1. BASPCAN Congress April 2015 RESPONDING DIFFERENTLY: Engaging families in voluntary services to prevent further intervention from the formal system. Presenters: Christine Secrist, PhD, LMFT Lori Mozena, MS, LMFT Julie Allison, MPA, Iowa Department of Human Services, Bureau Chief
2. Mid-Iowa Family Therapy Clinic, Inc. & The Iowa Department of Human Services WHO ARE WE?
3. Mid-Iowa Family Therapy Clinic, Inc. Provides: Family Centered Services to children and families referred through the Iowa Department of Human Services. Psychiatric and outpatient therapy services to children and their families. Community Care services to children and families following a CPS assessment.
4. Department of Human Services Intervene when child safety is at-risk Provision of services to children who are at risk Seek court intervention when needed Case management
5. Guiding Principals Children are safe Services must be available equally to all children statewide Children grow up best in their families Families can gain the skills necessary to effectively support their children Families need and deserve community support
6. In 2013, the Iowa legislature passed House File 590. This called for the implementation of a Differential Response approach to allegations of child abuse to be initiated statewide in Iowa beginning January 1, 2014.
7. In Iowa, there are two possible pathways a case can follow: The Child Abuse Assessment path or the Family Assessment path. The decision about designation of a path for an accepted case is made at the time the referral is accepted at Intake by DHS.
8. Only cases for which denial of critical care is alleged and for which there is no indication that the child is in imminent danger will be placed on the family assessment path. Additional specific screening criteria has been developed in Iowa Administrative Code, the criteria is used by DHS Intake staff and supervisors to determine the correct path for a case. DHS child protective assessment workers conduct all assessments.
9. Pathway Assignment Tool
10. A central piece to the implementation of a Differential Response approach was to utilize a statewide program called Community Care as the only formal service that could be offered to families completing a family assessment. Community Care began in Iowa in 2005 as a way to reduce risk and ensure safety without Department intervention; it allowed the provider the freedom to intervene with families without the restrictions of Department of Human Services limitations on service provision.
11. COMMUNITY CARE PROGRAM
12. COMMUNITY CARE Statewide voluntary service provided through a contract with the Department of Human Services. The purpose is to strengthen families by building on the familys resources and developing supports for the family in their community. 15
13. WHO IS ELIGIBLE FOR COMMUNITY CARE?
14. THE GOALS OF COMMUNITY CARE ARE: Reduce concerns for families that create stress and negatively impact relationships between family members. Partner with families to improve relationships within the family and build connections in their community. Provide contacts and services that meet the familys needs. 03/21/08
15. Goals continued: Meet the cultural needs of families by providing better matching of service providers. Develop support systems for families to increase the resources they have available, in order to reduce stressors the family may be experiencing. 03/21/08
16. COMMUNITY CARE MODEL
17. Central point of referral Electronic Engagement, assessment, and service planning Discharge Summary & After-Care Plan Community Care Manager Community Care Manager Community Care Manager Community Care Manager Community Care Manager Meet with the family Implementation of tailored interventions Outcomes: Prevent the reoccurrence of child maltreatment. Reduce the risk of child adjudicated CINA. Engage with families to increase the effectiveness of interventions and achieve successful completion of services. Participate in local DECAT and CPPC meetings in helping build upon community level prevention services. Provide contacts and services that satisfactorily meet the families identified needs. Effectively meet the cultural, economic, and environmental needs of families through better matching of service providers. Increase family support systems to improve the protective capacities of parents and caretakers to help reduce the risk of child abuse. Provide well trained service staff to deliver the service while having licensed clinical staff available for regular consultation. Traditional & Family Assessment Engagement Specialist contacts family, sets up appointment. If no contact: Regional Supervisor notified of case assignment COMMUNITY CARE MODEL Referral from DHS
18. CENTRAL POINT OF INTAKE All referrals to Community Care are electronically sent to a Department of Human Services (DHS) data base site. Mid Iowa staff retrieves the referrals from this site.
19. INTAKE Engagement Specialist will review the assessment completed by the Department to determine what are the most critical issues, prioritizing those issues and immediately attempting to engage the family in services. Engagement Specialist will have demonstrated the ability to effectively engage families on the telephone to participate in services. Engagement Specialist schedules an appointment with the family to meet with the appropriate care manager.
20. Engagement specialist begin the engagement of families through the initial phone contact attempt. Here is an example of that initial dialogue: "Hello, this is Melissa with the Community Care Program. We have received a referral from (CPW name) and I understand that you are interested in support and assistance with parenting skills with your toddler (DCC supervision of child). (After some discussion about the needs within their home and the services they may already have in their home) When would be a good time for our Case Manager to come out and meet with you to see how we can help you?
21. SO WHAT DOES COMMUNITY CARE DO?
22. The Care Manager will complete a family functioning assessment that builds upon the CPS assessment. Base on the assessment a family care plan is developed. The Family Care Plan is designed to address areas of risk as identified through the assessment. Safety/Risk Management Plan Crisis Plan
23. Based on the assessment, the care manager may deliver the following types of services: 1. Family Team Decision Making meeting 2. Safety planning 3. Crisis intervention
24. 4. Providing assistance such as rental deposit, food, etc., that relates directly to risk factors associated with child abuse and neglect. 5. Information and referral 6. Education on a variety of issues (for example, substance abuse, mental illness, impact of trauma, domestic violence) 7. Parenting skill development 8. Parent/child relationship building 9. Support services 10. Rewards Program
25. The Rewards Program is designed to encourage participation in the Community Care program for at least 5 meetings. The Rewards Program is utilized in order to develop a care plan and begin working on meeting the goals of the family, while reducing overall risk within the household. The reward of $25 is earned after 5 meetings and used to meet a small need within the household of the familys choice. Household needs have been most commonly identified as: Gas card/public transportation fees Baby supplies Assistance with utilities Assistance with rent Groceries Cleaning supplies Pest control Seasonal apparel Prescribed medication/co-pay
26. OUTCOMES OF THE COMMUNITY CARE PROGRAM
27. *2010 Population Census
28. Community Care Performance Measure Outcomes Results from 1/1/14 12/31/14 No higher level of services such as CINA for supervision or placement for 6 months from date of referral to CC. No confirmed or founded child abuse within 6 months from date of referral. Contact will be made within 14 days on 80% of all referred families. 85% of referred families report positive satisfaction with services.
29. OUTCOME #1: No higher level of services such as CINA for supervision or placement for 6 months from the date of referral: 5% or less As of 12-31-14, MIFTC has met this performance measure 6 out of 6 months.
30. OUTCOME #2: No Confirmed or Founded child abuse within 6 months from the date of referral: 5% or less Or More than 5% but less than 10% As of 12-31-14, MIFTC has achieved an average of 5.44%.
31. OUTCOME #3: A response will be received within 14 days of the referral date on all referred families: 80% MIFTC has met this outcome 12 out of 12 months with an average of 85.71%.
32. OUTCOME #4: 85% of families will be satisfied with Community Care services This measure is reported on a bi-annual basis. For January December 2014, our client satisfaction was at 100%.
33. Since the implementation of Differential Response in Iowa: Community Care has seen a statewide increase in the number of referrals to the program: 1,413 referrals for the entire 2013 year to 4,338 referrals for 2014 calendar year.
34. SUCCESS ACROSS IOWA Success Stories
35. Every other month, we gather stories from case managers of families being successful through participation in the Community Care program. Each bi-monthly edition is shared with DHS staff to give Child Protective Workers some examples of services and support provided by Community Care. These stories are helpful to the CPW when presenting the program to clients at the close of an assessment.