title page - Georgia Association of Homes and Services for Children

Report
Georgia’s Safety Response System
Presenter:
Lisa Lariscy
GA DHS/DFCS Project Director,
Safety Response System and Differential Response
Presentation to:
G-2
Date:
April 03, 2014
Georgia Department of Human Services
Vision, Mission and Core Values
Vision
Stronger Families for a Stronger Georgia.
Mission
Strengthen Georgia by providing Individuals and Families access to services
that promote self-sufficiency, independence, and protect Georgia's
vulnerable children and adults.
Core Values
•
•
•
•
Provide access to resources that offer support and empower Georgians and
their families.
Deliver services professionally and treat all clients with dignity and respect.
Manage business operations effectively and efficiently by aligning resources
across the agency.
Promote accountability, transparency and quality in all services we deliver
and programs we administer.
Develop our employees at all levels of the agency.
SRS Presentation Objectives
Georgia’s Safety Response System
Origin of SRS
Defining SRS
Implementation Process for SRS
Status of Statewide SRS with a View of Phase
One: Intake
Going Forward with SRS
•
Technical Assistance
GEORGIA
ACCWIC
Develop and implement our
child welfare practice and to
facilitate organizational change
Build Georgia’s capacity to
implement and engage
resources to support a
significant child welfare
practice change to ensure
fidelity and sustainability to
that practice change - Atlantic
Coast Child Welfare Implementation
Center (ACCWIC)
NRCCPS
Provide child welfare subject
matter expertise to strategically
support Georgia in utilizing the
latest state of the art child
welfare practice framework
focused on safety of children –
National Resource Center for Child
Protective Services (NRCCPS)
Two Evidence-based Models
Implementation Phases &
Drivers Framework
 Also used by the CB and
its T/TA Network
 Regional teams trained,
Pilot Counties immersed
 Open-source website to
support continued
learning
http://nirn.fpg.unc.edu
National Safety Model

Policy consultation,
Live Learning
Sessions, Intensive
Training Academy

Open-source
website to support
continued learning

Evidence based
safety intervention
model
http://action4cp.org
Georgia Safety Response System*
Allows for and guides strategic decision making for the safety of children.
• Intake Assessment /CPS Reports - A comprehensive Information gathering
and analysis process used to determine the most appropriate agency
response to an accepted CPS report.
• Through initial and ongoing contacts with the family, a comprehensive
safety assessment is conducted.
• At any time a safety concern is identified, it is addressed through the most
appropriate safety management practice (in home/out of home).
• Safety Plans are created to control the threat of danger to the child.
• A formal caregiver assessment is conducted to identify what must change
with the caregiver(s). Services will be provided that focus on enhancing the
caregiver’s diminished protective capacities.
*Adopted by Action 4 Child Protection
Implementation Science*
Allows for, and helps make informed strategic decisions for:
• Training, Supervision, Coaching
• Internal and External Collaboration/Coordination
• Feedback from practitioners and stakeholders
• Perspectives from all levels of the organization are heard
• Managers use data to guide implementation and align resources to
support needed improvements
• Ensures fidelity and sustainability to the child welfare practice change
*Adopted from the National Implementation Research Network
Implementation Drivers
Performance
Assessment
Systems Intervention
Coaching
Facilitative
Administration
Training
Selection
Integrated &
Compensatory
Leadership
Adaptive
Graphics by Steve Goodman,2009
Leadership Academy for Middle Managers • www.ncwwi.org
Data Driven
Decisions
Technical
(Fixsen & Blase, 2008)
A Service of the Children’s Bureau, a Member of the T/TA Network
Stages of Implementation
Sustainability
Innovation
Full Operation
Initial Implementation
Installation
Exploration
The Pilot
SRS Statewide Roll Out Scenario
Implementation Science
Phase
2011
Exploration and Program
Design
√
Project Installation
(Includes committee
variation to meet project
phases)
√
Initial Implementation
(Staff are trained and begin
practicing at the frontline )
September
2013
December
2014
February
2015
December
2015
February
2016
June
2017
√
Full Operation
(Learning is integrated into
practice policies and
procedures)
Innovation
(Well informed changes can
be made)
Sustainability
(Strategies to Support
Leadership & Practitioner
Changes)
SRS Phase 1 :
Intake
SRS Phase 2:
Family Support & Investigation
SRS Phase 3:
Family Preservation & Foster Care
Pilots’ Contribution to a Successful Implementation






Avoid sink or swim scenario. Detect and trouble shoot the
unexpected issues that could sink the change initiative.
Practice turning “intention into action” on a smaller scale.
Experiment with innovations without the pressure to predict every
twist and turn in the change process.
Increase awareness that change does not happen all at once.
Instill confidence that the process of change can be managed
responsibly.
Feed lessons learned on what works/does not work back to
implementation planners and decision-makers.
Georgia’s Safety Response System
Status of SRS
Pilot Status
Statewide Status
SRS – Pilot and Statewide
 SRS Pilot Counties Selected: Richmond/Urban/NE and
Sumter/Rural/SW
 SRS Counties Began Piloting the Model in Intake, Family
Support and Investigations 09/2012
 SRS Counties Began Piloting Family Preservation and
Foster Care 10/2013 (ongoing with challenges)
 SRS Phase One: Intake – began initial implementation in
09/2013
Implementation Capacity
• 60 item survey sent to pilot county and
regional staff, state implementation team,
state quality assurance and training
• Reflects staff perception of implementation
capacity
• N=67, 45% response rate
Implementation Capacity
Performance Assessment
(Fidelity) 3.20
Coaching
3.49
Live Learning
4.08
Training
4.52
Systems Intervention
3.60
Facilitative Administration
3.45
Decision Support
Data System 3.88
Selection
3.84
LEADERSHIP 4.40
Shared Vision, Values & Mission 5.15
Based on a Likert Scale of
1-7, N=64
SRS Capacity Built as of March 2014
 Statewide policies are being informed
by pilot and core group of SRS
Specialists
 73 SRS Specialists
 Safety Response System Academy
training – Ongoing
 Implementation Science training
established
 SRS Fidelity Review tools for Phases
1 and Phase 2 established
SRS Statewide Implementation
A View of SRS Phase One:
Intake
Intake Assessment
•This is the first assessment of safety in Georgia’s Safety
Response System.
•The Intake Assessment is a comprehensive information
gathering and analysis process used to determine the most
appropriate agency response.
Objectives
• Assist reporters to provide behaviorally specific, detailed information
• Identify present and impending danger, vulnerable children, and diminished
caregiver protective capacities
• Determine the response time
• Provide resource information
The SRS Intake Process
Engagement with the Reporter
• Obtain as much information as
possible
• Document Reporter's Specific
Concerns .
• What is the reporter trying to get
across concerning potential abuse
and/or neglect of the child?
• Expand on vague allegations & ask
probing questions
• Consider the six areas of Family
Functioning & ask specific
information of the reporter
regarding the children and family
• Ensure that all basic information
has been collected from the
reporter.
Review and Application of
History
●Complete Screenings on
known household members
and/or caretakers
●Consider information
obtained
●Does CPS history and this
report indicate an
escalation in types of
maltreatment, frequency of
allegations....
Does this report when
combined with
historical knowledge of
the family rise to the
level of maltreatment as
defined by GA Code and
DFCS Policy?
The SRS Intake Process
Child Safe – Family Support Assignment
Five Day Response
Yes
Child Unsafe – Investigation
0 to 24 Hours Response
The Intake Assessment
Six Areas of Family Functioning
1. Extent of Maltreatment
•
•
•
•
Captures the description, type and severity of maltreatment
alleged
Additionally captures the reporter’s knowledge of events
(first-hand/eyewitness, 3rd party, etc)
Identifies the alleged Maltreator
For all intakes
The Intake Assessment
2. Circumstances Surrounding the Maltreatment
• What was happening when the maltreatment occurred?
• Does the caregiver have an explanation?
– Acknowledgement, what were their attitudes & intentions
• Captures history of past CPS involvement
– patterns of maltreatment
– Identifying any progressing patterns of severity
• Identifies any protective measures taken by the nonmaltreating caregiver
The Intake Assessment
3. Child Functioning
• Captures day to day functioning of EACH child, whether
identified as a “victim child” or “no role”
• What is each child like normally?
–
–
–
–
Captures developmental concerns
Effects of maltreatment (emotional, psychological, physiological)
How is the child at the time of the report?
Will the child’s situation change quickly (safe at school vs. unsafe
when arriving home?)
– School? On grade level? Regular classes?
Crucial in determining vulnerability of child
The Intake Assessment
4. Adult Functioning (in general)
• How does this Adult (maltreator and non-maltreator, if
applicable) function as an adult?
–
–
–
–
–
–
Captures mental and physical health (both current and past)
Identifies substance use, employment, criminal behavior/history
Indications of violence
Significant stressors present in home
How does this adult relate to his community?
How does the adult cope, problem solve, communicate, etc?
The Intake Assessment
5. Parenting (in General)
• Captures history of protective behavior (or non-protective
behavior), along with parenting style (Not related to malt.)
• Identifies sensitivity to child’s needs and expectations for both
the child and self
– Is the parent satisfied as a parent?
– Is the parent more concerned with self than with child?
– What knowledge does the parent possess of normal child
development and behavior?
– How would you describe the parent/child relationship?
– What are expectations for the child?
– Do not gather for foster parents or house parents of CPA/CPI)
The Intake Assessment
6. Discipline (in general)
• Captures parent’s approach to discipline
• Identifies parent’s purpose and intention in discipline
• Identifies parent’s specific discipline methods
–
–
–
–
–
–
Does the parent remain self-control when using discipline?
Is discipline used to punish or to teach?
Is the discipline age-appropriate?
What boundaries/rules has the parent set?
How does s/he discipline the child?
When does child receive discipline?
• Do not gather for foster parents or house parents of CPA/CPI)
The Intake Assessment
History
• History can often be the tipping point--the point at which we
say yes, this is now an accepted report or moves us from a
family support assignment to an investigation.
• A thorough review of history and application to the decision
making is essential to determine appropriate disposition.
• The review of history and application of that history to the
current report takes time.
Status of SRS Phase One Intake
• All Intake Staff Trained as of 12/2013
• SHINES Modifications Identified
• SRS Specialists Support Activities:
– Provided Live Learning Activities
– On-site Support for Intake Staff statewide
– Provided individual coaching with Supervisors and intake
staff
– Reviewed approximately 7000 intake dispositions
– Detailed written feedback on dispositions overturned
Status of Intake Organizational Change







CICC Management In Place as of 12/2013
Electronic Reporting for Mandated Reporters in place
County/Region Phone Line Transition Process Established
Regions 3,4,5,7,8, 9, 13,14 & 15 transitioned to CICC
Integrated Voice Recorded Message
Volunteers in Place to Support Staffing Need
Formal performance expectations inclusive of Georgia’s Safety
Response System concepts and practices developed and
executed for intake staff.
SRS Specialists Reviews – 11/09/13 – 2/9/14
100%
95%
95%
93%
93%
93%
91%
90%
89%
Combined
CICC
88%
Counties
85%
80%
2,465
Rev'd
1,880
Rev'd
585
Rev'd
82%
3,145
Rev'd
82%
714
Rev'd
2,431R
ev'd
5,610
Rev’d
4,311
Rev'd
1,299
Rev'd
75%
Screen Out % agreement
Family support % Agreement
FS/SO combined
SRS Specialists Review Results
February 10 - 28, 2014
(Investigations)
100%
90%
90%
86%
88%
80%
80%
78%
79%
75%
71%
70%
66%
60%
56%
50%
46%
45%
40%
37%
34%
28%
30%
20%
Track Agr.
Malt. code agr.
CICC-416 rev's
History applied
County- 384 rev's
Correct PD
Combined 800 rev's
Correct ID
Analysis of Reviews
• 88% agreement rate for ~ 7000 cases.
• Activities under way to enhance understanding and practice
of SRS intake concepts related to Present and Impending
Danger
• Maltreatment types and codes being revised to better guide
staff in identifying maltreatment and to allow for consistent
practice
• SHINES History modifications being made to allow for more
efficient screening of CPS history
Questions regarding SRS Intake?
Georgia’s Safety Response System
Going Forward with SRS
SRS Phase Two: Early 2015
SRS Phase Three: Fall 2015
Going Forward with SRS Phases Two & Three
Lessons Learned from SRS Phase One: Intake
 Policies Finalized prior to Training and/or SHINES Design
Sessions
 SHINES Modifications Made Prior to Roll Out of Future Phases
 Continual Review of IS Drivers’ Effectiveness & Identifying Gaps &
Ways to Address (Surveys, Review Findings, Data..)
 Ensure Knowledge Capacity in Place Prior to Roll Out
 Plan of Initial & Ongoing SRS Specialists Support Prior to Roll Out
 Structured Collaboration with Regions through IS Region Plans
Going Forward with SRS Phases Two & Three
Adequate Staffing in Place Prior to Roll Out
Strategy to ensure SRS Specialists are
Understanding and Applying the Model Effectively
Advocate for and Obtain Funding for Fidelity
Review Team
Ensure Effective Staff Recruitment, Selection and
Development
Preparation for Phase 2 & Phase 3
• Implementation Science
Training
• Regions to develop
Implementation Plans
• Staff Acquisition and
Training
• SRS Project Team to
support the pilot work
• SRS Specialists will
continue to meet monthly
and enhance their capacity
and cascade learning
• SRS Academies are
currently planned on an
consistent ongoing basis
to build capacity and
model expertise
SRS Concepts for Readiness Activities
Family Functioning
Assessment
• The six areas in the FFA
• What information is needed in
each area?
• Maltreatment – new policy
• Caregiver Protective
Capacities (three types)
• Analyzing the family’s
functioning
Present Danger
• Understanding what
constitutes a PD Situation
• How to Assess for
Present Danger
• Safety Criteria –
observable, happening
now & significant
SRS Concepts for Readiness Activities
Present Danger Safety Plan
• Understanding the purpose of
the PD Safety Plan
• How to Plan Appropriately for
Controlling the Present
Danger
• How To Use the PD Safety
Plan appropriately
• Informal & Formal Safety
Service Providers
• Judging Provider
Suitability
• Conditions for Return to
the Home of the Caregiver
SRS Concepts for Readiness Activities
Impending Danger
• Understanding Impending
Danger
• Use and application of the
safety threshold in assessing
for ID
Impending Danger Safety Plan
• Understanding the purpose
of the ID Safety Plan
• How to Plan Appropriately
for Controlling ID
• Informal & Formal Safety
Service Providers
• Judging Provider Suitability
• Conditions for Return
SRS Concepts for Readiness Activities
• Identification of appropriate
collaterals
• Using collaterals to fill in
family functioning gaps & to
support/refute information
• Analysis & Understanding
of the Family’s Functioning
• Determining service
providers to strengthen
families
• Stages of Change
• Assessing Change
Safety Response System Project Team
Lisa C. Lariscy
Project Director, Safety Response
System
and Differential Response
[email protected]
(912) 222-5296 (BB)
Kristan Small-Isom
Safety Response System Coordinator
[email protected]
(404)463-8575 (Desk)
Ami Perryman
Safety Response System Coordinator
[email protected]
(706) 994-9104 (BB)

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