Casework Practice Model (CWPM)

and Outcomes Based

Service Delivery (OBSD)Presenters: Jacqueline Dagneau, Family Preservation Manager, OBSD, The Family Centre Julie Mann, Analyst, Program Policy Practice Analysis and Coordination, Ministry of Human Services Kim Spicer, Senior Manager, Outcomes and Practice Supports, Ministry of Human Services

To increase the knowledge and skill level of delegated staff and agency workers in relation to:◦ Casework Practice Model; and◦ Shared casework practices.

To have agency and delegated staff come to a common understanding of the issues related to:

Their role; The role of the “other” worker; and The role of the family with in a shared practice

framework.

Objectives of Session

2

History/Overview of Casework Practice Model

◦ Break

OBSD/ Shared Practice

◦ Exercises/Break

Discussion/Outstanding Issues

Conclusion

Workshop Agenda

3

◦ Transparency and openness of information sharing ◦ Increased involvement of family

◦ Increased community engagement

◦ More collaboration with resources

◦ Earlier permanency for children and youth

◦ Timely and supportive services

◦ Culturally appropriate services and supports

◦ To get back to doing social work with children and families

Before the Child Youth and Family Enhancement Act (CYFEA) & the Casework

Practice Model (CWPM) Front-line Staff Wanted….

4

Improved Outcomes for Children and Youth and Families· Supporting vulnerable children to live successfully in community· Children in Temporary Care will be re-united quickly with family· Children in Permanent Care will be placed in permanent homes more quickly· Youth transitioned to Adulthood successfully· Aboriginal children will live in culturally appropriate home

Philosophical Framework

Entrenching Our Goals in Legislation

Providing the Framework and Tools

Outcome Based Services (O.B.S.)§ Performance Measurement§ Collaborative Approach to Service Delivery§ Evidence-based Management

Agency &

CommunityPractice

ACYSPractice

SharedPractice

§ Safety§ Permanency§ Child well-being§ Family & community

connections

PRACTICE

Child, Youth and Family Enhancement Act

§ Differential Response§ Strengthen family & community

involvement§ Strengthening Aboriginal Involvement§ Strengthening Permanency

Casework Practice Model (CWPM)

§ Assessment§ Collaboration§ Engagement

Alberta Response Model

§ Community Engagement§ Differential Response§ Permanency Planning§ Outcomes Evaluation

Improved Outcomes for Children and Youth Flowchart

Version 5 - February 25, 2009 5

Increased focus on supporting families to build capacity.

Increased focus on need for permanency for children.

Meaningful consultation with Aboriginal communities.

Highlighted the importance of Assessment, Collaboration and Engagement.

CYFEA (2004) A Shift in Casework Practice

6

From Section 1of the CYFEA (2) For the purposes of this act, a child is in need of intervention if there are reasonable and probable grounds to believe that the survival, security or development of the child is endangered because of any of the following:

(a) the child has been abandoned or lost;(b) the guardian of the child is dead and the child has no other guardian;(c) the child is neglected by the guardian;(d) the child has been or there is substantial risk that the child will be

physically injured or sexually abused by the guardian of the child;(e) the guardian of the child is unable or unwilling to protect the child from

physical injury or sexual abuse;(f) the child has been emotionally injured by the guardian of the child;(g) the guardian of the child is unable or unwilling to protect the child from

emotional injury;(h) the guardian of the child has subjected the child to or is unable or

unwilling to protect the child from cruel and unusual treatment or punishment.

Definition Of A Child In Need Of Intervention Services

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Matters to be Considered is another area of this legislation that guides decision making by identifying values and principles such as:

• The family is the basic unit of society and its well-being should be supported and preserved;

• The importance of stable, permanent and nurturing relationships for the child; and

• The intervention services needed by the child should be provided in a manner that ensures the least disruption to the child.

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Definition Of A Child In Need Of Intervention Services (cont’d)

◦ Embeds the principles of the legislation: assessment, collaboration and engagement.

◦ Provides a framework for processes based on best practice, including:

Mandatory Decision Points; and Mandatory Supervisory Consultation during decision-

making.

◦ Child-centered and Family-focused.

◦ Moves from a “brokering role” to a social work role with children and families.

Casework Practice Model (2006)

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◦ Comprehensive intake and assessment components.

◦ More time to develop relationships leads to quality decisions.

◦ Plans developed with everyone involved in multi-disciplinary case conferences.

◦ Importance placed on all parties to work together, led primarily by family/child and caseworker.

◦ Outcomes focused, measurable results.

Key Features

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◦ Assessment information directly linked to case planning.

◦ Engagement with families.

◦ Early and meaningful involvement of First Nations Band Designate/Métis Resource Person.

◦ Clear decision points for supervisory consultation.

◦ Increased clarity when moving from assessment to investigation.

Key Features

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◦Assessment/Analysis

◦Engagement

◦Collaboration

◦Permanency for children including permanent homes for children in care

Overview of the Model

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◦An ongoing and dynamic process.

◦Acknowledging and reducing cultural and contextual bias.

◦Inclusive.

◦Opportunities, not challenges.

◦Clear connections to service planning.

Assessment/Analysis

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• Includes a multi-disciplinary approach.

• Goals must be negotiated with the participants to reach solutions.• Locus of control for planning shifts to family/childand supported by caseworker.• Differences in power should be acknowledged.

• Clearly defined activities linked to service plan.

• Clearer outcomes and measurements of success.

Collaboration

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• Everyone’s perspective of the concerns and possible solutions are presented fairly.

• Clearly involves a multi-disciplinary approach.

• Acknowledges a significant shift toward the family and child having greater control of outcomes, supported by the caseworker.

• Relationship between team members is key.

Engagement

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• Importance of having a Plan B.◦ If child can’t stay in the home, what are the options?

• Temporary care change under new Act.◦ Children under 6 years can only be in temporary care for up to 9 months.◦ Children 6 years or older can only be in temporary care for up to 12 months.◦ An extension of 6 months may be granted.

• Previous legislation permitted children to be in temporary care for a longer period of time.

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Permanency/Temporary Care

Phases• Intake

• Safety A - Assessment

• Safety B – Assessment (Detailed Assessment/DAR)

• Intervention (if necessary)• Family Enhancement Services• Protection Services

• Closure

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Dec

isio

n 1

Dec

isio

n 1

Max 5 working days

Max 30 working days

Every 3 months or as required by legal authority or case plan

Intake Closure

Con

tinue

d As

sess

men

t

Ongoing Assessment

Safety Phase

Anal

ysis

/Rec

omm

enda

tions

Anal

ysis

/Rec

omm

enda

tions

Cas

e Pl

anC

ase

Plan

Assessment Open Case

Family Enhancement

Services

Protective Services

Ass

essm

ent U

pdat

e an

d C

ase

Plan

Rev

iew

Anal

ysis

/Rec

omm

enda

tions

Anal

ysis

/Rec

omm

enda

tions

Max 10 working

days

Dec

isio

n 2

Dec

isio

n 4

Dec

isio

n 4

Dec

isio

n 3

Dec

isio

n 3

Dec

isio

n 5

Dec

isio

n 5

Dec

isio

n 6

Dec

isio

n 6Information

Gathering

Casework Practice Model

(Safety Phase

B)

(Safety

Phase A)

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Maximum of 5 working days to complete.

Supervisory decision point: Close – does not meet mandate of Child in Need of Intervention Close - with referral to community supports; or Recommend Safety Phase A Assessment (previously called

Investigation).

Note: May involve forensic investigation under emergency response, or the development of a safety plan.

Information resulting in an Intake is considered a Report under the Act.

Under legislation the identity of a person providing a referral is protected.

Intake

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Intake “Referral” and “Report”

Any individual who has reasonable and probable grounds to believe a child is in need of intervention must report the matter to a director.

The director must be available to receive referrals from

the community and respond to those that are deemed to be reports in a timely manner.

• A “referral” is where the director receives information from a person advising that a child may be in need of intervention.

• A “report” is where upon receiving the referral, a decision is made to initiate an investigation because the director is satisfied that the information was not provided maliciously, is not unfounded, was provided on reasonable and probable grounds, and discloses that a child was in need of intervention per s.1(2).

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Maximum of 10 working days to complete.

Strength-based assessment is used to explore themes and patterns with the child, family and social network, looking for opportunities to overcome barriers.

Information regarding three domains is gathered: child development, parenting capacity, and family and environmental factors.

Brief services can be provided to address immediate needs. These can include repatriation, grocery vouchers and damage deposits.

Supervisory decision point: • Close – does not meet mandate of Child in Need of Intervention;• Close - with referral to community supports;• Recommend Safety Phase B Assessment; or• Recommend a Protection Status (i.e. Court Order).

Note: May include the development of additional safety plans.

Safety Phase A - Assessment

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Maximum of 30 working days to complete.

•Assessors have additional time to gather information on three broad domains:

Child development; Parenting capacity; and Family and environmental factors.

• What does the family need?• Are there supports in the community or extended

family?• Can the family manage by itself?• Is the family looking for some more supports, or do they

want or need an Agreement?

Safety Phase B - Assessment

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At the end of 30 days…

Mandatory case conference occurs, involving all parties, led by assessor/caseworker and family/child, to look at the assessment, planning and next steps.

Supervisory decision point: Close – no longer meets the mandate of Child in Need of Intervention; Close – with referral to community supports; Recommend Family Enhancement Services; or Recommend Protection Services.

Note: Permanent placement options may be considered if child comes into care.

At the end of Safety Phase B, the following documentation must be completed by caseworker:

Safety Phase Assessment Part B; Genogram; and Ecomap.

Note: In CWPM, planning begins after thorough assessment is completed and all documents are generated.

Safety Phase B – Assessment (cont’d)

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• Either Family Enhancement (through Agreement with family) or Protection Services (through Supervisory Order or In-care Status with Court involvement).

• Resources identified and engaged to help family achieve outcomes identified in service plan.

Kinship/foster care/group care etc.

• Assessment and re-evaluation of need for intervention continues on-going basis.

• Supervisory decision (on-going): Does the child still need intervention? Have the outcomes been achieved?

Intervention

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Family Enhancement• Family Enhancement Agreement with Guardian• Enhancement Agreement with youth• Support and Financial Assistance Agreement

Protection Services (Court Order and In-care Status)• Supervision Order • Custody Agreement with Guardian • Custody Order• Interim Order• Temporary Guardianship Order • Secure Treatment Certificate• Secure Treatment Order• Permanent Guardianship Order• Permanent Guardianship Agreement• Adoption

Status Options: Agreements & Orders

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ClosureClosure, following Intervention, will occur after varying

amounts of time, and is based on: an analysis of the assessment information; and must be made in consultation with the casework supervisor,

the family, as well as the multi-disciplinary team.

Supervisory decision point:

Close – no longer meets the mandate of Child in Need of Intervention (i.e. service plan has been completed);

Close – with referral to community supports (i.e. where Family Enhancement Services have been utilized); or

Close – with Permanency Planning (i.e. if a PGO was granted there were permanency options with extended family or if adoption will be pursued, then file will close).

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• Simply put, these are services focused on the purpose of the work.

• Less emphasis on how, and more on what

happens.

• And, more emphasis on collecting and regularly reviewing relevant data on outcomes achieved.

We all want to know how we are doing.

What are “Outcomes Based Services”?

27

Building on the philosophy of the legislation and the tenets

of the Casework Practice Model,Assessment, Collaboration and Engagement,

the Outcomes Based Service Delivery Initiative supports the system-wide evolution of services

from thorough assessment to how the case plan and services

will achieve desired child and family ‘outcomes’.

Outcomes Based Service Delivery Initiative

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1. To improve the effectiveness of services that children and families receive and experience as they move in and out of the child intervention system.

2. To provide agencies, foster parents and caregivers with more flexibility to respond to the unique needs of children and families while focusing on intended outcomes and better supporting innovative practice.

3. To use outcomes data to align the work between the formal child intervention system, caregivers, and contract agency service delivery.

Goals of OBSD

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4. To develop a common quality improvement and learning process that will continue to guide joint practice and identify opportunities for improvement, using evidence to guide practice.

5. To develop a service delivery system that has the capacity to measure and focus on achievement of agreed upon outcomes as the central driver for both casework and resource allocation decisions.

6. To establish joint accountability for outcomes for vulnerable children, youth and families.

We all want the same thing.

Goals of OBSD

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Create/sustain a collaborative approach to service delivery in order to achieve five key outcomes.

1. Support vulnerable children to live successfully in the community.

2. Children in temporary care will be reunited quickly with their family.

3. Children in permanent care will be placed in permanent homes as quickly as possible.

4. Youth will be transitioned to adulthood successfully.

5. Aboriginal children will live in culturally appropriate placements/services.

OBSD Outcomes

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OBSDA collective focus on client

centred outcomes for vulnerable children and their families between contracted agencies,

caregivers and Human Services staff

Funding flexibility for service delivery agencies to

allow them to address service delivery and

environmental pressures

A collective shift in practice towards a collaborative way

of engaging and working with families

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Safety Support vulnerable children to live successfully in the

Community. (Preservation – children stay at home)

Permanency Children in temporary care will be reunited quickly

with their family. (Reunification – children return home)

Children in permanent care will be placed in permanent homes as quickly as possible.

Youth will be transitioned to adulthood successfully.

Examples of ‘Outcomes’ in Alberta

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Family and Community SupportAboriginal children will experience culturally appropriate

supports and environments.

Parents will have the capacity and supports to successfully raise their children.

Child Well-beingThe developmental needs of children will be supported.

Children will be successful in school.

Note: Alberta Outcomes are based on the National Outcomes Matrix and the data collected over 15 years.

Examples of ‘Outcomes’ in Alberta

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• Engaging families early• Collaborative practice • Collaborative and intentional single service plan and

service team meetings• Evidence-based approaches that support shared

practice• Child-centred, family-focused, strength-based• Valid and reliable tools• On-going support to the family• Community involvement/engagement

OBSD Practice Principles

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• Phase-in sites are being developed and implemented around the province through an evolutionary learning process to develop an effective approach before considering broader implementation.

• Most sites began with new intakes only, although some sites converted existing files as well.

• Worksites are partnered with an identified lead agency in a specific geographic area.

OBSD Phase-in Sites

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OBSD Phase-in Sites• Altered contracting and funding structure allows flexibility and

adaptability in service provision, and accountability to outcomes.

• Case planning happens collaboratively between the family, the caregiver, the agency and the caseworker, and is focused on outcomes.

• This agency is responsible for the provision of all services to the child and family according to a plan that is developed collaboratively between the family, the delegated worker, the caregiver and the agency.

• The delegated staff retains final decision over issues relating to delegated authority. Supervisors play critical role in the resolution process to guide agency and delegated staff through disagreements.

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REGION/WORKSITE LEAD AGENCY DATE IMPLEMENTED

Region 3 Wood’s Homes July 2009 Mahmawi - B&G, Enviros, Pathways July 2013

Region 6 The Family Centre August 2009 Kahkiyaw - Bent Arrow/Boyle St. February 2012

Region 7 WJS and Associates April 2010

Region 4 McMan Youth Services May 2010

Region 1 Wood’s Homes November 2010

Region 5 Midwest Family April 2011 (withdrew in Oct 2011)

Region 8 WJS and Associates 2012

Region 9 McMan/St. Aidans 2012

Region 2 McMan/SPEC 2012

OBSD Sites

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• Front End Loading Services• Early intervention with families in crisis—

earlier the better;• Finding creative supports that fit; and• Putting them in place to avoid the need for

more intrusive services.

Investing time with these families upfront leads to positive results.

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Early Results Suggests Shift in Practice

Leads to Positive Outcomes

More children receiving services in their home vs. out of home. (OBSD sites - 70% at home/30% in-care; opposite in non-OBSD sites)

More children are placed with their immediate or extended family.

Fewer children are coming into care.

Children are staying in care for shorter periods of time - overall 34% shorter.

More children are returning home.

Files are closing faster with lower rates of recurrence because the right supports are used, and families are supported after files are closed.

Practice is changing – ‘spill-over’ is happening into other units/staff.

Early Results Suggests Shift in Practice

Leads to Positive Outcomes (cont’d)

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• Delegated staff and agency staff collaboration is not always easy!!

• Decision points where agency staff and caseworkers need to come together & talk about next steps include:• When children are coming into care;• Placements;• Visit planning;• Supports to families as part of service planning; and • Permanency.

• This is done in collaboration with the family and their support network.

• There is often a need for agency and CFSA staff to meet prior to meeting with the family to ensure consistency of message and understanding of the “other’s” position.

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Shared Practice

Perspectives and Inherent Tensions

There is a natural (dual) tension between a focus on Safety vs. Well-being .

Families focus upon Permanence almost immediately.

Safety

CFSA

Well-being Agenc

y

Permanence

Family

Well-being

AgencySafety CFSA

Focus on Outcomes Involves not just dual tension between CFSA and the Agency but tri-partite tension between CFSA, the Agency and the family.

Delegated workers, agency workers and families often have quite different:•Perspectives;•Emphasis on what is most important;

•Delegated staff (safety), agency staff (well-being), family (permanence) •Ways of approaching issues and problem solving.

• Roles of delegated & agency workers/family need to be defined, known and respected.

• Delegated worker’s role – defined in legislation; different levels of staff have different levels of responsibility.

• Agency worker’s role – to support families moving through change to achieve outcomes; no delegated (legislated) responsibilities.

• • Family’s role – to be heard; to be an active participant,

maintaining familial responsibilities.

• Rights of child • Role of Children’s Advocate remains unchanged under OBSD,

advising on procedural rights, etc.

Role Clarifications Under OBSD

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There is consistency in the elements of practice used for OBSD.

• Solution-focused/appreciative inquiry.• What are we worried about? What’s working well? What

needs to happen?• Relationship/Engagement• Asset/strength-based • Evidence-based• Community-based

• Region 6 – Developed a Shared Practice

Framework Regions 1 & 4 – Signs of Safety – Safety Plan

Practice model(s)

44

OBSD Shared Practice Framework

Region 6 OBSD – DRAFT October 2011 45

OBSD Shared Practice Framework

Region 6 OBSD – DRAFT October 2011 46

• Occurs as quickly as possible.

• Is transparent and open.

• Includes family/child goals.

• Has goals, roles and expectations of all parties clearly articulated.

• Has room for creativity, innovation and flexibility.

• The real goal is for the family to come up with their own plan.

Planning with Families

47

Service planning/Service Team Meetings/Family Group Conferences

Family Enhancement Plan• Purpose/procedures

Supervision Order

Components of concurrent planning • Part A – Reunification• Part B - Permanency

Transition planning (children 16 and over) • Youth to Independence, Transitioning to Adulthood/Supports Process

Kinship Care

Foster CarePreparing a child/expectations at placement/role of child’s culture

Family Support for Children with Disabilities Program (FSCD)

Planning Processes

48

• OBSD allows for a shift in practice from staff working alone to working in multidisciplinary teams.

• Many OBSD sites have created different approaches to work together more effectively—one mechanism is the pre-service team meeting.• Team members discuss initial thoughts and strategies

before meeting with the family.• Areas of disagreement are identified and discussed.

• (Supervisors may assist in determining course of action.)

• Staff must present a united front regarding any differences when they meet with the family.

• Team members must feel supported—even if they agree to disagree.

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Pre-service Team Meeting

An OBSD goal is for the family to have a single plan:

• That has been developed collaboratively by the delegated worker, agency worker, family and other stakeholders (foster parents, community partners, school etc.);

• With goals that are clearly defined, attainable and relevant, and include time frames;

• With indicators of success that are measurable; and

• That is written in the language of the family.

Single Collaborative Family Plan

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Role Play Activity, in groups of 3 or 4:

• Read the scenarios;

• One person is an agency worker, one is a CFSA worker, others act as coaches;

• Have a pre-service team meeting to flesh out your initial thoughts/concerns;

• Have a service team meeting with coaches now in the role of family members; then

• Create a meaningful service plan.

Service Planning Activity

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Common themes in Pre-service Team Meetings

• Disagreements about what the “real” concern is: • What can we live with? • What can we let go?

• Tension between immediate risk and long term well-being.• Controlled immediate risks may help achieve long term

objectives.• These risks involve trusting team members.

• Challenging assumptions.

Activity Discussion Review

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Common Challenges in Service Team Meetings and Service Planning

• Defining and differentiating between: Goals; Tasks; and Signs of achievement.i.e. Attending a parenting class is a task, not a goal, and does not indicate that parenting behaviour has changed.

• Ensuring the plan is meaningful.i.e. A sign of achievement would be the parent demonstrates consist positive parenting skills such as time-outs and discussion.

• Including the family as active participants.i.e. Service plans developed by and with family—using the “voice” and language of the family, including children.

• Determining time frames.i.e. Goals and tasks are specific and tied to signs of achievement.

Activity Discussion Review

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Staff have an understanding of and sensitivity to working with families.

• Know “culture” reflects: a world view/philosophical approach, a particular value base, is grounded by language, traditional practices, customs and ways of interacting with each other, the community and the larger world.

• Understand the need to involve Aboriginal communities (i.e. Designate) in planning.

• Cultural communities (Aboriginal/ethnic groups) are not homogeneous and are unique in their practices and approaches.

• Work collaboratively with community people to enhance connectedness between the person and their cultural community (i.e. First Nation, Metis, immigrant/refuge communities).

• Access to language and cultural interpreters and knowledge-keepers (elders, imams, other religious leaders, etc.).

adapted from Canadian Accreditation Council Standards

Aboriginal/Other Cultural Competence

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Single service plan • Some regions are still working with multiple service plans• ISIS

Clarification of roles – needs to be revisited (often)• Delegated worker- delegated authority

Definition and implications• Agency worker• Family

Differences of opinion• Resolution process

Information sharing • How often, lines of authority, regular times to meet

Breaking down inter-ministerial barriers between Human Services, Justice (court processes), Education and Health

Areas Needing to be Addressed

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Supervision and shared supervision• Reflective practice• Balancing administrative, clinical and reflective needs• Lines of authority and autonomy

Aboriginal/other cultures • Involvement of First Nations Designate/Metis Resource

Legislated Requirement Facilitating involvement

• Knowing the limits of what it is that we know and don’t know• Accessing the available resources – who, protocols, etc.

Common use of, and understanding of, language• Jargon/acronyms/different meanings for common words

Areas Needing to be Addressed

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• Roles and relationships between delegated staff, foster care providers and lead agency service providers need to be well defined.

• Requires system wide commitment to improved outcomes (lead agency, foster parents and delegated staff alignment).

Do we know what we are working toward and are we all working toward the same thing?

• Critical thinking.

• Relationship, relationship, relationship.

• Requires solid data collection processes across the systems and agreement on indicators.

• Requires delegated staff, lead agency staff, foster parents, family and community to value and embrace each other’s expertise (risk and well-being) in order to create an optimal environment for children, youth and families.

Common Themes

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Questions

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• AASCF Websitehttp://www.aascf.com /Resource Library/OBSD or http://www.aascf.com Type in a word in the search box i.e. “AASCF Journals”, “AASCF-OBSD Newsletter”, “supervision”, “OBSD” and a number of resources will be identified

 • Alberta College of Social Workers

http://www.acsw.ab.ca

• Alberta Courts Information http://search.albertacourts.ca (Alberta Courts website with search tab highlighted; other tabs include Court of Appeal, Court of Queen’s Bench, Provincial Court and Court Services)http://justice.alberta.ca/Pages/home.aspx (Alberta Justice and Solicitor General home page with link to Alberta Courts home page provided)

 • Alberta Human Services, Enhancement Policy Manual: Intervention (Revised June 15, 2012),

http://www.child.alberta.ca/home/documents/childintervention/Enhancement_Act_Policy_Manual.pdf

• Canadian Association of Social Workers http://www.casw-acts.ca  • Department of Justice Canada Website

http:// www.laws.justice.gc.ca (The Law Site – This page allows you to search Canada’s consolidated statutes and regulations)

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Websites