1. Presented by Orange County Department of Social Services October 13, 2010 Graduated Sanctions

2. Orange County, New York County Supervised Child Welfare and Juvenile Justice System. Population: 390,000 Suburban / Rural County, with three small urban areas with a population of 25,000 in each city. Median Income: $69,913 Poverty Rate: 10.2% 19 School Districts Orange County

3. Juvenile Delinquency In NYS the DSS is the agency which serve the largest majority of JD Placements. NYS OCFS Placements are under 800 Statewide, with the majority of the placements coming from the City of New York.

4. Juvenile Delinquency

5. Persons In Need of Supervision

6. Persons in Need of Supervision (PINS) Reform Legislation Summary 2002 NYS PINS Legislative Change - increased the age limit for a PINS designation from 16 to 18 years of age. The new legislation creates major concern throughout the child welfare system regarding placement rates for children between 16 – 18. The concern for placement rates begins to elevate the need for reform, which is taken on County by County across the State.

7. PINS Data by Agency Truancy related cases and / or high risk cases are managed through Probation. Community and / or low to medium risk cases are managed through KEYS.

8. Persons in Need of Supervision PINS Referrals by Source (2009): Parents: 395 Educational: 271 Law Enforcement: 71 Community: 8 Probation Diversion: 207 Family Keys: 538

9. Orange County PINS 2009 PINS ReferralProbation Assessment KEYS Intervention Probation Intervention Successful Disposition DSS Funded Preventive Service Court Intervention Prevention 538 207 305 120 303 625 608 745 102 504 Includes JD Referrals

10. Orange County PINS 2009 Court Intervention 102 Disposition Foster Care When placement is ordered, the DSS assumes custody of the child for “appropriate placement”. Placements include: foster care, therapeutic foster care, group home and residential care. Probation Supervision Probation Supervision is generally ordered for a period of 12 months and includes specific requirements. Supervision Order Family Court has the authority to order the DSS to supervise the household for a period of 12 months. 22 48 12 Other, no finding, etc… 20

11. Family Keys Referral and Case Processing Flow Chart

12. Continuum of Care Graduated Sanctions

13. Preventive Services Continuum of Care Graduated Sanctions Custody Services

14. JD / PINS Service Continuum of Care Philosophical Funding Requirements Youth Voice No Eject, No Reject Performance Based 24 / 7 Crisis Intervention Unconditional Care Family FocusedNeeds Driven Planning Strength Based Individualized Planning Employment Community Service Community Attachment Cognitive BehavioralEvidence Based

15. Preventive Services Request for Proposals Custody Services RFP helps to keep the focus as time tends to shift perspective. Keeps competition in the market place, removes the influence of a single agency and helps to keep the continuum accountable to measuring performance. Allows for the specific allocation of resources into our five key areas: Low, Medium, High Risk, Custody Options and After Care.

16. Performance Based Contracting Performance-Based Contracting (PBC) - is a technique for structuring all aspects of an acquisition around the purpose and outcome desired as opposed to the process by which the work is to be performed. Performance Based Contracting is acquisition for results! Not acquisition for services!

17. Cost Savings

18. Cost Savings Making the argument for Community Investment The cost difference between residential placement and community based service is clear, in NYS the average costs of residential care exceed $110,000 annually, while the most expensive community based program costs $24,000 per year. Achieving a reduction in out of home placements would appear to drive costs downward, allowing for investment in community based programming. This is not always the case!

19. Cost Savings It seems so simple! Projecting cost savings is important, but projections do not free up space in a budget, unless achieved! We assume too often that a preventive program, well thought out and delivered will result in less expense on out of home care. Other factors apply: MASR (Maximum State Aide Rate) = residential per diem. Changes in the community population and one time events. The assumption that every child in the preventive program would end up in residential care. That discharges from care will occur on a consistent basis. Reimbursement is lower for community based, preventive services.

20. Orange County Post PINS Reform Efforts - Data

21. Cost Savings It get easier with practice Real Cost savings are needed, which requires a two pronged approach: Prevention of out of home placement, investment in a stronger continuum of care. Alternatives to residential placement, focused on shorter lengths of stay, after resources and specialized intensive services for children who lack a discharge resource. Investing in reductions in the length of stay and alternatives to residential care is the key. Money Follows the Child: a new investment in individualizing budgeting for children as an alternative to placement begins in 2005 – 2006.

22. Orange County Post PINS Reform Efforts - Data Preventive Focus Preventive and Alternative Focus

23. Standardized Assessments Are They Important?

24. Youth Assessment and Screening Instrument (YASI)

25. Assessment Drives Intervention Assessment

26. Orange County PINS 2009 PINS ReferralProbation Assessment KEYS Intervention Probation Intervention Successful Disposition DSS Funded Preventive Service Court Intervention Prevention 538 207 305 120 303 625 608 745 102 504 Includes JD Referrals

27. Assessment Drives Intervention KEYS Intervention Probation Intervention DSS Funded Preventive Service 305 303 Includes JD Referrals Low Risk: Community Accountability Board PINS Parenting Center for Hope Employment Project School Based CM Mandated Preventive Medium Risk: Intensive Case Management Family Support Program Youth Empowerment Srvs. Family Functional Therapy (FFT) High Risk: Residential Alternatives Community Connections Community Alternatives Transitional Support Services

28. DSS Service Delivery Process Universal Referral Made to the DSS The referral has a specific program Identification on the form, i.e. FFT, Employment. Changes may be made based on specific factors. Strength Based Needs Driven Assessment DSS reviews the referral, YASI and and sends the Case to contract agency, who is required to conduct a strength based needs driven assessment. Service Delivery Non for profit provides preventive service on a fee for service basis. Disposition Based on child performance in key areas, or based on placement rate.

29. Universal Referral Form The Universal Referral Form allows any community based or government agency to make a referral into the JD / PINS Service System. Referrals are prioritized based on level of need. Probation Officers have the ability to initiate emergency referrals based on risk of placement. All contracts have a 24 hour provision for first contact, with 72 hour initial assessment due to the DSS. All contracts must have a no-eject, no reject philosophy.

30. Continuum of Care Programs CAB: Community Accountability Board PINS Parenting: required for all PINS referrals Adolescent Employment Project: supported work Center for Hope: evening reporting, focused on gang diversion School Based: co-located in schools throughout the County ICM: focused on children with mental health issues Community Connections (SWK): mentoring, ICM project Functional Family Therapy (FFT): family focused Youth Empowerment Program: paraprofessional, mentoring project Family Support Program: ICM case management, with family focus Community Alternatives: reduced length of stay project Transitional Support Services: alternative to placement Residential Alternatives: wrap around model Short Term RTC: reduced length of stay placement After Care and IL Services: Post placement

31. Community Accountability Board The Community Accountability Board (CAB) is a community based alternative sentencing program for non-violent first-time offenders. As a Family Court Diversion, offenders report to a group of local community leaders and they negotiate an appropriate sentence for the offense. Very often is required to participate in community service and make some sort of academic achievement as part of his sentence.

32. Community Accountability Board Meaningful dialogue with offenders, victims, and members of the community; Lead the discussion about the activities that brought an offender to the Board and repairing damage to victims and reweaving the fabric of our community; Develop a Reparative Accountability Agreement with Offenders; Provide recommendations and information to all parties engaged in the process; and Report to the Coordinator.

33. Respite Services Respite services are required under the 2008 PINS Reform Law. Respite options include: Shelter Based – respite shelter also serves as the runaway, homeless youth shelter for the County. Preventive Respite – provided through a team of foster homes who have been trained to provide temporary respite services. Community Based – offers para-professionals for a period of 30 days that provide social and recreational activities outside of the home during specific hours of the day.

34. PINS Parenting Workshops Operates as a psycho-educational group offering parents of adolescents, specific skill building. Parent support groups are facilitated by the workshop coordinator following completion of the parenting workshop. Required for parent filed PINS petitions. Operated in three locations throughout the County with day care services provided in the early evening.

35. Employment Projects Employment Projects provide program funds to support the employment of an at-risk child in local businesses located throughout the County. Supported Work Agreement: all employers sign a supported work agreement, which serves as an employment contract, providing reimbursement for wages and payroll taxes. Employment sites must agree to assign a mentor the at-risk youth who provides on the job mentoring and community mentoring.

36. Employment Projects Orange County has a stand alone Employment Project, which allows fifty at-risk youth to be employed for a period of six months. Employers and mentors are recruited through the Chamber of Commerce. Annual award banquet is held to honor those children who have remained employed for a period of six months throughout the course of the year.

37. Center for Hope / Evening Reporting Focused on providing step down / after care services for at-risk children in the City of Newburgh. Also serves as an Evening Reporting Center. During and following completion of enrollment in any one of the PINS / JD prevention services, children are enrolled in programming offered through the Center for Hope. Programming focuses on: cultural activities, social activities, athletics, life skills, parenting supports, after-school and early evening activities.

38. Center for Hope / Evening Reporting The Center for Hope focuses on Gang Intervention and Prevention. Life Coaches from the Center for Hope are engaged to provide outreach services across Newburgh as a means of encouraging at- risk off the streets, into the program. Life Coaches are often former gang members or at-risk children from the neighborhood. The Center for Hope develops and strengthens protective factors against gang involvement and other problem behaviors.

39. Transportation Even though most programs are community based (home visiting) access to transportation resources is an essential component of the continuum. Fixed Routing Systems, provides transportation throughout the County through a fixed route bus system. All agencies funded for preventive services are permitted to access the transportation loops. Agencies are required to register with our transportation division and book trips on a six month reoccurring basis.

40. Transportation Sharing resources across program areas: transportation services also include Welfare to Work, Day Care Subsidy, Medicaid, Foster Care and Preventive services. The shared resources draw down Federal and State Dollars, which strengthen the transportation network. Orange County has 61,000 Medicaid recipients, 2,100 TANF recipients and 800 day care cases, when shared we managed 7,800 trips per month.

41. Fixed Routing System 155 CRYSTAL RUN RD 7:58 AM10:08 AM12:18 PM WEST MAIN ST & GARISS ST 2:57 PM4:57 PM 42 RYKOWSKI LANE 8:00 AM10:10 AM12:20 PM WEST MAIN ST & BUCKLEY ST 2:58 PM4:58 PM 1 NORTH GALLERIA DR 8:05 AM10:15 AM12:25 PM FERRY ST & UNION ST 3:09 PM5:09 PM 11 MALTESE DR 8:08 AM10:18 AM12:28 PM WATER ST & BROWN ST 3:01 PM5:01 PM 40 SMITH ST 8:14 AM10:24 AM12:34 PM JERSEY AVE & FRONT ST 3:03 PM5:03 PM 60 PROSPECT ST 8:16 AM10:26 AM12:36 PM JERSEY AVE & CHRUCH ST 3:04 PM5:04 PM 24 UNION ST 8:19 AM10:29 AM12:39 PM JERSEY AVE & SEWARD AVE 3:04 PM5:04 PM 21 CENTER ST 8:21 AM10:31 AM12:41 PM JERSEY AVE & PENNSYLVANIA AVE 3:04 PM5:04 PM 10 BENTON AVE 8:24 AM10:34 AM12:44 PM JERSEY AVE & OWEN ST 3:04 PM5:04 PM 70 FULTON ST 8:26 AM10:36 AM12:46 PM JERSEY AVE & COLE ST 3:05 PM5:05 PM 54 DOLSON AVE 8:27 AM10:37 AM12:47 PM EAST MAIN ST & BARCLAY ST 3:06 PM5:06 PM Sample Transportation Schedule

42. Transition and After Care CAB Adolescent Employment Project School Based ICM Residential Alternatives Community Connections Family Functional Therapy Youth Empowerment Program Family Support Program Community AlternativesTransitional Support Services Center for Hope

43. School Based Located in eight school districts and two community based locations, School Based Programs are designed to serve children with truancy issues. Case Management based model of services delivery, focused on short term intervention and clinical services offered through the district. Co-Location is the key factor, allowing for a partnerships to be developed with district across the County.

44. Intensive Case Management Mental Health Model of intensive case management services, highlighted by caseload ratios of 1:7. PINS and JD behavior can be symptoms of mental health disorders among adolescents. If the assessment indicates high needs in life domain of mental health, ICM is generally assigned to provide community based clinical services. Essential in this process is the linkages that are built to the mental health system to support the child’s long term treatment needs.

45. Family Support Program Short term, solution focused model that focuses on parent / child relationship and communication. Based on the “Homebuilders Model”. Intensive in home program, focused on a 30 to 90 day period of time. Intervention is hands-on in design, deployed during non traditional hours, includes a strong parenting skills component through in-home modeling.

46. Youth Empowerment Program Mentor model of service delivery, with professional case management support. Mentors are para-professionals who are hired to match the unique needs of the child. Mentor hours average 5 – 10 hours per week and include a modified employment program. Mentors are from the community / neighborhood of the child and family. Parent Advocates are often used as well, allowing parents with experience to provide one on one parenting assistance.

47. Functional Family Therapy FFT is a family intervention for at-risk youth ages 10 to 18 whose problems range from acting out to conduct disorders to alcohol and/or substance abuse. Clinical model of service delivery, focused on children with multiple needs ranging from behavioral, mental health and substance abuse. Provided through the Orange County Department of Mental Health, required license for clinical practice.

48. Residential Alternative High end, strength based, wrap around model of planning, followed by intensive case management, one on one mentors. “one foot in the door” children, designed for high risk children with strong probability of placement as determined by assessment. Intensive service delivery model, generally includes a minimum of 15 – 20 hours of para- professional mentor contact on a weekly basis, with back end clinical support through case management team.

49. Community Connections Merges community based model with day treatment program. Community model deploys case managers, skill builders into the community to work hands-on in a family’s home. Concurrent services are offered through a day treatment program focusing on educational, psycho-social and social programming at an office based location. Supports cultural, educational recreational activities.

50. Community Alternatives Provides an alternative to placement through a highly clinical intervention, “one foot in the door” target population. Intensive case management model, with ancillary services, i.e. employment, transportation, tutoring, home maker (in-home parenting skill training). Money follows the child design, allowing for individualized budgeting based on the needs of the child and family. Budget is developed during assessment and submitted for DSS approval.

51. Community Alternatives Individualized budgeting allows for highly flexible programming. Sometimes referred to as a residential without walls. Ancillary funds / flexible funds are an important component, as the flexibility in funding allows for the development of individualized service plans. Clinical Support provided through subcontract with 24/7 Mobil Mental Health Program located within the same agency.

52. Transitional Support Services Money follows the child design for children in residential placement. Allows for the development of an individualized plan and budget which would result in the discharge of the child from residential care. Flexible program design, with para-professional staff, high end clinical support and independent living skill development. Ancillary funds and flexible funds are essential in developing the plan for discharge.

53. Transitional Support Services For older children, merges TANF, SSI with independent living skills. TSS has built supportive apartment programs, by merging TANF, Food Stamps, Medicaid and Child Welfare Funding. Complex funding streams, allows for the development of multifaceted individualized plan. Employment is a mandatory component of the program, all children must be employed or engaged in community service. 24/7 Clinical Support subcontracted through the Mobil Mental Health Team.

54. Non Secure Detention Detention is provided on both a residential and community based level. Residential Non Secure Detention: short term residential program pending disposition. Community based: provided under one contract, allows for the use of community based detention, including case management supervision on a daily basis, GPS monitoring and curfew checks. Detention is the number one predictor of future residential placement. All efforts are made to avoid detention, as treatment recommendations are generally favorable of placement.

55. Short Term Residential Treatment Provides community based and residential services at the same time, by engaging the family throughout the residential stay. Community based program provides assessment and manages the intake application process for residential treatment. Upon placement, a community based team begins working with the family in the community in an effort to address the familial issues that may have played a role in the placement of the child.

56. Short Term Residential Treatment The community based team works with the clinical team at the residential to support return to the community. Home visits are supported by the community based team. Educational plans are merged with the local school district, with the community based team serving as educational advocates when needed. Home visits are not based on behavioral points and cannot be used for reward / punishment. Discharge date is non negotiable, and is included in the court order for placement.

57. After Care Services Educational Advocacy Independent Living Programs Case Management based. Housing Based: Supervised Independent Living Programs and Transitional Housing services. After Care Services: feed back into the continuum of care. Children discharged from custody are assessed again and re-entered into the program that would best meet their needs. After Care includes OCFS placements (secure placements) into the continuum of care.

58. Performance Based Contracting

59. Prevention of Placement

60. Performance Standard is 90% of children will remain in the community

61. Improved Academic Performance

62. Performance Standard: 75% of children will experience improved academic achievement

63. Performance Outcomes

67. Placement Data and Costs

68. Rising Intensity: Cost Per Case

69. Orange County Post PINS Reform Efforts - Data PINS Reform

70. Orange County Post PINS Reform Efforts - Data A Closer Look: PINS and JD Placements

71. For More Information Contact: David Jolly, Commissioner Orange County Department of Social Services DJolly@co.orange.ny.us (845) 291-4311