Performancebased Standards PbS

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• Performance-based Standards (PbS)
• for Youth Correction and Detention Facilities
• National Juvenile Justice Network 6th Annual
  Forum
• Kim Godfrey, Deputy Director
• Council of Juvenile Correctional Administrators
• Thursday, June 26, 2008
• Chicago

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PbS Measuring Performance and Improvement

• Council of Juvenile Correctional Administrators
  (CJCA)
• National non-profit organization dedicated to
  improvement of youth correctional services and
  practices so youths succeed when they return to
  the community
• Unites nations youth correctional CEOs to
  promote best practices, address common concerns
  and provide leadership for juvenile justice
• Directs several grant projects MacArthur
  Foundation Model for Change, Annual Directors
  Leadership Conference, New Directors Seminar,
  Suicide Prevention Resource Center
• Yearbook, Newsletter, website resources and
  connections
• www.cjca.net
• PbS Learning Institute PbS and Community-based
  Standards (CbS) for residential programs

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Presentation Overview

• How PbS was developed
• The scope of PbS Standards and Outcomes
• How PbS works
• 15 minutes!
• www.pbstandards.org or Help_at_pbstandards.org for
  more information

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PbS

• Guiding principal
• Run every facility as if the next child coming
  in is your own.
• Cycle to break the cycle of institutions
• Calm/positive staff-youth interaction
• Crackdown on crime, crowding, deterioration,
  predatory youths, escapes, staff abuses
• Exposure, investigation, Blue Ribbon Commissions
• Reform/ return to calm
• Continuous improvement process
• Highest standards, practices measured 2x year
• NOT one-time accreditation, pass/fail
  certification

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CRIPA Analysis 2006

• Mapped 10 years of investigations with PbS
• Conclusion Facilities that implement PbS as
  intended and should not expect a CRIPA
  investigation because CRIPA investigates based on
  failure to meet the bare minimum Constitutional
  standards and PbS sets the highest standards for
  operational success.

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Mental Health
DOJs Standard - A general deviation from
providing adequate care and protection that would
include a complete medical (including dental),
mental health and suicide screening of new
admissions. A review of the screening process
will include the following all screenings must
be conducted by qualified individuals who have
been trained to conduct such screenings initial
screenings should be reviewed and signed by a
qualified professional and the initial screening
must include the taking of the youths medical
history and a review of accompanying health
records.

• PbS Goal - To identify and effectively respond to
  youths health, mental health and related
  behavioral problems throughout the course of
  confinement through the use of professionally-appr
  opriate diagnostic, treatment and prevention
  protocols.
• Standard - Identify youths at time of admission
  who have acute health problems or crisis mental
  health situations and following evaluation,
  ensure delivery of appropriate health or mental
  health services.

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DOJ PbS

• Outcome Measures
• Percent of youths that had a complete intake
  screening by trained and qualified staff.
• Percent of youths presented for admission that
  had a complete intake screening (suicide, mental
  health and health) completed within one hour or
  less by trained and qualified staff.
• Expected Practices
• All youths presented for admission receive a
  complete health, mental health, and suicide
  intake screening.
• Staff assigned to do intakes are deemed qualified
  by state law and policy and/or agency policy.
  Qualification depends on education, training
  and/or certification requirements.

• Constitutional, Statutory and/or Case Law
• Constitutionally mandated right to adequate
  medical care, a concept that embraces mental
  health treatment and suicide prevention measures.
  See Patten v. Nichols, 274 F.3d 829, 835 (4th
  Cir. 2001)
• Youths in juvenile justice institutions receive
  adequate mental health care. Youngberg, 457 U.S.
  at 323, n.30 Nelson, 491 F.2d at 360 see also
  K.H. v. Morgan, 914 F.2d 846, 851 (7th Cir.
  1990)
• In assessing the constitutional adequacy of
  mental health practices consider if professional
  decisions substantially depart from accepted
  professional judgment. See Youngberg, 457 U.S.
  at 323
• Minimum Measures Needed to Rectify Deficiencies
• Facilities must have sufficient mental health
  and medical staff to meet the serious mental
  health and medical needs of their youth
  population.
• Facilities should develop and implement a mental
  health and suicide risk screening instrument for
  use in all of their facilities. They should also
  develop and implement a training program for
  staff who will administer the screenings. Only a
  qualified mental health professional should
  conduct an intake screening for each youth as
  soon as practicable upon admission to any
  facility.

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PbS History

• Perception high crime rates late 1980s, early
  1990s super predators and nothing works
• Institution was placement of choice
• What went on behind razor wire fences was
  ignored, unknown and largely avoided public
  perception formed by press, horrific incident
• Data usually meant someone was about to sue
• Recidivism not accurate measure of effectiveness
• Reality about 3,000 facilities holding about
  100,000 youths daily numbers decreasing

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1994 Conditions of Confinement Study

• About 1,000 secure facilities and found
  substantial and widespread deficiencies
• High rates of youths and staff getting hurt
• High rates of suicidal behavior
• Few timely or professional health screenings
• High levels of staff turnover
• Adherence to existing standards did not mean
  better facility

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1995 PbS Launched to Address COC Problems

• OJJDP selected the Council of Juvenile
  Correctional Administrators (CJCA) to direct and
  develop the project
• Basic belief a youths time in confinement
  should be a positive experience that provides
  help so the youth will succeed when back in the
  community
• Guiding principals First key to sustaining
  success
• Facilities should be places wed feel comfortable
  sending our own children
• Set standards at highest level of performance,
  not minimums
• Gradually transfer knowledge, skills and
  ownership of PbS from project to field
• Field driven to be meaningful and useful
  feedback
• Start with all stakeholders, related agencies at
  the table
• Create meaningful and user-friendly performance
  measures

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PbS Development Process

• National Advisory Board CJCA, NJDA, ACA, YLC,
  ABA-JJ, MH, CEA, NCCD
• Working group on each function area Safety,
  Order, Security, Health/Mental Health,
  Programming, Justice, and Reintegration
  comprised of experts, practitioners, advocates,
  researchers developed outcome measures to
  indicate performance related to standards
• Pilot, revise, field test, revise, implement
• feedback loop

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Performance Outcomes - Examples

• Rates of injuries as indication of level of
  safety
• Percentage of youths improving math and reading
  scores from pre-test to post-test indicating
  effectiveness of education program
• Number of instances youths placed in isolation
  and average duration to describe behavior
  management system and sense of order
• Interview youths and staff to ask about
  perception of safety reported as percentages who
  report fear describe quality of life for youths
  and staff

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PbS Participants 2008

• 185 sites in 30 states
• 36 distinct jurisdictions
• 119 correction, 56 detention and 10 assessment
  centers
• 18 female-only facilities
• gt100 beds 51
• lt50 beds93
• 50-99 beds41
• Indiana, Texas and New York facilities will
  participate in October 2008
• 17 new sites

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How PbS Works The Blueprint

• A set of seven goals and 27 standards for
  corrections and 19 standards for detention
  facilities to assess
• Safety
• Order
• Security
• Health and mental health
• Programming
• Justice
• Reintegration (Corrections Only)
• Performance toward meeting each standard is
  measured using one or more outcome measures,
  which are compared over time and to other
  participating facilities.
• PbS is a standards based performance improvement
  measurement system

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PbS Standard Layout
Each of the seven areas are formatted in the
following manner Area XXX Goal XXX1 Performanc
e Standard
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PbS Goals

• Safety To engage in management practices that
  promote the safety and well-being of staff and
  youths.
• Order To establish clear expectations of
  behavior and an accompanying system of
  accountability for youths and staff that promote
  mutual respect, self discipline and order.
• Security To protect public safety and to provide
  a safe environment for youths and staff, an
  essential condition for learning and treatment to
  be effective.
• Programming To provide meaningful opportunities
  and services to youths to improve their
  educational and vocational competence, to
  effectively address underlying behavioral
  problems and to prepare them for responsible
  lives in the community.

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PbS Goals

• Justice To operate the facility in a manner
  consistent with principles of fairness and that
  provides the means of ensuring and protecting
  youths and familys legal rights.
• Health and Mental Health To identify and
  effectively respond to residents health, mental
  health, and related behavioral problems
  throughout the course of confinement through the
  use of professionally appropriate diagnostic,
  treatment, and prevention protocols
• Reintegration To prepare youths for successful
  reintegration into the community while they
  reside at the facility

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PbS Outcome Measures
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How PbS Works Improvement Cycle

• April and October are data collection months.
• Draft Site report is received within 48 hours of
  close of data entry.
• Data corrections are made to anomalies, not
  recorded and outliers
• Final Site Reports are generated along with
  summary reports for all data collection forms 14
  days after receipt of the draft reports
• Improvement plan is developed and entered into
  website with targeted outcome measures.

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Data Collection

• Administrative Form
• 1 per site, 46 questions
• Incident Reports
• All incident reports for data collection period
  (12,849)
• Youth Record
• 30 random YR, 93 questions (5274)
• Youth Climate Survey
• 30 random youths, 38 questions (5668)
• Staff Climate Survey
• 30 random staff, 38 questions
• (5999)
• Youth Exit Interview
• All youths released since last data collection,
  24 questions
• (5899)
• Ongoing data entry

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Site Reports and Analysis

• Individual outcome measures
• Grouping by area
• Comparison over time
• Comparison to field average
• Outcome measures selected for improvement
• Critical outcome measures
• Tools correcting outcomes, dashboard

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Analysis Tools and Reports
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Jurisdictional Reports
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Omnibus Report
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Facility Improvement Plans (FIPs)

• Components of a Sites FIP
• Targeted Outcome Measures
• Targeted Outcome Measure Goals
• What is the problem?
• Action Steps
• Progress Notes
• Ongoing Review by Facility Administrator , PbS
  State Coordinator, and PbS Coach

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PbS Levels of Achievement
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Performance Profile
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Performance Profile Sample Size
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Performance Profile Critical Outcome Measures
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Outcome Measure Example Order

• Goal To establish clear expectations of behavior
  and an accompanying system of accountability for
  youths and staff that promote mutual respect,
  self discipline and order.
• Standards
• Maximize responsible behavior by youth and staff
  and conformance to facility rules
• Minimize the facilitys use of restrictive and
  coercive means of responding to disorder
• Maximize opportunities for youths to participate
  in activities and programs.
• Outcome Measures Incidents of youth misconduct
  use of physical restraint use of mechanical
  restraint use of isolation or room confinement
  and average duration of isolation or room
  confinement.

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Order 3 Physical Restraint Use

• The denominator is constructed using the total
  number of youth population for the month (4841)
• The numerator is constructed from incident
  reports of all physical restraints
• Raw score for the April 2008 data collection was
  26 physical restraints

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Outcome Measure Examples Safety

• Goal To engage in management practices that
  promote the safety and well-being of staff and
  youths.
• Standards
• Protect youth and staff from intentional and
  accidental injuries
• Promote management practices and behavior that
  minimize harm resulting form the use of
  restraints, isolation and environmental risks
• Protect youth and staff from fear.
• Outcome Measures Number of injuries to youths
  number of injuries to staff number of injuries
  to youths by other youths incidents of suicidal
  behavior with and without injury by youths
  percent of youths and staff reporting that they
  fear for their safety.

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Safety 3 Injuries to Staff

• The denominator is constructed using the total
  number of direct care staff hours for the month
  (3666.125)
• The numerator is constructed from incident
  reports of all staff injuries
• Raw score for the April 2008 data collection was
  2 injuries

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Safety 2 Youth Injuries per 100 person- days of
youth confinement

• 35 youth injury events in October 2002 data
  collection
• The April 2008 detention field average rate of
  youth injury was 0.609
• South Carolina Detention rate of youth injury for
  April 2008 was 0.327 which was 10 injury events
• Consistently below the field average for the last
  6 data collections

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Dashboard
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Why PbS Works

• PbS gives facilities data, twice year, showing
  levels of safety, order, security, programming,
  health/mental health services, justice and
  reintegration
• PbS improvement process guides facilities in ways
  to use the information to identify what works and
  celebrate success as well as see what is not
  working and a structured path to create change
• Improves accountability facilities have data to
  share
• Prevents future incidents, lawsuits by improving
  compliance with best practices and high standards
• Identifies progress over time, compared to other
  facilities
• Ongoing, personalized customer support
• Access to resources, networking across USA
• (Yale School of Managements Survey of PbS Users)

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How do we know?

• Field testimonials word-of-mouth and money
• 2004 Innovations in American
• Government Award
• CRIPA analysis Legal protection
• PbS Research Each kids individual experience
  best way to impact facility safety positive
  interactions youths and staff
• www.pbstandards.org
• Help_at_pbstandards.org