Child and Family Services Plan Annual Progress Report... : Submitted to: U.S. Department of Health and Human Services Administration for Children and Families.

              STATE OF ARIZONA
Department of Economic Security
Division of Children, Youth and Families
CHILD AND FAMILY SERVICES PLAN
ANNUAL PROGRESS REPORT 2007
Submitted to:
U.S. Department of Health and Human Services
Administration for Children and Families
June 2007 STATE OF ARIZONA
DEPARTMENT OF ECONOMIC SECURITY
DIVISION OF CHILDREN, YOUTH AND FAMILIES
CHILD AND FAMILY SERVICES PLAN – ANNUAL PROGRESS REPORT 2007
CONTENTS
SECTION TITLE
SECTION I Description of State Agency SECTION II Vision and Mission SECTION III Introduction and Overview
Part 1: Crosscutting Initiatives
1.
Family to Family
2.
Family-Centered Practice
3.
Integrated Child Safety Assessment, Strengths and Risk Assessment, and Behavior Based Case Planning
4. Home Recruitment, Study and Supervision Contract Part 2: Safety
A. Program or Service Description
1.
Child Abuse and Neglect Prevention Services
2.
Child Protection, and Child Abuse and Neglect Intervention and Treatment Services
B. Outcomes, Goals, Measures and Progress
C. Objectives and Activities for SFY 2008 Part 3: Permanency
A. Program or Service Description
1.
Time Limited Reunification Services
2.
Out-of-Home Children Services
3.
Adoption Promotion and Support Services
4.
Subsidized Guardianship and Independent Living Services
B. Outcomes, Goals, Measures and Progress
C. Objectives and Activities for SFY 2008 Part 4: Child and Family Well-Being
A. Program or Service Description
1.
Case Planning and Case Manager Contact with Parents and Children
2.
Services to Address Children’s Educational, Physical Health, and Mental Health Needs
B. Outcomes, Goals, Measures and Progress
C. Objectives and Activities for SFY 2008
Part 5: Systemic Factors
A. Program Description and SFY 2007 Accomplishments
1.
Statewide Information System Capacity
2.
Case Review System
3.
Quality Assurance System
4.
Staff and Provider Training
5.
Service Array and Resource Development
6.
Current Executive Initiatives
7.
Agency Responsiveness to Community
8.
Collaboration with Native American Tribes and Indian Child Welfare Act Compliance
9.
Foster and Adoptive Home Licensing, Recruitment, and Retention
B. Objectives and Activities for SFY 2008
SECTION IV Child and Family Services Training Plan
SECTION V Chafee Foster Care Independence Program (CFCIP) and Education and Training Voucher Program State Plan
SECTION VI Child Abuse Prevention and Treatment Act (CAPTA) Annual Progress Report
SECTION VII Financial Maintenance of Effort Form CFS-101 Part I – FFY 2007 Form CFS-101 Part I – FFY 2008 Form CFS-101 Part II Form CFS-101 Part III
ATTACHMENTS
1.
Agency Response to Citizen Review Panel’s 2006 Recommendations
2.
Letter of required notification regarding substantive changes in Arizona’s State Laws
3.
Disaster Preparedness and Response Plan 2007 Section I
Description
of
State
Agency
Child and Family Services Plan – Annual Progress Report 2007
Section I: Description of State Agency
ORGANIZATIONAL STRUCTURE OF THE AGENCY
AND DIVISION
In July, 1972, the Arizona State Legislature established the Department of Economic Security (the Department) by combining several State agencies providing employment and welfare services to Arizona residents. The purpose in creating the Department was to provide an integration of direct services to people in such a way as to reduce duplication of administrative efforts, services, and expenditures.
The Department is divided into nine divisions. These divisions are:
•
Division of Business and Finance
•
Division of Technology Services
•
Division of Employee Services and Support
•
Division of Developmental Disabilities
•
Division of Children, Youth and Families
•
Division of Child Support Enforcement
•
Division of Benefits and Medical Eligibility
•
Division of Aging and Community Services
•
Division of Employment and Rehabilitation Services
The Division of Children, Youth and Families (DCYF) provides services to children and families, which include child protective services, family support and preservation services, foster care and kinship care services, adoption promotion and support services, child welfare services, and health care services.
The Division serves as the state administered child welfare services agency, and is divided into four administrations:
•
Administration for Children, Youth and Families (ACYF)
•
Finance and Business Operations Administration (FBOA)
•
Comprehensive Medical and Dental Program (CMDP)
•
Program Services Administration
Arizona’s fifteen counties are divided into six regions, which are referred to as districts. District 1 (Phoenix and surrounding cities) and District 2 (Tucson) are the urban districts, while Districts 3 through 6 are the rural districts, although some rural counties are growing rapidly. Arizona is one of the fastest growing states in the United States. According to the Department of Economic Security’s Arizona Workforce Informer website, Arizona’s population increased 23% from the 2000 census to July 2006, reaching over 6,300,000 people. The population of Pinal County increased 67%, and the majority of counties grew between 10% and 30%.
The following chart provides the counties within each district.
Dist 1
Dist 2
Dist 3
Dist 4
Dist 5
Dist 6
Maricopa
Pima
Coconino Apache Navajo Yavapai
Yuma Mohave La Paz
Gila Pinal
Cochise Graham Greenlee Santa Cruz
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Child and Family Services Plan – Annual Progress Report 2007
Section I: Description of State Agency
District Operations
Each district provides:
•
investigation of child protective services (CPS) reports
•
case management
•
in-home services
• out-of-home services
•
contracted support services
•
permanency planning
•
foster home recruitment and training
•
adoptive home recruitment and certification
The Statewide Child Abuse Hotline is centralized for the receiving and screening of incoming communications regarding alleged child abuse and neglect. Incoming communications are centrally screened to determine if the communication meets the definition and criteria of a CPS report. Report information is triaged to determine risk of harm to the child, and to establish a response timeframe. Reports are investigated by Child Protective Services Specialists or referred to other jurisdictions (such as tribal jurisdictions) for action.
Central Office functions for the Division and the Administration include:
•
policy and program development
•
the Promoting Safe and Stable Families program
•
finance, budget, and payment operations
•
statistical analysis
•
field support
•
Interstate Compact on Placement of Children
•
the Child Welfare Training Institute (CWTI) for initial in-service staff training,
ongoing/advanced staff training, and out-service and education programs
•
new initiatives and statewide programs
•
contracting and procurement
•
continuous quality improvement
•
management information system/automation
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Section II
Vision
and
Mission
Child and Family Services Plan – Annual Progress Report 2007
Section II: Vision and Mission
Arizona Department of Economic Security Vision
Every child, adult, and family in the State of Arizona will be safe and economically secure.
Mission
The Arizona Department of Economic Security promotes the safety, well-being, and self-sufficiency of children, adults, and families.
Guiding Principles
System of care must:   be customer and family-driven
 
be effectively integrated
 
protect the rights of families and individuals
 
allow smooth transitions between programs
 
build community capacity to serve families and individuals
 
emphasize prevention and early intervention
 
respect customers, partners, and fellow employees
Services must:   be evaluated for outcomes
 
be coordinated across systems
 
be personalized to meet the needs of families and individuals
 
be accessible, accountable, and comprehensive
 
be culturally and linguistically appropriate and respectful
 
be strength-based and delivered in the least intrusive manner
Leaders must:   value our employees
 
lead by example
 
partner with communities
 
be inclusive in decision making
 
ensure staff are trained and supported to do their jobs
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Child and Family Services Plan – Annual Progress Report 2007
Section II: Vision and Mission
CRITERIA FOR BUDGET DECISIONS
•
Decisions should consider how they affect the safety, permanency and well being of the children and families that we serve.
•
Cuts by one agency should consider how they affect other agencies.
•
Look for win/win strategies.
•
Consider how investments or reductions will effect specific populations.
•
Always keep issues of racial and social justice in mind.
•
Short-term gain should not result in long-term crisis.
•
Look for internal efficiencies.
•
Look for cross systems approaches that may include investing more in one system that allows for savings in another.
•
Concentrate primarily on balancing the budget through improved outcomes.
•
Determine what every partner can and must do to accomplish the outcomes.
•
Blend funding and resources when it is more effective.
•
Bring everyone into the decision making process. Do not try to do it alone. Share the workload as well.
•
Include accurate measurements of progress. Share authority, responsibility, work, successes, and challenges. Celebrate success and hold ourselves and each other accountable for accomplishing our objectives.
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Section III
Introduction
Crosscutting Initiatives
Safety
Permanency
Child and Family Well-Being
Systemic Factors
Child and Family Services Plan – Annual Progress Report 2007
Section III: Introduction
INTRODUCTION
This introduction provides information about data sources, caseload volume, and staff resources, to furnish context for the service descriptions and performance evaluations that follow. Following this introduction, Section III of this Annual Progress Report is divided into five parts:
•
Part 1: Crosscutting Initiatives – Part 1 describes several multifaceted and statewide continuous improvement initiatives that have produced change in multiple systemic factors and performance areas.
•
Part 2: Safety – Part 2 provides descriptions of the State’s child abuse and neglect prevention, intervention, and treatment services; including family preservation and family support; the State’s safety goals, measures, and performance analysis; descriptions of recent accomplishments and other factors affecting performance; and the Division’s safety objectives and activities for program and performance improvement in SFY 2008.
•
Part 3: Permanency – Part 3 provides descriptions of the State’s services to support reunification, adoption, kinship care, independent living, or other permanent living arrangements; including time-limited reunification services, and adoption promotion and support services; the State’s permanency goals, measures, and performance analysis; descriptions of recent accomplishments and other factors affecting performance; and the Division’s permanency objectives and activities for program and performance improvement in SFY 2008.
•
Part 4: Child and Family Well-Being – Part 4 provides descriptions of the State’s case planning and case management services, including case manager contact with parents and children, and services to address children’s educational, physical health, and mental health needs; the State’s well-being goals, measures, and performance analysis; descriptions of recent accomplishments and other factors affecting performance; and the Division’s well-being objectives and activities for program and performance improvement in SFY 2008.
•
Part 5: Systemic Factors – Part 5 provides descriptions, performance analysis, recent accomplishments, and other factors affecting performance of the State’s statewide information system capacity, case review system, quality assurance system, staff and provider training, service array and resource development, agency responsiveness to community, and foster and adoptive home licensing, recruitment, and retention program; and the Division’s systemic objectives and activities for program and performance improvement in SFY 2008.
Information on the Division’s progress implementing the action steps and achieving the objectives that were listed in the Child and Family Services State Plan – Annual Progress Report 2006 is incorporated throughout this report, placed within the most relevant program description or CFSR item.
Primary Data Sources
This report provides data from a variety of sources; including other reports published by the Division or Department, the Child and Family Services Review (CFSR) Data Profile, internal data reports, case reviews, external evaluations of Division programs, and stakeholder focus groups and surveys. Data may be reported by federal fiscal year (FFY), State fiscal year (SFY), or calendar year (CY), depending on availability. Data for similar time periods may vary because of the date of extract from CHILDS (the Statewide Automated Casework Information System or SACWIS) or differences between data extraction
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Child and Family Services Plan – Annual Progress Report 2007
Section III: Introduction
programs, such as the Adoption and Foster Care Analysis and Reporting System (AFCARS). Data sources, extract dates, and operational definitions are included throughout the document. Frequently cited data sources include the following:
•
CFSR Data Profile – This data profile is generated from the State’s semi-annual AFCARS submission to the U.S. Department of Health and Human Services (DHHS). This profile was provided to the State by DHHS for the purposes of the CFSR and is considered the official CFSR data for determining substantial conformity with the CFSR national standards on safety and permanency. Data in this profile was extracted from CHILDS in February 2007.
•
Child Welfare Reporting Requirements Semi-Annual Report – This report is published by the Division, as required by Arizona State Statute, for the periods of October through March and April through September. Data is primarily extracted from CHILDS, and is as current as possible on the date of report publication.
•
Business Intelligence Dashboard – The Division uses a web-based “data dashboard” to track performance on some key indicators, including timeliness of initial response to reports; timeliness of investigation finding data entry; in-person contacts with children, parents, and out-of-home care providers; and child removals and returns. This data is current as of the most recent weekly refresh from CHILDS. Since this data changes weekly to reflect new entry and corrections, the date the data was retrieved from the dashboard is provided along with all such data in this report.
•
Practice Improvement Case Review – This data is generated by reviewing a random selection of investigation, in-home services, and out-of-home care cases using a review instrument similar to the CFSR On-Site Review Instrument. The Division conducted its last statewide quarterly review in June 2004, and has conducted annual reviews in each district since that time. Under the new system, statewide statistics are produced annually rather than quarterly. Therefore, data is frequently reported from the quarter ending June 2004 and calendar years 2005 and 2006. See Section III, Part 5, subsection A.2. Quality Assurance System for more information.
Investigative, In-Home Services and Out-of-Home Caseload Volume
The following chart provides the counties within each district, and the distribution of investigation, in-home cases and out-of-home cases assigned to each district in December 2006. In recent years, the investigation caseload distribution has shifted somewhat from the rural districts to District 1. In-home caseload has shifted to District 1 and away from Districts 2, 3, and 4. Out-of-home caseload has shifted in a small degree from Maricopa and Pima Counties to Districts 3 and 5.
District 1
District 2
District 3
District 4
District 5
District 6
Counties
Maricopa
Pima
Coconino Apache Navajo Yavapai
Yuma Mohave La Paz
Gila Pinal
Cochise Graham Greenlee Santa Cruz
Investigations
58.3%
17.8%
7.6%
6.5%
6.4%
3.4%
In-Home Cases
54.9%
20.6%
9.5%
5.9%
5.6%
3.5%
Children in Out-of-Home Care
52.0%
24.3%
7.9%
4.1%
7.8%
3.4%
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Child and Family Services Plan – Annual Progress Report 2007
Section III: Introduction
Data from the Child Welfare Reporting Requirements Semi-Annual Report in the following chart shows that the number of Hotline reports meeting the statutory requirements for an investigation by the Division decreased in FFY 2005 and FFY 2006, for the first time in at least the last five years. However, the total number of reports assigned to a CPS Specialist remains above levels in 2003 and prior. Furthermore, discontinuation of the Family Builders differential response program in June 2004 actually resulted in an increase of investigative assessments assigned to CPS Specialists in FFY 2005. The Division had been referring well over 5,000 reports annually to Family Builders for differential response, and had referred 1,145 reports from April 1 to June 30, 2004. When the Division began assigning all reports to a CPS Specialist for assessment the Division’s investigative caseload rose, even though the total number of reports decreased. Therefore, FFY 2006 is actually the first year since at least FFY 2000 that Division investigative workload has decreased.
Number of Hotline Reports for Investigation by Federal Fiscal Year
45,000 40,000 35,000 30,000 25,000 20,000 15,000 10,000 5,000 0
FY 2000 FY 2001 FY 2005 FY 2006
Data in the following chart comes from the Department’s Child Protective Services Bi-Annual Financial and Program Accountability Report, and shows the number of new and continuing in-home cases in the 18 months ending December 2006. New in-home cases are cases that have been open for at least 30 days or transferred from investigation to ongoing status in less than 30 days, have no child in out-of-home care, and were not identified as an in-home case in the prior month. In-home services caseload decreased in late 2005 and early 2006, but has increased since that time. In December 2006 the total in-home caseload was 5,467 cases, which was the highest volume of any month in the last 18 months.
Number of Reports
7,874
8,456
6,171
5,472
3,773
30,363
36,439
37,240
34,178
24,277
24,796
28,178
FY 2002 FY 2003 FY 2004 Federal Fiscal Year
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Child and Family Services Plan – Annual Progress Report 2007
Section III: Introduction
New and Continuing In-Home Services Cases
graph
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Data in the following chart comes from the Child Welfare Reporting Requirements Semi-Annual Report, and shows the number of new child removals and the number of children leaving out-of-home care during the six month periods ending March and September of 2003, 2004, 2005, and 2006. In FFY 2006 the number of new removals decreased and leveled, while the number of children exiting from out-of­home care continued to slowly increase.
Number of New Removals and Children Leaving Out-of-Home Care
Number of Children
5,000
4,000
3,000
2,000
1,000
0
graph
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According to the Child Welfare Reporting Requirements Semi-Annual Report, 9,906 children were placed in out-of-home care on September 30, 2005 – a 12% increase over the 8,839 children in out-of­home care on September 30, 2004. However, the annual rate of increase slowed from a high of 20% in FFY 2003 to 12% in FFY 2005, and a small decline was realized in FFY 2006. The following chart shows the number of children in out-of-home care on the last day of FFY 2000 through 2006. .
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Child and Family Services Plan – Annual Progress Report 2007
Section III: Introduction
Number of Children in Out-of-Home Care
graph
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Staff Resources
The following table shows the Division’s CPS Specialist annualized retention rate for the six month periods ending December 2005, June 2006, and December 2006; and the percentage of authorized CPS Specialist positions filled on the last day of each period. This data indicates overall improvement of staff retention from December 2005 to December 2006, although performance did decline from June 2006 to December 2006. The percentage of authorized CPS Specialist positions filled has continually improved statewide and in all districts but District 3. District 4 is facing the greatest challenges from turnover and vacant positions. The data on percentage of positions filled is based on the number of authorized positions. In December 2006, the Division’s number of authorized positions was approximately 86% of those required to meet the State’s caseload standards of 10 investigations, 19 in-home services cases, or 16 out-of-home children per month. Therefore, if the Division were to achieve 100% of authorized positions filled, staffing resources would continue to be less than those required to meet the caseload standards.
% Retained of Filled Positions (Annualized)
% Filled of Authorized Positions
12-05
6-06
12-06
12-05
6-06
12-06
District 1
63.8
81.3
75.7
63.2
66.9
74.6
District 2
68.4
74.3
67.3
72.1
82.6
88.1
District 3
71.9
69.4
63.4
76.0
88.0
81.3
District 4
68.8
57.9
53.8
50.8
60.3
69.8
District 5
67.4
84.4
65.6
72.9
83.1
93.2
District 6
56.5
87.5
67.7
67.6
79.4
82.4
Hotline
88.7
93.7
76.1
100
100
100
Statewide
68.2
78.6
71.0
70.4
76.3
82.6
The Division has been involved in many activities to improve the hiring process for CPS Specialists and Supervisors and recruit and retain the right staff. In SFY 2007 the Division continued to encourage staff retention by providing stipends to investigative staff and advanced educational opportunities such as tuition reimbursement and educational leave. The Division also continued to use the “Realistic Job
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Child and Family Services Plan – Annual Progress Report 2007
Section III: Introduction
Video” that was developed in 2006. This video portrays the opportunities and challenges associated with working for CPS in Arizona, and viewing is required for all new CPS Specialist applicants. Other activities in SFY 2007 to improve staff recruitment and retention include the following:
•
The “Hire for Fit Committee” was created in August 2006 to revise the entire interview process to a behavioral style. All Position Description Questionnaires (PDQ) were revised to include the Division’s values, vision and mission; the Division identified key competencies for all key positions to include flexibility and strengths of prospective employees; and an interview template and guide has been created and approved. The Committee is now creating a training curriculum for applicant interviewers.
•
The Division’s recruitment materials were revised to reflect the positive features of the work and the opportunities to improve the lives of Arizona children and families. All recruitment materials now have updated information pertaining to all Child Protective Service classifications. Any changes are incorporated at time of occurrence.
•
The Division is seeking an external firm to meet a need for standardized branding and marketing strategies for both in-state and out-of-state recruitment advertising.
•
In 2006 all State employees were offered a State of Arizona Employee Discount card that offers savings at 175,000 businesses nationwide; an employee Computer Purchase Program with option of payroll deductions; and Travelers and Liberty Mutual auto and home insurance at competitive rates with convenient payment options, including payroll deductions.
•
The Recruitment and Retention Advisory Board met regularly from October 2005 through October 2006. The Board created the Annual Award Ceremony to recognize employee achievements. The first Annual Award Ceremony was held at the Division’s Leadership Conference in August 2006. Awards for Manager of the Year, Employee of the Year, and Central Office Employee of the Year were presented. Due to budgetary constraints, the conference and award ceremony will not be held in 2007, but awards will be given through the “Pride Recognition Committee.” Staff accomplishments are also recognized through two quarterly “Traveling Recognition Awards,” known as the Visionary Award and the Spirit Award; and through other “Pride” Program awards for accomplishments above and beyond normal job duties.
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Child and Family Services Plan – Annual Progress Report 2007
Section III, Part 1: Crosscutting Initiatives
Part 1: Crosscutting Initiatives
The Division continues to pursue several multifaceted statewide continuous improvement initiatives that have produced positive change in multiple systemic factors and performance measures. These initiatives are described in detail below, and briefly referenced throughout Section III of this Annual Report.
1. Family to Family
Arizona is working to embed the Family to Family initiative into Arizona’s child welfare practice. This nationwide child welfare initiative, designed by the Annie E. Casey Foundation, provides principles, strategies, goals, and tools to achieve better outcomes for children and families. Using the Family to Family strategies, the Division is striving to achieve the following outcomes:
•
Reduce the number and rate of children placed away from their birth families
•
Among children coming into foster care, increase the proportion who are placed in their own neighborhoods or communities
•
Reduce the number of children served in institutional and group care and shift resources from group and institutional care to kinship care, family foster care, and family-centered services
•
Decrease lengths of stay of children in placement
•
Increase the number and rate of children reunified with their birth families
•
Decrease the number and rate of children re-entering placement
•
Reduce the number of placement moves children in care experience
•
Increase the number and rate of brothers and sisters placed together
•
Reduce disparities associated with race/ethnicity, gender, or age in each of these outcomes
Family to Family defines six goals and four strategies to achieve the child and family outcomes. The four core strategies that are the hallmark of Family to Family include:
1.
Recruitment, Development and Support of Resource Families – Finding and maintaining kinship and foster families who can support children and families in their own neighborhoods
2.
Building Community Partnerships – Establishing relationships with a wide range of community partners in neighborhoods where referral rates to the child welfare system are high and collaborating to create an environment that supports families involved in the child welfare system
3.
Team Decision Making (TDM) – Involving resource families, youth, parents, community partners and case managers in all placement decisions to ensure a network of support for the children and for the adults who care for them
4.
Self Evaluation – Collecting and using data about the child and family outcomes to find out where there is progress and where there needs to be change
The Division participated in site visits by representatives from the Annie E. Casey Foundation in July 2004, to assess Arizona’s readiness to become a Family to Family Program site. Implementation began in Maricopa County and considerable progress has been made to implement all four strategies in that site. In late 2006 Maricopa County was selected as a Family to Family Anchor Site for calendar year 2007. As a result, Arizona will receive more intensive technical assistance to further embed the strategies into practice.
Since 2005, the other districts have gained an understanding of the Family to Family approach and developed systems and resources to support Family to Family roll out. The Program Managers from all districts have been attending quarterly Family to Family meetings to identify progress and next steps. An
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Child and Family Services Plan – Annual Progress Report 2007
Section III, Part 1: Crosscutting Initiatives
initial Family to Family strategic planning meeting on statewide rollout was held in April 2007. Technical Assistance was provided at this meeting by the Annie E. Casey Foundation to help the districts form initial plans for rolling out all four Family to Family strategies in their counties. The districts will submit their initial action plans to the Division’s Central Office in June 2007, where they will be reviewed and returned to district workgroups for follow-up. A statewide Family to Family Oversight Committee has also been formed and held its first meeting in April 2007. This committee of Division staff, youth, parents, resource parents, juvenile court representatives, faith-based leaders, and other community partners monitors progress and makes recommendations about implementation of Family to Family.
Progress implementing each of the four strategies is described below:
• Recruitment, Development and Support of Resource Families – This strategy provides the framework for finding relatives and families for placement of children coming into care. In SFY 2006 all six districts filled Recruitment Liaison positions. These Liaisons developed Community Recruitment Councils and are actively engaging their communities in efforts to recruit new foster and adoptive families. The Community Recruitment Councils enlist foster and adoptive parents, foster youth, foster alumni, local contract agency staff, faith based and business partners, and any other community members with an interest in this initiative.
To support Division efforts, a Family to Family Conference was held in October 2006, hosted by Representative Leah Landrum-Taylor, Arizona Children’s Association, and the City of Phoenix. Guest speakers included Father George Clements, Founder of One Church One Child, Tim Briceland-Betts of CWLA, and local dignitaries. Invited guests included faith based organizations from across the State, Home Recruitment Study and Supervision (HRSS) contract providers, and State staff. The afternoon session was devoted to districts informing their faith organizations about their needs and requesting assistance with the recruitment and retention of resource families.
See Section III, Part 5, subsection A.9. Foster and Adoptive Home Licensing, Approval, Recruitment, and Retention for more information on the activities and achievements of the district Recruitment Liaisons, the Community Recruitment Councils, and other Division initiatives to recruit, develop, and support resource families.
•
Building Community Partnerships – With training and technical assistance on community partnership development provided by the Annie E. Casey Foundation, Assistant Program Managers (APMs) in District 1 developed 11 Community Strategy Committees in SFY 2007. The Committees engage community partners and strengthen relationships within targeted areas, to affect change in the nine Family to Family outcomes. Contract providers, schools, faith-based organizations, parents, resource families, and others attend the community meetings conducted by the field APMs. Six Community Specialist positions have been hired to assist the partnerships. Each Community Strategy Committee prioritizes the Family to Family outcomes they want to impact. For example, the Phoenix North Central Committee is developing a community resource book to give to families in crisis to prevent removal, and the Phoenix South Mountain section is working to increase community partner participation in TDMs. All Teams have been provided data on TDM occurrence and resource family availability in their zip codes, and an orientation and training on TDMs was delivered to District 1 community partners in late April 2007. Between January and March 2007 seven sections began holding Community Strategy Committee meetings. Other districts remain in the planning stages around this strategy.
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Child and Family Services Plan – Annual Progress Report 2007
Section III, Part 1: Crosscutting Initiatives
•
Team Decision Making – Team Decision Making (TDM) meetings provide a forum for family, friends, natural supports, Division staff, and community providers to discuss the strengths and needs of the family, and to identify the best placement for the child that will keep him or her safe and connected to family and community. These meetings are facilitated by trained staff that ensure the family’s voice is heard and respected, including the family’s cultural perspective and identification of significant relationships in the child’s life. TDM meetings are an opportunity to develop a plan to achieve the Family to Family outcomes on a child by child basis. The TDM facilitator guides the team to identify opportunities and resources to prevent removal and re­entry, or to quickly reunify with birth family if removal is necessary. The team explores resources to place children in their home communities, with siblings, and in family versus group care settings; and to support placement stability to prevent moves. Achievement of the Family to Family and other Division outcomes is highly inter-related on an individual and aggregate level. For example, prevention of entry or re-entry and early reunification will reduce the number of sibling groups needing non-related foster homes, giving the Division more flexibility to manage its foster family resources so that homes are available for sibling groups when needed. In turn, with fewer sibling groups in out-of-home care and fewer sibling groups placed separately, the Division will experience less strain on its transportation and visit supervision resources and will be better able to provide frequent visitation with parents and siblings placed separately.
TDM facilitators began to hold meetings in District 1 in June 2005. TDMs started at the Phoenix office with the highest number of removals, and are now being held throughout District 1 whenever a child is removed or removal is considered. By the end of 2007, TDMs in District 1 will also be held whenever a placement change is considered, including reunification with a birth parent. Implementation of TDMs for initial removals has also begun in District II, and all other Districts have begun their initial planning for implementation. A total of 23 TDM Facilitators are actively holding meetings in Districts I and II. The number of TDMs held in District 1 increased from 659 in the quarter ending December 2006, to 728 in the quarter ending March 2007. Roughly 50% in each quarter were held prior to the child being removed. The team recommended in-home services for about half of the children. Data indicates that the mother attends in more than 75% of TDMs, and the father attends in 38 to 39%. An involved youth attends in just fewer than 60% of TDMs.
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Self-evaluation – With technical assistance from the Annie E. Casey Foundation, District 1 has developed a self-evaluation team. This team monitors and analyzes outcome data to evaluate progress toward the Family to Family goals. Data available to the team includes out-of-home episode and placement event data from the University of Chicago’s Chapin Hall website. Information on the use of this data, particularly the benefits of entry cohort data analysis, has been presented to District 1 and Division management. The Division has hired a data analyst to support the use of this data and Division staff (including the Division’s data manager and CFSR manager, and a District 1 APM) have attended training provided by Chapin Hall. The Team Decision Making database is also functional, tracking all TDM meetings, their outcomes, participation by case role (for example, mother and father), and the parents feelings about the process. The Division is encouraging the application of self-evaluation data in day to day management to achieve outcomes. Arizona’s Family to Family Manager and District 1 APMs have been meeting periodically to discuss data in relationship to their daily work, disproportionality, and Family to Family outcomes.
See Section III, Part 5, subsection A.3. Quality Assurance System for more information about the Division’s activities and achievements in the use of data for continuous quality improvement.
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The Division is also working with the Annie E. Casey Foundation to implement Building a Better Future. This parent mentoring program trains birth parents to become advocates and active participants in child welfare agency meetings, such as policy meetings. Representatives from Arizona attended the Annie E. Casey Foundation’s “Parents Leading the Way: Setting a National Agenda in Child Welfare and Beyond” convening in Kentucky in November 2006. Eleven Building a Better Future sites from around the country shared information on program implementation with each other and Annie E. Casey Foundation consultants. The Division’s management will be meeting with Annie E. Casey Foundation consultants to discuss program launch in Arizona.
2. Family-Centered Practice
Engagement of family members in the continual evaluation of the family’s strengths and risks is the most effective method to identify services that meet the family’s unique needs, produce desired behavioral changes, and achieve desired outcomes. Concerted efforts to embed this and other family-centered practice principles throughout the Division gained momentum in 2001 and continue to date. Family-centered practice principles and techniques are trained to new staff, continuously emphasized to existing staff, and embedded throughout the Division’s philosophy, policies, programs, and activities. Recent efforts are providing tools, programs, and skills to gain more consistent application of family-centered practice in the day-to-day work of all field staff. For example:
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The newly integrated Child Safety Assessment (CSA), Strengths and Risk Assessment (SRA), and case planning process; Team Decision Making meetings; and Family Group Decision Making meetings are some of the opportunities in which the Division applies family-centered practice principles to engage birth family in identification of strengths, needs, goals, and services.
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A two day statewide training to all in-homes services CPS Specialists on Engaging Families to Enhance Child Well-Being and Safety began in January 2006, and occurred again in Phoenix in December 2006. The concepts from this training have been integrated into the Core training provided to all new CPS Specialists, and the entire Core training now focuses on family-centered practice and engagement of family in case planning.
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Family-centered best practice tips were added to the State policy manual and became available to staff in July 2006. Many of these focus on areas evaluated during the CFSR, such as the following tips related to preservation of connections to family and culture:
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“As the CPS Specialist is assessing the needs of the child, it is important to find a caregiver who is willing to ensure that the child can maintain connections to their family, friends, and others identified as important to the child.”
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“While the placement of a child cannot be denied or delayed based on race, color or national origin of the foster parent or child, a child benefits from maintaining connection to their race, culture and ethnicity. It is important for the CPS Specialist and the caregiver to ensure that the child maintains connection to their race, culture, and ethnicity in a variety of ways.”
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In conjunction with the Family to Family initiative, the Division is promoting shared birth and resource family parenting of children in out-of-home care. Requirements are defined in the resource family HRSS contract (described below), and trained through the PS-MAPP training (described in Section III, Part 5, subsection A.4. Staff and Provider Training). In addition,
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District 1 will begin conducting Ice Breaker meetings in the summer of 2007. The Ice Breaker meeting is an opportunity to build a bridge between the child’s family and the resource family providing temporary care for the child. Whenever possible, the Ice Breaker meeting occurs within three days of placement with a resource family, unless the placement will last less than two weeks or there are concerns for the safety of the participants. A meeting should also be held when a child is moved from one resource family to another, in which case the meeting can include both sets of resource parents and the birth parents.
During the Ice Breaker meeting the birth and resource parents are introduced. Guided by a Transition Questions Guide, the birth parents educate the resource parents about the child’s likes, dislikes, bed and play habits, etc. Agreement is reached on the visitation schedule, phone schedule, and other forms of communication between visits. The meeting is expected to ease the transition for all parties and reduce placement disruptions by:
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increasing birth parent involvement and assurance the child’s needs are being met;
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helping the child feel the support and concern of both the birth and resource parents, and that both sets of parents are working for a common goal and not against each other;
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increasing the ability of the resource family to provide the child support and consistency;
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increasing the mutual awareness of the strengths offered by both sets of parents and reducing preconceived attitudes.
• Technical assistance from the National Resource Center for Family-Centered Practice and Permanency Planning has been used to integrate family-centered practice principles and techniques in CPS field supervision. National consultant, Lorrie Lutz, conducted telephone conferences for supervisors in June and July 2005, providing an opportunity to discuss application of family-centered practice principals to the work of supervision. These calls set the foundation for supervisory roundtables that were facilitated by Ms. Lutz in August and September 2005. During the roundtables, Ms. Lutz discussed and modeled application of family-centered practice within supervisory interactions and discussed a Family-Centered Supervisory Guidebook. The Guidebook includes family-centered skills for supervisors and questions to consider during clinical supervision conferences. The Guidebook has also been used as a basis for discussion and skill development during district management meetings, which include CPS unit supervisors. In SFY 2007 the Division revised its supervisory training, including addition of content to support family-centered supervision.
3. Integrated Child Safety Assessment, Strengths and Risks Assessment, and Behavior Based Case Planning
The Division has been receiving assistance from the National Resource Center for Child Protective Services and the National Resource Center for Family-Centered Practice and Permanency Planning to improve the practice integration of the safety assessment, risk assessment, and case planning processes and tools, their implementation in the field, related documentation, critical decision making, and clinical supervision. Staff were trained on a new Child Safety Assessment (CSA) from November 2002 to April 2003, and a Family-Centered Strengths and Risks Assessment Tool (SRA) and related interview guide from January to March 2004. These assessment tools provide a holistic definition of comprehensive assessment to shift the Division away from incident-based assessments. Since implementation, all new CPS Specialists have received training on the CSA and SRA tools and processes during initial and on-the-job training.
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The CSA and SRA require a substantially different approach to working with families, including differences in the style and depth of assessment. The necessary shifts in practice and agency culture have required ongoing and persistent attention. The second phase of the comprehensive assessment and case planning project began with a thorough evaluation that including review of policies, procedures and case records; a statewide survey of CPS Supervisors and line staff; staff focus groups; observation of training delivered in two sites; and a comprehensive review of relevant training curriculum. The evaluation concluded that further work was needed to ensure staff conduct thorough assessments, apply sound decision making, and develop case plans with explicit links to the family’s identified safety threats and risks.
To address this need, the Division developed an integrated CSA/SRA/case planning and clinical supervision process. Documentation requirements and on-line instructions have been added to prompt comprehensive information collection and recording, and application of concepts inherent to the safety assessment and critical decision making processes, such as “The Six Fundamental Questions” and the “Safety Threshold” analysis. The process is organized in a logical sequential flow that builds upon information collected and decisions made. Documentation is by area of family or individual functioning and key decision, rather than the date and time of the interview or other event. The CPS Specialist and supervisor can, therefore, review at once all information pertinent to a potential safety threat or risk factor, evaluate whether the information is thorough, and determine the level of risk and necessity of intervention.
The Division’s new case planning process shifts practice from compliance based to behavior based case planning. Family members are assisted to identify strengths that will help them to achieve the goals in their case plan, behaviors that need to change to reduce or eliminate the identified risks and threats to child safety, and services and supports to achieve the behavioral changes. The resultant family intervention plan can be reviewed and modified between formal case plan staffings to avoid ineffective and wasteful service provision and improve outcomes for families. In addition to the family intervention plan, each case plan for a child in out-of-home care has a health care plan, an educational plan, and an out-of-home characteristics section that identifies federally required information such as whether the child is placed in close proximity to his or her home. If applicable, the case plan also includes a visitation plan, supports for the out-of-home caregiver, independent living services for children age 16 or older, and actions to pursue a concurrent permanency goal. The case plan concludes with space to record participant attendance, approval, and signatures.
Supervisors use the integrated tool to guide clinical supervision conferences and document the results. The improved process integrates clinical supervision requirements at critical decision points throughout the life of the case. During clinical supervisory discussions, the supervisor refers to the information gathered and documented by the worker. The new process replaces existing clinical supervision forms and guides the supervisor to review and discuss information with the worker at specific points during the life of a case.
Training on the integrated process occurred statewide from February through May 2007. Statewide implementation was complete by June 1, 2007. Random case reviews will be conducted regularly to ensure best practice application, identify promising practices, correct practice deficits, identify training needs, and provide on-site technical assistance. The first of these reviews occurred in District 2 in May 2007. Two cases from each supervisor were identified for evaluation, and facilitated discussion and feedback was provided to the supervisors and APMs by the NRC consultants.
In calendar year 2006 the Child Welfare Training Institute revised the method of teaching the CSA and
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SRA processes to increase comprehension and address several levels of learning, and, thereby, increase consistency of intended use as a guide for safety and case-planning. Child Welfare Training Institute (CWTI) staff are available to provide on-site and/or telephonic support as workers begin using the new integrated process. In addition, a half-day class on supervision of this process will be developed for all existing supervisors, and added to the Supervisor Core for all new supervisors. This follow-up is essential to embed the process in field practice and improve performance on safety assessment, safety planning, family assessment, and case planning.
Improvements in the CSA-SRA-case planning process and clinical supervision have a direct impact on achievement of all CFSR performance areas. There is a clear and direct relationship to performance on areas such as prevention of repeat maltreatment; services to protect child(ren) in-home and to prevent removal and re-entry; quality of risk assessment and safety management; needs and services of child, parents, and foster parents; and child and family involvement in case planning. In addition, individualized behavior based case planning will support appropriate assignment and timely achievement of permanency goals, and more comprehensive assessments will identify the child’s important relationships and connections, and methods to maintain these relationships.
4. Home Recruitment Study and Supervision Contract
The new Home Recruitment Study and Supervision (HRSS) contract for child specific recruitment; targeted recruitment; resource family orientation; resource family initial, advanced, and ongoing training; and licensed foster family placement, tracking, and monitoring services became effective in November 2006. The contract dictates new goals, objectives, payment points, and reporting requirements that align with the Family to Family goals and emphasize shared parenting. The Division believes that ongoing contact between resource families and birth families is an effective means to dispel myths and stereotypes about ethnicities, cultures, and people who are poor, mentally ill, or addicted to drugs or alcohol. When these myths and stereotypes are challenged, resource families and other team members will be more likely to support and facilitate activities to maintain connections with family, friends, community, faith, and culture. Anecdotal information suggests this strategy is effective. The CASA Coordinator in one county reports that she has seen an increase in attendance at court hearings by resource families, and has noted increased willingness of resource families to be involved in maintaining important connections for children in their care. Highlights of this contract related to the Division’s goals and the CFSR performance areas include the following:
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Child specific recruitment activities must be tailored to the child’s or sibling group’s unique background, culture, race, ethnicity, strengths, needs, and challenges.
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Contractors develop an individualized recruitment plan for each child referred, which must include direct contact with relatives, friends, and former caregivers, collaterals such as coaches, mentors, or teachers; and/or other significant adults identified in the child’s record or during interviews. Family Group Decision Making may be used to facilitate contact.
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Semi-annual recruitment plans are submitted to the Division, including strategies tailored to the populations identified by the District. Target populations include, but are not limited to, sibling groups, specific age ranges, neighborhoods and/or ethnic/racial groups. These plans are developed in collaboration with the Community Recruitment Council.
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All contractors must fully implement PS-MAPP training as the required initial preparation and training program. Contractors are required to provide opportunities for kinship caregivers to
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participate in PS-MAPP group preparation and selection training and mini PS-MAPP sessions regardless of the kinship caregiver’s intent to complete the foster parent licensing or adoption certification process. See Section III, Part 5, subsection A.4. Staff and Provider Training for more information on PS-MAPP training.
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The contract agency’s Foster Care Specialist must arrange a one-to-one meeting with any foster family wishing to have a child removed, prior to placement or adoption disruption. When removal is being considered, the Foster Care Specialist and the CPS Specialist shall request a Child and Family Team or TDM meeting prior to the child’s removal whenever possible.
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The Foster Care Specialist is required to make one visit within 72 hours of a child being placed in a resource home, make monthly visits to the resource family for the first six months after a new child is placed in the home, and make a minimum of quarterly home visits thereafter. For homes licensed in the past 6 months or with their first placement, weekly visits must occur during the first month of a child’s placement. Monthly in-home visits are required throughout placement for foster homes providing care to medically fragile children.
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The Foster Care Specialist develops an individualized support, training, and monitoring plan with each resource parent; including training and services requested or identified to be provided, crisis intervention services to be made available, any other supports needed to meet the special/unique needs of the family or the child, and time frames for training and support service provision.
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The HRSS contract includes 11 outcomes and 16 performance measures on which the agencies must gather and report data. Performance incentive payments are awarded to contractors who achieve at least 12 of the 16, based on the full year of performance. The performance measures promote shared parenting, sibling contact, placement stability, sibling group placements, placement within children’s own neighborhoods, timely application processing and training, resource family retention, and others. For example, two goals are: (1) When the case plan goal is reunification, resource families shall participate in a minimum of monthly contact with birth parents or primary caretakers, which could include participation in the monthly visitation; and
(2) Resource Families shall facilitate a minimum monthly contact between siblings who do not reside with them.
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Section III, Part 2: Safety
PART 2: SAFETY
A. Program or Service Description
1. Child Abuse And Neglect Prevention Services
Healthy Families Arizona
The Healthy Families Arizona program is a community-based, multi-disciplinary program serving pregnant women and families of newborns. The program is designed to reduce stress, enhance family functioning, support positive parent/child interaction, promote child development and health, and minimize the incidence of abuse and neglect. This voluntary home visitation program provides a Family Support Specialist (FSS) who assists the family to obtain concrete services and provides emotional support; informal counseling; role modeling; effective life coping skills; bonding; education on child development and school readiness activities; developmental assessments to identify developmental delays, physical handicaps, or behavioral health needs; and referrals when needed.
The program provides education on the importance of preventive health care, assistance and encouragement to access comprehensive private and public preschool and other school readiness programs, assistance in applying for private and public financial assistance and employment services, and assistance to improve parent-child interaction, develop healthy relationships, and access prenatal care. The FSS works closely with the child's medical provider in monitoring the child's health. Families may be visited anywhere from weekly to quarterly, according to the family's level of need. The program’s statutory authority was expanded in SFY 2004 to permit the program to serve women and their families prior to their child’s birth, and to serve people who have a substantiated report of abuse or neglect. Program services are available until the child reaches age five.
The contracts that began in January 2004 were renewed in January 2007. These contracts are renewable for one more year. The original contracts included expansion plans based on demographics and risk factors. The program has expanded several times since SFY2004, increasing the number of program sites from 23 to 58. The program now serves over 150 communities throughout Arizona, including all of the Division’s six administrative districts.
In SFY 2006 the Healthy Families Arizona Program funding level allowed the program to serve 5,008 families, which is an increase from the 3,564 families served in SFY 2005. In SFY 2006 the Program served 18.4% of eligible new births, and 7 new teams and 12 additional staff were hired to total 58 program teams. The program budget for SFY 2007 is approximately $21 million. With this funding, an estimated 5,689 families and 19% of eligible new births can be served. Additional funding for SFY 2008 has been requested from the legislature to further expand the Healthy Families Arizona home visitation program.
Evaluations of the Healthy Families program continue to document its effectiveness. The 2006 program evaluation includes the following findings regarding program participants:
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Child Abuse and Neglect: 99.24% of participating families had no substantiated CPS reports.
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Child Health: The immunization rate for babies was 84%, compared to 79% for 2-year-olds in the State; and 97.2% of children are linked to a medical provider.
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Child Safety: 93% of parents lock up household poisons, 99% use car seats, and 88% use smoke alarms.
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Maternal Life Course: 40% of mothers are employed full-time at 12 months, and 11.6% are enrolled in school.
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Maternal Stress: Significant improvement has been observed in several areas, including parenting competence, problem solving, and connecting to and using resources.
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Most recent Participant Satisfaction Result: 95.8% felt they received the services they wanted and needed.
In addition, the Healthy Families program successfully targets families that are likely to benefit from the program. Between one quarter and one third are teen mothers, about two thirds are single parents, roughly two thirds have less than a high school education, approximately one third received late or no prenatal care, and slightly more than 80% are not employed. The median annual income of program participants is $12,000, compared to $45,279 median income across the Arizona population in 2004.
Child Abuse Prevention Fund
The Child Abuse Prevention Fund provides financial assistance to community agencies for the prevention of child abuse. The funds are currently used for the Healthy Families Arizona Program, the Regional Child Abuse Prevention Councils, and the Child Abuse Prevention Conference. In 2007 the annual two day conference included forty workshops and provided information on the entire prevention and intervention continuum, from public awareness campaigns to prosecuting crimes against children. Over 800 people were in attendance. Three pre-conference workshops were held the day before the conference: “In their Best Interest: Toddlers and the Courts” (by invitation only); a meeting of Regional Child Abuse Prevention Council coordinators; and “Battling Meth in AZ” (open to all conference participants).
In January 2006 the Statewide Regional Child Abuse Prevention (C.A.P.) Councils developed a prevention plan that emphasizes five main areas: parenting support, economic security, health care, child care, and schools. The AZ CAN! Plan was released in March of 2006 and was distributed across Arizona. The purpose of the AZ CAN! Plan was to provide a framework detailing strategies and local actions steps that each community across the state could use to help prevent child abuse and neglect. The Councils met for a full day in January 2007 to learn about new parent resources, legislative advocacy, discuss Child Abuse Prevention month activities for April 2007, and talk about the impact of Proposition 203 (First Things First). In November 2006, Arizona voters passed Proposition 203, a citizen’s initiative that will fund early childhood development and health care programs at the local level. The money is generated by a tobacco tax and will be distributed to local advisory boards statewide. The division is hopeful that this money can be used to fund many of the programs and services suggested in the AZ CAN! Plan.
Bumper stickers and bookmarks with positive phrases such as "Make Time for a Child" and Prevention Works Wonders" continue to be distributed throughout the year and at the Child Abuse Prevention Conference. New awareness buttons and posters were designed and distributed during April 2007 (child abuse prevention month). The Division provided Department staff, the Governor’s Office, and all service providers a list of all activities organized by the Regional C.A.P. Councils occurring during the month of April 2007.
For more information on these services and initiatives, and the Child Abuse Prevention Fund’s accomplishments in FY 2007, please see the Child Abuse and Prevention Treatment Act (CAPTA) Annual Progress Report in Section VI of this document.
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Arizona Promoting Safe and Stable Families/Family Support and Family Preservation
Arizona Promoting Safe and Stable Families (APSSF) programs provide culturally competent community-based family support and preservation services to improve the safety and well-being of families, enhance family functioning, foster a sense of self-reliance, strengthen protective factors, reduce risk factors, and stabilize families. Families access these voluntary programs directly or by referral. Most programs have few restrictions or qualifications in order to receive services, and there are no income eligibility criteria. Contingent upon the needs of the family and the community’s resources, services are available to any family with a child requiring services – including biological, kinship, foster, adoptive, and non-English speaking families.
A broad array of free services are offered including, but not limited to: case management, housing support, assistance in securing child care, early intervention, food and nutrition, mentoring, parenting skills training, peer self-help, supportive counseling, transportation, emergency services, respite, and intensive family preservation services. Service providers are required to form collaborative partnerships for the provision of family-centered services and provide 25% in-kind matches to the funds provided by the Division. Services are available in all districts, and vary according to the needs of the community. In FY 2007, the Division contracted with 16 non-tribal service providers and 7 tribal nations to provide APSSF and Family Support and Family Preservation services to families and their children in both urban and rural settings. Since 1995 these programs have collectively served more than 95,000 families and their children.
In SFY 2007 the Division’s Office of Prevention and Family Support (OPFS) continued to provide technical assistance, training, and support services to program sites, including:
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current information updates;
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program monitoring visits to ensure program quality and contract compliance;
• ongoing technical support and family-centered practice training, which included goal setting and the assessment process;
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new staff training on PSSF program requirements, contract compliance, and staff responsibilities; and
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the Annual Statewide Family-Centered Practice Conference to be held in June 2007, including nationally recognized speakers and presenters on prevention programs and family centered practice principles.
In SFY 2007 the OPFS continued community outreach efforts by:
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producing the annual APSSF Services Program Directory of the statewide providers’ program information and distributing at PSSF sites, community agencies, Child Protective Services, the Child Abuse Prevention Councils, the Child Abuse Prevention Conference, the Family Centered Practice Conference and other locations;
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maintaining a section on the Department’s web site to provide information about APSSF programs;
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providing APSSF program information at community conferences and health fairs;
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updating and distributing the program brochure on APSSF programs in December 2006; and
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making available training on APSSF programs to all CPS Districts’ supervisors and managers, and the CPS Child Welfare Training Institute trainees.
Community providers continued to participate in the ongoing contracted independent program evaluation during SFY 2007. Participation included attendance at bi-monthly program evaluation team meetings and a data collection training, and provision of a variety of data to the evaluators each month. The most
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recent program evaluation report indicated the following for program participants:
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Families were diverse and represented all segments of Arizona’s population, albeit ethnic minority families were slightly over-represented compared to the State’s population.
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Families were found to have significant risk factors, including poverty, single parent households and children in out-of-home care.
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The percentage of families that were referred to the program by Child Protective Services (CPS) ranged from 9% to 14% over the last three years. Approximately 31% of the families report having had some contact with CPS. The Court or law enforcement agencies made 50% of referrals.
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Regardless of income, most families sought assistance to enhance their parenting skills.
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Families were directly involved in prioritizing their presenting issues and formulating their support plans.
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7,084 new families and 14,783 children, including families from Tribal Nations, received services in FFY 2006.
Data related to APSSF outcomes indicates the programs met or nearly met their targets for FFY 2005. This data included the following about Program participants:
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99% did not have a substantiated report of child abuse or neglect for six months after receiving services.
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95% indicated satisfaction with program services.
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87% reported improvement in their parental competence. This far exceeded the contractual expectations that 50% of the families would improve their parental competence. Twelve of the sixteen participating agencies exceeded 89% improvement.
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Overall, 69% of all families improved in at least one presenting issue.
Continuous Quality Improvement strategies include holding bi-monthly evaluation meetings for all providers, requiring 30 hours of on-going education in family centered practice for everyone employed in the programs, annual site-visits to review the quality of all aspects of the programs, and technical assistance to the providers to critically examine their outcomes. This is being accomplished via the use of logic models and strategic planning, incorporating lessons learned and knowledge gained from best-practice literature, and placing an emphasis on quality service delivery, especially in the areas of increasing the percentage of families that show improvement in at least one presenting issue and improving families’ self-reported parenting competence. Additional funding for program expansion is being sought from a recently passed State proposition that will make available several million dollars for prevention activities.
Homeless Youth Intervention Program
The primary objective of the Homeless Youth Intervention Program (HYIP) is to reduce risk factors
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related to homeless or potentially homeless youth and their families by:
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establishing a sense of self-reliance;
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providing family support, preservation, and reunification services; and
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providing independent living skills training.
The focus of this program is to reunify homeless youth with their families and enhance the parent-child relationship by providing the necessary resources and services to enable a safe and stable environment. Referrals are received from parents, schools, or any significant person in a child’s life. Participation by the youth is voluntary. Upon referral, staff contact the youth to gather input regarding his or her needs, resources, and interest in services; and to engage and motivate the youth to participate in services. Services may include, but are not limited to: case management, parent aide, parent training, shelter care, counseling, and crisis intervention. Services continue, as needed, to support and stabilize children in-home following reunification. When reunification is not possible, the focus becomes the enhancement of the homeless youth’s ability to be self-sufficient. Self-sufficiency services include: shelter care and supervision (with parental consent), employment skills training, employment assistance, personal living skills training, independent/transitional living programs, counseling, mentoring, and the provision of emergency supplies. Youth involved with CPS or the Juvenile Justice System are not eligible for this program. The Homeless Youth Intervention Program is available in Pima, Maricopa, and Yavapai Counties, and serves approximately 100 youth per year.
In providing services to meet the needs of homeless youth, the Program assisted youth by:
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providing for the basic needs of youth (i.e. clothing, food, shelter and medical care);
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screening and properly treating mental health issues;
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providing age and developmentally appropriate literature to youth to help them address their current living situations and relationship issues; and
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promoting the youth’s appreciation of life by aiding youth to identify and become more engaged in activities that they enjoy, and facilitating increased involvement in the positive aspects of their communities.
During SFY 2007 the Homeless Youth Intervention Program implemented strategies to aid age appropriate participants in obtaining and securing stable employment, and increase the percentage of youth with identified drug issues who participate in drug treatment services. Activities and accomplishments included the following:
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Of youth served from July 2006 through February 2007, 22% obtained and secured employment for at least 30 days.
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Case managers continued to network with their communities to identify potential employers and educate them on employment issues faced by youth in the community. HYIP program staff also established relationships with youth-employment programs and obtained job leads for youth.
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Less than 1% of youth identified substance abuse as a problem at the time of assessment. Of the 1%, 60% reported the behavior was eliminated by the time of case closure. 20% reported the behavior was reduced at the time of case closure.
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Program representatives continue to report a trend of risk and harm reduction this year, including decreased usage, knowledgeable usage, and needle exchange. However, Tucson program representatives report an increase in use and abuse of methamphetamine, and to a lesser degree, heroin.
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Of youth served during SFY 2007 through the end of April, 48% of HYIP participants completed all of their goals before closing, and 66% of the youth were reunited with their families.
Service Integration and Family Connections
Service Integration is a fundamental change in the way the Department does business. It builds individuals’ and families’ capacities to improve their lives by focusing on prevention and early intervention. Through service integration, individuals and families assess their strengths, engage in developing plans to build on those strengths, and reach progressive goals in the areas of safety and self-sufficiency. The collective resources of the entire Department, along with the resources of our partner agencies, community-based organizations, and faith-based groups, are utilized in supporting families’ efforts. The three primary goals of service integration include promoting self-sufficiency, strengthening families, and developing the capacity of extended families and communities.
The Department’s service integration strategies serve families that are involved with Child Protective Services in addition to families at risk of involvement with CPS. Many family, community, and Department partners participating in the Community Network and Breakthrough Series Collaborative Teams are current or former foster and/or adoptive parents caring for children involved in the child welfare and/or developmental disability areas. The Department’s major service integration strategies include the following:
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Family Connections Teams – These teams were developed in 2005 to reduce poverty and family violence by better integrating the Department’s human service programs. These wraparound intervention teams engage families to establish goals for self-sufficiency, child safety, and overall child and family well-being. Through the collaborative development of service plans, services that address housing, education, income, health care, and substance abuse are better coordinated. The responsibility for service delivery is shared among staff and case participants, including parents, children, faith-based communities, neighborhood groups, and treatment or service providers.
The multidisciplinary Family Connections Teams include child welfare, family assistance, and employment program staff and provide comprehensive integrated prevention and/or early intervention services to at-risk families, to increase family stability and self-sufficiency and reduce involvement with the Temporary Assistance for Needy Families (TANF) and CPS systems. The current teams serve families with active enrollment or high risk for enrollment in the TANF program, but no or limited active involvement with CPS. CPS Specialists and the Child Abuse Hotline can refer families to Family Connections teams. There are currently ten Family Connections teams – six in Maricopa County and four in Pima County. Four teams are linked to domestic violence shelters, where they target families who are exiting shelters and need services to help stabilize. Additionally, two of the teams provide services to maintain kinship placements, and another two provide supports for families identified through child welfare Team Decision Making meetings (TDMs) and other Family to Family initiatives. These teams seek to prevent court dependency and/or child removal.
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•
Local Integrated Offices – Local Department offices co-house programs and services such as Family Assistance Administration, Jobs, Jobs Services, CPS, DDD, and child support; and have streamlined the provision of employment services. Many of the offices have also redesigned their lobby and office space to accommodate co-location of community agencies and support a more integrated and smoother transition for families receiving multiple services. DES staff are working cooperatively to coordinate local services within their offices and communities.
•
TANF Service Coordinators – TANF Service Coordinators conduct an up-front assessment of families applying for TANF, to connect the family to all DES services and community services. The Service Coordinator determines eligibility for TANF, including Grant Diversion, Food Stamps, and medical assistance. Individuals involved in Grant Diversion, which is a one-time cash assistance to prevent the need for long-term services, are provided job development and post-employment support services. The goal is to reduce the TANF caseload by improving outcomes for families from the point of the initial interview by serving the family holistically, identifying the family’s strengths, and addressing all potential needs. There are currently 33 TANF Service Coordinators, including 20 in Maricopa County, 9 in Pima County and 4 in Cochise County.
•
Customer Service Representatives – Department of Economic Security Customer Service representatives screen families upon initial contact and connect each family to appropriate community and other Department programs. The goal is to improve customer service for families walking into Department offices and increase timeliness and access to needed services. There are currently eight Customer Service Representatives in Pima County, Maricopa County, and the Show Low area.
•
Breakthrough Series Collaborative (BSC) on Service Integration – Twenty local teams have been formed in Arizona’s 15 counties, including teams with tribal focus. The teams have equal representation of family, community, and Department partners working collaboratively to identify, test, and implement rapid, small, short term strategies aimed at improving the safety and self-sufficiency of families in the local community. These locally grown improvements are used to identify promising practices and build statewide system reform, resulting in larger and long-term improved outcomes for families served by the Department. Teams have been trained on the principles and values of effectively integrating services and the BSC Plan-Do-Study-Act (PDSA) methodology. Teams define problems, opportunities, and outcomes; engage in small tests of change that involve only two or three families at a time; and study and modify the results. Strategies with potential are refined and implemented on a much broader scale. Partnership development, increased capacity of families and communities to care for their families, and spread of successful ideas across the teams are primary features of this collaborative effort.
•
Service Integration Community Development/Family Leadership Workgroup – This team provides direct input from family members into Department programs, services, and practices. Engaging families in all aspects of service integration is its overall emphasis, accomplished through five focused areas: establishing qualified family leaders to consult on Department policies and procedures and work closely with Department management; streamlining to reduce barriers and duplication for families accessing multi-agency assistance; planning a combined summit of county Community Network Teams and family leaders to promote institutionalizing family leadership within all levels of Department; parents training other families in self-advocacy and understanding systems reform; and developing a compensation package for families who
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serve in leadership roles within Department committees, workgroups, and other related capacities.
•
Community Network Teams – Community Network Teams are currently located across all 15 Arizona counties. These teams develop plans; identify existing services, resources, and family supports within their local communities; and address gaps in services. These teams work on proposals and strategies to deliver improved services and better support to children and families in their communities, and to increase collaboration and cross-education among community members. Several teams use the Asset-Based-Community-Development (ABCD) methodology to increase the well-being of children and families.
2. Child Protection, and Child Abuse and Neglect Intervention and Treatment Services
The Arizona Child Abuse Hotline
The Arizona Child Abuse Hotline is the receiving point for all telephone, fax, and written communications from any person, law enforcement agency, or judicial entity concerned about possible or alleged abuse, neglect, abandonment, or exploitation of a child within Arizona. Sources include parents, relatives, mandated reporters, private citizens, and anonymous reporters. Trained CPS Specialists assess all incoming information and support the interview process by asking specific cue questions regarding the type of abuse or neglect alleged. For all incoming communications, Hotline staff determine whether the statutory criteria for a CPS report for investigation are met and the current safety and level of risk to the child. The Hotline notifies a field Unit Supervisor or standby staff immediately when an emergency response is needed.
Hotline staff continue to use interview cue questions that gather information on four domains within the State’s Strengths and Risk Assessment Tool: current incident and history of abuse/neglect; child characteristics; parent characteristics; and family, social, and economic factors. The training curriculum on the State’s Child Safety Assessment and Strengths and Risk Assessment Tool was modified to address Hotline assessment, and has been incorporated into the Hotline’s new employee training program. The Strengths and Risk Assessment Tool has been used for all communication determinations since its implementation. Some of the reduction in the number of CPS reports for investigation is believed to be a result of using this tool, since staff are trained to ask more specific questions and are therefore able to gather more clear information to determine whether statutory criteria are met. The cue questions and training provide continuity in policy and language throughout all phases of CPS intervention.
All communications about abuse or neglect of a child that are determined not to meet the statutory criteria for a CPS report for investigation are reviewed within 48 hours by a quality assurance specialist. Communications may not meet the criteria for investigation for reasons such as: (1) concern only/no allegation of child abuse or neglect; (2) out of CPS jurisdiction; (3) information is appropriate for law enforcement jurisdiction (such as when the perpetrator is not a parent or primary caretaker); (4) insufficient information; (5) truancy/custody issues only; and (6) incoming communication involves questions or information on a current CPS case. The Arizona Citizen Review Panel Eighth Annual Report (December 2006) found, “As in previous years, record reviews identified the Intake and Screening stage as a strength of the child protection system. Panels found that actions taken by the Child Protective Services Hotline were complete, accurate and timely in 24 cases reviewed and disagreed in one case with the hotline’s decision to not accept a call as a report.”
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The Hotline also receives many important calls that are not about abuse or neglect of a child. For example, calls requesting community resource information, notifying the agency that a youth in DES custody has run away, or alerting the Division to a foster parent or group facility license violation. The Hotline documents in CHILDS all communications of substance. All requests for copies of CPS reports are also processed by the Hotline. When requested by a person who is entitled to receive a copy, the report is redacted (when required) and mailed with an explanation of codes and procedures for appeal of the decision. In addition, the Hotline processes all clearance requests received from foster home licensing and adoptive certification agencies, statewide. These requests are processed by support staff, rather than Hotline CPS Specialists. Total Hotline staff is now 92, including 72 Child Protective Service Specialists, nine CPS Unit Supervisors, five management staff, and six clerical staff.
The Hotline continues to gather statistics regarding call volume and Hotline performance. For example:
•
The Hotline continues to reduce the length of time a caller must wait before speaking with a Hotline Specialist. The percentage of calls answered directly by a Hotline Specialists increased from 57.98% of 41,764 calls in April through October 2005, to 65.36% of 45,911 calls in April through October 2006.
•
In FFY 2005 and FFY 2006 the Hotline maintained an average wait time of five minutes for incoming calls, despite increased call volume.
•
Wait time has been positively affected by the availability of an incoming call menu offering a “triage” specialist for those callers with brief information requests or short questions. This allows quick response to approximately 100 calls per day, and directs callers with concerns of abuse and neglect to a Hotline Specialist expecting this type of call. In addition, Hotline supervisors ask staff to take an additional call when any queue time exceeds 20 minutes.
To build on Hotline initial training, “ongoing” training was implemented in January 2005 to address the current and long-term needs of Hotline Specialists. Between January 2005 and June 2006 topics have included safety and risk assessment implementation; DES service integration; correct research and data input; procedural changes regarding court orders and abuse between children in foster care; the correlation between animal, elder, and child abuse and domestic violence; and a safety and risk assessment update. The trainings provide tools to assist staff in accurate assessment of safety and risk, raise awareness of related services within the Department and community, and improve documentation to facilitate follow-up by direct service staff. Hotline initial and ongoing training will soon be included within the DCYF Child Welfare Training Institute. Ongoing training will occur on a semi-annual basis, at minimum, in order to partially meet requirements for all CPS Specialists within the Division to receive a minimum of 24 hours of ongoing training per year. Hotline staff also attend conferences and other training offered by the Department and community.
Child Safety Assessment and Comprehensive Strengths and Risk Assessment
Arizona law identifies that the primary purposes of CPS are: (1) to protect children by investigating allegations of abuse and neglect; (2) to promote the well-being of children in a permanent home; and (3) to coordinate services to strengthen the family and prevent abuse or neglect. To achieve these purposes, all communications meeting the criteria of a report are assigned to a CPS Specialist for investigation and family assessment, including assessment of child safety, risk of future harm, need for emergency intervention, and evaluation of information to support or refute that the alleged abuse or neglect occurred. Joint investigations with law enforcement are required when the report or the investigation
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indicates that the child is or may be the victim of an extremely serious conduct allegation, which if deemed true would constitute a felony. Such allegations include death of a child, physical abuse, sexual abuse, neglect, and certain domestic violence offenses. The joint investigations are conducted according to protocols established with municipal or county law enforcement agencies.
The Division’s Child Safety Assessment (CSA) and Family-Centered Strengths and Risks Assessment Tool (SRA) assist CPS Specialists to explore all pertinent domains of family functioning, recognize indicators of present or impending danger, and predict the likelihood of future maltreatment. The initial CSA is completed within 24 hours of seeing each child in the family, and again prior to investigation closure. The SRA is completed within 45 days of case opening or prior to case closure, whichever occurs first. CPS Specialists use the Family-Centered Strengths and Risks Assessment Interview and Documentation Guide to gather and evaluate information from parents and children. The Interview Guide provides questions for CPS Specialists to ask families when gathering information to assess the family’s strengths and functioning in each risk domain. The recommended questions are open-ended, non-confrontational, and phrased to engage family members in identification of their own unique strengths and needs. The resulting comprehensive family-centered assessment serves as a basis for case decisions and case planning.
Based on the results of the investigation and the CSA and SRA, the Division determines the level of intervention required; including whether to close the case, offer voluntary child protective services, file an in-home intervention or in-home dependency petition, or file an out-of-home dependency petition. This decision is primarily based on the existence or absence of present or impending danger and future risk of harm to any child in the family unit, the ability of the family unit to manage identified child safety threats; the protective capacities of the family unit to mitigate identified risks, and/or the ability of services and supports to mitigate the identified risks. The CPS Specialist considers the family’s recognition of the problem and motivation to participate in services without CPS oversight, the family’s willingness to participate in voluntary child protective services, existence of grounds for juvenile court intervention, and the agency’s knowledge of the family’s whereabouts. In–home services are offered to families with low to moderately high risk of future maltreatment, whose needs can not be sufficiently met through referral to community resources. If no protective action and/or services or supports can ensure the child's safety at home at the present time, a safety plan must be implemented, which may include out-of-home care. State policy does not identify report substantiation as a factor in determining the level of required intervention.
The Division is receiving assistance from the National Resource Center for Child Protective Services and the National Resource Center for Family-Centered Practice and Permanency Planning to improve the practice integration of the safety assessment, risk assessment, and case planning processes and tools, their implementation in the field, related documentation, critical decision making, and clinical supervision. See Section III, Part 1, Crosscutting Initiatives for more information on the CSA-SRA-case planning and clinical supervision process improvement project.
In-Home Children Services
In-home children’s services focus on families where unresolved problems have produced visible signs of existing or imminent child abuse, neglect, or dependency, and the home situation presents actual and potential risk to the physical or emotional well-being of a child. In-home children services seek to prevent further dependency or child abuse and neglect through provision of social services to stabilize family life and preserve the family unit. These services, including voluntary services without court involvement and court-ordered in-home intervention, are available statewide, although the actual design of services varies by
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district. Services include parent aide, parenting skills training, counseling, self-help, and contracted case management. Families may also receive referrals for services provided by other Divisions within the Department or other State agencies, including behavioral health services and other community resources.
Contracted services provided through the Division’s Family Support, Preservation and Reunification “In-Home Service Program” are available statewide. This integrated services model includes two service levels, intensive and moderate, which are provided based upon the needs of the child and family. The model is provided through collaborative partnerships between CPS, community social service agencies, family support programs, and other community and faith-based organizations. The contract provides an array of in-home services and service coordination, and better ensures the appropriate intensity of services is provided. Services are family-centered, comprehensive, coordinated, community based, accessible, and culturally responsive. Services include, but are not limited to: crisis intervention counseling; family assessment, goal setting and case planning in accordance with the results of the CSA and SRA; individual, family and marital therapy; conflict resolution and anger management skill development; communication and negotiation skill development; problem solving and stress management skill development; home management and nutrition education; job readiness training; development of linkages with community resources to serve a variety of social needs; behavioral management/modification; and facilitation of family meetings. The Program also assists families to access services such as substance abuse treatment, housing, child care, and many others. Services may be provided within a birth parent’s home or in the home of a pre-adoptive or adoptive kinship or foster family home. The model may also be provided to transition a child from a more restrictive residential placement back to a foster or family home, or from a foster home to a family home. The model supports shared parenting by assisting foster parents to partner with birth parents and empowering birth parents to keep active in their children’s lives.
The following elements are fundamental to the in-home services program and contract:
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Families are served as a unit.
•
The needs of the children are identified and addressed.
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Services take place in the family’s own home or foster home.
•
Services are crisis-oriented, thus initial client contact is made within four to twelve hours of receipt of the referral for an intensive case and within two business days for a moderate case.
•
Intensive Services are available to clients twenty-four hours per day, seven days per week, for emergencies.
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The assessment and treatment approach is based on the family systems theory.
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Emergency assistance may be available through the use of flexible funds.
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The service emphasizes teaching the family the necessary skills to achieve and maintain child safety and well-being.
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Each family’s community and natural supports are quickly identified and continue to be developed for the entire life of the case.
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Aftercare plans are in place when permanency is established.
The Division uses in-home service units to support delivery of integrated services and other in-home supports. Cases served include voluntary foster care, in-home court intervention, in-home dependency, integrated services, and other in-home support cases. Districts I, II, III and VI have specialized in-home service units and districts IV and V have In-Home Services Specialists.
The average monthly number of families receiving in-home services has increased from 4,376 in SFY 2005; to 4,829 in SFY 2006; and 5,154 to date in SFY 2007. The significant increase can be attributed to the increased use of court ordered in-home intervention as well as the implementation of the new integrated services contracts that increased the availability of in-home services to families.
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B. Outcomes, Goals, Measures and Progress
To integrate the Child and Family Services Review (CFSR) process and the Child and Family Services Annual Progress and Services Report, most of the Department’s Child and Family Services State Plan outcomes and goals match those used to determine substantial conformity during the CFSR. The target percentage for all the CFSR goals is the standard for substantial conformity during a Child and Family Services On-site Review, and is therefore a long-range goal representing a very high standard of practice.
Progress toward achieving most of the State’s safety outcomes and goals is measured using the Practice Improvement Case Review. The Practice Improvement Case Review process was substantially revised starting with the review conducted January 2005, and the period under review beginning July 1, 2004. Case review data is provided from the last quarterly statewide review using the former procedures (quarter ending 6/04), and the statewide combined results of the reviews conducted in 2005 and 2006, using the new procedures. Unlike the CFSR, safety outcomes measured through the PICR are measured using a sample of all cases on which a report for investigation was received during the sample period, rather than only cases opened for in-home or out-of-home services. This has allowed the Division to gather information about the achievement of safety outcomes in cases closed at investigation, as well as those opened for services. See Section III, Part 5, subsection A.3. Quality Assurance System, for more information on the Practice Improvement Case Review.
Safety Outcome 1: Children are, first and foremost, protected from abuse and neglect
CFSR Item 1: Timeliness of initiating investigations of report of child maltreatment
Goals and Measures
Safety Goal 1:
The percentage of investigations initiated within State policy timeframes will be
95% or more
Quarter ending 6/04:
65%
Calendar year 2005:
71%
Calendar year 2006:
72%
Safety Goal 2:
The percentage of investigations in which all children who are the subject of the
report are seen face-to-face before investigation closure will be 95% or more
Quarter ending 6/04:
81%
Calendar year 2005:
85%
Calendar year 2006:
85%
Practice Improvement Case Review (PICR) data indicates that Statewide, all children in the family are seen prior to investigation closure or transfer to ongoing in more than 80% of investigations. All children in the family were seen in 81% of the investigations reviewed in the quarter ending June 2004, and in 85% of the investigations reviewed in calendar years 2005 and 2006. In some of the 15% of investigations where a child was not seen, reasonable efforts were made to see the child but the child was not located or was out of the area and not available for contact. Generally it is a sibling who is not seen, rather than the alleged victim.
A timely initial response by CPS, law enforcement, or other emergency personnel was confirmed in 65% of the reports reviewed during the PICR in the quarter ending June 2004, 71% of investigations reviewed in 2005, and 72% of those reviewed in 2006. Districts 1 and 4, which were the last to be reviewed in
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2006, made a timely response to 80% and 87% of investigations, suggesting the rate of improvement increased in the latter part of 2006.
The State’s Business Intelligence Dashboard provides data on report response beginning with January 2004, and demonstrates improvement in timeliness of response. This data provides the percentage of reports to which Child Protective Services responded timely, either as the initial responder or within the mitigated timeframe if law enforcement or other emergency personnel made the initial response. In some cases where CPS responded late, the child was seen and confirmed to be safe by law enforcement or other emergency personnel within the required initial response timeframe. Statewide, CHILDS data available on the Dashboard on April 5, 2007 indicates the rate of timely response by CPS was 64% in CY 2004, 65% in CY 2005, 74% in CY 2006, and 80% in January 2007.
Dashboard data from April 5, 2007 indicates significant differences between districts’ rate of timely CPS response. From February 2006 through January 2007, District 2 consistently had a timely response rate well below all other districts. District 1 remained slightly below the four smaller districts, with a timely response rate fluctuating between roughly 70% and 80%. The four smaller districts have remained clustered together, with timely response rates primarily between 80% and 90%.
Timely CPS Response Rates by District
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There are some limitations to the data on timely response. For example, the data does not account for the length of a delay, which could be minutes, hours, days, or weeks. Furthermore, field supervisors consulted for this assessment indicated that they are unable to easily correct response data once it has been saved in CHILDS.
Factors Affecting Performance and Fiscal Year 2007 Accomplishments
Timely response is an area of strength for the Division and continues to improve. The Division’s performance in this area is supported by the following program and system improvements in SFY 2007:
•
CHILDS was modified in December 2006 to allow more accurate recording of the date and time the report was received by the field unit and assigned for investigation. Other modifications allow the CPS Specialist to document complete information on the date, time, and person who made the initial response; and the date and time of response by a CPS Specialist if the initial
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response was made by law enforcement or other emergency personnel.
•
The Business Intelligence Dashboard became available to supervisors and administrators in February 2006. The dashboard provides data, updated weekly, on the number of reports for investigation assigned to each district, unit, and CPS Specialist; and the percentage of investigations that have a timely CPS response documented in CHILDS. The Dashboard uses a yellow, red, and green stoplight symbol to give supervisors a quick visual indication of reports requiring response and the unit’s current and recent performance rates. This tool allows supervisors and administrators to monitor the frequency and documentation of timely CPS response, and manage staff resources to ensure timely response. In SFY 2007 the Division provided repeated training and managerial oversight to ensure supervisors were using the Dashboard. The Division has seen a significant increase in Dashboard use over SFY 2007.
•
In SFY 2007 State policy was clarified and distributed to all staff to confirm the definition of an initial response, and that a CPS Specialist must respond within the mitigated response time whenever an initial response is made by law enforcement or other emergency personnel.
•
Emphasis on joint investigation protocols led some staff to believe they can not respond to serious reports unless jointly with law enforcement. In SFY 2007, training regarding joint investigation policy and protocols was provided at the CPS unit level. This training included clarification that when law enforcement does not have sufficient resources to respond expeditiously, CPS can make the initial response and follow-up with law enforcement to complete the investigation jointly.
•
Many counties continue to use Advocacy Centers, such as Maricopa County’s ChildHelp, for conducting interviews and/or obtaining medical examinations, and involving law enforcement as necessary. Law enforcement are co-located at these sites, which increases timeliness in conducting interviews and facilitates decision-making regarding actions to ensure child safety. In addition, child advocacy centers with co-located CPS staff and law enforcement increase the ability to coordinate response times.
•
In some cases, jurisdiction issues involving Native American children or families living on reservations, military bases, or a bordering State require resolution before an initial response can be made. At times these issues are not resolved before the initial response time has elapsed. Stakeholders reported that the CHILDS automated system and development of ICWA units have improved the identification of Native American children, notification to the tribe, and thereby timely response and coordination with CPS on reports involving Indian children. The Division continues to consult with Arizona’s Native American tribes and train Division staff to improve coordination of services to Native American families.
•
Staff and stakeholders identified CPS Specialist and Supervisor vacancies, turnover, and experience as factors affecting the Division’s ability to respond timely to reports of maltreatment. Meeting initial response timeframes is especially challenging in areas with a high volume of reports and high rates of turnover and vacancy. See Section 1, Introduction and Overview, for more information on the Division’s activities to address staff recruitment and retention. In addition, the Division has addressed these factors through the following means:
•
The Division uses “roving staff” and temporary assistance from Central Office staff and others who are not permanently assigned to investigation positions. To address a
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concern that availability of roving staff may be difficult to maintain due to the requirement to spend much time away from home, in February 2007 the Division submitted to the Department’s Personnel Unit and the Arizona Department Administration a request for a Roving CPS Unit stipend. If approved, this stipend would allow for a unit of six CPS Specialists and one Supervisor to travel throughout the State and assist offices with excessive vacancies to conduct CPS investigations and other duties as assigned. The unit would be overseen by Central Office and scheduled based on the number of child abuse or neglect reports, staffing levels, and the capacity of the districts to cover staff storages.
•
Maricopa and Pima Counties have After Hours Units to respond to reports on nights and weekends, and sometimes respond to an overflow of reports during the week. Other districts rely on regular staff to be on stand-by on nights and weekends, which may impact retention and the ability to respond timely to the reports received after hours. However, After Hour Units may not be feasible in rural areas due to low volume of reports. In addition, travel distance in rural areas can occasionally exceed the allotted timeframes in high priority cases.
•
Although Arizona is the fastest growing State, which is likely to increase reports, the Division is hopeful that increased in-home services and specialized in-home staff will reduce the number of repeat reports and therefore the overall volume of reports for investigation. See Section III, Part 2, CFSR Item 3 for more information on the Division’s activities to increase in-home services.
•
Report volume is also related to the Division’s ability to respond timely. Within the 13 months of December 2005 through January 2007; June, July, and December had the first, second, and third lowest volume of CPS reports, and June and July 2006 had the first and third highest timely response rates. December 2006 had the lowest number of reports and only the sixth highest response rate, but this may be due to staff taking annual leave. March 2006 had the highest volume of reports and the lowest rate of timely response. The correlation is not always as clear as these months, but there is indication of a relationship between report volume and timeliness of response. Other factors affecting initial assessment/investigation volume include the following:
•
Communications identified as “actions” take significant staff time and are not included in the number of reports for investigation. Actions include communications such as that a child is being released from detention and the parent is unable to come get the child or can not be reached.
•
Arizona law allows the Division to receive reports of potential maltreatment (risk). Because Arizona does not have a differential response system, the Division may be responding to a broader range of situations than other State’s child protection agencies. These reports constitute a significant volume of work for the Division, and may hinder the agency’s ability to respond on time to higher risk reports.
•
Stakeholders recommended ongoing training of mandated reporters on reporting requirements. Reports and action requests are sometimes made on situations that could have been addressed in another manner. The CPS Hotline number and information on how and when to make a report are widely distributed, but more detailed training is less available due to staff shortages and other priorities. Therefore, the agencies’ community
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education efforts may encourage individuals to make reports rather than consider other resources or methods to meet the families’ needs.
CFSR Item 2: Repeat maltreatment
Goals and Measures
Safety Goal 3: a. The percentage of cases that have no more than one substantiated and similar
report of maltreatment within a 6 month period will be 95% or more
Quarter ending 6/04: 97%
Calendar Year 2005: 98%
Calendar Year 2006: 99%
b. The percentage of children that have no more than one substantiated report of
maltreatment within a 6 month period will be 94.6% or more Federal Fiscal Year 2004: 97.0% Federal Fiscal Year 2005: 96.9% Federal Fiscal Year 2006: 97.4%
Arizona achieved the national standard on repeat maltreatment during the 2001 CFSR, and continues to perform above the national standard of 94.6% for absence of repeat maltreatment. This measure is defined as the percentage of unique children who were the subject of a substantiated report within the first six months of the year who were the subject of another substantiated report within six months of the first report. CHILDS data indicates absence of repeated maltreatment has remained steady at 97% in FFY 2004, 96.9% in FFY 2005, and 97.5% in the year ending March 2006.
The Division also reviewed data on the percentage of children who were the subject of a CPS report in the first six months of the year and a second report within six months of the first, regardless of the investigation finding. In other words, all reports were considered, including those with unsubstantiated and propose substantiation findings. Following the federal syntax for the repeat maltreatment measure, the second report was not considered if it occurred within one day of the first report. The percentage of unique children who were the subject of repeated reports within six months was 9.1%, and the absence of repeated reports rate was 89.9%. Nearly 9 of every 10 children reported to CPS for suspected maltreatment are not reported to CPS again for at least six months. It was also noted that nearly 8% of second reports were made within a week of the first report, which suggests they may be new information regarding the same family situation already being assessed by the Division.
Factors Affecting Performance and Fiscal Year 2007 Accomplishments
The State’s low substantiation rate is a factor affecting the State’s performance on repeat maltreatment. Arizona’s Child Welfare Reporting Requirements Semi-Annual Report indicates substantiation rates declined from between 14% and 17% during FFY 2003 and FFY 2004, to 11% in FFY 2005, and 9% in the six month period ending March 31, 2006. Preliminary data from the period of April 1 through September 30, 2006 indicates a substantiation rate of 7%. The percentage for this most recent period may change as appeals of propose substantiated reports are resolved and open investigations are completed.
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Arizona’s substantiation rate is affected by the State’s appeal process and other factors. Roughly 10% of propose substantiated findings are eligible and appealed. The Division’s internal Protective Services Review Team (PSRT) reviews all cases where a timely and eligible appeal has been initiated. The PSRT overturns between 40% and 50% of the propose to substantiate findings, for reasons such as the incident does not meet the statutory definition of abuse or neglect, the case documentation does not sufficiently and clearly support a finding of probable cause that child abuse or neglect occurred, substantial risk of harm (required in all neglect allegations) is not present or clearly documented, or the alleged perpetrator is not the child’s parent, guardian, or custodian. The Division’s proposal to substantiate is upheld in roughly 85% of appeals heard by an Administrative Law Judge.
The Division’s strategies for improving safety and risk assessment and case documentation are expected to affect the accuracy of substantiation findings as an indicator of whether abuse or neglect that meets State statutory definitions did in fact occur. For more information on these strategies, see Section III, Introduction and Overview, Crosscutting Initiatives. In addition, the PSRT and the Child Welfare Training Institute have developed various methods to train new and existing staff on the substantiation guidelines:
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Standardized training provided to new CPS Specialists during initial Core Training was revised in 2006 to include a presentation with photographs. This training exposes staff to real images to practice observing, recognizing, and documenting abuse and neglect; applying the statutory requirements for a substantiated finding. The PSRT Unit also provides individualized training to CPS Specialists or units when requested.
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PSRT Reviewers provide written feedback to CPS Specialists when the PSRT amends a propose substantiation finding, explaining why the propose substantiation finding could not be supported and what observations and documentation would support a substantiated finding in the case. The CPS Specialist is offered an opportunity to meet with the PSRT reviewer for additional consultation.
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The PSRT Unit sends monthly tips via e-mail to all Division staff, including brief clear guidance and examples to increase knowledge about relevant statutes and documentation needs. These PSRT Tips are maintained in Public Folders, where they can be accessed by staff at any time.
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The PSRT Manager is participating in a documentation workgroup that is developing documentation guidelines and training for field staff, including content on documentation to support a propose substantiation finding. The workgroup will also write and distribute pamphlets as a quick reference on documentation of abuse or neglect.
Although the reduced substantiation rates do affect performance on the repeat maltreatment measure, they have not hindered the Division’s ability to ensure child safety. While the appeal process determines the report finding, the investigation finding does not dictate the level of CPS intervention with a family. The need for emergency intervention through voluntary or involuntary services is based on the assessment of safety and risk. Services may be provided by CPS regardless of the investigation findings. In fact, despite a decline in the number of unique children who are the subject of a substantiated report (7,021 in FFY 2004 and 5,884 in FFY 2005, according to the CFSR Data Profile dated April 5, 2007), the total number of new removals increased from 7,134 in FFY 2004 to 7,695 in FFY 2005 (according to the Division’s Semi-Annual Report). Data from the period of April through September 2006 indicates that 11% of reports assigned for investigation during that period resulted in the removal of a child from the home, although just 7% of reports were substantiated or proposed for substantiation. Many other reports
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that were not substantiated resulted in provision of in-home services. On the other hand, Arizona law does not compel a family to accept services when no child in the family is at imminent risk of harm. While CPS may offer and encourage CPS or community services, the family has a legal right to refuse the services if grounds for a dependency petition do not exist. In some cases low to moderate level risks are known to be present but the family is unwilling to address them, resulting in repeated reports to CPS.
The State’s strong performance in the area of absence of repeated maltreatment is also the result of the following programs and practices, activities, and system improvements:
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New Child Safety Assessment and Risk Assessment tools were implemented in 2003 and 2004 and are currently being refined and integrated. For more information on these strategies, see Section III, Introduction and Overview, Crosscutting Initiatives.
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Family-centered practice principles and techniques are trained to new staff and continuously emphasized to existing staff. Family-centered practice produces more individualized and effective case plans, in which family members are more motivated to participate. In turn, families are more likely to achieve behavioral changes to reduce risk of repeat maltreatment. For more information on Division activities to promote family-centered practice, see Section III, Introduction and Overview, Crosscutting Initiatives.
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DCYF after care policy requires that before case closure the family and Division or provider staff develop an aftercare plan of services and supports to address the current or anticipated needs of family members. Dependent on the current level of risks and needs, the agency provides the family with contact information and other assistance to establish links with ongoing supportive programs in the community prior to reunification or case closure. The In-Home Services Program contract lists after care planning as a fundamental element of the program. In addition, Team Decision Making (TDM) meetings are being expanded in District 1 to support after care planning. By the end of 2007 a TDM will be held prior to all reunifications.
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DCYF has collaborated with other State and community agencies to increase the availability of prevention and in-home services. Examples of programs include Healthy Families, Community Resource Centers supported through the Promoting Safe and Stable Families funding, and recent expansion of a range of in-home services. See Section III, Introduction and Overview, Crosscutting Initiatives for more information on the Division’s activities to increase the in-home service array.
Safety Outcome 2:
Children are safely maintained in their homes whenever possible and appropriate
CFSR Item 3:
Services to family to protect child(ren) in the home and prevent removal or re-entry into foster care
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Goals and Measures
Safety Goal 4: The percentage of cases where pre-placement preventive services were provided, if
appropriate, will be 95% or more
Quarter ending 6/04: 90%
Calendar Year 2005: 72%
Calendar Year 2006: 61%
Safety Goal 5: The number of children in out-of-home care will decrease by 200 or approximately
2% annually
Statewide 9/30/05: 9,906
Statewide 9/30/06: 9,833
Use of safety assessment, safety planning, and in-home services to prevent removal and re-entry has been a major initiative of the Division in SFY 2007. Data is beginning to indicate increased use of protective actions, safety plan implementation, and in-home services as an alternative to out-of-home care. Data includes the following:
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The number of in-home intervention petitions increased from less than 10 filed or converted in 2005, to 93 filed by December 20, 2006. This process allows the court to stay a dependency proceeding and order in-home-intervention when families agree to a case plan and participation in services.
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The average monthly number of families receiving in-home services has increased from 4,376 in SFY 2005; to 4,829 in SFY 2006; and 5,154 to date in SFY 2007.
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The number of children in out-of-home care decreased in FFY 2006, and in December 2006 the volume of in-home cases increased to the highest level since September 2005, despite a reduction in the number of reports for investigation. See Section III, Introduction and Overview, Investigative, In-Home Services and Out-of-Home Caseload Volume for more information.
The percentage of investigation cases rated strength during the Practice Improvement Case Review in the area of pre-placement services to prevent removal and re-entry decreased slightly, from 72% in 2005 to 61% in 2006. Fluctuations in this data are due in part to the small number of applicable cases reviewed (41 cases in 2006). However, this data does suggest that the State could serve even more children in-home to prevent removal. Improved application of the CSA and SRA tools should assist staff to better understand and identify safety threats and risks and develop grounds for in-home petitions or other options to motivate families toward change.
The Dependent Children in the Arizona Court System Fiscal Year 2005 report, published by the Arizona Supreme Court, Administrative Office of the Courts, indicates that the State’s Foster Care Review Board (FCRB) made a finding that the State made reasonable efforts to prevent removal of a child in 99% of FCRB hearings held in FY 2005, an increase from 94% in 2001 and 97.5% in 2003.
Factors Affecting Performance and Fiscal Year 2007 Accomplishments
The Division’s Strengthening Families: A Blueprint for Realigning Arizona’s Child Welfare System, published in September 2005, described the Division’s goal and strategies to expedite reunification for children in out-of-home care and strengthen families so children can remain safely in their homes. The
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Division set a related objective of reducing the number of children in out-of-home care. Implementation of this plan and other activities have supported the Division’s ability to identify families who can benefit from in-home services and provide effective services to maintain children safely in-home.
In February 2006 specialized CPS Units and staff were established throughout Arizona to serve families receiving in-home services, and in March 2006 the Family Support, Preservation and Reunification Services (In Home Services Program) contract was implemented throughout Arizona to provide a continuum of family-centered services. Development of this program has increased accessibility of in-home services, and stakeholders report that specialized staff have more knowledge of available services and are more likely to use the available services to prevent removal. In addition, the use of “monitoring units” in District 1 has allowed the Division to provide in-home services to more families. These units provide consultation and oversight to ensure services are being provided according to the contract requirements. Assessment, case planning, and contacts with the family are conducted by the contract agency staff.
In SFY 2007, the Division providing supervision and training to maintain these new services and raise the skill level among in-home service providers and CPS Specialists. In addition, meetings were held between in-home service providers and Division management to evaluate whether appropriate cases were being referred for in-home