Dances With Wolves: How Small States Fare on Indicators of Family Centered Practice

1
Dances With WolvesHow Small States Fare on
Indicatorsof Family Centered Practice

• Thomas E. Lengyel
• Director of Research
• Alliance for Children and Families
• September 20, 2005
• Revised September 26, 2005

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Structure of Presentation

• Review of indicators that measure Family Centered
  Practice
• Hawaiis CFSR results and improvement plan
• Comparison of six small states
• Analysis of problems and solutions (increasing
  complexity)
• Preserving connections
• Foster care re-entries
• Parent-child sibling visitation
• Child family involvement in case plan
• Needs services of child, parents, foster
  parents
• Patterns in problem solving among the states

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Indicators of Family Centered Practice (FCP) in
CFSR Reviews (1)

• Safety Outcome 2
• (3) Services to protect children in-home
  prevent removal
• (4) Assess ( reduce) risk of harm
• Permanency Outcome 1
• (5) Foster care re-entries
• Permanency Outcome 2
• (11) Proximity of foster care placement
• (12) Placement with siblings
• (13) Parent-child sibling visitations
• (14) Preserving connections

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Indicators of Family Centered Practice in CFSR
Reviews (2)

• Well Being Outcome 1
• (17) Needs services of child, parents, foster
  parents
• (18) Child family involvement in case planning
  review
• (19) Worker visits with child
• (20) Worker visits with parents

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HawaiiVariation Across Counties (Table 1)

• Cases were reviewed in Oahu (26), Maui (12), and
  Hilo (12)
• Maui clearly exceeded Oahu and Hilo on Safety 2,
  Permanency 1, and Well Being 1
• Though not rated strong, Maui caseworkers were
  far more successful at meeting standards for
  visitation
• Use Maui as a source of training ideas?
• Hilos strong suit was in preserving the
  continuity of family relationships connections

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HawaiiState Rating on FCP Indicators (Table 2)

• Hawaii rated as strong overall in three
  indicators
• Services to protect children in-home and prevent
  removal
• Proximity of foster care placement
• Placement with siblings
• Hawaii rated as needing improvement in the
  other 8 FCP indicators
• State did relatively well on maintaining children
  safely in their homes (Safety Outcome 2)
• State did very poorly on building the capacity of
  families to provide for their childrens needs
  (Well Being Outcome 1)

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Hawaiis Program Improvement Plan

• Hawaiis Response
• Relies very heavily on Ohana (family)
  Conferencing as a means to address deficiencies
  in its outcome indicators
• Of 31 indicators judged as needing improvement
  Ohana Conferencing was cited as a solution in 13
  (42)
• Divert cases from the system through an
  alternate response system
• Systematic quality assurance system
• Pilot programs

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Comparison of NH, MT, HI, ID, WV, RISmall
Social Service Delivery Systems (Table 2)

• NH achieved strength in 5 of the 11 indicators
• HI and ID were strong in 3 indicators
• WV (2) and RI (1) brought up the rear
• All the states were strong in proximity of foster
  care placement
• Standard may be lax
• Hawaii benefits from geography (i.e., same
  island placement)
• Continuity of family relationships connections
  was the strongest outcome area for this group
  (Permanency 2)
• Building the capacity of families was by far the
  weakest
• None of the five states achieved strength rating
  on any Well Being 1 indicator

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Differences Between States

• Smallest differences
• Proximity of foster care placement (/- 5)
• Services to protect children in-home (/- 14)
• Assessing risk of harm (/- 18)
• Largest differences
• Worker visits with children (/- 44)
• Worker visits with parents (/- 47)
• Hawaii caseworkers fell far short of the states
  standards for visitation

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Differences Between StatesAssessment

• States are most similar to each other in terms of
  indicators that reflect the old child-centered
  paradigm
• Assessing risk, placement resources, services to
  child
• States diverge most in indicators that require a
  broader focus on the family
• Assessment of services to all family members,
  including foster parents, family contact, family
  involvement in planning
• Implication Small states have not yet broadly
  implemented Family Centered Practice

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Problems and SolutionsPreserving Connections
(Table 9)

• Problems
• No effort to preserve connections with extended
  family (NH, MT, HI, WV, RI)
• No effort to preserve connection with culture
  (MT, HI, WV, RI)
• No effort to preserve connection with siblings
  (RI)
• Solutions
• Increase awareness of issue by staff,
  supervisors, foster parents (HI, WV)
• Improve matching of child foster family (HI,
  RI)
• Expand existing process to identify relatives
  (HI)

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Problems and SolutionsFoster Care Re-entries
(Table 5)

• Problems are very similar (by definition)
• Solutions diverge
• Augment capacity of staff (HI, ID, WV)
• Improve accuracy of information (NH, WV, MT)
• Develop impose standards of practice (ID, HI,
  MT)
• Add new type of resource to system (NH, RI)
• Expand use of existing process or resource (HI)
• Limit professional discretion (HI)

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Problems and SolutionsParent-child Sibling
Visitation (Table 8)

• Problems
• No effort to promote visitation between siblings
  (NH, MT, HI, ID, RI)
• Insufficient visitation with father (ID, WV, RI)
• Did not meet needs of child (NH, HI)
• Solutions
• Set standards policy (NH, WV, RI, MT)
• Raise awareness of issue/train staff providers
  (HI, RI, MT)
• Add resources to system (NH, HI)
• Expand circle of invested parties (HI, RI)
• Refocus resources on visitation (MT)

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Problems and SolutionsChild Family
Involvement in Case Plan (Table 11)

• Problems
• Mothers (80), fathers (80), and children (63)
  not involved in case planning
• Solutions
• System change Implement FCP (WV, RI)
• Develop enforce standards (ID, WV)
• New assessment procedure (NH, MT)
• Impose structure/limit discretion (HI)
• Remove barriers threats to family engagement
  (NH)
• New family engagement process (ID)
• Align private with public practice (RI)
• Fuller sharing of case information (NH)

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Problems and SolutionsNeeds Services of
Child, Parents, Foster Parents (Table 10)

• Problems
• Childrens, mothers, fathers, foster
  parents needs not assessed
• Services not provided
• Needs not met
• Solutions
• Fuller sharing of information (NH, WV, RI)
• Limit professional discretion (NH, HI)
• Expand existing processes (NH, HI)
• System change (WV, RI)
• Align private with public practice (WV, RI)
• New assessment procedure (MT)

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SolutionsCommon State Strategies (1)

• Develop implement standards (ID, HI, NH, WV,
  RI, MT)
• Improve communication coordination (NH, WV, RI,
  ID, MT)
• Build staff capacity (HI, ID, WV)
• Educate, train, raise awareness of staff and
  providers (HI, RI, WV)
• Improve data management accuracy (RI, WV, MT)
• Add resources (NH, RI, HI)

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SolutionsCommon State Strategies (2)

• Limit professional discretion (NH, HI)
• Paradigm shift/system change (WV, RI)
• Increase oversight (NH, MT)
• Align policies among providers institutions
  (ID, RI)
• Refocus existing resources (MT)
• Control system loading/diversion (HI)

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State StrategiesThemes (Ranked by Frequency)

• Get more out of existing staff and resources by
• Setting standards and monitoring compliance
• Constraining staff discretion
• Increased oversight and review
• Broader application of proven processes
• Improve information flow and data accuracy
• Revamp the system of practice
• Augment resources by
• Adding new resources
• Increasing capacity of staff

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Acknowledgements

• Many thanks to

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Contact Information

• Thomas E. Lengyel
• Director of Research
• Alliance for Children and Families
• tlengyel_at_Alliance1.org
• [phone], x. 3637