side in addition totraining everybody on this. We also theninvested by giving them each funding for onefull-time Family Finders. So they kind of workin conjunction with the family teamconferencing. We also fund the software, thespecial software they use, to really try to findrelative distance people. Say that software isnow available within each CMO. We continue totrain the field on the model, and we workclosely with family team conferencing.

The next initiative is a reunificationsupport group. I think this is probably the oneI'm most excited about. It's relatively new.It's been meeting now for about three months,and it's a reunification support group thattakes place in Orange and Osceola. We contractwith a provider named Journey's End, and theyactually provide two therapists who work withthe families that are either close to beingreunified or families that have already beenreunified.

And if we go back to the slide Greg talkedabout, about the five protective factors, thisreally hits on many of those because they are

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teaching them parenting, child development.They are also developing a support system withthese families so that when they get ready toreunify, they have a place they can go and getsupport. They meet other people that are in thesame situation that they are in. So that meetsmonthly. Any CMO can refer a case, a family tothis, and it's an all-inclusive support group.So they have a therapist for the kids to work onthat transition, and they have a therapist forthe parents to really work on what can youexpect, what do you need to know, what are somefactors to help you build yourself up. Theyhave also developed a specific curriculum thatworks with these families. So that's somethingthat we're really hoping that will continue togrow.

We held our first reunification picnic thisyear. It was in May. It's part of a nationaleffort as well to really start celebratingfamilies who've reunified and are successful atit. So at this picnic we brought in familieswho've been unified for six months or longer toreally celebrate their success, and to alsocelebrate the people who helped him along the

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journey. So it was a great way to reward thefamilies and to really show how wonderful theyhave done in this as well as to reward thepeople, the case managers, GALs, whoever it isthat they thought helped them through thisjourney.

I think the important thing about that,that's a great example, that kind of thing wedid by getting in-kind donations. So we got afree space. We got clowns that were free. Ididn't know we had clowns. And we had all kindsof donations in regards to food from Darden andbounce houses. And all this stuff was free, andit enabled us to put this on. And it was donein coordination with the CMOs.

TAPP, I talked a lot about TAPP, but Ithink the crucial thing in regard to familyengagement is we are now dedicating one module,so one day which is a three hour slot, onworking with birth families. And it's all aboutteaching them first of all the fact that abuseis usually a cycle, so who they are working within regards to the child in their home, mostlikely the parents had been involved in some waybefore, so teaching them some of that empathy,

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but then really showing them that they are thebridge. They are the ones that are more thanlikely going to have to model parenting for thefamilies. They are the ones that are going tohave to help the families, and the more that wetry to teach them, the more they can connectwith the family. When that child goes homewhich is a 50 to 60 percent chance, that theymight have that relationship so that they getthe call instead of the child going back intothe system. So the more that we can build thecapacity upfront, we feel that that's veryhelpful.

As you can imagine, the CMOs love thatmodule, so they have now asked that they betrained for existing foster parents. So we'vedone that several times, and that's always anavailable module that can be offered.

In addition to that, the assessmenttraining, we mandated assessment training forall staff. So it was set countywide, bothcounties. It was supervisors as well asworkers. And we developed an assessmenttraining that really went into an in depth ofhow you work with the family and how do you

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engage families because you can't really do anassessment, unless you're engaged with thefamily and they have a part of that. So thisassessment training was a full day training, andwe went really in-depth in regards to how do youdo a quality assessment? How does that drivethe case plan? And what is your role in regardsto the case manager in that?

In regards to practice and development, weare really interested in moving forward withhaving mentors for birth parents. We havementors for a lot of things. We do notcurrently have mentors for birth parents, but wesee that as being something that could be verysupportive. It was a conversation that began atthe reunification picnic. The difficulty willbe trying to get the parents to find who areable to do that, but we think the best mentorsfor these birth parents are people who walked inthe same shoes. So we are really interested intrying to find those families who reunifiedsuccessfully who are now willing to come backand mentor families that are on the samejourney.

Fatherhood initiative, nationally there is

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a lot to talk about really making sure that weare assessing families from the father side, Ithink in child welfare across the board. Guysthat have kind of been forgotten along withtheir family members. So there has been a lotof increase in regards to really looking at thepaternal side, and that's something that we wantto continue to grow in regards to getting thefather involved and making sure, even if they'rein prison, that we are connected with thatfather. We are also looking at the father'srelatives and making sure that they are engaged.

We talked about this earlier with Beth, butwe are really interested, we need to get thatinvolvement of birth families immediately. Ithas to happen immediately. So we are constantlylooking for ways -- it may not be that it canhappen at the ICC because of scheduling and thefact that there's all kinds of other things thathave to go on there, but we are intentionallylooking to find ways to really start off in thebeginning to get the families involved, informedand invested in trying to figure out what theyneed to do to be able to get their childrenback.

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Then lastly, we are really trying to movefrom a broker to a conduit. We are trying tomove the field thinking from this, and when Imentioned this, you know, I think historically,I think workers a lot of times see themselves asbeing a broker. They give the birth parent areferral, here you go, go do this, go do that.Here's your task plan, good luck. And we'vereally through all of this we've really tried tomove the needle on that to get people to realizethat they are the conduit. They have to be theadvocate to the parents. They have to be themotivator for the parent. They have to reallybe there to help that parent to be able to getinto the services to get their children back orto help them make the decision that it's justnot going to work that way. And we feel likewe've really started to move that needle throughprofessionalizing the field for the MSW program,our trainings and many other initiatives that wehave put in place.

MS. LEWIS: Okay. And then I wanted to(unintelligible) because this gets back to whatyou were talking about and what you are askingabout, René, and we feel like we have put

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together a really extraordinary foundation for awonderful system. When we are looking at theneeds of the families that are in-home, some ofthe extraordinary needs, the story that Theresatalked about, and the disruptions that we arelooking at with relatives. We're looking atwhat we can do.

We have child welfare specialists andresource specialist that are Family Servicesemployees that are co-located with the CMOs, andthey have clinical coordinators. We have also,as we talked about, really expanded the capacitywith Family Finders and family team conferencingwithin the CMOs. We have a number of agreementsand wonderful working relationships with APD,DJJ, the schools, CMS, and we've talked aboutall of those here. And we have wonderful familysupports, and we've mentioned a number of thosewith her mentoring programs and we've sent allthese kids to camp. We have a wonderfulrelationship with (unintelligible).

Finally the final piece of that, was ourIRIS database, and as I said, Theresa wasintimately involved in developing this Purchaseof Service model. When we were looking at what

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Burney has done and what Selena has done intheir selective areas and listening to whatTheresa has done, and putting all of thistogether, we really feel that Theresa, by herlead, can take family team conferencing to thenext level within the CMOs and working togetherand with all of these other systems in place andwith the IRIS database to be able to see the DJJinvolvement, to be able to see what kind ofservices we gave that family prior to cominginto care, with all of the other databases thatwere involved, we really feel like this is goingto really strengthen and be able to wrap thesefamilies.

So she is going to, by her leadership andworking with the families, team conferencingstaff within the CMOs, really take this to thenext level. That is where we're going. We'renot there yet, but that's where we are going.And that was the answer to René's question.

MR. KURTH: What I just wanted to kind ofadd, if you can put that back up real quick, Iknow we've talked a lot about family teamconferencing. We talked about clinicalcoordinators. We talked about Teresa's role

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from a wraparound perspective. We've talkedabout a variety of new partnerships that we'vehad with respect to the DJJ component. I knowsometimes even for me it's somewhatoverwhelming. How are we really all bringing ittogether?

And I think with respect to wraparound as aconcept, one of the things that we have reallyfocused on in the last year is building thatfamily team conferencing and clinicalcoordination component. Within our casemanagement partners have looked at Theresa as anew wraparound specialist to help bring this alltogether to really go to the next level.

Part of the aspect that I really want toemphasize here is the integrated resourceinformation system that we developed, and I'mhanding out right now. And the idea was that ifwe built a new provider panel, we have a varietyof these new service components. We are doingall of these great partnerships with DJJ. Weare doing components with the ICC process. Howdo we all pull it together from a databaseperspective?

So what I'm handing out to you all is that

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this is really our IT initiative, again we haveone IT guy, we did contract out with a vendorover the last year and a half, approximately,who particularly focused on helping us with aworkflow analysis in terms of what we wanted todo going forward. And out of that, thisinterfaces with FSFN, so that we can pullexisting data out of FSFN, but most importantlyit allows us to be able to coordinate with thePurchase of Service network, help with respectto understanding what's going on with the DJJcomponent and other various systems that we aregenerating.

On page, I think it's -- I know we didn'tput this on the chart, but on page 5 is probablythe best way to really sort of show you whatIRIS is really able to do. It's really creatinga depository, if you will, of all of thesevarious components that really helps us managefrom a collaborative perspective. And theDepartment and our providers and other folkswere involved with the workforce design of thisparticular initiative. It actually went live inthe last month, and we do have a number ofcomponents going forward that we would like to

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recommend for phase two.We have presented this to the wraparound

orange folks as a concept for them to look at inthe sense that they may be able to build on it.We have very significant architecture on theback end. I'm not an IT expert in terms of allthe HIPAA and FRPA and all that stuff but it's avery robust system that was developed by acompany that predominantly had done public worksIT projects, not necessarily social services.

This sort of is a way to say that as webuilt capacity within the field in partnershipwith others, we are now building a databasecomponent to really begin integrating all ofthat as well.

So as it relates to phase two, there's avariety of other things we would like to do. Weparticularly want to talk about tracking all ofour unusual incident reports and whatnot withinIRIS. We've talked about the concept of aniBook for kids in care. We have had somequality components around the checklist or theresource record and whatnot.

We certainly have some wonderfulopportunities to do mapping with respect to

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foster homes as well as resources. And then ofcourse we want to continue to do some ongoingrobust performance analysis as part of this aswell.

So there are some screen shots in here.Because of time components, I'm not going to gothrough all of these issues, but this is givingyou an idea as to what we have been able todevelop so far and what we can do going forwardwith respect to greater performance managementpulling all of our of our various componentstogether.

MR. SACHS: This is Walt. One easyquestion and one maybe more lengthy. This isnot a live case, this is fake information?

MR. KURTH: Yes.MR. SACHS: Yes?MR. KURTH: Yes.MR. SACHS: Because if all of this stuff

becomes public record I want to make sure wedon't have to redact everything in here. Thatwas the easy question.

Two, your interface with Remeans Shop (ph)or anybody in DCF IT regarding the developmentof this system, its firewalls, its security, its

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ability to control data and escape -- data thatescapes controls, how interfaced are you withour IT components?

MR. KURTH: Okay. Bart, I know you wereinvolved with this a little bit. We don't haveour IT guy, Mark Mine (ph), would be able toanswer that.

MS. MURRAY: We first started working withthe system and (unintelligible) introduced it tous, I did have David come over and working.We've been going through this as the systemprogressed. When we initially had it theDepartment was invited and we came and like Isaid working with David and our IT person hereto kind of work through the kinks.(Unintelligible) and so (unintelligible)training phase now where they are going to cometo the Department and train us on that system.But we have been -- but the Department has beeninvolved since it started.

MR. SACHS: Walt, again. I just heardheadquarters, IT issues around security and ifthe Tallahassee team on data security is notinvolved and we have our own disconnects,believe me, our region IT sometimes doesn't talk

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to our Tallahassee IT. So I want John who isnot here, but Christine to hear that we need tomake sure that we are climbing our ladder allthe way to Remean before somebody approvessomething like this with lots of legs.

The more data is disconnected, the moreproblem it becomes. And the fear of everybodyis that you recreate FSFN, and you pay for itwith federal dollars which would be illegal.And we don't want you going down that road. Andwe've seen the (unintelligible) and we've seenthis and we've seen that and it's all becauseFSFN won't do what everybody needs it to do. Sohere comes another system to replace the thingthat we've already paid for that won't do whatyou need it to do.

And I know you have a management crisis andyou have to deal with it, and this is how youdeal with it, but we've got to make sure we'renot putting money in the wrong place that getsdisallowed later that you have to eat. We don'tever want you to be risk bearing in thatscenario.

MR. KURTH: And I would just comment thatthe idea with IRIS is to take information from

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FSFN, so think of it as FSFN plus. It's not areplacement for it because we're not keeping thesame data elements that are already in FSFN, weare just taking it straight out of FSFN.

MR. SACHS: Totally understood. And I alsowant to make sure because it was commented onthat we are rushing on time, I want to make sureyou have enough time to say what you need tosay. So try not to let the time limit you. Soif you have something else on that modeling thatyou want to talk about, feel free to. I don'twant to hold you back.

MS. LIS: (Unintelligible) we're good.MR. KURTH: Just one thing on IRIS what I

would say that the process did slow down alittle bit, Walt, this last year largely becauseof the FSFN process. So we want to make surethat we weren't duplicating as it related tosome of the FSFN designs and whatnot. I thinkthe component -- what this is doing is it ismuch more of a management tool that, as Bartsaid, that builds on to FSFN and allows us toreally coordinate this with a vast array ofother systems that we have.

Okay. We can go ahead and go into quality

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management.MS. NORTON: At a very high level I just

want to mention what our quality managementsystem is because really no matter what we arelooking at, it's always the same generalprocess. And that's that you establish a targetor some expectation of achievement, and then yougo about determining what that looks like. Andyou can do that a variety of ways with caserecord reviews to more in-depth reviews. Youlook at FSFN management reports or maybe somereports that your system generates, criticalelements with in your system that generatesquality data.

Take a look at those. You evaluate whatthe performance is and then you determinewhether or not that's adequate. If it's not,then you engage in discussion with the providerabout how you are going to improve yourpractice.

Then you put something in place. You comeup with a plan, and you put the plan in place.Then you go back in you make sure that it'sshowing some sort of increase. That your planis in fact effective, and that's quality

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management no matter what you're looking at thatyou are going to follow that same generalprocess.

Within our system, we have, and I'm sureyou've all read the quality management sectionof the ITN, we do a lot of reviews. We do therequired Department reviews. We do contractreviews. We do targeted reviews when we thinkthere might be an issue. We do a priorityreview any time a child dies that we servedcurrently or we served within the past year. Wedo priority reviews when Greg thinks that thereis a systemic issue that requires furtherin-depth analysis.

We have performance specialists that pullFSFN reports. We drove down from assistanceperspective to a unit and at times we actuallyhave a tool that allows us to look at a worker'sperformance. We look at the data that we amasswithin our critical incident reporting system,exit interviews, all those things.

We are a busy department that spends a lotof time asking the question how can this bebetter? We are committed to a quality practicethat integrates -- or practice integrates

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quality within practice. We don't want togather information just for the sake ofgathering it. We actually take steps toimplement quality program improvements.

And these are some of them. I'm just goingto hit -- these are really high level, and theyall come out of -- the majority of these havecome out of some sort of an in-depth revieweither priority review, a targeted specialreview, for the most part.

The specialized medical unit, I thinkyou've heard enough about that where that cameout of a death review where we saw that thesystem of care was not integrated relative tothe delivery of medical services for kids whowere high need. So we set about constructing aunit with Devereux, with the child protectionteam, with Children's Advocacy Center and withCMS to develop a unit that would build capacityand meet the needs of those children. And we'vedone that successfully.

Our sexual safety program also came out ofa quality review. We looked at the Department'spolicy relative to the safe placement ofchildren in out-of-home care with sexual

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behavior issues, and saw that it really was notoperationalized well within our system, that wehad training needs. We needed to update 175.88which we went ahead and did.

We consulted with a child sexual abuseexpert and a refinement of our protocol. Thisled directly to the development of clinicalcoordinators, and training relative to sexualsafety planning for children. And we'veexpanded it and included caregivers becausethat's a huge piece of sexual safety.

So we've taken that information, and alsojust on the bottom bullet, incorporated much ofthe sexual safety training within our TAPPcurriculum so foster parents and adoptiveparents are prepared to handle the challenges ofkids who will, knowingly or unknowingly, come tothem with issues of sexual behavior.

The Regis Little task force we talked alittle bit about this and I think we handed outthe report the very first time we met. It was acollaborative effort with John Cooper and Cityof Life and Greg convening a community panel toreally look at the challenges of the childrenwho were DV aging out of the system and what

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kind of support we needed to put in place forthem.

We came up with a champions model regardingthe advocate program and the electronic bluebookare some of the ideas they came out of that.And that's in the process of being implemented.

The educational liaison program, actuallycame out of a 2007 look at childrentransitioning out of foster care into adulthood.What are their needs? We saw that a lot ofthese kids had -- they were non-diplomacy and inspecial diploma classes. We saw that was a realchallenge with the school system, and yet thisis the system that's very difficult for casemanagers and foster parents to navigate. So weestablished the educational liaison programwhich we rolled out in Orange County and then inthis past year in Osceola County.

We have had huge successes with this as wego about trying to resolve some of these realchallenges that parents have in trying to makesure their kids get their educational needs met.That study was also responsible forrestructuring independent living program for us.It highlighted the areas of support according to

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these youth, what they wish they would've hadwhen they were in the foster care system. So weembedded some of those things within ourindependent living case management contract.

Beth just mentioned the pediatricbehavioral health network. That TAPP trainingfor foster parents actually came out of anin-depth foster parent special review in 2008where there were huge issues relative toconsistent training among the different CMOs.Some folks did a really great job of trainingand preparing foster parents, others not somuch.

So we took it in-house. We refined it. Weupdated it and included all of the informationwe now know about brain trauma and development,sexual safety, behavioral management,psychotropic medications. We think we have apretty solid curriculum that we are alwayslooking, as we do with everything else that wedo in our department, always looking to see ifthere's an area that we can upgrade. And I'msure we'll be modifying that.

Even the post adoption program that you'veheard about came out of a quality improvement.

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We did a review of subsidies, and we saw thatthere were really challenges in meeting theneeds of families post adoption. Lots of issueswere emerging. There was a need for ongoingtherapeutic support or just support oreducation, and so even -- you see that this is avery broad -- covers really a spectrum ofservice deliveries. All of these things wereborn out of quality improvements, qualitypractices.

So we've operationalized our qualityinformation, and this is -- at a high level,some of the impact that we've had on the system.Family team conferencing, family engagement,Family Finders and the service center modelwhich was a redesign, it embedded the resourcespecialist and the child welfare specialist morewithin the service centers. Those came out ofcase reviews that showed that we really weren'tdoing a very good job of timely serviceinitiation. Often we would identify what thechallenges were, but there would be a lag interms of identifying what services the familiesneeded or making referrals to get those servicesin place.

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Engaging the family, birth family contact,quality case planning, those are all things thatwe identified within just our regular casereviews, and we went about training and puttingsome processes and positions -- really findingsome positions within case management in orderto address the quality of service positions.

I spoke about the credential providerpanel, the enhanced workforce qualifications.That really was a result of taking a look atwhere our workforce was coming from. Who arethese folks educationally? Did they -- we werehearing some kind of goofy things, you know, interms of practice and we really looked, we sawthat we had political science majors. We hadsome communication majors, we had a biologymajor. We had people who didn't have aneducational background.

And so we refined our direct staffqualification process. We allowed forexceptions to what is the requirement that theDepartment actually sets forth which is that youhave to have a degree in social work orsomething closely related to work in childwelfare.

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And we developed partnerships with theUniversity of Central Florida and are in theprocess of speaking with them about embeddingour pre-service training within theirundergraduate school of social work curriculum,so that when folks graduate from UCF, they don'thave to spend six or eight weeks in training.They can take the waiver test. They can go intophase two and we'll work with them towardcertification.

Our relationship with UCF also, you heardSelena mention the use of interns. We have anumber of MSWs who work for Family Services andhow that helps us is that we are able then tosupervise interns. You are required to have anMSW to have a BSW or MSW report to you as anintern, so we have a number of those.

You know, it develops the workforce. Itdevelops people who then can come to understandwhat we do and they can come and work with us.So we have a huge commitment to putting socialwork in child welfare.

Enhanced supervision for in-home andtraining cases. Any time a child dies and theydo a priority and death review, we actually

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track the trends that we see that create thecircumstances that allow for a child to die.And early on, probably 2006, 2007, we justnoticed a trend with in-home cases that thelevel of supervision was really not what itneeded to be for protective services, thosetraditional in-home cases. Nor were traineesreceiving additional supervision.

So we did modify our contract, and we dorequire that for all in-home cases a monthlysupervisor review be done, and also if it's atrainee who is not yet certified that they alsohave monthly supervision of all their cases.

And these are just some of the qualitypractice improvements that have come out ofquality management processes. And I justorganized them nicely for you under safety,permanency, well-being and the enhancement ofthe workforce.

And I'll just mention -- Michelle, I think,is passing out the in-home safety checklist.This is something we developed as a preventionstrategy out of some of our priority reviewswhere we saw that co-sleeping for us I would sayin the last five young children -- I have Mary

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shaking her head, she knows this to be true --co-sleeping has been a huge factor.

So between that and the drowning which isalso another issue -- actually those two are thenumber one and two reasons for children underthe age of five die in the state of Florida. Sothis is just a strategy for prevention. Theprevention specialist hand them out. Casemanagement hands them out. This just a nicetool to go through when you are working with thefamily just to remind them, you know, put yourchild on their back to go to sleep. Don't sleepwith them. That's why we spend so much time --and I'll tell you there isn't a week that goesby in our agency that one of the resourcespecialists has not asked for somebody to donatea crib or a bassinet for a baby because it'ssuch a huge issue that we have, and we aretrying to address it through education.

MR. WOODLEY: Excuse me. This is Arto.Karen, how do you deal with the drowning? Whatare your prevention tools that you use toalleviate drowning?

MS. NORTON: I was mentioning the in-homechild safety checklist, which I think you just

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got a copy of, which has -- just reminds folks,you know, we had a child death case, forexample, there was an 18-month-old child thatthe mother -- she put about 6 inches of water inthe bathtub and walked off and thought the childwas safe. That's not okay, this is whathappens. So it addresses those types of things.

MR. WOODLEY: Okay.MS. NORTON: I have more. Or do I not have

more? Am I running out of time?MS. WILLIAMS: This is Cheri. I want to

talk a little bit about the training.Inherently quality and training coexist as theydo within our agency. A lot of times when we goout and do our quality reviews and take a lookat practice, we identify training needs. Thisis just an array of the trainings that we havecompleted. We do want to mention that we havehad over 1,900 trainees attend our trainingsjust in the past year.

These trainings came out of things we were-- trends we were seeing within our qualityreviews. Melinda has already mentioned the artof assessment training, the sexual safetytraining we saw as Karen mentioned that 175.88

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was not being followed, the DCF operatingprocedure. We created our own new operatingprocedure and train the entire system of care onit.

We do offer these trainings, I'm going tomake sure that the new staff are also gettingtrained in these critical areas. Educationaladvocacy training and we have normalcy trainingto ensure -- for the normalcy training, weactually train case managers and group home andresidential staff together since they have towork so closely together to do this normalcytraining and ensure that normalcy is actuallypart a of mostly teenagers lives.

We also invite foster parents to all ofthese trainings. Again, we really operate underthe philosophy that as many different playerswho work together naturally within our system,if we can get them in the room together, notonly are they hearing the same message, but itgives the opportunity to build relationshipswith one another and really just all hear thesame message and walk out with a unified front.

Quality home visit training. Thefoundation of what we do is going into people's

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homes and working closely with families, so weconduct this training. Substance abusetraining. A lot of the (unintelligible), asKaren mentioned, a lot of them we see the trendof substance abuse parent -- substance abusingparents. So we actually have one of ourspecialization trainings in substance abuse.

We do have several specialization trainingsthat are 30 hour courses where people actuallyget certificates through these programs.Substance abuse, sexual abuse, mental health, anarray of different -- domestic violence, anarray of different topics.

The thinking behind the specializationtraining is that people from the differentservice centers will come to these trainings andget this increased amount of specialization andthen they can be an actual resource for otherswithin their service center because they havehigher expertise in this area.

Family engagement training. Melindaalready talked a little bit about that. Theimpact of trauma on attachment which we'vealready mentioned, and then CESAP, our ChildEndangerment Safety Assessment Protocol.

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Routinely we take a look at this tool, we engageour stakeholders and our CMOs to come around thetable and look at the tool and refine it asneeded. We really want the CESAP to be more ofa guided decision-making tool so people arereally taking a look at situations and ensuringthat children are safe in their currentenvironments, and we do annual training on thetool and recertify everyone on the current tool.

MS. NORTON: One of the things that youasked for was trended performance data, and whatI've given you is trending data, while, sinceour inception. But it starts with quarter twoof fiscal year '06/'07 and concludes with thelast quarter of the last fiscal year. So it'sthree and a half years of quality training, andI want to mention that this data is broken outby the three composites of safety, permanencyand well-being.

Safety, I think it's pretty clear what itis. Is the child safe? Are you making -- areyou addressing emerging dangers? Are youputting steps in place to make sure that thechild is safe?

Well-being is a little bit trickier. It's

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about quality service provisions. Is the homevisit a quality home visit? Are you seeingcaregivers and birth parents and relatives? Areyou having quality interactions with them? Isthe case plan a quality case plan? Supervision,is it appropriate and are the workers followingup on what their supervisor tells them to do?So those things contribute to the otherwell-being indicators of is a child's physical,dental, health, mental health and educationalneeds being met? So that's the well-beingindicator.

And then permanency is really the smallestarea. It is the smallest number of dataelements, and they go primarily, not totally,but primarily to time frames. Did reunificationoccur timely? Did you follow -- did you file aTPR petition timely? Those kinds of things.

So when you look at our performance you seethat there are significant improvements over theyears, progressive improvements, in the area ofwell-being. Safety showed about a 10 percentimprovement over the time period that we havetrended. And permanency tends to go relativelystable, pockets of improvement here and there.

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MR. SACHS: Karen, on these charts do youhave the knowledge of sort of the statewide baron the overall progressive improvement? Is itsimilar to your bars or are you improving morethan the state is, less than the state is?

MS. NORTON: I think well-being we wereimproving more than the state. We have made --a couple of things that have to do with that.We talked about the educational initiative, thefirst week possibly, and we talked about thesignificant improvements we have seen with oureducational liaison program, all of theeducational supports that we have put in place,and that has affected it.

We also really took hold of the DCF qualitymanagement guided supervisory discussion tool.We really thought the only way you're going todo good supervisory reviews is if you sit --you know, obviously, you have to sit down andtalk to folks. You can't just do a FSFN review.So we really incorporated that within oursupervisory forms. We spent a lot of timeworking with the CMOs on doing guidedsupervisory discussion, and also the importanceof developing processes to ensure the case

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managers are not just doing a great supervisoryreview, but you have some way to tell that yourworkers are actually following through on whatyou told them. So those things have reallyimpacted our (unintelligible).

The second chart is -- this was put out bythe central region. This is the central regionquality data, and you'll see that there are nowsix CBCs within the central region. And thisdata rolled up the child welfare outcomes as youall probably know there are seven CFSRs,Children Family Services Review outcomes, twohaving to do with safety, two having to do withpermanency, and three having to do withwell-being.

And this is how the Feds measure us, sothis is what the Department tracks. ICBC byoutcome, so you'll see the seven outcomes andthen you'll see the federal CFSR review which isthe findings of the in-depth review. Everyquarter the Department identifies two cases thatthey are going to look at in depth, and they doan in-depth case review, they interviewstakeholders, they talk to clients and thefindings from those reviews are rolled up into

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that. And it's a better look at the systemicnature of the (unintelligible).

So that's on there, and you'll see thetotal composites for the region. With Brevardreally doing, obviously, the leader here andHeartland underperforming just a little bitrelative to the rest of them, and everyone elsebeing sort of in the middle which I think isfairly significant from just a perspective issuein terms of the (unintelligible), CBCs, etcetera.

MR. SACHS: This is Walt. These chartsalways have more questions than answers forwhatever reason. For example, Heartland on hereI think shows up at the bottom in maybe five outof the seven measures.

Is it a fair representation to look at CBCsagainst other CBCs in a region like this whereyou have so much diversity and so much modelingdifference or can you explain this to others tomake it make sense? It's always great whenyou're near the top. We're doing better thaneverybody, but when Heartland has to show thison theirs I bet they have all kinds of reasonswhy their numbers aren't great.

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So I wonder what's the real value inlooking at this across the region or would it bebetter to look at you compared to a like leadagency, a lead agency who is similar in size,similar in demographics and how are youperforming against a more similar model?

MS. NORTON: I would say this is what ourregion looks like and I think I wanted you tosee that this is where we fall relative to ourregion. Do I think that you can compare FamilyServices, Hillsborough County and Brevardfairly? No, I don't think that. I think youneed to -- and I think we said this the firstday, that when you look at the performance of anagency, really you need to look at the clientsthey serve. Is it an urban, diverse communityor is it one that is rural and small and youhave a population that's scattered all over theplace or you don't really have an urban center?You have really no cultural challenges. Allthose things contribute to what is going toaffect your performance.

So, no, I don't think that it's fair, butthis is the data that the Department of Childrenand Families --

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MR. KURTH: If I can follow up, Walt. Wedo look at in terms of our overall performancemeasures, which we shared with our board lastweek, we didn't want to particularly look at howwe're doing relative to Hillsborough kids, forexample. We want to look at how we are doingrelative to our kids and Miami as well becausewe are a fairly urban area here as well. So wedo look at that, our overall CFSR components.

I think that what it does do as opposed toseeing how we're doing relative to others ratherI think the value of something like this is moreabout how do we really figure out a way to movethe needle over time because every county isgoing to have various benchmarks. Every countyis going to be a little bit different. The keyis how are we, with respect to what we havelocally, how are we improving on that?(Unintelligible.)

MS. WILLIAMS: This is Cheri. I just wantto mention some continuous -- following throughon activities. We already talked at a very highlevel of a lot of these, but each quarter or wedo trend and stratify performance based on thesequarterly quality reviews that we complete. We

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do trend and stratify it by critical practiceelements and CMO. So we look at what the mostimportant practice elements are and then wesplit it up by CMO and see who of our partnersare doing well.

MR. LOVE: Walt.MR. SACHS: Yes.MR. LOVE: I'm sorry. I apologize. I've

stuck it through longer, but I've got to goaddress some issues. I apologize. If you needme, give me a buzz. Everybody, thanks. I willtalk to you soon.

MR. SACHS: Thanks for your participation,Rod. Will you be able to join us in the postmeeting at all?

MR. LOVE: What time are we doing that?MR. SACHS: I'm thinking 4:30 time frame.MR. LOVE: Okay. Chrissy has my number.

Chrissy, if you would just give me a buzz or Ican call you real quick, then we'll go ahead andjump on that.

MR. SACHS: We'll find you. Thanks, Rod.MR. LOVE: All right. Thanks a lot.MR. KURTH: Thank you, Rod.MS. WILLIAMS: So we look at our data every

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quarter. We bring all of our partners withinthe CMOs together and internally we look at thedata. We take a look at who's doing well andwhat. We share best practices with one another.We action plan and come up with ideas on how toimprove in different areas. So there is acontinuous look at performance and a continuousbrainstorming for improvement and actionplanning.

We have a monthly supervisor forum where webring our supervisors throughout the networktogether, and again look at how we areperforming and talk about innovations and thingslike that.

Something I do specifically want to mentionis we really engage our case management staff inour quality practices. We open up our qualityreviews to any CMO staff who want to sit in andparticipate in those. We see those as veryteachable opportunities. Before we leave a CMOeach day when we are out doing our qualityreviews, we sit down with the case manager, thesupervisor and the director of that CMO and justhave a debriefing session with them and talkabout what we saw in the case, practice

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recommendations, things they did really well.We really try to have a strength-based approachwith them on those.

And we actually invite them to come toFamily Services and participate in theside-by-side reviews that we do with DCF aswell. I'm not aware of any other CBC who isdoing that, so we are really proud of the factthat we engage our CMO staff in that. And itdoes appear that DCF is going to be followingthat model and inviting more CMOs and frontlinestaff to participate in those types of reviews.

Continuous quality improvement plan, andagain we have our quarterly quality reviews. Wehave a plethora of internal quality processes inplace which you will see details in our qualitymanagement plan. We have our ongoingperformance monitoring. As Karen mentioned, wehave lots of targeted reviews, special reviews,priority reviews. We have a quarterly qualityreport where we take a look at some criticalmeasures within the system that we publishthroughout the network.

And then future improvements, things wewant to focus on in the future. We are going to

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do our own special reviews. DCF has specialreviews through quality that we are required toparticipate in, but we also do our own specialreviews. We are going to be doing a specialreview on placement stability as well asadoption disruptions. We are looking to, like Imentioned, continue having our CMO partnersinvolved in the DCF side-by-side which DCF isnow implementing as well. And we will bedeveloping more internal validations andinternal quality checks of our internal systemswithin Family Services.

MR. SACHS: I have a quick question. Thisis Walt. On the quarterly quality reviews andthe engagement with your CMOs, is there a CMOwho is less than participatory, less thanreactive, less than supportive of a qualityoversight program and a program that requiresthem to command excellence? Is there atroublemaker amongst your group? And if thereis, if you have a relationship with a CMO whohas a bad behavior, how do you deal with that atthe meetings and at the engagement studydiscussions? Because everything isn't perfectall the time, and I want to get real here. It's

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beautiful to have a bullet, but someone tell mewhat's really going on.

MS. NORTON: Well, that tends to follow the(unintelligible). I would say that everyone --we have our peer review process. We have aprotocol (unintelligible) process and we open upour peer review team annually and ask for theCMOs to suggest staff that they would like toparticipate. And once that happens and we sendthem through quality training et cetera, we'venot had anybody decline to participate in that.

So we do have that representation on ourpeer review team, folks from all over. We havehad challenges through the years with some CMOsthat do not perform as well, and we generallybase, you know, that assertion on quality orperformance status.

So we get together with folks every month,you know, we have our team performance call. Wehave, you know, a variety of meetings thatreally focus on their performance, and we engagethem in that. In the process of that, you know,at times you have to, you know, this gives youthe opportunity to take a real critical look atyour system so they have a really good sense of

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what quality -- the quality of our practicereally is.

So I think we're at an advantage with that,but once you have the information, you have todo something with it.

MR. KURTH: One of the things I'd like toadd -- this is Greg. I mean, every organizationgoes through growing pain sometimes. Everyonehas peaks and valleys, and a lot of what we'vebeen able to do is actually put in someintensive, direct, technical assistance both onthe QA side with possibly Cheri going down.We've had our child welfare specialists and oneof our system directors who will augment theirtime and whatnot, focus a little bit more on aparticular service center area, sometimes thereare some staffing issues that a CMO has to getover.

So we work with them, try to help themthrough that process and whatnot. Certainly wecould get a little bit stretched as well, butit's really about what kind of technicalassistance can we provide and get in there andhelp out.

MR. SACHS: You've not had to get to the

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level of management actions, withholding offunds, call for restructuring, termination ofcontract, any of that level of intervention?

MR. KURTH: Well, we have done a little bitof shifting out in the last three yearsespecially in Osceola County where we did bringon, about two years ago, a new case managementorganization. And at times, because we do havemultiple CMOs, we've done a little bit of what Iwould call market share allocation. Ironically,sometimes the CMO might actually be best todownsize a little bit to help them deal withwhatever their leadership issues are, and toreally help them through the process we have hadsome success in actually doing that as opposedto just moving --

MR. SACHS: Taking them out of rotation.(CROSSTALK.)MR. KURTH: -- (unintelligible).MR. SACHS: (Unintelligible) any cases.MR. KURTH: Freeze intake, reduce intake by

maybe taking a little bit of the unit to anotherCMO and whatnot, so we've done things like that.

MR. SACHS: Thank you.MS. DUNCAN: This is Carolann. Do you take

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into account the acuity of the kids when youlook at the CMO from a, you know, overallperspective looking at the difficult kids thatthey may get might skew that number? A think.I don't know.

MR. KURTH: Well, since everyone is on arotation, it kind of smooths a lot of that out alittle bit. So I don't, you know, we had anissue with One Hope United a few years ago wherethey were predominately taking a lot of kidsfrom the night unit, so some of those kids werea little bit more challenging and whatnot, notto mention the fact that the intake was a littlebit higher for them. So we do have some missedcomponents that we have to work around.

MR. SACHS: Walt again. On your org chart,page 3 of 5, you have under your senior directorof quality and performance licensing, Medicaidand adoptions. Get my head around why that's agood idea? If quality is quality, quality isquality and training and performance and UMspecialists and that, why is it also licensing,Medicaid management and adoptions? And if it'slicensing because that's oversight, then whyisn't it contract monitoring also?

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MR. KURTH: On the licensing process,actually the licensing specialist here areactually really doing the initial actual homestudy process as part of training as well. Sowe have integrated our initial licensingprocess, our case management organizations stillhave the actual license. We actually do all theinitial work, so that's really, mostly atraining component where those folks are doinginitial training as well as that of the homestudy process as well.

And then the relicensing process I wouldlook as kind of a quality component. Wedefinitely wanted to have that outside of theCOO who does oversee placement. So that's whywe put that relicensing component there, and wedid recently get the attestation model where wecame in for CBC and the state to get that.

In terms of the Medicaid component, youknow, I think some of this has to do with justcustomer support. This is an area where itcould go elsewhere in some respects, but a lotof what they are doing, especially in theadoption eligibility component, they do come inwhen we are doing a subsidy. They all sit down

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with these families that come in and the subsidyfolks end up doing eligibility as well.

So that's why we have the adoptions alltogether right now within our operation.

MR. SACHS: I understand adoptions andMedicaid kind of being together, but why underquality? Because I'm not getting it. It seemsmore operational than anything else.

MR. KURTH: It could definitely beoperational as well, I mean --

MR. SACHS: Does it just span a control?MR. KURTH: -- I think it's --MR. SACHS: Too many people under

operations (unintelligible) quality.MR. KURTH: Yeah. I think it's a little

bit of balancing out. We have two countydirectors underneath the COO right now as wellas that of the placement and utilizationmanagement. So were looking at balancing thatout and whatnot. But it was definitely adiscussion that we had internally about thatcould possibly be under operations, but wantedto give the COO a little bit more of anopportunity to focus on those other components.

MS. NORTON: Adoption licensing, I mean,

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there's a lot of crossover there. The training,it's the same training curriculum. The skillset for the staff is very similar. A lot of thefoster parents end up adopting, so there's some(unintelligible).

MR. COOPER: This is John. Based on myearlier question about independent living withcounty directors it almost seems that licensingto some degree is still with the CMOs, thatlicensing and adoption would be under the countydirectors as an operational component.

MR. KURTH: We could definitely look atthat. A lot of what we wanted to have thosecounty directors focus on was the ongoingpermanency activities, John, with respect tofocusing on the CFSR components. You know, it'sa different kind of skill set as well, and if wewant to make those folks really available forcourt related (unintelligible) based issues.

MR. SACHS: Walt again. You know ourcontract, it doesn't lay out an org chart. Itdoesn't tell you how to run your program. Ifyou are the recipient of this award, would yoube willing to commit contractually to thisorganizational design where you have this

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representation in Osceola County? Because thefear amongst many would be it's a nice chart,but we never saw it.

MR. KURTH: (Unintelligible) leverage --MR. SACHS: Two years later, we got

nothing, and they never implemented the plan andone of the big reasons that we are talking aboutit is the under representation in Osceola. Sonot saying it would be there, but saying wouldyou commit to doing it if it were there? Wouldit be a resisted issue at the table?

MR. KURTH: I would definitely commit. Ifwe were to propose an org chart with you, Walt,we propose a lot of things and a lot of othercomponents that we would want to make sure thathow do we live up to that in the contractualcomponent. I want to give us a little bit offlexibility --

MR. SACHS: Sure. I understand.MR. KURTH: -- at times. Looking at this

org chart knowing some things that could changedown the road, but I would absolutely say yes,Walt, in the spirit of that, this is what wewould want to commit ourselves to going forward.

MR. COX: Nick. I just was wondering, you

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all have been doing this five or six years, whyare you reorganizing now? Why didn't we do it-- because of the ITN? Was it because of ITNcalled for it or is this something you all havebeen thinking about for a while? I'm justwondering why now?

MR. KURTH: We kind of have gone through acouple of different types of changes, and Scotthad asked that a little bit earlier, I think oneis beginning about a year ago, a lot of theissues were really precipitated from a placementperspective. We needed to do some things around-- very differently around licensing. We neededto do something very different around placement.So especially with the quality parentinginitiative we can bring placement in-house anddoing licensing and training very differently,it necessitated us to begin looking at that alittle differently.

Then when we really assessed what our childwelfare specialists were you doing, the folkswere co-located within the case managementorganizations. I think what we were missing wasas much as they were there out within the CMOcomponents, each county has its unique needs,

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slightly different court system. Who's the oneperson in the respective county that can reallyfocus on that particular component?

So we've been thinking about that for alittle bit, and the other component that's alsonew here, Nick, is that the contract managementpiece we've done relatively well, but werelooking at doing this in a much broaderperspective under the auspices of the CEO tofocus more on those provider relationships andstreamline communications going forward. AndI've gotten a lot of feedback from our partnersabout that.

MR. COX: Sorry (unintelligible).MR. SACHS: No. I'm glad you asked that

because that was actually a more in-depthanswer. That was good.

UNIDENTIFIED SPEAKER: Very useful.SERGEANT GLACIER: I have two questions.

One, when was this flowchart made?MR. KURTH: Well, we just finalized it in

the last week. We've been talking about it forquite some time, but what you have here wasfinalized in the last week.

SERGEANT GLACIER: Okay. My second

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question is, may be a little sensitive, butwould you want your children in the care of yourorganization?

MR. KURTH: Absolutely.SERGEANT GLACIER: Fair enough.MR. KURTH: Absolutely.MR. SACHS: Any more questions on quality

management? Well, we may not be finished. Doyou have more?

MR. KURTH: No, we're done.MR. SACHS: Okay. Last week we asked for a

faith-based listing, were we able to get thatfrom you or has that been delivered? I wantedto make sure that we got that, if we have it.And was there anything else that you had saidthat you would get for us that we need to getfrom you?

UNIDENTIFIED SPEAKER: Yes.MR. SACHS: Don't want to leave the table

without getting stuff. And while that's beingpassed out, I'll go ahead and start with ourteam and find out what sort of final questionsyou have. Then we'll let you guys do a wrap up.

UNIDENTIFIED SPEAKER: We have one(unintelligible).

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MR. SACHS: Oh, you have one more. I'msorry.

MR. KURTH: Do you want me to do closingcomments before you ask questions, Walter?

MR. SACHS: No, we'll go through our finalquestions and then you can close with comments.But you have one more section?

UNIDENTIFIED SPEAKER: The strength in thesystem (unintelligible).

MR. SACHS: Okay.MR. KURTH: We are going to kind of go

through this very quickly, and I just want toemphasize we really -- we think that there arethree broad areas with respect to what we havebrought to the ninth circuit and that's really a-- what we think is a robust network from ascalability perspective in terms of support. Avariety of different partnerships that'sactually been able to engage the community on abroader schedule and certainly that of theconcept of leveraging public and privateresources.

So we talked about all of these today, andI won't go through all of them in detail. We'vespent a lot of time on various prevention.

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Opportunities, we are very proud of the workthat Burney's done in the DJJ component andcertainly a variety of post adoption supportprograms. We talked in the first couple of daysabout other various adoption related activitiesand some of the extraordinary capacity that wehave been able to create. And we are reallyproud of the fact that every one of our CMOs hasthat adoption capacity.

Various other system strengths, we'vetalked about much of what the resourcespecialist in the early days were able to do andthe purchase of service component that we havecreated. I'm not going to go through the restof these, but we are the first lead agency thatwas certified under the (unintelligible) modelwere we make recommendations now under licensingand are essentially accepted by the Department.

We've done a variety of normalcy activitiesfor kids. When we get into some of the otherinnovative partnerships, we spent a little bitof time, not a whole lot, but we spent a littlebit of time talking about APD. We recentlyentered into a new partnership with a new agencycalled Milestone that just gives you an idea as

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to what we are trying to do to work on aprovider who understands specialty DV kids.

We talked about the specialized therapeuticmodel, for example, the specialized medicalunit, and a variety of other components thatwe've been able to create with otherstakeholders. The other component here -- wetalked about -- going back to I think it was thethird day -- it was Big C and Little C. Wetalked about how we were able to really bringabout this broad level of community outreachwithin the community, and what we've done reallywell is creating nontraditional providers withinthe system to be a part of it. MMYA that Burneyhas partnered with for example, is one of thosenontraditional providers within west Orange thatreally never have been involved with childwelfare before.

We talked about faith-based components anda variety of components around the expertisethat we've been able to really imbue in thesystem and partnership with a variety of otherfolks. I won't go through a lot of these, but Ithink that the vast array of trainings thatKaren covered for example, the impact and the

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scalability, again, is rather significant.We talked a little bit about database

supports, and we briefly touched about IRIStoday that we are very excited about. We spenta lot of time about expanded family supportsthat we have within the system and certainly thefact that we are very excited about the ongoingquality parenting initiative. You have given usa little bit of constructive feedback todayabout the focus in Osceola County. The idea ofhaving a very focused marketing approach withrespect to recruitment there. I think thosewere very good comments, and things that we areprocessing.

I want to remind everybody that we were oneof the first lead agencies in the state to beaccredited under network standards. That wasthree years ago. And we know a lot of otherCBCs have been in the process of following.

In terms of other system strengths, we havereally proven that we can maximize communityresources. We talked about the variousdonations and new funders and grants. We talkedabout the leveraging of the community servicecenter for example. The impact that public

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allies is having in our network.And then as it relates to child safety.

Certainly, the fact that we've kept ratiosfairly low over the last couple of years. Wehave areas on the reunification timeliness thatwe know that we have to work on, but at the sametime we have one of the best reentry rates inthe state.

So that's really I think in a nutshellwanting to do my closing comments if I could.

MR. SACHS: Let's go through our questionsand then you can do that and it will be a niceclosure for the event.

Arto, I'll start with you. Do you have anyadditional questions for our friends at FamilyServices?

MR. WOODLEY: No questions. Thank you foryour time. Just a quick comment, I realize howextraordinarily difficult it is to do what youdo. And I know we've asked some difficultquestions, and I hope you understand that thequestions we ask really is in the spirit ofwhat's best for the young people in thiscommunity. But I do want to underline that wereally appreciate what you have done, and we

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appreciate the information that you providedover the last few weeks. Thank you.

MR. SACHS: Shane.MR. DEBOARD: No questions.MR. SACHS: Going right down the row here.

You guys are all in a row so I don't have toname you.

UNIDENTIFIED SPEAKER: No questions.SERGEANT GLACIER: Scott. What Arto says.MR. SACHS: What Arto says.

(Unintelligible). Good. Down on the end, Dawn.MS. MURRAY: I have nothing.MR. ATKINS: I agree with Arto. But I just

have to ask one quick little question. And it'sjust that I've read over some of the commentsthat were made by the community member at thecommunity meeting, and some of them were veryimpressive as far as your delivery of servicesare concerned. However, one issue that keptpopping up, and it's been ringing in my head,and that is foster care payments.

And there was one issue that really grabbedme because I do know that it's really important,you know, to have finances to run a family. Idon't have any kids but I know it takes money to

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do that, and it just appears to me just from theway that the message was communicated by theseindividuals that there must be an apparent gapin that payment process. You know, for fosterparents to be able to or having to call you to,you know, where's the money, so to speak.

What is it that you plan to do or if thereis -- because I cannot sit here and believe thatthese foster parents have not contacted youregarding payment. What's going on with that?

MR. KURTH: Well --MR. ATKINS: Unless these foster parents

are just making something up.UNIDENTIFIED SPEAKER: Are you talking

about timeliness of payments?MR. ATKINS: Timeliness of payments. Some

of them were like, you know, 15 days late.MS. LEWIS: That is a relatively recent

development. Under Wendy's leadership we weregetting foster parents -- foster parent paymentsout within the first week, so that within thefirst five days when the new month came on, wecould roll out a FSFN 2C and trying to line upso we could pay out of FSFN 2C. We dovalidations with our CMOs which means that they

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come in and we go over every child that is incare and check to make sure that the informationthat we have is the same information that's inFSFN.

That has pushed things back 15 sometimes asmany as 20 days. However, we did communicatewith the foster parents three times in a rowwith every paycheck that this was coming, and weknew this was going to come and it was going tobe a short period of time until we had thingslined up and we would be able to pay out ofFSFN, that it was going to be a process.

We realized when that came up that'sprobably something that we need to send out withevery single paycheck because, you know, whenyou communicate, we've always been told it'sthree times, BTA, three times you send it homethree times. It's a short period of time.

MR. SACHS: Carolann?MS. DUNCAN: I don't have any more

questions. I know it's been a difficultprocess, but I appreciate your professionalism.

MR. SACHS: Nick?MR. COX: I just want to say thank you

because I've enjoyed this. Whenever I do this,

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I always seem to learn something like the two ofyou, I'm going to go back and talk about youtwo. I mean, you learn something that you wantto take in. And I know you all share the stuffat the FCC, but I mean, I agree this has been atough process. But at the same time, it's beenhelpful to me. It'll help me take stuff back tomy region too. Thank you, very much.

MR. SACHS: John?MR. COOPER: No, I just want to echo some

of the comments. I just want to tell Greg,thank you and your staff for the time,dedication that you put into the processespecially your board for showing up andsupporting you and working on the process. Iappreciate that.

Just to acknowledge some of the greatthings that have been done, you know, theadoptions especially in the last three yearshave been very impressive. I think at least 200three years in a row. Those are big numbers, soit's much higher than our target. And also theeffort that we put into prevention services inOrange and Osceola County the last two years,and the prevention specialists, diversion

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specialists, your staff there. Great workthere. Thank you.

MR. SACHS: And from me, and again, Iappreciate your professionalism and the teamthat you put together especially the support bythe board. That cannot be understated howpowerful that is and how meaningful that is tous. It is also apparent to me that yourecognize where there are opportunities forimprovement in your system. We talked aboutfoster homes in Osceola County. We talked aboutparent participation in family teamconferencing. The organizational model, thatyou pay attention to both counties as much aspossible, branding, the whole brandingphilosophy. So it's clear to me that you are onpath, that you understand where opportunitiesfor improvement are and that was wellrepresented.

Our process as we get through this is thatwe will depart today and go into some personaldeliberations about our decision making. Wehave a whole lot of material to digest, much ofwhat you presented is still coming to us viapaper for us to absorb. There are some

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transcripts that some of us may want to go backand reread some things that were said and whatwas thought.

I believe we've announced today, Chrissyleft the room, but John you can confirm the 22ndis the date under which we will regroup,publicly, and to deliberate our decision andcome forth with a recommendation that will bemade to Mr. Cooper. Then he will be making adecision. Has that been announced?

MR. COOPER: I will consult with thesecretary, you know, from that day on andhopefully our goal is to make that announcementthe 25th, that Monday.

MR. SACHS: The following week, on Mondaythe 25th. So a little bit of time between nowand then, but we've got a lot of work to do inour heads as well as putting togetherinformation and coming back to the table. Soagain for me, I appreciate all of yourparticipation and professionalism.

I'll let you make your final comments.MR. DEBOARD: Greg, can we get all of your

slides in one chronological, coherent place?Because when I go back and look at all of this

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information on my notes and everything else, youknow, I don't have a lot of the information thatwas contained in your slides. I just can'twrite as fast as you were going through it, so Iwon't be able to cross-reference my notes witheach section of your PowerPoint so I can reallymake a solid comparison compared to what CBCSeminole has done and then what you have done.Without those slides, I'm not going to be ableto do it.

So if you guys could get that informationto Chrissy so she can give it to us, then I canpull up my computer and print it or however Ichoose to look at it. I need all of theinformation, all of the slides that you've donein the order that you've done it.

MR. SACHS: I have confirmed with Chrissythat we do have everything through last Friday,and so today is the only --

MR. DEBOARD: Today is the only thing thatwe are missing. Very good.

MR. SACHS: And we will be getting that Isuppose very soon.

MR. DEBOARD: Right. Okay.MR. SACHS: And I do want to go through the

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fairness questions after you are done. So we'lllet you finish and then I'll have one morecomment.

MS. SCOTT: I'm sorry. Greg, before youstart, I mean, I have worked personally with somany of you, I just can't think of a group thatreally cares about kids. And thank you forputting up with me.

MR. COX: You're welcome.MS. SCOTT: No, they take my -- I mean, for

years.(CROSSTALK.)MR. SACHS: (Unintelligible).MS. SCOTT: Yeah, no, me (unintelligible).MR. SACHS: Not to me here, me there.MS. SCOTT: No, me there.MR. SACHS: Go ahead.MR. KURTH: Well, I wrote some notes out, I

have several pages. I do want to kind of referto my notes. I do have some closing comments,and I know that we're kind of running out oftime. I just kind of want to go through all ofthis -- well, I'm not going to go through everysingle component, but I do want to make astatement.

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You know, last week I said that much of oursingular focus really has to be about sharedleadership just for stronger safety andwell-being and permanency of our kids. I reallywant to emphasize in the first three years, Ithink we emphasized a lot of components aboutright size in the system, getting casemanagement contracts in place, working onadministrative efficiencies and systems andwhatnot, and we have done that both in thepublic and the private side.

I think our last three years have beenpredominantly really about building capacity.We've talked about the provider network. Wetalked about a variety of prevention supportsand whatnot. I think that going over the next 4to 5 years, I really think that now we are posedto go to the next level. We are well aware ofour strengths and our weaknesses, and thisprocess has really crystallized both. I had ahunch at what our strengths and weaknesses were,and it's actually taken it to another level.

I really believe that now we can go to thenext level in which we are really achieving moreof a shared vision in this community relative to

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how we do child protection. One of the thingsis that we have always emphasized the fact thatefficiency is a priority for us, and werecognize that being one of the lower fundedCBCs in the state we've got to kind of becognizant of that.

However, today we are serving more kids inprevention programs than we actually are in theformal child welfare system. Thanks to theTitle 4E waiver and a variety of other supports,we have never been able to have the opportunityto do that before. Our board and our staff arealways asking ourselves how are we really addingvalue, and this is something that we reallyfocused on a couple of years ago in thestrategic training -- of the strategic planningprocess.

We talked a lot about leveragingpartnerships. And community service center forexample was able to take one dollar of our DCFcontract and leverage about three dollars, forexample, on the private side. One of the thingsthat we always realize is that we have tocontinue to collaborate broadly and that ourcapacity has changed with our providers, so in

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tune we have to change a little bit to betteradapt to all of that.

One of the things is that you probably haveno doubt heard that the issue of administrativeefficiencies with the other vendor, could havepossibly be achieved a little bit greater with atri-county proposal. We obviously agree withthat, and we know that if we have the ability todo some kind of expansion and taking in otherservice centers somewhere or two and whatnot, weprobably could bring down our indirect rate aswell.

But this process didn't afford us to that.What we had to really do in this process is thatwhat we wanted to do is present a proposal thatI think was in the spirit of what you talkedabout earlier, Walt, how is it really addingvalue? And I think many of the relationshipsand the community components some of which issometimes is difficult to value is rathersignificant.

Every region has its unique challenges, andours is one of the largest in the state. Wehave the most child abuse reports here as a leadagency catchment area. Osceola County has

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certainly very unique challenges. The housingissue that we have emphasized is extraordinary.When we look at Orange County for example and welook at the school lunch program and we look ata lot of other challenges, what we really askall of you to do is look at the performance ofwhat we've been able to do, and the context ofthe communities that we are being asked toserve.

One of the things that I've really learnedin this process is that leadership can not bejust constrained to a few constituencies. Andwe've obviously done what we could to bring inmore government, certainly faith-based partners,other nontraditional stakeholders, certainlyadvocates and donors. We've talked about thepartnership with IKEA for example that took afew years to nurture and the extraordinarypartnership with CNL where they canceled theirentire employee Christmas party so that all ofour youth could have a Christmas party everyyear. We know we haven't been perfect, and weare certainly not infallible. Obviously ourfocus going forward is going to be much greateron shared leadership and network development.

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And we know that scalability reallymatters. One of the things that we've talkedabout is that we now have about 200 contractsand rates with various providers. And I'm surewe haven't made every provider happy all of thetime, but we really wanted to envision communityas a way to move beyond just the providercomponents, and really be at the forefront ofhow we talk about child welfare in a positivelight. And that's particularly neighborhoodassociations and other organizations,faith-based and churches really gettinginvolved.

On a personal level I've been involved withthe quality improvement center forprivatization. I was on the national advisoryboard and which I was part of the demonstrationproject, and it's a little bit interesting to gooutside of Florida because people in the rest ofthe country very much are kind of in awe aboutwhat our state is doing. A lot of other statesare struggling with public and privatepartnerships, and we've gone through a lot ofchallenges and a lot of evolutions and whatnot,and I have to tell you Florida is very much a

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model for the rest of the country in terms ofhow to engage community around child protection.Many other states are actually looking towardsus with respect to how to emulate that.

I'm really proud of our families andchildren. And obviously I'm really proud of thefact that many of you, Lesley was involved withfoster care recruitment a few years ago,Sergeant Glacier on the alliance and Mary andall of the other folks around this table that weworked with in other capacities.

One of the things that I just want tomention to you is that there is the story ofShawn that I want to share with you. This wasShawn who was at Westgate. One of our partners,where he was literally, you know, I shouldn'tsay abandoned, but he got out of the car whenhis caregivers went down to get I think it was afree lunch or something for a timeshare -- andJohn is familiar with this story. And DonWinstead (ph) came down to really present aboutthis.

Shawn was at the point of not surviving ifwe had not intervened, thanks to folks atWestgate. This was a child who got out of the

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car where he was actually locked in, went to abuffet table to start eating some food. Hiscaregivers had actually locked him into a closetand strung him up with fishing wire. Heactually -- I think he was on the verge ofhaving one or two of his feet amputated, John?The child would have died had there not beenintervention with Westgate.

What makes me feel good about it and why Ido what I do is that what happened in Shawn'scase is we were able to get him adequatelyplaced. We had him in a program called TheHaven in Brevard which is actually a residentialprogram. He had some struggles early on, butsomebody at The Haven wanted to adopt him.

So a few months ago I was proud of the factthat we were able to go to the courthouse inOsceola County and I was actually able to atleast be there and they think, John, you werethere as well to witness that finalization. Soto me that's what it's all about, is thecommunity coming together, figuring out a way tosave kids, and then doing what we can to getthem into those respective loving homes.

So from all of us here at Family Services

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of Metro Orlando and our board and whatnot, wethank you for the opportunity to come to thetable. And we are absolutely willing to go tothe next step to talk about those componentsthat we need to change to really satisfy all ofyou, that we can continue in the progress withrespect to community based care in the ninthcircuit. So with that I want to thank you allvery much for your time because I know it's beenextraordinary on your end.

MR. SACHS: Thank you, Greg.UNIDENTIFIED SPEAKER: Thank you.MR. SACHS: Last question and maybe a

comment as well, fairness. I have to ask youdid you have enough time to present what youneeded to present to us to allow us to make thebest value decision? Do you feel like you needmore time to present anything to us?

MR. KURTH: I think what we would like -- Iwould say the answer, Walt, is we do have enoughtime. I'm understanding that we have to giveyou a little bit more information on the orgprocess a little bit. We want to make sure thatwe get that to you in the next day or two.

I would ask all of you if there is any

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other questions or concerns, that you somehowlet us respond to that. You have given us somethoughts, especially you, Walt, in the fostercare thing in Osceola County where that was veryprofound. I think we have some nucleuscomponents that we want to implement, but thereare some other things that we know we can do alittle differently, and want to continue thatdialogue with all of you about some of thoseareas of focus.

MR. SACHS: One of the provisions in theITN is the Department reserves the right toalways ask for more information to help us makea decision. So if when Chrissy is receiving theinformation from you and then distributes it, ifthe evaluation team needs more, we would thenengage you again and possibly even have to setup another meeting to gain more information. Idoubt that, but that is a provision in the ITNthat allows us to be fully informed.

MR. KURTH: Okay.MR. SACHS: My primary concern is that you

were given enough time to do your presentationin that you feel like you have covered what youneeded to cover to get us educated on decision

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making.Then the second question and maybe even

more important is the fairness of the process.Was there any part of this that you felt wasunfair? I don't want to use the word rigged,but you know what I'm getting to. Is thereanything that you felt was inappropriate or thatFamily Services was treated unfairly?

MR. KURTH: No. Certainly, the process hasbeen -- I know it's been laid out fairly andwhatnot and at times when we've sent someinformation to the Department, I know Chrissyhas been terrific. She gave us -- there was oneconcern that we had about some information thatyou all received anonymously. I'm glad that wehad the opportunity to respond to that because Iwas a little bit concerned about that statement.If there's other things like that out there thatyou have concerns about, please give us theopportunity to respond to that.

MR. SACHS: Absolutely. Again, Iappreciate the participation from theDepartment. Anybody else on our team haveanything that I forgot to talk about? Shane,I'm especially looking at you.

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MR. DEBOARD: No, sir.MR. SACHS: We are good. Okay. Thank you

very much, and we are adjourned. And manythanks to our court reporter.

(The meeting concluded at 4:34 p.m.)

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CERTIFICATE OF REPORTER

STATE OF FLORIDAss:

COUNTY OF SEMINOLE

I, HEATHER K. HOWARD, court reporter,hereby certify that I was authorized to and didreport the October 5, 2010 Florida Department ofChildren and Families CBC Negotiations (FamilyServices of Metro Orlando), and that the transcriptis a true and accurate transcription of my notes andrecordings.

I further certify that I am not a relative,employee, attorney or counsel of any of the parties,nor am I a relative or employee of any of theparties' attorneys or counsel, nor am I financiallyinterested in the outcome of the foregoing action.

DATED this 2nd day of November, 2010.

___________________________________HEATHER K. HOWARD, Court ReporterNotary Public-State of FloridaNotary Commission #DD 996777Commission Expires: 06/07/14

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