Download - Sustainable Permanency Practices Brief March 2018 · The purpose of this research brief is to synthesize: 1) effective practices related to sustaining ... understanding barriers faced

SuggestedCitation:Metz,A.,Bartley,L.,Farley,A.&Cusumano,D.(2018).EffectivelyImplementingEffectivePracticesfor SustainablePermanency:ASynthesisofResearchandPractice.ChapelHill,NC:National ImplementationResearchNetwork,UniversityofNorthCarolinaatChapelHill.

EffectivelyImplementingEffectivePracticesforSustainablePermanency:ASynthesisofResearchandPractice

SubmittedbytheNationalImplementationResearchNetwork

March2018

BackgroundPurposeoftheProject.TheColoradoDepartmentofHumanServices’(CDHS)DivisionofChildWelfareisengaginginworktocreateaSustainablePermanencyPracticeModelthatmeetstheneedsofchildren,youthandfamilies;reducesthelikelihoodofreentryintofostercare;andembedstheuseofpermanencybestpracticesthroughoutthestateforchildrenandfamilies.Drivenbythegoalofreducingthecurrentrateofreentryintooutofhomecarefrom19.2%to8.2%,CDHSiscommittedtousingapredictiveanalyticsandcoachingservicedeliverystrategytoensurecaseworkersandsupervisorsareabletoengagechildrenandfamiliesinservicesandprogramsmatchedtotheirspecificneeds.

PartnersintheProject.CDHSispartneringwithCaseyFamilyPrograms,theNationalImplementationResourceNetwork(NIRN),andEckerdConnectstodevelopandimplementaSustainablePermanencyPracticeModel.InpartnershipwithCDHS,NIRNwillsupportinitialdevelopmentandlong-termcapacitytouseandscalethepracticemodelacrossthestate.AlsoengagedinthiscollaborativeendeavorisEckerdConnects,whowillbeengineeringthepredictiveanalyticsmodelandbuildingthecapacityofsupervisorsandcasemanagerstousedatatoinformpracticedecisions.Thepracticemodelwillinclude:1)casemanagementpracticesspecificallyforchildrenidentifiedashighriskforre-entry;and2)permanencypracticesforallchildrenandfamiliesinoutofhomeplacement.Thepredictiveanalyticsmodelwillinformthepracticeapproachandalignmentofresourcesbasedonriskofreentrypriortocaseclosure.Coachingwillbeprovidedtosupporttheuseofpredictiveanalyticsandotheravailabledatatoidentifyhigh-riskchildrenandpotentialareasofneedforthesechildrenandtheirfamilies,andtousepermanencypracticeswithfidelitytoaddresstheseidentifiedneeds. Acrossthisproject,CaseyFamilyProgramsservesasthefunderandprovidesoversightandstrategicconsultationtoallpartners.

EffectivePracticesforSustainablePermanency:NecessarybutInsufficientTorealizeourgoalofreducingreentryintofostercareforchildrenandfamiliesrequiresasystemicapproachtoscale,sustain,andcontinuouslyimprovepermanencypracticesinchildwelfare.Thisapproachisparticularlyimportantforvulnerablechildrenandfamiliesimpactedbymaltreatmentasweknowthatfailedinterventionoftenleadstoreentryintooutofhomecare.Theformulabelowdescribesthecriticalpiecesneededtoscaleandbuildsustainablecapacitytouseevidence-informedandevidence-basedpracticesthatwillreducechildandyouth’sreentryintofostercare.


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Inordertoobtainpositiveoutcomesforchildrenandfamilies,childwelfaresystemsneedtoselectanduseeffectivepractices,implementthepracticesinadeliberateandadaptivemanner,andcreateanenablingcontextthatsustainsandcontinuouslyimprovesthesepractices(Metz&Easterling,2016).Thesethreeconditionsrefertowhatisimplemented(effectivepractices),howitisimplemented(effectiveimplementation)andwhereandwithwhom(enablingcontext)itisimplemented.Theformulaismultiplicativebecauseweaknessinanyofthesethreeareaswillcompromisethepossibilityofachievingtheintendedoutcomes.

• EffectivePractices:Strategiesorpracticesthataresupportedbyevidence,feasibletoimplement,fittheneedsofthechildren,families,andcommunity,andarewelldefined

• EffectiveImplementation:Intentionalandvisibleinfrastructuretobuildstaffcompetencyandcreateorganizationalandsystemsstructurestosupporteffectivepractices

• EnablingContext:Stakeholdercollaboration,communicationandfeedbackloops,andongoinguseofdatatocontinuouslyimproveeffectivepracticesinlocalcontexts

Thepurposeofthisresearchbriefistosynthesize:1)effectivepracticesrelatedtosustainingpermanencyforchildrenwhohavepreviouslybeeninanoutofhomeplacementthusreducingtheirlikelihoodofreentryintofostercare;2)effectiveimplementationsupportsforensuringthatpermanencypracticesareimplementedwithintegrity;and3)anenablingcontextthatsupportsauthenticstakeholderengagementanddatauseinservicetocontinuousimprovementofpermanencypractices.Thisbriefprovidesasummaryoffindingsforeachareaoftheformula.Tomeetthisneed,weconductedatargetedresearchreviewtounderstandandalignrelevantresearchwithformulacomponents.Initially,literaturewascollatedfroma2017CaseyFamilyProgramsbrief,SupportingLifelongFamilies:EnsuringLong-LastingPermanencyandWell-Being,andotheroriginatingdocuments,whichyieldedapproximately29documentsforreview.Next,atargetedliteraturesearchwasconductedusingtheUniversityofNorthCarolinaarticlesearchdatabasewiththefollowingsearchterms:permanency,re-entry/reentry,out-of-homecare,fostercare,reunification,andchildwelfare.Finally,relevantchildwelfareliteraturewasdrawnfromtheChildWelfareInformationGatewayandCaliforniaEvidence-BasedClearinghouse.Inordertoselecteffectivepractices,itisessentialtocomprehensivelyassesstheneedsofthetargetpopulation.Thisincludessecuringandanalyzingdataonthescopeoftheat-riskpopulationwithinthecommunityorjurisdiction,demographiccharacteristics,andrelevantriskfactorsandchildoutcomes—oftenthroughstateadministrativedata,localchildwelfaredata,andagencycasedata.Ideally,datawillbeexaminedlongitudinallyandconsidernuancessuchasgeographicaldifferencesanddisproportionaterepresentation.Buttheselectingentityshouldalsoconsiderbroader,moresystemicfactors,or“rootcauses”oftheproblem.Forexample,Akinetal.(2012)arguethatassessingtargetpopulationneedsinchildwelfarealsoencompassesunderstandingbarriersfacedbyparents—suchaspovertyandsocialsupports,parentalclinicalneeds,parenting,andhomeandenvironmentalstressors,aswellassystemsbarriers—suchasstaffingcapacityandturnover,siloedchildandparentservicesystems,orbarrierswiththelegalsystem—thatmayimpedepermanency(Metz,Bartley,&Maltry,2017).


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Thus,webeginbysummarizingpossiblepredictorsofre-entryintofostercareconsistentlycitedacrossresearch.ThoughpredictiveanalyticsmodelingwillprovideCDHSwithafirsthandunderstandingofthecharacteristicscommontofamiliesexperiencingreentryintofostercarewithinitschildwelfaresystem,thissummaryalsoprovideshelpfulcontextasweillustratehowthesefactorshaveinformedpolicyandpractice.Higherratesofre-entryintooutofhomecarehavebeenlinkedto1)child,2)parentandfamily,and3)caseorservice-levelcharacteristicsasfollows(Bronson,Saunders,Holt,&Beck,2008;Carnochan,Rizik-Baer,&Austin,2013;Kimberlin,Anthony,&Austin,2009):

• ChildCharacteristicso Raceandethnicityo Infantageandpre-teen/teenagedo Medical,mental,orbehavioralhealthneeds

• Parent/FamilyCharacteristics

o Parentalambivalenceaboutparentingroleo Lackofparentingskillsandsocialsupporto Highnumberofparentproblemso Parentalsubstanceabuseo Highnumberofchildrenlivingthehomeand/orreturninghomeo Lowincome/povertystatus

• Case/Service-LevelCharacteristics

o Shortlengthofstayinfostercareo Neglectasmaltreatmenttypeo Highnumberofplacementso Placementingrouphomeorresidentialsetting(vs.kinshipcare,whichhasbeen

associatedwithlowerratesofre-entry)o Lackofparentinvolvementincaseplanningo Lackofparentvisitationandcontacto Unmetneed/continuingneedforservicesatthetimeofreunification.


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EffectivePracticesStrategiesorpracticesthataresupportedbyevidence;feasibletoimplement;fittheneedsofthechildren,families,andcommunity;andarewelldefined.PracticestoSustainPermanency/ReduceReentry

DefinitionorCoreComponentsIdentified MainFindingsofResearch Citations

Therapeuticsupportstoenhanceparent-childinteractions

Corecomponentsinclude:• Extensivetrainingandongoing

consultation/coachingandsupportforcaregivers;

• Therapeuticsupportsforchildren;• Emphasisonconcrete

encouragementandpraiseforpositivechildbehavior;and

• Useofadevelopmentalframework.ExamplesofEBPsthatusethesecorecomponentsincludeTreatmentFosterCareOregon(TFCO-P)andParentChildInteractionTherapy(PCIT)

• Inastudyof54childrenrandomlyassignedtoafostertreatmentmodelorregularfostercare,permanentplacementsfailedfor36%ofthechildreninregularfostercarevs.only10%ofthechildreninEIFC.

• StudieshaveshownthatPCITiseffectiveinreducingchildbehaviorproblems,improvingparentingoutcomes,andreducingmaltreatmentrecurrenceamongphysicallyabusiveparents.

Fisher,Burraston,&Pears,2005Carnocahn,Rizik-Baer,&Austin,2013

Intensivein-homeservicesduringandafterfostercare

Corecomponentsinclude:• Interventionatthecrisispoint

(therapistsseefamilieswhentheyareincrisis,within24hoursofreferral);

• Treatmentinnaturalsettings;• Accessibilityandresponsiveness

(therapistsareoncall24/7;familiesaregivenasmuchtimeastheyneed);

• Intensity(servicesaretimelimitedandtypically4weeks-eachfamilyreceives40-50hoursofdirectservice);

• Inanevaluationofanintensivein-homefamilyreunificationprogram,familiesintheprogramexperiencedfewerre-referralstoauthoritiesthancomparisonfamilies24monthsafterprogramintake(25.2%vs.32.5%).

• Itisimportanttonotethatresearchoneffectivenessofsimilarservicemodelsinreducingsubsequentmaltreatmentandre-entryintofostercarehasbeenmixed,withsomestudiesnotinganincreasedrateofre-entryandothersfindingnosignificantdifferencebetweenprogramparticipants

Kimberlin,Anthony,&Austin,2009Pine,Spath,Werrbach,Jenson,&Kerman,2009Fraser,Walton,Lewis,Pecora,&Walton,1996


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• Lowcaseloads(2-3familiesatatime);

• Useofresearch-basedinterventions;and

• Flexibility(servicesareprovidedwhenandwheretheclientwishes).

andcontrol/comparisongroupparticipants.

Carnocahn,Rizik-Baer,&Austin,2013Lee,Jonson-Reid,Drake,2012

Increasedcontactbetweenworkersandcaregivers

Corecomponentsinclude:• Establishingopen,honest

communicationwithcaregivers;• Requestingfamilyparticipationand

feedbackinplanningprocesses;and• Instructionandreinforcementinthe

performanceandcompletionofmutuallyagreed-uponactivities.

• AreviewofbothliteratureandpreviousCFSRFinalReportshavehighlightedtheimportanceoffamilyengagementinpromotingreunification.

• Someresearchhassuggestedthatincreasedcontactandtimespentbetweencaseworkersandfamiliesimprovesengagementandfacilitatessuccessfulreunification.

• Inanotherstudy,theonlysignificantpredictorsoftimelyreunificationwereage(eachyearyoungerachildwas,therewasa5%increaseinreunificationodds)andcaseworkerinclusionofcaregiverincaseactivitiesanddecisions.

• Childrenhadahigherchanceofreunificationwithin12monthsafterplacementinout-of-homecarewhenthecaseworkerinvolvedthecaregiverindecisionsandactivitiesimpactingthechildrencomparedtocaseswhereno

Bronson,Saunders,Holt,&Beck,2008ChildWelfareInformationGateway,2011Yampolskaya,Armstrong,Strozier,&Swanke,2017


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effortsweremadetoencouragecaregivers’participation.

ComprehensiveAssessments

Accurateassessmenttounderstandunderlyingcausesofmaltreatmentisdefinedasaprocessthat“involvesdevelopinganindividualized,family-centeredunderstandingofachildandfamily’scircumstances,environment,andpotentialinordertoidentifyeachfamily’suniqueneeds,determinetheextentoftherisktothechild,andtoconstructanappropriateinterventionplan.”

• StateexperiencesascapturedinCFSRreportsindicatethatinitialfamilyassessmentsplayavitalroleininformingcaseplans,whichcaneitherfacilitateorhinderreunification.

• Asnotedabove,unmetfamilyneedsatthetimeofreunificationhavebeenlinkedtohigherratesofre-entryintofostercare,andsimilarly,onestudyonfailedreunificationshighlighted“poorassessmentordecision-makingbythecaseworkerorserviceprovider”asafactorinnearlytwo-thirdsofthecases.

• Comprehensiveandtimelyfamilyassessmentcanbeusedtoassessafamily’sstrengthsandneedsadequatelytomatchthemappropriatelytoservicestomeetthoseneeds.

PromisingassessmentsidentifiedinliteratureincludetheNorthCarolinaFamilyAssessmentScalesforReunification1andtheStructuredDecisionMakingReunificationReassessment2.

Bronson,Saunders,Holt,&Beck,2008ChildWelfareInformationGateway,2017ChildWelfareInformationGateway,2011

1http://www.nfpn.org/assessment-tools2https://www.nccdglobal.org/assessment/structured-decision-making-sdm-model


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Caregiverskilldevelopment

Definedas“servicestoincreaseparents’skilllevelsinanumberofareas”includingbutnotlimitedto:

• Behavioralmanagementtechniques;• Copingskills;and• Problem-solvingskills.

• Reviewsofexperimental/quasi-experimentalstudiesandconceptualliteraturerelatedtoreunificationandre-entryidentifiedparentskilltrainingasacommonfeatureacrossprogramsandasaserviceoftenassociatedwithimprovedreunificationandreducedre-entryintofostercareoutcomes.

• AnannualreportfromtheCaliforniaDepartmentofSocialServicesreportedmaltreatmentrecurrenceratesforchildrenwhoseparentscompletedtheIncredibleYearsprogram(achild,parent,andteachertrainingprogram)as2to6percentagepointslowerthanchildrenofparentswhodidnot.

Bronson,Saunders,Holt,&Beck,2008ChildWelfareInformationGateway,2017Carnocahn,Rizik-Baer,&Austin,2013

Mentalhealthandsubstanceabuseservices

Threepromisingtypesofservicedeliveryinclude:

• Intensivecasemanagementincluding“recoverycoaches”tofacilitateassessments,conductserviceplanning,andeliminatebarrierstoaccessingtreatment;

• Tailoredprogramsforchild-welfareinvolvedmothersandtheirchildren;and

• Stronguseofsocialsupport.

• Inastudyofmorethan6,000childrenwhore-enteredfostercareinCalifornia,childrenwhosecaseplanincludeddrugoralcoholservicesweremorethantwiceaslikelytore-entercare.

• Severalstudiesreportthelikelihoodofreunificationincreaseswhenmothersinsubstanceabusetreatmentprogramsalsoreceivematchedservicestoaddressco-occurringproblems.

Shaw,2006Bronson,Saunders,Holt,&Beck,2008ChildWelfareInformationGateway,2011


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Anti-povertyandconcreteservicesforfamilies

Materialsupportsweredefinedas“anyreceptionoffinancially-relatedassistance,includinghousing,rent,utilities,foodorclothing,appliances,furnitureorhomerepairandotherfinancialhelp.Traditionalservicesincludereceptionofthefollowing“medicalordentalcare,disabilitycare,cookingorcleaninghelp,mentalhealthservices,alcoholordrugtreatment,parentingclasses,maritalfamilycounseling,childcounseling,legalservices,daycare,respitecare,discussiongroups,educationclasses,andemploymentassistance”

• Familieswhoneedconcreteservicesandreceivethemaremorelikelytoreunifythanthosewithunmetneeds.

• Anti-povertyservicesthatincludedmaterialsupportsresultedinareductioninlaterreportsandplacementsofchildren.

• Effectiveprogramsorpracticesprovideservicestomeetafamily’sconcreteneedsandcoachfamiliesonhowtoaccesscommunityresourcestomeettheirneedsindependentlyinthefuture

ChildWelfareInformationGateway,2011Bronson,Saunders,Holt,&Beck,2008Simon&Brooks,2016Lowman&Siegel,2012

Socialsupport “Helpingparentsstrengthentheirsupportnetworksandbuildingcommunitypartnershipsforchildprotectionprovideinformalandformalopportunitiesforfamiliestodealwithstresses”

• Socialsupporthasbeenidentifiedasacriticalcomponentofpost-reunificationsupport,andlackofsocialsupportorasocialnetworkhasbeenlinkedtoincreasedriskofre-entryforchildren.

ChildWelfareInformationGateway,2017Bronson,Saunders,Holt,&Beck,2008Kimberlin,Anthony,&Austin,2009

Respitecare Definedasshorttermcareservicesprovidedinthetemporaryabsenceoftheregularcaregivertochildrenwhoa)arein

• Respitecarehasbeenfoundtolowerstressamongfamilies.AnARCHstudyfrom2007notedthatalthoughfamilieswithpriorCPS

Carnocahn,Rizik-Baer,&Austin,2013


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dangerofabuseorneglect;b)haveexperiencedabuseorneglect;orc)havedisabilities,chronic,orterminalillnessesinordertoenablethefamilytostaytogetherandkeepthechildlivinginhisorherhomeandcommunity.

historywerereferredmoreoften,theirsubstantiationratewaslower.

Familygroupdecisionmaking

Definedasprocesses(e.g.,familyteammeetings,teamdecision-making)duringwhichfamiliesarealignedwithagencypersonnelandothersasactiveparticipantsinidentifyingunderlyingissuesandmakingdecisionsandplanningforcareoftheirchildren

• Parentalinvolvementinsix-monthprogressmeetingsisassociatedwithlowerratesofre-entryamongyoungerchildren.

• Overall,familygroupdecision-makingprocessesarelinkedtogreaterfamilyengagement,increasedreunification,andreducedratesofre-entry.

ChildWelfareInformationGateway,2017Kimberlin,Anthony,&Austin,2009

Assessmentofparentalambivalence/readiness

Anassessmentofreadinessforreunification,suchastheNorthCarolinaFamilyAssessmentScaleforReunification(NCFAS-R),canbeusefulinhelpingcaseworkersdeterminewhenandwhethertoreunifyafamilyandidentifyandplanforsupportsthatmaybeneededduringthetransitionperiod

• Astudyexaminingtheimpactofvariousfactorsuponre-entryintofostercareforasampleof512childrenfoundthatchildrenwhoseparentswereviewedasmotivatedtoimproveparentingwere60%lesslikelytore-entercare.

• Conversely,parentalambivalenceabouttheparentingrolehasbeenlinkedtoincreasedratesofre-entry.

Wells&Correia,2012Bronson,Saunders,Holt,&Beck,2008

Mentalandbehavioralservicesforchildren

Programsshouldaddresschildtraumabothrelatingtothereasonforremovalandtheremovalitselfaswellasstressorsassociatedwithreturninghome.

• Childmentalandbehavioralhealthneedsarecommonlycitedaspredictorsofre-entryintofostercare.

Jedwab&Shaw,2017


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Foryouthwithmorecomplexneeds,servicescaninclude:

• Carecoordination• Teammeetings• Youthmentoring• Afterschoolcare• Tutoring• Parentcoaching• Respitecare• Psychiatricservices• Outpatienttherapy• 24/7crisisinterventionfor

caregivers

• Inastudyof4,642childrenexitingfromcaretoreunificationoverathree-yearperiod,theauthorsfoundthatwhenchildbehavioralchallengeswereindicatedasareasonforremovaltheywere1.5timesmorelikelytore-entercarethanchildrenwithoutthisindicator.

Madden,McRoy,Maher,&Ward,2009Roberts,O’Brien,&Pecora,2017

Post-reunificationservices “Post-reunificationpracticesoccurafterachildisreturnedhomeandhelptosupportafamilyinmaintainingsuccessfulreunification.”

• Inareviewofstates’FinalCFSRReports,post-reunificationservicesarecitedasacrucialpracticeinreducingmaltreatmentrecurrenceandre-entrytofostercare.

• Researchhighlightsthatservicesthatenhanceparentingskills,providesocialsupport,connectfamiliestobasicresources,andaddresschildren’sbehavioralandemotionalneedsarecriticalandcanhelptopreventre-entryintocare.

Carnocahn,Rizik-Baer,&Austin,2013ChildWelfareInformationGateway,2011


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EffectiveImplementationMethodsIntentionalandvisibleinfrastructuretobuildstaffcompetencyandcreateorganizationalandsystemsstructurestosupporttheuseofeffectivepracticesforsustainablepermanency3Infrastructuresupportsthatbuildstaffcompetencytodeliverpermanencypracticesandcreateadministrative,data,andsystemssupportsforeffectiveimplementation

DefinitionorContext MainFindingsofResearch Citations

Caseworkertrainingtosupportuseofpermanencypractices

Trainingthatincludesbothworkersandsupervisorsatthesametimeandaddressesdefinitions,relationships,andpracticewasthetypeoftrainingmostrelatedtotransfertoskillsandknowledge.

• Trainingplusreinforcementwasthemostsuccessfulwaytotransfertrainingknowledgeandskillsinonestudyofchildwelfareworkforcetraining.Thereinforcementinvolvedahalf-dayofface-to-facecaseconsultation.

Antle,Barbee,Sullivan,&Christensen,(2008)

Accesstoongoingcoaching,supervisionandsupporttoensurefidelitytopermanencypractices

Effectivesupervisionwasdefinedas:• “Successfulapplicationof

knowledgetopractice,connectingcaseworkerstotheagencymission,buildingsupportiveorganizationalstructures,beinganeffectiveleader,andpromotionsuccessamongemployees.”

• Coachingandsupervisionthatreinforcesskills,includesobservations,reinforcesrelationships,andprovidesfeedbackandongoingsupporttostaff.

• Effectivesupervisionincreasesworkerretentionandstaffsatisfaction,andlikelihoodofeffectivepractice.

• Supervisoreducational,social,andadministrativesupportcancontributetoaworker’seffectivenessinqualityservicedelivery,improvingworkercapacitytodefine“nextsteps”,improveclientengagement,andimprovegoalattainmentamongclients.

• “Deliveryofqualitysupervisions,supervisorsbeingskilledinmentoringandprovidingfeedback,andsupportivepracticestandardshavebeenrelatedtosuccessfulchildwelfarecasecompletion,

ChildWelfareInformationGateway,2015Saldana,Chamberlain,&Chapman,2016

3Effectiveimplementationincludesmethodsdemonstratedtosupporttheuseofeffectivepracticesinpublicchildwelfare.Whilenotallmethodshavebeenempiricallytestedwiththeuseofeffectivesustainablepermanencypracticesspecifically,thesemethodshavebeenidentifiedthroughrigorousresearchtosupporttheuseofevidence-basedpracticesandprogramstoimproveoutcomesforchildrenandfamiliesincludingpermanency.


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lowerre-entryintothesystem,aswellasCWSstaffretention”

Assessmentsofpermanencypractice(Fidelity)

Fidelitydataaredatathatmeasuretheextenttowhichtheevidence-basedorevidence-informedprogramorpracticehavebeenimplementedasintended.

• Fidelitymonitoringdemonstratedaprotectiveeffectonstaffturnover,thereforedecreasingthenumberofchildwelfarestaffonacase,inonestate-widerandomizedtrialinchildwelfare.

Aarons,Sommerfeld,Hecht,Silovsky&Chaffin,2009

Dedicationoffundingtosupportpost-reunificationservices

Fundingis:• Designatedspecificallyforpost-

reunificationserviceswithcleareligibilityrequirements;

• Flexible;and• Braidedtoleverageallexistingand

availablestreams(TitleIV-B,SSBG,Medicaid,TANF,etc.).

• StatesareunabletodrawdownfederalTitleIV-Efundingforcasemanagementandsupportsonceachildisreunifiedwithhisorhercaretaker.OtherfederalfundingsuchasTitleIV-Bcanbeusedtosupportpost-reunificationservices,buttherearechallengingtimelimits(e.g.,uselimitedtoa15-monthtimeperiodbeginningwhenthechildisofficiallyplacedintofostercare).4

• Unmetserviceneedsatthetimeofreunificationhavebeenshowntoincreasetheriskofre-entry.Reunificationcanbeatimeofadjustmentforfamiliesandthatstresscanmakeitdifficulttomaintain

ChildWelfareInformationGateway,2011Sciamanna,2013Roberts,O’Brien,&Pecora,2017Bronson,Saunders,Holt,&Beck,2008

4AnalysisofhowtheFamiliesFirstActwillimpactpermanencyservicesisneeded.


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stability,especiallywhenthereareanumberofcomplexandco-occurringneeds.

EnablingContextStakeholdercollaboration,communicationandfeedbackloops,andongoinguseofdatatocontinuouslyimproveeffectivepracticesinlocalcontexts(e.g.,coordinationwithcourtsorJuvenileJustice)5Systemsalignmenteffortsincludingstakeholderengagementstrategiesanddatauseforimprovement


Effectivecollaborationamongstakeholderstosupportcoordinationandimplementationofpermanencypractices

Keyfindingsrelatedtoeffectivecollaborationincludedsharedvision,buildingonexistingrelationships,academicsupport,problemsolvingandresourcesharing,andmaintainingcollaborationsovertime.

• Inastudyof11childwelfaresystemsimplementingSafeCaretoreducechildneglectrecidivismrates,sitesthatwereabletofullysustainthemodelreportedsignificantlygreaterlevelsofeffectivecollaborationasmeasuredbyacollaborationscale.

Greenetal.,2016

5Promotinganenablingcontextincludesstrategiesdemonstratedtosupportsystemsalignmentinpublicchildwelfare.Whilenotallstrategieshavebeendemonstratedtosupportalignmentforsustainablepermanencypracticesspecifically,thesestrategieshavebeenidentifiedasbestpracticestosupportsystemsalignmentinservicetoimprovedoutcomesforchildrenandfamilies.


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Coordinationwithcourtstosupportpermanencypractices

Researchfindingsdemonstratedtheimportanceofcollaborationbetweenpublicagencystaffandfamilycourtinsupportingsustainablereunificationefforts.

• Youngerchildrenwhoseexitsfromcarewereinitiatedbythechildwelfareagencyasopposedtoacourtsystemwerelesslikelytore-entercare.

• Similarly,astudyanalyzing3years’worthofdatafromastate’sadministrativechildwelfaresystemfoundthatchildrenwhosereunificationwascourt-orderedagainsttheagency’srecommendationweretwiceaslikelytore-entercare.

Kimberlin,Anthony,&Austin,2009ChildWelfareInformationGateway,2011Jedwab&Shaw,2017.

Effectivedatasystemsforqualityimprovementofpermanencypractices6

Carefulanalysisofdatainchildwelfareisrequiredtounderstandhowwellservicesarebeingdelivered,whetherservicesaremeetingtheneedsofchildrenandfamilies,andifservicesresultindesiredoutcomesforchildrenandfamilies.Fidelity,monitoring,andfeedbackhavebeenidentifiedasessentialcomponentsofsuccessfulandsustainedimplementationofevidence-basedprogramsorpractices.

• ResearchhasindicatedanumberofbenefitsresultingfromeffectiveCQIprocessesincludingincreasedstaffretention,increasedinvolvementofstaffinusingdataforimprovement,improvedreferralprocesses,andimprovedoutcomesforchildrenandfamilies.

• Improvedoutcomesforchildrenandfamiliesincludereductionsinthenumberofchildrenplacedinout-of-homecare,increasedpercentagesofchildreninfamilyhomes,decreasednumberofchildreningrouphomes,increasedadoptions,improvedplacementstability,andincreasednumberofinvestigationsthatareopenlessthan60days.

Chovil,2009Aarons,Sommerfeld,Hecht,Silovsky&Chaffin,2009Sedler,Bruns,Walker,Kerns&Negrete,2015Packard,McCrae,Phillips,&Scannapieco,2015Ahn,Carter,Reiman,&Hartzel,2017

Policiesthatsupportpermanencypractice

Agencypoliciesandpracticesrefertopracticesagenciescanputintoplaceto

Agency-levelpromisingpracticesthatreducethelikelihoodofreentryinclude:

• Pre-Planning

Hatton&Brooks,2008

6Pleasenotethatpredictiveanalyticswouldbeincludedindatauseactivitiesdesignedtosupporteffectiveimplementationofeffectivepractices.


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supportpermanencyandreducethelikelihoodofreentry.

• Postplacementservices• Settingupformalandinformal

services• Participatorycaseplanningpractices• Assessingfamilyreadinessfor

reunifyingchildren• Effectiveparent-childvisitation

Public-privatepartnershipsinservicetotheuseofsustainablepermanencypractices

Childwelfarepresentsuniquechallengesinensuringeffectivepublic-privatepartnershipssinceservicesareoftencoordinatedorprovidedthroughcommunity-basedorganizations,andpublicchildwelfareagenciesfrequentlyrelyonanetworkofserviceproviders.Additionally,manytreatmentsforfamiliesareprovidedthroughbehavioralandmentalhealthsystems.

• Effectivepublic-privatepartnershipsarestrengthenedthrougheffectiveteamingstructuresthatcansupportinformationsharing,problemsolving,andfeedbackandcoordinationamongthepublicagencyandnonprofitserviceproviderswhosupportpermanencyforfamilies.

Metz,Bartley,&Maltry,2017


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SummaryandNextStepsInpartnershipwiththeNIRN,CaseyFamilyProjects,andEckerdConnects,CDHSiscreatingaSustainablePermanencyPracticeModelthatmeetstheneedsofchildren,youthandfamilies.Acriticalpieceofthisworkinvolvesaligningcaseworkersandsupervisors’useofpermanencybestpractices,strengthenedbycoachinganddatafrompredictiveanalyticsthatidentifychildren,youth,andfamilies’needs.Inordertodevelopcapacitytoadoptandimplementapermanencypracticemodel,effectivepracticesmustbeselected,operationalized,andembeddedwithinasystemthatsupportstheiron-goinguseandcontinuousimprovement(Metz&Easterling,2016).Thisbriefsharedavarietyofbestpracticestosupportsustainablepermanencyandreducereentryintofostercare(e.g.,whatisimplemented)whilealsoidentifyingcriticalfactorsineffectiveimplementation(e.g.,howpracticesareimplemented)anddevelopmentanenablingcontext(e.g.,whereandwithwhom)thatsupportsthiswork.Withtheknowledgefromthisbriefinhand,nextstepstowardreachingthegoalofreducingreentryintofostercareincludeusingdatadrawnfrompredictiveanalyticstoidentifythemostfrequentbarrierstosustainedpermanencyandaddressingthesechallengeswithbestpracticesintheformofcasemanagementandtargetedservicesforchildrenandfamilies.Asthesebestpracticesareidentified,theyshouldbeexaminedandoperationalized(whatisitthatcaseworkersandsupervisorswill“sayanddo”tosupportsustainablepermanency?).Oncebestpracticesareidentifiedandoperationalized,systemsfortrainingandcoachingcanbedevelopedandemployedtofostertheabilitiesandskillsoffrontlinechildwelfarestaff.Atthesametime,attentionmustbegiventothesystemswithinwhichthesepracticeswillreside,soconditionstosupporton-goingimprovementandproblemsolvingareavailable.Asnotedearlier,identifyingandusingeffectivepracticesisanecessarybutinsufficientsteptoreducereentryrates.Attentionmustalsobedirectedatcreatingsystemstosupporttheiruseandcontinuousimprovementinordertoachievepositiveoutcomesforchildren,youth,andfamilies.ReferencesAarons,G.,Sommerfeld,D.H.,Hecht,D.B.,Silovsky,J.F.,&Chaffin,M.J.(2009).Theimpactofevidence-basedpracticeimplementationandfidelitymonitoringonstaffturnover:Evidenceofaprotectiveeffect.JournalofConsultingandClinicalPsychology,77,270-280.Ahn,H.,Carter,L.M.,Reiman,S.,&Hartzel,S.(2017).Developmentofaqualityassuranceandcontinuousqualityimprovement(CQI)modelinpublicchildwelfaresystems.JournalofPublicChildWelfare,11,166-189.Akin,B.A.,Bryson,S.A.,McDonald,T.,&Walker,S.(2012).Definingatargetpopulationathighriskoflong-termfostercare:barrierstopermanencyforfamiliesofchildrenwithseriousemotionaldisturbances.ChildWelfare,91,79-101.Antle,B.F.,Barbee,A.P.,Sullivan,D.J.,&Christensen,D.N.(2009).Theeffectsoftrainingreinforcementontrainingtransferinchildwelfare.ChildWelfare,88,5-26.Bronson,D.E.,Saunders,S.,Holt,M.B.,&Beck,E.(2008).ASystematicReviewofStrategiestoPromoteSuccessfulReunificationandtoReduceRe-entrytoCareforAbused,Neglected,andUnruly


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Children.TheOhioStateUniversity:CollegeofSocialWork.Retrievedfrom:http://www.ocwtp.net/pdfs/reun-reentry%20final%20report.pdfCarnochan,S.,Rizik-Baer,D.,&Austin,M.J.(2013).Preventingreentrytofostercare.JournalofEvidence-basedSocialwork,10,196-209.

ChildWelfareInformationGateway(2017,October).SupportingSuccessfulReunifications.Retrievedfrom:https://www.childwelfare.gov/pubPDFs/supporting_reunification.pdfChildWelfareInformationGateway(2015,April).Supervisingforqualitychildwelfarepractice.Retrievedfrom:https://www.childwelfare.gov/pubs/factsheets/effective-supervision/.ChildWelfareInformationGateway(2011,June).FamilyReunification:WhattheEvidenceShows.Retrievedfrom:https://www.childwelfare.gov/pubPDFs/family_reunification.Pdf.Chovil,N.(2009).Onesmallstepatatime:Implementingcontinuousqualityimprovementinchildandyouthmentalhealthservices.ChildandYouthServices,31,21-34.Fisher,P.A.,Burraston,B.,&Pears,K.(2005).TheEarlyInterventionFosterCareProgram:Permanentplacementoutcomesfromarandomizedtrial.ChildMaltreatment,10,61-71.Fraser,M.W.,Walton,E.,Lewis,R.E.,Pecora,P.J.,&Walton,W.K.(1996).Anexperimentinfamilyreunification:Correlatesofoutcomesatone-yearfollow-up.ChildrenandYouthServicesReview,18(4/5),335-361.Green,A.E.,Trott,E.,Willging,C.E.,Finn,N.E.,Ehrhart,M.G.,&Aarons,G.A.(2016).Theroleofcollaborationsinsustaininganevidence-basedinterventiontoreducechildneglect.ChildAbuseandNeglect,53,4-16.

Hatton,H.&Brooks,S.(2008).PreventingRe-entryintotheChildWelfareSystem:ALiteratureReviewofPromisingPractices.NorthernCaliforniaTrainingAcademy:TheCenterforHumanServices.Retrievedfrom:http://www.childsworld.ca.gov/res/pdf/PreventingRe-entry.pdf

Jedway,M.&Shaw,T.V.(2017).Predictorsofreentryintothefostercaresystem:Comparisonofchildrenwithandwithoutpreviousremovalexperience.ChildrenandYouthServiceReview,82,177-184.

Kimberlin,S.E.,Anthony,E.K.,&Austin,M.J.(2009).Re-enteringfostercare:Trends,evidence,andimplications.ChildrenandYouthServicesReview,31,471-481.

Lee,S.,Jonson-Reid,M.,&Drake,B.(2012).Fostercarere-entry.Exploringtheroleoffostercarecharacteristics,in-homechildwelfareservices,andcross-sectionservices.ChildandYouthServicesReview,34,1825–1833.

Loman,L.A.,&Siegel,G.L.(2012).Effectsofanti-povertyservicesunderthedifferentialresponseapproachtochildwelfare.ChildrenandYouthServicesReview,34,1659-1666.

Madden,E.E.,McRoy,R.G.,Maher,E.,&Ward,K.(2009,April).TravisCounty,Texas,ChildProtectiveServicesReintegrationPilotProject.Seattle:WA:CaseyFamilyPrograms.


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Metz,A.,Bartley,L.,&Maltry,M.(2017).Animplementationscienceandservice-providerinformedblueprintforintegrationofevidence-basedandevidence-informedpracticesintoNewJersey’sChildWelfareSystem.TheUniversityofNorthCarolina:NationalImplementationResearchNetwork.Retrievedfrom:http://www.state.nj.us/dcf/about/divisions/strategicdev/Blueprints_Sept2017.pdf

Easterling,D.,&Metz,A.(2016).Gettingrealwithstrategy:Insightsfromimplementationscience.TheFoundationReview,8(2),Article11.

Packard,T.,McCrae,J.,Phillips,J.,&Scannapieco.M.(2015).Measuringorganizationalchangetacticstoimprovechildwelfareprograms:Experiencein13counties.Humanserviceorganizations:Management,Leadership,&Governance,39,444-458.

Pine,B.A.,Spath,R.,Werrbach,G.B.,Jenson,C.E.,&Kerman,B.(2009).Abetterpathtopermanencyforchildreninout-of-homecare.ChildrenandYouthServicesReview,31,1135-1143.

Roberts,Y.H,O’Brien,K.,&Pecora,P.J.(2017).SupportingLifelongFamilies:EnsuringLong-LastingPermanencyandWell-Being.CaseyFamilyPrograms.Retrievedfrom:https://cdn.casey.org/media/supporting-lifelong-families-full.pdf

Saldana,L.,&Chamberlain,P,&Chapman,J.(2016).Asupervisor-targetedimplementationapproachtopromotesystemchange:TheR3Model.AdministrationandPolicyinMentalHealth,43(6),879-892.

Sciamanna,J.(2013).Reunificationoffosterchildrenwiththeirfamilies:Thefirstpermanencyoutcome.StatePolicyAdvocacyandReformCenter.Retrievedfrom:http://www.nrcpfc.org/is/downloads/Reunification_FChildren_w.Fam.pdf.

Sedler,G.,Bruns,E.J.,Walker,S.C.,Kerns,W.E.,&Negrete,A.(2015).Developingaqualityassurancesystemformultipleevidence-basedpracticesinastatewideserviceimprovementinitiative.Administration,Policy,andMentalHealth,44,29-41.

Shaw,T.V.(2006).Reentryintothefostercaresystemafterreunification.ChildrenandYouthServicesReview,28,1375-1390.

Simon,J.D.&Brooks,D.(2016).Post-investigationserviceneedandutilizationamongfamiliesatriskofmaltreatment.ChildrenandYouthServicesReview,69,223-232.

Wells,M.&Correia,M.(2012).ReentryintoOut-of-HomeCare:ImplicationsofChildWelfareWorkers'AssessmentsofRiskandSafety.SocialWorkResearch,36(3),181-195.

Yampolskaya,S.,Armstrong,M.I.,Strozier,A.,&Swanke,J.(2017).Cantheactionsofchildwelfarecasemanagerspredictcaseoutcomes?ChildAbuseandNeglect,64,61-70.

Download - Sustainable Permanency Practices Brief March 2018 · The purpose of this research brief is to synthesize: 1) effective practices related to sustaining ... understanding barriers faced

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