Webinar: Blueprint for Family First Update, December 2022

Deputy Commissioner of Child Welfare Mary Havick, and Interim Family First Program Director Tiffany Bivins shared a live webinar update on the progress of the Blueprint for Family First implementation in Georgia with a brief overview of milestones and progress this year as well as a preview of the work ahead in the 2023 calendar year.

Special guest, Katie Rollins from Chapin Hall at the University of Chicago, shared some national context on the Family First Act rollout across the U.S. as well.

As always, if you have any questions, please email us at [email protected] or click here to submit a question here on the website.

Slides available here .

Rough Computer-Generated Transcript:

Mary Havick  00:06

Good afternoon, everyone, and welcome to our Family First implementation update Webinar. My name is Mary havoc, and I serve as Deputy Commissioner Child Welfare at Georgia's Department of Human Services Division of Family and Children's Services. And I am pleased to be here with you all today and want to thank you all for taking the time to join us for this update. Whether you are with us live today, or watching it recorded later. We have been doing a lot of work since our last webinar, behind the scenes that we feel like lays a strong foundation for our implementation. We're going to go into much more detail about that work today, as well as kind of recap Georgia's Family First implementation journey overall, and share with you some context for how Georgia is doing in terms of national implementation. And just looking across the board at what the national landscape looks like. I want to share with you all if you're not aware yet that we have a new family first leader, and that is Tiffany Bivins, who is serving as our interim family first director. Our transition to Tiffany's leadership has been seamless. She has been with us from the beginning, and was the first person that we hired on to the family first team. Brian, if you will advance us to this first slide, I want to just start with a brief overview of the Family First Prevention Services Act. Most of you all are aware that this is the most significant federal child welfare legislation that has been passed in decades that aims to prevent the unnecessary placement of children in foster care, as well as promotes family based care for children who are in foster care. And while the family first legislation itself is largely focused around foster care, we feel like that there is a larger opportunity with Family First around prevention. And so we see Family First is one component of our overall efforts to expand our existing prevention practice. I think it's important to also remember that Family First really supports work that we are already doing related to maintaining children safely in their homes. In fact, we've been doing that work through our family preservation program for decades. What this allows us to do is offer some new evidence base and intensive services that are not currently part of our service array. And for us to draw down federal funding for those services, which have previously that funding has only been available for children who are in foster care. And while we are focused on implementing prevention services, we're still determining how we may implement QR TPS in later phases of our Family First work. I also think it's important to note that while this is largely focused on preventing the unnecessary placement of children into foster care, there aren't any penalties for states for children entering foster care that are associated with this act. The funds that are available because of this for family preservation services are also still available to support children when they do need to enter foster care. If you all have questions today, throughout the webinar, I want to encourage you to use our Q&A feature that is attached here and we will take those questions and compile them and answer them in a future newsletter after the webinar. If you think of a question that didn't come to mind, while we were together here, you can always submit questions through our Blueprintfamilyfirst.org website. Next I am going to introduce you all All to Katy Rollins, who's going to provide an overview of the national implementation efforts. And Katie has been a great friend to Georgia in this work and has been Georgia's main contact through Chapin Hall and leading the project here for them. And if you're not familiar with Chapin Hall, they're a child welfare consulting and technical assistance group that is based out of the University of Chicago, and is also doing similar work in several other states across the country. Katie?

Katie Rollins  05:34

Great. Thank you so much, Mary, for that introduction. And good afternoon to everyone. As Mary said, my name is Katie Rollins, and I'm with Chapin Hall at the University of Chicago. Next slide, please. I'm part of a team at Chapin Hall that's currently partnering with Georgia on planning and implementing family first, though, as Mary mentioned in our rules, in addition to working with Georgia, my team and I work with human services and child welfare agencies nationally. So I'm here today really to share with you some of that national perspective to provide some updates and some insights about implementation of family first nationally, and how Georgia fits into that national picture. Next slide, please. So I want to start with taking a moment to frame family why Family First is so important on the national and on the historic scale, and why it could be so important in Georgia. So I think to fully conceptualize the paradigm shift that family first represents, it's helpful to take a step back and look briefly at national priorities and the trajectory of American child welfare in recent decades. as Mary mentioned title for refunds the primary funding stream federal funding stream for child welfare, has historically been limited, especially to the foster care population. And accordingly, the historical structure of child welfare has embodied a relatively reactive and punitive response to families in crisis. So even when best practice and the best of intentions were present, intervention with families has typically occurred because of how Child Welfare restructured after a family crisis or maltreatment had already occurred. The twin focuses of child welfare services have historically been on foster care, and investigations of allegations of maltreatment with far fewer and less consistent resources allocated to prevention through federal funds. So as you can see on this slide, the total annual expenditures on Child Welfare Services exemplify these historic and often still present priorities. So these data are from fiscal year 2018. And as you can see, about half of both federal and state, state and local funds supported out of home placements, while the second greatest expenditure was on adoption and guardianship arrangements. The third greatest investment was in Child Protective Services. And meanwhile, preventive services while arguably reflecting the needs of far more families in many jurisdictions, has simply not been a part of the Child Welfare mandate and federal funding structure, and it received just 13% of federal funding. And Family First is important in this context, for an obvious reason, it shifts the paradigm to fund prevention with an uncapped federal entitlement funding stream nonetheless. Next slide. So at the same time, the annual costs of maltreatment in the United States are huge, and not just from the fiscal lens presented on this slide. As you're aware, the human costs of maltreatment, of course, are huge. Also, family first, again, is important because for the first time, it shines a spotlight and harnesses federal funding streams to address prevention and prevent these costs downstream and prevent the human toll of maltreatment that our communities are experiencing. Next slide. Okay, so I could talk for half an hour about this slide and go into depth on every piece of legislation depicted here on this arrow. But I just want to take about a minute and just point out that the trajectory of child welfare legislation over the decades has mirrored the pattern that I'm discussing here. So the first policy on this slide is Mother's pensions, which aim to provide financial support to widowed or single moms. others to keep their families together. So the goal was really Family Preservation through provision of a pension. More recent legislation in the past 50 years, has focused much more on essential child protection, foster care and permanency functions. In that context, when family first passed in 2018, it marked a significant step forward that we're really excited to implement here in Georgia because of its focus on prevention. Next slide. All right. So I want to provide a little context on how family first implementation is going nationally, you're somewhat aware of how it's going in Georgia. And you might be curious how it's going in other states as well. I mentioned that family food first was passed in 2018. Its passage was somewhat of a surprise. It had been intended for an earlier year when it wasn't passed. And it was added to a a budget federal budget bill. And when it was passed, a lot of the groundwork and preparation actually hadn't happened yet. We're grateful that it passed. But there hadn't been a lot of preparation in the States. So to be honest, the first year or two after family first pass, States spent time figuring out what was in the legislation and doing the preparation that often would have occurred before the legislation was passed. Which is one reason why we see family first implementation moving a little bit slowly. So as you can see in this map, 35 prevention plans are current or currently approved. As you may know, prevention plans are the plans that states need to submit in order or jurisdictions need to submit in order to gain approval to leverage family first funds. So of these 3532 states, as well as Washington DC, and to Cherokee tribes, which you can see here are approved, 14 more have submitted but not yet been approved, and a subset of states have not yet submitted plans. So as you know, Georgia is happily among those that are approved, gaining approval in a cohort, a very large cohort of states that gained approval in 2022. Whereas many plans have endured significant scrutiny from the Children's Bureau prior to approval, which has often delayed approval, Georgia's plan was approved incredibly quickly, reflecting I think, the thoughtfulness and the high quality of the plan. So after gaining plan approval, the next step is for each jurisdiction to implement and begin delivering family for cpp. So you might also ask how many jurisdictions are starting to deliver family for cbps and have that impact on families? Next slide.

Katie Rollins  12:53

So with that in mind, another way to understand the extent to which family first has been implemented is to look at how many jurisdictions are claiming, which means that they've begun to draw down federal funds to cover part of the cost of delivering family first services. So claiming is just a good indicator of whether Family First is up and running, so to speak, in jurisdictions because it shows the services are being delivered and some of the core administrative infrastructure is functioning. So you can see here that there are 16 jurisdictions that are currently claiming. And that includes 14 states as well as one tribe in Washington DC. So again, the uptake is somewhat slow. Next slide. So you might ask, why is uptake slow? And there are a few reasons for this at a high level? The answer is, it's really complicated. As I just discussed, Family First is a paradigm shift. It requires changes in practice and service service delivery at the local level. It requires new contracts in many cases, it requires changes in administrative structures related to contracting data it claiming and getting all these ducks in a row and doing so well can take time. Another important question might be why are so many states in limbo where their plan has been approved, but they haven't begun to claim and implement yet, and this is where Georgia is as well. And there's an understandable and natural impatience to implement as much a family first as quickly as possible once the plan is approved. A well there's a well intentioned desire in most states to just roll out as many services as quickly as possible. And it Chapin Hall we urge jurisdictions we partner with to balance that urgency with also a careful approach taking time to plan and implement really well. Because we have found that jurisdictions that implement too fast, they often run into challenges and mishaps and they have to go back and redouble their efforts which is worth avoiding. Next slide. So how does all of this national perspective apply to Georgia, and I wanted to sort of pull out three big ingredients that we're hoping will lead to implementation success in Georgia and they relate directly to all of you here today. The first ingredient in success is going to be meaningful collaboration between the state the districts, the regions, the counties, providers, families, and other stakeholders. So as all of you are invited to join meetings, workgroups or focus groups as appropriate in light of your role, please join, we need your input and your partnership in order to make family first to success. All of these entities play a critical role in rolling out EBPs at the local level. The second ingredient is continuous improvement, which relates to collaboration because it's something that you will be involved in, we can't improve family first from the state level alone. So throughout implementation information will be generated for use by the state as well as district regional and local entities about the degree to which we're successfully reaching families delivering services services as intended, and achieving the results that we hope to reach. So family first, implementation probably won't be perfect on day one, and we'll need your partnership overtime to get it right. And finally, Georgia has clap crafted a deliberate phased implementation strategy with two of the five EBPs MST and FFT rolling out in a subset of counties initially, in 2023, followed by a broader implementation statewide. Like I said, I think this is the best approach chip, analysts found that a phased implementation approach is by far the most advisable. And we're really happy to be working with Georgia on this strategy, please know that more information will be forthcoming about a schedule for a plan phase two, once phase one is underway. So with that in mind, I want to thank you so much for your time today and turn it over to Tiffany Bivins.

Tiffany Bivins  17:22

Thank you so much, Katie. Good afternoon, everyone. My name is Tiffany Bivins. And I am the interim Family First Program Director here at defects. And over the next several slides, I really want to talk about the blueprint for phase one. And really take you on that journey that Mary mentioned earlier, I want to first provide a recap that really talks about briefly, where we've been in the work that we've done leading up into this point. And then I want to give you a status update that talks about where we are and what we're doing currently to prepare for phase one, which is underway and coming very soon. And then I'll provide a snapshot of just some next steps and where we're going and what you can expect once we get phase one up and running. Next slide. So when thinking about planning for implementation, we had to first really determine the population that we were going to serve, we knew that we were going to be focusing primarily on the prevention services side of family first, at least to begin with for phase one. And so in order to provide those services, we really needed to take a look at what population here in Georgia would benefit most from the from those services, excuse me, and how to prepare for service delivery. Next slide. So in doing that, we had to reference the family first or federal candidacy definition, which is that a candidate is a child who is identified in a prevention plan as being at imminent risk of entering foster care, but who could remain safely in the home or in a kinship placement if services or programs that are necessary to prevent entry are provided or in place. And so looking at that candidacy definition, we then had to craft our own definition that aligns with that, really identifying our target population here in Georgia. Next slide. So in doing that, some of you may remember we had early on a candidacy workgroup that was comprised of some providers and internal stakeholders and staff leadership here at defects where we came together to really flesh this out, look at definitions from other states. Look at our population here the types of cases we were receiving, and really try to nail down a an accurate but yet a simplified definition that we could work from here. And what we came up with from the work in the candidacy workgroup as well as further work thereafter was that we were really going to focus on our children and youth and families who are receiving ongoing services and our family preservation program area. What we found was that the family preservation program area really aligns nicely with existing family first requirements. This is the population that we're serving in efforts to prevent removal. So it only made sense. And then we also had the expected and parenting youth who will be served in foster care. And this is an actual population that is required by the Family First Act. Next slide. So as you drill this down even more, what we determined as our target populations will be here with these three listed. So we have like I said, the children and families being served and Family Preservation, we have our children and youth post permanency. And this really relates back to number one, because it needs instances it will be for those cases that have opened cases in family preservation as well. And then our third category, as I mentioned, the expected parenting youth in foster care, which we will be including in subsequent phases of implementation. Next slide. So after we, we determined our target population and who we were going to serve, we then had to determine what services we wanted to at least begin with, as we lead to phase one of implementation and beyond. Next slide. And with that, we had to look at the title for the Clearinghouse. So all of our title for E prevention services that we had to select from they had to meet this criteria that was put in place by the clearing house. They had to be evidence based First off, and then they had to fall into the allowable categories of mental health, substance abuse treatment and prevention, and home parenting skills. Next slide. And this is just to recap with the title for each clearing house actually is because I know it's been a while since we've talked about the EBPs and service selection. But the clearing house was established by the ACF and this was the listing of all the services. You know, early on states were submitting evidence based programs to be rated and approved. And then once they were rated and approved, we were able to include those services in our conversations about the ones that we ultimately ended up including in our prevention plan. Next slide. Taking those requirements and qualifications, we then entered a pretty streamlined process for selecting EBPs here in Georgia. Next slide. And this is when our prevention services workgroup came into play that we met over the summer for six weeks, over 2021, the summer of 2021. And many of you here today are listening to this recording. You may have been a part of this workgroup. So if so thank you. This was an amazing workgroup, we did a lot of great work, just really digging into the process of figuring out what services would best serve the children and youth here in Georgia, what treatment needs were we seeing and how we wanted to expand capacity over time, we knew that we were going to begin with well supported services as far as the rating on the Clearinghouse. But beyond that, we really needed to have a process that allowed us to look into what services would best benefit our children, youth and families here. Next slide. And this really looks at a lot of that process and what that process entailed for us to select the initial services that we include in our plan. We definitely started by looking at data about the target population here in Georgia, we held focus groups with caregivers and youth we met with caregivers from our Parent Advisory Group and youth from our youth advisory group, all with lived experience who really were able to weigh in on what types of services would have been beneficial or were beneficial for them during their involvement with defects. We took all of that information, presented it to the prevention services workgroup. And then we had a lot of rich discussion during our meetings with the prevention services workgroup members were a lot of you all as providers and even you know internal staff and leadership from defects all weighed in and provided just that experience of what you were See, as far as the treatment needs, the service gaps, and what we really needed to pay attention to and highlight. We also looked at data from our provider survey that we sent out during February and March of 2021. That asked a lot of those same questions. And it allowed us to really look at current service capacity throughout the state. We had input from our core group of internal stakeholders. And then we were constantly watching the Clearinghouse at this time, just to receive update updates, and you know, really look at what services were being approved and how they were being rated. Next slide. Taking all of that information into account, it really boiled down to us figuring out what services met the fit and feasibility factors. And so in looking at the fit, again, just asking ourselves, when it comes to the children and youth that we're serving here, what EVPs really would meet those needs that were identifying what would really help to provide that treatment that more intensive treatment that we see that our children and youth need here. And then with feasibility, looking at those EVPs that we had to select from, which were more feasible to actually implement here in Georgia and looking at costs we all know to implement these evidence based programs. There are costs involved, looking at those costs, looking at training needs, looking at licensure. Also looking at current capacity here throughout the state, do we have current providers that are offering some of the selected evidence based programs? And how do we leverage that. So looking at these two factors put together, we really tried to select the evidence based programs that we thought would be the best to start with, including our prevention plan. Knowing that we would continue to build service capacity over time, we will continue to expand. And we would continue to add to that list of evidence based programs. Next slide.

So with all that work, we ended up with our list here of five evidence based programs, which I have coined as our starting five. And these are the programs that we've included in our prevention plan. We have healthy families, America, that's going to serve your children and families with a child up to 24 months of age parents is teachers, that's going to serve children up to age of kindergarten entry, brief strategic family therapy that's going to serve children, adolescents, ages six to 17 years old. And then we have for our older population, multisystemic therapy, or MST is going to serve our youth aged 12 to 17. And Functional Family Therapy or FFT, which will serve our children aged 11 to 18. As you can see, something that we wanted to focus on as well as making sure that we selected as far as our initial services, that we wanted to make sure that these services accounted for a broad age range. And that's what I think we did here. But again, we'll continue to build on this list as we go. Next slide. So we've talked about some of the groundwork that we really had to dig into in order to prepare for actual GA implementation. And so we're going to talk a little bit now about the work that we've been doing in preparation for phase one. Next slide. So in implementing and preparing for phase one, we first had to submit our title 40 Prevention Plan, which Katie talked about. This here outlines the plan sections wanted to include all of the sections that we had to provide information on in order to submit our complete plan to the Feds for approval. So as you see, we talked about eligibility and our definition for candidacy candidacy, we had to include information about our service descriptions and how will oversee and monitor those services. We had to include information about our child's specific prevention plan and how we plan to implement that and practice as well as monitoring child safety. How we will not only assess safety initially but how we will monitor safety ongoing over time throughout the life of the case. We had to provide our strategy for evaluation, how we plan to train our workforce and our staff and support them. And any information about prevention case loads. You will be able to access this plan it is approved. You're able to access it and read it. We'll make sure that this plan is on our blueprint, family first website for you to access and enjoying. Next slide So, as Katie mentioned, we had to submit our plan. We did that in October, and our plan was approved in October. So we're very excited. And we're very proud of the work that not only for us as a family first team, but all of the efforts from you all as providers who have weighed in, whether it's on workgroups or different conversations outside of those groups, just providing your feet but feedback and input. And just giving us information that was just very helpful in this work from field staff to leadership or internal stakeholders and external stakeholders. This was definitely a group effort. And we just want to extend a thank you to everyone who has provided any type of feedback or input that we were able to really incorporate into our completion of this plan that has been approved on our first submission. So again, we're very excited to begin this work now that we have an approved plan. Next slide. Once we submitted our plan, and our plan was approved, even before our plan was approved, we started to draft our implementation plan. Because the title 40 prevention plan is more of a high level plan of how we plan to implement that we actually had to take the high level plan and really drill down into actual action steps and tasks that we would need to complete in order to get phase one up and running. So we completed the first draft of our implementation plan. And I only say that because this plan is a living, breathing document that we will continue to update over time as we complete tasks, add tasks as we go, and just continue to take a look at what work needs to happen and what work needs to be added and even who we need to invite into this work to assist. So the implementation plan is essentially our work plan. And it's our implementation tool that we've been working from. Along with the implementation plan. We've also assembled an implementation team that we have been working with for a while now. And they have come together to really help us carry these tasks out and complete the work necessary. To begin phase one. We will talk more about the breakdown of the implementation plan on the next slide. structure has seven workstreams. And that essentially represents the major overarching categories of the family first implementation work. And this also when it comes to our implementation team, we have internal subject matter experts that represent each of these streams, and assist with leading the work, as well as bringing on various team members and staff that will help assist with carrying out the work for these different streams. So you see, we have core foundations, practice and assessment, workforce capacity and training, policy and guidance. It see Qi and fiscal. So our implementation team has been working very hard to just get this work off the ground and prepare for phase one. Next slide. Speaking of phase one, we've talked about the groundwork, we've talked about the work we've been doing in preparation. And we're here now we are here at phase one, we will be starting this phase in early 2023. We are extremely excited, we just wanted to give a brief overview of what phase one will look like for us here in Georgia. Next slide. So phase one will include four counties. And we'll be implementing two of our starting five evidence based programs. And I think Katie touched on this a little bit, we really wanted to make sure that we had a phased implementation. And then we had a slow, very methodical and effective start. And we did that because we wanted to be able to have the time to really analyze the data that we'll be collecting, apply those lessons learned, and really take our time to assure that planning for phase two and subsequent phases, we'll be able to really apply everything that we've gathered from phase one to just make sure that not only each phase of implementation, but once we implement statewide that we're able to do so effectively and efficiently. So we're excited to begin with our first four counties which will be decap, Chatham, Cherokee and Richmond. We will be implementing MST and FFT. MST will be in Chatham and Richmond and FFT will be in DeKalb and Cherokee and implementing these four EVPs and phase one, we will not have any changes to policy or shines. So our staff here in phase One counties, they will operate from an SOP which essentially says that we're following existing policy and practice and pop and processes with the additional case tasks of the child specific provision plan, which is an actual Family First requirement, and the service referral that will be specific to these two evidence based programs. Next slide. So let's talk a little bit about next steps. Once we get phase one up and running early next year, we want to talk about just the steps leading up to that, and steps that we'll even, you know, look at completing once we get phase one underway. Next slide. So in gearing up for phase one, we're going to continue preparing and supporting our Phase One counties, we've been meeting with leadership from these four counties for almost a year now, continuing to engage with them will start to engage on with their field staff and frontline staff as well. county directors will be assisting them with some readiness assessments. And it just really allows us to continue to get a better idea of how to support each county, we're going to be continuing with our meetings with them even once phase one begins, we're going to be implementing some hands on site visits. Again, we're really making sure that our Phase One counties receive the support and attention that they need to successfully implement these evidence based programs. We're also going to be delivering staff trainings for our Phase One staff as well as leadership for phase one counties. Our training team is currently working diligently in creating the curriculum for this to include family first requirements, as well as just a refresher of current practice. And so we will be delivering those trainings in preparation for phase one. And there will also be coaching available to staff wants, phase one is underway on an ongoing basis. Again, just going back to that support that we will make sure we were providing to our Phase One staff. We will be selecting, we're in the process now. And we'll be selecting our providers and initiating those contracts with them. And then we will be able to deliver our provider trainings, we really just want to make sure all of our providers that are providing services for our Phase One counties are trained and just the Phase One processes that we have in place will be beginning phase one and early 2023. And once we have phase one up and running, we're right back at it planning for phase two, as well as just our overall phased implementation plan. And, as always, once we have more information about that, we'll be able to share that information. Next slide. So I just want to say thank you all for attending. As you know, you can see, there's just been a lot of work that has gone into this implementation in this phase implementation. And we're very excited to have phase one underway. Here is the email that you can submit any of your additional questions to and we'll be able to answer those questions in a future newsletter. If you do not, you know, submit those questions in the q&a. And I'm just going to throw it to Mary again, just to close this out. But again, thank you all so much for attending.

Mary Havick  38:41

Thank you, Tiffany. And I just want to close with a reminder of our philosophy that we can't do it alone and do it well. And we value tremendously the input of our key stakeholders as well as the broader child welfare community, in helping us to create a family first program that is really going to create stronger families for a stronger Georgia. So you can expect in 2023 to hear from us on how phase one is going. And for us to be seeking your input as we begin planning for phase two. Please drop your questions in the q&a for us. And thank you so much for joining us today. Goodbye

Related to: 

• Blueprint Family First