Title IV-E Roundtable University of Minnesota June 3, 2015 Joan Levy Zlotnik, PhD, ACSW Director, Social Work Policy Institute National Association of Social Workers THE NATIONAL ASSOCIATION OF SOCIAL WORKERS

The Child Welfare Workforce No specific information on education and training – <40% with a BSW or MSW degree) – varies across states from <10% to 60%. High rates of turnover – varies by agency & by county even in state administered systems. High workload (recent reports from VT, CO, SC, GA, MA, MN). Insufficient clinical training & assessment skills ©2015 National Association of Social Workers. All Rights Reserved. 2

Workforce Issues Impact Child Outcomes Workforce issues DO impact child outcomes: – More workers a child has, increases likelihood of more foster care placements (Milwaukee County). – Worker turnover impacts return to care (FL-Eckerd using predictive analytics). ©2015 National Association of Social Workers. All Rights Reserved. 3

Workforce Issues Impact Child Outcomes  Workers with social work degrees: Quicker to achieve permanency outcomes. Greater sense of competency - self- efficacy Greater frequency of child visits Better use of community resources. Services more specific to level of severity of risk for further abuse & neglect. ©2015 National Association of Social Workers. All Rights Reserved. 4

Launching Use of Title IV-E Growing use through the 1990s Requires schools of social work to partner with the state/county agencies Brings new BSWs into child welfare practice Provides degree education (usually at master’s level) for current child welfare workers. Enhances child welfare elements in the curriculum. ©2014 National Association of Social Workers. All Rights Reserved. 5

Use of Title IV-E to support BSW & MSW Education 1992 – 24 programs accessed Tit1e IV-E 1996 – 68 programs (91% began after ’91) Early 2000s – estimated IV-E use in 40 states CSWE’s 2011 statistics report – 35 states CSWE’s 2013 statistics report – 33 states SWPI 2012 survey (Zlotnik & Pryce) (94) – 2/3 operating for over 15 years – 70% remained the same size or decreased over past 3 years ©2014 National Association of Social Workers. All Rights Reserved. 6

Using Title IV-E to Support SW Education ©2014 National Association of Social Workers. All Rights Reserved. 7

Key Issues Interpretations of Title IV-E training policy in some jurisdictions appears to restrict use The application of stringent rules and outdated regulations does not support the essential development of a skilled workforce. Impacted by:  Changes in the leadership and administration of public child welfare agencies and ACF Regional Offices  Conflicting opinions and Departmental Appeals Board decisions regarding cost allocation of training expenses across federal programs  Privatization of child welfare services  Narrow interpretation of what topics can be covered by Title IV-E (see Child Welfare Policy Manual). ©2015 National Association of Social Workers. All Rights Reserved. 8

Recommendations for Action Federal financing policies should support consistent and sustainable funding sources and strategies to ensure the child welfare workforce has necessary practice competencies to promote the health, safety and well-being of children, across the full array of child welfare programs.  Ensure consistent interpretation of Title IV-E training policies across states and regional offices  Support rigorous, multi-site evaluation of Title IV-E educational partnerships – ascertain impact on social work education, staff recruitment and retention and child welfare outcomes.  Ensure that national social work and provider organizations, child welfare advocates, and ACYF should work together  Special attention should be made to ensure that child welfare supervisors have the prerequisite knowledge and skills to provide administrative, educational and supportive guidance to the front- line workforce. ©2015 National Association of Social Workers. All Rights Reserved. 9

Research Findings - Worker Outcomes  Factors relating to retention: Personal factors Organizational factors: Supervision, co-worker support, job satisfaction, sense of fairness, salary & benefits.  Workers expected to use clinical judgment and assessment tools ©2015 National Association of Social Workers. All Rights Reserved. 10

Worker Expectations Should Be Opportunity for autonomy. Support for clinical judgments, BUT – Vulnerability to liability and media scrutiny. – Limited recognition of professional role. – Vulnerable to the political climate. – Absence of learning organization culture and climate. – Insufficient availability of quality services and supports for children and families. ©2015 National Association of Social Workers. All Rights Reserved. 11

Supervision Supervision affects worker practices and client outcomes – Goal attainment – Assessment and engagement – Client satisfaction – Self-efficacy Quality of supervision affects workers – Feelings of emotional support – Sense of competence – Organizational commitment – Personal accomplishment – Job satisfaction.

13 Staff Turnover and Child Abuse Study comparing California counties High functioning counties – lowest turnover rates – best paid staff – compliance with recognized practice standards – low rates of re-abuse. Lowest functioning counties – Highest turnover – Lowest staff pay – Highest rates of re-abuse f

Workforce Issues Impact Agency Outcomes Worker turnover is costly to agencies – Recruitment, hiring, retraining – estimates of at least ½ of the worker salary Worker turnover is costly to other workers – Increased workload – Problematic organizational culture and climate – Absence of peer support – Work-family imbalance – Emotional exhaustion – Supervisors providing direct services ©2015 National Association of Social Workers. All Rights Reserved. 14

Some Unanswered Questions How much time does it take to be a fully- trained worker? Or supervisor? What is the impact of worker burn-out (emotional exhaustion) on child outcomes? Why are workforce changes not sustained across years? When reviewing child maltreatment fatalities: – How many workers a family has had? – What the educational background of the worker(s)? – How long the worker(s) has been on the job? ©2015 National Association of Social Workers. All Rights Reserved. 15

CDF/Children’s Rights National Child Welfare Workforce Policy Workgroup (2007) workforce-improvements.html 14 Components of an Effective CW Workforce ( CDF/CR Child Welfare Policy Workgroup )

Current Policy Environment Commission to Eliminate Child Abuse & Neglect Fatalities – es.usa.gov/ es.usa.gov/ – Attend hearings – Submit comments  Workforce must be part of the recommendations. ©2015 National Association of Social Workers. All Rights Reserved. 17

Policy Environment Implementation of the PL PREVENT SEX TRAFFICKING AND STRENGTHENING FAMILIES ACT PREVENT SEX TRAFFICKING AND STRENGTHENING FAMILIES ACT – Reauthorized Adoption Opportunities and Family Connections grants – Includes policies and procedures (including case worker training) related to sex trafficking victims and runaways ©2015 National Association of Social Workers. All Rights Reserved. 18

Policy Environment Child Welfare Financing Reforms Moving funds toward the front-end of care A 25 year conversation!!!!! ©2015 National Association of Social Workers. All Rights Reserved. 19

Policy Environment President’s 2016 Budget Recommendations – Increase fed investments in the front end to prevent removals and placements. – Use specialized family care rather than congregate care/fed oversight for cong care. – 5 year CMS-ACYF Demo to implement evidence- based psychosocial interventions related to youth experiencing trauma and reduce psychotropic med use. – Chafee funds to 23. – Enhanced capacity building for tribes and tribal organzations to use IV-E. ©2015 National Association of Social Workers. All Rights Reserved. 20

Policy Environment SENATOR WYDEN DRAFT BILL – COMMENTS DUE JUNE 12 Summary oc/child%20welfare%20BillSummary1.pdf oc/child%20welfare%20BillSummary1.pdf Full draft oc/ERN15204.pdf> oc/ERN15204.pdf ©2015 National Association of Social Workers. All Rights Reserved. 21

Wyden Draft Bill Suggestions Expands federal reimbursement under Title IV-E to time- limited (up to 12-months) family services to stabilize a family in times of crisis. Allows States and Tribes to seek reimbursement for these family services on behalf of children identified as candidates for foster care (at imminent risk of entry) or who are in foster care. Provides reimbursement for these services without regard to the income of the child’s biological parents. Establishes national benchmark measures and outcomes based reimbursement rates to help target federal dollars to cost-effective programs and services. ©2015 National Association of Social Workers. All Rights Reserved. 22

Wyden Draft Bill Suggestions Increases funding for community-based prevention and intervention services through the Promoting Safe and Stable Families (PSSF) program – Requiring funds be used on evidence-based programs Provides funding for research and technical assistance to inform States and Tribes’ use of family services under IV-E, as well as funding for research and technical assistance to identify additional evidence-based prevention and post- permanency interventions ($4 million per year). ©2015 National Association of Social Workers. All Rights Reserved. 23

Policy Issues to Consider Are we working to develop and test evidence-based interventions? – What is the definition of Evidence-Based Practices? – Where are the gaps in EBPs? What do we know about the success and effectiveness of MIECHV to address child welfare issues? What are all of the settings/systems that MUST work together to improve outcomes? – Do agencies have the “right” cadre of staff (training, workload, expertise, commitment) to implement evidence-based interventions? ©2015 National Association of Social Workers. All Rights Reserved. 24

Policy Issues to Consider How do we balance needed services (mental health, substance abuse, health) for parents and for children and youth? What can be learned from early childhood focused interventions targeting 0 to 3 in places like Oregon for Medicaid eligible children? Are there resources to train the workforce? What processes are needed to ensure the well-being of the workforce? ©2015 National Association of Social Workers. All Rights Reserved. 25

Well-being: Parallel Process Child SUPPORTIVE NURTURING CAREGIVERS PHYSICAL & MENTAL HEALTH SAFE & SECURE LIVING ARRANGE- MENTS ECONOMIC SECURITY Child Welfare Worker SUPPORTIVE & EDUCATIONAL SUPERVISION QUALITY ORGANIZATIONAL CULTURE & CLIMATE SKILLS, KNOWLEDGE & RESOURCES TO IMPLEMENT EVIDENCE-BASED INTERVENTIONS REASONABLE WORKLOADS

Promoting Workforce Well-being Promote Hiring and Retention of Competent Staff BETTER CHILD WELFARE OUTCOMES Apply Evidence- Informed Retention Strategies Promote Policies that Fund Social Work Education & Professional Dev. Create and Sustain University-Agency Partnerships Build Healthy Organizational Culture and Climate Support High Quality & Supportive Supervision Apply Clinical & Evidence-Based Knowledge to Engage with Families and Promote Strengths

Supervision: The Safety Net for Front-Line Practice for-front-line-child-welfare-practice.html for-front-line-child-welfare-practice.html Children at Risk: Optimizing Health in an Era of Reform children-at-risk.html. children-at-risk.html Educating Social Workers for Child Welfare Practice: The Status of Using Title IV-E Funding to Support BSW & MSW Education title-iv-e-funding-to-support-social-work-students.html Investing in the Social Work Workforce releases-new-report-on-needed-workforce-investments.html releases-new-report-on-needed-workforce-investments.html Resources

Factors Influencing Retention: Systematic Review of the Research child-welfare-workforce-initiative.html child-welfare-workforce-initiative.html CDF/Children’sRights National Child Welfare Workforce Policy Workgroup – child-welfare-workforce-improvements.html child-welfare-workforce-improvements.html Child Welfare Information Gateway: National Child Welfare Workforce ©2014 National Association of Social Workers. All Rights Reserved. 29

THANK YOU For More Information Joan Levy Zlotnik, PhD, ACSW ©2015 National Association of Social Workers. All Rights Reserved. 30