NORTH CAROLINAS MULTIPLE RESPONSE SYSTEM

1
NORTH CAROLINAS MULTIPLE RESPONSE SYSTEM

• R. Patrick Betancourt
• MRS Program Coordinator
• Holly McNeill
• MRS Policy Consultant
• North Carolina Department of Health and Human
  Services
• North Carolina Division of Social Services
• Family Support and Child Welfare Services Section

2
Key NC DSS MRS Contacts

• Patrick Betancourt (MRS Program Coordinator)
• [phone]
• patrick.betancourt_at_ncmail.net
• Holly McNeill (MRS Policy Consultant)
• [phone]
• holly.mcneill_at_ncmail.net
• Sara Mims (Work First CPS Policy Team Leader)
• [phone]
• sara.mims_at_ncmail.net
• Katherine (Kate) Johnson (Data Management Team
  Leader)
• [phone]
• katherine.johnson_at_ncmail.net
• Teresa Turner (Staff Development Team Leader)
• [phone]
• teresa.turner_at_ncmail.net

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The goal of MRS is to ensure the safety,
permanence, well being, and self-sufficiency of
children and their families through the
integration of family centered practice
throughout all of family support and child
welfare.
Everyone Desires Respect
Everyone Needs to be Heard
Work First Child Welfare Collaboration
Use of Shared Parenting Meetings during Out of
Home Placements
Strengths Based Structured Intake
The safety, permanence, well-being, and self
sufficiency of children and their families
2 Approaches to CPS Reports
Use of Child Family Team Meetings during
In-Home Services
Everyone has Strengths
Law Enforcement CPS Collaboration
Re-Design of In-Home Services
Partnership is a Process
Judgments can Wait
Partners Share Power
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NORTH CARLOINAS MULTIPLE RESPONSE SYSTEM
EXPANSION MAP
Alleghany
Northampton
Gates
Warren
Ashe
Stokes
Surry
Currituck
Caswell
Person
Rockingham
Vance
Camden
Hertford
Pasquotank
Granville
Perquimans
Halifax
Wilkes
Watauga
Yadkin
Chowan
Forsyth
Guilford
Orange
Durham
Bertie
Franklin
Avery
Alamance
Mitchell
Nash
Alex- ander
Caldwell
Davie
Yancey
Edgecombe
Tyrrell
Madison
Martin
Washington
Iredell
Wake
Davidson
Dare
Chatham
Randolph
Wilson
Burke
McDowell
Buncombe
Rowan
Catawba
Pitt
Beaufort
Haywood
Johnston
Hyde
Swain
Greene
Cabarrus
Lee
Lincoln
Rutherford
Harnett
Hender- son
Cleveland
Wayne
Montgomery
Graham
Jackson
Moore
Gaston
Polk
Stanly
Mecklenburg
Lenoir
Craven
Transylvania
Macon
Pamlico
Cherokee
Cumberland
Clay
Hoke
Jones
Richmond
Sampson
Anson
Union
Duplin
Scot land
Carteret
Onslow
Robeson
2002 MRS Sites
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Bladen
Pender
2003 MRS Sites
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New Hanover
Columbus
Brunswick
2006 MRS Sites
48
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Family centered social workers approach families
differently? They.

• respect the families they work with by
• listening to what they have to say,
• focusing on their strengths,
• refraining from making hasty judgments,
• sharing power with them as partners, and
• remaining engaged with them in the process of
  partnership.

Family centered social workers treat families the
way they themselves would like to be treated if
they were the ones involved with the child
welfare system.
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Strengths-Based, Structured Intake

• This first stage of CPS is a professional
  service that utilizes objective structured tools
  and allows the social worker opportunities to
  conduct strengths-based interviews of reporters
  and document the information necessary to
  accurately and consistently identify, screen, and
  assign new reports of child abuse, neglect and
  dependency.
• Strengths based, structured intake
• Values the reporter and his decision to call DSS
  by supporting, encouraging, and listening to him.
• Emphasizes the identification of family
  strengths, extended family and community support
  systems.
• Provides a spring board for services to be
  delivered more quickly.
• Reduces the number of inappropriate reports
  accepted for CPS assessment
• Increases consistency from worker to worker and
  county to county.
• Increases safety for children, adult victims of
  DV, and social workers

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Two Approaches to Reports of Child Maltreatment
The investigative assessment approach utilizes a
forensic assessment process designed to determine
whether or not abuse or other specific
maltreatment has occurred and provides necessary
services to prevent a further incident. Its
intent is to address reports that present serious
safety concerns for children and/or potential
criminal charges against the alleged perpetrator.
The family assessment approach utilizes a
prevention oriented assessment process designed
to respond to indicators of anticipated problems,
as well as the specific reported incident in
neglect and dependency reports.

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Investigative Assessment Approach

• Appropriate for reports that involve
• These reports may not be assigned to the family
  assessment approach.
• An allegation meeting the definition of abuse in
  NCGS 7B-101
• A physician or law enforcement officer taking a
  child into custody by statute
• A medically neglected disabled infant with a life
  threatening condition
• A child hospitalized due to suspected abuse or
  neglect
• A known or suspected methamphetamine lab
• A child in a foster home, group home, or other
  out-of-home placement
• Families who choose not to participate in the
  Family Assessment Approach

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Characteristics of the Investigative Assessment
Approach

• First interview is conducted with the child,
  often without the parents knowledge
• Collateral contacts are made without the
  parents knowledge and/or permission
• Report is either substantiated or
  unsubstantiated
• Specific maltreatment is identified
• Perpetrator name is entered into a centralized
  data base
• Services begin after the case decision to
  substantiate

10
Family Assessment Approach

• Appropriate for reports that would meet the
  definitions of neglect or dependency in
  N.C.G.S.7B-101.
• These reports may be assigned to the
  investigative approach if needed to ensure child
  safety.
• Families may be struggling with issues of
• child supervision
• educational neglect
• domestic violence without imminent child harm
• inappropriate discipline
• unmet basic needs
• substance abuse
• These are situations in which there are needs
  that, if addressed, could stabilize the family
  and enable the parents to better care for their
  children

11
Family Assessment Approach Characteristics

• Parents are contacted and interviewed first, or
  at the same time the child is interviewed
• Professional collateral contacts are interviewed
  with the knowledge of the parent, preferably with
  their permission, and in their presence
• At the end of the assessment the family is found
  to be In Need of Services, Services Provided
  and No Longer Needed, Services Recommended, or
  Not in Need of Services
• No specific maltreatment is identified
• No perpetrator name is entered into a centralized
  data base
• Services are initiated upon initial contact with
  the family, or as soon as possible during the
  assessment

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Two Approaches Provide Opportunities To

• Use authority and resources more effectively
• Engage families and communities as partners in
  efforts to keep children safe and nurtured
• Enhance cooperation and strengths of families
• Address an overloaded CPS system
• Spend more time with the highest risk families

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Two Approaches Address CPS concerns by

• Ensuring that children are safe
• Avoiding negative labels and the issue of fault
  for parents who do not intentionally abuse their
  children
• Working in partnership with parents
• Identifying families strengths and needs
• Providing services and resources matched to
  families needs
• Not missing clear needs to protect children in
  cases of intentional maltreatment
• Not missing early opportunities to engage some
  families in services that could enable them to
  better parent their children

14
Coordination of Law Enforcement and CPS

• Current law requires DSS to report evidence of
  abuse to LEA and the DA
• The type and content of information gathered by
  DSS and LEA is similar, yet intended for a
  different outcome
• - DSS to determine if a parent/caretaker
  maltreated the child
• - LEA to determine if a criminal act as
  occurred
• Requires a close working relationship between DSS
  and LEA to achieve joint efforts in interviewing
  and ensuring safety of families and children
• Suggested that a MOA be jointly developed between
  DSS and LEA to ensure an effective working
  relationship

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Benefits of Coordination of LEA and CPS

• Perpetrators are accountable for intentionally
  harming children
• The number of interviews that children experience
  will be reduced
• Children are not re-traumatized by being
  interviewed multiple times
• The evidence process for criminal prosecution
  will be enhanced

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Redesign of In-home Family Services

• In-home, involuntary, protective services that
  are unique and individual to the jointly
  identified family strengths and needs
• The level and intensity of services are based
  upon the risk for future harm and needs of each
  individual family
• Families with the greatest risks and needs are
  provided with the most intensive services and
  contacts, while those with fewer receive less
• Services are delivered within the context of the
  familys own community and culture

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Child and Family Team Meetings

• Intended to engage the family and other
  interested parties in team decision making and
  provide the family with every support possible
• The family and the social worker jointly decide
  who will be invited to the meeting
• - This may include extended family, the child
  (if appropriate), formal and informal supportive
  relationships.
• Involved with the family throughout the life of
  the child welfare case
• Addresses the familys strengths and needs and
  how these impact the childs safety, permanence
  and well-being
• Addresses what needs to occur to help the family
  to safely parent their children
• Is with the family as partners, not about them as
  service recipients

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Goals of Child and Family Team Meetings

• To recognize the birth families as the expert in
  their situations
• To improve the decision making process
• To encourage the support and buy-in of the
  family, extended family and the community in the
  planning and assessment process
• To develop specific, individualized and
  appropriate interventions for children and
  families

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Shared Parenting Meetings

• Meetings (and other contact) between the social
  worker, birth parents and foster parents to
  discuss the care of the child when out-of-home
  placement is necessary
• Everyone at the table has important information
  to share that will likely positively influence
  the childs transition to foster care and the
  timely achievement of a safe, nurturing,
  permanent home
• Parents have an opportunity to have valuable
  input into the care of their child
• Foster parents have an opportunity to share
  information about themselves, what they observe
  and have learned about the child while in their
  care
• Plans can be made regarding visitation, medical
  appointments and transportation

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Benefits of Shared Parenting Meetings

• The birth family is actively involved in their
  role as parents of their child
• Nurturing relationships are cultivated between
  the birth and foster parents
• Foster parents can become mentors for the birth
  family regarding appropriate parenting
• Children in foster homes experience a more stable
  transition period, have shorter lengths of stay,
  and are safer and more permanent in their birth
  families homes upon exit from foster care

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Collaboration between DSSs Work First Family
Assistance and Child Welfare Programs

• WFFA provides families with financial, employment
  and community services supports to assist
  families in becoming self-sufficient (child care,
  employment counseling, transportation)
• Many families involved with the WFFA program are
  also involved with child welfare cases
• WFFA and Child Welfare staff need to share
  information, case planning and resources with one
  another regarding families they jointly share
• WFFA services can provide follow-up or
  preventative services with families once issues
  concerning child safety are resolved

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Benefits of Collaboration between WFFA and CWS
Programs

• Family members do not need to repeat their
  stories because the program areas share
  information with one another
• When WFFA is involved as a preventative effort,
  the number of children needing CPS and Placement
  Services will be reduced
• Voluntary, on-going services provided through
  WFFA will prevent recidivism

23
Duke Universitys Terry Sanford Institute of
Public Policy, Center for Child and Family Policy
conducted an evaluation that found MRS

• has not adversely affected the level of
  childrens safety
• has not significantly altered DSSs initial
  response or decision making time frames
• has not altered the length of time from report to
  the initiation of services
• allows for better coordination and communication
  across agencies
• comprehensive cost-effectiveness analysis was not
  feasible

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MRS Impact on Service Workers Perspective (Duke)

• MRS is more respectful to the families than the
  traditionally used approach
• MRS makes the families more open, less defensive
  and less resistant
• Families are more receptive to social workers
  under MRS than previously
• The whole situation is taken into consideration,
  and not just the specific incident
• Families are offered many needed services that
  they would not otherwise receive
• Social workers and supervisors are allowed
  greater flexibility in decision making and
  service delivery
• Child and Family Teams (CFTs) allow families the
  opportunity to take charge of their family and to
  work with other professionals to meet their
  existing needs
• When utilized consistently, CFTs were described
  as God-sent, the resource that safeguards
  safety, and time savers

Social workers and supervisors unanimously agreed
that MRS is a good way to serve families that
allegedly maltreat their children.
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The Duke MRS Evaluation can be found at

• http//www.dhhs.state.nc.us/dss/mrs/docs/mrs_eval_
  rpt_6_30_06_all_combined.pdf

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NC DSSs Strategy for Statewide Implementation of
MRS involves

• Legislation
• Training
• Evaluation
• County DSS Capacity Building

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The 2005 Long Session of the General Assembly
provided

• Revisions to N.C.G.S.7B through S.L. 2005-55
  (effective 10/01/2005)
• Replacement of the variations of the word
  investigate with assess (this allows for both
  investigative and family assessments)
• Statutory definitions for the Family Assessment
  Response and Investigative Assessment Response
  N.C.G.S.7B-101 (11a) and N.C.G.S.7B-101 (11b)
• No longer requires a visit to the childs
  residence during child care setting related CPS
  investigative assessments N.C.G.S. 7B-302

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The 2005 Long Session of the General Assembly
provided

• State Budget
• North Carolina Families Accessing Services
  through Technology (NCFAST)
• School-Based Child and Family Team Initiative
• Continuation of MRS
• Establishing a System of Care with the use of
  Child and Family Team Meetings
• 2,000,000 for the addition of new county CPS
  workers

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Training

• Meet every identified need of the county
  Departments of Social Services
• Enhancing current Family-Centered Meetings (CFTs
  and Shared Parenting) and Facilitator training
• Developing curriculum to enhance the use of Child
  and Family Team meetings in cases that DV,
  substance abuse, and/or mental illness impact the
  childs safety
• Continue to sustain MRS and address workforce
  development needs by building in family centered
  practice into both pre-service training and
  on-going child welfare training
• Mentor and coach current facilitators
• Develop and pilot web-based child welfare training

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Evaluation

• Evaluation project oversight and management
  through NC DSS Data and Evaluation Team
• Contract with Duke to conduct extended, in depth
  evaluation of MRS implementation
• Site Visits
• Focus groups / interviews
• Data analysis
• Record Reviews
• Contract with NC DHHR DIRM develop a web based
  automated data management system
• NC DSS efforts to ensure practice and policy
  compliance includes
• use of the NC DHHS Data Warehouse for monthly
  county/case specific information
• site visits
• record reviews

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County DSS Capacity Building

• Monthly regional meetings
• Quarterly Pilot County meetings
• MRS Web Site http//www.dhhs.state.nc.us/dss/mrs/
  index.htm
• MRS E-Mail Address nc.mrs_at_ncmail.net
• MRS E-Mail Listing
• MRS Quarterly Newsletter published electronically
• NC DSS Consultation
• Field Staff
• Childrens Program and Work First Program
  Representatives
• MRS Policy Consultant
• Central Office Staff
• MRS Program Coordinator
• Child Family Services Review Team