Transcript Slide 1

A Focus on Two Defining Principles of
Systems of Care: Family Involvement and
Interagency Collaboration
NRCOI March 5th Conference Call
© 2005 ICF Consulting Group, Inc. All rights reserved.
Overview of Discussion:
• Overview of Improving Child Welfare Outcomes through Systems
of Care (SOC) Initiative funded by the Children’s Bureau.
• Overview of National Evaluation and Data Collection Plan.
• Presentation of preliminary data on impact of grant funding.
• Introduction to two of our grant communities (CA and CO) and their
experiences around two of the most salient SOC Principles: Family
Involvement and Interagency Collaboration.
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“We need a better understanding of what is
reasonable to expect [systems change] efforts to
accomplish, particularly in light of local and macro
contextual factors (e.g., resource constraints,
relationships, target populations)…More information is
needed about the level, breadth and staging of efforts
within and across [initiatives], within multiple contexts
and with comparable goals if we are to gain a deeper
understanding of the pathways to achieving [systems]
change…”
---Roundtable on Community Change
The Aspen Institute
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Defining Systems of Care
“A system of care incorporates a broad, flexible
array of services and supports for a defined
population(s) that is organized into a coordinated
network, integrates service planning and service
coordination and management across multiple
levels, is culturally and linguistically competent,
builds meaningful partnerships with families and
youth at service delivery, management, and policy
levels, and has supportive management and policy
infrastructure” (Stroul, 2002).
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The SOC Demonstration Cluster
Family-to-Family
System of Care
Contra Costa, CA
Jefferson County Systems of
Care
Jefferson County, CO
Family-Centered Systems of
Care
KS
(Cherokee and Re no
counties)
Caring Communities
Demonstration Project
Clark County, NV
The Community Taking
Responsibility for Assisting in
Developing Life and
Empowerment
Bedford Stuyvesant,
Brooklyn, NY
Improving Child Welfare
Outcomes Through SoC
NC
(Alamance, Bl aden, a nd
Mecklenberg counties)
Medicine Moon Initiative (MMI )
to Improve Tribal Child
Welfare Outcomes Through
Systems of Care
ND (S pirit Lake, Turtle
Mountain B and o f the
Chippewa Indians, Three
Affiliated Tribes, and
Standing Rock)
Improving Permanency
Outcomes Project
OR (C lackamas,
Umatilla/Morrow, and
Washington counties)
Locally Organize d Systems of
Care for Children in
Pennsylvania
PA (Dauphin and
Northumberland counties)
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National TA and Evaluation Center
for Systems of Care
• Double-Barrel Approach: Combine Technical
Assistance (TA) and Evaluation
– Provides “full service” support for grantees
– An Empowerment Evaluation Approach: TA and
Evaluation inform each other
– Strengthens ability to learn and disseminate
• Technical Assistance
– Consultant model of TA (comprehensive focus on
long-term, proactive engagement with sites)
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Research Questions
• How and to what extent did grantees incorporate and
implement Systems of Care principles and build
infrastructure into their child welfare agency?
• To what extent has the implementation of a SOC
principle-guided effort led to organizational and systems
change? What type of systems change resulted?
• What are the characteristics of “high implementing SOC
grantees? What are the different characteristics and
outcomes associated between high and low SOC
implementation sites?
• To what extent has the implementation of a SOC guided effort
led to changes in case practice and service delivery and
subsequent changes in outcomes for children and families?
Evaluation Logic Model
Program
Foci and
Investments
• Family
Involvement
Infrastructure,
Policy and
Practice
•Planning
•Governance
•Cultural
Competence
• Interagency
Collaboration
•Individualized,
Strength-based
•Communitybased
•System
Management
•Communication
Short-term
Outcomes
Families
• 
Satisfaction
• 
Buy-in staff

•
•
Empowerment

Utilization of
services
Intermediate
Outcomes
Long-term
Outcomes
 Positive
 Positive
outcomes for
target
population:
outcomes for
child welfare
population:
• Safety
• Safety
•Permanency
•Permanency
•Well-being
•Well-being
•Policy
•Finance
Services
• ↓ Duplication
•

Access to
services
Systems of care
approach
implemented
more broadly
• Comprehensive
and coordinated
services
Accountability
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Interim Findings
• Increased Agency Support for SOC Principles
• Variation by Site
• Evidence of Increased Implementation of
Collaborative Case Planning and Service
Provision
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How did we measure change?
• Child Welfare Survey Data
• T1 (n=668) and T2 (n=589)
• Agency Support for SOC Principle (Systems)
• Caseworker Internalization & Implementation of
SOC Principle (Practice)
• Examples from the Field – CA and CO
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Impact of SOC Principles on CW Agency
and Caseworker Practices
Interagency
Collaboration
CommunityBased
Services
Family
Involvement
Cultural
Competence
Accountability
Individualized
Strengths-Based
Changes in Agency Support
Of
SOC Principles
Changes in Caseworkers’
Practice
of SOC
Principles
How has CW agency support for Interagency
Collaboration changed?
Cross-Site Findings
5
4
3
2.86
2.66
2
1
Time 1 (n=668)
Time 2 (n=589) *
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How has CW agency support for Interagency
Collaboration changed?
Site Specific Findings
5
4.38
4
3.95
4
4.02
4.06
4.15
6
8
9
3.45
3
2.71
2
1
Overall
1
2
3
4
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How has Caseworker Implementation for
Interagency Collaboration changed?
Cross-Site Findings
7
6
5.73
5.84
Time 1 (n=540)
Time 2 (n=486) *
5
4
3
2
1
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Changes in Family Involvement
• Caseworker and Stakeholder Perceptions of
Change (Time 1 & Time 2 Surveys)
• Practice Changes
• Contextual Factors
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How has CW agency support for
family involvement changed?
Average Agency Support for Family Involvement
Average Agreement
5
4
Time 1
3
Time 2
2
1
Overall*
1
2*
3
4*
5
6
7
8
9*
Sites
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Have grant communities been successful
in increasing family involvement in the
child welfare system?
Success of Systems of Care in Increasing
Family Involvement in Child Welfare System
5
4.38
4
3.95
4.02
4.00
4.06
4.15
OR
PA
3.45
3
2.71
2
1
Overall
CA
CO
KS
NC
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Practice Changes: System Level
• Recruitment and involvement of families in governance
and planning activities have been strong, but retention is
an ongoing challenge.
• Families appear to have a stronger voice as partners in
decision-making.
• Grant communities have been active in identifying
financing focused on promoting or sustaining family
involvement.
• Grant communities have worked to educate families and
the community on family involvement.
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Practice Changes: Peer Level
• Grant communities have actively worked on
planning, implementing, or improving peer
support models
– CA parent partners mentored 247 families in 2007
– Anecdotal evidence that parent mentors positively
impact families
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Practice Changes: Case Level
• All grant communities are providing training on Child and
Family Teams (CFTs), Team Decision-Making (TDM),
“wraparound” services, or Family Group Decision Making
(FGDM).
• Several communities have developed new policies or
guidelines regarding the implementation of CFTs, TDM,
or FGDM.
• Grant communities have implemented mechanisms to
educate parents involved with child welfare about the
child welfare system.
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What interim conclusions can we draw
about implementation of System of Care
principles in the context of Child
Welfare?
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Interim Conclusions:
• Grant communities are doing business in a different way as a result
of participation in this initiative
• Grant communities have incorporated SoC principles into their
practice
• Areas of greatest success in implementation of the principles are in
family involvement and interagency collaboration
• Areas of greatest challenge are in cultural competency and
accountability
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Interim Conclusions:
• Grant communities are leveraging their positions to promote policy
change
• Training case workers and families on participatory processes
including Team Decision Making have the potential to lead to
sustained changes in practice
• Current evidence supports the contention that while there has been
impact on front line practice, this impact has been uneven and not
fully realized
• Context plays a significant role in the capacity of grantee
communities to implement SoC principles
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Examples From the Field
CONTRA COSTA COUNTY
COLORADO
Family Involvement
Interagency Collaboration
Judi Knittel
Cheryl Barret
Susan Franklin
Holly Haman-Marcum
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