Minnesota Department of Human Services Child and Family ...

St. Louis County Public Health and Human Services June 2011 Child and Family Service Review i

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Minnesota Department of Human Services

Child and Family Service Review

County Self Assessment Update

St. Louis County Public Health & Human Services June 2011

St. Louis County Public Health and Human Services June 2011 Child and Family Service Review ii

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Minnesota Child and Family Service Review

Instructions for Conducting the County Self Assessment Update

Purpose of the County Self Assessment Update The county self assessment is the first phase of the Minnesota Child and Family Service Review (MnCFSR). The self assessment process provides the county an opportunity to evaluate strengths and areas needing improvement across eight systemic factors. These systemic factors provide a framework for the delivery of child welfare services and achievement of safety, permanency and well-being outcomes. The county also examines child welfare data to assess the effectiveness of the child welfare system and evaluates performance on seventeen federal data indicators.

St. Louis County Public Health and Human Services June 2011 Child and Family Service Review iii

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During the first round of MnCFSRs, the self assessment process allowed counties to identify systemic strengths and areas needing improvement, and provided a method to examine data related to safety, permanency and well-being performance. Issues raised in the self assessment were further evaluated through the on-site case reviews or community stakeholder interviews. In addition, information from the county self assessment was shared with other program areas at DHS to inform plans for statewide training, technical assistance, practice guidance and policy development. During the second round of MnCFSRs, counties will review their initial Self Assessment and, using that as a baseline, update their evaluation of core child welfare practices and systems. Counties are also asked to provide comment on strategies that contributed to improved practice and/or barriers encountered. Process for Conducting the County Self Assessment Update Department of Human Services (DHS) Quality Assurance regional consultants provide the county Self Assessment Update document at the first coordination meeting held with the county, and offer ongoing technical assistance as the county completes the document. The Self Assessment Update document includes county specific data on national standard performance along with safety and permanency data. The county Self Assessment Update is completed and submitted to the Quality Assurance regional consultant approximately two weeks prior to the onsite review. Completed Self Assessment Updates are classified as public information and are posted on the child welfare supervisor’s website. Counties are strongly encouraged to convene a team of representatives of county agency staff and community stakeholders to complete the Self Assessment Update. Children’s Justice Initiative Teams, Child Protection Teams or Citizen Review Panels are examples of community stakeholders who play a role in the county child welfare delivery system. These community stakeholders bring a broad and meaningful perspective to the evaluation of systemic factors and performance related to safety, permanency and well-being. Staff members and community stakeholders who participate in the county Self Assessment Update process also provide a valuable resource to the development of the county’s Program Improvement Plan. The agency may also consider options such as focus groups with community stakeholders or consumer groups, or consumer surveys as ways to gather information for the Self Assessment Update. Connecting the Self Assessment Update process to other county needs assessment or planning requirements, such as CCSA, maximizes the use of time and resources to conduct the Self Assessment Update.

St. Louis County Public Health and Human Services June 2011 Child and Family Service Review 1

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PART I: GENERAL INFORMATION DHS Quality Assurance staff will identify the period under review. The county is requested to designate a person who will be primarily responsible for completing the self assessment and provide contact information below.

Name of County Agency

St. Louis County Public Health & Human Services

Period Under Review

For Onsite Review Case Selection Sample: 12 Cases Period for Part IV Data Tables: __ Period Under Review (PUR) for Onsite Case Review: _April 1, 2010 – June 9, 2011___

County Agency Contact Person for the County Self Assessment

Name: Mark Nelson Title: Social Service Supervisor Address: 320 West 2nd Street Phone: ( 218 ) 726-2085 Fax: ( 218 ) 725-5186 E-Mail: [email protected]

Key Dates

Month/year of initial MnCFSR: ____October 2004

Date Self Assessment Update Submitted: 05/18/2011

PART II: SYSTEMIC FACTORS

The framework for completing the Self Assessment Update is divided into four sections: updates of systemic factors, review of program improvement plan activities, detailed responses to questions targeting specific practices, and updated ratings of overall systemic factors. Use the following guidance when responding to each of the eight Systemic Factors. Section 1: Updates. Review information the county provided in the initial self assessment and describe changes in that Systemic Factor

since the initial MnCFSR, including strengths, promising practices, and ongoing challenges. It is unnecessary to restate information provided in the initial self assessment. If the initial self assessment continues to accurately reflect a description of a particular Systemic Factor, note that no significant changes have occurred since the initial review.

Section 2: Program Improvement Plan Review. Review the agency’s Program Improvement Plan (PIP) from the initial MnCFSR. For

each systemic factor, identify whether the agency was required to prepare a PIP. If applicable, describe systemic improvements resulting from PIP activities or barriers to achieving improvement. If the agency was not required to address the systemic factor in their initial PIP, this section is not applicable (NA).

Section 3: Target Questions. Some systemic factors include a set of targeted questions designed to focus agency attention on specific

practice areas or activities. Target questions represent promising practices or practice areas identified as needing improvement in the first round of the MnCFSR. Target questions are applicable to all counties and should include more detailed responses. Provide information regarding agency practice, promising approaches or identified barriers in these specific areas. To avoid duplication, review the target questions for each systemic factor prior to responding to Sections 1 and 2.

Section 4: Ratings. Quality Assurance regional consultants will provide the agency rating for the overall systemic factor from the initial self assessment. Determine an updated rating for each Systemic Factor according to the following scale:

Area Needing Improvement Strength

1 2 3 4 None of the practices or requirements are in place.

Some, but not all, of the practices or requirements are in place and some function at a lower than adequate level.

Most, but not all, of the practices or requirements are in place and most function at an adequate or higher level.

All of the practices or requirements are in place and all are functioning at an adequate or higher level.


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A. Information System (SSIS) A1. Review information included in the agency’s initial self assessment. Consider the agency’s responses to questions A1-A4. Summarize changes in the agency’s information system since the last MnCFSR.

System Changes

The agency has scaled up needed resources and practice changes to utilize and in some ways accommodate the presence of SSIS in our practice. Written and online resources are available. Staff mentors have been developed, as well as a coordinator. Staff committees monitor SSIS developments and provide the outlook for agency planning and budgeting. Documentation and time recording work routines have become more firmly established. The reporting capacity of SSIS has become an important function.

The agency has worked on making reporting information more accessible and useful to supervisors & managers.

Managers and supervisors have access to SSIS Charting and Analysis.

A2. If applicable, how effective were Program Improvement Plan strategies in supporting improved safety, permanency and well-being outcomes?

Summary of Strengths Barriers Identified/Initial Plans

NA NA

A3. Target Question

Target Question

Describe the agency’s use of SSIS reports in supervision. Consider how reports are used during supervisory consults to monitor key case activities. The reporting capacity of SSIS is routinely tapped by supervisors for monitoring workload, reviewing work practice and compliance, monitoring placement histories, reviewing service authorizations, doing annual reports on service areas, completing customized reports on areas of particular concern, and looking at trending information. Most of these relate to case consults, but SSIS is a program consult tool as well.


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Continue to use SSIS for the county PIP and the state PIP.

The “timeliness” report goes out regularly to staff.

See note above. The agency wants to utilize the reporting capacity of SSIS to support supervisors and staff.

Overall First Round Systemic Factor Rating for Information System:

Overall Systemic Factor Rating for Information System—Current


1 2 3 x x 4

B. Case Review System B1. Review information included in the agency’s initial self assessment. Consider the agency’s responses to questions B1-B7. Summarize changes in the agency’s case review system since the last MnCFSR.

System Changes

The agency has been more strategic in managing case decisions with staff (i.e. intake meetings, pre-petitions, case assignment teams, decision-making teams, and ICWA team meetings) as well as conducting supervisory reviews of cases. The Safety Organized Practice initiative has provided a comprehensive format and means for enhancing the nature and structure of these consultations, discussions, and decisions.

Agency staff now have access to Mapping and Consultation staffings as needed in addition to the above supervisory and consultative options.

B2. If applicable, how effective were Program Improvement Plan strategies in supporting improved safety, permanency and well-being outcomes?



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The agency PIP focused in part on building up a case review practice for supervisors in 2006. This was achieved thru identifying tools and routines for doing so.

The agency works collaboratively with community partners and families to safely prevent out-of-home placements. Frequent caseworker visits with children and parents, as well as formal safety planning, supported agency efforts to monitor risk and safety.

The agency practice’s supported child relationships with tribes and families.

The agency demonstrated stronger performance on assessing needs and providing related services over the 2004 review.

The agency responsiveness to the community was a systemic strength.

The integration of Signs of Safety into practice has provided a rigorous review by use of a common language and framework.

With Signs of Safety many workers have felt more comfortable, confident, and reflective in sharing their practice which has led to better safety plans, increased accountability, and expanded use of community supports.

A change in the leadership of the county attorney’s office has expanded the capacity for collaboration with the agency – which has led to increased information sharing and strategic planning.

A key barrier was the “time” resource which continues to compromise supervisor opportunity for case reviews of “non-crisis” cases that short of having intentional review schedules would otherwise not come to the attention of supervisors. Safety Organized Practice training has continued to aid supervisors by providing a common language and format with staff for the review of cases.

Delays were evident in achieving timely permanency.

Need for additional efforts to support placement stability.

Need for timely & comprehensive relative searches.

Inconsistent practices in assessing and addressing non-resident parent needs, engaging appropriate family members in case planning, and ensuring that written case plans were provided to families.

Improve practices with fathers.

Ensure that high quality visits occur with parents and children each and every month.

Court case review system and staff turnover negatively impacted findings.

Geography challenges the agency in response to referral situations and in case planning. The county is larger than the state of Connecticut. Travel distances can be significant, and access to resources is uneven at best – and often without desired availability.

Fewer staff resources than best practice would require.

Urban/ rural count with response times compromised by distance, and sometimes severe weather.

High cost of car travel for many clients in accessing resources, and for families doing their child visits.

High incidence of families served with no/low-income, and marginal employment with limited time off to work on their case


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plan during the day.

B3. Target Questions

Target Questions

Describe how timely and appropriate permanency goals are established for children, including the agency’s use of team decision-making processes.

Agency court liaison staff, permanency case managers, and county attorney’s all work to track calendars.

Court reports document timelines.

CJI is a resource to dealing with barriers and needed supports.

Court does not always take timelines into account.

Delays in drafting related permanency petitions in the county attorney’s office have affected timeline compliance.

Improvements in timeliness have occurred since the 2009 CFSR.

Permanency options are part of supervisory reviews for CHIPS cases.

The Division Director monitors permanency reports.

Supervisors & managers meet with the county attorney to support permanency timelines.

Discussion with area tribes on how to address our mutual interests for timely permanency.

For both proposed and actual LTFC placement dispositions, reviews for other permanency options will be part of the ongoing review process.

Describe the agency’s use of Concurrent Permanency Planning and how the broader child welfare system supports these efforts. Permanency planning is central to our approach in all our child welfare cases. Whether it is active efforts in ICWA cases, reasonable efforts in non-ICWA cases, or working for reunification in a placement, the whole range of practice efforts rest on the concurrent permanency planning concept. The agency actively recruits and educates providers and permanency homes. For example, foster care


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providers understand the need for connecting with children yet simultaneously realize the possibility of parental reunification. Families and/or legal custodians are briefed on concurrent permanency planning.

Describe the agency’s use of Trial Home Visits (THV). Include agency criteria or policies used to determine when and in which cases THVs are appropriate to support successful reunification. The agency utilizes THVs where possible to enhance safety and stability during a reunification stage in CHIPS proceedings. The agency does not have a formal policy directing use of this option. However, the agency recognizes the value of THV in permitting earlier reunifications, and will continue to promote its use.

Describe changes in the county’s Children’s Justice Initiative (CJI) Team since the last review. Consider and discuss current priorities, projects, and work plans. The county has two CJI teams: one north & one south.

The south CJI meets bi-monthly and has a broad range of participants. It affords an opportunity to address compliance with IV-E, ICWA, expectations of collaterals, and updates on agency practices. In the south, a new judge is assuming the CJI leadership in 2011. Unknown yet who this may impact CJI. It may be an opportunity to further expand judge participation in CJI (and it’s related issues).

The north CJI team meets quarterly with two judges now serving as co-chairs. The team functions well, and is considering how they might address youth participation in court. (review with stakeholders).

Overall First Round Systemic Factor Rating for Case Review System:

Overall Systemic Factor Rating for Case Review System—Current


1 2 3 x x 4

C. Quality Assurance System C1. Review information included in the agency’s initial self assessment. Consider the agency’s responses to questions C1-C5. Summarize changes in the agency’s quality assurance system since the last MnCFSR.


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System Changes Case reviews occur at a minimum at critical decision-making points – intake, transfer, and closure. Checklists for intake, transfer, closing provide review clarity. Administrative reviews for Out-of-Home Placement occur. SSIS generates edit prompts, and the reporting capacity assists in reviews. Periodic/monthly case reviews with supervisor & worker. The high ratio of workers to supervisors minimizes the frequency &

depth of reviews. Safety Organized Practice case mappings occur. Pre-petition screenings occur. Weekly decision-making team reviews occur to direct workload & assess for potential closure. Weekly Family Assessment, Investigation, and ICWA team consultation meetings occur. Re-assessment of Risk is used more frequently. Plans developed to utilize Rapid Response for child maltreatment referrals. Improving collaborative efforts with the county attorney. Contracted with a local agency to provide culturally specific FGDM for African-American families and children.

With respect to the agency’s capacity to evaluate the adequacy and quality of child and family services, and the capacity to identify means for program improvement:

Children and Family Division supervisory staff and management have both an annual retreat and weekly meetings to discuss and implement program improvements. Previous actions have addressed the foster care system, out-of-home placement strategies, best practice, major service initiatives (i.e. SOP), organizational change (supervisory rotations), community meetings (Child Abuse Summits), and staffing strategies.

Agency staff have quarterly meetings with Bois Forte and Fond du Lac human service agencies to discuss best practice, improved procedures, and related developments. Monthly meetings also occur to support these efforts.

Two multi-disciplinary child protection teams have been established. They also serve as the Child Mortality Review teams for the county.

Supervisors participate in Regional Best Practice Meetings. A supervisor serves on the DHS FGDM Advisory Council. Staff are active members of the local CJI. Agency staff are active on First Witness multi-disciplinary team. Interagency review teams are in place for truancy. The agency works with other agencies, counties, and the state in supporting SOP. The agency receives an FGDM state grant and promotes the practice as an important tool for engaging families in solutions.


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The agency works with local schools and college students on research efforts related to children and family services. The agency is the grant partner with the Visitation Center for a federal OVW grant involving domestic violence. In conjunction

with this, the agency assesses it’s capacity for responding for addressing DV in the child protection services. CFS director and supervisory team conducted a meta analysis of organizational structure and processes.

C2. If applicable, how effective were Program Improvement Plan strategies in supporting improved safety, permanency and well-being outcomes?


The timeliness priorities were clear.

Engaged in implementation of 2009 PIP recommendations but the integration in practice is a work in progress.

The growing supervisory span has been a limiter on the case review practice.

Staffing resources.

Supervisor time is limited with lots of administrative demands and obligation that have reduced supervisory capacity to be as available for system and case-related support work.

C3. Target Questions

Target Questions

If applicable, discuss what the agency is learning from qualitative case reviews and how results are used to enhance practice and support system improvements. In units, teams, practice groups, and supervisory consults, the Safety Organized Practice approach to case reviews, mappings, and consultations has aided in promoting a common language in practice and the means for framing safety, permanency, and well-being questions. We believe the outcome has been to increase capacity for engaging parents, and has improved working relationships with collaterals – both of which are known by research to increase safety for children.

Describe the agency’s use of the following data reports to identify practice areas needing improvement and monitor the effectiveness of improvement strategies: Internal reports (e.g. SSIS Charting and Analysis and General Reports, Crystal, Safe Measures) DHS reports (e.g. Timeliness of Initiating Assessment, Performance Updates)


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Other Dave Glesener

Overall First Round Systemic Factor Rating for Quality Assurance System:

Overall Systemic Factor Rating for Quality Assurance System—Current


1 2 3 x x 4


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D. Staff and Provider Training D1. Review information included in the agency’s initial self assessment. Consider the agency’s responses to questions D1-D5. Summarize changes in the agency’s staff and provider training system since the last MnCFSR.

System Changes

The agency has been strategic in the provision of training for new and experienced staff that covers the CPS minimum of fifteen hours, but more importantly provides a foundation for practice (Core Training), and promotes use of Safety Organized Practice. Pre-service and First Year Training of Foster parents (refer to the D3 answer for detail) has continued.

The agency received a DHS grant to provide area leadership in support of Signs of Safety training and support for an expanded practice of the same. In addition, the county supports a variety of staff trainings related to Signs of Safety.

D2. If applicable, how effective were Program Improvement Plan strategies in supporting improved safety, permanency and well-being outcomes?


Case review as strengthened by the Safety Organized Practice initiative. Increase of case consults including mappings, and utilization of SOP tools in case discussions and presentations.

Foster care training.

Span of supervision limitations.

Unclear and uncertain directions in CHIPS practice in south St. Louis County. Permanency not always viewed as a priority. Child interest seems to be subordinate to child interests.

Parent/Guardian/Child Visitation in CHIPS proceedings unevenly managed, and not clearly related to child interests with respect to frequency, duration, and safety.

D3. Target Questions

Target Questions


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Describe training needs identified in the county’s initial MnCFSR and whether the county was able to access training that was effective in addressing areas identified as needing improvement. NA – But the county has been able to secure basic needed training, and develop and maintain training initiatives (i.e. Safety Organized Practice). Nevertheless, the ongoing limitation of resources has limited access to wider participation in state and national conferences which would otherwise enhance practitioner development. In a time of resource shortages, the funding of training can be a challenge.

Describe resources/strategies the agency uses to promote stable placements by preparing foster parents and supporting them in meeting the needs of children. Identify efforts to match children to specific foster care providers and enhance their capacity to meet children’s needs (e.g. training to address child specific needs). A Professional Development Coordinator continues to handle the organizing, updating and professionalizing the process of pre-service and in-service training for foster and potential adoptive homes. Pre-service & First Year Training

As a result over the last five years our foster care program developed a strategic plan that includes an initial inquiry call that helps the potential foster parent to determine if foster care is a good fit for them and an invitation to the next group orientation, a 2 hour orientation that gives further, more in-depth information about the realities of doing foster care and an opportunity to apply to our foster care program, and 7.5 hours of Early Service Training that gives a thorough overview of what our agency expects from our foster families.

Each of these pieces give increasingly in-depth information about the children and youth in foster care, the child’s family and culture, and what is needed to work the team approach to foster care that we promote in St. Louis County.

Following licensing each person has 1 year to receive at least 12 hours of training in six core topic areas. These trainings cover child development and attachment, the effect of abuse on child development, culture and working with the child’s family, positive parenting and behavior management, and health and safety issues in foster care. Ongoing In-service Training

Each foster parent must receive at least 12 hours of training per year. Our strategic plan includes Advanced Training Levels 1, 2, and 3. This training model is designed to move a person from general knowledge on a specific issue related to foster care towards competency and integration of new skills into the care of foster children. All of the recommended training topics contained in DHS rule 2960 as well as many other topics are covered. Method of Training Presentation


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These classes are often presented in a 2 hour face to face setting but in levels 2 & 3 move into a 6 – 8 hour format often with multiple classes offered on the same topic to build in transfer of learning.

Our program has invested and built up an in-house Resource Library for the use of foster families that includes DVD’s, Video’s, Audio tapes, books, and handouts on a wide variety of topics related to the care of foster children. These materials include introductory (level 1) information as well as much more in-depth level 2 & 3 materials.

Our program also has numerous on-line classes pre-approved that foster families can access to fulfill their training requirements. Evaluation of Training Needs Each member of the licensing team meets with their foster families and discusses training needs of the foster home during re-licensing. Those needs are then relayed to the PD Coordinator and integrated into the annual planning of training. The PD Coordinator also reviews all training evaluations noting what classes are going well, and any other training needs foster parents indicate and interest in. The PD Coordinator is also connecting with agency child protection staff to get recommendations related to foster parent training based on their interactions and contact with our foster families. Evaluation of Training Effectiveness During the re-licensing process training the foster families participated in are discussed and transfer of learning is evaluated. Recommendations for changes are relayed to the PD Coordinator as needed. An evaluation is offered on the content of the training and the effectiveness of the trainer during each training session. That information is utilized by the PD Coordinator in the planning process of future trainings.

Efforts to strengthen child welfare supervision have included local supervisor training, leadership core (DHS), and child welfare supervisor training (DHS).

The University of Minnesota – Duluth and other area university training is available.

Agency training is provided.

The annual St. Louis County Human Services Conference provides a whole range of applicable trainings – and affords an opportunity for the agency staff to provide training for our child welfare collaborative partners.

Every two years the agency conducts north and south county foster care fairs that involve foster care provider appreciation, connection to the community, support, and recruitment.

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Overall First Round Systemic Factor Rating for Staff and Provider Training System:

Overall Systemic Factor Rating for Staff and Provider Training System—Current


1 2 3 X 4 x

E. Service Array and Resource Development E1. Review information included in the agency’s initial self assessment. Consider the agency’s responses to questions E1-E3. Summarize changes in the agency’s service array and resource development system since the last MnCFSR.

System Changes The agency continues to be more intentional in efforts to engage the broader community in our “practice.” Further our partnership with other counties in county-initiated core training developments (SOP) reflects on the agency’s desire to effectively and efficiently manage our limited resources in providing safety and services for families and children. A summary of where the agency is today is as follows: The agency provides intense services as early in our involvement with families as possible in order to resolve issues that address

child safety concerns and related issues that may increase the possibility for an out-of-home placement. The agency incorporates prevention and intervention efforts that include: Family Assessment and Family Assessment case

managment, and Family Outreach (child welfare assessment and voluntary services),. In addition, the agency provides a variety of other related program services that build capacity for families to safely care for their children (Children’s Mental Health, Home Care Specialists, Respite Care, Respite Day Care, Intensive Family-Based Services, Extended Family Services, Teen Parent Program, Truancy – Interagency Review Team, and CADI Case Management).

The agency partners and contracts with a number of community agencies to provide related services. These include day treatment services, prenatal services, mentoring, Families First with Fond du Lac, and the Superior Babies program.

The agency would like more wraparound services, respite care providers, daycare services, and culturally suitable foster homes. Limited resources available to support relatives who obtain custody.


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Limited jobs are available for support or retention of extended families in the region. Schools have limited the educational support available for students with special needs which compromises the success of the

student and their family, and in some cases this forces the placement of a child outside of their community only to have their educational needs met.

Reduced waiver funds. Focused on effort to prioritize use of Fond du Lac homes for Indian children needing foster care in south St. Louis County. With a DHS grant, the agency is developing and providing a community of Signs of Safety Practice in NE MN with counties and

tribes. Provision of culturally appropriate FGDM services. Community-based CMH with Northwoods Children Home program in order to stabilize children in homes. Entered a new service model with HDC for trauma-based services for stabilization and reunification. Family drug and dependency court. Adolescent transition to adulthood position within the Division. Worked with a group home provider to establish a transition program for adolescents in need of a structured setting for care

(Little Sands Group Home Choices program). .

E2. If applicable, how effective were Program Improvement Plan strategies in supporting improved safety, permanency and well-being outcomes?


NA

E3. Target Question

Target Questions


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Identify how Structured Decision Making (SDM) tools are used in supervision to guide case decisions and/or to match services to families’ needs. Describe practice or policy changes related to the use of risk reassessment and reunification tools.

SDM tools are completed.

SDM tools are referenced in case transfer discussions and meetings.

Helps to determine where case is best served (or closed).

Used in conjunction with SOP.

Safety tool is used but less frequently referenced in light of SOP resources.

Overall First Round Systemic Factor Rating for Service Array and Resource Development System:

Overall Systemic Factor Rating for Service Array and Resource Development System—Current


1 2 3 X x 4

F. Agency Responsiveness to the Community F1. Review information included in the agency’s initial self assessment. Consider the agency’s responses to questions F1-F7. Summarize changes in the agency’s responsiveness to the community since the last MnCFSR.

System Changes

Continued increase in the per capita incidence in child maltreatment referrals for the county.

The county has significant numbers of low-income residents (i.e. 30% in Duluth), which correlates with higher incidences of child maltreatment, and increased instability of family units.

The struggling economy simultaneously reduces opportunities for financial and social stability of families, and reduces (and


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sometimes eliminates) needed human services resources to assist them.

The State of Minnesota has a low spending priority for state funding of needed child welfare and protection services (since 1996 Minnesota ranks 48th of 50 states in level of state funding for child welfare services – leaving local units of government with the funding burden). Working with local communities becomes critical in resolving child welfare issues.

Family Group Decision Making (FGDM) remains an effective means for finding family (read community) solutions.

While there has been a concerted focus to not rely on “child placement” solutions, there nevertheless has been a rise in placements. Reduced resources continue to frustrate this effort (i.e. community supports such as library services and recreation).

F2. If applicable, how effective were Program Improvement Plan strategies in supporting improved safety, permanency and well-being outcomes?


F3. Target Question

Target Question

Describe agency efforts to include external stakeholders (e.g. child protection teams, tribes, local collaboratives, courts, etc.) in the development and implementation of the Program Improvement Plan.

Collaboration with universities (UMD, St. Scholastica)

Foster care reviews.

ICWA Tribal Partners meetings.

Multi-disciplinary team review of cases.

Inclusion of stakeholders in meetings.

Presentations at CJI.

County attorneys in pre-petition meetings.


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Discussions with judges.

Meetings with GAL.

Methadone clinic meetings.

HDC trauma-based program.

SARB – Student Attendance Review Board with ISD 709, corrections/probation, and community partners to reduce truancy .

First Witness multi-disciplinary team.

Modified service from residential programs (i.e. Choices with Little Sands Group Home and In-home CMH services from Northwoods).

Overall First Round Systemic Factor Rating for Agency Responsiveness to the Community:

Overall Systemic Factor Rating for Agency Responsiveness to the Community—Current


1 2 3 4 X x

G. Foster and Adoptive Home Licensing, Approval and Recruitment G1. Review information included in the agency’s initial self assessment. Consider the agency’s responses to questions G1-G2. Summarize changes in the agency’s foster and adoptive home licensing system since the last MnCFSR.

System Changes


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The agency continues to maintain a professional development coordinator who oversees a comprehensive training program that aids in development, retention, and hopefully overall satisfaction of homes serving St. Louis County.

The agency foster care program is exploring a partnership with UMD’s Regional and Tribal Partner’s Program to develop a recruiting strategy.

The agency foster care program will prepare for and conduct an emergency preparedness drill in the Fall of 2011.

Concerning disparities, a special development was completed by an MSW intern (who is also a SLC staff member) in 2009 to recruit African-American families to serve as foster homes. Also, Fond du Lac Social Services and St. Louis County have had special meetings to assess utilization of various foster care options in ICWA cases, and subsequently worked to give priority to homes licensed by the band.

The SLC foster care program underwent a thorough internal assessment that resulted in 17 targeted areas for change and improvement. Significant progress has been achieved.

G2. If applicable, how effective were Program Improvement Plan strategies in supporting improved safety, permanency and well-being outcomes?


Disparities initiatives.

Review and implementation of change in foster care program.

Have increased cultural diversity in foster care.

Recruitment and retention of African-American foster homes.

Need further work on cultural diversity in foster care.

DHS moratorium on corporate providers has limited beds for children with disabilities.

Overall First Round Systemic Factor Rating for Foster and Adoptive Home Licensing System:

Overall Systemic Factor Rating for Foster and Adoptive Home Licensing System—Current



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1 2 3 X x 4

H. Supervisor and Social Worker Resources H1. Review information included in the agency’s initial self assessment. Consider the agency’s responses to questions H1-H4. Summarize changes in the agency’s supervisor and social worker resources since the last MnCFSR.

System Changes

The organizational chart may be similar but the organizational ways of working are of note. The agency has expanded reliance on cross-unit functions:

Pre-petition meetings occur on cases considered for CHIPS – and are discussed in a Signs of Safety context.

Permanency planners meet weekly for case assignment and discussion of practice issues.

Intake for ICWA is specialized in one unit, but overlaps with the Initial Intervention Unit.

Division Decision-Making Teams determine unit assignment, and sometimes case closure status.

Social service specialists serve across unit boundaries.

FGDM is a division wide resource, including a special outside agency contract for FGDM for African-American families and children.

Teaming cases across units to provide broader supports for staff.

Peer support efforts are under development for child protection staff to expand support and mitigate turnover given the difficulty of child protection work. .

The high supervisory span of control continues to be a concern.. Caseloads also exceed the CWLA prescribed levels.

Training of new staff draws down resources because of the higher turnover. Despite this hurdle, the agency endeavors to promote and train in the use of Safety Organized Practice.


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H2. If applicable, how effective were Program Improvement Plan strategies in supporting improved safety, permanency and well-being outcomes?


Emphasized cross-unit supports and teaming, and multiple and comprehensive organizational decision-making formats.

Intensive Family-Base Services work across units providing active efforts and reasonable efforts.

ICWA case managers work with area tribal case managers to serve ICWA eligible children.

With the agency implementation of Signs of Safety, work has focused on efforts with early intervention, rapid response, rigorous assessments and safety planning, expanded use of FGDM, and collaboration with family and community partners.

Limited resources mean broad supervisory span of control – for both programs and staff.

Overall First Round Systemic Factor Rating for Supervisor and Social Worker Resources:

Overall Systemic Factor Rating for Supervisor and Social Worker Resources—Current


1 2 X x 3 4

Community Issues Review the information the agency provided in the initial Self Assessment. Discuss changes or community issues that have emerged since the last MnCFSR that could impact planning and delivery of services to children and families and achievement of safety, permanency and well-being outcomes.


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Diminished resources – program and staffing cuts, and less accessibility.

Increased stress on family systems, poor economy.

More restricted categories of available resources – with problematic funding and service mandate issues.

Cuts in primary prevention and community resources (i.e. Parks & Rec, and libraries).

Low participation by the state in funding children’s services (Minnesota ranks near the bottom nationally in providing funding for child welfare services – leaving local government with mandates and the financial responsibility for essential funding of services).

More strategic agency involvement with community providers – CP Summit, ICWA, DAIP-Supervised Visitation Center (OVW Grant), and Family Group Decision-Making (FGDM).

Collaborations – probation screeinings, CJI, Inter-Agency Review Team (IRT), ICWA Dialogue meetings with area tribes.

Several year trend of higher child maltreatment numbers.

No abatement in disparities of out-of-home placement or child maltreatment numbers for children and families of color.

The poverty rate continues to increase, especially for children.

School systems are under tremendous economic pressure.

Bois Forte expanded its child protection & child welfare system (tribal court, on reservation tribal maltreatment response now provided). (rescinded from P.L. 280).

Many community problems are increasingly viewed by corrections & law enforcement as “social problems”.

The economic downturn of 2008/9 and the related reduction of resources continues to challenge the agency especially given increasing needs.


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ART III: ASSESSMENT OF SAFETY, PERMANENCY AND WELL-BEING PERFORMANCE Use the five-year trend data supplied by DHS along with other SSIS reports to examine the agency’s performance and respond to the following safety, permanency and well-being questions.

A. Safety

Outcome S1: Children are, first and foremost, protected from abuse and neglect.

Outcome S2: Children are safely maintained in their homes whenever possible and appropriate.

1. Safety Indicator 1: Absence of Maltreatment Recurrence (Table1). If the county met the national standard, identify factors that contribute to strong performance. If the county did not meet the national standard, identify and discuss barriers.

Issue may be a screening practice that puts the county below the national standard.

Data may not accurately reflect recurrence.

The agency has continued to focus on best practice, including Signs of Safety.

Quality supervision has contributed to supporting and providing best practice.

Barriers –

New staff training.

Resource issue – limited staff.

2. Safety Indicator 2: Absence of Child Abuse/Neglect in Foster Care (Table 1). If the county met the national standard, identify factors that contribute to strong performance. If the county did not meet the national standard, identify and discuss barriers.


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Data appears to include facilities that are not licensed or controlled by county (i.e. correctional facilities).

Barriers may include:

Continue to work on recruitment, training, support, and regular contact by the family worker.

The expectations are high – previous concerns still apply.

3. Trends in Child Maltreatment (Tables 2-3). Examine the data on reports of child maltreatment. Identify trends and factors that may have contributed to an increase or decrease in the number of maltreatment reports.

Child maltreatment in St. Louis County continues at a persistent pace.

The Family Assessment track is used for a majority of child maltreatment responses.

Poverty is high – which correlates with higher child maltreatment (6X).

More Domestic Violence reported.

Prenatal exposure definition expanded.

Apparent increase in drug use (i.e.meth & lower cost drugs).

New screening guidelines for child maltreatment in 2007.

Threatened injury reports.

Fewer affordable housing resources in Duluth.

4. Family Assessment (Table 3). Describe protocols or criteria that guide the assignment of child maltreatment reports for a Family Assessment or investigation. Describe the process the agency uses to determine when track changes may be necessary.


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St. Louis County is currently using Statewide Screening Guidelines. The default response for all reports of maltreatment is Family Assessment unless the report alleges substantial child endangerment or there is a significant history of trying to engage parents regarding concerns without success. There is also a case assignment team that is used to make decisions on more complicated cases, including a screener, intake supervisor and intake worker. Track changes can be made by the case consult team or in consultation with the supervisor. Changes are based on new information regarding immediate safety concerns or learning that an investigative response is not required and we can engage parents in a plan.

The agency maintains a ratio consistent with state averages.

5. Timeliness of Initial Contact in Assessments or Investigations (Tables 4-5). Examine the data on timeliness of initial contacts. Identify factors that contribute to timely face-to-face contacts with children, and factors that contribute to delays.

Factors that contribute to a timely response include: daily intake meetings where response times are prioritized, the non-offending parent and child are accessible and there are adequate resources to respond. Factors that contribute to delays are inability to prioritize historical abuse cases where the child is not having contact with the alleged offender (no current abuse issue but still substantial child endangerment), coordination with law enforcement when they lack resources, coordination with law when they request we delay contact for criminal investigation reasons and inability to locate the child and non-offending parent after numerous attempts.

The agency is working with DHS on a county specific effort to develop strategies to monitor and manage timely responses.

6. Alcohol and Other Drug (AOD) Issues (Tables 6-7). Describe agency practices for addressing the needs of children and families experiencing difficulties with alcohol or other drugs. Examine worker competencies and training needs related to addiction, treatment, and relapse planning. Identify promising approaches or current barriers to addressing substance


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use issues.

Promising approaches include:

CHIPS drug court.

Expansion of prenatal exposure – connecting expectant mothers with services (Superior Babies).

PHN connection to Social worker services in DEC.

CD unit does Rule 25 evaluations.

Presentations on CD for staff at Best Practice meetings.

Barriers include:

Availability of needed treatment options – system is getting better at identification and enforcement – but not getting better with treatment success.

7. Other Safety Issues. Discuss any other concerns, not covered above, that affect safety outcomes for children and families served by the agency.

Mental health issues of parents is a major factor affecting child safety and well-being.

Positive development:

Better safety planning with families due to Safety Organized Practice initiative.

Individualized worker focused on transition for older children in foster care.


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B. Permanency

Outcome P1: Children have permanency and stability in their living situations.

Outcome P2: The continuity of family relationships and connections is preserved for children.

1. Permanency Composite 1: Timeliness and Permanency of Reunification (Table1). Identify and comment on overall strengths and barriers to the county’s performance on the four measures included in Permanency Composite 1.

Better than the national average for reunification in 12 months. Strengths include:

Tracking, documentation, reports.

Level IV’s reviews of child placement.

Clerk monitoring of timeliness on discharge.

Barrier:

Challenged with a cohort of child placements that are for a longer period of time.

Many ICWA placements take longer to reunify, or they often result in Long Term Foster Care rather than a permanency option.

2. Permanency Composite 2: Timeliness of Adoptions (Table 1). Identify and comment on overall strengths and barriers to the county’s performance on the five measures included in Permanency Composite 2.

Strengths:

Adoption occurs in less than 24 months due to staffing focus (i.e. step-parent adoptions).

Barriers

Delayed process with families from jurisdictions other than the county.


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Some financial disincentive to transition from foster care to completed adoption for families.

Understaffed for the workload – which reduces the needed face time with families that would otherwise move things along faster for adoptions.

Inflexible enforcement by state in the “non-splitting” of children.

3. Permanency Composite 3: Permanency for Children and Youth in Foster Care for Long Periods of Time (Table 1). Identify and comment on overall strengths and barriers to the county’s performance on the three measures included in Permanency Composite 3.

Occurs yet we do have regular reviews.

Courts and GAL are supportive of children not returning home – no other suitable options.

Rare to have children over 16 placed in LTFC, so children reaching 18 have been there for some time.

Per DHS policy, continuing to inform children in foster care about options in foster care past the age of 18.

4. Permanency Composite 4: Placement Stability (Table 1). Identify and comment on overall strengths and barriers to the county’s performance on the three measures included in Permanency Composite 4.

Barriers:

Relative placements are frequently unstable.

ICWA standards may be met the prescribed placements (i.e. relative), but the concurrent expectations for placement stability become a challenge to meet.

Disturbed children with MI are frequently placed in least restrictive settings – but frequently disrupt in care.


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Strengths:

New service development with provider to offer in-home aftercare service for support and stability of reunification.

5. Relative foster care (Table 9). Describe agency efforts to promote timely relative searches, emergency licenses and relative foster care placements. Include a description of agency efforts to consider both maternal and paternal family members, and outline strategies for supporting stable relative placements.

Strengths:

ICWA has designated staff person for relative searches & home studies.

Family Group Decision-Making (FGDM) generates relative information.

Pre-petition meetings address relative/family questions.

Transport kids to other states as needed.

Agency discussion (occurs in FGDM, pre-petition meetings, intake screening, and case mappings) makes special note of fathers and paternal family information and participation.

Challenge:

Supporting relative placements could be improved with more frequent contact & identification of local supports.

6. Long-term foster care. Describe the agency’s current practices related to the use of long-term foster care as a permanency option for children. Include information regarding the process for identifying and ruling out other, more permanent options, and the process for reassessing the ongoing appropriateness of the long-term foster care goal.

Viewed as a last option.

Look at relatives first ICWA.


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Note Question 5 answers.

Level IV assesses LTFC, and the Division periodically reviews these cases.

One social worker is now specialized with LTFC focusing on preparation for independence. Building on similar previous experience with another worker.

7. Other Permanency Issues. Discuss any other issues of concern, not covered above, that affect permanency outcomes for children and families served by the agency.

C. Well-being

Outcome WB1: Families have enhanced capacity to provide for their children’s needs.

Outcome WB2: Children receive appropriate services to meet their educational needs.

Outcome WB3: Children receive adequate services to meet their physical and mental health needs.

1. Parent involvement. Discuss strategies the agency has implemented since the last MnCFSR to improve performance in the following areas:

Engaging fathers in needs assessment, service delivery and case planning. Identify promising approaches or current barriers to involving fathers.

FGDM north and south.

Bigger push to find out about the non-custodial parent.

Visits arranged for non-custodial parent.

Issue always discussed in decision-making related meetings.


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Support adjudication via county attorney office referrals for testing.

IFBS helps non-custodial parents.

Father’s legal clinic.

Engaging non-custodial parents in needs assessment, service delivery and case planning. Identify promising approaches or current barriers to involving non-custodial parents.

FGDM north and south.

Bigger push to find out about the non-custodial parent.

Visits arranged for non-custodial parent.

Issue always discussed in decision-making related meetings.

IFBS helps non-custodial parents.

Engaging families of color.

In relation to both disparities and the need for culturally relevant & appropriate services, the agency has established an additional FGDM program staffed by an African-American social worker with a program to serve African-American families - in order to further facilitate engagement with agency services.


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2. Caseworker visits with children (Charting and Analysis Reports SSIS4 and SSIS5). Describe the agency’s process for determining the frequency of face-to-face worker visits with children. Identify promising approaches or current barriers to frequent worker contact. Describe caseworker practices that contribute to quality visits with children.

Agency monitors monthly contacts, and alerts workers to the need.

Built into case plan, and referenced in OHP.

Issue covered in supervisory reviews and consults on case.

Safety Organized Practice principles presume contact with child where physically possible.

Geography and relative placements (frequently at a distance) create an ongoing challenge to meet this goal.

3. Educational status of children. Describe current agency practices for ensuring that children’s educational needs are assessed and addressed through services. Identify promising approaches or current barriers to addressing children’s educational needs.

Barriers

Truancy interventions have been problematic in coordinating efforts.

Promising practices

North – multi-agency review team.

Advocacy skills of staff (knowledgeable of special education, IEP).

Court has expectation of accountability of this child need.

Children allowed to remain in foster care while completing high school & beyond.


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Mandated reporter training available & provided to school personnel clarifying educational neglect, truancy, and child maltreatment.

Family Outreach to address educational needs.

4. Health care for children. Describe current agency practices for ensuring that children’s medical and dental needs are assessed and addressed through services. Identify promising approaches or current barriers to addressing children’s health care needs.

Child find referrals.

Working more with Public Health staff.

Integration of Public Health and Human Services.

Promoting provision of physical and dental within 30 days of placement.

Helping clients find dental care.

SMRT process in place to access TEFRA for children.

5. Mental/behavioral health care for children. Describe current agency practices for ensuring that children’s mental and behavioral health needs are assessed and addressed through services. Specify practices that support timely completion of Children’s Mental Health Screening Tools to inform case planning. Identify promising approaches or current barriers to addressing children’s mental health needs.

Designated a lead person to make sure screenings are done.

Monitor numbers of screenings (we are above the state average).

Tremendous improvement in screening trend for the agency.

Specialized CMH units – workers trained in the assessment tools.

CADI services and worker specialization to support provision.


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6. Other Well-being Issues. Discuss any other issues of concern, not covered above, that affect well-being outcomes for children and families served by the agency.


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Part IV: Safety and Permanency Data

DHS provided St. Louis County with five years of trend data (2005 to 2010) for consideration in review of the county’s current self-assessment.


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DHS Research, Planning and Evaluation DHS Child Welfare Data Release Report

PART V: SUMMARY OF STRENGTHS AND NEEDS Based on examination of data and narrative responses provided in early sections of this report, summarize the information in response to the following questions.

1. What specific strengths of the agency’s programs have been identified?

Community partnerships. Safety Organized Practice focused on engaging families. The agency provides intense services as early in our involvement with families as possible to resolve issues that address child

safety concerns and related issues that may increase the possibility for an out-of-home placement. The agency incorporates prevention and intervention efforts that include: Family Assessment and Family Assessment case

managment, and Family Outreach (child welfare assessment and voluntary services),. In addition, the agency provides a variety of other related program services that build capacity for families to safely care for their children (Children’s Mental Health, Home Care Specialists, Respite Care, Respite Day Care, Intensive Family-Based Services, Extended Family Services, Minor Parent Program, Truancy – SARB/School Attendance Review Board, Truancy Review Team North – TRT, and CADI Case Management).

Focus on ICWA – specialized units. Effort directed at special initiatives (i.e. Family Group Decision-Making, Family Drug Court, Domestic Violence grant). Organizational development and practice within the CFS Division.

2. What specific needs have been identified that warrant further examination in the onsite review? Note which of these needs are the

most critical to the outcomes under safety, permanency and well-being for children and families in the county.

Racial disparities concerns. Maltreatment responsiveness (timeliness has been met if child is with the offender)

o Resources decreasing. o Violence increasing.


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o Some things not immediate safety risk – so prioritized (i.e. ed.neglect). Very difficult cases with few suitable resources.

o Multi-problem “deep-end” Would like to know if there might be community services – that if in place – would improve our outcomes? Uncertain and reduced third-party and government funding. Sustained increasing trend of child maltreatment referrals. Recurring threats of violence from clients to child protection staff.

3. Please complete the following evaluation of the county self assessment process in terms of its usefulness to the county and

recommendations for revision. a) Were you allowed adequate time to complete the county self assessment process?

Yes x X No Comments:

b) Did you find the data provided helpful to your evaluation of safety, permanency and well-being performance? Yes x No

Comments:

c) Did you engage county child welfare staff and/or community stakeholders in the county self- assessment process? Yes No x

Comments: The supervisors were the final “voice” for the self-assessment, but intended to reflect what staff and our community partners have been telling us – as well as offering our perspective. So in the end, it is a mix – but the supervisors were the only ones to specifically engage with these questions. The same is true for 2011.

d) Did you find the county self assessment an effective process for evaluating your county’s child welfare system? Yes x X No

Comments:


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e) Will you use findings from the county self assessment to plan for systemic and/or organizational improvements in your county’s child welfare system? Yes x X No

Comments:

f) Any additional comments or recommendations for improving the self assessment process: The on-site pre-visit by DHS staff was valuable in understanding the and preparing for the audit. The lead staff from DHS (Steve Johnson) has been very accessible, and responsive to the agency.

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