Transcript Slide 1

The Mission
of DSHS
The
Department of
Social and
Health Services
will improve
the safety and
health of
individuals,
families and
communities
by providing
leadership and
establishing
and
participating in
partnerships.
One
Department
Vision
Mission
Core set of Values
Because Mind Matters
Screening and Assessment Panel
Discussion
August 27-28, 2012
Denise Revels Robinson, MSW,
Assistant Secretary, Children’s Administration
Department of Social and Health Services
Barb Putnam MSW,
Supervisor, Well-Being Unit
Children’s Administration
Washington State Department of Social & Health Services
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Children’s Administration Service Structure
State administered public child welfare system.
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Department
Vision
Mission
Core set of Values
Children’s
Administration
serves children
and families in
their
communities
through three
regional offices
and 45 field
offices and by
partnering with
26 federally
recognized
American
Indian tribes.
Washington State Department of Social & Health Services
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Service Delivery Activities
In Fiscal Year 2011
1.55 million
children1 in
Washington
Children
exiting care2
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Department
Vision
Mission
Core set of Values
There are approximately 1.55 million children in Washington1
Children’s Administration received 77,882 reports alleging
possible child abuse in State Fiscal Year 20112
Of those referrals, 37,992 were screened in for investigation.
(35,772 did not meet the legal criteria for abuse, neglect, or
abandonment or were referred to Alternative Services) 2
• 2,658 children (51%)
went home
• 1,514 children (29%)
were adopted
• 513 children (10%)
placed in
guardianships
• 414 (8%) reached age
of majority.
1. www.Census.Gov ; 2.FamLink
Washington State Department of Social & Health Services
On June 30, 2011, there were 9,987 children in the
care of Children’s Administration2
Of those, 8,966 were in out-of-home care such as
foster care or group homes. (1,021 were state
dependent but living at home.)2
Of those children placed in out-of home care, 3,147
lived with relatives. (Approximately 10% of relative
caregivers are licensed.)2
6,507 children exited care2
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Safety is at the forefront of
every aspect of our work
We endeavor to safely:
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Department
Vision
Mission
Core set of Values
• Maintain children in their own homes
preventing out-of-home placement
• Serve and support children with relatives or in
temporary licensed out-of-home placement
• Return children home as quickly as possible
• Secure permanent homes for children who
cannot return home
• Decrease over-representation of children of
color in the public child welfare system
Washington State Department of Social & Health Services
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Values, Guiding Principles
and Priorities
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Department
Vision
Mission
Core set of Values
• Safety, permanency, and well-being are sought for all
children and families regardless of race, ethnicity, or
place of residence.
• Child safety, permanency, and well-being are the shared
responsibility of parents and foster parents, caregivers,
tribes, service providers, and community members.
• Practice improvement is data driven and outcomes are
communicated transparently both within the
Administration and publically.
• Efforts to reduce racial disproportionality are
embedded into all aspects of our work.
• Supervisors are supported toward competency,
accountability, and professional development.
Washington State Department of Social & Health Services
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Children’s Administration
Programs and Services
Public child welfare for Washington state
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Department
Vision
Mission
Core set of Values
• Child abuse intake and investigation
• Services to support children and
families
• Foster care and relative placement
• Adoption and post-adoptive services
• Adolescent Services
• Foster family home and facility licensing
Washington State Department of Social & Health Services
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Specialized Services and Programs
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Department
Vision
Mission
Core set of Values
• Fostering Well Being
– Care Coordination services for complex
health, dental and mental health concerns
including psychotropic medications.
• Regional Medical Consultants
– Six part time Pediatricians out-stationed in
regional offices are available to support case
worker needs in the field.
• Foster Care Assessment Program assessment for
children/youth languishing in care and have
behavioral difficulties.
Washington State Department of Social & Health Services
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Screening
• Initial Health Screens
• Child Health and Education
Track
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Department
Vision
Mission
Core set of Values
Washington State Department of Social & Health Services
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Initial Health Screens
Purpose:
• Intent is to help identify and manage a
child’s urgent medical problems that may
be overlooked in the transition from their
home into out of home placement with a
caregiver.
• Physician physical screening that occurs
within the first 72 hours to five days of a
child or youth initially coming into care.
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Department
Vision
Mission
Core set of Values
Washington State Department of Social & Health Services
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Activities of the Initial
Health Screen
Health Screen is a well child exam that
consists of a quick review of the child’s
current health status that includes:
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Department
Vision
Mission
Core set of Values
– Height, weight and growth
– Blood pressure and other vital signs
– Immunizations
– Health status
– Complete physical exam
– Referrals to other specialists if needed
Washington State Department of Social & Health Services
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Capacity Building
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Department
Vision
Mission
Core set of Values
• State Medicaid partners created a billing
code a specialized form and protocols for
the physician use.
• Initially physicians needed extensive
communication and training regarding
the purpose and billing procedures.
• Worked extensively at the regional level
to identify local qualified medical
providers.
• Currently physicians are fully engaged in
the process.
Washington State Department of Social & Health Services
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Child Health and
Education Tracking (CHET)
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Department
Vision
Mission
Core set of Values
• Legislatively mandated in 2000 to develop
comprehensive screening capability in child
welfare.
• Approximately 80 trained staff and
supervisors deployed throughout the
regions who screen all children and youth.
• CA’s role is to comprehensively screen and
when identified, refer to the experts for a
comprehensive assessment.
Washington State Department of Social & Health Services
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CHET Program Goals
•
•
•
•
•
Identifies the long term well-being needs of
children and youth in care.
Solicits information from people who have
known the child/youth for 30 days or longer.
Is a “snapshot” of the child/youth at the
beginning of the child’s placement.
Provides a baseline for on-going monitoring.
CHET screens are completed within the first
30 days of placement.
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Department
Vision
Mission
Core set of Values
Washington State Department of Social & Health Services
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Who are the Screeners?
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Department
Vision
Mission
Core set of Values
• Dedicated social workers who are and
trained to administer screening tools.
₋ Not case carrying, except in small offices.
• Have an interest in the wellbeing needs of
children coming into care.
• Have an understanding of child welfare and
the movement /responsibilities within the
system.
• Have an understanding of resources in their
local communities.
Washington State Department of Social & Health Services
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Domains
AREAS OF FOCUS:
CHET screens children in five domains:
•
•
•
•
•
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Department
Vision
Mission
Core set of Values
Physical Health
Social/Emotional
Education
Developmental
Connection to family, community, peers,
and other significant relationships
Washington State Department of Social & Health Services
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Tools
The Screener administers the following
standardized validated tools:
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Department
Vision
Mission
Core set of Values
– Denver (birth to one month)
– Ages and Stages Questionnaire (ASQ) (1 month – 5
years)
– ASQ – Social Emotional (3 months – 5 ½ years)
– Mental Health: Pediatric Symptom Checklist – 17
(PSC-17) (ages 5 ½ -18)
– Global Assessment of Individual Needs – SS (13 –
18 years)
Washington State Department of Social & Health Services
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Pediatric Symptoms Checklist
(PSC – 17)
• Developed as brief screen to identify
possible psychosocial problems in pediatric
settings for children 4-17 years.
⁻ based on original 35-item PSC -- Leiner et al.
2007
• Includes 17 items that fall into 3 domains
₋ Externalizing problems (7 items)
₋ Attention problems (5 items)
₋ Internalizing problems (5 items)
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Department
Vision
Mission
Core set of Values
• Has clinical cutoff scores for each scale
Washington State Department of Social & Health Services
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PSC-17 Sample Questions
INSTRUCTIONS: Please read each question carefully and check off the box for the
response that you believe is most true for your child during the past 6 MONTHS.
#
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Department
Vision
Mission
Core set of Values
DOES YOUR CHILD
(0) Never
(1) Sometimes
(2) Often
1
Fidget, is unable to sit still.
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2
Act as if driven by motor
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3
Daydream too much
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4
Distract easily
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5
Feel sad
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6
Feel hopeless
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7
Have trouble concentrating
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8
Fight with other children.
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9
Feel down on him/herself
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10
Worry a lot
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11
Seem to be having less fun
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12
Not listen to rules
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13
Not understand other people’s feelings
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14
Tease others
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15
Blame others for his/her troubles
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16
Refuse to share
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17
Take things that do not belong to him/her
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
Washington State Department of Social & Health Services
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PSC – 17 Results
• In Washington State fiscal year 2011,
CHET Screeners administered the tool
for 5,143 children and/or youth.
• Based on scores:
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Department
Vision
Mission
Core set of Values
– 54% had “No Apparent Concerns”, and
– 46% had “Possible Mental Health
Concerns” which resulted a referral for a
comprehensive mental health
assessment.
Washington State Department of Social & Health Services
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Post Implementation:
What We Know
Domains
Internalizing
Externalizing
Attention
Total Score
Possible Concerns
Identified
30%
24%
19%
46%
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Department
Vision
Mission
Core set of Values
Washington State Department of Social & Health Services
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Assessment: Mental Health
Service Referrals
• If the child/youth scores are at the cut-off
point, the child is referred to the Regional
Support Network (RSN) for a comprehensive
mental health evaluation.
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Department
Vision
Mission
Core set of Values
• Additionally, at any point while the child is in
out-of-home care if there is an identified
mental health concern, he or she is referred
to mental health services.
Washington State Department of Social & Health Services
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Additional Resources
• Evidenced Based Programs:
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Department
Vision
Mission
Core set of Values
– Intensive Family Preservation Services –
Homebuilders
– Project SafeCare
– Functional Family Therapy
– Incredible Years
– Parent Child Interactive Therapy
– Multidimensional Treatment Foster Care
– Promoting First Relations
– Wraparound
Washington State Department of Social & Health Services
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Challenges
• We continue to need:
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Department
Vision
Mission
Core set of Values
– A full array of Evidenced Based treatments
that address the specialized trauma and
other mental health needs of foster children
and youth in the publicly funded mental
health system, especially for 0-5 children.
– Barrier free access to mental health services.
– Training and better understanding in mental
health of the unique needs of children and
youth in foster care.
Washington State Department of Social & Health Services
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Next Steps
• Currently examining tools that are
trauma screens.
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Department
Vision
Mission
Core set of Values
• Anticipate implementing a trauma
screen in the next year within the CHET
process for those children and youth
entering care.
Washington State Department of Social & Health Services
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