Child and Family Services Reviews:Child and Family Services Reviews:Findings, Strategies and SuccessesFindings, Strategies and Successes

National Resource Center for Organizational ImprovementNational Resource Center for Organizational Improvement

A service of theA service of theChildren’s Bureau, U. S. Department of Health and Human ServicesChildren’s Bureau, U. S. Department of Health and Human Services

2

Sources: Sources: Children’s Bureau PowerPointsChildren’s Bureau PowerPoints

• FindingsFindings From the Initial Child and Family From the Initial Child and Family Service Reviews 2001-2004Service Reviews 2001-2004

• 52 Program Improvement Plans: 52 Program Improvement Plans: StrategiesStrategies for Improving Child Welfare Services and for Improving Child Welfare Services and OutcomesOutcomes

• Strategies That Address Critical Practice Strategies That Address Critical Practice Areas:Areas: SuccessesSuccesses and Challenges in and Challenges in ImplementationImplementation

3

Analysis of the First Round of PIPsAnalysis of the First Round of PIPs

Looked at strategies in all 52 PIPsLooked at strategies in all 52 PIPs

Analyzed Results of 33 Completed PIPsAnalyzed Results of 33 Completed PIPs• Includes 33 States that completed their PIPs as of April Includes 33 States that completed their PIPs as of April

20062006• Conducted content analysis of the 33 States PIPsConducted content analysis of the 33 States PIPs• Identified measures used by States to gauge progress Identified measures used by States to gauge progress • Interviews with State administrators, QA directors and Interviews with State administrators, QA directors and

other staffother staff

4

Goals of the PIP processGoals of the PIP process

• Improve outcomes for children and Improve outcomes for children and familiesfamilies

• Strengthen delivery of effective servicesStrengthen delivery of effective services• Coordinate partnerships throughout child Coordinate partnerships throughout child

welfarewelfare• Establish ongoing self-monitoring and Establish ongoing self-monitoring and

continuous improvementcontinuous improvement

5

Cross-Cutting PIP ThemesCross-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:Most frequently implemented strategies:• Change/develop policy and train staffChange/develop policy and train staff• Family meetings, i.e., Family Conferencing, Family meetings, i.e., Family Conferencing,

Family Group Decision Making, Family Family Group Decision Making, Family Team Meetings, etc.Team Meetings, etc.

• Monitoring through supervisory reviews, Monitoring through supervisory reviews, Quality Assurance/CQIQuality Assurance/CQI

Engagement of Children and Engagement of Children and FamiliesFamilies

(27 States were applicable)(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 Parents should drive assessment and planning

processprocess• Be less prescriptive in policy development, more Be less prescriptive in policy development, more

training and educationtraining 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 – Engagement – Lessons LearnedLessons Learned

8

What strategies address engagement of What strategies address engagement of fathers in case planning and service fathers in case planning and service

provision?provision?• Develop or revise existing policy and practice to Develop or revise existing policy and practice to

locate absent parents (4 states)locate absent parents (4 states)• IImplement models of practice to assess, engage mplement models of practice to assess, engage

and plan with fathers (4 states)and plan with fathers (4 states)• Enhance and implement policy or pEnhance and implement policy or proceduresrocedures to to

better engage and assess fathers (5 states)better engage and assess fathers (5 states)• Enhance training and training curriculum to Enhance training and training curriculum to

better engage and plan with fathers (3 states)better engage and plan with fathers (3 states)

9

Common Safety Strategies in Program Common Safety Strategies in Program Improvement PlansImprovement 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 enhance practices and processes to improve practice and

consistency (focused on practice models)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 timeframes clarify policies around investigations, such as timeframes • disposition processdisposition process

10

Common Safety Strategies in Program Common Safety Strategies in Program Improvement PlansImprovement Plans (cont.)(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, cross-train community partners, foster parents,

residential staff and law enforcementresidential 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 Common Safety Strategies in Program Improvement PlansImprovement Plans (cont.)(cont.)

• Research and evaluation ( 21 States)Research and evaluation ( 21 States)• study areas of substance abuse, juvenile justice, and domestic study areas of substance abuse, juvenile justice, and domestic

violenceviolence• analyze specific populationsanalyze specific populations• pilot specific practicespilot specific practices

• Collaboration (16 States)Collaboration (16 States)• focus on collaboration with community partners, other State focus on collaboration with community partners, other State

agenciesagencies• implement strategies to work with tribes to cross-train and provide implement strategies to work with tribes to cross-train and provide

services services • Supervision ( 11 States) Supervision ( 11 States)

• focus on supervisors’ role and oversight responsibilities related to focus on supervisors’ role and oversight responsibilities related to safety/risk assessments, in-home services cases, etc.safety/risk assessments, in-home services cases, etc.

12

Common Permanency Strategies in Common Permanency Strategies in Program Improvement PlansProgram 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” modelsBest practice” models• Targeted servicesTargeted services

• Quality assurance and monitoring activities (at least 45 Quality assurance and monitoring activities (at least 45 States)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 Common Permanency Strategies in Program Improvement Plans Program Improvement Plans

(continued)(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, Factors Associated with Timely Reunification, Guardianship, and Permanent Relative PlacementGuardianship, and Permanent Relative Placement

The strongest The strongest associations associations with timely with timely reunification reunification guardianship, guardianship, and permanent and permanent relative relative placement placement include:include:

Caseworker Visits with Parents Caseworker Visits with Parents

Child’s Visits with Parents and Child’s Visits with Parents and Siblings in Foster Care Siblings in Foster Care

Services to Children, Parents, & Services to Children, Parents, & Foster ParentsFoster Parents

Family/Child Involvement in Family/Child Involvement in Case PlanningCase Planning

ASFA Requirements Regarding ASFA Requirements Regarding Termination of Parental RightsTermination of Parental Rights

Placement StabilityPlacement Stability

15

What strategies address reduction What strategies address reduction in time to achieve permanency?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 Establish State and local stakeholder groups to identify

barriers to permanency achievementbarriers to permanency achievement• Identify and disseminate best practice models and Identify and disseminate best practice models and

guidelines for permanencyguidelines 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 Strategies Addressing Reunification for Reunification for

Most Improved StatesMost Improved States

• Strengthen supervision on permanency planning Strengthen 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 Developing data reports to monitor reunification (3 of the 5 States)of the 5 States)

• Enhancing quality of parental visitation (1 of the 5 Enhancing quality of parental visitation (1 of the 5 States)States)

17

What strategies address What strategies address improvements in improvements in

permanency planning?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 Review processes for appropriateness and

timeliness of permanency goalstimeliness 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 What strategies address permanency for youth in foster care?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 - Implement new assessment tools/strategies to complete themthem

- Focus on transitioning Native youth (one State)- Focus on transitioning Native youth (one State)

19

What strategies address What strategies address permanency for youth in foster permanency for youth in foster

care? (continued)care? (continued)• Collaborate with youth/other stakeholders Collaborate with youth/other stakeholders (at least 6 (at least 6

States)States) - Youth Advisory Boards- Youth Advisory Boards - Other agencies, e.g., mental health- Other agencies, e.g., mental health• Disseminate information on services Disseminate information on services (at least 4 States)(at least 4 States)

- Chaffee information/educational opportunities- Chaffee information/educational opportunities - Handbooks- Handbooks• Efforts to preserve youth connections Efforts to preserve youth connections (at least 2 States)(at least 2 States)

- Primarily through relative searches and permanent - Primarily through relative searches and permanent placementsplacements

• Policy and procedural changes Policy and procedural changes (at least 2 States)(at least 2 States)

- Staffings, new case planning strategies- Staffings, new case planning strategies

20

Factors Associated with Timely Factors Associated with Timely AdoptionAdoption

The strongest The strongest associations associations with timely with timely adoption adoption include:include:

Needs & Services for Children, Needs & Services for Children, Parents, & Foster ParentsParents, & Foster Parents

Holding timely permanency Holding timely permanency hearingshearings

Holding timely six-month case Holding timely six-month case reviews reviews

ASFA requirements regarding ASFA requirements regarding termination of parental rights termination of parental rights

21

Strategies for Addressing Strategies for Addressing Adoption of Most Improved States Adoption of Most Improved States

• Training for judges and/or courts on TPR and Training for judges and/or courts on TPR and concurrent planning (8 of the 9 States)concurrent planning (8 of the 9 States)

• Concurrent planning policy development Concurrent planning policy development implementation or training (8 of the 9 States)implementation or training (8 of the 9 States)

• Focus on supervision of permanency planning (8 of Focus on supervision of permanency planning (8 of the 9 States)the 9 States)

• Use of specialized teams reviewing adoption Use of specialized teams reviewing adoption progress (4 of the 9 States)progress (4 of the 9 States)

• Strengthened capacity of information systems Strengthened capacity of information systems measuring progress to adoption (8 of the 9 States)measuring progress to adoption (8 of the 9 States)

22

Strategies Addressing Strategies Addressing Re-entry for Most Improved StatesRe-entry for Most Improved States

• Training on clinical skills and supervision related Training on clinical skills and supervision related to discharge planning (3 of the 6 States)to discharge planning (3 of the 6 States)

• Policy, training on enhancing input from families Policy, training on enhancing input from families prior to discharge (3 of the 6 States)prior to discharge (3 of the 6 States)

• Examination of data and reasons children re-enter Examination of data and reasons children re-enter (3 of the 6 States)(3 of the 6 States)

• Implement multidisciplinary review prior to Implement multidisciplinary review prior to reunification (2 of the 6 States)reunification (2 of the 6 States)

• Improve access to services post discharge (3 of the Improve access to services post discharge (3 of the 6 States)6 States)

• Training on needs of older foster children (2 of the Training on needs of older foster children (2 of the 6 States)6 States)

23

What strategies address the What strategies address the frequency and quality of frequency and quality of

permanency hearings, 6-month permanency hearings, 6-month reviews, and of TPR proceedings?reviews, and of TPR proceedings?

• Use information to schedule/track hearingsUse information to schedule/track hearings• Use reports from information system to track Use reports from information system to track

hearingshearings• Coordinate efforts through CIP re-Coordinate efforts through CIP re-

assessmentsassessments• Make policies, laws, rules ASFA compliantMake policies, laws, rules ASFA compliant

24

What strategies address the What strategies address the frequency and quality…(continued)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 Joint training of agency/judicial/legal

partiesparties• Focus 6-month reviews on family-centered Focus 6-month reviews on family-centered

practicepractice• Improve access to legal representationImprove access to legal representation

25

What strategies address the role What strategies address the role of the courts in improving Case of the courts in improving Case

Review System?Review System?• Coordinate efforts through CIP re-assessmentsCoordinate efforts through CIP re-assessments• Use information systems to track events and Use information systems to track events and

identify barriers/backlogsidentify barriers/backlogs• Court/agency task forces and interagency Court/agency task forces and interagency

agreements to address barriersagreements 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 Children’s Bureau PowerPointsPowerPoints

Findings From the Initial Findings From the Initial Child and Family Service Reviews 2001-2004Child and Family Service Reviews 2001-2004

(67 slides)(67 slides)http://www.acf.hhs.gov/programs/cb/cwmonitoring/results/http://www.acf.hhs.gov/programs/cb/cwmonitoring/results/

52 Program Improvement Plans: 52 Program Improvement Plans: Strategies for Improving Child Welfare Services and OutcomesStrategies for Improving Child Welfare Services and Outcomes

(121 slides)(121 slides)www.acf.hhs.gov/www.acf.hhs.gov/programprograms/cb/cwmonitoring/results/pip_presentation_final.ppt s/cb/cwmonitoring/results/pip_presentation_final.ppt

Strategies That Address Critical Practice Areas: Strategies That Address Critical Practice Areas:

Successes and Challenges in ImplementationSuccesses and Challenges in Implementation (44 slides)(44 slides)

www.acf.hhs.gov/programs/cb/cwmonitoring/www.acf.hhs.gov/programs/cb/cwmonitoring/strategiesstrategies/sld001.htm /sld001.htm

27

National Resource Center for National Resource Center for

Organizational ImprovementOrganizational Improvement

http://muskie.usm.maine.edu/helpkids/http://muskie.usm.maine.edu/helpkids/