Child and Family Services Reviews: Findings, Strategies and Successes National Resource Center for Organizational Improvement A service of the Children’s Bureau, U. S. Department of Health and Human Services

2 Sources: Children’s Bureau PowerPoints Findings From the Initial Child and Family Service Reviews Findings From the Initial Child and Family Service Reviews Program Improvement Plans: Strategies for Improving Child Welfare Services and Outcomes52 Program Improvement Plans: Strategies for Improving Child Welfare Services and Outcomes Strategies That Address Critical Practice Areas: Successes and Challenges in ImplementationStrategies That Address Critical Practice Areas: Successes and Challenges in Implementation

3 Analysis of the First Round of PIPs Looked at strategies in all 52 PIPs Analyzed Results of 33 Completed PIPs Includes 33 States that completed their PIPs as of April 2006Includes 33 States that completed their PIPs as of April 2006 Conducted content analysis of the 33 States PIPsConducted content analysis of the 33 States PIPs Identified measures used by States to gauge progressIdentified measures used by States to gauge progress Interviews with State administrators, QA directors and other staffInterviews with State administrators, QA directors and other staff

4 Goals of the PIP process Improve outcomes for children and familiesImprove outcomes for children and families Strengthen delivery of effective servicesStrengthen delivery of effective services Coordinate partnerships throughout child welfareCoordinate partnerships throughout child welfare Establish ongoing self-monitoring and continuous improvementEstablish ongoing self-monitoring and continuous improvement

5 Cross-Cutting PIP Themes Strengthened agency capacityStrengthened agency capacity Strengthened professional developmentStrengthened professional development Improved social work interventionsImproved social work interventions Enhanced quality assuranceEnhanced quality assurance Expanded community resourcesExpanded community resources Stronger partnershipsStronger partnerships

6 Most frequently implemented strategies: Change/develop policy and train staffChange/develop policy and train staff Family meetings, i.e., Family Conferencing, Family Group Decision Making, Family Team Meetings, etc.Family meetings, i.e., Family Conferencing, Family Group Decision Making, Family Team Meetings, etc. Monitoring through supervisory reviews, Quality Assurance/CQIMonitoring through supervisory reviews, Quality Assurance/CQI Engagement of Children and Families (27 States were applicable)

7 Critical role of supervisorsCritical role of supervisors Cultural change needed at all levelsCultural change needed at all levels Parents should drive assessment and planning processParents should drive assessment and planning process Be less prescriptive in policy development, more training and educationBe less prescriptive in policy development, more training and education More is needed than just trainingMore is needed than just training Focus on infrastructure first, then practiceFocus on infrastructure first, then practice Start smallStart small Engagement – Lessons Learned

8 What strategies address engagement of fathers in case planning and service provision? Develop or revise existing policy and practice to locate absent parents (4 states)Develop or revise existing policy and practice to locate absent parents (4 states) Implement models of practice to assess, engage and plan with fathers (4 states)Implement models of practice to assess, engage and plan with fathers (4 states) Enhance and implement policy or procedures to better engage and assess fathers (5 states)Enhance and implement policy or procedures to better engage and assess fathers (5 states) Enhance training and training curriculum to better engage and plan with fathers (3 states)Enhance training and training curriculum to better engage and plan with fathers (3 states)

9 Common Safety Strategies in Program Improvement Plans Develop new practices or processes (47 States)Develop new practices or processes (47 States) focus on revising risk and safety assessmentsfocus on revising risk and safety assessments alternative/differential response systemsalternative/differential response systems engagement and planning with familiesengagement and planning with families enhance practices and processes to improve practice and consistency (focused on practice models)enhance practices and processes to improve practice and consistency (focused on practice models) create special units or reorganize unitscreate special units or reorganize units Develop or enhance policies (38 States)Develop or enhance policies (38 States) clarify policies around investigations, such as timeframesclarify policies around investigations, such as timeframes disposition processdisposition process

10 Common Safety Strategies in Program Improvement Plans (cont.) Training (38 States)Training (38 States) focus on developing skills of stafffocus on developing skills of staff supervisorssupervisors cross-train community partners, foster parents, residential staff and law enforcementcross-train community partners, foster parents, residential staff and law enforcement Info Systems (25 States)Info Systems (25 States) Services ( 21 States)Services ( 21 States) develop new servicesdevelop new services enhance existing servicesenhance existing services

11 Common Safety Strategies in Program Improvement Plans (cont.) Research and evaluation ( 21 States)Research and evaluation ( 21 States) study areas of substance abuse, juvenile justice, and domestic violencestudy areas of substance abuse, juvenile justice, and domestic violence analyze specific populationsanalyze specific populations pilot specific practicespilot specific practices Collaboration (16 States)Collaboration (16 States) focus on collaboration with community partners, other State agenciesfocus on collaboration with community partners, other State agencies implement strategies to work with tribes to cross-train and provide servicesimplement strategies to work with tribes to cross-train and provide services Supervision ( 11 States)Supervision ( 11 States) focus on supervisors’ role and oversight responsibilities related to safety/risk assessments, in-home services cases, etc.focus on supervisors’ role and oversight responsibilities related to safety/risk assessments, in-home services cases, etc.

12 Common Permanency Strategies in Program Improvement Plans Develop or enhance policies (all States)Develop or enhance policies (all States) Case planning, procedures, hearings, etc.Case planning, procedures, hearings, etc. LegislationLegislation Practice guidelinesPractice guidelines Develop new practices/procedures (all States)Develop new practices/procedures (all States) General casework practicesGeneral casework practices “Best practice” models“Best practice” models Targeted servicesTargeted services Quality assurance and monitoring activities (at least 45 States)Quality assurance and monitoring activities (at least 45 States) Improvements in data/systemsImprovements in data/systems Improvements in supervisionImprovements in supervision Review of specific populationsReview of specific populations Establishing new practice standardsEstablishing new practice standards

13 Common Permanency Strategies in Program Improvement Plans (continued) Collaborative activities (at least 38 States)Collaborative activities (at least 38 States) Memoranda of Understanding (MOU) or interagency agreementsMemoranda of Understanding (MOU) or interagency agreements Courts/legal/judicial issuesCourts/legal/judicial issues Tribes, youth, other stakeholdersTribes, youth, other stakeholders Training (at least 38 States)Training (at least 38 States) Cross trainingCross training Worker and supervisor trainingWorker and supervisor training Foster and adoptive parent trainingFoster and adoptive parent training Policy trainingPolicy training Increase or Enhance Resources (at least 35 States)Increase or Enhance Resources (at least 35 States) Staff hiring/retentionStaff hiring/retention FundingFunding New/expanded servicesNew/expanded services

14 Factors Associated with Timely Reunification, Guardianship, and Permanent Relative Placement The strongest associations with timely reunification guardianship, and permanent relative placement include: The strongest associations with timely reunification guardianship, and permanent relative placement include: Caseworker Visits with Parents Child’s Visits with Parents and Siblings in Foster Care Services to Children, Parents, & Foster Parents Family/Child Involvement in Case Planning ASFA Requirements Regarding Termination of Parental Rights Placement Stability

15 What strategies address reduction in time to achieve permanency? Improve court functions related to permanencyImprove court functions related to permanency Monitor through use of QA case reviewsMonitor through use of QA case reviews Monitor through use of dataMonitor through use of data Establish State and local stakeholder groups to identify barriers to permanency achievementEstablish State and local stakeholder groups to identify barriers to permanency achievement Identify and disseminate best practice models and guidelines for permanencyIdentify and disseminate best practice models and guidelines for permanency Revise policies, procedures, and court rulesRevise policies, procedures, and court rules Establish State-level permanency specialist positionsEstablish State-level permanency specialist positions Joint training of agency/judicial/legal partiesJoint training of agency/judicial/legal parties Decrease caseloadsDecrease caseloads Improve case transfer processImprove case transfer process

16 Strategies Addressing Reunification for Most Improved States Strengthen supervision on permanency planningStrengthen supervision on permanency planning (2 of the 5 States) (2 of the 5 States) Concurrent Planning (3 of the 5 States)Concurrent Planning (3 of the 5 States) Developing data reports to monitor reunification (3 of the 5 States)Developing data reports to monitor reunification (3 of the 5 States) Enhancing quality of parental visitation (1 of the 5 States)Enhancing quality of parental visitation (1 of the 5 States)

17 What strategies address improvements in permanency planning? Concurrent planningConcurrent planning Establish statewide or local permanency unitsEstablish statewide or local permanency units Develop and implement new case plansDevelop and implement new case plans Develop or strengthen policies and proceduresDevelop or strengthen policies and procedures Review processes for appropriateness and timeliness of permanency goalsReview processes for appropriateness and timeliness of permanency goals Family group decision-makingFamily group decision-making Comprehensive child and family assessmentsComprehensive child and family assessments New training for staff on permanency planningNew training for staff on permanency planning

18 What strategies address permanency for youth in foster care? Expand services to youth (at least 9 States)Expand services to youth (at least 9 States) - Recruit/identify new service providers - Recruit/identify new service providers - Expand specific services (housing, mentoring, life skills) - Expand specific services (housing, mentoring, life skills) - Establish stabilization centers (one State) - Establish stabilization centers (one State) Strengthen staff capacity (at least 4 States)Strengthen staff capacity (at least 4 States) - Add youth specialists - Add youth specialists - Train existing staff - Train existing staff Improve case planning/transitional plans (at least 7 States)Improve case planning/transitional plans (at least 7 States) - Implement new assessment tools/strategies to complete them - Implement new assessment tools/strategies to complete them - Focus on transitioning Native youth (one State) - Focus on transitioning Native youth (one State)

19 What strategies address permanency for youth in foster care? (continued) Collaborate with youth/other stakeholders (at least 6 States)Collaborate with youth/other stakeholders (at least 6 States) - Youth Advisory Boards - Youth Advisory Boards - Other agencies, e.g., mental health - Other agencies, e.g., mental health Disseminate information on services (at least 4 States)Disseminate information on services (at least 4 States) - Chaffee information/educational opportunities - Chaffee information/educational opportunities - Handbooks - Handbooks Efforts to preserve youth connections (at least 2 States)Efforts to preserve youth connections (at least 2 States) - Primarily through relative searches and permanent placements - Primarily through relative searches and permanent placements Policy and procedural changes (at least 2 States)Policy and procedural changes (at least 2 States) - Staffings, new case planning strategies - Staffings, new case planning strategies

20 Factors Associated with Timely Adoption The strongest associations with timely adoption include: The strongest associations with timely adoption include: Needs & Services for Children, Parents, & Foster Parents Holding timely permanency hearings Holding timely six-month case reviews ASFA requirements regarding termination of parental rights

21 Strategies for Addressing Adoption of Most Improved States Training for judges and/or courts on TPR and concurrent planning (8 of the 9 States)Training for judges and/or courts on TPR and concurrent planning (8 of the 9 States) Concurrent planning policy development implementation or training (8 of the 9 States)Concurrent planning policy development implementation or training (8 of the 9 States) Focus on supervision of permanency planning (8 of the 9 States)Focus on supervision of permanency planning (8 of the 9 States) Use of specialized teams reviewing adoption progress (4 of the 9 States)Use of specialized teams reviewing adoption progress (4 of the 9 States) Strengthened capacity of information systems measuring progress to adoption (8 of the 9 States)Strengthened capacity of information systems measuring progress to adoption (8 of the 9 States)

22 Strategies Addressing Re-entry for Most Improved States Training on clinical skills and supervision related to discharge planning (3 of the 6 States)Training on clinical skills and supervision related to discharge planning (3 of the 6 States) Policy, training on enhancing input from families prior to discharge (3 of the 6 States)Policy, training on enhancing input from families prior to discharge (3 of the 6 States) Examination of data and reasons children re-enter (3 of the 6 States)Examination of data and reasons children re-enter (3 of the 6 States) Implement multidisciplinary review prior to reunification (2 of the 6 States)Implement multidisciplinary review prior to reunification (2 of the 6 States) Improve access to services post discharge (3 of the 6 States)Improve access to services post discharge (3 of the 6 States) Training on needs of older foster children (2 of the 6 States)Training on needs of older foster children (2 of the 6 States)

23 What strategies address the frequency and quality of permanency hearings, 6-month reviews, and of TPR proceedings? Use information to schedule/track hearingsUse information to schedule/track hearings Use reports from information system to track hearingsUse reports from information system to track hearings Coordinate efforts through CIP re- assessmentsCoordinate efforts through CIP re- assessments Make policies, laws, rules ASFA compliantMake policies, laws, rules ASFA compliant

24 What strategies address the frequency and quality…(continued) Clarify policyClarify policy Monitor timeliness of hearings and reviewsMonitor timeliness of hearings and reviews Identify barriers to timelinessIdentify barriers to timeliness Joint training of agency/judicial/legal partiesJoint training of agency/judicial/legal parties Focus 6-month reviews on family-centered practiceFocus 6-month reviews on family-centered practice Improve access to legal representationImprove access to legal representation

25 What strategies address the role of the courts in improving Case Review System? Coordinate efforts through CIP re-assessmentsCoordinate efforts through CIP re-assessments Use information systems to track events and identify barriers/backlogsUse information systems to track events and identify barriers/backlogs Court/agency task forces and interagency agreements to address barriersCourt/agency task forces and interagency agreements to address barriers Review/revise policies, procedures, and court rulesReview/revise policies, procedures, and court rules Joint training of agency/judicial/legal partiesJoint training of agency/judicial/legal parties Implement best practices (standards, case planning)Implement best practices (standards, case planning)

26 Children’s Bureau PowerPoints Findings From the Initial Child and Family Service Reviews (67 slides) 52 Program Improvement Plans: Strategies for Improving Child Welfare Services and Outcomes (121 slides) Strategies That Address Critical Practice Areas: Successes and Challenges in Implementation (44 slides)

27 National Resource Center for Organizational Improvement