Transcript Slide 1

DOING MORE WITH LESS:
Making Reasonable Efforts
Findings When There Are Not
Enough Resources To Reach the
Permanency Goals
Together We Can
October 5, 2010
Lafayette, Louisiana
Goals
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The history- why
Reasonable efforts
Changing landscape
Making/taking it personal
Initiatives
What we do and why we do it
Leadership/Partnership
The future
I saw them tearing a
building down- a gang
of men in my home
town
My Trip Here
BUDGETS
THESE ARE TOUGH
ECONOMIC TIMES
WHAT NOW??
Status in States
• States' tax revenue fell 11.7% in 1st 3 mos of
’09- the steepest decline on record
• 45 states reported taxes for Apr and May
have seen revenue declines of about 20%
• Corporate income taxes down 18.8% in the
first quarter, personal income taxes
dropped 17.5%; & sales taxes declined 8.3%
• State tax revenues at 2005 levels in the 1st
quarter, erasing 3 yrs of gains for new
programs & salaries
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With stimulus money, states face deficits
more than $200 billion in the next few yrs
Last Year
Budget
Gaps
According
to the Wall
Street
Journal,
January 4,
2010
10 States & Their Deficits
• California- Massive cuts in education,
layoffs etc- $20Billion deficit in 2011
• Oklahoma- Ok but energy price drop26% revenue drop
• Arizona- Hit by housing and tourism
drop- 30% budget gap
• Illinois- pension payment delays &
others- $11 Billion gap/$5B owed/ 47%
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Hawaii- 3 day a month furloughs,
Ed cuts, income tax- 21% budget gap
10 States & their Deficits
• New Jersey- 3rd highest deficitalready cut $800 million and now more
• New York- 3 Billion deficit-double next
year- delay payments- 100,000 layoff
• Nevada- House W & M chair says
submit budgets 50% of last years
• Colorado-efforts to balance budget run
into law requiring education increases
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Michigan- unemployment worst in
the nation- revenue down lots
History of Child Welfare:
Understanding the
Responses
WE HAVEN’T
ALWAYS SOARED
WITH THE
EAGLES IN
TAKING CARE OF
OUR CHILDREN
History
• 1st reported case of abuse in US
• 18th century - Children were indentured
to work and learn a trade
• 1832 Cholera epidemic- orphan asylums
• 1853 response to them was NY
Children’s Aid Society– 1853-1890
moved 92,000 kids to Midwest
• 1886- Charles Birtwell of Boston
Champions return home
• 1909- White House Conference adopts
Birtwell and temp foster care
payments
History
p 2
• 1923- 34 states had Children’s Aid
Societies- kids exploited- criticism
of placing kids out and multiple
placements
• 1959- Maas and Engler study- Children
in Need of Parents- kids spent 3
years in care- neglect, abandonment
and poverty reasons for placement
• The 60’s- Fleming Rule- can’t refuse
AFDC for bad homes- keep AFDC &
reasonable efforts to improve
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AND SO THE FEDS
STEPPED IN!!
1974 Child Abuse
Prevention and Treatment
Act (CAPTA)
• Child abuse prevention- Children’s
trust funds
• National Standards for child
protection
• Coordinated community response for
investigation and prosecution
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GAL/CASA for every child
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Research and other grants
1978
Indian Child Welfare
Act
• Set out for children of native
Americanheritage
• Process to address problems
• Different standards
• Choice of tribe
I hope this starts
to capture your
attention on the
history of where
we have come from
1980 Adoption Assistance
and Child Welfare ActIV-B & IV-E
• Policy to insure that children receive
proper care while in foster care
• Policy of Feds:
– 1. No child in care who could be
safely home
– 2. Procedural reforms
– 3. Planning reforms
– 4. Reunification
Public Law 96-272
• The Adoption Assistance and Child
Welfare Act of 1980
• To get Fed funds, States must:
implement services, provide
protections for families & develop
mandates and timetables
• Policy- END FOSTER CARE DRIFT
• TRUST IN STATE JUDICIARY- juvenile
and family court
Federal Requirements of
96-272
• Evaluation of reasonableness of
services to preserve families
• Periodic review hearings in foster
care cases
• Adherence to deadlines for
permanency planning decision
• Procedural safeguards concerning
placement and visitation
1993 Family
Preservation Act
• Grants to state courts to review
systems by looking at statistics
• Grants to states to improve
systems practice in abuse and
neglect proceedings
• Known as Court Improvement
Projects
1974
Multi-Ethnic Placement
Act
• MEPA
• Response to policy initiatives
delaying permanency
• Some limits on placement standards
• Has severe penalties
1995 Block Grants
• Just what it says
• Feds provide $$ for states to use
as best they saw it with limited
regulations
Adoption and Safe
Families Act
Nov 19, 1997
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Promotes health and safety of the child
Promote TIMELY decision making
Clarifies “reasonable efforts”
Continues Family Preservation Program
Requires TPR in certain situations
Foster care is TEMPORARY
Permanency planning begins immediately
Need for innovation
1999
Foster Care
Independence Act
• Provides resources for kids aging
out of the system
2001
Strengthening Abuse and
Neglect Courts Act
• SANCA
• Helping Court fulfill the mission of
ASFA
• Brings $$ to the Courts
• But not much
2008
Fostering Connections Act
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Education stability- attend/achieve
Health care- Medicaid- EPSDT
Can extend foster care to 21
Can us subsidized guardianship
Kinship care- ID relatives- training
Over time- delinks IV-E 1996 AFDC
Training support
Tribal issues
DOES
IT
SOUND
LIKE
THE
SYSTEM
DIDN’T
GET
IT?
It’s not so much what we
don’t know that holds us
back, it’s all we do know
that just isn’t so!
The average movement of
a child to a less
restrictive or more
permanent placement
occurs nine days before
the next Court hearingand it doesn’t matter
whether that hearing is
six months, three months
or one month later
NOW- FROM THE
PERSPECTIVE OF THE
AGENCIES AND
COURTS- DOES THIS
LOOK FAMILIAR
REASONABLE EFFORTS
45 C.F.R. Sec 1356
Sec 1356.21 (b) of AFSA and
Regs
Reasonable Efforts under
96-272
• Ensures that no child should be in foster
care who can effectively and safely
be protected in own home
• When removal is necessary, reunification
is the goal before any other
arrangement is tried unless it is not
possible to reunify while protecting
the child’s safety
Who Should Provide the
Oversight
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Executive Branch?
Legislative?
NO- it is the Judicial branch
Specifically- Juvenile and Family
Courts
• Through- Reasonable Efforts Findings
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1997- THE ISSUES ON
REASONABLE EFFORTS
Dissatisfied w/compliance with 96-272
Growth in foster care numbers
High profile child death cases
Concern over increasing costs
Too many kids growing up in the system
Dramatically changing welfare system
Innovations in child welfare practices
Computer information management
ASFA CLARIFIES
REASONABLE EFFORTS
• Child’s safety is paramount (not reunification)
• Child’s right to permanency vs parents right to
the child
• R/E to preserve family precedes foster care
• R/E not required if aggravating facts exist
• R/E not required if felony conviction for injury
to child or sibling
• R/E not required if a prior involuntary TPR
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Must find Contrary to child’s welfare
to remain at home
p 4050
REASAONABLE EFFORTS TO
MOVE CHILD TO PERMANENCY
• Reunification takes a back seat if it is
inconsistent with timely permanency
• If R/E are not necessary, hearing on
permanency has to happen in 30 days
• R/E to reunification, adoption or
placement with guardian can be
concurrent
The Regs on ASFA
gave us more to do
and sat on the
system HARD
FEDERAL REGS AS OF JAN. 25,
2000-REASONABLE EFFORTS
p. 1
• Judicial statement that it was contrary to child’s
welfare to remain at home
p 4050
• No distinction between R/E in emergency or nonemergency removal
• States get 60 days to get judicial determination
of R/E to provide judicial determination of
removal- not on a specific date
• W/I 12 mos child enter foster care, State gets a
judicial determination that R/E made to
implement case plan for permanency- finality
• IV-E eligibility absolutely linked to judicial
determination of R/E
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NO Nunc pro Tunc entry on R/E at first hearing
FEDERAL REGS AS OF JAN
25, 2000 REASOANBLE
EFFORTS p 2
• IV -E funds will not be available if Court
doesn’t make a reasonable efforts
finding for removal
p. 5052
• Problems• 1. Form over substance
• 2. Court finding is critical- use wisely
• 3. Agency efforts at first contact are !!!!!
• 4. What are the necessary services?
• 5. What of unaccompanied refugee minors
P 4052
REGS IN FEDERAL REGISTER
OF REASONABLE EFFORTS
p 3
• When R/E are required, state and Court
determines level of effort that is
reasonable-Based on safety considerations
and circumstances of family
• Sometimes based on assessment of family,
state decides it is reasonable to make no
efforts to keep child in home or reunify
• The Court, if it agrees with the state’s
decision, should find that the agency’s
efforts were reasonable, NOT that
reasonable efforts were not required
p. 4053
Is it starting to
feel a little
MESSY??
RECENT CHANGES IN
WELFARE EFFECTING
REASONABLE EFFORTS
CHANGING LANDSCAPE OF
CHILD WELFARE SERVICES
• Tighter Time-Lines and Higher
Level of Accountability to:
– Ensure the safety and well-being
of children– health & safety
– Assess the willingness and ability
of parents/caregivers
– Mobilize services for the child
and family
– Expedite the achievement of the
permanency goal within unless
there are “Compelling Reasons”
CHANGING LANDSCAPE OF
CHILD WELFARE SERVICES
• Greater Emphasis on Collaboration
and Partnerships
– Community-Neighborhood Responses,
Systems and Services - Keeping the
services as close and as accessible
to the child and family as possible
– Partnerships - Emphasize
Partnerships within the system
families, the family's natural
supports, service providers, court
participants and foster families
CHANGING LANDSCAPE OF
CHILD WELFARE SERVICES
• Accountability of all:
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parents
providers
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system
funders
• Three targets:
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Youth Partnerships Tribes
• Measurements:
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Composites, not measures
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0 to 3- or some young age
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Mandatory TPR at some age
CHANGING LANDSCAPE OF
CHILD WELFARE SERVICES
• Outcomes:
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Measurable and real- agency,
Court and programs
• Examples- ACE; case manger visits;
finding fathers; extended families;
CFTM; residential issues
• Philosophy and Practice:
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Will change with outcomes and
accountability- the CFSR
THIS TIME IS A
DIFFERENT TIME
THAN MOST OF US
REMEMBER
We were going along OK
and then found some one
was after us
The “New Normal” – recovery may be
slower and shallower
•Current recession- more than a cyclical event– drive
deep structural changes in every industry
•Economic activity & demand patterns will not simply
return to pre-recession levels– 2011 won’t be 2007
•Some pre-recession trends will be reversed; others will
be sharply accelerated
•Every country is going through some level of adjustment
or restructuring – the question is to what end?
What are the characteristics of the New Normal
for their industries, their markets, and the people
they serve?
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Human Services organizations that restructure
for their New Normal will be best prepared to
serve their citizens in both good & bad times
Are we are at a crossroads?
•We can choose to keep doing what we are doing, or
•We can use this time of the economic crisis to make
the structural changes we need to prepare
the Services Delivery infrastructure for later.
1.Control costs through good fiscal management and
good use of the resources we have
2.Redesign Service Delivery to be cross-program and
child and family outcome-focused
•In this way, we can have the same impact on our
service delivery infrastructure as we have for the
highway infrastructure – make an investment
from which our children will enjoy the benefits
IS IT STARTING TO
FEEL LIKE YOU ARE
BEING ASKED TO DO
THINGS YOU HAVEN’T
DONE IN DIFFERENT
WAYS?
WORKING TOGETHER TO
EXAMINE THE ISSUE OF
REASONABLE EFFORTS
Doing Things Early
30 Minutes
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Who takes the phone call
What questions are asked
What is the follow through
How is the information assessed
Who makes the first personal contact
How is the message conveyed
What is the request for involvement
Who is invited to the table
What happens to the child
30 Hours
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The decision on placement of child
Visits- parents and siblings
Assessment of risk/safety
Services to address risk/safety
Timeliness of service start
Location of service delivery
Assistance for proper referrals
Involvement of support network
Follow up of assigned staff
30 Days
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Is there participation
Are the right services available timely
Additional resources
Re-assessment of risk/safety
Re-assessment of service needs
Continue to increase support network
Is the service working- if not, change
Consequences for service failure
Reward for service success
Early
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Find absent parent//father/family
Extended family involvement
Establish paternity
Good assessments-reassessments
Concurrent planning
File contempt when there is
no/little compliance
• Reward families for changes
and active positive participation
Better
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Agency must be excellent
Case loads manageable- for all
30-30-30
Frequent contacts with others
Engage informal family supports
Time- time- time AND FAST!!
Together- together
MEDIA
Family/team meetings
AND THE CASE LOADS
AND WORKLOADS
GO UP??
Who Likes Change
Anyway?
Red
Yellow
Green
Blue
Red
Blue
Yellow
Green
Blue
Red
Statements of Change
• If you want to make enemies, try to
change something
Woodrow Wilson
• The main changers in this life are the
people who want to change
everything- or nothing
Lady Astor
• If you don’t like change, you’re going to
like irrelevance even less. Gen. Eric Shinseki,
Former Army Chief of Staff
• Change is the law of life. Those who look
only to the past or present are
certain to miss the future John F. Kennedy
Things to Look At
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Kids aging out
Kids in care too long
Cases open too long
Filing per statute and timelines
Family structure and abuse Nos.
Educational advocates
Health care initiatives
Kids in home- Parents out
DATA, DATA, DATA,
Things I Have
Learned
If the agency
isn’t working well,
the system won’t
either
Caseloads are
important!!
The whole system
tends to keep
doing things the
same way
Change comes
from a few and
threatens many
A Judge can fix
a little but not
the whole thing
Money is
important
The only way to
fix it is to....
IT IS TIME TO
TAKE THE
MUZZLE OFF AND
FOR YOU TO
TALK
NAME 3 PROGRAMS
OR SERVICES
THAT YOU USE
REGULARLY
NAME 3 PROGRAMS
OR SERVICES
THAT ARE
CRITICAL IN A
TYPICAL CASE
NAME 3 PROGRAMS
OR SERVICES THAT
ARE NOT TOO
EFFECTIVE OR
HELPFUL
WHAT 3 PROGRAMS
OR SERVICES THAT
CHILDREN NEED
FOR REUNIFACTION
EFFORTS
NAME 3 PROGRAMS
OR SERVICES
THAT PARENTS
NEED FOR
REUNIFCATION
NAME 3 PROGRAMS
OR SERVICES THAT
PROSPECTIVE
ADOPTIVE PARENTS
SHOULD HAVE
AND THE BIG
ONE!!
NAME 3 THINGS THE
DSS CAN DO TO
IMPROVE THE
SERVICES TO
CHILDREN &
FAMILIES
INITIATIVES
Community
• Involve all stakeholders
• Expand the network of informal
and formal supports
• Establish prevention, reunification
and permanency options
• Ensure that the community has
financial resources to “do the
job
• Support the efforts of those who
take care of those least
capable of taking care of
themselves
The Children
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Ensure early appropriate placement
Provide personal items for security
Work on school consistency
Provide neighborhood placement
Visitation
Sibling placement or visits
Inform of status regularly
Address health & mental health
Involve in the planning of lives
Individual Families
• Assist with visitation & transportation
• Ensure that concurrent planning is
used and is appropriate & done well
• Pay special attention to families with
alcohol and drug problems
• Provide early referral to services
• Good assessment and evaluation
• Locate and engage extended family
member
– Decide who will work to get things done
Help for Individual
Children and Families
• Advise families and others in the case
and community about rules &
timetables
• Make sure families are engaged in
assessing, planning and decision making
• Develop case plans that really respond to
the child and family needs- services,
accessible, available, timely &
culturally competent
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Explore relative placements early
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Help and force families to watch the
clock- use this therapeutically
The Executive Branch
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This is the primary valve
Make sure it is on board
Former NY commissioner Bell said …
Meet regularly
Communicate often
Challenge
Support
BE PREPARED
The Judiciary
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Move the cases- timely permanency
No/limited continuances
Know the CFSR/PIP
Know service delivery process
Facilitate meetings
Meet with community programs
Encourage full family participation
Engage other agency systems:
– Education, mental health, DD, child
support, United Way, foundations, etc
SUGGESTIONS
• Training
• Joint training
• Know the service delivery
system
• Certification
• Teach
• Learn Agency rules & process
SUGGESTIONS
• Assist with Leadership turnover
• Create uniform practice- each
•STANDARDS
• Case load Work load
Reports
• Judges, Courts, Case workers agency
attorneys, GAL/CASA, parents
attorneys, service providers
Better
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DSS must be excellent
Case loads manageable- for all
30-30-30
Frequent contact
Engage informal family supports
Time- time- time
Together- together
MEDIA
Family/team meetings
THE CFSR AND PIP
IN
LOUISIANA
The CFSR
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1st 10 states last year
Standards higher and composites
Teams to review work
Compare last time to this
Requires a state team approach
Are intense and extensive
Chance to show partnership
Followed by the PIP??
3 factors and systemic
Louisiana’s CFSR
• Went through March, 2010
• One of the last states
• Once fall below the Nat’l Standards,
have to put together a plan to
improve (PIP)
• PIP must address short comings of
the system in the 3 areas and
systemic areas
LEADERSHIP
Leadership
• Inspires, excites and molds common
belief and experiences of all into
a common belief
• Has passion & courage to express it
• Clear, realistic goals & borrows from
others
• Never knows enough/as much as they
need to
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Willing to listen
• Adoptable & able to deal w/ Change
Problems in Perspective
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How long to get- how long to fix
Who does it take to get it going
Where does a person start
What is the message
How to get it across
Is it always clear
Where to start
Leadership
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Knows why it is there
Knows how it got there
Remembers why it is there
Gives others their credit
Takes responsibility for things
Ensures the tools are there
Measures the possibilities
Takes a stand
Leadership
• Is not taking people were
they want to go
• It is taking people where
they know they ought to
be in their very best
moment
COLLABORATION ESSENTIAL INGREDIENTS
Collaboration –
Essential Ingredients
Heightened Need for
Partnerships
• Give priority to child safety
• Keep focus on individual children
and families and case by case
decision making
• Increase attention to prevention
and early support
• Engage families in shared decision
making from the beginning
• Focus on strengths of family and
community
Collaboration Tips
1.
2.
3.
4.
Create a common purpose
Listen
Discover people’s talents
Fairness
• The same rule applies to all
5. Manage differences and power
imbalance
• It is safe to disagree with
someone in power
Collaboration Tips
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9.
Consistency
Look for success
Plan for uncertainty
Keep talking
• Do not bear resentment
without discussion
10.Keep moving
• Resist inertia
,
FOUNDATION FOR
SUCCESS
• Vision - What needs to be different?
What Outcomes Improved?
• Respect - Trust, acceptance and
removing barriers
• Leadership and Ownership - Strong
leadership with strong ownership
• Commitment of Leaders and Key
Stakeholders »Participate
- Own
»Empower Staff - Advocate & Sell
MAKING IT WORK CRITICAL STEPS
• Build Upon Current Personal and
Professional Networks
• Find Common Ground
• Identify Clearly and Document
Issues:
– Target Population, Geographic Area,
Problem or Services Needing to be
Addressed
– Obstacles and Barriers
– Data Identifying Trends, Chronology
– Case Studies and Examples
MAKING IT WORK CRITICAL STEPS, Cont.
• Describe Current Status of
Coordination and Collaboration
• Identify What is Working and Needs
to Continue and be Enhanced
• Identify the Benefits to be Achieved:
– Consumers
Community/Neighborhood
– Service Delivery System / Schools
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Key Decision Makers
»“Investors”
Staff
MAKING IT WORK CRITICAL STEPS, Cont.
• Identify the Change Required
– Focus on Program or System Level of Collaboration
– Type of Change Required: Attitude, Behavior,
Technology, System
– Dimension of Change: Developmental, Transitional,
Transformational
• Ownership of Key Decision Makers
• Collaborative (Participatory) Planning
• SMART Plan of Action
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Input - Necessary Resources
Process: Workflow / Sequence
Outcome: Impact Measures / Targets
Sustainability
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Things will happen
Thick skinned
Truly believe
Who is responsible
Select great people
Reward excellence
Identify the next
QUOTE
• In war, it is axiomatic that the
victors of the last war fight
the new one with the tactics
of the old. Having won, the
victor is content with what
won for him;
but the vanquished wants to
know why he lost and looks
for new tactics.
•
Historian Robert Leckie
The Future
AGENCY
RESPONSIBILITIES
Agency
Responsibilities
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Who
Who
Who
Who
Who
Who
Who
has the resources?
has the staff?
monitors the children?
has the statutory duty?
has the federal funding?
gets the consent decree?
gets criticized in the media?
Agency
Responsibilities
• Who has this as their main task?
• Who has access to National Resource
Centers?
• Who can get grants from this?
• Who does this 24 hours/7 days?
• And who gets off the hook when it
isn’t done right or well?
Agency
Responsibilities
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To
To
To
To
To
meet standards
keep caseloads/workloads low
train staff well
provide resources to meet goals
provide safety, permanency
and well being
• To pass the CFSR
• To make sure children are priority
Agency
Responsibilities
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To
To
To
To
To
To
identify barriers
find ways around barriers
provide avenues for options
provide action to results
ask for help when needed
get the job done without excuses
JUDICIAL
RESPONSIBILITIES
Judicial
Responsibilities
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To
To
To
To
To
To
know the law
know the parties
know the system
expect competence
demand outcomes
not compromise
Judicial
Responsibilities
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To
To
To
To
To
To
To
not surrender
not accept less than the best
care enough to complain
know where to go to get it done
be willing to go the distance
see the faces of the children
use every tool to ensure timely
permanency and best placement
PARTNERING
Partnering
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Each has the same/similar goal
Each understand the other
Each has something to gain or lose
Each will add something significant
One balances the other
One supports the other
One challenges the other
Partnering
• Who leads and who follows
• At what point which one
• Who has primary responsibility and
for what
• How to come to the terms of it
• How to respond to changes of partner
• Who takes the tough action first
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Who makes up first
Partnering
Who has ultimate responsibility
Who will accept ultimate blame
Who has the most to lose
Who will ensure that it succeeds
Where is the consistency for time
Who will care more about children
WHO SHOULD
RESPOND AND
HOW??
Who Should Respond
• The Agency
• Since they start at the AgencyIntake and CPS-others are
reacting and should respond to
them and the process they
start and the processes they
implement
The Courts
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Partnership
Cooperative
Reasonable expectations for times
How much can others do
How much can the courts do
Working/meeting with partners
Making new partners
The Community
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This is about the family in its support
The family, extended family & friends
The neighborhood and community
The United Way, foundations and
others
• And the non-traditional, non-public
providers- and the faith based
WE CANNOT
LET THE WRECK
HAPPEN TO
CHILDREN
& FAMILIES
Things To Watch
We All Have to Watch
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This is our job and passion
We cannot ignore the reality of $$
$$ not the most important thing, butFunding is changed for years
Programs & expectations must also
Demands of scarce resources
Communicate for the system- use Media
What happens to the service folks
The local, state and national scenes
Things to Watch- 2
• Watch the new- Congress and new bills
• Enforce the old?- NYTD, Fostering
Connections, ASFA/CFSR/PIP, etc
• Governor’s & leg’s ratings- Nov. election
• Small agency survival
• Agency consolidation
• Contributions- United Ways, Foundations
• Agency turnover- at the top
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Agency turnover at case worker
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Data- data- data!!!!!!
Things to Watch - 3
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Federal budgets
Local & state budgets
Nationally- other state’s budgets
Agency changes to tough times
CASELOAD/WORKLOAD
TA & help from Resource Centers
Increased cooperation from others
New leadership taking these
challenging times to lead us
• New family dynamics and support
Things To Watch•
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4
Residential placement numbers
Multiple placements- kids moving
Safety assessments at the start
Using relatives as placement option
Using relatives as resources
Time lines for cases
The younger population- under 6
Extended family contacts
– Comparative data- county to county;
region to region; court to court; etc
Issues to address
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Services availability
Services available in a timely way
Services done in 12 months or less
Parent(s) in jail or prison
Continuances
TPR with no ID’d adoptive parent
Length of time of final ruling on TPR
Process to find an adoptive family
Changing mindset of system people
Doing more with less- $$ & people
REDEFINE:
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Who we serve
Who we support
Who we include
Who must include
What we insist on
Who the team is
How we work with
Success
Failure
Partners come in all sizes....
And they will support
you....
And respect your creativity
for thinking outside the box....
They'll be there when you
need a shoulder to lean on....
Or a great big hug....
understanding what you're all
about....
They see beyond the black &
white to discover your true
colors
And accept you the way you are...
Even when you change the world
.... play the right music
So
Practice patience and
tolerance.....
The Old
Woman
LONG TERM
EFFECTS OF
ABUSE AND
NEGLECT
Facts
• In 2006, an estimated 905,000
children were victims of child
abuse or neglect according to
the Department of Health and
Human Services
• Physical injuries may or may not
be immediately visible, but
abuse and neglect can have
consequences for children,
families, and society that last
a lifetime
Factors Affecting the
Consequences
• Not all abused and neglected
children will experience longterm consequences
• Researchers have begun to explore
why some children suffer longterm consequences of abuse
and neglect while others
emerge relatively unscathed
• The ability to cope and even thrive
following a negative experience
is called “resilience”
Factors
(Cont’d)
• Outcomes of individual cases vary
widely and are affected by a
combination of factors:
– The child’s age and developmental
status when the CA/N occurred
– The type of abuse (physical, sexual,
neglect, etc)
– The frequency, duration, and severity
of abuse
– The relationship between the victim
and his or her abuser
Physical Health
Consequences
• According to the National Survey of
Child and Adolescent Well- Being
(NSCAW), more that one-fourth
of children who had been in
foster care for longer than 12
months had some lasting or
recurring health problem
Physical Health
Consequences
• Some physical outcomes identified
by researchers include:
– Shaken baby syndrome
– Impaired brain development
– Poor physical health (i.e. allergies,
arthritis, asthma, bronchitis, high
blood pressure, and ulcers)`
Psychological Consequences
• The immediate emotional effects
of abuse and neglect –
isolation, fear, and an inability
to trust – can translate into
lifelong consequences including
low self-esteem, depression,
and relationship difficulties
Psychological Consequences
• Researchers have identified links
between CA/N and the
following:
– Difficulties during infancy
• Poor mental and emotional
health
– Cognitive difficulties
– Social difficulties
Behavioral Consequences
• Not all victims of CA/N experience
behavioral consequences
• However, behavioral problems
appear to be more likely among
this group even at a young age
• An NSCAW survey of children ages
3-5 in foster care showed these
children displayed clinical or
borderline levels of behavioral
problems at a rate more than
twice the general population
Behavioral Consequences
• Later in life, CA/N appear to make
the following more likely:
– Difficulties during adolescence
– Juvenile delinquency and adult
criminality
– Alcohol and other drug abuse
– Abusive behavior
Societal Consequences
• Society as a whole pays a price
for CA/N, in terms of both direct
and indirect costs
– Direct costs: maintaining child
welfare system, expenditures by the
judicial, law enforcement, health,
and mental health systems ($24
billion/year)
– Indirect costs: long-term
consequences like juvenile and adult
criminal activity, mental illness,
substance abuse, domestic violence
Summary
• Much research has been done about the
possible consequences of CA/N
• The effects vary depending on the
circumstances of the A/N, personal
characteristics of the child, and the
child’s environment
• Consequences may be mild or severe;
disappear after a short period or last
a lifetime; and affect the child
physically, psychologically,
behaviorally, or a combination of the
three
Summary
• Much research has been done about the
possible consequences of CA/N
• The effects vary depending on the
circumstances of the A/N, personal
characteristics of the child, and the
child’s environment
• Consequences may be mild or severe;
disappear after a short period or last
a lifetime; and affect the child
physically, psychologically,
behaviorally, or a combination of the
three
NAME 3 PROGRAMS
OR SERVICES THAT
ADOPTIVE PARENTS
NEED TO GOOD
CARE OF A CHILD