new child welfare service array enhancing systems collaboration

New Child Welfare Service Array

Enhancing Systems Collaboration

ICN September 11 & 12, 2007 2

Experiences Across the Country and from Within Iowa

• National Trend is to Share Child Protection with the Community– It cannot be one agencies job to keep children safe—it must be a

community endeavor– Sampling of the States with Shared Roles:

• Kansas• Florida• California • Massachusetts• Illinois• Wisconsin• New York• Missouri

• More trained “eyes” in the home ensuring safety of children• Enhances ability for a wider net of professionals to understand how to

assess safety and risk—to understand the difference, to understand how to effectively develop in home safety plans and to recognize when children have to be removed



• There are effective methods to set up the transition that will positively impact the results– All must understand that there are predictable tensions during early

stages of ANY contract• Fear and loss • Role Confusion • Tension About Recommendations

– Resist the temptation if things don’t go smoothly (and they will not!) to Create Myths About “Good Old Days”

– Have logical, rapid response and locally driven problem resolution processes in place

– Ensure that resource families and other key partners understand the process shift

• Courts• Attorneys• Casa• Law Enforcement



• Need to Intentionally Create an Environment of Learning– There will be contractual/practice issues to

resolve –THIS IS A GIVEN!– Each problem, each local and statewide

resolution and each learning has to be shared across the state

– Statewide Standards and Local Solutions to Problems Can Co-exist

• Examples from R&R Contract


The apparent successful bidders are:

Boys & Girls Home •Mid Iowa

•LSI

•Families First

•LSI

•Four Oaks

•Tanager Place

•Mid Iowa

•Family Resources

•CFI

•First Resources

•CFI•Mid Iowa

•CFI

CFI


New Service Array

The new service array is divided into two separate service packages:

• Safety Plan Services

• Family Safety, Risk and Permanency Services

These services begin on October 1, 2007.


Characteristics of The New Service Array

• Aligned with the Department’s Model of Child Welfare Practice and CFSR

• Encourage greater flexibility and innovation

• Designed to build on family strengths

• Enhance caregiver’s protective capacities

• Connect families to community resources and informal support systems

• More family-focused

• Use of evidence-based practices in service delivery.


Change in Case Definition

Current Definition:

1 Case = Each child receiving services

Definition effective October 1, 2007:

1 Case = 1 Family Constellation


New Definitions

• Case: For Safety Plan Services, case means: � the child or children on whom the Department has initiated a child

protective or CINA assessment; and any whole, half, or step siblings of that child or children who reside in the same household; and the parents, stepparents, adoptive parents or caretakers of the alleged abuse victims.

• Case: For Family Safety, Risk, and Permanency Services, case means: the child, or children, who are victims of abuse and meet the Department’s criteria for opening ongoing services, or a child or children who are subject to a court order based on child in need of assistance proceedings; and any whole, half, or step siblings of these children who reside in the same household at the time of service referral or move into the household during the service delivery period, or are in placement under the care and supervision of the Department; and the parents, stepparents, adoptive parents, or caretakers, such as relatives or significant others of the parents, of the above children.


Population to be Served

Intact Families

APPLAFoster and Group

Care

Children who need to be safely maintained within their families

Children who are in out-of-home placement and

the goal isreunification with their

family or placement with a relative

Children for whom the goal is to achieve or maintain alternative

permanent family connections, including

placement in an adoptive

or guardianship arrangement or

independent living


Criteria for Family Safety, Risk and Permanency Services

Family Safety, Risk

and Permanency

Services

Placement in out-of-home care under the

care and responsibility of the Department

Adjudication as a child in need of assistance by juvenile court

Need for Department-funded child welfare interventions,

based on one of these factors:

A child in the family is six [6] years of age or older, is a founded victim of

child abuse or neglect, and the child’s Department assessed risk

level is moderate or high

A child in the family is under six [6] years of age and is a founded victim of child

abuse or neglect, regardless of whether the child’s Department- assessed risk

level is low, moderate, or high


Family Functioning Assessment

Assess child/children and/or family within the context of their family system, environment, and community in order to obtain the

best assessment of their strengths, needs, and possible

resources

Assess child/children and/or family’s strengths and needs

related to the safety, permanency, and well-being

of the children

Assessment should determine if there are any substance

abuse, domestic violence, or mental health issues directly

impacting the safety, permanency, and well-being of

the children in the case

Assessment and interviews are conducted with the child/

children, family members, and others as necessary in order to develop the best

understanding of the child/children and their situation

Obtain information about the child/

children and family’s history and historical

functioning

Provision of basic physical and behavioral health

screening for children is expected so that appropriate

referrals for treatment canbe recommended


Examples of Service Activities and Supports

• Family functional assessment• Visitation planning and supervision of visitation between

parents and children and between siblings• Crisis intervention responses• Family functioning interventions• Family reunification services and activities• Concurrent and permanency planning service activities• Safety checks and supervision service activities• Household management assistance and instruction• Transportation assistance• Activities, or provision of funding, to help children and their

family secure necessary concrete supports• Individualized case-specific services

NEW SERVICE ARRAY WORKER PROCESS


Worker Process Flow ChartO

ng

oin

g S

erv

ice

Ph

ase

Ch

ild A

bu

se A

sse

ssm

en

t P

ha

se CPW CONDUCTS

ASSESSMENT

CPW /Supervisor determines that case will be confirmed/founded and will

meet the criteria for services within DHS

SWCM MAY BE

ASSIGNED TO

SHADOW CASE

CPW and

SWCM visit

family

Family Introduction Meeting1.) SWCM introduced and role in the case explained2.) Safety plan is reviewed 3.) Identification of family needs to be addressed4.) Timeline for assessment completion and service provision

CPW COMPLETES CHILD ABUSE ASSESSMENT

HAND OFF TO SWCM FOR

ONGOING SERVICES

SWCM TAKES

OVER CASE

Case referred for Family

Team Meeting

SWCM and Provider meet

jointly with family and

develop the initial case

plan

FACS selects provider – email sent to provider initiating

services

3055 generated and submitted to

provider

Safety to be assessed at specified intervals for the life of the case.

OR

Provider introduced/Case Plan developed

SWCM MONITORS

PROGRESS OF CASE

OR

Case referred for Family

Team Meeting

SWCM visit

familymonthly

SWCM conducts case plan reviews

with family

OR

Case review conducted during

Family Team Meeting

SWCM monitors

family progress toward

outcomes

SWCM determines safe case closure point

CASE CLOSED

CPW determines

safety level of children

Unsafe: Placed out of home

Conditionally Safe: Safety Services May

Be Initiated as Appropriate

Safe: No servicesIf a case is receiving Safety Plan Services and the child(ren) are removed, CPW can continue or terminated Safety Plan Services. If Safety Services are terminated Family Safety, Risk and Permanency Services may be initiated

during the assessment phase.

CPW opens case in FACS and

sends 3055, face sheet and safety

plan

Safety Services are reauthorized

by sending ONLY 3055

Safety Constructs:Moving From Understanding to

Practice


Refining our approach• Safety assessment and planning are

already core functions of the work CPWs, SWCMs, and community professionals do.

• Our goal is to become even better – to clarify and make more consistent our practices around safety


Not just a CPW thing.

• All of us are responsible for assessing and planning for safety.

• Safety assessment and planning occur throughout the life of a family’s case

• This ongoing assessment will be reflected in our documentation throughout the life of a case.


Impact of good safety assessment

• Linked to placement decisions – and placement rates.

• Linked to reunification decisions – and reunification rates.

• Can be a matter of life or death for a child


Safety versus Risk

We have to be clear…

• safety is an immediate and impending threat which requires our immediate attention

• risk are those issues that may be contributing factors or underlying conditions that are responsible for the safety concerns


What is the difference?

SAFETY

REFERS TO PRESENT OR IMPENDING DANGER FROM

MALTREATMENT

RISK

REFERS TO THE PROBABILITY OR LIKELIHOOD THAT A CHILD WILL SUFFER MALTREATMENT IN THE

FUTURE

LACK OF SAFETY SIGNALS A NEED FOR IMMEDIATE

ACTION

IDENTIFICATION OF RISKS HELP DETERMINE THE FOCUS OF THE CHANGE PROCESS AND ISSUES

THAT WILL IMPACT SUCCESSFUL INTERVENTION


DEFINITION OF SAFE

CHILDREN ARE CONSIDERED SAFE WHEN:

• There are no present or impending dangers or

• When existing dangers are controlled by the caretaker’s protective capacities


DEFINITION OF UNSAFE

CHILDREN ARE CONSIDERED TO BE UNSAFE WHEN:

• They are vulnerable to present or impending danger

and

• Caretaker is unable to assure the child is protected or

• Lacks the caretaker/protective capacities to do so

Definition of Conditionally Safe

•One or more signs of present/impending danger identified. This situation is not expected to place the child in impending danger of maltreatment because protective capacities or lack of child vulnerability offset the threat of imminent danger to the child.

•One or more signs of present/impending danger identified. Child’s vulnerability and/or protective capacities don’t offset the impending danger of maltreatment. Controlling safety interventions have been initiated and based on these safety interventions, the child will remain in the home at this time.


THREE BASIC CONSTRUCTS OF SAFETY

• THREATS OF MALTREATMENT

• VULNERABILITY

• PROTECTIVE CAPACITIES


THREATS OF MALTREATMENT

• Situation ( e.g. Unsafe home, criminal activity)

• Behavior (e.g. Impulsive actions, assaults)

• Emotion (e.g. Immobilizing depression)

• Motive (e.g. Intention to hurt the child)

• Perception (e.g. Viewing child as a devil)

• Capacity (e.g. Physical disability)


DEFINITION OF VULNERABLITY

The degree in which a child cannot on his own, avoid, negate or

minimize/modify the impact of present or impending danger.


DEFINITION OF PROTECTIVE CAPACITIES

Family strengths or resources that reduce, control and/or

prevent threats of maltreatment from arising as

well as factors and deficiencies that have a negative impact on child

safety.


SAFETY ASSESSMENT• A decision-making and documentation

process that evaluates safety threats, present danger, child vulnerability, and family protective capacities to determine the safety response.

• An on-going process, rather than a one-time event. It will occur at critical junctures throughout the course of DHS involvement.


TIMES TO ASSESS FOR SAFETYFormal Safety assessments will be completed:

• Initial visit with the family

• Completion of the protective and family assessment

• Prior to initiation of unsupervised visitation

• Prior to family reunification

• Prior to case closure


SAFETY DECISIONS

• SAFE

• UNSAFE

• CONDITIONALLY SAFE


SAFETY PLAN

• A specific, formal, concrete strategy for controlling threats of maltreatment/harm or supplementing protective capacities.

• Employed immediately when a family’s protective capacities are insufficient to manage immediate threats of maltreatment/harm.

• Is designed to manage the foreseeable danger in the least restrictive manner to allow CPS intervention to proceed.


STRATEGIES FOR ASSURING SAFETY

• CONTROL

• SUPPLEMENT AND

• REDUCING VULNERABILITY


DIFFERENCE IN:SAFETY PLAN CASE PLANPurpose is to control immediate threats of

harm

Purpose to change behaviors and/or

conditions.

Limited to foreseeable danger threats

Can address a wide range of family needs.

Implemented immediately upon

identifying foreseeable dangers

Put in place after through assessment


DIFFERENCE IN:SAFETY PLAN CASE PLAN

Activities are concentrated and

intensive

Activities can be spread out over time

Must have immediate effect

Has long term effects achieved over time

Providers role and responsibilities are

exact and focused on the threats

Provider’s role and responsibilities vary according to client

need.

MOVING FROM SAFETY TO RISK

GOING FROM THE CONCRETE TO THE FEATHER BED


WHAT IS RISK?

• Underlying Conditions – Those factors that are internal within the family constellation.

• Contributing Factors – Those factors that are putting external pressure on the family constellation.


Why are we concerned about risk?

• Impacts the types of interventions that are most likely to be successful.

• Provides direction for the family in achieving the identified outcomes.

• An unattended risk MAY escalate into a safety threat.


Identifying Risk Factors

Underlying Conditions

• Domestic Violence

• Substance Abuse

• Mental Illness

• Physical Illness

• Unrealistic expectations

• Uncontrolled Anger

• Impulsiveness

Contributing Factors

• Neighborhood

• Poverty

• Limited access to resources due to

– Language barriers

– Cultural barriers

– Rural demographics

• No social supports

• Lack of transportation


The Path of Underlying Conditions and Contributing Factors

Identify the underlying conditions or contributing factors to the threat of harm in the case

Did this “risk” impact or lead to the

maltreatment?NO YES

Is this factor likely to become

significant enough to impact the ongoing safety/risk

of the child(ren)?

Is this factor changeable?

NO

NOYES

Factor not included in

Family Plan

What behaviors need to change to resolve the

safety threat?

Identified behavioral changes

are included in Family Plan

What needs to be controlled or

supplemented to manage the risk?

Identified methods for controlling or

supplementing the condition are included

in the Family Plan


The Family Plan

• Identifies the safety threat to be ameliorated

• Identifies the behaviors or conditions based on the risk factors that need to be changed, controlled or supplemented in order to ameliorate the safety threat

• Documents specific behaviors that the plan benchmarks for changes.


Putting it all together

• Safety

• Risk

• Family Plan

• Underlying conditions and contributing factors


Threats of Maltreatment

Protective Capacities Child Vulnerabilities

Safety Constructs and Family Functioning Domains

DOMAIN: Family Safety

DOMAINS: Parental Capabilities, Family Interactions, Home Environment

DOMAINS: Child Well-Being,

Family Interactions, Home Environment


Writing the Family Plan

Understanding safety and risk provides the basis for developing the overall Family Plan goals.

Family Plan goals are behaviorally specific based on the safety and risk factors.

No matter what your job function in CPS, there is nothing more important than understanding

the differences between conditions in a family that create

risk of maltreatment and conditions that create threats to

child safety.

Communication Between DHS and

Service Contractors


Communication ProcessesP

rogr

am Is

sues

[com

mun

icat

ion

for

gene

ral

serv

ice

deliv

ery]

Con

trac

t Iss

ues

[com

mun

icat

ion

rela

ted

to c

ontr

act

requ

irem

ents

]

Ser

vice

Issu

es[c

omm

unic

atio

n fo

r pr

ovid

ing

serv

ices

to a

spe

cific

fam

ily]

DHS Worker

Contractor/Sub-contractor

Case specific issue is identified and

resolution attempted

Not Resolved

Process Stops

Supervisor

DHS Worker


Case Specific Conflict

Reviewed

Process Stops

Social Work Administrator reviews conflict and resolution

attempts

DHS Worker identifies a

program issue

Supervisor reviews program issue and approves the completion of a question

submission format

Supervisor and DHS Worker completes question

submission format

Question(s) submitted to

Central Point of Contact

Answer submitted to the web for public view

DHS Worker identifies a

program issue


A dispute over the contract terms is

identified

Supervisor is informed of the

dispute and reviews to ensure that it is a contract

issue

Social Work Administrator reviews contract dispute and refers to the contract

monitor

Contract Monitor reviews the

disputes and attempts to resolve

the issue

Process Stops

Not Resolved

Dispute is elevated to the contract owner where

dispute is negotiated with the

contractor

Contract owner’s

decision is final

Social Work Administrator attempts to resolve conflict with

contractor

Resolved

Process Stops

Service Area Manger reviews conflict and

resolution attempts and make final decision


DHS staff completes the electronic question form (SP, FSR&P Questions)

DHS staff sends form to Service Area (SA) screener

SA screener reviews the question and submits to Central Point at

[email protected]

Central Point receives question and submits for response

Approved response posted to website

Safety Plan Services (SP) and

Family Safety, Risk, and Permanency Services (FSR&P)Question/Response Process

The responses to the questions will be posted to the website on Mondays and Thursdays @

<http://www.dhs.state.ia.us/children_family/child_welfare/welfare_system.html>


Non-DHS staff completes the electronic question form (SP, FSR&P Questions)

Non-DHS staff sends form to Mindy Norwood at [email protected]

Mindy Norwood receives question and submits for response

Approved response posted to website

Safety Plan Services (SP) and

Family Safety, Risk, and Permanency Services (FSR&P)Question/Response Process

The responses to the questions will be posted to the website on Mondays and Thursdays @

<http://www.dhs.state.ia.us/children_family/child_welfare/welfare_system.html>

Decision-Making Process for Current Ongoing Cases


What’s Left to Get Ready for October 1, 2007

• Review current cases to determine direction and family constellation;

• Update current cases in all systems;

• Learn the new service array expectations;

• Adapt to our new role in service delivery;

• Become familiar with new computer screens and payment processes


CPW/Supervisor determine service is

needed based on assessment

Founded or confirmed cases in

the population served transferred

to SWCM/Supervisor

SWCM/Supervisor determine service

needed

Transfer of Current Case or New Case

Family, Safety, Risk and

Permanency Services

Current Child Welfare Services

Case to be closed prior to

12/31/07

Agency notified and

transfer packet

completed and sent

SAM authorization

for interim services

Exception cases with no active child welfare

services

Community Resource

Engagement and Monitoring

Case remains

with SWCM

DEPARTMENT OF HUMAN SERVICESONGOING SERVICES FLOW CHART

(Effective October 1, 2007)

Service Array Referral Process Interim Authorization Process[ends 12/31/2007]

No Child Welfare Service Process 3055 extended ONLY to

anticipated date of case closure

NOD generated canceling current

services and new 3055 completed for new

service array


FAMILY SAFETY, RISK AND PERMANENCY SERVICES

Current Case Transfer Packet ContentsFor current DHS cases being referred to the Family Safety, Risk, Permanency

contractor, the following items shall be included in the referral packet to the new contractor:

• 3055, including specific behavioral expectations

• Current Case Plan

• Summary of treatment services of relevant family members, including substance abuse, domestic violence, mental health. Do not release third-party reports and documents.

• Court Orders that best explain the court’s current expectations.

• Safety Plan, if there is a current Safety Plan distinct from the family’s case plan.

• RELL screen: Ensure the RELL screen is up to date & includes all family and household members.


New CasesTransfer Packet Contents

• 3055 Authorizing Services

• CPW Assessment

• Family Functioning Assessment

• Safety Plan (if applicable)

• Case Manager Contact Information

• Family Team Meeting Facilitator Contact

Information

FAMILY SAFETY, RISK AND PERMANENCY SERVICES

“Changing the system means giving up the way things have always been done that are no

longer working.”

William Glasser

new child welfare service array enhancing systems collaboration

Documents

new service array

family constellation

child protective

new definitions case

child protection

systems collaboration

mid iowa lsi families

family strengths