Getting to Permanence: The Practices of High-Performing Child Welfare Agencies

JUNE 23, 2016

Child Welfare Strategy Group

Not pictured: Meha Desai, Consultant

Presenters

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From the Annie E. Casey Foundation’s Child Welfare Strategy Group

Morgan ColeProgram Associate

Katrina BrewsaughSenior Associate

Evette Jackson Senior Associate

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Questions?

Poll: Audience

What is your role in the child welfare field?

A. AdministratorB. SupervisorC. CaseworkerD. AdvocateE. Foster parentF. Service providerG. Other

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This webinar is for agency staff, advocates, community members, the legal community, data analysts, providers and others. We will discuss:

• The importance of permanence —including for teens

• Current permanency outcomes and indicators

• What drives permanence?

• Strategies to boost permanence

Today’s discussion

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Casey’s desk guide: A key tool for agency improvement

The two-volume Child Welfare Leader’s Desk Guide to Building a High-Performing Agencydescribes practices that shape permanency, including:

• Focus on Child and Family Outcomes (Practice #1)

• Make Relationships and Permanence the Focus of Casework (#8)

• Develop Competent Front-End Decision Making (#6)

• Meet Teens Needs for Family and Other Supports (#9)

• Develop a Broad Service Array (#3)• Build A Healthy Caregiver Network (#10)

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Permanency means having a “family for life,” an enduring family relationship that:

• is safe and meant to last a lifetime

• offers the legal rights and social status of full family membership

• enables physical, emotional, social, cognitive and spiritual well-being; and

• assures lifelong connections to birth and extended family, siblings, other significant adults, family history, race and ethnic heritage, culture, religion and language*

SOURCE: Casey Family Services, A Call to Action: An Integrated Approach to Youth Permanency and Preparation for Adulthood. In collaboration with California Permanency for Youth Project, Casey Family Programs and the Jim Casey Youth Opportunities Initiative. 2005.

What is permanence?

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“Family relationships —particularly parent/child

relationships — are the cornerstone of

child development.”

Consensus Statement on Group Care

for Children and Adolescents:

A Statement of Policy of the American

Orthopsychiatry Association (2014)

Leaving foster care without permanent, caring adult relationships exposes youth to poorer life chances. Compared to other young adults, those who age out of foster care are:*

2 times as likely to drop out of high school2 times as likely to be unemployed and unable to meet basic needs6 times as likely to have physical and mental health issues2.5 times as likely to become young, system-involved parents3 times as likely to be incarcerated by age 193 times as likely to experience homelessness for one day or more

SOURCE: Casey National Alumni Study, Midwest study of the adult function of former foster youth: Outcomes at age 27, Chapin Hall Center for Children.

Why permanence?

Family aids child development at all ages

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“Why do you want a family?It’s about my entire life. It’s not just about

my childhood. I want to know that I’m going

to have a place to come home to during

Christmas breaks. I want to know that I’m

going to have a dad to walk me down the

aisle — that I’m going to have grandparents

for my children. No one can make it completely on their own.”

― Youth from 2014 CWSG survey

Youth who age out miss the benefits of belonging to a family

Finding permanence for some kids may require extra attention to data, policy and practice considerations. Make sure to review your agencies’ permanency outcomes for kids by race, ethnicity and gender,

sibling groups, teens and sexual orientation and gender identity

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Current indicators: What drives permanence?

Factors affecting outcomes

• Reason for entry

• Initial placement type

• Placement stability

• Length of stay in placement

• Strong, caring ongoing relationships with family and caregivers

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19,041

29,601

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

23,346

Youth emancipating from care

SOURCE: KIDS COUNT Data Center, 1999-2014

Current outcomes: Despite improvement, too many youths age out each year

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Current indicators: Who is in foster care?

SOURCE: Adoption and Foster Care Analysis and Reporting System (AFCARS), 2014 children served

Male52%

Female48%

0-5years40%

6-12years 30%

13-15yrs.13%

16-21yrs. 18%

653,255 kids and youth were in care for at least eight days in 2014

Rates of entry

• More than 264,000 children entered foster care.

‒ Kids of all ages: 3.6 per 1,000‒ Teens: 2.6 per 1,000 ‒ Children 0-12: 3.78 per 1,000

• In 26 states, 25% of entries were teens (13 and older)

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Kids of color comprise 48% of the general population but make up 54% of kids entering care

52%

14%

24%

10%

46%

22% 22%

10%

0%

10%

20%

30%

40%

50%

60%

White AfricanAmerican

Hispanic Other orMultiracial

Disproportionality in entries in 2014N=264,703

General Population Entry Population

SOURCE: AFCARS 2014 and U.S. Census Bureau

White44%

African-American24%

Hispanic22%

Multi-racial7%

Native American

2%

Asian/Hawaiian1%

Race/ethnicity of kids served in 2014N= 653,255

Current indicators:Children of color disproportionately represented

14SOURCE: Chapin Hall Center for Children (2012)

For kids in out-of-home care, initial placement in family settings is crucial to better outcomes. They experience well-being and

developmental benefits in families

88%

7%

34% 35%

0%10%20%30%40%50%60%70%80%90%

100%

Family (Kin/Foster) Group

Med

ian

Placement type

Initial placements

0-1213+

Range50 – 93%

Range31 – 78%

Range18 – 67%

Range1 – 42%

Current Indicators:Kids need stable living situations, relationships

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Likelihood of permanence diminishes drastically based on age, length of stay*

31.34%42.37%

53.04%58.37%

22%28% 30% 30%

0102030405060708090

100

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29

Perc

ent

Months

Time until permanency is reached among foster care entrants*

Under Age 12 Age 12+

*Chart represents an actual jurisdiction

8 mo. for 12+

18 mo. for 0 -11

Current indicators: How long a child is away from home can affect permanency

According to U.S Children’s Bureau’s Child & Family Services Reviews (CFSR) permanency outcomes were not broadly achieved. 62% of states failed to achieve federal standard for at least 1 CFSR permanency measure2; 6 states failed federal standard for all 3 measures

Exits care

SOURCES: AFCARS 2014 and U.S. Census Bureau Also, refer to previous CWSG webinar on Measuring Racial Disparity*Children in care on 9/30/2014

For each white child who…

1.82 Black

children

0.88 Black

children

1.25 Black

children

1.00 Hispanicchildren

0.96Hispanicchildren

0.92 Hispanicchildren

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Current indicators:Kids of color face disparity at key points, affecting permanency

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Poll: How familiar are you with your agency’s permanency outcomes?

1Unfamiliar

10Extremely

knowledgeable

5 Somewhat

familiar

What drives permanence?

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Before care In care After care

Permanence

Practice/ Policy

Service/Supports

Data

Boost permanence by using targeted approaches in all stages

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Before care

• % of cases receiving in-home services

• % of children entering care, exiting in fewer than 30 days

• # of youth from juvenile justice system court-referred to placement

• % of teens removed for behavior

In placement

• % in custody placed with kin

• % of kids initially placed in family settings

• % initially put in group care

• # of youths who go AWOL

• % who remain in care after 2 years

After care

• % of children entering care who exit to reunification or kin within one year

• % entering care achieving permanence within 2 years

• % of teens who emancipated or aged out

• % 18-21 in extended care

Strategy: Use data to track performance indicators to gauge permanency outcomes, inform practice

* Disaggregate all data by age, race and gender** Refer to Casey’s desk guide for additional performance indicators

Sample indicators

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An effective pool of preventive services addresses:

• Family issues prior to court oversight

• Specific needs that bring a family to the agency’s attention

• Behavior problems or parent-child conflict

• Safety and builds on family strengths and child well-being

Practice examplesIn 2012, 27% of older youth were removed and placed for child behavior

only* Delaware FAIR Teen CONNECT

*Source: The Annie E. Casey Foundation.(2015) Too many teens: Preventing unnecessary out-of-home placements. Baltimore, MD: Author. Retrieved from www.aecf.org/resources/too-many-teens/

• Screening and referral to FAIR provider based on risk and safety assessment

• Timely response to families is critical

• Family engagement is central this practice

• 40% reduction in teen entries into child welfare

• 28% return on investment

• Utilizes evidence-based and best practices

• Manualized, evidence-based and a cost effective intervention for birth and foster parents based on attachment theory

• Focuses on youth with challenging behaviors

• Decrease in youth aggression, conduct and oppositional behaviors

• Increase in parenting satisfaction

Strategy: Access to prevention services can reduce unnecessary entries

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Benefits to family engagement

This practice can lead to increased:

• Opportunities for family to be involved in decision making and maintain connections to child

• Trust and relationships with families

• Opportunities to meet child and family needs in least-restrictive settings

• Initial placements with relatives

• Timely reunification

• Placement stability and an increase in conversations that lead to permanency

Team Decision Making (TDM)

Key decision points

Facilitated

Family/youth involved

Strategy: Include families from the beginning and throughout the life of a case

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Kin

ship

Remove barriers that limit the approval of relatives

Fost

er F

amily

Target recruitment to ensure foster home network can serve population

Gro

up P

lace

men

t

Restrict group settings to meeting short-term therapeutic needs; eliminate use of emergency/ assessment shelter

Placement continuum

Practice examples

• Kinship Process Mapping (KPM)

• Licensing/approval standard, waivers for kin

• Family Search and Engagement

• Recruitment, Development and Support (RDS)

• Trauma Training Curriculum (TST/ARC)

• TEEN Connect

• Expedited Permanency Meetings (EPM)

• Director sign off policy

• Placing youth near home of origin

Provide youth in out-of-home placement with developmentally appropriate, trauma- informed services that support their ability to live in families

Strategy: Prioritize kin, family foster care to increaseplacement stability, improve outcomes

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Strategy: Frequent caseworker contact strongly associated with improved safety, permanency outcomes

PRACTICE STANDARDS

• Caseworker facilitates visits between children and birth parent

• Sibling visits are critical

• Face-to-face visits are key to effective casework

• Visits should be done regularly, regardless of child’s placement

• Provide support services when needed

+FREQUENCYAt least monthly

QUALITYFace-to-face, focused on family strengthens and services needs

Improve safety and

permanency outcomes

SOURCE: U.S. Health and Human Services, Administration fro Children and Families. Findings from initial 2001-2004 Child and Family Services Review. Retrieved from www.acf.hhs.gov/sites/default/files/cb/findings_from_the_inital_cfsr.pdf

+

Strategy: Post-reunification, adoption services are key to sustain permanency outcomes, reduce re-entries

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In-home services stabilize reunification and reduce re-entries

Practice standards

Provide:

• Ongoing casework after exit

• In-home therapeutic service to stabilize reunification

• Aftercare therapeutic intervention provided by residential treatment providers (www.BuildingBridges4Youth.org )

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Poll: What do you feel is the TOP priority to improve for your agency?

A. Preventing unnecessary entries

B. Engaging families at all key decision points throughout the life of a case

C. Making initial placements with relatives and families

D. Providing after-care supports to minimize re-entry

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Casey recommends

• Pay attention to permanence and family search from day one and thereafter

• Continuously collect and assess data on permanence and identify, address inequitable permanency outcomes by race, ethnicity, age and gender

• Engage families at key decision points, including in placement options, and involve them in services and treatment

• Provide children with stable living situations, caring relationships and ongoing family connections and prioritize permanence

• Build a robust service array so most children live in families, using group placements for only short-term therapeutic care

• Provide parents, caregivers sufficient supports to develop children and concrete, trauma-informed skills to use in everyday life to ensure children’s well-being

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See endnotes for links to:

• Casey’s desk guide

• Too many teens: Preventing unnecessary out-of-home placements

• Team Decision Making case study: Engaging families in placement decisions

• Back on track: Transforming Virginia’s child welfare system

• Building successful resource families practice guide

• Stepping up for kids: What government and communities should do to support kinship families

Casey resources can help

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Endnotes and additional resources

Practice resources • A Child Welfare Leader’s Desk Guide to Becoming a High-Performing Agency (2015)

http://www.aecf.org/resources/10-practices-part-one/

• Model foster home licensing standards http://www.grandfamilies.org/Portals/0/Model%20Licensing%20Standards%20FINAL.pdf

• Too many teens: Preventing unnecessary out of home placements http://www.aecf.org/resources/too-many-teens/

• Team Decision Making case study: Engaging families in placement decisions http://www.aecf.org/resources/team-decision-making/

• Back on track: Transforming Virginia’s child welfare system http://www.aecf.org/resources/back-on-track/

• Building successful resource families practice guide http://www.aecf.org/resources/building-successful-resource-families/

• Stepping up for kids: What government and communities should do to support kinship families http://www.aecf.org/resources/stepping-up-for-kids/

For print copies of the desk guide, please email dortiz@aecf.org

Next steps

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Please share your ideas and promising practices

Casey will update the desk guide in 2017. What should be included? Do you have a promising practice to share with the field?

Please email your feedback and ideas to Morgan Cole at mcole@aecf.org.

Questions?

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