QRTP Frequently Asked Questions Below you will find a list of frequently asked questions regarding Wisconsin's work to establish Qualified Residential Treatment Programs (QRTP). This information was last updated in September of 2020. How do congregate care facilities fit in with the goals of Family First and Wisconsin’s Child Welfare Transformation Initiative? Put simply, the goal of FFPSA is to keep kids with their families. To achieve that end, the law shifts resources away from group care settings and toward in-home prevention services. When a child cannot safely remain in their home, every effort will be made to place the child with a relative or like-kin caregiver. When that is not possible, the next preference is to place a child with a foster family. While we work to meet FFPSA QRTP requirements and elevate the quality of congregate care facilities for children who require those placements, our goal is for there to be a smaller number of children served for shorter periods of time. This means, in part, that we are taking a phased approach in our congregate care strategy--both so that we can direct resources to the in-home and family-centered work, and so that any changes we make to congregate care point to the congregate care system of the future, not that of the present. What’s all this talk about quality? Wisconsin is committed to elevating quality care for all children in congregate care settings. We want to successfully keep children in our state, ensuring that they are served in an appropriate setting based on their needs, and in an environment that is trauma informed. We want to become partners in excellence in elevating the quality of care for all children who experience out of home placement in congregate care settings. The QRTP requirements in Family First are important first steps that provide a foundation for advancing quality, but we expect this partnership in elevating quality to be an ongoing process that will extend well beyond meeting the basic requirements of Family First. Will all group homes and residential care centers be required to become QRTPs? DCF’s future goal for congregate care facilities is that all DCF Chapter 52 (residential care center) or DCF Chapter 57 (group home) facilities will be certified as QRTPs. DCF hopes that all current group homes and residential care centers will pursue certification once available, likely in the Spring of 2021. QRTP certification will not be required to operate a DCF Chapter 52 or 57 facility in the initial phase of FFPSA implementation (October of 2021). When QRTP certification does become required in the future for all or some Chapter 52 or 57 facilities, DCF will provide an extended period of notice and transition. How will this impact the licensing of new group home or residential care centers? Any new group home or residential care center seeking to be licensed will be expected to be working toward QRTP certification once available. DCF intends to limit the licensing of new group home facilities, outside of specific circumstances. It is the hope that with the transition of child welfare in Wisconsin, more children and youth will be able to be served in family-like settings, and additional group home facilities will not be needed in our future child welfare system. How is the department considering special populations that are carved out in FFPSA? DCF’s goal is that all DCF Chapter 52 and 57 facilities will become QRTP certified facilities. DCF believes that the quality of care that will be elevated by certification of QRTP facilities is beneficial for all children/youth in congregate care, but particularly for these special populations identified by FFPSA, including victims of (or at risk of) sex trafficking and pregnant and parenting teens. Will all shelter care facilities be required to become QRTPs? No, facilities licensed under Chapter DCF 59 as Shelter Care Facilities will not be required to become QRTP certified facilities, as these facilities are meant to provide short-term, non-treatment-based placement stays. Will I have to apply for a new facility license if I want to become a QRTP? No, if your facility is currently licensed as a DCF Chapter 52 or 57 facility, the QRTP certification will be in addition to your existing facility license. The certification process is still being determined by DCF, but you will have to apply for the QRTP certification (like the DCF Chapter 52 or 57 license), go through a review process, and then receive certification. If I am currently licensed as a group home but currently operate more like a shelter care facility, or if am interested in changing my business model, may I apply to change my license? Yes. What will be required to become a QRTP in Wisconsin? While Wisconsin is still determining what QRTP certification requirements will be, federal requirements outline basic components required for QRTP facilities, with Wisconsin’s implementation information outlined below. The below list is the federal requirements at this time. Additional requirements may be outlined by DCF. Implementation of a Trauma Informed Treatment Model (TITM) Federal Requirement Wisconsin Implementation Facilities are required to implement a Trauma Informed Treatment Model Sec. 201 (4)(A) Based on Trauma Informed Treatment Models (TITM) from SAMHSA and other county-based child welfare systems, Wisconsin is developing a state-wide TITM for QRTP certified facilities. This will consist of an agency self-assessment and a model. The TITM is part of the foundation in elevating the quality of Wisconsin’s congregate care system. What is still being determined: Ø How implementation will occur Ø What will be required of facilities Ø How DCF will partner with facilities to ensure fidelity of the TITM The TITM is currently in the Design Phase through Q3 2020. Within Q4 2020, it is anticipated that a Draft of the TITM and Implementation Plan will be circulated to stakeholders for feedback. Nursing Staff available 24/7 Federal Requirement Wisconsin Implementation Registered or Licensed Nursing Staff or other Clinical Staff who - are on-site during business hours - are available 24/7 Sec. 201 (4)(B) The department recognizes that it may not be efficient for every single facility to establish 24/7 nursing staff. Given the individual needs of all facilities in Wisconsin, DCF plans to offer a 24/7 “telehealth” option to support facilities in meeting the federal requirement. There may be an option for facilities with available nursing staff to “opt out” of this service. DCF plans to develop and release a Request for Business (RFB) for a Contractor to fulfil these duties for QRTP facilities state-wide and/or regionally, to meet this need. As DCF is in the process of developing this RFB, there is a limited amount of information that can be shared. The RFB will be released and available in Q1 or Q2 2021, dependent upon available funding sources. 6 months of Aftercare Federal Requirement Wisconsin Implementation 6 Months Aftercare post-discharge Sec. 201 (4)(F) The HLOC team and the Together & Connected (prevention/in-home) team are working with community partners to develop a workgroup to determine how aftercare should be defined in Wisconsin. Community partners included in the group are: 1. Group Home and RCC facilities, both child welfare and youth justice-focus placements 2. In-home service providers 3. WAFCA 4. Youth Justice and Child Welfare County Representatives 5. Juvenile Detention Facility Representative Decisions will likely be made in Q4 2020. Accreditation Federal Requirement Wisconsin Implementation Accredited by any independent, not-for-profit accrediting organization approved by the Secretary. Sec. 201 (4)(G) All bodies approved through the Children’s Bureau will be accepted by DCF. Bodies are subject to change at the discretion of DCF or the Children’s Bureau at any time. Ø Council on Accreditation Ø CARF International Ø The Joint Commission Ø EAGLE Accreditation Ø Teaching-Family Association Family Involvement in Treatment Planning Federal Requirement Wisconsin Implementation Involve the family in treatment planning Sec. 201 (4)(C)(D)(E) All changes regarding how the QRTP facilities will be required to work with the family of the youth in placement will be listed in Admin Rule or Policy. DCF is gathering information from stakeholders regarding current treatment plans. More information to come in early 2021 and will be released in the QRTP Policy. Is the Department exploring changes to rates to support the QRTP requirement? DSP is partnering with the Public Consulting Group (PCG) to evaluate rate setting for congregate care settings including residential care centers, group homes, and child placing agencies (treatment foster care homes). The intention of this work is to understand our current rate setting process, identify gaps, and to explore future solutions that encourage quality, short-term congregate care stays and allow Wisconsin providers to meet the needs of Wisconsin children and youth.