Family Team Meetings in Iowa

1. Family Team Meetings in Iowa Presentation for FTM Seminar December 8, 2008 Krystine L. Lange, MSW, LISW CFSR State Coordinator Department of Human Services Hoover State Office Building, 5th Floor Des Moines, Iowa 50319 Phone: [515] 281-6215 klange@dhs.state.ia.us

2. IA-CFSR Findings: There is such variation and such a dramatic range of practice and performance for the department, as well as the court, in different geographic areas. Consistency of practice and performance is goal for which to strive. An example of variation in practice is in provision of family team meetings. Service Area Performance for Family Team Meeting Sioux City27.72% Waterloo 38.59% Dubuque 53.62% Ames 22.85% Council Bluffs 40.31% Des Moines 37.26% Cedar Rapids 28.00% Davenport 60.37%

3. Eight IA-CFSRs • What do they tell us about family team meeting practice in Iowa?

4. Family Team Meetings • Family team meetings are seen as beneficial by all. • Family Team meetings are being utilized as an effective mechanism to engage families, providers, court partners, etc • Reduction in DHS caseloads attributed to increased family visits,effective use of family team meetings and use of the safety constructs. • Family Team meetings are seen as promising practices by all focus groups. Family team meetings significantly contribute to respect and involvement of families. • Family Team Meetings and case planning activities engage a family team to work collaboratively.

5. Family Team Meetings Focused Inquiry: How well have we engaged with our families and others? • Family team meetings are an integrated practice strategy and effective way to engage families. • Many stakeholders stated that they felt part of the team during family team meetings. • Foster parents say, “We are an important part of the team.”

6. Family Team Meeting Concerns • Focus groups stated that “institutionalized” family team meetings has diluted the FTM philosophy and the level of engagement of families • Integrated use and value of family team meetings as a consistent practice. The only concern was that stakeholders wanted more of them. Generally the family team meeting occurs within 20-25 days after intake!! • Focus groups identified the need for ongoing family team meetings. • Refinement of documentation of visits and family team meeting content with parents is needed to capture ongoing assessment, progress, and needs. Documentation should reflect the analysis and synthesis of information over time.

7. Family Team Meeting Concerns • Family team meetings don’t always engage maternal and paternal resources and supports for children. • Uproar, worry, and dissatisfaction about limitations on frequency. This is a misperception by stakeholders. • Some stakeholders are concerned about worker facilitated meetings and fidelity to the long-term model. The misperception was that neutrality is required for a family team meeting facilitator. There was an assumption that the worker would have an adversarial relationship with the family. [rather than a trust based relationship.]

8. Disproportionality Projects:Family Teams • Partnership for Safe Families (PSF) facilitating family team meetings for African American families. One of the cases reviewed was facilitated by PSF. • ICWA and concurrent planning form used at Family Team Meetings assure inquiry regarding Native American Heritage.

9. Assessment, Plan Development, Monitoring and Tracking Progress • Participation of the worker and CPW in the first family team meeting, where the initial case plan is developed • FTMs are used to develop the plan, which involve the parents, children, and support systems are utilized frequently to develop a plan where everyone is on the same page. They are an accepted part of practice. The initial plan provides a good road maps for families. • In one area of the state, FTMs are conducted every 60 days to monitor progress and keep all team members with common goals and strategies.

10. Contributes to CFSR: • Assessment and Involvement in Case Planning: FTMs are increase sharing of information and understanding of the family; their strengths and needs. They are also used to develop the plan, which involve the parents, children, and support systems are utilized frequently to develop a plan where everyone is on the same page. They are an accepted part of practice. The initial plan provides a good road maps for families.

11. Contributes to CFSR: • Service Array: FTM are used to develop individualized plans for children and families. Family team meetings are empowering and result in individual needs being identified and addressed. • Family and Child Engagement : FTMs are being utilized as an effective mechanism to engage families, providers, court partners, etc

12. Contributes to CFSR: • Risk of Harm: Family team meeting and team work contributed to decreasing risk of harm • Permanency: FTMs contribute to the appropriateness of the permanency goal and the timeliness of establishing goals. • Physical, Dental and Mental Health Needs: Family team meetings cover well-being needs.

13. Contributes to CFSR: • Stability: Excellent teaming; everyone was rallying around this child with special needs for quick problem resolution in family team meetings to maintain this placement. • Connections: Family team meetings and thoughtful planning help to assess, plan for, and honor ongoing connections.

14. Family and Others’ Comments • In two cases, FTMs were utilized. One mother stated, “I loved my Family Team Meetings” and used them “to build my support system”. • One parent said, “The family team meeting went good; it was all about us.” • Legal representatives see better and more cohesive plans and Judges indicate that since the increase in family team meetings, there has been more input of a family in case planning.

15. Family and Others’ Comments • Professionals who work in other counties and compare practice say that Winneshiek County staff work WITH the family rather than in an adversarial way and that it is much more effective -- they have better outcomes. • Attorneys, Providers, and Caseworkers said: Family Team meetings are seen as a valuable resource to identify and address root causes.

16. Family Team Org Structure • One in-house family team meeting facilitator in the County, with the primary function of conducting FTMs on all new cases. • Family team meeting occurred in all of the DHS cases in Cerro Gordo County. • Family Team meetings contribute to truly engaging parents in the planning process. They have been fully integrated into practice. Frequency of follow-up meetings, even monthly, result in identifying progress, contributing to accountability of families and the system, and keeps everyone on the same page.

17. Family Team Org Structure • Family team meetings are being held every 60 days to review progress. 93.6 % of families have FTMs in Council Bluffs. • Decorah family team meetings may be held monthly. • 95% or more of families in Davenport have family team meetings. • 100% in Decorah.

18. Family Team Org Structure • Community has been on board with Family Team Meetings for over 12 years. Some stakeholders are concerned about recent limitation on availability and frequency of purchased facilitation. Positive partnership with Juvenile Court Services. • Focus of FTM on: Permanency for Teens; Pre-Removal Conference; • FTMs view the specific holistic needs of families and children.

19. Are we using FTMs appropriately and effectively? • YES. YES. YES. Universal support for family team meetings and integration into practice. • Frequent and effective FTMs seen in cases to effectively develop a case plan. • Workers are building trust based relationships and effectively facilitating FTMs. • JCS is using FTMs on select cases for discharge planning.

20. What should be our FTM Goals for 2009 • 1st: Consistency in practice and availability of family team meetings. • 2nd: Consistency in quality