Crowne Plaza Hotel, Foster City, California January 23, 2008 STRENGTHENING PARTNERSHIPS TO BUILD A PLAN FOR CAPTA CHANGES

Who’s Here?  Early Start/ Regional Centers  County Child Welfare  State Departments (Social Services, Health, Maternal and Child Health)  Family Resource Centers  Education  California Social Worker Education Center  Other Key stakeholders

Today’ s Focus  Recap the requirements of the Keeping Children and Families Safe Act of 2003 (P.L and Child Abuse and Prevention and Treatment Act (CAPTA).  Examine ways that systems can effectively work together to ensure that children involved with child welfare system who may be eligible for Early Start are identified.  Describe the Part C and Child Welfare Systems and Services.

Today’ s Objectives  Share the rationale for early developmental screening for children in Child Welfare.  Establish effective informal relationships.  Identify clear, concrete action steps to form the basis for continuing collaboration.

Some Common Goals  Identify solutions that build on larger systems change efforts.  Identify young children in need of services and connect those children with the services they need early.  Improve health outcomes for young children.  Strengthen interagency collaboration to leverage funding, technical assistance and training.

States receiving CAPTA funds must develop and implement “provisions and procedures for referral of a child under the age of 3 who is involved in a substantiated case of abuse or neglect to early intervention services funded under part C of the Individuals with Disabilities Education Act” [106(b)(2)(A)(xxi)]. Since 2003 it’s been the Law ….

Restated in IDEA in 2004… States must provide “a description of the State policies and procedures that require the referral for early intervention services under Part C of a child under the age of 3 who is involved in a substantiated case of child abuse or neglect” [637(a)(6)(A)] Individuals with Disabilities Act (IDEA) Individuals with Disabilities Act (IDEA)

Interpretation … -Screening can be used to determine whether an evaluation is needed. -Intent of the law: CWS children will receive special attention to determine whether an early intervention referral is needed. See Child Welfare Policy Manual

Who Refers…. -Referral can come from social worker or other referral sources (e.g., physicians) to screen and refer. -No requirement to refer siblings under age 3 who are not the subject of abuse or neglect, but best practices dictate you should refer siblings who may have delays.

Context for Implementation  California Outcomes and Accountability (fully operational in all 58 counties)  Second Round Children and Family Services Review [02/2008] Los Angeles, Santa Clara, Fresno - Sites Los Angeles, Santa Clara, Fresno - Sites  Standardized risk and safety tools used in all counties Assessing protective capacity, families needs and strengths Assessing protective capacity, families needs and strengths

Context for Implementation  Mental Health Services Act – Prevention and Early Intervention  Other Initiatives [First Five, Early Childhood, ABCD Screening Academy Infant Mental Health, Early Head Start].

California’s Data snapshot..  In 2003 we had 93,000 in FC today we have 77,000.  *In 2006 CDSS had 482,706 child maltreatment referrals of which 108,230 were substantiated.  Of that total 27,785 were ages Zero to three. ( in-Home/out of home) Zero to three. ( in-Home/out of home) * Needell, B., Webster, D., Armijo, M., Lee, S., Cuccaro-Alamin, S., Shaw, T., Dawson, W., Piccus, W., Magruder, J., Exel, M., Smith, J., Dunn, A., Frerer, K., Putnam Hornstein, E., & Ataie, Y. (2006). Child Welfare Services Reports for California. Retrieved [32/16/07r], from University of California at Berkeley Center for Social Services Research website. URL: 2 Extract

How Many Children Under the Age of Three Are in Child Welfare Supervised Foster Care? As of October 2006* < ,163 13,474 13,474 * Child Welfare Services/Case Management System Data. These reports are based on children aged 0 to 18, overall totals may not match other point-in-time reports that include ages 0 to 20 and missing age values

2006 California: Substantiated Referrals per 1,000 by Age and Ethnicity *Series Total

Why bridge connections between child welfare and Part C?  Highest rates of abuse and neglect occur in infants and toddlers 16.1 per 1000 children under age per 1000 children under age 3  High rates of developmental delay in this population 23-61% of children known to CW have delays in development, communication, behavior 23-61% of children known to CW have delays in development, communication, behavior

Child Protection Services Structure  A substantiated case provides in-home and out of home protective services to prevent or remedy neglect, abuse, or exploitation, for the purpose of preventing separation of children living with their families. Differential responseDifferential response Family to FamilyFamily to Family Evidence Based InterventionsEvidence Based Interventions

Child Protection Services Structure.The services plan must address the needs of the child and the family ( for the child mandated to address the health, educational and mental health needs)  Families more be engaged  Up to 60 days to do case plan  PHN HFCA project  Service array expanded

Opportunities for Collaboration Between Agencies  Forms of collaboration Consultation regarding assessments/services Consultation regarding assessments/services Joint evaluations/staffing Joint evaluations/staffing Sharing of information Sharing of information Combined home visits Combined home visits Inclusion of CW in IFSP or EI staff in TDM’s, team meetings Inclusion of CW in IFSP or EI staff in TDM’s, team meetings

Challenges  Demands for services far exceed the available resources  Increasing capacity  Coordination of screening and evaluations  Multiple placements  Infant mental health issues  Complex needs of biological families  Multiple caregivers--consent  Part C as a voluntary service vs court ordered services

Training  What training is available that will help EI providers work with families referred through CW.  Training should focus on clinical interventions specific to CW populations (EB clearinghouse)  Some programs have created liaison position to coordinate services between CW and EI  Joint training builds relationships

Funding  Advocacy is needed for funding the CAPTA regulations in order to make the appropriate changes  Medi-Cal pays for screens and medically necessary treatment

Consider this…  Create multiple pathways for screening using primary physicians or other resources  Participating agencies should work together to contribute to the plan of care to meet the child’s needs.  Need to engage and inform judges and court officers about the needs of infants and toddlers in CW.

THE POWER OF EARLY INTERVENTION And Beauty of

LOS ANGELES MONTERREY SAN BERNARDINO HUMBOLDT County models