Georgia’s Safety Response System

1. Georgia’s Safety Response System Presenter: Lisa Lariscy GA DHS/DFCS Project Director, Safety Response System and Differential Response Presentation to: G-2 Date: April 03, 2014 Georgia Department of Human Services

2. Vision, Mission and Core Values Vision Stronger Families for a Stronger Georgia. Mission Strengthen Georgia by providing Individuals and Families access to services that promote self-sufficiency, independence, and protect Georgia's vulnerable children and adults. Core Values • Provide access to resources that offer support and empower Georgians and their families. • Deliver services professionally and treat all clients with dignity and respect. Manage business operations effectively and efficiently by aligning resources across the agency. • Promote accountability, transparency and quality in all services we deliver and programs we administer. • Develop our employees at all levels of the agency.

3. SRS Presentation Objectives Georgia’s Safety Response System Origin of SRS Defining SRS Implementation Process for SRS Status of Statewide SRS with a View of Phase One: Intake Going Forward with SRS

4. Technical Assistance Develop and implement our child welfare practice and to facilitate organizational change Build Georgia’s capacity to implement and engage resources to support a significant child welfare practice change to ensure fidelity and sustainability to that practice change - Atlantic Coast Child Welfare Implementation Center (ACCWIC) Provide child welfare subject matter expertise to strategically support Georgia in utilizing the latest state of the art child welfare practice framework focused on safety of children – National Resource Center for Child Protective Services (NRCCPS)

5. Implementation Phases & Drivers Framework Also used by the CB and its T/TA Network Regional teams trained, Pilot Counties immersed Open-source website to support continued learning Two Evidence-based Models • National Safety Model • Policy consultation, Live Learning Sessions, Intensive Training Academy • Open-source website to support continued learning • Evidence based safety intervention model http://action4cp.org http://nirn.fpg.unc.edu

6. Georgia Safety Response System* Allows for and guides strategic decision making for the safety of children. • Intake Assessment /CPS Reports - A comprehensive Information gathering and analysis process used to determine the most appropriate agency response to an accepted CPS report. • Through initial and ongoing contacts with the family, a comprehensive safety assessment is conducted. • At any time a safety concern is identified, it is addressed through the most appropriate safety management practice (in home/out of home). • Safety Plans are created to control the threat of danger to the child. • A formal caregiver assessment is conducted to identify what must change with the caregiver(s). Services will be provided that focus on enhancing the caregiver’s diminished protective capacities. *Adopted by Action 4 Child Protection

7. Implementation Science* Allows for, and helps make informed strategic decisions for: Training, Supervision, Coaching Internal and External Collaboration/Coordination Feedback from practitioners and stakeholders Perspectives from all levels of the organization are heard Managers use data to guide implementation and align resources to support needed improvements Ensures fidelity and sustainability to the child welfare practice change *Adopted from the National Implementation Research Network

8. Implementation Drivers Performance Assessment Systems Intervention Coaching Organization Drivers Facilitative Administration CompetencyDrivers Training Selection Integrated & Compensatory Data Driven Decisions Leadership Adaptive Technical (Fixsen & Blase, 2008) Graphics by Steve Goodman,2009 Leadership Academy for Middle Managers • www.ncwwi.org A Service of the Children’s Bureau, a Member of the T/TA Network

9. Stages of Implementation The Pilot

10. SRS Statewide Roll Out Scenario

11. Pilots’ Contribution to a Successful Implementation • Avoid sink or swim scenario. Detect and trouble shoot the unexpected issues that could sink the change initiative. • Practice turning “intention into action” on a smaller scale. • Experiment with innovations without the pressure to predict every twist and turn in the change process. • Increase awareness that change does not happen all at once. • Instill confidence that the process of change can be managed responsibly. • Feed lessons learned on what works/does not work back to implementation planners and decision-makers.

12. Georgia’s Safety Response System Status of SRS Pilot Status Statewide Status

13. SRS – Pilot and Statewide • SRS Pilot Counties Selected: Richmond/Urban/NE and Sumter/Rural/SW • SRS Counties Began Piloting the Model in Intake, Family Support and Investigations 09/2012 • SRS Counties Began Piloting Family Preservation and Foster Care 10/2013 (ongoing with challenges) • SRS Phase One: Intake – began initial implementation in 09/2013

14. Implementation Capacity • 60 item survey sent to pilot county and regional staff, state implementation team, state quality assurance and training • Reflects staff perception of implementation capacity • N=67, 45% response rate

15. Implementation Capacity Performance Assessment (Fidelity) 3.20 Coaching 3.49 Systems Intervention 3.60 Live Learning 4.08 Facilitative Administration 3.45 COMPETENCY 3.98 ORGANIZATION 3.66 Training 4.52 Decision Support Data System 3.88 Selection 3.84 LEADERSHIP 4.40 Based on a Likert Scale of 1-7, N=64 Shared Vision, Values & Mission 5.15

16. Statewide policies are being informed by pilot and core group of SRS Specialists 73 SRS Specialists Safety Response System Academy training – Ongoing Implementation Science training established SRS Fidelity Review tools for Phases 1 and Phase 2 established SRS Capacity Built as of March 2014

17. SRS Statewide Implementation AView of SRS Phase One: Intake

18. Intake Assessment • This is the first assessment of safety in Georgia’s Safety Response System. • The Intake Assessment is a comprehensive information gathering and analysis process used to determine the most appropriate agency response. Objectives • Assist reporters to provide behaviorally specific, detailed information • Identify present and impending danger, vulnerable children, and diminished caregiver protective capacities • Determine the response time • Provide resource information

19. The SRS Intake Process

20. The SRS Intake Process Yes Child Safe – Family Support Assignment Five Day Response Child Unsafe – Investigation 0 to 24 Hours Response

21. The Intake Assessment Six Areas of Family Functioning 1. Extent of Maltreatment • Captures the description, type and severity of maltreatment alleged • Additionally captures the reporter’s knowledge of events (first-hand/eyewitness, 3rd party, etc) • Identifies the alleged Maltreator • For all intakes

22. The Intake Assessment 2. Circumstances Surrounding the Maltreatment • What was happening when the maltreatment occurred? • Does the caregiver have an explanation? • Acknowledgement, what were their attitudes & intentions • Captures history of past CPS involvement • patterns of maltreatment • Identifying any progressing patterns of severity • Identifies any protective measures taken by the non-maltreating caregiver

23. The Intake Assessment 3. Child Functioning • Captures day to day functioning of EACH child, whether identified as a “victim child” or “no role” • What is each child like normally? • Captures developmental concerns • Effects of maltreatment (emotional, psychological, physiological) • How is the child at the time of the report? • Will the child’s situation change quickly (safe at school vs. unsafe when arriving home?) • School? On grade level? Regular classes? Crucial in determining vulnerability of child

24. The Intake Assessment 4. Adult Functioning (in general) • How does this Adult (maltreator and non-maltreator, if applicable) function as an adult? • Captures mental and physical health (both current and past) • Identifies substance use, employment, criminal behavior/history • Indications of violence • Significant stressors present in home • How does this adult relate to his community? • How does the adult cope, problem solve, communicate, etc?

25. The Intake Assessment • Parenting (in General) • Captures history of protective behavior (or non-protective behavior), along with parenting style (Not related to malt.) • Identifies sensitivity to child’s needs and expectations for both the child and self • Is the parent satisfied as a parent? • Is the parent more concerned with self than with child? • What knowledge does the parent possess of normal child development and behavior? • How would you describe the parent/child relationship? • What are expectations for the child? • Do not gather for foster parents or house parents of CPA/CPI)

26. The Intake Assessment 6. Discipline (in general) • Captures parent’s approach to discipline • Identifies parent’s purpose and intention in discipline • Identifies parent’s specific discipline methods • Does the parent remain self-control when using discipline? • Is discipline used to punish or to teach? • Is the discipline age-appropriate? • What boundaries/rules has the parent set? • How does s/he discipline the child? • When does child receive discipline? • Do not gather for foster parents or house parents of CPA/CPI)

27. The Intake Assessment History • History can often be the tipping point--the point at which we say yes, this is now an accepted report or moves us from a family support assignment to an investigation. • A thorough review of history and application to the decision making is essential to determine appropriate disposition. • The review of history and application of that history to the current report takes time.

28. Status of SRS Phase One Intake • All Intake Staff Trained as of 12/2013 • SHINES Modifications Identified • SRS Specialists Support Activities: • Provided Live Learning Activities • On-site Support for Intake Staff statewide • Provided individual coaching with Supervisors and intake staff • Reviewed approximately 7000 intake dispositions • Detailed written feedback on dispositions overturned

29. Status of Intake Organizational Change • CICC Management In Place as of 12/2013 • Electronic Reporting for Mandated Reporters in place • County/Region Phone Line Transition Process Established • Regions 3,4,5,7,8, 9, 13,14 & 15 transitioned to CICC • Integrated Voice Recorded Message • Volunteers in Place to Support Staffing Need • Formal performance expectations inclusive of Georgia’s Safety Response System concepts and practices developed and executed for intake staff.

30. SRS Specialists Reviews – 11/09/13 – 2/9/14

31. SRS Specialists Review Results

32. Analysis of Reviews • 88% agreement rate for ~ 7000 cases. • Activities under way to enhance understanding and practice of SRS intake concepts related to Present and Impending Danger • Maltreatment types and codes being revised to better guide staff in identifying maltreatment and to allow for consistent practice • SHINES History modifications being made to allow for more efficient screening of CPS history Questions regarding SRS Intake?

33. Georgia’s Safety Response System Going Forward with SRS SRS Phase Two: Early 2015 SRS Phase Three: Fall 2015

34. Going Forward with SRS Phases Two & Three Lessons Learned from SRS Phase One: Intake • Policies Finalized prior to Training and/or SHINES Design Sessions • SHINES Modifications Made Prior to Roll Out of Future Phases • Continual Review of IS Drivers’ Effectiveness & Identifying Gaps & Ways to Address (Surveys, Review Findings, Data..) • Ensure Knowledge Capacity in Place Prior to Roll Out • Plan of Initial & Ongoing SRS Specialists Support Prior to Roll Out • Structured Collaboration with Regions through IS Region Plans

35. Going Forward with SRS Phases Two & Three • Adequate Staffing in Place Prior to Roll Out • Strategy to ensure SRS Specialists are Understanding and Applying the Model Effectively • Advocate for and Obtain Funding for Fidelity Review Team • Ensure Effective Staff Recruitment, Selection and Development

36. Preparation for Phase 2 & Phase 3 • Implementation Science Training • Regions to develop Implementation Plans • Staff Acquisition and Training • SRS Project Team to support the pilot work • SRS Specialists will continue to meet monthly and enhance their capacity and cascade learning • SRS Academies are currently planned on an consistent ongoing basis to build capacity and model expertise

37. SRS Concepts for Readiness Activities Family Functioning Assessment • The six areas in the FFA • What information is needed in each area? • Maltreatment – new policy • Caregiver Protective Capacities (three types) • Analyzing the family’s functioning Present Danger • Understanding what constitutes a PD Situation • How to Assess for Present Danger • Safety Criteria – observable, happening now & significant

38. SRS Concepts for Readiness Activities Present Danger Safety Plan • Understanding the purpose of the PD Safety Plan • How to Plan Appropriately for Controlling the Present Danger • How To Use the PD Safety Plan appropriately • Informal & Formal Safety Service Providers • Judging Provider Suitability • Conditions for Return to the Home of the Caregiver

39. SRS Concepts for Readiness Activities Impending Danger • Understanding Impending Danger • Use and application of the safety threshold in assessing for ID Impending Danger Safety Plan • Understanding the purpose of the ID Safety Plan • How to Plan Appropriately for Controlling ID • Informal & Formal Safety Service Providers • Judging Provider Suitability • Conditions for Return

40. SRS Concepts for Readiness Activities • Identification of appropriate collaterals • Using collaterals to fill in family functioning gaps & to support/refute information • Analysis & Understanding of the Family’s Functioning • Determining service providers to strengthen families • Stages of Change • Assessing Change

41. Safety Response System Project Team Ami Perryman Safety Response System Coordinator ajperryman@dhr.state.ga.us (706) 994-9104 (BB) Lisa C. Lariscy Project Director, Safety Response System and Differential Response lclariscy@dhr.state.ga.us (912) 222-5296 (BB) Kristan Small-Isom Safety Response System Coordinator Krsmall@dhr.state.ga.us (404)463-8575 (Desk)