Iowa CFSR Review Update

1. Iowa CFSR Review Update July 2008 Iowa CFSR UPDATE

2. CFSR Review • Iowa has initiated a CFSR review process • We are replicating the federal CSFR process using state and local staff and stakeholders to complete the reviews and focus groups. This is our second Iowa CFSR. We will complete 8 reviews, one in each service area by November 2008. • Four (4) cases will be reviewed per site. Iowa CFSR UPDATE

3. CFSR Review • The process includes between 7 and 9 focus group interviews at each site, to gather information and feedback from our child welfare partners regarding how children and families are fairing in our child welfare system. • To date, this review covers Polk and Tama County • Court, Youth, and Tribal members are key focus group participants. Iowa CFSR UPDATE

4. Preliminary Information General perception that DHS is doing better than ever. Recognition of efforts to: • improve practice • engage families, the community, Tribes, and other stakeholders • develop services that are targeted at the specific needs of children and families. Iowa CFSR UPDATE

5. Promising Practices Practices that are recognized and praised include: • Family Team Meetings • Functional Family Therapy • Pre-Removal Conferences • Youth involvement in ELEVATE • Early involvement in Birth to Three Services • Disproportionality Projects • Parent as Partners Iowa CFSR UPDATE

6. Concerns • Jury is still out on Iowa Kids net- the transition is seen as negatively impacting connections, proximity, stability, etc. • Demographics in Iowa are changing- increased drug use, increasing poverty, changing racial or ethnic diversity • Transportation and service gaps are huge concerns for rural counties Iowa CFSR UPDATE

7. Partnerships • Meaningful partnerships between the Court and DHS, and the leadership role of the Juvenile Court Judges are recognized and valued by child welfare partners. Iowa CFSR UPDATE

8. Courts • Timely Court Hearings and Reviews, coupled with Foster Care Review Board reviews assure that there is timely review of cases. Permanency hearings are timely. Notice to caregivers continues to be a problem. Iowa CFSR UPDATE

9. Foster Care • Concerted efforts are being made by the department to access and address safety concerns related to children in the home or while in foster care. Investigations are timely. Iowa CFSR UPDATE

10. Outcomes for Children • Promising Practices and successful strategies to improve outcomes for children and families are being collected from individual sites and are shared with state, service area, and local staff. Iowa CFSR UPDATE

11. Systemic Factor Patterns and Themes Case Review Iowa CFSR UPDATE

12. Case Review Strengths • There are written case plans for children, which are updated regularly. Family Team Meetings is a promising practice. DHS workers describe a variety of ways parents are involved in planning Iowa CFSR UPDATE

13. Statewide Information System Strengths • The statewide information system has the required information in the system: legal status, demographic characteristics, location, and goals for the placement of every child in foster care. Data reports are useful. Areas Needing Improvement • The system has a long learning curve, is not user friendly, and changes/improvements take too long and the data reports are not real time, so always looking back at practice. Iowa CFSR UPDATE

14. Quality Assurance Strengths • There is a wide range of activities directed at improving practice. Activities that are in place: case reading, supervision role in clinical consultation/quality, peer review of cases, standardized minimum requirements developed for all supervisory approval, etc. Areas Needing Improvement • Reports are not as timely as would be helpful. Iowa CFSR UPDATE

15. Worker Training Strengths • New worker training, ongoing training, access to training content, and supervisory training- Individual needs are being assessed and training is being offered accordingly. • Foster parent training (PSMAPP vs. NOVA) is much better now- although access to classes remains a problem for rural families. Areas Needing Improvement • More advanced training for skilled practitioners is needed. Iowa CFSR UPDATE

16. Service Array Strengths • Pre-removal conferences and family team meetings are a promising practice. There is broad support and recognition of benefits by many. Areas Needing Improvement • There is a lack of resources in the rural counties; the range, options, and accessibility to services are limited. TRANSPORTATION IS A CRITICAL issue. • There is a gap in mental health and substance abuse services for parents and children Iowa CFSR UPDATE

17. Responsiveness to the Community Strengths • Strong collaboration with child welfare partners and great improvements have been see in practice. • Youth are involved and asked about needed system and practice changes. “I’m one of the Youth DHS listened to and took my recommendations. It made me feel really good.” “They ask Youth to be involved all the time.” • Involving community stakeholders in looking at individual cases and life of the case decisions is a promising practice. Areas Needing Improvement • There is a concern that no one seems to know about or understand Child and Family Services Plan [4B]. Iowa CFSR UPDATE

18. Licensing and Recruitment Strengths • Standards are in place and applied equally. • General recognition of the need for foster parents to meet ethnic and racial diversity needs of children. Areas Needing Improvement • While there is a general recognition of need for foster homes for older youth and delinquent youth, the lack of such homes is a concern Iowa CFSR UPDATE

19. Case Review Patterns and Themes Iowa CFSR UPDATE

20. Case Review Patterns and Themes • Item 1- Timeliness of Investigations- All applicable cases indicated timeliness of investigation and seeing the child face to face timely • Item 2- Repeat Maltreatment- In all cases applicable no child in the family experienced repeat maltreatment within a six month period of the report during the period under review. Iowa CFSR UPDATE

21. Preventing Removal and Safely Maintaining Children at Home- Item 3 Strengths • In most cases, the department made concerted efforts to provide service to prevent removal or safely maintain the children at home - team members had a clear understanding of what were the risk and safety issues of the child and family. Areas Needing Improvement • In one case, the needs of parents were not assessed and no services were provided to the parents. Iowa CFSR UPDATE

22. Case Review Patterns and Themes • Item 4- Risk of Harm- In most cases concerted efforts were made to assess and address safety concerns relating to children in the home or while in foster care • In one case there was no risk or safety assessment, and focus groups indicate that some safe closure criterion are not always met before cases are closed. • Item 5- Re-entry into Foster Care- All applicable cases were strengths- the children did not have re-entry into foster care or concerted efforts were made to avoid re-entry. Iowa CFSR UPDATE

23. Case Review Patterns and Themes • Item 6- Stability Strengths • Most children in foster care were in a stable placement, and any changes to the placement were in the best interest of the child and consistent with achieving permanency goals. The workers made excellent efforts to maintain stability and worked with relatives to assure stability. Areas Needing Improvement • One child is in a temporary setting with a plan to be placed in shelter while awaiting residential care. Iowa CFSR UPDATE

24. Case Review Patterns and ThemesItems 7-10: Permanency Goals 7. Appropriate and Established Timely 8. Reunification, Guardianship, Permanent Placement with a Relative Achieved and Timely 9. Adoption Achieved and Timely 10. Another Planned Permanent Living Arrangement (APPLA PERMANENT) & Preparation for Adulthood Iowa CFSR UPDATE

25. Permanency Goals Strengths • The majority of cases reviewed were determined to be appropriate permanency goals and established timely Areas Needing Improvement • Federal tool does not take into consideration culturally based procedure. Iowa policy does not identify maintaining tribal culture and relations as a “compelling reason” for not terminating parental rights. Iowa CFSR UPDATE

26. Case Review Patterns and ThemesItem 11-16 Permanency Outcome 2 11. Proximity 12. Sibs placed together 13. Visits with Parents and Siblings in Foster Care 14. Preserving Connections 15. Identifying Relatives 16. Maintaining Parent Child Relationship Iowa CFSR UPDATE

27. Permanency Outcome 2 Strengths • In all cases children were placed close enough to parents to facilitate face to face contact between parents and child. Areas Needing Improvement • In one cases, there was not a concerted effort to place siblings together for 2 years. • Visits between the parents and siblings placed together indicated strengths in the efforts of workers to schedule and maintain visits, however engagement of fathers and efforts to locate parents remain a concern. • Transportation is sometimes a barrier to facilitating visits with children in foster care and parents. Iowa CFSR UPDATE

28. Preserving Connections Strengths • Children placed with relatives maintain strong connections • All ICWA requirements were met Areas Needing Improvement • In some cases the relative connections were not explored- lack of contact with family often lead to workers not exploring the family. • In cases where connections were explored, there was concern about why connections were not explored earlier. Iowa CFSR UPDATE

29. Case Review Patterns and ThemesItems 17-20: Case Work Practice • Item 17- Assesment and meeting the needs of children, parents, and foster parents • Item 19- Involving parents in case planning • Visits with Children • Visits with Parents Iowa CFSR UPDATE

30. Case Work Practice Strengths • In some cases, ongoing needs assessments were done, and intensity was increased when needed. Efforts were made to made to meet the assessment needs with supports and services. Areas Needing Improvement • Fatherhood engagement • Assessing the parents and identifying needs Iowa CFSR UPDATE

31. Case Work Practice Involving Parents and Children in Case Planning • Multiple members of the family are involved in case planning and are considered valuable members of the team. • In some cases parents felt that their input was not sought or valued- even when they showed interest. Iowa CFSR UPDATE

32. Case Work Practice Visits with Parents and Children • The quality and strength of visits with children need to be addressed and access to children placed far away is a concern. • In many parental visits, the father was not engaged or identified. Some parents were only visited when there was a concern regarding the child. Iowa CFSR UPDATE

33. Case Review Patterns and Themes Health and Well-Being Iowa CFSR UPDATE

34. Education Strengths • In all cases applicable, concerted efforts were made to assess children's educational needs at the initial contact or ongoing and identified needs were appropriately addressed. • IEPs were established and appropriate to the case. Iowa CFSR UPDATE

35. Mental Health Needs Strengths • In one case, the JCO’s efforts to get the appropriate level of mental health care may have saved the life of the child. Areas Needing Improvement • Although mental health needs were assessed in one case, they were not addressed through needed therapy. There was lack of coordination with the child’s psychiatrist. Iowa CFSR UPDATE

36. Youth Input • Individual living services, PAL stipend, and college grants are valued by youth. Youth recognize efforts to involve them in child welfare system improvement through ELEVATE and local initiatives. • The children recognize that turnover affects them. They lose out on needed services and don’t build trust. Iowa CFSR UPDATE