Attachment N - Private Contractor Annual Report-.docx

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Attached to
Residential Child Care Services
Solicitation number
BPM054507
Issued by
Maryland

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This is a Private Contractor Annual Report attachment for the Maryland Department of Human Services, Social Services Administration's Residential Child Care Services contract opportunity. The report serves as a required submission document for private contractors providing residential child care services across nine program categories in Maryland. Contractors must complete and submit this annual report to document their operational activities, service delivery, and compliance with contractual obligations throughout the performance period. The report functions as an accountability mechanism, enabling the state to monitor contractor performance, track service utilization, and ensure adherence to program standards and regulatory requirements established for residential child care providers.

The annual report attachment establishes reporting requirements and standardized formats that contractors must follow when submitting performance data to the state. This documentation requirement is essential for contract administration, allowing the Department of Human Services to evaluate contractor effectiveness, identify operational trends, and make informed decisions regarding contract renewals and future procurement. The report format ensures consistent data collection across all contracted residential child care providers, facilitating comparative analysis and quality assurance monitoring. Contractors are required to maintain accurate records and submit timely reports as a condition of their contract terms and continued participation in the residential child care services program.

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File Type Posted
Attachment M - Annual Audit Report Requirements.docx DOCX document
Attachment L.-DHS-Hiring-Agreement.pdf PDF
Attachment J- Data Sharing Agreement (Sole Source)-CPA revised 7.17.pdf PDF
SSA.RCC-26-001-S Amendment 2.pdf PDF
Attachment D MBE-Forms-1 D-1A Sample.pdf PDF
Attachment O.-Contract-Affidavit.pdf PDF
SSA.RCC-26-001-S Questions and Responses - Series 2 (1).pdf PDF
Letter - Expression of Interest - Residential Child Care Services.pdf PDF
Attachment G -Conflict-of-Interest-Affidavit.pdf PDF
Attachment I.-Non-Disclosure-Agreement-Contractor.pdf PDF
Attachment D MBE-Forms-1 (2).pdf PDF
SSA.RCC-26-001-S Questions and Responses - Series 1 a.pdf PDF
Attachment Q - Policy SSA.CW #24-01- Trauma Responsive and Appropriate Transport of Children’s Belongings (v3).pdf PDF
Attachment H- LDSS Directory - Sheet1.pdf PDF
SSA.RCC-26-001-S Amendment 1.pdf PDF
Attachment E - Certificate of Lobbying (1).docx DOCX document
Attachment C. Bid-Proposal-Affidavit.pdf PDF
Revised Letter - Expression of Interest - Residential Child Care Services.pdf PDF
1. Attachment B- RCC- EOI SOW (2).pdf PDF
Attachment-P.-Bidder-Offeror-Information-Sheet.pdf PDF
SSA.RCC-26-001-S Amendment 3.pdf PDF
Attachment F.-Maryland-Living-Wage-Requirements-Affidavit-of-Agreement.pdf PDF
Attachment F.-Maryland-Living-Wage-Requirements-Affidavit-of-Agreement.pdf PDF
Attachment F.-Maryland-Living-Wage-Requirements-Affidavit-of-Agreement.pdf PDF
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ATTACHMENT N– DHS PRIVATE CONTRACTOR ANNUAL REPORT

SFY 2X (July 1, 202X to June 30, 202X)

Department of Human Services - Private Contractor Annual Report

Submit to Social Services Administration by December 2 of Each Year for the Prior Fiscal Year

Agency:

Program:

Section I. Demographics of DHS Youth Served (Answers reflect ONLY DHS Children & Youth)

1a.
Fiscal Year Total Admissions:

(actual number);

1b.
Total Discharges:

(actual number);

1c.
Number of Rejections:

(actual number);

1d.
Number of Ejections:

(actual number);

2a.
Racial Breakdown:
Asian
#
,
%
;
Black/African American
#
,
%
;
White
#
,
%
;
American Indian or Alaskan Native
#
,
%
;
Pacific Islander or Native Hawaiian
#
,
%
;
Unable to Determine
#
,
%
;
2b.
Ethnic Breakdown of Admissions:
Hispanic
#
,
%
;
Non-Hispanic
#
,
%
;
Unable to Determine
#
,
%
;

Note: Self-identification or self-reporting is the preferred method of gathering information on race and ethnicity (note: children of Hispanic origin may be of any race). The child (if old enough) should be asked, or the information should be obtained from the child’s family members. “Unable to determine” should only be used if there is no one who can provide the information or if the child/family refuses to provide it.

3.
Age at Admission:
0-5
#
,
%
;
6-10
#
,
%
;
11-15
#
,
%
;
16-18
#
,
%
;
Over 18
#
,
%
;
4.
Gender of Admission:
male
#
,
%
;
female
#
,
%
;
5.
Previous Placements:
higher
#
,
%
;
lateral
#
,
%
;
lower
#
,
%
;

Previous placement refers to the immediate placement prior to admission into your program. A lateral move refers to movement from one program into another of the same type. Based on the following continuum:

(Highest level of care) Psychiatric Hospitalization - Residential Treatment Center (RTC) - Therapeutic Group Home - Large Group Home or Small Group Home - Alternative Living Unit - Treatment Foster Care - Semi independent living - Independent living - Regular Foster Care - Shelter Care - Kinship Care - Biological Family Home (Least restrictive level of care)

6a.
Racial Breakdown of Discharges (see question 2 above):
Asian
#
,
%
;
Black/African American
#
,
%
;
White
#
,
%
;
American Indian or Alaskan Native
#
,
%
;
Pacific Islander or Native Hawaiian
#
,
%
;
Unable to Determine
#
,
%
;
6b.
Ethnic Breakdown of Discharges:
Hispanic
#
,
%
;
Non-Hispanic
#
,
%
;
Unable to Determine
#
,
%
;
7.
Age at Discharge:
0-5
#
,
%
;
6-10
#
,
%
;
11-15
#
,
%
;
16-18
#
,
%
;
Over 18
#
,
%
;
8.
Gender of Discharges:
male
#
,
%
;
Female
#
,
%
;
9.
Placements of Discharges (Use same scale as shown in 6 above) :
Higher
#
,
%
;
Lateral
#
,
%
;
Lower
#
,
%
;
10.
Length of Placement :
0 - 3 Months
#
,
%
;
3 Months – 1 Year
#
,
%
;
1 Year – 18 Months
#
,
%
;
Over 18 Months
#
,
%
;

Section II. Outcomes of DHS Youth Served

Safety Outcome: Children shall be protected and safe from abuse and harm.

1. Safety Indicator: Of all children and youth in your program during the period under review what number and percentage, if any, were the subjects of substantiated or indicated maltreatment by a foster parent or agency staff?

Number:

Percentage:

2. Safety Indicator: Of all the children and youth in your program during the period under review, what number and percentage, were the subjects of critical incident reports involving physical harm to them from any source?

Number:

Percentage:

Permanence Outcome: Children will have permanence and stability in their living situations.

Permanence Indicator: Of all the children and youth discharged from your program during the period under review, what number and percentage were reunified with their family or placed in adoptive homes within 24 months following the time of removal from their home.

Number:

Percentage:

Well-being Indicators:
# of runaways
,
# of critical incidents
,
# of school aged children enrolled in school
,
# of children receiving supportive services according to the case plan
,

Section III. (Optional) Ranking Your Program Strengths and Issues Confronted

Use additional sheets as needed.

Place in rank order the five greatest achievements/successes of your program during the past year.

(a = greatest achievement your program experienced during the past year.)

a.

b.

c.

d.

e.

Place in rank order the five greatest problems your program has faced during the past year and what have you done about them? (a = greatest problem your program faced. ) a.

b.

c.

d.

e.

Please note any program changes and/or expansion impacting your program. (Use additional pages if needed.)

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