Children Youth and Families Chapin Hall Driving Innovative

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Children, Youth and Families Chapin Hall Driving Innovative Practices Bryan Samuels, Executive Director of

Children, Youth and Families Chapin Hall Driving Innovative Practices Bryan Samuels, Executive Director of Chapin Hall Lutheran Services in America Annual Conference May 1, 2019

2 Bridging the gap between what we know and what we do

2 Bridging the gap between what we know and what we do

Chapin Hall at the University of Chicago is a research and policy center, focused

Chapin Hall at the University of Chicago is a research and policy center, focused on a mission of improving the well-being of children and youth, families, and their communities. Chapin Hall provides public and private decision-makers with rigorous data analysis and achievable solutions to support them in improving the lives of society’s most vulnerable children, youth and families.

Four Current Studies 1. Los Angeles Family Bonding Initiative 2. Building Bridges Feasibility Study

Four Current Studies 1. Los Angeles Family Bonding Initiative 2. Building Bridges Feasibility Study of Postdischarge Outcomes 3. FFPSA: Using data to define Candidacy 4. Voices of Youth Count

Chapin Hall Lifecycle for Moving Research to Action

Chapin Hall Lifecycle for Moving Research to Action

Family Bonding Initiative: Improving Outcomes • Improved Child Outcomes: Frequency & duration of visits

Family Bonding Initiative: Improving Outcomes • Improved Child Outcomes: Frequency & duration of visits correlate with stronger attachment, better future relationships, improved health & mental health outcomes (Wells, Vanyukevych, & Levesque, 2015) • CSW/HSA Impact: Parents are twice as likely to attend visits when the caseworker helps resolve scheduling conflicts (Nesmith, 2015).

Levers for improving visit efficiency and quality Visit Locations Visit Monitoring Visit Timing Efficient

Levers for improving visit efficiency and quality Visit Locations Visit Monitoring Visit Timing Efficient and successf ul visits Placement Distance Schedulin g Mode of transport

Goals for Optimization of Visit Locations • Minimize travel distance for the maximum number

Goals for Optimization of Visit Locations • Minimize travel distance for the maximum number of travelers, using total mileage traveled and travel time using road networks • Use the mid-points of parent/child trips to identify new “optimal” locations for visitation centers • Maximize efficiency and effectiveness of visitation practice

Geographic Distribution • Parent & Child Locations Data Source: LA County DCFS Administrative Data,

Geographic Distribution • Parent & Child Locations Data Source: LA County DCFS Administrative Data, 10/03/20

Distance in Miles from Parent to Placement by Placement Type Congregate Care-Public 29 Foster

Distance in Miles from Parent to Placement by Placement Type Congregate Care-Public 29 Foster Care-Private 31 Foster Care-Public 22 Guardian-Private 28 Guardian-Public 15 Other-Private Other-Public 10 19 3 Relative-Private 18 Relative-Public 15 SILP-Public 19 Avg. Miles Total Avg. Data Source: LA County DCFS Administrative Data, 10/03/201

Parent Locations & Visitation Sites Avg. Travel Time (Minutes) Avg. Travel Distance (Miles) 13.

Parent Locations & Visitation Sites Avg. Travel Time (Minutes) Avg. Travel Distance (Miles) 13. 7 25. 0 12. 8 24. 3 11. 9 23. 5 Child Parents & Children Data Source: LA County DCFS Administrative Data, 10/03/20

Distance to Visitation by Placement Type Avg. Distance to Visitation Center (Miles): Existing 0.

Distance to Visitation by Placement Type Avg. Distance to Visitation Center (Miles): Existing 0. 1% 4. 7% 5. 4% 15. 6 16. 3 Congregate Care-Public Relative-Public 18. 8 Foster Care-Private 15. 6 13. 5% 45. 6% 13. 6 12. 0 Foster Care-Public Foster Care-Private Foster Care-Public SILP-Public 9. 5 10. 6 Relative-Private 10. 4 Relative-Public Parent 30. 7% Relative-Private 9. 0 12. 8 11. 5 SILP-Public Child Congregate Care. Public Avg. Child Avg. Parent Data Source: LA County DCFS Administrative Data, 10/03/20

Time to Visitation by Placement Type Avg. Time to Visitation Center (Mins): Existing 0.

Time to Visitation by Placement Type Avg. Time to Visitation Center (Mins): Existing 0. 1% 4. 7% 5. 4% 31. 5 32. 6 Congregate Care-Public Relative-Public 29. 6 Foster Care-Private 33. 5 13. 5% 45. 6% 23. 0 24. 5 Foster Care-Public Foster Care-Private Foster Care-Public SILP-Public Relative-Private 17. 4 Relative-Private 23. 2 23. 1 SILP-Public Parent 30. 7% 19. 0 Relative-Public Child Congregate Care. Public 29. 6 Avg. Child Avg. Parent Data Source: LA County DCFS Administrative Data, 10/03/20

Considerations for reducing mileage, costs, and travel time 14 1. Incorporate analytic results into

Considerations for reducing mileage, costs, and travel time 14 1. Incorporate analytic results into contracting process for visitation sites in optimal locations 2. Customize strategies by placement type. For privately managed cases, shorten placement distances by: 1. Aligning placement processes and policy to promote geographically informed placements to reduce travel distances 2. Targeting foster home recruitment in areas that are closer to home 3. Continue to emphasize the benefits of placing children with relatives, which tend to be closer to parents 4. Customize visitation plans to allow the replacement of visits requiring long travel to those that are coordinated with the daily activities of youth, or facilitated by technology. 5. Explore opportunities to maximize visitation in off hours when trips are shorter. 6. Maintain up-to-date information on parent work schedules to facilitate efficient visit scheduling.

Long-Term Outcomes: Building Bridges Initiative (BBI) Best Practices • Lengths of stay < 6

Long-Term Outcomes: Building Bridges Initiative (BBI) Best Practices • Lengths of stay < 6 months (ideally < 3 or 4 months); • Partnerships and collaborations to address post discharge outcomes; • Permanency for every child; • Comprehensive family engagement; • Moving away from standardized behavioral approaches such as points and levels and using individualized trauma-sensitive approaches in collaboration with the youth and families; • Youth-guided care/self-regulation strategies; • Use of data to implement robust Quality Improvement practices

Feasibility Trial: Post Discharge Outcome Assessment • Survey development • Provider recruitment • Provider

Feasibility Trial: Post Discharge Outcome Assessment • Survey development • Provider recruitment • Provider staff training and ongoing support • Findings & lessons learned • Recommendations

Completion Rates by Agency

Completion Rates by Agency

Successes and Challenges • Successes • Average 10 -12 minutes to complete • Most

Successes and Challenges • Successes • Average 10 -12 minutes to complete • Most caregivers knowledgeable about youth 6 months post treatment • Caseworkers or other service providers are interviewed if there is no caregiver • 60% response rate • Challenges • Caregivers may be difficult to reach during daytime hours • No survey option for emancipated youth • One provider withdrew because of limited capacity for interviews • Variability among success rates

Lessons Learned: Family Engagement • Lack of contact info is one of the biggest

Lessons Learned: Family Engagement • Lack of contact info is one of the biggest challenges • Families are willing to answer “sensitive” questions • Families want to feel that someone cares about their child • You have to relate to the family member based on where they are emotionally • You can never anticipate every scenario • Caseworkers can be a source of info, but call as a last resort

Lessons Learned: Staff Engagement • Recognize what motivates your staff • Tie why staff

Lessons Learned: Staff Engagement • Recognize what motivates your staff • Tie why staff are being asked to make calls to your company’s mission and values • Help staff understand how this effort benefits them • Consider asking families to sign a release; use this form to also collect info from them • Recognize the rhythm of the day/month and create a call schedule that fits the rhythm • Recognize changing technology presents challenges and be willing to embrace change

Family First Prevention Services Act: State Data Analysis • Facilitate critical thinking among jurisdictions

Family First Prevention Services Act: State Data Analysis • Facilitate critical thinking among jurisdictions using data and evidence to define candidacy for the preventive provision of FFPSA • Illustrate the volume, distribution, and needs of potential candidate groups that can be used to refine target populations for FFPSA preventive services • Guide discussion of the implications of choices around candidacy definition

Defining Potential Candidate Populations • While FFPSA specifically names certain groups who will be

Defining Potential Candidate Populations • While FFPSA specifically names certain groups who will be eligible for services (e. g. pregnant and parenting teen wards), it is less clear when discussing the criteria for claiming for services delivered to families with children at imminent risk of removal • Candidacy can be defined along a continuum of narrow to broad, leveraging preventive services to stabilize populations and prevent child removal

Definitional Continuum for Preventive Candidacy under FFPSA Indicated/substanti ated investigations not resulting in removals

Definitional Continuum for Preventive Candidacy under FFPSA Indicated/substanti ated investigations not resulting in removals Narrow Families receiving preventive services on a voluntary basis, including unfounded investigations Medium Narrow Families with known risks for child welfare involvement, including substance use or housing instability, families receiving AR Medium Broad Families in community areas with high confluence of known community level risks Broad

Approach to Candidacy Definition • Construct visuals with groups of local stakeholders to build

Approach to Candidacy Definition • Construct visuals with groups of local stakeholders to build consensus on potential candidate populations • Engage local data analysts to provide estimates of numbers of cases/children in each potential candidate pathway • Map cases to understand geographic distribution • Utilize assessment data to understand the prevalence of issues that may correspond to evidence based interventions • Conduct gap analysis to gauge capacity to meet identified population needs • Evaluate the implications of definitional choices

25 Target Populations with Candidate Pool

25 Target Populations with Candidate Pool

Out of Home Call taken, CWS referrals N=6856 Substantiated (n=28, 943) Remain in home

Out of Home Call taken, CWS referrals N=6856 Substantiated (n=28, 943) Remain in home N=23, 745 N=6280 Adoption/ SGH Age Out Teen parents 1821 N=129 Intact, voluntary N=11, 981 No Services N=17, 465 Call not taken N=2915 Unsubstantiated (N=74, 525) Investigation Subsequent investigation; no removal Legend: = potential candidate = if identifiable = not candidates Subsequent investigation; removal N=2460 Call Referred for AR (not yet in place) Initial Call Pregnant & Foster Home Parenting teens N=367 Removal N=4, 442 Congregate Care Call taken, Investigation N=81, 000 Hotline N=276, 538 Reunification <6 months N=2524 Relative Home No further contact Substantiation Service Permanency

Implications of Candidacy Definition • Workforce – How large a workforce will be required

Implications of Candidacy Definition • Workforce – How large a workforce will be required to case manage new preventive cases? • Technology – What IT system modifications will be necessary to capture and document preventive service provision and case management activities? • Fiscal – What will the financial burden be for the unclaimed portion of preventive service provision? • Capacity to Deliver Evidence Based Interventions – Are community based interventions available in sufficient numbers to serve the identified population?

Knowledge Gap for Homeless Youth “The precise number of homeless and runaway youth is

Knowledge Gap for Homeless Youth “The precise number of homeless and runaway youth is unknown due to their residential mobility and overlap among populations. Determining the number of these youth is further complicated by the lack of a standardized methodology for counting the population and inconsistent definitions of what it means to be homeless or runaway. ” Congressional Research Service, 2013

National Policy Research Initiative: Voices of Youth Count

National Policy Research Initiative: Voices of Youth Count

22 Partner Communities

22 Partner Communities

Definition of Homeless or Unstably Housed Vo. YC defines its target population broadly to

Definition of Homeless or Unstably Housed Vo. YC defines its target population broadly to include 13 - to 25 -year-olds who are either homeless or unstably housed. Homeless youth can be: • sheltered (i. e. , sleeping in emergency shelters, transitional housing, and hotels or motels) or • unsheltered (i. e. , sleeping on the street, in parks, or otherwise outside; in vehicles or in abandoned buildings/vacant units, on trains/buses or in train/bus stations; or at 24 -hour restaurants/laundromats/retail establishments). • unstably housed youth include youth sleeping in their own apartment, the home of a parent or other relative, the home of a friend/girlfriend/boyfriend, a hospital/emergency room, a residential treatment facility, at the home of someone the youth was having sex with, or a juvenile detention center or jail who lack a stable place to stay.

National Estimate: Youth Totals Youth experiencing homelessness or unstable housing at least once over

National Estimate: Youth Totals Youth experiencing homelessness or unstable housing at least once over a 12 -month period in the US: 1. 25 million youth, ages 13 -17 7. 94 million youth, ages 18 -25 … reported “homelessness”: 0. 29 million youth, ages 13 -17 2. 26 million youth, ages 18 -25

National Estimate: Not Just an Urban Problem Household prevalence 23. 8% 20. 1% 8.

National Estimate: Not Just an Urban Problem Household prevalence 23. 8% 20. 1% 8. 2% 5. 5% 6. 0% 3. 7% 1. 6% Couch surfing 1. 3% Homelessness Couch surfing Ages 13 -17 Homelessness Ages 18 -25 Rural Non-rural One in three households reporting youth homelessness resides in the 40% of counties with the least population density.

Homelessness only ≥ < Couch surfing & homelessness Hi . Couch surfing only BT

Homelessness only ≥ < Couch surfing & homelessness Hi . Couch surfing only BT LG La t. ni c/ sp a Am te hi r. - Af Bl ac k/ W ed oy pl l ge lle co em yr 4 - oo sc h 0 00 8, $4 0 00 Share of youth within each housing experience category 2, $1 hi gh de r d un le ro l en pl. / m co pl. < e m in co co m hh hh Breaking Down Homelessness & Couch Surfing 60% 50% 40% 30% 20% 10% 0% Neither

Over-represented Subgroups 29% Ever in Foster Care vs. 2% of general youth population 23%

Over-represented Subgroups 29% Ever in Foster Care vs. 2% of general youth population 23% LGBQA vs. 7% of general millennials population 39% of Females Pregnant or a Parent 46% Spent Time in Juvenile Detention, Jail or Prison vs. 15% of general (older) youth population 47% African American vs. 12% of general youth population

Initial Observations for National Estimate Youth experiencing homelessness are largely hidden and among the

Initial Observations for National Estimate Youth experiencing homelessness are largely hidden and among the most underserved youth Youth from low-income families are more like to become homeless, while middle-income youth are likely to couch surf only. Early entry points for prevention and diversion are frequently missed “Housing first” is critical - housing instability impedes youths’ ability to stay in school, maintain employment, and participate in programs Yet, housing is insufficient. Comprehensive system-level efforts to address youths’ education, career, and social-emotional needs, as well as linkages to broader social assistance programs, are vital to sustained exits from homelessness Needs and over-representations of significant subgroups need to be addressed (e. g. , parenting, LGBTQ, Youth of Color) Systems need to modernize and adapt to recognize transience and technology dependence of these youth

Chapin Hall’s Strategic Direction External priorities Child Welfare: Youth Homelessness: Community Capacity: Internal priorities

Chapin Hall’s Strategic Direction External priorities Child Welfare: Youth Homelessness: Community Capacity: Internal priorities Rigor Integration Innovation Influence