Georgia’s Safety Response System

Presenter: Lisa LariscyGA DHS/DFCS Project Director,Safety Response System and Differential Response

Presentation to: G-2

Date: April 03, 2014

Georgia Department of Human Services

Vision, Mission and Core ValuesVision

Stronger Families for a Stronger Georgia.

MissionStrengthen Georgia by providing Individuals and Families access to services that promote self-sufficiency, independence, and protect Georgia's vulnerable children and adults.

Core Values• Provide access to resources that offer support and empower Georgians and

their families. • Deliver services professionally and treat all clients with dignity and respect.

Manage business operations effectively and efficiently by aligning resources across the agency.

• Promote accountability, transparency and quality in all services we deliver and programs we administer.

• Develop our employees at all levels of the agency.

SRS Presentation Objectives

Georgia’s Safety Response System Origin of SRSDefining SRS Implementation Process for SRS

Status of Statewide SRS with a View of Phase One: Intake

Going Forward with SRS

•

Technical Assistance

GEORGIA

ACCWIC

NRCCPS

Develop and implement our child welfare practice and to facilitate organizational change

Build Georgia’s capacity to implement and engage resources to support a significant child welfare practice change to ensure fidelity and sustainability to that practice change - Atlantic Coast Child Welfare Implementation Center (ACCWIC)

Provide child welfare subject matter expertise to strategically support Georgia in utilizing the latest state of the art child welfare practice framework focused on safety of children – National Resource Center for Child Protective Services (NRCCPS)

Two Evidence-based Models

Implementation Phases & Drivers Framework Also used by the CB and

its T/TA Network Regional teams trained,

Pilot Counties immersed Open-source website to

support continued learning

National Safety Model Policy consultation,

Live Learning Sessions, Intensive Training Academy

Open-source website to support continued learning

Evidence based safety intervention model

http://nirn.fpg.unc.edu

http://action4cp.org

Georgia Safety Response System* Allows for and guides strategic decision making for the safety of children. • Intake Assessment /CPS Reports - A comprehensive Information gathering

and analysis process used to determine the most appropriate agency response to an accepted CPS report.

• Through initial and ongoing contacts with the family, a comprehensive safety assessment is conducted.

• At any time a safety concern is identified, it is addressed through the most appropriate safety management practice (in home/out of home).

• Safety Plans are created to control the threat of danger to the child. • A formal caregiver assessment is conducted to identify what must change

with the caregiver(s). Services will be provided that focus on enhancing the caregiver’s diminished protective capacities.

*Adopted by Action 4 Child Protection

Implementation Science*

Allows for, and helps make informed strategic decisions for: • Training, Supervision, Coaching • Internal and External Collaboration/Coordination• Feedback from practitioners and stakeholders • Perspectives from all levels of the organization are heard• Managers use data to guide implementation and align resources to

support needed improvements • Ensures fidelity and sustainability to the child welfare practice change

*Adopted from the National Implementation Research Network

(Fixsen & Blase, 2008)

Performance Assessment

Coaching

Training

Selection

Systems Intervention

Facilitative

Administration Data Driven Decisions

Adaptive Technical

Integrated & Compensatory

Com

pet

ency

Drive

rs

Com

pet

ency

Drive

rsO

rgan

ization

Drivers

Org

anization

Drivers

LeadershipLeadership

Implementation Drivers

Graphics by Steve Goodman,2009

Leadership Academy for Middle Managers • www.ncwwi.org A Service of the Children’s Bureau, a Member of the T/TA Network

Stages of Implementation

Sustainability

Innovation

Full Operation

Initial Implementation

Installation

Exploration

The Pilot

SRS Statewide Roll Out ScenarioImplementation Science

Phase 2011September 2013

December2014

February 2015

December 2015

February 2016

June2017

Exploration and ProgramDesign

√

Project Installation(Includes committeevariation to meet projectphases)

√

Initial Implementation(Staff are trained and begin practicing at the frontline ) √

Full Operation (Learning is integrated into practice policies and procedures)

Innovation (Well informed changes can be made)

Sustainability(Strategies to Support Leadership & Practitioner Changes)

SRS Phase 1 :Intake

SRS Phase 2:Family Support & Investigation

SRS Phase 3:Family Preservation & Foster Care

Pilots’ Contribution to a Successful Implementation Avoid sink or swim scenario. Detect and trouble shoot the

unexpected issues that could sink the change initiative. Practice turning “intention into action” on a smaller scale. Experiment with innovations without the pressure to predict every

twist and turn in the change process. Increase awareness that change does not happen all at once. Instill confidence that the process of change can be managed

responsibly. Feed lessons learned on what works/does not work back to

implementation planners and decision-makers.

Georgia’s Safety Response System

Status of SRS

Pilot StatusStatewide Status

SRS – Pilot and Statewide

SRS Pilot Counties Selected: Richmond/Urban/NE and Sumter/Rural/SW

SRS Counties Began Piloting the Model in Intake, Family Support and Investigations 09/2012

SRS Counties Began Piloting Family Preservation and Foster Care 10/2013 (ongoing with challenges)

SRS Phase One: Intake – began initial implementation in 09/2013

Implementation Capacity

• 60 item survey sent to pilot county and regional staff, state implementation team, state quality assurance and training

• Reflects staff perception of implementation capacity

• N=67, 45% response rate

Selection 3.84

Training 4.52

Coaching3.49

Performance Assessment

(Fidelity) 3.20

Systems Intervention 3.60

LEADERSHIP 4.40

Decision Support Data System 3.88

CO

MPE

TEN

CY

3.98 O

RG

AN

IZATIO

N

3.66Facilitative

Administration 3.45

Based on a Likert Scale of 1-7, N=64

Implementation Capacity

Shared Vision, Values & Mission 5.15

Live Learning

4.08

SRS Capacity Built as of March 2014Statewide policies are being informed

by pilot and core group of SRS Specialists

73 SRS SpecialistsSafety Response System Academy

training – Ongoing Implementation Science training

establishedSRS Fidelity Review tools for Phases

1 and Phase 2 established

SRS Statewide Implementation

A View of SRS Phase One: Intake

Intake Assessment

Objectives• Assist reporters to provide behaviorally specific, detailed information• Identify present and impending danger, vulnerable children, and diminished

caregiver protective capacities• Determine the response time • Provide resource information

• This is the first assessment of safety in Georgia’s Safety Response System.

• The Intake Assessment is a comprehensive information gathering and analysis process used to determine the most appropriate agency response.

The SRS Intake Process

Engagement with the Reporter

• Obtain as much information as possible

• Document Reporter's Specific Concerns .

• What is the reporter trying to get across concerning potential abuse and/or neglect of the child?

• Expand on vague allegations & ask probing questions

• Consider the six areas of Family Functioning & ask specific information of the reporter regarding the children and family

• Ensure that all basic information has been collected from the reporter.

Review and Application of History

●Complete Screenings on known household members

and/or caretakers

●Consider information obtained

●Does CPS history and this report indicate an

escalation in types of maltreatment, frequency of

allegations....

Does this report when combined with historical knowledge of the family

rise to the level of maltreatment as defined by GA Code and DFCS

Policy?

The SRS Intake Process

Yes

Child Safe – Family Support Assignment Five Day Response

Child Unsafe – Investigation0 to 24 Hours Response

The Intake Assessment

Six Areas of Family Functioning1. Extent of Maltreatment

• Captures the description, type and severity of maltreatment alleged

• Additionally captures the reporter’s knowledge of events (first-hand/eyewitness, 3rd party, etc)

• Identifies the alleged Maltreator• For all intakes

The Intake Assessment

2. Circumstances Surrounding the Maltreatment• What was happening when the maltreatment occurred?• Does the caregiver have an explanation?

– Acknowledgement, what were their attitudes & intentions• Captures history of past CPS involvement

– patterns of maltreatment– Identifying any progressing patterns of severity

• Identifies any protective measures taken by the non-maltreating caregiver

The Intake Assessment

3. Child Functioning• Captures day to day functioning of EACH child, whether

identified as a “victim child” or “no role”• What is each child like normally?

– Captures developmental concerns– Effects of maltreatment (emotional, psychological, physiological)– How is the child at the time of the report?– Will the child’s situation change quickly (safe at school vs. unsafe

when arriving home?)– School? On grade level? Regular classes?

Crucial in determining vulnerability of child

The Intake Assessment 4. Adult Functioning (in general)

• How does this Adult (maltreator and non-maltreator, if applicable) function as an adult?

– Captures mental and physical health (both current and past)– Identifies substance use, employment, criminal behavior/history– Indications of violence– Significant stressors present in home– How does this adult relate to his community?– How does the adult cope, problem solve, communicate, etc?

The Intake Assessment 5. Parenting (in General)

• Captures history of protective behavior (or non-protective behavior), along with parenting style (Not related to malt.)

• Identifies sensitivity to child’s needs and expectations for both the child and self

– Is the parent satisfied as a parent?– Is the parent more concerned with self than with child?– What knowledge does the parent possess of normal child

development and behavior?– How would you describe the parent/child relationship?– What are expectations for the child?– Do not gather for foster parents or house parents of CPA/CPI)

The Intake Assessment

6. Discipline (in general)• Captures parent’s approach to discipline• Identifies parent’s purpose and intention in discipline• Identifies parent’s specific discipline methods

– Does the parent remain self-control when using discipline?– Is discipline used to punish or to teach?– Is the discipline age-appropriate?– What boundaries/rules has the parent set?– How does s/he discipline the child?– When does child receive discipline?

• Do not gather for foster parents or house parents of CPA/CPI)

The Intake Assessment History

• History can often be the tipping point--the point at which we say yes, this is now an accepted report or moves us from a family support assignment to an investigation.

• A thorough review of history and application to the decision making is essential to determine appropriate disposition.

• The review of history and application of that history to the current report takes time.

Status of SRS Phase One Intake

• All Intake Staff Trained as of 12/2013 • SHINES Modifications Identified• SRS Specialists Support Activities:

– Provided Live Learning Activities– On-site Support for Intake Staff statewide– Provided individual coaching with Supervisors and intake

staff– Reviewed approximately 7000 intake dispositions– Detailed written feedback on dispositions overturned

Status of Intake Organizational Change

CICC Management In Place as of 12/2013 Electronic Reporting for Mandated Reporters in place County/Region Phone Line Transition Process Established Regions 3,4,5,7,8, 9, 13,14 & 15 transitioned to CICC Integrated Voice Recorded Message Volunteers in Place to Support Staffing Need Formal performance expectations inclusive of Georgia’s Safety

Response System concepts and practices developed and executed for intake staff.

SRS Specialists Reviews – 11/09/13 – 2/9/14

Screen Out % agreement Family support % Agreement FS/SO combined75%

80%

85%

90%

95%

100%

93%

82%

89%

93%

82%

88%

91%

95%

93%

CombinedCICCCounties

2,465Rev'd

1,880 Rev'd

585Rev'd

3,145Rev'd

2,431Rev'd

714 Rev'd

4,311Rev'd

1,299Rev'd

5,610Rev’d

SRS Specialists Review Results

Track Agr. Malt. code agr. History applied Correct PD Correct ID20%

30%

40%

50%

60%

70%

80%

90%

100%

90%

80%

75%

46%

56%

86%

78%

66%

28%

34%

88%

79%

71%

37%

45%

February 10 - 28, 2014

(Investigations)

CICC-416 rev's County- 384 rev's Combined 800 rev's

Analysis of Reviews• 88% agreement rate for ~ 7000 cases.• Activities under way to enhance understanding and practice

of SRS intake concepts related to Present and Impending Danger

• Maltreatment types and codes being revised to better guide staff in identifying maltreatment and to allow for consistent practice

• SHINES History modifications being made to allow for more efficient screening of CPS history

Questions regarding SRS Intake?

Georgia’s Safety Response System

Going Forward with SRS

SRS Phase Two: Early 2015

SRS Phase Three: Fall 2015

Going Forward with SRS Phases Two & Three

Lessons Learned from SRS Phase One: Intake Policies Finalized prior to Training and/or SHINES Design

Sessions SHINES Modifications Made Prior to Roll Out of Future Phases Continual Review of IS Drivers’ Effectiveness & Identifying Gaps &

Ways to Address (Surveys, Review Findings, Data..) Ensure Knowledge Capacity in Place Prior to Roll Out Plan of Initial & Ongoing SRS Specialists Support Prior to Roll Out Structured Collaboration with Regions through IS Region Plans

Going Forward with SRS Phases Two & Three

Adequate Staffing in Place Prior to Roll Out Strategy to ensure SRS Specialists are

Understanding and Applying the Model Effectively Advocate for and Obtain Funding for Fidelity

Review Team Ensure Effective Staff Recruitment, Selection and

Development

Preparation for Phase 2 & Phase 3

• Implementation Science Training

• Regions to develop Implementation Plans

• Staff Acquisition and Training

• SRS Project Team to support the pilot work

• SRS Specialists will continue to meet monthly and enhance their capacity and cascade learning

• SRS Academies are currently planned on an consistent ongoing basis to build capacity and model expertise

SRS Concepts for Readiness Activities

Family Functioning Assessment

• The six areas in the FFA• What information is needed in

each area?• Maltreatment – new policy • Caregiver Protective

Capacities (three types)• Analyzing the family’s

functioning

Present Danger • Understanding what

constitutes a PD Situation• How to Assess for Present

Danger• Safety Criteria –

observable, happening now & significant

SRS Concepts for Readiness Activities

Present Danger Safety Plan

• Understanding the purpose of the PD Safety Plan

• How to Plan Appropriately for Controlling the Present Danger

• How To Use the PD Safety Plan appropriately

• Informal & Formal Safety Service Providers

• Judging Provider Suitability• Conditions for Return to

the Home of the Caregiver

SRS Concepts for Readiness Activities

Impending Danger • Understanding Impending

Danger• Use and application of the

safety threshold in assessing for ID

Impending Danger Safety Plan • Understanding the purpose

of the ID Safety Plan • How to Plan Appropriately for

Controlling ID• Informal & Formal Safety

Service Providers• Judging Provider Suitability• Conditions for Return

SRS Concepts for Readiness Activities

• Identification of appropriate collaterals

• Using collaterals to fill in family functioning gaps & to support/refute information

• Analysis & Understanding of the Family’s Functioning

• Determining service providers to strengthen families

• Stages of Change• Assessing Change

Safety Response System Project Team

Lisa C. Lariscy

Project Director, Safety Response System

and Differential Response lclariscy@dhr.state.ga.us

(912) 222-5296 (BB)

Kristan Small-Isom Safety Response System Coordinator Krsmall@dhr.state.ga.us (404)463-8575 (Desk)

Ami Perryman Safety Response System Coordinator ajperryman@dhr.state.ga.us(706) 994-9104 (BB)