Bryan Samuels, Executive Director

1. The Intersection of Safety, Permanency and Child Well-Being Bryan Samuels, Executive Director Bryan Samuels, Executive Director

2. CHILDREN IN FOSTER CARE ON 9/30

3. STATE CHANGES IN CASELOADS: 2002-2011 Data Source: Adoption and Foster Care Analysis and Reporting System, U.S. Department of Health and Human Services

4. WELL-BEING CHALLENGES AMONG CHILDREN KNOWN TO CHILD WELFARE Dolan, M., Casanueva, C., Smith, K., & Ringeisen, H. (2011). NSCAW Child Well-Being Spotlight: Children Placed Outside the Home and Children Who Remain In-Home after a Maltreatment Investigation Have Similar and Extensive Service Needs. OPRE Report #2012-32, Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.

5. EMOTIONAL AND SOCIAL CAPACITIES ARE INEXTRICABLY INTERTWINED WITHIN THE ARCHITECTURE OF THE BRAIN

6. TRAUMA’S IMPACT ON SOCIAL AND EMOTIONAL FUNCTIONING AND RESULTS IN POOR OUTCOMES

7. PERMANENCY IS INSUFFICIENT FOR ACHIEVING LONG-TERM POSITIVE OUTCOMES Bellamy, 2008. Roller White et all, 2007. Simmel et al, 2007.

8. RESEARCH IS FRAGMENTED… Mental Health Education Neuroscience Juvenile Justice Medicine Child Welfare …AND NOTALIGNED

9. A SHARED FRAMEWORK ALIGNS THE BEST KNOWLEDGE AND MOVES US IN A COMMON DIRECTION Mental Health SOCIAL & EMOTIONAL WELL-BEING FOR CHILDREN AND YOUTH EXPOSED TO ABUSE, NEGLECT, and VIOLENCE Juvenile Justice Education Medicine Neuroscience Child Welfare

10. INTEGRATING WELL-BEING WITH SAFETY AND PERMANENCY

11. A FRAMEWORK FOR WELL-BEING • Cognitive Functioning • Physical Health and Development • Emotional/ Behavioral Functioning • Social Functioning Within each domain, the characteristics of healthy functioning relate directly to how children and youth navigate their daily lives: how they engage in relationships, cope with challenges, and handle responsibilities. Environmental Supports Personal Characteristics Developmental Stage (e.g., early childhood, latency)

12. THE FRAMEWORK IN PRACTICE: OUTCOME DOMAINS BEYOND SAFETY AND PERMANENCE

13. ESTABLISHING THE RIGHT EVIDENCE-BASED SERVICE ARRAY TO SUPPORT WELL BEING De-scaling what doesn’t work, scaling up what does • Parenting Classes • Trauma Screening • Functional Assessment • Anger Management De-scaling what doesn’t work Investing in what does • Evidence-Based Trauma, Mental Health & Parenting Interventions • Generic Counseling INEFFECTIVE APPROACHES RESEARCH- AND EVIDENCE BASED APPROACHES

14. USING MEDICAID TO INTEGRATING SAFETY, PERMANENCY AND WELL-BEING Multiple Medicaid vehicles allow for identification and treatment of complex trauma: • Early Periodic Screening Diagnosis and Treatment • State Plan Services, including preventive services, described in section 1905(b) of SSA • Alternative Benefit Plans • Home and Community-Based Services • Health Home – central coordination for health services • Managed Care • Integrated Care Models • Section 1115 Research and Demonstration Programs

15. PRACTICES BEYOND SAFETY AND PERMANENCE TO IMPROVE OUTCOMES “Simply removing a child from a dangerous environment will not by itself undo the serious consequences or reverse the negative impacts of early fear learning.” National Scientific Council on the Developing Child (2010)

16. Questions? bsamuels@chapinhall.org