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TABLE OF CONTENTSINTRODUCTION.2OVERVIEW OF WORKBOOK AND ACTION ITEMS.3SECTION I……………………………………………………………………………………………...…5Service Needs/Availability.7Additional Services Needed.7Family Engagement.8Post Discharge.9SECTION II……………………………………………………………………………………………..10CONGREGATE CARE PROFILE10 Getting to Know Your Congregate Care System13 Opportunities and Strategies for Reducing Congregate Care13 SECTION III……………………………………………………………………………………………...14FOSTER BOARDING HOME CAPACITY14Family First Targets14Data Analysis: Estimating Needed Foster Home14Strategy Development: Recruiting/Retaining Foster Parents16Stakeholder Input and Feedback17SECTION IV18QUALIFIED RESIDENTIAL TREATMENT PROGRAM (QRTP)18QRTP Status19Discharge from a QRTP19Post Discharge from a QRTP20SECTION IV(a)21QRTP Assessment Requirements2130-Day Assessment2160-Day Assessment22Status Reviews/Permanency Hearings23Business Process23SECTION VI(b)25QRTP Trauma-Informed Care25 Leadership25SECTION V26ORGANIZATIONAL CHANGE AND READINESS FOR IMPLEMENTATION27SECTION VI.………………………………………………………………………………….……...…..28Family Engagement……………………………………………………………………...28SUMMARY…………….…………………….……………………………………………………………29RESOURCES30

INTRODUCTION

The Family First Prevention Services Act (FFPSA) was signed into law on February 9, 2018. This law restructures federal funding to promote and maximize the use of prevention services, resulting in the reduction of foster care and congregate care placements, while prioritizing the use of family-based foster boarding homes and emphasizing the importance of kin caregivers. FFSPA makes major reforms intended to keep children safely at home with their families, and when that is not possible, to use the least restrictive form of placement that is appropriate to meet the child’s needs.

Since passage of this legislation, the New York State Office of Children and Family Services (OCFS) has partnered with districts, voluntary agencies, and other stakeholders to analyze the potential impacts of the FFPSA implementation and to create guidance for districts and agencies to align with the administrative provisions of the Act. Some activities include:

· OCFS facilitating monthly Statewide Implementation Team (SIT) meetings

· Providing webinar series to assist local implementation

· Providing technical assistance (TA) to all districts/agencies regarding congregate care

· Choosing assessment tools for QRTP admittance: CANS, CASII

· Providing data/foster home data packets and other available resources

· FFPSA transition funding

· Creating a FFPSA “Candidacy Definition”

· Assessing the landscape of prevention services Evidence-Based Programs (EBP) to inform the State Plan

· Transforming our foster care placement continuum

· Facilitating system changes to support the FFPSA implementation requirements

Collectively, our goal is to enhance our array of prevention services, reduce the number of children in congregate care, increase the number of family-based foster homes, and provide effective services that meet the needs of children and their families. Our purpose is to achieve permanency in the shortest amount of time possible, resulting in a safe and stable environment.

MOVING TOWARD FFPSA IMPLEMENTATION REQUIRES OCFS, Districts and Voluntary Agencies to

· review and refine removal and placement protocols,

· increase recruitment and retention of kin and non-kin foster parents,

· conduct a critical assessment and redesign of congregate care system,

· explore QRTP accreditation and the assessment process, and

· enhance prevention services array.

This workbook is a guide to prepare for FFPSA implementation by gathering and assessing relevant data, identifying bright spots and challenges, and aligning practices, procedures, and policies within the provisions of the law. Links to data and other information are provided throughout the document and there is a resource section at the end.

OCFS appreciates the input of our districts, agencies, and advocate partners in helping to develop the contents of this guidance document.

OVERVIEW OF WORKBOOK AND ACTION ITEMS

This workbook is a general guide to assist districts and agencies in the implementation of the FFPSA in New York State. Goals for transforming foster care in New York State include increasing kinship foster care to 50 percent, decreasing congregate care (CC) to 12 percent, and providing prevention services, including EBPs, to support children and families. To meet our goals, we have developed this workbook to help guide districts and agencies in developing business processes, strategies, and workplans to align with the FFPSA.

Below is a checklist of the recommended steps and actions as described further in the workbook.

STEP

ACTIONS

Complete

Understand Child Welfare Population

Obtain/Analyze Data

|_|

Understand In-Home Services Population

Obtain/Analyze

|_|

Understand Readmission In-Home and/or

Foster Care Population

Obtain/Analyze Data

|_|

Understand Services Needed/Available for

Child Welfare Population

Obtain/Analyze Data

|_|

Consider Front Door Strategies to Reduce Admissions When It Is Safe to Do So

Assess Current Practices/Research and Analyze

Alternate Strategies

|_|

Consider Back Door Strategies to Reduce

Time in any Foster Care Setting



|_|

Consider Strategies to Reduce Reentry/Admission



|_|

Understand Current Reliance on Congregate Care

Obtain/Analyze Data from Data Warehouse

and Bubble Charts

|_|

Identify Technical Assistance Needs

|_|

Consider Front End Strategies to Reduce

Admissions

Consider Back End Strategies to Reduce Time in Care

Assess Current Practices

|_|

Research and Analyze Alternate Strategies

|_|

Understand FBH Capacity and Kinship Placements

Obtain/Analyze Data

|_|

Identify TA Needed

|_|

Consider Front End Strategies to Recruit and Retain Foster Homes and to Increase Kinship Placements

Consider Back End Strategies to Achieve

Permanency


|_|

Research and Analyze Alternate Strategies

|_|

Understand QRTP Requirements

Assess Requirements Against Current Status

|_|

Identify Changes Needed

|_|

Develop Plan to Implement and Comply

|_|

Understand Assessment Requirements

Assess Requirements

|_|


|_|

Identify Changes Needed

|_|

Coordinate with Stakeholders to Develop an FFPSA Implementation Plan

Stakeholder Meetings to Develop Business Process

|_|

Implement Business Process

|_|

SECTION I

In-Home Services Population

Getting to Know Your Prevention Services Population

Districts and agencies should use data to inform their understanding of who receives prevention services, which types of services are used most often, and how families have engaged with prevention services over time. Knowing the demographics and number of children receiving prevention services in their home can help districts and agencies make informed decisions about the types of services to contract for and provide.

Another important resource is the disproportionate minority representation (DMR) data that may be found on the Family First website: https://ocfs.ny.gov/reports/sppd/dmr/DMR-County-Comparison-2019.pdf. We encourage districts to utilize that data in conjunction with their own internal processes to provide a comprehensive overview of their population served as it pertains to race/ethnicity.

Children receiving in-home services as of:

Total In-Home Population

#

%

RACE

White

%

Black/African American

%

Asian

%

American Indian or Alaskan Native

%

Native Hawaiian or Other Pacific Islander

%

Unknown

%

HISPANIC ORIGIN

Yes

%

SEX/GENDER

Male

%

Female

%

AGE RANGE

0-5

%

6-12

%

13-17

%

ALLEGATION TYPE

Abuse

%

Neglect

%

Monitoring and Analysis Profiles (MAPS) data can show what percentage of foster care admissions each year had protective, preventive, both or no services in the 12 months prior to entry.

Link: https://ocfs.ny.gov/main/reports/maps/

Utilizing Bright Spots Preventive Data Sets shows who from Open Preventive cases transitioned to foster care in 12 months. Using the latest possible 12-month period, look at numbers and percentages of this population.

In-Home Preventive Cases Closed as of: / /

#

%

CLOSURE REASONS

Entered Foster Care

%

Moved Out of State

%

Services No Longer Needed

%

Other (cannot locate, client request/refusal, death)

%

The median length of stay for the in-home population is 393 days. Districts can access this information through Chapin Hall (Chapin Hall’s Center for Child Welfare Data). For access or a tutorial, contact: [email protected]

Monitoring Analysis Profiles (MAPS) data reflects what percentage of foster care admissions each year had protective, preventive, both or no services in the 12 months prior to entry.

After reviewing the data, agencies and districts will be asked to consider the following questions:

Front Door

Back Door

How many children receive in-home services? How many of these children enter foster care?

How many children enter and exit foster care in a relatively short period of time (i.e., 30 or 60 days)? Why?

How much of your in-home services system is related to neglect allegations? How many enter foster care? Could an alternative to placement be considered for any of these children?

Could short stayers be prevented from ever entering foster care?

How much of your in-home service system is related to abuse allegations? How many enter foster care? Could an alternative to placement be considered for any of these children?

How many children remain in foster care at the one-year mark? Is foster care still the best option for these children? Are there additional supports that can be placed in the home?

SERVICE NEEDS and SERVICE PROVISION

Understand the service needs and services currently available to your in-home services population. This data can inform decisions about which additional services you may need to provide families to increase supports and improve their stabilization.

Compare service needs of families with services currently available in your district:

SERVICES

SERVICE NEEDS

SERVICE AVAILABILITY

CAPACITY/ ACCESIBILITY

Entitlement Benefits Advocacy

|_|

|_|

|_|

Education Advocacy

|_|

|_|

|_|

Mental Health Services for Youth

|_|

|_|

|_|

Mental Health Services for Adults

|_|

|_|

|_|

Behavioral Health Services

|_|

|_|

|_|

Family Therapy

|_|

|_|

|_|

Parenting Classes

|_|

|_|

|_|

Crisis Intervention/Respite Services

|_|

|_|

|_|

Substance Abuse Treatment Services for Youth

|_|

|_|

|_|

Substance Abuse Treatment Services for Adults

|_|

|_|

|_|

Domestic Violence Victim Services

|_|

|_|

|_|

Domestic Violence Perpetrator Services

|_|

|_|

|_|

Domestic Violence Family Services

|_|

|_|

|_|

Sex Trafficking

|_|

|_|

|_|

Sex Abuse Victim

|_|

|_|

|_|

Sex Abuse Child/Youth Perpetrator

|_|

|_|

|_|

Rape Crisis Services

|_|

|_|

|_|

Crime Victims Advocacy

|_|

|_|

|_|

LGBTQ Services

|_|

|_|

|_|

Transgender Youth Services

|_|

|_|

|_|

Incarcerated Families Services

|_|

|_|

|_|

ADDITIONAL SERVICES NEEDED

Are there additional services not listed above that are available in your district, or needed to reduce entry and/or reentry into foster care?

SERVICES

SERVICE NEEDS

SERVICE AVAILABILITY

CAPACITY/ ACCESIBILITY

|_|

|_|

|_|

|_|

|_|

|_|

|_|

|_|

|_|

Analyzing Family Engagement When Receiving In-Home Services

IN-HOME SERVICES - FAMILY ENGAGEMENT

Engaging families and treating them as partners promotes safety, well-being and stability. A family is engaged when they have an active role in identifying their needs and strengths, and when they work collaboratively with professionals to develop a plan that addresses their concerns.

How do you measure family engagement in your organization?

How often do you measure family engagement in your organization?

What strategies are used to engage families at the practice level?

How are youth engaged at the practice level?

Are children/youth engaged, as appropriate, in a discussion about concerns? If yes, how?

Are children/youth engaged in a discussion about their concerns and needs? If yes, how?

Do case records reflect the voice of the family in a discussion of their family dynamics? If yes, how?

Do case records reflect a partnership with family to devise solutions to noted concerns? If yes, how?

What are the challenges/barriers to engage families at the practice level?

What additional strategies can be used to engage families at the practice level?

REMOVAL DECISION

What is the process for the decision to remove a child?

What is the role of the family in the decision to remove a child?

What efforts are made to obtain the child/youth voice during a removal process?

How does the district/agency help families identify who in their natural network can assist in a situation?

What is your Blind Removal Process? (see 20-OCFS-ADM-19) This section can be utilized to incorporate your Blind Removal process, inclusive of the following:

1. Blind Removal Committee

2. Blind Removal Committee Protocol

3. Case Selection Process

4. Blind Removal Monitoring and Tracking Plan

5. Quality Assurance Process

What is your Kin-First Firewall practice? (see 20-OCFS-ADM-18) This section can be utilized to incorporate your Kin-First Firewall practice inclusive of:

1. the efforts that will be made to identify, notify, and engage kinship resources;

2. the process for making a non-kinship placement request;

3. the protocol for secondary-level review of non-kinship placement requests, including a staffing description of the reviewer(s) and how efforts to achieve kinship placements will be evaluated;

4. how the need for additional efforts will be evaluated and directed, including examples of additional strategies that will be utilized to achieve kinship placements;

5. how non-kinship placements are granted (and only when all possible and appropriate efforts to place the child with kin are fully exhausted).

Describe the process for review of placement/level of care decisions. Is there a review team (administrative review team)? Is there a standardized tool utilized for the decision-making process? Who approves placement decisions?

What is the process for discharge from foster care? Who is involved in the decision? What is the role of the youth/family in the decision-making process?

POST DISCHARGE

Discharge planning and family-based aftercare support is essential to help maintain placement stability.

Utilizing the services checklist on pages 5 and 6, plan for which services are needed and which services are currently available to families for post-discharge support.

SECTION II

Congregate Care Profile

GETTING TO KNOW YOUR CONGREGATE CARE SYSTEM

Districts and agencies should use the OCFS Data Warehouse and Worksheet A to build a picture of who receives congregate services, which types of congregate care settings are used most often, and how reliance on congregate care has looked over time. OCFS Data Warehouse/FFPSA Folder/Congregate Care Profiles and Comparison to KinshipFoster Care and Certified Foster Boarding HomeThe reports in Data Warehouse provide an overview of all children served in Institutions, Group Residences, Group Homes, Agency Operated Boarding Homes, and SILPS (collective known as congregate care or ‘CC’) on the last day of any given month/year. Children absent from congregate care are included and displayed in a separate series of columns to allow for easy comparison. Similarly, to facilitate hypothesis testing, two versions of the CC Profile report are available. One report divides your congregate care population into groups based on case type, i.e. Child Welfare (abuse, neglect, destitute, voluntarily placed) JD, PINS. The other report delineates children based on their current facility type, i.e. Institution, Group Residence, Group Home, etc. Also included in the FFPSA folder is a link to the In-Care Summary report. This report provides aggregate demographic information on all children in the care and/or custody of the selected district or agency residing in a Kinship Foster Care, Certified Foster Boarding Home, Institution, Group Residence, Group Home, Agency Operated Boarding Home, SILP, or other 24-hour care setting, including those out-of-state. When paired with one of the Congregate Care Profile reports described above, this report can help you explore the similarities and differences between your entire foster care population and children served in congregate care settings. It also enables the monitoring of the proportion of served population in home-based setting.Use the reports in Data Warehouse to document data in the charts below and to begin to analyze your congregate care system.Notes: You can find these data resources in the Data Warehouse Family First folder or the OCFS Family First webpage: https://ocfs.ny.gov/main/sppd/family first data.php

1. Data Warehouse Family First folder (monthly reports on demand, by district or agency): 0. Children in Care by Facility Type0. Family First Prevention Services: Outcome Monitoring Report0. Statewide Children in Care by Agency: Facility Setting and Home District2. District by Agency2. Agency by District

1. OCFS Family First webpage: 1. Quarterly statewide reports (same reports as those in the Data Warehouse, but produced quarterly)1. Foster Care System Quarterly Capacity Report

Links to other data reports, such as Aggregate MAPS Care Days Data by District and Relative Trend Report.

How many children are cared for in congregate care (CC) settings? Do CC placements make a small, moderate, or substantial part of your foster care system? How stable is your system?

Children in care as of:

Total In-Care Population

(In-Care Summary Report)

Total CC Population

(CC Profiles)

#

%

#

%

Number (#) of children

100%

100%

How has the size/percentage of your CC system changed over time?

(To answer this question, use the date filter function on the In-Care Summary report to run a report for each of the dates specified, recording the number/percentage of children listed as being in CC)

Year

# in CC

% in CC

12/31/14

%

12/31/15

%

12/31/16

%

12/31/17

%

12/31/18

%

12/31/19

%

Based on above, is your system

|_| Decreasing

|_| Stable

|_| Increasing

|_| Not Consistent

Do children served in CC settings differ from your other foster care settings in any way? If yes, why do you think these differences exist?

Children In Care as of:

Total In-Care Population

(In-Care Summary Report)

Total CC Population

(CC Profiles)

#

%

#

%

RACE

White

%

%

African American

%

%

Asian

%

%

American Indian or Alaskan Native

%

%

Native Hawaiian or Other Pacific Islander

%

%

Other

%

%

Unknown

%

%

HISPANIC ORIGIN

Yes

%

%

Sex

Male

%

%

Female

%

%

AGE RANGE

<10 years

%

%

10-12 years

%

%

13 years

%

%

14 years

%

%

15 years

%

%

16 Years

%

%

17 years

%

%

18 years and above

%

%

GOAL

Discharge to Parents/Legal Guardian

%

%

Discharge to Independent Living

%

%

Discharge to Adoption

%

%

Discharge to Adult Residential Care

%

%

Discharge to Other Relative

%

%

Other Goal

%

%

No Goal

%

%

CASE TYPE

JD

%

%

PINS

%

%

Child Welfare (Article 10, destitute and voluntarily placed)

%

%

Children in Care as of:

#

%

FACILITY TYPE

Foster Boarding Home

%

Kinship Foster Boarding Home

%

Congregate Care

%

Institution

%

Group Residence

%

Group Home

%

Supervised Independent Living

%

Agency Operated Boarding Home

%

Other

%

TIME IN CURRENT CC SETTING

<= 1 months

%

2 – 3 months

%

4 – 5 months

%

6 – 9 months

%

10 – 12 months

%

13 – 24 months

%

24+ months

%

Who are your major CC partners?

This information can be found on the website and in the Data Warehouse, in the “Family First Reports” folder. The report is titled, “Children in Care by County: Facility Settings and Home County,” and provides location and placement type of children in care.

List the 3 agencies/districts you partner with most often to provide CC services

# of children served

% of CC Population

%

%

%

IDENTIFYING OPPORTUNITIES AND EXPLORING STRATEGIES FOR REDUCING CONGREGATE CARE

OCFS has released a data package created specifically for FFPSA planning that will provide districts with a visual map illustrating the flow of children into and out of congregate care over the course of a calendar year. An individualized “Bubble Chart” package is available for each district that had children admitted to a congregate care setting during the time period studied. Packages are currently available for children admitted to congregate care in 2017 and 2018.

Technical assistance documents and recorded webinars related to the Bubble Chart packages can be found here: https://ocfs.ny.gov/main/sppd/family-first-data.php.

Questions you can explore by looking at your Bubble Chart package include:

Front Door

Back Door

What are the main pathways into CC in your district? How many children enter CC as new admissions? Step-ups? How many enter a new program as a lateral transfer? How many will return to a CC program after an extended absence or time on trial discharge?

How many children enter and exit congregate care in a relatively short period of time (i.e., 30 or 60 days)? Why?

Are you using CC as an emergency placement or for diagnostic purposes? How many children enter and exit CC within a short time frame?

Could short stayers be prevented from ever entering CC?

How many children spend time in a foster home before moving into CC? Could anything be done to reduce the likelihood of step ups?

Why are children transferred to another CC program? Who makes the decision?

How often are children moving between CC programs—what prompts the move? How well are children being matched to CC providers?

How many children exit CC to kinship foster care? Could anything be done to expedite those moves?

How much of your CC system is related to a JD or PINS case? Could an alternative to placement be considered for any of these children or is this the right level of care?

How many children remain in CC at the one-year mark? Is CC still the best option for these children?

How many entries are to Agency-Operated Boarding Homes or group homes? Could any of these children be served in foster homes if additional services or supports were offered?

SECTION III

Foster Boarding Home Capacity

Districts continue to develop and support a sufficient number of supportive foster homes that help facilitate safety, permanency, and well-being for youth in foster care. In 2021, the FFPSA will be implemented in New York State, and it is expected that as children are placed in a setting that provides the right intervention for the right amount of time, at the right intensity, to the right youth, the need for foster homes will increase.

Gaining a comprehensive understanding of the foster home capacity in your district, as well as the quality of those homes, are important aspects of planning and preparing for the FFPSA. OCFS provides this chapter of the foster home data-driven workbook to support districts as they prepare for the FFPSA. and develop and sustain an adequate number of supportive foster homes.

Foster Home Data Packets: In July 2019, OCFS produced foster home data packets utilizing a longitudinal data file provided by Chapin Hall Center for Child Welfare Data. The data packet includes demographic, utilization, and outcome data for all foster homes associated with your district for 2018 and 2019. District level foster home data packets are available on the OCFS website at: https://ocfs.ny.gov/main/sppd/family-first-data.php. In addition to the aggregate foster home data packets, each district may request a foster home level Excel file that districts can use to identify specific foster homes.

The workbook below utilizes data from the foster home data packets.

Family First Targets

Performance

The FFPSA kinship target is to have 50 percent of the children in care on 9/30/21 placed in kinship foster homes. What is your district’s performance toward meeting the FFPSA kinship target? Note: This data point is also available through the link above and in a pre-defined Family First Data Warehouse report.

If your district is below the targeted performance, what are some factors that impact your performance? If you are trending toward the 50 percent target, what are some strategies that are working?

Data Analysis:

Estimating the Number of Needed Foster Homes

Locate your Foster Home Data Packet at: https://ocfs.ny.gov/main/sppd/family-first-data.php

(The district-level data packets are located at the bottom of the page.)

Data Driven Foster Home Planning

Foster Home Characteristics

Estimated

# Needed

Foster Home Inventory

How many foster homes were “active” at the end of the year? (An active foster home has not fostered a child in the last six months. This is an important indicator because data shows that foster parents who are inactive for six or more months are unlikely to foster another child.)

What are some reasons those foster homes did not have a placement for at least six months? (Examples: They refused placements; the agency did not seek to place a child with them; they are not open to the ages/needs of children in need of placement.)

Estimated number of foster boarding homes needed for “One Family, One Home”

One Family, One Home is about placing children from one family together in one foster home with no other unrelated foster children. This is a component of the New York City Administration for Children's Services "Home Away From Home" initiative. "The One Family, One Home approach has many advantages: keeping siblings together, reducing stress on children and caregivers, improving placement stability, and other child welfare outcomes. One Family, One Home requires maintaining a family foster care pool of relative and nonrelative caregivers that is large enough to accommodate the number of family groups in foster care."[footnoteRef:2] [2: Home Away From Home: Lessons for Building a One Family, One Home Foster Care System, Executive Summary, Timothy Ross, PhD; Lucas Gerber, MA, Yuk C. Pang, PhD.; Action Research, April 2019, p. 4.]

The Foster Home Data Packet provides data on the number of families (cases) in LDSS foster care on 12/31/19. If foster children in your district were placed in “One Family, One Home,” how many foster homes are needed?

Using the Foster Home Data Packet, how many active foster homes are available to the children in your care custody?

To estimate need, subtract the total number of active foster homes from the total number of families in foster care.

Certified or Approved Therapeutic Foster Boarding Homes (TFBH):

How many TFBH are in your district?

Do you currently have a sufficient number of TFBH to meet current need?

Consider your district’s needs after FFPSA implementation (9/30/21). How many more children do you anticipate will require a lower level of care?

Location of Foster Homes:

Where are your foster homes located?

Are they in the same neighborhoods/villages as the foster children? Note: Request a foster home level file from OCFS. This file contains zip code information. (Contact: [email protected].)

If there are gaps in geographic locations of foster homes, estimate the number of homes needed by neighborhood/village.

Race/Ethnicity of Foster Homes:

What is the race and ethnicity of your foster parents? Do they represent the race and ethnicity of the children in foster care? (Note: The race/ethnicity of children in foster care is available via a predefined report in the OCFS Data Warehouse FFPSA folder.

If there are gaps, estimate the number of foster homes needed, by race/ethnicity.

Strategy Development:

Recruiting and Retaining Foster Parents

In the fall of 2019, each district submitted foster home recruitment and retention plans. Districts looked at foster home and child characteristics data to develop a strategic plan geared at recruiting foster homes, especially kinship foster homes, as well as retaining current foster homes.

Do the strategies in your district’s Recruitment and Retention Plans address the needs documented above?

Have you/are you implementing the strategies included in your Recruitment and Retention Plans?

If you are continuing to contemplate strategy development, consider the following planning questions:

· Are there existing, effective recruitment, and retention strategies that could be built upon?

· Are you aware of strategies used in other districts/voluntary agencies that might work in your district?

· If you are contemplating starting a new strategy, can it be adequately implemented with your current resources? If you begin a new strategy, will this replace another activity?

Monitoring Strategy Effectiveness

Monitoring the implementation and impact of strategic plans is critical to the success in building foster home capacity.

Think about your monitoring plan for the strategies developed in the recruitment and retention plan.

· What is your monitoring plan?

· Who is responsible for implementing the monitoring plan?

· Do the monitoring activities measure the implementation and effectiveness of the strategies?

· What metrics will be used to track improvement in recruitment and retention?

Stakeholder Input and Feedback

To provide ongoing feedback, track strategy implementation and effectiveness, consider convening a focus group of

· foster parents (those who have fostered and those who have never fostered) and members of your foster parent recruitment/retention team to assess the characteristics of foster parents who engage in fostering quickly.

· foster parents who work well with teens and older youth to determine what makes a foster home successful in this age group.

· youth in foster care to understand what makes a successful foster home from a youth’s perspective.

· kinship foster parents to gain insight into the unique supports needed when a relative is a foster parent.

SECTION IV QUALIFIED RESIDENTIAL TREATMENT PROGRAM (QRTP)

The only congregate care settings that will receive long-term federal financial support (Title IV-E reimbursement), otherwise Title IV eligible children, are the following:

· Qualified Residential Treatment Programs (QRTPs)

· Supervised Independent living settings for youth 18 years and older

· Settings serving prenatal, postnatal, parenting youth

· High quality residential care and support services for youth found to be or at risk of sex trafficking

Title IV-E maintenance payments are not available after the first 14 days of a youth’s placement in a non-specified congregate care setting. (Non-specified are congregate care settings other than those detailed above.)

QRTPs must comply with the following requirements:

· Provide a trauma-informed treatment model

· Have licensed nursing and clinical staff on-site during business hours and on-call during non-business hours

· Provide at least six months of post-placement family support services

· Be licensed and accredited by an independent accreditation organization

· Include family members in the treatment plan

· New York Statewide Central Register of Child Abuse and Maltreatment (SCR) and, where applicable, out-of-state child abuse and neglect register checks for all employees

QRTP Title IV-E Maintenance Funding

· IV-E maintenance funding is available for a youth’s placement in an approved QRTP only if the state-specified assessment is completed within 30 days by a qualified individual (QI); and

· Within 60 days of the start of each placement in a QRTP, a court (in New York the Family Court), or an administrative body appointed or approved by the court, independently, must consider the required 30-day assessment of the appropriateness of the QRTP and documentation made by the QI conducting the assessment; determine whether the needs of the child can be met through placement in a foster family home, or if not, whether placement of the child in a QRTP provides the most effective and appropriate level of care for the child in the least restrictive environment; and whether the placement is consistent with the short-term and long-term goals for the child, as specified in the child’s permanency plan; and finally, approve or disapprove the placement.

· 30-day assessment is not completed on time: No Title IV-E maintenance payments for duration of placement

· 30-day assessment on time/CC not approved: Title IV-E maintenance stops 30 days post review

· 60-day assessment not completed on time: Title IV-E maintenance limited to first 60 days

· 60-day assessment on time/CC not approved: Title IV-E maintenance stops 30 days post decision

QRTP Status

Using the chart below, document your status as it relates to each requirement:

Requirement

Current Status

Needs/Strategies

Accredited by independent not-for-profit accreditation organization:

Commission on Accreditation of Rehabilitation Facilities (CARF), Council on Accreditation (COA), Joint Commission Accreditation (JCA), or other independent, not-for-profit organization approved by DHHS

Licensed congregate care agency

Trauma-informed treatment model to address child’s emotional and behavioral needs identified during assessment

Nursing and clinical staff on-site (consistent with model) and available 24/7

Facilitate and document outreach to family, family participation in treatment program. Sibling connections and contact information for family and fictive kin maintained.

Provide discharge planning and family-based aftercare for minimum of six months post discharge.

The agency must conduct criminal background record, New York SCR and, where applicable, out-of-state child abuse and neglect register checks for all employees.

Placement Procedures

What is the process for ongoing reviews of the status of youth in care?

Who approves continued placement decisions?

DISCHARGE

What is the process for discharge from congregate care?

Who is involved in the decision? What is the role of the youth/family in the decision-making process?

POST DISCHARGE

The FFPSA requires discharge planning and family-based aftercare support for at least six months post-discharge from a QRTP. Utilizing the services checklist on pages 6 and 7, plan for which services are needed and which services are currently available to families for post-discharge support.

What practices and/or strategies are used to help achieve permanency for youth in care?

|_| Family finding immediately upon

placement

|_| Family group decision-Making

|_| Permanency roundtables

|_| Targeted recruitment, development, and support of kin and

resource family

|_| Wraparound services

|_| Formalized support groups

Based on the assessment you completed, what are the areas you are prioritizing or identifying? What is your Family First plan?

Requirement

Action/Steps

Person’s Responsible

Time Frames

Notes/ Assistance Needed

SECTION IV(a) QRTP ASSESSMENT REQUIREMENTS

The FFPSA includes specific assessment requirements for a child placed in a QRTP.

1. New Admissions

· Each child must be assessed within 30 days of placement by a qualified individual (QI). The QI must be a licensed clinician who is not an employee of the agency or affiliated with any placement agency (waiver provision applies), using either of the two validated assessment tools: CANS or CASII.

· The respective family court must make an additional assessment within 60 days of placement and determine that the placement is “appropriate.”

· If either the QI or the family court assessment determine that the youth’s placement in the QRTP is not appropriate, only 30 days of IV-E funding are available from the date of such a decision to transition the youth to a more appropriate setting or placement.

In the case of any child who is placed in a qualified residential treatment program for more than 12 consecutive months or 18 nonconsecutive months (or, in the case of a child who has not attained age 13, for more than 6 consecutive or nonconsecutive months), the State/Tribal agency shall submit to the Secretary the most recent versions of the evidence and documentation specified at the permanency hearing and the signed approval of the head of the State/Tribal agency for the continued placement of the child in that setting.

2. Lateral Transfers

· Children who move from a QRTP to another CC setting

· Children who move from a non-specified CC into a QRTP

· Children who move from a QRTP program into another QRTP program

· Children initially placed with ACS Children’s Center and transferred to another CC program

· Child moved from detention, RTF or runaway shelter

3. Return from Absence/Trial Discharge

· Absent or on trial discharge for 14 days or longer, and return to the same QRTP program

4. Step-Up

· Step-up refers to a child’s movement from a Foster Boarding Home or Pre-Adoptive Home to a QRTP program

Use the table below to assess how your current procedures align with the FFPSA requirements:

30-Day Assessment

FFPSA Requirement

Current Status

Changes Needed

Purpose

Assessment of strengths and needs and determination whether the needs of the child can be met with family members or through placement in a foster family home; and if not, whether a CC would provide the most effective and appropriate level of care for the child in the least restrictive environment and be consistent with the child’s long-term and short-term goals as specified in the child’s permanency plan.

What assessments are currently conducted?

Staff

QI: Licensed Clinician: Physician, Psychiatrist, Psychologist, Nurse Practitioner, Psychoanalyst, Registered Nurse, Clinical Social Worker, Marriage and Family Therapist, Mental Health Counselor, Master Social Worker, Licensed Creative Arts Therapist; within their scope of practice. Not employed by OCFS or the district or affiliated with placement setting (federal waiver provision available).

Who conducts?

Timing

May start prior to placement but must be completed within 30 days of placement.

When are they conducted?

Participants

Conducted in conjunction with family (all biological members, relatives, fictive kin) and permanency and treatment teams (family resources - teachers, medical/mental health providers, clergy, others); youth over 14 can include two from permanency team.

Who participates? How is family involved? How is the voice of the family included?

Docu-

mentation

Case plan, efforts to identify and include family/perm team, contact info for all, evidence that meetings held at convenient time, evidence of parents input, etc. Justification for CC vs FBH

What documentation is completed?

Tool

Evidence-based validated tool approved via IV-E plan amendment

What tools are used?

60-Day Assessment

FF Requirements

Current Status

Needs

Purpose

To consider the 30-day assessment, determination and documentation.

To determine whether the placement of the child can be met through placement in a foster family home and if not, whether placement of the child in the QRTP is the most effective and appropriate level of care for the child in the least restrictive environment and whether the placement is consistent with the child’s short-term and long-term goals as specified in the child’s permanency plan.

To approve or disapprove assessment and determination

Staff

Family Court

Process

If not approved by court in 60 days of placement, can only claim Tile IV-E for first 60 days.

If the court disapproves the placement in the QRTP, Title IV-E funding available for 30 days to transition to next placement.

What documents are brought to court?

Who presents in court?

What stakeholders may challenge the recommendation?

What is the process if the court does not agree with the recommendation?

Status Reviews/Permanency Hearings

FFPSA Requirements

Current Status

Needs

Documentation/

Services

· Continued justification for QRTP

· Treatment and services need

· Expected length of services

· Efforts to prepare for exit

Business Process

Based on the strengths and challenges identified above, document below your plan for coordinating with other stakeholders and creating a business process to comply with the FFPSA assessment requirements.

Who will be included in the planning process?

Who will lead the planning?

How will the plan be communicated?

How will the plan be monitored?

What are the time frames for planning and implementation?

SECTION IV (b)TRAUMA-INFORMED CARE

FFPSA requires that a QRTP use a trauma-informed treatment model to address a child’s emotional and behavioral needs. Trauma-informed care is based on knowledge of the impact of trauma, aimed at ensuring environments and services that are welcoming and engaging for children, families, and staff. Developing and maintaining a QRTP trauma-informed model requires the transformation of processes, people, and systems throughout the agency and district.

Use the below worksheet to assess how current practice, policies, procedures, and training align with a trauma-informed model of care:

Leadership

Leadership and organizational change

Describe how all members of district/agency leadership, including commissioners and executive directors have been trained in trauma-informed care principles. How frequently?

Within the past year, has district/agency leadership reviewed or revised its mission/philosophy/values to align with trauma-informed care? Describe the review process.

Is there a documented process for assessing practices, procedures, and policies that may have been, or could be, retraumatizing to individuals at any level of the district/agency? Did the process contain input from staff, youth, families, and outside stakeholders?

How does leadership encourage staff to employ trauma-informed principles and approaches that encourage growth and healing?

Are front-line staff trained on policies through orientation, competency reviews, and job descriptions? How does leadership recognize when additional supports are needed?

Do district/agency staff receive ongoing training to include the definition and signs of secondary trauma, compassion fatigue, burnout, psychosomatic responses, and strategies for self-care? Does the training normalize secondary trauma as an accepted part of working with traumatized clients and not as an indication of individualized pathology?

Are the district/agency supervisors trained regarding effective communication and reinforcement of the value of taking breaks, scheduling vacations, and participating in supervision? If so, how?

Has the district/agency implemented the national Culturally and Linguistically Appropriate Services (CLAS) standards? If yes, how? If no, what are the barriers?

Describe how district/agency staff are trained in developing and providing individualized services that are culturally responsive to all clients.

Describe how district/agency staff are trained in treatment practices and models that are trauma-informed and based on the current research.

Do district/agency staff receive training on the use of trauma history assessment and how to identify potential triggers that may lead to unsafe behaviors?

Describe how treatment approaches incorporate the healing values of traditional cultural connections and recognize and address historical trauma that may impact the youth’s or family’s ability to feel safe, establish relationships, and benefit from services.

Does the district/agency have a policy or procedure regarding what a potential trauma-inducing event is?

Has the district/agency implemented individualized client de-escalation strategies and safety planning strategies that include the identification of individual triggers and collaboratively developed an effective regulation plan?

How does the district/agency address potential trauma-inducing events with youth and families?

What is the district/agency process for engaging and empowering clients and families? This should include participation of the client and family in all planning, services, and decisions during treatment.

Does the district/agency have an up-to-date list of affordable, accessible resources for the needs of youth and families with trauma histories? How was the list made? How often is it checked for accuracy?

Has the district/agency considered aspects of the physical environment that make a difference in youth and families feeling comfortable and welcomed when designing or redesigning their physical space?

Are district/agency workers expected to welcome youth and families, and ensure they feel respected and supported in all interactions? How has this expectation been conveyed to staff? How has this expectation been conveyed to youth and families?

SECTION V

ORGANIZATIONAL CHANGE AND READINESS FOR IMPLEMENTATION

Assessing readiness will help districts and agencies prepare for successful FFPSA implementation and proactively build capacity in needed areas.

Use the below worksheet to assess district/agency readiness for organizational change.

Organizational Change

Does leadership believe change is needed and is beneficial? If yes, how is this evidenced?

Does leadership believe change is possible? If yes, how is this evidenced?

Do staff believe change is needed and beneficial? If yes, how is this evidenced?

Do staff believe change is possible? If yes, how is this evidenced?

Is there a shared commitment for change among district/agency leadership, staff, and stakeholders? If yes, how is this evidenced?

Has the district/agency been successful in obtaining resources to support change? What resources have been obtained?

Does the district/agency have an effective process for communicating change? If yes, describe the process.

Do staffing levels support effective functioning and implementation of new practices?

Are district/agency leadership and staff generally receptive to change, and willing to try new ways to address problems? If yes, how is this evidenced?

SECTION VIFAMILY ENGAGEMENT

Comprehensive family engagement improves outcomes and is a best practice throughout the life of a child welfare case. Quality family engagement starts at the practice level. Effective, collaborative case planning relies on the caseworker’s/planner’s transparent efforts to continuously engage family members and others, as appropriate.

Use the below worksheet to assess district/agency readiness for change and implementation regarding family engagement.

Family Engagement

Does leadership value family engagement and empowerment, and believe partnerships with families is needed and is mutually beneficial to the family and the agency? How is this evidenced?

Do staff value family engagement and empowerment, and believe partnerships with families is needed and is mutually beneficial to the family and agency? How is this evidenced?

Do staff use diligent efforts to identify, find, communicate with and engage fathers? How is this evidenced?

Do staff create concrete goals specifically matched to the families’ needs? How is this evidenced?

Is there a shared commitment for improved family engagement among district/agency leadership, staff, and stakeholders? How is this evidenced?

Is family voice incorporated into policies and procedures? How is this evidenced?

Are policies, procedures, and other district/agency documents written in family-centered language? If yes, please describe.

Are parents and youth members of district/agency advisory boards or councils? If so, how are their voices lifted?

SUMMARY

Based on your analysis of the FFPSA, your data, strengths, and challenges, summarize below the plans for FFPSA implementation by September 29, 2021

Please respond to each of the items below to summarize your plans for FFPSA implementation:

How does leadership demonstrate a strong commitment to placing youth in the least restrictive setting? How is this communicated to staff?

How will your district/agency collaborate to analyze data and current policies and procedures related to congregate care?

How will you collaborate to identify and implement strategies to reduce reliance on congregate care?

What additional assistance/resources might be needed to reduce the number of children in congregate care?

What additional assistance/resources might be needed to increase the number of family-based foster homes, inclusive of kinship resources (both foster care and non-foster care)?

What additional assistance/resources might be needed to provide effective services that meet the needs of children and their families so that permanency is achieved in the shortest amount of time as possible?

What other strategies and changes will be employed to prepare for, and comply with, the provisions of the FFPSA?

Consider your sustainable advantages:

· What are you best at?

· What is your uniqueness?

· What opportunities does the FFPSA present?

· What challenges exist?

RESOURCES

This section includes an inventory of best practices, strategies, resources, and practice models from New York State and nationally to assist with FFPSA implementation. OCFS will continue to share resources as they are reviewed and approved. Please feel free to submit additional resources for consideration to [email protected].

· New York State Family First Readiness

The New York State Family First Readiness webpage provides updated resources pertaining to the state’s implementation of the Family First Prevention Services Act (FFPSA). An overview of the FFPSA, current New York State guidance, and federal guidance are some of the resources included on the page. Keep up to date with state guidance by checking this site regularly.

· New York State Foster Care Recruitment

Foster families act as healing agents for children in care. They are often the first step in helping children cope with the new reality of their lives. In turn, districts and voluntary agencies are responsible for recruiting, training, and supporting foster parents. The system is expected to provide a pool of qualified foster parents who can accommodate the needs of children and youth in placement. To meet that expectation, each agency must have a robust recruitment and retention program for kinship, foster, and adoptive families. Learn about cutting edge best practices and real-life examples of innovative strategies in action at: www.recruit4fostercare.org/strategies.html

· Lean

Lean is a management philosophy and a re-engineering model used by companies to better serve customers by making their operations more efficient and effective. OCFS uses Lean to examine its processes, remove unnecessary steps and obstacles, and deliver more efficient and effective results to children, families, and communities. A Lean project emphasizes viewing the process through the eyes of the customer, eliminating steps that add no value, and making the process flow. See if Lean could be a valuable strategy for your LDSS/VA.

· FamilyFirstNY.org

This website is designed to assist New York districts as they prepare for the residential provisions of the FFPSA. It includes background on the provisions of the FFPSA, examples of successful reform efforts in New York districts, best practice models and strategies from across the country, and practical tools for country-level analyses and policy improvements. The Redlich Horowitz Foundation may also provide technical assistance to support your reform efforts.

· Health Home Serving Children (HHSC)

The Medicaid Health Home Serving Children (HHSC) program serves children/youth from birth up to the age of 21 who meet two chronic conditions or a single qualifying condition and appropriateness criteria. HHSC is a group of health care and service providers working collaboratively to assist the child/youth in receiving the care and services needed to stay healthy. A child/youth enrolled in a Health Home will have a care manager that works with the child/youth to develop a care plan and connect the child/youth with services. More information about HHSC can be found here: HHSC. A Health Home that serves your district can be found here: HHSC Map.

RESOURCES

· Children and Family Treatment and Support Services

These new mental health and substance use services, available with New York State’s Children’s Medicaid, give children/youth (under 21) and their families the power to improve their health, well-being, and quality of life. These services strengthen families and help them make informed decisions about their care. More information can be found here:

CFTSS

· Children’s Waiver - Home and Community-Based Services (HCBS)

The Medicaid Children’s Waiver Home and Community-Based Services (HCBS) program serves children/youth from birth to age of 21 with qualifying health and/or behavioral health challenges. The waiver provides access to a wider array of services to meet their individual and unique needs. HCBS waiver services are utilized to meet children and families in non-traditional settings, both in their home and community. Services are provided in a family-driven, youth- guided, culturally, and linguistically appropriate system of care, which accounts for the strengths, preferences, and needs as well as the desired outcome of the individuals. More information can be found here:

https://omh.ny.gov/omhweb/guidance/hcbs/

· Early Intervention Program (EIP)

The EIP serves infants and toddlers from birth to 3 years old with disabilities or developmental delays and their families. Children must be referred to their local EIP in the district where they reside. Children referred to the EIP with a suspected developmental delay must have a multidisciplinary evaluation to determine eligibility for the program and must meet state eligibility criteria to receive services. Children referred to the EIP with a diagnosed condition with a high probability of resulting in developmental delay will have a multidisciplinary evaluation to determine outcomes and the services needed to achieve child and family outcomes. Children with or without Medicaid can receive early intervention services. More information about EIP can be found here: EIP.

· 30 Days to Family

Operates on the philosophy that all families include members who are willing and able to care for children. Every effort is made to search for relatives who will keep siblings together, maintain children in their school of origin, and preserve the child’s important relationships with friends and supportive adults. 30 Days to Family goal is to place 70 percent of children served with safe and appropriate relatives within 30 days of entering foster care.

· Family Finding

This program is based on the core belief that capable family members can be located and engaged to meet the needs of youth in care. Originally designed for older youth who have spent many years in foster care, Family Finding offers methods for discovering and engaging relatives to meet youths’ needs for relational and/or permanency, and help them build a “lifetime network.”

· Hard-to-Find Homes

Many agencies experience ongoing challenges in finding homes for older youth, sibling groups, children with behavioral or medical needs, and youth who identify as LGBTQ. The overall approach for recruiting Hard-to-Place homes may take several different approaches; however, the majority of your efforts should employ targeted and child-specific recruitment strategies.

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