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Court-Based Child Welfare Reforms: Improved Child/Family Outcomes and Potential Cost Savings Webinar


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Court-Based Child Welfare Reforms: Improved Child/Family Outcomes and Potential Cost Savings Webinar

  1. 1. SPARC Webinar September 5, 2012Family Wellness Court Judge Erica Yew California Superior Court Santa Clara County 1
  2. 2. Trauma-Informed CourtExtension of Problem-Solving Courts What is it and WHY? Therapeutic alliance  Vivian Brown: 50 to 60% of outcome rests upon a positive therapeutic alliance  Only 1 to 2% is related to the treatment model or methodology used  20 years of adult drug court research indicates that the #1 incentive for people is their relationship with their judge or their probation officer 2
  3. 3. Considerations for a Trauma-Informed Court Taking your time, even if it is an illusion Reduce waiting if possible Noise Setting Listening and validating where possible HONESTY RESPECT HOPE TRANSPARENCY: Clear communications and expectations 3
  4. 4. Trauma-Informed Systems FWC values statement includes trauma- informed system Commitments by Partner Agencies Provider education Continual system assessment and modification – 360 assessment Trauma specific services: DADS Seeking Safety (PTSD and addiction), Mental Health trauma based cognitive behavioral therapy 4
  5. 5. FWC Overview Target population: Pregnant women and parents, with children 0 to 3, whose abuse of methamphetamine and other substances have placed their children in or at risk of out-of-home placement. Ten year experience, repeated subsequent pos-tox births Started with grant in March 2008 5
  6. 6. FWC Primary Partners for Grant US$ 6.3 million over 5 years Superior Court Social Services Agency (SSA), SSA’s Department of Family and Children’s Services (DFCS) and SSA’s County Counsel First 5 Department of Drug and Alcohol Services (DADS) County Mental Health (MH) Legal Advocates for Children and Youth (LACY) – children counsel Dependency Advocacy Center (DAC) – parents counsel 6
  7. 7. Primary FWC Goals (1) Early identification of and intervention for the needs of pregnant women and parents with substance use disorders. Rapid engagement and successful retention in treatment and care Reduction in subsequent pos-tox births 7
  8. 8. Primary FWC Goals (2) Early identification and intervention for developmental delays, disabilities and concerns for children 0-3 whose parents come before the FWC Creation of a comprehensive System of Care across all systems serving children in or at risk of out-of-home placement as a result of parents’ methamphetamine and other substance abuse 8
  9. 9. FWC Eligibility Criteria The parent has given birth to an infant that has been exposed to methamphetamine or other substance abuse during the pregnancy; OR The parent has a child under the age of three that was either born drug exposed or has been raised in a substance abuse afflicted environment with documented abuse and/or neglect; AND The parent does not demonstrate intractable mental health issues as presented in the filed petition; AND The parent is not likely to face long term incarceration 9
  10. 10. FWC Customer Characteristics Fast-track cases History of CWS involvement as children 40% were foster children themselves Prior cases in CWS, many with prior termination of parental rights, 9 prior births, multiple pos-tox births 10
  11. 11. More Customer Characteristics  Extensive trauma history (give examples – multiple deaths, abandonment, kidnapping, prostitution as 8 yo)  80% cross over with DV  90% incarceration history 11
  12. 12. More about Customer Characteristics Methamphetamine primary drug of choice: national, state and local data indicate that 75-80% of child welfare cases are drug and alcohol related. In Santa Clara County the drug of choice is methamphetamine where preference is around 64-67%. Homeless or living in substandard housing, 65% chronic homelessness Extremely low income, 66% have annual income of less than $10,000  TWD $ 285,000  Average California income US$ 61,017  Average U.S. income US$ 52,029  Federal Poverty Level for parent and 1 child US$ 14,570 12
  13. 13. FWC Services (1) Therapeutic court environment, with regular reviews Early connection to TANF, food stamps, other programs Case management by the court Legal representation Early drug and alcohol assessment and treatment Residential inpatient-treatment for women; and for women with their children Transitional Housing Units (THU) for women, men, children Mentor Parent support Domestic violence advocacy and services Transportation assistance (bus tokens, bus tokens for children, bicycles, car seats) Linkages to shelter and housing 13
  14. 14. FWC Services (2) Limited funding to assist with barriers to case plan completion (books, birth certificates, funeral transportation) Linkages to employment and benefits services, record clearance Coordination with Criminal Court partners, fine conversion Therapeutic services, dyadic and PCIT included Pregnancy prevention education Comprehensive developmental and behavioral screening, assessment and interventions for all children Child appointed special advocates (CASA’s) for many children and parents = an extension of role 14
  15. 15. FWC Services (3) Linkage to health coverage and primary care physicians Linkage to dental and vision care through charitable organizations Access to a wide array of parenting classes Home visitation and Public Health Nurses with regular reporting – transparency Diapers, children’s and adult clothing & shoes, hygiene products, groceries/meals, milk, books, toys, strollers Early care and education services GED assistance Language assistance Budget and nutrition information and workshops Medical and dental health care for children Tattoo removal and MORE…. 15
  16. 16. Children’s Services Overview Funded by FIRST 5 Santa Clara County Medi-Cal/EPSDT (Early Periodic Screening and Diagnosis and Treatment) is leveraged MHSA (Prop 63: Mental Health Services Act – 1% income tax on excess of personal income of $1 million), County General Fund and reimbursement via public children’s insurance programs are also utilized for Mental Health services System of Care: Tiered system based on level of need as determined by screening and assessments utilizing standardized tools and evidence-based practices 16
  17. 17. FWC Multidisciplinary Team/MDT Judge  Social Work Liaison Court Resource  County Counsel Manager  Child’s Attorney DV/Trauma Therapist  Parent Victim Witness  Parent’s Attorney & Advocate♦ Mentor Eligibility Worker  Social Worker Child Advocate  Therapist  Home Visitor DADS rehab counselor  Public Health Nurse Adult MH Coordinator♦  Special Support People First 5 Specialist (SARC, parent advocates) 17
  18. 18. FWC Hearings Hearings may occur daily, weekly, twice a month or once monthly depending on parent progress Staffings are held with the court team prior to the hearing to discuss case progress, concerns and develop joint recommendations – COMPREHENSIVE Incentives or Sanctions may be given Resources given 18
  19. 19. FWC Data Doors Opened March 14, 2008 As of April 2011, data below:  1 to 2+ years of services per family (FR → FM) 290 parents served  3 re-entries (mental health and housing) in 3 years  11-12% re-entry rate in California  1 subsequent pos-tox births in 3 years (despite many births and population that had repeated prior pos-tox births, mothers with 8 children previously removed) 19
  20. 20. More about the Results Santa Clara County Reunifications Rates  2009 = 48%, no separate tracking for Fast Track cases  2010 = 53%, FWC may be improving general outcomes  FWC as of September 2010 for Fast Track cases = 71% 350 children served  100% of children whether parents succeed or not 20
  21. 21. Primary Keys to Success Commitment at highest agency administrative levels Shared values Passion and commitment of involved staff Comprehensive service model Service model that evolves as additional client needs are identified Incorporation of the parents’ voices (through mentors and the actual parents before the court – surveys, court experience) Promoting the parent-baby bond 21
  22. 22. Joanne Moore, DirectorWashington State Office of Public Defense
  23. 23. Why was the Parents Representation Program Started? 1999 Report for the Legislature:  State of Parents’ Attorneys  Excessive Caseloads and Low Pay  Little Time to Communicate with Parents  or Help them Engage  Frequent Continuances and Case Delays
  24. 24. Program Model Reasonable Attorney Caseloads Program Social Workers Funds for Independent Experts Frequent Trainings Central Support
  25. 25. OPD Parents Representation Program Pilot 2000‐2005 Expanded to 2/3 of Washington State 6,700 Open Cases Fully Funded by State Funds – Right to Counsel
  26. 26. New Practice Standards Parents Representation Program Standards Addressed  Substandard Practices Standards Lead to Improvements:  Enhanced Communication   Early Parent Engagement   Increased Access to Services and Visitation   Timely Case Resolution
  27. 27. Evaluations and Data Four Small Evaluations During the Pilot 2010 OPD and 2011 Washington State Center for  Court Research OPD Program Counties Improved Reunification Rates  While Non‐Program Counties Did Not45.0%40.0%35.0%30.0%25.0%20.0%15.0% OPD Counties Non OPD Counties Pre Program Period Post Program Period
  28. 28. Child Welfare System Impact Before Parents Representation Program, parents and their  attorneys were virtually absent from the statewide policy  decisions Policy contributions over the last decade by the Parents  Representation Program include:  Membership in statewide committees such as the state  Supreme Court Foster Care Commission and Catalyst for  Kids’ Washington State Parent Advocacy Committee  Collaboration with the department and other stakeholders to  develop Expert and Evaluator Guidelines  Local projects such as visitation centers and family treatment  court
  29. 29. The Permanency Project
  30. 30. The Team Anne Marie Lancour, M.A.T., J.D. Heidi Redlich Epstein, J.D., M.S.W. Mimi Laver, J.D. Kathleen McNaught, J.D. Elizabeth Thornton, J.D. Cristina Cooper, J.D. Jeffrey Adolph, J.D. Margaret Burt, J.D.Honorable Stephen Rideout (ret.) , J.D. Scott Trowbridge, J.D.
  31. 31. Goal: Reduce children’s stay in foster care• Help children in foster care find safe,permanent homes, faster• Identify and break down systembarriers to permanency• Save scarce state and county dollars• Train on best practices that promotepermanency
  32. 32. • Our CQI Process • ABA measures success through Continuous Quality Improvement (CQI) • ABA identifies system changes to improve permanency outcomes • ABA visits counties monthly during project period and develops tools and procedures • ABA develops county network and shares solutions statewide
  33. 33. Key Project Components• Advisory Board Comprised of family or juvenile court Judges and Masters, local child welfare agency administrators, attorneys, key agency staff, and a range of other stakeholders.• ABA Project Director Visits the project county monthly to work with the Advisory Board• Permanency Planning Specialist
  34. 34. Our Approach• Develop local action plan• Recognize small steps add up to change• Keep permanency planning focus• Identify childrens needs early• Refine court procedures in permanency areas• Provide legal analyses and technical assistance
  35. 35. Project Tasks The project undertakes five major tasks:1. Identifying and analyzing delays;2. Interactively developing recommendations and implementing reforms;3. Establishing written protocols, procedures, and providing multidisciplinary training;4. Monitoring reforms and changes; and5. Sharing project results throughout the state.
  36. 36. Overcoming Barriers• Missing or unidentified parents• Relatives entering the case late• Increase in teen population• Lack of training on permanency planning issues• Late starts in offering services• Inadequate concurrent planning• Difficulty in obtaining evaluations and/or expert testimony• Delays in court procedures
  37. 37. Case Data Drives Change • Staff analyze cases, tracking how long it takes a child to achieve permanency • Collect data and detect trends to both create solutions and measure outcomes • Project targets key skills and topics for improvement based on data review
  38. 38. • Pennsylvania Results • Over 20 project counties • Children in PA project counties have saved an average of 9 months in foster care before finding permanent homes. • Counties have saved a total of $9,460,000 - and counting - in foster care costs. • Better court-agency communication and increased investment in improved outcomes for children and families.
  39. 39. Pennsylvania Results, Cont. The Project has provided over 35 unique trainings in Pennsylvania countiesExamples include:• The relationship between ASFA, permanency, andsubstance abuse treatment• Trial testimony skills for caseworkers and serviceproviders• Strategies to meet the education needs of children infoster care• Older youth in foster care and APPLA as a permanencygoal as well as alternatives to it
  40. 40. PA Results: County Examples• Blair County develops a Family Treatment Drug Court• Northampton County develops an Interim CourtDirective/Permanency Plan to eliminate delays in servicereferrals• Lackawanna County introduces a new court procedure, theDependency Compliance Conference, to increase accountabilityand expedite permanency• Westmoreland County initiates a 90-day multidisciplinary caseconference process
  41. 41. Overall OutcomesSince 1989, more than 40 counties across four states havesaved time and money with the Permanency Project:• $25 million total saved in foster care costs• Over 2200 kids benefitted directly• Average of one less year waiting in foster careNew York - $15,272,000 saved, 15 month average time reductionWyoming - $704,000 saved, 11 month average time reductionKentucky - $237,600 saved, 9 month average time reduction
  42. 42. Harnessing the Results1989 – A focus on adoption casesTermination Barriers Project begins with funding from the New York StateDept. of Social Services and the U.S. Dept. of Health and Human Services.1991 – NYS Office of Children and Family Services continues to fund theProject for the next 13 years.2004 – The project is successfully completed in 20 small, medium, and largecounties throughout NYS.2004 – New focus on all permanency types, emphasizing reunificationPennsylvania contracts with ABA for largest PermanencyBarriers Project to date. KY and WY also contract with the Project.2005 – ABA wins Adoption Excellence Award for work on the NYPermanency Barriers Project
  43. 43. Expanding the Program• Working with former project counties to provide additional TA and “refresher” trainings• Engaging new locations• Increasing the focus on and tracking of child well-being indicators
  44. 44. Questions/Contact Information Anne Marie Lancour ABA Center on Children and the Law 740 15th Street, NW Washington, DC 20005 (202)662-1756