Front End Redesign:  Serving Children Effectively Starting with the Right Assessment November 18 th , 2004 Dependency Cour...
Today’s Presenters Gregory J. Kurth, MA  Executive Vice President Dr. Fotena Zirps, PhD. Senior Vice President for Program...
Why Redesign Orange/Osceola State Nation Abuse Reports (% of Child Population) Substantiations (% of Reports) Removals (% ...
Essentially, the Removal Rate per 1000 in Orange and Osceola was 32 % above State Average 75% above National Average
Some Facts <ul><li>59% of children who died of abuse and/or neglect in 2002 had 5+ major risk factors: </li></ul><ul><li>P...
… More Facts <ul><li>Pattern of escalating and/or continuing incidents of domestic violence (25% of deaths). </li></ul><ul...
Why Implement Change? <ul><li>Many Children are Entering Care Unnecessarily; </li></ul><ul><li>Some child/abuse victims ma...
Front-end Redesign Principles <ul><li>Community Involvement </li></ul><ul><li>Safety Focus  </li></ul><ul><li>Engagement B...
Safety versus Risk Potential Harm  Longer Term Lower to Moderate Degree Mitigation (long term) Now or Near Future Higher D...
New Tools for the  Front-End Process <ul><li>SAFETY ( C hild  E ndangerment  S afety  A ssessment  P rotocol -- CESAP) </l...
C hild  E ndangerment and  S afety  A ssessment  P rotocol
CESAP Requirements <ul><li>A ‘life of the case’ protocol. </li></ul><ul><li>Assessing moderate to severe harm immediately ...
Safety Determination Form   <ul><li>For Child Protective  Investigations : </li></ul><ul><li>Within 24 hours of CPI seeing...
Safety Determination Form  (continued)   <ul><li>For Child Protective  Services : </li></ul><ul><li>Within 5 working days ...
Exercise 1
Exercise 2
Safety Planning <ul><li>Must address issues identified on CESAP. </li></ul><ul><li>Must ensure safety of child if implemen...
<ul><li>CORRECT SERVICES </li></ul><ul><li>CORRECT MODE OF COMMUNICATION </li></ul><ul><li>CORRECT TIMING </li></ul><ul><l...
Exercise 3 “ Here’s the real test!”
C alifornia  F amily  R isk  A ssessment
California Family Risk Assessment <ul><li>Quantifies a Risk Score of Low, Medium, High, Very High </li></ul><ul><li>Compos...
Putting It All Together <ul><li>SAFETY: </li></ul><ul><li>If SAFETY FACTORS exist and SAFETY PLAN is appropriate, refer to...
Family Assessment and Service Tool (FAST) *Depends on legal sufficiency   OHC Unwilling/Unable Unsafe High risk PS Willing...
The Resource Specialist Functions as a ‘resource’ for placement stabilization via consultation. Works closely with the CPI...
Community Based Interventions <ul><li>Where the risk to the child is deemed  low  to  moderate , FSMO will fund services t...
Summary <ul><li>Ineffectively rendered child protective services are  dangerous  to children and destructive of families. ...
Summary  continued <ul><li>Services must be relevant to the issues presented by families and must be rendered with a sense...
2600 Technology Drive, Suite 250, Orlando, Florida  32804 Tel: 407-398-7975  Fax: 407-578-0074  www.fsmetroorlando.org
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Front End Redesign: Serving Children Effectively Starting with the Right Assessment

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This was a presentation on evidence-based practices for child welfare safety assessments. The presentation created a comprehensive framework for rationalizing safety decisions and planning with services.

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Front End Redesign: Serving Children Effectively Starting with the Right Assessment

  1. 1. Front End Redesign: Serving Children Effectively Starting with the Right Assessment November 18 th , 2004 Dependency Court Improvement Summit Orlando, FL
  2. 2. Today’s Presenters Gregory J. Kurth, MA Executive Vice President Dr. Fotena Zirps, PhD. Senior Vice President for Program Excellence
  3. 3. Why Redesign Orange/Osceola State Nation Abuse Reports (% of Child Population) Substantiations (% of Reports) Removals (% of Substantiations) Removals (per 1,000 of Child Population) 7.0 5.3 4.0 8.2% 4.2% 8.9% 31.6% 36.5% 29.4% 20.3% 25.6% 26.4%
  4. 4. Essentially, the Removal Rate per 1000 in Orange and Osceola was 32 % above State Average 75% above National Average
  5. 5. Some Facts <ul><li>59% of children who died of abuse and/or neglect in 2002 had 5+ major risk factors: </li></ul><ul><li>Patterns of escalation or frequency of incidents of abuse or neglect (47% of deaths). </li></ul><ul><li>Caregiver unable to meet children’s immediate needs (44% of deaths). </li></ul><ul><li>Caregiver’s age, mental health, alcohol or substance abuse affected their ability care for the child ( 42% of deaths). </li></ul><ul><li>Caregiver’s criminal history presented a potential threat of harm (31% of deaths). </li></ul>
  6. 6. … More Facts <ul><li>Pattern of escalating and/or continuing incidents of domestic violence (25% of deaths). </li></ul><ul><li>Living conditions were physically hazardous to the health of the child (23% of deaths). </li></ul><ul><li>Caregiver was unable or unwilling to protect the child from abusive caregivers/paramours (25% of deaths). </li></ul>
  7. 7. Why Implement Change? <ul><li>Many Children are Entering Care Unnecessarily; </li></ul><ul><li>Some child/abuse victims may be remaining home who should be placed; </li></ul><ul><li>In-Home families are not receiving effective child protective services; </li></ul><ul><li>The System has not clarified the difference b/w Risk and Safety </li></ul><ul><li>Workers lack prescriptive guidelines </li></ul>
  8. 8. Front-end Redesign Principles <ul><li>Community Involvement </li></ul><ul><li>Safety Focus </li></ul><ul><li>Engagement Based Practice </li></ul><ul><li>Prescription </li></ul><ul><li>System Integration </li></ul><ul><li>Responsiveness </li></ul><ul><li>Relentless Management </li></ul><ul><li>& Quality Improvement </li></ul>
  9. 9. Safety versus Risk Potential Harm Longer Term Lower to Moderate Degree Mitigation (long term) Now or Near Future Higher Degree Prevention (short term)
  10. 10. New Tools for the Front-End Process <ul><li>SAFETY ( C hild E ndangerment S afety A ssessment P rotocol -- CESAP) </li></ul><ul><li>RISK (California Family Risk Assessment: Structured Decision Making Risk Tool) </li></ul>
  11. 11. C hild E ndangerment and S afety A ssessment P rotocol
  12. 12. CESAP Requirements <ul><li>A ‘life of the case’ protocol. </li></ul><ul><li>Assessing moderate to severe harm immediately or in the near future. </li></ul><ul><li>Safety Determination Form. </li></ul><ul><li>Safety Plan. </li></ul>
  13. 13. Safety Determination Form <ul><li>For Child Protective Investigations : </li></ul><ul><li>Within 24 hours of CPI seeing the child. </li></ul><ul><li>Whenever circumstances suggests change in child’s safety status (I.e. new person(s) in the home; illness of child, etc.). </li></ul><ul><li>Every 5 working days following the determination that any child in a family is unsafe and a safety plan is implemented (Until evidence and circumstances indicate otherwise) . </li></ul><ul><li>At the conclusion of the investigation. </li></ul>
  14. 14. Safety Determination Form (continued) <ul><li>For Child Protective Services : </li></ul><ul><li>Within 5 working days after initial case assignment. </li></ul><ul><li>Every 3 months from case opening. </li></ul><ul><li>When considering closure of an in-home case. </li></ul><ul><li>Every 5 working days following the determination that any child in a family is unsafe and a safety plan is implemented. </li></ul><ul><li>Whenever evidence or circumstances suggest that the child’s safety status may have changed. </li></ul>
  15. 15. Exercise 1
  16. 16. Exercise 2
  17. 17. Safety Planning <ul><li>Must address issues identified on CESAP. </li></ul><ul><li>Must ensure safety of child if implemented. </li></ul><ul><li>Must not be used if child’s safety can’t be assured. </li></ul>Safety Plan Termination <ul><li>When safety factors are no longer evident. </li></ul><ul><li>Must be predicated on safety and not ‘task completion.’ </li></ul><ul><li>Risk may be present and ongoing. </li></ul>
  18. 18. <ul><li>CORRECT SERVICES </li></ul><ul><li>CORRECT MODE OF COMMUNICATION </li></ul><ul><li>CORRECT TIMING </li></ul><ul><li>CORRECT AMOUNT </li></ul><ul><li>CORRECT CONDITIONS </li></ul><ul><li>CORRECT MONITORING </li></ul>Essential Elements of a Safety Plan
  19. 19. Exercise 3 “ Here’s the real test!”
  20. 20. C alifornia F amily R isk A ssessment
  21. 21. California Family Risk Assessment <ul><li>Quantifies a Risk Score of Low, Medium, High, Very High </li></ul><ul><li>Composed of two Indices: Neglect and Abuse </li></ul><ul><li>Like CESAP, assesses current allegations </li></ul><ul><li>Unlike CESAP, looks at prior abuse and CPS history </li></ul><ul><li>Assesses characteristics of well-being of children </li></ul>
  22. 22. Putting It All Together <ul><li>SAFETY: </li></ul><ul><li>If SAFETY FACTORS exist and SAFETY PLAN is appropriate, refer to VPS or Court-ordered PS; </li></ul><ul><li>If no SAFETY PLAN is viable, then refer for OHC </li></ul><ul><li>RISK: </li></ul><ul><li>NO SAFETY FACTOR exists </li></ul><ul><li>If low to moderate, refer for community services </li></ul>
  23. 23. Family Assessment and Service Tool (FAST) *Depends on legal sufficiency OHC Unwilling/Unable Unsafe High risk PS Willing/Able Unsafe High risk PS Unwilling/Unable Safe High risk Highly Unlikely Scenario Willing/Able Safe High risk OHC Unwilling/Unable Unsafe Moderate risk VPS or PS Willing/Able Unsafe Moderate risk PS or Nothing * Unwilling/Unable Safe Moderate risk CBI Willing/Able Safe Moderate risk PS or OHC* Unwilling/Unable Unsafe Low risk VPS Willing/Able Unsafe Low risk Nothing Unwilling/Unable Safe Low risk CBI or I&R Willing/Able Safe Low risk Service Alternative Willing and/or Able Safety Risk
  24. 24. The Resource Specialist Functions as a ‘resource’ for placement stabilization via consultation. Works closely with the CPI on diverting children from coming into care. Conducts and maintains a ‘mapping’ of the community’s ‘traditional’ and ‘non-traditional resources. Assists the CPI in the assessment of safety vs. risk. Consults with the CPI in the development of a safety plan. Assists in generating referrals for CBA services. Continuously assesses ‘gaps’ in services. Assists the CPI in the diligent search for relative placements.
  25. 25. Community Based Interventions <ul><li>Where the risk to the child is deemed low to moderate , FSMO will fund services that will: </li></ul><ul><li>Limit number of families entering the child welfare system; </li></ul><ul><li>Engage families in the change process at every level; </li></ul><ul><li>Use safety/risk assessment to inform case management decisions; </li></ul><ul><li>Marshalling of local services to children & families. </li></ul>“ Check out our RFQ on www.fsmetroorlando.org for a Diversion/Prevention Initiative!”
  26. 26. Summary <ul><li>Ineffectively rendered child protective services are dangerous to children and destructive of families. </li></ul><ul><li>Focus on situations where children’s safety is threatened and rely on the community to respond to lower risk situations. </li></ul><ul><li>We must engage families in the effort to keep their children safe. </li></ul>
  27. 27. Summary continued <ul><li>Services must be relevant to the issues presented by families and must be rendered with a sense of urgency. </li></ul><ul><li>The new system of care must have the capacity for monitoring its effectiveness and for self correction. </li></ul><ul><li>The End </li></ul>
  28. 28. 2600 Technology Drive, Suite 250, Orlando, Florida 32804 Tel: 407-398-7975 Fax: 407-578-0074 www.fsmetroorlando.org
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