Seeing the Forest AND the Trees: Customer Satisfaction and Comprehensive Family Services

1. Seeing the Forest AND the Trees: Customer Satisfaction and Comprehensive Family Services November 14, 2003 Child Welfare League of America “Tools that Work”

2. Authors • Blake Jones, MSW, LCSW, ABD (Social Work) (bljone00@pop.uky.edu) • University of Kentucky • Ruth A. Huebner, PhD, Child Welfare Researcher (Rutha.huebner@mail.state.ky.us) and • Sissy Cawood, MA, Director of Service Region • Kentucky Cabinet for Families and Children

3. Topics • Rationale for Comprehensive Family Services • Review of supporting literature • Description of Comprehensive Family Services • Customer Satisfaction as an Outcome Measurement • Program Evaluation of CFS • Results • Discussion

4. Rationale for CFS • New paradigm for engagement of families and “community partners” > Solution-focused vs. punitive (Christensen, Todahl, & Barrett, 1999) > Strengths-based vs. deficit-based (Powell & Batsch, 1997) > Collaborative vs. insular (Brun & Rapp, 2001) > Principles of Effective Family Focused Interventions (Kumpfer & Alvarado, 2003)

5. Studies of CFS-type Approaches • Family-centered, strengths-based approach increases attachment, parental knowledge, and enhanced interaction among family members (Caro & Derevensky, 1991). • Linkages to social services, health care, housing, and employment increase self-sufficiency • (Lie & Moroney, 1992) • Community-based approach to child protection is touted as one of the most effective way to “reform” CPS (Waldfogel, 2000)

6. Comprehensive Family Services Putting It All Together

7. CFS: A Philosophy • Community-based • Strength-based • Prevention-focused • Partnership-driven • Integration of CFC services • Everyone A Leader

8. CFS IS NOT: • A Program • An Initiative • A Team Meeting • Dependent on a facilitator • “Levels” • Only for “some” families

9. CFS IS: • The way we think about our families, our co-workers and ourselves.

10. CFS IS: • Treating our families, our co-workers and ourselves with respect and dignity.

11. CFS IS: • Believing that our families, our co-workers and ourselves have strengths.

12. CFS IS: • Believing that families and co-workers can contribute to the success of our work.

13. CFS IS: • Partnerships with the community, other CFC agencies and our clients.

14. CFS IS: • Actively listening to and respecting the opinion of others.

15. CFS IS: • Focused on families rather than programs.

16. CFS IS: • A belief that families can make good decisions about keeping children safe and being self sufficient.

17. CFS IS: • The way we do business.

18. Implementation • Co-house family support and Protection and Permanency • Establish Levels of CFS • Universal – strength based assessment • Targeted – referrals within the agency • Intensive – Family team meetings with community partners • Roll out the program county by county as ready. • Reinforcement and mentoring at all levels

19. Comprehensive Family Services Putting It All Together

20. CFS Videotape

21. Discussion • What did you observe that was similar between the two stories? • What was different? • How was the client treated and what was the worker’s philosophy of intervention? • How is this different from typical treatment in child protection and family support? • What were outcomes?

22. CFS Summative Evaluation Are These Services Effective?

23. Challenges in Program Evaluation • CFS is complex involving multiple practices • CFS varies for each person, but all customers should be treated as partners with a belief in strengths • CFS is universal - all customers • CFS is targeted - needing resources • CFS is intensive - needing full partnerships

24. Customer Satisfaction • Involve Customers in Guiding Practices • Consider clients as customers • Empowers people to ask their opinion • Satisfied customer worker harder, achieve better outcomes, and spread the word. • Council on Accreditation and CFSR standards require customer input.

25. Outcome: Customer Satisfaction If CFC uses CFS beliefs and practices Then Customer Satisfaction should Be higher.

26. Population for Sampling • 491,913 Total Population • Foster Adoptive: 2290 • Personnel: 5521 • Community Partners: 13496 • P&P Clients: 22412 • Child Support: 91056 • Family Support: 357952

27. Process Overview

28. Response Rates 52% overall

29. CFS Summative Evaluation Methodology

30. Method Customer Satisfaction Database CFS Indicators Added • Months CFS in place by county • Average: 5.59 months • CFS Yes or No by county • 63.8% had CFS in place

31. Client Groups and CFS

32. Average Total Client Satisfaction F (2, 4105) = 105.34; p = .000, power = .99

33. Significant Differences for All Clients • Call returned • Easier to make appointments • Staff treat me with respect • Family is more able to care for themselves • Family is safer and more secure with help and referrals made by the agency

34. P & P ClientsSatisfied Most - Not Significant

35. Family Support Significant Difference

36. Child Support

37. Comments from Clients: Percent X2 (1, 1142) = 13.15; p = .001

38. Community Partner Average Total Satisfaction F (1, 3185) = 23.0, p = .000; power = .98

39. Community Partner Most Satisfied • Calls returned • Communication • Treated with respect • Helps Community Families to be more independent, safe, and secure

40. Foster Parent Total Satisfaction F (1, 1387) = 17.93, p = .000; power = .98

41. CFS: Foster Pre-Adoptive Parents • NO differences in: • Recommending fostering to others • Pride in helping families • Biggest differences: • Quality visits to child • Receives information

42. % Satisfaction with Quality Visits to Foster Child F (1, 1387) = 46.73; p=.000

43. Other Significant Differences

44. Time and CFS • The longer CFS was in place, the higher • Client Satisfaction • Community Partner Satisfaction • Foster Parent Satisfaction • All statistically significant at the .000 level.

45. CFS a way to do business Customer Satisfaction an Outcome

46. Limitations • Regional differences in the way CFS is implemented (e.g., access to services, rates of poverty, rural regions) • Confounding variables (interpersonal relationship skills of certain workers) • Survey has not been empirically validated

47. What does this mean for practice? • CFS shows promise • Not cause and effect with this data • Different effects for different programs • Probably other effects at work • CFS is consistent with best practices in the literature

48. Questions and Discussion