1. 1 Department of Human Services (DHS)/Child Welfare Services (CWS) Branch Child & Family Services Review (CFSR) & Program Improvement Plan (PIP)

2. 222 Building on our Momentum in Child Welfare Services Partnering with Families, Youth, the Courts and our Communities

3. 3 CFSR Reviews conducted in partnership with Federal and State child welfare agency: Reviews conducted in partnership with Federal and State child welfare agency: –Federal Team -- representatives from the Children’s Bureau and the Administration of Children and Youth –Hawaii State Team included DHS/CWS employees & community stakeholders. The reviews are structured to help States identify strengths and areas needing improvement in meeting safety, permanency and well-being outcomes for abused and neglected children. The reviews are structured to help States identify strengths and areas needing improvement in meeting safety, permanency and well-being outcomes for abused and neglected children.

4. 4 Purpose CFSRs enable the Children's Bureau to: CFSRs enable the Children's Bureau to: –(1) ensure conformity with Federal child welfare requirements; –(2) determine what is actually happening to children and families as they are engaged in child welfare services; and –(3) assist States to enhance their capacity to help children and families achieve positive outcomes.

5. 5 Safety Outcomes: Children are, first and foremost, protected from abuse and neglect. Children are, first and foremost, protected from abuse and neglect. Children are safely maintained in their homes whenever possible and appropriate. Children are safely maintained in their homes whenever possible and appropriate.

6. 6 Permanency Outcomes: Children have permanency and stability in their living situations. Children have permanency and stability in their living situations. Continuity of family relationships and connections is preserved for children and their families. Continuity of family relationships and connections is preserved for children and their families.

7. 7 Well-Being Outcomes: Families have enhanced capacity to provide for their children's needs. Families have enhanced capacity to provide for their children's needs. Children receive appropriate services to meet their educational needs. Children receive appropriate services to meet their educational needs. Children receive adequate services to meet their physical and mental health needs. Children receive adequate services to meet their physical and mental health needs.

8. 888 Systemic Factors -- –Statewide Information System –Case Review System –Quality Assurance System –Staff and Provider Training –Service Array –Agency Responsiveness to the Community –Foster and Adoptive Parent Recruitment, Licensing and Retention

9. 9 The Review Process CFSR is a two-stage process: 1. Statewide Assessment State completes a self analysis of its child protective services, foster care and adoption programs – evaluating strengths and weaknesses. State completes a self analysis of its child protective services, foster care and adoption programs – evaluating strengths and weaknesses. Using data prepared by the Children’s Bureau, the State compares performance on safety and permanency outcomes to established national standards. Using data prepared by the Children’s Bureau, the State compares performance on safety and permanency outcomes to established national standards.

10. 10 The Review Process Continue 2. Onsite review ● case records reviews; ● case records reviews; interviews with children and families engaged in services; and interviews with children and families engaged in services; and interviews with community stakeholders, such as the courts, community agencies, birth parents, foster youth, resource families, caseworkers and service providers. interviews with community stakeholders, such as the courts, community agencies, birth parents, foster youth, resource families, caseworkers and service providers.

11. 11 After the CFSR States determined not to have achieved substantial conformity in all the areas assessed are required to develop and implement a Program Improvement Plan (PIP). States that do not achieve their required improvements sustain penalties as prescribed in the Federal regulations. States determined not to have achieved substantial conformity in all the areas assessed are required to develop and implement a Program Improvement Plan (PIP). States that do not achieve their required improvements sustain penalties as prescribed in the Federal regulations. The first round of CFSR around the country was completed by 2004. No state was found to be in substantial conformity in all of the seven outcome areas or seven systemic factors. The first round of CFSR around the country was completed by 2004. No state was found to be in substantial conformity in all of the seven outcome areas or seven systemic factors.

12. 121212 2003 CFSR - Hawaii Results Did not achieve conformity 6 of the 7 outcome areas and 5 out of the 7 systemic factors Did not achieve conformity 6 of the 7 outcome areas and 5 out of the 7 systemic factors Hawaii was required to develop and implement a PIP Hawaii was required to develop and implement a PIP

13. 13 CFSR – 2003 Key Areas Needing Improvement in Hawaii Timely response to reports Timely response to reports Action must be taken to ensure the risk of harm to children is addressed Action must be taken to ensure the risk of harm to children is addressed Involvement of the family and child in case planning Involvement of the family and child in case planning Less re-entry into foster care and more stability in foster placements Less re-entry into foster care and more stability in foster placements Face-to-face contacts with children, parents and foster parents Face-to-face contacts with children, parents and foster parents Quality assurance monitoring and continuous system improvement Quality assurance monitoring and continuous system improvement

14. 14 CWS Priorities Ensure child safety by a timely response to all reports of child abuse and neglect accepted for investigation by CWS Ensure child safety by a timely response to all reports of child abuse and neglect accepted for investigation by CWS Conduct ongoing safety, risk and needs assessments on all children and families in cases active with CWS Conduct ongoing safety, risk and needs assessments on all children and families in cases active with CWS Ensure that every family and every child are actively involved in developing their case plan Ensure that every family and every child are actively involved in developing their case plan Ensure that every child in our care, every family and every foster family are visited at least once a month by the assigned caseworker and afforded the opportunity of a face-to-face interview in cases active with CWS Ensure that every child in our care, every family and every foster family are visited at least once a month by the assigned caseworker and afforded the opportunity of a face-to-face interview in cases active with CWS

15. 15 Hawaii Strategic Priorities During First PIP Decrease workload of CWS staff Decrease workload of CWS staff –Development of new intake screening tools and procedures –Revised assessment tools and procedures –Enhancements to our purchase of service contracts to expand services to families Increase service array Increase service array –Make timely and appropriate services available to children and families –Increases in Ohana Conferencing, Comprehensive Counseling contracts, substance abuse, Family Strengthening Services and others

16. 16 Strategic Priorities (cont.) Timely Adoption & Permanency Timely Adoption & Permanency –Improve coordination and collaboration between the Department and the Court –Recruit & retain resource families Quality Assurance Quality Assurance –Supervisory Review –Quality Case Reviews (mini CFSR in partnership with Maui Community College)

17. 17 Hawaii Process PIP was successfully completed and officially closed by the Children’s Bureau on March 25, 2009. PIP was successfully completed and officially closed by the Children’s Bureau on March 25, 2009.

18. 18 Hawaii CFSR 2009 HAWAII - June 1- 5, 2009 HAWAII - June 1- 5, 2009 –Oahu, Maui & Kauai –Reviewed: 40 foster-care cases 40 foster-care cases 25 in-home services cases 25 in-home services cases

19. 19 Hawaii Exit Interview on June 5, 2009 Linda Mitchell, Federal CFSR Team Lead, reported: Efforts from the PIP led to improved practice in Hawaii compared to the 2003 CFSR. Efforts from the PIP led to improved practice in Hawaii compared to the 2003 CFSR. Many strengths found in the Hawaii 2009 CFSR Many strengths found in the Hawaii 2009 CFSR –Differential Response System -- Voluntary Case Management (VCM) and Family Strengthening Services (FSS) are seen as supportive and respectful of the families. –Ohana Conferencing and Youth Circles, as well as Family Finding services and Family Connections Consortium to engage children, youth and families.

20. 20 Hawaii Exit Interview Cont. –Internal mini CFSRs with information being given to the local sites. –Keiki Placement Project and supervisory reviews. –Increased investment in services to families. –Involvement of foster youth with Ohana Is Forever Conference and the Family Court and the Hawaii Foster Youth Coalition. –Supreme Court’s Standing committee on Children in Family Court to expedite Termination of Parental Rights (TPR) Appeals. –Outreach efforts to the Native Hawaiian community.

21. 21 Preliminary Findings National Standards associated with Outcomes : National Standards associated with Outcomes : –Hawaii met 4 of the 6 national data standards associated with Outcomes.

22. 22 Preliminary Findings (cont) Of all children who were victims of a substantiated or indicated maltreatment allegation, what percent were not victims of another substantiated or indicated maltreatment allegation within the 6-months following that maltreatment incident? (National standard: 94.6% or higher) 97.8% - MET Of all children who were victims of a substantiated or indicated maltreatment allegation, what percent were not victims of another substantiated or indicated maltreatment allegation within the 6-months following that maltreatment incident? (National standard: 94.6% or higher) 97.8% - MET

23. 23 Preliminary Findings (Cont) Of all children served in foster care in FY 2004, what percent were not victims of a substantiated or indicated maltreatment by a foster parent or facility staff member during the fiscal year? (National standard: 99.68% or higher) 99.49% - Not met (narrowly missed by 0.19%) Of all children served in foster care in FY 2004, what percent were not victims of a substantiated or indicated maltreatment by a foster parent or facility staff member during the fiscal year? (National standard: 99.68% or higher) 99.49% - Not met (narrowly missed by 0.19%)

24. 24 Preliminary Findings (cont) Preliminary Findings (cont) Timeliness and permanency of reunification (National standard: 122.6 or higher composite score) 120.4 Not met – missed by 2.2 Timeliness and permanency of reunification (National standard: 122.6 or higher composite score) 120.4 Not met – missed by 2.2 Timeliness of adoption (National standard: 106.4 or higher composite score) 112.5 Met Timeliness of adoption (National standard: 106.4 or higher composite score) 112.5 Met

25. 25 Preliminary Findings (cont) Achieving permanency for children in foster care for long periods of time (National standard: 121.7 or higher composite score) 123.5 Met Achieving permanency for children in foster care for long periods of time (National standard: 121.7 or higher composite score) 123.5 Met Placement stability (National standard: 101.5 or higher composite score) 102.4 Met Placement stability (National standard: 101.5 or higher composite score) 102.4 Met

26. 26 Safety Outcomes Safety Outcome 1 (Children are first and foremost protected from abuse and neglect) Hawaii received strong ratings based on timeliness of response to reports of abuse/neglect and no recurrence of maltreatment. Safety Outcome 1 (Children are first and foremost protected from abuse and neglect) Hawaii received strong ratings based on timeliness of response to reports of abuse/neglect and no recurrence of maltreatment. Safety Outcome 2 (Children are safely maintained in their homes whenever possible and appropriate) Hawaii has an array of services to prevent placement including VCM, FSS, Family Drug Court and Enhanced Healthy Start. Safety Outcome 2 (Children are safely maintained in their homes whenever possible and appropriate) Hawaii has an array of services to prevent placement including VCM, FSS, Family Drug Court and Enhanced Healthy Start. –Hawaii needs to address continuing risk and safety assessment in CWS cases. There was a lack of direct caseworker contact, relying on service providers and resource family contacts.

27. 27 Permanency Outcomes Permanency Outcome 1 (Children have permanency and stability in their living situation) – an area needing improvement. Permanency Outcome 1 (Children have permanency and stability in their living situation) – an area needing improvement. –Areas for improvement include: establishing appropriate permanency goals and meeting goals timely; parent/child visitation; need to establish appropriate, realistic goals and change them timely as situations develop; and concurrent goals are listed but not being worked. Permanency Outcome 2 (Continuity of family relationships and connections is preserved for children). Permanency Outcome 2 (Continuity of family relationships and connections is preserved for children). -- Strengths noted: placement in close proximity to family, use of relative placement, placement with siblings, extended family support, and preserving the primary connections for children in foster care. –Areas needing attention include: meaningful review and permanency hearings, timeliness of TPR, clarification and documentation of “compelling reasons” for delay

28. 28 Well-being Outcomes Well-Being Outcome 1 (Families have enhanced capacity to provide for their children’s needs) -- inconsistency in on-going assessment and engaging parents in case planning. Ohana Conferencing and Youth Circles were noted as positive and helpful. Well-Being Outcome 1 (Families have enhanced capacity to provide for their children’s needs) -- inconsistency in on-going assessment and engaging parents in case planning. Ohana Conferencing and Youth Circles were noted as positive and helpful. Well-Being Outcome 2 (Children receive appropriate services to meet their educational needs) received strong ratings. The educational needs of children are met and workers and foster parents advocate for the children to get services for them. Well-Being Outcome 2 (Children receive appropriate services to meet their educational needs) received strong ratings. The educational needs of children are met and workers and foster parents advocate for the children to get services for them. Well-Being Outcome 3 (Children receive adequate services to meet their physical and mental health needs) had mixed ratings. Medical and dental care was being provided but with a shortage of dental care providers. Concerns about lack of mental health assessments & community based mental health services; need for on-going assessment and treatment for key underlying issues like the witnessing of domestic violence. Well-Being Outcome 3 (Children receive adequate services to meet their physical and mental health needs) had mixed ratings. Medical and dental care was being provided but with a shortage of dental care providers. Concerns about lack of mental health assessments & community based mental health services; need for on-going assessment and treatment for key underlying issues like the witnessing of domestic violence.

29. 29 Systemic Factors Statewide Information System Statewide Information System – Is okay and there has been an improvement in the quality of data. Case Review System Case Review System - Area needing improvement. - Area needing improvement. Quality Assurance System Quality Assurance System –Hawaii spends far less than other states that have established QA teams, and the results were greater than expected following the 2003 CFSR. The next steps include strengthening the QA system and utilization of the CQI Council.

30. 30 Systemic Factors (Cont) Staff and Provider Training Staff and Provider Training –Area needing improvement Service Array and Resource Development Service Array and Resource Development -- Expansion in service array since 2003. -- Expansion in service array since 2003. Agency Responsiveness to the Community Agency Responsiveness to the Community -- Multiple partnerships with the Court and communities, special effort to engage the Native Hawaiian Community -- Multiple partnerships with the Court and communities, special effort to engage the Native Hawaiian Community Foster and Adoptive Home Licensing, Approval, and Recruitment Foster and Adoptive Home Licensing, Approval, and Recruitment -- Increased trainings and support to resource families. -- Increased trainings and support to resource families.

31. 31 Strengths and Concerns Strengths Strengths –Relative placement and preserving connections –Ohana Conferencing and Youth Circles –Family Drug Court –Collaboration with the Community and the Courts –Differential Response –Tremendous leadership – moved the state, engaged community and youth –Quality Assurance

32. 32 Strengths and Concerns (continued) Concerns Concerns –Consistency in CWS practice, especially continuing risk and safety assessment –Use of emergency/temporary placements -- need up-front efforts to keep children in home –Court and legal challenges

33. 33 FIRST STEP Program Improvement Plan (PIP) II PRACTICAL, DOABLE, SUSTAINABLE (PDS)

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36. 36 CQI Use data and other information to monitor progress toward achieving goals in each Section’s action plans Report recommendations and analysis back to the Steering PIP Committee Steering PIP Committee Strategy Workgroups Strategize action steps Island Subgroups Carry out action steps Report progress and barriers to implementation

37. 373737 How can you be involved? –Participate in community workgroups –Partner in development and implementation of the PIP –Commit to ongoing participation and collaboration

38. 383838 Why is Your Partnership Important? It will take all of us to develop and implement the systemic changes that are necessary to successfully improve safety, permanency and well-being outcomes for Hawaii’s keiki and families

39. 39 Interested? Want to be involved? Stay tuned: cfsr.dhshawaii.netcfsr.dhshawaii.net