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

              CHILD AND FAMILY SERVICES
Annual Progress Report 2012
Division of Children Youth and Families
STATE OF ARIZONA
Submitted to:
U.S. Department of Health and Human Services
Administration for Children and Families
June 2012 STATE OF ARIZONA
DEPARTMENT OF ECONOMIC SECURITY
DIVISION OF CHILDREN, YOUTH AND FAMILIES
CHILD AND FAMILY SERVICES ANNUAL PROGRESS REPORT 2012
TABLE OF CONTENTS
SECTION I Description of State Agency ................................................................................. 1
SECTION II Vision and Mission ................................................................................................ 3
SECTION III Case Volume and Workforce Resources ............................................................... 5
SECTION IV Programs And Services to Achieve Safety, Permanency, and Well-Being
Outcomes ............................................................................................................... 9
SECTION V Systemic Factors .................................................................................................. 49
SECTION VI Outcomes, Goals, and Measures ........................................................................ 111
SECTION VII Factors Affecting Performance and SFY 2012 Accomplishments ................... 134
SECTION VIII Strategies and Action Steps for SFY 2013 ........................................................ 156
SECTION IX Chafee Foster Care Independence Program and Education and Training
Voucher Program Annual Progress Report 2012 .............................................. 162
SECTION X Child Abuse Prevention and Treatment Act Annual Progress Report 2012 ..... 174
SECTION XI Comprehensive Medical and Dental Program Health Care Services
Update 2012 ....................................................................................................... 192
ATTACHMENTS
1. Agency Response to Citizen Review Panel’s 2010 Recommendations
2. Letter of required notification regarding substantive changes in Arizona’s State Laws
Note: Arizona has reviewed its disaster plan and determined no changes are necessary. Therefore, no disaster plan is being submitted with this annual report. Section I
Description of State Agency
Child and Family Services Annual Progress Report 2012
Section I: Description of State Agency
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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 reduce duplication of administrative efforts, services, and expenditures by integrating direct services to families and individuals.
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 Adult Services
Division of Employment and Rehabilitation Services
The Division of Children, Youth and Families (the Division) is the state administered child welfare services agency responsible for developing the Child and Family Services Plan and administering the title IV-B programs under the plan. The Division provides child protective services; services within the Promoting Safe and Stable Families program; family support, preservation, and reunification services; family foster care and kinship care services; services to promote the safety, permanence, and well-being of children with foster and adoptive families; adoption promotion and support services; and health care services for children in out-of-home care. The Division includes the following administrations:
 Child Welfare Administration
 Finance and Business Operations Administration
 Data and Technology Administration
 Policy Administration
 Comprehensive Medical and Dental Program
 Office of Child Welfare Investigations (housed within the Department’s Director’s Office)
Arizona’s fifteen counties are divided into five regions. The Central, Southwest, and Pima Regions encompass the state’s urban areas. The Northern and Southeast Regions are rural. The counties within each region are:
Central Southwest Pima Northern Southeast
Eastern Maricopa Western Maricopa Pima Apache Cochise
Pinal Yuma Coconino Gila La Paz Mohave Graham
Navajo Greenlee
Yavapai Santa Cruz
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Section I: Description of State Agency
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Regional Operations
Each region 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, and
 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 according to the level of alleged safety threat or risk of harm to the child, 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 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; and
management information system/automation.Section II
Vision and Mission
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Section II: Vision and Mission
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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.
Values
 Respect – We respect each other, our stakeholders, our customers, our staff. We recognize their differences and uniqueness – we treat all with equality and professionalism.
 Diversity – We value the diversity of all people and strive to make decisions based on equity and fairness and are committed to eliminating discrimination.
 Collaboration – We recognize that partnerships and teamwork are the core foundation of our business. Our collaboration with policymakers, service providers, community providers, and families enables us to develop programs and services that improve the quality of life for all our citizens.
 Accountability – We hold ourselves personally responsible for our commitment to our clients, partners, and coworkers. We say what we mean, mean what we say, and continually strive to improve our services and outcomes.
 Innovation – We engage in visionary and strategic thinking and creative problem-solving, challenge the status quo, invite new ways of doing things, and look to multiple and diverse sources for ideas and inspiration.
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Section II: Vision and Mission
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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
Section III
Case Volume and
Workforce Resources
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Section III: Case Volume and Workforce Resources
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Case Volume and Workforce Resources
1. Case Volume
Initial Assessment, In-Home, and Out-of-Home Case Volume
The number of reports assigned for assessment by a CPS Specialist increased by 9% in FFY 2011, to
36,623 reports. CPS Specialists responded to 3,168 more reports in FFY 2011 than in FFY 2010 (Child
Welfare Reporting Requirements Semi-Annual Report). This is the largest number of reports assigned in
a year since FFY 2005. The number of assigned reports has been increasing since the low of 32,316
experienced in FFY 2009. Thirteen of the state’s fifteen counties, including the state’s two largest
counties, experienced an increase in reports assigned for assessment in FFY 2011. The increase was 8%
in Maricopa County (1,667 additional reports) and 11% in Pima County (689 additional reports).
Maricopa and Pinal Counties also received 182 reports in FFY 2011 that were not assigned for
assessment due to caseload volume. All of these unassigned reports were received between April 1, 2011
and September 30, 2011 and were category three or four reports. More than 80% of these reports
contained no specific allegations or alleged historical abuse without current injuries. This is a decrease
from 288 unassigned reports in FFY 2010 and 501 unassigned reports in FFY 2009.
Number of Hotline Reports Assigned for Investigation by Federal Fiscal Year
37,240
34,178 34,298 34,723
32,316 33,455
36,623
0
10,000
20,000
30,000
40,000
FFY 2005 FFY 2006 FFY 2007 FFY 2008 FFY 2009 FFY 2010 FFY 2011
The Division encourages the use of in-home services as an alternative to out-of-home care when the
children can remain safely in the home. Data from the Department’s Child Protective Services Bi-Annual
Financial and Program Accountability Report shows monthly in-home caseloads had dropped to 3,371 in
July 2009 due to the state’s budget crisis, but gradually increased to 5,980 by May 2010. During FFY
2011, the Division’s monthly in-home caseload was between 4,800 and 5,600 cases, with the exception
of April and May 2011 when the in-home caseload exceeded 6,800. This in-home caseload count
includes in-home cases in which no child was ever removed during the current case episode. Cases that
remain open for in-home services after a removal and reunification are not counted. Cases that remain
open for in-home services after a removal and reunification are not counted.
The trend of growth in the number of children in out-of-home care continued in FFY 2011. According to
the Child Welfare Reporting Requirements Semi-Annual Report, there was a 21% increase from March
31, 2005 to September 30, 2011. The number of children in out-of-home care has remained above 10,000
since September 2008. By September 30, 2011, the number of children in out-of-home care exceeded
11,500; following a 9.7% increase since September 30, 2010. The following chart shows the number of
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Section III: Case Volume and Workforce Resources
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children and young adults in out-of-home care on the last day of March and September in the last seven
FFYs. This data includes youth who voluntarily remained in out-of-home care after turning 18.
Number of Children in Out-of-Home Care on Last Day of Month
9,536 9,906 9,902 9,833 9,773 9,701 9,721
10,303 10,404 10,112 10,207 10,514 10,707
11,535
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
3/05 9/05 3/06 9/06 3/07 9/07 3/08 9/08 3/09 9/09 3/10 9/10 3/11 9/11
The Child Welfare Reporting Requirements Semi-Annual Report provides the number of child removals
and the number of children leaving out-of-home care during the six month periods ending March and
September of each FFY. This data includes youth who voluntarily return to care or exit care after turning
18. In FFY 2006 through March 2008 the numbers of entries and exits followed a similar pattern, with
slightly more entries than exits. A substantial increase in removals during the second half of FFY 2008
produced the rise in the out-of-home care population at that time. In the second half of FFY 2009, exits
exceeded new removals for the first time since April through September of 2001. However, entries again
exceeded exits throughout FFYs 2010 and 2011. In the second half of FFY 2011, entries increased by
14%. When entries exceed exits, the out-of-home population and agency workload increase.
Number of Children Entering and Exiting Out-of-Home Care in Six Month Periods
3,617
4,078
3,753 3,773 3,683
3,924 3,742
4,546
3,889 3,819 3,936 4,010 3,978
4,531
2,726
3,488 3,506 3,595 3,553
3,824
3,512
3,773 3,590
3,894
3,650 3,559 3,649 3,574
0
1,000
2,000
3,000
4,000
5,000
3/05 9/05 3/06 9/06 3/07 9/07 3/08 9/08 3/09 9/09 3/10 9/10 3/11 9/11
Entries
Exits
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Section III: Case Volume and Workforce Resources
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2. Workforce Resources
CPS Specialist Caseload Size
Growing CPS Specialist workload continues to be a challenge. In addition to the increased number of Hotline reports, in-home services cases, and children in out-of-home care, the Division has significant challenges hiring and retaining staff. As a result, caseloads far exceed the Division’s standard.
Arizona’s caseload standard for CPS Specialists is:
 for investigations, 10 reports per month per CPS Specialist;
 for in-home services, 19 cases per month per CPS Specialist; and
 for out-of-home (foster care) services, 16 children per month per CPS Specialist.
In CY 2011, the Division’s average monthly workload per filled full-time employee position was:
 for investigations, 15 reports per CPS Specialist;
 for in-home services, 34 cases per CPS Specialist; and
 for out-of-home (foster care) services, 29 children per CPS Specialist.
According to the Division’s Child Protective Services Bi-Annual Financial and Program Accountability Reports, CPS Specialists were carrying caseloads that were, on average, 45% above the standards in the first half of SFY 2010, 66% above the standards in the second half of SFY 2010, 61% above the standards in the first half of SFY 2011, and 68% above the caseload standards in the second half of SFY 2011. As of December 2011, if all 970 authorized CPS Specialist positions were filled, an additional 308.7 positions would be required to meet the Arizona caseload standards.
Staff Retention and Vacancy Rates
The following tables show the annualized retention rate for CPS Specialists in 2007 through 2011, and the percentage of authorized CPS Specialist positions filled on the last day of each year. The turnover rate is calculated by dividing the total number of staff leaving the Division by the total filled positions (including training). When calculating the percent filled of authorized positions, the positions of newly hired staff attending the Child Welfare Training Institute are counted in the number of authorized positions, but not in the number filled.
2007 2008 2009 2010 2011
% Retained of Filled Positions (Annualized)
71.4
66.6
78.0
74.4
73.7
% Filled of Authorized Positions (December 31)
85.2
80.0
79.3
79.8
82.0
Statewide, the annualized retention rate has remained below 80% in the last five years, and fell in 2010 and 2011. In 2011, the regional annualized retention rate ranged from 59.2% in the Northern Region to 79.6% in the Central Region. From June 25 to December 31, 2011, 100% of the 134 CPS Specialists who left their positions did so by separating from state service through retirement, dismissal, or resignation. None of the 134 left due to a promotional move, transfer within DCYF, or transfer to another state agency. The rate of filled to authorized positions increased in CY 2011, but remains below the five year high of 85.2% in CY 2007. On December 31, 2011, the regional percentage of filled to authorized positions ranged from 71% in the Southeastern Region, to 84.1% in the Pima Region.
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See Sections VII and VIII for information on the Division’s strategies and activities for reducing caseload size and improving staff recruitment and retention.
See Section X, Child Abuse Prevention and Treatment Act Annual Progress Report 2012, for more information on the Division’s workforce.Section IV
Programs and Services to Achieve Safety, Permanency, and Well-Being Child and Family Services Annual Report 2012
Section IV: Programs and Services to Achieve Safety, Permanency, and Well-Being
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Programs and Services to Achieve Safety, Permanency,
and Well-Being
1. Child Abuse and Neglect Prevention Services
Healthy Families Arizona
The Healthy Families Arizona (HFAz) program is a nationally credentialed, community-based, family-centered, voluntary home visitation program serving at risk prenatal families and families with children age newborn through five. The infant must be under three months of age at enrollment into the program as services are focused primarily on prevention through education and support in the homes of new parents. Program services are designed to strengthen families during the first five years of a child’s life, when vital early brain development occurs. The program is designed to prevent child abuse and neglect and promote positive parenting, child development, and wellness.
A trained Family Support Specialist (FSS) provides emotional support and assists the family to obtain concrete services. Healthy Families Arizona services include:
 supporting effective parent-child interactions;
 providing child development, nutrition, and safety education;
 teaching appropriate parent-child interaction and discipline;
 promoting child development and providing referrals for screening if delayed;
 encouraging self-sufficiency through education and employment;
 providing emotional support and encouragement to parents; and
 linking families with community services, health care, child care, and housing.
The FSS works closely with the child's medical provider to monitor the child's health. Intensity of services will vary based on family needs, moving gradually from weekly to quarterly home visits as families become more self sufficient.
In state fiscal year 2011, funding for the HFAz statewide system included just over $6.5 million from the Department and $6 million from First Things First (FTF), allowing for a total of 34 sites to provide the Healthy Families Arizona program. The Department funds originate from designated lottery funds and the federal Community-Based Child Abuse Prevention Grant. The Department remains the central administration to the HFAz multi-site system, including sites funded through FTF. The Department and FTF have maintained the Interagency Service Agreement to ensure a collaborative relationship and to share the costs and resources for the administration of the HFAz program. In March 2011, HFAz completed its third successful national re-accreditation from Prevent Child Abuse America. Healthy Families sites all passed their peer site visits with no additional action required, a feat never before accomplished by a state system in the history of accreditation.
The Healthy Families America® Program has been designated an “effective” program by the Office of Juvenile Justice and Delinquency Prevention. In Arizona, the Healthy Families program is committed to continuous improvement. Site evaluations and quality assurance activities ensure efficiency in practice, and more than a decade of annual program evaluations have consistently demonstrated that Healthy Families Arizona is a highly effective program.
According to the Healthy Families Arizona Annual Evaluation Report FY2011, 3,135 families were reached by Healthy Families programs in SFY 2011. This represents all families in the program, Child and Family Services Annual Report 2012
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regardless of how long they have been in the program. The average length of time that families continued in the program was 317 days. The evaluation highlights both prenatal and postnatal services. Outcomes in 2011, for families after 12 months in the program, include the following:
 Child Abuse and Neglect: 99.9% of participating families had no substantiated CPS reports.
 Substance Abuse: 51.6% of families had an initial positive screening at 2 months, and that percentage decreased to 19.5% at 6 months, and 16.1% at 12 months.
 Child Health: There was a 62.7% immunization rate for babies by 12 months.
 Child Safety: 97.7% of parents lock up household poisons, 99.1% use car seats, and 91.8% use smoke alarms at 24 months.
 Maternal Life Course: 32% of mothers were employed at 24 months, 11.4% were enrolled in school full-time, and 6.3% were enrolled part-time.
 Maternal Stress: Significant improvement was observed in several areas, including problem solving, personal care, mobilizing resources, depression, home environment, and parenting efficacy.
Positive Parenting Program Initiative
The Positive Parenting Program (Triple P) is an evidenced-based parenting program that has had impressive results increasing parenting skills and reducing child abuse and neglect. The Division has been participating in a broad-based consortium of community stakeholders to bring the Triple P model to Arizona. The consortium is comprised of professionals from Phoenix Children’s Hospital, Prevent Child Abuse Arizona, Parenting Arizona, the Child Crisis Center, Southwest Human Development, Eight – Arizona Public Television, First Things First, Arizona Partnership for Children, and many other organizations. The community partners are deeply committed to the process and many are financially invested.
The Division’s goal for participation in this consortium is to use a community-based approach to elevate the quality of parenting programming, across several providers, for families served by CPS and other families who have risk factors for abuse or neglect. Arizona’s families will benefit from the use of a strong parenting program that is implemented consistently with a high degree of fidelity and monitored at the state level. To reach this goal, the Division and its community partners set the following objectives:
 Obtain training on at least one level of Triple P and achieve accreditation of forty practitioners, supervisors, and administrators from several organizations across the state, including two Division staff
 Achieve an initial, broad-based implementation of Triple P with different at-risk populations across the state, including approximately fifty families involved with CPS and Healthy Families participants
 Assess parental satisfaction
 Assess fidelity of implementation, provider and CPS satisfaction, and lessons learned
 Provide updates to key stakeholders and make recommendations regarding the further implementation of Triple-P within Division programs and on a population-level approach
Over the last several months the consortium has worked diligently to meet its objectives and has made the following progress:
 There are five levels of Triple P provider courses. Each level has a training course and certification process. In CY 2011, sixty community partners became certified in Triple P Level 3 or Level 4. Level 3 is primary care, during which practitioners deliver approximately four brief Child and Family Services Annual Report 2012
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individual parenting sessions. Level 4 is known as Standard Triple P, during which practitioners deliver approximately ten individualized parent sessions.
 In February 2012, twenty of the sixty certified practitioners completed the initial training in Triple P Level 2 (brief seminars and tip sheets). These practitioners are currently in the practice phase, leading to certification.
 In late 2011, forty-nine parents/caregivers participated in a Triple P intervention. Services continue to be delivered in several central and northern Arizona communities.
 To date, eight satisfaction surveys have been received and reviewed, showing positive results. Additional surveys are pending analysis.
 Assessment of parental satisfaction and implementation fidelity is ongoing. During calendar year 2011 the practitioners experimented with different implementation strategies.
 Arizona's implementation experience, including the number of months to full implementation, is similar to other states. Many valuable lessons are being learned. Consistent coaching, training, peer support, and leadership will be critical for a successful large-scale roll out of Triple P. One of the consortium members noted that the content of Triple P is very similar to other evidenced-based parenting programs, but that Triple P has a more intense structure and delivery system that emphasizes role playing and self-monitoring. Triple P is seen as a system that dovetails well with, and fills gaps in, other family intervention programs.
During CY 2012, the consortium members are continuing to deliver Triple P services, coordinate efforts and cross refer families across Maricopa County, seek funding for a larger scale roll out, and if funding allows, experiment with a new online Triple P program. Triple P International reports that early evaluation data is showing the online curriculum is achieving results equivalent to in-person Triple P.
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 and Regional Child Abuse Prevention Councils. Regional Child Abuse Prevention Councils are located throughout Arizona. These Councils include volunteers from the business, professional, and civic sectors who work together on educational campaigns to increase public awareness of the problem of child abuse.
The Councils are involved in activities to support Child Abuse Prevention Month each April. In 2012, activities included distribution of thousands of blue ribbons throughout Arizona, official proclamations from city and regional governmental entities declaring April as Child Abuse Prevention Month, coordination of media campaigns highlighting Child Abuse Prevention, and distribution of thousands of pamphlets on child abuse, child abuse prevention, and programs available to help parents and their children. Most of the Councils also sponsored one or more major events including kickoff breakfasts, luncheons, award dinners, activity fairs, prevention conferences, and training. The multi-media campaigns included the use of radio public service announcements, banners, billboards, and movie theatre advertisements. Several communities held fun family-day outings and other events. Throughout child abuse prevention month, staff and stakeholders are encouraged to participate and actively support child abuse prevention. The Regional Child Abuse Prevention Councils were also instrumental in the Child and Family Services Annual Report 2012
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third annual statewide campaign to provide approximately thirty-two workshops on the devastating effects of adverse childhood experiences and the healing community solutions that focus on the development of the Five Protective Factors.
The Division and numerous community partners held several child abuse prevention kick-off events in Maricopa County. One such event, the Child Abuse Prevention EXPO, was arranged by the Child Abuse Prevention Coalition, which is made up of several community agencies and the Department. This celebration included a proclamation by Governor Brewer, key stakeholder commentaries, and enjoyable activities for children and families. A host of supporters attended, including Emcee Marie Saavedra from Channel 3’s Morning Show. Speakers included: Chandler Councilmembers Trinity Donovan and Rick Heumann; Chandler Police Chief Sherry Kiyler; former Arizona Cardinal Bertrand Berry; and Shannon, a child who was abused and treated at the Childhelp Children’s Center of Arizona. The EXPO featured booths and information for kids and families including displays of fire trucks, ambulances, a mobile command unit, an Arizona National Guard Hummer, and a helicopter. For the children, there were bounce houses, a dunk tank, crafts, and an art area hosted by Free Arts of Arizona.
The Arizona Substance Abuse Partnership (ASAP)
The Arizona Substance Abuse Partnership (ASAP) was established by Executive Order 2007-12 in June 2007. Staffed by the Governor’s Office for Children, Youth and Families – Division for Substance Abuse Policy, and chaired by the Governor’s Policy Advisor for Health and Human Services, ASAP is composed of representatives from state governmental bodies, federal entities, and community organizations. ASAP serves as the single statewide council on substance abuse prevention, enforcement, treatment, and recovery efforts. It is ASAP’s mission to ensure community-driven, agency-supported outcomes to prevent and reduce the negative impacts of alcohol, tobacco, and other drugs by building and sustaining partnerships between prevention, treatment, recovery, and enforcement professionals. ASAP aims to improve coordination, identify and address gaps, and ensure efficiency and effective spending. The Division’s Office of Prevention and Family Support continues to participate in the governor’s Arizona Substance Abuse Partnership.
In January 2008, Executive Order 2008-01: Enhanced Availability of Substance Abuse Treatment Services for Families Involved with Child Protective Services (CPS) was signed, which prioritized substance abuse treatment to families involved in the child welfare system. This executive order dictated that every effort be made to ensure appropriate and immediate substance abuse treatment for parents involved in the CPS system, in order to provide a safe and stable environment for children. ASAP’s child welfare strategic focus area was tied to Executive Order 2008-01. The executive order’s prioritization of substance abuse treatment services to families involved with CPS marked a systematic change in state planning and policy, and continues to impact the work of ASAP as an overarching paradigm. ASAP took this one step further by adopting drug endangered children as a strategic focus area, which has expanded to include children of incarcerated parents and the child welfare population. This broad focus on drug endangered children, children of incarcerated parents, and child welfare ensures that all children impacted by substance abuse receive the state’s attention.
ASAP consists of four subcommittees, including a Community Advisory Board, and five strategic focus areas: prescription drugs, underage drinking, child welfare (focusing on treatment, drug-endangered children, and children of incarcerated parents), law enforcement, and prevention/community partnerships. Action steps carried out by the member agencies help to guide the body, its subcommittees, and member agencies in focusing their efforts efficiently and effectively on selected priorities. The four Child and Family Services Annual Report 2012
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subcommittees include the Community Advisory Board and the following:
 Arizona Underage Drinking Committee – The Community Advisory Board and the Underage Drinking Committee merged during the third quarter of SFY 2011. In SFY 2011, members from the Underage Drinking Committee and ASAP attended a statewide strategic planning session on prevention of underage drinking. In May 2012 a strategic planning session was held to develop strategies to reduce underage drinking.
 Methamphetamine Task Force – In SFY 2011, the Meth Task Force was restructured and merged with the Rural Law Enforcement Methamphetamine Initiative. The goals and focus of the group have shifted to address law enforcement issues in Arizona’s rural communities. Its primary objective is to carry out the goals of the Rural Law Enforcement Meth Initiative (RLEMI) grant, which was awarded to the Meth Task Force. RLEMI state plans address methamphetamine production, distribution, and use in rural communities. The initiative included a needs assessment capturing methamphetamine prevention, services for children affected by methamphetamine use or production, media-based public education efforts, and environmental hazards. The RLEMI rural community meetings included Drug Endangered Children (DEC) training on developing a DEC protocol for recognizing DEC situations, and determining appropriate action. Meth Task Force members attended the RLEMI national summit to enhance training and coordination of intelligence-led policing in rural and tribal communities. The Rural Law Enforcement Meth Initiative grant concluded on October 31, 2011.
 Substance Abuse Epidemiology Work Group - The Substance Abuse Epidemiology Workgroup strives to ensure that a data-driven decision making process is used to identify priorities, emerging trends, and the state’s capacity to respond. Indeed, all strategic focus areas are addressed through data-driven policies that pay attention to emerging trends and recognize the importance of addressing the unique needs of individuals with co-occurring/morbid conditions.
In November 2011, the Impact of Substance Abuse: A Snapshot of Arizona report was released by the Substance Abuse Epidemiology Workgroup. The report details the impact of methamphetamine, alcohol, prescription drugs, and emerging issues on Arizona, paying attention to vulnerable populations such as detained youth and incarcerated adults.
The Substance Abuse Epidemiology Work Group, the Department, and the Arizona Department of Health Services/Division of Behavioral health Services (ADHS/DBHS) continue to work collaboratively to share data and assess Arizona’s substance abuse treatment capacity. Beginning in late SFY 2010, the Substance Abuse Epidemiology Work Group combined efforts with the Statistical Analysis Center of the Arizona Criminal Justice Commission to create and administer a Drug Data Clearinghouse to record substance abuse related data, referred to as the Community Data Project. The Community Data Project website was completed in September 2010 and is located at: www.bach-harrison.com/arizonadataproject/. This website communicates community needs to policymakers and decision-makers. It serves as a valuable tool for grant and report writing, needs assessments, program evaluation, prevention and intervention planning, and data-driven decision making.
To address the growing concern over prescription drug misuse in Arizona and related consequences, the ASAP has endorsed a prescription drug reduction initiative. In November 2011, the Centers for Disease Control and Prevention issued a report indicating that deaths from prescription pain relievers have reached epidemic proportions in the United States. For the first time in history, drug poisoning deaths Child and Family Services Annual Report 2012
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have become the number one cause of accidental deaths in America. In 2010, 13% of Arizona adults reported some type of prescription misuse in the past thirty days and 10.4% of youth reported some type of misuse in the past thirty days. An alarming 76.7% of misuse involved prescription pain relievers. Arizona has also seen a corresponding, and dramatic, increase in opioid-related cases in emergency departments and drug poisoning deaths involving prescription drugs (Arizona Department of Health Services, http://azdhs.gov/plan/index.htm).
The Arizona Governor's Office for Children, Youth, and Families and the Arizona Criminal Justice Commission hosted a prescription drug expert panel in February 2012 that involved local experts from law enforcement, the prevention field, and the medical community. Using the strategies proposed by the National Office of Drug Control Policy (ONDCP) (http://www.whitehouse.gov/ondcp/prescription-drug-abuse) as a starting point, the attendees formulated a set of data and research-driven strategies to be used in a multi-systemic, multi-agency approach to reduce prescription drug misuse in Arizona and improve the health of Arizona's communities and families. The proposed strategies will be conducted as a feasibility study or pilot project implemented in three counties. Counties were selected based upon the following criteria: (1) the severity of the prescription drug misuse in each geographical area as indicated by the prevalence and consequence data; (2) the willingness of each county to use a data-driven decision making approach and for their efforts to be evaluated; and (3) the county's capacity for strategy implementation. Based upon these factors, Yavapai, Pinal, and Pima counties were selected as pilot sites. The start date will be staggered to allow for lessons learned to be incorporated into the next county. Both process and outcome measures will be tracked as a way of monitoring success, and for determining the feasibility of implementing the model statewide.
The Arizona Alliance for Drug Endangered Children (DEC) is part of ASAP’s connection with child welfare. The 2012 Arizona Alliance for DEC goals are:
 Increase the number of training presentations to state and local law enforcement agencies - The Arizona Alliance for DEC will focus more attention on training law enforcement agencies in order to identify more at-risk children, improve the use of DEC investigative techniques, and encourage better reporting to CPS and county attorney offices.
 Increase membership and participation in Arizona Alliance for DEC and bi-monthly meetings - The Arizona Alliance for DEC will continue to meet on a bi-monthly basis to work toward the fulfillment of its goals and to identify additional goals and action items.
 Release new guidelines and continue to promote creation of county and tribal DEC programs – The Arizona Alliance for DEC will continue outreach activities to counties and tribal communities in an effort to provide “Train-the-Trainer” sessions to meet the goal of establishing formal DEC Alliances in each county and within each tribe in Arizona.
Activities of the Alliance in SFY 2012 included the following:
 The DEC and the incarcerated parents initiative merged their training materials and created an exercise in which participants discuss the steps their agencies would take in a drug-endangered child scenario. The exercise sparks a group discussion about how treatment services would be determined and administered, and how systems could determine the presence of other children in the home and other reasons to report to CPS.
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 The DEC Alliance established work groups to create a Law Enforcement Risk Assessment Tool, created a memo of understanding between represented agencies, and will revise the DEC protocols. The DEC Alliance's proposed child risk assessment and placement report for use by law enforcement was resubmitted to CPS, after incorporating changes suggested by CPS Child Abuse Hotline management. The Arizona Alliance for Drug Endangered Children is awaiting approval by CPS for use of the form by law enforcement. The form includes the relatives name, address, and phone number, to allow CPS to easily locate the children.
 The National Guard continued to provide the DEC Alliance with a full time employee to act as a DEC coordinator.
 Funding and donations were secured to maintain the DEC recreational vehicle (RV) and provide necessary supplies (videos, games, snacks, diapers, formula, extra clothing) to maintain the children in the RV until CPS can arrive and take custody.
 The DEC Alliance continues to offer training to tribal communities and organizations. For example, DEC training for tribal CPS case workers was delivered in May 2012 at the Arizona Inter-Tribal Council office.
Arizona Promoting Safe and Stable Families/Family Support and Family Preservation
Since 1995, Arizona Promoting Safe and Stable Families (APSSF) Family Support and Family Preservation programs have collectively served at least 113,648 families and their children. In FFY 2011 (October 2010 – September 2011) APSSF program resources were used to support 754 families (with 1,508 children) to participate in the in-home services program. Please see the In-Home Children Services section for more information.
2. Child Protection, and Child Abuse and Neglect Intervention and Treatment Services
The Arizona Child Abuse Hotline
The Arizona Child Abuse Hotline (Hotline) is the Division’s first point of contact for all concerns or allegations of abuse, neglect, abandonment, or exploitation of a child within Arizona. The Hotline receives telephoned, faxed, and written communications from mandated and non-mandated sources, including parents, relatives, private citizens, law enforcement agencies, judicial entities, and anonymous sources. Trained CPS Specialists use interview cue questions and other tools to focus the call and obtain all available facts to determine whether the information meets the legal criteria for a CPS report for investigation, and whether there is indication of present or impending danger of harm to a child. Hotline staffs use the state’s Child Safety Assessment and Strengths and Risk Assessment tools to guide the collection of information about safety threats and risks, including: (1) the extent of the current maltreatment, (2) the circumstances surrounding the maltreatment, (3) child characteristics and functioning, (4) adult parent/caregiver characteristics and functioning, (5) parenting practices, and (6) disciplinary practices. Hotline Specialists assign a response time based on whether the allegations suggest the child is in present danger, impending danger, or at risk of abuse or neglect.
Hotline Specialists assign all CPS reports to a local office CPS Unit Supervisor and notify the supervisor or standby staff of situations that require an immediate response. In addition, calls that do not meet the criteria for a CPS report but allege criminal activity or contain information that a child may be at risk of harm are reported to law enforcement. All communications about abuse or neglect of a child that are Child and Family Services Annual Report 2012
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determined to not meet the statutory criteria for a CPS report for investigation are reviewed within 48 hours, excluding weekends and holidays, by a Quality Assurance Specialist. Communications may not meet the criteria for investigation for reasons such as the concern: (1) does not meet the statutory definition of child abuse or neglect; (2) is outside of CPS jurisdiction (such as when the perpetrator is not a parent or primary caretaker); or (3) includes insufficient information to locate the child. The Hotline also receives many important calls that are not about abuse or neglect of a child, such as calls to seek or share information on a current CPS case, to alert the Division to foster parent or group home facility license violations, to request copies of CPS reports, or to request community resource information.
In addition to CPS Specialists and CPS Unit Supervisors, the Hotline employs one Hotline Quality Assurance Specialist, one Practice Improvement Specialist, one Regional Automation Liaison, three management staff, and four support staff. Hotline support staff process all requests for copies of CPS reports from parents or custodians, court personnel, pre-adoption certification or foster home licensing agencies, and other persons entitled to confidential CPS report history. When requested by a person who is entitled to receive report information, the report is redacted (when required) and mailed with an explanation of codes and procedures for appeal of the investigation finding decision. Hotline support staff also answer the Hotline triage queue. This queue is for Hotline customers who have short questions or requests, such as requests for community resource information.
The Hotline continuously gathers statistics regarding call volume and Hotline performance. Call volume is the total number of calls received at the Hotline (this includes all calls, including thousands of calls that do not involve a report of maltreatment or a current CPS case, abandoned calls, and any other call into the call center). “Direct calls” refers to calls answered immediately by a Hotline Specialist, which do not wait in queue for any length of time. The abandonment rate is the percentage of calls where the caller hangs up while in queue, prior to speaking with a specialist. Queue wait time is the number of minutes a caller must wait in queue to speak with a specialist. The following table provides Hotline data from CYs 2008 through 2011:
Call Volume Direct Calls Abandonment Rate Queue Wait Time (Minutes)
CY 2008
131,175
73.45%
10.19%
5.8
CY 2009
123,059
71.98%
12.15%
4.9
CY 2010
134,523
53.41%
20.32%
6.4
CY 2011
144,098
53.60%
17.03%
5.9
Call volume increased by 9,575 calls in CY 2011. Although call volume increased, the percentage of direct calls remained the same and the abandonment rate decreased by 3.29 percentage points. There was a significant change in Hotline intake procedures in July 2010, which required adjustment by Hotline staff. Hotline staff were more proficient with the new procedures in CY 2011, which increased their ability to answer directly and more quickly.
To address queue wait time and call abandonment, the Hotline has a call triage option that callers with short questions select so they are not in queue with callers who have concerns about a child. Hotline management also provides quick response to Specialists who need supervisory consultation while a caller is on hold. To increase efficiency with this process, Hotline Specialists now use a supervisory queue when supervisory assistance or consultation is needed. Additionally, Specialists are required to take successive calls when calls are in queue, rather than completing documentation before taking the next call; and Hotline Supervisors are required to take calls when call volume or queue wait times are high.
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All training on Hotline functions is internally created and provided by Hotline management and the Hotline trainer. Hotline 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. Semi-annual ongoing training was added in January 2005 to address the current and long-term needs of Hotline Specialists. Routine training for Hotline staff regarding safety and risk assessments occurs during the initial Hotline training program and in ongoing training. In October 2011, all Hotline staff (except support staff) received four hours of ongoing training to strengthen safety decisions and assessments made at the Hotline. This training focused on the Hotline Safety Decision Tool to gain a better understanding of present and impending danger within the CPS Response System. This training also focused on specific family conditions, such as domestic violence and mental health issues, and how these conditions impact child safety. As a result of this training, staff are prepared to gather more specific information, so they are better able to identify present and impending danger and make more clear determinations about child safety. The interview cue questions and safety and risk assessment training provide continuity in policy and language throughout the Division, from the Hotline to completion of the CPS intervention with a family. Hotline staff also attend conferences and other training offered by the Department and community, when available and funded.
The Division’s CFSR Program Improvement Plan (PIP) and Child and Family Services Plan 2010 - 2014 (CFSP) included a strategy to align child abuse report acceptance and prioritization procedures with the Division’s Child Safety Assessment (CSA) and Strength and Risk Assessment (SRA) tools and decision-making processes. The Child Abuse Hotline received technical assistance from the National Resource Center on Child Protective Services (NRCCPS) to better align the current report acceptance and prioritization procedures with the Division’s CSA and SRA model and decision–making processes. New Hotline cue questions were developed to assist Hotline staff in the collection of more relevant and comprehensive information about the circumstances surrounding the maltreatment and family dynamics that impact child safety. All the information gathered at the Hotline is available to the CPS Specialist who conducts the initial assessment, thereby assisting the CPS Specialist with the collection of sufficient information to accurately assess safety and risk. Revised report prioritization procedures assign an initial response timeframe based on an assessment of present or impending danger, rather than the severity of the reported incident. Children in situations that have resulted in or are likely to result in serious or severe harm at any moment require an immediate response. An initial response is required in 48 hours if serious or severe harm is not occurring in the present, but is likely to occur in the near future. Reports that do not describe an unsafe child require an initial response within 72 hours or seven days, depending on whether the report describes an actual incident of abuse or neglect versus risk, and the length of time since the reported incident. Implementation of the new procedures occurred in July 2010. During SFY 2011, further technical assistance was received to evaluate implementation of the new procedures and the effects on Division outcomes. The evaluation report was published in a report by the NRCCPS in February 2011. The evaluation concluded that the quality of information collection was “sufficient at reasonable levels” at this early implementation phase, and “provided a better understanding of family dynamics that represent possible safety threats to children.” As intended, the new response system resulted in report assignment based on indication of present or impending danger. In September 2011 the NRCCPS conducted a second post-implementation evaluation. This evaluation found a decrease in the sufficiency of information collected since the prior evaluation, and an improvement in the accurate assignment of response priorities 1 and 2.
Program improvement activities continue at the Hotline. In January 2012, the Child Abuse Hotline received consultation services from the Change and Innovation Agency to examine current Hotline procedures and practices, and identify changes to improve efficiencies. The primary goals are to increase capacity to answer more calls, thus reducing customer queue wait time and the abandonment rate, and to Child and Family Services Annual Report 2012
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provide better outcomes for the Hotline's external and internal customers. Thirteen ideas were recommended and approved. Examples include development of different interview scripts for reporting source types, revision of the written format for CPS reports and Hotline communications, creation of an on-line reporting option for mandated reporters, implementation of an alternative investigation process at the point of the Hotline, and enhancements to the CHILDS database system. The action planning process has started and the goal is to implement the majority of the recommended changes by September 2012.
Comprehensive Child Safety Assessment (CSA) and Strengths and Risk Assessment (SRA)
Arizona law identifies the primary purposes of CPS as (1) to protect children by investigating allegations of abuse and neglect; (2) to promote the well-being of children in a permanent home; (3) to coordinate services to strengthen the family; and (4) to prevent, intervene in and treat child abuse and neglect. To achieve these purposes, CPS Specialists investigate maltreatment allegations and conduct family assessments, including assessments 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 allegations or investigation indicate that the child is or may be the victim of a criminal conduct allegation, which if deemed true may constitute a felony offense. 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 and/or county law enforcement agencies.
The Division’s integrated CSA-SRA-Case Planning and clinical supervision process is designed to provide CPS Specialists with a mechanism for assessing present and impending danger of serious or severe harm to children and determining the need to take action to ensure child safety. The process includes concepts such as the six fundamental questions and safety threshold analysis, which aid critical decision making for accurate safety assessment. Use of this comprehensive safety assessment, risk assessment, case planning and clinical supervision process has a direct impact on achievement of all CFSR safety goals, including prevention of repeat maltreatment, protection of children in-home to prevent removal and re-entry, quality of risk assessment, and safety management. The Division’s safety and risk assessment tools assist CPS Specialists to explore pertinent domains of family functioning, recognize indicators of present or impending danger, and assess the likelihood of future maltreatment. The initial CSA is completed within 21 days of case opening, and again prior to case closure. If a child in the case is removed for any period of time or the case is opened for ongoing services, the SRA is completed within 45 days of case opening or prior to case closure, whichever occurs first. The Family-Centered Strengths and Risks Assessment Interview and Documentation Guide provides interview questions that engage and motivate family members while gathering information to assess strengths, protective capacities, and risks in each domain of family functioning. 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 safety and risk assessments, 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 danger, impending danger, or 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, Child and Family Services Annual Report 2012
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the family’s willingness to participate in voluntary child protective services, the 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 high risk of future maltreatment, whose needs can not be sufficiently met through referral to community resources. If there are safety threats to the child in the home, 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.
In-Home Children Services
In-home children 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 or 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 are available statewide and include voluntary services without court involvement and court-ordered in-home intervention. Services can include parenting skills training, counseling, self-help, and skill building activities. Families can also receive referrals for services provided by other Divisions within the Department or other state agencies, including behavioral health services and other community resources.
Services provided through the Division’s Family Support, Preservation, and Reunification Services contract, known as the “in-home service program,” are available statewide. This integrated services model includes intensive and moderate level family support and reunification services, provided in accordance with 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 child safety assessment; 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 in-home service program also assists families to access services such as substance abuse treatment, housing, and child care. Services may be provided within the home of a birth parent, guardian, pre-adoptive or adoptive parent, kinship caregiver, or foster family. 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 service program and contract:
 Families are served as a unit.
 The needs of the children are identified and addressed.
 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. Child and Family Services Annual Report 2012
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 In-home services are available to clients twenty-four hours per day, seven days per week, for emergencies.
 The assessment and treatment approach is based on family systems theory.
 Emergency assistance may be available through the use of flexible funds.
 The service emphasizes teaching the family the necessary skills to achieve and maintain child safety and well-being.
 Each family’s community and natural supports are quickly identified and continue to be developed for the entire life of the case.
 Aftercare plans are in place when permanency is established.
Maricopa County’s specialized in-home Substance Exposed Newborn Safe Environment (SENSE) program continues to be available for families who come to the attention of CPS due to having a substance exposed newborn. The primary goal of the program is to ensure that vulnerable infants and their families are provided a coordinated and comprehensive array of services to address identified safety and risk factors. The SENSE team includes the family, an in-home service CPS Specialist, and representatives from the behavioral health network, Healthy Families Arizona, the Family Preservation/in-home service program, and Arizona Families F.I.R.S.T. programs.
The Division has several methods to monitor in-home service quality and outcomes. Data reports that measure in-home service outcomes continue to be given to the providers quarterly. Providers are responsible for achieving the following outcomes:
 90% of families receiving in-home services will not have a report of abuse or neglect during program participation.
 90% of families will not have a child enter into the Department’s custody during program participation.
 80% of families that successfully completed services will have no new CPS reports made within six months of closure.
 85% of families that successfully completed services will not have a child placed in custody within six months of closure.
In-home service outcomes are exceeding these performance goals. Of families that received in-home services between January and September 2011, 93.2% did not have a new CPS report within six months of service closure and 96.2% did not have a child enter the Department’s custody within six months.
Family client and CPS Specialist satisfaction surveys also give the providers feedback about service quality. Every family that receives in-home services is given a satisfaction survey at the time of program closure. The survey measures the family’s level of agreement with questions such as “My ideas were included when deciding what my family needed,” “This program helped my situation improve,” and “Overall, my family is satisfied with the services we received from the In-Home Service Program.” The survey also provides an opportunity for families to comment on what they liked or disliked about the program, and what the family felt was most helpful. Each provider reports family client survey results annually to the Division. The CPS Specialist satisfaction survey is administered annually to measure satisfaction with the responsiveness of the provider to CPS and the family, the provider’s ability to meet the needs of the family while addressing the safety and risk factors identified by CPS, and overall service delivery. This survey also provides an opportunity for CPS to give qualitative feedback to the providers.
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3. Time Limited Reunification Services
Arizona Families F.I.R.S.T. (Families in Recovery Succeeding Together)
The mission of Arizona Families F.I.R.S.T. (AFF) is to promote permanency for children and stability in families, protect the health and safety of abused and/or neglected children, and promote economic security for families. This is accomplished through the provision of family-centered substance abuse and recovery support services to parents/caregivers whose substance abuse is a significant barrier to maintaining or reunifying the family.
AFF provides an array of structured interventions statewide to reduce or eliminate abuse of, and dependence on, alcohol and other drugs, and to address other adverse conditions related to substance abuse. Interventions are provided through contracted community providers, using modalities that include educational, outpatient, intensive outpatient, residential treatment, and aftercare services. Some factors contributing to the programs’ success include an emphasis on face-to-face outreach and engagement at the beginning of treatment, concrete supportive services, and an aftercare phase to manage relapse occurrences. More than 47,000 individuals have been referred to the AFF program since its inception in March 2001. Data from the most recent program evaluation indicates that 4,954 individuals were referred in SFY 2011 for substance abuse screenings or assessments and an estimated 3,298 clients received treatment and supportive services. Despite continuing funding reductions, the number of referrals in SFY 2011 was 15% higher than referrals in SFY 2010. AFF contractors made initial contact with families within an average of one day, a decrease from 1.4 days in SFY 2010. However, the average amount of time for clients to accept AFF services increased from five days in SFY 2010 to 14.7 days in SFY 2011.
There continue to be no waiting lists for AFF services. Services are available in all areas of Arizona, with the recent and temporary exception of Pinal and Gila counties. The former Pinal and Gila County AFF Provider non-renewed their AFF contract effective February 29, 2012. Resolicitation of the AFF contract is expected to occur in early SFY 2013. In the meantime, staff have been instructed to refer clients potentially requiring substance abuse treatment services to Regional Behavioral health Authority (RBHA)-contracted agencies in both counties that are Substance Abuse Prevention and Treatment Grant (SAPT) providers. Full contact information for each agency has been provided for staff use.
During 2011, changes were made to improve the quality of data used for the annual AFF evaluation. These changes improved the ability to match client information from provider agencies with CHILDS data. As a result, unmatched client data rates reduced from 8.3% to 4.1%, providing a considerable increase in data accuracy regarding child permanency and maltreatment recurrence. In addition, the process to determine annual child permanency rates was changed to condense the permanency categories, eliminate non-permanent exit reasons, and eliminate duplication. Interim quarterly data reports have also been modified so they directly address current key outcome areas, including time from referral to first outreach, average number of drug screens per client, time to client acceptance of AFF services, and client level of care. Data meetings/webinars have been held with the contracted AFF providers to give technical assistance and ensure continued accurate data submission. All AFF providers have been instructed in using the three reports on missing data that are available through the web portal, and are strongly encouraged to use these. For agencies that transmit data, upload reports are available for review, to ensure data transmission accuracy. Web portal spot checks have been conducted with most AFF providers to ensure that client file data match the client monthly reports and web portal entries.
AFF providers continue to improve and enhance substance abuse services. For example: Child and Family Services Annual Report 2012
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 TERROS, the Maricopa County AFF Provider, has put much effort into improving services by increasing the frequency of outreach and engagement contacts with new AFF clients through phone calls and home visits. In addition, in November 2011, TERROS implemented a new Motivational Enhancement (MOVE) Group, which provides an in-depth orientation of the AFF program to new clients, including review of program components, the role of child welfare, and efforts by TERROS staff to reduce participant fear and improve continued client engagement. As a result of these efforts, 70% of clients who attended a MOVE group kept their initial intake appointment, compared to 48% who did not attend. Client surveys upon completion of the MOVE groups strongly indicate the support and optimism they felt in beginning treatment. In addition, TERROS has started a letter campaign to improve participation rates, sending written confirmation of upcoming intake appointment details to all new clients.
 “Childless adult” reductions to AHCCCS coverage effective July 8, 2011, adversely affected many AFF clients. In response, TERROS has increased training of their outreach, case management, and Recovery Coach staff regarding Title XIX eligibility and application requirements. This training stresses increased follow-up with clients regarding their submitted applications. The goal has been to keep as many AHCCCS-eligible clients as possible from being dropped for lack of timely response to initial or renewal paperwork requirements.
 The Parent to Parent Recovery Coach Program has been successfully incorporated into the AFF program in Maricopa County. This program has maintained the four main original goals, which are to: (1) engage parents into treatment; (2) encourage parents to remain in treatment; (3) assist parents in navigating through the child welfare system; and (4) guide parents through the process of their individual recovery. In August 2011, a Continue Recovery Environment and Transitional Education (CREATE) group was piloted by TERROS, the goal of which was to provide a continued care environment for clients and peers to join together, share resources, and support each other in the recovery process. This is accomplished by providing a link to continued care via the exploration of community resources while demonstrating evidence of recovery in action. The group has since become available through two of TERROS' subcontractors as well. Several clients have graduated from the program.
 In October 2011, TERROS Recovery Coaches began co-facilitating treatment groups. This has proven to be invaluable for clients in early recovery, as Recovery Coaches provide firsthand knowledge and experience of the recovery process, and prepare clients for the challenges as well. They also provide information on 12 Step support groups and other community resources. A new Recovery Coach Distribution Model has been adopted, which was designed to address the high demand for Recovery Coach services. Under this model, Recovery Coaches are now being assigned to TERROS and subcontractor sites, rather than being assigned to specific cases, in order to maximize services to a larger number of AFF clients. This allows the use of Recovery Coaches in all phases of treatment, beyond the initial stage.
 The Substance Exposed Newborn Safe Environment (SENSE) Program expanded into Yuma in SFY2012. This is a specialized, highly-coordinated, and intensive response system for families of substance-exposed newborns. The program closely coordinates Family Preservation, AFF, professional nursing, and Healthy Families services. Since July 2011, ten SENSE cases have been referred to Catholic Community Services (CCS)/AZPAC, the Yuma County AFF Provider. SENSE has not yet begun in La Paz County.
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 In Yuma County, the AFF provider attends TDMs and conducts monthly staffings with AFF clients, case managers, and support service agencies. CPS referrals to the AFF Program have increased dramatically over the past 12 months, more than doubling the number of AFF clients compared to FY2011.
 Attendance by community stakeholders at the monthly Yuma AFF Collaboration Meeting has greatly increased during the past year. These meetings are the vehicle to discuss program successes, barriers, and challenges, and to refine collaborative efforts – particularly with Yuma’s RBHA-contracted treatment providers.
 In Northern Arizona, the AFF providers routinely attend TDMs, Child and Family Team (CFT) meetings, and Adult Recovery Team meetings. The AFF provider in Yavapai County continues to attend approximately twenty TDMs per year, the AFF provider in Coconino County attends twenty-four, and the AFF provider in Apache and Navajo Counties attends an average of fifteen per year. In addition, Northern Region providers continue to coordinate services with CPS, the local RBHA-contracted providers, and other community agencies. Weekly meetings with CPS and local RBHA providers throughout the region enhance communication among all, to ensure families are receiving quality services.
 In northern Arizona, AFF/AZPAC merged with the Empower U program to provide clients with financial education and the tools to move forward economically and socially. Additionally, the Family Drug Court in Yavapai has collaborated with AFF to coordinate engagement and treatment efforts to increase success rates. AZPAC is also providing women’s empowerment and anger management groups to AFF clients to provide comprehensive services and decrease barriers of receiving those services elsewhere.
 Staff from the Mohave and La Paz County AFF provider, WestCare AZ, continue to attend approximately thirty CFTs or TDMs per month. WestCare continues to expand their range of available services. For example, WestCare AZ provided trainings to the Department’s Jobs staff, increasing the total number of Jobs referrals to the AFF program and encouraging Jobs' regular participation in quarterly AFF Collaboration meetings. In addition to job skill and preparation classes, WestCare trains AFF clients in retail operations through the use of their thrift store. In the store, clients are able to complete court-ordered community service hours and learn the value of volunteerism, while gaining a marketable skill and work experience. Clients can also receive vouchers to obtain needed items from the thrift store. Weekly domestic violence victims groups for females have been added at the request of the courts. Successfully-recovering male and female alumni continue to manage several of WestCare’s halfway and sober-living homes, helping prior clients to transition to substance-free and recovery-supported employment. WestCare also continues to organize sober social and community events on a regular basis to help clients support each other in embracing and maintaining recovery. To further enhance the support available from and to alumni, WestCare has expanded formal alumni activities to the Mohave County area. This effort has been led by a committed core group of AFF alumni, who are following a proven alumni curriculum to become supports for each other and role models for clients still completing their substance abuse treatment. Lastly, WestCare has become an AmeriCorps site this year in Mohave County, utilizing two retired military veteran volunteers to provide peer-to-peer outreach to those who have served in the military and their family members. Some of these veterans are also AFF clients. Child and Family Services Annual Report 2012
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 All Southeastern Arizona Behavioral Health Services (SEABHS) provider sites use integrated child and adult services based upon the CFT and Adult Recovery Team processes. Peer support providers, known as Recovery Support Specialists (RSS) and family support partners (FSP), provide services at each provider location. Services include outreach to newly referred AFF clients, re-engagement for those who drop out of services, S.M.A.R.T. Recovery groups, wellness recovery action planning, and assistance in navigating the behavioral health system to assure necessary services are provided. SEABHS has ten employment specialists to provide supported employment, supported education, pre-vocational training, job-seeking, and extended employment supports to individuals re-entering the job force. AFF participants are encouraged to use these services as a part of their recovery and aftercare planning.
Housing Assistance
The Housing Assistance Program provides financial assistance to families for whom the lack of safe and adequate housing is a significant barrier to family preservation, family reunification, or permanency. Housing assistance is provided in the form of vendor payments for rent, rent arrearages, utility deposits, and utility arrearages. Housing assistance payments can only be made if other community resources are not available. Eligibility requirements include that at least one child in the family is involved in an open CPS case and that the adult caregiver (usually, but not always, the parent) is a U.S. citizen or otherwise lawfully present in the U.S.
This program is available statewide, following verification of the applicant’s citizenship. There is no waiting list to receive these funds, although affordable housing may not be available for rent in all communities. The maximum amount of money available to individual families through this program is $1,800. In SFY 2011:
 The Housing Assistance Program provided financial support for the reunification or permanent placement of 905 children within 346 families, statewide. This was a notable increase from the 511 children and 206 families served in SFY 2010.
 The total amount expended statewide increased from $193,176.89 in SFY 2010 to $474,178.42 in SFY 2011.
 An estimated $3,801,235.30 would have been expended by the Division for foster care maintenance if the 905 children who benefited from Housing Assistance during SFY 2011 had entered or remained in foster care for the length of time housing assistance was provided to each family. Based on the SFY 2011 Housing Assistance Program Expenditures of $474,178.42 there is a cost avoidance of $3,327,056.88.
4. Out-of-Home Children Services
Permanency Planning
Permanency planning services are provided for all families who are the subject of an ongoing services case with CPS. CPS Specialists engage parents, children, extended family, and service team members to facilitate the development and implementation of a family-centered, behavior-based, written case plan. The family-centered case plan is developed jointly with the family, linked to the safety threats and risks identified through the child safety and risk assessment process, and written in behavioral language so the Child and Family Services Annual Report 2012
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family clearly understands the changes and activities necessary to achieve reunification or another permanency goal.
Timely achievement of the best permanency option for each child in out-of-home care is supported by the Division’s clear policies on the selection of permanency goals, including timeframes for consideration of goals other than reunification. Each child is assigned a permanency goal based on the circumstances necessitating child protection services, the child’s needs for permanency and stability, and Adoption and Safe Families Act (ASFA) requirements. The initial permanency goal for children in out-of-home care is family reunification, unless the court finds that reasonable efforts to reunify are not required due to aggravating circumstances, as defined by the Adoption and Safe Families Act.
Timely permanency hearings within twelve months of the child’s removal support achievement of the Division’s permanency goals. At the time of the child’s initial removal pursuant to court order, the parent(s) are informed that substantially neglecting or willfully refusing to participate in reunification services may result in a court order to terminate parental rights at the permanency hearing. For children younger than three at the time of removal, Arizona law requires a permanency hearing within six months of the child’s removal from the home.
The Family-Centered Strengths and Risks Assessment Interview and Documentation Guide provides questions for CPS Specialists to ask families when gathering information to assess strengths and functioning in each risk domain. The recommended questions are open-ended, non-confrontational, and phrased to engage family members in the identification of their own unique strengths and needs. Information gathered during the interviews is used to develop a family-centered case plan to support achievement of the permanency goal and address the child’s educational, physical health, and mental health needs. The Interview Guide results in a case plan that is tailored to the unique needs identified by the family or other sources. CPS Specialists arrange and monitor services to address risks within the home, maintain family relationships, and support timely achievement of the permanency plan; facilitate information sharing among team members; and report progress and barriers to the juvenile court and Foster Care Review Board (FCRB). The Division conducts a planned transition of the child to the home when the parent has successfully addressed the safety threats that prevented him or her from caring for the child safely without Division involvement. Follow-up and support services are put in place to ensure a safe and successful reunification.
Concurrent permanency planning is required in cases where there is a poor prognosis of reunification within twelve months of the child’s removal. Concurrent planning is the simultaneous pursuit of reunification and another permanency goal in cases where the prognosis of reunification within twelve months is poor. Concurrent planning focuses the family and team on permanency from the outset of the case, so that reunification is given the greatest chance to succeed and another permanency option is ready to be finalized if reunification cannot be achieved. The family and service team work together to increase the likelihood of reunification while simultaneously identifying and readying a permanent placement in case reunification is not successful. The Division’s policy and training emphasizes the need to implement concurrent planning activities, as opposed to simply identifying a concurrent permanency goal. These activities include thorough kinship search and assessment, selection and placement of the child with the caregivers who will adopt or obtain guardianship of the child if reunification is not possible, and preparation of the permanent home (such as early completion of home studies, certification requests, and adoption subsidy applications). Early selection and placement of the child in the permanent home improves placement stability and may increase placement of siblings together by avoiding situations where siblings are initially placed separately and team members become reluctant to move the children to a permanent home that can care for the sibling group. Child and Family Services Annual Report 2012
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A permanency plan of adoption or guardianship may be considered if reunification is not successful within the timeframes identified in federal and state law. Agency preference for permanency goals places adoption second only to family reunification. State policy directs that a goal of adoption be assigned and termination of parental rights (TPR) be pursued according to ASFA requirements. At the twelfth month permanency hearing, if the court determines that termination is in the child's best interest, the court may order the Department or the child's attorney or guardian ad litem to file a motion for TPR within ten days and set a date for an initial hearing on the motion within thirty days. Termination of parental rights shall not be initiated when it has been determined that such action is not in the child's best interests and this decision is approved by the region’s Program Manager or designee.
All other permanency options must be fully considered before implementing a permanency goal of long-term foster care or independent living as another planning permanent living arrangement. The Division has clearly communicated statewide that long-term foster care is a goal of last resort. Division policy requires management approval of the long-term foster care goal, which is the state’s version of alternative planned permanent living arrangement (APPLA) for children younger than sixteen. Many regions also require management approval for a goal of independent living, which is the Division’s APPLA goal for youth age sixteen or older. Youth with a goal of long-term foster care or independent living often live in a stable setting with relatives or foster parents.
Placement and Placement Support
Out-of-home placement services are available statewide for children who are unable to remain in their homes due to immediate safety concerns or impending and unmanageable risk of maltreatment. Placement services promote safety, permanency, and child and family well-being through supervision and monitoring of children in out-of-home placement, and support of the out-of-home caregiver’s ability to meet the child’s needs. State policy requires a complete individual placement needs assessment for every child who requires out-of-home care, and that whenever possible the Division:
 place children in the least restrictive placement available, consistent with the needs of the child;
 place children in close proximity to the parents’ home and within the child's own school district;
 seek adult relatives or adults with whom the child has a significant relationship to meet the placement needs of the child in out-of-home care;
 place siblings together unless there is documented evidence that placement together is detrimental to one of the children; and
 place children with caregivers who can communicate in the child's language.
Placement types include licensed or court approved kinship homes, non-relative licensed foster homes, group homes, residential treatment centers, and independent living subsidy arrangements. By court order a child may be placed with an unlicensed person who has a significant relationship with the child. Arizona statute confirms the preference for kinship placement and requires specific written findings in support of the decision whenever the Court finds that placement with a grandparent or another relative (including a person who has a significant relationship with the child) is not in the child’s best interest. Identification of potential kinship foster caregivers is to begin at the time of initial assessment/investigation. Within thirty days of a child’s placement in out-of-home care, the Division must try to identify and notify all adult relatives and persons who have a significant relationship with the child. When a child in out-of-home care is not placed with an extended family member, or is placed with an extended family member who is unable or unwilling to provide a permanent placement for the child, the CPS Specialist must initiate searches for extended family members or other significant persons prior to key decision points during the life of the case and no less than once every six months. If current Child and Family Services Annual Report 2012
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contact information about certain relatives is unavailable, the CPS Specialist can use the state’s Parent/Relative Locate program for a professional search by a contracted agency.
The CSA-SRA-Case planning process, Team Decision Making (TDM) meetings, and Child and Family Team (CFT) meetings are used to identify caregivers, services, and supports to meet each child’s needs. A TDM meeting is held for most removals or potential removals, during which parents, family members, CPS staff, and community partners formulate a plan for the child’s safety. If it is determined that removal is necessary, the team determines the child’s placement, giving preference to placement with relatives and proximity to the birth family.
Policy requires that the Division promote stability for children in out-of-home care by minimizing placement moves and, when moves are necessary, providing services to make placement changes successful for the child. To achieve the permanency goal and support the child and caregiver, a case plan specifying the necessary services and interventions is developed by the child, family members, out-of-home care provider, service providers, attorneys, and CPS. Among other information, the written case plan identifies the child’s educational, physical health, and mental health needs, and services to the child or caregiver to address those needs. CPS Specialists further support placement stability by:
 ensuring every child in out-of-home care has an individualized out-of-home care plan included in the case plan;
 providing children and out-of-home care providers current information about matters affecting the children and allowing them an opportunity to share their thoughts and feelings;
 reviewing each case every six months through the Foster Care Review Board process or the Department’s administrative review procedures; and
 making monthly in-person contacts with children in out-of-home care and their caregiver(s) to assess their safety, well-being, and service needs – including visiting alone with the child if verbal.
State law and policy support placement stability by giving the foster parent the right to request a review of any decision to change a child’s placement prior to the removal of the child. This review focuses on the child’s placement needs and whether additional services to the family can maintain the child’s placement. If the decision is made to change the child’s placement, policy requires that a transition plan be developed that includes notification of all parties about the move, communication between the prior and future out-of-home provider, pre-placement visitation, and the planning of supportive services. Legislation was recently passed specifically for foster parents. The foster parent bill of rights includes the following:
 to be treated with dignity and respect;
 to be included as a valued member of the team that provides services to the foster child;
 to receive support services that assist the foster parent to care for the child;
 to be informed of all information regarding the child that will impact the foster home;
 to contribute to the permanency plan for the child in the foster home;
 to have placement information kept confidential when necessary for protection of the foster parent and the foster parent’s family;
 for assistance in dealing with family loss and separation when a child leaves the foster home;
 to be informed of agency policies regarding the foster parent’s role;
 to receive training to enhance the foster parent’s skills;
 to be able to receive services and reach agency personnel at all times;
 to be provided reasonable respite;
 to confidentiality regarding issues that arise in the foster home; Child and Family Services Annual Report 2012
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 not be discriminated against on the basis of religion, race, color, creed, sex, national origin, age, or physical handicap; and
 to receive an evaluation of performance.
For Native American children, placements must take place in accordance with the Indian Child Welfare Act and the tribe must be notified whenever a placement change is considered.
Behavioral health and other services are available to assess and treat the mental health and placement support needs for every child in out-of-home placement. For more information on behavioral health services, see Section IV, 8. Services to Address Children’s Educational, Physical Health, and Mental Health Needs.
Kinship Caregiver Identification, Assessment and Support
When out-of-home placement is necessary, preference is given to placement with relatives and persons who have a significant relationship with the child. Staff are reminded that kinship relationships are not necessarily blood relationships, and required to identify all of the child’s important emotional connections. Kinship placements provide the best possible method for maintaining connections to neighborhood, community, faith, family, tribe, school, and friends. Kinship placements typically provide homes for entire sibling groups, thereby reducing the number of sibling groups needing non-related foster homes and increasing the Division’s flexibility to manage its foster family resources so that homes are available for sibling groups when needed. The Division has focused on identifying and engaging kin as early as possible in the life of a case, increasing the percentage of children placed with kin, and increasing the supports provided to kinship caregivers, including licensure.
Division policies require that within thirty days of a child’s placement in out-of-home care, the Division exercise due diligence to identify and notify all adult relatives and persons who have a significant relationship with the child of the child’s out-of-home placement and of their option for being considered as a placement for the child. Two forms are sent to each relative. The first provides notification of the child’s removal, information about the Division’s child placement policies, and instructions for contacting the CPS Specialist. The second form is completed and returned by the relative, to request consideration as a placement for the child now or in the future, involvement with the child in other ways (such as visits), and/or contact by the CPS Specialist to discuss the child. This form also requests the relative provide information about the identity or location of other relatives.
The assessment of a relative or significant person who expresses an interest in being a placement option must be initiated within ten working days of their request. The assessment begins with a discussion of the child’s needs and the potential caregiver’s interest and intentions towards the child now and in the future, a preliminary determination of the potential caregiver’s ability to meet the child’s placement needs and support the case plan, and a preliminary determination that the potential caregiver can pass criminal and child abuse background checks. Based on the results of this discussion, a formal home study may be initiated.
The Division’s policies and procedures include several opportunities and supports to ensure each child’s relatives are identified and contacted. For example:
 Policy requires that the relatives’ names and contact information be gathered from the parents and children, as well as any other potential sources (such as each located relative). Arizona juvenile court rules also require that at the preliminary protective hearing the court order the parent or guardian to provide the names, types of relationship, and all available information necessary to Child and Family Services Annual Report 2012
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locate persons related to the child or who have a significant relationship with the child. The court must further order the parent or guardian to inform the Department immediately if the parent or guardian becomes aware of new information related to the existence or location of a relative or person with a significant relationship to the child.
 The integrated CSA-SRA-Case planning process guides staff to explore family connections as a resource for ensuring child safety and for placement options in the event that the child enters out-of-home care. A case note type of relative contact is also available in CHILDS, so that staff can easily locate information about kin and assessments of kin as placement resources.
 Use of the data dashboard and other managerial oversight of contact with parents continue to assist the Division to identify parents whose whereabouts are unknown. Identification and contact with a missing parent is often a pre-requisite to identification of kin.
 If a relative cannot be located, the CPS Specialist can make a referral to the Division’s Parent/Relative Locate Unit.
 TDM meetings are a helpful resource for locating kin. In SFY 2011, a relative attended 63% of emergency removal TDMs and 68% of TDMs where removal was being considered.
 Exhibit 12 of the Division’s on-line policy manual, Relative Search Best Practice Guide, provides theoretical information about the importance of finding and involving relatives in child welfare cases, and describes practice standards for conducting diligent and comprehensive relative searches.
The Division recognizes that the relationships between kinship caregivers, the children in their care, and the birth parents present special issues that require sensitivity, knowledge, and skill among CPS Specialists and service providers. The Division continues to develop the knowledge and skills of staff in relation to these special needs, and to identify services and supports to promote permanency and stability with kinship foster caregivers. SFY 2012 activity included the following:
 Relatives report that they are committed to caring for the children regardless of financial compensation, but placement of children can put significant financial strain on the kinship families, particularly given the current economic crisis and cuts to Temporary Assistance to Needy Families (TANF). In SFY 2012 the Division continued to actively encourage kinship caregivers to become licensed so they can receive financial benefits, the support of a licensing worker, and the greater perception of legitimacy afforded by completion of the home study and training processes. Staff are required to discuss licensure and encourage kinship caregivers to become licensed in situations where it appears that the placement will not be of short duration. Policy requires staff to review with the kinship caregiver a form that provides information about all the benefits available to kinship caregivers, including TANF benefits, licensing, and non-financial services.
 For those kinship families where licensing is not appropriate or possible, it is recommended that the kinship caregivers apply for TANF benefits for the child(ren). If the children are benefit-capped or the caregiver encounters problems associated with obtaining TANF benefits for the child, the Division’s Kinship Specialist is available to resolve case specific barriers. The Division has an agreement with the Family Assistance Administration to expedite TANF applications for kinship foster caregivers. Child and Family Services Annual Report 2012
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 Kinship caregivers are not required to be licensed foster parents for children in the care and custody of the Department; however, should they choose to apply for licensure, kin must meet the same licensing standards as non-kin foster parents with the exception of certain non-safety standards that may be waived as a result of the federal Fostering Connections legislation. On a case-by-case basis, the Division works with the OLCR and contracted licensing agencies to grant waivers of non-safety related licensing standards that would prevent kinship foster caregivers from becoming licensed. From July 2011 through March 2012, 180 kinship foster families were able to become licensed due to a waiver for non-safety related standards. The waivers most often relate to some aspect of the sleeping arrangements. A smaller number relate to income requirements or certain flexibilities needed to complete necessary training. Many sibling groups are placed in these homes.
 The Division’s HRSS contract providers assist the Division to train and license relatives as resource families. Two providers in the greater Phoenix area have developed specialized units dedicated to licensing kinship foster caregivers. Staff from these units give specialized supports in consideration of the unique needs of kinship caregivers. Child care is offered during class times and specially trained licensing workers assist the kinship caregivers to complete necessary paperwork. Services are offered in both English and Spanish and licensing workers accommodate each family's preferred meeting time and place for most appointments. In SFY 2012, two agencies had staff dedicated solely to working through the licensing process with kinship caregivers. Their outreach and support have contributed to a substantial increase in the number of licensed kin. One agency has five units solely dedicated to serving kinship families (located in Phoenix, Tucson, Yuma, Apache Junction and Prescott). From July 2011 through April 2012, this agency had 80 families complete the licensure intake and orientation. Of those, 50 families completed the training to become licensed and 35 are currently in the process and will complete licensure in June 2012. Currently, this agency has 70 licensed homes where 143 children are placed. The second agency has one unit with thirteen employees serving the Phoenix area. From July 2011 through April 2012, 159 families completed the licensure intake and orientation. Of those, 104 families began the training and 66 completed the training and are licensed. An additional 28 families are in the process of becoming licensed. Currently, this agency has 163 licensed kinship homes where 207 children are placed.
 The Division continues to distribute its Kinship Foster Care for Relatives Caring for Children in CPS Custody booklet. This booklet is available in English and Spanish, and provides more extensive information for kinship caregivers, including information about:
 the benefits provided to children in care;
 financial and non-financial benefits available to kinship caregivers;
 the benefits of becoming licensed;
 the licensing process and licensing requirements, including standards related to criminal history;
 licensing waivers;
 the Division’s expectations for the care and supervision of children, provision of transportation, and communication about the child’s medical, dental, educational, and behavioral health status and needs;
 medications or therapies for children;
 approved discipline techniques;
 visitation with parents and siblings;
 caregiver participation in meetings and court hearings; and
 case plans and permanency plans. Child and Family Services Annual Report 2012
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 Three of the state’s regions have staff designated to provide additional support to kinship caregivers. These supports often include in-person contacts to identify and resolve unmet needs, and provision of information about local services and supports.
 A ninety minute kinship module, updated annually to reflect current information and resources, is provided during CPS Specialist core training. Community professionals, kinship caregivers, and the DCYF Kinship Specialist co-facilitate the training to educate new CPS Specialists on topics specific to kinship care, including support services and resources for kin, role and boundary issues, permanency for children placed with kinship families, and feelings associated with kinship caregiving. From July 2011 through April 2012, 248 CPS Specialists were trained in the kinship module at initial CPS Specialist core. The kinship module has also been adapted for supervisors. In SFY 2012, 37 participants received this training in supervisor’s core.
 A computer-based training on kinship laws, policies, and forms is available for staff. From July 2011 through March 2012, 377 DCYF staff completed that training.
 The Division is a member of the Central Arizona Kinship Care Coalition, which is an advocacy and information group of kinship caregivers and Phoenix area agencies involved with kinship caregivers. The Coalition has legislative, events, and education subcommittees that address issues of importance to kinship families. A Division staff person co-chairs the Coalition and serves on the Coalition’s training and education team, which assisted to update and deliver the core training kinship module and developed and delivered training on the CPS system for kinship caregivers. The Coalition publishes an informational pamphlet for kinship caregivers, including those who are caring for children who are not involved with CPS. This pamphlet provides essential information to help kinship caregivers access services and supports. The Coalition also developed a client-led and client-only board of directors. The Coalition has identified four priority goals for CY 2012: (1) collaboration and base-building to include state-wide exposure, (2) advocacy and marketing, (3) outreach to unconnected kinship caregivers, and (4) work to increase financial and other resources for kinship caregivers.
 Kinship resource and family support centers that offer services to strengthen kinship families currently exist in the urban areas. These centers are dedicated to the creation and preservation of adoptive, foster, kinship, and guardianship families. The centers provide a place for families to gain access to information, and community professionals who can help them build happy healthy families. Information is provided on topics such as discipline, attachment and bonding, brain development, legal issues around kinship care, and what to look for in a behavioral consultant and behavioral diagnosis. Arizona’s Children Association continues to provide two strong and multi-dimensional programs for kinship caregivers in Phoenix and Tucson. The AzCA kinship programs offer information, education, and resource referrals for kinship foster caregivers and adoptive families. On-site services include assistance completing guardianship packets for probate court, a legal clinic with access to an attorney, support groups for caregivers (emotional support), case management, advocacy for caregivers dealing with system issues, senior support services for caregivers over fifty-five, adoption or guardianship training, youth activities, social activities for caregivers, skill building classes, and parenting class referrals. Many of these services are offered in both English and Spanish and free or low cost child care is often available. Duet and Family Resource Center are two other programs in the Phoenix metro area that offer kinship services.
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 The Arizona Statewide newsletter for foster parents and adoptive parents continues to include kinship foster caregivers in their mailings and in some of their articles.
On June 30, 2011, there were 3,643 children placed in 2,206 kinship foster homes. Of the 3,643 children, 383 were placed in licensed kinship homes and 3,260 were placed in unlicensed kinship homes. Of the 2,206 kinship homes, 224 were licensed and 1,982 were not licensed.
The Interstate Compact on the Placement of Children and Timely Interstate Placement Home Studies
The Interstate Compact on the Placement of Children (ICPC) is a contract between and among the fifty states, District of Columbia and the U.S. Virgin islands that standardizes national procedures to ensure suitable placement and supervision for children placed across state lines. Any person, court, or public or private agency wishing to place an Arizona child for care in another state must proceed through the ICPC. Likewise, any person, court, public or private agency in another state wishing to place a child for care in Arizona must proceed through the ICPC. The Arizona Compact Administrator is responsible for reviewing ICPC referrals and sending them to the Compact Administrator in the receiving state, and for referring requests for placement in Arizona to a local receiving agency. The local receiving agency oversees the evaluation of the referral and notifies the sending state’s Compact Administrator of the placement approval or denial.
The Safe and Timely Interstate Placement of Foster Children Act of 2006 encourages timely home studies. A home study is considered timely if within sixty days of receiving a request to conduct a study “of a home environment for purposes of assessing the safety and suitability of placing a child in the home,” the state completes the study and sends the other state a report, addressing “the extent to which placement in the home would meet the child’s needs.” Arizona received 1,427 ICPC requests for a home study of an Arizona family as a potential placement resource in FFY 2011; 100 more than the 1,326 requests in FFY 2010. In FFY 2011, Arizona made 1,232 requests to other states for home studies, which was almost 200 more than in FFY 2010.
5. Adoption Promotion and Support Services
Adoptive Home Identification, Placement, and Supervision Services
Adoption promotion and support services are provided with the goal of placing children in safe nurturing relationships that last a lifetime. These services include: placement of the child on the Central Adoption Registry, assessment of the child’s placement needs, preparation of the child for adoptive placement, recruitment and assessment of adoptive homes, selection of an adoptive placement, supervision and monitoring of the adoptive placement, and application for adoption subsidy services. Adoption promotion and support funds are used to support adoptive families through pre-placement adoptive family-child visits and facilitation of post-placement visitation with siblings. Adoption promotion and support services also include post-adoption individual, group, or family counseling services for adoptive children, adoptive parents, and the adoptive parents’ other children. These counseling services supplement the services that are available through the title XIX behavioral health system. Services are provided by contracted providers who are experts in adoption. There are no geographic limitations on adoptive home identification, placement, and support services, although some support services, such as specialized counseling, may be more readily available in some areas.
The Department places a child in an adoptive home that best meets the safety, social, emotional, physical, and mental health needs of the child. Meeting the child’s needs is the primary consideration Child and Family Services Annual Report 2012
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in the selection of a family. Contracts for foster care and adoption home study, recruitment, and supervision emphasize targeted and child specific recruitment. The contracts encourage placements for sibling groups, teens, children whose ethnicity is over-represented in the foster care system, and children with special needs. The Division and its contract providers are collaborating to address disproportionality by specifically targeting recruitment within African American and Hispanic populations. The Division has also requested that the agencies recruit homes in specific geographical areas.
Arizona uses an array of interstate resources in order to expeditiously locate permanent homes for children across jurisdictional lines. These include the Adoption Exchange Association’s AdoptUsKids, internet resources such as Adoption.com, features on nationally syndicated programs, publications such as the Arizona Adoption Exchange Book, quarterly newsletters to Arizona’s licensed foster parents and parents receiving adoption subsidy benefits, and listing on the CHILDS Adoption Registry. Adoption promotion funds are available statewide, to provide transportation services that encourage, facilitate, and support cross-jurisdictional placements. Transportation services include pre-placement visits, and visits with siblings and relatives living out of state or in other regions of Arizona. No changes are expected to this program and the Division will continue to encourage staff to use this resource.
Arizona was awarded $1,083,779 in federal adoption incentive payments in FFY 2011. This money was used to support adoptive home recruitment resources and efforts. The funding has also been used to support current adoptive parents who are having challenges navigating the behavioral health system and are caring for children who are at risk of re-entering the foster care system. This service was a recurring request from adoptive parent focus groups. There are no planned changes for the use of incentive funding next year.
Adoption Subsidy
The Adoption Subsidy program subsidizes adoptions of special needs children who would otherwise be difficult to place for adoption because of physical, mental, or emotional disorders; age; sibling relationship; or racial or ethnic background. The physical, mental, or emotional disorders may be a direct result of the abuse or neglect the children suffered before entering the child welfare system. Services include monthly maintenance payments, eligibility for title XIX services, reimbursement of services rendered by community providers, crisis intervention, case management, and information and referral.
The number of children eligible and receiving adoption subsidy continues to increase. The number of children served in the adoption subsidy program grew from 14,559 on September 30, 2010, to 16,314 on September 30, 2011. In FFY 2011, 1,755 new special needs adoptions were subsidized and the Department reimbursed $2,055,904 of nonrecurring adoption expenses.
The Adoption Subsidy program continues to offer post-adoption support to adoptive families of special needs children. Adoption subsidy staff provide support and resources to families, and collaborate with community agencies to assist in meeting the needs of adoptive children. For example:
 Adoption subsidy policy continues to be included in the Children’s Services Policy Manual, which is available on the Division’s internet and intranet sites.
 Adoption subsidy staff continue to collaborate with staff from the Regional Behavioral Health Authorities and participate in CFT meetings to coordinate services to meet the behavioral health needs of adoptive children. Child and Family Services Annual Report 2012
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 A Mental Health Specialist position was recently established in the Adoption Subsidy program. This position will provide adoptive parents with support to obtain behavioral health services for the children with special needs they adopted. The Division anticipates that the Mental Health Specialist will be onboard by August 2012.
 Adoption subsidy staff participated in the November National Adoption Day celebrations.
 The Lodestar Family Connections Center in Phoenix and the KARE Family Centers in Tucson, Phoenix, and Yuma continue to be valuable post-adoption resources used by families. The Division continues to identify new community resources for all children eligible for adoption subsidy.
More information on the Division’s programs and activities to promote and support adoption is located in Section V, 8. Foster and Adoption Home Licensing, Approval, Recruitment, and Retention.
Inter-country Adoption Act of 2000 (ICCA)
The ICCA seeks to ensure that inter-country adoptions are in the child’s best interests and protect the rights of children, birth families, and adoptive parents involved in adoptions from countries subject to the Hague Convention on Protection of Children. The Act also improves the ability of the federal government to assist United States citizens seeking to adopt children from countries subject to the Convention. Children adopted from other countries who enter the Arizona child welfare system receive the same services as any other child in out-of-home care.
Case information was reviewed for each child who entered out-of-home care during FFY 2011 and was identified in CHILDS as having been previously adopted. This review did not identify any children who entered out-of-home care in FFY 2011 and were the subject of an inter-country adoption ending in dissolution. There was one child who entered out-of-home care who had been adopted from a Russian orphanage. Efforts to return this child to the adoptive parent have not been successful and the plan has been changed to severance and adoption, but the parent's rights have not yet been terminated.
6. Subsidized Guardianship and Independent Living Services
Subsidized Guardianship
Guardianship subsidy provides a monthly partial reimbursement to caretakers appointed as permanent guardians of children in the care, custody and control of the Department. These are children for whom reunification and adoption has been ruled out as unachievable or contrary to the child’s best interest. Medical services are provided to title XIX eligible children through the Arizona Health Care Cost Containment System (AHCCCS). Administrative services include payment processing, administrative review, and authorization of services. Many of the permanent homes supported by the Subsidized Guardianship program are kinship placements.
This program is available statewide to children exiting out-of-home care to permanent guardianship. The average number of children per month receiving guardianship subsidy benefits during FFY 2011 was 2,442, which was a 3.2% increase over FFY 2010, and a 6.7% increase over FFY 2009.
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Independent Living and Transitional Independent Living
Provision of services to support young adults is most directly related to the percentage of cases rated strength during the PICR on other planned permanent living arrangement, but effective services also improve placement stability, reduce foster care re-entry, increase the percentage of youth placed with siblings and relatives, reduce the number of youth in out-of home care, and increase the number and percentage of youth who exit to permanency rather than at age of majority. Youth and Division staff work together to establish youth-centered case plans that include services and supports to assist each youth to reach his or her full potential while transitioning to adulthood; and to maintain safe, stable, long-term living arrangements and relationships with persons committed to their support and nurturance. State policy requires an individualized independent living case plan for every youth age sixteen and older in out-of-home care, regardless of his or her permanency goal. Life skills assessments and services are provided to ensure each youth acquires the skills and resources necessary to live independently of the state foster care system at age eighteen or older.
Youth who do not have a goal of reunification, adoption, or guardianship are assisted to establish another planned permanent living arrangement by participating in services, opportunities, and activities through the Arizona Young Adult Program, which is Arizona’s state Chafee Program. The Arizona Young Adult Program provides training and financial assistance to children in out-of-home care who are expected to make the transition from adolescence to adulthood while in foster care. Youth served under the Arizona Young Adult Program are currently in out-of-home care, in the custody of the Department. Just over 10% of children in out-of-home care on September 30, 2011, had a permanency goal of independent living. This percentage has remained stable at 10% to 13% over the last several years. The number of youth served by Arizona’s Young Adult Program has decreased slightly, from 1,343 in CY 2010 to 1,319 in CY 2011.
State policy allows youth to continue to receive Division services and supports to age twenty-one through voluntary foster care services and/or the Transitional Independent Living Program. Young adults served under the Transitional Independent Living Program are former foster youth, ages eighteen through twenty, who were in out-of-home care and in the custody of the Department while age sixteen, seventeen, or eighteen. This Program provides job training, skill development, and financial and other assistance to former foster youth, to complement their efforts toward becoming self-sufficient. During CY 2011, 158 former foster youth received assistance from this program – a decrease from the 201 former foster youth served in CY 2010
A statewide Independent Living Policy Specialist provides consultation and technical assistance to staff and contracted agencies serving young adults, including annual meetings to develop competencies and identify systemic improvements necessary to achieve positive outcomes for these youth. Goal directed support and oversight is also provided by regional managers, supervisors, and program specialists.
Stakeholders have reported the need for more timely and accessible services to address the unique needs of families with teenagers. The Division and the Department of Health Services/Division of Behavioral Health Services (DBHS) continue to provide and develop services specifically geared toward teenagers. Examples include the following:
 Transition to Adulthood service planning assists children who will be moving from the children’s behavioral health system into the adult system. A representative from the adult behavioral health system is required, upon request, to attend the youth's CFT beginning when the youth is Child and Family Services Annual Report 2012
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seventeen years and six months, to provide information on available services and facilitate transition into the adult system.
 The ACEC Clinical Subcommittee has completed the first two development phases of a training for system partners, youth, and parents about DBHS' Transition to Adulthood Practice Protocol. The training’s purpose is to ensure everyone involved understands DBHS’ practice recommendations for behavioral health providers addressing the needs of youth nearing the age of majority. This training is a collaborative effort between local RBHAs, the Division, the Division of Developmental Disabilities, the Administrative Office of the Courts, the Department of Education, and behavioral health providers. In the first phase, the subcommittee developed the training content and identified the presentation medium. In the second phase, the subcommittee developed and completed the initial pilot presentation of the webinar. Based on the pilot, the subcommittee will now make necessary changes and begin planning for the broader roll-out to system partners.
 Some child services continue to age twenty-one, when appropriate. This is supported by a special capitation rate for youth ages eighteen to twenty-one years old, which helps the RBHAs cover the cost of these services, although budget reductions and a multiple five percent rate decrease have constrained the providers’ ability to offer services.
 Support and Rehabilitation Services are available for children, adolescents, and young adults, including a variety of home-based and community services with a goal of keeping children in their homes and community.
 The Child and Adolescent Service Intensity Instrument (CASII), is used for all children ages six through seventeen to identify the need level and recommended service intensity. The results inform the CFT process, through which services and supports to best meet the youth’s needs are identified. The CFT process mandates a crisis plan and a Strengths, Needs, and Cultural Discovery (SNCD) for youth with a CASII score of four, five, or six (indicating high needs). These youth will also be assigned an intensive/dedicated case manager to provide support in the delivery of services.
More information about youth and stakeholder involvement in program evaluation and development, the Division’s activities to improve outcomes for young adults, services and systems to support young adults, and related accomplishments is located in Section IX, Chafee Foster Care Independence Program and Education and Training Voucher Program Annual Progress Report 2012.
Young Adult Transitional Insurance (YATI)
Young adults who reached the age of eighteen while in out-of-home care may be eligible for medical services through the YATI Program, a Medicaid program operated by AHCCCS. All foster youth who are Medicaid eligible are pre-enrolled into an AHCCCS plan as they turn eighteen years of age. This program provides continuous health coverage until the age of twenty-one, regardless of income. Approximately 500 additional youth who reached the age of eighteen while in foster care during the last year will benefit from this program.
Child and Family Services Annual Report 2012
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Education and Training Vouchers
Through funding received from the Federal Education and Training Voucher (ETV) Program, vouchers to support post-secondary education and training costs, including related living expenses, are provided to eligible youth up to age twenty-three years. In accordance with the current state Chafee Foster Care Independence Program (CFCIP), a youth may apply for assistance through the state ETV program if the youth:
 was in out of home care in the custody of the Department when age sixteen, seventeen, or eighteen;
 is age eighteen to twenty-one and was previously in the custody of the Department or a licensed child welfare agency, including tribal foster care programs;
 was adopted from foster care at age sixteen or older; or
 was participating in the state ETV program at age twenty-one.
Additional information about the Independent Living, Transitional Independent Living, Young Adult Transitional Insurance, and Education and Training Vouchers Programs is located in