Atlantic Coast Child Welfare Implementation Center Partners for Change A member of the National Training and Technical Assistance Network, a service of the Children’s Bureau, U.S. Dept. Health and Human Services Implementation of a Safety Model in Child Welfare Cathy Fisher, Project Director, ACCWIC Susan Richards, Director of Training, SAMS Project Director, West Virginia DHHR/Bureau for Children &Families Toby Lester, CPS Policy Specialist, West Virginia DHHR/Bureau for Children &Families Kathy Simms, National Resource for Child Protective Services February 22, 2013 Implementation Framework Performance Assessment (Fidelity) Systems Intervention Coaching Facilitative Administration Training Staff Selection Integrated & Compensatory Decision Support Data System LEADERSHIP © Fixsen & Blase, 2008 The Role of Leadership Align the change with agency mission, vision, and values Provide clear, frequent communication making the case for the change and supporting implementation Seek support and feedback from stakeholders Foster an organizational environment that is conducive to change, learning and improvement Provide rationale for changes in policies, procedures, structure, staffing, etc. Garner needed resources Ensure sustainability Competency Drivers Are: Mechanisms that help develop, improve and sustain one’s ability to implement an intervention with fidelity and benefits to children and families. Staff Selection Training Coaching Performance Assessment Organization Drivers Are: Mechanisms to create and sustain hospitable organizational and systems environments for effective services. Systems Intervention Facilitative Administration Decision Support Data System West Virginia SAMS Project Purpose Purpose: To implement a new Child Protective Services (CPS) safety assessment and intervention system in West Virginia that: Utilizes a change management approach to fully implement the new system Permanently changes practice in West Virginia Results in better outcomes for children and families SAMS Vision A systematic and effective continuum of safety assessment and intervention decisionmaking from receipt of referral to case closure SAMS Implementation Goals DHHR/BCF staff awareness, understanding, and commitment External stakeholder and provider awareness, understanding, and commitment Comprehensive and supportive structures (i.e., policy, computer systems, quality assurance) Consistent and consultative supervision Competent and capable staff Implementation with fidelity SAMS Implementation Implementation of SAMS began 2009 SAMS was the priority initiative and resources were secured to support the implementation Consistent engagement of key state and field leadership contributed to SAMS success Engagement of several key Implementation Drivers contributed to successful practice change Driver-Systems Intervention Performance Assessment (Fidelity) Systems Intervention Coaching Facilitative Administration Training Staff Selection Integrated & Compensatory Decision Support Data System LEADERSHIP © Fixsen & Blase, 2008 Communication and Engagement Internal CPS Social Workers and Supervisors Upper Management Legal State Office External Judicial/Legal Providers Key Leaders in Child Welfare Communication and Engagement Internal Newsletters “Talking Points” Documents Memos Training Q & A Processes External “Round Table” discussions Trainings Redesigned WebPages Brochures What we quickly learned Slow Down! Determine baselines regarding knowledge and skill; plan accordingly Engage Early and Often Subject Matter Experts at all discussions and trainings Misinformation travels fast! 2nd Attempt Surveyed DHHR Staff, Providers, Judges, CASA, Caregiver’s Attorneys, Guardian Ad Litems, and other key stakeholders to measure their Agreement with the need to change Knowledge of key SAMS practice concepts Level of agreement regarding changes Effect of past strategies Results Identified problematic attitude and/or practice issues Identified strengths and replicated successes Able to strategically communicate and engage internal and external partners A better understanding by Internal and External Stakeholders of the decision making model, the necessity for practice change and how families can be positively impacted Drivers-Training and Coaching Performance Assessment (Fidelity) Systems Intervention Coaching Facilitative Administration Training Staff Selection Integrated & Compensatory Decision Support Data System LEADERSHIP © Fixsen & Blase, 2008 Coaching Training and Coaching Training by itself is an ineffective approach to implementation. Functional components of staff training: knowledge of the program and practices, demonstrations of key skills, and practice to criterion of key skills. Core coaching components: teaching and reinforcing skill development, adaptations of skills to fit the personal styles of practitioners (changing form, not function). Coaches need to be trained and coached to provide specialized coaching functions. Implementation Background Worker training was delivered immediately following supervisor training and supervisors had not yet had a reasonable opportunity to develop their competency in the PCFA. The lack of opportunity for supervisors to develop foundational competency of the PCFA prior to workers attending training resulted in supervisors lacking knowledge, skill and confidence to support the worker training experience. Implementation Change Supervisors made the primary target audience for implementation activities delivered by ACTION, NRCCPS and SAM Special Forces. Fundamental purpose for implementation activities modified to develop supervisors so they could take charge in leading the implementation effort with their workers. Objectives for the Changed Focus 1. 2. 3. 4. 5. Increase knowledge regarding PCFA necessary for providing case practice consultation. Understanding how the principles for intervention are important for achieving practice objectives. Develop interpersonal skills necessary for coaching and modeling the PCFA intervention stages. Build supervisor confidence for working with staff to develop their knowledge and skill and/or influence their professional mentality. Establish the expectation that supervisors are fundamentally responsible for developing the competency of their worker for completing the PCFA. New Implementation Strategy Intensive learning program for supervisors to develop knowledge related to the intervention concepts, criteria, processes, and principles for PCFA and CPE. Activities conducted to develop their capacity to supervise the intervention process. At the conclusion, a Supervisor Proficiency Assessment conducted to assess the supervisors’ ability to effectively manage and support the implementation of the intervention model with workers. After the Proficiency Assessment, Special Forces and supervisors to work together to develop worker competencies related to the PCFA and CPE process., involving supervisors actively participating in training, practicum, and consultation/coaching experiences. Supervisor Proficiency Assessment Supervisor Consultation Process Expert guided discussions that correspond with each of the PCFA intervention stages; providing standardized, systematic practice and promoting effective caseworkercaregiver relationships that result in caregiver self-awareness and mutually identified goals that identify what must change while ensuring client selfdetermination. Supervisor Consultation Guide Provides an organized structure for consulting with casework staff related to PCFA practice issues and decisionmaking requirements . Emphasizes specific supervisor consultation expectations as a case proceeds through each intervention stage of the PCFA process. Emphasizes supervisor-caseworker consultation as the essential method for directing practice. Where We Are Now PCFA supervisor proficiency process completed for all supervisors. Developing a supervisor proficiency process for the IA and FFA. Rolling out Coaching training for all supervisors to reinforce concepts. Lessons Learned Lessons Learned Pay attention to supervisory competency development from the beginning. Allow adequate time for supervisors to learn and become comfortable with the new practice model so they can reinforce it with their staff. Pay attention to the relationship between supervisor proficiency and fidelity – without supervisor proficiency the chances of fidelity to the model are greatly diminished. Closing Comments Outcome: WV has achieved 70% fidelity rate. Focus on salient implementation drivers contributed to an increase in practitioner performance Planning and implementing a sustainability plan anchors the practice change in the system Leadership owns the responsibility for sustaining the change. References Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M. & Wallace, F. (2005). Implementation Research: A Synthesis of the Literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network (FMHI Publication #231). Presenters’ Contact Information Cathy Fisher: cfisher@ssw.umaryland.edu Toby Lester: Toby.D.Lester@wv.gov Susan Richards: Susan.M.Richards@wv.gov Kathy Simms: kathy.simms@actionchildprotection.org