Building a Vision for Child Welfare for the 21 st Century: Technical Expertise to Population-Level Improvement Uma Ahluwalia, Director, Montgomery County, MD, Department of Health and Human Services Frank L. Alexander, Director, Boulder County, CO, Department of Housing and Human Services Children’s Bureau State Team Planning Meeting Washington, D.C., July 18, 2018 1
Driving Outcomes for Families and Children • Building Child Welfare Systems that Achieve Population-Level Outcomes • What We Hope to Achieve: Frank Alexander (5 mins) • Services and Systems Integration and Child Welfare • Boulder County, CO: Frank Alexander (20 mins) • Montgomery County, MD: Uma Ahluwalia (20 mins) • The Opportunity Before Us-Population Level Support for Child Well- Being: • Uma/Frank (15 mins)
The Challenge As We See It Siloed Funding Siloed Processes Siloed Systems Inefficiency, Redundancy, Poor Outcomes You can work really hard, and serve a lot of people, but if you are not focusing on deep connections and root cause then you ultimately won’t have an impact.
Traditional Human Services Delivery $ In the absence of a systemic response to inadequate community response structures, participants, partners and social service staff carve their own paths, creating their own workarounds to improve the client experience. Cycles of abuse and neglect continue and child protection systems remain isolated from community.
Insights about Need and Risk HHS Navigation Screening Pilot Data Over 4000 screeners administered in a month to general assistance population.
Social Determinants of Health Underscores the relationships between social factors and health outcomes in communities. Pushes for service frameworks and structures to align and function together on behalf of families and individuals. 6
Integrated Services Model Integrated Services Model of Care Moving beyond ‘programs’ to an integrated continuum of whole-person care. Receive the Connection Enter Increased right to through any EBP Informed stability and services at community door, tell Case self- the right and natural Management your story sufficiency time supports once
Connected Community Practice $
Welcome t to Kestrel in Lo Louisville, C CO! A mixed-use inter-generational neighborhood designed within the four guiding principles of affordability, connectivity, sustainability and diversity. 200 homes • 129 1-3 bed townhomes • 17 buildings , 2 and 3 stories • Floor plans 623 to 1,310 sq ft. • A 71-unit, 3-story building for • residents with a household member age 55+ 341 total residents 128 are 55-and-over, 86 are 18-and-under 60 are living with a disability
Integrated Services: Practice Continuum Transform orming Ou g Our C Com ommunity Practice continuum highlighting family based services Navigation Practice Eligibility Supports, Emergency Assistance, Family Resource Navigation, Community Support, Primary Care Self Sufficiency Practice Case Management, TANF, Early Intervention Services, Diversion Services, Financial Development High Intensity Practice Child Welfare Ongoing Case, Crisis Services, Youth Corrections Programming, Jail, Homeless Services, Wraparound
Integrated Services: Components of Practice Self-Sufficiency High Acuity Clinical Navigation Case Management Case Management Entry Entry Entry • • • Screen Assess Assess • • • Triage and Referral Case Plan Case Plan • • • Referral Referral • • Reassessment Reassessment • • Reassessment Entry Reassessment Entry Screening Services Assessment Services Assessment Services & Programs Case Plan Case Plan
Child Welfare Referrals Boulder County New Child Welfare Referrals 600 500 400 300 200 Referrals have increased 65% since 2010 from 4,130 to 6,792 100 0 New Referrals Linear (New Referrals)
Self Sufficiency Progress Percent and Number of HHs Showing Improvement by Domain 237 90% 212 80% 70% 167 154 60% 50% 40% 66 30% 48 44 40 20% 28 27 18 10% 0% The bar highlights the percentage of households improving above the prevention line for each domain. Scores based on comparison of entry and exit assessments for households completing case management programs where initial scores indicated vulnerability for the given domain.
Housing Case Management Outcomes 1382 5030 Pre and Post 2564 Referral Counts Data looks at individuals 1084 exiting housing case management programs and Pre Referral Post Referral No Referral whether they experienced a subsequent Child Welfare Referral or Case Involvement 1210 in the 12 months following their exit from the program. Pre and Post 5030 Involvement 407 Counts 3413 Pre Involvement Post Involvement No Involvement
Integration In Action
Integration In Action 3 Kimber can continue to track her progress and interact with other resources. Boulder Connect Salesforce Client Portal STATE HHS Connect Internal Case Management System 2 Local Housing Panel reviews and approves Kimber for Housing Stabilization 3 rd Program. Connects Boulder County Integrated Party Data Warehouse Kimber to other 1 Kimber shows up at the shelter and the appropriate services. community provider assesses for risk, reviews existing data and submits a referral to Housing Panel for assistance.
Putting Families First and the Promise of Integration July 2018
55% Racial or Ethnic 36% Growth in the Senior 159,010 Children in the 6 Zip Codes of Extreme 1.04m Residents Minority Population by 2025 Public School System Need — 41% non-English Spoken at 2015 projection is 196,000 35% currently receiving Residents living <200% 33% Foreign Born home individuals FARMS Federal Poverty Level Caseload Changes for FY16 - Serving 31,000 99,000 clients served in FY17 A Staff of Over 1600 FY17 Uninsured Adults, TCA – 5% Decrease More than 130 Programs Average client accessed 1.8 Children, and services/benefits in 1.2 SNAP – 8% Decrease Over 600 Provider Contracts Pregnant Women service areas in FY17 MA – 3% Increase Montgomery County At-a-Glance.
Assessment Total # of Calls to Screening New Investigations Investigation (33% Increase) (12% Increase) Response 2500 Alternative 14,894 Response 2000 1026 830 9915 1500 1000 4829 4489 1203 1127 500 30% 49% FY'17 (JULY-APR) FY'18 (JULY-APR) 0 Calls to Screening Reports of Maltreatment FY'17 (July-Apr) FY'18 (July-Apr)
In-Home Services There have been 215 families served this fiscal year 120 100 94 96 87 91 84 79 80 75 78 77 75 60 40 20 0 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Apr-18
Out-of-Home 5% increase in the monthly average 430 426 426 425 424 423 420 419 418 415 413 413 412 412 410 405 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Apr-18
Average Length of Stay FY’18 average length of stay for all children has been 32 months 110% 100% 90% 80% 56% 60% 70% 60% 50% 40% 30% 44% 40% 20% 10% 0% FY'17 (July-Apr) FY'18 (July-Apr) 0-14 months 15+ months
New entry zip codes 20886 20912
Factors at Entry 2017 This graph represents the different types of maltreatment involved in the 142 shelters in Type of Maltreatment (N of Shelters = 142) 2017. Please note, there are several shelters that have more than one maltreatment type associated with them. Percentages do not add to 100%. Figures reflect the % of the overall cases that came in. For example, "Neglect" was involved in 88% (N= 125) of Abandonment the 142 shelters in 2017. /Relinquishment /VPA , 25% (N= 35) Sexual Abuse, 9% (N= 13) Physical Abuse, 11% (N= 15) Neglect, 88% (N= 125) 0% 20% 40% 60% 80% 100% Overall % of Cases
The Structure of HHS and Intersects with MCPS • HHS Enterprise • MCPS intersects Aging and Disabilities –Intergenerational • programming and DD kids turning 21 and entering • Integrated Enterprise adult system BHCS – MCPS kids referred to crisis center – topped Aging and Disabilities • 1700 this year – the highest referrals we have seen Behavioral Health and Crisis Services in my 11+ years. Child and adolescent mental Children, Youth and Family Services health, in home mental health for kids in care and juvenile substance abuse referrals and diversion Public Health CYF – Child Welfare, Early Childhood, Community • Services to End and Prevent Homelessness Schools, At Risk Youth and Positive Youth Office of Community Affairs – Community Development, Tutoring and Mentoring, Eligibility Action Agency Public Health – School Health, School Based Health • Centers and High School Wellness Centers, Disease surveillance SEPH – McKinney Vento protected homeless kids • and families OCA/CAA – HeadStart and Anti-Poverty • 26
Elements of a Partnership • Multiple intersects • Deep and trusting relationships at the leadership level • A clearly articulated value proposition – have answered the why and the how to get it done • A willing partner in our respective attorneys • An executed MOU that is clear and supportive of the needs of all parties • Don’t let perfect be the enemy of the good 27
Recommend
More recommend
