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Dances With Wolves: How Small States Fare on Indicators of Family Centered Practice

Dances With Wolves: How Small States Fare on Indicators of Family Centered Practice. Thomas E. Lengyel Director of Research Alliance for Children and Families September 20, 2005 Revised September 26, 2005. Structure of Presentation. Review of indicators that measure Family Centered Practice

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Dances With Wolves: How Small States Fare on Indicators of Family Centered Practice

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  1. Dances With Wolves:How Small States Fare on Indicatorsof Family Centered Practice Thomas E. Lengyel Director of Research Alliance for Children and Families September 20, 2005 Revised September 26, 2005

  2. Structure of Presentation • Review of indicators that measure Family Centered Practice • Hawai’i’s CFSR results and improvement plan • Comparison of six small states • Analysis of problems and solutions (increasing complexity) • Preserving connections • Foster care re-entries • Parent-child & sibling visitation • Child & family involvement in case plan • Needs & services of child, parents, & foster parents • Patterns in problem solving among the states

  3. Indicators of Family Centered Practice (FCP) in CFSR Reviews (1) • Safety Outcome 2: (3) Services to protect children in-home & prevent removal (4) Assess (& reduce) risk of harm • Permanency Outcome 1 (5) Foster care re-entries • Permanency Outcome 2 (11) Proximity of foster care placement (12) Placement with siblings (13) Parent-child & sibling visitations (14) Preserving connections

  4. Indicators of Family Centered Practice in CFSR Reviews (2) • Well Being Outcome 1 (17) Needs & services of child, parents, & foster parents (18) Child & family involvement in case planning & review (19) Worker visits with child (20) Worker visits with parents

  5. Hawai’i:Variation Across Counties (Table 1) • Cases were reviewed in Oahu (26), Maui (12), and Hilo (12) • Maui clearly exceeded Oahu and Hilo on Safety 2, Permanency 1, and Well Being 1 Though not rated strong, Maui caseworkers were far more successful at meeting standards for visitation Use Maui as a source of training & ideas? • Hilo’s strong suit was in preserving the continuity of family relationships & connections

  6. Hawai’i:State Rating on FCP Indicators (Table 2) • Hawai’i rated as strong overall in three indicators Services to protect children in-home and prevent removal Proximity of foster care placement Placement with siblings • Hawai’i rated as “needing improvement” in the other 8 FCP indicators • State did relatively well on maintaining children safely in their homes (Safety Outcome 2) • State did very poorly on building the capacity of families to provide for their children’s needs (Well Being Outcome 1)

  7. Hawai’i’s Program Improvement Plan Hawai’i’s Response: • Relies very heavily on Ohana (family) Conferencing as a means to address deficiencies in its outcome indicators • Of 31 indicators judged as needing improvement Ohana Conferencing was cited as a solution in 13 (42%) • Divert cases from the system through an “alternate response” system • Systematic quality assurance system • Pilot programs

  8. Comparison of NH, MT, HI, ID, WV, & RI:Small Social Service Delivery Systems (Table 2) • NH achieved strength in 5 of the 11 indicators • HI and ID were strong in 3 indicators • WV (2) and RI (1) brought up the rear • All the states were strong in proximity of foster care placement Standard may be lax Hawai’i benefits from geography (i.e., same island placement) • Continuity of family relationships & connections was the strongest outcome area for this group (Permanency 2) • Building the capacity of families was by far the weakest None of the five states achieved strength rating on any Well Being 1 indicator

  9. Differences Between States • Smallest differences Proximity of foster care placement (+/- 5%) Services to protect children in-home (+/- 14%) Assessing risk of harm (+/- 18%) • Largest differences Worker visits with children (+/- 44%) Worker visits with parents (+/- 47%) • Hawai’i caseworkers fell far short of the state’s standards for visitation

  10. Differences Between States:Assessment • States are most similar to each other in terms of indicators that reflect the old child-centered paradigm • Assessing risk, placement resources, services to child • States diverge most in indicators that require a broader focus on the family • Assessment of & services to all family members, including foster parents, family contact, family involvement in planning • Implication: Small states have not yet broadly implemented Family Centered Practice

  11. Problems and Solutions:Preserving Connections (Table 9) • Problems • No effort to preserve connections with extended family (NH, MT, HI, WV, RI) • No effort to preserve connection with culture (MT, HI, WV, RI) • No effort to preserve connection with siblings (RI) • Solutions • Increase awareness of issue by staff, supervisors, foster parents (HI, WV) • Improve matching of child & foster family (HI, RI) • Expand existing process to identify relatives (HI)

  12. Problems and Solutions:Foster Care Re-entries (Table 5) • Problems are very similar (by definition) • Solutions diverge • Augment capacity of staff (HI, ID, WV) • Improve accuracy of information (NH, WV, MT) • Develop & impose standards of practice (ID, HI, MT) • Add new type of resource to system (NH, RI) • Expand use of existing process or resource (HI) • Limit professional discretion (HI)

  13. Problems and Solutions:Parent-child & Sibling Visitation (Table 8) • Problems • No effort to promote visitation between siblings (NH, MT, HI, ID, RI) • Insufficient visitation with father (ID, WV, RI) • Did not meet needs of child (NH, HI) • Solutions • Set standards & policy (NH, WV, RI, MT) • Raise awareness of issue/train staff & providers (HI, RI, MT) • Add resources to system (NH, HI) • Expand circle of invested parties (HI, RI) • Refocus $ resources on visitation (MT)

  14. Problems and Solutions:Child & Family Involvement in Case Plan (Table 11) • Problems • Mothers (80), fathers (80), and children (63) not involved in case planning • Solutions • System change: Implement FCP (WV, RI) • Develop & enforce standards (ID, WV) • New assessment procedure (NH, MT) • Impose structure/limit discretion (HI) • Remove barriers & threats to family engagement (NH) • New family engagement process (ID) • Align private with public practice (RI) • Fuller sharing of case information (NH)

  15. Problems and Solutions:Needs & Services of Child, Parents, Foster Parents (Table 10) • Problems • Children’s, mother’s, father’s, & foster parents’ needs not assessed • Services not provided • Needs not met • Solutions • Fuller sharing of information (NH, WV, RI) • Limit professional discretion (NH, HI) • Expand existing processes (NH, HI) • System change (WV, RI) • Align private with public practice (WV, RI) • New assessment procedure (MT)

  16. Solutions:Common State Strategies (1) • Develop & implement standards (ID, HI, NH, WV, RI, MT) • Improve communication & coordination (NH, WV, RI, ID, MT) • Build staff capacity (HI, ID, WV) • Educate, train, raise awareness of staff and providers (HI, RI, WV) • Improve data management & accuracy (RI, WV, MT) • Add resources (NH, RI, HI)

  17. Solutions:Common State Strategies (2) • Limit professional discretion (NH, HI) • Paradigm shift/system change (WV, RI) • Increase oversight (NH, MT) • Align policies among providers & institutions (ID, RI) • Refocus existing resources (MT) • Control system loading/diversion (HI)

  18. State Strategies:Themes (Ranked by Frequency) • Get more out of existing staff and resources by: • Setting standards and monitoring compliance • Constraining staff discretion • Increased oversight and review • Broader application of proven processes • Improve information flow and data accuracy • Revamp the system of practice • Augment resources by: • Adding new resources • Increasing capacity of staff

  19. Acknowledgements Many thanks to:

  20. Contact Information Thomas E. Lengyel Director of Research Alliance for Children and Families tlengyel@Alliance1.org (414) 359-1040, x. 3637

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