Crowne Plaza Hotel ,

Foster City, California

January 23, 2008

STRENGTHENING PARTNERSHIPS TO STRENGTHENING PARTNERSHIPS TO BUILD A PLAN FOR CAPTA BUILD A PLAN FOR CAPTA

CHANGESCHANGES

Who’s Here?Who’s Here? Early Start/ Regional CentersEarly Start/ Regional Centers County Child WelfareCounty Child Welfare State Departments State Departments (Social(Social

Services, Health, Maternal and Child Services, Health, Maternal and Child Health)Health)

Family Resource CentersFamily Resource Centers Education Education California Social Worker California Social Worker

Education CenterEducation Center Other Key stakeholders Other Key stakeholders

Today’ s FocusToday’ s Focus

Recap the requirements of the Keeping Children and Recap the requirements of the Keeping Children and Families Safe Act of 2003 (P.L. 108-36 and Child Abuse and Families Safe Act of 2003 (P.L. 108-36 and Child Abuse and Prevention and Treatment Act (CAPTA).Prevention and Treatment Act (CAPTA).

Examine ways that systems can Examine ways that systems can effectively effectively work together to work together to ensure that children involved with child welfare system who ensure that children involved with child welfare system who may be eligible for Early Start are identified.may be eligible for Early Start are identified.

Describe the Part C and Child Welfare Systems and Services.Describe the Part C and Child Welfare Systems and Services.

Today’ s ObjectivesToday’ s Objectives

Share the rationale for early developmental screening for Share the rationale for early developmental screening for children in Child Welfare.children in Child Welfare.

Establish effective informal relationships.Establish effective informal relationships.

Identify clear, concrete action steps to form the basis for Identify clear, concrete action steps to form the basis for continuing collaboration.continuing collaboration.

Some Common GoalsSome Common Goals Identify solutions that build on Identify solutions that build on

larger systems change efforts.larger systems change efforts. Identify young children in need Identify young children in need

of services and connect those of services and connect those children with the services they children with the services they need early.need early.

Improve health outcomes for Improve health outcomes for young children.young children.

Strengthen interagency Strengthen interagency collaboration to leverage collaboration to leverage funding, technical assistance and funding, technical assistance and training.training.

States receiving CAPTA funds must States receiving CAPTA funds must develop and implement “provisions and develop and implement “provisions and procedures for referral of a child under the procedures for referral of a child under the age of 3 who is involved in a substantiated age of 3 who is involved in a substantiated case of abuse or neglect to early case of abuse or neglect to early intervention services funded under part C intervention services funded under part C of the Individuals with Disabilities of the Individuals with Disabilities Education Act” [106(b)(2)(A)(xxi)].Education Act” [106(b)(2)(A)(xxi)].

Since 2003 it’s been the LawSince 2003 it’s been the Law….….

Restated in IDEA in 2004…Restated in IDEA in 2004…

States must provide “a description of the State States must provide “a description of the State policies and procedures that require the policies and procedures that require the referral for early intervention services referral for early intervention services under Part C of a child under the age of 3 under Part C of a child under the age of 3 who is involved in a substantiated case of who is involved in a substantiated case of child abuse or neglect” [637(a)(6)(A)]child abuse or neglect” [637(a)(6)(A)]

Individuals with Disabilities Act (IDEA)Individuals with Disabilities Act (IDEA)

Interpretation …Interpretation …

--Screening can be used to determine whether Screening can be used to determine whether an evaluation is needed. an evaluation is needed.

--Intent of the law:Intent of the law: CWS children will receive CWS children will receive special attention to determine whether an special attention to determine whether an early intervention referral is needed. early intervention referral is needed.

See Child Welfare Policy Manual www.acf.hhs.gov/j2ee/programs/cb/laws_policy/laws/cwpm/index.jsp

Who RefersWho Refers….….

--Referral can come from social worker or Referral can come from social worker or other referral sources (e.g., physicians) to other referral sources (e.g., physicians) to screen and refer.screen and refer.

-No requirement to refer siblings under age 3 -No requirement to refer siblings under age 3 who are not the subject of abuse or neglect, who are not the subject of abuse or neglect, but best practices dictate you should refer but best practices dictate you should refer siblings who may have delays.siblings who may have delays.

Context for ImplementationContext for Implementation

California Outcomes and Accountability (fully California Outcomes and Accountability (fully operational in all 58 counties)operational in all 58 counties)

Second Round Children and Family Second Round Children and Family Services Review [02/2008]Services Review [02/2008] Los Angeles, Santa Clara, Fresno - SitesLos Angeles, Santa Clara, Fresno - Sites

Standardized risk and safety tools used Standardized risk and safety tools used in all countiesin all counties Assessing protective capacity, families Assessing protective capacity, families

needs and strengthsneeds and strengths

Context for Implementation Context for Implementation

Mental Health Services Act – Prevention Mental Health Services Act – Prevention and Early Interventionand Early Intervention

Other Initiatives [First Five, Early Other Initiatives [First Five, Early Childhood, ABCD Screening Academy Childhood, ABCD Screening Academy Infant Mental Health, Early Head Start].Infant Mental Health, Early Head Start].

California’s Data snapshot..California’s Data snapshot..

In 2003 we had 93,000 in FC In 2003 we had 93,000 in FC today we have 77,000.today we have 77,000.

*In 2006 CDSS had 482,706 child *In 2006 CDSS had 482,706 child maltreatment referrals of which maltreatment referrals of which 108,230 were substantiated. 108,230 were substantiated.

Of that total 27,785 were Of that total 27,785 were agesages Zero to three. Zero to three. ( in-Home/out of home)( in-Home/out of home)

*Needell, B., Webster, D., Armijo, M., Lee, S., Cuccaro-Alamin, S., Shaw, T., Dawson, W., Piccus, W., Magruder, J., Exel, M., Smith, J., Dunn, A., Frerer, K., Putnam Hornstein, E., & Ataie, Y. (2006). Child Welfare Services Reports for California. Retrieved [32/16/07r], from University of California at Berkeley Center for Social Services Research website. URL: <http://cssr.berkeley.edu/CWSCMSreports/> 2 Extract

How Many Children How Many Children Under the Age of Under the Age of Three Three Are in Child Welfare Supervised Are in Child Welfare Supervised

Foster Care?Foster Care?

As of October 2006*As of October 2006*<1 4.311<1 4.3111-21-2 9,1639,163

13,47413,474

* * Child Welfare Services/Case Management System Data. These Child Welfare Services/Case Management System Data. These reports are based on children aged 0 to 18, overall totals may reports are based on children aged 0 to 18, overall totals may not match other point-in-time reports that include ages 0 to not match other point-in-time reports that include ages 0 to 20 and missing age values20 and missing age values

20062006

California:California: Substantiated Referrals per 1,000 Substantiated Referrals per 1,000

by Age and Ethnicityby Age and Ethnicity

<1 yr 1-2 yrs

3-5 yrs 6-10 yrs

11-15 yrs16-17 yrs

Black

(22.0*) Native

American

(13.9*)

ALL

(11.1*) White

(9.8*) Hispanic

(11.3*) Asian/PI

(4.3*)

62

2724

22

18

13

44

1826

13

9

5

24

12

1111

9

7

24

1110

109

6

22

1212

12

10

7

9

45

54

3

*Series Total

Why bridge connections between child Why bridge connections between child welfare and Part C?welfare and Part C?

Highest rates of abuse and neglect occur in Highest rates of abuse and neglect occur in infants and toddlersinfants and toddlers 16.1 per 1000 children under age 316.1 per 1000 children under age 3

High rates of developmental delay in this High rates of developmental delay in this populationpopulation 23-61% of children known to CW have delays 23-61% of children known to CW have delays

in development, communication, behaviorin development, communication, behavior

Child Protection Services StructureChild Protection Services Structure

A substantiated case provides in-home and A substantiated case provides in-home and out of home protective services to prevent out of home protective services to prevent or remedy neglect, abuse, or exploitation, or remedy neglect, abuse, or exploitation, for the purpose of preventing separation for the purpose of preventing separation of children living with their families.of children living with their families.

• Differential response Differential response • Family to FamilyFamily to Family• Evidence Based InterventionsEvidence Based Interventions

Child Protection Services StructureChild Protection Services Structure

.The services plan must address the needs .The services plan must address the needs of the child and the family ( for the child of the child and the family ( for the child mandated to address the health, mandated to address the health, educational and mental health needs)educational and mental health needs)

Families more be engagedFamilies more be engaged Up to 60 days to do case planUp to 60 days to do case plan

PHN HFCA projectPHN HFCA project Service array expanded Service array expanded

Opportunities for Collaboration Opportunities for Collaboration Between AgenciesBetween Agencies

Forms of collaborationForms of collaboration Consultation regarding assessments/servicesConsultation regarding assessments/services Joint evaluations/staffingJoint evaluations/staffing Sharing of informationSharing of information Combined home visitsCombined home visits Inclusion of CW in IFSP or EI staff in TDM’s, Inclusion of CW in IFSP or EI staff in TDM’s,

team meetingsteam meetings

ChallengesChallenges

Demands for services far exceed Demands for services far exceed the available resources the available resources

Increasing capacityIncreasing capacity Coordination of screening and Coordination of screening and

evaluationsevaluations Multiple placementsMultiple placements Infant mental health issuesInfant mental health issues Complex needs of biological Complex needs of biological

familiesfamilies Multiple caregivers--consentMultiple caregivers--consent Part C as a voluntary service vs Part C as a voluntary service vs

court ordered servicescourt ordered services

TrainingTraining What training is available that will help EI What training is available that will help EI

providers work with families referred through providers work with families referred through CW.CW.

Training should focus on clinical interventions Training should focus on clinical interventions specific to CW populations (EB clearinghouse)specific to CW populations (EB clearinghouse)

Some programs have created liaison position to Some programs have created liaison position to coordinate services between CW and EIcoordinate services between CW and EI

Joint training builds relationshipsJoint training builds relationships

FundingFunding

Advocacy is needed for funding the CAPTA Advocacy is needed for funding the CAPTA regulations in order to make the regulations in order to make the appropriate changesappropriate changes

Medi-Cal pays for screens and medically Medi-Cal pays for screens and medically necessary treatmentnecessary treatment

Consider this…Consider this…

Create multiple pathways for screening Create multiple pathways for screening using primary physicians or other resourcesusing primary physicians or other resources

Participating agencies should work together Participating agencies should work together to contribute to the plan of care to meet the to contribute to the plan of care to meet the child’s needs.child’s needs.

Need to engage and inform judges and Need to engage and inform judges and court officers about the needs of infants court officers about the needs of infants and toddlers in CW.and toddlers in CW.

THE POWER OF

THE POWER OF

EARLY INTERVENTION

EARLY INTERVENTION

And Beauty of

LOS ANGELES

MONTERREY

SAN BERNARDINO

HUMBOLDT

County models