State/Federal Virtual Stakeholder Meeting for the CFSR 3rd Round Performance Improvement Plan Children and Family Services Division – Cory Pedersen, Director Rethinking Child Welfare in North Dakota
February 2, 2021 – 10:00am to Noon February 3, 2021 – 10:00am to Noon February 5, 2021 – 10:00am to Noon • Welcome and Overview • Welcome and Overview • Welcome and Overview Cory Pedersen/Lauren Sauer Cory Pedersen/Lauren Sauer Cory Pedersen/Lauren Sauer • Quality Assurance and Continuous Quality • Realign Service Delivery System • Timely Permanency/Recruitment and Improvement Retention Diana Weber Leanne Miller/Lauren Sauer Kelsey Bless/Heather Traynor • Discussion/Federal Q&A • Discussion/Federal Q&A • Discussion/Federal Q&A Participants Participants Participants • Closing • Closing • Closing Cory Pedersen/Lauren Sauer Cory Pedersen/Lauren Sauer Cory Pedersen/Lauren Sauer
Background • Child and Family Services Review in 2016 • PIP Approved April of 2019 • PIP Runs to March 31, 2021 • PIP Measurement Period currently extends to March 31, 2022 (or at the state option September 30, 2022)
Goal 1: Design and implement a Continuous Quality Improvement process to identify the strengths and needs of the service delivery system; monitor and evaluate the system changes to positively impact outcomes for children and families. • Systemic Factor Item 25: Quality Assurance • Strategy 1.1: Implement a statewide case review process by completing a review of System randomly sampled foster care and in-home services cases in each North Dakota region once per year to evaluate safety, permanency, and well-being outcomes. Implement a process to gather stakeholder input related to Systemic Factor Item functioning in each North Dakota region once per year. • Strategy 1.2: Create a Theory of Constraints (TOC) Administrative Team to guide the quality improvement efforts and recommend and support practice improvements and quality services that promote the achievement of safety, permanency, and well- being outcomes for children and families beyond the CFSR and PIP.
Goal 2: Ensure safety for children and well-being for children and families by improving caseworker’s skills and engaging the court to increase family engagement, thoroughly assessing and addressing identified risk and safety factors and providing services quickly and effectively. • Safety Outcome 2: Children are safely • Strategy 2.1: Implementing intensive safety-informed supervision to ensure maintained in their homes whenever possible comprehensive risk and safety assessments and high-quality case worker visits and appropriate. with children and families. • Wellbeing Outcome 1: Families have • Strategy 2.2: Increase family engagement through collaboration between the enhanced capacity to provide for their counties and juvenile justice which makes services required findings part of the children’s needs. court record, holds caseworkers accountable to the court and encourages family participation. • Systemic Factor Item 20: Written Case Plan • Systemic Factor Item 26: Initial Staff Training • Strategy 2.3: Develop systems, using Theory of Constraints, that will decrease the • Systemic Factor Item 27: Ongoing Staff Training amount of time from CPS assessment to the start of in-home services. • Systemic Factor Item 29: Array of Services • Systemic Factor Item 30: Individualizing • Strategy 2.4: Develop guidance to incorporate needs assessment for children, parents, and foster parents throughout the life of the case. Services
Goal 3: Realign the service delivery system to engage and empower families earlier in the case to improve outcomes and inform practice • Safety Outcome 2: Children are safely • Strategy 3.1: Implement Family Centered Engagement (FCE) in collaboration with maintained in their homes whenever possible Dual Status Youth Initiative (DSYI) statewide to engage families in the development and appropriate. of case plans, facilitate the sharing of information and resources, and reduce foster care placement rates. • Permanency Outcome 1: Children have permanency and stability in their living • Strategy 3.2: Implement workflow improvements, policy supports, and technical situations. assistance to the workforce that promote engagement with absent (nonresident) parents. • Permanency Outcome 2: The continuity of family relationships and connections is preserved for children.
Goal 4: North Dakota will experience increased achievement of timely permanency. • Permanency Outcome 1: Children have • Strategy 4.1: Implement strategies to improve the termination of parental permanency and stability in their living rights (TPR) process in identified areas of the state, which will increase situations. achievement of timely permanency. • Systemic Factor Item 23: Termination of Parental • Strategy 4.2: Utilize collaborative organizational structures (TOC Rights Administrative Team and CIP Task Force) to inform practice specific to the achievement of timely permanency. • Strategy 4.3: Reduce the use of out of home placements to improve outcomes for children and families. • Strategy 4.4: Increase availability of guardianship subsidies to support permanency timeliness for foster children.
Goal 5: Strengthen and reframe the statewide foster and adoptive parent diligent recruitment plan to support the recruitment of families who meet the needs of the children they serve and who reflect the ethnic and racial diversity of children served by the foster care program • Permanency Outcome 1: Children have • Strategy 5.1: Enhance statewide recruitment and retention efforts to increase the permanency and stability in their living number of specific and specialized family foster and adoptive homes, as well as situations. locate relative placement options so that the diversity and needs of children in placement are supported. • Systemic Factor Item 35: Diligent Recruitment of Foster and Adoptive Homes • Strategy 5.2: Enhance statewide recruitment and retention efforts to increase the number of adoptive homes to reduce the number of children awaiting timely • Systemic Factor Item 36: State Use of Cross- permanency when parental rights have been terminated. Jurisdictional Resources for Permanent Placements • Strategy 5.3: Implement diligent recruitment to increase the number of Native American foster homes and create ICWA resources and training, which will improve ICWA placement preference compliance.
PIP Virtual Stakeholder Meeting February 2, 2021 – 10:00am to Noon February 3, 2021 – 10:00am to Noon February 5, 2021 – 10:00am to Noon • Welcome and Overview: • Welcome and Overview: • Welcome and Overview: Cory Pedersen/Lauren Sauer Cory Pedersen/Lauren Sauer Cory Pedersen/Lauren Sauer • Quality Assurance and Continuous Quality • Realign Service Delivery System • Timely Permanency/Recruitment and Improvement Retention Diana Weber/Amy Oelke Leanne Miller/Lauren Sauer Kelsey Bless/Heather Traynor • Discussion/Federal Q&A • Discussion/Federal Q&A • Discussion/Federal Q&A Participants Participants Participants • Closing: • Closing: • Closing: Cory Pedersen/Lauren Sauer Cory Pedersen/Lauren Sauer Cory Pedersen/Lauren Sauer
• Leanne Miller, QA Unit Manager • Lauren J. Sauer, Assistant Director Quality Assurance and Continuous Quality Improvement
• No integrated and coordinated process for QA activities • Contracted QA but no CQI • Creation of the Quality Assurance Unit
• PIP Baseline Review between January – March 2020 • QA Case Reviews in accordance with the PIP Measurement Plan • Operated in accordance with the Round 3 Procedures Manual
• Stakeholder input related to Systemic Factor Item • Case Record Review • Stakeholder Surveys
The Issue • No coordinated processes to Identify and Research the problem & Develop, Implement and Monitor the solution. • Improve outcomes for children and families.
The Solution • Design and implement a Continuous Quality Improvement program
What Are We Doing, Where Are We Going, & What Are/Will Be the Fruits of Our Labor??? • Technical Assistance from the Capacity Building Center for States • Implementation of a Theory of Constraints Administrative Design Team • Subcommittees focused on • Teaming, Staff/Stakeholder Participation, Training • CQI Cycle and Theory of Constraints • Data Collection and Dissemination • Development of CQI Plan • Development of CQI Procedural Manual
Engaged Data-Informed Solution-focused Theory of Constraints-informed Continuous Quality Improvement Program
Good morning!
February 3, 2021 OWveelcrovmieew& Cory Pedersen Lauren Sauer RDeealivliegrnySSeyrsvtiecem Diana Weber
Transformational Practice Change Remarkable Convergence Timeline
Transformational Practice Change Ch-ch-ch-ch-changes (YIKES!) How it felt in ‘real time’
Intake Gather information related to present and impending danger threats Triage, urgency, and response time decisions SFPM Workflow Process Assessment Initiation Assess for present danger threats Create Present Danger Plan when necessary CPS Assessment Manage Present Danger Plan as indicated Collect information related to safety information policy, process, and practice protocol Safety Assessment at the Conclusion of the CPS Assessment Determine if maltreatment finding requires protective services & identify maltreatment Identify impending danger threats operating in the family type & level of intervention required to control the threats Safety Determination Analysis and Planning Determine how impending danger is manifested in Evaluate parent/caregiver protective Determine if child is safe or unsafe If unsafe, create a Safety Plan the family capacities Case Transition Staffing Review and manage the safety plan Share full kit of assessment information with case management Protective Capacity Family Assessment (PCFA) and Case Plan Identify parent/caregiver protective capacities associated with Identify and implement interventions to address impending danger & Identify ways to measure the effectiveness impending danger threats parent/caregiver protective capacities of interventions Protective Capacity Progress Assessment (PCPA) Measure and evaluate progress related to decreasing impending danger threats and enhancing Revise Case Plan & Safety Plan as necessary parent/caregiver protective capacities Case Closure Confirm the existence of a safe home Warm handoff to the family
Transformational Practice Change Foundational Support Tools • 8 forms, 4 hardcards • Ongoing revisions has requested/needed 12.14.20 • Official roll out
Transformational Practice Change Foundational Support Policy rewrites • 607-05 Child Welfare Practice Policy Manual • 640-01 Child Protection Services • 610-05 In-Home Case Management • More to come as Foster Care is redesigned
Transformational Practice Change Part I SFPM Training Timeframe: August – November 2020 Participants: 9 cohorts • Supervisors first • CPS workers, IH/FC case managers • HSZ directors • Field service specialists • CFS program administrators, QA unit • Tribal child welfare Prerequisite training: “Primer” Curriculum: Safety Assessment, Planning, and Management; TOC concepts Training materials: Tools/forms, resource guide, FAQs, Program redesign, FRAME changes
Transformational Practice Change Ongoing Coaching & Support Coaching Teams Supervisor Support sessions FAQs Tool revisions • Added hardcard 3B based on coaching team feedback • Ongoing form revisions based on user feedback
Transformational Practice Change Informing Child Welfare Partners
Transformational Practice Change Part II SFPM Training Timeframe: January – April 2021 Participants: 11 cohorts • Supervisors first • CPS workers, IH/FC case managers • HSZ directors • DJS supervisors and case managers • Field service specialists • CFS program administrators Prerequisite: Part I SFPM training (or 4-hour presentation, if DJS or tribal child welfare)
Transformational Practice Change Safety Framework Under Construction Updating child welfare certification curriculum Motivational Interviewing being planned SFPM Refreshers FAQs HSZ-specific technical assistance Weekly meetings between CFS program administrators and FSS’s assigned to IH/FC programs Practice Fidelity QA
Break, please?
SB2124 + (SFPM + PDP + SP + PCFA + CP + PCPA²) x (DHS + CFS + FSS) + CFSTC + HSZ – COVID = PIP Safety Framework and PIP Goals 2 & 3
Key Practice Area Safety-Informed Supervision Challenges • Lack of consistent supervision • Lack of initial/ongoing training • Few tools available Varied application of practice • requirements Vision Develop safety-informed • supervision model • Train and implement the model • Assess fidelity to the model
SFPM Application Safety-Informed Supervision identify and New direction control present Supervisor role clarified Supervision tools danger Fidelity checks case closure gather information, identify impending danger threats, and develop safety plan protective Safety assess parent/ capacities Framework caregiver progress protective Practice assessment with capacities child and family team case planning complete with child and protective capacities family team family assessment
SFPM Application Safety-Informed Supervision Supervision guides
SFPM Application Safety-Informed Supervision Quality at the Source • Clearly identifying quality work • Requiring standard work • Ensuring efforts deliver expected outcomes Multiple levels of QA CPS workers & case managers Supervisors Field service specialists
Key Practice Area Collaboration & Case Transitions Challenges • Lack of consistent communication between HSZ and juvenile court in Services Required cases which contributed to insufficient family engagement in services • Delays in transitioning cases from CPS to In-Home Vision • Revise, test, and disseminate protocol related to juvenile court and HSZ collaboration for substantiated cases • Identify bottlenecks for case transitions and implement new protocols to assure timely handoff
Juvenile Court Changes Collaboration & Case Transitions Expanded collaboration • South Central judicial district • Southeast judicial district • Statewide dissemination More data to come as expansion occurs • Data not expected until after PIP implementation period ends
SFPM Application Collaboration & Case Transitions TOC concepts to impact case transition timeliness • Full kitting a case • Warm handoffs • Blue light time • Protected time Warm Handoff 2 – Case Transition Staffing • Formalized process • Present Danger assessment and plan • CPS assessment • Safety determination and safety plan • Strategy for family engagement
Key Practice Area Comprehensive Needs Assessments Challenge • Lack of consistency in completing quality assessments Vision • Evidence-based assessment tool • Technical assistance • Checklists
SFPM Application Comprehensive Needs Assessments
Key Practice Area Family Engagement Challenges • Lack of early engagement with families • Lack of absent parent engagement Vision • Family Centered Engagement meetings • Policy revisions • Visual depiction of the workflow process • Train skills to effectively engage families in assessment process • Technical assistance • Evaluate fidelity
SFPM Application Family Engagement FCE statewide as of 07.01.2020
SFPM Application Family Engagement 610-05 In-Home Case Management policy manual SFPM workflow process in place Training in process Technical assistance will be ongoing Fidelity evaluation of SFPM
RECRUITING FOSTER OR ADOPTIVE PARENTS
GOAL 5~ STRENGTHEN AND REFRAME THE STATEWIDE FOSTER AND ADOPTIVE PARENT DILIGENT RECRUITMENT PLAN TO SUPPORT THE RECRUITMENT OF FAMILIES WHO MEET THE NEEDS OF THE CHILDREN THEY SERVE AND WHO REFLECT THE ETHNIC AND RACIAL DIVERSITY OF CHILDREN SERVED BY THE FOSTER CARE PROGRAM (PERMANENCY OUTCOME 1, SYSTEMIC FACTOR ITEMS 35 & 36). Enhance statewide recruitment and retention efforts to increase the number of specific and specialized family foster and adoptive homes, as well as locate relative placement options so that the diversity and needs of children in placement are supported. Enhance statewide recruitment and retention efforts to increase the number of adoptive homes to reduce the number of children awaiting timely permanency when parental rights have been terminated. Implement diligent recruitment to increase the number of Native American foster homes and create ICWA resources and training, which will improve ICWA placement preference compliance.
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