1. The Future of Continuous Quality Improvement in Wisconsin’s Child Welfare System

2. Background WI-DCF is in the process of evaluating current assumptions, processes and possibilities of CQI in Child Welfare in WI. WI-DCF partnered with the National Resource Center for Organizational Improvement to develop a shared vision and commitment to action for CQI in child welfare for WI. WI-DCF held a facilitated discussion and development session with the NRC for Organizational improvement on November 13 th and 14 th. This meeting included DCF staff, county directors/managers, training partnership staff, children’s court improvement project staff, and University of WI-Madison Social Work staff. dcf.wisconsin.gov

3. Desired Future State Principles of WI Child Welfare CQI Program dcf.wisconsin.gov  A strong partnership between counties and the state (DCF/DSP)  Joint commitment to continual improvement of child welfare processes and practices  Affect real positive change in outcomes for children, youth and families

4. dcf.wisconsin.gov Draft-Vision of Wisconsin Child Welfare CQI Framework 1.Making the Paradigm Shift From Quality Assurance to Improvement: CQI= Process, Practice and Outcome Improvement CQI process will help state and counties fully engage in improvement efforts State, counties, and other partners (courts, tribes, etc.) work collaboratively on improvement efforts. Facilitated sharing and ongoing analysis with counties to improve outcomes, practice and process at the local and state level State would support counties to build and sustain internal CQI capacity 2.Data is transformed into information and knowledge and is used to make informed decisions about improving policy and practice. 3.CQI is more than a case review process; pieces are aligned and analyzed collectively 4.CQI tools and processes are available for county use (“inside out” application). 5.DCF actively supports and make capacity building investments in county action planning and organizational improvement efforts.

5. Current State of CQI Multiple case review processes with inconsistent criteria Multiple action plan processes; inconsistent support for action planning and no robust follow-up Relatively few cases and few counties are reviewed per year across state Primary focus is on quality assurance and not on afecting quality improvement DCF Resources across divisions are not aligned to improve practice and policy dcf.wisconsin.gov

6. Problems Resulting from Current CQI Process Current Quality Improvement efforts do not result in informing statewide program and policy changes or sustain change at the local level Roles and responsibilities of partners are not clearly defined Lack of integration of current resources creates duplication of effort and partners working at cross purposes Primary focus is on meeting federal CFSR reporting and not on improving practice and policy The current process does not significantly deepen our mutual understanding of the strengths and weaknesses of the child welfare system in Wisconsin dcf.wisconsin.gov

7. Multiple Sources Data Systems Case Reviews Worker Surveys Court/Legal System data & knowledge Child and Family Safety Permanency Child Well-being Think, Talk and Identify/Define Areas for Improvement CQI Child Welfare in Wisconsin: Moving Towards a Learning System Turning data into information & knowledge useful to the field and community Define Improvement Needs Assesses & Understand Develop Specific Actions Plans Implement & Monitor

8. Future State Child Welfare CQI Model Assess ID Strengths and Gaps Root Cause Identify Solutions Prioritization Assess ID Strengths and Gaps Root Cause Identify Solutions Prioritization DSP/County Plan Develop Specific Action Plan Quick Wins Immediate, short-term & long-term Determine Needs Technical Assistance Training Coaching/Mentoring Plan Develop Specific Action Plan Quick Wins Immediate, short-term & long-term Determine Needs Technical Assistance Training Coaching/Mentoring Define Strategic Plan Performance Data Case Reviews County Need Survey/Focus Groups Federal Requirements Define Strategic Plan Performance Data Case Reviews County Need Survey/Focus Groups Federal Requirements County Assistance: DSP, Training Partnership and BRO Implement Action Plans Charters Communication Resource management Success Measures/Goals Implement Action Plans Charters Communication Resource management Success Measures/Goals County Assistance: DSP, Training Partnership and BRO Monitor Progress/Adjust Accountability Evaluation Continuous adaptation Recognition Monitor Progress/Adjust Accountability Evaluation Continuous adaptation Recognition DSP/County Practice Model Inputs Organizational Effectiveness

9. Next Steps for CQI Future State 1.DCF will work with counties, tribes and legal partners to identify CQI players and define roles, responsibilities and relationships 2.Stakeholders will participate in design and implementation of future state: –Counties/Tribes/Legal System- WCHSA, Court and Tribe Appointed Advisory Group Provide DCF feedback, advice and guidance on future design –Courts/Legal System will participate as partners in work groups to explore and develop CQI efforts linking Child Welfare and the Court/legal System counties, courts, tribes SHARED BUY-IN dcf.wisconsin.gov

10. CQI Action Plans  Building a Foundational Administrative Structure Improving Child Welfare Outcomes, Practice and Processes Improving Outcomes and Practice at the System Level Improving Outcomes and Practice at the Local Level Developing a learning collaborative Developing a support structure: training, facilitation and TA Supporting counties to practice CQI at the local level dcf.wisconsin.gov

11.  Design and Developing a Case review process Develop a cross-walk to align practice model, federal standards, practice areas, intended results and outcome measures  Distinguish quantitative data and practice that requires a qualitative case review Develop a universal case review tool to cover a range of case/practice functions Define triggers for the reviews  Targeted and General Align with overall CQI fame work and goals CQI Action Plans dcf.wisconsin.gov

12.  Building our Data Infrastructure Support data collection, analysis and dissemination of quantitative and qualitative data Understand and develop the Infrastructure to support increased analytic capacity Create a case review database Develop and support increased analytic support at the state and local level Develop and administer a worker/supervisor survey to receive routine feedback and insight into key practice areas dcf.wisconsin.gov CQI Action Plans

13.  Action Planning Process Develop Action Planning Model (Define, Assess, Plan, Implement and Monitor). Use Organizational Effectiveness tools/process as a foundation for action planning Translate learning into improved outcomes and practices dcf.wisconsin.gov CQI Action Plans

14. Comments, Ideas and Questions?

15. dcf.wisconsin.gov A new vision for Independent Living

16. dcf.wisconsin.gov Background

17. About 425 youth age out of care each year. In 2012, the youth who aged out averaged over 4 years in care in their life.

18. The Picture for aged out youth is bleak. Homelessness: – Based on a study of child welfare youth in the Midwest, 37% are homeless after aging out; Higher unemployment rates: – Former foster teens experience 52% unemployment rate versus 24% for their peers; Lower enrollment in post-secondary education: – Approximately 20% of foster youth attend college compared to 60% of the general population; Higher pregnancy rates: – By age 19, over half of former or current female foster youth had been pregnant at least once; and Higher rates of criminal system involvement: – By age twenty-four, 59% of male former foster care youth had been convicted of a crime, compared to 10% of males of similar age in the general population.

19. What have we done? Funding to counties to provide a federally-designated array of services (since 2000). Summer 2013, focus groups with various stakeholders to better understand the service delivery models. October 2013, inclusive Organizational Effectiveness process to develop a strategic plan for Independent Living. 2014 IL Allocations will go out as planned. Changes projected in 2015.

20. Eligible and Served Youth Under 18 18 and Over NumberPercent NumberPercent Milwaukee Served 18863% 26343% Eligible, Not Served 11137% 34657% Balance of State Served 40355% 39435% Eligible, Not Served 32745% 72065%

21. Vision for the Future More choice of how to deliver services No wrong door for youth Focus on the outcomes Better use of community partnerships