Dr. Bob Lonne , co-author of Reforming Child Protection, 2009

1. Dr. Bob Lonne, co-author of Reforming Child Protection, 2009 We should commit to a “clear and unwavering focus on positive outcomes for children and families as the central goal of a dynamic system that promotes the well-being of children and their parents, families and communities”, Lonne et al ,Reforming Child Protection p. 100 Alberta’s OBSD is an important reform initiative, because it focuses on delivering better outcomes and entails changed policies and practice, in particular, different ways of working with vulnerable and needy children and families. Re-thinking our current approaches is an essential step to a successful reform agenda and OBSD presents as a real opportunity to improve processes and outcomes and foster a communal web of social care. Lonne, Alberta Child Welfare: Opportunities for Better Processes and Outcomes, AASCF Journal, Special Edition, 2012

2. To Have Successful Adults, Children Need a Healthy Family That is Supported by a Healthy Community Dr. William Bell, Casey Foundation Historically, we have separated the child from the family and the child/family from the community. We need to re-think the paradigm to one of inclusiveness that sees the child/family and community as a whole - as the “client”. If the community is not able to support families, it needs to become healthy and work needs to be done to support the community to re-build/become stronger.

3. Lessons Being Learned Through the Implementation of Outcomes Based Service Delivery (OBSD)An UpdateAASCF Conference - January 25, 2013 Sandra Maygard Alberta Association Services for Children and Families, OBSD Lead Kim Spicer Department of Human Services, Senior Manager; Outcomes and Practice Support; Policy, Practice and Program Development Branch

4. What is OBSD Many different approaches/models being used world-wide - in Education, Health, Corrections, Business and Child Intervention • A paradigm shift • Child Intervention is not the end of the continuum but a part of a larger continuum that looks at the needs and supports of children and families, over time and from a broader perspective Community Based Supports ↔ Child Intervention ↔ Community Based Supports Four years into OBSD, we see major shifts in the practice which have become the major drivers of the process at this time • Increased focus on strength/asset based vs. deficit based practice approaches: Signs of Safety, Circle of Courage, Resiliency • Shared practice with joint responsibility for outcomes that are child/family driven A shift in funding • Agencies have a say in service provision; increased flexibility

6. Child, Youth and Family Enhancement Act (2004) A Shift in Casework Practice Increased focus on supporting families to build capacity Increased focus on need for permanency for children Meaningful consultation with Aboriginal communities Highlighted the importance of Assessment, Collaboration and Engagement

7. Casework Practice Model (CWPM) (2006) Embeds the principles of the legislation in the tenets of assessment, collaboration, engagement and permanency for children (including permanent homes for children in care) Comprehensive intake and assessment components • Increased clarity when moving from assessment to investigation • Assessment information directly linked to case planning Engagement with families • More time to develop relationships leads to quality decisions • Plans developed with everyone involved in multi-disciplinary case conferences • Importance placed on all parties working together, led primarily by family/child and caseworker Child-centered, family-focused , outcomes with measurable indicators Provides for mandatory decision points and supervisory consultation, based on best practice Early/ meaningful involvement of First Nations Band Designate/Métis Resource Person Moves from “brokering” to a “social work” role with children and families

8. Goals of OBSD • To improve effectiveness of services that children/ families receive/experience as they move in and out of the child intervention system • To provide agencies, communities and caregivers more flexibility to respond to the unique needs of children and families, while focusing on intended outcomes and better supporting innovative practice • To use outcomes data to align the work between the formal child intervention system, community agencies and caregivers • To develop a community quality improvement and learning process that will continue to guide joint practice and identify opportunities for improvement using evidence to guide practice • To develop a service delivery system that has the capacity to measure and focus on achievement of agreed upon client centered outcomes as the central driver for both casework and resource allocation decisions and • To establish joint accountability for outcomes for vulnerable children, youth and families

9. 5 Key Outcomes Guide OBSD • Supporting vulnerable children to live successfully in the community • Children in temporary care will be reunited quickly with their family • Children in permanent care will be placed in permanent homes as quickly as possible • Youth will be transitioned to adulthood successfully • Indigenous children will live in culturally appropriate placements/ services

10. Phase-In Sites One community based lead entity/agency working collaboratively with CFSA in specific geographic areas. • Joint accountability to outcomes • Flexibility and adaptability in service provision • Altered contracting and funding structure allows flexibility and adaptability in service provision and accountability to outcomes Lead Agencies are responsible for the provision ofservices to the child and family based on a plan developed collaboratively between the family, caseworker, caregiver and agency

11. Phase-In Sites REGION/WORKSITELEAD AGENCYDATE IMPLEMENTED Region 3 Woods Homes 2009 Mahmawi-Atoskiwin -Pathways/Enviros/B&G 2013 Region 6 The Family Centre 2009 Kahkiyaw- Bent Arrow/Boyle St. 2012 Region 7 WJS and Associates -Athabasca/Slave Lake/Lac La Biche 2010 Region 4 McMan Youth Services -Olds/Stettler/Drumheller 2010 Region 1 Wood’s Homes - Lethbridge 2010 Region 5 Midwest Family (withdrew in Oct 2011) 2011 Region 8 WJS and Associates -Peace River/High Level /High Prairie 2012 Region 9 McMan– Ft. McMurray 2012 Region 2 McMan/SPEC –Medicine Hat/Brooks 2012

12. OBSD is Not a Passing Fad! There is widespread support for OBSD from: The leadership within the Ministry of Human Services • The language of OBSD is very congruent with the Social Policy Framework • The Minister, Deputy Minister and Assistant Deputy Ministers speak to OBSD on a consistent basis • The internal staff support has increased dramatically over the last few months – indicating a commitment to supporting the implementation of OBSD more broadly CFSA’s • All regions have delegated staff to lead the process of OBSD implementation Agencies • The AASCF has funded an OBSD Lead position for since November 2010 • Many agencies have adopted the principles and have changed practice and in some cases how they seek funding for non-OBSD programs

13. Leaders of Thought and Practice Help to Shape OBSD Within the last year we have had the benefit of being challenged by innovative thinkers and programs achieving positive outcomes for children and families: • Dr. Christopher Bauer – Ethics in Practice – how to create ethical workplaces • Dr. William Bell of the Casey Foundation (May 2012) who’s goal is to safely reduce the number of children in foster care 50%by the end of the decade while improving the education, mental health and employment outcomes of vulnerable children. • Dr. Mike DeGagné, Executive Director of the Aboriginal Healing Foundation • Dr. Robert Lonne(Nov 2011, Oct 2012) co-author of Reforming Child Protection child protection from an ethical perspective – what does it mean, how is it different? • Dr. Bill Madsen (Sept 2011, Feb/March 2012), Family-Centered Services Project – strength based approaches to working with families • Dr. NicoTrocme– National Outcomes Matrix, National Child Welfare Outcomes/Stats KtunaxaKinbasket Child &Family Services (Cranbrook, BC) has been working with Signs of Safety(SOS) as a practice model for a number of years, with much success. Some DFNA’s are working with SOS Conference and Think Tank Presenters - Learning Our Way (2011), Think Tanks (May, June 2012), Prairie Child Welfare Consortium (May 2012)

14. Learning is On-going and Being Shared Real openness on the part of the Ministry/CFSA’s to learning as we move forward Learning from the OBSD initiatives is influencing and being influenced from the top down (the leadership) and from the bottom up (front-line practitioners ) within Human Services, CFSA’s , DFNA’s and Agencies Links have been established with other projects/initiatives: • Aboriginal Community Discussions • Integration of Dept of Human Services • Social Policy Framework • Practice Framework/Ethical Practice Many opportunities have been created to share information and learn from the experiences of those working in OBSD sites • Workshops at the AASCF annual and other conferences (Learning Our Way, 2011) • AASCF-OBSD newsletters (7 to-date) and AASCF Journal • Presentations: i.e. Foster Parent’s Assoc., Agency board/staff groups,Alberta College of Social Workers Conference etc.

15. Early Results Suggest a Positive Shift in Practice Between 10 -12 % of open child welfare files are being handled from an OBSD perspective (15% is considered the “tipping point”) • Over 1400 OBSD files are currently open • More children stay home and are receiving services in their home vs. out of home • 70% at home/ 30% in care in OBSD sites – opposite (30/70) in non-OBSD sites • More children are placed with their immediate or extended family • More children who come into care, stay for a shorter durations • Files are closing more quickly with lower rates of recurrence • (only 3 children came back into care in 2 years - Calgary) • More explicit focus on intended ‘outcomes’ for the child and family • 87% vs.40 % children stayed in their community school – Edmonton/North Central Office

16. Practice Principles • Engage families early • Collaborative practice • Collaborative and intentional single service plan and service team meetings • Evidence based approaches that supports shared practice • Child centred, family focused, strengths based • Use of valid and reliable tools • On-going support to the family • Community involvement/engagement

17. Relational Practice Key to all the work is: Relationship, relationship, relationship!!! Agency/CFSA staff need many opportunities for dialogue/clarification to share their vision /philosophy/approach to service delivery Supervisors play a pivotal and critical role: • Reflective supervision, critical thinking and discussion of the “big picture” are very important • Assisting with awareness of how beliefs, values and biases impact decision making (i.e. perception of single moms, role of men/fathers, extended families) For families where there has been success, critical factors include: • Early engagement • Intensive family contact • Positive relational work The best indicator of success is the nature of the relationship of the client to the worker

18. Collaboration Delegated staff and Agency staff collaboration is not always easy!! • Need to ensure that there is joint agreement of how issues will be resolved • Common understanding of principles and the language being used Areas where issues arise: • Agencies/communities need a better understanding of the Casework Practice Model, legal issues and responsibilities of delegated workers • Ministry staff could benefit from a more in depth understanding of agency’s expertise in supporting and enhancing well being of children/families • Decision points where Agency/CFSA workers need to talk about next steps i.e. Case planning when children come into care, placements and family supports as part of service planning

19. Perspectives and Inherent Tensions Delegated workers, agency workers and families often have quite different: • Perspectives • Focus on what is most important • Delegated staff(safety), Agency staff(well-being), Family (permanence) • Ways of approaching issues and • Problem solving There is a natural (dual) tension between a focus on Safety vs. Well-being Families focus upon Permanence almost immediately Focus on Outcomes Involves: not just dual tension between CFSA and Agency but tri-partite tension betweenCFSA, Agency and Family

20. Role Clarification Roles of delegated worker/agency worker/family need to be defined, known and respected • Delegated responsibility - definition, implications understood • Agency – to support families to move through change to achieve outcomes • Family – to be heard; to be an active participant who maintains familial responsibilities Rights of child have not changed • Children’s Advocate, procedural rights • United Nations Convention on the Rights of the Child – foundational Roles and responsibilities appear to be easy to navigate early in involvement but tend to become more complex the longer the involvement

21. Practice model(s) Need for agreement and consistency of approach(s) used by CFSA and Agency staff. Bill Madsen uses the analogy of a pizza with many slices, with each practice model/approach a slice. It is the whole that is needed – not a single approach • Assessment / planning for safety as well as mitigating risk/danger • Signs of Safety /Collaborative Helping • Appreciative Inquiry • What are we worried about? What’s working well? What needs to happen? •  Motivational Interviewing/ Narrative and Solution-Focused Therapies • Relationship/Engagement • Asset/ strength based • Evidence based • Community based Region 6 - Developed a Shared Practice Framework Regions 1 & 4 are using Signs of Safety –Safety Plans vs. Service Plans

22. Engagement and Planning with Families Clearly involves a multi-disciplinary approach A significant shift towards the family and child having greater control of outcomes, supported by the caseworker Relationship between team members is key. Planning with families: • Occur as quickly as possible • Is transparent and open • Include family/child goals • Goals, roles and expectations of all parties are clearly articulated • Has room for creativity, innovation and flexibility • Everyone’s perspective of the concerns and possible solutions are presented fairly

23. Single Collaborative Family Plan An OBSD goal is for the family to have a single plan (this is not yet the case in all regions) : • The plan is developed collaboratively by the delegated worker, agency worker, family and other stakeholders (foster parents, community partners, school etc.) • Goals are clearly defined, attainable and relevant • Goals include time frames • Indicators of success are measurable • The plan is written in the language of the family

24. Case Planning • Happens collaboratively between the family, the caregiver, the agency and the casework • Is focused on outcomes • Includes a multi-disciplinary approach • Goals are negotiated with the participants to reach solutions • Locus of control for planning shifts to family/child led and supported by caseworker • Differences in power should be acknowledged • Clearly defined activities linked to service plan • Outcomes and measurements of success need to be clearly defined The delegated caseworker retains final decision making over case management.

25. Common Themes • Roles and relationships between delegated staff, foster care providers and lead agency service providers need to be well defined, but not “written in stone” • Working without a “play book” is hard at times but allows for much more creativity and innovation • Delegated staff, lead agency staff, foster parents, family and community value and embrace each other’s expertise (risk and well being) to create an optimal environment for children, youth and families • Key is relationship, relationship, relationship!!!! • Requires system wide commitment to improved outcomes (lead agency, foster parents and delegated staff alignment) – Do we know what we are working toward and are we all working towards the same thing? • Critical thinking is essential and the role of supervisor is of utmost importance • Solid data collection processes are required across the systems, with agreement on indicators • Practice is changing – ‘spill-over’ is happening into other units/staff groups • Agencies say they have a greater voice in planning how services are delivered: • Greater clarity regarding roles and purpose of an intervention • Greater recognition of contribution of agency service provision to the wellness and safety of the children and families they are serving • Ministry and agency staff “would not go back” to what was

26. OBSD Casework Practice Measures Framework Alberta has chosen to adopt the National Child Welfare Outcomes Indicator Matrix (NOM) framework as a tool to support the evaluation of the impact of intervention services on children and families. The Framework aligns with the NOM and is focused on supporting stronger frontline practice while incorporating the collection of additional information regarding the attainment of outcomes for children receiving child intervention services in Alberta. Definitions, collecting and analysing data/ information have been developed, refined and used to inform the ongoing implementation of OBSD • Files will be reviewed for examples of the elements that reflect OBSD (Feb- Apr 2013) • The first annual report has been drafted

27. Casework Practice Measures Framework • Arranged in the 4 National Outcomes Child Welfare Matrix domains: Safety, Well-being, Permanence and Family and Community Support • The measures are broken down by ministry and agency measures that are intended to be complementary in nature • Formalized analysis and reporting cycles/processes established to effectively capture and report on the achievement of the specific outcomes identified

28. Linking OBSD Outcomes to NOM Safety Supporting vulnerable children to live successfully in the Community (Preservation – children stay at home) Permanency Children in temporary care will be reunited quickly with their family (Reunification – children return home) Children in permanent care will be placed in permanent homes as quickly as possible Youth will be transitioned to adulthood successfully Family and Community Support Aboriginal children will experience culturally appropriate supports and environments Parents will have the capacity and supports to successfully raise their children Child Well Being The developmental needs of children will be supported Children will be successful in school

29. Examples from the Framework Safety - 1.1 Incidents of Safety of Children while Receiving Services Description: This is a measure of safety. This measure will capture incidences of suspected maltreatment and abuse for those children currently receiving services. This will capture children receiving OBSD services with a current legal authority and are subject to a Safety Assessment Report. If a child has multiple occurrences in the timeframe please count them only 1 time. The data is to be reported in the year of the incident of safety, in a year to date manner. Ministry will report on this measure quarterly. Family & Community Support - 3.1Parenting Capacity Description: This is a measure of family and community support. The percentage of parents who’s ‘parenting capacity’ has improved during the course of their involvement in child intervention. Please report the total number of parents involved in service and the % that reported an increase in capacity. Reporting schedule is annually by Lead Agency

30. M M Recurrence Interventions, Experiences & Services Children in Temporary Care will be re-united quickly with family Children in Permanent Care will be Placed in permanent homes more quickly Supporting vulnerable children to live successfully in community Child At HomeNo Legal Status Experience APreservationNot In Care Experience BReunificationTemp Care Experience CLegal Permanency Permanent Care Screening SAR A & B “Investigation” Not In Care Agreement (FE) In Care Temp. (CP) In Care Perm. (PGO/PGA) Not In Care Order (CP) SFP Statistics Statistics Statistics Statistics Adopt / PrivGuard Objective: Diversion Objective: A1 – Family Preservation Objective: B1 – Family Reunification Objective: C1 – Legal Permanency Primarily Age Based Objective: C2 – Transition to Adulthood NM NM NM M M M Proxy Youth transitioned to Adulthood successfully Did Not Open (No Legal) Case Closed(No In Care Legal) Case Closed(No PGO) SFA Aboriginal children will live in culturally appropriate homes NM Family /Independent (Parents, Ind, etc.) Aboriginal Provider Non-Aboriginal Provider Home Based (Foster / Kinship, etc.) Facility Based (Residential, Group, etc.) NM NM M Permanency Based (Adoption, Private Guard. M M Milestone: Aboriginal Placements & Services Milestone: Placement Mix & Step Down Placements

31. Funding Shift • Fromunits of service toprovision of outcomes • Single contract – provision of all services • Currently using a case rate model Future rates/ contracts are being developed • Agencies have flexibility around costs • “Exceptional” Cases - not included • There are still many unanswered questions

32. Business Relationships Agencies need time to build capacity and partnerships required to deliver a continuum of supports • Lead Agencies – HR (hiring/training/retention), IT, Financial, Legal • Community Resources Focus on change management is critical to success Agency/CFSA need frequent opportunities to meet /discuss issues and confront differences Co-location is positive to the building of communication and trust Contracts need to be flexible and maintain openness to amendments based on assumptions (that may not be accurate) • Agencies need support in subcontracting (i.e. clarity of expectations) • A new way of funding and delivering services is very challenging.

33. KPMG /Centre for Research (ACCFCR) Interim Evaluation Report (Feb 2012) There is improved collaborative decision-making between Regional staff and service providers – work together as a team Lead agencies engage with families earlier in the process and help to build on areas of strength in the development of their service plans. As a result, families take greater ownership of their service plan and goals There has been a shift to working with the whole family rather than just the child in need Stronger, richer relationships with families are developed – staff are more accessible Schools have become the strongest community partner – natural meeting place There are collaborative provincial working groups leading the discussions Data collection, outcome measurement, funding approaches and practice implications

34. Evaluation Recommendations Many of the recommendations made in the KMPG report were addressed before the report was finalized: Declare and demonstrate long term commitment to the OBSD initiative • Leadership has committed increased time and resources to OBSD • An RFI is being finalized in Edmonton – with the intent of all files being handled from an OBSD approach; Calgary has tendered for a 2nd site • Develop and integrate outcome measures into the initiative • The Framework has been developed and is being refined • Expand OBSD in a strategic manner, mindful of what has been learned to date • The learning from the sites is being assessed, shared and creating the foundation for future steps • Clarify the OBSD funding approach • The funding model is still under discussion and will be reflective of the changes in practice Recognition of the huge amount of work being done by Lead Agencies prior to obtaining legal status

35. Areas Still Evolving • Clarification of roles – needs to be revisited (often) • Collaboration - new relationships are being created-partnerships/mergers/alliances • Community Engagement - create allies/ work with the community to strengthen families; schools are “community hubs”; engagement of prevention and early intervention programs, churches • Funding model is not “set in stone”, is evolving and discussions are underway • Impact of Change – managing change on a wide scale • Information sharing - how often, lines of authority, regular times to meet • ISIS – difficult to input –”client’s voice’ • Lead agency – how many lead agencies? What about the other agencies • Legacy files and children requiring intensive services (2-3-4 staff/1 client)

36. Areas Still Evolving • Measuring Outcomes and Evaluation - both qualitative & quantitative approaches • Need for Systemic Change - breaking down “silos, cross-ministry involvement (Health Education Justice); stigma, shifts in power and shared decision making; re-education of caseworkers, judges and lawyerS • Single service plan -some regions are still working with multiple service plans • Staffing Issues – need for different staff skill sets; training and re-training of old staff, turnover/retention • Understanding OBSD - implications, opportunities and challenges • Use of Language - we use “old” words but the meaning is not commonly understood or has shifted (i.e. collaboration/ permanence) - need new words

37. Areas Still Evolving - Indigenous People Indigenize the system Number and ratio of Aboriginal children “in care” continues to increase - 67% in Alberta; 95% in Manitoba • We need more than cultural sensitivity • Understanding of the continuing impact of colonization and repressive policies, different “world-view”, practice and language Re-build Indigenous communities • Third world conditions • Development of natural leaders • Healing from effects of colonization, policy, practices Role of education/knowledge mobilization • Group/foster homes – teaching models • Involvement of universities, colleges, research centres

38. Next Steps Indigenous Over-representation – Working Together Kahkiyaw, an Indigenous OBSD site is operational in Edmonton and a Calgary site has been tendered and will be operational spring 2013 Catherine Twinn, ADM and Sharon Steinhauer, Blue Quills are involved with community discussions Learning opportunities have been created: • Reclaiming Our Youth (RAP) trainings (Circle of Courage) is being made available • omantew, (a Cree concept which means to create the space that welcomes a visitor/client and gives them an environment to thrive and carry on from; once you’ve experienced omantew it is something you want to give to people) has been piloted Signs of Safety is currently being used as the practice model by Kinbasket in BC; by Woods Homes, some DFNA’s and is of interest to many of the OBSD sites Learning from OBSD is being shared to meet the needs of Indigenous children and families

39. Next Steps Broader implementation of OBSD - stakeholder engagement through RFI, learning events, AFPA, AASCF Support Practice • Expand the knowledge/skill base of ideas/ approaches that support OBSD • Identify training and support needs and build tools to support implementation • Readiness Assessment Tool – identifies areas to be addressed • On-line workshops have been developed - Casework Practice Model and OBSD, Report Writing and Documentation, Preparing and Presenting in Court • Workplace strategies - staff hiring, learning, skill sets and retention • Communities of Practice - forums for supervisors • Create spaces for dialogue about the issues; opportunities to share experiences

40. Development of a Practice Framework A Practice Framework outlines core values, principles and beliefs to support leading practice approaches to working with children and families • “Think Tanks” with over 200 people - Ministry/ CFSA/ DFNA/ Agency/ academics/ researchers contributed to the discussions (May, June 2012) • Purpose is to identify principles associated with leading practice to inform the development of a child intervention practice framework • Themes were consistent with those of OBSD: • Engagement of families in respectful and meaningful ways • Authentic cultural responsiveness • Collaboration • Strength based approaches • Reflective and relational practice • Focus on outcomes

41. Why a Practice Framework? Feedback indicates leading practice elements utilize a less forensic approach • Support focus on the development of a practice framework by building on what works well OBSD sites reflect the success of using a supportive, shared practice approach in working with families • These approaches are based on foundational principles that support intentional practice. This feedback is affirmed in research by academics • Dr. William Bell, Dr. Bob Lonne, Dr. Bill Madsen • The Practice Framework is a reflection of the Social Policy Framework in providing a vision for the future: • The use of principles to guide practice - decision making and how (actions and behavior) supports and services will be provided. • Links policy development, training and quality assurance activities to core principles • Use of common language and shared understanding of roles and responsibilities connects policy, programs and supports • Identifies the drivers of change, strategies to achieve positive outcomes, and indicators to measure success.

42. More Next Steps Funding • Full analysis of current funding and recommendation for a consistent approach to funding • Development of finalized contract policy recommendations, contracts schedules and clauses that are OBSD appropriate Communication • An integrated reporting process for regions, ministry and agencies • Collection, communication and distribution of what is being learned: • Results of the KPMG evaluation, OBSD Annual Report circulated • AASCF and Ministry web-sites/ newsletters / vignettes

43. Change Management The central issue to creating change is never just strategy, structure, culture, or systems. The core of the matter is always about changing behavior of people… how they see and think about what is new or proposed... John Kotter

44. Questions

45. Contact Information Sandra Maygard: smaygard@aascf.com 780-451-0898 Kim Spicer: kimberly.spicer@gov.ab.ca 780-643-9429

46. Resources AASCF Web-site: www.aascf.com/ResourceLibrary/OBSD Casey Foundation – Casey Family Programs: www.casey.org Christopher Bauer Ethics: www.bauerethicsseminars.com Department of Human Services: http://humanservices.alberta.ca/family-community/15156.html Family-Centered Services Project , Dr. Bill Madsen:www.family-centeredservices.org KtunaxaKinbasket Child & Family Services Society (KKCFSS) http://www.slideserve.com/adamdaniel/before-and-after-signs-of-safety-child-protection-in-the-aboriginal-community OBSD Vignettes: www.aascf.com/ResourceLibrary/OBSD/forums and presentations Signs of Safety:www.signsofsafety.net United Nations Convention on the Rights of the Child http://www2.ohchr.org/english/law/crc.htm