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February 2013

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Goals
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Healthy development and growth for the children of the
Commonwealth
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Long term learning success, including reading proficiency for all children by 3 rd Grade
Strategies
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Establish a coordinated system of care for children and families
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Ensure that all state agencies & state agency partners that touch young children & their families have policies and staff that support the healthy growth & development of children
Approaches across agencies
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Screening
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Cross-agency training
Data sharing

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Total number of children under the age of 6 in Massachusetts:
443,000 (2010 U.S. Census)
DCF
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Serves 1,300 children <3 y.o. in placement, 1,000 children 3-5 y.o. in placement
Serves 5,300 children <3 y.o. not in placement, 5,200 children 3-5 y.o. not in placement
DHCD currently serving 3,000 children under the age of 6 in its
Emergency Assistance (shelter) program
DMH
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DPH
CBHI conducts avg. of 112,000 behavioral health screenings/yr. for children <3 y.o.
CBHI conducts avg. of 50,000 behavioral health screenings/yr. for children 3-6 y.o.
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Early Intervention providers serve 31,000 children under the age of 3 annually
WIC serves 40,000 infants and 117,000 children ages 1 – 5 annually
Growth and Nutrition Clinics serve 1,000 children birth – 6 annually

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1 st Leadership Retreat held 5/14/2012 – “Fulfilling the
Promise: Building Strong Inter-Agency Partnerships for the
Success of Young Children”
Purpose: Engage state leadership and initiate planning
55 participants from 16 state agencies
Discussion topics:
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Universal engagement of families and communities
Workforce development
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Assessment and screening
Strengthening inter-agency data systems.
Outcomes/Recommendations:
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Advance cross-agency data sharing by adopting a universal informed consent form
Begin work on creating cross-agency professional development opportunities for staff at state agencies that serve children & families w/ children

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2 nd “Fulfilling the Promise” Leadership Retreat held
10/24/2012
Purpose: Move cross-agency collaboration forward
46 participants from 16 state agencies
Discussion topics:
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Identification of common principles and practices across agencies that are aligned with supporting the positive development of children.
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Use of states' early learning standards for child development and learning outcome goals
The role of state services to families and children to support children's growth
Outcomes/recommendations:
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Begin creating & rolling out cross-agency professional development opportunities for staff at all partner agencies, starting w/ topics such as brain development & impact of early relationships.
Explore formal connection or joining of EOHHS Family
Access/Resource Center initiative with Race to The Top-related work

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Planning for cross-agency professional development underway – first 3 training opportunities being developed, rollout begins spring 2013 (DPH, EEC,
DCF, DMH, ORI, DHCD & DTA participating in planning process)
DCF and EEC have held three regional meetings bringing together regional & local DCF and EEC staff with Supportive child care providers; State-wide pool of Supportive child care slots now in development
Series of joint trainings held for staff from DHCD’s homeless shelter providers and homeless child care providers

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EEC collaborating w/ Dept. of Public Health (DPH),
Dept. of Mental Health (DMH), Dept. of Children and
Families (DCF), Dept. of Transitional Assistance (DTA)
& Office for Refugees and Immigrants (ORI)
Goal: Develop & roll out a suite of professional development opportunities for front-line staff serving young children and their families, so that staff are better equipped to support families’ efforts to help their children develop, learn and grow
Training topics include:
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Building Capacity to Support the Early Learning and Development of Massachusetts’ Children
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Social and Emotional Competence of Children
Concrete Support in Times of Need

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Embed early childhood developmental knowledge and support throughout DCF & its networks
Enhance parents’ understanding of their child’s development through access to screening
Enhanced procedures for connecting DCF-served families w/ young children to needed services and supports
Provide access to behavioral health evaluation and services when there are concerns
Improving access to/utilization of Supportive child care

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Embed early childhood developmental knowledge and support throughout DHCD and its provider networks, including HomeBASE
Enhance homeless & formerly homeless parents’ understanding of their child’s development through access to screening
Support access to high-quality early education for homeless and formerly homeless families

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Joint oversight of the Early Childhood Mental
Health Program
Expand capacity of the Mass. Child Psychiatry
Access Project MCPAP
Provide training and education to EEC licensors,
CFCE staff, and CCR&R staff on mental health issues in children:
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Recognizing signs of possible mental health issues
Intervention strategies for non-clinical/first responders
Access to specialized community resources

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Provide leadership & assistance in embedding health guidance and support across multiple programmatic systems
Support creation of universal system of socialemotional screening for children birth – 5 with linkages to community resources
Help child care providers access annual health care practices consultation required by QRIS
Support families & children transitioning from Early
Intervention to Special Education

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Race to the Top/Early Learning Challenge Grant
 Integrating early childhood development and brain science across
DCF programs, policies, practices and professional development
Early Education and Care
 Enhancing collaboration with EEC to maximize access to
Supportive Child Care
Early Intervention
 Automatic referrals to Early Intervention for all children under 3 who are subject of a “supported” allegation of abuse and/or neglect
Family Resource Centers
Joint Procurement with Department of Mental Health
 Caring Together
Cross-Over Youth
 Collaboration with the Department of Youth Services to improve services to children served within child welfare and juvenile justice

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A LOOK FORWARD: 2012 – 2015
OUR TRANSFORMATION JOURNEY
FOCUSES ON
IMPROVEMENTS
INNOVATIONS
INTEGRATION

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 Strengthen Basic Core Practices (Home visits, visits with children in foster care, interviewing children)
 Managing with Data
 Kinship First
 Fatherhood Engagement
 Placement & Educational Stability
 Child & Family Wellbeing
 Family Engagement/Family Voice in Policy and Management (Senior staff, management meetings, Area Boards)
 Massachusetts Child Trauma Project

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2008 – 2011 DCF Accomplishments:
Our RESPONSES are BETTER.
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Implemented Integrated Casework Practice
Model
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Implemented Differential Response
Implemented Short Term Stabilization track
Implemented standardized Risk Assessment
Tool
Improved core functions and incorporated innovations
Established Clinical Approaches: Safety
Organized, Trauma – Informed, Solution
Focused Practices

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2008 - 2011 DCF Accomplishments:
Our RESULTS are BETTER.
(FY 2011 compared to FY 2009)
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Fewer Children in Foster Care – More than 2,000 fewer children in the foster care system
Child Safety – Absence of Repeat Maltreatment improved from 88.6% to 92%
Fewer Child Victims – Fewer Child Victims entering Care
4,662 to 3,406 a 27% decrease
Kinship First – The number of children placed with kin increased from 20% to 26%
Fewer Children in Congregate Care – The number of children in congregate care decreased from 1,769 to 1,510 a
15% decrease
Improved Reunification Rate – A 17% improvement in the number of children entering care within the past twelve months who reunified within 12 months

51A Reports
% Investigations Supported
% Initial Assessments with Finding of Concern
80,875
60%
Children <18 in Caseload 34,954
Children < 6 12,906
Children 6 >12 10,181
45%
# Clinical Cases 19,390
# Adoption Cases 1,805
Average # New Cases per Month 1,361
Average # Cases Closed per Month 1,436
Children <18 in Placement 7,355
Youth >18 voluntarily Signing back into Care 1,634
% of Child Caseload in
Placement
% < 6 32%
% 6 <12 21%
21%

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How DHCD is Collaborating Across
Agencies to Support Education of the
Child/Whole Child Development
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EEC
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Referrals to homeless child care slots for families living in shelters/hotels
Training for shelter and child care providers on developmental needs and risk factors for young homeless children
Ages and Stages Questionnaire training for shelter providers
DPH
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F.O.R. Families (Follow-Up Outreach Referral) – Home visiting and service referrals for DHCD-served families living in hotels
DCF outreach and health & safety assessments
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Connections made to open cases
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Identification of cases where intervention may be needed
ESE – Notification to school departments of families entering hotels with children who are age 2 and older
Horizons for Homeless Children
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Playspace Programs in shelters, hotels, local state agency offices

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Families with children who face a housing emergency are provided with temporary shelter and stabilization services
Some shelter providers offer parenting classes and other child-focused activities to promote better outcomes for children
DHCD’s Div. of Housing Stabilization (DHS) is working to engage fathers in their children’s development whenever possible

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DMH’s Collaborative Efforts to Support
Education of the Child/Whole Child
Development – Existing Initiatives
MCPAP—Massachusetts Child Psychiatry Access Project
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Regional children’s mental health consultation teams
Support pediatric practices in meeting the mental health needs of their patients
CBHI—Children's Behavioral Health Initiative
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Part of MassHealth, the Commonwealth’s Medicaid program
Specialized behavioral health services for families and their children with significant behavioral, emotional, and mental health needs
Pediatric Screening for mental health has increased from 15% to 67% in 4 years
Department of Children and Families
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Consultation for preschool children in supported DCF care
Clinical Consultation by DMH psychiatrists
Connections to mental health systems of care when necessary and appropriate
Design of shared delivery system for residential services to be implemented May, 2013
Interagency planning & care coordination for challenging youth with serious mental health issues

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DMH’s Collaborative Efforts to Support
Education of the Child/Whole Child
Development – New Initiatives
EEC’s Early Childhood Mental Health Consultation Program
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Technical assistance
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Program monitoring
Mental Health Training and Consultation
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Massachusetts Child Psychiatry Access Project (MCPAP) and CBHI service teams
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Trainings for Early Education Program Staff
• First series: Statewide training program for preschool teachers Developing skills for working with parents who have mental health and substance abuse issues
• EEC’s Coordinated Family and Community Engagement
Programs, Child Care Resource and Referral grantees,
Licensor’s, and other EEC staff
Statewide Community Crisis Intervention Project
Involving DMH’s PPAL—Professional Parent Advocacy League

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Primary Diagnoses:
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Attention Deficit/Hyperactivity Disorder (ADHD)
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Post-Traumatic Stress Disorder (PTSD)
Primary Age Range: 4 to 5 y.o.
Primary Services Provided and Supported for Young Children
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Child Psychiatry Consultation
Case Management
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Individual and Family Flexible Supports to DMH clients and to their siblings, including respite for families
Therapeutic After School Programs
Parent/Professional Advocacy League (PPAL): Group &
Educational Forums for Parents
Residential Services (limited)

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Services and Supports for children with serious emotional disturbance and their families
Practice Improvements and Research and
Training at a systemic level
Parent Support to any parent whose child is experiencing mental health challenges
Clinical Consultation to staff at other child serving agencies

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CBHI utilization by children 12 and under during FY11
Age Group
Under 6 months
6 months-2 year olds
3 - 6 year olds
7 – 12 year olds
Totals
Total Visits Total Screenings Percent Behavioral Health Need identified
355,181
491,201
104,621
287,810
1.65%
5.29%
270,352
297,991
1,414,725
174,330
199,954
766,715
10.47%
12.03%
(avg) 7.36%
Behavioral Health Screenings for children <13 y.o. 1/1/2008 – 6/30/2011
Totals Service
Intensive Care Coordination
Family Support and Training
In-Home Therapy
In-Home Behavioral Services
Therapeutic Mentoring
Youth Mobile Crisis
Total (duplicated) served
26,436
21,011
35,216
3,265
18,315
7,027
111,270