Children and Youth Services Outcomes Based Services (OBS)

1. Children and Youth ServicesOutcomes Based Services (OBS) • Phase I • Region 3 – Calgary and Area Outcomes Forum - May 28, 2009

2. Presentation Outline • Calgary and Area CFSA – Building the Foundation • OBS Initiative – Building Momentum • Phase 1 – Calgary and Area • Forest Lawn & Area MST • Request for Proposal Process • Woods Homes • Phase 1 Activities – Provincial and Regional • Challenges and Opportunities

3. Calgary and Area CFSA • Building the Foundation

5. Who are we? • Key stats • Staff • Sites • Client Volume • Child Protection • Family Enhancement • Understanding our outcomes-measuring and tracking • Current Continuum of Contracted Agencies • Number of Agencies • Services purchased

6. Service Transformation • Regional/Provincial Process • How long has it been going on • Creation of Guiding Principles • Learning Labs • Staff and agency engagement • Identification of potential pilot sites/services

7. Experience Researched and introduced innovative programs (learning labs): • Multiple Risk Youth Hub • High Fidelity Wrap Around • Capital Hill Group Home • Reached +180 children, youth and their families • Focus Established five regional outcomes (based on Child and Youth Enhancement Act): • Supporting vulnerable children and youth to live successfully in the community. • Children and youth in temporary care will be reunited quickly with their family. • Children and youth in permanent care will be placed in permanent homes as quickly as possible. • Youth will be transitioned to adulthood successfully. • Aboriginal children and youth will live in culturally appropriate placements. • CFSA Staff & AgencyEngagement Committedto ensure stakeholder input and participation: • CFSA agency survey 2006 • 7 contracted agencies involved in learning labs Readiness for Outcomes Based Services • Leadership Established foundation for change: • Guiding principles • Investment in new programs and agency relationships • Formalized organizational roles and responsibilities

8. Outcome Based Services • Building Momentum

9. Transformation- James McGregor Burns • Change- • to substitute one thing for another • To give and take • To exchange places • Transformation- • Metamorphosis in form or structure • Quantitative & Qualitative Change • Process replacing new culture & value systems to take the place of the old

10. Outcome Based Services • The Outcomes Based Services: • create a system that has capacity to focus on & measure achievement of agreed upon outcomes both case work and resource allocation decisions. • Build on the Casework Practice Model, • Assessment, Collaboration and Engagement, • OBS will support system wide transformation of our services a comprehensive assessment will direct the case plan and contracted services to achieve desired child and family ‘outcomes’.

11. Outcome Based Services-Provincial & Regional Integration • Established Provincial OBS scope • Established project governance • Solidified best practice research • Engagement – agency and staff (e.g. this Forum) • Moving towards a consolidated approach • Evaluation • Data Analysis • Technical - Contracting • Practice Shifts

12. OBS Phase 1 – Calgary and Area • Who and How

13. OBS Phase 1 – Forest Lawn and Area MST • Lead delivery site and lead agency concept- build partnerships-relationship, joint practice, responsibility and accountability, with a focus • Why geographical location approach? contained area, aligned with other services in the area-health/education/city/ police/diversity serving community agencies-community focus-attempt to provide services in the community and transitions families to those services • Selection of Community site process- competitive process, manager and team leader high level of commitment to the philosophy of outcome based services- evidence based practice- regional goals- Site has services ranging from investigations to adoptions- leads to a strong focus on Permanency. • . • Key stats and demographics- Forest Lawn and Area - average 12-14 new cases/month- 70/30 split in/out of care-high needs area-diverse population-multilingual/immigrants/refugee pop.- young children- • well serviced area- community resources • Fit with lead agency model- Woods Homes- long history, relationship of trust- staff familiar with agency and their philosophy-

14. Practice Changes • Team Approach with CFSA, family and Agency staff- it is a shift in the partnership and collaboration, with agency assuming an increased level of particpation/responsibility and accountability. Our staff needs to learn as opposed to told, to work in collaboration with the agency- roles and responsibilties shift but don’t know exactly how it will look yet. • One case plan- developed jointly with CFSA, agency family, youth and children (when appropriate), significant others- professional & family identified- involvement in case plan development and review - achieves two things first it clarifies and simplifies for the family the often confusing system issues that we involve them in; it provides and opportunity for • No change in case plan without family, youth, child’s (when appropriate), CFSA case worker or agency staff involvement and agreement So far we have been using the case work practice model as our framework and foundation for building a casework process. Many of these elements are contained in the CWPM- • Dispute resolution process - there will be disagreement and we need a respectful, transparent way of resolving issues based on our values and principles. • Focused on 5 Regional Outcomes - these give us a framework to work within- keeping kids at home, returning as soon as possible, achieving permanency, and culturally appropriate services. • NOM- safety, permanency, wellbeing, parent capacity and community connections indicators measured and reported on - staff have really appreciated this model of service accountability and measurement - it makes sense to them- they have lots of questions about the how we will measure and make it work on an individual client level, there has been lots of good discussion about these and they are becomeing part of our language. • they want to complete the loop and improve their practice with what they learn.

15. OBS Phase I – Request for Proposal Process and Outcome • Lead Agency concept • Engagement of Forest Lawn leadership team • Interview and Discussion processes • Screening of Proposals • Initial Interview Process • Interview 2 Process • Services Without Boundaries • Key Learnings

16. OBS Phase 1 – Woods Homes • Wood’s Homes is a nationally accredited multi-service organization providing a wide variety of services to children, youth and families with presenting concerns that include child maltreatment issues, serious behavioural issues, mental health issues and school problems. • Woods Homes has an annual budget of $22M and a staff compliment of 300. We operate programs in Calgary, Canmore, Lethbridge, Strathmore, Fort McMurray and Fort Smith. • We serve children and youth from birth to age 24 • We have developed a flexible continuum that includes crisis services, community based family supports, residential, foster care and school based services. • Woods Homes is funded by a diverse mix of contracts and fee for service arrangements from delegated authorities and government sources, school boards and community donations.

17. OBS Phase 1 – Woods Homes: Our Interest in this Opportunity • We recognize the fragility of the system and welcome the opportunity to contribute to the change process. • Our values align with the intent of an outcomes driven service delivery system in improving results for vulnerable families • We have been developing services focused on improving accessibility, integrating services across systems and addressing service gaps • We have developed an outcomes focus including a credible research department and affiliations with post secondary institutions • Our financial capacity includes significant experience managing complex financial arrangements • Our practice includes attention to developing, maintaining and evaluating partnerships

18. OBS Phase 1 – Woods Homes: Possibilities for Change: Practice • More timely response and access to support services for families • Improved opportunities for family engagement • More effective team based decision making, communication and case planning • Shared commitment to developing continuity of care and determining meaningful results • Practice will be informed by results measured over time • Out of home services will become specialized interventions rather than simply placements

19. OBS Phase 1 – Woods Homes: Possibilities for Change: Cost Savings • Creative tension within the fiscal model will drive innovation with a focus on real time • Average expenditure per child will be impacted by greater coordination of services and fewer services per case • Role flexibility will reduce the need for specialized services • Concentration on the initial crisis and “front end services” can reduce out of home placement • Outcomes will drive practice and funding priorities. Inefficiencies will be come more obvious sooner and action to change practice will be more responsive.

20. OBS Phase 1 – Calgary and Area • Joint Planning Activities

21. Key Activities • Provincial • Provincial Regional Leadership Team • Status reporting • Consultation re: Phase I scope and approach • Evaluation team outputs • Technical team outputs • Regional • Negotiation activity for both administrative and service delivery contracts • All agency engagement • Exploring practice shifts with Forest Lawn & Area and Woods Homes front line workers

22. Joint Planning Underway • Alignment of service delivery • Casework practice model (CWPM) • Exploration of practice shifts to deliver on specific outcomes • Development of service provider network • Current community capacity • Establish relationships • Determine system and structure needs • Staffing • Information technology • Physical space • Process manual • Engagement • CFSA staff- Forest Lawn and Area and other MST staff • Woods Homes staff • All agencies • Implementation support

23. Implementation • Proposed go-live family support services- July 2009 • Out of home placements- October 2009 • Provision of project support- CFSA and Agency Staff • Key collaboration activities • Woods Homes/Forest Lawn Staff • OBS – various CFSA and Agency teams • Evaluation • Compare to other MST in Calgary

24. OBS Phase 1 – Calgary and Area • Challenges and Opportunities

25. Challenges • Calgary and Area • Keeping up the momentum • Maintaining the focus of transformation vs. change • Establishing Provincial Requirements • Regional readiness- Provincial staging in process • Competitive process- ensuring engagement not alienation • Staff engagement- relevancy & addressing workers needs • Collective responsibility- move from “n of one” • Woods Homes • Change process is demanding with considerable time and communication pressures • Pace is daunting • Competitive process related to the tender and the collaboration needed to succeed at the next steps • Understanding and managing the risk issues, financial and otherwise as we go forward • Expectations of this initiative are huge!!

26. Opportunities • Calgary and Area • Improved outcomes & wellbeing for children, youth & families • Transition to new practice with families • Full implementation of Family Enhancement Act & Casework Practice Model • Evidence of intervention outcomes • Clarifying Business Relationship with agencies & CFSA • Clarifying Strategic Relationships with agencies & CFSA • Reducing administrivia • Woods Homes • Participation in a transformation change process that will focus on measuring and improving results for families and vulnerable children while improving our understanding of what works • Shared ownership of a system of care and commitment to continuous quality improvement • The development of flexible collaborative practice and partnerships across agencies and systems

27. Thank you! • Ruth Copot • Pat Gilbert • Jon Reeves • Susan Gardiner