The Change is Not a Flash in the Pan Tuesday, April 17, 2012 Christian Child and Family Services Conference - PowerPoint PPT Presentation

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The Change is Not a Flash in the Pan Tuesday, April 17, 2012 Christian Child and Family Services Conference

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Title: The Change is Not a Flash in the Pan Tuesday, April 17, 2012 Christian Child and Family Services Conference


1
The Change is Not a Flash in the PanTuesday,
April 17, 2012Christian Child and Family
Services Conference
  • Normer AdamsExecutive Director
  • Georgia Association of Homes and Services for
    Children
  • The changes occurring in foster care and group
    home
  • care are unprecedented. Fewer children are
    entering foster
  • care, even fewer are cared for in congregate
    care. More
  • families are being supported by home and
    community
  • based services. This workshop will explore the
    decades of
  • public policy development that have lead to these
    changes
  • in response to abuse and neglect. This workshop
    will be
  • invaluable to those who are considering what
    services will
  • be supported by the Federal and State governments.

2
The Change is Not a Flash in the Pan
  • Change is mandated by
  • Federal and State Public Policy
  • National Advocacy
  • Evidence Based Practice

3
Personal Stories
  • Early Medicine George Washington died from his
    cure.
  • In the Practice of Family Therapy Eric Bern
    How do you know that it works.
  • Abel Ortiz - Georgia's Governors Welfare Policy
    Person - "We will reduce foster care by 50.  

4
Evidence Base Practice
  • The Power of the Anecdote DARE
  • Studies in Foster Care Academy of Pediatrics
    and Adolescent Medicine 2008 50 better
    outcomes with placement with kin.
  • 2006 Chapin Hall Placement Stability Study
    Placement with Kin more Stable

5
Movement to Home and Community
  • Nursing Home Industry
  • Most powerful of human service provider groups.
  • No growth in a decade
  • Home and Community Services
  • Papua New Guinea
  • 3rd World of 3rd World
  • 16 out of 100 die in first year
  • Phone book description of family preservation and
    a community based services

6
A Short History of Child Welfare
  • English doctrine of parens patriae, which means
    ultimate parent or parent of the country,
    dominated early Colonial America policy.
  • Super parent concept of the State

7
Hands Off Approach
  • Charities did most of the benevolent work.
  • Development of Orphans Homes
  • Georgia had two of the first
  • New Ebenezer 1738
  • Bethesda for Boys in 1740
  • Orphan trains to the West Apprenticeship and
    Reformation

8
Beginning of Foster Care
  • Interstate Compact on Placement of Children
  • In 1887, Michigan passed the first law in the
    United States regulating the placement of
    children within the state. 1895, required
    out-of-state, child-placement agencies to post a
    bond for each child the agency brought into the
    state of Michigan.
  • In 1899, Indiana, Illinois and Minnesota enacted
    similar but stricter laws which had  the effect
    of prohibiting the placement of incorrigible,
    diseased, insane or criminal children within
    their state boundaries.
  • Putting Up for Adoption
  • When the trains pulled into the stations, the
    caretakers would get the children cleaned up
    ready for inspection. The children would be put
    upon a stage to try to get the attention of
    potential parents. This became known as being Put
    Up For Adoption.

9
Modern Era
  • 1909 Roosevelt's Whitehouse Conference on
    Children created the Childrens Bureau in 1912.
  • to investigate and report "upon all matters
    pertaining to the welfare of children and child
    life among all classes of our people."
  • 1921 - Sheppard-Towner Act also known as the
    Maternity and Infancy Act brought the childrens
    bureau to the states.

10
Improvements in Child Welfare
  • Prior to this act, 16 children died in first
    year
  • After less that 1 child died

11
Social Welfare
  • Government increased involvement in child welfare
    and Research driven policy
  • 1922 Prince vs Mass. Confirmed the States
    legitimacy in child welfare
  • 1946 Aid to Dependent Children was added to the
    Security Act.

12
New Child Reporting Laws
  • 1946 - Dr. Caffey Article on childrens trauma
    equals child abuse
  • 1962 - C. Henry Kempe, article The Battered Child
    Syndrome in the Journal of the American Medical
    Association

13
The Modern Era
  • 1935 Social Security Act, Aid to Dependent
    Children
  • Tucked in the SSA was a provision authorizing the
    CB to cooperate with state public welfare
    agencies in establishing, extending and
    strengthening, especially in predominately rural
    areas, child welfare services for the protection
    and care of homeless, dependent, neglected
    children and those in danger of becoming
    delinquent.
  • 1962 Amended Provided Funding for Child Welfare
  • By 1967 nearly all states had laws placing the
    responsibility for child protection in
    government's hands.
  • 1973 Senator Walter Mondale wrote Nowhere in
    the Federal government could we find one official
    assigned full time to the prevention,
    identification and treatment of child abuse and
    neglect. Lead to passage of the CAPTA.

14
Increased Federal Involvement
  • Child Abuse Prevention and Treatment Act (CAPTA
    Public Law 93-273 - Funding for investigation
    and prevention

15
Increased Federal Involvement
  •  In 1980, Congress passed the Adoption Assistance
    and Child Welfare Act (Public Law 96-272 42
    U.S.C. 420). The act made federal funding for
    foster care dependent on certain reforms.
  • IV-E became a household term
  • Paid for 30 of all foster care
  • mandated that a child be in an least restrictive
    environment (read family like and near their
    families.

16
Increased Federal Involvement
  • Adoption and Safe Families Act of 1997
  • focus on States' capacity to create positive
    outcomes for children and families
  • Child and Family Services Reviews (CFSRs)

17
Adoption and Safe Families Act of 1997
  • ensure conformity with Federal child welfare
    requirements
  • determine what is actually happening to children
    and families as they are engaged in child welfare
    services and
  • assist States to enhance their capacity to help
    children and families achieve positive outcomes.

18
Adoption and Safe Families Act (ASFA) of 1997
  • Permanency
  • Children have permanency and stability in their
    living situations.
  • The continuity of family relationships and
    connections is preserved for families.
  • Safety
  • Children are, first and foremost, protected from
    abuse and neglect.
  • Children are safely maintained in their homes
    whenever possible and appropriate.
  • Wellbeing.
  • Families have enhanced capacity to provide for
    their children's needs.
  • Children receive appropriate services to meet
    their educational needs.
  • Children receive adequate services to meet their
    physical and mental health needs.

19
ASFA Introduced Shorter Time Limits For Making
Decisions About Permanent Placements
  • Permanency hearings to be held no later than 12
    months after entering foster care.
  • States must initiate termination of parental
    rights proceedings after the child has been in
    foster care 15 of the previous 22 months, except
    if not in the best interest of the child, or if
    the child is in the care of a relative.

20
ASFA Forever Families Sooner
  • Required States to initiate court proceedings to
    free a child for adoption once that child had
    been waiting in foster care for at least 15 of
    the most recent 22 months, unless there is an
    exception.
  • Allowed children to be freed for adoption more
    quickly in extreme cases.

21
ASFA Increased accountability
  • Required States to increase documentation of
    child-specific efforts to move children into
    permanency.
  • Required HHS to establish new outcome measures to
    monitor and improve State performance

22
ASFA LEAD TO the CHILD FAMILY SERVICES REVIEW
RESULTS-ORIENTED APPROACH
  • On January 25, 2000, the Federal Department of
    Health and Human Services issued regulations for
    ASFA establishing the Child and Family Services
    Review (CFSR).
  • The review covers child welfare services funded
    under Titles IV-B and IV-E of the Social Security
    Act including
  • Child Protective Services,
  • Foster Care,
  • Adoption, and
  • Family Preservation and Support Services.
  • Georgia received 9.4 million in IV-B and 79.4
    million in IV-E in SFY 2007.

23
Fostering Connections Act of 2008
  • Kinship guardianship assistance payments for
    children living in foster care with relatives
    (Sec. 101).
  • Notice to relatives (Sec. 103). H.R. 6893 would
    require state agencies to exercise due diligence
    to identify and provide notice to all adult
    grandparents and other adult relatives of a child
    within 30 days after the child is removed from
    his or her home.
  • Licensing standards for relatives waivers (Sec.
    104). The Act clarifies that states may waive
    non-safety licensing standards.
  • Expanding the Adoption Incentives Program (Sec.
    401). The Act enhances incentives in current law
    to promote the adoption of children from foster
    care.
  • Placing siblings together (Sec. 206).
  • Family Connection Grants (Sec. 102). H.R. 6893
    authorizes a new grant program in Subpart 1 of
    Title IV-B for activities designed to connect
    children in foster care (or at risk of entering
    foster care) with family. Funds can be used for
    1) kinship navigator programs 2) intensive
    family-finding efforts 3) family group
    decision-making meetings for children in the
    child welfare system, with special attention to
    children exposed to domestic violence or 4)
    residential family substance abuse treatment
    programs.
  • Transitional Care Funds - Continuing federal
    support for children in foster care after age 18
    (Sec. 201).

24
National Advocacy GroupsThe Pew Commission 2003
  • The nonpartisan Pew Commission on Children in
    Foster Care was launched on May 7, 2003.
  • The panel was charged with developing practical,
    evidence-based recommendations related to federal
    financing and court oversight of child welfare to
    improve outcomes for children in foster care.
  • Goals included the movement of children from
    foster care to safe, permanent families and to
    prevent unnecessary placements in foster care.

25
Casey Foundation
  • Mission - All children need a safe, nurturing,
    family to protect and guide them - all children
    have a lifelong connection to a caring,
    supportive family.     
  • Goals and Mission -      
  • decreasing the number and rate of children
    entering foster care
  • increasing the rate and number of children
    connected to stable and permanent families
  • ensuring the welbeing of children by having their
    emotional and physical needs met and
  • reducing inappropriate disparities related to
    race, gender, age, and ethnicity in the child
    welfare system.

26
Chapin Hall at the University of Chicago
  • Sound policy is based on continuous knowledge
    building evidence based practice.
  • Better policy emerges when researchers engage
    with policymakers and practitioners in long-term
    collaborations - research to practice.
  • A commitment to rigor, independence, and
    innovation is essential to our work performance
    based contracting.

27
Casey Family Programs
  • 2020 Strategy - By the year 2020, the nation will
    reduce the number of children in foster care by
    50 percent and improve self-sufficiency
  • Reduction and reinvestment - Casey believes that
    proactive service ultimately saves U.S. taxpayer
    money.  Eight Components of Change
  • Build political will
  • Develop leadership
  • Provide quality front-line supervision
  • Set reasonable caseloads
  • Engage community
  • Collaborate across systems
  • Enforce data-driven accountability
  • Allow time

28
Law Suits Children's Rights
  • NJ, DC, OK, GA, and WI Lawsuits 
  • Performance Outcomes State's agreement focuses
    the outcomes on performance measures.  These
    measures will filter down to private providers
    who provide services to children.  Providers will
    be asked to provide data to the State every six
    months.   
  • Community Based Care The settlement requires
    that children be served within 50 miles of their
    homes with certain exceptions.  
  • Family Focused Care - This settlement moves
    children toward family based care.  Family based
    care is defined very narrowly to only include
    foster care and family placement.   
  • Shorter Lengths of Stay Fewer children will be
    in care for longer than 15 months under this
    agreement.  Growing up in foster care will be
    rare.  Resources to push children into permanency
    will increase the longer a child is in care.   
  • Fewer Moves The goal is to have less than 5 of
    foster children experience more than two moves. 

29
ASFA Performance Measures
  • Program Improvement Plan (PIP)
  • Safety
  • Permanency
  • Welbeing

30
Safety
  • Children Safely kept in their homes
  • Removals Prevented
  • Prevention of Reabuse

31
Permanency
  • Prevent Reentry
  • Stability of Placement
  • Adoption
  • Reunification
  • Preserve Connections with Family
  • Continuity of Family Relationships
  • Proximity
  • Placement with Siblings
  • Parent and Siblings Visits
  • Relative Placement

32
Well-being
  • Enhanced Capacity of Parents to Care for Children
  • Education Needs provided
  • Mental Health needs met
  • Physical Health needs met

33
The Future - Now
  • More Family Preservation
  • More Performance Based Contracting
  • More Family Centered Care
  • More Work with Children in their families
  • Less children in foster care
  • More community based care

34
Family Centered CareResults
35
The Results
36
Family Centered Practicevs. Child Centered
  • Family Centered
  • Family is client
  • Family is respected
  • Family knows best
  • Collaboration with family
  • Family is decision maker
  • Child Centered
  • Child is client
  • Family is ignored
  • Agency knows best
  • Family is isolated
  • Therapist is decision maker

37
Importance of Outcomes
  • Prevention will be throughout the continuum of
    care.
  • All contracts will be measured for outcomes.
  • Evidence based practices will be expected
  • Providers will partner with the State around
    outcomes.
  • Data increasingly important

38
The Future - Now
  • More Family Preservation
  • More Performance Based Contracting
  • More Family Centered Care
  • More Work with Children in their families
  • Less children in foster care
  • More community based care

39
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