1. 1 North Dakota Children and Family Services Review Paul Ronningen, Division Director Don Snyder, Permanency Unit Manager

2. 2 Vision Statement To provide quality,efficient and effective Child Welfare Services to ensure positive outcomes for children and families in North Dakota.

3. 3 Goal  To meet Federal Outcome Standards for Children and Families in the areas of Safety, Permanency and Well-Being  To achieve and maintain an average of 97% in case file reviews state wide.

4. 4 History of the N.D. CFSR The North Dakota Children and Family Services Federal Review was completed in 2001 North Dakota’s Program Improvement Plan consisted of two major components –To replicate the Federal CFSR Process within the state –To implement the Wrap Around Process utilizing the Single Plan of Care.

5. 5 The Development of the North Dakota CFSR Plans were made to replicate the Federal CFSR process within the 8 Regions of the State. The following processes were developed and implemented.

6. 6 The State Review Team This team consists of Department of Human Services/Children and Family Services Division serves as quality assurance and site leaders. Roles include coordinating the review process within the region; conducting entrance, exit, and stakeholder interviews; providing leadership, quality assurance and debriefing; developing and releasing final reports; and coordinating program improvement efforts.

7. 7 The Case File Review Team 50 child welfare staff were recruited and trained. Each reviewer must be culturally competent and knowledgeable of Tribal differences and customs. There is Native American Representation on each Review Team. Using Child Welfare Staff as reviewers serves a dual purpose. Following the review, workers are able to implement areas of best practice within their own counties and tribes.

8. 8 The Case File Draw Process 8 files per region are randomly chosen. Typically 4 of these files are foster care cases, while the other 4 files involve the child receiving child welfare services while remaining in the home. These files represent Counties, Native Americans, and the Division of Juvenile Services. The Single Plan of Care Process is also reviewed, using a modified Instrument.

9. 9 The Stakeholder Interview Process The Interview Schedule: Tuesday: 9 a.m. – Caseworkers 12 noon - Legal/Court 3:30 p.m. - School/ Education 6:30 p.m. - Foster Parents Wednesday: 10 a.m - Community Service Providers 2 p.m. – Administrators  Legislative Members and County Commissioners were recruited to attend these groups. The Supreme Court staff are a permanent member and attends all reviews.

10. 10 The Case File Review Process  There are a total of four teams with at least two experienced members and one trainee. Each team is responsible for reviewing one file per day, for a total of two files per review. The Schedule is as follows: Tues/Wed: 8 a.m. – Entrance Interview 8:30 – Staffing 9 a.m. – Review of Case Files 11 a.m. – 4 p.m. – Interviews 4 p.m. – Completion of Review Instrument 5 p.m. – Debriefing Thursday: 8 a.m. – Debriefing 2 p.m – Exit Interview  The Review Instrument has been computerized and lap top computers are utilized by the Reviewers.

11. 11 The Quality Assurance Process A member of the State Review Team is available to assist the Case File Reviewers throughout each day. The State Review Team reviews each of the completed instruments. A Regional Supervisor is also in attendance. Comments and recommendations are provided. The instrument is returned to the Case File Review Team who makes any necessary changes, and prepares for the debriefing process.

12. 12 The Debriefing Process The State Team and the Review Teams meet at: Tuesday @ 5:00 p.m. Wednesday @ 8:00 a.m. The Review Team provides background information, a case history, a list of who was interviewed, and the individual ratings for all items and outcomes on the review instrument for their individual case An open discussion is held and decisions are made regarding specific ratings Challenges and strengths regarding the Child Welfare System and/or Individual Files are noted

13. 13 The Final Reporting Process Copies of the Review Instruments, Rating Scales, and Stakeholder Comments are forwarded to the Regional Supervisor and County Directors. The County is responsible for submitting a Program Improvement Plan to address any Items or Outcomes not rated as Strengths or Substantially Achieved. Stakeholders are also sent Stakeholder Comments and Rating Scales.

14. 14 The Definition and Philosophy of the North Dakota Wrap Around Process  Wraparound is a process, not a program.  The process maintains that the family is the “expert” to their own family.  The Child and Family Team is integral to the process.  The Single Plan of Care is the computerized treatment/service plan that supports the Wraparound Process.  Planning efforts revolve around the individualized strengths and needs of the child and family.

15. 15 The Implementation of the Wraparound Process in North Dakota  A decision was made for the wraparound process to be utilized within those agencies providing child welfare services throughout the state.  Coordination among agencies led to the implementation of a training team.  County, Division of Juvenile Justice, PATH, Public School, and Partnership Employees were trained.  The Single Plan of Care Document was developed and implemented.  Training and Implementation efforts continue.

16. 16 THE CHILD AND FAMILY TEAM  The team consists of the child and family, and those persons most pertinent in the life of the child and family.  The team develops a plan to prevent the removal of a child from the home, or to promote reunification of those children currently in foster care  The team meets on a regular basis to provide ongoing support and to update the plan  The team “wraps” services and supports around the family to ensure their safety, permanency and well-being

17. 17 THE SINGLE PLAN OF CARE (SPOC)  A computerized treatment/service plan that supports the Wraparound Process  Incorporates a comprehensive assessment of the strengths and needs of a child and family in all life domains  Developed based on the specific strengths and needs of the child and family  Developed by the child and family, with assistance from the team  Consists of specific tasks and measurable outcomes  Promotes the use of formal and natural supports/resources

18. 18 Safety Outcomes ItemNational Standard ND Review 2001 ND Review 2003 ND Review 2004 192 86.487.5 29089.388.588.4 383937594.7 49078.081.392.7

19. 19 Permanency Outcomes Item Nat. Standard ND 2001ND 2003ND 2004 59284.783.381.8 68786.29296.7 790 9296.7 883 93.389.5 9324450100 10859010085.7 1189 100 1290 100 13859110088.9 149092 89.7 1590918588 168787.590.989.3

20. 20 Well-Being Outcomes ItemNat. Standards ND 2001 ND 2003 ND 2004 17905076.281.7 1880 85.790 19907878.691.5 2082 75.686.2 21909192.396.1 2290918087.5 23908062.988.9 Overall8383.790.1

21. 21 Recommendations  The inclusion of State Legislators and County Commissioners.  The Supreme Court Representatives are permanent members of the Stakeholder staff.  The majority of reviewers should consist of County Social Service staff.  Promoting the content, location, and frequency of worker/child and worker/parent visits are paramount.

22. 22 Recommendations (cont.)  Ongoing in-depth reviews of those cases involving children in care for over 18 months  The implementation of the Wrap Around Process utilizing the Single Plan of Care  In-depth reviews of those cases involving repeat maltreatment Develop and implement two special Native American project to meet the deficiencies of a shortage of Native American foster/adopt homes.

23. 23 Action Items –Continuation of Actions identified on the State Program Improvement Plan –Continued implementation of the Wrap Around Process –Continuation of State CFSR Process –Expanding Cultural Competency within North Dakota’s Child Welfare System –Collaboration with Tribes to tie in Safety, Permanency, and Well-Being with Native American cultural components such as the Medicine Wheel –Expand our final reporting process to include updates to tribes that were a part of the review process.

24. 24 ACTION ITEMS (cont.)  A sub-group of the review team will make follow up site visits to those regions where challenges were identified with in 120 days.  Expanding our efforts to improve Foster Care Re-Entry Outcomes  NRC will be conducting a Review of Re- Entries into Foster care in North Dakota

25. 25 2005 Update on Case Ratings 4 of North Dakota’s 8 regions have been reviewed to date. Out of these 4 regions, a total of 32 cases have been reviewed. Overall Ratings are 95%, 100%, 97.2% and 99.1% For an overall of 97.8% Great Work North Dakota!