1. Title IV-E Waiver Trauma Assessment and Treatment Data Collection Webinar
Claudia Zundel, MSW, Director of Child, Adolescent and Family Services
Ashley Brock Baca, PhD System of Care Project Manager
Tyler Allen, Title IV-E Waiver Administrator, Division of Child Welfare
Rebecca Orsi, PhD CSU, Title IV-E Waiver Evaluator
October 27, 2016
This is the slide used for the title page.

2. Agenda
Overview of the Title IV-E Waiver evaluation from the evaluation team at Colorado State University and HSRI
Overview of the trauma screening/assessment/treatment process
Trauma assessment/treatment data collection
Trauma assessment/treatment data entry using Google forms
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3. Why an Evaluation? Required by federal waiver Terms & Conditions
Children’s Bureau wants to learn how best to use Title IV-E to achieve goals of safety, permanency & well-being
Increase understanding of how agencies collaborate across systems.
Children’s Bureau is specifically interested in data related to childhood trauma.
5-year demonstration project; flexible funding to move from federal support focused on out-of-home placement and foster care to more family focused interventions (kinship care, permanency roundtables, family engagement, trauma-informed assessment/treatment).
Process study will examine cross systems collaboration.
CB interested in trauma as many systems explore what it means to be trauma-informed.
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4. Trauma Related Treatment
Brief Trauma Model
Trauma Screening
Completed by child welfare staff using statewide screening checklist
Trauma Assessment
Completed by CMHC or other partner providers using a common assessment tool
Trauma Related Treatment
Provided by CMHC or other partner providers
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5. Evaluation Questions
Are children who receive trauma-focused treatment more likely to improve in overall emotional, behavioral and social functioning?
Are children who receive trauma-focused treatment:
less likely to be placed in out-of-home care?
more likely to experience fewer placement setting changes?
less likely to run away from foster care?
more likely to have shorter stays in out-of-home care (for those who do not runaway)?
more likely to exit out-of-home care to reunification, adoption, or relative guardianship?
have fewer substantiated re-reports?
First question: reduction in trauma symptoms addressed by the data collected using Survey Monkey. May also include TOP and/or other measures in Trails that are more holistic.
Second and third question: after children who received treatment are identified (also SM), we can go back to Trails to look at child welfare outcomes, in addition to behavioral health.
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6. Trauma Process Flowchart
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7. Trauma Process Details
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8. County Department Does Screening
Referral to Provider (either Mental Health Center or Private Provider)
Now will include private providers
Provider enters information in Google Forms-either indicate using TOP or enter assessment tool information
This replaces SurveyMonkey and Excel spread sheets
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9. Trauma Assessment/Treatment Data Collection
Data from the Trauma Assessment will be entered into a secure, HIPAA compliant Google form. Each mental health provider agency will have its own Google form.
The State of Colorado has a Business Associates Agreement (BAA) with Google that specifies the data security and ensures HIPAA compliance. A copy of the BAA can be found at
Data will be collected on children who screen positive (by the child welfare caseworker) and are referred for assessment by a mental health clinician.
The mental health clinician will enter the ASSESSMENT data into the Google form, as well as treatment data.
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10. Trauma Assessment/Treatment Data Collection
For children whose assessment indicates a need for treatment, the trauma symptom tool (NOT the trauma history) should be repeated every 3 months and at the conclusion of treatment. This data should also be entered into the Google form.
For children whose assessment does NOT indicate a need for treatment, the initial assessment will be the only data collection.
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11. How to Get Access to Your Google Form
We will set up a unique Google data entry form for each mental health provider agency (CMHCs and private providers).
You will be able to view, but not edit, previously entered data in spreadsheet form through Google.
There will be a separate Google registration form to register to receive access to the data entry form.
The addresses of all people who need access should be entered into the registration form.
Access to the Google data entry form is controlled by your address. You will receive an that your Google form has been shared with you.
County child welfare agencies can request viewing access to the Google forms for all providers in their county.
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12. Google Registration Form Part 1
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13. Google Registration Form Part 2
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14. Google Registration Form Part 3
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15. Google Form Data Entry Screen 1
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16. Google Form Data Entry Screen 2
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17. Google Form Data Entry Screen 2 Part 2
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18. Google Form Data Entry Screen 3
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19. Google Form Data Entry Screen 4
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20. Google Form Data Entry Screen 5
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21. Google Form Data Entry Screen 6
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22. Google Form Data Entry Screen 6 Part 2
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23. Google Form Data Entry Screen 7
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24. Google Form Data Entry Screen 8
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25. Google Form Data Entry Screen 9
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26. Google Form Data Entry Screen 10
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27. Google Form Data Entry Screen 10 Part 2
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28. Title IV-E Waiver Interim Evaluation Report Findings
Interim Evaluation Report covers the period from July 1, June 30, 2015
Including the first year of the trauma interventions: July 1, 2014-June 30, 2015
10 counties involved in the trauma interventions
Data sources: Child welfare data from TRAILS and mental health data entered into SurveyMonkey
IER covers the period from July 1, June 30, 2015
Including the first year of the trauma interventions: July 1, 2014-June 30, 2015
10 counties involved in the trauma interventions
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29. % of Youth Who Screened in Who are Referred for Assessment
Number of kids who received a trauma screening and were referred for assessment
Counties with Waiver Intervention Funding for Trauma Screening, Assessment and Treatment
Screening Reach
Fidelity
% of Youth with a Case Opening on or after 7/1/14 through 6/30/15 Who Received a Screening
% of Youth Who Screened in Who are Referred for Assessment
All
38.6%
98.9%
Large Counties (4)
41.9%
Medium Size Counties (5)
6.2%
100.0%
Balance of State (small) Counties (1)
13.3%
Becky- present table
Alli- Add context, if applicable
Site visit notes which may help explain the penetration rate: staff indicated they do not always complete the screen due to workload, staff say the screen takes an hour and a half, not knowing the family well enough to feel comfortable doing the screen, forgetting to do the screen/not having a reminder in place to do the screen, perceived redundancy in the screening and assessment processes.
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30. Number of kids who received a trauma assessment or treatment at a CMHC
Trauma Assessment Reach
(penetration rate)
Trauma Treatment Reach (penetration rate)
CMHC Trauma Assessment Children Referred from Child Welfare and Treatment of those assessed
19.6%
74.5%
Becky- present table. Number referred is Number with initial assessment is 103, of which virtually all were recommended for treatment.
Alli- add context, if applicable
Could be due to CMHCs not getting all the referral information they need, could be due to difficulty engaging families, some noted that the assessment process takes up to 8 hours, some CMHC’s had stretched capacity due to the number of children referred.
One solution: Now holding joint staffings to address those families/referrals falling through the cracks
Questions:
- In addition to the contextual factors we mentioned, what are the reasons for the 19.6% penetration rate? What’s happening with the other 80% of kids?
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31. Questions?
For questions about the overall evaluation for the Title IV-E Waiver, contact Becky Orsi at
For general questions about the Title IV-E Waiver, contact Tyler Allen at or Korey Elger at
For questions about the trauma screening/assessment/treatment process, contact Claudia Zundel at
For questions about the trauma assessment/treatment data entry in the Google forms, contact Patty Montoya at or Ashley Brock-Baca at
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