Outcomes Based Service Delivery and the Casework Practice Model

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Presenters:
Jacqueline Dagneau, Family Preservation Manager, OBSD, The Family Centre
Julie Mann, Analyst, Program Policy Practice Analysis and Coordination, Ministry of Human Services
Kim Spicer, Senior Manager, Outcomes and Practice Supports, Ministry of Human Services
To increase the knowledge and skill level of
delegated staff and agency workers in relation to:
◦ Casework Practice Model; and
◦ Shared casework practices.
To have agency and delegated staff come to a
common understanding of the issues related to:
 Their role;
 The role of the “other” worker; and
 The role of the family with in a shared practice
framework.
2

History/Overview of Casework Practice Model
◦ Break

OBSD/ Shared Practice
◦ Exercises/Break

Discussion/Outstanding Issues

Conclusion
3
◦ Transparency and openness of information sharing
◦ Increased involvement of family
◦ Increased community engagement
◦ More collaboration with resources
◦ Earlier permanency for children and youth
◦ Timely and supportive services
◦ Culturally appropriate services and supports
◦ To get back to doing social work with children and families
4
Improved Outcomes for Children and Youth and Families
·
·
·
·
·
Philosophical
Framework
Entrenching
Our Goals in
Legislation
Supporting vulnerable children to live successfully in community
Children in Temporary Care will be re-united quickly with family
Children in Permanent Care will be placed in permanent homes more quickly
Youth transitioned to Adulthood successfully
Aboriginal children will live in culturally appropriate home
Community Engagement
Differential Response
Permanency Planning
Outcomes Evaluation
Alberta Response
Model
§
Child, Youth and Family
Enhancement Act
§
§
Differential Response
Strengthen family & community
involvement
Strengthening Aboriginal Involvement
Strengthening Permanency
Casework Practice
Model (CWPM)
§
§
§
Assessment
Collaboration
Engagement
§
§
§
§
§
Providing the
Framework
and Tools
Outcome Based Services (O.B.S.)
§
§
§
Performance Measurement
Collaborative Approach to Service Delivery
Evidence-based Management
Shared
Practice
ACYS
Practice
§
§
§
§
Agency
&
Community
Practice
Safety
Permanency
Child well-being
Family & community
connections
Improved Outcomes for Children and Youth
Flowchart
Version 5 - February 25, 2009
PRACTICE
5
Increased focus on supporting families to
build capacity.
Increased focus on need for permanency for
children.
Meaningful consultation with Aboriginal
communities.
Highlighted the importance of Assessment,
Collaboration and Engagement.
6
From Section 1of the CYFEA (2) For the purposes of this act, a child is in
need of intervention if there are reasonable and probable grounds to
believe that the survival, security or development of the child is
endangered because of any of the following:
(a) the child has been abandoned or lost;
(b) the guardian of the child is dead and the child has no other guardian;
(c) the child is neglected by the guardian;
(d) the child has been or there is substantial risk that the child will be
physically injured or sexually abused by the guardian of the child;
(e) the guardian of the child is unable or unwilling to protect the child from
physical injury or sexual abuse;
(f) the child has been emotionally injured by the guardian of the child;
(g) the guardian of the child is unable or unwilling to protect the child from
emotional injury;
(h) the guardian of the child has subjected the child to or is unable or
unwilling to protect the child from cruel and unusual treatment or
punishment.
7
Matters to be Considered is another area of this
legislation that guides decision making by
identifying values and principles such as:
•
The family is the basic unit of society and its wellbeing should be supported and preserved;
•
The importance of stable, permanent and
nurturing relationships for the child; and
•
The intervention services needed by the child
should be provided in a manner that ensures the
least disruption to the child.
8
◦ Embeds the principles of the legislation: assessment,
collaboration and engagement.
◦ Provides a framework for processes based on best practice,
including:
 Mandatory Decision Points; and
 Mandatory Supervisory Consultation during decisionmaking.
◦ Child-centered and Family-focused.
◦ Moves from a “brokering role” to a social work role with
children and families.
9
◦ Comprehensive intake and assessment components.
◦ More time to develop relationships leads to quality
decisions.
◦ Plans developed with everyone involved in multidisciplinary case conferences.
◦ Importance placed on all parties to work together,
led primarily by family/child and caseworker.
◦ Outcomes focused, measurable results.
10
◦ Assessment information directly linked to case
planning.
◦ Engagement with families.
◦ Early and meaningful involvement of First Nations
Band Designate/Métis Resource Person.
◦ Clear decision points for supervisory consultation.
◦ Increased clarity when moving from assessment to
investigation.
11
◦ Assessment/Analysis
◦ Engagement
◦ Collaboration
◦ Permanency for children including permanent
homes for children in care
12
◦ An ongoing and dynamic process.
◦ Acknowledging and reducing cultural and
contextual bias.
◦ Inclusive.
◦ Opportunities, not challenges.
◦ Clear connections to service planning.
13
• Includes a multi-disciplinary approach.
• Goals must be negotiated with the participants to
reach solutions.
• Locus of control for planning shifts to family/child
and supported by caseworker.
• Differences in power should be acknowledged.
• Clearly defined activities linked to service plan.
• Clearer outcomes and measurements of success.
14
•Everyone’s perspective of the concerns and
possible solutions are presented fairly.
•Clearly involves a multi-disciplinary approach.
•Acknowledges a significant shift toward the
family and child having greater control of
outcomes, supported by the caseworker.
•Relationship between team members is key.
15
•
Importance of having a Plan B.
◦ If child can’t stay in the home, what are the options?
•
Temporary care change under new Act.
◦ Children under 6 years can only be in temporary care for
up to 9 months.
◦ Children 6 years or older can only be in temporary care
for up to 12 months.
◦ An extension of 6 months may be granted.
•
Previous legislation permitted children to be
in temporary care for a longer period of
time.
16
• Intake
• Safety A - Assessment
• Safety B – Assessment (Detailed
Assessment/DAR)
• Intervention (if necessary)
• Family Enhancement Services
• Protection Services
• Closure
17
Information
Gathering
Max 5 working
days
Decision 2
Decision 11
Decision
Safety
Phase
(Safet
y
Phase
A)
Max 10
working
days
Decision 33
Decision
Continued Assessment
Ongoing
Assessment
(Safety
Phase
B)
Case Plan
Plan
Case
Analysis/Recommendations
Analysis/Recommendations
Decision 44
Decision
Family Enhancement
Services
Protective Services
Open Case
Decision 66
Decision
Analysis/Recommendations
Analysis/Recommendations
Decision 55
Decision
Assessment
Assessment Update and
Case Plan Review
Intake
Closure
Every 3 months or as required by legal authority or case plan
Max 30 working
days
18
Maximum of 5 working days to complete.
Supervisory decision point:
 Close – does not meet mandate of Child in Need of
Intervention
 Close - with referral to community supports; or
 Recommend Safety Phase A Assessment (previously called
Investigation).
Note: May involve forensic investigation under emergency
response, or the development of a safety plan.
Information resulting in an Intake is considered a Report
under the Act.
Under legislation the identity of a person providing a referral
is protected.
19
Any individual who has reasonable and probable grounds to
believe a child is in need of intervention must report the
matter to a director.
The director must be available to receive referrals from the
community and respond to those that are deemed to be
reports in a timely manner.
• A “referral” is where the director receives information from a
person advising that a child may be in need of intervention.
• A “report” is where upon receiving the referral, a decision is made
to initiate an investigation because the director is satisfied that
the information was not provided maliciously, is not unfounded,
was provided on reasonable and probable grounds, and discloses
that a child was in need of intervention per s.1(2).
20
Maximum of 10 working days to complete.
Strength-based assessment is used to explore themes and patterns with the
child, family and social network, looking for opportunities to overcome
barriers.
Information regarding three domains is gathered: child development, parenting
capacity, and family and environmental factors.
Brief services can be provided to address immediate needs. These can include
repatriation, grocery vouchers and damage deposits.
Supervisory decision point:
• Close – does not meet mandate of Child in Need of Intervention;
• Close - with referral to community supports;
• Recommend Safety Phase B Assessment; or
• Recommend a Protection Status (i.e. Court Order).
Note: May include the development of additional safety plans.
21
Maximum of 30 working days to complete.
•Assessors have additional time to gather information
on three broad domains:
 Child development;
 Parenting capacity; and
 Family and environmental factors.
• What does the family need?
• Are there supports in the community or extended
family?
• Can the family manage by itself?
• Is the family looking for some more supports, or
do they want or need an Agreement?
22
At the end of 30 days…
Mandatory case conference occurs, involving all parties, led by
assessor/caseworker and family/child, to look at the assessment,
planning and next steps.
Supervisory decision point:
 Close – no longer meets the mandate of Child in Need of Intervention;
 Close – with referral to community supports;
 Recommend Family Enhancement Services; or
 Recommend Protection Services.
Note: Permanent placement options may be considered if child comes into care.
At the end of Safety Phase B, the following documentation must be
completed by caseworker:
 Safety Phase Assessment Part B;
 Genogram; and
 Ecomap.
Note: In CWPM, planning begins after thorough assessment is completed and all documents are generated.
23
• Either Family Enhancement (through Agreement with
family) or Protection Services (through Supervisory
Order or In-care Status with Court involvement).
• Resources identified and engaged to help family
achieve outcomes identified in service plan.
 Kinship/foster care/group care etc.
• Assessment and re-evaluation of need for
intervention continues on-going basis.
• Supervisory decision (on-going):
 Does the child still need intervention?
 Have the outcomes been achieved?
24
Family Enhancement
• Family Enhancement Agreement with Guardian
• Enhancement Agreement with youth
• Support and Financial Assistance Agreement
Protection Services (Court Order and In-care Status)
• Supervision Order
• Custody Agreement with Guardian
• Custody Order
• Interim Order
• Temporary Guardianship Order
• Secure Treatment Certificate
• Secure Treatment Order
• Permanent Guardianship Order
• Permanent Guardianship Agreement
• Adoption
25
Closure, following Intervention, will occur after varying
amounts of time, and is based on:


an analysis of the assessment information; and
must be made in consultation with the casework supervisor,
the family, as well as the multi-disciplinary team.
Supervisory decision point:
 Close – no longer meets the mandate of Child in Need of
Intervention (i.e. service plan has been completed);
 Close – with referral to community supports (i.e. where
Family Enhancement Services have been utilized); or
 Close – with Permanency Planning (i.e. if a PGO was granted
there were permanency options with extended family or if
adoption will be pursued, then file will close).
26
•
•
•
Simply put, these are services focused on the
purpose of the work.
Less emphasis on how, and more on what
happens.
And, more emphasis on collecting and regularly
reviewing relevant data on outcomes achieved.
We all want to know how we are doing.
27
Building on the philosophy of the legislation
and the tenets
of the Casework Practice Model,
Assessment, Collaboration and Engagement,
the Outcomes Based Service Delivery Initiative
supports the system-wide evolution of services
from thorough assessment
to how the case plan and services
will achieve desired child and family ‘outcomes’.
28
1.
2.
3.
To improve the effectiveness of services that children and
families receive and experience as they move in and out of
the child intervention system.
To provide agencies, foster parents and caregivers with more
flexibility to respond to the unique needs of children and
families while focusing on intended outcomes and better
supporting innovative practice.
To use outcomes data to align the work between the formal
child intervention system, caregivers, and contract agency
service delivery.
29
4.
5.
6.
To develop a common quality improvement and learning
process that will continue to guide joint practice and identify
opportunities for improvement, using evidence to guide
practice.
To develop a service delivery system that has the capacity to
measure and focus on achievement of agreed upon outcomes
as the central driver for both casework and resource
allocation decisions.
To establish joint accountability for outcomes for vulnerable
children, youth and families.
We all want the same thing.
30
Create/sustain a collaborative approach to service delivery in order to
achieve five key outcomes.
1.
Support vulnerable children to live successfully in the community.
2.
Children in temporary care will be reunited quickly with their family.
3.
4.
5.
Children in permanent care will be placed in permanent homes as
quickly as possible.
Youth will be transitioned to adulthood successfully.
Aboriginal children will live in culturally appropriate
placements/services.
31
A collective focus on client
centred outcomes for
vulnerable children and
their families between
contracted agencies,
caregivers and Human
Services staff
Funding flexibility for
service delivery agencies to
allow them to address
service delivery and
environmental pressures
A collective shift in practice
towards a collaborative way
of engaging and working
with families
32
Safety
Support vulnerable children to live successfully in the
Community. (Preservation – children stay at home)
Permanency
Children in temporary care will be reunited quickly
with their family. (Reunification – children return
home)
Children in permanent care will be placed in
permanent homes as quickly as possible.
Youth will be transitioned to adulthood successfully.
33
Family and Community Support
Aboriginal children will experience culturally appropriate
supports and environments.
Parents will have the capacity and supports to
successfully raise their children.
Child Well-being
The developmental needs of children will be supported.
Children will be successful in school.
Note: Alberta Outcomes are based on the National Outcomes Matrix and the
data collected over 15 years.
34
•
Engaging families early
•
Collaborative practice
•
Collaborative and intentional single service plan and
service team meetings
•
Evidence-based approaches that support shared
practice
•
Child-centred, family-focused, strength-based
•
Valid and reliable tools
•
On-going support to the family
•
Community involvement/engagement
35
•
•
•
Phase-in sites are being developed and
implemented around the province through an
evolutionary learning process to develop an
effective approach before considering broader
implementation.
Most sites began with new intakes only, although
some sites converted existing files as well.
Worksites are partnered with an identified lead
agency in a specific geographic area.
36
•
•
•
•
Altered contracting and funding structure allows flexibility and
adaptability in service provision, and accountability to outcomes.
Case planning happens collaboratively between the family, the
caregiver, the agency and the caseworker, and is focused on
outcomes.
This agency is responsible for the provision of all services to the
child and family according to a plan that is developed collaboratively
between the family, the delegated worker, the caregiver and the
agency.
The delegated staff retains final decision over issues relating to
delegated authority. Supervisors play critical role in the resolution
process to guide agency and delegated staff through disagreements.
37
REGION/WORKSITE
LEAD AGENCY
DATE IMPLEMENTED
Region 3
Wood’s Homes
July 2009
Mahmawi - B&G, Enviros, Pathways July 2013
Region 6
The Family Centre
Kahkiyaw - Bent Arrow/Boyle St.
August 2009
February 2012
Region 7
WJS and Associates
April 2010
Region 4
McMan Youth Services
May 2010
Region 1
Wood’s Homes
November 2010
Region 5
Midwest Family
(withdrew in Oct 2011)
April 2011
Region 8
WJS and Associates
2012
Region 9
McMan/St. Aidans
2012
Region 2
McMan/SPEC
2012
38
•
Front End Loading Services
• Early intervention with families in crisis—earlier
the better;
• Finding creative supports that fit; and
• Putting them in place to avoid the need for more
intrusive services.
Investing time with these families upfront leads to
positive results.
39
More children receiving services in their home vs. out of home.
(OBSD sites - 70% at home/30% in-care; opposite in non-OBSD sites)
More children are placed with their immediate or extended family.
Fewer children are coming into care.
Children are staying in care for shorter periods of time - overall 34%
shorter.
More children are returning home.
Files are closing faster with lower rates of recurrence because the right
supports are used, and families are supported after files are
closed.
Practice is changing – ‘spill-over’ is happening into other units/staff.
40
•
Delegated staff and agency staff collaboration is not
always easy!!
•
Decision points where agency staff and caseworkers need
to come together & talk about next steps include:
•
•
•
•
•
•
•
When children are coming into care;
Placements;
Visit planning;
Supports to families as part of service planning; and
Permanency.
This is done in collaboration with the family and their
support network.
There is often a need for agency and CFSA staff to meet
prior to meeting with the family to ensure consistency of
message and understanding of the “other’s” position.
41
Delegated workers, agency workers and families often have quite different:
•Perspectives;
•Emphasis on what is most important;
•Delegated staff (safety), agency staff (well-being), family (permanence)
•Ways of approaching issues and problem solving.
Permanence
Family
Safety CFSA
Well-being
Agency
Safety
CFSA
There is a natural (dual) tension between a
focus on Safety vs. Well-being .
Well-being
Agency
Families focus upon Permanence almost
immediately.
Focus on Outcomes Involves not just dual tension between CFSA and the Agency but
tri-partite tension between CFSA, the Agency and the family.
•
Roles of delegated & agency workers/family need to be
defined, known and respected.
• Delegated worker’s role – defined in legislation;
different levels of staff have different levels of
responsibility.
• Agency worker’s role – to support families moving
through change to achieve outcomes; no delegated
(legislated) responsibilities.
•
• Family’s role – to be heard; to be an active participant,
maintaining familial responsibilities.
•
Rights of child
• Role of Children’s Advocate remains unchanged under
OBSD, advising on procedural rights, etc.
43
There is consistency in the elements of
practice used for OBSD.
• Solution-focused/appreciative inquiry.
• What are we worried about? What’s working well?
What needs to happen?
• Relationship/Engagement
• Asset/strength-based
• Evidence-based
• Community-based
• Region 6 – Developed a Shared Practice
Framework
Regions 1 & 4 – Signs of Safety – Safety Plan
44
Region 6 OBSD – DRAFT October 2011
45
Region 6 OBSD – DRAFT October 2011
46
•
Occurs as quickly as possible.
•
Is transparent and open.
•
Includes family/child goals.
•
Has goals, roles and expectations of all parties
clearly articulated.
•
Has room for creativity, innovation and flexibility.
•
The real goal is for the family to come up with their
own plan.
47
Service planning/Service Team Meetings/Family Group Conferences
Family Enhancement Plan
• Purpose/procedures
Supervision Order
Components of concurrent planning
•
•
Part A – Reunification
Part B - Permanency
Transition planning (children 16 and over)
• Youth to Independence, Transitioning to Adulthood/Supports Process
Kinship Care
Foster Care
Preparing a child/expectations at placement/
role of child’s culture
Family Support for Children with Disabilities Program (FSCD)
48
•
•
OBSD allows for a shift in practice from staff working
alone to working in multidisciplinary teams.
Many OBSD sites have created different approaches to
work together more effectively—one mechanism is
the pre-service team meeting.
•
•
•
•
Team members discuss initial thoughts and strategies
before meeting with the family.
Areas of disagreement are identified and discussed.
• (Supervisors may assist in determining course of
action.)
Staff must present a united front regarding any
differences when they meet with the family.
Team members must feel supported—even if they
agree to disagree.
49
An OBSD goal is for the family to have a single plan:
•
That has been developed collaboratively by the
delegated worker, agency worker, family and other
stakeholders (foster parents, community partners,
school etc.);
•
With goals that are clearly defined, attainable and
relevant, and include time frames;
•
With indicators of success that are measurable; and
•
That is written in the language of the family.
50
Role Play Activity, in groups of 3 or 4:
•
Read the scenarios;
•
One person is an agency worker, one is a CFSA
worker, others act as coaches;
•
Have a pre-service team meeting to flesh out
your initial thoughts/concerns;
•
Have a service team meeting with coaches now
in the role of family members; then
•
Create a meaningful service plan.
51
Common themes in Pre-service Team Meetings
• Disagreements about what the “real” concern is:
• What can we live with?
• What can we let go?
• Tension between immediate risk and long term
well-being.
• Controlled immediate risks may help achieve long term
objectives.
• These risks involve trusting team members.
• Challenging assumptions.
52
Common Challenges in Service Team Meetings and Service
Planning
• Defining and differentiating between:
 Goals;
 Tasks; and
 Signs of achievement.
i.e. Attending a parenting class is a task, not a goal, and does not
indicate that parenting behaviour has changed.
• Ensuring the plan is meaningful.
i.e. A sign of achievement would be the parent demonstrates consist
positive parenting skills such as time-outs and discussion.
• Including the family as active participants.
i.e. Service plans developed by and with family—using the “voice” and
language of the family, including children.
• Determining time frames.
i.e. Goals and tasks are specific and tied to signs of achievement.
53
Staff have an understanding of and sensitivity to working with families.
•
Know “culture” reflects: a world view/philosophical approach, a particular value
base, is grounded by language, traditional practices, customs and ways of
interacting with each other, the community and the larger world.
•
Understand the need to involve Aboriginal communities (i.e. Designate) in
planning.
•
Cultural communities (Aboriginal/ethnic groups) are not homogeneous and are
unique in their practices and approaches.
•
•
Work collaboratively with community people to enhance connectedness between
the person and their cultural community (i.e. First Nation, Metis,
immigrant/refuge communities).
Access to language and cultural interpreters and knowledge-keepers (elders,
imams, other religious leaders, etc.).
adapted from Canadian Accreditation Council Standards
54
Single service plan
• Some regions are still working with multiple service plans
• ISIS
Clarification of roles – needs to be revisited (often)
• Delegated worker- delegated authority
 Definition and implications
• Agency worker
• Family
Differences of opinion
• Resolution process
Information sharing
• How often, lines of authority, regular times to meet
Breaking down inter-ministerial barriers between Human
Services, Justice (court processes), Education and Health
55
Supervision and shared supervision
• Reflective practice
• Balancing administrative, clinical and reflective needs
• Lines of authority and autonomy
Aboriginal/other cultures
• Involvement of First Nations Designate/Metis Resource
 Legislated Requirement
 Facilitating involvement
• Knowing the limits of what it is that we know and don’t
know
• Accessing the available resources – who, protocols, etc.
Common use of, and understanding of, language
• Jargon/acronyms/different meanings for common words
56
•
Roles and relationships between delegated staff, foster care providers
and lead agency service providers need to be well defined.
•
Requires system wide commitment to improved outcomes (lead agency,
foster parents and delegated staff alignment).
Do we know what we are working toward
and are we all working toward the same thing?
•
Critical thinking.
•
Relationship, relationship, relationship.
•
Requires solid data collection processes across the systems and
agreement on indicators.
•
Requires delegated staff, lead agency staff, foster parents, family and
community to value and embrace each other’s expertise (risk and wellbeing) in order to create an optimal environment for children, youth and
families.
57
58
•
AASCF Website
http://www.aascf.com /Resource Library/OBSD or
http://www.aascf.com Type in a word in the search box i.e. “AASCF Journals”, “AASCF-OBSD
Newsletter”, “supervision”, “OBSD” and a number of resources will be identified
•
Alberta College of Social Workers
http://www.acsw.ab.ca
•
Alberta Courts Information
http://search.albertacourts.ca (Alberta Courts website with search tab highlighted; other tabs
include Court of Appeal, Court of Queen’s Bench, Provincial Court and Court Services)
http://justice.alberta.ca/Pages/home.aspx (Alberta Justice and Solicitor General home page with link
to Alberta Courts home page provided)
•
Alberta Human Services, Enhancement Policy Manual: Intervention (Revised June 15, 2012),
http://www.child.alberta.ca/home/documents/childintervention/Enhancement_Act_Policy_Manual.p
df
•
Canadian Association of Social Workers
http://www.casw-acts.ca
•
Department of Justice Canada Website
http:// www.laws.justice.gc.ca (The Law Site – This page allows you to search Canada’s consolidated
statutes and regulations)
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