Court-Based Child Welfare Reforms: Improved Child/Family Outcomes and Potential Cost Savings Webinar

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SPARC WebinarSeptember 5, 2012

Family Wellness CourtJudge Erica Yew

California Superior CourtSanta Clara County

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Trauma-Informed CourtExtension of Problem-Solving Courts

What is it and WHY? Therapeutic alliance

Vivian Brown: 50 to 60% of outcome rests upon a positive therapeutic alliance

Only 1 to 2% is related to the treatment model or methodology used

20 years of adult drug court research indicates that the #1 incentive for people is their relationship with their judge or their probation officer

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Considerations for a Trauma-Informed Court

Taking your time, even if it is an illusion Reduce waiting if possible Noise Setting Listening and validating where possible HONESTY RESPECT HOPE TRANSPARENCY: Clear communications and

expectations

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Trauma-Informed Systems

FWC values statement includes trauma-informed system

Commitments by Partner Agencies Provider education Continual system assessment and

modification – 360 assessment Trauma specific services: DADS

Seeking Safety (PTSD and addiction), Mental Health trauma based cognitive behavioral therapy

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FWC Overview

Target population: Pregnant women and parents, with children 0 to 3, whose abuse of methamphetamine and other substances have placed their children in or at risk of out-of-home placement.

Ten year experience, repeated subsequent pos-tox births

Started with grant in March 2008

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FWC Primary Partners for GrantUS$ 6.3 million over 5 years

Superior Court Social Services Agency (SSA), SSA’s Department of

Family and Children’s Services (DFCS) and SSA’s County Counsel

First 5 Department of Drug and Alcohol Services (DADS) County Mental Health (MH) Legal Advocates for Children and Youth (LACY) –

children counsel Dependency Advocacy Center (DAC) – parents counsel

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Primary FWC Goals (1)

Early identification of and intervention for the needs of pregnant women and parents with substance use disorders.

Rapid engagement and successful retention in treatment and care

Reduction in subsequent pos-tox births

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Primary FWC Goals (2)

Early identification and intervention for developmental delays, disabilities and concerns for children 0-3 whose parents come before the FWC

Creation of a comprehensive System of Care across all systems serving children in or at risk of out-of-home placement as a result of parents’ methamphetamine and other substance abuse

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FWC Eligibility Criteria

The parent has given birth to an infant that has been exposed to methamphetamine or other substance abuse during the pregnancy; OR

The parent has a child under the age of three that was either born drug exposed or has been raised in a substance abuse afflicted environment with documented abuse and/or neglect; AND

The parent does not demonstrate intractable mental health issues as presented in the filed petition; AND

The parent is not likely to face long term incarceration

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FWC Customer Characteristics Fast-track cases History of CWS

involvement as children

40% were foster children themselves

Prior cases in CWS, many with prior termination of parental rights, 9 prior births, multiple pos-tox births

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More Customer Characteristics

Extensive trauma history (give examples – multiple deaths, abandonment, kidnapping, prostitution as 8 yo)

80% cross over with DV 90% incarceration

history

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More about Customer Characteristics

Methamphetamine primary drug of choice: national, state and local data indicate that 75-80% of child welfare

cases are drug and alcohol related. In Santa Clara County the drug of choice is methamphetamine where preference is around 64-67%.

Homeless or living in substandard housing, 65% chronic homelessness

Extremely low income, 66% have annual income of less than $10,000 TWD $ 285,000 Average California income US$ 61,017 Average U.S. income US$ 52,029 Federal Poverty Level for parent and 1 child US$ 14,570

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FWC Services (1) Therapeutic court environment, with regular reviews Early connection to TANF, food stamps, other programs Case management by the court Legal representation Early drug and alcohol assessment and treatment Residential inpatient-treatment for women; and for

women with their children Transitional Housing Units (THU) for women, men,

children Mentor Parent support Domestic violence advocacy and services Transportation assistance (bus tokens, bus tokens for

children, bicycles, car seats) Linkages to shelter and housing

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FWC Services (2) Limited funding to assist with barriers to case plan

completion (books, birth certificates, funeral transportation)

Linkages to employment and benefits services, record clearance

Coordination with Criminal Court partners, fine conversion

Therapeutic services, dyadic and PCIT included Pregnancy prevention education Comprehensive developmental and behavioral

screening, assessment and interventions for all children

Child appointed special advocates (CASA’s) for many children and parents = an extension of role

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FWC Services (3) Linkage to health coverage and primary care

physicians Linkage to dental and vision care through charitable

organizations Access to a wide array of parenting classes Home visitation and Public Health Nurses with regular

reporting – transparency Diapers, children’s and adult clothing & shoes,

hygiene products, groceries/meals, milk, books, toys, strollers

Early care and education services GED assistance Language assistance Budget and nutrition information and workshops Medical and dental health care for children Tattoo removal and MORE….

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Children’s Services Overview

Funded by FIRST 5 Santa Clara County Medi-Cal/EPSDT (Early Periodic Screening and

Diagnosis and Treatment) is leveraged MHSA (Prop 63: Mental Health Services Act – 1%

income tax on excess of personal income of $1 million), County General Fund and reimbursement via public

children’s insurance programs are also utilized for Mental Health services

System of Care: Tiered system based on level of need as determined by screening and assessments utilizing standardized tools and evidence-based practices

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FWC Multidisciplinary Team/MDT

Judge Court Resource

Manager DV/Trauma Therapist Victim Witness

Advocate♦ Eligibility Worker Child Advocate DADS rehab counselor Adult MH Coordinator♦ First 5 Specialist

Social Work Liaison County Counsel Child’s Attorney Parent Parent’s Attorney &

Mentor Social Worker Therapist Home Visitor Public Health Nurse

Special Support People(SARC, parent advocates)

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FWC Hearings

Hearings may occur daily, weekly, twice a month or once monthly depending on parent progress

Staffings are held with the court team prior to the hearing to discuss case progress, concerns and develop joint recommendations – COMPREHENSIVE

Incentives or Sanctions may be given Resources given

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FWC Data

Doors Opened March 14, 2008 As of April 2011, data below:

1 to 2+ years of services per family (FR → FM)

290 parents served 3 re-entries (mental health and housing) in 3 years 11-12% re-entry rate in California 1 subsequent pos-tox births in 3 years (despite

many births and population that had repeated prior pos-tox births, mothers with 8 children previously removed)

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More about the Results

Santa Clara County Reunifications Rates2009 = 48%, no separate tracking for Fast

Track cases

2010 = 53%, FWC may be improving general outcomes

FWC as of September 2010 for Fast Track cases = 71%

350 children served100% of children whether parents succeed or

not

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Primary Keys to Success

Commitment at highest agency administrative levels

Shared values Passion and commitment of involved staff Comprehensive service model Service model that evolves as additional client

needs are identified Incorporation of the parents’ voices (through

mentors and the actual parents before the court – surveys, court experience)

Promoting the parent-baby bond

Joanne Moore, DirectorWashington State Office of Public Defense

Why was the Parents Representation Program Started?

1999 Report for the Legislature: State of Parents’ Attorneys

Excessive Caseloads and Low Pay Little Time to Communicate with Parents or Help them Engage

Frequent Continuances and Case Delays

Program Model

Reasonable Attorney Caseloads Program Social Workers Funds for Independent Experts Frequent Trainings Central Support

OPD Parents Representation Program

Pilot 2000‐2005 Expanded to 2/3 of Washington State

6,700 Open Cases Fully Funded by State Funds – Right to Counsel

New Practice Standards

Parents Representation Program Standards Addressed Substandard Practices

Standards Lead to Improvements: Enhanced Communication  Early Parent Engagement  Increased Access to Services and Visitation  Timely Case Resolution

Evaluations and Data Four Small Evaluations During the Pilot 2010 OPD and 2011 Washington State Center for Court Research

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

OPD Counties Non OPD Counties

OPD Program Counties Improved Reunification Rates While Non‐Program Counties Did Not

Pre Program Period Post Program Period

Child Welfare System Impact Before Parents Representation Program, parents and their attorneys were virtually absent from the statewide policy decisions

Policy contributions over the last decade by the Parents Representation Program include: Membership in statewide committees such as the state Supreme Court Foster Care Commission and Catalyst for Kids’ Washington State Parent Advocacy Committee

Collaboration with the department and other stakeholders to develop Expert and Evaluator Guidelines

Local projects such as visitation centers and family treatment court

The Permanency Project

The TeamAnne Marie Lancour, M.A.T., J.D.

Heidi Redlich Epstein, J.D., M.S.W.Mimi Laver, J.D.

Kathleen McNaught, J.D.Elizabeth Thornton, J.D.

Cristina Cooper, J.D.Jeffrey Adolph, J.D.Margaret Burt, J.D.

Honorable Stephen Rideout (ret.) , J.D.Scott Trowbridge, J.D.

Goal: Reduce children’s stay in foster care

• Help children in foster care find safe, permanent homes, faster

• Identify and break down system barriers to permanency

• Save scarce state and county dollars

• Train on best practices that promote permanency

• ABA measures success through Continuous Quality Improvement (CQI)

• ABA identifies system changes to improve permanency outcomes

• ABA visits counties monthly during project period and develops tools and procedures

• ABA develops county network and shares solutions statewide

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Our CQI Process

Key Project Components

• Advisory BoardComprised of family or juvenile court Judges and Masters, local child welfare agency administrators, attorneys, key agency staff, and a range of other stakeholders.

• ABA Project DirectorVisits the project county monthly to work with the Advisory Board

• Permanency Planning Specialist

Our Approach

• Develop local action plan• Recognize small steps add up to change• Keep permanency planning focus• Identify children's needs early• Refine court procedures in permanency areas• Provide legal analyses and technical assistance

Project Tasks

The project undertakes five major tasks:

1. Identifying and analyzing delays;

2. Interactively developing recommendations and implementing reforms;

3. Establishing written protocols, procedures, and providing multidisciplinary training;

4. Monitoring reforms and changes; and

5. Sharing project results throughout the state.

Overcoming Barriers• Missing or unidentified parents• Relatives entering the case late• Increase in teen population• Lack of training on permanency planning issues• Late starts in offering services• Inadequate concurrent planning• Difficulty in obtaining evaluations and/or expert

testimony• Delays in court procedures

Case Data Drives Change

• Staff analyze cases, tracking how long it takes a child to achieve permanency

• Collect data and detect trends to both create solutions and measure outcomes

• Project targets key skills and topics for improvement based on data review

• Over 20 project counties

• Children in PA project counties have saved an average of 9 months in foster care before finding permanent homes.

• Counties have saved a total of $9,460,000 - and counting - in foster care costs.

• Better court-agency communication and increased investment in improved outcomes for children and families.

Pennsylvania Results••

The Project has provided over 35 unique trainings in Pennsylvania counties

Examples include:• The relationship between ASFA, permanency, and substance abuse treatment • Trial testimony skills for caseworkers and service providers• Strategies to meet the education needs of children in foster care • Older youth in foster care and APPLA as a permanency goal as well as alternatives to it

Pennsylvania Results, Cont.

PA Results: County Examples

• Blair County develops a Family Treatment Drug Court

• Northampton County develops an Interim Court Directive/Permanency Plan to eliminate delays in service referrals

• Lackawanna County introduces a new court procedure, the Dependency Compliance Conference, to increase accountability and expedite permanency

• Westmoreland County initiates a 90-day multidisciplinary case conference process

Overall OutcomesSince 1989, more than 40 counties across four states have saved time and money with the Permanency Project:

• $25 million total saved in foster care costs

• Over 2200 kids benefitted directly

• Average of one less year waiting in foster care

New York - $15,272,000 saved, 15 month average time reduction

Wyoming - $704,000 saved, 11 month average time reduction

Kentucky - $237,600 saved, 9 month average time reduction

Harnessing the Results1989 – A focus on adoption casesTermination Barriers Project begins with funding from the New York StateDept. of Social Services and the U.S. Dept. of Health and Human Services.

1991 – NYS Office of Children and Family Services continues to fund theProject for the next 13 years.

2004 – The project is successfully completed in 20 small, medium, and largecounties throughout NYS.

2004 – New focus on all permanency types, emphasizing reunificationPennsylvania contracts with ABA for largest Permanency Barriers Project to date. KY and WY also contract with the Project.

2005 – ABA wins Adoption Excellence Award for work on the NYPermanency Barriers Project

Expanding the Program

• Working with former project counties to provide additional TA and “refresher” trainings

• Engaging new locations

• Increasing the focus on and tracking of child well-being indicators

Questions/Contact Information

Anne Marie LancourABA Center on Children and the Law

740 15th Street, NWWashington, DC 20005

(202)662-1756 [email protected]

www.americanbar.org/child