Jun 8, 2018 — The following Program Improvement Plan (PIP) will describe the efforts Oregon is undertaking to improve the Child.
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Oregon Re -Submitted PIP 6-8-18 21-18 18188-17 Child and Family Services Review Round 3 Program Improvement Plan State/Territory: Oregon Date Submitted: May 4, 2017 Date Resubmitted: July 18, 2017 Date Resubmitted: October 9, 2017 Date Resubmitted: December 18, 2017 Date Resubmitted: February 21, 2018 Date Resubmitted: March 2, 2018 Date: Partial Resubmission June 8, 2018 Date Approved: (specified by Bureau) PIP Effective Date: (specified by Bureau) End of PIP Implementation Period: (specified by Bureau) End of Non -Overlapping Year: (specified by Bureau) Reporting Schedule and Format: Oregon will report 30 days after the end of each quarter on the progress made on PIP goals.
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Oregon Re – Submitted PIP 6 – 8 – 18 21 – 18 18188 – 17 Introduction The following Program Improvement Plan (PIP) will describe the efforts Oregon is undertaking to improve the Child Welfare Program and outcomes for children and families. The plan has been organized into four sections. This best represents Child Welfare Program organizational and functional structure: Improving Child Safety Improving Child Permanency Improving Child Well – being Improving Workforce Development Through this PIP , Oregon will explain how each strategy and its underlying activities will contribute to improved CFSR outcomes over the next two years . The goals, strategies, and key activities have been revised to clarify the intent of each strategy as well as to explain how Oregon will measure and sustain practice changes. The expected impact of strategies and activities is also noted. Each PIP goal and strategy addresses the CFSR findings and strikes at the root of individual outcome areas measured by the CFSR. A c omprehensive analysis of both quantitative and qualitative CFSR data was conducted by central office and field staff, in conjunction with partners, to gain an in – findings. Through this process, several practice themes were identified, including lack of concerted efforts to locate and engage parents, and inadequate safety assessments, both initially and ongoing. Furthermore, Oregon has struggled with recruitment and retention of caseworkers and foster par ents. The lower staffing levels, combined with the lack of experienced workers and foster parents, ha ve had a direct impact on the level of service provided to children and families engaged with the agency. W hat emerged from comprehensive analysi s was that many of the selected strategies result in activities that cross over multiple aspects of child welfare practice model, including safety, permanency, well – being a nd the systemic factors. A comm on element incorporated in the PIP is the development and utilization of data to measure performance. Each main goal has incorporated fidelity to the model and continuous quality improvement strategies to improve overall practice. The utilization of data from fidelity reviews and predictive analy tics research, will enable the agency to develop better performance improvement plans and make better data – informed decisions . Oregon has developed several strategies to increase the retention rate and knowledge level of new and experienced staff, including supervisors. accomplishment of the Program Improvement Pla n goals (see Goal 4 – Improving workforce development). Based on the new strategies, Oregon expect s to see positive multiplier effects to its child welfare practice. For example, a key activity to improve training will have a cumulative, even if difficult to measure, positive impact on child safety and stabilization over time. A brief analysis of these impacts is included in a summary before each action plan item . As the PIP came together into one cohesive plan, the draft was sent to the following groups for review: Child Welfare District and Program Managers Child Welfare Advisory Committee Indian Child Welfare Advisory Committee Youth Advisory Committee Parent Advisory Committee Racial Equity Advisory Committee Tillicum – R.E.A.C.T. The feedback from these staff and community partners was reviewed with the central office P rogram M anagers, Executive Projects staff, and Department leadership. Moving forward with the execution of the PIP, the Oregon Child Welfare Program will conduct quarterly reviews to track PIP progress and will conduct routine reviews of PIP progress with the Child Welfare Advisory Committee. The PIP also works to align the resources and work underway with the Unified Child and Youth
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Oregon Re – Submitted PIP 6 – 8 – 18 21 – 18 18188 – 17 Safety Implementation Plan (Unified Plan) and the Child and Family Services Plan . Child Welfare Program will use formal project management to develop detailed project plans, work teams, and work plans for those areas of the PIP that require project planning. PIP strategies , Unified Plan tasks have been aligned to prevent duplication Please see the following attachments for additional information : Attachment 1: PIP Workgroups Membership Attachment 2: Child Welfare Advisory Committee Membership Attachment 3: PIP Measurement Plan Goal Calculation Worksheet Attachment 4: First Year of Caseworker Professional Development Plan Background and CFSR Development Method Oregon worked in conjunction with Region X – year work plan to prepare for and implement the Round 3 CFSR Review, which commenced with the approval of the 5 – year Child and Family Services Plan in 2014. 1 Over the course of several months during 2015 and early 2016, Oregon engaged in the state self – assessment process, examined qualitative case review and statistical data review measures, conducted stakeholder interviews, administered surveys, and provided multiple opportunities for stakeholder fee dback and review of the state self – assessment, which was submitted in March, 2016. 2 Child Welfare Program received the final data from the case reviews conducted during the Round 3 period. The PIP kickoff event took place on January 31, 2017. The k ickoff, which provided information from the final report and outlined the process for PIP development, was attended by over 70 staff, stakeholders, and community partners. Subsequent to the kickoff, the Child Welfare Program initiated six workgroups to address the areas where Oregon was not found to be in substantial conformity (Attachment 1: Implementation Supports: PIP Workgroup Membership). These workgroups, composed of staff in various positions within the Child Welfare Program, tribal representatives, clients, and stakeholders, were actively involved in the causal analysis of current outcomes and the development of strategies and proposed activities included in this PIP. The Child Welfare Advisory Committee, which is serving as the Steering Committee for the PIP, provided oversight of this workgroup process, in addition to staff leading the workgroups. (Attachment 2: Implementation Supports: DHS CWAC Membership). 3 The workgroup facilitators met weekly to share findings and identify common causal factors, cross program, and/or cross system issues. This iterative process allowed for shared learning as well as shared development of the PIP goals, strategies, activities, and proposed measures. 4 1 Oregon was approved to engage in the state – conducted case review process. Oregon engaged in an intensive and comprehensive process of training staff and stakeholders in the case review, using the On – Site Review Instrument and the guidance developed by the Our training and review process, including the curriculum, the sampling methodology and the case review process was reviewed and approved by the CFSR team. 2 methodology for Round 3 resulted in the review of 96 cases from April 1, 2016 through September 30, 2016 (64 foster care cases and 32 in – home cases). Each case review was conducted by trained case reviewers, and received additional quality assurance review by both a QA team and a member of the Federal CFSR Review team prior to final authentication of the review. 3 methodology for the purpose of establishing a baseline for PIP case review measurement and continuous quality improvement began February 1, 2017. The period to develop the baseline is February 1, 2017 through January 31, 2018. This will be followed by a second 12 – month period, February 1, 2018 through January 31, 2019, where results will be measured against the baseline on a rolling monthly basis. For the baseline and PIP periods, Oregon will select cases for review from all branches rather than the stratified schedule of selected districts and branches used in Round 3. This will advance Improvement and continuous quality improvement more broadly than was possible during the 6 – month period used in Round 3.
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Oregon Re – Submitted PIP 6 – 8 – 18 21 – 18 18188 – 17 4 All strategies and activities will be conducted within the confines of available resources, which at the time of the PIP development, are undetermined in either the federal or state budgets. The PIP builds upon work already underway with key strategies for targeted practice improvement. The plan uses the CFSR case review process, the Quality Assurance review tools, routine business review to monitor progress towards the PIP goal, including both statewide routine monitoring and improvement plans and monitoring progress at the District or regional and branch levels. Measures toward progress on the Quality Assurance Review tools and the Quarterly Business Review data measures will be focused on reaching the established target goals for each measure. Measures toward progress on CFSR data items 1, 2, 3, 4, 5, 6, 12, 13, 14, and 15 will be established once the baseline has been determined after January 31, 2018 (Implementation Supports: Attachment 4, PIP Measurement Plan Goal Calculation Worksheet).
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Goal 1: Improving Child Safety Goal Statement Oregon will ensure a swift, safe, and comprehensive response to reports of child abuse . Much of the root cause for poor safety outcomes in Items 1, 2, and 3, can be attributed to a fragmented system of response to abuse, incomplete or insufficient safety assessments and oversight to assure maintenance of safety decisions and planning. The go al was selected based on information gathered through CF SR data from Round 3, data and conclusions in various i nternal and external audits and fidelity reviews that consistently showed findings in this area . Oregon believes that timely face to face contact s with all child victims and completion of comprehens ive child safety assessments is vital to ensuring child safety and well – being. Oregon is scheduled to implement a Centralized Child Safety Hotline in spring of 2019 to increase consistency in screening decisions and develop a professionally trained screening workforce to improve child safety outcomes. In addition, Oregon has greatly st rengthened the commitment to the safety model by invest ing additional resources to improve practice and retain workforce . Child Safety and Permanency Consultants with safety model and coaching expertise are housed in child welfare branches aro und the state and provide in person coaching, training and ongoing consultation to caseworkers and supervisors. The Legislature provided Oregon Child Welfare with investments including the allocation for 50 MAPS (Mentoring, Assisting, Promoting Success) – formerly known as CETs (Consultant Education Trainers) – these are internal positions that augment our services by responsibilities are to support caseworkers through their first year on the job with a focus on training and retention. The p osition will provide both general an d case – specific consultation, support and training of new and existing caseworkers, and will facilitate the effective functioning of units within the branch. In addition, funding has been delegated for two additional professiona l development areas of adva nced worker training and line child welfare supervisor skill development. New enhanced worker training has been developed and implemented to help ensure the new workforce has the skills necessary to utilize the safety model in their day to day caseworke r practice. Oregon has struggled with high rates of caseworker turnover and a large percentage of less experienced staff have entered supervisory positions in recent years. Supervisors are the key to ensuring caseworkers are assessing safety concerns thr ough consistent application of the safety model therefore it is important that supervisors receive the training , and tools necessary. Oregon recognizes staff retention and a highly trained workforce are vital to impacting safety model fidelity resulting in better child safety outcomes. Analysis of the Data & Underlying Issues : Screening reports were reviewed by child safety consultants who identified inconsistent application of screening rule and procedure around the state, leading to inconsistent responses to child safe ty. Screening r eviews also identified o verextended in delays in approving or assigning Closed at Screening reports. Those that end up assigned rather than closed are often already out of compliance with timely response. Closed at Screening Fidelity Reviews found that reviewers disagreed with closing reports in between 12 – 43% of the time. The safety consultant team also conducted a statewide review of completed CPS assessments in January 2017 focused on time liness to initial contact and recurrence of maltreatment. CPS assessments from July through December 2016 identified as not meeting mandated timelines were selected for the review. The findings from these reviews indicated that delays in making initial fa ce to face contact and poor or inconsistent documentation of initial safety assessments had a negative impact on timely and accurate child safety decisions. This was found specifically related to the family conditions of domestic violence and substance abu se. Additional Fidelity Reviews to evaluate application of the practice model have been completed by the Child Saf ety Team in 9 of the 16 districts as an ongoing continuous quality improvement process. Trends identified in these reviews include lack of completion of all required interviews, insufficient collateral contacts, lack of comprehensive safety information ga thering leading to incomplete application of the safety threshold criteria. As a result, these themes are the focus of targeted action plan ning with districts. There has been continued analysis regarding the comprehensiveness of the assessment and the appropriateness of the safety decision on the first maltreatment episode. This data is reviewed monthly by the Safety Consultant and district leadership and used to determine the focus of consultant and leadership activities for the month. Further analysis of the review findings is also indicative that lack of sufficient ongoing safety monitoring contributes to reoccurring maltreatment during trial home visits. Ongoing consultant coaching has included a focus on ensuring conditions for return are accurately identified and monitored to meet the safety needs of the children, and the conditions are met before
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children are returned home with an o ngoing safety plan. Our review of recurrence of maltreatment during trial home visits has indicated in some instances courts have sent children home prior t o conditions for return being met and re – abuse occurred. foster care is approximately twice the federal standard, analysis has been done to determine the root causes. Reports of maltreatment in foster care currently include children who have experienced maltreatment during a trial home visit, as well as reports of historical familial abuse that arise while a child is in foster care. In addition, our data analysis has determined that over half of confirmed victims experiencing maltreatment in foster care involves a perpetrator(s ) other than the foster parent. Ch ild safety consultants have teamed with field staff and other program consultants in reviewing cases where maltreatment oc curred in foster care. Barriers to practicing the safety model with fidelity continue to be staff and supervisor turnover and lack of ongoing, susta inable training on how to supervise to the practice model. New staff who complete new worker training indicate their supervisors d o not always appear to fully understand the practice model so their newly learned skills are difficult to maintain in that cult ure. Supervisors have also confirmed that new staff often do come back to their district with more advanced skills than they as supervisors may have in multiple areas of practice. Root Causes Identified: Current structure of 15 indepen dent hotlines around the state Inadequate training for screening staff and supervisors Lack of clarity in regards to responsibility for screening , assignment and assessment when m ultiple counties are involved Safety model requires strong critical thinking skills to understand the family condition in addition to determining if abuse/neglect occurred Comprehensive safety information not consistently gathered due to high caseloads Ongoing caseworkers are not consistently applying practice model elements to confirm children are safe in their foster care environments Frequent CPS worker turnover High percentage of inexperienced supervisors across the s tate Lack of ongoing safety model training for caseworkers and supervisors Lack of requested support to overtaxed foster parents has resul ted in maltreatment to children Strategies and Links to Outcomes: Strategy #1 : Ensure a consistent statewide response to allegations of abuse. Recognizing that consistent and accurate screening decisions are paramount to positive child safety outcomes, d evelopment is new 24/7 Centralized Child Safety Hotline . Implementation of the Centralized Hotline is e xpected to support on – site leadership , enhanced training opportunities, and consistent application of statute, rules and procedures . Consistent and timely screening decisions should result in a direct imp act on child safety outcomes, in particular around ini tial contact timeliness with alleged victims. New screening training on specific elements of the safety model along with administrative rule changes will ensure all screeners and supervisors have strong poli cy and practice guidance for assignment decisions and for gathering the right safety related information from callers. Multiple avenues of work related to a consistent statewide response have beg un with hotline screeners to ensure docum en tation of screening reports after hours are completed accurately resulting in timely response to initial contact with alleged victims. Implementation of the Inter – County Case Responsibilities Procedure was developed in partnership with district leadersh ip and has been disseminated statewide. This should result in more clarity around responsibility of consistency in screening assignment and assessment to the correct county. Strategy #2: Improve timeliness to face to face contact with children and families during CPS assessments. Data is used to monitor timeliness to face to face contact in all 16 districts by collaboration between Child Safety Consultants , supervisors, program managers and other staff . The information is reviewed each month and a summary of root cause analysis is provided through monthly reports completed by the consultants and shared with district leadership. Action items including additional t raining on rule and fac e to face contact requirements, supervisor monitoring, correct data entry , computer system
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Strategy Activity Expected impact of the strategy and collective activities A. Ensure a consistent, statewide response to allegations of abuse (aligns with Unified Plan, Task G). A.1 Supervisors, program managers and consultants will coach screening staff to accurately identify and document date and time of screening reports received outside of business hours. Activities started January 2017 and will continue through full impleme continuous quality improvement effort. Quarter 1 and ongoing . A.2 Safety team completing monthly analysis of timeliness to initial contact utilizing ROM Report CPS.03 in all 16 Districts. Follow up debriefs then occurring on a bi – monthly basis with all districts in which these cases are identified and discussed. Qu arter 1 and ongoing A.3 Statewide communication will be disseminated clarifying the date Quarter 1 and ongoing . – and implemented to address inconsistencies and timeliness of assignment delays when multiple counties are involved in a case. Statewide communication will be disseminated and ongoing coa ching will be provided to staff by the Child Safety Consultants. Quarter 1 and ongoing . A.5 Develop and implement a centralized hotline operation supported by consistent policies and on – site leadership . Develop project implementation plan with the assistance for ACTION for Child Protection. Quarter 1 Develop workforce and staffing plan with the assistance of ACTION for Child Protection. Quarter 1 Develop rules and procedures with the assistance of ACTION for Child Protection. Quarter 2 Develop trai ning curriculum, coaching plan and CQI plan with the assistance of Action for Child Protection. Quarter 2 Implementation begins April 2019. A.1 – 3 Increase accuracy of documentation and timely response to reports of abuse and neglect. A.4 Clarifies county of primary CPS assessment assignment reducing delay of timely contact. A. 5 The centralized hotline will result in trained screening staff responding to reports of abuse/neglect 24/7. A.5 Hotline supervisors devoted only to screening will result in reports of child neglect and abuse being reviewed and addressed more timely, improving timeliness to initial contact. A.5 Timely supervisory staffing of reports will occur as a result of the ded icated staffing structure of the centralized hotline. A . 5 Trained staff and adequately resourced supervisors will make accurate screening decisions, consistent with rule, and timely assignments of reports.
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Strategy Activity Expected impact of the strategy and collective activities B. Improve timeliness to face to face contact with children and families during CPS assessments B.1 OR – Kids change request to reflect the due date and time of initial contact on the screening report and in the email not ification of assignment to help workers identify and achieve initial contact timelines. Quarter 2 . B.2 Child Welfare data systems and reports modified to accurately capture the due date of initial contact on Within 5 Day Response referrals; defined as calendar days to be consistent with CPS Rule. Completed January 2018. B.3 Targeted data collection occurring in all 16 districts on a monthly basis regarding timeliness to initial contact utilizing ROM reports. Child Safety Consultants gathering and analyzing timeliness data including root cause analysis of all cases not meeting timeliness standards . Q uarter 1 and ongoing B.4 Monthly timeliness data will be reviewed with local leadership in all 16 districts on a bi – monthly basis. Action items will be implemented and monitored on a bi – monthly basis , s pecific to the needs of each district. Quarter 1 and ongoing B.5 CPS workers will utilize available technology including Surface Pros, Speak Write and iPhones to accurately enter initial contacts into OR – Kids that reflect timely response to reports of abuse. Quarter 1 and ongoing B.1 Child safety will be improved by responding more timely to allegations of child abuse and neglect. B.1 The system updates will provide an immediate reminder of due dates which will result in increased accurate response time for seeing children. B.2. Clear and consistent definitions and tracking of timelines for contact will reinforce practice for CPS workers response to safety. B.3. Ongoing analysis of timeliness data will identify root cause issues that will be the basis for action items to improve timely r esponse of face to face contact with all children and adults. B.4 Monthly reviews debriefed with each district will demonstrate a measured improvement in timeliness of response. B.4 Action items developed will result in sustained practice improvements and local accountability by district leadership. B.5. Trained staff who understand child safety implications as well as system requirements of timely initial contact. B.5. Supervisors and program managers will be able to review work in real time to assess if all required contacts have occurred within timeframes. Strategy Activity Expected impact of the strategy and collective activities C. Improve comprehensive safety assessments and ensure safety services adequately manage child safety during in – home plans including but not limited to trial home visits. C.1 Targeted data collection regarding recurrence of maltreatment will be gathered an d reviewed monthly with local leadership in all 16 districts. The reviews include root cause analysis on a representative sampling of children experiencing re – abuse in each district. Specific trends and themes will be identified and relevant action items that address child safety will be developed with district leadership. Quarter 1 and ongoing C.2 Based on CPS Fidelity Reviews completed in 9 of 16 districts statewide practice areas impacting child safety planning and decisions C.1 Overall child safety will be improved by conducting consistent comprehensive safety assessments. C.2 Reduction in recurrence of maltreatment specifically related to identified abuse types specific to threat of harm, domestic violence, neglect, etc.
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have been identified. District specific Action Plans have been developed for seven of the sixteen districts . While each district is able to individualize their Action Plan accordingly , a ll districts have similar elements of focus including but not limited to: ensuring all required interviews are completed, making sufficient collateral contacts, gathering comprehensive safety related information and accurately applying the safety threshold criteria. The remaining districts will have Action plans completed by December of 2018 that will include the following statewide practice areas: ensuring all required interviews are completed, making sufficient collateral contacts, gathering comprehensive safety related information and accurately applying the safety threshold criteria. In addition, specific district practice trends will be included. Quarter 3 . C.3 Action Plans will be reviewed with districts at 6 months from development to mon itor results of activities and goal progression and adjust the Action Plan as necessary based on the individual needs relating to safety in each district. Q uarter 3 and quarterly, ongoing C.4 Action plans will include continuous quality improvement plans including topic specific labs, mini – trainings focused on domestic violence and substance abuse , group supervision, targeted fidelity reviews of in – home criteria, safety plans, face to face contacts, collateral contacts, 60 – 90 – day check – ins, and quality ass urance by supervisors and consultants. Quarter 3 and ongoing. C.5 CPS consultants will partner with OR – Kids trainers and provide ongoing OR – Kids documentation (documenting to safety) trainings to staff completing CPS assessments. These trainings review the practice model and provide structured coaching to demonstrate the proper and timely documentation of safety assessment activities including accurate documentation of all safety decisions and actions. Q uarter 1 and ongoing. C.6 Classroom trainin g for new hires will include practice model review, as well as in depth discussion and training on how to conduct a comprehensive assessment, assessing for present and impending danger, developing safety plans, ongoing family assessments/case plans, monito ring child safety, and meeting expected outcomes timelines during initial and ongoing safety assessments and documentation requirements in OR – Kids are included in new worker training (Refer to Goal 4, Strategy C, Workforce Development , for further details) . Quarter 1 and ongoing. C.7 The ongoing CFSR will continue to measure items 2 and 3 to determine effectiveness of structured training and action plans. C.8 ROM reports will be utilized to measure and identify practice issues and training needs. Quarter 1 and ongoing . C.3 Increased local leadership understanding and accountability for managing improvements in conducti ng assessments that ensure safety threats are identified and managed sufficiently when present or impending danger is identified. C.2 – 4 Action plans will provide clear structure and accountability for each district to conduct comprehensive assessments that sufficiently manage safety. C.4 Casework staff will make improved safety decisions in cases involving domestic violence and substanc e abuse. In addition, recurrence of maltreatment will be decreased . C.5 – 6 Casework staff and supervisors will understand able to assess safety, evaluate the in – home criteria, and make necessary adjustments to safety plans. C.7 Oregon Child Welfare will increase and improve child safety and ongoing risk assessments. C.8 Oregon will utilize real time data and reports to continuously assess practice and develop benchmark goals for improved child safety outcomes.
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Strategy Activity Expected impact of the strategy and collective activities D. Improve child safety throughout the life of the case, by conducting frequent and accurate safety monitoring activities. D.1 Supervisors will receive training to effectively determine whether quality of face to face contact is taking place, and ongoing safety is being monitored. Supervisors will in turn utilize the 90 – day staffing meetings to provide coaching, support and to ensure frequent and accurate safety monitoring is consistently occurring. Quarter 1 and ongoing. (Refer to Goal 2, Strategy A, activities A . 1 and A . 2 for further details ). D.2 Consultants will collect data resulting from the CFSR case reviews, ROM reports and QBR information that demonstrate if safety is being monitored ongoing and accurately on a consistent basis. Action plans will be implemented and monitored at the district level to address gaps identified by the reviews. Quarter 1 and ongoing Other activities in the Program Improvement Plan, are designed to improve overall safety, in conjunction with this strategy. (Refer to Goal 2, Strategy D , Activities D1 – 4 , and Strategy F, Strengthen the Support for Certified Families , for further details ). D . 1 – 2 Children in substitute care and in – home will be safer. Caseworkers will have more clear direction, coaching and frequent reminders of how to assess and ensure safety throughout the life of the case. D . 1 – 2 Maltreatment rates both in – home and in foster care will decrease as a result of frequent and ongoing safety monitoring
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