Sacramento County CSA Report - Final 5-30-17

County Children’s Trust Fund Commission, Board or CouncilThe Sacramento County Children’s Coalition is designated to carry out the County’s Children’s TrustFund (CCTF). Their mission is to assess community needs, evaluate existing services, and makerecommendations to the Board of Supervisors in order to promote the health and well-being of childrenand families in Sacramento County. The Children’s Coalition advocates for children’s issues by fundingprograms protecting children, monitoring and reporting the results of these grant-funded projects. Inaddition, they provide policy oversight and community education about the needs of children andfamilies. Sacramento County does not deposit any portion of the Community-Based Child AbusePrevention (CBCAP) allocation into the CCFT.Sacramento's CCTF is currently funding KidsFirst. KidsFirst provides family support to children ages 6through 17 and their families, including low income families of Citrus Heights, families with pastinvolvement in child welfare, families with history of domestic violence, grandparents and othercaregivers. The CCTF also provides ongoing funding to CAPC for comprehensive, County-wideprevention work, including: 1) Promoting prevention and intervention of child abuse and neglectthrough operation of an information and referral phone line; 2) Educating and training mandated childabuse reporters in the definition, detection and legal reporting responsibilities in child abuse andneglect; and 3) Reviewing and assessing the performance, training, education and outreach needs of thechild protection, safety and service delivery system in Sacramento County, including coordination of theSacramento County Child Death Review Team and publication of the annual Sacramento County ChildDeath Review Report. CAPC also reports directly to the Children’s Coalition on their activities quarterlyon use CCTF dollars. The information regarding the Child Death Review Report is reported to thecommunity on CAPC’s website (http://www.thecapcenter.org/why/research-and-publications/child-death-review-team).PSSF CollaborativeSacramento County does not currently have a formal Promoting Safe and Stable Families (PSSF)collaborative in the form of an agency, commission, board, or council. However, Sacramento CountyCPS does currently participate in multiple collaboratives with community partners, some of which helpto direct PSSF funding. Currently, Sacramento County’s PSSF funding is allocated to provide: casemanagement services in the Informal Supervision program, adoptive parent recruitment and post-adoption services, case management services for alcohol and other drug treatment via the SpecializedTreatment and Recovery Services (STARS)/Bridges program, and funding short-term counseling mentalhealth services.Systemic Factors California - Child and Family Services ReviewManagement Information SystemsSacramento County utilizes the Child Welfare Services/Case Management System (CWS/CMS), astatewide database for child welfare services. All social workers, supervisors, managers, and supportstaff have access to CWS/CMS on their workstations. Depending on their job functions, some staff areprovided with laptop computers and netbooks, which allows them to access their desktop, includingCWS/CMS through remote access. Having remote access allows staff to perform data entry intoCWS/CMS and case documentation while in the field or in a location other than their assigned worksite.In order to ensure proper usage and maintenance of CWS/CMS, new user trainings are regularlyprovided for social workers and interns. Also, on an as needed basis, CWS/CMS trainings for specific job 100

California - Child and Family Services Reviewclassifications such as Family Service Workers, Public Health Nurses, and clerical staff are offered. In addition, Katie A trainings, Commercially Sexually Exploited Children (CSEC) training, and other casework-related trainings include a hands-on instruction on CWS/CWS documentation. In order to improve practices and assess the provision of child welfare services, Sacramento uses SafeMeasures, a data-analysis software for child welfare agencies. SafeMeasures extracts data entered in CWS/CMS to produce statistical reports to measure compliance and performance in state and federal measures and regulations. SafeMeasures is used by managers, supervisors, and social workers in Sacramento to have updated case information to support their work. Managers use SafeMeasures to make data-driven decision at an agency-level, focusing on performance and outcomes. Supervisor uses SafeMeasures to monitor caseloads in their unit and compliance with several requirements, such as monthly face to face contacts, timely investigation, referral closure, and Katie A Screenings. Social Workers use SafeMeasures as a tool to manage overdue and upcoming task specific to their caseload. Sacramento uses also Business Intelligence (BI), a reporting tool that gathers data in CWS/CMS and creates statistical reports for analysis. Program Administration (PA) staff are versed in Business Intelligence and regularly uses this tool to create program improvement reports. BI allows users to create customized reports in both referrals and case universe of CWS/CMS such as Referral Duration Report, Commercially Sexually Exploited Children (CSEC) monthly report, Expecting and Parenting Youth (EPY) report, and many more. These BI reports are used to evaluate services delivery to children and families. In addition to PA staff, several Program Planners and Program Specialist in the Emergency Response Division and Permanency Division have access to BI and are able to refresh regularly produced statistical reports. BI is a well-utilized reporting tool in Sacramento Child Welfare. In addition to CWS/CMS and BI, Sacramento County utilizes the Structured Decision-Making, a web- based tool used to assist social workers in conducting assessment and making decisions at every critical stage in child welfare practice to ensure safety, permanency, and well-being of children. SDM tools include, but not limited to, Intake Hotline tools, Safety Assessment, Risk Assessment, Family Strength and Needs, Reunification Reassessment, and In-home Risk Reassessment. To ensure accurate use of SDM assessment tools, Sacramento conducts regular SDM training and a Web SDM training to newly hired-social workers. In preparation for the SDM 3.0 changes, five program specialist and one Emergency Response Supervisor completed a SDM trainer course at Northern California Training Academy and subsequently provided a division-wide training in October 2015. SDM is used division-wide and is utilized to its full capacity. Program-level applications include:  Immediate Response Interactive System (IRIS) is a web-based application used by the Emergency Response Bureaus to tract and monitor immediate response referrals and ensure compliance such as timely investigation, SDM completion, and staffing requirements. Emergency Response managers, supervisors, and lead clerical staff have access to IRIS and input/ update data as needed. One limitation of this tool is that it does not measure performance outcomes and does not have the ability to generate statistical reports. IRIS is not underutilized and is used on a daily basis throughout the ER bureaus.  Asset Management System (AMS) is a workload assignment tool, in the form of an excel spreadsheet, used in the Emergency Response Bureaus to determine the agency’s workforce capacity to respond to child abuse and/or neglect reports. This system tracks the availability of staff to response to immediate response and 10-day referrals on a particular day and timeframe, and also records social worker’s daily tasks that impact their availability. To ensure accuracy of101

data, staff with “modify” access is limited to the Immediate Response Coordinator and 10-day California - Child and Family Services Review Coordinator, who assigns referrals depending on the response type, and to the Bureau Point of Contact. AMS requires quarterly and annual maintenance and trouble-shooting to ensure efficiency. AMS is not underutilized, is used on a daily basis throughout the ER bureaus, and serves the purpose it was designed to meet.  Court Report Timeliness (CRT) database is a Microsoft ACCESS database used in court programs to ensure compliance with court report timelines. In addition, this system tracks requests and reasons for Court continuances and Order to Show Cause (OSC) hearings. CRT reports are sent to supervisors and program managers on a monthly basis to ensure compliance and to monitor any existing barriers to court report timeliness. However, CRT may be underutilized by supervisors as a mechanism to monitor social worker compliance.  Independent Living Program (ILP) Database is an application used to gather ILP-related data such as client information, caseload assignment, and services delivered. Four contracted services providers through the school district as well as Extended Foster Care staff and supervisors are all authorized users. This database provides statistical reports related to ILP services delivered in the county. The ILP database is currently underutilized, as it is capable of many functionalities than it is actually used for. An example is that delivered services are not documented in the ILP database, as this is documented by social workers in CWS/CMS.  Foster Home Licensing database is an application use to tract county foster homes, including licensing status. This system has several challenges such as creating statistical reports. To address this, the county is currently exploring using Efforts to Outcome (ETO) to replace the current Foster Home Licensing database.Management Information Systems - ProbationSacramento County Probation utilizes the Child Welfare Services/Case Management System (CWS/CMS),Probation Information Program (PIP) and Safe Measures. Placement Officers make data entries into PIPwhich are integrated with CWS/CMS. Placement Officers additionally complete CWS/CMS data sheetswhich are submitted to clerical staff for entry into CWS/CMS. CWS/CMS data is reviewed by SupervisingProbation Officers on a monthly basis.Case Review SystemCourt StructureSacramento County’s Juvenile Delinquency and Dependency Courts are overseen by one PresidingJudge. On the Dependency side, there are five Courts, administered by three referees and two Judges.Each Dependency courtroom oversees all aspects of Juvenile Dependency cases, from Detention/Initialhearing, through Adoption, with detentions/initial hearings, arraignments, jurisdiction, dispositionalhearings and status reviews occurring on the morning calendar and trials or contested matters occurringin the afternoon. Each party to a case has legal representation in the court room, consisting of CountyCounsel for the Department, Children’s Law Center for each child and Parent Advocates of Sacramentofor Parents or Dependency Advocates of Sacramento for each parent.In addition to the above mentioned structure, in an effort to achieve better outcomes for children andfamilies and improve relationships, Sacramento County has had a Dependency Drug Court (DDC) forover 12 years, and has recently implemented an Extended Foster Care (EFC) Court. The DDC was apartnership between the Presiding Judge of the Juvenile Court, the Criminal Justice Cabinet, CPS and 102

California - Child and Family Services Review Alcohol and Other Drug Services. The court is overseen by one judge and has active participation from all, including Bridges, Inc., the service provider. This program integrates the court process with services, oversight, monitoring and outcomes for each family involved, including a graduation ceremony for successful participants. This effort has been extensively evaluated by an outside agency for all 12 years of operation and has proven to be very positive partnership, as well as a program that brings better outcomes for families. A newer partnership, aimed toward better outcomes for youth in EFC, is the implementation of EFC Court. This court is overseen by the Presiding Judge, with a goal of improving collaboration between the social worker, youth, attorneys and the court. The county social worker supervisor is in the court room acting as the court officer so there is always someone who has the latest information, which assists in lessening continuances. There is a focus on improving practice, establishing clear expectations, accountability and ultimately achieving better outcomes for the youth involved. Review Process The flow chart in Appendix D reflects an overview of the Child Protective Services Service Delivery/Court Process in Sacramento County. In Sacramento County, the case review process begins in one of four ways; 1) a child is removed under exigent circumstances; 2) CPS requests a protective custody warrant from the court; 3) CPS request removal of the child at a detention hearing; 4) CPS requests court intervention and leaves the child with the parent/s on a Non-detaining petition. A petition must be filed in Juvenile Court within forty eight hours of removal and the hearing occurs within seventy two hours of the removal or decision to bring the matter to court. The court is presented with the petitions and a report from the social worker with the results of the initial investigation of the allegations, an assessment of the risk and safety, and recommendations regarding custody of the child. The parents receive a copy of the petitions and report on the date of the hearing and are advised of their rights by the court. The court reviews and considers the information along with any information from the involved parties and makes a decision to release the children, refers them for Informal Supervision services or detains them pending a jurisdictional and dispositional hearing. In the case where children are detained, the court will make preliminary orders regarding visitation and placement and will set a jurisdictional/dispositional hearing fifteen days after the initial detention hearing. In Sacramento County, the Jurisdiction/Disposition hearing is done together. During the period between initial hearing and the Jurisdiction/Disposition hearing, a Court Services Social worker engages the family, caretaker, extended family and other involved parties in a more in depth investigation and assessment of the facts and works with the family to create a case plan. At the Jurisdiction/Disposition hearing, the court can release the children to the parent/s with no further services or it can take jurisdiction, declare the child/ren dependents of the court and make dispositional orders as to the specifics of the case plan submitted by the social worker. Typically a family will be offered reunification services and the court will set a six month status review hearing. In rare cases, the court may find that the parents are not entitled to reunification services and in those instances, the court will set a permanency review hearing within 120 days to determine the appropriate permanent plan for the child. Once a child is made a dependent of the court, he/she will have his/her case heard for a status review at six months and a permanency planning hearing at twelve months, with the possibility of up to six additional months if reunification is likely. The child and family are assigned to a Permanency Social Worker at the time of detention, and that social worker is responsible for working with the family until permanency is reached. The social worker is responsible for all aspects of engagement in case planning and services, visitation, placement oversight, ongoing case management and preparation of court reports and recommendations to court. From the beginning of the case, the focus is on concurrent planning, with efforts going toward reunification services, as well as determining the concurrent plan for103

each child. If a child does not reunify with a parent in the allotted time, the social worker completes a California - Child and Family Services Reviewcomprehensive assessment regarding adoption as a permanent plan. Sacramento County requeststermination of parental rights on behalf of each child in accordance with social work assessment andwithin the legal requirements. Social workers complete an assessment and if it is determined thatadoption is not in the best interest of the child, the information is documented in the court report andsubmitted to court. As can be seen in the flow chart above, if a child is not assessed for adoption orguardianship, their case will continue to come before the court every six months for a status reviewhearing with a focus of finding permanency.Dual Status YouthThere are also youth who are involved in the dependency or delinquency system who during their case,end up before the other system. In these situations, Sacramento CPS and Probation have a collaborativepolicy of completing a joint assessment on behalf of the youth. Most recently Sacramento County CPSand Probation have partnered to adopt the Cross Over Youth Practice Model to better address theneeds and outcomes for this population. The focus is on reducing the number of youth in the childwelfare system that cross over into the Juvenile Justice System. The approach focuses on teamwork andcollaboration, with each agency first completing an individual assessment with the youth and thenproceeding to have a face to face joint meeting between CPS and Probation to assess the information,complete a report and joint recommendations as to the status that will most benefit and support theyouth within the legal construct. If the court concurs, based on the recommendation, the court willdismiss status in one area and the remaining agency becomes the lead service provider on behalf of theyouth.Case Review ChallengesThe Court and CPS are both tasked with different pieces of oversight toward the goal of ensuring childsafety and positive outcomes for families. This relationship requires collaborative efforts, but at its core,it can also be perceived as hierarchical and adversarial, with the court having oversight of CPS as itpertains to the information CPS provides the court and the court’s ability to sanction CPS in certainsituations. These are also two systems that, while operating for the good of children and families, donot always speak the same language, one coming from a highly legal and structured framework, theother from a social work perspective of best practice and engagement trying to communicate in a legallysufficient manor. This can set up a dynamic for difficulties in communication that can manifest in waysthat strain the relationship. Some feedback from our Focus Groups is that expectations can vary fromone court to another, leaving social workers trying to anticipate how each court wants informationpresented, or which area will require more information depending upon the court. Additionally parents,children and caretakers gave feedback that they often do not understand what is being said in Court andunclear regarding the expectations. Caretakers went on to say that they see themselves as supportingthe social worker’s plan for the child, but they are not always informed or part of any detaileddiscussions regarding the plan, other than the general focus of reunification.An area of challenge raised by our Court partners is with the timeliness of court reports. CPS strives fortimeliness for all programs and court reports, but acknowledges that historically it has been a challenge,resulting largely from high caseloads, staff vacancies and an increase in duties for the social workers. Inthe last few years in particular, high vacancy rates and large numbers of new staff have impacted courtreport timeliness. CPS Management and the Court have made efforts to enhance communication at ahigher level to ensure the Court is aware of issues impacting CPS, as well as to hear the Court’sconcerns. At an agency level, the CPS Deputy Director attends the bi-monthly Dependency StandingCommittee, hosted by the Court and attended by all legal partners representing parties to thedependency hearings. This is an opportunity for discussion at a high level regarding any changes goingon in the court, trends they might be seeing regarding practice, as well as an opportunity for CPS to 104

California - Child and Family Services Review share workload impacts, new initiatives and practices and any other updates. The Department and the Court also hold a quarterly Operational Meeting where staff from both entities come together to focus on ensuring smooth operations, identifying challenges and finding and implementing solutions and maintaining open communication. This has proven effective in enhancing the ability of both systems to address operational needs while keeping communication open. Noticing The court, the department, and the attorneys representing each party to the hearing ensure that each child receives a timely review and permanency hearing in accordance with the law, as well as subsequent review hearings at the legally required intervals. In regard to noticing for hearings, we ensure proper notification to all parties, including Tribes via our Paralegal and Clerical staff. For the initial hearing the department is responsible for noticing a parent and this is done by way of verbal or written notification. Parents are provided notice during the initial hearing of the date and time for the jurisdictional and dispositional hearing and formal notice is sent to all parties, including caretakers, by CPS clerical and paralegal staff. Sacramento county has Paralegal staff who do the Tribal notification on behalf of children for the initial and .26 hearing, and clerical staff in each program who do all other noticing, including to the Tribes at regular review hearings. The social worker provides updated information for each party to be noticed in advance of each hearing to enable clerical staff to provide the proper notice. Case Planning CPS engages families in case planning at multiple points during a case, whether it’s an initial case plan for Informal Supervision, an initial case plan for Court Services, or a case plan update during the reunification period. In each instance, the social worker works with the family and other supports to identify strengths and needs related to the safety and risks identified through the assessment, and together, they come up with a case plan to address the family’s needs and remediate the risk and safety factors identified. It is the responsibility of each social worker to ensure communication with the caregiver, identify and communicate with relative supports and any tribal partners, as well as Mental Health providers or Alcohol and Other Drug partners in each case and incorporate their information into the case plan. Social Workers obtain feedback and input from each individual involved through face to face contact, team meetings and written or telephone contact throughout the duration of the open case and uses this information to work with the family to create and update the case plan. The case plan is developed and updated as part of a process that continues with each meeting with a family and those involved, and culminates in a written document presented to the court at each hearing. The engagement process for case planning at each stage should be a collaborative process and can include safety planning, use of Safety Organized Practice tools, Child and Family Team Meetings, Team Decision making and Structured Decision Making tools. To establish an initial case plan, the social worker works with the family and child to identify the individual areas of need and utilizes the engagement tools that work for each family. Sacramento County is focused on Safety Organized Practice and its tools to engage families. A social worker can utilize can utilize an array of tools to engage various family members to become an active part of the process, such as Three Houses to engage the child, or developing a Safety Network to engage the parents and other supports, as well as utilizing a Team Decision Making or Child and Family Team meeting to discuss placement and supports and engage the extended support system. The focus of all of these efforts should be on determining visitation, services, placement and concurrent planning and incorporating these elements into a case plan document. In terms of the assessments, the social workers perform an initial assessment of the parent and children, utilizing observations and feedback from their interactions. Based on this assessment, the social worker105

can refer the parent or child for Access services or for short term counseling from a contracted provider. California - Child and Family Services ReviewIt is the role of the social worker to ensure the services the family engages with are appropriate andeffective and to monitor this through ongoing communication with the family and the service providers.Sacramento County has established good partnerships with our County Behavioral Health Services, aswell as having specific contract providers for short term counseling. In both instances, there is arequirement that providers be trained in trauma informed practice.In addition to trauma informed practice, Sacramento County is moving toward behaviorally-based caseplans. This is a newer area of focus and a challenge noted by staff is the very cumbersome case plandesign within CWS that is a difficult document to engage families with and is not necessarily conduciveto shifting from services to behavior changes. Social workers will be receiving training in this area toenhance and support the transition to behaviorally based case plans. Another area of challenge in caseplanning is that while the social worker does engage the caretaker in discussions around the needs ofthe child, the case plan does not specifically address the caretaker’s needs.Case Review System - ProbationCourt StructureProbation is an integral part of the Sacramento Superior Courts in both adult and juvenile matters. TheDepartment also prepares the investigative reports for both juvenile and adult offenders, which assistthe Sacramento County Superior Courts in making decisions on the disposition and sentencing ofoffenders. Juvenile Court intake officers conduct an evidence-based detention assessment at the timeof booking to determine if a minor will be detained or released.Using a validated risk/needs assessment and information collected from various sources, officersdevelop an intake report prior to arraignments or settlement hearings that provide the court valuableinformation regarding a minor’s home life, schooling and any previous criminal history. In the report,officers make recommendations to the court for disposition (sentencing) based on the youth’s needsand public safety concerns.Officers serve as presenters in the juvenile courtroom, ushering non-detained minors and families intothe courtroom, providing last-minute case information, and researching probation issues at the court’srequest. When hearings conclude, probation officers provide families and minors relevant informationabout the case and next steps.Juvenile Court Services officers also work with victims of the alleged crimes, to develop the social studyreports and seek restitution on behalf of the victims. Probation maintains Juvenile Court Records andmanages requests for record seals.Juvenile Court ProceedingsThe Probation Department is involved in several aspects of Juvenile Court proceedings. The parent andchild will be required to attend all hearings, unless the appearance is specifically waived by the child'sattorney. The parent will receive information about hearings either in the mail or by phone.Detention HearingsIf the child is being detained in the Youth Detention Facility, there will be a detention hearing in no morethan 72 hours from their booking date, counting only court business days. At the detention hearing, theJudge will determine if the in-custody minor will be kept at the Youth Detention Facility, releasedwithout restrictions or go home on electronic monitoring or home supervision while awaiting their trial. 106

California - Child and Family Services ReviewThe detention hearing also serves as the arraignment for the minor, where the court will read the charges against the child and appoint an attorney if the parent cannot afford one. After the child is booked into the Youth Detention Facility, a Probation Officer will tell the parent and child the date and time of their detention hearing. If the parent doesn’t know, they can call (916) 875- 6996 for information. Arraignments The child will be arraigned in Juvenile Court if they were not detained at the Youth Detention Facility and if either the District Attorney has decided to charge the child with an offense, or if during a citation hearing before a Probation Officer, it was determined the offense was serious enough that it needed to be heard by a Juvenile Court Judge. The parent will receive notification by phone and/or mail from Probation regarding the child’s court date for their arraignment. The purpose of the arraignment hearing is to appoint an attorney for the child if the parent cannot afford one and to read the petition containing the charges against the minor. Settlement Conference In Sacramento County, the next hearing is a Settlement Conference. At this hearing, the child’s defense attorney, the deputy district attorney and the judge attempt to resolve the case without the necessity of a trial. If the child admits guilt, a dispositional hearing generally will be heard immediately, or will be set for 10 days later. If the child does not admit guilt the case is scheduled for a jurisdictional hearing – a juvenile court trial. Jurisdictional Hearing If the child does not admit responsibility, the case will be scheduled for a trial called a jurisdictional hearing. At this hearing, evidence and witness testimony are presented to the judge. There are no juries in Juvenile Court. During the jurisdictional hearing, the deputy district attorney must prove the charges. Both the District Attorney and the Defense will have the opportunity to call witnesses, present evidence and cross examine witnesses. If, at the conclusion of the jurisdictional hearing, the judge determines that the charge or charges are not true, the case is dismissed. If, on the other hand, the judge determines that the charge or charges are true, the case proceeds to a dispositional hearing – the time when the judge will impose sanctions and treatment. Dispositional Hearing A disposition hearing is equivalent to a sentencing hearing in adult court. If the judge rules that the child committed the offense, then the judge will review the child’s social study report that is prepared by the probation department in advance of the settlement conference. The judge will hear comments from both the child’s attorney and the deputy district attorney. The judge may then hear comments from the child’s parent or guardian as well as from the child. On some occasions, victims and victims’ family members may make a statement. The judge will decide how the child will be rehabilitated, how he or she will repair the harm caused to the victim and the community, and what sort of sanctions are necessary.107

Conditions of Probation California - Child and Family Services ReviewWhether the child admits responsibility or the judge determines after trial that the charges are true,dispositions may include community service, home supervision, electronic monitoring, counseling ortreatment, restitution to the victim, court fines, and foster care. They may also include commitment tothe Youth Detention Facility or the state Division of Juvenile Facilities. These requirements, along withothers – such as attending school, drug testing, and obeying all laws – are court-ordered conditions ofProbation.Checking in at the CourthouseParents for both in-custody and out-of-custody minors must check in at the customer service windowupon arrival to the courthouse. Parents will receive a pager and be directed to the appropriatecourtroom. The pager will be used to alert the parent to any pre-conference with the child’s attorneyprior to a hearing. The pager will also be used to alert the parent to the start of the hearing. Aprobation officer who serves as the court presenter will page the parent and then escort the parent intothe courtroom when it is time for the hearing to begin.There is a dress code and code of conduct for everyone who attends a hearing. Both the parentsclothing and conduct display respect for the Court and show the Court that the parent takes the caseseriously. If attire and conduct are not in compliance with the Court rules, the parent will not beallowed in the courtroom, and the child’s case will be rescheduled.At check in, the parent may receive a copy of an intake report on the child’s case to review.After the HearingImmediately following the hearing both parents and out-of-custody minors will be directed to Window 1– Probation. This is located in the same area as court reception. The Probation Officer at the windowwill provide the parent information on the outcome of the child’s hearing, answer questions and directparents on their next steps.Review ProcessThe flow chart below reflects an overview of the Probation/Court Process in Sacramento County. 108

California - Child and Family Services ReviewNoticing The Probation Department and Sacramento County District Attorney’s Office are responsible for noticing a minor or their parent/guardian in accordance with the law. Noticing of a minor or parent/guardian is done by way of verbal or written notification. Additionally, minors and parent/guardians may be noticed by the Court during proceedings. Case Planning Process Probation engages the minor and their families in case planning at multiple points during a case. In each instance, the probation officer works with the minor and other supports to identify strengths and needs related to the safety and risks identified through the Positive Achievement Change Tool 2.0 (PACT) assessment, through Assessments.com, and together, they develop a case plan to address the minor’s needs to remediate the risk and safety factors identified. The case plan is updated and modified at six month intervals by the minor’s assigned probation officer. The case plan is presented to the Court whenever the minor is before the Court. Reform Efforts Resource Family Approval (RFA) Efforts As part of California Assembly Bill 403 “Foster Youth: Continuum of Care Reform”, Sacramento County Probation has created a position for one Senior Deputy Probation Officer to seek out and establish new foster care families and create a streamlined process for an individual/family to provide care for a related or nonrelated court dependent or ward on a short term or long term basis. This position will be tasked to assist the potential Resource Family with completing the application, obtaining First aid and CPR certification and a health screening. Additionally, the officer will conduct background check, complete a home environment assessment, a permanency assessment, and face to face interviews with the family. Additional family finding will be assisted by contracts with Lilliput and Sierra Forever Families.109

Foster and Adoptive Parent Licensing, Recruitment and Retention California - Child and Family Services ReviewSacramento County Child Protective Services (CPS), under the auspices of the California StateDepartment of Social Services (CDSS), operates its own Foster Home Licensing (FHL) and Adoptionprograms. As such, FHL staff recruits, trains, monitors, evaluates and supports potential and existingresource parents to provide out of home care through adoption for children in our care. In addition, thecounty enjoys a partnership with approximately thirty-eight (38) Foster Family and Adoptive Agencies,who provide placement and services for youth requiring higher level placements, as well as adoptiveplacements. The goal of CPS is always to place children in the least restrictive setting, with a focus onkin, and to maintain placement of siblings together whenever possible, as well as to find permanencythrough reunification, adoption or guardianship. Sacramento is currently planning for theimplementation of Resource Family Approval (RFA).RecruitmentRecruitment of resource families is an ongoing effort in Sacramento County. FHL staff participates in avariety of activities, including Health Fairs, Church events and other community events to provideinformation and to recruit resource parents. Other efforts include the development of recruitmentbrochures targeting the following communities; schools, Native Americans and Spanish speakingcommunities. Targeted and focused recruitment is a strategy CPS uses by offering a monetaryrecruitment incentive to currently licensed resource families for each successful applicant they refer thatbecomes licensed. In the last year, Sacramento County, in partnership with three Foster FamilyAgencies, has been focusing efforts on recruiting affirming homes to address the needs of the Lesbian,Gay, Bisexual, Transgender, Queer/Questioning (LGBTQ) youth population. The group has workedcollaboratively to recruit, license and train foster parents to become affirming and supportive homes forthe LGBTQ population. Future efforts will include a recruitment brochure and a youth voices video.LicensureSacramento County is its own licensing entity and provides all the follow-up for the recruitment efforts.FHL staff follow-up with any specific requests of interest and offer those interested an opportunity toattend a monthly FHL orientation, which is currently provided in English and Spanish. Once a potentialresource parent attends the orientation, the FHL staff follows up with each participant to offerassistance with the application, either individually or via a workshop. Once licensed, they becomeeligible for placement and are monitored regularly by FHL staff, and services are provided by casecarrying social workers when children are placed in the home.RetentionOnce a family becomes licensed, the FHL staff provides ongoing support and training for retentionpurposes. FHL staff provides PRIDE (Parent Resource for Information, Development, Education) trainingfor all newly licensed resource families, as well as offering a variety of on-going trainings, including bi-monthly CPR and First Aide Training free of cost. In addition to training, the FHL staff support and retainresource families through a variety of efforts. One significant strategy has been the use of a ResourceParent Liaison through the AmeriCorps program. FHL has utilized an existing Resource parent and/orNREFM to work alongside FHL staff to connect with resource parents, assist them in their process, helpnavigate issues with delays in reimbursements, securing respite care and reimbursement and generalcommunication and problem solving. During the foster parent feedback session, having the supportliaison for foster parents was noted as very helpful in providing direct information as well as being aconnection between the agency and foster parents. Foster parents noted that communication withsocial workers can be difficult so having the ability to contact someone who is familiar with their issuesis very helpful. 110

California - Child and Family Services ReviewRecently, through our reform efforts, and in response to foster parents’ feedback regarding the need for respite care, the county has identified homes and funding for this service to be available to county foster homes. FHL also provides support to existing resource parents by helping financially support the annual holiday party, hosting a resource family picnic, maintaining a clothes closet, receiving and distributing donations from the local Lioness Club, and hosting an annual resource family appreciation dinner. Evaluation FHL has tried to infuse evaluation of the process at every phase, starting with the orientation, where we request direct feedback from participants to enable us to address and individual concerns, as well as adapt the orientation as needed. FHL also receives individual feedback after our PRIDE training and an exit interview is scheduled with any caregiver who withdraws their license. Finally, FHL staff participates in a Shared Leadership meeting with existing resource families where they can hear and respond to any feedback or suggestions regarding the process. On a daily basis, the Foster Parent liaison is able to communicate directly with foster parents regarding their specific needs or general feedback. Maintaining Standards FHL adheres to Title 22 regulations in all areas of the licensing process, from orientation through inspections and complaint resolution. Following the orientation and application, potential resource parents must participate approximately 30 hours of training in the first year, including a six week Pride Class, CPR and First Aide training, Cultural Competency and Rules and Regulations. In addition to the training requirement for the resource families, the FHL staff conducts annual inspections with written notification provided to the family regarding any deficiencies with a 30 day corrective action time frame. FHL staff also collaborates and communicate with Community Care Licensing (CCL) staff on a quarterly basis regarding trends, best practices and any training updates regarding regulation modification. If there is a pending complaint, FHL staff communicates regularly with CCL staff and attorneys. FHL staff participate in the Child Welfare Director’s Association (CWDA) meetings for all Licensing and Kinship programs to remain current, and the participate in an audit overview by CCL every 3 years. In order to ensure compliance regarding criminal record clearance, each FHL Licensing Program Analyst (LPA) monitors the process. When a rap sheet is received, FHL clerical provides the information to the assigned LPA. The LPA is immediately notified if rap sheet lists criminal convictions. The LPA notifies the applicant or licensee in writing regarding the need for criminal exemption within 5 days of receipt of rap sheet. The applicant or licensee has 45 days to respond. If the home is licensed, the home is placed on a hold pending clearance, to ensure youth are not placed in the home. If no response is received, the family s notified in writing that the exemption shall not proceed and the application is considered withdrawn. If the home is licensed, the process of license revocation may commence and the license is placed on HOLD. The FHL LPA makes requests for certified copies of criminal convictions during these 45 days to further investigate. If the family responds requesting exemption, the LPA provides required documentation within the allotted timeframes, and proceeds to process the exemption based on the guidelines and standards as outlined in title 22 regulations. Based on the assessment of LPA, the LPA submits exemption requests for approval or denial to FHL supervisor and the FHL Program Manager. Once a decision is made, it is provided in writing to applicant or licensee. If denied, the applicant or licensee may appeal to CDSS CCL within 10 business days of receipt of denial.111

Placement resources California - Child and Family Services ReviewSacramento County works with thirty-eight (38) FFA’s and hosts a monthly FFA meeting to bring thegroup together to discuss current issues and focus on system improvements, trends and newregulations. In an effort to ensure accountability and positive outcomes, Sacrament County has alsoentered into an MOU with all thirty eight (38) FFA’s to date to ensure agencies are providing the servicesnecessary and are focused on positive outcomes for families and tracking and reporting data based onthe outcomes desired. When we cannot secure a relative placement or a county home, we havepartnership with these agencies, many of whom have homes locally, as well as in other jurisdictions.Sacrament County has had a long standing partnership with the Sacramento County Office of Education(SCOE) around the needs of youth in foster care. SCOE has a School Connect Database that every homeis entered into along with any specific population or demographic the family would like to work with,such as special needs they are trained to provide care for, as well as ages and ethnicity and if they canwork with Lesbian, Gay, Bisexual, Transgender (LGBT) youth. CPS placement staff utilizes this data baseto look for placements when there are no kin available or a youth has a higher level of need. SCOE alsoco-locates staff within CPS to streamline the enrollment of children 0-3 in preschool, which is a servicethat helps support the caretakers and contributes to placement stability.In regard to our efforts with local Tribes, our FHL placement staff communicates directly with Tribes todiscuss placement resources. There are not many federally recognized Tribes in the Sacramento area,so much of the work to engage Tribes on behalf of individual children is done via telephone or writtencorrespondence. When there is not local Tribe or placement resource from a specific Tribe, Sacramentohas utilized the placement services of the Indigenous Nations: Child and Family Agency, as well as theAmerican Indian Child Resource Center in an effort to locate native homes for children and theseagencies have been part of our monthly FFA meetings. Sacramento FHL has created a recruitmentbrochure aimed toward Native American families.In the last few years, Sacramento County has experienced a number of youth entering into care whoidentify as LGBTQ. In an effort to secure affirming homes for this population, Sacramento County hascollaborated with three FFA’s to specifically address recruitment and training for families to providehomes for this population. Over the course of the last year, the collaboration has come together aroundthe needs of these youth and has pooled resources, time and money toward the goal of increasing thenumber of affirming homes to provide care for these youth. To date, there have been two recruitmentevents geared toward education around the needs of LGBTQ youth in foster care and recruitment ofhomes, as well as an LGBTQ training geared toward existing resource families to provide education andto demystify the population in the hopes of creating capacity in existing homes. Sacramento Countyrecently secured funding that will go toward creating a recruitment brochure for this population, ayouth voices video to share the stories and needs of these youth, as well as to enhance training effortsfor resource families around this population.In 2014, Sacramento County partnered with the Center for Social Policy (CFSP) to work on strategies tosupport expectant and parenting youth. Through this collaboration, we identified six (6) strategies, oneof which was building capacity around whole family foster homes. The group researched the topic,surveyed youth regarding needs and as a result, created a curriculum to train existing foster parents tomaintain youth in the home if/when the youth became pregnant. This strategy capitalized on maintainthe youth in the current placement and increasing the capacity of that caretaker instead of moving theyouth. The curriculum was shared with the FFA’s so that we can build capacity with existing homes andmaintain relationships so youth do not have to move when they become pregnant. 112

California - Child and Family Services ReviewReform Efforts Resource Family Approval (RFA) Efforts In July of 2015, Sacramento County established an RFA Steering Committee to assist with all aspects of the planning and implementation of RFA. The group, primarily comprised of various levels of CPS staff, and most recently Probation, came up with a plan for implementation and staffing levels, to focus on transitioning from two distinct processes of foster family recruitment and kinship approval, to one process that is a family-friendly, child-focused resource family approval process. This plan was submitted to CDSS in April of 2016 and was subsequently approved the same month. Sacramento County has been learning about and working on a RFA process since May of 2015. In April of 2016, Sacramento County submitted an Implementation Plan and proposed staffing structure to CDSS. The plan was approved the same month. A RFA Steering Committee was established in July of 2015 and has been meeting approximately twice a month to prepare for implementation. There are also four subcommittees: Training (Internal and External); Legal; Data and Monitoring; and Forms/Processes. Some of the activities that have taken place since July 2015 are:  Selected Efforts to Outcomes (ETO) as the RFA database  Attended CWDA Mountain Valley Regional meetings monthly  Held information sessions for social workers, supervisors and clerical staff that will be moving into the RFA program  Met multiple times with a neighbor county to learn about their RFA process  CPS met with Probation to learn about their current process  Met with Jennifer Rodriguez from the Youth Law Center to learn about Quality Parenting Initiative (QPI) Although RFA has not yet been implemented we are on target to implement on January 1, 2017. Foster Parent Recruitment, Retention and Support (FPRRS) Sacramento County is participating in the Foster Parent Recruitment, Retention, and Support (FPRRS) program and has received a state allocation to implement several strategies aimed at moving youth from congregate care to lower levels of care with emphasis on addressing disproportionality. These strategies include a foster parent recruitment campaign, increasing Intensive Treatment Foster Care (ITFC) homes and placements, providing respite care for county foster homes and increasing Wraparound services. Recruitment and retention of family members and quality caregivers are critical to ensuring lowest level of care, improving placement stability and decreasing length of time in foster care. As part of our efforts to increase Intensive Treatment Foster Care (ITFC) beds, Sacramento County has a Memorandum of Understanding with Stanford Youth Solutions and Uplift (formerly known as EMQ/Families First) for these agencies to do targeted recruitment focused on teens and pregnant and parenting teens. Through the efforts to date, for the fiscal year 2015-16, 528 inquires were made, 41 people/families attended an orientation and ITFC beds were increased by ten (10), with nineteen (19) additional families in the process of becoming certified. These efforts will continue in 2016-17 fiscal year. Sacramento County is also partnering with two agencies, Lilliput Family Services and Sierra Forever Families, to provide Family Finding and Kinship Support Services to support stepping youth down, having113

more youth placed with kin and to impact disproportionality. Lilliput provides intensive family finding to California - Child and Family Services Reviewyouth upon initial removal. Youth are referred 30 days after removal from their homes and Lilliput seeksout and engages as many relatives as possible, in an effort to keep children and youth connected to theirfamilies and ultimately place them into kin homes whenever possible. Along with the extensive familyfinding efforts, they also provide multiple levels of kinship support to the family, as needed.Sierra Forever Families provides intensive family finding services as a part of their work under theirDestination Family Program. Destination Family is a program for permanent placement youth who haveone or more barriers to finding permanency. Some examples of barriers are sibling groups, disabilities,resistance to permanency, behavioral concerns, etc. There are identified Destination Family supervisorsand social worker within the Department who are partnered with Sierra Forever Family DestinationFamily workers and they work the cases as a team. Under the Destination Family Program, SierraForever Families conducts permanency readiness assessments, makes targeted recruitment efforts andoffers permanency preparation and support for pre and post adoptive services. Sierra works with ayouth until legal permanency has been established and the typical duration is 18 months to 2 years.In addition to these efforts, Sierra Forever Family is also doing targeted recruitment in the AfricanAmerican community, with the goal of increasing the number of African American Foster Parents, aswell as creating a pool of mentors for youth in placement. To enhance these efforts, Sierra ForeverFamilies has hired staff to focus in this area, as well as to network with community agencies in theAfrican American Community to support the outreach and recruitment efforts.Sacramento County implemented a Permanency Steering Committee to oversee the partnerships withboth agencies and both agencies prepare and submit quarterly data reports to Sacramento County. Theagencies are treated as true partners and they have badge access to three (3) CPS sites and theCWS/CMS computer system. During planning and implementation, the Steering Committee metmonthly, however it was determined that monthly meetings were no longer warranted due to thesuccess of the committee in handling issues quickly and efficiently as they came up. The SteeringCommittee now meets on a quarterly basis to review the data reports submitted by the agencies.Sacramento County also assists with data reporting by providing outcome data for Lilliput, due to theshort duration they work a case, in comparison with Sierra who services the case until Permanency hasbeen achieved.Sacramento County also offered respite care to county foster homes, with seven homes identified toprovide this service. While no county homes utilized the respite care, the beds were utilized foremergency placements for youth with whom we encountered challenges in securing an appropriateplacement. This also provided staff with a period of time to further assess the needs of the youth and toidentify and support the future placement. This service will continue as a respite resource as it wasidentified by a need from existing foster parents.Finally, in regard to Wraparound services, Sacramento CPS partnered with Probation and the twoagencies they utilize, Stanford Youth Solutions and River Oaks Center for Children, to provide thisservice. The focus was to utilize this service to step youth down from congregate care and in the 2015-16 fiscal-year, a total of 10 youth were involved in this service which ultimately supported their existingplacement or assisted with a step down. This service will continue into the 2016-17 fiscal year.Staff, Caregiver and Service Provider TrainingStaff DevelopmentThe CPS Workforce Development Unit in Program Administration has designated one planner position,three specialist positions and two Sr. Office Assistant positions to provide or coordinate training for CPS 114

California - Child and Family Services ReviewStaff. In addition the Workforce Development Unit works closely with designated division wide trainers to coordinate and develop new social worker cohort trainings, Program and/or Unit Specific trainings. Consultation and collaboration with Sacramento County Counsel is required for all trainings that involve court, mandate information or legal aspects of a training topic. Social Worker Induction Training Sacramento County CPS understands the importance of educating new Social Workers on policies and procedures. Newly hired social workers receive Induction Training coordinated by the CPS training department. CPS utilizes department staff, collaborates with outside partners and trainers from the Northern California Training Academy, UC Davis. Over the course of five weeks new social workers receive orientation to the CPS and Child Welfare-specific trainings to provide basic knowledge of policies, procedures, essential functions and internal and community resources. The five-week social worker induction orientation and training that is provided to new social workers in CPS training covers the following topics:  General Agency Orientation  Medical Neglect  Public Health Nursing  Medi-Cal 101  Safe Sleeping  Birth and Beyond/Differential Response  Secondary Trauma  Defensive Driver  Legal Mandates  Body Check  Safe Measures  NASW Code of Ethics  Pathways to Well Being (formally Katie A)  Medical and Dental Needs for Foster Children  Alcohol and Drugs Overview  Safety Plan Policy  Intake  Investigations  Family Assessment  CWS Case Management  Court  Permanency  Adoption Services  CWS/CMS  Children Exposed to Domestic Violence (CEDV) California Common Core The Northern California Training Academy, UC Davis completed its last Core 2.5 class in November 2016 will initiate Core 3.0 in the spring of 2017. Core training is designed to provide newly hired social workers with a foundational understanding and skill set related to Child Welfare practice in California. All Core training requirements must be completed within 12 months of the date of hire.115

Core training incorporates online knowledge based trainings, classroom based trainings and field California - Child and Family Services Reviewactivities for reinforcement. It consists of 7 modules: Module 1- Foundation Block (Part 1) Module 2- Foundation Block (Part 2) Module 3- Engagement Block Module 4- Assessment Block (Part 1) Module 5-Assessment Block (Part 2) Module 6- Case Planning & Service Delivery Block Module 7- Monitoring & Adapting; Transition BlocksNew social workers are also assigned a field advisor for Core 3.0 that assists them in completing theirfield activities in order to reinforce the skills they learned in both their online and classroom trainingmodules.A peer trainer is also assigned to new social workers within their program before receiving a fullcaseload. Peer trainers are identified by their supervisors as journeyman level workers. The peer trainersoffer on the job training to new staff.The CPS Workforce Development Unit works closely with the Northern California Training Academy, UCDavis to monitor the progress and completion of Common Core to ensure that the training requirementsare met within the stated timeframe of one year.Core Training Program for SupervisorsThe Northern California Training Academy, UC Davis provides Supervisor Core for all new child welfaresupervisors. Supervisor Core is in the process of having its curriculum revised to include the followingtopics covered in 4 online training sessions and 11 classroom days: Online training resources a) Policy and Practice b) Fiscal Essentials c) SDM and Safe Measures d) CWS/CMS for Supervisors e) Classroom skill building a) Supporting New Child Welfare Social Worker Training and Common Core b) Coaching c) Casework Consultation d) Managing Child Welfare Performance e) Adaptive Leadership f) Advanced Assessment Practice g) Team Development h) Putting it all TogetherSupervisor Core will also include a coaching section so that supervisors can monitor social workers skilldevelopment and identify areas in which they may need additional training to perform their job duties.Social Worker and All Staff TrainingThe department provides employees with ongoing education and training to expand knowledge andunderstanding of their jobs. Each CPS direct service worker and those that supervise or manage themmust take at least 20 hours of training each fiscal year. Both mandatory and elective trainings counttoward this training requirement. All CPS staff must attend mandatory trainings that are focused on 116

California - Child and Family Services Reviewpolicies and procedures developed in the department. In addition, CPS provides the following required trainings that must be completed at regular intervals:  Car Seat Training  Defensive Driving  AB 1825 – Sexual Harassment and Workplace Violence Training CPS Workforce Development Unit also works closely with our Training County Counsel in order to identify trainings that have a legal component to them in order to ensure the competency of social workers, supervisors, managers and administrators. In order to meet the training needs of staff in relation to being able to identify and support the treatment of emotional trauma, including the trauma associated with a child’s maltreatment and removal from the home, the following trainings are provided to staff:  Safety Organized Practice (SOP) Foundational Training  Nurtured Heart Training  Children Exposed to Domestic Violence  In it Together: The Intersection between Mental Health and Child Welfare  Pathways to Well Being At the beginning of training modules, learning objectives and desired outcomes are listed and discussed with participants. In order to assess the skill development of new and experienced social workers, evaluations are completed at the conclusion of each training module. Workers are asked to articulate what they learned and how they will apply the content to their daily workflow. These evaluations are a reflection of how comfortable the workers are with the materials that were presented as well as if there is any follow up that is needed. Supervisors follow up with their social workers to assess their skill development and offer coaching and instruction in the areas that are needed. Monthly individual supervisions are used to monitor and review the social worker’s learning ability and how they effectively utilize the tools that were presented. Supervisors are also responsible for quarterly and annual evaluations for new and experienced social workers in order to assess their skill development, highlight their performance milestones and areas to enhance. In order to address the training needs with respect to the underserved populations and ensuring that children’s cultural needs are being met, CPS prides itself on the collaborations we have with the Sacramento community partners and resource centers as well as our Civil Rights Advisory Groups (Caucuses). Their purpose is to ensure cultural diversity and is a good resource for bringing specific needs and awareness of underserved populations to our Department. The following trainings are incorporated to address underserved populations:  Commercially Sexually Exploited Children (CSEC)  Crossover Youth Practice Model  LGBTQ Youth  AOD and Youth  Working with Immigrant Families in conjunction with the Mexican Consulate Provider Training Sacramento County CPS collaborates closely with many subcontractors and services providers throughout Sacramento County. In an on-going effort to provide consistency in services and updated information to these providers, Sacramento County provides training and technical assistance to subcontractors in the form of out-service trainings including:117

 Mandated Child Abuse Reporting Training (MCART) provided to schools, outside agencies and California - Child and Family Services Review the general public as requested.  Partner agencies participate in department training provided to staff.  Partner agencies often participate in trainings offered through the Northern Training Academy, UC Davis. This includes training in techniques and practices that CPS utilizes. The expectation is that these strategies will be utilized in services provided to the families.  Commercial Sexual Exploitation of Children (CSEC) Trainings provided to service providers.  Trainings provided to students at California State University, Sacramento. CPS provides BSW and MSW field placement instruction primarily for students at California State University, Sacramento. Most of Sacramento county interns are Title IV-E Recipient working towards their MSW degree. Social workers who hold a MSW act as a field instructor to the interns.Caregiver TrainingTraining is required for foster parents and prospective adoptive parents. Sacramento County previouslyused the PRIDE model (Parent Resources for Information, Development and Education) to facilitatethose training needs.Beginning January 1, 2017, Resource Family Approval (RFA) is being implemented. RFA is a new approvalprocess that combines elements of the current foster parent licensing, relative approval and approvalsfor adoption and guardianship. RFA supports the Continuum of Care Reform and the Quality ParentingInitiative.Prospective Resource Families must attend the Pre-Approval Training which is 12 hours of classroomtraining in addition to CPR/First Aid Training. Sacramento County CPS provides Pre-Approval Training inconjunction with American River College.The Pre-Approval Training Goals are to:  Meet the protective, developmental, cultural and permanency needs of children placed with a Resource Family  Strengthen families, and focus on lifelong relationships for the child  Strengthen the quality of Resource Family services by providing a standardized training and assessment process.  Share resources among public and voluntary child welfare agencies, colleges and universities, foster parent and adoptive parent associations and national child welfare organizations.The Pre-Approval Training is conducted in 4 classes, occurring twice a week, addressing the followingtopics:  Class 1: Overview of Child Welfare and Court Systems, Role of Resource Family, Permanency Options and Personal Rights of Foster Youth  Class 2: Child and Adolescent Development, Effects of Abuse and Neglect on Development, Mental Health, Medication and Positive Discipline  Class 3: Trauma Informed Caregiving, Secondary Trauma, Birth Family Relationships and Visitation, Cultural Competency and LBGT  Class 4: Health and Education Issues and Supports, Foster Youth Safety at School, Supports and Services 118

California - Child and Family Services ReviewStaff Training – Probation Staff Development The Probation Placement Unit requires all new officers to participate in a one month Probation Placement Officer Core Course. The course is put on by the Resource Center for Family Focused Practice through the U.C. Davis Extension Center for Human Services. The course educates officers over four weeks to provide basic knowledge of policies, procedures, essential functions and legal requirements. Agency Collaboration Sacramento County continues to enjoy a wide variety of collaborative partnerships and has embarked on new initiatives and partnerships during the last several years. We continue to have regular meetings to discuss practice, operations, problem solving and relationship building with our public partners such as the Court, Probation, Law Enforcement, Behavioral Health Services (BHS), Public Health, Education, and the Department of Human Assistance (DHA). In addition, we meet regularly with community partners, such as our Birth and Beyond sites, a variety of Foster Family Agencies (FFA), Group Home providers, First Five Commission, Faith Based Organizations, Domestic Violence service providers, Alcohol and Other Drug service providers, Alta Regional Center, Housing providers, Medical and Dental partners, the Mexican Consulate and Labor Organizations to discuss programs and services, to engage in a dialogue regarding system strengths and challenges, as well as program and services implementation and to look for new opportunities to partner. In the last several years, CPS has collaborated with a variety of partners to improve placement and case planning efforts, as well as to implement new practices and initiatives, which has strengthened existing partnerships, and assisted in creating new partnerships. During the Stakeholder Feedback meetings collaboration was noted as a top strength, as was the diversity of the Stakeholder group and its investment in the process. At the same time, it was noted by Stakeholders that even with all of the collaborative efforts, communication across systems does not always occur timely and can be an area for improvement. The following are specific examples of the collaborations and related services or programs. Extended Foster Care (EFC) In 2012, CPS collaborated with the following partners, Probation, DHA, the Courts, County Counsel, the Public Defender, Children’s Law Center (CLC), Alta Regional Center, Former Foster Youth Advocate and Labor representatives to plan, develop and implement Extended Foster Care, which would enable youth turning 18 while in foster care to remain in care and receive services until age 21. A Steering committee was formed to bring partners together to bridge cross system practices and service provision, as well as to develop the service delivery process, share data and create operational paths to address service delivery challenges and barriers. As a result of this collaboration, challenges with payments were addressed by DHA, Alta Regional Center was able to commit to staffing cases for youth who would be better served through their system, and Probation and CPS agreed to co-locate staff to serve this population and to share resources and information as it pertained to service delivery to clients and this is now an ongoing practice. Additionally, CPS and Probation share placement resources regarding this population when possible and Probation is able to access the CPS Centralized Placement unit for support. Most recently, as part of the ongoing monitoring and improvement efforts, this collaboration has resulted in the development of an EFC court day where the Presiding Judge hears only EFC cases to ensure continuity of services and better outcomes for the young adults.119

Katie A California - Child and Family Services ReviewIn 2013 CPS, Behavioral Health Services, along with Parent and Youth partners formed a SteeringCommittee to plan, develop and implement the Katie A assessment tool. The process included briningthe partners together to develop a tool, test the tool, share data to determine and remediate systemimpacts, train staff and implement the assessment tool. During the implementation process, CPSengaged labor in negotiations to ensure concerns were address and the assessment tool wassuccessfully implemented in July of 2014. CPS internally engaged the support of CPS ProgramAdministration Quality Assurance to track progress on an ongoing basis and to share data with programfor monitoring and evaluation.Expectant and Parenting Youth (EPY)In 2014, the Center for the Study of Social Policy (CSSP) approached our county to work on issues facingexpectant and parenting youth. CPS approached the Children’s Law Center, the firm that representsdependent youth, to partner around better serving this population. An implementation team wasformed comprised of CPS, CLC, CSSP Consultant, UC Davis Consultant and a Former Foster YouthAdvocate. The group developed surveys to understand the issues facing the population and what theirneeds were, as well as surveying caretakers. From this, the group developed strategies, includingteaming meetings for EPY youth, creating mentors, building capacity for caretakers to become a wholefamily foster home, education on reproductive health and priority access to Child Action and Headstartand data sharing. The group is in its third year and continues on a path to implement the strategies.Family Finding and Kinship SupportSacramento County has placed focus on our ability to place children with relatives or non relatedextended family members when they must be placed in out of home care in an effort to help withplacement stability and permanency outcomes. It is imperative for our social workers to include familyfinding efforts whenever they engage with a family and to document that information in CWS/CMS.There are situations when more intensive family finding efforts are needed and when there may be abarrier to a youth finding permanency. In order to improve outcomes for youth in these situations,Sacramento County has contracted with two partner agencies to focus on finding legal and relationalpermanency for children/youth placed in foster care who have one or more barriers to permanency.This can include family finding, engagement in the process and supportive services. To dateaccomplishments include the following: the contractor Sierra Forever Families accomplished thefollowing: family identified for 79 youth; 61 youth have been introduced to family; 54 have establishedongoing family connections; 18 clients have been referred to the Adoptions Unit; 10 adoptions havebeen finalized. Our contractor Lilliput Children’s Services accomplished the following: 315 youthreceived family finding, navigation services and relative certification (includes both dependent and nondependent youth); 14 children were placed with relatives; 8 Finalizations for Relative Certification andNavigation. In addition to the specific outcomes, an area of opportunity has been identified which is toinclude these partners in our Permanency Case Reviews to look for ways to create permanency for thoseyouth reviewed.Commercially Sexually Exploited Children (CSEC)In June of 2014, when SB 855 was passed, Sacramento County CPS worked diligently to pull severalpartners together to determine the best way to serve the CSEC population. A CSEC steering Committeewas formed and included senior level leaders from Sacramento County Department of Health andHuman Services, Probation, the Juvenile Court, District Attorney’s Office, the Sherriff’s Department,Sacramento Police Department, Sacramento County Office of Education, Sacramento CountyDepartment of Counsel, Children’s Law Center, Child Protective Services, Sacramento County Division ofBehavioral Health Services, Division of Public Health, Children’s Receiving Home, UC Davis CAARECenter, Weave, Another Choice Another Chance, Victim Advocate Organization, Sacramento County 120

California - Child and Family Services ReviewPublic Defender’s Office and Sacramento City Unified School District and Direct and Legal Service providers. Through a series of planning meetings reviewing the law, data available and best practices, a \"Memorandum of Understanding Sacramento County Commercially Sexually Exploited Children (CSEC) Program Inter agency Protocol\" was developed and approved by the Sacramento County Board of Supervisors and went into effect on September 15, 2015. This MOU set forth an agreement for all parties to work together to serve this population and to share information and collaboratively approach practice. The collaborative approach includes identifying specific social workers in each program to act as primary CSEC social workers, use of the WestCoast Children's Clinic Commercially Exploited Children Identification Tool (CSE-IT), as well as utilizing the partners to participate in Multi-disciplinary Team (MDT) meetings that are held to staff each case, discuss placement issues and develop a plan to keep the youth safe and to identify any needed services. As of the writing of the report, the MDT’s were occurring and staff have been trained on the CSEC tool. Crossover Youth Practice Model (CYPM) Sacramento County’s Crossover Youth Practice Model (CYPM), which was developed in consultation with Center for Juvenile Justice Reform at Georgetown University, includes a protocol that was developed with the primary goal of appropriately and effectively reducing the number of youth involved in the child welfare system who cross over from Child Protective Services to Juvenile Justice in Sacramento County. Additional goals of the CYPM Protocol include:  Strengthening relationships between Child Protective Services, Probation, Behavioral Health Services, education, and community partners to collaboratively serve children, youth and their families in Sacramento County;  Enhancing family self-sufficiency and self-reliance;  Sustaining family connections;  Increasing number of children living safely in family settings;  Reducing racial and ethnic disproportionality and disparities in the child welfare and juvenile justice systems;  Reducing entries into out of home placement via the Probation Department.  Reducing length of stay in out of home placements; and  Reducing recidivism into the juvenile justice system and/or re-entry into the child welfare system. The CYPM Protocol represents the commitment of Sacramento County Department of Health and Human Services (Child Protective Services and Behavioral Health Services), Sacramento County Juvenile Probation Department, the Juvenile Court of Sacramento County, Sacramento County Counsel, and the Sacramento County Office of Education to continue advancing collaborative partnerships to achieve this goal. It is the intent of these partners to establish and strengthen a culture of collaboration that extends beyond the scope of the Protocol to achieve this goal and best meet the needs of crossover youth. This includes establishing a culture of teamwork and consistent communication between Child Protective Services, Probation, and when appropriate, Behavioral Health Services. The purpose of the CYPM Protocol is to define the collaborative practices these agencies will institute to improve services for Sacramento County youth. The kick off for implementation is October 2016.121

Prevention Initiative California - Child and Family Services ReviewThe IV-E Prevention Initiative is a contract between DHHS/CPS and Sacramento County Child AbusePrevention Center (CAPC) to provide prevention services to families with youth ages 6 and older. Theseservices are voluntary child abuse prevention and early intervention services utilizing the Birth andBeyond Family Resource Centers (FRC). CAPC subcontracts with six community based organizations thatoperate the Birth and Beyond FRC’s that are established in nine communities throughout SacramentoCounty with a high occurrence of child abuse and neglect. The Birth and Beyond programs havedemonstrated to be effective, both through the data they keep and provide on the prevention side, aswell as through community feedback from the Stakeholder meetings citing the value of the programsand the need for expansion into areas these services do not currently exist.Since the initiatives implementation in July 2015 more staff have been added to the Birth and Beyondsites. All staff have been trained in the expansion services for school age children for services such asEffective Parenting, Crisis intervention Services, Differential Response Services, Home Visitation, andHealth Promotion. Included in the Crisis intervention services are subcontracts for domestic violencegroups and individual counseling. There is currently an Information and Referral Resource Specialistthat is out stationed at the Child Protective Services Hotline .5 days per week to reach families that maybe evaluated out at intake by CPS, but may still need additional services. In addition to the resourcespecialist reaching families the Emergency Response Social Workers have access to the information andReferral Resource Specialist services. By expanding these services the goal is to decrease entries and re-entries into CPS and increase a safe environment for children. In the 2013- 2015 AmeriCorps ImpactEvaluation for the Birth and Beyond Home Visitation Program it was noted that Parents with previousCPS history, receiving 25-34 hours of home visitation services receive the maximum benefit fromparticipating in the home visitation program in relation to CPS recidivism.CPS and the Birth and Beyond sites continue to track and share data to monitor the progress.Additionally, a new service component of domestic violence counseling and education services havebeen added as a resource to each site, further expanding the resources and supports available tofamilies.Foster Youth ServicesSacramento County provides Independent Living Services through our county social workers, as well asthrough our partners in Foster Youth Services. We have strategic contracts in four (4) districts, Elk GroveUnified School District, San Juan Unified School District, Twin Rivers Unified School District, andSacramento City Unified School District, who each provide services through their Foster Youth Servicesprogram. Each contracted provider provides services to all youth ILP eligible residing within their districtand attending a school in their district. Each program includes Independent Life Skills (ILS)classes/workshops that provide instruction in basic life skills and assist the youth in setting and obtainingrealistic goals for their future. The curriculum for their ILS classes focuses on social skills, healthawareness, finances, job/career development, and survival skills for independent living, while 75% of thecurriculum consists of experiential (hands-on) activities. In our focus groups with youth currently infoster care, they reported that the ILP services were very valuable and that they would like to see themstart at an earlier age and they suggested the services be mandatory.Dependency Drug CourtThe Sacramento County Dependency Drug Court has been in operation for over 12 years now. It is oneof the largest and most active Drug Courts in the nation. The program deals with larger caseloads thanany Court in the country. It has been thoroughly evaluated since its inception. 122

California - Child and Family Services Review When the Court was launched the critical players were the Presiding Judge of the Juvenile Court, the Courts, the Criminal Justice Cabinet, the County Department of Health and Human Services and specifically Alcohol and Drug Services. There are three key components to program success – The Court is overseen by an active and engaged Judge, who has direct involvement with the participants on a regular basis. All Counsel, including those representing parents, children and the County. In particular, parent’s counsel is key to the referral of clients to the Court and connection to, and support of services. Finally, the case management of services and supports for the program, funded by dollars from both CPS and Alcohol and Drug Services, is run by Bridges, Inc.. Staff from Bridges actively engage identified participants, meet with them weekly, manage their connection to treatment and testing services, coordinate their completion and graduation and work hand in hand with the Court and agencies toward parent success. Over the years the program has proved to be highly successful. The majority of identified participants graduate. They are likely to reunify both more quickly and more successfully than non-participants with AOD issues, and far less likely to recidivate within five years than either non-participants or non- graduates. The cost savings of this program in terms of out of home care savings is substantial over the life of the program and this has proven to be a model program and collaboration for Sacramento County. Tribal Partnerships Sacramento County has a small percentage of families in CPS that are members of a Federally recognized Tribe. In Sacramento County, we utilize special skills culture workers and have 2.0 FTE Native American Special Skills staff (1 Masters – vacant and 1 Bachelor level filled) within CPS to assist in providing case management for native families. We also try to follow the spirit of the law for any family who indicates they have Native American Heritage. This begins with inquiry and noticing of Tribes, and then is ongoing with our efforts to engage any identified Tribe. Often times, the Tribes are out of county or state and we try to engage them on behalf of the family. In terms of placement efforts for native children, we contact the Tribe first and follow any recommendations of families they might have and we try to include a native representative at Team Decision Making meetings. We also work with a local placement agency, Indigenous Nations as an additional placement resource when needed. We also work with Indian Child Welfare Act (ICWA) experts in matters pertaining to jurisdiction and termination of parental rights. At a local level, we work with and refer families to the Sacramento Native American Center (SNAC), which provides parenting, Alcohol and Other Drug, Mental Health and Medical and Dental Services. Our social workers receive updates and progress reports when a family is receiving services from SNAC. We also host the Sacramento County Native American Roundtable, which is a monthly forum where Sacramento County CPS and local Native American service providers and community can come together to focus on ICWA matters, such as initial inquiry, placement resources, expert witness and other practice issues. This is also a forum where the strengths of the larger group can be utilized to identify and resolve challenges or barriers on behalf of the families. Lesbian, Gay, Bisexual, Transgender, Queer/Questioning (LGBTQ) The LGBTQ Collaborative is a joint effort on behalf of Sierra Forever Families, Stanford Youth Solutions, Sierra Child and Family Services and Sacrament County Child Protective Services. The collaboration evolved out of a need to identify and support families who could provide loving, supportive, affirming and permanent homes for LGBTQ youth in foster care in Sacramento County. The Rise study in Los Angeles determined that 19% of youth living in foster care identified as LGBTQ. These youth had a higher than average number of foster care placements and were two times more likely to be living in123

congregate (group home) care. These youth are also more likely to run away from foster homes, placing California - Child and Family Services Reviewthem at more risk.The LGBTQ Collaborative has come together to join resources to recruit, train and support families toprovide affirming homes for these youth in foster care. Since its inception, the LGBTQ Collaborative hasheld a Foster Parent information and recruitment event and provided an LGBTQ training for existingfoster parents to increase existing capacity to provide supportive homes for these youth and hascanvassed the Freedom Fair this summer. Through this effort, the group has provided orientation to atleast sixty (60) potential families and at least sixteen (16) families have come forward expressinginterest in becoming caretakers and are moving through the licensing process. This process has includedengaging LGBTQ youth in foster care and their caretakers to present at the events to address the needsof youth. The collaborative is planning more recruitment and training efforts and plans are in the worksto create a resource family recruitment brochure specific to this population, as well as a youth voicesvideo for youth to tell their stories and share the need for affirming and supportive homes.Resource Family Approval (RFA)As stated in the Resource Family Approval (RFA) Written Directives, “The purpose of the ResourceFamily Approval Program is to implement a unified, family-friendly, and child-centered resource familyapproval process to replace the existing multiple processes for licensing foster family homes andapproving relatives and nonrelated extended family members as foster care providers, and approvingfamilies for legal guardianship or adoption.” Sacramento County has been learning about and workingon a RFA process since May of 2015. In April of 2016, Sacramento County submitted an ImplementationPlan and proposed staffing structure to CDSS. The plan was approved the same month.A RFA Steering Committee was established in July of 2015 and has been meeting approximately twice amonth to prepare for implementation. There are also four subcommittees: Training (Internal andExternal); Legal; Data and Monitoring; and Forms/Processes. Some of the activities that have taken placesince July 2015 are:  Selected Efforts to Outcomes (ETO) as the RFA database  Attended CWDA Mountain Valley Regional meetings monthly  Held information sessions for social workers, supervisors and clerical staff that will be moving into the RFA program  Met multiple times with a neighbor county to learn about their RFA process  CPS met with Probation to learn about their current process  Met with Jennifer Rodriguez from the Youth Law Center to learn about Quality Parenting Initiative (QPI)Although RFA has not yet been implemented we are on target to implement on January 1, 2017.Program Example – Reduction of African American Child Deaths (RAACD)The child welfare system has long struggled with disproportionate outcomes for children of color,particularly, African American children. In 2011, as a result of reviewing local data around child deaths,Sacramento County Board of Supervisors member, Phil Serna, commissioned a Blue Ribbon Commissionto address the issue specific to African American child deaths within the community. The Commissionwas comprised of community leaders, stakeholders, policy makers, service providers, healthprofessionals, parents and grandparents. A series of community meetings were held seeking a broadarray of feedback and input around areas of maternal and perinatal health, infant sleep related deaths,as well as homicides. The Commission developed this information into specific and targeted 124

California - Child and Family Services Review recommendations which were released in April of 2013 in the Sacramento Blue Ribbon Commission Report on Disproportionate African American Child Deaths. As a result of the report, a Steering Committee on the Reduction of African American Child Deaths (RAACD) was formed with the goal of reducing deaths among African American children between 10 and 20 percent by the year 2020. The Steering Committee is a large public/private partnership funded by the County of Sacramento and First 5,with representation from the following partners: Christian Fellowship Ministry, United Way California Capitol Region, Del Paso Heights Community Association, Kaiser Permanente, Sacramento County Sheriff, Department of Human Assistance, Community Impact Center/Liberty Towers, First 5 Sacramento, Dignity Health, Target Excellence, Sierra Health Foundation, California Association of Black Pastors, County Public Health Officer, Sacramento Superior Court, UC Davis Health System, Sacramento County Child Protective Services, Center for Community Health and Well-being, Inc., Child Abuse Prevention Council, Roberts Family Development Center, Greater Urban League, Sacramento Association of Black Social Workers, South Sacramento Building Health Communities, Sacramento County Office of Education, Sacramento Probation Department, Parent and Youth representatives, as well as evaluation members, University of California, Davis, Sacramento County Department of Public Health and the California Department of Public Health. The Steering Committee is targeting six (6) communities that have the highest number of African American child deaths, and involves five (5) strategies which are: 1) Advocacy and Policy; 2) Equitable Investment and Systemic Impact; 3) Coordinated System of Support; 4) Data-driven Accountability and Collective Impact; 5) Communication and Information Systems. The Steering Committee has been working at establishing its infrastructure and technical support to carry out the strategic plan. Most recently, a Request For Proposal to establish Community Incubator Leaders (CIL) within the target communities was successfully bid and is in the process of being implemented. These CIL’s will be the hub in each community, responsible for establishing grassroots leadership that is trauma informed, engages youth and other grassroots organizations and establishes cultural brokers who can work within the community and with CPS. To further this effort and to utilize the cultural brokers to support early intervention efforts, CPS social workers will be co-located with the CIL’s in an effort to provide a supportive and engaging intervention with families and to participate in Multi Disciplinary Teams (MDT) as needed. Not only will this give more visibility in the community, which was noted to be lacking in the Stakeholder Feedback, but it will help bring services into the community to be more accessible to those utilizing the service. This is a very exciting and innovative effort on behalf of the entire community of Sacramento in an effort to have a significant impact on preventing African American Child Deaths and we look forward to continuing to be part of this collaboration moving forward toward the goal. Other Agency Collaborations ILP Advisory is a collaborative that meets monthly and is hosted by Sacramento County EFC/ ILP program joined by a variety of community partners that include but are not limited to : THP+FC and THP+ providers, ILP contracted providers/Foster Youth Services, CASA, Job Corp, CLC, One Stop Career Centers, Planned Parenthood, Transitional Age Program, Sutter Teen Program, and SCOE. The purpose of the advisory committee is to coordinate efforts to provide ILS services to Transition Age Youth, ensure outreach to youth for classes and events, and provide education, description of services, availability, and referral processes for community agencies. Community agencies have the opportunity to present information to the group regarding their programs. Community agencies participating have included Youth Employment Opportunity Program/Employment Development Program, Goodwill Industries Job Readiness Program, Job Corp, Asian Services, Conservation Corps, Laverne Adolpho Housing Program, and Compassion Planet.125

Sacramento County also participates in the Higher Education Collaborative hosted by Sacramento California - Child and Family Services ReviewCounty Office of Education (SCOE) that ensures Sacramento County Youth are receiving services thatsupport higher education through events provided by many of the local community Colleges fortransitional age foster youth. The higher education collaborative meets bi-monthly to support ongoingefforts to improve and provide those services to youth in need of education planning and support.Events for youth have included topics that cover Financial Aid, Chafee grants, Youth leadership,educational program resource fair, EOPS, and foster youth services.Service ArrayPrevention Focused Services and Community-Based family Support Services Birth and Beyond (B&B)Program is a comprehensive primary prevention and early intervention program that provides supportservices for pregnant women and families with children ages 0-17 via neighborhood-based FamilyResources Centers (FRC). The program became operational in 2000, pursuant to a directive from theSacramento County Board of Supervisors to the Family Support Collaborative (FSC) in 1998. As part ofthe Child Abuse Prevention Initiative, in 2015 services were expanded to families with children 6-17years old.There are currently nine FRC strategically placed in neighborhoods with the highest concentrations offamilies at risk of child abuse and neglect. The FRC include La Familia Counseling Center, River Oak FRC,Mutual Assistance Network Firehouse Community Center, Arcade Community Center, WellSpaceHealth’s North Highlands Multi-Service Center, Folsom Cordova Community Partnership, SacramentoChildren’s Home Meadowview Family Resource Center, North Sacramento Family Resource Center andValley Hi Family Resource Center. The FRC are the neighborhood hub that provides a continuum of childabuse and neglect prevention services. Services include but not limited to home visitation, crisisintervention, evidence based parenting workshops, health education, medical and dental services, childsafety, physical fitness, support and social groups, school readiness and child development activities andfinancial and employment assistance. B&B identified a need for domestic violence services and thatservice gap was addressed with the increased 2015 funding. Ongoing gaps in services include lack ofhousing resource available to families engaged in B&B FRC services as well as mental health andsubstance abuse needs. Each B&B FRC operates on the same program-wide budget and standardminimum staffing structure to ensure capacity is reached. The B&B FRC program has the capacity toserve the following number of parents annually. The capacity is a duplicate count as some parentsreceive more than one service.  FRC Effective Parenting Workshops – 1540 Parents  Home Visitation – 2108 Parents per quarter  Crisis Intervention – 2246 Parents per quarterHowever, in the FY 20152016, B&B FRC program served significantly more parents than capacity in eacharea. Programs rely on blended funding from Local First5; Medical Administrative Activities (MAA);Corporation for National and Community Service; Title IV-E Waiver, as well as CAPIT and CBCAP funds.B&B has an extensive infrastructure including 7 non-profit organizations that operate the FRCs and theChild Abuse Prevention Council that serves as the “backbone organization” coordinating thecollaborative, training staff, monitoring model fidelity and evaluation. Each of the non-profit agenciescontribute match funding to support the program.B&B works in collaboration with CPS to ensuring safety and well being of children through a programcalled Differential Response (DR). DR is a strategy that allows for more than one method of initial 126

California - Child and Family Services Reviewresponse to reports of child abuse and neglect. The goal is to prevent future occurrences of reports of suspected neglect or abuse. DR has three referral paths.  Path 1: This path is selected (A) when a family is referred to CPS for child maltreatment, however, it is evaluated out by the hotline because it does not meet the threshold for child abuse and neglect; (B) contact with CPS for assistance where no hotline has been made; and/or (C) they are at risk of child abuse and neglect due to family factors including substance abuse, mental health or domestic violence. These families are linked/referred to community based agencies on a voluntary basis and offered identified services. The Child Abuse Prevention Counsel has staff person working with CPS hotline 9 hours per week linking these families to Birth and Beyond or other community services to strengthen the family.  Path 2: This path involves families in which the allegations meet threshold for abuse and neglect at low to moderate risk. Assessment indicates the family would benefit from specific services to improve child safety and mitigate risk. CPS and B&B complete a joint meeting to ensure warm hand off to services in their community. CPS may also have a Public Health Nurse or Mental Health Clinician do a joint visit and assessment depending on the needs of the families.  Path 3: This path is similar to path 2, wherein, the allegations are determined to meet the threshold for abuse and neglect and are identified as high-risk based on specified review criteria, in alignment with traditional CPS services. Therefore, it is determined that the child is not safe and action must be taken to protect the child. CPS & B&B complete a joint visit with the family to link them to services and supports to keep the child safe in their homes. CPS may also have a Public Health Nurse or Mental Health Clinician do a joint visit and assessment depending on the needs of the families. Project Screening, Outreach, and Referral Services (Project SOARS) is a program operated by Sacramento County Office of Education (SCOE) and funded by First 5 Sacramento which provides free and voluntary comprehensive services for children who may be at risk of developmental delay and/or disability. Services are available to families who have children within the age range of infancy through age five in Sacramento County. Family Advocates conduct developmental screenings, hearing and vision screenings, and refer families for early intervention and other comprehensive services. Once referrals have been made, the Family Advocates continue to provide direct support through ongoing home visits to ensure that families access follow up assessments and other needed comprehensives services. As of October 2015, Project SOARS partnered with the South/Central CPS Informal Supervision unit to identify children who may be at risk of developmental delays and/or disability. In late 2016, services expanded to each region to include East and North. Social workers make direct referrals for any children zero to five years of age on their caseload who might be at risk. In the 2015-16 program year, Project SOARS received 15 referrals from social workers in the Informal Supervision Unit, and have provided 75 comprehensive services to families. In June 2007, Sacramento County Department of Health and Human Services (DHHS) Divisions of Child Protective Services (CPS) and Alcohol and Drug Services (ADS) partnered with the Sacramento County Juvenile Dependency Court to submit a federal grant under the Promoting Safe and Stable Families (PSSF) program. The purpose of the grant was to create a program that would increase permanency and well-being for children affected by methamphetamine or other substance abuse. In October 2007, the grant was awarded and deemed, Early Intervention Family Drug Court (EIFDC). In February 2008, the program was implemented with the collaboration of CPS, ADS, the Sacramento County Juvenile Court,127

and Bridges Specialized Treatment and Recovery Services (STARS) Program. Additionally, in November California - Child and Family Services Review2008 a Casey Foundation Grant was awarded to STARS to implement Celebrating Families, an interactivefamily oriented parenting series, which was implemented in February 2009.The EIFDC program was implemented in Sacramento County in February 2008 in order to:  Increase the number of children who can remain safely at home; while parents undergo intensive substance abuse treatment;  Reduce the risk that infants or other children in the home will be harmed in the future;  Increase the availability of substance abuse treatment to parents;  Increase developmental screenings, assessments and other treatment for drug-exposed infants, and;  Link families to resources in their community that help parents refrain from alcohol/drug use. Develop sustained support plans through linkages to Family Resource Centers (FRC), faith based organizations, and other community resources.While EIFDC utilizes many services that have been in place in Sacramento County for many years, thefeatures that make this program unique are:  Immediate access to substance abuse assessment and treatment, including residential treatment when needed;  “Judicial” oversight via voluntary participation in administrative review hearings to monitor compliance with case plan and treatment services;  Continuing care in the form of extended access to Recovery Specialist services and follow up, and;  Formal linkage and connections to community resources to prepare for the closure of the CPS case.These services are provided when a family is referred to CPS after the mother and/or infant test positivefor substances at delivery or prenatally (during the third trimester of the pregnancy), or if a family has achild under the age of five and is deemed to have need for these services. Families are offered InformalSupervision (IS), which provides intensive voluntary services [pursuant to Welfare and Institutions Code(WIC§ 301(a)] in lieu of filing a petition for protective custody. Mother and father are assessed forsubstance abuse services and immediately referred to the appropriate level of treatment, be itresidential or outpatient. The parents also gain immediate access to a Recovery Specialist, via STARS,who assists in engaging the parent in substance abuse services, encourages participation and monitorscompliance. Recovery Specialists also remove barriers that keep parents from participating in services.Services provided by STARS are funded by CPS realignment and PSSF funds.Administrative oversight offers parents an opportunity to share their successes and challenges with anauthority figure who can provide incentives and sanctions as necessary. The administrative hearing isalso a time for parents to establish a peer group with others who are going through the program. Aftersix months of successful participation in IS Services with CPS and STARS oversight, parents “Graduate”from the program.Participation in the EIFDC may last between 6 to 12 months with CPS continually assessing the safety ofthe children while in the parent’s care. If the parent's failure to comply with program requirementsjeopardizes the children’s safety the department must then place children in custody. During the firstsix years of implementation, a total of 1,440 parents and their 2,042 children were served in EIFDC. In 128

California - Child and Family Services Review 2017 CPS is expanding Informal Supervision services to families with children up to age of twelve years old. EIFDC will also expand by two recovery specialist to serve additional 60-68 parents per year. Reunification Services Sacramento County offers an array of services for families to address their case plan goals. Parenting Education groups are offered for free at the many FRCs and other community based organizations. Short Term Counseling (STC) services are provided for CPS Parents/Caregivers to a) avoid removal of the family’s child(ren) from the home; or b) reunify the family following the removal of the child(ren) from the family home due to neglect, physical emotional, and/or sexual abuse; or c) avoid placement failure. Over 23 contracted providers throughout the county provide services in a variety of communities and settings, including FRC’s. Short Term Counseling services are offered in individual, family, and conjoint counseling for up to ten 50-minute sessions. Treatment plan relates to mitigating the unsafe behaviors negatively impacting children. There are also group counseling which are twelve 90- minute sessions. These psycho-educational groups are trauma focused to address child abuse and neglect issues, general counseling, domestic violence, anger management and sexual abuse. The last mode of services is Mental Health Assessments. Assessments identify the parent’s clinical diagnosis or developmental disability, recommendations for specific social, mental health or other available services to assist the part to develop skills necessary to parent the child and describe any particular techniques to assist the parent to gain the skills necessary to parent the child. Family Reunification STC is funded by PSSF Limited Family Reunification funds. If Drug and Alcohol issues are identified, families are referred to Sacramento County’s System of Care for assessment and referral for treatment. Sacramento also has a Dependency Drug Court (DCC) which began in 2001. DDC promotes and supports recovery from alcohol and other drugs as part of the reunification plan for parents. DDC is a parallel court, where in, issues pertaining to the underlying case are not discussed during DDC proceedings. The purpose of DDC hearings is to monitor the provisions of drug treatment services and the parent’s compliance with that portion of their court ordered case plan. DDC is collaboration between Juvenile Court, CPS, Alcohol and Drug Services, parents’ and minor’s counsel, County Counsel and Bridges Specialized Treatment and Recovery Services (STARS). Once a parent is ordered into DDC, they are assessed for substance abuse services and immediately referred to the appropriate level of treatment, be it residential or outpatient. The parents also gain immediate access to a Recovery Specialist, via STARS, who assists in engaging the parent in substance abuse services, encourages participation and monitors compliance. Recovery Specialists also remove barriers that keep parents from participating in services. Services provided by STARS are funded by CPS realignment and PSSF funds. Compliance review hearings occur every 30 days. This is an opportunity for parents to share their successes and challenges with the DDC judicial officer who can provide incentives and sanctions as necessary. After 180 days of consecutive compliance with all DDC orders, parents Graduate from DDC. STARS continue to work the parent in Aftercare services. Aftercare is a four month program designed to return more responsibility to the parent allowing them to utilize the recovery principals learned in treatment. The number of parents and children participating in services has increased over the years. Between October 2011 and September 2014, a total of 909 parents entered into the DDC program, along with their 1,211 children. Another service offered to families is called Fast Track. This is a short-term intensive service program from Uplift Family Services. The goal is to keep children at home with their parents while the family is involved with court interventions. The program is developed to serve families in the Dependent Supervision Program with current allegations of domestic or a history of domestic violence. The129

components of service include: development of child and family teams with natural resources; intensive California - Child and Family Services Reviewcase management; intensive behavioral interventions; use of community-based resources.Adoption ServicesSacramento County has an Adoption bureau made up of four units that provide support to adoptivefamilies from the foster care system. There are four home study workers who work with prospectiveadoptive families through the licensing process. Families receive Parent Resource InformationDevelopment and Education (PRIDE) training. Not only are they educated on Foster Care regulationsand personal rights, but they have an opportunity to network with other families going through theAdoption process.Adoption Assistance Program (AAP) is a State program created to encourage the adoption of specialneeds children and remove the financial disincentives for families to adoption. AAP benefits includemonthly financial benefit, medical insurance through Medi-Cal, non-recurring adoption expenses, andpayment for residential treatment. Sacramento County has two AAP social workers that monitorrequest. If a child requires a higher level of care placement, they assist families in locating anappropriate placement. Children can also receive Wraparound services as an alternative to residentialtreatment or when stepping the child down from the higher level of care.Sacramento County has one post adoption social worker who helps facilitate birth family and adopteereunions. Another service is written letter and pictures exchanges for families. Adult Adoptees can alsoreview their file.There are several agencies in Sacramento County that provide services post adoption. Capital AdoptiveFamilies Alliance (CAFA) is a nonprofit agency that provides peer-led Support Groups,education/training, advocacy, respite, resource library, community connections, family events andsummer camp. Sierra Forever Families offers monthly support groups for adoptive parents, mentalhealth services for the family and child, skills training and coaching.A need that has been identified in Sacramento County is to have more mental health providers whohave knowledge and competency of adoption. Lilliput Children’s Services is a Training for AdoptionCompetency (TAC)-certified site in Sacramento County. TAC is a training designed to provide mentalhealth and child welfare professionals with the clinical knowledge and skills to serve adoptees, childrenpreparing for adoption, birth families, and prospective and adoptive parents. Lilliput offers thisintensive training throughout year.Kinship Care/Support ServicesSacramento County partners with two agencies to provide Family Finding and Kinship Support: LilliputChildren’s Services and Sierra Forever Families. Lilliput is contracted to provide intensive family findingto 75-90 children and youth per year upon initial removal. Referrals occur 30 days after removal fromtheir homes. Lilliput seeks out and engages as many relatives as possible. The goal is to keep childrenand youth connected to their families and ultimately place them into kin homes if possible. The childwelfare department does provide a certain level of family finding, however Lilliput provides far moreintensive family finding services which includes the utilization of search engines, as well as conductingengagement and support efforts once kin is located. Lilliput’s Family Finding services include additionalsupport for kin, depending on the specific needs of the family. Prior to a placement occurring, theLilliput Family Finder helps facilitate sibling visits and visits with the relatives (upon approval), conductsassessments of the child’s needs and makes referrals as appropriate, conducts a preliminary relativeevaluation for the CPS worker and attends court hearings with the relative to assist them withunderstanding that portion of the process. After a placement occurs, the relative is offered voluntary 130

California - Child and Family Services Reviewnavigation services through Lilliput, in which they are assigned an in-home case manager to help support and stabilize the new placement by ensuring any up-front emergency needs are met and barriers are addressed. Typical length of services is about 4-6 months. CPS anticipate that Lilliput’s Family Finding will lead to better permanency outcomes because children who are placed with kin ultimately have a greater chance of obtaining permanency. The demand for family finding service is high and many requests are turned away. Lilliput capacity is very low comparison to the number of children who come into care. Services provided by Lilliput under contracted are funded by CPS realignment and Title I-VE waiver funds. Lilliput also has Kinship Support Services Program (KSSP). This is a free, State funded program designed to provide resources to improve the support of and outcomes for families formed through kinship care. Types of supportive services include information and referrals, in home support, support groups, family activities, children’s recreation, assistance with basic needs, respite, advocacy, tutoring and homework help, legal referrals and guardianship assistance. Sierra Forever Families provides intensive family finding and case management services. Services that they offer will be described in more detail under Permanency Planning Services. Sacramento County also has a Kinship unit that assesses relatives/NREFMs for placement. The Kinship unit can assist with obtaining pool fences, baby gates, TV straps to enhance safety/meet mandates, as well as facilitate the purchase of beds, dressers, bedding, car seats and strollers for families with financial hardships. Once Resource Family Approval (RFA) begins in January 2017, relatives and NREFMS will receive training such as PRIDE and CPS/First Aid and other supports including access to foster parent liaison and foster parent mentors. Independent Living services Sacramento County has 12 social workers in the Extended Foster Care (EFC) Program who provide Independent Living Plan (ILP) services in addition to case management. Social workers are meeting with youth individually to create Transitional Independent Living Plans and assess ongoing regarding the youth needs. Social workers are meeting youth on an individual basis providing one on one assistance in areas that include budgeting, resume building, completing job applications, and providing referrals to community resources for various things such as job skills training, job readiness programs, mental health agencies, and mentoring agencies . In addition, Sacramento hosts monthly ILP classes which are youth led by two AmeriCorps members. The AmeriCorps members are part of the Youth Investment Center Program, funded by United Way and AmeriCorps. AmeriCorps members are former foster youth who serve as mentors, guiding youth life skills activities to build skills necessary for a successful transition to adulthood, including graduation from high school. They facilitate the AB12 Orientation and P.A.U.S.E, which covers topics on education, career development, health, relationships, daily living skills, financial resources, and housing information. Sacramento County currently has four ILP contracted providers, Elk Grove Unified School District, San Juan Unified School District, Twin Rivers Unified School District, and Sacramento City Unified School District. Each contracted provider offer services to all youth ILP eligible residing within their district and attending a school in their district. Each program includes Independent Life Skills (ILS) classes/workshops that provide instruction in basic life skills and assist the youth in setting and obtaining realistic goals for their future. The curriculum for their ILS classes focuses on social skills, health awareness, finances, job/career development, and survival skills for independent living, while 75% of the curriculum consists of experiential (hands-on) activities. Titles of classes routinely held throughout the year consist of: Financial Literacy, Employment, Apartment Hunt, Health and Fitness, Cooking class,131

Smart eating, Price is right, Who am I, Cultural awareness, Job readiness/resume writing, College tours, California - Child and Family Services Reviewexpecting and parenting youth (EPY) in foster care, and commercially sexually exploited children (CSEC).In addition to the regular ILP classes throughout the year, our contracted providers support and plan ILPevents and workshops that are held throughout the year that provide our youth support in budgeting,resume assistance, coaching re: employment skills, and other life skills development. Some past andupcoming events open to all youth ILP eligible have included:  10th annual Health and Education and Career Conference  “Fix it City”  Job Shadow Day  Attitude Explosion: An interactive Youth Conference Focusing on Creative Innovation through the Arts.  Personal Growth Classes o Support and empowerment o Boundaries and Expectations o Constructive use of time o Social CompetenciesTransitional Housing Placement-Plus-Foster Care (THP+FC), is a program that provides supportivehousing to youth age 18 to 21 who are in foster care. This program provides a wide range of supportiveservices, including job training, educational support, and counseling. Youth who require additionalsupport are referred to this program by their EFC social worker.THP+FC providers include Environmental Alternatives, Aspiranet and Lutheran Social Services. They areworking collaboratively with our Department social workers to provide services. The goal for the youthin this program is to acquire independent living skills in preparation to emancipate from foster care.THP+FC providers are responsible for strengthening Independent living skills prior to exiting foster careby providing services in self care, daily living, housing and money management, career planning, socialrelationships, work life, education, and transportation. These services are provided in the form of groupclasses and on an individual basis from their “life coach” assigned by the provider.Permanency Planning ServicesSince July 2014, Sacramento County has implemented a permanency initiative to target youth you havebeen in care 24 plus months to receive Permanency Case Reviews. The Permanency Case Reviewmapping/framework was developed in collaboration with Casey Family Programs. The goal of thepermanency case reviews is to make concerted efforts to facilitate permanency for these youth in care.The Permanency Case Review process starts with the social worker and their supervisor having regularconversations regarding permanency during staffing. Specific clients are identified by the ProgramManagers for Permanency Case Review. The Permanency Case Reviews include social workers,supervisors, program managers, and a permanency liaison from Casey Family Programs. The teamassesses the youth’s permanency status, any impediments to achieving permanency and to determineany next steps that would propel them on to permanency. An action plan is developed withgoals/strategies and action steps to reach that goal. If, as a part of the planning for a Permanency CaseReview, it is decided that it is critical to include partners, the youth, family, caregivers or otherstakeholder, the Permanency Case Review team will set up a Child and Family Team meeting.Sacramento County has a Permanency Partnership with Sierra Forever Families and Lilliput ChildrenServices. Lilliput Children Services were discussed earlier under Kinship support. Sierra Forever Familiesis contracted to provide intensive family finding and case management services to 111 children. 132

California - Child and Family Services ReviewServices are funded with CPS realignment, Title I-VE Waiver and PSSF funds. Originally there were two programs, CapKids and Destination Families. When Sacramento entered the IV-E Well Being Project, CapKids Program merged under Destination Families. Destination Family is a program for permanent placement youth who have one or more barriers to finding permanency. Some examples of barriers are sibling groups, disabilities, resistance to permanency, behavioral concerns, etc. There are identified Destination Family Supervisors and Social Worker at each site in Permanency Services, who are partnered with Sierra Forever Family Destination Family workers. The Family Workers work the cases as a partnership. Under the Destination Family Program, the Sierra Forever Family Destination Family (DF) workers provide the following services, or a combination thereof, to children in the program: Identification of additional barriers to permanence, family finding, child readiness assessment for adoption which includes an assessment of needs and making appropriate referrals to address the needs, targeted recruitment efforts, permanency preparation with the child, arranging and supporting sibling/biological family visitation, and providing stabilization support through the finalization of legal permanency. A certain level of all these services is accessible through the assigned CPS social worker, however the time spent and the level and extent of the services is significantly amplified through participation in the DF program. CPS anticipates that DF services will lead to better permanency outcomes because of the comprehensive approach taken to ensure all needs are being addressed, coupled with the targeted recruitment efforts necessary to find the best family match for each child and their unique needs. CPS social workers have significant other responsibilities such as Court reports and meeting legal mandates which the Sierra DF workers don’t have, thereby allowing the Sierra DF workers to spend the time necessary in both finding an appropriate permanent family, as well as supporting the child’s movement through the permanency process. There is no timeframe for the DF work and therefore the process is able to play out under the child’s timeframe. DF Workers works with a youth until legal permanency has been established. A typical duration is 18 months to 2 years. If a child is already being serviced through Destination Family and moves outside Sacramento County, service provider will continue to provide services. However, new referrals are only limited to children placed in County. Many youth who meet the criteria for service, but are placed in congregate care out of county, are unable to access service. Programs/Services for Unique Populations Behavioral Health Services (BHS) and CPS work collaboratively to provide braided funding for two Senior Mental Health Counselors who provide assessment services for caregivers and children to avert the family’s entry or reentry into the CPS system. As part of the Differential Response Team, CPS social workers utilizes the expertise of the mental health clinicians as needed. The goals for this partnership is 1) increase the number of families participating in mental health services; 2) improve access and linkage to mental health services for children and families; 3) reduce the rate of children with a re- substantiation of abuse due to mental health related allegations; and 4) reduce the number of children entering foster care for the first time due to mental health related allegations. Child and Family Institute and UC Davis CAARE Center provide short-term crisis counseling for children who have recently experienced, witnessed, or disclosed trauma or abuse through the Child Abuse Treatment Program (CHAT). This is a Federally funded program that services children and youth victims ages 0 to 18 who do not have access to such services due to a lack of resources, a lack of insurance or Medi-Cal ineligibility. Services may include individual counseling for children and adolescents , group therapy, family counseling, community referrals and collaboration with community organizations, parent education and support, school advocacy, assistance in establishing a funding source in order to transition into long-term counseling services, if indicated and services for individuals with disabilities and interpreting services.133

In 2010, the Department of Health and Human Services (DHHS), Child Protective Services Division (CPS), California - Child and Family Services Reviewwas one of four counties that entered into a Memorandum of Understanding (MOU) with the CaliforniaDepartment of Social Services for the Residentially Based Services Reform Pilot Project (RBS) inaccordance with the provisions of AB1453. Residentially Based Services were defined as the behavioraland therapeutic interventions delivered in group care setting in which multiple children reside in thesame housing unit and receive care and supervision, including a range of interventions from residentialtreatment to post-discharge community-based services. The primary purpose of the pilot projects wasto inform best practice for the future reform in anticipation of SB403, The Continuum of Care ReformAct.The RBS Program model is based on a review of research indicating that key program practices andinterventions are most likely to be effective in helping critical care youth stabilize in placement andachieve permanent connections with shorter lengths of stay in residential care.The key program components for the Sacramento RBS Program include  Extensive family involvement in care planning  Short-term, highly intensive group care and treatment  Parallel, pre-discharge services with the family and community  Permanency services, including family finding and family connection support  Post-residential discharge aftercare and supportThe RBS Program has served youth who have disrupted family relationships and would otherwise beplaced in RCL 12-14 group home placement for long periods of time. RBS has served 103 youth andtheir families since the inception of the RBS pilot project in 2010. Of the 88 youth that have exited theprogram since that time, 41% of those youth have achieved permanency. The current RBS providersinclude the Children’s Receiving Home of Sacramento and Martin’s Achievement Place.The RBS Pilot Project is scheduled to sunset December 31, 2016, with the option for counties to requestan additional extension through December 31, 2019. Sacramento County’s decision regarding extensionwill be based on the readiness of the current RBS providers to transition to Short Term ResidentialTherapeutic Programs as outlined in the Continuum of Care Reform requirements.Culturally Relevant ServicesCPS has 60 special skills social worker positions to meet the needs of ethnic and/or minoritypopulations. Special Skills include Native American culture, African American culture, Hmonglanguage/culture, Spanish language/culture, Russian language/culture and Vietnameselanguage/culture. The staffs are located throughout the continuum of CPS.As mentioned earlier, Sacramento has a Birth and Beyond program with nine Family Resources Centers(FRCs) located in neighborhoods with the highest concentrations of families at risk of child abuse andneglect. Each location has a variety of culturally relevant services for that community. For exampleparenting workshops and home visitation program are available in Spanish, Hmong, Russian, Farsi,Tagalong, Vietnamese, Chinese and Urdu.In April 2013, the Sacramento Blue Ribbon Commission Report on Disproportionate African AmericanChild Deaths described the 20-year problem of disproportionate African American child mortality inSacramento County. Based on the recommendation from that report, the Steering Committee onReduction of African American Child Deaths (RAACD) was formed and approached to achieving the goal 134

California - Child and Family Services Reviewof reducing child deaths were developed. The Steering Committee on RAACD created a strategic plan that includes a Cultural Broker Service Model. Six focus neighborhoods were identified based on the highest number of African American child deaths (Valley Hi/Meadowview, Arden-Arcade, North Sacramento/Del Paso Heights, Oak Park, North Highlands/Foothill, and Fruitridge/Stockton Boulevard). A partnership was developed with seven established community organization to act as Community Incubator Leads (CILs). CILs will be responsible for (a) coordinating the network of RAACD efforts in its neighborhood, including cultural brokers, trauma-informed care, community grassroots messaging, youth leadership and engagement, (b) building and strengthen community relationships and (c) managing regranting programs for small local organization involved in the RAACD activities. Multiple agencies will be co-located at each CIL including but not limited to CPS, probation, law enforcement, Department of Human Assistance, child support and Sacramento Employment and Training Agency (SETA). CPS will have one Informal Supervision special skills African American cultural social worker stationed at six locations to provide case management services for families needing CPS intervention. In addition to CPS social workers, there will also be Cultural Broker workers who are families or peers with extensive community and child welfare related experience. These workers will receive training and mentoring. The goal is to have the CILs in full implementation by February 2017. Programs that target underserved populations In 2014 Children’s Law Center (CLC) of Sacramento in collaboration with CPS was selected for the Expectant and Parenting Youth in Foster Care (EPYFC) National Peer Network. Children’s Law Center was award $50,000 per year for three years to develop and implement a multi-generational and developmentally informed service for expecting and parenting youth (EPY) in foster care. Sacramento’s vision is:  To create a collaborative approach to serving EPY by both social workers and attorneys  To decrease incidents of pregnancy for youth in foster care  To develop trauma informed practices and services  To increase positive outcomes for EPY and their children Sacramento’s priority strategies are:  Improve the Whole Family Foster Care Program  Circles of Support meeting implemented for EPY  Create a network of mentoring groups for EPY  Embed sexual and reproductive health policy into countywide practice  Ensure priority access to key supportive services for EPY  Include youth voice in planning and development of programs and policies CPS has been also making efforts to address the needs of our Lesbian, Gay, Bisexual, Transgender, Queer/Questioning (LGBTQ) youth in foster care. Starting in October 2016, CPS is identifying social worker staff in each program and region to be LGBTQ Resource Specialists. These volunteers would work directly with this population of foster youth as case carrying social workers as well as serve as a Resource Specialist to peers. Once volunteers are identified, a Plan, Do, Study, Act will start to gather information as to the volume and type of needs that emerge as well a use the data to inform our practice.135

Services Provided to Find Permanent Family for Children Ages Zero to Five California - Child and Family Services ReviewAs previously mentioned, Sacramento County has a strong collaboration with Lilliput Children’s Servicesand Sierra Forever Family providing services in promoting permanency for children, including children inthis age group.Services Which Address the Developmental Needs of Infants, Toddlers and ChildrenIn 2010 Sacramento County Department of Health and Human Services, CPS and partner agenciesimplemented the Health Exams, Assessments, Referrals and Treatment Services “HEARTS for Kids”, withthe funding from the First5 Sacramento Commission and the Mental Health Services Act. This programserves children 0‐5 years of age w h o a r e p l a c e d i n p r o t e c t i v e c u s t o d y . Some childrenstart with the medical exam and some (newborns, children who were hospitalized, children whosaw another medical provider the day they were placed into custody) are referred directly to publichealth nurse (PHN) and early intervention clinicians.A Public Health Nurses (PHNs) conducts a home visitation to complete a developmental screening andto ensure that the children are linked with a provider who can address their medical and dental needs.The PHNs use the ASQ (Ages and Stages Questionnaire) developmental screening tool. PHNs alsoprovide education and community resources during the home visit. They conduct several home visits ifneeded to complete a developmental screening and refer the children to appropriate developmental andmental health services if needed.An Early Intervention Mental Health Clinicians (EI) conducts a home visit to work with the child andcaregiver to address bonding and behavioral issues. They asses the child’s social and emotional functionby using the ASQ-SE screening tool. The EI works closely with the PHN and administers a seconddevelopmental assessment if the PHN identifies delays that need further monitoring. The EI ensures anynurse’s referrals have been made. The EI also makes referrals if new behaviors/concerns arise and thereferrals were not made previously.There are 18.3 FTE Public Health nurses who support social workers around health issues.  PHN assigned to the Emergency Response  3.5 PHNs for Hearts for Kids (entry medical exams for children 0‐5 years of age)  3.0 PHNs for Court Services where they interview parents at detention hearings and order/review medical records  The remaining 7.3 are assigned to the regions to provide support to Permanency Services.Services Available to Children and/or Caregivers with Physical, Mental or OtherDisabilitiesAll children with an open case have a mental health screening completed within the first 30 days. If thescreening indicates a need, a referral is made to Sacramento County’s Mental Health Access team.Behavioral Health Services has contracts with several providers located throughout the County to servechildren and/or caregivers with Medi-Cal insurance. Services include but not limited to outpatientmental health, inpatient mental health, flexibly integrated treatment (FIT), WRAP, therapeuticbehavioral services, and parent-child interaction therapy (PCIT). Behavioral Health Services also offersan array of prevention and early intervention programs, such as suicide prevention crisis line,postvention counseling, bereavement, support groups and grief services, mobile crisis assessment andintervention, mental health consultation for preschoolers and daycare setting, and violence and bullyingprevention, education, and outreach. There are also suicide prevention, education outreach andengagement specialty for LGBTQ youth, Latino Cultural, Russian Speaking/Slavic Community Cultural,African American Cultural, Native American/Indian Cultural, and Asian Pacific Islander Cultural. 136

California - Child and Family Services ReviewSacramento has a policy and procedure for medical neglect allegations. The purpose of the policy is to determine when an allegation meets the definition of medical neglect, make an accurate assessment of child’s needs as it relate to medical neglect and know the consultation resources when medical neglect allegation is received. Referrals and cases are assigned to specific social workers who specialize in medical neglect cases. A Medical Neglect Review Team (MNRT) made up of professional from different disciplines come together regularly to provide consultation and assistance for cases involving chronic and/or complex medical issues. MNRT consist representatives from CPS, Public Health, Senior and Adult Services, California Children’s Services (CCS), and California Regional Services. Native American Children and Indian Child Welfare Act (ICWA) Services Sacramento County has two federally recognized tribe, the Buena Vista Rancheria of Me-Wuk Indians and Tribe of Miwok people, Wilton Rancheria and . In September 2013, the Tribe was designated the geographic boundaries of the Service Delivery Area (SDA) of Sacramento County. They provide cultural resources, education, health and housing services. Their ICWA Department provides case management, court advocacy, family preservation services, foster parent recruitment, and referrals to service providers within the community such as behavioral health, Alcohol and Drug and parent education. One agency, the Sacramento Native American Health Center (SNAHC) provides culturally competent, holistic, and patient continuum of care. There are no tribal or ethnic requirements to receive care. However of those served, 26% are Native American from both local and out-of-state Tribes. CPS also serves children and families from surrounding counties federally recognized Tribes including, the United Auburn Indian Community, Shingle Springs Band of Miwok Indians, and Ione Band of Miwok Indians. Quality Assurance System Sacramento County utilizes a quality assurance process, both division-wide and in a program level, to evaluate ongoing practices, policies, and procedures in order to ensure quality services to children and families in the child welfare system. CWS/CMS and SafeMeasures are used division-wide to monitor and evaluate the provision of child welfare services. Supervision of staff is an integral component of quality assurance process division-wide. Managers, supervisors, and social workers participate in monthly, supervision, in part to review performance data obtained from SafeMeasures and other data sources. Supervision for social workers is sometimes bi- monthly, weekly, or more frequent as needed if they are a new worker. Team unit meetings are generally held monthly with managers, weekly to bi-monthly with supervisors, and monthly with social workers to disseminate information, train, and review quality assurance measures and outcomes. Supervisors oversee the quality of decisions made by social workers through staffing referrals and cases, and when needed, subsequent staffing occur with managers on more complicated referrals/cases. Furthermore, with the integration of Safety Organized Practice (SOP) more managers, supervisors, and social workers are staffing cases utilizing the SOP framework to better organize and improve quality of family engagement, critical thinking, and solution focused planning. Three SOP coaches, each with twenty-five hours available per month, are also working with supervisors and managers to support development and deepening of SOP practices. Program-specific quality assurance processes include, but not limited to, the following:137

Emergency Response Intake Program California - Child and Family Services Review  The Emergency Response Intake program produces a monthly report to track monthly hotline calls, social worker availability, and referral assignment to determine agency capacity in responding to child abuse and neglect referrals.  All immediate response referrals are entered on Immediate Response Information System (IRIS) to ensure timely investigation within 24 hours and completion of the Structured Decision Making (SDM) Safety Assessment tool. Supervisors and managers monitor IRIS daily for quality assurance.  Intake supervisors and social workers staff all Immediate Response (IR), 10 day, and evaluate out referrals that are questionable. The staffing is elevated to management if the supervisor and social worker cannot come to a decision.  A monthly Intake Peer Review, consisting of Intake supervisors, is held to review evaluate out referrals and ensure accurate and quality determination of decision at the intake level.Emergency Response Field Programs  Managers and supervisors track compliance with timely investigation on Immediate Response and 10 day referrals.  “Five and under children with open referrals” reports are distributed to supervisors to emphasize, track, and monitor the most vulnerable aged children.  Supervisors staff “Over 60 days open referrals” with social workers to determine a course of action.  Supervisors participate in a rotating Field Peer Review to review decisions made by field social workers to evaluate out a referral.  Supervisor and social worker staffing also occur with their manager and region’s Informal Supervision supervisor to determine if a family meets criteria for acceptance into the Informal Supervision (IS) program.  Managers conduct case reviews such as two closed referrals each month from each unit and high risk referrals. Findings from these case reviews are discussed at supervisor meetings to improve consistent investigation, documentation, and conclusions.  Supervisors review referrals for closure for quality assurance, and they coach their workers to improve family engagement, service delivery, investigation, documentation, and conclusions.Informal Supervision Program  IS supervisor and managers use SafeMeasures to monitor social worker face to face contacts and case plan status.  IS supervisors meet with their social workers at least twice monthly to review cases and discuss families’ case plan services and objectives, families’ compliance and progress, and to make decisions on next steps.  All IS case closures are then reviewed by their managers for a higher level of quality assurance.Court Services Program  Court Services produces a report that provides monthly data on caseload assignments and social worker availability to determine agency capacity to investigate petitions filed with the Juvenile Court. In addition, this report provides other information such as compliance with social worker contact, count of runaway or missing children, and number of child abuse and neglect referrals assigned to Court Services.  Managers and supervisors track court report timeliness and work with staff to improve time lines. 138

California - Child and Family Services ReviewPermanency Program  Permanency Programs produce a monthly report to track and monitor several data such as social worker face to face contact with children, regional breakdown of total cases, children in placement, caseload assignment, and completion of SDM tools.  Permanency monitors face to face contacts, case plans, and timeliness of contacts being entered within five days after seeing a family. Permanency also tracks how many children have reunified, how many were sent to adoptions/guardianship during last month or quarter, and how many have been on a caseload two years or more.  Permanency supervisors review all court reports and managers and supervisors track timeliness of court reports both at “10 days out” and “30 days out” to facilitate conversations about plans for being timely. Additionally, supervisors update managers at end of the week regarding court reports that are due and status for being timely. In addition to program-specific quality assurance processes, Sacramento also has initiatives/ strategies, with quality assurance components, to monitor outcomes for children and families. It includes the following: Permanency Case Review Sacramento County implemented Permanency Case Reviews for children who have been in care for two years or more. The Permanency Case Review process starts with the social worker and their supervisor having regular conversations regarding permanency during one-on-one staffing. Specific clients are identified by the Program Managers for Permanency Case Review. The reviews include social workers, supervisors, managers, and a permanency liaison. Youth, family and services partners may be invited to the case reviews if they are critical components to the meeting. An action is developed with goals/strategies and action steps to reach that goal. During the first three months of implementing the Permanency Case Reviews, several debriefings were set up for ongoing learning and continuous quality improvement with the process. Before the end of the Permanency Case Review session, there were quick team debriefs to discuss what worked and did not work with the process, as well as suggestions to improve the process. A quick Team Debriefing took place immediately after the Permanency Case Review Meeting to gain knowledge about the process (what worked, what was helpful, what were the challenges, and suggestions for improving the process). There was also a Social Worker and Supervisor Monthly Debriefing that was facilitated by the Program Planner. Information gathered in this meeting determined any changes with the workers knowledge, skills, attitudes, feelings, and practices that may directly impact permanency for a child. A program planner consolidated this information for distribution to the Permanency Case Review workgroup and Permanency Partners. The Program Planner also identifies common theme and data analysis. Currently a Program Planner and/or Program Specialist follows up with the Program Manager quarterly to gather information the Permanency Case Reviews and outcomes. Child and Family Services Review (CFSR) A qualitative case review process was implemented in California’s 58 counties on September 30, 2015. These reviews provide a better understanding of county practices, policies and procedures from the perspectives of various case participants. They are an integral part of the Sacramento’s efforts to achieve positive outcomes in the areas of child safety, permanency and well-being for all children and families. Case reviews, along with statistical data analysis, are an important part of Sacramento County’s efforts for continuous quality improvement (CQI).139

The Sacramento County Federal Case Review process includes utilizing the Administration for Children California - Child and Family Services Reviewand Families’ (ACF) Onsite Review Instrument (OSRI) for review of all cases. This tool is completed forthe 25 required cases per quarter. Each reviewer must complete a lengthy process to become acertified case reviewer. The path to certification includes attending a 4-day training program,completing at least three coaching calls spread over several weeks and completing a final exam whichthe trainee has two weeks to complete. While Sacramento currently has 12 certified reviewers, only fivecomplete reviews on a quarterly basis. Of these five reviewers, only two reviewers are dedicated tocase reviews fulltime. Sacramento County is in the process of hiring two additional fulltime casereviewers to increase capacity to meet state and federal mandates.Monitoring Foster Family Agencies (FFAs)Sacramento County currently has Memoranda of Understanding (MOU) with 37 Foster Family Agencies(FFA). The MOU outlines performance goals for FFAs in the areas of safety, permanency and well-being.FFAs are required to submit an outcomes report semi-annually detailing their performance in thetargeted areas. FFAs with low performance levels are required to report quarterly until performanceimproves. The monitoring process includes site visits and corrective action plans as needed. Whennecessary, Sacramento County utilizes placement holds for FFAs with poor performance levels and/orunresolved safety issues. Sacramento County works closely with Community Care Licensing, sharinginformation and conducting joint site visits and home inspections.PlacementSacramento County has a Centralized Placement Support Unit (CPSU), which is comprised of placementsupport social workers and child workers. Placement workers secure placement for children with a goalof matching children’s needs to the skills and abilities of a foster parent, or when appropriate, a grouphome. They adhere to the placement policy, locate the least restrictive setting (most family-like setting),and coordinate the move of the child to the new home. Child workers are assigned to children placedinto protective custody. They work with families to locate possible relative/non-related extended familymembers (NREFM) for placement, and complete background checks and home evaluations the sameday of removal or within the 72 hour custody hold.The Kinship Unit assesses relatives/NREFMs for placement completing a detailed evaluation thatincludes criminal background checks (including local, Department of Justice, Federal Bureau ofInvestigation, live-scan results), obtaining police reports and certified convictions, child abuse andneglect checks (including Central Child Abuse Index (CACI) and CWS/CMS database), Megan's LawChecks, Adam Walsh Checks, and in home inspections (including follow up checks for any issuesrequiring a corrective action plan to meet approval standards). Kinship social workers’ assessmentsinclude a review of all adults in the home, as well as those adults who would have significant contactwith the children. They evaluate, and approve or deny relatives’ and NREFMs’ homes for placementusing criteria and standards equivalent to the criteria and standards used to approve or deny licensedcounty foster homes. If a relative/NREFM is denied approval based on criminal or CPS history, theproposed caretaker can appeal the decision by requesting a “Harris Hearing” through the State ofCalifornia.Sacramento County follows legal mandates that children are placed in least restrictive family settingssuited to the child’s needs, including placing with relatives, non-related extended family members(NREFMs), siblings, within their county of residence, and school or origin. Sacramento County alsocomplies with the following federal laws: The Multi-Ethnic Placement Act and Interethnic AdoptionProvision (MEPA-IEP), which prohibits a “child’s foster care or adoptive placement to be delayed ordenied based on the child’s or caretaker’s race, color, or national origin”, and the Indian Child WelfareAct (ICWA), which specifies a hierarchy for placement of Indian children: (1) “Placement with member of 140

California - Child and Family Services Review Indian child’s extended family”; (2) “placement in a foster home approved, specified or licensed by the Indian child’s tribe”; (3) “placement with an Indian foster home licensed or approved by an authorized non-Indian licensing authority”; and (4) “placement with an institution for children approved by the Indian tribe or operated by an Indian organization that has a program suitable to meet the Indian child’s needs”. Sacramento follows a hierarchy of placement, starting with the least-restrictive and family-like environment (relatives/NREFMs, Sacramento foster homes, foster family agencies, Children’s Receiving Home, intensive treatment foster care homes as treatment intervention, and group homes as a treatment intervention). Sacramento makes diligent efforts to place siblings together unless it is not in the best interest of one or more of the siblings, and placing children in their school of origin. Supervisors and social workers staff all requests to place children in group homes with their Program Managers. If approved, the managers provide their signature and send to their Division Manager for higher level consideration and approval. Division Managers then send to the Deputy Director for final consideration, approval and signature. If children require a group home level 13 or 14, or out of state group home placement, the case is required to go before the Interagency Management and Authorization Committee (IMAC). IMAC is an interagency placement committee comprised of representatives from Child Welfare, Probation, Mental Health, Education and Alta Regional Services. IMAC reviews the case including all information regarding the youth’s family, placement history, criminal offenses, mental health treatment, and current level of behavioral and educational functioning and provides recommendations and coordinates services, including residential placement and mental health treatment. Furthermore, group home placements are re-assessed after 60 days and require further approval from the Division Manager for an extension. Team Decision Making Meetings (TDMs) Sacramento County utilizes Team Decision Making Meetings (TDMs), which are facilitated team meetings regarding placement decisions for children. Participants include social workers, social work supervisors, parents, extended family members, community representatives, service providers, caregivers, and children when appropriate (ten and older). The goal is to ensure the safest and least restrictive placement for the child. Additionally, a thirty day action plan with assigned tasks is developed with participants to support the placement decision. TDM data is entered into Efforts to Outcome (ETO) database and CWS/CMS. A monthly TDM report is produced that details how many referrals were received for TDMs, and how many were held for that month, in order to monitor TDMs usage. Compliance with ICWA and Multiethnic Placement Act (MEPA) All initial and subsequent placement changes are processed by the Centralized Placement Support Unit (CPSU). Once the CPSU social worker has found placement options, they present them to the case carrying social worker who selects the best placement for the child. In accordance with MEPA, a child’s foster care or adoptive placement will not be delayed or denied based on the race, color or national origin of the prospective resource or adoptive parents or the child. MEPA does not affect the ICWA’s preferences for placing Indian children with members of the extended families or other tribal members. In regards to ICWA, when a child or family member indicates they have American Indian heritage, they are identified in CWS/CMS. Once ordered, paralegal staff completes an ICWA search and report the outcome to the Court. If it is found that ICWA applies, the Court will make the finding. Sacramento works with the Indian tribe to find the most appropriate out-of-home placement for an Indian child. Social Workers are to identify the Indian community in which the parent or extended family member141

maintains social and cultural ties. When placing an Indian child in out-of-home care, the prevailing social California - Child and Family Services Reviewand cultural standards of that community are followed. Placement priorities for Indian children are: 1) amember of the Indian child’s extended family; 2) a foster home approved, specified or licensed by theIndian child’s tribe; 3) an Indian foster home licensed or approved by an authorized non-Indian licensingauthority; and 4) an institution for children approved by the Indian tribe or operated by an Indianorganization which has a program suitable to meet the Indian child’s needs.Mental Health MonitoringWith the implementation of Katie A/Pathways to Mental Health, an emphasis on mental healthscreening, monitoring, and collaboration with Behavioral Health Providers were established. All childrenand youth are assessed for mental health needs within 30 days opening a case. CPS developed a MentalHealth Screening Tool that is used by social workers for these assessments. Social workers document thecompletion of the screening tool and outcome of the assessment in CWS/CMS. Prior to the publicationof the Mental Health Screening report in SafeMeasures, Program Administration distributed monthlyreports, pulled from Business Objects, for managers and supervisors on mental health screeningcompliance, overdue screenings, and screenings due within 60 days, as well as alerts to any possibledata entry issues. Managers and supervisors were required to review mental health screenings on theirrespective programs and/or units.Children in mental health services are required to receive regular Child and Family Team (CFT) meetingsto address their mental health needs and transition out of child welfare. CPS Social workers areresponsible for facilitating CFT meetings for class member children, while the Intensive Care Coordinator(ICC) with Mental Health Services is required to facilitate ICC-CFT for subclass members. The first CFTmeeting occurs within 60 days of assignment of a child to a mental health provider, and subsequent CFTmeetings occur at minimum once every 90 days. In November 2015, Sacramento developed andimplemented a process for documenting CFT meetings in CWS/CMS. Monthly compliance reports,produced by Program Administration, are currently being provided to managers and supervisorsregarding CFT meetings for children identified as receiving class services to monitor the county’sprogress in conducting CFT meetings.Sacramento Child Welfare and Behavioral Health Services (BHS) continue to share data and providereports quarterly to management. The report includes number of children screened, not screened,screenings that led to mental health referral, whether they referred to Child Access or private provider,number of referrals received by BHS Access, number of child welfare referrals, whether or not they areenrolled in mental health services or pending, class and subclass designations and number of ICC or IHBSservices provided. Starting in October 2016, Program Administration implemented a monthly Pathwaysto Well-Being Dashboard that shows compliance with mental health screenings and CFT meetings.Prescription and Psychotropic MedicationSacramento Child Welfare partnered with Department of Health Care Services (DHCS) and the CaliforniaDepartment of Social Services (CDSS) to develop guidelines setting parameters around the treatmentand prescribing methods of psychotropic medication for foster youth. The guidelines, which werereleased July 2015, identified essential elements that prescribers should consider prior to prescribingpsychotropic medication. CPS opted into a Global Data Sharing Agreement with DHCS and CDSS allowingthem to match data between CWS/CMS and the Medi-Cal systems specific to each foster youth whouses psychotropic medication. Comprehensive reports are provided to child welfare agencies on aquarterly basis with data specific to their foster youth population. This data allows CPS to identifyprescribing characteristics that pose the most risk to foster youth, as well as help better track all fosteryouth who are using psychotropic medication. 142

California - Child and Family Services ReviewSacramento has a Psychotropic Medication Coordinator who monitors and tracks the JV-220 Application Regarding Psychotropic Medication. The coordinator sends out a comprehensive report quarterly to managers which indicate the number of active JV-220s and expired JV-220s. The coordinator also sends out reminders to case carrying social workers and their supervisors at least one month prior to the JV- 220 expiring. Judicial changes were made to the Psychotropic Medication Authorization process effective July 1, 2016. The new process elicits more input from the case carrying social worker, the child, and others to determine if psychotropic medication intervention is warranted. Additionally the social worker or probation must file a County Report on Psychotropic Medication with the court at each scheduled progress and status review hearing regarding orders authorization psychotropic medication. Additionally, Sacramento Child Welfare is collaborating with Behavioral Health Services (BHS), the Court, and Probation to develop a process for obtaining second reviews on all JV- 220s prescribing psychotropic medication for foster youth. Physical Health Monitoring Sacramento collaborates with Public Health (PH) to supervise Foster Care Public Health Nurses (PHN) who coordinate health care services and serve as liaisons with health care professionals and any other health related providers. The overarching goal is to ensure that the medical, dental, and mental health needs of each foster are met. Public Health Nurses collect health information and other relevant data to record in the Health and Education Passport (HEP) for each foster child. Because PHNs’ caseloads are high, they are unable to actively monitor every child’s case; therefore a three tier priority was established. Priority 1 is given to children ages 0-5, medically fragile children, and/or children on psychotropic medication; priority 2 is given to children with medical issues within past year; and priority 3 is given to children with no medical issues. A referral process is being developed when social workers discover a child has a new medical issue that would make them a high priority. Business Objects and Safe Measures are utilized to run two reports. Children that are medically fragile (complex health conditions, medical neglect, and chronic medical illness) are coded with a special project code in CWS/CMS by social workers or the PHN. There are workers in each region who specialize in medical neglect cases. To ensure the validity of our data reporting, regular monitoring of cases identified as medical neglect are compared to reports run by Business Objects and information from the PHN. Managers, Supervisors, and Social Workers can look in Safe Measures to see the HEP and how many were provided to the current caretaker. Educational Needs As mentioned earlier under service array, with the Education Equals Initiative, CPS is partnered with Sacramento County Office of Education (SCOE). There are SCOE Instructional Case Managers (ICM) in Court Services and at each Permanency Bureau region. They gather all educational information for children grades K-12 and input into CWS/CMS and Foster Focus (SCOE database). A report can be pulled from Safe Measures regarding a child’s current school and grades. The ICM provide information to the social workers upon request. Also one month prior to status review hearing, the ICM provides Education Progress Summary to the social worker and supervisor for 7-12th graders. This report includes information on any suspensions, grades, attendance, and notes about child’s behavior in school, and is attached to Court reports for review. Sacramento County completes the Non minor Dependent Exiting Extended Foster Care Quarterly Statistical Report (SOC 405X). Information from that report includes number of youth who are enrolled or completed high school or equivalency as well as college and vocational education enrollment. a143

Sacramento recently developed the “Outcomes for Youth Exiting Foster Care at Age 18 or Older” California - Child and Family Services ReviewDashboard to track outcomes, including completion of high school or equivalency, for this population.Special Needs ChildrenSacramento has a system in place to ensure children with chronic and/or complex medical issues arereviewed before a multidisciplinary team. The Medical Neglect Review Team (MNRT) consists ofprofessionals from different agencies including CPS, PH, California Children’s Services (CCS) andCalifornia Alta Regional Services. The purpose of MNRT is to ensure the medical information andresources have been considered, assessed and coordinated prior to closure of a referral or case. MNRTare required when the allegation is based on medical neglect of a child or during the investigation thesocial worker obtains information that here may be medical neglect of a child.Special project codes are used for children identify as a medical fragile child. PHNs ensure medicalservices are in place and the child is seeing the appropriate providers. PHNs will also work with fosterparents via education by phone regarding how to best service and meet needs of child.HEARTS for Kids is another program that screens all children ages 0-5, who are placed into protectivecustody. Screenings include a medical clearance exam and developmental screening using the ASQ(Ages and Stages Questionnaires). Depending on the outcome of the screenings, children are referredto SCOE, California Alta Regional Center, Head Start, and WIC as needed.Case Planning ProcessCase plans are reviewed with parents/guardians and age appropriate children to engage them in theprocess throughout the life of their case. Case plans contain goals and objectives designed to facilitatepositive change; they are updated at least every six months, and are attached to court reports. CasePlans are created in CWS/CMS, and reviewed and approved by supervisors to ensure all principalelements are included. Social Workers obtain case plan signatures from participating family members inagreement of the plan; they document their contacts with families in CWS/CMS, and then enter thatinformation in court reports.Concurrent PlanningConcurrent planning is “a planning process, while the child is in the Family Reunification component, toaddress the child’s need for a permanent family by working toward reunification, and at the same timeestablishing an alternative or contingency permanent plan for the child through adoption, guardianshipor placement with a relative.” In Sacramento County, concurrent planning starts as early as isappropriate and no later than three to four months after the Detention hearing, and then again nine toten months after the Detention hearing if the child remains in out of home care. During these timeperiods, social workers and supervisors, during the course of social workers’ one-on-one supervisionwith their supervisors, discuss, complete, and sign a “CS918A” concurrent staffing form that is located inCWS/CMS and forwarded to the concurrent planning clerk and program manager. Also, during monthlycase staffing, social workers and supervisors have ongoing conversations regarding the family’s progresstoward reunification, whether there are any impediments to permanency and/or alternatives forachieving permanency. Social workers are required to document the concurrent plan and concurrentactivities in CWS/CMS as well as in court reports, and must include information on whether a child isplaced in a relative/NREFM home, and if so, the relative’s view on permanency; if there is no relative,the continuing efforts being made to locate family/NREFMs; and whether the current caregiver isinterested in permanency.Children identified from “CS918A” concurrent staffing forms that do not have a concurrent plan in place,receive an “Enhanced Concurrent Planning Staffing”, which is scheduled at four, ten, and sixteen months 144

California - Child and Family Services Review after the Detention hearing. These staffings are formal and are attended by the social worker, a rotating Permanency supervisor, and a rotating adoption supervisor. Meeting Termination of Parental Rights Timelines At the Jurisdictional/Dispositional Hearing, which is set approximately three weeks after the Detention Hearing, a recommendation is made to offer parents with reunification services or to bypass parents who are not eligible for reunification services due to Welfare and Institutions Code Section 361.5(b) findings. Parents receiving reunification services are generally entitled to six months of reunification services with children three and younger, and twelve months of reunification services with children four and older. If parents are making substantive progress, reunification services can be extended another six months and up to eighteen months. Children who are returned to parents under Dependent Supervision are monitored by the Court, and in-home review hearings are set every six months. In Sacramento County, when there is a recommendation to terminate reunification services for a parent, an enhanced concurrent planning staffing is held. This staffing occurs when a determination has been made to terminate services, or occurs no later than one or two months before the Status Review Hearing recommending termination of services. As described above, it is a formal staffing that includes an Adoption supervisor to assist with permanency planning. Termination of parental rights timelines are monitored by Child Welfare and the Court. At the time the Court terminates family reunification services for a parent, the Court sets a Welfare and Institutions Code Section 366.26, Selection and Implementation Hearing, in six months. The case is transferred to an Adoption Social Worker who reviews, completes an assessment, and makes a recommendation for the most appropriate permanent plan (i.e., adoption, guardianship, permanency services with a goal of adoption, guardianship, other, etc…). If the recommended permanent plan is adoption, parental rights are terminated at the 366.26 hearing, and subsequent hearings are set every six months to monitor the progress until adoption is achieved. 366.26 hearings may be continued if further information is needed, and they may be set for trial if a parent is contesting their parental rights being terminated, which will delay or stop termination of parental rights depending on the outcome of the 366.26 hearing. Development of Transitional Independent Living Plan (TILP) Social Workers complete a Transitional Independent Living Plan (TILP) with youth who are 15 ½ or older. The social worker develops and creates the TILP with the youth and attaches it to the court report for review by counsel and the referee/judge. Supervisors and social workers, during their monthly one-on- one supervision, identify any youth who are eligible for the Independent Living Program (15 ½ or older) and create a plan for completion of the TILP. The TILP is then updated every six months and attached to all subsequent court reports. Supervisors can monitor whether a TILP was completed by checking Safe Measures or checking CWS/CMS to see if it was documented. Additionally, supervisors can review the TILP at the time they are reviewing court reports. Programs Supported by CAPIT/CBCAP Funding Sacramento County braids CAPIT, CBCAP, First 5 Sacramento, Title IVE, Medical Administrative Activities, and Corporation for National and Community Service funds to support the nine (9) Birth & Beyond Family Resource Centers (B&B FRCs). B&B has an extensive infrastructure including seven (7) non-profit organizations that operate the FRCs and the Child Abuse Prevention Council that serves as the “backbone organization” coordinating the collaborative, training staff, monitoring model fidelity and evaluation. Each of the non-profit agencies contribute match funding to support the program. Birth & Beyond Family Resource Centers are community service hubs providing a continuum of child abuse and neglect prevention services. The overall goal is to reduce the number of entries/re-entries145

into the Sacramento County Child Welfare System (CWS) by improving parenting knowledge, skills, and California - Child and Family Services Reviewbehavior. Each B&B FRC operates on the same program-wide budget and standard minimum staffingstructure to ensure capacity is reached. The B&B FRC program has the capacity to serve the followingnumber of parents annually. The capacity is a duplicate count as some parents receive more than oneservice:  FRC Effective Parenting Workshops – 1540 Parents  Home Visitation – 2108 Parents per quarter  Crisis Intervention – 2246 Parents per quarterAs evidenced by the number of parents served in the 2015/2016 program year, the B&B FRC programserves more parents than capacity. The following numbers of parents were served program-wide(duplicated):  FRC Effective Parenting Workshops – 2047 Parents  Home Visitation – 4010 Parents  Crisis Intervention – 3908 ParentsThe B&B FRCs program offered enable parents to individualize their services based on need. The threeprimary services include: Home Visitation, FRC Workshops, and Crisis Intervention. Parents receiveevidence-based Nurturing Parenting Program (NPP) services in either group-based workshops at the FRCor one-on-one Home Visitation in their home. B&B FRC staff are trained to assess and triage familiesbased on need and risk level for child abuse and neglect.  Parents engaged in home visitation re assessed using the Adult Adolescent Parenting Inventory (AAPI) to establish their “dosage” based on risk level and need. Parents, in concert with their Home Visitor develop a Family Nurturing Plan to determine service dosage, parenting constructs that need improvement, and to track progress throughout the duration of their service dosage. Parents complete the AAPI again at the mid-point of and end of their agreed upon dosage to measure gains in parenting knowledge.  Parents engaged in FRC Effective Parenting Workshops/Classes are also assessed using the AAPI at the beginning, mid-point (lesson 6), and end of the class series (lesson 15) to measure gains in parenting knowledge. The NPP in the FRC is court-approved to meet the requirements for parents working towards reunification.  Crisis Intervention is a short-term service to stabilize families that are experiencing crises. Parents’ needs and stress level are assessed by the Crisis Intervention Specialist using a pre and post assessment tool. Families requiring a higher degree of services are case managed until their needs are met. Crisis Intervention families are encouraged to engage in either FRC or Home Visitation services.The B&B program utilizes the evidence-based Nurturing Parenting Program (NPP) and its prescribeddosage through home visitation and group-based workshops, to teach parents replacements to corporalpunishment, child development, parent/child roles, establishing family routines, building empathy, andempowerment to develop parenting skills as an alternative to child abuse and neglect. During weeklyhome visits and 12 week workshops, Home Visitors and FRC Aides deliver NPP’s Prenatal/Infant/Toddler,Pre-School, School-Age and Father’s Inc. curriculum.Developed in 1983 by Dr. Stephen Bavolek, 1.5 million families in 50 states and 12 countries havereduced risk for child abuse through NPP. It is recognized as valid and reliable by the National Registry of 146

California - Child and Family Services ReviewEffective Programs and Practices, Substance Abuse and Mental Health Services Administration, Child Welfare League of America and Center for Substance Abuse Prevention. California’s Child Welfare Evidence-Based Clearinghouse rates NPP at the highest level for relevance to child protection and a Scientific Rating of 3, “Promising Research Evidence.” With a 13-year history of positive outcomes for parents, an independent evaluation AmeriCorps Impact Evaluation Birth & Beyond Home Visitation Program 2013-15 (LPC Consulting Associates, Inc./JBS International, Inc. December 2015, was conducted to assess the impact of the B&B program on families with prior CWS involvement. This quasi-experimental study compared 496 B&B home visitation parents with previous child welfare referrals who received 8 hours of NPP and a comparison group of 985 parents who did not participate in B&B services, using propensity score matching of child welfare records. A Cox regression analysis showed a statistically significant difference between parents receiving home visitation and those who did not. The comparison group had a 41% greater rate of substantiated child welfare referrals than parents participating in any NPP services (HR=1.42, significant at p <0.05) throughout the 4-year period when all other variables were held constant. The comparison group had a 173% greater rate of substantiated child welfare referrals than parents participating in home visitation 25-36 hours throughout the 4-year period (HR= 2.73, significant at p < 0.05). Pre/post comparison of average AAPI scores for parents receiving at least 8 hours of NPP showed statistically significant improvement (p < 0.001) in their parenting skills. Parents increased an average of 1.1 points (on a 10- point scale) across all of the five NPP parenting domains measured. Prior to 2015, the most significant gap in B&B services was the limitation to only serve parents with children 5 years of age and under. This was a result of First 5 Sacramento funding restrictions. In January 2015, B&B received funding from Sacramento County to serve parents and children 6 years of age and older. B&B had also identified a need for domestic violence services and that service gap was addressed with the increased 2015 funding. Ongoing gaps in services include lack of housing resources available to families engaged in B&B FRC services as well as mental health and substance abuse needs. However, no significant services have been discontinued in the past 5 years. Since B&B’s inception in 2000, demographic and socioeconomic data have been used to determine and validate accessibility of services. B&B FRCs remain strategically located in neighborhoods where 75% of all Sacramento County families reside and in 2015 represented 83% of all child abuse allegations. B&B annually reviews data, including but not limited to, percent of children in poverty, parent education, no/late pre-natal care, single parent households, violent crime, and child abuse substantiated reports, Services are offered in a multitude of languages such as English, Spanish, Russian, Hmong, Vietnamese and Punjabi, to meet Sacramento County’s diverse population. County’s Monitoring Mechanism of CAPIT/CBCAP Funding B&B Service provider Data Entry staff collect/enter data in real time into a comprehensive B & B data collection system managed by an External Evaluator (EE). Monthly, the EE provides both individual site and program-wide data to the fiscal agent (CAPC), all B & B sites, and county program planners. Quarterly, CAPC submits formal aggregate data reports to the county. Annually, the EE collects and CAPC reports child welfare recidivism data to the County. County Program Planners participate in a variety of activities, which include, but are not limited to regular site visits, quarterly file reviews and regular participation in program wide meetings. Depending on the issue, CAPC, county staff, B & B site management, and B & B agency leadership, determine what corrective action should be taken, timeline for the corrective action, and measures to ensure compliance with the timeline. CAPC and the county monitor corrective action progress.147

Unique invoices were developed to reflect the various funding sources. Monthly, they are reviewed and California - Child and Family Services Reviewapproved by the fiscal agent then forwarded to the County Program Planners for review and approvalprior to the distribution of funds. An independent evaluator and the fiscal agent (CAPC) use a braidedmethod to determine the percentage of CBCAP/CAPIT funds that are being used for services rendered.CAPC reports participation rates annually to the county. The unique invoices were also developed toreflect the various funding sources. They are completed monthly by the providers. The providersforward them to the fiscal agent, who reviews and approves them. The fiscal agent forwards theinvoices to the County for review and approval prior to distribution of the funds.Programs Supported by PSSF FundingSacramento County funds Stars/Bridges, Short Term Counseling, Informal Supervision and AdoptionPromotion and Support services with PSSF funding.County’s Monitoring Mechanism of PSSF FundingSTARS/BridgesSacramento has contracted with Children and Family Futures (CFF), a California based non-profit policyanalysis and research firm to evaluate its Family Drug Court Programs (FDC), including Drug DependencyCourt (DDC), Early Intervention Family Drug Court (EIFDC), and the Children In Focus (CIF) enhancement.The purpose of the evaluation is to measure each FDC program’s ability to promote positive alcohol anddrug-related and child maltreatment-related outcomes among participating families. The evaluation ofSacramento Family Court Programming connects data across collaborative partners under data sharingagreements. The CPS creates special project reports from the Child Welfare Services/Case ManagementSystem (CWS/CMS) dataset including the specific child welfare data elements needed for the evaluation.Sacramento’s ADS Division extracts substance use treatment records from the California OutcomesMeasurements System (CalOMS) and sends them to CFF monthly. Providers use the CalOMS datacollection system to report information to the state Alcohol and Drug Programs (ADP) authority. Inaddition, the STARS program tracks AOD-related data and treatment compliance for each participant inAOD treatment and provides an export of those data to CFF monthly.CFF conducts a process evaluation to answer the following key questions:  How many parents and children are being referred to FDC-related programs in Sacramento County?  How do parents and children represent overall Sacramento demographics?  Are DDC and EIFDC incorporating FDC Best Practices?  Are parents satisfied with the DDC and the EIFDC programming?  Do parents successfully complete the program?  What are the costs and potential savings associated with implementing DDC and EIFDC?CFF conducts an outcome evaluation to investigate the effects of participation in Sacramento FDCProgramming on child well-being, permanency and safety, and on parental involvement andengagement in treatment. Outcomes are based on the Children and Family Services Review (CFSR)outcomes and adult treatment outcomes, and then grouped into five overarching questions:  Do children remain at home?  Are parents successful in their AOD treatment?  Are child who are removed from their parents, reunified?  Do children experience fewer episodes of maltreatment reoccurrence?  Are children less likely to re-enter into OOHC following program exit?The DDC and EIFDC comparison groups include families that would have been eligible for eachrespective program, had the program been operating at that time. The DDC comparison group includes 148

California - Child and Family Services Reviewfamilies that entered child welfare between January 1, 2001 and May 31, 2001. The EIFDC comparison group includes families that entered child welfare between February 16, 2006 and September 25, 2008. A historical comparison group was used for DDC and EIFDC to overcome ethical issues of not offering services to families who could benefit from the Family Drug Court Programming. CFF prepares a report yearly that is presented to CPS, Alcohol and Drug Services and Dependency Court Standing Committee. The Early Intervention Family Drug Court (EIFDC) steering committee includes representatives from CPS Informal Supervision, clerical, STARS/Bridges, Alcohol and Drug Services and our evaluator with Children and Family Futures. The steering committee meets every two months. During these meetings, the committee reviews and monitors the EIFDC process and services provided by STARS/Bridges. Similar to the EIFDC steering Committee, there is a committee that meets to address the Dependency Drug Court services. That committee is referred to the Alcohol and Drug Services and CPS collaborative. This collaborative includes representatives from CPS Permanency and Court Services Bureau, STARS/Bridges, Alcohol and Drug Services and our evaluator with Children and Family Futures. The collaborative meets quarterly to discuss referrals, access to services, trends, etc. Depending on the issue, Alcohol and Drug Services contract monitor and CPS liaison determine what corrective action should be taken and monitor the compliance. The Alcohol and Drug Services contract monitor reviews and invoices submitted monthly by STARS/Bridges. Short Term Counseling CPS tracks number of referrals, service modality, number of sessions completed, and ethnicity. CPS is in the process of developing a method of evaluating services to outcomes. Once a year a provider meeting is held, which includes, the CPS contract monitor, CPS Contracts Department, Fiscal and contracted providers. The purpose of the meeting is to discuss any changes to the contract, service provisions and requirements, invoicing and insurance. Monthly CPS Contracts monitor clinicians’ licensures to ensure they are up to date. A systematic process is currently not in place to monitor the quality of services. CPS contract monitor and CPS Contracts determine what corrective action should be taken and monitor the compliance. CPS contract monitor reviews and approves all service requests submitted by CPS social worker. Based on the families Family Reunification service component designation, CPS Fiscal allocates PSSF funding. Providers submit invoices monthly for services rendered to CPS Fiscal review and approval. Sierra Forever Families The Sierra Forever Family Destination Family (DF) workers provide the following services, or a combination thereof, to children in the program: Identification of additional barriers to permanence, family finding, child readiness assessment for adoption which includes an assessment of needs and making appropriate referrals to address the needs, targeted recruitment efforts, permanency preparation with the child, arranging and supporting sibling/biological family visitation, and providing stabilization support through the finalization of legal permanency. A certain level of all these services is accessible through the assigned CPS social worker, however the time spent and the level and extent of the services is significantly amplified through participation in the DF program. Destination Family services are a part of the contract with Sierra Forever Families, however the PSSF funding also supports adoptive parent training and mentor support groups.149