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HomeMy WebLinkAboutThe Alliance THE ALLIAN CE >>, Volume 1, Issue 1 NO\~ember 2001 Community-Based Care in Florida Florida's legislatively mandated plan to transition the child welfare system to community- based care will be the largest and most ambitious initiative of its kind in the country. The state is making good progress and the children served are reaping the benefits. LEGISLATIVE MANDATES In 1996, the Florida Legislature mandated that the Department of Children and Families (DCF) establish pilot programs during fiscal year 1996- 97 that privatized child welfare services through contracts with community-based agencies. The stated purpose was to strengthen the support and commitment of communities to actively participate in the care of children and families within the child protection system and to increase the efficiency and accountability of the system. One of the four original pilots, Sarasota county in District 8 remains fully intact. Additional sweeping legislation was passed during the 1998 legislative session. Florida Statute 409.1671 amends the original privatization legislation in several significant ways. DCF had to submit a plan by July 1, 1999 for privatizing all foster care and related services by 2003. The legislation defined" related services" as family preservation, independent living, emergency shelter, residential group foster care, therapeutic foster care, coII/illlled 0/1 page 2 INSIDE THIS ISSUE 1 Community-Based Care in Florida 1 Welcome to the Alliance 3 Putting Ourselves in Their Place by Luanne Panacek 4 Kansas Child WeHare Reform by Dr. Patricia Sokol 5 Alliance Contest w=-,....,.... Announcing ,....,....~ A New Communication from ~n~ty, ~~ ~'l'l, ':&."''\ ~,\ ':~ y: '. ,- 'tJ) o + "' -.'" CD U r iLl '".Q, .~'/ 's. ~ a:t:@ Communities Building Better lives for Children and Families Welcome to the inaugural issue of the ALLIANCE, a quarterly newsletter designed to inform and educate the 500+ members of 32 Community Alliances covering all 67 counties in the state of Florida. The ALLIANCE contains a diverse collection of information and educational articles tailored for people participating in the local Community Alliances. Created by the central office of Community- Based Care (CBC), Department of Children and Families (DCF), this newsletter is another tool used by CBC to actively support emerging private-public partnerships. Published quarterly and distributed primarily through electronic means, this newsletter will contain information on Florida Community-Based Care issues, Community Alliance topics and activities, updates on the Community- Based Care initiatives across the nation and other related articles of interest. The ALLIANCE will be distributed to members of Community Alliances, whose function it is to ensure community participation as state- provided Child Protective services are assumed by local, high quality non- profit human service agencies. Please make as many copies and distribute this newsletter as you see fit. These newsletters will be posted on the DCF website and can be located by going to: http://wwwS.mvflorida.com/cf web/m\.florida2/healthhu man/publications/pubs.htmL Once you arrive on the "publications" page, scroll down to the section titled Community- Based Care where you will find the newsletter in a pdf format ready for viewing or do"nload. .!21 IA. ..!ltX/IIiC / CBC ilf F/onda - mlftilflled pm jJage ! intensive residential treatment, foster care supervision, case management, post-placement supervision, adoption, permanent foster care, and family reunification. In 2001 the statute was amended to say" include, but not limited to .." (the stated programs). Child protective service intake and investigations - the only child welfare services not covered by privatization- will remain in the public sector, to be managed by the department, or by the sheriff's departments. in some counties. Over time, the "label" describing the initiative has changed from privatization to community-based care (CBC) to better reflect the true intent of the legislative mandate and the mission of the Department: "... to work in partnership with local communities to ensure the safety, well-being and self-sufficiency of the people we serve." The state has sought input from hundreds of stakeholders in dozens of focus groups in all districts to get a sense of how the system could be further improved as the state makes the transition to community-based care. The Department was particularly interested in building partnerships in the community to significantly impact the quality, effectiveness, and efficiency of services at the local level to support the Lead Agencies. Based on the success of such efforts in the Sarasota pilot, Florida Statute 20.19 was enacted in 1999, making the Community Alliance the central point for broad- based community input and collaboration. The Alliances are comprised of mandated partners and other community stakeholders including community leaders, client representatives, and funders of human services in each community. While the legislation in Chapter 20 listed specific duties for Community Alliances; it did not limit the scope. As stated, Community Alliances will provide for resource utilization and development, needs assessment, establishment of community priorities, development of outcome goals, provision for community education and advocacy, and promotion of prevention and early intervention services. Currently, there are 32 Alliances representing the interests of communities in all 67 counties in our state. Key Features: . Florida's Community-Based Care Lead Agency model will be statewide. . Lead Agencies will be "competent, community-based nonprofit agencies or public entities." . The state, through an Invitation to Negotiate (I1N) process will select Lead Agencies, each responsible for a geographic area that is no smaller than a county. . The Lead Agencies will work in partnership with the department and a diverse group of community stakeholders. . The Lead Agencies will operate under a global budget transfer, assuming close to full risk for the costs of all child welfare services and supports needed by all enrolled children and families. . The state expects full implementation of CBC by 2004. . The state recently established a Risk Pool that providers can access when the number of new cases increases by a predetermined percentage. . Lead Agencies have the opportunity to access other funding sources including Medicaid. . Lead Agencies can individually design their service delivery system to meet the needs of their community. GOALS The principal goal is to achieve better outcomes for vulnerable children and families served by child welfare. In the Invitation to Negotiate (I1N) competitive procurement process, the Department cites goals that are consistent with the Adoption and Safe Families Act and other legal mandates. For example, the Department cites these broad goals in their recent ITN's: . Children experience safety and will be protected from abuse and neglect. . Children will have timely permanency and stability in their living situations. . Children "ill experience improvements in functioning and well being. . There will be increased community ownership of the child protection system. POPULATION As previously noted, the Lead Agency will serve all children and families in need of foster care and related services. The state has developed a projected timeline for the complete phase-in of community-based care statewide. (The time line may change as community readiness will drive when the initiatives are actually launched.) When fully implemented, the CBC Lead Agencies will serve over 70,000 children and families each year. ROLES AND RESPONSIBILITIES Lead Agencies The expectations are that Lead Agencies will create and sustain more efficient organization and management of service delivery. They are responsible for: . Creating service delivery networks . Assuring access to a full array of services and supports . Ensuring care management/ care coordination through coordinated case management . Stimulating stronger community ownership, involvement and investment . Coordinating and integrating community resources . Ensuring financial oversight and management . Developing and using a system of care model that includes enhanced prevention and early intervention COlfh;'lIed Olf jJage 6 ,/Ie. ~l/b;I/Ja- 2 Putting Ourselves in Their Place: Septennberll,2001 Luanne Panacek EXf(lIIII'e Direc/or q/lbe Cb/ldren j- Board q/ H/I/.rboTOlrgb COHI/(J As you know much has changed in just a couple of days. I have kept a journal since I was in high school and, if you'll bear with me, I 'd like to share with you what I wrote at midnight on September 11th. "We have fled Washington D.C. today. Never in my lifetime would ~ have believed that I would have to flee anywhere in the Uruted States. We were lucky to get a rental car since the city was in absolute pandemonium. Right around the same time the first plane was crashing into the World Trade Center, my boyfriend was supposed to be landing in New York Gty. I called him and after three frantic anempts, I got through to him. He was in an airport limo watching everything unfold in front of him. He was screaming over the phone about how unbelievable the sight was. I could tell from his voice that he was scared, but all I cared about was that he was safe. Then the second plane hit the second towe.r. People ~tarted to call me frantically on my cell phone, my SISter, beggmg me not to fly home that day from D.C. Then I started combing the hotel trying to find Barbara, Tana, Ed, anyone... because it occurred to me that what was happening was too well orchestrated and that we were sitting at ground zero in D.C. Then something did happen at the Pentagon. People in the hotel started getting upset, crying, running around not sure where to go to be safe. It was still unclear what had happened at the Pentagon, a bomb or a helicopter or plane crash, when they announced that a car bomb had gone off at the State Department, the building immediately behind us. Two loud explosions scared everyone and they reported that maybe two more bombs had gone off at the Pentagon. Then the :v reporter said no those weren't explosions, those were soruc bo.oms of ~he fighter jets taking off to intercept another Jet headmg toward Washington. My cell phone was ringing every minute but no one could get through and I couldn't get out on my cell phone or any of the hotel phones. I had 14 voice mail messages in less than 10 minutes. But I co~ldn't.do. anything to let anyone know that I was OK. Very qUIck thinking on the part of Barbara (a colleague), who said we needed to get out of Watergate Plaza as quickly as possible, is the only reason we were able to get a rental car. She said by the time she got to Avis there were no cars left and the place was nuts. As we crossed the Memorial Bridge, the same place I walked th~ n:oming at 8 am, we watched the Pentagon bum. It's nudn~ght now, afte.r driving all day, and I'm still shaking. As we said countless times to each other and silently to ourselves today in the car, we are so grateful to be alive and grateful to be on our way home." (End of Journal entry.) 9-13-01: I will spare you the details of the trip from there to here with six people and their luggage in a vehicle meant for four. I can t~ll you that. there were no rental cars available anyplace we hit after leavmg D.C. without a $1500 price tag attached to the regular fee. I am thoroughly exhausted, and shaken and numb, haven driven in last night at 11:00 pm. I feel that way and I was much further from the terror and chaos that thousands and thousands of others experienced. It occurred to me in the last two days that I have spent most of my adult life trying to find a way to adequately express to th: avera.ge person, in a real and visceral way, what 1 out of 4 ch.ildren. m our community experience in their daily lives... thiS feeling that you and I have experienced over the last two and half days comes very close. The terror of abuse and neglect, the violence around them in everyday life, the unpredictability of the violence, the unavailability of nec~ssary resources, particularly those taken for granted by us, like food and safe shelter...these are the things that as many as 60,000 children in Hillsborough county deal with daily. It is not just the presence of violence itself that is so devastating nor the lack of basic necessities. It is the com~lete inabili~y to control or predict what will happen next m your environment that is so insidious. Real, honest ~o ~?d te:ror, i~ a part of the lives of these kids daily. And it IS ltvmg WIth this kind of unrelenting terror, that breeds violence in children and adults. Perhaps you already understand this. ~ we offer our compassion and prayers for all those most directly affected by the terrorist attacks of two days ago, ~lease .do t~e same for the children here and everywhere who live daily WIth terror but who aren't as equipped as us adults to handle it.~ II". .//I;jIM j Kansas Child Welfare Refonn Patricia Tennant Sokol, M.S.W., D.P.A., Director, Con.rorlill/?/ fir C/;;Id Welfim Stlldia, Lolli.r de la Parle Florida Almtal Health In.rtitllle Many of you have expressed interest in what other states are doing to develop community- based systems of care for child welfare. Through a series of articles in this newsletter, we will examine what other states are doing in community-based systems of care for children and families. This initial article will explore the Kansas Child Welfare Initiative. The state of Kansas is a pioneer in child welfare reform, starting their statewide community- based care system reform in the mid-90s. Beginning in 1996, Kansas "privatized" three components of their child welfare system: 1) family preservation, 2) adoption, and 3) foster care. This initiative has resulted in dramatic positive outcomes. The following is a sample from the first four years of the Kansas initiative illustrating the positive results from these three components for children and their families: CORE V ALVES OF SYSTEMS OF CARE: . Child-Centered . Family-focused . Community-based . Culturally competent OUTCOMES Adoptions: There were 730 cases transferred to the Lead Agencies statewide. In the first year there was a 44% increase in adoptions. In the second yeartheyexperienced an 81 % increase in finalized adoptions. Family Preservation: All new cases are assigned to the Lead Agencies and no cases were transferred from the state operatIon. . 99% of the children served have remained safe and did not require removal from their families during program partiCipatIOn, .96% of the children have continued living safely with their families six months after treatment, and . 94% remained in their homes throughout this period. Foster Care: Over 3,400 children were transitioned to the Lead Agencies at the beginning of the initiative. Within a short transition time frame for such a large number of cases, most of the outcomes established by the state were met. By examining the performance standards stipulated in Kansas' contracts with the community-based care agencies we can see that community- based care is helping to improve the quality of life for the children served. Year 4 Average contract of all standard Kansas KANSAS OliTCOME CBC (2000) agencies Children in the care and supervision of the contractor will 98% 99.6% not experience confirmed abuse/neglect while in placement Children will not experience substantiated abuse/neglect 98% 99.6% within 12 months of reintegration Children referred to the contractor will have no more than 70% 86.2% three placement moves subsequent to referral Children will be placed with at 70% 69% least one sibling Children who are reintegrated do not re-enter out-of-home 80% 72% placement within one year of reintegration LESSONS LEARNED The state and lead agency staff in Kansas are very open about the Lessons Learned from their experiences. Many writers concentrate on the financial aspects of the lessons learned, however we are exploring systems issues and lessons learned. 1. The initiative had a positive, unanticipated affect on the Kansas child protective services system by freeing state child protective services workers to do a better job at the "front-end" of the system. However, "... many state staff felt a sense of professional loss as their role shifted away from direct work with the families." (Markowitz & Schafer, Lessons from the Kansas Child Welfare Initiative, Children's Vanguard, November, 1998.) 2. Manage by outcomes - State agencies are often tempted to demand detailed and voluminous data in the "process arena", counting number of days to do a particular job, the number of sessions one has attended or delivered, etc. In this new framework, the emphasis must be placed on outcomes more than process; whether children remain safe, how often children are moved from one out-of-home setting to another, or how quickly they reach permanency. cof/hill/ed Of/ pgge 5 I be . .1//;;,,1<>' 4 Kansas - ClJflllil/lfd .fvm page -I U!lyolIlJ/a/lt1ge 0'process YOlllllldermllle /Oe proriders' abi/IIY /0 be 11I1I0t'a///'f alld create sO/II/lollS oil/side /be box, "says January H. Scon, President and CEO, Kansas Innovations, Inc. The next issue is how to present the outcome data. It is best to share all data openly even with the risk that there are those folks who will put a negative spin on the data and therefore the system reform it supports. "If state and lead agencies consistently and honestly report true outcomes, they can effectively combat anecdotal horror stories and half-truths, and keep the focus on what is really happening to the children and families they serve." (Markowitz & Schafer, 1998.) 3. Community-based systems of care - In child welfare the successful management of the services for children and their families depend on several players in the community. Of significant importance, besides the lead agency, are the courts, the protective service workers and the sheriff's office Oawenforcement). All must jointly and collaboratively accept responsibility for the goals and outcomes of the community- based system of care in order for it to function properly. This can not be a 'top down' approach to community systems, but must grow out of the desire of the local community to do their very best collaborative work for the children and families in their own community. "COI/lli{g 1f{!fe/IJer ;j- t1 ;J{jllillli/{g, klhi{g Iqge/IJer is a pm(eJ'J~ (lIId JPol'le;i{!f 1f{!fe/lJer is Slltt:'m: " Hell!)! Ford 4. Establish a baseline of information before implementing system reform - It is crucial for state agencies planning community-based system of care reforms to establish a baseline of performance before the initiative begins. Only in this way can they objectively compare the performance of the new and old systems and counter the inevitable criticism cast on the reform through hearsay, anecdotal stories and adverse events that are unavoidable in any child protective service system. (Markowitz & Schafer, 1998.) To be successful, community- based systems of care require the commitment of all community partners and the state agencies to develop the best system of services for children and their families in their local community. As Kansas very candidly reports, the state agency must allow the community to develop their own system of care that matches the strengths and needs of that individual community. The greatest effect that a state agency can have when designing a major system reform such as we have in Florida and has been accomplished in Kansas, is to allow the local communities and their Lead Agencies to design the process of how they will deliver the mandated services and then hold them accountable for the achievement of outcomes. Only in this way will the local communities and their lead agencies have the ability to be creative and innovative in their design of their own community-based system of care. References: 1. Markowitz & Schafer, Lessons from the Kansas Child Welfare Initiative, Children's Vanguard, November 1998. 2. Telephone interview with January H. Scon, President and CEO, Kansas Innovations, Inc. (785) 274-3800 - iscorr@kii.com. ~ NAME THE NEWSLETTER CLAIM THE PRIZEI What should we name this newsletter? Do you or any member of your Alliance have some suggestions? Why not put on those "creative" thinking caps and submit one idea, or several suggested names to us? There is no limit on the number of names you can submit. What a great way to have some fun and help out, too! The O>mmunity- Based Que central office is now accepting entries for the "Name the Alliance Newsletter" contest and will continue to accept suggestions through the last week in December. A committee will vote on all names submitted and the winning submission will be announced when Newsletter # 2 is published in January; 2002. The winning name will be become the official name of the newsletter and a unique gift, reminiscent of "old Florida" will be awarded to the person! Alliance providing the chosen name. Now is your chance to "think outside of the box" by helping us name this exciting new product from the O>mmunity- Based O1re office. Please send all submissions to: ~ or mail them to us at: O>mmunity- Based O1re Building 2, Room 202 1317 Wmewood Blvd. Tallahassee, FL 32399-0700 11'1' , . ///;;llm' f CBC ;" Fiend: - IM//Hued ;rom page 2 ROLES AND RESPONSIBILITIES (Continued) Department ofCbildren and Families . Facilitate the preparation and transition of the care and supervision of children and families to local Lead Agencies . Coordinate with local and statewide planning groups in identifying and remedying challenges . Negotiate and oversee Lead Agencies contracts Monitor performance and ensure all state and federal protections for children are enforced . Provide statutorily mandated pre-service and in-service training and technical assistance to Lead Agencies . Define statev.~de outcomes/indicators and ensure quality assurance When fully implemented, it is projected that the CBC initiatives will privatize the positions of approximately 3,500 current DCF employees. Many of those employees will transition to the Lead Agencies. QUALITY AND ACCOUNTABILITY Each Lead Agency contract defines core outcomes and indicators and describes how Lead Agencies will be held accountable. Basic outcomes for Lead Agencies include indicators related to: Safety- children will live in an environment that is free from abuse or neglect. . Permanency- children served by the child welfare system will live in safe, permanent homes within the time frames established by ASFA. . Appropriate placements - children's placement settings will reflect their level of need. . Functionality and well being will improve in various functional areas as a result of the services they receive. . Satisfaction and Involvement- children and families will be involved in all phases of service planning and delivery. . System performance standards related to access, quality as evidenced by accreditation, licensing, and grievance and appeals requirements FLORIDA'S CURRENT COMMUNITY-BASED CARE INITIATIVES Beginning in January 1997, the state agency transferred responsibility for coordinating the care of all children in the child welfare system in Sarasota County to the Sarasota Coalition for Families and Children, with the YMCA functioning as the Lead Agency. A few years later the YMCA expanded to Manatee County and most recently is in the transition! start-up phase in Desoto County. The YMCA Coalition is responsible for all children who need protective services, foster care, and adoption services. Last year, the YMCA served approximately 2800 children with a $15 million operating budget. All services following initial investigation are the responsibility of the Lead Agency. The Legislature mandated Pinellas and Pasco Counties, formerly District 5 and now counties within the Suncoast Region, to be the first to complete the transition to CBC. Assisted with more than $1 million of start-up funds, Family Continuity Programs, Inc. entered into a transition contract in 2000. The service contract has a projected budget of approximately $25 million. This Lead Agency has phased in all children and families in the child protection system as of April 2001. The department is currently in the process of selecting a Lead Agency in response to an Invitation to Negotiate (ITN) in Duval County Oacksonville), and negotiating transition contracts in Hillsborough, and Palm Beach counties. The Lead Agency in Flagler & Volusia is in the midst of transition and will begin negotiating the service contract in the fall of 2001. The award in District 1 is under review and should be resolved shortly. "Neighborhood and community-based work today is being driven from a central, real-life core (individual, family, neighborhood) outward, as opposed to implanted (imposed) from the outside in by fixed bureaucracies, organizations, and programs. This approach means that organizations must listen and respond to the needs of all types of individuals and families in unique neighborhoods and diverse communities. The theory is that people know their problems; they know their solutions to their problems; and they have the resources to solve their problems. People are experts on themselves; the organization's job is to coach them and to help them discover their own strengths. The approach is not a negation of problems, it is simply a different more constructive, positive and respectful one." Emenhiser, DL; King, DW;Joffee, SA; Penkert, KS. (1998) NelJPork.r, ilfflger.r, & Partner.r/Jip.r in a 11fanaged Care f:,/mronmenl. CWLA Press, Washington, DC. .Q1 ALLIANCE DEFINITION An Alliance is a group of stakeholders, community leaders, client representatives and funders of human selVices which functions as a focal point for community participation and governance of community-based selVices. An alliance maycover more than one county. The alliance shall represent the diversity of the community. l/li'. .i//';/Im' 6- De;velopillg (l Con1munity Alliance The first steps toward the community setting goals, standards, and measurable outcomes for social services in our county. The Role of the Community Alliance in Seminole County is to Shape the Relationships for Dealing with Problems Not to make the Relationships The Community Itself and the Providers of Service will make those Relationships. I. Alliance Goals & Roles I 2 What is the mutual goal for our Alliance? We all want better outcomes for vulnerable residents of our County, especially for children and their families. I Alliance Goals & Roles I 3 What is the Community Alliance? The statute states that . . . "The Department shall, in consultation with local communities, establish an alliance of stakeholders, community leaders, client representatives and funders of human services in each county to provide a focal point for community participation and governance of community- based services. The alliance shall represent the diversity of the community." I Alliance Goals & Roles I 4 What is the Alliance to do? . Undertake planning for resource utilization. · Conduct a needs assessment and set community priorities. . Decide on community outcomes for programs and . servIces. . Be a catalyst for developing community resources. . Educate the community and be an advocate on issues related to the delivery of services. . Promote prevention and early intervention services. I Alliance Goals & Roles I 5 Who are the Statutorily defined members? · The local DCF district administrator · A representative from county government · A representative from the school board · A representative from the county's United Way · A representative from the county's sheriff's office · A representative from the circuit court corresponding to the county · A representative from the county's children's board (if one exists) I Alliance Goals & Roles I 6 Here are some questions that the Alliance will want to answer . . . · Have we, in this county, done a good j.Qh for our children and families? · Are our services good enough for our own families? · Are we maximizing the use of all of our resources? · Are we spending enough to prevent problems? · Have we reduced the barriers for families to get the help that they need, and can families get this help early on, and can they get it easily? I Alliance Goals & Roles I 7 Questions to be answered (Con't) · Have we as a community defined the types of services that WE need, and do have WE have a system of care that has a full array of services? · How can state agencies partner with the community to reach our goals? · How can we make things better for the vulnerable residents of our County? I Alliance Goals & Roles I 8 What is the primary role of our Alliance? Planning and System Design · Develop needed array of services and have a plan for service delivery. · Identify local and state resources and coordinate their delivery to our residents. · Identity other community partners who need to be "at the table." I Alliance Goals & Roles 9 What is the ongoing roles of the Alliance? · To ensure that our resources are having the maximum impact on local problems. · To create incentives for local funding. · To create incentives for improved performance by providers. · To encourage more efficient performance by all service delivery agencies. I Alliance Goals & Roles I 10 Who develops plans and does the research? · The Alliance may commission groups, organizations or committees to develop plans and conduct research in areas of interest to it. · The Alliance then reviews the plans and research and takes action based on those submissions. · The Alliance does not represent anyone faction in the county, but represents all of the people in the county. I Alliance Goals & Roles I 11 Local Agencies -United Way - Health & Welfare Groups - Mental Health Association ~ -Etc. )J Local Public ~ Agencies -School Board -Sherifrs Office -County/City Governments - Police Departments - Etc. The Public (as represented by the Alliance) The Children and Families we all Serve 11 Funders -United Way - Local Governments -Foundations -Others Providers - National - Local - For Profit V -Not for Profit ~ State Agencies ~ -DCF -DOE -DJJ - Health Department -Court System - Elder Affairs - Etc. What is the Role of DCF? · To facilitate change, not to be the only change agent. · To coordinate with other interested groups to solve . community-wide problems. · To ask the Community, as represented by the Alliances, to set priorities. · To work with groups and providers to seek workable solutions to the problems. · The role of the Community is expanded, with answers coming from the Community. I Alliance Goals & Roles I 13