1. A Project of the L.A. Gay & Lesbian Center
The RISE Project Recognize Intervene Support Empower Permanent Families for LGBTQ Children and Youth
California Child Welfare Council
Presentation, March 12, 2014
Curtis F. Shepard, Ph.D., Director, Children, Youth & Family Services
Lisa Parrish, Director, RISE Project

2. Background Federal Permanency Innovations Initiative (PII)
The RISE Project: one of 6 PII projects funded by the U.S. Dept. of Health & Human Services, Administration on Children & Families, Administration for Children, Youth & Families, Children’s Bureau
5-year demonstration project to improve permanency for LGBTQ children and youth in the child welfare system
A public-private collaboration led by the L.A. Gay & Lesbian Center
with foster care providers, including:
Five Acres
Hathaway Sycamores Children & Family Services
Penny Lane Centers
Southern California Foster Family and Adoptions Agency
Vista Del Mar
& key partners:
L.A. County Departments of Children and Family Services and Mental Health
The Children’s Law Center
Williams Institute, UCLA School of Law
Holarchy Consulting
National Institute for Permanent Family Connectedness, Seneca Family of Agencies
Westat

3. An Emphasis on Research & Evaluation
RISE purpose at a glance:
Survey the number of LGBTQ children and youth in foster care
Test and evaluate the effectiveness of two new program interventions to reduce barriers to permanency for LGBTQ children and youth in the child welfare system
Outreach and Relationship Building (ORB) organizational support via training and coaching for public and private agency staff
Care Coordination Team (CCT) services for LGBTQ children and youth with open child welfare cases, including gender-variant children and dual-status youth involved with the Probation system
The scope and purpose of this project are unprecedented for the Children’s Bureau. As such the project has evolved over time to its present configuration as a full-blown Research Project, requiring us to adhere to all of the protocols and standards that such projects demand.
Distilled to a simple description, however, the purpose of RISE is to…..

4. RISE Theory of Change
When lesbian, gay, bisexual, transgender and questioning (LGBTQ) foster youth and their families are competently identified and appropriately served, then they will be able to achieve safe and stable permanency.
The “Theory of Change” under which we are operating is…..

5. Gathering Existing Information
Advocates believe there is disproportionate representation of and disparities in experience and service provision within child welfare for LGBTQ children and youth
--BUT--
Lack of data about this
In 2011 RISE collected information about LGBTQ youth in the L.A. child welfare system:
Baseline data about residents of GLASS (Gay and Lesbian Adolescent Social Services) group homes
44 case reviews of current and former youth at DCFS
Youth Speak-Outs
DCFS Staff & Foster Care Agency Staff Speak-Outs
Expert Roundtable on Identification of LGBTQ Youth
Advocates believe there is disproportionate representation of and disparities in experience and service provision within child welfare for LGBTQ children and youth. However, until now there has been a notable lack of data to support this assumption.
So in 2011, early in the project, RISE collected information about LGBTQ youth in the L.A. child welfare system.
Details on Info Gathered
This included Baseline data about residents of GLASS (Gay and Lesbian Adolescent Social Services) group homes:
--47% Black, 34% H, 16% White, 3% Other
--Over HALF were younger than age 13 at their first placement.
--Mean length of stay was 5.8 years (nearly 2x the 3 years that defines long-term foster care)
--Females had longer lengths of stay than males (6.2 years vs. 5.4)
--Black children had longer lengths of stay than white or Hispanic children (7.6 years vs. 4.2)
--61% of the children had probation involvement
Commonalities among the Cases – approximately 24 open and 20 closed (GLASS) cases reviewed
--High levels of suicidal ideation
--Demonstrable lack of connecting struggles with sexual orientation or gender identity to acting out behaviors
--Children who seemed to fare best had stability and stayed in one placement for an extended period of time
--There was a disconnect between training and practice
--There was no staff training on this topic at all
--Very little documentation around identity and connection to safety in out of home care
--Youth who were older or entered the system at an older age had more successful outcomes
Youth and DCFS Staff and Foster Care Agency Staff Speak Outs, Expert Roundtable
--Will there be disciplinary action taken against adults/staff who verbally abuse, reject, dismiss or undermine LGBTQ youth?
--It is beneficial to see LGBTQ adults who have “made something of their life.”
--Boundaries need to be put into place and staff needs to be held accountable for their actions when they are disrespectful towards LGBTQ youth.
--There should be more visuals (rainbow flags, supportive posters) in group homes that show support for LGBTQ youth.
--Group homes should have LGBTQ support groups and GSA’s.
--Staff need to be trained thoroughly on LGBTQ issues and there should be a specialized training on transgender issues
--Language should be inclusive and part of the everyday routine and create a systematic change.
--Safety is the biggest issue for youth, workers need to let LGBTQ youth now that they are safe in their care.

6. Foster Youth Survey, Age 12+
Identification of and data collection about LGBTQ youth in child welfare system is not done systematically
Safety concerns are appropriate, given the prevalence of systemic anti-gay and anti-transgender bias
RISE designed a one-time confidential telephone survey (sub-contracts with UCLA School of Law Williams Institute, Holarchy Consulting, Westat)
Random sample of nearly 3,000 contacts generated by LA DCFS, stratified by age and 17+ to oversample older youth
786 (26%) completed telephone surveys in 2013
Preliminary results are generally demographically representative
Clearly, Identification of - and data collection about - LGBTQ youth in child welfare system is not done systematically
Safety concerns are appropriate, given the prevalence of systemic anti-gay and anti-transgender bias
In order to paint a more complete picture of LGBTQ children and youth in foster care, RISE designed a one-time confidential telephone survey (sub-contracts with UCLA School of Law Williams Institute, Holarchy Consulting and Westat)
LA-DCFS provided the contact information for a random sample of 2,967 foster youth ages year in out-of-home care in Los Angeles County. We used a stratified random sampling technique, where we split the sample into two age groups: years, 17 years and up. We drew equal numbers of participants from these two groups. We stratified the sample by age in order to: ensure a large enough sample within the older age group (17+) to be able to compare our results to previous studies of youth transitioning out of foster care, many of which focus on youths ages 17 and older; and to ensure a large enough sample within the older age group to make an accurate estimate of LGBTQ prevalence.
786 (26%) completed telephone surveys in 2013
Generally demographically representative

7. Foster Youth Survey, Age 12+ cont’d
RISE Foster Youth Survey Research Questions:
What percentage of youth in care identify as LGBTQ?
Is this percentage larger than that in the non-foster care population?
Are there key differences in experiences in foster care between LGBTQ and non-LGBTQ youth?
PRELIMINARY RESULTS!
What percentage of youth in care identify as LGBTQ?
14% of youth responding identified as LGB or Q
5% of youth responding identified as transgender
Is this percentage larger than that in the non-foster care population?
The Williams institute reports :
U.S. gay and lesbian population estimates range from %
U.S. transgender population estimates range from %
3. Are there key differences in experiences in foster care between LGBTQ and non-LGBTQ youth?
Mostly similar outcomes, except LGBTQ youth:
Were hospitalized more often: 40% vs. 31% had spent a night in a hospital
Were hospitalized more often for emotional distress: 26% vs. 9% reported hospitalization for emotional reasons
LGBTQ youth reported less positive experiences in the system: 14% vs. 6% felt they were treated “not very well”

8. Foster Youth Survey, Age 12+ cont’d
Summary of Preliminary RISE Foster Youth Survey findings:
Disproportionate representation in out of home care
Some key differences in experiences in foster care
Perceived disparities in appropriate service provision for LGBTQ youth
Foster Youth Survey Report will be submitted to the Children’s Bureau for review in April 2014 and available publically later in 2014.

9. Outreach and Relationship Building Training and Coaching Development
Most public and private agency staff reported little or no professional training on LGBTQ identity and practice application. LA County DCFS has a module for new hires and select other staff developed and delivered by Al Killen-Harvey, a Southern California LGBTQ expert trainer.
RISE developed an organizational level intervention component called “Outreach and Relationship Building (ORB)” designed to deliver six hours of LGBTQ training to public and private staff in the child welfare system
RISE also developed a “Coaching Network” so trained agencies meet regularly to build upon and sustain change in practice and policy
As indicated previously, RISE has developed a two-pronged intervention designed to improve permanency outcomes – both emotional and legal permanency – for LGBTQ foster youth. The first of these is an organizational-level intervention component called “Outreach and Relationship Building (ORB)” designed to deliver six hours of LGBTQ training to public and private staff in the child welfare system.
RISE also developed a “Coaching Network” so trained agencies meet regularly to build upon and sustain change in practice and policy.

10. ORB Training Module One
LGBTQ Foundations Module learning objectives:
Language about sexual orientation, gender identity, and gender expression (SOGIE) and education about LGBT experience (i.e. coming out)
Barriers to permanency experienced by LGBTQ youth in child welfare (i.e. anti-gay bias, heterosexism, anti-transgender bias)
Function and elements of LGBTQ affirming environments, symbols
Legal framework (AB 458) and professional responsibilities as social worker in child welfare system in California
Guidance on managing disclosures as it relates to child or youth’s sexual orientation, gender identity, and gender expression
We call RISE’s training and coaching component ORB, the catchy acronym for Outreach & Relationship Building.
AB1856, which was passed in 2012 and went into effect in 2013, requires existing training programs for foster youth caregivers to include information related to cultural competency and best practices for serving LGBT young people. RISE has built upon a number of pre-existing curricula to create two training modules, which are administered voluntarily, since RISE is a research project. I will very briefly describe the learning objectives for each module.
Background
AB 458 prohibits discrimination against LGBTQ youth in systems of care and required some minimal training.
AB 1856 requires more caregivers to receive training.

11. ORB Training Module Two
Social Work with LGBTQ Children and Youth learning objectives:
Review active listening, motivational interviewing, and self-awareness to use with LGBTQ youth
Asking about identity and using inclusive language
Support for the coming out process or experience for youth or family
Skills related to sustaining an affirming environment, responding to supporting/questioning comments, responding to negative comments
Challenges with managing disclosures about sexual orientation or gender identity
Integrating principles of healthy relationships into conversations with youth
The second 3-hour module if the RISE 6-hour training series, Social Work has the following learning objectives.

12. ORB Coaching Network ORB Coaching Network Is…
A supportive peer network where coaches build capacity and skills to recognize barriers, intervene with best practice, and help agency staff strengthen skills that lead to safety, well being and permanency for LGBTQ youth.
The monthly Coaching Network provides support in:
Sustaining agency training and continued education
Creating agency plans for implementation of best practices
Identifying changes to agency policy as needed

13. ORB Coaching Network Coaching Network Strategic Goals
2/3rds of agencies trained by ORB will participate in the RISE Coaching Network in 2014
Training Boosters and Learning Labs delivered to partner coaches with content related to building capacity to respond to anti-gay bias, heterosexism, and transgender bias
Booster – Skill and Knowledge Refresher
Learning Lab – Practice and application of skills
In 2014 partner coaches develop a mini-plans that address implementation and integration of coaching as a tool to sustain organizational change.

14. ORB Training and Coaching Progress
ORB Training Pilot from January-May 2013, 687 staff trained to test curriculum, fidelity assessment plan and evaluation instrument
984 staff trained in total in calendar 2013
310 DCFS Staff
674 private agency staff (5 pilot foster care agencies)
Fidelity assessment of training delivery monthly began February 2013
Coaching Network started to sustain organizational practice and policy change in April 2013, meets monthly
The pilot testing of ORB took place from January to May 2013, during which 687 staff in 2 DCFS offices and 5 foster care provider agencies received training. In total, in calendar year 2013, we trained…..

15. ORB Next Steps and Evaluation
ORB Training and Coaching continues countywide for DCFS Offices and private child welfare agencies, projected training of more staff through 2015
ORB Evaluation Plan target (voluntary research participation) of 470 participants for each of two more rounds of pre- and post-test training data collection focusing on knowledge acquisition, plus a web-based survey 2 months after completion of both modules focusing on application of training in practice
RISE is currently designing a foster parent curriculum to be tested in 2014

16. Care Coordination Intervention Design
RISE has created Child and Family Teams modeled on the Wraparound program, each with a Facilitator, Parent Partner and Youth Specialist
RISE includes Family Finding Specialist and the care coordination teams have been trained on Family Search and Engagement by Seneca’s National Institute for Permanent Family Connectedness
The RISE care coordination teams are also trained on LGBTQ identity and employ family education to increase LGBTQ support and acceptance under the direction of clinicians
Goals: to increase family acceptance, emotionally permanent connections and legal permanent status
The other RISE intervention component is care coordination services.

17. CCT Progress
RISE tested care coordination services in 2012 – 2013 with 14 youth (ages 18 – 24) in Transitional Living Program at LAGLC
Focus on engaging and strengthening family connections for runaway and homeless LGBTQ youth very promising for their well-being
RISE care coordination enrollment for LGBTQ DCFS clients began in July 2013, clients ages 5 – 19 are now eligible, including children at home on family maintenance and dual status youth
7 clients are enrolled (currently ages ranging from 16 – 19)
1 more will enroll by 3/14/2014
40 slots are targeted to be filled by July 2014
For a variety of reasons, some having to do with requirements and restrictions related to research, and some having to do with the complexity of DCFS and the other agencies we’re working with, the CCT has been slow to launch compared to other elements of the project. (Curt, do you really want to say this?) What we have done thus far and where we are now is…..

18. Care Coordination Services, cont’d
Westat evaluation of RISE care coordination services:
Baseline interview surveys of enrolled youth (n=40) on wellbeing and permanent connections (children under age 11) and sexual orientation and gender identity (age 11+)
Mid-point qualitative interview with youth focusing on services to date and environment of support and acceptance
End-point interview surveys on wellbeing and permanent connections (children under age 11) and sexual orientation and gender identity (age 11+)
Recruitment for an evaluation comparison group (n=20+)
Administrative data review on placement stability, legal permanency history
Evaluation will be completed by September 2015
Again, this being a social science research project, everything we have developed programmatically much be measurable and subject to evaluation. The Federal Government has contracted with Westat to head the PII evaluation. Westat’s evaluation of the CCT encompasses…..

19. Looking Ahead: Year Five and Beyond….
Outreach and Relationship Building Training Evaluation Results
Care Coordination Evaluation Results
Implementation Case Study
Beyond 2015, continuing direct services in Los Angeles
Expanding training, coaching and services to other jurisdictions

20. Conclusion Questions and Answers For more information please contact:
This project is funded by the Children's Bureau, Administration on Children, Youth and Families, Administration for Children and Families, U.S. Department of Health and Human Services, under cooperative agreement number 90-CT-0154.
For more information please contact:
Curt Shepard –