Facilities

Connecticut Children’s Place (CCP)

Connecticut Juvenile Training School (CJTS)

Riverview Hospital for Children

Wilderness School

Improvements/Achievements 2009-10

The Department's first agency-wide strategic plan demonstrates that a sweeping reform of the State's child welfare system has led to important improvements in the lives of Connecticut's children and families. Comparing Calendar Year 2009 to Calendar Year 2008 shows the Department is continuing progress in a number of key outcome areas.

Fewer children must be removed from home

Child removals declined from 2,374 in CY2008 to 2,196 in CY 2009.
The rate of child removals per 1,000 children in the overall State population declined from 3.0 in CY2008 to 2.79 in CY2009 -- thereby placing the State well below the 4.1 national average.

· More children served at home

o As the result of increased in-home services, 80 percent of the children served by the Department on Dec. 1, 2009 were living at home compared to 62 percent on the same date in 2000 and 73 percent in 2007.

· Long-term trend shows fewer children in care due to abuse and neglect

Supported by improved assessment tools, greater access to in-home services that allow children to remain safely at home, lower caseloads, and more timely permanency, Connecticut has dramatically reduced the number of children in care. There is a 24.9 percent reduction in the number of children under age 18 who are in care due to abuse and neglect in the three-year period ending August 2010 -- going from 5,173 in August 2007 to 3,880.

Fewer child victims are re-victimized

The percentage of children who are subject to repeat abuse or neglect declined from 6.1 percent in CY2008 to 5.4 percent in CY2009.

Children in state care achieve permanency more quickly.

The percentage of children reunified within 12 months increased from 61 percent in CY2008 to 65.9 percent in CY2009. The average wait declined from 12.5 months in Cy2008 to 12.3 months in CY2009.
The percentage of children adopted within 24 months increased from 33.5 percent in CY2008 to 36.5 percent in CY2009. The average wait declined from 36.7 months in CY2008 to 33 months in CY2009.
The percentage of children whose guardianship was transferred within 24 months increased from 69.9 percent in CY2008 to 76.7 percent in CY2009. The average wait declined from 22.8 months in CY2008 to 18.6 months in CY2009.

More Permanent Homes

During state fiscal years 1997 to 2005, an average of 615 permanent homes (both adoptions and subsidized guardianships) were found annually for children in foster care -- more than four times the number in 1996. In FY2009, 643 adoptions were finalized and 220 subsidized guardianships granted for a total of 863 new permanent homes. In FY2010, 690 adoptions were finalized and 213 subsidized guardianships were transferred for a total of 903 new permanent homes.

Lower recidivism for delinquents

The percentage of children committed as delinquents who were re-committed within 18 months of ending a prior delinquency commitment) declined 4 percent in CY2008 to 1.1 percent in CY2009.

National Accreditation for the Connecticut Juvenile Training School

In August 2009, the Connecticut Juvenile Training School (CJTS) received accreditation from the American Correctional Association (ACA). ACA creates national best-practice standards for juvenile and adult correctional facilities. CJTS had to be 100% compliant with 30 mandatory standards. There were also 425 non-mandatory standards in which CJTS had to be 90% compliant. CJTS achieved a score of 98.7 percent -- placing CJTS in a small group of facilities receiving such a high score.

A more fluid behavioral health system with fewer children in residential care and fewer hospital inpatient discharge delays

o Due to the availability of in-home behavioral heath services for about 3,000 children and families and as of August 17, 2010, there has been a 30 percent reduction in the number of children in residential care since August 2007 and a 50 percent reduction since April 2004.

The percentage of discharge delay days for children in a hospital inpatient unit declined 50.4 percent during CY2009 (5,043 days) compared to CY2008 (7,492 days). In addition, the average number of days HUSKY children/youth spent on an in-patient hospital setting to receive treatment for an acute behavioral health condition (medically necessary days) decreased from 13.16 (first quarter of CY'09) to 11.09 days (4^th Quarter CY'09). For children experiencing a delay in their discharge from an inpatient hospital, the average delay declined from 128.5 days in CY2008 to 107.05 days in CY2009. The total number of incidences of discharge delay declined from 628 in CY2008 to 547 in CY2009.
Time spent waiting in a hospital emergency department by children requiring an appropriate behavioral health treatment setting decreased from an average of 1.9 days in 2008 to 1.5 days in 2009.

More opportunity to successfully transition out of care

The number of children in care who were enrolled in a post-secondary education program from 490 in CY2008 to 668 in CY2009:

· Successfully meeting Exit Plan Outcomes

The Department's performance in achieving the outcomes set out in the Juan F. Exit Plan demonstrates a similar advance in the quality of services for children and families. Over the four quarters of State Fiscal Year 2010, the 22 goals in the Exit Plan were met in 75 percent of the possible instances (66 out of a possible 88).

Bureau of Child Welfare

· The Department received approximately 93,000 calls to the Hotline in SFY2010. These included over 45,000 reports of suspected abuse or neglect, of which over 24,500 were accepted for investigation. Approximately 6,800 reports were substantiated.

· At any point in time, the Department serves approximately 36,000 children and 16,000 families across its programs and mandate areas.

Supportive Housing for Families

· The Supportive Housing for Families (SHF) program provides direct housing support and case management services to prevent children from being removed from their families and to support the reunification of children with their family.

· Target Population: The target population for the SHF program is families involved with DCF child protective services where families are inadequately housed or at risk for homelessness or where housing issues present a barrier to reunification. In FY2010, approximately 500 families benefitted.

· Referrals: Referrals to the SHF program are made on behalf of eligible families by DCF social workers in area offices across the state. Applicants are screened for eligibility/appropriateness for the service and either engaged in services or placed on a waiting list.

· Services Provided: The SHF program provides two primary services: Access to Housing Subsidies and Case Management Support to Families.

Interstate Compact

· Connecticut administers four distinct interstate compacts to facilitate the placement and movement of children across state lines. The most frequently used is the Interstate Compact on the Placement of Children, which monitors the placement of children crossing state lines for the purposes of foster care, relative care, adoption, and residential care. Additional compacts include the Interstate Compact on Juveniles, the Interstate Compact on Mental Health and the Interstate Compact on Adoption and Medical Assistance.

Adoption and Subsidized Guardianship

· Connecticut supports the adoption of children from the public child welfare system by providing a financial and medical subsidy to those children deemed "special needs." Connecticut also supports the permanent placement of children with relatives by providing a financial and medical subsidy to relatives willing to provide a home to their relative children in the public child welfare system.

· In FY2010, 690 adoptions were finalized and 213 subsidized guardianships were transferred for a total of 903 new permanent homes.

Adolescent and Transitional Services

The Department works to provide each youth in our care with the skills, supports and resources to succeed as adults by offering a holistic, strengths-based and culturally competent service system to meet the needs of youth in every facet of out-of-home care, including:

Mentoring
Youth Advisory Boards
Life Skills Program
Preparing Adolescent for Self Sufficiency (PASS)
SWET Program
CHAP (Independent Living) Program
Re-Entry Program
Post Secondary Education
Post Secondary Educational Support Program
Connecticut Youth Opportunities Strategy
-Parenthood Program
Fatherhood Program
Wilderness School
Safe Harbor Program
Job Corps Program
Medicaid
Sibling Connections
Work To Learn Program

Voluntary Services

· Voluntary Services were provided to approximately 1,250 children at any one time. These children received residential and community based services to address complex behavioral health needs. Parents whose children qualify can ask for assistance and receive services from DCF funded programs without relinquishing guardianship.

Bureau of Behavioral Health and Medicine

In Home and Community Based Services

A 30 percent reduction in children in residential care overall since August 2007 is attributable to a number of factors. One clear improvement is that Connecticut now has the capacity to serve approximately 3,000 children a year in intensive home-based programs, which largely did not exist only a few years ago. Some of the initiatives that help children and families with mental health and substance abuse treatment needs in their homes include:

· “Family Support Teams” for children returning home from residential care or at risk of requiring out-of-home placement (served 512 children and their families during SFY2010);

· “Wrap around” services that help both children and parents in whatever way is required, including non-traditional help such as mentoring and respite (served 1,057 families during SFY2010);

· Intensive in-home psychiatric services for children returning home from psychiatric hospitals or residential care or at risk of requiring hospitalization or out-of-home placement (served 1,961 children and their families during SFY2010). DCF has also partnered with CSSD to make this service available statewide to court-involved youth; and

· Specialized programs for families in which parents are also provided with intensive substance abuse treatment and other clinical services (300 families served during SFY2010).

Therapeutic Group Homes

· Another key initiative has been the development of therapeutic group homes. These group homes provide intensive clinical services and allow children who would otherwise need a more institutional treatment setting to live in a home-like environment and attend school in the community. Over the last four years, DCF contracted for 54 therapeutic group homes with a capacity to serve 283 children and adolescents. This initiative has been instrumental in enabling children to reside in home-like community based settings.

Extended Day

· The statewide network of Extended Day Treatment Programs has been engaged in a program and performance improvement project for the past 3 years. The project has introduced evidence-based and best-practice interventions to achieve a higher level of clinical care and greater consistency in quality across programs. New program elements include implementation of protocols for improving family engagement in care, trauma-informed and evidence-based therapeutic recreation activities (Project Joy groups), a trauma-informed treatment framework (Risking Connection training for all staff), and use of an objective scale to measure client progress, functioning, satisfaction, and outcomes (Ohio Scales).

Connecticut Community KidCare

· Connecticut Community KidCare continues to operate according to the nationally-recognized and endorsed system of care model, embracing the value of Family Driven care in meeting the state’s behavioral health mandate of servicing children with behavioral health needs and their families. KidCare services are centered on the best interest of the child and family involvement. Strength-based and cultural competent assessment and care are key values. KidCare enhanced and developed community-based, group home and residential services to ensure that children get access to the appropriate level of service when they need it and, whenever possible, to receive those services in their home and in their community.

Connecticut Community KidCare provides a variety of family-focused community-based, mental health programs for children throughout the state including: emergency mobile psychiatric services; care coordination services; parent advocacy services, child guidance clinics, extended day treatment programs and substance abuse treatment programs for youth, including innovative family-focused treatment and supportive housing programs. FY2010 was the first complete year of the newly-enhanced and expanded Emergency Mobile Psychiatric Service (EMPS) system that saw more than a 50 percent increase in the total of crisis calls handled by the system statewide.

CT Behavioral Health Partnership (CTBHP)/Administrative Services Organization (ASO)

The overarching goal of the CTBHP is to improve access to key services, more effectively allocate resources through enhanced utilization management, and improve the quality of care for youth in the public behavioral health system (HUSKY, or DCF involved). Over the past year, the Behavioral Health Partnership has engaged in many activities designed to enhance the quality of care children receive within the behavioral health service system. Highlights include:

· Greater efficiencies and better care on hospital inpatient units: CY 2009 saw a continuation of a statewide initiative to reduce the number of discharge delay days on psychiatric inpatient units that treat HUSKY children and adolescents and to bring lengths of stay more in line with national averages. Targeted interventions continue to include (1) quarterly individualized length of stay data reports prepared by the Partnership, which are shared with hospital leadership to track progress; (2) a pay-for-performance incentive to reward hospitals for decreasing their discharge delay days; (3) attendance by DCF and CTBHP clinical staff at weekly on-site inpatient rounds; and (4) daily reviews of children on discharge delay by CTBHP's senior management. As a result, the percentage of discharge delay days declined 50.4 percent during CY'09 over the total days reported in 2008 (7,492 days reduced to 5,043 days). In addition, the average number of days HUSKY children/youth spent on an in-patient hospital setting to receive treatment for an acute behavioral health condition (medically necessary days) decreased from 13.16 (first quarter of CY'09) to 11.09 days (4^th Quarter CY'09). Hence inpatient psychiatric care continues to be offered in a more efficient fashion and children are being discharged to appropriate levels of care more expeditiously.

· ED/EMPS Collaboration: Collaboration between local Emergency Departments (EDs) and the children's Emergency Mobile Psychiatric Services teams (EMPS) was initiated this year through a Performance Incentive Program that fostered written agreements between the two entities to work together when appropriate to divert children from inpatient care. The agreement also required the EDs to capture data on referral sources so EMPS teams could outreach to high-volume referral sources.

· Continued decrease in time spent in Emergency Departments: Time spent in the Emergency Department by children for whom an immediate disposition was not available (i.e., access to an inpatient unit or discharge to the community with an individualized crisis/treatment plan) decreased from an average of 1.9 days in 2008 to 1.5 days in 2009. This improvement is attributed to greater access to inpatient units (see above) greater coordination with EMPS teams and community providers, and on-going tracking of youth in the EDs by the ASO to support diversion.

· Enhanced Care Clinics: The number of Enhanced Care Clinics (EECs) increased through an additional open application process. There are currently 35 identified clinics throughout the state that receive a 25 percent Medicaid outpatient rate increase in exchange for maintaining additional hours of evening or weekend service and guaranteeing emergent, urgent and routine care within prescribed time frames. Additional requirements were added over the past year and include establishing consultative relationships with pediatric or primary care providers to allow the transfer of medication management for children who are stable on their medications and need only routine follow-up. Routine substance abuse screenings for all clients was also added as a requirement for all existing ECCs.

· Foster Care Disruption Study: A three year foster care disruption study came to a close during CY'09 with findings that support the need for early identification of those youth with a known behavioral health history at time of initial placement to inform comprehensive treatment planning. Following identification of a HUSKY youth who had accessed behavioral health services prior to placement, CT BHP clinical staff and peer support staff were effectively used to assist foster parents and DCF caseworkers to identify and address the needs of newly-placed youth. Youth with such support disrupted from their foster homes 50 percent less than those without the support. While this study has ended, this identified best practice will continue within existing staff resources.

Short Term Assessment and Respite Centers

Short Term Assessment and Respite Homes are temporary congregate care programs that provide short-term care, assessment and a range of clinical and nursing services to children removed from their homes due to abuse, neglect or other high-risk circumstances. Staff provides empathic professional care for youth within a routine of daily activities similar to a nurturing family structure. The youth receive assessment services, individual and group therapy, and educational support in a structured setting. Care coordination is provided to support family reunification or transition to foster care, congregate care, or other settings as appropriate.

State-Run Treatment Facilities

DCF’s behavioral health facilities are Riverview Hospital for Children and Youth and Connecticut Children’s Place.

Riverview Hospital for Children and Youth, located in Middletown, offers in-patient psychiatric services on eight units for children and youth up to 18 years old. Interdisciplinary teams (consisting of child/adolescent psychiatrist, nurse, clinician, rehabilitation therapist, direct care and educational staff) work in concert with the patient and their family to provide individualized treatment aimed at stabilization and prepare them for a return home or a placement to a less-restrictive setting. Riverview Hospital is a teaching and education center for child psychiatry, psychology, social work, rehab therapy and nursing. The hospital is a training site for both Yale University and the University of Connecticut. Riverview is accredited by the Joint Commission on Accreditation of Health Care Organizations. During FY 2010, over 287 children were served at Riverview Hospital.

The Connecticut Children’s Place (CCP), located in East Windsor, is a behavioral health care program that uses a multi-disciplinary treatment approach incorporating residential care, medical services, clinical assessment, evaluation and therapy, and an education program. CCP also offers a therapeutic recreation program to explore creative talents and offers sports and other activities. Services are provided in partnership with the child/youth, families and community in order to meet the individual needs of each child/youth and prepare them for transition to home or a less restrictive environment. The age range of children served is generally from 12 to 21 years. During FY2010, 101 children were served at CCP.

Bureau of Juvenile Services

The Connecticut Juvenile Training School (CJTS)

CJTS continues to prepare boys for successful community re-entry through evidence-based educational, treatment and rehabilitative services.
A transitional unit was established for boys preparing to leave CJTS. They enter the unit during the last two months of their stay. While in this unit, youth participate in programming that prepares them for living at home.
The CJTS curriculum manager has created a training team, expanded the number of trainings, ensured the training modules for new and experienced staff is in compliance with ACA accreditation standards and created formal lesson plans for every training.
In August 2009, CJTS received accreditation from the American Correctional Association (ACA). ACA creates national best-practice standards for juvenile and adult correctional facilities. CJTS had to be 100% compliant with 30 mandatory standards. There were also 425 non-mandatory standards in which CJTS had to be 90% compliant. CJTS achieved a score of 98.7%. Achieving accreditation with such a high score places CJTS in a small and prestigious group of facilities.
The Raise the Age Legislation that increases the age of jurisdiction for Superior Court Juvenile Matters to include 16 sixteen year olds went into effect on January 1, 2010. Seventeen year olds will come under the court's jurisdiction on July 1, 2012. CJTS will begin preparations for the resulting anticipated increase in youth to this facility. The plans for CJTS to accommodate both the older youth, resulting from this legislation, and younger youth involve separating the younger youth onto their own subpart of the campus.

Girls’ Programs and Services

The Program Guidelines for Girls' Services in Connecticut is the foundation for all programs and services for girls. The Bureau is working with other public agencies and private service providers to develop a self-assessment instrument to be used with juvenile justice-involved girls.
The Bureau is developing a continuum of care for girls committed as delinquent. The continuum includes three levels of residential care: (1) transitional group home; (2) residential facility; and (3) secure facility. In addition to residential care, the continuum also includes transitional education services and a full array of community-based services. The secure facility is in development. Once completed, this facility will complete the continuum.
A "Girls' Provider Group" meets monthly with the Director of Girls' Services to discuss models of care, educational programming, vocational training, recreational offerings and how best to coordinate services for girls to ensure their successful transition and re-entry into the community.
DCF worked collaboratively with the Court Support Services Division to establish a practice model for girls in the juvenile justice system.
The development of a state-operated, secure treatment facility for girls on parole is progressing.

Service Coordination with the Judicial Branch

The Bureau -- working with the Court Support Services Division (CSSD) of the Judicial Branch, as well as parents, advocates, providers, and other state agencies – continues implementation of the Joint Juvenile Justice Strategic Plan. The plan has been placed in a "Results Based Accountability" format. Some of the priorities for the next 12 months are diversion, intervention, and supporting local planning teams.

The Bureau, working with CSSD, assures that court-involved children and their families receive timely and appropriate services in the community. The collaboration is intended to reduce the number of children committed delinquent through continued statewide operation of prevention, treatment and diversion services. Additional collaborative work with CSSD focuses on assessing and planning for child welfare-involved children in detention as well as joint case planning for children at imminent risk for delinquency commitment and out-of- home placement.

Parole Services

The mission of Parole Services is to serve children, adolescents and their families in Connecticut’s juvenile justice system, to protect public safety, to collaborate with the courts, communities and partners, and to provide a continuum of effective prevention, treatment, and transitional services.

During the past year, Parole Services has strengthened its assessment and treatment planning, made staffing modifications to improve service delivery and enhanced services to improve outcomes.

Parole Services continues to utilize ConnCAP, the integrated assessment, treatment planning, and case management system that considers the legal, social welfare, mental health, substance abuse, education and medical history of the subject child and family. The system requires reviewing existing records, interviewing youth and family, and administering the Youth COMPAS and other screening and assessment tools when identifying the risks and needs of a child or youth.

Parole services utilizes an array of services that are child-centered, family-friendly, and community-oriented. These services will improve children’s ability to stay in the least restrictive setting and to successfully and safely re-integrate within their families and communities. Available services include:

· STEP -- an educationally focused re-entry and delinquency prevention program aimed at reducing recidivism, truancy and school suspensions, improving academic success and increasing support and services to families and youth who are transitioning from a secure or residential facility to their community educational setting.

· Multisystemic Therapy -- an intensive, in-home, community-based treatment for adolescents with anti-social and/or delinquent behaviors including ongoing substance abuse. The main goals are to keep adolescents in the community, improve school functioning, and reduce recidivism.

· Multi-Dimensional Family Therapy (MDFT) -- an intensive home-based program that serves children and youth who have behavioral health needs such as substance abuse and/or co-occurring disorders, and their families. MDFT offers intensive clinical services and support to children and youth returning from out-of-home care or who are at risk of requiring out-of-home care due to substance abuse or co-occurring disorders.

· Wraparound -- Wraparound funds offer the ability to purchase specific goods or services, not available through contract, needed to maintain individual youth in their community.

Other Parole Services initiatives include:

To enhance practice and improve service provision, Parole Services administers the Youth COMPAS to young females incarcerated at York and provides the results to their DCF social workers for treatment planning.
Parole staff has been trained in Motivational Interviewing techniques to enable them to obtain more accurate information from individuals and families.
Parole Services has developed a Gang Initiative program. Certified staff works collaboratively with police departments and state agencies, and provides information, updates and assistance to the Bureau and residential providers in working successfully with gang-involved youth.
To ensure that Parole Services staff receive required and up-to-date training, Parole Services created the position of Training Social Work Supervisor. This Supervisor works in collaboration with the DCF Training Academy and the CJTS Curriculum Manager.

Bureau of Continuous Quality Improvement (BCQI)

· The Bureau's Quality Assurance Division collaborated each quarter with the Court Monitor's Office to review and assess cases statewide to determine the extent to which the agency is meeting its performance mandates in regard to case planning and needs met of children and families as outlined by the Juan F. Exit Plan. Areas of strength and those needing improvement are identified and utilized to improve agency practice and guide resource allocations in these key areas.

· Quality Assurance staff conducted case study reviews to evaluate specific child welfare outcomes as required by the Juan F. Exit Plan.

· Development efforts and activities this past year, most notably through the creation of an inter-bureau quality improvement model and committee, continued to enhance the structure, action plans, and goals of the quality improvement teams established in each area office and facility to improve case practice. The committee is also a forum for knowledge sharing and planning on how to best accomplish the Agency's mission and mandates.

· The Bureaus of Continuous Quality Improvement and Child Welfare established a Young Parent Taskforce to assess and enhance services for young parents involved with the Department. Activities include identifying resources and service gaps, building workers' skills and training to better address the specialized needs of this population and to promote self-sufficiency as they transition from DCF care.

· The Bureau conducts ongoing quarterly monitoring reviews of all residential and therapeutic group home facilities to evaluate their compliance with PNMI regulations.

· The Program Review and Evaluation Unit for Community Programs has assumed responsibility for the Department's credentialing of agencies and individuals providing services to DCF-involved children and families in six specific service areas. The unit also will assume responsibility for the Department's certification of Medicaid eligible in-home services.

· The Program Review and Evaluation Unit for Congregate Programs provided oversight for the initial approval and continued utilization of out-of-state residential facilities.

· The Program Review and Evaluation Unit for Congregate Programs continued to oversee compliance by the Residential Treatment Programs and Therapeutic Group Homes with the Private Non-Medical Institutions (PNMI) standards relating to treatment plan development and implementation. This initiative captures federal revenues for the State General Fund and serves to enhance the quality of the treatment planning and services provided to children and youth in the PNMI-involved programs.

· The Program Review and Evaluation Unit for Congregate Programs continues to collect restraint and seclusion data from both in-state and out-of-state providers. Comparative reports are made on frequencies of restraints and seclusions for all programs, in and out of state, that serve Connecticut children.

· The Bureau has developed a web-based, child-specific reporting system for restraints and seclusions that will replace the current aggregate monthly reporting system. This system will require real time reporting of all uses of restraint and seclusion and allow the Department to track the use of these interventions on a child-specific basis,

· The Bureau has implemented a Restraint and Seclusion Advisory Group, which includes staff from the private facilities and all areas of the Department, to address best practice and reduction issues for restraint and seclusion.

· The Department's Quality Assurance Division has maintained an agency-wide database to track all report findings and recommendations concerning DCF, generated both internal and external to the Department, including the Department's response and actions taken to improve its operations and performance.

· Quality Assurance staff conducted a comprehensive review of the Department's Office of Ombudsman providing recommendations to improve customer service, including data tracking and reporting, internal procedures and protocols, and using their findings and activities to educate and inform Agency practice and planning efforts.

· In collaboration with other state agencies, the Bureau has enhanced and conducted regional training exercises with the statewide behavioral health response teams that provide disaster and trauma recovery to communities following critical events and emergencies resulting from natural disasters or from acts of terrorism. A training seminar regarding preparation and response to pandemic influenza, involving state and national experts, was provided to behavioral health and disaster response staff from various state agencies and private providers.

· The Risk Management Unit continued to receive, triage and coordinate responses to significant events that occur at congregate care settings. Additionally, the unit tracks and monitors critical incidents and special investigations. Unit management developed a series of monthly and quarterly reports to facilitate more timely and appropriate responses.

· The Training Academy provides timely training programs that assist DCF staff and community providers to respond effectively to children and families.

· The Training Academy developed a series of certification training programs to better prepare staff for their role by functional assignment. These certification training programs included practice areas such as: Training Supervisor, Permanency Planning, Adolescent Services, and the Fatherhood Initiative.

· The Training Academy continued to offer a variety of educational support programs and other workforce development programs designed to reinforce on-going educational and professional growth of DCF staff. These workforce development programs include the graduate education stipend program, the Master of Social Work field education program, tuition reimbursement, the internship program, staff mentoring programs, and several post-masters certification programs.

· As an expansion of the Training Academy, the Bureau has developed a Provider Academy to offer a variety of trainings on child welfare to the provider community to help develop and maintain quality care.

· The Planning and Best Practices Division conducted four reviews of DCF area offices in 2010. The Connecticut Comprehensive Outcomes Review (CCOR) is the state's qualitative case review. CCOR is modeled on the federal Child and Family Services Review (CFSR) and looks at case practice across seven outcomes in the areas of safety, permanency and well-being.

· In 2009, the Planning and Best Practices Division facilitated the development of a Program Improvement Plan (PIP) to respond to the CFSR findings. The PIP was approved in January 2010, and the Division is responsible for quarterly reporting to the Children's Bureau and facilitating the implementation of the activities in the DCF Area Offices.

· The Medical Review Unit, in collaboration with Risk Management, tracks and reports on medication errors in all DCF licensed facilities in order to improve performance in this area.

· The Bureau of CQI is cross-training central office nursing staff and provider nurses working in DCF licensed facilities. Collaborating with the Department of Public Health and the Department of Developmental Services, the Bureau has developed nursing standards for the 140 agencies DCF licenses. BCQI works with DCF licensing staff prior to site visits to review the provider's medical policies, nursing standards, and medication administration processes.

· The Office for Research and Evaluation (ORE) provides ongoing staff support for the Department's Strategic Plan (SP). ORE produces the SP measures on a quarterly basis for each Area Office using a format accessible by each Area Office. The Quality Assurance Division is a partner in preparing those SP measures that are also Exit Plan measures.

· The Office for Research and Evaluation introduced Geographic Information Systems (GIS) to the Department. Map-based analyses have been developed to support foster care recruitment and emergency planning. The foster care recruitment work was accepted for presentation at the 13th Annual National Child Welfare Data and Technology Conference. ORE also collaborated with the Behavioral Health Bureau to use "Spatial Adaptive Filtering" to analyze the geographic distribution of substance abuse test scores.

· The Programs and Services Data Collection and Reporting System (PSDCRS), a project led by the Office for Research and Evaluation, was implemented on July 1, 2009. PSDCRS is an outcomes data collection system supporting contracted community services. Phase one implementation focused on twenty-two behavioral health and therapeutic foster care services, and additional programs will be implemented in PSDCRS for the coming fiscal year, including Child Welfare and Prevention programs.

· In December of 2009, the Department entered a new stage of operation when reviewing child fatalities and critical incidents, transitioning from a best practice model developed in conjunction with the Child Welfare League of America (CWLA) to an internal CQI framework. The guiding principles and practices of the revised framework are based on awareness and sensitivity of the personal and professional trauma that fatalities often bring about. This has sustained a consistent methodology that emphasizes respectful and relevant fact-finding and identification of key elements in case practice determined to be excellent, acceptable or in need of improvement. The process is designed to maximize organizational learning and prevention through: (1) objective case analysis and systemic consultation following child fatalities.; (2) on-going workforce development; (3) collaboration across DCF Bureaus, Divisions and external systems; (4) linkages of findings with current literature and research; and (5) standardized support for multidisciplinary staff.

· The DCF Institutional Review Board has expanded its membership to include more community members, begun providing training on its mission to increase the knowledge base of DCF stake-holders, and is revising its policy and practices.

Equal Opportunity and Diversity

· The Department is committed to an aggressive and comprehensive affirmative action plan to assure equal employment opportunity as well as to provide services and programs to the public in a fair and culturally-competent manner. The plan provides quality assurance to DCF by ensuring a culturally-competent and diverse workforce necessary to deliver the best quality services to our children and families. Affirmative action and equal employment are immediate and priority objectives, and they play an important and necessary role in all stages of the employment process. Currently 48 percent of our full time workforce and 32 percent of top managers are persons of color.

· The Department fully supports the state code of Fair Practices and federal and constitutional mandates concerning affirmative action and equal employment opportunity

Bureau of Prevention

Office of the Ombudsman

· The Office of the Ombudsman continues to track and respond to requests for information from private citizens, the Office of the Child Advocate, and other state officials. The office responded to approximately 4,000 inquiries in FY2009.

· The office assigns staff to each of the DCF-operated facilities to listen and respond to concerns of residents.

Prevention Division

· The Department has integrated the Family with Service Needs unit with the Bureau of Prevention. This has created an expansion of the FWSN services by merging with existing Juvenile Criminal Diversion Programs, Positive Youth Development Programs, and the Wilderness School. New programs initiatives will include substance abuse programs, truancy prevention, a parent education program and "FWSN Days" at the Wilderness School. Services will be created for both families and youth who are involved with the Department as well as those who are not. The Bureau of Prevention now has the capacity to plan for and meet the needs of children and youth from birth to aged 18 as well as their families. Prevention Liaisons in each Area Office continue to serve as conduits between the local communities and the Bureau.

· Positive Youth Development (PYDI)/Strengthening Families

Two programs across the state (Torrington and Enfield) serve high-risk families with children age 6 to 13. Based on local need, DCF-funded community providers have selected to implement program models from available evidence-based programs or promising practices. Parents learn how to become more effective in their role and how to build stronger relationships with their children and stronger families overall. In addition, four sites (New Haven, West Haven, Hartford and Willimantic) provide after-school programming using evidence-based/promising practices programming. The program developer's train-the-trainer model has allowed the state to develop local capacity for Strengthening Families 10-14. As of June 30, 2010, 147 parents/caregivers and 545 children have been served in the PYDI/Family Strengthening Initiative.

· Parents with Cognitive Limitations Workgroup

It is estimated that at least one of three families in the child welfare system are headed by a parent with cognitive limitations. These families are often involved in all of the participating workgroup members' systems. With the Department as the lead, this interagency workgroup includes: the Department of Social Services; Bureau of Rehabilitation Services; State Department of Education; Department of Developmental Services; Department of Labor; Department of Mental Health and Addiction Services; Court Support Services Division; Department of Correction; Connecticut Council of Family Service Agencies; The Connection, Inc.; The Diaper Bank; Real Dads Forever; Brain Injury Solutions, LLC; Brain Injury Association; Office of Protection and Advocacy for Persons with Disabilities; and Greater Hartford Legal Assistance. The group works to develop a comprehensive, coordinated, efficient and effective system of policies, practices and services for families headed by a parent or other caregiver with cognitive limitations. Major accomplishments include the development of an assessment guide and a day-long training on identifying and working with parents with cognitive limitations (with CEUs for social workers). More than 1,000 DCF workers, other state workers and community providers throughout the State have been trained over the last six years. Ten trainings are scheduled for 2010-2011.

The Workgroup is in the process of developing training and a sub-website on translating written documents into "Plain Language."

· Shaken Baby Prevention Initiative: Empowering Parents

Because persistent crying is a trigger for shaken baby, DCF formed a collaborative with a number of State Agencies (DPH; DOC; DMHAS and the Office of the Child Advocate) to look at preventing shaken baby through parental skill building and education. Two interventions were chosen to evaluate. The Happiest Baby on the Block (HBB) is a behavioral intervention teaching parents strategies for soothing crying babies. The Period of Purple Crying is a cognitive intervention that normalizes crying by putting it in the context of normal infant development and teaches parents to never shake a baby. The initiative was supported with funding and staff from the five members of this collaborative. An independent evaluation was conducted by Dr. Linda Frisman, Director of Research at DMHAS. In June, additional agencies joined this collaborative. The Collaborative is partnering with the MA Children's' Trust Fund to offer their program, Babies Cry, Have a Plan. Plans include offering this training to young people residing in the three DCF-run facilities as well as offering it to providers who serve fathers through the DSS Fatherhood Initiative.

· CT Safe Sleep Collaborative

The Connecticut Safe Sleep Collaborative, co-chaired by the Department and the Office of the Child Advocate, is working on developing a message for a Statewide Public Awareness Campaign on Safe Sleep.

· Youth Suicide Prevention Advisory Board

Established legislatively, the Youth Suicide Prevention Advisory Board consists of members of public and private agencies as well as parents. Responsibilities include making recommendations, conducting awareness campaigns, and training. Over 400 DCF social workers, parents, school staff, and community providers were trained in SFY2010 on recognizing suicide risk, adolescent substance abuse, and depression. A media campaign continues to inform the public and raise awareness about this issue. Collaboration with the Interagency Suicide Prevention Network and the departments of Education and Mental Health and Addiction Services has resulted in enhanced community contacts and expanded training opportunities.

· www.CTParenting.com

To give families easy access to information and resources on a wide array of topics related to family health, safety, education, and general well-being, DCF developed www.CTParenting.com. The Department completed a collaboration with the Department of Public Health to expand information on the site relating to healthy pregnancy and maternal health, and the two departments joined efforts to publicize the website with a multi-media awareness campaign funded by a federal grant. DCF's Facebook page is also promoting the site through the use of daily posts and the development of monthly themes to increase its usefulness to parents, including themes on healthy parent-child relationships and how parents can support their children's educational success. More than 1,000 individuals access the site weekly.

· Early Childhood Programs

Early Childhood programs currently offered through the Department support the social and emotional health of families and children ages birth through eight. These programs include the DCF Head Start Partnership, the Early Childhood Consultation Partnership, the Parents in Partnership programs, and Child FIRST Programs.

o The DCF Head Start Partnership began as a pilot in 1999 and is currently operating in every DCF area office targeting families with children under the age of five. The Partnership works to improve services to help strengthen families and to help children thrive. As a result of the Partnership, more young children in DCF placement are receiving a high-quality preschool experience, more offices are engaging in joint treatment planning, and potential foster parents are identified. Besides benefitting from the comprehensive educational and health services (vision, dental, hearing, etc.) offered by Head Start, the children's families also receive additional support and resources that help reduce the families' level of stress.

· The Early Childhood Consultation Partnership (ECCP)

ECCP is an early childhood mental health consultation program funded by DCF and administered by Advanced Behavioral Health. The program is designed to meet the social and emotional needs of children birth to five in their early care and education setting by building the capacity of caregivers through support, education, and consultation. ECCP is staffed by 20 Master’s-level Early Childhood Mental Health Consultants who work out of local community behavioral health agencies throughout Connecticut. The goal of the ECCP is to reduce the risk factors associated with suspension and expulsion by providing supports and mental health consultation to maintain them in their early care and education settings. To date, ECCP has served 11,686 children in core classrooms with a 98.85 percent success rate in placement retention. A total of 738 unduplicated early care and education centers have been served with provision of training, consultation and technical assistance to 440 teachers. ECCP services have been provided in a total of 808 Core Classrooms. ECCP has served an additional 568 children receiving services from the Department of Children and Families and maintained the placement of 99 percent of these children in their early care and education setting.

· Building Blocks for Brighter Futures

Building Blocks for Brighter Futures is a federally-funded, six-year project to provide comprehensive support to families where a child up to six years old has a diagnosis of a serious mental health challenge. The mission of Building Blocks is to connect families with individualized services and supports to promote social and emotional health for the identified child. Building Blocks serves New London, Norwich and Groton. Populations of focus are culturally diverse families, military families and teen parents. Building Blocks is staffed by licensed mental health clinicians and "family partners" (families who have received services). In tandem, they provide screening, assessment, referral and intervention, intensive in-home psychotherapy, play therapy, sibling support groups, peer to peer parent support, case management and wraparound services. To date 217 severely emotionally challenged children and their families have been served.

· The Early Childhood Parents in Partnership Program

The Early Childhood Parents in Partnership Program has served nearly 2,000 families identified as neglecting or abusing their children or to be at-risk of neglect or abuse since its inception in the early 1990s. Participants have included parents with mental illness, parents with cognitive challenges, teen parents, and substance-abusing parents. Children are between the ages of birth and six years old. The PIP model offers center-based playgroups, home visits, social activities and parent education as well as a link to community providers. Families participate for an average of 18 months and supports are provided several times a week. After participating in the program, 96 percent of families are free of any referrals for abuse or neglect. PIP recently selected three applicants to provide PIP in their communities. The program has added a focus on Results Based Accountability.

· Child FIRST

Child FIRST programs have been expanded and are now operating in Bridgeport, Hartford, New Haven, New London, Norwalk, and Waterbury. The program identifies children and provides comprehensive, services and supports that "wrap around" children (prenatally through age five years) who are living in high-risk environments or who show the earliest signs of emotional, behavioral, or developmental problems and their families. Child FIRST is a home-based, psycho-educational and psychotherapeutic intervention that promotes a secure parent-child attachment and buffers the brain of the young child from environmental/psycho-social stress.

· Families with Service Needs (FWSN)

The FWSN unit consists of seven FWSN liaisons who are out-posted in Juvenile Courts and the corresponding Area Offices. FWSN services include:

o Consultation - Consult on FWSN cases as well as Delinquency cases, to Juvenile Probation, DCF Area Office staff, Juvenile Court and various community providers.

o Coordination of Services and Collaboration - Work with staff at various levels within the DCF Bureaus, Court Support Services Division, and in the community, to provide community-based prevention and early intervention for at-risk youth, as well as collaborate with existing programs such as Positive Youth Development Programs.

o Diversion - Utilize the Wilderness School and Juvenile Criminal Diversion Programs, which include substance abuse programs, truancy prevention, and a parent education program, to help prevent and or divert children from the juvenile justice system.

o Training - Develop and implement trainings to develop a better understanding and awareness of the FWSN process and Juvenile Justice System.

· The Wilderness School

Wilderness School, located in East Hartland, is a prevention, intervention and transition program for troubled youth. The School offers high impact wilderness programs intended to foster positive youth development. Courses range from one-day experiences to 20-day expeditions. Designed as a journey experience, the program is based upon the philosophies of experiential learning and is considered therapeutic for the participant. Studies have documented the Wilderness School's impact upon the self esteem, increased locus of control (personal responsibility), and interpersonal skill enhancement of adolescents attending the program.

Division of Special Reviews and Staff Support:

The Department's Bureau of Continuous Quality Improvement provides comprehensive case analysis and systemic consultation in the aftermath of a child fatality or critical incident. The case review, teaching and training focus is designed to generate feedback and information for professional learning, organizational development and staff support. The humanistic approach acknowledges the personal and professional trauma associated with a critical incident. The reviews offer a consistent methodology that emphasizes respectful and relevant fact-finding and identification of key dimensions in case practice determined to be excellent, acceptable or in need of improvement.

The Department’s family-centered, culturally competent and community-based Mission, Guiding Principles and Practices serve as the basis for the Fatality Review process and as a framework for its reports. All reports are redacted, placed on the DCF Intranet for staff learning, and forwarded to the DCF Training Academy for integration into curriculum.

At the heart of this revised framework is the awareness that child welfare workers will inevitably encounter trauma and secondary stress, in a similar fashion as those colleagues in law enforcement, emergency medical care and those that work with trauma survivors. Work to prevent and limit the harmful affects of primary and secondary trauma now includes: (a) psycho-education and debriefing; (b) staff preparedness and estimations of exposure; (c) clear protocols at local and statewide levels; and, (d) active inclusion of the Employee Assistance Program (EAP).

The Special Review Team is collaborating with the Connecticut Office of the Child Advocate and the Statewide Child Fatality Review Panel when conducting Reviews, analyzing patterns and trends, and providing information to the public. These partnerships have included other state agencies and community providers to expand the scope and utility of the “lessons learned” from child fatalities and critical incidents.

In conjunction with the Child Welfare League of America (CWLA), the DCF Special Review Team is facilitating conferences and meetings with other states across the country to engage in research and transfer-of-learning activities. Collaborations include work with Massachusetts and New York on child welfare teaming, and participation in a Breakthrough Series with the Annie E. Casey Foundation on safety and risk assessment.

Beginning in June of 2008, the DCF Training Academy and the Division have collaborated on comprehensive full-day seminars for front-line staff and supervisors to address critical workforce needs related to Secondary Traumatic Stress (STS) and organizational stress. Through FY2010, more than 600 DCF interdisciplinary staff have participated in the day-long seminars. In January of 2009, a qualitative analysis of twelve seminars involving approximately 200 staff was developed, placed on the DCF Intranet, and published in two child welfare journals (2009 and 2010). Implementation is underway to include STS seminars in all pre-service training as well as in local DCF area offices and facilities in both the public and private sector. To date, evaluations and staff feedback has been excellent.

Division of Multicultural Affairs:

The demands for the development of culturally and linguistically-competent services are a major challenge facing human services and behavioral health providers today. The shifts in racial, ethnic, linguistic, religious, special needs, disability, gender-orientation, and immigration status diversity have required that the Department discover approaches and skills that will enable staff to effectively work with people from diverse backgrounds.
The Division of Multicultural Affairs was created for the purpose of developing, implementing, and sustaining initiatives and policies designed to celebrate and support the diverse needs of staff and clients.

The Division of Multicultural Affairs is part of the Bureau of Continuous Quality Improvement.