Annual Report 2010

Presented to the Connecticut Department of Children and Families (DCF)

Prepared by members of the FAVOR,Inc Connecticut Citizen Review Panels

For Additional Information Regarding The FAVOR’s Citizen Review Panels (CRPs)
Please Contact: Hal Gibber, Executive Director, FAVOR, Inc., 2138 Silas Deane Highway, Rocky Hill, CT 06067
Tel: (860) 563-3232, x201 Toll Free: (866) 630-6055 Fax: (860) 563-3961 Email: hgibber@favor-ct.org

Table of Contents (Section Titles)

• Introduction
• Barriers and Obstacles Encountered, Process Recommendations
• Foster Care, Policy and Practice
  • A Review of Selected Policies and Practice
  • Some Relevant Literature Review on Foster Care
• Findings and Recommendations

• ---

• Appendices

• ---

• Family Satisfaction Questionnaire
• CRP Membership Application Form
• Leaders of the Two Working Groups

Introduction

Thank you for your interest and ongoing support and collaboration with Connecticut’s Citizen Review Panels. These Citizen Review Panels (CRP) were formed as a result of the Child Abuse Prevention and Treatment Act (CAPTA), as amended by the Keeping Children and Families Safe Act of 2003. Each Panel is mandated to evaluate the policies and practices of the Connecticut Department of Children and Families (DCF) and to make recommendations for the improvement of child protective services. As a result of the recommendations, the Department is required to review and respond to the CRP’s report in writing. We appreciate the commissioner’s kindly and thoughtful response. The Panel’s Annual Report and DCF’s response are both publicly available documents that can be shared with anyone interested in our work.

In 2005, the Department of Children and Families contracted with FAVOR, Inc., a statewide family advocacy organization for children’s mental and behavioral health, to administer two Citizen Review Panels. The Department continued the contract in 2007 and then again in 2010, with FAVOR to manage and further develop the two Citizen Review Panels and to assist the Panels in developing this Annual Report for 2010.

The CT Citizen Review Panels are comprised of parents and professionals who have personal and/or professional experience with Connecticut Child Protective Services through DCF. Our members represent a broad spectrum of diverse cultural, economic and geographical constituencies from across the state of Connecticut. These members are responsible for determining the most pertinent areas of focus to review and establish the recommendations themselves. Additionally, through the panel members and those we reach through our public meetings, discussions and forums, Connecticut’s citizens can be mobilized to become an influential voice for child protection that transcends agency or provider self-interest in the system. Panel members can and do provide a valuable link and leadership to the state and nation’s family movement. We seek to establish and implement a full partnership with DCF.

Our CRP work for Fiscal Year 2011 began with a well planned and aggressive outreach process which resulted in a greatly expanded Panel membership for this year. Overall, close to forty individual parents and professionals regularly attended our meetings and helped to plan each meeting or focus group while simultaneously fully participating in each meeting. Our group was both geographically and ethnically diverse and we are particularly proud of our success in recruiting additional fathers, and community professionals to our group. CRP members for this year can be found in our appendix.

An expanded orientation and training curriculum was implemented at our first two group meetings. Representatives of the Department participated at these meetings and provided valuable feedback and input as the Panels organized themselves into two primary workgroups and made decisions on the priority activities for this year’s work. We went on to the task of reviewing and discussing the Commissioner’s response to our recommendations from last year and the Department’s response informed our decision-making concerning this year’s priorities. It was concluded that the two CRPs and a regional infrastructure would assist us going forward in further expanding our membership, recruiting additional professionals who work in child welfare agencies across the state, and helping in improving both the quality and representativeness of the report. Established relationships with area office staff, Department managers and leadership, Training Academy personnel, and other community partners remain a focus for our collaboration and successful partnerships.

At our third CRP meeting in the fall, the Panel members decided upon two prioritized areas for our focus and work this year. Given our interest and observations, that the child welfare population often interacts with the behavioral health and juvenile justice systems, and the Department’s interest in improving both its child welfare and Behavioral health Foster care service systems, we decided that one panel would review Foster care policy and practice, and the second panel would work to modify and update the customer satisfaction survey we had developed last year. The survey’s purpose was to address the effectiveness and quality of family engagement by social workers in their work with the biological families they interact with in their care and protection functions. We planned to partner with one or two DCF area offices so as to administer our survey to recently closed cases in one area, whiles the second panel would seek to hold qualitative interviews with DCF Foster parents by attending local support groups.

We were interested in the Foster parents view of the degree of understanding and support they experience with the area office staff, frequency and quality of interaction and communication with the biological families(where safe and appropriate), their level of competence and preparedness as well as their familiarity with the treatment planning and Administrative Case Review(ACR) process. We prepared to interview DCF Foster parents in the community in partnership with relevant area office staff.

Dr Blake Jones, Ph.D. is a Licensed Clinical Social Worker with over 10 years of experience as a clinician, researcher and adjunct professor in the University of Kentucky College of Social Work (UKCOSW). Dr. Jones is the former program coordinator for the Kentucky Fatherhood Initiative and is a husband and the father of two young sons. He is the coordinator of the UKCOSW’s Continuing Education program and a national consultant in the areas of child abuse and neglect, Citizen Review Panels (CRP), and citizens participation in the child protective services system.

Our CRP’s along with the third CT panel affiliated with the state advisory committee additionally benefited from a full day technical and training session presented by Dr. Blake Jones to the three groups collectively.

This Year’s Experience, Barriers and Obstacles Encountered and Process Recommendations For the Future

The work of the panels this year was challenging, given certain “bumps in the road” experienced along the way. Staffs to the Panels were proud of the level of parent participation, the diversity of the group and what we perceived as a growing level of trust towards DCF, its staff and the care and protection process. We initially received a very complimentary note from Dr. Blake Jones our national CRP expert and trainer on the strength, scope and energy level of our members after the training last spring. We later received feedback from our DCF contact liaison that another impression of the group was that it was too large to be manageable and productive. That there were not enough community professional members and that the objectivity and credible representativeness of the group was an issue given there were no clear assurances that none of the parents have an “Open Case”pending. This impression or perception was one that was shared by DCF staff, the State Advisory Council (S.A.C.) and by the consultant /trainer.

Staff to the two FAVOR panels were directed to reduce the size of the groups by more than half, diversify their membership by recruiting additional community professional to replace and supplement the remaining family representatives and to administer a new registration and membership form and process so as to assure no parents with “Open Cases” could participate at least not currently and until the case was closed.

Staff brought this information to the Panel members in a clear and direct fashion. The goals were to strengthen the Panels in its membership while further assuring the objectivity of its recommendations. A second and equally important goal was to minimize the impact of the intervention relative to the trust and credibility advances of recent years. Dismissed Panel members were assimilated into various focus groups, and minutes of our meeting were sent to all of our current and former members so as to not send a louder message of rejection, but rather one of difficult decisions and meeting necessary and responsible change so as to strengthen our credibility with DCF and overall membership capacity. This was a difficult balance to achieve in terms of the two outcomes sought. Thus far, the situation and process have remained stable but a great deal of time and trust was lost. This experience within the group is not totally separate from the Care and Protection process itself.

Given two or three months of delay, discussion and healing, we began in April to connect the Panels with two area offices to implement the questionnaire to families of recently closed cases and to interview both DCF staff and Foster parents about their perceptions of policy and practice. The panel looked for strengths and areas for improvement while using a continuous quality improvement (CQI) approach. Our thought is to continue this Foster care focus into next year while making recommendations for strengthening communications between the CRP, Foster parents and DCF Staff. We want to engage in behavioral health and juvenile justice service systems both within DCF, and across the state agencies, to private provider and integrated community service systems with emphasis on systems of care, wraparound and family advocacy /care coordination principles and practice. It appears that this may be necessary or recommended given each of the four area offices initially agreed to work with us and then found themselves unable to do so. The notification came late in the process and were due to volume of local activity and “concern over potential issues of confidentiality”. After checking with the Department, it was decided not to seek a second time extension, but present a thoughtful and candid discussion of our work, our process this year and our initial findings.

Foster Care, Policy and Practice

A Review of Selected Foster Care Policies and Practices

After deliberating on a number of important topics to focus this year’s work on, the panels settled on reviewing DCF foster care policies, best practices, and their impact on safety and quality of foster care. The panels were divided into two working groups. One group focused on reviewing DCF foster care policies, and the second group focused on soliciting feedback from biological and foster parents in relation to their experiences with the foster care system.

A selection of DCF foster care policies were made available to the group to review and comment on. Below are some of the policies reviewed and comments frequently made in regards to those policies.

• TREATMENT FOSTER CARE POLICY REVIEW AND COMMENTS
  • Policy 36-55-1.5 -the role and responsibilities of Foster Parents. This policy illuminates the critical role the treatment foster care system provides to our community in general and the child welfare protective services system in particular. The first responsibility of the treatment foster parent is to provide services to children who must live away from their family of origin when such family cannot provide a positive nurturing environment or meet the special needs of the child.
  • Section two states- the foster parents and the child’s social worker are partners in carrying out the plans of the treatment team so the child receives the full spectrum of appropriate services.

  Comment: Panel members think depending on the circumstance that led to the child’s removal from their parent as well as the treatment plan, this partnership should include the family of origin right from the onset of treatment planning. This will ensure a continues relationship between child and family of origin even while the child is in foster care and in an out of home placement.

  • Section three states the foster parent, DCF social worker and supervisory staff, birth parents, educational, medical, mental health professionals and the child’s attorney shall all be included in the child’s treatment plan team.

  Comment: As much as this section embraces the principle of inclusion, in our view the birth parent is in a company of professionals, which by itself is very intimidating. The birth parent must have the services of an advocate to explain the process and policy implications so they are well informed to participate effectively for better outcomes for their child while in foster care.

  • Section five makes it explicit that foster parents would accept the heritage, culture and language of the child and the birth family. The foster parent would also acknowledge the importance of the birth family.

  Comment; Panel members expressed concerns about some foster parents disregard for birth parents and that they do not include them in many important facets of the child’s experience. Since we did not get the opportunity to interview a sample of foster parents, we are not sure if this is an issue of training and exposure of foster parents to this policy or if it is a service practice which should meet a higher standard. There is a need for improved relationships between foster parents and the child’s birth parents or family of origin.

  • Section six deals with the responsibility of foster parents to the birth parents: - foster parents shall accept, cooperate with, and support arrangements made for the birth family and the child to have contact including visits and correspondence.

  Comment: This policy stipulation does not state who is responsible for the establishment of a relationship between the foster parents and the birth parents. CRP members repeatedly commented on the need for improved communications between foster parents and family of origin of children in foster care. Birth parents find it very difficult to obtain medical records or the specific medication regimen their child is on while in foster care. Panel members felt that irrespective of the goal of foster care, the family of origin of children in foster care must be involved in the treatment plan for the child. The only exception being where the safety of the child can be compromised.

  • DCF policy 41-19-4-procedure for Foster Care Matching, section one stipulates that the foster care placement is initiated by the child’s social worker after consultation with the child’s family, social work supervisor and other professionals as necessary to determine the appropriate type of placement for the child including possible placement with relatives.

  Comment: Panel members overwhelmingly stated that whiles the policy calls for relatives of the child to be considered as possible placements options, in practice, the relatives or kin are seldom considered. The panel suggests that in cases where such efforts are made, it must be documented in the case review report so later inquiries can substantiate compliance with the policy. The panel felt that when it comes to matching children with foster parents, relatives of children should be the first option when they are capable, appropriate and safety is assured.

  • Policy 36-55-1.4- DCF responsibility to Biological parents while child is in placement. Section one states- the social worker has the responsibility to work with the biological (or adoptive) parents to help them rectify the problem(s), which resulted in the abuse or neglect of their child.

  Comment: Panel members felt that much is needed to be done on the implementation of this important policy. The group felt that when a child is in foster care the social worker seldom works with the biological parents to identify and address the family needs that might have contributed to the removal of the child. The group opinioned that social workers need to be trained in the wrap-around practice model to equip them with a holistic perspective of some elements of the socio-cultural and economic stressors biological parents connected with the child protective services encounter.

  • Section three states- the department through the social worker shall continually evaluate the home of the biological parents and keep aware of changes in their psychosocial circumstances.
  • The social worker shall provide a clear explanation to the parents, child and caretakers of why the child requires placement.
  • It is the responsibility of the social worker to establish an ongoing relationship with parents through planned appointments and contacts in order to jointly identify and develop goals for family reunification.

  Comment: Panel members expressed satisfaction with the details and stipulations of the policies as written. However, their greatest concern was how these policies are implemented. Members suggested the need for effective supervision and training to ensure that foster care policies are properly implemented and that the foster care service practice mirrors policy stipulations. We felt doing this will build enhanced collaboration and trust between the department, foster parents and biological family.

Literature Review on Foster Care

Foster care is defined as the provision of planned, time-limited, substitute family care for children who cannot be adequately maintained at home, and the simultaneous provision of social services to these children and their families to help resolve the problems that led to the need for placement (Blumenthal, 1983, p.296). Foster care is intended to serve as a temporary haven for abused or neglected children who cannot safely remain with their families. However for some children, the journey through foster care is characterized by further trauma and abuse; and even in the best situations, foster care is inherently fraught with uncertainty, instability, and impermanence. The number of children and families who require foster care services has grown substantially over the past two decades, and these families are typically contending with a multitude of complex psychosocial and environmental problems.

Public opinion polls reveal that the public is largely uninformed about foster care, yet highly critical of the system. In a 2003 poll of voters by the Pew Commission on Children in Foster Care, most respondents were generally unfamiliar with the child welfare system that administers foster care, but more than 50% believed it needed major changes, if not a complete overhaul. An analysis of the current state of the foster care system finds that it is not a cohesive system but a combination of many overlapping and interacting agencies, all charged with providing services, financial support, or other assistance to children and their families. Lack of coordination among agencies, chronic underfunding, and low morale have led to a system that exacts a toll on everyone it touches. Children may suffer, so do foster parents and the relatives who step in to care for children who cannot remain with their birth parents; so do harried caseworkers; and so do birth parents who would like to reunite with their children but find the path difficult. Too few of the players in the system have adequate training for their responsibilities and, as a result, children and families frequently do not receive the services and supports they need. Instead, the child welfare system labors in an atmosphere of distrust, impending failure, and reflexive, uniform solutions that rarely succeed for anyone. In a paper authored by Shelley Waters Boots and Rob Geen the concept of kinship in foster care and the child welfare system was highlighted. While the state, through the child welfare system, has only recently begun to rely on relatives as foster parents for children at risk in their own homes, the practice grew substantially in the past decade. This growth, and federal legislation encouraging states to place foster children with family members, has thrust kinship care into the policy spotlight, igniting debates within the child welfare and welfare systems about how to publicly support kinship care families.

When the Adoption and Child Welfare Act of 1980 was passed, forming the basis of the federal foster care law, it was almost unheard of for a child’s relative to act as a foster parent. More than two million children in the United States now live in kinship care arrangements; 10 percent of these, or approximately 200,000, are foster children. The 1996 welfare reform act officially encouraged states to give relatives first priority in providing care for foster children, solidified the role of kinship care as a federal policy issue, and provoked discussion among policymakers as to how welfare policy would affect kinship care. Engaging relatives and biological parents in cases where it is safe to do so has proven to lead to better outcomes for children in foster care and we believed that much emphasis needs to be put in this area of DCF treatment foster care along with the child welfare component.

Findings and Recommendations

1. Representatives of FAVOR and the Citizen Review Panels would like to implement the work with the DCF staff committee to review the satisfaction survey and provide said feedback to the CRP’s. We sought to do that this year in partnership with selected area offices and central office staff. This did not come to fruition and we recommend trying again next year.
2. We recommend Foster parents become full participating members of the child’s treatment team. The Department mentioned that this was challenging but, nevertheless supported our recommendation from last year. The timeframe was ongoing and we are requesting an update.
3. The Department should consider adapting the family conferencing model to utilize the wrap-around approach to care planning. Families we have worked with and trained are available to assist in this effort including DCF foster parents where appropriate. Biological families might participate as well to begin the reunification process at the time of placement, a practice utilized in other service models and levels of care.
4. We request that the Department updates us on our third recommendation from last year involving biological family notification and foster parent direct participation. We believe this to be one of DCF’s performance or outcome measures in the consent decree or something close to it.
5. The Panels recommend that DCF review the initial and inter agency recommendations in Dr Robert Plant’s recently published “white paper” on children behavioral health with emphasis on management of services and systems recommendations numbers 53,54 and 56.
6. The Panels look forward to working with the Department in researching best practices in foster care, and beginning the discussion of meeting the different levels of quality, clinical support and access between the child welfare and specialized or treatment foster care models. It seems that oftentimes the needs of the children are similar and kids being removed from their families may be experiencing serious trauma whiles being relocated to a safer living environment. Children in the child welfare system should have same access to the quality of service in the treatment foster care system.
7. We recommend adopting a shared approach to improving communication between DCF area and central office staff and the CRP’s and families who receive DCF services in general. True family engagement will be realized through the establishment of trust and by working together. The CRP’s stand ready to meet with DCF area and central office staff on a bi-monthly basis throughout the year. This will complement a partnership relationship with the training academy and the individual Department managers and social workers. We would hope to avoid some of the “false starts” we experienced this year.
8. The CRP’s would like to express their interest in and offer their participation as DRS is implemented. We believe it would be helpful.
9. The panels would like the Department to consider using the CBHAC and the community collaboratives to become more familiar with the child welfare system and lend their support and input to the CRP process.

Appendices

Appendix A: Family Satisfaction Questionnaire (DCF child welfare closed cases)

Family Satisfaction Questionnaire

We are interested in your opinions about the service that you received. Please give us your feedback by answering this brief questionnaire. This information will help us evaluate and improve family engagement, keep children safe, and improve the quality of cooperation and communication between families and DCF social workers. We are interested in your honest opinions. Please, answer the following questions.

Printable version of Family Satisfaction Questionnaire

Appendix B: (withheld for privacty considerations)

Appendix C: CRP Membership Application Form

FAVOR, INC.
Application for
Citizen Review Panel (CRP)

1. General Information
   1. You are a (circle one):  Caregiver / Provider / Advocate / Other (explain ________)
   2. Name:                ________      _____   _________________________________  ___
   3. Address: ______       _                                   ________________________________
   4. Phones – Home: ______________Work: _______________Cell: __________
   5. E-Mail:______________________________________________________________
   6. Preferred contact method (circle one):   Mail / Phone / Email
   
   
2. What supports would you require to participate on the Citizen Review Panel (check all that applies)?

__________	Stipend for Meeting Attendance ($25 = ½ Day; $50 = Full Day)
__________	Reimbursement for Transportation
__________	Translation Services
__________	Other________________________________________________________________



3. What days and hours are you available to attend meetings?
1. Mon _________ Tues _________ Wed _________ Thurs ________ Fri _________
2. Weekends – Sat ______________________Sun ___________________________


4. Do you have open/active case with DCF Child Protective Services? 
1. (circle one) Yes / No / Not Applicable


5. Are you a member of any local advisory committees? e.g. Community Collaborative, Family Support Groups, Juvenile Justice & Public Policy Groups. ____________________________________________________________________________
   ____________________________________________________________________________
   
   
6. Have you received any specialized training that would benefit the CRP? ____________________________________________________________________________
   ____________________________________________________________________________
   
   
7. What else would you like us to know about yourself and your ability to serve on the citizen review panel (CRP)? ____________________________________________________________________________
   ____________________________________________________________________________
   
   
8. Do you have any interest or topic you would like us to review? ____________________________________________________________________________
   ____________________________________________________________________________
   
   

Signature: ________________________ Date: __________________________

Printable version of the CRP MEMBERSHIP APPLICATION FORM

Appendix D: Leaders of the Two Working Groups

Family Satisfaction Survey

• Ellen Wright
• Neva Caldwell
• Michelle Tournas
• Denise Tillman
• Brenetta Henry
• Susan Williamson
• Heather Brown
• George McDonald

Review of Foster Care Policies

• Tawana Bourne
• Sincilina  Beckett
• Kathy Carrier
• Debbie  McCusker
• Alicia Briddell
• Rebecca Turgeon
• Janet Ortiz