California Independent Living Program Transformation Breakthrough Series Collaborative Appendices California Department of Social Services * County Welfare Directors Association Administrative Office of the Courts * Annie E. Casey Foundation * Casey Family Programs Stuart Foundation * Walter S. Johnson Foundation * Zellerbach Family Foundation In Partnership with Child and Family Policy Institute of California New Ways to Work 1
Appendix A -- Change Package The Challenge The transition to adulthood and economic independence can be challenging for any adolescent and generally occurs over many years, with substantial support from family and friends. In fact, about half of youth ages 18-24 in the United States live at home and nearly two-thirds of young adults in their early 20 s receive economic support from their parents. In contrast, when youth in foster care turn 18, they transition out of the system, often with only minimal preparation for life on their own, without the ongoing supports that would support them in becoming happy, productive adults. California has approximately 25,000 foster youth 1 who are 15 years and older in probation and child welfare-supervised foster care. Children and youth of color are disproportionately represented in this foster care population. These youth, who are Black, Native American and Hispanic, are placed in out-of-home care at rates that are higher than their numbers in the community, and at rates much higher than white youth entering the foster care system. In 2006 there were 9,988,199 children residing in California, and 74,508 in out-of-home care. Black children made up 6.3% of the child population, yet represented 27.7% of children in out-of-home care. Native American children made up 10.2% of the child population and represented 2.3% of the children in out-of-home care. Hispanic children made up 49.9% of the child population and 42.8% of children in out-of-home care. White children made up 33.1% of the child population and 25.9% of children in out-of-home care. i But these numbers understate the magnitude of the issue. National studies have shown that children and youth of color become increasingly over-represented in the foster care population as they progress through child welfare decision-making processes, staying in placement longer and achieving permanency with families at much lower rates. And research reveals that there are disparities in the services and supports these youth of color receive, including fewer and lower quality services, fewer foster parent support services, fewer contacts by caseworkers, less access to mental health services, less access to drug treatment services, and higher placement in detention or correctional facilities, contributing to poorer outcomes than white youth as they leave the system ii. Once emancipated from the system, these foster youth will face daunting odds. Research has shown that over half of youth aging out of foster care have not graduated from high school, 25% have become homeless at least once, and nearly 60% are unemployed 12-18 months after leaving the system. Many suffer from post-traumatic stress disorder, and too many leave the system without any connection to an adult, family or community. iii Counties and their Independent Living Programs (ILP) in California, aware that data indicates that many foster youth are not being adequately prepared for and supported into adulthood, have been involved in a great deal of discussion on the need to provide transition services, including Independent Living Program services, in an effective and efficient manner. As a result of these discussions along with the system improvement efforts of a variety of public, private, philanthropic, caregiver, and advocacy partners, along with foster youth themselves -- an impressive array of programs and services to improve foster youth outcomes has emerged at 1 ILP serves youth in both child welfare and probation-supervised foster care; therefore, the term foster youth is used inclusively throughout this Change Package to refer to both populations. 2
both state and county levels during recent years. These initiatives, programs, and services generally promote shared responsibility and integrated services across multiple systems touching the lives of foster youth, including Education, Workforce, Health/Mental Health, Child Welfare, Probation and Caregivers/Placement Homes. Though teamwork and cross-system service delivery is considered essential in improving outcomes and successfully preparing California foster youth for transition, these system improvements currently reach only a small portion of transition aged foster youth, and challenges to integration and statewide implementation remain. Independent Living Programs have an important role to play in leveraging the resources and services of these systems, providing the leadership and operational support to provide connections between and the alignment of the services, supports, and opportunities available in a community rather than attempting to provide a comprehensive set of services through ILP alone. Background and Overview California was one of six states chosen to participate in a National Governor s Association (NGA) Policy Academy on Youth Transitioning out of Foster Care. The Academy, which ran from June 2006 through December 2007, provided a unique opportunity for teams of state leaders to work with national and state experts to help improve outcomes for youth transitioning from foster care to adulthood. California s NGA team, under the leadership of the California Department of Social Services, brought together a broad representation of state leadership, partners and advocacy organizations including the Employment Development Department, California Workforce Investment Board, Education/Foster Youth Services, Mental Health, Community Colleges, County Welfare Director s Association, Child and Family Policy Institute of California, California Youth Connection, Casey Family Programs, California Permanency for Youth Project, New Ways to Work, California Connected by 25, CASA, First 5, and others. Most importantly, the NGA team incorporated input and recommendations from youth through the advocacy of the California Youth Connection (CYC), recognizing that foster youth are the experts of how the system operates and whether or not their needs are being met. Change to the foster care system without input from foster youth themselves would drastically inhibit the positive outcomes the collaboration set out to create. Through an inclusive inter-disciplinary process focused on addressing the challenges faced by transition aged foster youth, the NGA Policy Academy for Youth Transitioning Out of Foster Care provided an opportunity to assess current efforts in California, make recommendations, and implement change to systematically address key challenges and improve transition outcomes. This process resulted in a new vision for California s Independent Living Program. The NGA Team s new vision for permanency and transition programs and services Supports young people themselves are at the heart of the planning and decision-making process. Engages caregivers and service providers as critical partners to the success of permanency and transition services Emphasizes Permanency, Education, and Employment preparation that is integrated into every aspect of a youth s daily life, rather than offered as training in single session workshops and activities. Envisions a broad array of integrated, relevant, developmentally appropriate services, supports, and opportunities individually planned to meet each youth s needs. Provides that transition services are community-based, leveraging resources and opportunities and integrated across a range of public and private systems. 3
The Breakthrough Series Collaborative ( BSC or Collaborative ) methodology was identified as an effective approach that could help counties in California translate NGA s recommendations and vision into action, with a goal of redefining and reshaping programs and services promoting permanency and preparation for adulthood that is developmental in nature and related to an age group much broader than the age range currently served by ILP programs in California. Collaborative Mission The mission for each participating team in this BSC is to ensure every foster youth achieves: Permanency every youth has lifelong connections with family and supportive adults; Education every youth receives a quality education, high school diploma, and support in pursuing postsecondary opportunities; and Employment every youth has work experience and training opportunities that prepare them for and place them in living wage employment and careers. Participating teams will work to achieve these youth-centered goals by focusing intensively on the following system-level goals: Youth-Centered & Youth-Adult Partnerships - developing relationships and partnerships with and engaging youth in all aspects of transition planning, decisionmaking and implementation; Engagement of Supportive Adults and Community caregivers, and other supportive adults and community members hold high expectations, provide opportunities, play meaningful roles in planning and supporting early and continuous preparation for and supported transition to successful adulthood for youth; and Using a Collaborative & Integrated Approach in Practice collaborative service, supports and opportunities for youth are provided early and continuously to provide successful transition to adulthood. Partner with Youth in Shared Leadership supporting youth in leadership and mentoring roles Within this mission, service systems will take on collaborative responsibility to coordinate and integrate cross-system services and supports into the day-to-day case management, caregiving, education, and other community-based activities, services, and supports for foster youth. This approach will require that young people are consistently and meaningfully involved in developing and implementing individual plans to help them attain their goals, while simultaneously developing key life skills and strengthening community and permanency connections not only beginning at the age of 15.5, but at an early age and as a continuous developmental process. As a result of this coordination and integration, youth will know that adults and organizations value and care about them, and that their input, goals and dreams are not only respected, but are fundamental in the planning of their own futures. Framework The ILP Breakthrough Series Collaborative Framework highlights a comprehensive set of changes that when packaged together will result in a system that achieves dramatically 4
improved outcomes for the youth being served. In order for participating counties to ensure permanency, education and employment goals are achieved, there are ten key themes that must be addressed and serve as a framework for organizing and guiding the practices that will be tested as part of this BSC. Although these ten themes are presented as separate and distinct, they are intricately related and there is a synergistic effect when working across all of the themes. It is essential for participating teams to consider each theme in this framework independently, as well as to consider the framework as a whole and how each theme strengthens, is connected to, and supports the others. There is no one-size-fits-all or magic bullet solution to this complex challenge, thus the framework is intentionally descriptive rather than prescriptive. This framework sets out merely to describe the quality and collaborative approach that is needed to achieve this transformation, while allowing participating teams to implement the approach using strategies that will meet the needs of local foster youth within the county context, partnerships and resources. The first section, Youth-Centered & Youth-Adult Partnerships, includes the fundamental shift that youth voice brings to the table that our services and interventions focus on youth and be driven by youth. It further highlights that youth have and need from others high expectations and aspirations, that they are allowed the opportunity to develop lifelong relationships, and are engaged as partners in planning, decision-making and leadership. The second section, Practice Priorities, includes the three fundamental themes for ILP transformation as identified by the NGA Policy Academy focused on specific practice priorities. Teams will test strategies specific to permanency, education and employment and implement new practices that encourage high goals and aspirations, provide experiential learning, community-based opportunities and an individualized, supported pathway to success. In section three, Partnership and Integrated Practice, includes two themes that cross-over all of the other sections and focus on the interplay, integration, and coordination between them. These themes intentionally focus on breaking down the silos that might otherwise exist. Teams will test strategies that focus on engaging and empowering those who are at the center of this work, coordinating planning, leveraging teamwork by child welfare and probation casemanagers, caregivers, families, communities, agencies and youth themselves in order to offer a rich array of transition opportunities, experiences and supports to meet the individualized needs of children and youth in care and transitioning foster youth. The final section, Spread and Sustainability, includes four themes that will be addressed by each team, the county, and the county leadership throughout this BSC. Each team will identify creative ways to ensure that local practice improvements developed through the practice changes tested in the first three sections ( Youth-Centered and Youth-Adult Partnerships Partnership and Integrated Practice and Practice Priorities ) are fully implemented, spread throughout the county, and sustained over time. 5
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A.I Youth-Centered and Youth-Adult Partnerships I.a Nurturing self-confidence and affirming youths identities with focus on youths individual race, culture, ethnicity, sexual orientation, and gender identity I.b Addressing physical and emotional health I.c Developing lifelong relationships and trust with youth including demonstrated respect and sensitivity(or responsiveness) to race, culture, ethnicity, sexual orientation, and gender identity I.d Engaging youth to self-identify their goals and/or aspirations, then developing a plan to attain those goals I.e Partnering with youth for planning and shared decision-making I.f Identifying, recruiting, and supporting youth to play active leadership roles in staff training and system change efforts B. Practice Priorities B.II Permanency: Developing and Supporting Permanent Connections with Family and Supportive Adults through Active Engagement with Youth II.a Continuously exploring a range of options for permanency from reunification through adoption in culturally sensitive and responsive ways II.b Finding and supporting culturally sensitive and responsive connections through active engagement of youth, caregivers and extended family or community II.c Preparing youth for connection/reconnection to family of origin II.d Engaging natural helping networks in order to form lasting connections to community and community supports II.e Respecting race, culture, ethnicity, sexual orientation, and gender identity in the pursuit, development, and support of permanent connections II.f Using the court process to reinforce efforts to accomplish these sub-themes B.III Education: Pursuing and Supporting High-Quality Education, High School Diplomas, and Post-Secondary Education III.a Conducting early and ongoing high-quality and holistic assessments of strengths, challenges, needs, current level of achievement, and academic goals and dreams in culturally sensitive and responsive ways III.b Promoting school stability and eliminating barriers (e.g. school transfers, transcripts, transportation) III.c. Providing quality in-school and out-of school interventions for youth based on self-identified and assessed needs III.d Encouraging post-secondary plans, goals, aspirations, and preparedness from an early age and providing sustained support to achieve educational goals with a focus on youths individual race, ethnicity, and culture III.e Promoting access to, enrollment in, and retention/success in post-secondary education with a focus on youths individual race, ethnicity, and culture B.IV Employment: Preparing Youth for and Supporting the Transition to Living Wage Employment and Careers IV.a Conducting initial and ongoing assessments of skills, goals, career aspirations, strengths, challenges, needs, and employment goals and dreams in culturally sensitive and responsive ways IV.b Preparing and supporting youth in a developmental continuum of career awareness, exploration, and preparation activities within the community with a focus on youths individual race, ethnicity, and culture IV.c Ensuring that youth participate in real world exposures and work experiences 7
in areas of interest for all youth prior to leaving care, starting in the early teens and building a developmental sequence regardless of youths individual race, ethnicity, and culture IV.d Promoting access to, enrollment in, retention/success in post-secondary education, occupational training, career technical education, internships, apprenticeships, and other career pathway education and employment opportunities leading to living wage employment and careers regardless of youths individual race, ethnicity, and culture C. Partnership & Integrated Practice C.V Engaging Supportive Adults and the Community V.a Supporting all adults in holding high, accountable expectations with all youth and themselves V.b Developing sustainable relationships and trust among partners through continuous demonstrated respect and responsiveness to each others race, culture, ethnicity, sexual orientation, and gender identity V.c Supporting caregivers and adults to function as transition mentors and guides. V.d Providing opportunities, experiences, and supports for youth to engage in leadership/civic roles and volunteerism in the community V.e Supporting older youth in care and former foster youth in serving as mentors and guides for children and youth in care C.VI Using an Integrated and Collaborative Approach to Transition Reflected in Every Aspect of Practice, Including Permanency, Education, and Employment VI.a Effectively aligning caregiving activities, case-management activities, and life skills preparation and connecting services, supports, and opportunities across all appropriate agencies and programs to support successful transitions VI.b Identifying, coordinating, and integrating early and ongoing aligned assessments of interests, strengths, and needs VI.c Synthesizing assessments, information, strengths, needs, goals, and dreams into a single, integrated, coordinated youth-led and youth-centered case plan and approach across agencies and programs. VI.d Integrating permanency, education and employment values, services and supports through day-to-day case-management activities, inter-agency coordination and court interventions. D.VII Providing Shared Agency and Community Leadership in Integrated Transition VII.a Creating a common understanding and language of transition issues and establishing a shared vision for youth with all partners, including youth, caregivers, community, courts, agency, and media VII.b Building community awareness of and investment in improving outcomes for transitioning youth VII.c Recruiting champions and assuming responsibility for adopting and implementing quality approaches within all levels of the organization VII.d Coordinating policies across systems to embed new practices, including issues of confidentiality VII.e Promoting a culture of innovation to support small tests of change 8
D. Spread and Sustainability D.VIII Using Data with Diverse Audiences to Ensure Improvement VIII.a Collecting and sharing timely results based on youth outcome data, including permanency, education, and employment VIII.b Actively soliciting, obtaining, and sharing data on youths perceptions of being respected and valued by partners working together to assist in their transition VIII.c Partnering with youth in the collection and use of data VIII.d Sharing results with all involved partners and the community in ways that are meaningful and respect confidentiality VIII.e Involving all partners, especially youth, in interpreting results and designing continuous quality improvements that are data-driven D.IX Ensuring Appropriate Services and Supports IX.a Providing access to relevant services readily available and accessible in the community, including housing. IX.b Ensuring equitable access to services and supports to eliminate disproportionality and disparate outcomes in services/supports and outcomes IX.c Leveraging partnerships and resources, eliminating duplication, and improving utilization of available resources IX.e Strengthening the role of the court in promoting collaboration, shared responsibility and accountability for transition planning, services and outcomes IX.f Establishing policies and formalized agreements across systems to ensure sustainability and access to all appropriate services and supports. D.X Maintaining and Supporting a Qualified, Competent, and Well-Trained Workforce to Implement Practice and Culture Changes X.a Recruiting staff from communities from which children, youth, and families come X.c Training, supporting and supervising all staff, including case management social worker and probation officers, to ensure culturally responsive skills and competencies X.d Training, supporting and supervising all staff, including case management social worker and probation officers, to ensure priority of youth permanency, education, and employment practices, systems and resources. X.e Training, supporting and supervising all staff, including case management social workers and probation officers, to ensure transparent, cross-system partnerships, protocols, and integrated permanency transition practice. X.f Training, supporting and supervising all staff, including case management social worker and probation officers, to ensure collaboration skills X.g Training, supporting and supervising all staff, including case management social worker and probation officers, to ensure understanding of core practices such as grief and loss X.h Partnering with current and former foster youth in a variety of roles including trainers, advocates, mentors, and staff 9
Glossary This glossary is intended to clarify what the BSC staff and faculty mean when they use certain words and terms. We recognize that different places and people may have different meanings for some of these words. This glossary is by no means intended to be the final word on what these terms mean or how they feel in action. We encourage individual teams to work together to develop their own definitions that best meet their needs. Assessment: Gathering, examining, and using the facts of a situation to make decisions. In child welfare, assessments may be made to: Determine and Understand the strengths and needs of a youth, family, parent, or community. Decide if the agency needs to take action to protect a child (safety assessment); or Decide the chance that a child may be hurt or neglected in the future (risk assessment). Breakthrough Series Collaborative: The joining together of teams who are all working on practice improvements in a particular area. It involves trying many small changes in practice to see if they produce better results for larger change. Teams measure their work so that they can continue with changes that work, and stop doing those that don t. Community: People and families who live near each other or who have something else in common. Cross-system partners: Other agencies and community groups who work with the same children and families as child welfare does. This includes schools, doctors and hospitals, and courts. Culturally responsive: The ability of individuals and systems to respond respectfully and effectively to people of all cultures, classes, races, ethnic backgrounds, sexual orientations, and faiths or religions in a manner that recognizes, affirms, and values the differences of individuals, families, tribes, and communities, and uses each other s cultural strengths to improve results. Disparity: Refers to unequal treatment or services (types, quality, and quantity of services available) resulting in less positive outcomes for one group than another group. Disproportionality: Refers to a situation in which a particular racial/ethnic group of children is represented in foster care at a higher percentage than their numbers in the general population. It also refers to a situation in which a particular racial/ethnic group experiences poorer outcomes when transitioning out of foster care compared to other racial/ethnic groups. For example, in 2000, black children made up 15.1 percent of the children in this country but 36.6 percent in the child welfare system. Youth-centered practice: Meeting youth where they are; practice recognizes the strengths of the youth and builds on these strengths to achieve optimal outcomes for youth and families; engaging youth to identify and develop a plan to achieve their goals, hopes and dreams. Family driven: Families have a primary decision-making role in the care of their own children as well as the policies and procedures governing care for all children in their community, State, Tribe and nation that includes: choosing supports, services and providers; setting goals; 10
designing and implementing programs; monitoring outcomes; partnering in funding decisions; and determining the effectiveness of all efforts to promote the well-being of children and youth Kin: Maternal and paternal relatives (through blood, adoption, or marriage), tribe or clan members, godparents, stepparents, or any adult who the child, youth, or family recognizes as having a significant bond with them. Kinship care: A type of out-of-home care in which the full-time care of the child is provided by relatives, godparents, stepparents, or other adults who have a kinship bond with the child. This could include a close friend, a neighbor, or a member of a child's Tribe. This is also called "relative care." Children may be placed formally in homes of relatives by the courts (kinship foster care) or they may be placed informally on a voluntary basis by the parent or guardian. Safety: Absence of an imminent or immediate threat of moderate-to-serious harm to the child. http://www.childwelfare.gov/admin/glossary/glossarys.cfm Strength-based: A perspective that emphasizes an individual or family's capabilities, support system, and motivation to meet challenges. Looking at a person s or family s strengths, not their weaknesses. http://www.childwelfare.gov/admin/glossary/glossarys.cfm Participating jurisdictions Child welfare or tribal social service agencies and partnering courts that take part in this BSC. Permanency: Permanency is both a process and a result that includes: The involvement of the youth as a participant or leader in the process; A safe, stable and secure parenting relationship Love, unconditional commitment Lifelong support in the context of a legal relationship if possible; The opportunity to maintain contacts with important persons, including siblings. iv Permanency and Transition programs and services: Programs and services operated by the county agency and its partners to support youth s positive outcomes in permanency and transition out of foster care. Examples include ILP services, workforce development programs, education services, lifeskills mentoring, permanency development programs. Resource Family: Includes kin, foster parents, legal guardians, or adoptive parents. Reunification: The process of reuniting children in foster care with their families and reinstating custody of the children to their parents/guardians. Reunification continues to be the preferred permanency option, when it can be done in a safe and timely manner. http://www.childwelfare.gov/admin/glossary/glossaryf.cfm#family_reunification Well-being: How well a child s schooling, health, and mental health needs are being met. 11
Acronyms NGA: National Governor s Association CYC: California Youth Connection CFPIC: Child and Family Policy Institute of California CFP: Casey Family Programs WSJ: Walter S. Johnson Foundation Co-Investment Partnership: The California Independent Living Program Transformation BSC is a project of the California Child Welfare Co-Investment Partnership, whose purpose is coordinating investments and approaches to substantially improve child welfare outcomes of safety, permanency and well-being in California. Key stakeholders who comprise the Co- Investment Partnership include the California Department of Social Services, County Welfare Directors Association, Administrative Office of the Courts, Annie E. Casey Foundation, Casey Family Programs, Stuart Foundation, Walter S. Johnson Foundation, and the Zellerbach Family Foundation. ILP/ILS: Independent Living Programs/Independent Living Skills BSC: Breakthrough Series Collaborative BSC Leadership Team: The Leadership Team represents key stakeholders within California who serve as the key decision-making body for the BSC. BSC Faculty: Faculty represent key stakeholders in the designated practice areas who are practice experts who are called upon to listen to teams and share their expertise and experience. 12
Appendix B -- About the Breakthrough Series Collaborative (BSC) Methodology The BSC methodology was developed in 1995 by the Institute for Healthcare Improvement (IHI) and Associates in Process Improvement (API). This quality improvement method has been used extensively in the field of health care for more than ten years. The IHI has led BSCs in over 25 different topic areas, including reducing delays and waiting times in emergency rooms; reducing Caesarean section rates; improving end-of-life care; and improving critical care. In 2000, Casey Family Programs (CFP) joined with the IHI to learn and adapt the BSC methodology for child welfare. Since that time, CFP has sponsored and led BSCs on six different topics and many child welfare jurisdictions have launched their own BSCs to address key issues in their agencies. The BSC is a specific quality improvement method designed to enable participating teams to make dramatic improvements in a focused practice topic over a short period. The intention of a BSC is not to create an entirely new body of knowledge. Instead it is intended to fill the gap between what has been identified as best practice and what is actually practiced in the field. Often, particularly in public agencies, policies already reflect these best practices. But for many reasons, these practices are not always being implemented in the field. The key to a BSC is using a variety of techniques to bridge this gap between what is known and what is done. There are several critical characteristics of the BSC methodology that help agencies quickly test and then fully implement these practices in ways that are appropriate for the individual agency as well as sustainable over time. 1) All BSC work is grounded in a comprehensive Change Package -- Each BSC is based upon a comprehensive framework that guides the work of the teams. The Change Package for this BSC (see Appendix A) was developed over several months and included input from diverse partners: representatives from workforce development, education, mental health, child welfare line staff, supervisors, administrators, researchers, family members, youth, community partners and other stakeholders. This Change Package identifies ten key themes for California ILP Transformation and will guide agencies testing and implementation of best practices. Rather than selecting one of these themes to focus on, each team must commit to work in all theme areas (not simultaneously, but throughout the life of the project) to ensure complete system-wide impact. It is the synergy that occurs when working on these components simultaneously that creates maximum system improvement. 2) Rapid Plan-Do-Study-Act (PDSA) cycles are used -- PDSA cycles are one of the keys to the rapid changes witnessed in a BSC. Instead of spending weeks, months, or years planning for massive changes, teams are encouraged to test an idea as soon as it occurs. 3) Anyone can have and test ideas -- Ideas for practice and system improvement do not come only from management. Workers throughout the agency, supervisors, managers, young people involved with the system, birth families, caregivers, community members, and everyone involved in the system have a great deal of experience and knowledge, and thus all have good ideas they can test. 13
4) Consensus is not needed -- Instead of spending time trying to convince one another of a better way of practice, the BSC encourages team members to test their ideas in the field instead of simply talking about their ideas in a meeting room. Team members do not need to agree with one another for an idea to be tested; instead the convincing comes naturally once people start to see the results of the tests. 5) Changes happen at all levels (not just at the top) -- All people have valuable knowledge and expertise, whether they are the senior leader of the project at a commissioner/director/administrator level or a young person on the team. As each person involved tests changes, the impacts occur at all levels -- from individual caselevel clinical practice all the way through system-wide policies. 6) Ideas are shared generously -- This methodology is entitled the Breakthrough Series Collaborative for a very distinct reason. Each participating team in the BSC can benefit greatly from the successes and learnings of all others. In-person meetings, a project extranet site, and monthly conference calls present opportunities for teams to capitalize on the successes of others as well as to learn from efforts that were not as successful. 7) Successes are spread quickly -- Many pilot projects begin and then remain in a pilot site; in other instances, the pilot disappears once a project is completed. The BSC method prevents this from happening. Once a change has been tested successfully and fully implemented throughout the target site, the team is responsible for spreading that specific small change immediately throughout the entire jurisdiction. Lessons learned are shared between and across the state, county, or tribe, and each site has the opportunity to modify change strategies in order to ensure that the practice change works for that specific geographic, cultural, or ethnic community. 8) Measurement is for improvement, not for research -- Measurement is a critical aspect of the BSC methodology, as the BSC strives to gauge improvements over time. In this BSC, each participating team will be required to select, track, and report on a body of measures -- some will be standardized across all teams and required; others will be site-selected and specific. Measures will be tracked and reported on regularly throughout the course of the project (see Appendix 2). By looking at progress in these collective measures each month, even when the numbers are small or not scientifically tracked, teams can tell if they are making a positive impact on children and families. The BSC methodology has proven successful in its transition from health care to the field of child welfare. Jurisdictions have tested and spread improvements in many areas of child welfare practice, including: Safety and Risk Assessment Permanency Education California Differential Response Etc, We expect that teams participating in this BSC will be able to test and successfully implement similar system-wide changes in the area of Independent Living Programs. Teams will be making 14
a positive impact on practice within their jurisdictions by testing ideas in areas that may include strategies like: Engaging families, caregivers and youth in decision-making and planning processes Building partnerships with community organizations that result in better opportunities for current and former foster youth. Focusing permanency, educational and employment services to meet the needs of individual youth; Using data gathered regarding practice and program outcomes to support practice improvements; Applying the lessons learned to improve training opportunities for workers; Improving communication and integration with cross-system and other community partners; Developing one integrated case plan for youth coordinated across systems and partners. 15
Appendix C -- Individual and Team Responsibilities Each participant on the Core Team has specific responsibilities based on his or her role. These are outlined below. Senior Leader -- This individual is responsible for the following areas of leadership: Leadership in Practice o Provide staff the opportunity to test practice changes based on the Change Package; o Play a strong role in selecting and convening the target site and Core Team according to requirements and recommendations from BSC faculty and staff; o Remove identified barriers that impede progress from occurring on a practice level, i.e., the lack of use of culturally responsive tools and training; o Monitor permanency and transition outcomes for current and former foster youth; and o Expand successful practice changes from the target site throughout the jurisdiction. Leadership in Infrastructure and System Improvements o Create innovative tests of policy and practice changes; o Provide the team with the resources, including time, materials, and equipment, access to local experts, and support from agency leadership; o Support the spread of successful practice and policy changes in real time throughout the agency; o Confront organizational culture barriers that impede improvements from occurring, including addressing issues of institutional and structural racism; and o Monitor system-level outcomes for permanency and transition services for current and former foster youth. Leadership in Community Awareness and Action o Make entire jurisdiction aware of the work of the BSC o Actively promote youth and caregiver engagement; o Actively engage the judicial branch, other government systems, advocates, community providers, and school systems in the change effort; and o Develop relationships with and educate diverse community groups who are equally committed to opening up the discussion and ultimately increasing positive outcomes for youth transitioning from foster care. BSC-Specific Tasks for Senior Leaders: o Attend four learning sessions; o Participate in all Collaborative monthly conference calls o Participate in bi-monthly senior leader conference calls; o Provide time for the Core Team to attend all four learning sessions (all travel expenses will be paid for teams selected to receive scholarships 16
o Sign a Memorandum of Agreement with the Child & Family Policy Institute of California (CFPIC that formalizes all expectations described in this document). Day-to-Day Manager -- This person has the following roles: Lead the Core Team in ensuring that the team conversation is genuine and that all voices, including those of families and young people, are heard. Lead the Core Team in testing changes; and Serve as the primary team liaison to the BSC staff and faculty. BSC-Specific Tasks for Day-to-Day Managers: o Submit required PDSA reports and other BSC assignments in a timely manner; o Ensure that data, monthly reports, and lessons learned are shared with team members and agency staff; o Attend four learning sessions; and o Update the senior leader on progress in the target site and team challenges. Core Team -- The members of the team will actively test changes in the target site as well as: Attend four learning sessions; Complete pre-work, prior to the first learning session, which includes coming prepared to the first learning session with clear goals for practice and system improvements; Ensure that youth, families and caregivers are actively engaged as true and equal partners within the Core Team, Extended Team and in larger system discussions; Communicate regularly with other teams, BSC staff and faculty; Participate on BSC conference calls once per month; Participate and share learnings on the BSC extranet; Use required data measures to help assess progress and guide future improvements; Initiate, maintain, and evaluate the tests of change in the target site; and Participate in a larger evaluation of the Breakthrough Series Collaborative Methodology. Extended Team -- Team Members will: Actively engage in the change process to improve outcomes related to permanency and transition services for youth; Provide feedback and insight to the senior leader and Core Team on the issues of permanency and transition services, practice and policy changes, and future improvements; and Serve as vocal and active champions of this work throughout the broader community. 17
Appendix D: Frequently Asked Questions 1. Can a private agency apply to this BSC? No, a private agency cannot apply as the lead applicant. However, a private agency can seek participation through their public child welfare agency. 2. My agency is interested in applying but we are not sure how to select people for our 10-person Core Team. While there are no strict rules for selecting core members beyond the specific competencies that must be represented (as detailed in the application), there are many considerations that should be taken into account, based on lessons learned from previous BSCs. It is important that all Core Team members possess several key characteristics. Team members should be: Creative and innovative thinkers; Opinion leaders among their peers and colleagues; Skilled in working with others; Good listeners; Open-minded to new ideas, ways of doing things, and changes; Early adapters to change; and Doers, rather than planners. It is recommended that Core Team members be selected from the target site. 3. Instead of a worker and supervisor, can we have three managers to make up our Core Team? No. It is essential that all levels of leadership and participants in this work are equally represented. We are looking to gather a diverse view across the board. This includes level of expertise, experience, and input. In a BSC we have found that it is absolutely critical that members of the Core Team are as close to the work as possible in order to test changes in practice. 4. We ve identified a consumer/youth for our Core Team but he or she cannot attend the learning session meeting. Can that person still be a Core Team member? No. It is essential that all team members attend all of the learning sessions. This will ensure that all voices are represented, contribute to team cohesion, and lead to improved results for the agency. When searching for members for your Core Team, please make sure you get an advanced commitment to attend all four in-person learning sessions as well as all Collaborative calls. This participation is crucial to maximize the learning for all involved in this Collaborative. If you find that a potential Core Team member is not going to be available for all of the required meetings, you may want to find another person for that slot. 5. When looking for a birth parent and a youth, are we only to recruit folks that had a positive experience with the system? 18
No. However, you have to make sure that the chosen person is able to look past their own experience with the system in order to provide some objective input into the team learnings. 6. What can my agency gain by participating in this BSC? Participation in this BSC will result in learning and implementing a quality improvement methodology that is known to create positive system improvement. We anticipate smallscale rapid acts of change will transform practice, as well as the systemic features that support the desired transformation in areas such as specific assessment tools, integrated assessment schemas, worker decision making, supervision, training, protocols, and policies. 7. Does my agency have to commit to the life of the project or can we pull out if it becomes too much work? Participation for the life of the project is expected. We want agencies to know upfront that we recognize that this is going to be a project filled with hard work and a long time commitment. Your commitment for the life of the project is crucial for the success, not only of your team, but of the Collaborative as a whole. 8. The application is long, what if I cannot have it completed by the stated due date? The BSC planning team acknowledges that the application is lengthy. However, the amount of detail that is requested is done so purposefully in order to ensure that we are able to choose 20 teams that are fully prepared to participate in this Collaborative. Unfortunately, we cannot extend the application due date. We are allowing teams 25 business days to complete the application and the BSC planning team members are available to provide any teams that require further instruction with technical assistance as they complete the application. Project Director: Karen Lofts-Jarboe, karen.loftsjarboe@cfpic.org Project Manager: Ben Halili, ben.halili@cfpic.org 9. What if I do not have any demonstration examples to provide on my application? If you do not have any demonstration examples to provide, simply leave this portion of the application blank. However, the selection team will be looking at past work done in your jurisdiction as one indication of your potential for success in this Collaborative, and your agency will receive a lower score as a result of leaving these items blank. 10. What does a Plan-Do-Study-Act (PDSA) look like and what is involved in completing one? A PDSA is a methodology for improvement. This methodology provides several benefits, including but not limited to: Changes are connected to priorities Early successes act as motivators Reduced tendency toward over-planning No delays for consensus or permission Measurement is for learning 19
Sharing (and stealing ) of successes and learnings Examples of the long term benefits from PDSAs used in past BSCs can be found at the following links: Recruitment and Retention, Kinship Care http://www.casey.org/resources/projects/bsc/) and Massachusetts Adolescent Permanency (http://www.hunter.cuny.edu/socwork/nrcfcpp/info_services/youth-permanency.html) 11. Is there a cost to the target sites to participate? How much money can we expect to receive to help us implement the strategies or changes we decide upon? All project specific requisites, e.g., attendance at four learning sessions, use of an extranet to log measures, stipends for caregivers and youth to attend the learning sessions, technical assistance from expert faculty and other jurisdictions, conference calls, etc., are funded by the project. That said, the time commitments required to participate in a BSC are significant and are the responsibility of the participating jurisdiction. Moreover, to encourage and ensure sustainability of changes, no additional monies will be provided as part of this BSC. ii Robert B. Hill, ph. D, Analysis of Racial/Ethnic Disproportionality and Disparity at the National, State, and County Levels, Casey- CSSP Alliance for Racial Equity in the Child Welfare System, 2007 Casey Family Programs. iii Robert B. Hill, PhD, Synthesis of Research on Disproportionality in Child Welfare: An Update, Casey-CSSP Alliance for Racial Equity in the Child Welfare System, October 2006. iv Call to Action: An Integrated Approach to Youth Permanency and Preparation for Adulthood. Casey Family Services, in collaboration with California Permanency for Youth Project, Casey Family Programs and the Jim Casey Youth Opportunities Initiative, Inc. April 2005. 20