2. Seeing the Forest AND the Trees: Customer Satisfaction and Comprehensive Family Services November 14, 2003 Child Welfare League of America “Tools that Work”

3. Authors Blake Jones, MSW, LCSW, ABD (Social Work) (bljone00@pop.uky.edu)bljone00@pop.uky.edu University of Kentucky Ruth A. Huebner, PhD, Child Welfare Researcher (Rutha.huebner@mail.state.ky.us) andRutha.huebner@mail.state.ky.us Sissy Cawood, MA, Director of Service Region Kentucky Cabinet for Families and Children

4. Topics Rationale for Comprehensive Family Services Review of supporting literature Description of Comprehensive Family Services Customer Satisfaction as an Outcome Measurement Program Evaluation of CFS Results Discussion

5. Rationale for CFS New paradigm for engagement of families and “community partners” > Solution-focused vs. punitive (Christensen, Todahl, & Barrett, 1999) > Strengths-based vs. deficit-based (Powell & Batsch, 1997) > Collaborative vs. insular (Brun & Rapp, 2001) > Principles of Effective Family Focused Interventions (Kumpfer & Alvarado, 2003)

6. Studies of CFS-type Approaches Family-centered, strengths-based approach increases attachment, parental knowledge, and enhanced interaction among family members (Caro & Derevensky, 1991). Linkages to social services, health care, housing, and employment increase self-sufficiency (Lie & Moroney, 1992) Community-based approach to child protection is touted as one of the most effective way to “reform” CPS (Waldfogel, 2000)

7. Comprehensive Family Services Comprehensive Family Services Putting It All Together

8. CFS: A Philosophy Community-based Strength-based Prevention-focused Partnership-driven Integration of CFC services Everyone A Leader

9. CFS IS NOT: A Program An Initiative A Team Meeting Dependent on a facilitator “Levels” Only for “some” families

10. CFS IS: The way we think about our families, our co-workers and ourselves.

11. CFS IS: Treating our families, our co- workers and ourselves with respect and dignity.

12. CFS IS: Believing that our families, our co-workers and ourselves have strengths.

13. CFS IS: Believing that families and co- workers can contribute to the success of our work.

14. CFS IS: Partnerships with the community, other CFC agencies and our clients.

15. CFS IS: Actively listening to and respecting the opinion of others.

16. CFS IS: Focused on families rather than programs.

17. CFS IS: A belief that families can make good decisions about keeping children safe and being self sufficient.

18. CFS IS: The way we do business.

19. Implementation Co-house family support and Protection and Permanency Establish Levels of CFS Universal – strength based assessment Targeted – referrals within the agency Intensive – Family team meetings with community partners Roll out the program county by county as ready. Reinforcement and mentoring at all levels

20. Comprehensive Family Services Comprehensive Family Services Putting It All Together

21. CFS CFS Videotape

22. Discussion What did you observe that was similar between the two stories? What was different? How was the client treated and what was the worker’s philosophy of intervention? How is this different from typical treatment in child protection and family support? What were outcomes?

23. CFS CFS Summative Evaluation Are These Services Effective?

24. Challenges in Program Evaluation CFS is complex involving multiple practices CFS varies for each person, but all customers should be treated as partners with a belief in strengths CFS is universal - all customers CFS is targeted - needing resources CFS is intensive - needing full partnerships

25. Customer Satisfaction Involve Customers in Guiding Practices Consider clients as customers Empowers people to ask their opinion Satisfied customer worker harder, achieve better outcomes, and spread the word. Council on Accreditation and CFSR standards require customer input.

26. If CFC uses CFS beliefs and practices Then Customer Satisfaction should Be higher. Outcome: Customer Satisfaction

27. Population for Sampling 491,913 Total Population Foster Adoptive: 2290 Personnel: 5521 Community Partners: 13496 P&P Clients: 22412 Child Support: 91056 Family Support: 357952

28. Process Overview

29. Response Rates 52% overall

30. CFS CFS Summative Evaluation Methodology

31. Method Customer Satisfaction Database CFS Indicators Added Months CFS in place by county Average: 5.59 months CFS Yes or No by county 63.8% had CFS in place

32. Client Groups and CFS

33. Average Total Client Satisfaction F (2, 4105) = 105.34; p =.000, power =.99

34. Significant Differences for All Clients Call returned Easier to make appointments Staff treat me with respect Family is more able to care for themselves Family is safer and more secure with help and referrals made by the agency

35. P & P Clients Satisfied Most - Not Significant

36. Family Support Significant Difference

37. Child Support

38. Comments from Clients: Percent X 2 (1, 1142) = 13.15; p =.001

39. Community Partner Average Total Satisfaction F (1, 3185) = 23.0, p =.000; power =.98

40. Community Partner Most Satisfied Calls returned Communication Treated with respect Helps Community Families to be more independent, safe, and secure

41. Foster Parent Total Satisfaction F (1, 1387) = 17.93, p =.000; power =.98

42. CFS: Foster Pre-Adoptive Parents NO differences in: Recommending fostering to others Pride in helping families Biggest differences: Quality visits to child Receives information

43. % Satisfaction with Quality Visits to Foster Child F (1, 1387) = 46.73; p=.000

44. Other Significant Differences

45. Time and CFS The longer CFS was in place, the higher Client Satisfaction Community Partner Satisfaction Foster Parent Satisfaction All statistically significant at the.000 level.

46. CFS a way to do business Customer Satisfaction an Outcome

47. Limitations Regional differences in the way CFS is implemented (e.g., access to services, rates of poverty, rural regions) Confounding variables (interpersonal relationship skills of certain workers) Survey has not been empirically validated

48. What does this mean for practice? CFS shows promise Not cause and effect with this data Different effects for different programs Probably other effects at work CFS is consistent with best practices in the literature

49. Questions and Discussion