Teaming with Families, Child Welfare and Mental Health Systems in the Development of Residential Tre

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Teaming with Families, Child Welfare and Mental
Health Systems in the Development of Residential
Treatment Standards

• Presenters
• Dean Bailey, DHHS Residential Programs Manager
• Leslie Rozeff, Director, Child Welfare Training
  Institute

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Workshop Objectives

• Learn strategies for effectively engaging
  stakeholders in policy development and program
  planning
• Gain an understanding of ways to create
  systems/practice changes
• Identify components of residential care that are
  family-centered and evidenced-based

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University and State Partnership
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Maines Background and History

• Most residential programs, group homes were
  developed between 1970 and 2003
• Types and designs varied by the state agency who
  was funding the program
• Minimal licensing regulations applied to
  residential programs
• Licensing site visits on average once every 2
  years

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Impetus of Maines Child Welfare Reform Efforts

• Major reform efforts began in 2001 following a
  tragic child death
• Annie E. Casey Strategic Consulting Group
  provided resources with a focus on reducing
  reliance on residential care
• Federal Child and Family Service Reviews
• Merger of Department of Behavioral and
  Developmental Services and Department of Human
  Services into a new Department of Health and
  Human Services

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A Paradigm Shift towards Stakeholder Engagement

• National Shift towards Family-Centered Practice
• Recognition of the crucial role families,
  providers and others play in achieving permanency
• Creation of Maine Child Welfare Services created
  a Family-Centered Practice Model in 2005
• Explicit leadership expectations to be more
  inclusive

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Strategies for Engaging Stakeholders
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• In order to achieve the outcomes of safety,
  permanency and well-being for children, child
  welfare agencies are increasingly partnering with
  a diverse range of stakeholders to jointly share
  responsibility for child protection.

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By engaging stakeholders you..

• Build the idea that the entire community, not
  just the child welfare agency, bears
  responsibility for child protection
• Increase your capacity to meet the needs of
  families and children by including more than just
  your agency
• Are working with a broader array of groups which
  is necessary to make systemic program improvements

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Characteristics of Effective Collaboration

• ENVIRONMENTAL
• a history of collaboration or cooperation in the
  community
• favorable political/social climate
• MEMBERSHIP
• mutual respect, understanding and trust among the
  partners
• appropriate partnership (no key stakeholder is
  missing)
• ability to see collaboration as in their
  self-interest and to take an interest in the
  success of other members
• ability to compromise
• PURPOSE
• concrete, attainable goals and objectives
• shared vision
• unique purpose

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• COMMUNICATION
• open and frequent communication
• established informal and formal communication
  links
• PROCESS/STRUCTURE
• shared stake in the process and outcome
• not limited to one level of decision-making
• flexibility
• clear roles and policy guidelines
• adaptability
• RESOURCES
• sufficient funds
• a skilled convener

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What this accomplishes

• Informs stakeholders of the Departments reasons
  for change
• Stakeholders views have been heard
• When the decision is made, there are no surprises
• Curtails political blow back

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To Involve Youth.

• HAVE YOUTH CO-CHAIR
• MAKE YOUTH RESPONSIBLEfor the activities they
  say they want to do.
• THINK OUTSIDE THE BOXand take risks youth will
  respond. One practitioner used e-polling to get
  information from youth regarding what actions to
  take to prevent copycat San Diego school
  shootings.
• RESPOND TO WHAT PARENTS AND YOUTH TELL
  YOUFamilies want to know what youre going to do
  tomorrow, not next year, so it is important,
  said one practitioner, to do something to get
  off the dime.

• HAVE A YOUTH SUBCOMMITTEEthat meets at times
  convenient for youth and does helpful tasks and
  activities be consistent in operating it and in
  reporting about it.
• VALUE YOUTH INVOLVEMENTIf they feel valued and
  believe that you will follow through on their
  suggestions, youth will stay involved.
• MAKE IT FUNThink about your activities in
  youthful terms. Always check in by asking, Is
  this fun? and How do you want to do it?
• ACT ON YOUR SUGGESTIONSIf they see no action on
  their suggestions, theyll stop talking.

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To Involve Parents..

• APPLY THE MAGIC FORMULAfood, child care,
  performances by their children, and interesting
  and relevant topics and activities.
• ENLIST THE MEDIA AS PARTNERSMedia will do things
  free for families, and theyre very interested in
  youth activities. One practitioner said her
  collaboration asked all the local media to be
  part of the stakeholders group, and now there is
  a countywide TV show produced by youth.
• USE INDEPENDENT FACILITATORSnot connected with
  any particular organization, to be sure families
  are heard.
• FREE YOURSELF FROM THE NOTIONthat everyone has
  to sit together smaller subgroups might be a
  better venue for parents and youth to speak up
  (at least initially).
• PROVIDE MONEYand other tangible support so that
  community peopleyouth and familiescan afford to
  be involved. Avoid scheduling meetings at times
  that conflict with families other obligations.

Adapted from T. N. Thornton, C. A. Craft, L. L.
Dahlberg, B. S. Lynch, K. Baer. (2000). Best
Practices of Youth Violence Prevention A
Sourcebook for Community Action (pp. 119).
Atlanta, GA Centers for Disease Control and
Prevention, National Center for Injury Prevention
and Control
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Creating Systems and Practice Changes
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Initiating the Change Process

• Hold different types of community forums
• Identify key champions/cheerleaders of the effort
• Invite participation from all relevant groups
• Ensure mutual respect and clear decision making
  process

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Provider Outreach Efforts

• Residential Review
• Maine Childrens Services Reform Reforming
  Residential Services Workgroup
• Local Forums
• Interdepartmental Resource Review
• Ad Hoc Workgroups (District Forums, etc.)

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• Develop common language, educational messages and
  values such as
• Stability is not permanence
• Residential Treatment is an intervention,
• not a placement
• Other tag lines youve used????

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Provide Data
Over and Over
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AFCARS 2004 DataWhere were the waiting children
living?
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Maine Child Welfare Demographics

• July 2004
• 2,909 Children in Care

• March 2009
• 1,977 Children in Care

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Child Welfare Residential Placements
Maines Child Welfare has reduced the use of
Residential Services by 72.6 in 5 years
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(No Transcript)
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Identifying components of residential care that
are family-centered and evidenced-based
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Shifting Provider Perspectives From
Child-Centered to Family-Centered

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Engaging Maines Residential Providers

• Involvement
• Communication
• Resource sharing
• Joint problem solving
• Partnership

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Residential Standards Workgroup

• Evolved out of a larger effort- Legislatively
  mandated Reforming Childrens Services
• Who was involved
• Process

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Areas of Focus

• Mental Health Treatment (qualifications, models)
• Family Centered (policy, roles and expectations
  for providers)
• Behavior Management (policy expectations for use
  of restraint, consequences)
• Treatment Planning (type, content, process)

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Implementation Whats Next?

• Standard rates
• Contract reviews
• How this will be implemented
• Monitoring quality

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We all share a Responsibility for OUR
Youth
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Contact Information
Dean Bailey, LSW, MPA 207-538-1873 deanb_at_stepstone
s4youth.org
Leslie J. Rozeff, LCSW 410-706-2059 lrozeff_at_ssw.um
aryland.edu