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Child and Family Services Agency Performance Oversight Fiscal Year 2013-14

Thursday, February 27, 2014
Testimony of Director Brenda Donald

Government of the District of Columbia


Child and Family Services Agency
 

Testimony of
Brenda Donald, Director
 

Hearing “Child and Family Services Agency Performance Oversight, Fiscal Year 2013-14”
 

Council of the District of Columbia
Committee on Human Services
 

Jim Graham, Chair
 

February 27, 2014
 

John A. Wilson Building
1350 Pennsylvania Avenue, NW  Room 123
Washington, DC 20510-6250
2 p.m.
 


Good afternoon, Chairman Graham and members of the District Council Committee on Human Services. I’m Brenda Donald, director of the DC Child and Family Services Agency. I appreciate this opportunity to report on the progress leaps CFSA made in the past year and how they have significantly strengthened the city’s safety net for abused and neglected children and youth and their families.
 

First, let me say thank you for your ongoing support and your public acknowledgement of the progress CFSA has made over the past two years. I can honestly say how privileged I am to wake up every day with the passion and energy to lead this work, and I hope I will be able to continue in this role for a long time to come.
 

‘State of the Agency’
 

Since January 2012, CFSA has been on a track of accelerated reform, performance improvement, and achievement. Strong internal focus and strategies, diligent work from CFSA managers and staff, and enthusiastic support throughout the local child-serving community have brought about the dawning of a new day in District child welfare. Today, I can say with confidence that CFSA is a totally different agency than it was two years ago. Three indicators provide a good picture of the current state of the agency.
 

First, CFSA is self-directed and self-monitoring. For decades, District child welfare reform was driven by court-imposed and other external directives. Today, CFSA has the internal capability and will to set our own ambitious agenda for achieving what matters most—and that is, consistently delivering positive outcomes for the District children, youth, and families who need our help.
 

In 2012, we established the Four Pillars agenda, where each pillar is based on shared values, represents an area ripe for improvement, and is driven by evidence-based strategies. In FY13, we monitored our performance quarterly against a series of specific outcome targets so that we know exactly where we succeeded and lagged—and I’ll present performance highlights for each pillar later in my remarks. But the overall achievement is simply this: the Four Pillars is a home-grown agenda for excellence, not one dictated from outside. It’s based on values that CFSA, our child-serving partners, and the community share. The outcome targets of the Four Pillars are all self-imposed; they involve both data collection and analysis; and they have focused, energized, guided, and propelled CFSA to higher levels of performance. I am deeply grateful to all the managers and staff at CFSA who have made it possible for me to report today that collectively, we are in the leadership role in local child welfare, as we should be. Successful self-discipline and self-management are truly well entrenched at CFSA.
 

Second, CFSA is rapidly transforming child welfare practice in the District, infusing it with the best practices and innovations that support positive outcomes. FY13 began and ended with two extraordinary achievements destined to have a major impact on practice. At the beginning of the year, we won the five-year, $3.2 million federal grant to make Trauma Systems

Therapy the foundation of serving children and youth throughout District child welfare. At the end of the year, we won federal support as a Child Welfare Demonstration Project, commonly known as the “IV-E waiver.” With it, we will gain the flexibility to use federal funds previously earmarked only for foster care to test innovative solutions to serving at-risk children and families. This spring, we will begin to increase investment over the next five years in preventing child abuse and in helping families keep their children safe without entering foster care. Our long-time partners the Healthy Families/Thriving Communities Collaboratives will play a key role in developing and coordinating a stronger and more nuanced array of community services capable of addressing a range of family needs from mild to serious.
 

I’m highlighting these two strategies first from among the many underway because the implications are agency-wide and the benefits to those we serve are so significant. Trauma Systems Therapy is teaching us to use cutting-edge techniques based on brain research to help even the most traumatized children and youth to heal and thrive. As the number of District children in care continues to decline, the IV-E waiver is supporting the sweeping strategic transition we must make away from foster care and toward prevention and family support as our primary focus.
 

At the same time, a host of targeted best practices and innovations are improving specific functions throughout the agency. I’ll discuss some of them later in my remarks. But in regard to our overall state of affairs, our collective pursuit of becoming a high-performing child welfare agency has forged an unprecedented level of teamwork at CFSA. As silos come down, a holistic, cohesive, and coordinated internal system is on the rise—one that will provide a more efficient and effective experience to clients from intake through exit.
 

This leads to the third key indicator about the overall state of the agency. CFSA is forging the solid infrastructure needed to institutionalize and sustain best practices and performance gains. We have made significant investments in staff, technology, and training. We have restructured to align the organization with our strategic agenda. We have outstanding management bench strength, especially on the leadership team. Over the past two years, we have completed 20 court-ordered performance standards for a total of 68 (74%) out of 92 and have sustained all but one. The community should be glad to hear that that the reforms CFSA is making today have a strong potential to endure.
 

Four Pillars Strategies
 

Turning now to the Four Pillars, I want to describe some of the key strategies we’re using to achieve better outcomes for children, youth, and families and to share the significant progress we’ve made in the past year.
The value behind Narrowing the Front Door safely is that we want more children to grow up with their families so we remove children from home only when necessary to keep them safe.
 

 In FY13, we took to full capacity the best practice known as Differential Response, which offers two pathways for handling reports of child abuse and neglect. We increased resources devoted to the supportive family assessment response to low- and moderate-
risk reports. Social workers partner with families to identify issues and needs and to connect them to community services, so the families get help without entering the child welfare system. In response to reports of high-risk situations, CFSA continues to conduct traditional investigations that determine whether abuse or neglect occurred and identify the maltreater.
 

 In FY13, children entering care dropped to 406 from 506 the previous year. The District foster care population also continued to decline by 14.5% (from 1,542 children to 1,318) at the end of FY13
The pillar of Temporary Safe Haven motivates us to ensure that foster care is a good but interim place for children to live while we work to get them back to a permanent home as quickly as possible. In 2013, CFSA made significant gains in living up to this value, particularly in keeping children in family-like (as opposed to institutional) settings.
 

 Our Kinship Administration continued to make placement with relatives the first choice, and our rate of placing children with kin climbed from a baseline of 16% to 24%. While this gain was modest, it did free enough space in traditional family foster homes so that CFSA could end a long-standing contract for emergency shelter care.
 

 Most District children and youth in care were in family-based settings, with those in congregate care down to only 4% of the total foster care population.
 

 Placement stability improved, with 77% of District children and youth in care experiencing two or fewer placements over the past 12 months.
 

 After years of negotiation, the District and Maryland signed a “border agreement” that makes it easier for each jurisdiction to place a child in foster care in the other locale. It cuts paperwork and waives the need for state approval before the District can enroll children in Maryland schools. It also solidifies procedures for rapid placement of children with their relatives in emergency situations.
 

The Well Being pillar stands for every child’s right to a nurturing environment that supports healthy growth and development, good physical and mental health, and academic achievement. Institutions don’t make good parents. But when we must bring children into care for their safety, this pillar calls on the public agency to be the best parent we can. In 2012, we created a new Well Being Administration to take the lead in coordinating good-care programs. While achieving the focus we want requires considerable growth in both viewpoint and practice, we began to see progress in 2013.
 

Chairman Graham, as a result of your encouragement, CFSA is ramping up ability to identify and access treatment for substance abuse for both parents and youth. In 2012, we were one of two jurisdictions in the nation selected to receive technical assistance from the U.S. Department of Health and Human Services’ National Center on Substance Abuse and Child Welfare. Over the past several months, a national expert has guided a multi-agency planning process. Part of that work has involved developing a program structure that includes routine screening, comprehensive assessment, and options for treatment for CFSA clients. In 2013, we developed the tools and procedures for screening youth, referring those who need treatment to appropriate programs, sharing data with treatment providers, and capturing treatment outcomes when individuals consent for CFSA to receive that information. Taking multiple agencies from nothing to a solid infrastructure took time and means that actual results to date are limited. Nonetheless, some early accomplishments are noteworthy.
 

 In August 2013, we implemented a substance abuse screening tool for youth age 11 and older entering foster care or moving to a new placement. In FY13, we screened 86% of the target group and found 9% screened positive.
 

 CFSA requested and received from the District’s Addiction Prevention and Recovery Administration (APRA) a dedicated substance abuse assessor and dedicated appointment times for our adult clients. This reduced the wait time for a substance abuse assessment from 14 days to 24 hours.
 

 In FY13, most adults and youth who entered treatment finished the program: 100% completion rate for youth and 70% for adults.
 

 We completed a Memorandum of Agreement (MOA) so that when clients consent, CFSA can get their assessment and treatment results from APRA.
 

 Superior Court expanded the Family Treatment Court program, which CFSA funds in part, to begin accepting custodial fathers (not just mothers) and different types of substance abuse treatment (not just residential). Supporting academic achievement is also high on our agenda. For the first time in the summer of 2013, CFSA set out to assess the proficiency level in reading and math of every school-age child in out-of-home care. On this first try, we managed to assess 70% of the target group and are now mining the results for what our children and youth in care need academically. Meanwhile, the high school graduate rate for youth in care was 71% in FY13—higher than the overall city rate but not high enough, so we have more to do.
 

Earlier, I talked about our broad-based strategy to become a trauma-informed public child welfare system. In FY13, we made significant inroads by training more than 1,800 employees and partners including CFSA and private-agency social workers and managers, attorneys and judges, foster parents, counselors, and others throughout the child-serving community
 

Finally, the Exit to Permanence pillar is about ensuring that every child and youth leaves foster care as quickly as possible for a safe, permanent home or life-long connection and that older youth in care master the skills to succeed as adults. In 2012, I moved CFSA’s Office of Youth Empowerment to report directly to me and worked with the OYE Administrator and staff on substantive reforms. This resulted in moving away from a one-size-fits-all approach to tailoring responses to the needs of distinct groups. In FY13, we completed program restructuring. Here are the main achievements.

 A total of 102 youth in care were attending college, and eight graduated from a four-year program.
 

 The Career Pathways program served 105 youth, ages 17 to 20, who are not college-bound but want to pursue substantive vocational training leading to employment. Depending on their interests, youth can choose from a broad range of fields such as cosmetology, information technology, construction, plumbing, health care, hospitality, culinary arts, law enforcement, and more. Upon completion of training, CFSA subsidizes internships with reputable companies.
 

 Learning to handle money is an important life skill. E$crow Bank on DC is an online and live-workshop curriculum that helps youth age 15 and up develop basic financial literacy and financial management skills. We have also established a matched savings account program which will allow our young people to build financial assets for future needs.
 

 Also in 2013, CFSA standardized monthly stipends for youth in Independent Living Programs and the monthly allowance and clothing allowance for youth in group and foster homes. In cooperation with youth advocates, we also completed a Youth Bill of Rights.
Achievements I’ve described under the Four Pillars framework today are far from the only ones CFSA accomplished in FY13. But they do serve to illustrate we are forging ahead on many fronts and measurably improving outcomes for those we serve.
 

The CFSA Piggy Bank and Other Myths
 

I know you are keenly interested in discussing the fortunate financial position CFSA now occupies. The irony of having to explain why we have so much money is certainly not lost on those of us who remember the days CFSA scrambled to make ends meet and had to come hat-in-hand for additional resources. And while it’s a little embarrassing to having to keep explaining our good fortune, I assure you I would rather be in this position than the other.
 

There are three basic reasons for CFSA’s strong financial position, and they are all good reasons: (1) continuing reduction in the number of kids in foster care; (2) increased draw-down of federal dollars; and (3) better fiscal management, including elimination of unneeded or nonproductive programs and laser-focused negotiations on provider contracts. As a result, we have been able to do more with less, support significant investments and enhancements that we can finance within our own budget, and still have money left to address critical needs in other agencies.
 

First, let me be clear. Mayor Gray and DM Otero give CFSA unwavering support. They have total confidence in me and my team, they understand our Four Pillars strategic agenda, they are committed to ending the LaShawn lawsuit, and they encourage reinvestment of dollars into prevention services to continue safely reducing the number of kids in foster care. At no time has anyone dipped into the so-called CFSA piggybank to raid critical CFSA funds to plug holes in other agencies.

As you know, the Administration, in conjunction with the OCFO, conducts quarterly financial projections for each agency to determine our spending patterns against our budget. Before we determine any projected surpluses, we first look at own needs. Sometimes that means plugging our own internal agency shortfalls, but more often, it includes investments to accelerate our Four Pillars priorities. In FY12, we had a number of strategic investments for which we requested and received $4.5 million in reprogrammed funds (and you will recall we briefed you extensively on these investments). Due to timing and other complications, we were challenged to responsibly spend all of the money as planned, but we laid the foundation for a number of important investments such as crisis mobilization services for foster parents. Still, that left us with money to address needs in sister agencies, some of which will provide further supports for the families we mutually serve.
 

For example, the reprogrammings included $3.5 million for the Children and Youth Investment Trust, $6 million for mental health rehabilitative services, $2.9 million to forestall TANF reductions, and $500,000 for homeless youth. Other directors may have chosen to keep those funds in CFSA and expand our reach, but that’s not the approach we are taking. While we sometimes jumpstart services for the purposes of expediency, such as funding substance abuse assessors or mental health specialists co-located within the neighborhood Collaboratives, our ultimate goal is to have those resources within the agency responsible for providing the services. That has been the successful model we built with the Department of Behavioral Health (then the Department of Mental Health) ten years ago, where we transfer funds for our client needs via an annual MOU. In fact, we have added $500,000 in reinvestment dollars to expand evidence-based mental health services. In turn, DBH pursues a Medicaid plan amendment so that these services will be funded with federal dollars. So while it might appear to some that CFSA is losing money, the reality is that we are spreading money around—by design—so that the children and families we are increasingly serving at home are able to access a richer array of services.
 

Finally, it must be tempting, perhaps even irresistible, for our stakeholders to come up with wish lists when they believe money is on the table. In reality, we have invited all of these stakeholders to the table many times to providing input into what we are doing and how we can do it better. In November, approximately 50 stakeholders participated in our budget briefing, which ended with not one recommendation about additional services or programs. In fact, one of the advocates said, “I can’t believe I’m saying this, but you have already thought of everything, so we have nothing to add.”
 

You will also recall at last year’s budget hearing, you asked the Court Monitor to submit a list of ideas that would address outstanding LaShawn measures. Every item on her list was something we were already doing or had already built into our budget. The point is not that we know it all. The point is that we have a solid strategic agenda that guides our work, and our budget is designed to support that agenda. And because we routinely monitor our outcomes, we know in real time where we have performance gaps and when strategies are not working. We also listen to our partners about service gaps, as you heard during the first round of testimonies from the Foster Parent Advocacy Center, foster youth, and the Young Women’s Project. We are innovative, but we are also strategic in investing in proven programs and strategies. I take my role as fiscal steward very seriously, and I stand behind the tough decisions I have made to end certain longstanding partnerships and contracts.

I hope I have addressed most of your concern about our financial picture but I am ready to address any specific questions you may have.
 

Future
 

In closing, I want to assure this committee and the community that CFSA is well on the way to being the high-performing child welfare agency our clients deserve and that we intend to achieve that status in 2014. In FY13, we invested heavily in an infrastructure of the right people, strategies, and partnerships. Now at the mid-point of the second quarter of FY14, we are working our agenda with diligence, momentum, and enthusiasm. We monitor our progress quarterly, and I expect to see steady accomplishment of the outcomes all of us want for the children and families we serve.
I appreciate your interest in our work and our agenda, and I look forward to your support as CFSA achieves the next level in delivering the best possible outcomes to children, youth, and families who need our help. Thank you.