Sacramento County CSA Report - Final 5-30-17

Sierra Forever Families provides quarterly reports to Sacramento County for the Adoptive Parent California - Child and Family Services ReviewRecruitment activities which track demographics, the number of referrals, matches, and permanencyoutcomes. They also provide an annual report that reflects the above data captured throughout theyear. The Sacramento County Permanency Steering Committee has a quarterly meeting which includesvarious administrators and community partners. Sierra Forever Families is one of the partners inattendance as well as the County’s Program Planner who monitors the contract. This committee reviewsthe reports and monitors the services provided as well as tracks outcomes reported by Sierra ForeverFamilies. In addition, Sierra Forever Families provides quarterly reports to Sacramento County, whichtracks demographics, the number of referrals, matches, and permanency outcomes.The Program Planner also consults with the CPS Destination Family Supervisors to discuss the quality ofservices being provided by Sierra Forever Families. Additionally, the larger team of Sacramento CountyDestination Family Supervisors, social workers, and the corresponding Sierra Destination Family teamhave regularly scheduled meetings to address the status of referrals, services being provided, barriers,etc.The CPS Program Planner assigned to the contract reviews the quarterly data, has routine meetings withthe Sierra Forever Families Destination Families Supervisor to monitor the quality of services beingprovided, and to address any concerns regarding services performed. The Program Planner also reviewsand approves all invoices related to the services provided.Informal SupervisionStatistics are compiled weekly by the Informal Supervision supervisor and includes information aboutthe number of families and children who receive services from the one Informal Supervision socialworker as well as the service outcomes for these families. The statistical information is reported to theprogram manager, when requested.The Informal Supervision supervisor has bi-weekly scheduled supervision along with frequent staffingwith the Informal Supervision social worker to discuss the services the families are receiving from theInformal Supervision program. On average, an Informal Supervision case is open between 6 – 9 months,and case reviews are completed by the supervisor every 90 days and include a review of the SDM 90 dayRisk Reassessment tool and the updated case plan for the family. When a case is closed, the supervisorcompletes a comprehensive review of the case using the Informal Supervision Supervisor’s QualityAssurance Case Review Form.The Informal Supervision supervisor reviews and monitors the work of the social worker and providesfeedback and guidance to the social worker, as needed, to ensure families are receiving the appropriateInformal Supervision services to meet their needs. The program manager is responsible for meetingmonthly with the Informal Supervision supervisor and providing oversight to the supervisor if there areareas in need of improvement.Post Adoption ServicesThe post adoption social worker keeps a monthly log of requests from the public for information. Thetypes of requests include information about adoptive parents from children, adoptive siblings fromchildren, adoptive children from parents, medical information, and history regarding CPS involvement.An Adoption Supervisor oversees the services provided by the post adoption social worker with regularmonthly staffing and review of the log. The Program Manager ensures through staffing with thesupervisor that requests are being handled. 150

The Adoption supervisor has bi-weekly scheduled supervision and reviews and monitors the work of the social worker and provides feedback and guidance to the social worker, as needed, to ensure families are receiving the appropriate post adoption services to meet their needs. The program manager is responsible for meeting monthly with the Adoption supervisor and providing oversight to the supervisor if there are areas in need of improvement. Quality Assurance – Probation In 2012 Probation developed a Placement Intake Unit. This Unit consists of a Supervising Probation Office, a Senior Deputy Probation Officer and a Deputy Probation Officer. Cases referred by the Court for suitable placement are reviewed by one of the two Placement Intake Officers. The Officers are responsible for interviewing each probation youth and their families to identify relatives, other family members or Non Related Extended Family Member (NERFM) willing to provide care for the probation youth. Identified persons are contacted and interviewed by the Intake Unit for potential placement. Additionally, if a probation youth must be placed in a group home setting the case is evaluated to sync the probation youth’s needs with services offered by the provider. Attempts to locate local placements are given first consideration. In 2012 a Group Home Auditor Probation Officer was created to conduct annual audits of group home programs used by Sacramento County Probation. The audits include a review of the program’s policy and procedures, employee files, resident files, and assessment of the programs structural grounds for compliance with the California Department of Social Services, Community Care Licensing requirements and standards. The auditor additionally conducts investigations into critical events or allegations regarding a group home. Critical Incident Review ProcessCalifornia - Child and Family Services Review Sacramento Child Welfare has an infrastructure in place to review and monitor critical incidents involving child fatality and near fatalities. Quality Improvement Committee The purpose of the Quality Improvement Committee (QIC) is to review child deaths and major injuries and to use this information to improve outcomes related to child safety and well-being. A Quality Assurance report written about a specific critical incident is presented for discussion at monthly QIC meetings. The QIC provides support and direction to staff and partners involved in the case and make recommendations that inform policies, procedures and practice. QIC membership consists of the CPS Deputy Director, all CPS Division Managers, two representatives from the CPS Oversight Committee, two Program Planners responsible for writing the reports, four Program Managers and three Program Planners representing various CPS Program regions (Currently, Emergency Response Intake, Emergency Response Field Investigations, Permanency and Program Administration). Additionally, the Program Manager of the bureau most recently working with the family is included as well as subject matter experts as needed. There is a smaller QIC subcommittee consisting of the Program Planners responsible for writing the report, an Emergency Response and Permanency Program Planner, representatives from the CPS Oversight Committee and QIC Support Team staff provided by the CPS Program Administration Bureau.151

The subcommittee meets monthly to review the Quality Assurance report and make preliminaryrecommendations for improvement. The report, along with any recommendations made by the QICsubcommittee, are then presented to the aforementioned full QIC.Continuous Quality Improvement/Quality Assurance (CQI/QA) FrameworkSacramento uses a Continuous Quality Improvement/Quality Assurance framework designed tomeasure the quality of services provided by assessing the impact and effectiveness of those serviceshave on children and families. The framework also incorporates the Plan, Do, Study, Act model andrepresents a key strategy for creating a learning culture, strengthening critical thinking, enhancingcritical incident and case reviews and improving the quality of investigations and service delivery. Aspart of the CQI initiative, Sacramento recently conducted a quantitative study on reentry, with emphasison voluntary placements to gather information on its prevalence and specific policies and practices thatcontribute to reentry to foster care. This study revealed that there are different pathways to which achild could reenter the Child Welfare System. As a result of this finding, the agency has an opportunityto refine practices to be more strategic in partnering with families and service providers to deliverrelevant interventions to prevent and/or reduce reentry.Child Death Review Teams (CDRTs)Sacramento County Child Protective Services believes awareness regarding child abuse and neglectacross our community is critical to child safety. CPS continues to strengthen long-term partnership withthe Child Death Review Team, which includes representatives from Law Enforcement, Public Health,Probation, medical professionals, Vital Records, Coroner’s office, and members of the Child AbusePrevention Council (CAPC). The CAP Center facilitates the work of the Sacramento County Child DeathReview Team (CDRT) which reviews the death of every child from birth through 17 years of age inSacramento County. The primary function of the Sacramento County CDRT is to identify how and whychildren die in order to facilitate the creation and implementation of strategies to prevent future childdeaths. National Resource Center (NRC) Training and Technical Assistance California - Child and Family Services ReviewNot applicable.Sacramento County does not utilize the training and technical assistance that is available through thefederal partners at the Western Pacific Implementation Center, the NRC or the Quality ImprovementCenters.Peer Review SummaryThe California Child and Family Services Review (C-CFSR) is a cyclical process which begins with theidentification and analysis of the current system, implementation of solutions which are tested, and anongoing evaluation and revision of those solutions to achieve continuous improvement. This activeprocess is repeated on a continuous basis to meet the changing needs of the system over time. The C- 152

California - Child and Family Services ReviewCFSR has several components beginning with the County Self-Assessment (CSA) and Peer Review. It is a five-year cycle and includes the following components:  County Self-Assessment (CSA)/Peer Review  County System Improvement Plan (SIP)  Annual SIP Progress Reports  State Technical Assistance and Monitoring  Qualitative Case Reviews  Outcomes and Accountability County Data Reports County child welfare agencies and probation departments are responsible for jointly conducting the Peer Review in collaboration with the California Department of Social Services (CDSS). The Peer Review is the process by which counties learn, through qualitative examination of county practice, how to improve services for children and families with respect to a specific outcome. During the review, staff from peer counties interview host county case carrying social workers and probation officers regarding county practice. Utilizing peers from other counties promotes the exchange of best practice ideas between the host county and the peer counties. Focus Area Sacramento County conducted its third Peer Review from August 1 to August 5, 2016. The focus area for the Peer Review was reentry in an effort to prevent the reentry of children into foster care after a discharge from placement. Method Sacramento County selected peer counties based upon their strong performance in the companion measures, reentry and reunification within twelve months. Child welfare social workers from Shasta, Monterey, Contra Costa and Ventura and probation officers from El Dorado, Santa Clara and Yolo participated as peer reviewers. There were a total of six child welfare services peers and three probation peers. The first day of the peer review (August 1, 2016) was spent with introductions, interviews and debrief trainings, mock interviews, and mock debriefs. An overview of the process was given which included a review of the C-CFSR process, a description of Sacramento County, identification of the Reentry into Foster Care outcome measure which would be the focus of the review and a discussion of county performance and progress on the outcome measure. Participants included three California Department of Social Services (CDSS) consultants, a CDSS program manager who facilitated the review, and Sacramento County CWS and Probation staff and administrators. CDSS provided standardized tools for use during the Peer Review, based upon a review of the literature for best practices relating to the focus area. During the five-day review, there were three review teams comprised of two child welfare and one probation peer. Each team reviewed six child welfare and two probation cases. A total of 24 randomly- selected cases were reviewed, which included 18 child welfare cases and six probation cases. All 18 of the child welfare cases had reunification which occurred within 12 months, but two-thirds of these cases had a reentry into foster care. Similarly, a subset of the six probation cases experienced reentry into foster care after reunification. Peer reviewers were provided time to debrief following the completion of interviews. They also took this time to analyze the interview information to identify common themes regarding strengths and153

challenges of the Sacramento County Child Welfare and Probation systems. They also provided California - Child and Family Services Reviewrecommendations for improvement.On the final day, August 5, 2016, peer reviewers, CDSS staff, CSA planning team, representatives fromchild welfare and probation management, and interviewed social worker and probation officersgathered for a presentation of the results and recommendations from the Peer Review.Summary of FindingsThe Peer Review Team was asked to identify and assess the strengths and barriers/challenges forSacramento County related to reducing the number of children who reentering foster care. The PeerReview participants also made recommendations for improvement by sharing promising practices fromtheir own counties. To help with interview and information gathering, the interview teams focused onthe following categories:  maintaining connections  engagement; assessments and services  placement matching  reunification  training, resources, policies and proceduresThe following are the strengths and challenges pertaining to child welfare in each other identifiedcategories:  Maintaining Connections o Strengths – Many cases reviewed were able to have relative placements. Many county placements remained near family or had a solid plan in place to support visitation and family participation in services with the child in care. Siblings are placed together whenever possible. o Challenges - Changes in case workers lead to challenges because the newly assigned worker does not know the family history and this causes trouble in maintaining a positive relationship with the family. External family finding is done by an outside provider. Staff does not seem to know how to use this tool for ongoing family finding and looking for permanent connections.  Engagement o Strengths - The County has Safety Organized Practice (SOP) and other Multidisciplinary Team (MDT) options for engagement such as mapping. The County has positive relationships with service providers and families. Staff retention is high; leading to experienced workers. o Challenges - Services were routinely included in case plans, but they were not individualized. High caseloads and the intensity of the work that they require results in the case workers having less quality time to spend with the families.  Assessments and Services o Strengths - Referrals and services were provided to parents in a timely manner. There are many available services in the County and there is little to no wait time to access these services. Staff conducts regular assessments. o Challenges - The services provided are not standardized. Staff does not develop individualized service plans. Wraparound Services (WRAP) are offered at reunification 154

California - Child and Family Services Review as part of the transitions plan, but they should be utilized more in the front end for prevention.  Placement Matching o Strengths - Relative placement is a priority. The county maximized local placement options. Foster families/Foster Family Agencies (FFAs) worked with biological parents in transitioning to home, visitation and education. o Challenges – No placement matching identified. There is a lack of group homes in the state.  Reunification o Strengths – Family placements and available services supported timely reunification. The cases had placement stability. o Challenges – Parents have completion of mandated services, but behavioral change is not a factor for reunification. The County needs stronger transition plans. Services are terminated too soon after the children return home. There is no aftercare.  Training, Resources, and Policies and Procedures o Strengths – Sacramento County has numerous community resources. There are many training opportunities. Workers have access to many assessment tools. o Challenges – lack of emphasis on behavioral changes and its impact on reunification. Staff are compartmentalized and don’t know about other programs. There should be a handoff of cases between workers at the case transfer or when the child reenters foster care. Case reviews of probation cases revealed the following strengths and challenges in the following area:  Maintaining Connections o Strengths - There is positive parent involvement towards reunification o Challenges - Probation is not focused on helping youth create lasting connections.  Engagement o Strengths - There are officers who have been with the department for an extended period of time and have a lot of helpful skills o Challenges - There are cultural issues and a resultant distrust of law enforcement.  Assessments and Services o Strengths - The probation officers have a good relationship with the youth, family and service providers. o Challenges – There is a lack of suitability assessment and recommendation to court for placements.  Placement Matching o Strengths - The probation officers make appropriate placement recommendations. o Challenges - There are a lack of pre-placement services.  Reunification o Strengths - Transitional support services, such as WRAP, are available. o Challenges - Placement orders are vacated too soon. There are no home trials or transition planning.155

 Training, Resources, and Policies and Procedures California - Child and Family Services Review o Strengths - The probation officers utilizes IMAC which is a helpful assessment tool. o Challenges -The probation officers are compartmentalized by region.Peer Promising PracticesPeer Reviewers were asked to recommend promising practices from their counties regarding policies,practices, trainings and resources to improve outcomes for child welfare and probation. Below are theirrecommendations:  Child Welfare o Case distribution process (balance case distribution with complex cases and amount of cases) o Tailoring case plan services to clients’ needs with the client and focus on behavioral changes o Visitation model (ask for 30-60 placement return at disposition to allow for longer transitional visits) o Regular clinical staffing that involve service providers o MDT staffing at critical times in referral/case o Safety plans: behaviorally specific, includes support network, addresses danger statement and safety goals o SafeCare (three step program to work with families in the home to prepare the home for safety, health to ensure appointments, and parenting to provide parent/child interacting coaching. This can be used during Family Reunification (FR) and Family Maintenance (FM). o Taking more time to return children home to better ensure parent/child readiness  Probation o New cases assigned via unit rotation – reentry and siblings go back to original probation officer if the officer is still in the unit o Pre-adjudicated WRAP – Can this be part of the waiver population for Title IV-E funds? o Keep placement orders open for a period of 30-60 days following return home o Utilize a screening tool Pre-PIP order to determine placement suitability versus eligibility o Devise a case chronological or service history sheet to easily assess the previous attempts at rehabilitation o Parent and Peer PartnersChild Welfare Outcome Data MeasuresChild WelfareThe following outcome measures serve as the basis for the Sacramento County Self Assessment (CSA)and are used to track the County’s performance over time. The data source in this report is the UCBerkeley California Child Welfare Indicators Project (CCWIP). At the time the County’s CSA wascompleted in 2012, UC Berkeley CCWIP utilized Federal Child and Family Services Review (CFSR) Round 2outcome measures and standards. However, in 2015, UC Berkeley CCWIP updated their data to CFSRRound 3, with updated outcome measures, methodology, and standards. Therefore, this CSA Reportwill focus on the County’s performance as defined by the CFSR 3 outcomes and methodology. The 156

following sections describe the federal and state outcome measures and compares significant changes from the previous CSA (2012). All Child Welfare current baseline performance is taken from 2016 Quarter 3 extract. 3-S1 Maltreatment in Foster Care Analysis The criteria for this Federal Outcome Measure has changed since the previous CSA. The previous measure S2.1 (No Maltreatment in foster care) calculated the percentage of children served in foster care during the year who did not have a substantiated maltreatment allegation by a foster parent or a residential facility staff member. The new outcome measure 3-S147 depicted in the graph above measures the number of children with substantiated reports of all maltreatment by any perpetrator while a child was in foster care during a 12-month period. During the last four years, the county’s performance fluctuated over time.California - Child and Family Services Review Oct 2012 to Sept 2013 Oct 2013 to Sept 2014 Oct 2014 to Sept 2015 Oct 2015 to Sept 2016 10.48 7.45 4.59 8.74 However, the most recent data available for the time period of October 2015 to September 2016 reveals that Sacramento County’s current performance is at 8.74. This is not meeting the national standard of 8.5 or lower, and is moving away from the desired direction. For the most recent time period, the Under 1 and 3-5 age groups of children met the national standard with 2.75% and 4%, experiencing no substantiated reports of maltreatment while in foster care. However the other age groups experienced high rates of substantiated maltreatment was 11-15 at 14.62%, followed by 16-17 at 11.09%, 6-10 at 9.39%, and 1-2 at 8.73%. 47 In calculating the performance for the measure S1 Maltreatment in Foster Care, rate is multiplied by 100,000 days to produce a whole number, which is easier to interpret. Therefore, performance for this measure is expressed as a rate per 100,000 days.157

Our data for the time period of October 2015 to September 2016 reveals that females are victims ofmaltreatment in foster care at a rate of 12.51% compared to males at a rate of 5.01. Our data alsoreflects that there is an overrepresentation of African American children that are victims ofmaltreatment in foster care at rates higher than others ethnicities. This is an area the county will needto focus as strategies are developed for the new System Improvement Plan (SIP) to reduce the numberof children experiencing maltreatment while in foster care.Our previous performance trends from October 2012 to June 2016 revealed that we were moving in therequired direction. However, external factors that may have affected our declining performance of thisoutcome measure might include the change in the measure which increases the pool of potentialperpetrators. As the county’s data indicated, the majority of children experiencing maltreatment infoster care are preteens to older teenagers which may be attributed to the number of youth with moreintense behavioral concerns. External factors may also include limited qualified respite options toprovide a release on the pressure valve for foster families. As the county continues to monitor progressof this measure, the effect of CSEC population will also be considered as the department’s practice haschanged in that more petitions are expected to be filed on perpetrators than in prior practices.3-S2 Recurrence of Maltreatment 25.0%20.0%15.0% 13.9% 14.3% 13.5% 13.2%10.0% 11.5% 12.8% 12.1% 10.9% 11.0% 11.1% 10.8% 10.2%5.0%0.0% JAN 12 - APR 12 - JUL 12 - OCT 12 - JAN 13 - APR 13 - JUL 13 - OCT 13 - JAN 14 - APR 14 - JUL 14 - OCT 14 - DEC 12 MAR 13 JUN 13 SEP 13 DEC 13 MAR 14 JUN 14 SEP 14 DEC 14 MAR 15 JUN 15 SEP 15 Children with recurrence (%) National Standard (9.1% or lower)Analysis California - Child and Family Services ReviewThis federal outcome measure has changed with the implementation of Round 3 of the Federal Childand Family Services Review. When the CSA 2012 was developed, outcome measure S1.1 No Recurrenceof Maltreatment compared the total number of children who were victims of a substantiatedmaltreatment allegation during a 6-month period with the number of children who were not victims ofanother substantiated maltreatment allegation within the next 6 months. However, the currentanalogous measure is S2. It compares total number of children who were victims of a substantiatedmaltreatment allegation during a 12-month period with the number of children who had anothersubstantiated allegation within 12 months. The national standard for this measure is 9.1% or lower.Based on information available from UC Berkeley, the county’s performance for measure S2 for theprevious baseline period (January 2012 to December 2012) identified in the CSA was 10.9%. The currentbaseline data for the period October 2014 to September 2015 reveals that Sacramento County’s currentperformance is at 10.2%. Consequently, Sacramento County has not met the national standard for this 158

measure. There were no significant differences between ethnicity, age or gender on this outcome measure. External factors that may have affected performance of this outcome measure include drug and alcohol abuse and domestic violence to name a few. No strategies were identified in the last 5 year SIP to address this outcome measure. However, according to feedback from the Executive Management Team (EMT) focus group, the County is working on addressing this area through a CQI-PDSA which is the implementation of Safety Organized Practice and progression of teaming practices to support families. CBCAP/CAPIT funded activities that may have impacted this outcome include Birth & Beyond (B&B) services. As noted earlier, parents who received B&B services showed an improvement in parenting skills and were less likely to have a substantiated child welfare referral than parents who did not receive the services. 3-P1 Permanency In 12 Months (Entering Foster Care) 100% 80% 60% 50.6% 51.2% 49.2% 48.9% 48.7% 47.5% 47.7% 48.3% 46.8% 47.3% 48.4% 47.3% 40% 20% 0% JAN 12 - APR 12 - JUL 12 - OCT 12 - JAN 13 - APR 13 - JUL 13 - OCT 13 - JAN 14 - APR 14 - JUL 14 - OCT 14 - DEC 12 MAR 13 JUN 13 SEP 13 DEC 13 MAR 14 JUN 14 SEP 14 DEC 14 MAR 15 JUN 15 SEP 15 Exit to Permanency National Standard (40.5% or higher)California - Child and Family Services Review Analysis This Federal Outcome Measure has changed since the previous CSA. The current CFSR 3 outcome of Permanency in 12 Months defines permanency (Entry cohort) as an exit to reunification or guardianship, whereas the previous CFSR 2 (C1.1 Reunification within 12 month) outcome used in the CSA focused on reunification (Exit cohort). In the time period between October 2014 and September 2015 there were a total of 44.5% of children who achieved permanency via reunification, which exceeds the national standard. The national standard is performance greater than or equal to 40.5% and the most recent State performance is 35.2%. Sacramento County’s overall performance for all children entering foster care is at 47.3% which is exceeding both the State and National levels. There were no significant performance trends between ethnicity and gender as children in these categories exceed both the State and National levels on this outcome measure. Although Native American children had better outcomes than the State’s performance, they reunified below the national standard at 37.5%. Also, in the time period between October 2014 and September 2015, the 16-17 age groups performed below standard at 37.5%. By placement type, 50% of Shelter, 49.7% of FFA, 48.1% of Group Home, 44.6% County Foster Home, and 41.4% of Kin achieved permanency via reunification, guardianship, or adoption in 12 months. The two strategies identified in Sacramento’s last 5 year SIP assisted the County’s efforts to ensure permanency in 12 months was the use of Structured Decision Making (Strategy 1) tools geared toward159

reunification are completed timely. The other strategy was Team Decision Making (Strategy 5) for exit California - Child and Family Services Reviewplacements. These tools provide a consistent methodology for social workers to assess reunificationreadiness of a family from a safety/risk perspective.PSSF funded activities that may have impacted this outcome include short term counseling and alcoholand other drug treatment services provided by STARS. One reason short term counseling services areprovided for CPS Parents/Caregivers is to reunify the family following the removal of the child(ren) fromthe family home due to neglect, physical, emotional, and/or sexual abuse. Short term counselingservices are offered in three modes: individual, family, and conjoint counseling in up to ten, 50-minutesessions. The treatment plan relates to mitigating the unsafe behaviors negatively impacting children.Group counseling is 12, 90-minute sessions. These psycho-educational groups are trauma focused toaddress child abuse and neglect issues, general counseling, domestic violence, anger management andsexual abuse. The last mode of services is Mental Health Assessments. Assessments identify the parent’sclinical diagnosis or developmental disability, recommendations for specific social, mental health orother available services to assist the parent to develop skills necessary to parent the child and describeany particular techniques to assist the parent to gain the skills necessary to parent the child.Sacramento County also uses PSSF funds to fund six STARS staff. STARS is designed to help parentscomplete the Alcohol and Drug (AOD) treatment requirements in the Child Welfare Case Plan. Theserequirements may include: entering and completing an AOD treatment program, alcohol and drugtesting, and attendance at support group meetings. If CPS identifies drug or alcohol involvement,parents are referred to either Early Intervention Family Drug Court or Drug Dependency Court andSTARS.3-P2 Permanency In 12 Months (In Care 12-23 Months) 100% 75% 50% 50.8% 50.7% 52.7% 53.3% 52.7% 49.9% 50.9% 55.4% 51.4% 47.9% 44.1% 47.7% 49.5% 49.2% 53.9% 45.9% 25% 0%Exit to Permanency National Standard (43.6% or higher)AnalysisThis measure did not exist in this form during the last CSA. This new measure describes children in fostercare on the first day of the 12-month period that had been in care between 12 and 23 months. Itparticularly examines the percent of children discharged to permanency within 12 months of being infoster care. The most recent data available for the time period of October 2015 to September 2016reveals that Sacramento County’s current performance is at 45.9%. This outcome is above the nationalstandard for the current time period. 160

California - Child and Family Services Review As was the pattern with exits to permanency in the first 12 months of care, children placed in a group home are less likely to exit to permanency (16.3%) than children with the FFA (43.2%) or with kin (50.6%). It is likely that this pattern is due to the fact children placed in group homes are older, and stepping them down to a more family like setting may pose a challenge given their more intensive needs. Sacramento County generally has been above the national standard on this outcome. As clearly represented in the data for this measure, the majority of exits during this period of time as well as from the last several years were to adoption. However, ethnicity seems to have an effect on this measure. For the reported period, African American children tend to have delayed exits (33.8%) to permanency in the first 12 months of care than other ethnicities. For example, Caucasian children exit to permanency at a rate of 54% and Asian / Pacific Islander children at a rate of 61.1%. In terms of the delayed exits of African American children to permanency, an external factor may be cultural. African American families historically take care of kin informally. A grandmother can often raise her grandchildren, but she doesn’t need the formality of adoption to be the mother figure for the children. Also, there may be systemic or institutional bias in approving African American families’ home studies. This is an area the county will need to focus as strategies are developed for the new System Improvement Plan (SIP) to address the overrepresentation of African American children experiencing delayed permanency while in foster care. Short term counseling and STARS services may impact this outcome. Both of these services are designed to mitigate the unsafe behaviors which led to a child’s entry into care. Through the provision of short term counseling and STARS alcohol and other drug services, parents may be able to successfully reunify with their child(ren). 3-P3 Permanency In 12 Months (In Care 24 Months Or More) 50% 40% 30% 20% 24.1% 25.8% 25.5% 23.0% 21.0% 21.7% 18.8% 20.0% 18.2% 19.6% 23.7% 22.0% 25.2% 29.8% 26.6% 28.3% 10% 0% Exit to Permanency National Standard (30.3% or higher) Analysis This measure is of all the children in foster care on the first day of the period that have been in care for 24 months or more. It measures what percent were discharged to permanency within 12 months. Measure 3-P3 is very similar to CFSR2 (C3.1), but it removes the criteria of “prior to turning 18.” In the current CFSR 3 outcome, a youth who turns 18, but exits to reunification is now counted as having achieved permanency.161

The national standard is performance greater than or equal to 30.3% and the most recent Stateperformance is 29% (October 2015 to September 2016). The most recent data available for the timeperiod of October 2015 to September 2016 reveals that Sacramento County’s overall performance for allchildren in foster care for 24 months or more is at 28.3% which is not meeting the National level.Historically, Sacramento has not met the national standard in this measure. To address thisperformance, the County is increasing awareness of this population and making active efforts to attainpermanency for youth in care for 24 months or longer. Since July 2014, Sacramento County hasimplemented a Permanency Initiative to target youth to receive permanency case reviews. The reviewsinclude social workers, supervisors, managers, a permanency liaison, and the youth, family, and servicepartners if they are a critical component to the meeting. The goal of the permanency case reviews is tomake concerted efforts to facilitate permanency for these youth in care.According to the data, ethnicity seems to have an effect on this measure. For the reported period,Native American children (14.3%), African American children (21.1%) and Latino children (27.7%) tend tohave delayed exits to permanency if they have been in care 24 months or longer than other ethnicities.For example, Asian / Pacific Islander children at a rate of 38.5% and Caucasian children exit topermanency at a rate of 36.9%. By placement type, 100% of Pre-Adopt, 44.8% of Kin, 28.6% of CountyFoster Home, 26.8% of FFA, 7.7% of Guardianship, and 4.4% of Group Home achieved permanency in 24months or longer.Given the timeframes in care, children ten years old and under were significantly more likely to exit topermanency than youth eleven years old and older.Outcome by Age Oct 2015 to Sept 2016 Oct 2014 to Sept 2015 Oct 2013 to Sept 2014 1–2 71.4 84.6 78.6 3–5 54.9 74.4 49.0 6 – 10 45.5 35.2 40.0 22.7 25.7 22.8 11 – 15 8.8 3.4 5.2 16 – 17This in part reflects that older children are more difficult to find adoptive homes. Nonetheless, there is a California - Child and Family Services Reviewgrowing pattern for older youth to stay in care so that they are eligible to become Non-minorDependents (NMD) and receive extended services and support until the age of 21. There have beeninstances where minor’s counsel has recommended that youth refuse all forms of permanency in orderto stay in foster care.As observed in the data trends, the most likely exit to permanency after a child has been in care formore than 24 months is adoption. In fact, for the latest three reported periods, the majority of childrenin care have exited exclusively to adoption. As previously mentioned, the lack of achieving all forms ofpermanency may in part be due to the fact that older youth are opting to stay in care to receiveextended services and support since the implementation of Extended Foster Care.Other external factors that may have affected the performance is the fact that youth in placement 24months or more are likely to be older youth, likely to have experienced more trauma, and likely to havemore symptomatic behaviors. In the currently available family setting placement options, there needsto be a hyper focus on placement stability and addressing the well-being of the youth. Caregivers needto have a strong trauma lens with which to view their foster children. The County will need to recruit 162

and train caregivers to be empathetic, understanding, as well as skilled at managing /de-escalating trauma-related behavior. This outcome may be affected by Sacramento County’s use of the CapKids program. Sacramento County utilizes PSSF funds to fund some of the services provided by the CapKids program. The CapKids program provides enhanced family engagement and child specific recruitment services to support efforts to secure adoptive or guardianship homes for children in long term foster care who have been identified as \"hard to place.\" Services provided by the Contractor include case management, child specific recruitment, assistance, matching and family disclosures. They assist with the logistics of pre-placement visits and support families and caregivers to ensure smooth transitions for youth into adoptive or guardianship homes. They provide up to 24 post adoption two hour support sessions as well. The goal is to provide all supportive services to increase permanency outcomes for hard to place children and youth. The three federal permanency measures outline the importance of practice in the beginning of a case. Given that reunification is the most likely outcome to increase the number of children exiting to reunification, barriers to reunification and overrepresentation of ethnic children experiencing delayed permanency while in foster care need to be addressed. The forthcoming SIP plan will further address these barriers and in collaboration with community partners seek to address and mitigate factors that impede reunification. 3-P4 Re-entry to foster care in 12 months 25% 20.5% 19.8% 20.7% 19.7% 20% 17.1% 15.3% 14.5% 14.7% 15% 10% 5% 0%California - Child and Family Services Review Children with Re-Entries (%) National Standard (8.3% or lower) Analysis This measure has been modified since the last CSA. The previous measure C1.4 looked at an exit cohort of children who discharged to reunification only in a 12 month period and followed those children for 12 months to determine if they reentered care. The new measure (3-P4) uses an entry cohort methodology. Specifically, it measures all children who entered care in the 12-month period and who are then discharged within 12 months to reunification or guardianship to determine percentage of those reentering foster care within 12 months. Sacramento County did not meet the national standard of 8.3% or lower for this measure for the current performance (i.e. October 2013 to September 2014) or any time during the last three years. Data also163

reflects that there is an overrepresentation of both African American and Latino children that reenterfoster care at rates higher than others ethnicities. The factors of age and gender did not appear to havean effect on the outcome of this measure.The children who were most likely to reenter care were those that were last placed in an FFA home(21.3%) followed by children who were placed in a county foster home (20%). However, children whowere placed in a kinship home (6.3%) were least likely to reenter care. There are many benefits toplacing children with relatives which include an increased ability to stay connected with siblings andother family members. According to feedback from both the Executive Management Team (EMT) andCommunity Stakeholder focus groups, the need for fostering natural supports for families so thatsustainable aftercare and support plans for families with good safety networks can be in place at caseclosure was identified. This is likely true across the nation, and for this reason, it is federally mandatedthat relatives get preference in placement.An external factor for this measure is the lack of caregiver and family access to effective supports andservices in the community. Also, with the limited array of placement options available, there may beobstacles like significant cultural differences between the foster youth and their caregivers. The Countywill need to better assess whether or not caregivers are prepared to work with the biological family forthe ultimate good and well-being of the youth; and ensure that caregivers work together over thetransition from foster placement back home. Considerations need to me made to determine if thecaregiver can be built in respite option that can provide a sense of consistency and continuity in theparental experience of the youth.This measure will be a focus of the pending System Improvement Plan as it is below the nationalstandard and a companion measure to 3-P1. The goal of improvement for both of these measures willbe to exit children to permanency in a timelier manner without increasing reentry into care. Enhancingservices within the community to improve support for the family after the CPS case is closed will likelybe a focus.3-P5 Placement Stability 10 8 6 4.95 5.29 5.36 5.66 5.21 4.65 5.06 5.41 5.21 5.1 5.06 5.03 5.28 5.39 5.47 5.2 4 2 0Moves Per 1,000 Days California - Child and Family Services Review Placement moves per 1,000 days National Standard (4.12 moves per 1,000 care days or lower)Analysis 164

This federal outcome measure has changed significantly with the implementation of Round 3 of the Federal Child and Family Services Review. The CFSR 2 examined children in care for the specified number of months such as measures C4.1 (8 days to 12 months), C4.2 (12 months to 24 months), and C4.3 (at least 24 months in care). However, the prior measure did not accurately account for the actual number of placement moves, which meant that a child with three placement moves was counted the same as child who has 10, 20, 30 moves, etc. The new measure, 3-P5 observes an entry cohort of all children who entered care in the 12-month period and accurately accounts for the actual number of placement moves per 1000 days in care. In Sacramento County, infants entering care are meeting the standards for this measure. However, other age groups have historically not met the national standard. The national standard is performance lower than or equal to 4.12%. Sacramento County’s Placement Stability performance rate during period 10/01/15 to 09/30/2016 was 5.2. The chart above reveals that Sacramento County did not met the national standard for this measure for this period or any time during the last four years. The gender factor did not appear to have an effect on the outcome of this measure. However, outcomes by ethnicity had an effect on this outcome consistently across reporting periods as outlined in the chart below. Outcome by Ethnicity Oct 2013 to Sept 2014 Oct 2014 to Sept 2015 Oct 2015 to Sept 2016 Native American 9.61 7.70 2.34 Latino 5.99 5.27 5.23 African American 5.75 5.20 5.38 Caucasian 4.68 4.82 5.23 Asian American 4.36 3.48 5.19 /Pacific Islander In the in the time period between October 2015 and September 2016, Native American children had significantly improved placement stability than both the State and national standard. During the last 5 year SIP, the baseline performance for this outcome was at a rate of 5.13 placement moves per 1,000 days of foster care. While Strategy 5 (Hold a Reunification/Exit TDM prior to reunification occurring) and Strategy 10 (by December 2015, 60% of non-relative placements will be made by the CPSU) were identified, they have not improved the performance of this measure.California - Child and Family Services Review 2B Timely Response165

Analysis California - Child and Family Services ReviewThe graph above depicts the percent of cases that received timely responses on referrals by quarter andby response time. Measure 2B includes both attempted and completed contacts. Sacramento Countyhas been at or above the state goal of 90% of cases with a timely response for immediate response (IR)referrals for the past four years. From July 2012 to January 2015 Sacramento County had been at orabove the state goal of 90% of cases with a timely response for 10 day responses. The quarters in whichSacramento County fell below the national standard were the first quarter of 2012, the second andfourth quarter of 2015, and the second and third quarter of 2016. It is the expectation of the EmergencyResponse (ER) supervisor that social workers will complete 100% of responses within the mandatedtimeframes. This goal has been achieved for the last four years for immediate response referrals andfrom quarter 2 of 2012 to the first quarter of 2015 for 10-day responses. In the fourth quarter of 2016,Sacramento County was at 88.1% for 10 day referrals and above the state goal at 94.4% for IR referrals.In addition, when examining response timeliness by ethnicity and age of the victim, no trends can beidentified that distinguish one group from the others. Sacramento County’s response to referrals acrossthese categories has been consistent.Sacramento County utilizes various tools and methods to increase the chances the response time will bemet. The Emergency Response Intake program’s use of Immediate Response Interactive System (IRIS), aweb based program used by a designated ER supervisor to enter and monitor immediate responsereferrals, has assisted with meeting or exceeding the national standard of 90%. Another tool thatsupported the County’s efforts is the Asset Management System (AMS). AMS is a spreadsheet used totrack the number of social workers available to receive IR and 10 Day referrals on any given day ortimeframe. One of the goals of AMS is to quickly identify which field social workers are available to beassigned 10 Day referrals, which can also maximize the number of days the investigating social workerhas to meet the timely response requirement.According to the May 1, 2012 Sacramento County CSA, Timeliness of Referral Investigation wasnegatively affected by staff layoffs, staff reassignment and an increase of duties for the social workers.Since that 2012 CSA, Sacramento County has increased the amount of social workers and has positivelyaffected our Timeliness of Referral Investigation. Sacramento County is actively seeking ways to recruitand retain social workers. 166

California - Child and Family Services Review2F Monthly Visits (Out of Home) 2F – Timely Visits (Out of Home) 2F – Timely Visits (Out of Home) – In Residence Analysis The graph above for 2F: Timely Visits (Out of Home) depicts the percent of children who had timely in- person monthly visits from a social worker in a given year. The graph for 2F: Timely Visits (Out of Home)- in Residence illustrates the percent of children who had an in-person visit from a social worker in the home where they resided. Sacramento County CPS was slightly below meeting the 95% state standard for Timely Visits and exceeded the state standard for Visits in Residence.167

The standard for 2F: Timely Visits was previously 90% of all cases were required to have face-to-face California - Child and Family Services Reviewmonthly contacts. This standard was raised to 95% as of federal fiscal year 2015. The data above is priorand after that implementation date. Sacramento County was consistently meeting the standard prior tofederal fiscal year 2015. However, after the higher standard was implemented, Sacramento County hasnot achieved the new standard. From October 2015 to September 2016, Sacramento County achieved87.4% of Timely Visits (Out of Home); and 79.9% of Timely Visits in Residence (Out of Home) for thesame timeframe. From July 2015 to December 2015, Sacramento County CPS’s vacancy rate rangedfrom 15.1% to 17.9%, which could have directly impacted the outcome, due to fewer social workerscompleting face-to-face contacts in a timely manner. The vacancy rate has fluctuated, but has onlydropped below 10% one time (February 2016) since July 2015.No trends can be identified with regard to timely visits by ethnicity of the child that distinguishes onegroup from the others. However, older children in age categories 11-15 years and 16-17 years havelower timely visit percents in both overall visits and in residence visits than younger children. This maybe due to different factors including older children are more likely to go absent without permission fromplacement, older children sometimes do not make themselves available for in person contacts, and anemphasis on ensuring younger children with less self-protective capacities are seen monthly and in theirresidence.Sacramento County CPS Division Managers implemented monthly monitoring (reports) of Measure 2F in2015, in order to assess and address barriers impacting our ability to meet the state standard. Efforts tomeet the standard, as accomplished before, will continue. In regard to 2F: Visits in Residence,Sacramento County CPS has maintained 29.6 to 34.9 percentage points over the state standard of 50%for the past four years.4A Placement with Some or All Siblings4A – Youth Placed with Some or All SiblingsAnalysisMeasure 4A examines the percent of sibling groups placed in Child Welfare supervised foster care.Sacramento County puts emphasis on placing siblings together whenever possible. As the graphs abovedepict, from the prior CSA timeframe in 2012 to the current CSA data timeframe, Sacramento hasremained relatively consistent in the percent of children placed with some or all siblings. The percent ofchildren placed with all siblings in care has ranged from a high of approximately 53% to a low ofapproximately 46% in Q1 of 2016. 168

Many factors affect the ability of the agency to place children with siblings, including the size of the sibling set and the needs of the children. Sacramento County utilizes a Centralized Placement Support Unit (CPSU) for placements. The CPSU social workers are trained to routinely attempt to place siblings together first before placing them separately. 4B Least Restrictive Placement (Entries First Placement) 4B Least Restrictive Placement (Point In Time)California - Child and Family Services Review Analysis The first graph above shows the breakdown of first placement types for children ages 0-17 years entering care. Foster Family Agency (FFA) placement types were the most common type of first placement at the time of the prior CSA and have remained the most prevalent to date. Group169

home/shelter placements are the second most common type of first placement; however, SacramentoCounty has utilized the Children’s Receiving Home (which is counted as a group home) as a firstplacement when necessary, and this factor accounts for many of the first placements types as grouphome/shelter.Beginning in 2017, Sacramento County is actively implementing the Continuum of Care Reform (CCR)and Resource Family Approval (RFA) model. These efforts will work toward reducing the number ofgroup home placements and increasing home-based family setting placements.The second graph depicts the breakdown of placement types on specific days from the time period ofthe prior CSA to the current data reporting period for the current CSA. Non-minor dependents areincluded, which impacts the count of placements noted as “Other.” As shown in this graph, whenlooking at data from a point in time, the count of placements with relatives increases from the percentof first placements with relatives. During the timeframe shown in the graph, relatives went through therelative approval process with Sacramento County’s Kinship program, and some relatives were not ableto be cleared until the full kinship process was complete, thereby resulting in a need for a different typeof first placement. Sacramento County maintains a commitment to placing with relatives first wheneverpossible.8A – Outcomes for Youth Exiting Foster Care at Age 18 or Older DENOMINATOR Completed Obtained Youth Youth Youth with Whereabouts High School or Employment w/Housing Received Permanency Known during Arrangements Connection Equivalency ILP Quarter Services 18 (100.0%) 15 (100.0%) *** 12 (92.3%) 8 (72.7%)2012 Q1 18 5 (27.8%) 3 (16.7%) 17 (94.4%) 14 (77.8%) 2 (50.0%) 4 (66.7%)2012 Q2 15 9 (60.0%) 3 (20.0%) 14 (93.3%) 10 (66.7%) 4 (100.0%) 4 (100.0%)2012 Q3 13 7 (53.8%) 4 (30.8%) 10 (76.9%) 10 (76.9%) 7 (77.8%) 10 (76.9%)2012 Q4 11 5 (45.5%) 0 7 (63.6% 8 (72.7%) 22 (95.7%) 23 (79.3%)2013 Q1 4 3 (75.0%) 0 3 (75.0%) 2 (50.0%) 7 (87.5%) 46 (93.9%)2013 Q2 6 3(50.0%) 0 5 (83.3%) 5 (83.3%) 55 (96.5%) 44 (97.8%)2013 Q3 4 0 0 3 (75.0%) 2 (50.0%) 292013 Q4 4 3 (75.0%) 0 4 (100.0%) 4 (100.0%) (963.97%) 40(9(79.55.%2%) )2014 Q1 9 3 (33.3%) 1 (11.1%) 6 (66.7%) 8 (88.9%)2014 Q2 13 7 (53.8%) 1 (7.7%) 11 (84.6%) 10 (76.9%) California - Child and Family Services Review2014 Q3 23 17 (73.9%) 7 (30.4%) 21 (91.3%) 21 (91.3%)2014 Q4 29 18 (62.1%) 9 (31.0%) 26 (89.7%) 27 (93.1%)2015 Q1 8 2 (25.0%) 0 6 (75.0%) 5 (62.5%)2015 Q2 49 32 (65.3%) 24 (49.0%) 45 (91.8%) N/A2015 Q3 57 41 (71.9%) 37 (64.9%) 50 (87.7%) N/A2015 Q4 45 33 (73.3%) 25 (55.6%) 39 (86.7%) N/A2016 Q1 30 28 (93.3%) 17 29 N/A2016 Q2 40 28 (70.0%) (562.37%) (963.67%) N/A2016 Q3 42 32 (76.2%) 22(5(75.25.%4%) ) 39(9(09.20.%9%) ) N/A*** Youth Receiving ILP services was no longer tracked as an outcome under the new methodology effective 2015 Q2AnalysisSacramento County has seen varying outcomes for youth aging out of foster care for the years 2012 -2016. Different trends can be seen for foster youth who obtain high school equivalency, employment,housing arrangements and permanency connections. 170

California - Child and Family Services ReviewHigh school credential attainment as the outcome with the most fluctuation, while employment rate was the outcome with the lowest overall performance. The employment rate remained unchanged from Q4 2012 to Q4 2013. However, the rate slowly began to improve. Youth with Housing Arrangements and Youth with a Permanency Connection both consistently had the highest performance. The California Fostering Connections to Success Act was signed into law September 30, 2010 through Assembly Bill (AB) 12 and became effective January 1, 2012. No strategies were identified in Sacramento’s last 5 year SIP to address this measure. However, in 2015, UC Berkeley California Child Welfare Indicators Project (CCWIP) began capturing outcomes for non-minor dependents (NMDs) participating in the “AB12” program for this measure. The above data reflects that as of Q2 2015, non- minors age 18-21 are counted in the outcome performance. The inclusion of non-minor dependents in the data impacted the steady rise in outcome achievements for youth aging out of foster care in credential attainment and employment, and a steady increase in housing arrangements and permanency connections. With the implementation of AB12, foster youth turning 18 have opted to remain in extended foster care up to age 21, increasing the number of youth in care and allowing additional time and support toward reaching their educational goal. The percentage of employment for NMDs has also risen as these youth have reached the employment age. AB12 has allowed these youth to take advantage of additional supportive services designed to aide and prepare them to be self- sufficient and successful in adulthood. There are no trends to distinguish between racial, geographical or ethnic groups in Measure 8A. However, external factors that may have affected employment outcomes for foster youth, is a deficit in early work experiences. In traditional biological families, youth are more likely to have the opportunity to get drivers education and obtain their California Drivers License. They are more likely to have access to a vehicle to work evenings, weekends and summers. They may be more established and well- known/trusted in their neighborhood to do things like mow lawns, other odd jobs, or paper routes. They are more likely to have parental support for things like paying for special clothing/uniforms/shoes for their early job experiences. Youth may have more options for summer “internships” at their parents’ places of employment. Their parents may offer to help them with a financial goal (i.e. like saving for a car… the parent may offer to match whatever the youth can earn towards it). These are all typical experiences of many youth that help prepare them (their “soft skills” and their resumes) for future employment, that foster youth may be less likely to experience. Additional contributing factors to the increase of outcome achievements for this measure may include: Countywide Foster Youth Service Partnership, the Education Equals Initiative, SILP, ILP Advisory Collaborative, THP+FC, and Permanency Case Reviews.  The Sacramento County Office of Education (SCOE) spearheaded the Countywide Foster Youth Service partnership with school district liaisons, CPS and other foster care representatives. SCOE staff collaborated with social workers, schools and authorized personnel to ensure each child’s educational record was updated and transferred timely to expedite enrollment.  SCOE and CPS collaborated on a 5 year (2011 – 2016) grant, Education Equals Initiative, with the goal to achieve dramatic improvement in educational outcomes for foster youth through engagement, school stability, and academic achievement from preschool to college. Core program elements included education-informed home placement, systemic information gathering and sharing and customized case management and collaboration. The program ended on November 30, 2016.171

 Sacramento County Independent Living Program (ILP) services are provided through four school districts: Elk Grove, Sacramento, Twin Rivers and San Juan. Twelve Extended Foster Care (EFC) social workers work closely with youth to create Transitional Independent Living Plans and assess ongoing needs. Social workers provide life skills assistance related to budgeting, resume building, completing job applications, and providing referrals to job readiness programs, job skills training, mental health agencies and mentoring agencies. The ILP Advisory Committee also meets monthly to coordinate efforts to provide independent living services to Transition Age Youth.  Transitional Housing Placement-Plus-Foster Care (THP+FC) provides supportive housing for youth in foster care.  Permanency Case Reviews were implemented in July 2014 to target youth who have been in care 24 plus months. A benefit of the Permanency Case Reviews may be the identification of permanency connections for youth.Sacramento County completes the NMD EFC Quarterly Statistical Report and has developed a quarterlyDashboard entitled, “Outcomes for Youth Exiting Foster Care at Age 18 or Over.” Probation Outcome Data Measures3-S1 Maltreatment in Foster CareAge OCT2011- OCT2012- OCT2013- OCT2014- OCT2015- SEP2014 SEP2015 SEP2016Group SEP2012 SEP2013 1 3Under 1 1 2 2 5'1-2'3-5'6-10'11-15 316-17 Total 3Data Source48Analysis California - Child and Family Services ReviewThe table above describes the number of substantiated reports of maltreatment by any perpetratorwhile a probation youth was in foster care. The data shows for the most recent time period there wastwo instances of maltreatment for a probation youth in foster care.49 This is below the national averageof 8.5. The Sacramento County Probation Department is given the responsibility by the Legislature andthe Juvenile Court for the appropriate residential placement of wards committed to the care, custodyand supervision of the Probation Officer for suitable placement. Appropriate placements focus on thesafety, stability, and well-being of the probation youth, while satisfying the expectations of existing lawsand the Court, and providing for community safety. The Probation Department’s group home auditors48 CWS/CMS 2016 Quarter 3 Extract. DRAFT Program version: 2014.10.30 Database version: 09NOV2016:16:20:4149 Webster, D., Armijo, M., Lee, S., Dawson, W., Magruder, J., Exel, M., Cuccaro-Alamin, S., Putnam-Hornstein, E., Wiegmann,W., Rezvani, G., Eyre, M., Sandoval, A., Yee, H., Xiong, B., Benton, C., Tobler, A., White, J., & Kai, C. (2017). CCWIP reports.Retrieved 2/10/2017, from University of California at Berkeley California Child Welfare Indicators Project website. URL:<http://cssr.berkeley.edu/ucb_childwelfare> 172

conduct initial and annual on-going inspections of residential placement programs where probation youth under the supervision of Sacramento County Probation Department are placed with the goal of rehabilitating the probation youth back into the community. A complete physical tour of the facility takes place, using the standards set forth by Community Care Licensing’s Group Home Administrative Assessment Tool. This site visit will include an inspection of the general condition and maintenance, of both the interior and exterior of the program facilities. The inspection shall include an assessment of whether the facility meets health and safety standards, and any deficiencies will be noted. The preliminary results of the group home auditors assessment will be discussed verbally with the facility director or administrator prior to leaving the facility. A thorough report of finding is then completed and submitted to administration with recommendations. 3-P1 Permanency in 12 Months for Children Entering Foster Care OCT2011-SEP2012 OCT2012-SEP2013 OCT2013-SEP2014 OCT2014-SEP2015 13.2% Reunified 16.4% 19.2% 18.3% 7% Adopted 0.9% 78.9% Guardianship 100% Emancipated 12.5% 12% 13.7% Other 1.6% 1.6% 3.8% Still in care 69.5% 67.2% 64.1% Total 100% 100% 100% Data Source50 Analysis The table above depicts all exits to permanency within 12 months including reunification, adoption, and guardianship using a cohort of all who entered care (first and subsequent entries) in a 12 month period.49 With Continuum of Care Reform, Probation has created a position for one Senior Deputy Probation Officer to seek out and establish new foster care families and create a single process for an individual/family to provide care for a related or unrelated 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.California - Child and Family Services Review Along with the additional officer, Probation has added Intensive Family Finding, consisting of providing family finding services to youth who typically end up in congregate care upon initial entry into the probation system. This effort will increase capacity to maintain youth in the least restrictive setting and lay the groundwork for securing permanent and stable homes. These services will also be provided to youth currently placed in congregate care in an effort to increase capacity to step youth down to family- based settings with caregivers who are committed to offering permanency and to establish connections and relationships for the youth. The plan also includes money for initial placement support for relatives who take emergency placement of probation youth with the immediate costs of caring for the youth. Many times, youth have nothing when they are removed from the home. A stipend will be provided to relatives in emergency placement situations to purchase clothing, food, hygiene products, and other items needed for the youth. This stipend will help support the placement of youth with family members who would likely refuse the 50 CWS/CMS 2016 Quarter 3 Extract. DRAFT Program version: 2014.11.30 Database version: 06DEC2016:09:11:06173

placement without immediate emergency support. This strategy will be implemented by Probation.These changes will help strengthen current foster parent recruitment and retention strategies includingtransitioning youth out of congregate care and into lower levels of care. The overall goal of thesestrategies is to increase capacity to place children and youth in the least restrictive settings in order tolay the groundwork for securing a permanent and stable home for each youth.Our research has shown that 70% of our first time placements abscond when placed at an instateprogram. This high rate increases our length of time to achieve permanency. This will be an area that isaddressed in our next system improvement plan.3-P2 Permanency in 12 Months for Children in Care for 12-23 MonthsTypes Of Permanency OCT2011- OCT2012- OCT2013- OCT2014- OCT2015- SEP2012 SEP2013 SEP2014 SEP2015 SEP2016Exited to reunification 25.5% 19.4% 35.7% 32.6% 35.3%Exited to adoptionExited to guardianshipExited to non-permanency 25.5% 32.3% 14.3% 30.2% 14.7%Still in care 48.9% 48.4% 50% 37.2% 50% Total 100% 100% 100% 100% 100%Data Source50AnalysisThe table above depicts the number of probation youth who were in care the first day of the 12-monthperiod, who had been in care between 12 and 23 months, which were discharged to permanency within12 months.49 The number of youth discharged to permanency has remained fairly consistent over thepast five years. The 2016 Peer Review suggested probation youth remain with the same PlacementOfficer until terminated from probation to improve the number of probation youth exiting placement toreunification. This would further improve communication between the officer, probation youth,family/guardian, placement program and other service providers.This population tends to include probation youth ordered to participate in and complete a Juvenile SexOffender program. The average time frame to complete a Juvenile Sex Offender Program is between 12and 18 months.Our numbers in for youth who achieve permanency in 12 to 23 months have improved, over the same California - Child and Family Services Reviewtime period when youth who achieve permanency in less than 12 months have remained about thesame. The increase in performance in this area is attributed to our out of state placements and juvenilesex offender foster care populations. Another possible reason is the youth who struggle in their firstyear and abscond, have now had time to adjust to life in foster care. 174

3-P3 Permanency In 12 Months For Children In Care For 24+ Months Types Of Permanency OCT2011- OCT2012- OCT2013- OCT2014- OCT2015- SEP2012 SEP2013 SEP2014 SEP2015 SEP2016 Exited to reunification 13.9% 15.8% 11.8% 15.2% 45% Exited to adoption 20% 35% Exited to guardianship 2.6% 100% Exited to non-permanency 16.7% 34.2% 32.4% 45.5% Still in care 69.4% 47.4% 55.9% 39.4% Total 100% 100% 100% 100% Data SourceError! Bookmark not defined. Analysis The table above depicts the number of probation youth who were in care for 24 months or more, which were discharged to permanency within 12 months.49 This population tends to include probation youth ordered to participate in and complete a Juvenile Sex Offender program. The average time frame to complete a Juvenile Sex Offender Program is between 12 and 18 months. Our numbers remain consistently low in this area as the average age of entry into Probation Foster care is around age 16. With this age of population, permanency is automatically achieved before 24 months. 3-P4 Reentry to Foster Care OCT2011-SEP2012 OCT2012-SEP2013 OCT2013-SEP2014 31.8% 13% Children with re-entries 25% 68.2% 87% 100% 100% Children with no re-entries 75% Total 100% Data Source50California - Child and Family Services Review Analysis The chart above depicts the number of probation youth who entered foster care in a 12-month period, who discharged within 12 months to reunification or guardianship, which re-entered foster care within 12 months of their discharge.49 The chart indicates there has been no significant change in the number of probation youth reentering into probation foster care. It also indicates there are a significantly larger number of those who do not reenter then those who do. Preventing reentry is very important to Probation. Information derived from the 2016 Peer Review indicated reasons for positive outcomes may be attributed to the skill and years of service of Placement Officers, the use of an assessment team before a probation youth is placed, the number of family visits to probation youth in placement, and the review of Out-of-State cases by an IMAC committee. Wraparound services are regularly provided to probation youth reunifying with parent/legal guardian. Further, this population tends to be older in age and therefore not eligible for reentry. There were a total of 23 cases that exited foster care in the above chart. While it is our desire to move towards no re-entries into foster care, only 3 cases experienced a re-entry in the first 12 months. With one less re-entry, we would be under the national average.175

C1.4 Reentry Following Reunification (Exit Cohort) OCT2011- OCT2012- OCT2013- OCT2014- SEP2014 SEP2015 SEP2012 SEP2013 12% 14.8%Reentered in less than 12 months 10.2% 18.2% 88% 85.2% 100% 100%No reentry within 12 months 89.8% 81.8% Total 100% 100%Data Source51AnalysisThe chart above depicts the number of probation youth discharged from foster care to reunificationduring the year, which reentered foster care in less than 12 months from the date of the earliestdischarge to reunification during the year.49 The chart indicates there has been no significant change inthe number of minors reentering into probation foster care. It also indicates there are a significantlylarger number of those who do not reenter then those who do. Preventing reentry is very important toJuvenile Probation. Wraparound services are regularly provided to probation youth reunifying withparent/legal guardian.3-P5 Placement Stability per 1,000 Days OCT2011- OCT2012- OCT2013- OCT2014- OCT2015- SEP2015 SEP2016 SEP2012 SEP2013 SEP2014 3.66 1.81Under 1 2.28 3.63 2.98 2.922-Jan5-Mar10-Jun15-Nov 2.47 2.38 3.5316-17 1.89 2.07 1.94Total 2.12 2.2 2.58Data Source52Analysis California - Child and Family Services ReviewThe above chart depicts probation youth who entered care in the 12-month period and the rate ofplacement moves per 1,000 days in care.49 The rate for the most recent period was 2.4 placementmoves per 1,000 days in foster care. Probation has been well below the national standard of 4.12placement moves per 1,000 days in care for the past five years. This low placement number may be inpart due to Probation having its own auditor and continual evaluations of the programs used.Even though our permanency with 12 months data is above the national average because of our highabscond rate during the first placement, it appears from placement stability data that the subsequentplacement is successful.51 CWS/CMS 2016 Quarter 3 Extract. Program version: 2.00 Database version: 6B0BFD9D52 CWS/CMS 2016 Quarter 3 Extract. DRAFT Program version: 2014.11.30 Database version: 16NOV2016:10:21:41 176

2F Timely Caseworker Visits With Children Age Group OCT2012-SEP2013 OCT2013-SEP2014 OCT2014-SEP2015 OCT2015-SEP2016 Under 1 89.4% 90.7% 80.1% 88.8% '1-2 83.1% 89.4% '3-5 '6-10 '11-15 78% 70.4% 16-17 64.5% 64.7% Total 69.2% 66.8% Data Source53 Analysis The above chart depicts the percentage of monthly contacts with probation youth in placement during a one year period. The percentage of total contacts has increased significantly over the past four years. Measures implemented to improve the percentage of youth contacted include: a Supervising Probation Officer monitoring face to face contacts of officers and minors on a monthly basis. Additionally, in 2014 the addition of a CWS/CMS clerical staff to make timely entries improved monthly statistical data. The remaining probation youth not contacted in part can be attributed to those probation youth who are absconds from placement and have active warrants.49 2F Timely Caseworker Visits In The Residence Age Group OCT2012-SEP2013 OCT2013-SEP2014 OCT2014-SEP2015 OCT2015-SEP2016 Under 1 98.4% 100% 98.4% 99.5% '1-2 98.4% 99.7% '3-5 '6-10 '11-15 96% 96.5% 16-17 94.8% 95.6% Total 95.3% 95.9% Data Source53California - Child and Family Services Review Analysis The above chart depicts the percentage of monthly contacts with youth in care during a one year period. The percentage of total contacts has increased significantly over the past four years. Measures implemented to improve the percentage of youth contacted include: a Supervising Probation Officer monitoring face to face contacts of officers and minors on a monthly basis. The remaining probation youth not contacted in part can be attributed to those probation youth who are absconds from placement and have active warrants.49 53 CWS/CMS 2016 Quarter 3 Extract. Program version: 2014.09.16 Database version: 6AF4B244177

4B Least Restrictive Placements (Entries First Placement)Age Group OCT2011- OCT2012- OCT2013- OCT2014- OCT2015- SEP2012 SEP2013 SEP2014 SEP2015 SEP2016<1 mo 34.7% 29.3% 65.3% 70.7%1-11 mo 100% 100%'1-2 yr'3-5 yr'6-10 yr'11-15 yr 37% 38.4% 33.8%16-17 yr 63% 61.6% 66.3%18-20 yr Total 100% 100% 100%Data Source544B Least Restrictive Placement (Point-In-Time Placement)Placement Type 1-Oct-12 1-Oct-13 1-Oct-14 1-Oct-15 1-Oct-16 0.8% 2.8%Pre-Adopt 0.4% 1.7% 44.2% 44.2% Kin 2.6% 0.4% 0.8% 10% 5.5% 13.3% 19.3%Foster 0.4% 8.8% 9.4% FFA 0.9% 1.2% 0.8% 12.1% 13.3% 10.4% 3.9%Court Specified Home 100% 100%Group 53.1% 57.3% 51%ShelterNon-FC 21.9% 18.7% 12.4%Transitional Housing 5.8%Guardian - DependentGuardian - OtherRunaway 11.8% 7.1% 7.7%Trial Home Visit SILP 7.5% 13.3% 15.8%Other (?) 1.8% 2.1% 5.8%Missing California - Child and Family Services Review Total 100% 100% 100%Data Source51AnalysisThe first chart above depicts the number of probation youth to enter foster care by placement type.49Placement numbers peaked between July 2012 and June 2014 and have declined ever since. This can beattributed to a correlation in the decreased number of referrals to the Court by both Probation and lawenforcement. Further possibilities for causes of the declining number of probation youth in placementas assessed by the 2016 Stakeholders Meeting are an awareness by probation for a need to makechanges in the way business is done, the strong investment of Placement officers and service providersin these probation youth and a strong collaboration across entities to combine efforts to improveservice results.54 CWS/CMS 2016 Quarter 3 Extract. Program version: 2013.12.09 Database version: 6AF3129A 178

The second chart above indicates the various placement options attempted with probation youth in Sacramento County.49 The vast number of placements has been to group homes. A significant increase in the number of minors entering transitional housing and SILP’s has been due to EFC. This will be an area that is addressed in our next system improvement plan. 4E ICWA & Multi-Ethnic Placement Status Placement Status 1-Oct-12 1-Oct-13 1-Oct-14 1-Oct-15 1-Oct-16 3 2 3 Relatives 3 2 2 3 2 Non Relatives, Indian SCPs 4 Non Relatives, Non Indian SCPs Non Relatives, SCP Ethnic Missing Group Homes 3 SILP Other Missing Total 3 Data Source51 Analysis The chart above indicates the number of minors placed under the Indian Child Welfare Act (ICWA) and the number of minor’s with multi-ethnic backgrounds.49 This ethnic group has historically been a minor total of Sacramento County Probation’s total placement population. 8a Outcomes for Youth Exiting Foster Care at Age 18 or Older The Outcomes for Youth Exiting Foster Care at Age 18 or Older (Measure 8A) is used to collect data for youth exiting family care while under the supervision of the Probation Department. The ILP coordinator completes this data on a quarterly basis. Age Group DENOMINATOR Completed Percentage Who Percentage Whereabouts High School Completed High Who Known During or School or Obtained Obtained Quarter Equivalency Equivalency Employment EmploymentCalifornia - Child and Family Services Review Youth Who Exit at Age 18 38 9 24% 6 16% NMD Age 18 28 NMD Age 19 22 12 43% 7 25% NMD Ages 20-21 50 9 41% 11 50% 43 86% 28 56% Re-Entry NMD Ages 18-21 13 8 62% 8 62% Total 151 81 54% 60 40%179

Age Group Youth Percentage of Youth with Percentage of w/Housing Youth Permanency Youth with Arrangements Connection Permanency w/Housing Connection ArrangementsYouth Who Exit at Age 18 25 66% 29 76% 93%NMD Age 18 24 86% 26 86% 92%NMD Age 19 17 77% 19NMD Ages 20-21 42 84% 46Re-Entry NMD Ages 18-21 9 69% 12 92% 87%Total 117 77% 132The data indicates a higher success rate amongst older probation youth in all categories. Thisinformation gives direction to give more attention to the younger probation youth to improve successfuloutcomes. Summary of Findings California - Child and Family Services ReviewChild WelfareThe C-CFSR process was a collaborative endeavor embraced by Sacramento County’s Department ofHealth and Human Services, Child Protective Services Division and the Probation Department. Multiplepartners participated in focus groups and/or large stakeholders meetings. These partners includedcounty staff, parents, relatives, non related extended family members, foster youth, and systempartners such as courts, county departments and community service providers. The feedback and candidcomments addressed at both the focus groups and Stakeholders meetings demonstrated the communityin Sacramento County greatly cares about the welfare of children and families.The overall feedback from the Focus groups, Peer Reviews and Stakeholder meetings expressedstrengths and challenges in the areas of service array, engagement, the court process, and workforcedevelopment. Many strengths were identified including, but not limited to, the use of Safety OrganizedPractice, the extent of services available in Sacramento as compared to other counties, theimplementation of specialized courts to address Extended Foster Care and CSEC youth, and newemployees hired as part of cohorts who receive extensive training. However, there were alsoconstructive comments from these diverse partners on how Child Protective Services and Probationcould improve services and outcomes. Through the course of the focus groups with the parents, fosteryouth, and substitute care providers, it became clear that timely written and verbal communicationbetween the social workers and substitute care providers is in need of improvement. For example,communication exchanges regarding treatment authorizations, Health Education Passport, visitations,etc. can be enhanced to better support the child’s needs while in care. The focus groups highlighted theneed for reduction in social worker caseloads, improved communication between parents and socialworkers, equity in resource referrals to target gender specific issues relating to domestic violence andhousing programs. There was also an expressed need for social workers to be culturally informed whenengaging with the Lesbian, Gay, Bi-Sexual, Transgender, and Queer (LGBTQ) family dynamics. 180

California - Child and Family Services ReviewA few themes revealed from the stakeholder meetings were family isolation and repeated exposure to domestic violence, substance abuse, mental health, unemployment /low employment are putting children at risk of maltreatment and neglect in the community. The majority of children who enter care enter by reason of general neglect is typically related to substance abuse, domestic violence, or mental health challenges. Additional gaps in service identified by peers, stakeholders, and social workers were a lack of culturally appropriate mental health services for children and adults, lack of services for fathers, lack of alcohol and other drug services treatments, and limited resources for families in isolated geographic locations. Stakeholders also identified adjustments to recovery for parents and collaborations between service providers and county agencies to better align services to the needs of children and youth. Many of the suggestions offered for improvement are already underway as is evidenced by the County’s participation in the Title IV-E Well-Being project. The Title IV-E Well-Being project will allow more flexibility to provide preventative services and permanency services to youth and their families. These strategies will help to reduce the number of youth entering the child welfare system and improve permanency outcomes for foster youth. The County is also in the beginning stages of implementing Resource Family Approval (RFA) which is a unified, family friendly and child-centered resource family approval process. This new approval process will replace the existing processes for licensing foster family homes, approving relatives and non-relative extended family members as foster care providers or legal guardians, and approving adoptive families by combining elements of all the processes into a single approval standard. These initiatives include many of the recommendations made throughout the CSA. Finally, stakeholders identified the recruitment and support of foster parents as a need. Foster parent recruitment, retention, and support have already become a focus of improvement moving into the creation of the next SIP. Recruitment of resource families will also focus on the more challenging population of children to place in out-of-home care. Other strategies will be developed to address some of the identified areas needing improvement by reengaging both internal and external partners. Strategies for the SIP will be discussed with multiple stakeholders in an effort to improve Outcomes while maximizing the use of existing resources. The Federal Outcome Measures revealed challenges in that child welfare continues to need improvement in three areas: Recurrence of maltreatment, Permanency in 12 months (in care 24 months or more), Re-entry to foster care in 12 months, and Outcomes for youth exiting foster care at age 18 or older. While Child Welfare is succeeding both the State and National levels for Permanency in 12 months (entering foster care), it is a companion measure to Re-entry to foster care in 12 months, which is not meeting the national standard. This data is very telling and will require the county to reexamine reunification practices. The CSA process also revealed the populations identified as being at greatest risk of maltreatment. Poverty is highest in concentrated areas of the southern and northern part of the county. The number of individuals admitted for drug treatment in fiscal year 2014/15 was highest in northern and southern communities. From 2000-2012, the highest child death rate occurred in South Sacramento. In addition, African American children died at almost two times the rate of other children in Sacramento County. African Americans were more likely to live in poverty. Overall, African American children and families showed higher maltreatment indicators compared to other races. The County has demonstrated progress with the implementation of the Title IV-E Well-Being Project, which includes the use of SOP and preventive and permanency services. Other areas of progress include181

the expanded use of teaming and the formation of the RAACD steering committee, with a goal to reduce California - Child and Family Services ReviewAfrican American child deaths.The Department of Health and Human Services, Child Protective Services Division and the ProbationDepartment have a strong collaborative relationship and have worked diligently to improve outcomesfor children and families. Sacramento County values and will benefit from the wide array of informationobtained from the 2016 County Self Assessment (CSA) process. The County is on schedule to prepare anew five-year System Improvement Plan (SIP) using the qualitative and quantitative informationgathered throughout the CSA process. The information gathered yielded important data which will beused to inform the development of the next SIP. The departments remain committed to workingtogether and utilizing resources to continue to focus on improving Safety, Permanency and Well-Beingoutcomes for children and families as the County moves forward in the planning and implementation ofnew SIP goals.ProbationProbation has made substantial progress since the last System Improvement Plan started in 2012.In May of 2014, Probation developed a CWS/CMS check sheet for officers to complete. The sheet isthen submitted to clerical staff for entry into the CWS/CMS system. The clerical staff have attendedCWS/CMS update training in April of 2014. The Placement Supervisors audit the CWS/CMS system datathrough Safe Measures and do so no less than quarterly. With this change, the percentage of CWS/CMSentries made by the department has increased dramatically. During the month of October 2015, 85.9%out of home placements had a face to face contact recorded in the CWS/CMS System. This increase inthe amount and accuracy of the data being entered in the CWS/CMS system allows the department todepend on the data reported out by Safe Measures.Since 2012, Probation also developed a Placement Intake Unit. This unit consists of a SupervisingProbation Officer, a Senior Deputy Probation Officer and a Deputy Probation Officer. The officers areresponsible for interviewing each probation foster youth for the purpose of identifying additionalrelative and potential non-related extended family members. The identified persons are contacted bythe unit and evaluated for potential placement. This change in practice is seen as one of the reasons thenumber of relative and non-related extended family member placements have increased.Another addition was the use of WRAP services as prevention to removal from the home on casessupervised by the department prior to the foster care order. The officers now have the ability tocomplete WRAP referral exceptions and additional contracts were developed with 2 providers in thecommunity. These contracts were only for non-foster care probationers who were still living in thehome with their parents. Use of WRAP continues to increase in the field.With the changes in Continuum of Care Reform Sacramento County Probation has created a position forone Senior Deputy probation Officer to seek out and establish new foster care families and create asingle process for an individual/family to provide care for a related or unrelated court dependent orward on a short term or long term basis. This position will be tasked to assist the potential ResourceFamily with completing the application, obtaining First aid and CPR certification and a health screening.Additionally, the officer will conduct background checks, complete a home environment assessment, apermanency assessment, and have face to face interviews with the family. With this additional positionthe department also designated money for help with Foster Parent Retention and Recruitment Support(FPPRS): upfront financial support in 2015-16 and expansion in 2016-17. Money can be used for staff toimprove services and supports for home-based care; child care for licensed foster parents, approvedresource families and relative caregivers, intensive relative finding, outreach to potential foster familyhomes, resource families, and relatives. 182

California - Child and Family Services Review Along with the additional officer, Probation has added Intensive Family Finding. This consisting of providing family finding services to youth who typically end up in congregate care (level 10-12) upon initial entry into the probation system in an effort to increase capacity to maintain youth in the least restrictive setting and lay the groundwork for securing permanent and stable homes. These services will also be provided to youth currently placed in congregate care (level 10-12) in an effort to increase capacity to step youth down to family-based settings with caregivers who are committed to offering permanency and to establish connections and relationships for the youth. The plan also includes money for initial placement support for relatives who take emergency placement of probation youth with the immediate costs of caring for the youth. Many times, youth have nothing when they are removed from the home. A stipend will be provided to relatives in emergency placement situations to purchase clothing, food, hygiene products, and other items needed for the youth. This stipend will help support the placement of youth with family members who would likely refuse the placement without immediate emergency support. This strategy will be implemented by Probation. These changes will help strengthen current foster parent recruitment and retention strategies including transitioning youth out of congregate care and into lower levels of care. The overall goal of these strategies is to increase capacity to place children and youth in the least restrictive settings in order to lay the groundwork for securing a permanent and stable home for each youth. Probation has joined CPS in the development of the Crossover Youth Practice Model (CYPM). Developed at the Center for Juvenile Justice Reform at Georgetown University, the model was designed to help address the issues these youth are presenting in our communities and develop strategies to meet their needs. By implementing this model, Sacramento County Probation hopes to improve outcomes for crossover youth with: a reduction in the number of youth placed in out-of-home care, a reduction in the disproportionate representation of children of color, a reduction in the number of youth crossing over into, and staying within, the justice system, an increase in positive social and academic outcomes, including post-secondary education and career readiness; and a positive future shaped by grit and determination from transformational life experiences. All sworn officers are being trained in this model. In the coming year, Probation anticipates the opening of the Warren E. Thornton Youth Center (WETYC) A development team has been established to create a diversion type program with respite beds. The facility will contain three units: A Unit – Located within the main WETYC building, this 30-bed unit would function as a Short Term Residential Therapeutic Program within the meaning of Assembly Bill 403. It would serve youth, ages 13-18, who would previously have gone into group homes or the Youth Detention Facility; B Unit – Also located within the main WETYC building, this 15-bed unit would serve youth, ages 13-18, with a higher degree of intervention required to address issues of alcohol and drug abuse and addiction; C Unit – Also located within the main WETYC building, this 15-bed unit would be designated to serve young women, ages 13-18, who have been exposed to trauma, abuse and neglect, most often as victims of sexual exploitation and human trafficking. Overall we performed poorly in permanency in 12 months and relative placements as shown by the county self-assessment. We look forward in developing our new system improvement plan to address these areas of concern. Populations at Greatest Risk of Maltreatment - Audits, Investigations The Probation Department created Placement Auditor position currently held by two Senior Deputy Probation Officers. The Department’s group home auditors conduct initial and annual on-going inspections of residential placement programs where probation youth under the supervision of183

Sacramento County Probation Department are placed with the goal of rehabilitating the probation California - Child and Family Services Reviewyouth back into the community. A complete physical tour of the facility takes place, using the standardsset forth by Community Care Licensing’s Group Home Administrative Assessment Tool. This site visit willinclude an inspection of the general condition and maintenance, of both the interior and exterior of theprogram facilities. The inspection shall include an assessment of whether the facility meets health andsafety standards, and any deficiencies will be noted. The preliminary results of the group home auditorsassessment will be discussed verbally with the facility director or administrator prior to leaving thefacility. A thorough report of finding is then completed and submitted to administration withrecommendations.Additionally, the Auditor position is designated to investigate all complaints made by youth while inPlacement, their parents or by Community Care Licensing. The preliminary results of the auditor’sinvestigation will be discussed verbally with the facility director or administrator prior to leaving thefacility. A thorough report of finding is then completed and submitted to administration withrecommendations.County Strengths (CYPM – WETYC – Field Programs)The Juvenile Field Probation Officers monitor juvenile offenders under the courts' jurisdiction. Allyouth who are placed on probation are given a risk and need assessment to determine the likelihoodof reoffending as well as to identify service needs. Youth are supervised utilizing innovativestrategies to support positive change.Home Supervision and Electronic MonitoringA youth may be placed on either Electronic Monitoring or Home Supervision instead of being detainedat the Youth Detention Facility. Home detention options can be used while the minor is awaitingtheir court appearance for disposition (sentencing) or as part of the disposition and formal probationordered by the court.Officers monitor the youth's compliance with their conditions of release or probation including schoolattendance.Several things are considered before a minor is accepted or rejected for Home Supervision orElectronic Monitoring, to include:  Community safety  Flight Risk  Willingness to obey contract program rulesCandidacy Assessment Unit  Youth and parents report to the Warren E. Thornton Youth Center immediately after Court or upon release from Youth Detention Facility to meet with a probation officer  Update the Positive Achievement Assessment Tool (PACT), complete the Imminent Risk assessment and develop a Case Plan  Referrals to counseling services, DNA collection and assignment to a probation officerYouth Service CenterServes Elinor L. Hickey Academy, North Area Community School, and Gerber Community School  Youth suspended or expelled from a comprehensive high school can enroll and attend a full day of school at a community school  Obtain counseling services, complete community service hours and possibly enroll in a trade program 184

California - Child and Family Services Review Participate in pro-social activities through the Boys & Girls Club Education Based Supervision Model-(EBSM) The Education Based Supervision Model integrates Deputy Probation Officers into school districts. Officers provide case management services to youth on probation and provides support to the school and all students on campus. Officers strive to increase average daily attendance and graduation rates, lower truancy, lower expulsion and suspension rates, decrease fights and incidents on campus, and improve student safety. Title IV-E Waiver Title IV-E waiver allows Federal funding to provide community based resources (FFT, MST, WRAP) for those youth identified with low to moderate risk and elevated needs with the goal of reducing out of home placements and keeping children and families together. Deputy Probation Officers provide comprehensive case management services for these youth and their families working in collaboration with community based providers. Specialized Supervision Juvenile Justice Diversion and Treatment Program (JJDTP) A full service partnership in collaboration with Behavioral Health and River Oak Center for Children, JJDTP provides mental health services to youth and families. Commercially Sexually Exploited Children (CSEC) Deputy Probation Officers provide a comprehensive and collaborative response to ensuring that commercially sexually exploited children (CSEC) are identified and receive the services they need to overcome trauma and live healthy, productive lives. Sex Offender/Arson Deputy Probation Officers provide intensive supervision to ensure compliance with court orders and targeted treatment plans. Reducing African American Child Deaths (RAACD) Deputy Probation Officers working in collaboration to implement a multi-faceted plan to reduce African American Death in the County of Sacramento. Through an MDT process, needs are identified and officers will provide supervision, support, and rehabilitative services to youth on juvenile probation. These services include parenting classes, child well-being, educational and vocational training.185

AppendicesAppendix A – Supervisor Focus Group Service Array California - Child and Family Services Review Supervisor Focus Group Service Array What’s Working Well Sacramento County has a wide array of services available when compared to other counties Birth and Beyond is a great resource, including the home visitation program. The expansion of age qualifications allows more families to get help and divert from CPS court involvement. The warm handoff with Birth and Beyond at the Emergency Response and Informal Supervision. Katie A. helps assess and link children to services early. Referring children to Mental Health services through Child Access is easy and Mental Health services provided to children are good. Sacramento County has an array of Alcohol and Drug services and accessing services is easy with Systems of Care. Drug Dependency Court/ Early Intervention Family Drug Court The recovery specialists from the STARS program have a strong collaboration with CPS social workers, are responsive to the client’s needs, and provide REAL talk with the clients. CPS has strong community partnerships with Birth and Beyond, schools, CSEC providers, and Law Enforcement. Services provided by Public Health nurses and early child screening with Hearts for Kids Prevention services provided by Informal Supervision No waitlist for services such as parenting education groups, individual counseling and other group counseling services. Having multiple of services available at one location, like Strategies for Change and Birth and Beyond. Accommodate most requests at families’ geographic locations. Lilliput provides services to families pre and post Dependency Court involvement. Challenges Culturally appropriate mental health services are needed for children and adults. Difficult to arrange for Mental Health and physical health for children in group homes. Availability of services is not geared toward working parents. More evening and weekend services are needed. Lack of services available in some areas of Sacramento County. All inclusive service providers are needed to serve “dead zone” areas (far southern part of the County, Galt, Delta, Folsom, Orangevale, etc.). Lack of specific services for fathers. Housing for families is needed. Child care in general is lacking for families, and Child Action is not readily available and has a waiting list. Translation services are changing frequently and there are not enough languages or translators available. Need more cultural/bilingual social workers. Drug testing – down to one provider who has limited hours and there is a lag in obtaining drug testing results 186

California - Child and Family Services Review Need alcohol and other drug services for children with substance abuse issues.  Alta’s length of time to assess is too long.  Inconsistencies with Wellness Recovery Action Plan (WRAP). They do not understand CPS’ practice and they lack staff – have waiting list now.  More Team Decision Making (TDM) meeting facilitators are needed so that TDMs occur timely.  Limited service providers for Commercially Sexually Exploited Children (CSEC).  Need more foster care and adoptive homes.  Lack of homes for transsexual youth.  Challenge of securing placement for children with sexual acting out behaviors.  Lack of post adoption services. Own insurance may not cover services, or medical provider not experienced with attachment disorders or other trauma from prior removal.  Alcohol and Drug assessments conducted by Systems of Care are not as good or comprehensive as STARS. Clients self report and are not challenged by their responses.  Bus passes are limited to three months for Informal Supervision clients versus six months for Court involved families. Next Steps  Consider mobile service provider or negotiate with service providers to offer flexibility in their schedules.  Suggestion to arrange a collaborative meeting between STARS, System of Care, and CPS to address and assess needs of families and open communication. Bring mental health and Alta into the process.  Increase recruitment of foster parents and service providers.  Funding for Child Action to increase access.  Reinstate hospital social workers and county social workers collaboration meetings.  Have drug testing results available on-line for social workers to access.  Have services consistent among all programs (more bus passes available to Informal Supervision families and including the children, individual counseling services for IS clients, etc.)  Group counseling reports have canned language. Recommend reports are behaviorally based (what was learned versus did they attend).  Systems of Care collaborate and communicate when assessing a CPS client.187

Supervisor Focus Group California - Child and Family Services Review Engagement What’s Working Well There is an emphasis on the importance of engagement and improving the quality of engagement. Structured Organized Practice is in progress and is promising. Three is a wide array of tools for social workers and supervisors to increase engagement. Use of three houses is less traumatizing with children. Seeing more engagement with children and obtaining their voice. There is more thinking outside the box in safety planning and supports with increase parent buy-in. Supervisors have embraced Structured Organize Practice and have boards in their offices with SOP columns. Good continuum across programs, all looking at harm, danger and impact of child. When have Team Decision Making meetings, works very well. Multi Disciplinary Team Meetings with Probation has improved. New workers getting into CORE training is helping. Adoption and Guardianship workers do a great job educating families on legal permanency and the process. 15 days requirement to see families at early assignment is great for families. Increase cross collaboration with supervisors and divisions. Use of technology (i.e. smart phones to call and text staff and families help with communication; Virtual Private Network) Seeing more relatives involved also changes focus to relatives available. Challenges High caseloads are a barrier. Need more workers with diverse special skills. Scheduling Team Decision Making (TDM) meetings is a challenge; takes 2-3 weeks and sometimes not enough rooms or facilities. Lack of timely availability when families are in crisis or a court report/decision needs to be made. Too much texting between social workers and clients instead of communication by telephone or in person. Some Birth and Beyond sites are not responsive and they do not take difficult cases – high risk and high needs. Engagement is difficult with parents with severe mental health and substance abuse issues. Negative perception in the community of CPS can cause resistance with efforts to engage. Parent’s denial that there is a problem can be a barrier to engagement. Next Steps More online instead of paper based to save time. Increase morale; appreciation for social workers and look at what can be taken away to lessen work load. Reinforce Safety Organized Practice (SOP) from beginning to end through the life of a referral or case. Have community run “brown bag” to discuss a variety of topics monthly. Provide more SOP coaches for workers, supervisors and managers. Implement Social workers and supervisors should not just e-mail; call or meet in person to discuss cases and issues. 188

California - Child and Family Services Review Supervisor Focus Group Court Process What’s Working Well  Specialized Courts such as Extended Foster Care youth and CSEC  Court officers provide great communication via e-mails and court summaries.  Minute orders are uploaded into CWS/CMS timely  Handoff from Emergency Response to Court Services is working.  Court is beginning to hold parents accountable and is reflective in Court orders.  Deputy County Counsel (DCC) is helpful in thinking outside of the box for runaway children.  DCC working with CPS to improve the 241.1 assessment and process  Court is holding CPS accountable for not placing with relatives  Judges/Referees are looking at what is best for families and/or children.  Court praises the families for the work they have done.  Transcription support to get Court documents files.  DCC trainings for Court and new social workers have been good.  Court room facilities are nice.  Dependency Drug Court and especially EIFDC have a caring environment while at the same time provide consequences and accountability.189

Challenges California - Child and Family Services Review Staff is not trained timely regarding changes in law. Difficulty engaging the Court; communication is not good. Disconnect with County Counsel; lack of respect for social workers and lack of compassion for new staff. Some County Counsel do not get back to supervisors or social workers timely when there are problems with court reports/other issues. County counsel requires more information than Prima Facie in Detention reports. Private attorneys are challenging to work with. The Court focuses on compliance instead of behavior changes. Court rooms are inconsistent; social workers feel they have to tailor their court reports to the court room they will be in. Minute orders are not received timely; sometimes takes a few months. CPS staff present in court is no longer a high priority for their cases being heard, which creates hours of wait and is felt as disrespectful. Lack of respect from the Court to CPS staff; they are permissive of disparaging social workers in open court. The Court does not make families who are present a priority when hearing cases that day. Clients are unable to get in contact with their attorneys. Management allow child’s attorney and county counsel to personally attack social workers and they permit them to go directly to managers instead of working with line staff supervisors and social workers. Court and attorneys often do not prepare for court, they do not read court reports, and cannot recall past discussions. Children’s attorneys do not see children in placement and have an adversarial relationship with CPS. Considerations for continuances are given to counsel but not to social workers. Late issuance of Protective Custody Warrants approvals by the Court. Unreasonable court orders (i.e., requiring social worker to transport non-transportable (unsafe) clients, visitation ordered as daily contact). Children are kept out of school too many times due to court continuances. Parking meter is down constantly, it is expensive, and there are not enough spaces. Parking should be separated between clients and staff; it is an isolated and steeply recessed area with no security. Court has unrealistic expectation of reports from community providers. Writing detention reports by ER workers are difficulty because of high staff changes or staff don’t write detention reports that often. Workers are very busy, high caseloads and have difficulty responding to Court questions from DCC or Court Officers. Court is not giving CPS JV180 timely so that the Department can respond. 190

California - Child and Family Services Review Next Steps  Periodic ongoing trainings in court report writing and chain of evidence/burden of proof is needed.  Bring back “Coffee with the Court” to improve relationships.  Facilitate joint meetings with the Court to address what works and challenges, and use a neutral facilitator.  Have County Counsel write the Department’s petitions like they do in San Diego with utilization of 15 minute teaming meetings between counsel and staff.  Ensure information shared by the Court with management is filtered down to line staff.  Have adoption finalization hearings in the P.M. so that they are not comingling with biological families.  Update new video on the orientation on Court processes for parents and caregivers.  Have Court Officers speak up and be involved with the Court process.  Court Officers should be engaged with families if necessary utilizing SOP.  Set up a system or process so social workers can get JV180 timely.  Hear cases when social workers and or families at the Court first. Supervisor Focus Group Workforce Development What’s Working Well  New employee’s cohorts coming with extensive training.  Emergency Response new worker protocol incorporates peer trainer and trainings before case assignment.  New employee cohorts are building comradery and support among each other.  Hiring process is more streamline and faster  Mass interviewing is good.  Hiring people who want to do the work.  Supervisors are letting people go during the probationary period when appropriate.  Supervisors feel very supportive from upper management including Program Managers, Division Manager and Deputy Director.  Bringing back a hiring and training unit is great.  New technology helps us stay connected (Smart phones, VPN, etc.)  CORE 3.0 is good.  Supervisors provide relevant program specific trainings.191

Challenges California - Child and Family Services Review High caseloads. Workload - work being added but nothing taken away. Lack of plan to retain and motivate social workers. Masters in Sociology or other fields are usually stuck in a Bachelor’s position and cannot promote. New social workers hear how jaded seasoned workers are and the negativity. Lack of hands on training for staff. Salary for supervisors is only 50 cents more than social workers; no incentives for supervisors. Many new supervisors are not trained or equipped to train; lack of experience. Some experienced social workers do not want to promote to supervisors. Lack of trainings to promote, or not afforded to everyone. Supervisors and social workers are not being released for transfers to new positions. No peer trainers for supervisors. Recruitment is needed with better skill levels; seems CPS is hiring anyone. Not retaining all title IV-E interns who are going to other neighboring counties. Matching is not occurring well with current hiring process. Programs should be able to assess what programs would best be suitable for each candidate. Too many new social workers require too much time from supervisors. Inconsistencies on caseload assignments based on social worker skill or caseload. Performance evaluations are not user friendly, are too long, and supervisors do not have time to complete them. No time to participate in personal development because “too slammed” with work. Emergency Response and Permanency Academies do not continue. Matching not occurring well with current hiring process and supervisors are not able to select their own new hires. When staffs are promoted, they are still working in their former position because not back filled. Next Steps Do social worker appreciation events outside of SW appreciation month, such as Picnics, clubs, bar- b-quest and other events. Promote more mentoring programs at all levels. Collaboration with Mental Health Services so that social workers can get their licensing hours. Offer pay comparable to other counties. Offer alternative work schedules, i.e., 9/80’s, 4/10’s, and telecommuting. Scatter schedules to increase coverage. Align hiring process with California State University Sacramento graduates. Include supervisors on the interview panel and allow supervise to select their staff. Provide peer counselors and support groups for social workers. Pay supervisors more than the staff they supervise. Provide daycare subsidy. Make sure new workers are not overburden with work right away, but allow Supervisors to assess Social Workers if they are ready to take cases. Program Managers and Division Managers need to use SOP tools from the top down, not just Supervisors and social workers. Have a performance evaluation that is user friendly, meaningful and condensed. Quicker notification responses by law enforcement and management on threats to social workers and other staff. Have specific promotional training. Have more options available and opportunities to attend desired trainings versus required trainings. 192

California - Child and Family Services ReviewAppendix B – Social Worker Focus Group Service Array Social Worker Focus Group Service Array What’s Working Well  SAFE Center – Good relationship with all partners- LE, DA’s, Victim Advocates.  ER PHN’s Huge IR response Med. Records, contacting doctors.  SR Mental Health Counselors.  Katie A tool helped identify and address Mental Health issues with families (ER).  Miracle Room.  Center for Father’s and Families.  CAPC information and referral specialist.  Med neglect review team.  Visitation sites at Granite are safe.  TDM at County Building outside work area.  A Community for Peace-Good collaboration-Focused/Stationed worker.  WEAVE for CSEC youth-come and talk to youth-tangibles(clothes, snacks, backpacks).  Wrap services for Mental Health issues-come take kids off grounds from CRH.  B & B referral process to connect families quickly.  Relationship/communication between social workers and STARS workers-convenient location.  EIFDC court success & availability to help and support families,-accountability.  Destination Families/Sierra-support youth-professional-good communication.  CASA/ability to establish relationship with youth.  FSW’s/ engagement with kids and family.  Nurses/assess child before placement.  Security/presence helps deter behavior.  Lilliput/good @ finding relatives and working with those families.  Technology/allows for quicker response and thinking ahead.  Some FFA’s have good communication/transportation/supervised visits/home oversight.  WRAP & FIT at CPSU.  WEAVE workers coming t CPSU for CSEC youth.  IS supports keeping children safe at home.  Added security at CPSU.  LE assigned to CDS.  Nurses at CRH 7 days a week.193

Challenges California - Child and Family Services Review Child Placement Support Unit (CPSU) is in a bad location for Commercially Sexually Exploited Youth (CSEC) youth; there are safety issues, the comfort room is too small, and there is not enough staff. The recommendation is to move CPSU to another location. There are not enough resources for Commercially Sexually Exploited Youth (CSEC) youth and youth with mental health and behavioral issues. Some services are only located in one area, i.e. Community for Peace located in Citrus Heights only. Housing challenges. Not enough foster homes. There is a lack of internal communication between Child Development Specialists (CDS), Family Service Workers (FSW) and Social Workers. Mental health/crisis intervention/trauma training is needed for Child Development Specialists (CDS) and Family Service Workers (FSW) Independent Living Services should start earlier for teens. Have WEAVE (Women Escaping a Violent Environment) on site at CPSU. Next Steps Mental health crisis interventions. Mental health training for staff and caretakers. Set up an emergency shelter with staff that can work with challenging behaviors (group home). Need higher level of service for CSEC, transgender and LGBTQ children. Need WEAVE on-site at CPSU. Need for parents to get free child care. Start Independent Living Program earlier for youth. Mandatory job corp. programs for youth. Physically move CPSU out of CRH away from current location. Have all services available/accessible to all i.e. A Community for Peace. CPSU needs resources to meet children’s needs i.e. clothing etc. Recruit more service homes for special needs and autistic children. Internal communication needs improvement/documentation regarding placement. Social Worker Focus Group Engagement What’s Working Well Access to parents who are incarcerated. On-going self-awareness - being prepared not to react and choosing not to engage in negativity. Having the ability to remain calm. Remembering what child/family has been through, use of empathy, and not taking things personally. Helping each other out - peer support. Having resources available early on for foster parents. Team Decision Making Meetings (TDMs) – engages other family members. Safety Organized Practice (SOP) – mapping and Three Houses tool help with engagement. Program Specific Workgroups (PSW’s) have helped with changes that support social workers. Child Developmental Specialists (CDS) staff being able to take children outside to play. 194

California - Child and Family Services Review Challenges  Sibling visits “fall through the cracks”.  Engagement with teens is challenging.  No time for Safety Organized Practice (SOP) due to high caseloads and work demands.  Training is needed regarding all cultures.  Immediate supports are lacking for relative caretakers.  Too much paperwork for social workers and not enough clerical support.  Need more internal supports for staff.  New social workers should shadow experienced workers more.  The Children’s Receiving Home visitation area needs regular cleaning.  More training is needed on “how” to do the job, i.e. interviewing.  Need cultural brokers.  Need to hire youth advocates.  Need for more consistent training for all. Next Steps  New staff should shadow experienced workers a lot to figure out their approach.  Improve/clean up visitation areas – CPSU areas are falling apart.  Training on practical skills/role play interviewing.  Counseling for staff; therapist on site for staff to check in with; safe place with easy access for staff.  Find ways to promote positive and supportive work environment. Social Worker Focus Group Court Involvement What’s Working Well  Providing as much visitation as possible for parents.  The Court tries to do what is best for the child, and the Court works well when it encourages all voices and listens.  The Court creates necessary layers of accountability and needed authority, and validates Social Workers’ investigation and efforts.  Staff have positive experiences with County Counsel.  Court Officers are helpful when they have a strong relationship with the Court.  Court relationships are improved with increased communication. Challenges  Parents do not understand what is happening in court. Suggest enhancing the parent orientation and/or having parent advocates.  Some County Counsel do not speak up in court.  Certain court rooms do not trust social workers.  There are unrealistic court orders being made.  Relationship with child’s counsel is poor; no teamwork.  Long waits for social workers in court; court does not prioritize social worker’s time.  Children do not know why they are at court.  Court needs to be trained on social worker’s role to establish more respect.195

Next Steps California - Child and Family Services Review Enhance parent/court orientation. Make sure child’s voice is heard by the Court and attorneys. Social Workers going to court more frequently to enhance relationships. Social Workers and children’s’ attorneys working together to improve outcomes for children Bench officers should call cases sooner when a Social Worker is present. Train the Court on what social workers do to establish more respect. More social workers. More CASA workers. Social Worker Focus Group Workforce Development What’s Working Well Court Services Cohort worked well as a support in providing in-depth and thorough training and the time to learn the work. Peer trainers. Public Health Nurses at the Children’s Receiving Home Safety Organized Practice (SOP). Winscribe works. Wellness Incentives. Challenges High caseloads. Overall training plan is needed. Recommend Using retirees or line staff to train on how to do the job. Peer mentoring money is not worth it. Too many part-time positions for Child Development Specialists (CDS). Child Development Specialists (CDS) and Family Service Workers (FSW) are not trained for the population’s higher needs. Child Development Specialists (CDS) and Family Service Workers (FSW) need trauma training. There is lack of constructive feedback and acknowledgement of good work. Social Workers are unable to obtain clinical hours to obtain their license. Lack of flexible work hours (4/10’s, 9/80’s, telecommuting). Peer mentors need to be utilized more. More wellness activities are needed. More communication is needed internally between social workers, Family Service Workers (FSW), and Child Development Specialists (CDS). 196

California - Child and Family Services Review Next Steps  Look at school website to see how they communicate with parents and how can we use our intranet better.  People do not know who does what – provide a profile once a month.  Use staff with skills and retirees to help train.  Explore a 3 or 5 day response time for referrals.  Comfort Room at CPSU should be separate from CPS staff space.  Move CPSU location to a safer area of Sacramento.  Training Child Developmental Specialists on mental health issues and how to handle children with challenging and dangerous behaviors.  CPS being present in the community at fairs and festivals.  Cross program shadowing.  More communication between line staff and management (build morale).  Wellness timeouts/incentives/stipends.  Share positive outcome cases/positive stories.  Ongoing regular feedback including consistent evaluations.  Peer Mentors.  Peer support team for debriefing. Appendix C – CPS Division Organizational Chart See Below Appendix D – CPS Service Delivery / Court Process Flow Chart See Below197