Improved outcomes for children and families in NYC Child Welfare System

1. 5/27/2009 Presentation for Alberta Provincial Forum CATHOLIC GUARDIAN SOCIETY &HOME BUREAUIMPROVED OUTCOMES FOR CHILDREN AND FAMILIES IN NEW YORK CITY Concerned Communities Caring for Children and Families

2. CURRENT TRENDS IN NYC CHILD WELFARE SYSTEM The NYC Child Welfare System as a whole which is undergoing many concurrent changes that have or will impact IOC Outcomes both positively and negatively, including: • Philosophy that all children should be placed in family settings; • Closure of congregate care programs including residential treatment centers, group homes, and Supervised Independent Living Programs; • Placement of more teens in FBH programs with additional supports; • Increased number of TFBH placements for adolescents with mental illness; • Increased permanency hearings (annually to semi-annually) impacting the Family Court system’s ability to finalize adoptions in a timely manner; • Implementation of alternatives to placement resulting in greater use of community-based preventive services; • National and local economic crisis that has recently resulted in funding cuts to the foster care rate and foster parent support funding; • Anticipated cost of Foster Care Services are distributed based on performance on permanency outcomes; agencies had the latitude to reinvest savings on agency-determined methods to expedite permanency.

3. CGSHB – Agency Overview The CGSHB service continuum includes: • Child Welfare Services: PPRS, FBH, TFBH, Congregate Care, Special Medical Services, Juvenile Justice Initiative (IPAS) • Support Services • Juvenile Justice Services: NSD • Maternity and Private Adoption Services • MR/DD Services • Family Shelter Services • Family Day Care Services • Five Community-Based Services Offices

4. Serves approximately: 1,000 children; 625 birth families; 700 foster families Staff Includes: Program Director, Social Services Director, 3 Site Directors, 13 Supervisors, 69 Caseworkers, 2 FBH Special/Exceptional Children Caseworkers, 1 FBH Case Work Floater, 2 Court/PH Liaisons, 1 Missing Child Tracker Regular FBH Program – Now Participating in IOC CGSHB FBH Program Serves Children & Families in Manhattan & the Bronx • Five Satellite Offices: • Manhattan/Washington Heights and Inwood - 652 West 187th Street • Manhattan/Central Harlem - 34 West 134th Street • Bronx/Parkchester – 1990 Westchester Avenue • Bronx/Fordham - 2432 Grand Concourse • Bronx/Tremont - 1780 Grand Concourse

5. CGSHB IOC Initiative Overview Currently 9 FC Agencies Selected • Major Changes • Expedited Permanency – adapted Family-to-Family model • Case Practice – Family Team Conferencing • New Payment for Services Methodology: agencies pay for step-ups • To become system-wide in 2009

6. IOC Objectives and Goals • Greater placement stability for children (fewer moves in care) • Shorter lengths of stay in foster care and improved permanency outcomes • Reduced use of residential care – fewer step-ups, less time spent • Fewer re-entries into foster care • Fewer youth aging out without permanent adult connections • Youth better prepared for adulthood • More stability in provider agency workforce

7. CGSHB Improved Outcomes for Children (IOC) Project Governance Structure Quality Management Dept. Director DATA Needs and Reports MIS Director, Consultant Director TFBH Teen Unit

8. Family Team Conferencing Implementation Plans: Staffing Status 2 • Specialty Staff * Contingent on grant application funding

9. Family Team ConferencingNotification and Scheduling • ACS Child Safety Conference – Removal Decisions • 3 – 5 day Parent to Parent Meeting • 20 Day Conferences – facilitated by ACS • Once conferences are implemented program supervisory staff will schedule in conjunction  with unit supervisor • Unit assistant send out letters • FTC/SPR Conferences • QM will identify cases requiring conferences and send “coming due” alerts to program staff • Supervisors in FBH Program will develop schedules in conjunction with Supervisors of Facilitators and return to QM • QM will issue report of all conferences scheduled for the month • Unit assistants for programs will use Connections for scheduling and send out letters • Case Planners and Facilitators will confirm attendance • “Critical” Conferences • Placement Preservation, Goal Change, Trial/Final Discharge • Caseworkers and Supervisors will identify cases requiring Critical FT Conferences and notify ACS Scheduler

10. Phase I: Family Conferencing Framework - Foster Care Quarterly Permanency Conference Provider Facilitates* ACS Attends Quarterly Permanency Conference Provider Facilitates* ACS Attends Initial Child Safety Conference ACS Facilitates Follow Up Child Safety Conference ACS Facilitates Provider Attends Provider Facilitates Quarterly Conferences every 3 months thereafter, with ACS attending every 6 months Placement Week 1 20 Days Month 3 Month 7 Month 10 Month 13 Quarterly Permanency Conference Provider Facilitates* ACS Attends Quarterly Permanency Conference Provider Facilitates* No ACS Presence Parent to Parent Meeting: Provider agency will hold a meeting 3-5 days after initial placement to establish an ongoing relationship between birth and foster families, and to initiate service planning and visiting arrangements. ACS will not be present. • Family Team Conferences: • Placement Preservation Conference • Reunification/Discharge Conference • Pre-Adoption Conference • Goal Change Conference • Event triggered; ACS Facilitates; Provider attends. *ACS may facilitate some of these conferences initially

11. Phase II: Family Conferencing Framework - Foster Care Initial Child Safety Conference ACS Facilitates Follow Up Child Safety Conference ACS Facilitates Provider Attends Permanency Conference Provider Facilitates ACS Attends Permanency Conference Provider Facilitates ACS Attends Permanency Conference Provider Facilitates ACS Attends Provider Facilitates Conferences every 6 months thereafter, with ACS attending each conference Placement Week 1 20 Days Month 3 Month 6 Month 12 Parent to Parent Meeting: Provider agency will hold a meeting 3-5 days after initial placement to establish an ongoing relationship between birth and foster families. ACS will not be present. • Family Team Conferences: • Placement Preservation Conference • Reunification/Discharge Conference • Goal Change Conference • Permanency Planning Conference (Agency facilitates)

12. Family Team ConferencingFamily Participation • Education • Mailings • Presentations to Foster Parent Association • Guest Speakers • Teen and Other Groups • Materials to Include in FP Training • CGSHB Website • Support • Unit Assistants schedule the conferences at times that are most convenient to parents, caregivers and children – after school, evenings and weekends • Unit Assistants provide follow-up phone calls and letters and document diligent efforts to increase participation in conferences.

13. Family Team ConferencingConsensus Decision Making CGSHB will utilize the agency’s organizational structure or chain of command, deferring those decisions that are stalemated in conferences to the Site Director, Director of Social Services, Director of FBH Programs, Assistant and Associate Executive Directors and Executive Director as necessary. In the event that a decision cannot be reached internally at the agency after all avenues of agreement have been exhausted, CGSHB will engage the ACS Office of Family Permanency Team Conferencing leadership for technical assistance and advice on resolving the situation following the ACS Family Team Conferencing (FTC) Protocol.

14. Family Team ConferencingDocumentation, Data and Reports • Documentation in CONNECTIONS (State Management Information System) • SPR Tab • Progress Notes • Quarterly Conference FTC Facilitator Form • CNNX Refresher Training • Management Reports and Systems Development • Supervisors and Managers Report Folders on CGSHB Public Drive • Services Tracking Database

22. Case Management DelegationEnsure Best Practice • Emphasis on Training • Regular Supervision • Supervision Matrix • Supervisory Checklist • Continuous Quality Improvement • Focus on the Children and Families – Strengths and Needs • Employee Teamwork • Commitment to Training and Recognition • Communication and Feedback • Measurement and Analysis – CNNX Data Reports, Contacts Review

23. Implementation Challenges Scheduling of FTCs – QM developed a monthly calendar, using time slots for each facilitator covering a particular site. Role of Facilitator – the functions evolved over time, at first we attempted specific site assignments but then used floating facilitators between sites. Workload for Case Management and Case Work Staff – late evenings, weekends, 2+ hour conferences. Worked with ACS to limit the number of conferences and the length of conferences. Participation and Missed Service Plan Reviews/FTC – QM developed monthly rating reports to closely monitor performance for each site. Performance improved but needs further improvement. Data Management – developed Master Blaster and Services Tracking System.

24. Provider Agency Measurement System (PAMS) and Scorecard • PAMS is a comprehensive evaluation system designed to evaluate the quality of services provided by each foster care agency. • Elements: Case Record Reviews, on-site visits, Foster Parent/Childcare Worker Interviews, and Child Interview at the Supervised Independent Living Programs • Results: Used to discern “meaningful differences” in program quality, and to identify program strengths and needs. PAMS reviews every foster care program at all agencies in an annual review cycle. PAMS results are factored into ACS’ SCORE CARD • PAMS achieves this in three ways – • Random selection of cases • Development of Instruments or questionnaires • Scoring, data analysis and producing reports.

25. Score Card Overview • Scorecard is a comprehensive, annual evaluation of all foster care programs serving New York City‘s children and families. Conducted by the ACS Office of Research and Evaluation (ORE), Scorecard evaluates process, practice, and outcome indicators in Safety, Permanency, Well Being, Foster Parent Recruitment and Support. • Scorecard measures are a combination of case-specific and aggregate performance. A comprehensive view of case-specific practice in every foster care program is provided by the intensive Provider Agency Measurement System (PAMS) review. • Scorecard also provides a system of accountability for ACS and provider agencies. Scores are used to inform the Mayor’s Office of Contracts Contractor Performance Evaluations, and are used with agencies by the Office of Agency Program Assistance (APA) to improve practice. APA analyzes practice and outcome data collected for Scorecard to identify areas of strength and areas in need of improvement with each provider agency.

26. Scorecard Practice Areas • Safety • Well Being • Permanency • Foster Parent Recruitment & Support

27. Score Card Overview: Practice Areas • SAFETY • Practice: • PAMS on-line review of notes and reports to evaluate progress note accuracy; Frequency and Quality of Contacts with Children, Foster Parents; Accuracy of FASP-New York State Family Assessment and Service Plan, etc.); • Assessment of Safety of Foster Homes based on Foster Home Visits during PAMS Review. • Process: • Timeliness of Responses of Corrective Actions for Incidents of Neglect/Abuse in Foster Homes; • Timeliness of Foster Home Certifications. • Outcomes: • Frequency of Indicated Abuse/Neglect Cases in Foster Homes; • Rates of AWOLS or “Missing Episodes”.

28. Score Card Overview: Practice Areas • WELL BEING • Practice: • Includes a combination of on line and paper case record review of notes and reports during PAMS review of the following indices: • Frequency and Quality of Sibling Visitation • Quality of Medical/Mental Health Services • Education Assessments and Services • Preparing Youth for Adulthood • Recreation • Provision of Family Planning Services • Outcomes: • Rates of Step Ups • Rates of Lateral Movements

29. Score Card Overview: Practice Areas • PERMANENCY • Practice: • PAMS review of progress notes and FASP for frequency and quality of Family/Child Visits and Case Work Contacts; • Service Planning with Families; • Adoption Practice; • Discharge Planning with Adolescents who do not have a Permanency Goal of Discharge to Parent/Relative. • Outcomes: • Permanency Discharge Rate (excludes Discharge to Self as a Permanency Discharge); • Adoption Finalization Rate based on goals set.

30. Score Card Overview: Practice Areas • FOSTER PARENT SUPPORT • Practice: • Results of Interview of Foster Parents during PAMS and responses given by foster parents regarding support and assistance with adoption, mental health, family planning, relationship with case worker, etc. • Process: • Timeliness of Foster Parent Training • Outcomes: • Meeting Foster Home Recruitment Targets and Retention

31. Number of Step-Ups SAMPLE IOC OUTCOMES AND RESULTS *Actual numbers are represented in yellow, FY09 Proposed numbers are represented in pink. ** FY09 proposed and actual step-ups represent children stepping up for the first time in FY09 *** Due to technical issues, Coalition step-up rate for this time period is calculated using children in care on July 1st as denominator

32. SAMPLE IOC OUTCOMES AND RESULTS Residential Care Day Usage for Children who Stepped-Up *Actual numbers are represented in yellow, FY09 Proposed numbers are represented in pink *The average time spent in residential care is based on a point in time cohort and therefore under states the actual length of average step up because some of the children have not completed a step up spell.

33. END Of PRESENTATION