Background Regarding Arizona's CPS Reform Efforts
When Governor Janet Napolitano assumed office in January 2003, she pledged to make the protection, well-being and permanency of Arizona's most vulnerable children one of her top priorities. On her third day in office, Governor Napolitano established the Governor's Advisory Commission on Child Protective Services Reform. This group ? comprised of legislators, court representatives, advocates, community providers, agency directors and law enforcement ? was charged with developing recommendations on numerous issues related to child protection and child welfare. After more than 80 meetings that included key stakeholders, such as foster and adoptive parents, treatment providers, advocates, mentors, and other volunteers, the Commission forwarded to the Governor its list of more than 200 recommendations for improving Arizona's child protection system. These recommendations covered areas of CPS reports, CPS records, CPS structure, juvenile justice, health, education and community. In August 2003, Governor Napolitano hired David Berns as Director of the Department of Economic Security. Director Berns brought to the position a national reputation for finding innovative ways to deliver excellent human services in cost-effective ways. His vision of integrating human services to reduce poverty and prevent family violence was seen as a cornerstone to strengthening families so that they might provide safe home environments for their children. Governor Napolitano and Director Berns hosted three public forums to seek communities' input on to how best to improve Arizona's child protection system. More than 600 people attended those forums and 120 individuals offered their testimony. Hundreds of written comments also were received, which both Governor Napolitano and Director Berns read. The end result was the Governor's Action Plan for Reform of Arizona's Child Protection System, released in September 2003. This plan set forth the Governor's priorities for immediately addressing some of the issues within the CPS system and the challenges families faced in accessing child welfare services. This action plan included approximately 42 strategies for improvement in six areas: (1) ensuring a multi-disciplinary response to reports of abuse and neglect; (2) preventing child abuse and neglect; (3) clarifying the mission and role of CPS; (4) ensuring effective delivery of services to children and families; (5) providing adequate support for children and families served by the system as well as those who provide services; and (6) increasing community involvement. Last Fall, Governor Napolitano also called the state Legislature into Special Session to begin addressing those strategies that required legal changes or additional funding. Between the Governor's Action Plan and the legislative Special Session, the Department of Economic Security's Division of Children, Youth and Families was tasked with implementing broad changes in CPS. The Division responded by inviting the participation of more than 600 stakeholders ? including staff members, service and treatment providers, community members, consumer families, youth, law enforcement officers and advocates ? on teams formed to implement strategies in each of those areas. The attached "one-pagers" represent a high-level summary of the most notable successes during 2004 in each of the six major areas covered in the Governor's Action Plan.
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Creation of a Multi-Disciplinary Response to Reports of Abuse and Neglect
The Governor's reform plan called for Arizona to adopt a response system that provides for the joint investigation by CPS and law enforcement on the most serious, high risk cases of child abuse and neglect and appropriate consideration of CPS and community based providers on lower risk cases. The plan included the development of investigative processes that are multi-disciplinary, incorporating as appropriate other professions such as medical and behavioral health personnel and domestic violence specialists.
One year later . . .
? Joint Investigations: Joint investigations by CPS and law enforcement are now required by Arizona law on the most serious allegations of abuse and neglect. Accordingly, CPS worked with law enforcement and county attorney officials in each county to develop multidisciplinary protocols, which detail the procedures for intake, investigation, and information sharing on these cases. More than 600 joint investigations have been conducted since the implementation of the new law in July 2004. Forensic Interview Training: Per the new requirements of Arizona law, over 200 CPS investigators statewide received training in forensic interviewing and processes. The CPS Child Welfare Training Institute now incorporates forensic interview training into basic case manager training. Thirty-one percent of CPS staff have received this training since June 2004. Co-location: In 2004, CPS expanded its co-located sites by ten: three with law enforcement and seven with behavioral health, bringing the total number of co-located offices to 27. There are now 23 CPS staff working or slated to work out of children's advocacy centers throughout Arizona. Bringing multiple disciplines under one roof reduces the need for multiple interviews that may re-traumatize the child and provides a forum for quickly determining what services a child and family needs. 100% Investigation by CPS: As of July 1, 2004, CPS now investigates 100% of calls to the CPS Hotline that qualify as reports of abuse or neglect. A total of 34,033 reports were investigated in SFY 2004, a 14% increase over SFY 2003 with 29,252. Redesign of Family Builders: The redesigned Family Builders program, now available in 5 counties, accepts referrals only after an investigation by CPS. These services are available to families with children at moderate risk of future maltreatment whose needs cannot be sufficiently met through community resources and who do not require more intensive services. Child Safety Assessment and Strength and Risks Assessment Tools: All CPS investigators now use two comprehensive tools, designed with assistance from national consultants, to assist with immediate safety determinations as well as an assessment of a family's strengths and the future risk of harm to a child. Reporting Process, Including Mandatory Reporters: CPS hotline specialists who take reports of abuse or neglect have an improved set of cue questions consistent with the new strength and risk assessment tools and multi-disciplinary protocols. CPS has also designed a web-based reporting form for use by mandatory reporters of child abuse and neglect. This form is currently being piloted with hospitals, counselors, schools and other community based agencies around the state. In addition, the CPS Hotline implemented a triage system for callers. The triage system links those wanting to report new allegations of abuse or neglect to a Hotline Specialist more quickly. Callers who want to provide updated information on existing cases, need other types of child welfare information, or want referrals to services can select Option 1. Individuals wanting to report abuse or neglect can select Option 2 and are connected directly to a Specialist.
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Development of a Statewide Prevention System
The Governor's plan recognized that the child welfare system requires an entire rethinking of how and when services are delivered to children and families. Services must be provided to families who may be at risk of child maltreatment before that abuse or neglect occurs and outside of the stigma that is often associated with the child protection system. Moreover, since poverty can be a key contributing factor to child abuse and neglect, the plan emphasized that we must begin to connect families with child care, employment opportunities and nutritional assistance as soon as those needs are identified. DES Director Bern's main charge has been to work with his staff and with the communities around the state to develop an Arizona model for addressing issues of safety, poverty and economic security for all children and families in the state.
One year later . . .
? Prevention Programs: Funding for the Healthy Families Arizona program, a home visitation program designed to provide supportive services and education to parents of newborns, doubled in SFY2005. As a result, in 2004, the program grew by 25 teams and served 2,301 families in SFY 2004. This is an additional 4% of eligible families over SFY 2003 of 2,220. In SFY 2005, Healthy Families plans to serve 3,712 families.. Additionally, all families, regardless of any previous history with Child Protective Services, are now eligible to be screened and assessed into the program and can be served by the program before the birth of the child. This effective prevention program, just awarded national accreditation for another four years as a program of excellence, now serves 51 sites in over 100 Arizona communities from Nogales to Page. Integration of Services: The Department of Economic Security is working to better integrate its human service programs to reduce poverty and family violence. The creation of intervention teams called Family Connections, which include child welfare, family assistance and employment program staff, will engage families to establish goals of self-sufficiency, child safety and overall well-being. Collaborative development of service plans include family, governmental and community resources to address issues like income, housing status, education, health care, substance abuse, mental health and community involvement. Two pilot teams will begin assisting families in February. The goal is to expand that number to 10 by the end of the year. Development of a Prevention Continuum: To begin the development of a statewide prevention system, key stakeholders created a prevention framework. That framework identifies a continuum of Arizona programs known to reduce risk factors for child abuse and neglect and to increase family and community strengths. Implementation of the continuum will focus on four main priorities: parenting and family support, economic security, health, and child care. Prevention and Intervention with Dually-Involved Youth: Based on recommendations from CPS, juvenile justice agencies, and the courts, interagency protocols that address needs of children involved in juvenile justice and child welfare will be available later this year. These protocols will improve information sharing between these two areas, service delivery to youth transitioning out of one or both systems, and continuity in case management services.
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Clarification of the Mission and Role of Child Protective Services
The Governor's Plan called for clearer direction to CPS investigators and case managers, law enforcement officials, and mandatory professional reporters - as well as to the community - regarding the role of Child Protective Services.
One year later . . .
? ? Mission of CPS: Arizona law and CPS policy now make it clear that the primary purposes of CPS are (1) to protect children by investigating allegations of abuse and neglect; (2) promote the well-being of children in a permanent home; and (3) coordinate services to strengthen the family and prevent abuse or neglect. Substance Abuse, Including Substance Exposed Newborns: Many families involved with child protective services struggle with drug or alcohol abuse. Arizona law and CPS policy now make clear that in determining whether a child has been neglected, consideration shall be given to a parent's drug or alcohol abuse, including a mother's abuse of a dangerous drug, narcotic drug or alcohol during pregnancy if the child is demonstrably adversely affected at birth or within the first year of birth. Arizona law and CPS Policy also make it clear that a child may be taken into temporary custody if the child has been physically injured as a result of living on premises where dangerous drugs or narcotic drugs are manufactured. The number of substance exposed children removed in SFY 2003 was 245. In SFY 2004 there were 350 children removed. Medical Guidelines: Several medical professionals assisted CPS in the creation of guidelines for identifying substance exposed newborns in order to provide adequate care and safety. These guidelines will be formally published in February 2005 and distributed to Arizona's medical community. Central Registry Information for Employment Purposes: Arizona's central registry provides information about perpetrators of abuse and neglect. Arizona law now requires all applicants for direct service positions (working with children or vulnerable adults) with the Department of Economic Security to be checked against the CPS Central Registry to verify whether an applicant is the subject of a CPS report. This policy has been implemented by the Department. To date, 42 applicants have been checked and cleared against the CPS Central Registry.
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Delivery of Timely, Effective Services to Children and Families
The Governor's Plan called for Arizona to transform its currently isolated child welfare system into an integrated system, which provides timely, effective services driven by the needs of each child and family. The plan recognized that children involved in the CPS system often require a multi-agency system response to meet their needs and that state agencies must work together to deliver those services timely and effectively.
One year later . . .
? 24 Hour Urgent Behavioral Health Response: Children who are removed from their parent/guardian may be referred for a behavioral health assessment within 24 hours of removal and offered services based upon the assessment results. Through December 31, 2004, Arizona Department of Health Services (ADHS) reports more than 3,000 children have received the Urgent Behavioral Health response since implementation of the policy in late 2003. Understanding Behavioral Health Services Needs: ADHS, CPS, and partners, through the Children's Executive Committee, published "The Unique Needs of Children Involved with CPS." This report is now available as a tool for all partners in the child welfare system, including behavioral health staff, to better understand the behavioral health needs of children and their families/caregivers involved with CPS in all phases of the dependency process. Behavioral Health Assessment Tool for Children Ages Birth to Age 5: As of the fall of 2004, a new tool is being introduced to CPS case workers and utilized by the Regional Behavioral Health Authorities (RBHAs). This tool assesses children from birth to age 5 regarding trauma and attachment issues. It has a core assessment with an addendum that specifically applies to the child welfare population and addresses the unique needs of infants and toddlers. Maximization of Medicaid Reimbursements: The Action Plan called for CPS to maximize Medicaid reimbursements for children in the foster care system. The percentage of children who qualify for Title XIX reimbursement was 86% in SFY 2003 and increased to 88% in SFY 2004. The current SFY 2005 level is at 92%. Uninterrupted Health Coverage for Up to 60 Days: Effective January 4, 2005, children who are Title XIX eligible and returning home now receive transitional health care coverage through an AHCCCS health plan. Uninterrupted health care coverage has not been an option when children left foster care to return home. This now allows families time to secure health care coverage for their children without losing needed services. Any behavioral health services for the child will also continue to be provided through the RBHA during this transition period. Sharing of CPS Records: Arizona law and CPS Policy now require the Department to provide CPS information to specific persons or agencies that have a legitimate need for the information. The revisions also clarify that while CPS information must be maintained by the Department as required by Federal law, the exceptions for public release of CPS information shall be construed as broadly as possible. Under the new law and policy, CPS is able to correct, clarify and confirm information released by other sources. Community Network Teams (CNTs): Community Network Teams ? which include more than 400 volunteers statewide ? have been established in each Arizona county. Their charge is to identify service gaps in their communities and find ways to assist the Department in filling those gaps. To date, five counties ? Pima, Pinal, Gila, Graham, and La Paz ? have submitted their work plans and are collaborating with the Department to address local needs
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Providing Adequate Support for Children and Families Served by the System As Well As Those Who Provide Services
In her Plan, the Governor noted the many challenges facing those that provide support to the CPS System, including CPS investigators and case managers carrying caseloads well above the national standards without the resources to do their jobs, and a lack of available foster homes. She also noted inadequate support systems for foster families, relative placements, and group homes as well as supports for children in the foster care system. Recognizing the valuable contributions of each of these supports, the Governor's Plan called on Arizona to do whatever is necessary to keep them as partners in our child welfare system, including adequate reimbursements, appropriate assistance and open communication.
One year later . . .
Support for Children and Families ? The Number of Children Who Achieved Adoption within 24 months of Severance: Adoption of foster children continues to increase. In SFY 2003, 232 children were adopted within 24 months of having parental rights terminated, This represents 30% of the eligible foster children waiting for adoptive homes. In SFY 2004, 294 children were adopted within 24 months of parental rights termination. This represents 36% of the eligible foster children waiting for adoptive homes. Stabilizing Placements: In SFY 2004, 85% of children in care had no more than two placements compared to 83% in SFY 2003. As the number of children in foster care increased during this same period, this is a great improvement. Family to Family: CPS has been working with the Annie E. Casey Foundation to be selected as a Family to Family program site. This program teams foster families, birth families and agency staff in caring for children and rebuilding families. Among other things, the program includes specific strategies for recruiting foster families from the child's community to maintain family and community ties. Title IV-E Waiver: DES is seeking approval from the U. S. Department of Health and Human Services a waiver to implement intensive reunification services. This would allow federal Title IV-E dollars to be used for services to expedite reunification of children in out-ofhome placements. Breakthrough Series Collaborative on Kinship Care: A 5-person Team based in District II is implementing strategies to increase identification and support of kinships caregivers. This will be done initially in the pilot sites in District II and, using the Casey strategy of "Plan, Do, Study Act/Adjust" (PDSA's), effective interventions will be spread throughout all districts.
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Support for Staff ? ? 10% Salary Adjustment: As a result of the CPS Special Session, all CPS staff received a 10% increase to their salaries effective January 17, 2004. CPS Investigator Stipend: CPS investigators now receive a monthly 10% stipend if they investigate a minimum of 6 reports per month and have 36 months of CPS experience. In December 2004, 122 investigators received the 10% stipend.
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MSW Stipend: CPS case workers, program specialists and program supervisors with a Master of Social Work degree now receive a $1,000 stipend every year. As of January 2005, there are 168 stipend recipients. Bilingual Certification: In SFY 2004, 252 CPS employees participated in bilingual certification testing with 191 certified as bilingual in Spanish, Navajo, or Hopi. . Employee Assistance and Tuition Assistance Programs: These programs have now been restored for all DES staff. The DES Employee Assistance Program provides counseling referrals and assistance to employees. The Tuition Assistance Program provides educational assistance for CPS staff seeking Masters degrees related to their job position. "Life of a Case" Curriculum for New CPS Case Managers: CPS collaborated with Arizona State University to create a new case manager core curriculum that guides case managers through a more practical, experiential approach to case practice work. After piloting the new curriculum last fall, it is now fully incorporated into the CPS Training Institute. Family Centered Practice Supervisor Conference: DES hosted the statewide Family Centered Practice Supervisor Conference with 250 CPS supervisors and field managers in attendance. Arizona child welfare practice is focusing on the importance of the family in CPS casework. The 2004 Supervisor's Conference highlighted family centered practice in serving Arizona's children and their families. Enhanced Supervisory Training: CPS supervisors will now meet four times a year. These meetings are designed to strengthen the supervisor relationship through collaborative partnership that focuses on skill and knowledge. The first meeting will occur in March 2005. Equipment Support: CPS purchased 350 cell phones and 19 new cars in FY 2004. More than 90 upgraded vehicles were deployed to staff in FY 2004. Over 60 computers were provided to CPS field staff with improved performance capability. Additional car seats for use by CPS staff in transporting children were also purchased.
Support for Resource Families ? ? ? ? Foster Care Daily Rate Increase: Per funding appropriated during from the CPS special session, DES increased the daily foster rate reimbursement for foster parents by $7.50 in FY 2004 for the first time since 1996. This is a 61% increase for the basic daily foster care rate for children age 0 to 11and a 64% increase for children ages 12 and over. Recruitment of Resource (Foster) Families: The number of licensed foster homes available on December 31, 2003 was 1,851. On December 31, 2004, the number had increased by 15% to 2,183 licensed homes. Standardized Resource (Foster) Parent Training Curriculum: There is now a standardized curriculum to be used by contracted providers for all foster parents statewide. Resource Family Inquiries: A web-based tool has been developed to better serve families interested in becoming foster or adoptive parents. This tool was implemented in April 2004 and currently receives an average of 15 to 20 hits per week from families asking about foster and adoption information. Over 300 inquiries have been received and information has been provided on basic foster parent questions and orientation information. Faith-based Resource Family Recruitment Efforts: A team, Faith in Kids, composed of several faith-based organizations is working toward non-profit status with the goal of recruiting and providing supports to foster and adoptive families within faith-based organizations.
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Increased Community Involvement in the Child Welfare System
A message heard consistently and resoundingly throughout the Commission and public input process was the need for state government to actively engage the community in the child protection system to report abuse and neglect, to support children and families when a child has been removed, and to support families after reunification occurs. "Community" includes not only the traditional volunteers in the child protection system, such as Foster Care Review Board members and Court Appointed Special Advocates, but also faith-based organizations, philanthropic entities, the corporate and business world, neighborhoods and individual members of the public. The Governor's Plan explained that the role of the collective community must be recognized in its own right as part of the solution in ensuring a healthy future for Arizona's children and called for CPS to also do a better job of educating the public about the CPS system.
One year later . . .
? ? Open Court Hearings: Courts in all Arizona counties are piloting open hearing programs for juvenile court proceedings. Data is being collected and will be compiled for a legislative report due in November 2005. Community Network Teams (CNTs): Community Network Teams ? which include more than 400 volunteers statewide ? have been established in each Arizona county. Their charge is to identify service gaps in their communities and find ways to assist the Department in filling those gaps. To date, five counties ? Pima, Pinal, Gila, Graham, and La Paz ? have submitted their work plans and are collaborating with the Department to address local needs. Consumer Involvement: Implementation of the recommendations in the Governor's Action Plan, legislative changes that occurred during the 2003 Special Session, and other efforts to improve the state Child Protective Services system are coordinated through a statewide network of action teams. These teams are composed of more than 600 volunteers, including neighborhood leaders and community-based organizations, working in partnership with state officials to keep kids safe. Governor's Oversight Committee on CPS Reform: Members of the Committee meet on a quarterly basis with the Governor to provide the Governor's Office, CPS and other interested state agencies feedback regarding the "real life" impact of on-going reform efforts. The twenty-four members include case managers and supervisors with CPS; case managers with contracted service providers; representatives from law enforcement and probation; a foster youth; kinship, foster care and shelter care providers; pediatricians; a parent; a school social worker; a tribal social service representative; and representatives from community and faith-based volunteer organizations. Foster Youth Participation: The Foster Youth Advisory Board now meets periodically with the Governor and CPS administrators to discuss issues and make recommendations for improving outcomes for youth in foster care. A panel discussion with current and former foster youth is now also a critical component of core caseworker training. Foster youth are working in all six CPS districts to design peer mentoring programs. The Boys and Girls Clubs have partnered with CPS to provide free after-school opportunities aimed at meeting the social, recreational and educational needs of foster youth. Foster Care Review Board (FCRB): The FCRB advises the juvenile court on progress toward achieving a permanent home for children involved in dependency actions and in out-of-home placements. In addition to making recommendations related to the children's
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individual cases, the Board now also publishes a finding that identifies any significant service gaps or systemic problems in a case. This is intended to help CPS identify service areas that need to be strengthened. The quarterly data from the Board is shared with CPS statewide, who determine what actions need to be taken in their respective communities to address the service gaps. Faith-Based Group: Community volunteers of various religious denominations have joined to form Faith in Kids, an effort aimed at recruiting and supporting foster families within faith communities. The group is working on establishing non-profit status and is planning a statewide conference. Anticipated timeline for the conference is summer of 2005. Working With Community Groups to Increase Knowledge of the CPS System: o The CPS Speaker's Bureau provided 98 presentations to schools, physicians, universities and municipal agencies. o The Comprehensive Medical and Dental Program delivered 33 presentations in 2004 on the health care delivery system for children in foster care and the special needs of this population. Target audiences included health care professionals, CPS case managers, foster caregivers and licensing agency staff. o The Family to Family Coordinator delivered 25 presentations on the Family to Family program in 2004. Audiences included CPS staff, foster caregivers, and contract providers. o The Governor's Office and the DES Deputy Director for CPS made over 25 presentations at national conferences, the Foster Care Review Board, and local entities on the progress of CPS reform. o In May 2004, the Department assisted the Arizona Association for Foster and Adoptive Parents with the Blue Ribbon Campaign for Foster Care Awareness Month aimed at highlighting the need for more homes for Arizona's abused and neglected children. The significant media attention from these events had an immediate impact: in Maricopa County, 28 percent of the calls from potential foster parents in the month of May came during the three days surrounding the Blue Ribbon event. Some foster parent recruiters reported receiving nine times the number of calls from potential foster parents in May than in previous months. Work has begun on events to support Foster Care Awareness Month in 2005. Keeping the Public Informed: Members of the public are kept informed through the CPS Reform Watch bulletin, distributed monthly to all members of the Governor's Commission on CPS Reform, the related subcommittees, and the Oversight Committee on CPS Reform. The bulletin also is published on the Governor's web site and on the DES web site. It is distributed by several community partners, including the Protecting Arizona's Family Coalition, and is provided to media representatives who regularly cover CPS. The bulletins will be published quarterly in 2005.
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