Permanency Process to Ensure Quality and Timely Services are delivered to Children and Families

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1 Youthville is one of the largest, nonprofit child welfare agencies in Kansas, specializing in foster care, adoption, counseling, and psychiatric residential facility treatment (PRTF). The agency has more than 80 years of experience in helping children and families by providing child welfare services and clinical care. Youthville has over 600 employees, most of whom provide care for more than 1,400 children every day, and assist over 6,500 families each year. For more than 12 years, Youthville has been the state s contractor for Child Welfare Community Based Services (CWCBS) for Region 5 (Sedgwick County) Reintegration/Foster Care. During this time Youthville served over 5,800 children in the contract. Though Youthville holds the Region 5 contract Youthville has foster homes all across the state to serve these youth. Permanency Process to Ensure Quality and Timely Services are delivered to Children and Families Social and Rehabilitation Services (SRS) Investigates Allegations of Abuse and/or Neglect and Makes Recommendations to the Court- Service delivery begins after SRS has done an investigation and determined they believe the child should be removed from the home. After SRS has presented their findings to the court and if the court agrees the youth should be removed from their home, Youthville receives an intake referral from SRS. SRS Refers the Case to Youthville and Youthville Begins Assessing the Child s Needs and Provides Placement Recommendations to the Court- Permanency, ideally through reintegration, is the top priority of Youthville and is achieved through the delivery of quality family-centered services focusing on safety, stability, and the well-being of the child and family. Immediately after referral a Permanency Team is assigned to the case and contacts the child and parents to coordinate an initial team meeting. Simultaneously, the team is assessing the child s placement needs and looking for an appropriate placement for the child. Youthville s first priority is for the child to be placed with kin/relatives. However, Youthville cannot make this decision alone and the court system must approve of the placement with kin/relatives. Currently 21% of children are placed in relative homes. Permanency Plan Established Between Youthville and the Family- Assessment continues through the initial team meeting, as strengths and needs are discussed openly. Youthville and the family collaborate to explore two possible permanency tracks simultaneously to ensure permanency is not delayed. Youthville also works with parent advocacy groups and allows volunteers from those organizations to act as third party participants in this process. During these meetings, the Court Orders the family must abide by and the services mandated by the Court are also discussed. A plan is discussed with the family to determine how the family plans to achieve completion of the required court orders. Examples of a standard court order that parents would be required to complete are as follows: *Anger Management Classes *Clinical Interviews and Assessment *Individual Therapy *Parenting Classes *Family Therapy * Urine Analysis Testing *Psychological Evaluations Each of these services cost a significant amount of money. Most families have difficulty with the financial resources needed to complete the requirements. Often the completion of these requirements isn t completed as quickly as hoped, solely for lack of financial resources. During the creation of the permanency plan Youthville encourages the family to draw from their natural support network, which have sometimes become detached from the family. Youthville works with the family to reconnect that support system, which usually increases the families success to achieve independence from the child welfare system. Youthville staff also work to connect the family to any services needed. Once services are in place the families work toward completion of these services which are continually monitored and reassessed. Youthville Permanency Staff advocates on the child s behalf in court proceedings and provides the court recommendations about what they believe is in the best interest of the child. At the time permanency is achieved, Youthville staff continues to provide support to the child for an aftercare period of 12 months.

2 Foster Care Services to Children and Families Foster parents are people who provide all the things any parent should provide for their child such as shelter, food, clothing, medical care, a nurturing environment, and positive discipline. Foster parents serve as a child s substitute caregiver when a child cannot live at home. The vast majority of foster parents work outside the home in addition to being a foster parent. Foster parents are normal people who choose to provide this vital role in the life of children. To become a foster parent a person may be married or single, must be over 21 years of age, in good health, be able to financially provide for their own family, live in a house or apartment that passes Kansas Department of Health and Environment s (KDHE) licensing requirements, and be able to pass a Kansas Bureau of Investigation (KBI)/Child Abuse and Neglect (CANIS) background check. The process to become a foster parent generally takes between three and six months. Prior to caring for children foster families must obtain a minimum of 30 hours of training to provide basic foster care. To provide foster care to children needing more advanced care an additional 40 hours of training may be required annually. Youthville strongly believes that well trained foster parents provide a stable environment for children. In addition to the training requirements to become licensed by the State, Youthville also requires parents to receive training on Dr. Bruce Perry s Neruosequential Model of Therapeutics (NMT). NMT is a best practice approach that is based upon the impact that childhood trauma has upon the developing brain. The use of NMT promotes healing, increases placement stability, and helps children move past the traumatic events in their life to help them become productive citizens. NMT has been adopted as the clinical framework for all Youthville programs, allowing for coordination and continuity of care to all children as they receive services from different Youthville programs. In addition to receiving initial and on-going training, foster families also receive a bi-monthly stipend to help offset some of the cost of caring for children in foster care. The amount of stipend varies depending on the level of care the child requires. There are various levels of foster homes. As each level of foster care increases in acuity, the number of visits by their foster care worker, the number of services provided, and the supports the child needs also increase. Youthville Foster Homes Statewide Wichita Metro Area Foster Homes Beds Available in Those Homes

3 Adoption Services to Children and Families Youthville's believes that every child deserves a family, including the more than 900 Kansas children awaiting adoption. There are currently 300 children awaiting adoption through Youthville. In 2009 over 300 adoptions were finalized through Youthville. The parental rights of these children have been severed through the court system or relinquished by the birth parents. These children rely on their relatives, foster families, or families they have never met to open their hearts and homes. Youthville prepares families to become adoptive parents through its foster care program and the adoption unit. The children awaiting adoption in Youthville's care vary in age, ethnicity, and background. The process to become an adoptive parent includes attending the Permanence and Safety-Model Approach to Partnerships in Parenting (PS-MAPP) which takes approximately 5 months. Once approved, the matching process can begin, which can take an additional 9 to 18 months depending on the children eligible for adoption. Upon being matched with a child, the transition time is child specific and based on the strengths and needs of the child and the potential matched family. There is minimal expense to adopt a child from foster care. The potential family is financially responsible for any background check fees. The state will pay for attorney fees at finalization and many upfront adoption costs. Residential Treatment Services (PRTF and Secure Care) Youthville operates two residential treatment campuses. The Dodge City campus is a 57 bed Psychiatric Residential Treatment Facility (PRTF). The Newton campus includes a 56 bed PRTF and a 12 bed Secure Care facility. All residential treatment programs are accredited by The Joint Commission, certified by the Kansas Department of Social and Rehabilitation Services (SRS), and licensed by the Kansas Department of Health and Environment (KDHE). The Dodge City campus features animal-assisted treatment, a working farm and ranch, and specialty treatment for youth with problem sexual behaviors. The Newton campus features an expressive arts program. Both campuses offer on ground education through a partnership with local school districts. PRTF s provide comprehensive mental health treatment to children and adolescents who, due to mental illness, substance abuse, or severe emotional disturbance, can not safety be maintained in the community. The program is designed to offer a short term, intense, focused treatment to promote a successful return of the child to the community. Youth only remain in the PRTF setting as long as is medically necessary and then transition back to their family or a less restrictive community living situation. Youthville utilizes Dr. Bruce Perry s Neruosequential Model of Therapeutics (NMT). NMT is a best practice approach that is based upon the latest research regarding the impact that childhood trauma has upon the developing brain. The PRTF staff work to actively engage the child, their family, and other agencies to offer strengths-based, culturally competent, medically appropriate treatment designed to meet the individual needs of the resident. As a PRTF our primary purpose is to equip the youth, their family, their foster family, kinship placements, and the community with the necessary skills for the youth to be able to return to a family based setting quickly. To be eligible for this level of care the youth must be deemed to be at substantial risk of harming themselves or others, or a youth who is so unable to care for his or her own physical health and safety as to create a danger to their life; and the services can reasonably expected to improve the recipients condition so that the services will no longer be needed; and all other ambulatory care resources available in the community have been identified and if not accessed determined to not meet the immediate treatment needs of the youth. Youthville s newest service is a 12 bed female secure care program located on the Newton PRTF campus. This service provides assistance to youth who have been adjudicated children in need of care and need to be served in a fully secure residential facility. These youth are generally not dangerous to self or others, but have been court ordered to be held securely, often times because they have a history of running from other placements. Youthville s program is the only secure care program in the State of Kansas for female youth. This service fills a critical need in the continuum of care. These youth are offered individualized services to meet their specific needs and are held securely awaiting further court action.

4 Kansas Outcomes The Kansas child welfare system ranks very positively when compared with other states child welfare outcomes. The data to compile these rankings is based upon standardized reporting definitions required to be reported to the federal government on the Child and Family Service Reviews (CFSR s). The CFSR s enable the federal government to: (1) ensure conformity with Federal child welfare requirements; (2) determine what is actually happening to children and families as they are engaged in child welfare services; and (3) assist States to enhance their capacity to help children and families achieve positive outcomes. All outcomes are in place to measure child welfare system effectiveness in the following areas. How Kansas Compares Nationally The Kansas child welfare system ranks 6 th nationally when all CFSR 2 nd round child welfare outcomes are averaged. Outcome 1, Safety- Children are, first and foremost, protected from abuse and neglect. The Kansas child welfare system ranks 2 nd nationally. Outcome 2, Safety- Children are safely maintained in their homes whenever possible and appropriate. The Kansas child welfare system ranks 8 th nationally. Outcome 1, Permanency- Children have permanency and stability in their living situations. The Kansas child welfare system ranks 4 th nationally. Outcome 2, Permanency- The continuity of family relationships and connections is preserved for families. The Kansas child welfare system ranks 1 st nationally. Outcome 1, Well Being- Families have enhanced capacity to provide for their children's needs. The Kansas child welfare system ranks 1 st nationally. Outcome 2, Well Being- Children receive appropriate services to meet their educational needs. The Kansas child welfare system ranks 12 th nationally. Outcome 2, Well Being- Children receive adequate services to meet their physical and mental health needs. The Kansas child welfare system ranks 7 th nationally.

5 Privatization Facts Privatization by the State of Kansas started in 1996 after a lawsuit was filed by the ACLU on behalf of children in the foster care system due to very poor outcomes. Currently the funding structure is based on a fixed and variable case rate whereby there is a fixed amount given to each contractor every month regardless of total census, as well as a variable rate which is a specific case rate paid for each child in the contract. Contracts are risk based and require specific outcomes. However, there are many external factors influencing performance; namely the court and mental health systems. Differences in the Systems Parents have more visits with their children Children get to see their siblings more often Children have more contact with their case workers Time away from family has decreased Workers are assigned to a specific type of case, which equals specialized care The plan of care is developed by the family and worker as a team More children are placed Prior to Privatization Once per month minimum required, often in an office environment. Once per quarter, minimum requirement. Infrequent, often not assigned a specific worker. Averaged over 4 years to permanency. Workers were handling all aspects of case including Investigation, Family Preservation, Foster Care, and Adoption. Case Plan developed by worker and given to family. Over 30% of children were living in a residential facility. Today at Youthville Once per week minimum required, with interactions occurring often in the home and at times which maintain the family s culture and traditions. Twice per month minimum requirement, at Youthville often more frequent. The child s assigned worker visits the child in their home at least once per month. Average under 2 years to permanency. Youthville has special units, which creates lower caseload ratios, leading to more intense services being provided which increases the speed at which a child gains permanency. Plans are developed collaboratively with direct family input about the services and needs they see for the family and the child. Statewide and in Youthville s region, Region 5, around 6% of children are living in a residential facility. in a family setting Evidenced Based Practices Not required. Mandated through contract. Youthville has implemented Structured Decision Making, which is a well known evidence based assessment being used in 16 states and around the world. Additionally Youthville has implemented Dr. Bruce Perry s Neruosequential Model of Therapeutics (NMT). NMT is a best practice model which addresses childhood trauma to promote healing to help the child move past the traumatic events in their life to be successful. NMT has been adopted as the clinical framework for all Youthville programs. Refusal of Services Availability Providers could refuse to provide prevention or placement Service delivery and support by SRS direct line staff was limited to business hours of 8 to 5. No eject/no reject contractual provisions ensure all children are served. Youthville provides services 24 hours a day 365 days a year to children and families in crisis. MYTH! Costs are higher in today s system than prior to privatization. Before Privatization After Privatization Number of children in foster care 5,693 in ,259 average per year 2005 to 2009 Finalized adoptions, indicator of higher overall permanency rate FFY FFY FFY (253 of those facilitated by Youthville) *At the time of privatization where was not an accurate system in place to monitor the true cost to the State of Kansas for providing these services. The initial reports of costs were very low. This caused one agency to go out of business completely and Youthville to go into bankruptcy. Prior to privatization, SRS did not have explicit child welfare performance measures to be used as a benchmark. Without any benchmarks comparisons of performance pre-and-post partnership are difficult. Additionally, data from pre-privatization includes both Juvenile Offender (JJA was established as a standalone agency in 1997) and Child in Need of Care (CINC) populations preventing reliable comparison of exclusively the CINC population.

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