Community Support for Families - Lessons Learned From an Interactional Perspective

Transcription

1 CONNECTICUT s Community Support for Families Program Lessons learned from an Interactional Perspective Christine Lau MSW Department of Children and Families Tina Jefferson MSW Department of Children and Families Rachel Marotta BA Department of Children and Families Kimberly Nilson MSW Department of Children and Families Marcy Kane PhD Wellmore Behavioral Health Victoria Bosse PsyD, LMFT Wellmore Behavioral Health Lillanya Gray MSW University of CT Performance Improvement Center

2 INTRODUCTIONS

3 LEARNING OBJECTIVES Overview of collaboration established among the child welfare agency, Community Partner Agencies, and the Performance Improvement Center that led to successful implementation of the Community Support for Families program Review of Family Satisfaction and experiences around family engagement

4 DCF F A M I L I E S CSF PIC

5 Community Partner Agencies (CPAs) Wheeler Clinic Village for Families and Children Wellmore Behavioral Health Wheeler Clinic Community Health Resources Child and Family Guidance Center CommuniCare, Inc Clifford Beers Guidance Clinic

6 CT Facts DCF: Legislative mandates include prevention, child protective services, childrenʹs behavioral health, and juvenile justice Annual operating budget of approximately $810 million Provides contracted as well as direct services through a central office, fourteen (14) area offices, and two (2) facilities psychiatric and juvenile training school State administered system, divided into 6 regions Centralized operation (Careline) for reporting abuse/neglect Operating under a Consent Decree since 1991 as a result of a Class Action Law Suit CT s major cities have some of the highest rates of child poverty in the nation (Bridgeport: 28%, Waterbury: 28%, Hartford: 46.1%, and New Haven: 34.1%)

7 CT Department of Children and Families Data

8 Accepted Reports by Year *FAR started March 2012 **Data through September 29, 2014

9 Substantiated Allegations by Type

10 DRS Implementation Why? Component of our Strengthening Families Practice Model Move to more Family centered practice Customize response to: Ensure child safety Promote child and family well being Better meet the needs of families Decrease rate of repeat maltreatment Reduce likelihood of families being re referred to DCF Reduce the number of children entering care

11 DRS Implementation Primary allegation neglect (2011, 87.8%) Traditional investigation are ineffective in engaging families where neglect is identified issue Key predictor of future maltreatment is previous referral to CW agency (~80% investigations are families with prior history)

12 CT s DRS INTAKE Family Assessment Response (FAR) lower risk reports Investigations higher level of risk

13 Family Assessment Response (FAR) Implemented DRS March 5 th 2012 Accepted CPS Report meets statutory definition of abuse/neglect 72 hour response time (lowest risk response time available) At time of implementation 15 Rule Out Criteria applied at Careline to determine track Track can be changed from FAR to Investigations based on safety concerns In June 2014, reduced to 5 Rule Out Criteria to increase population receiving FAR and access to CSF Track determination based on face to face contact with family rather than presenting allegations at time of call

14 FAR s Process Use of Structured Decision Making (SDM) to help inform critical decisions throughout the life of a case Screening and Response Priority Tools at Careline Safety and Risk Assessment (FAR/Investigation) Assessment of the family s Protective Factors No formal determination no victim or perpetrator identified no finding Assess level of need and familyʹs willingness to engage in services Transition Meeting (client is transferred to CSF and DCF case is closed) No information is shared about the family s progress, level of cooperation following Transition Meeting

15 FAR Data 25,500 FAR cases completed 7,755 (30%) had a subsequent report 3,772 (49%) FAR 3,983 (51%) Investigations Data as of 10/24/14 1,190 (30%) substantiated 816 (20%) out ofhome placements

16 Response Track Change Report by Month: March 2012 through October

17 100% Report Activity by Response Type Annual Totals 90% 80% 70% 60% 72.4% 63.1% 60.6% 50% 40% 30% 20% 27.6% 36.9% 39.4% 10% 0% 2012 Total 2013 Total 2014* Total FAR Intake *Through 10/15/2014

18 Community Support Families Program

19 TIMELINE September 2011 Plan to fund 6 Community Partner Agencies March 2012 DRS rolled out statewide April 2012 Contracts executed July 2012 Expansion to add 2 Community Partner Agencies

20 CT CSF Established partnerships through a competitive procurement process with 7 Community Partner Agencies to cover 6 regions. (Two regions have 2 providers). Region 1 Child and Family Guidance Center Region 2 CommuniCare, Inc. Region 2 Clifford Beers Guidance Clinic Region 3 Community Health Resources Region 4 Wheeler Clinic Region 4 Village for Families and Children Region 5 Wellmore Behavioral Health Region 6 Wheeler Clinic Established MOA with University of CT School of Social Work to function as the Performance Improvement Center (PIC)

21 Eligibility Criteria to CPA Recommended Case Dispositions Safety Risk Case Disposition SAFE Very Low High Recommended for transfer to the Community Partner Agency. Transfer is predicated on the family s willingness to receive services from contracted provider. Family has multiple needs that can best be met by the Program.

22 Voluntary Family driven Individualized Parenting education Community Support for Families Utilizes Wraparound process

23 STAFFING MODEL Community Support Workers conduct Family Team Meetings provide case management services/care coordination help the family develop their plan of care Assess needs of the family refer the family to needed resources/services in their community Help build network of supports

24 STAFFING MODEL Parent Navigators assigned based on complexity of need Mentor, advocate, engage and empowers the family Staff/Advocate Partnership Provide support to families to connect to the needed resources in their community Participate in trainings and meetings to create team approach

25 THE PROGRAM Families must be willing to engage in services and meet eligibility criteria Each Office has an assigned Gatekeeper to review and approve referrals Outcomes collected around rates of family engagement, access to community services, satisfaction, and subsequent DCF referrals Involvement ranges from 30 days up to 6 months based on family s level of need Each Community Support Worker maintains a maximum of 12 cases

26 CORE COMPONENTS Builds a network of community supports and resources Family Satisfaction Survey completed to help evaluate outcomes DCF/CPA Transition Meeting Family Team Meetings Connects families to concrete, traditional and non traditional resources and services in their own community Program promotes independence and facilitates permanent connections for families on an ongoing basis or in times of need Strengthening Family Protective Factors Survey Ongoing assessment of family needs Assists the family in developing solutions that mitigate safety concerns, reduce risk, and meet the needs of their family

27 PROTECTIVE FACTORS FRAMEWORK Nurturing and Attachment Knowledge of Parenting and of Child and Youth Development Parental Resilience Social Connections Concrete Supports for Parents

28 Focus of Intervention Caregivers Enhancing Social Supports Resource Management, supporting basic needs Coping Skills/Behavioral Health support Parenting education and support Household Relationships Substance Abuse issues Physical Health

29 Services Families Receive During CSF Advocacy Parenting skills, education, and support Housing (Connection to landlords, funding for Security Deposits..) Referrals to local Support Groups Utilization of Natural Supports Referrals and/or fund Recreational Activities Referrals for Mental Health Services child Referrals for Substance Abuse Treatment Programs Educational Training/Services/Supports Employment Services Referrals for Early Childhood Programs/Services Referrals to Recovery Supports, Faith based Organizations, Care Coordination, Transportation, Food Assistance, and Legal Services

30 VIDEO

31 Building Partnerships: DCF CSF Meet and Greet Opportunities Shadowing Joint Training Opportunities Testimonials from Parents Regional Meetings with CSF/DCF Staff Monthly Provider Meetings: DCF/CSF/UCONN to address implementation issues Area Office/Regional Gatekeepers Posting of CSF staff in area offices Semi Annual Meetings to share data, share successes, and develop strategies to address challenges Community Presentations Building community resources

32 Understanding What Works for DCF Regular meeting times Regular re education to service and eligible families Build and re build trust Designated FAR workers CSF Project Coordinator Continuous QI, problem solving Informational meetings pre referral Transition meetings Adjusting to DCF workers schedules/needs Gatekeepers and solid referral processes

33 UCONN PIC MOA executed outlining scope of work Quality Improvement Data Analysis/Evaluation Individual site visits to build relationships Receive quarterly extracts of DCF data All providers enter client level data caregivers/children (PSDCRS data) Receive quarterly PSDCRS extracts Participation in CSF/DCF Meetings Develop statewide and site specific reports Focus past two years: Data Quality

34 IMPACT of FAR

35 CSF Data 86.7% of families referred to program accepted services 95.8% of those referred established a Plan of Care 2,590 families and 4,960 children served since implementation Subsequent reports during (23.3%) and after (28.8%) CSF Statewide average Length Of Service is 4.5 months

36 Top 5 Family Needs : Assessed / Addressed

37 Wraparound Funding Paid Basic Needs $690,067 Recreational Activities $88,876 Behavioral Health $19,967 Education $26,997 General $21,933 Total $847,841

38 Family Satisfaction Survey Response Rate: 58.8%

39 Lessons Learned Low volume of referrals to CSF Unfamiliarity with the program Trust no information shared, typically keep cases open in ongoing services Identifying appropriate referrals In 2013, conducted FAR Case Reviews which prompted changes in policy and practice Inequity of Case Assignments in number and intensity (investigations and FAR) Staffing issues initially designated FAR staff, now all staff handle both FAR/Investigations High level of need in families substance abuse, domestic violence, mental health Access to community services limited without DCF open case Basic Needs Housing need SIGNIFICANT DCF/CSF Data Quality issues refine definitions ongoing

40 We d like to acknowledge and thank those that helped with today s presentation.. Ernest Cloman Anthoney Lilley Shauna Goodwin Heather Thomas Julie Flemming Oretha Harris Rosemary Wieworka Joshua Pierce Kenza Moubchir

41 salamat merci danke gracias paldies takk falemnderit Thank you! Department of Children and Families Child and Family Guidance Center CommuniCare, Inc. Clifford Beers Guidance Clinic Community Health Resources Wheeler Clinic Village for Families and Children Wellmore Behavioral Health University of CT School of Social Work

42 Contact Information Kimberly Nilson MSW Program Manager CT Department of Children and Families Marcy Kane PhD Vice President of Child Services Wellmore Behavioral Health Lillanya Gray MSW Project Manager UConn School of Social Work