Fulfilling the Promise of Systems Integration: Ensuring the Rights of Children and Families

1. Fulfilling the Promise of Systems Integration: Ensuring the Rights of Children and Families Presented by: Pat Arthur, National Center for Youth Law Brent Pattison, TeamChild Anne Lee, TeamChild

2. Presentation Overview • Highlight essential federal laws establishing the rights of children and families in education, child welfare, and health care. • Identify practical and legal barriers to navigating systems. • Delve into potential unintended consequences of system collaboration from a child and family perspective. • Explore ways to measure effectiveness of our efforts consistent with the legal rights and needs of children and families.

3. Sources of Authority Defining Rights for Children in Multi-Systems Coordination • State and federal constitutions • State and federal statutes • Agency regulations • Agency directives and policy • Court decisions (case law) • Settlement orders/consent decrees

4. Sources of Authority Defining Rights for Children in Multi-Systems Coordination • “State Plans” submitted to federal agencies responsible for administering federal programs • Interagency Agreements & Memoranda of Understanding • Contracts between providers and agencies • Individual treatment, education or case plans

5. Key Federal Laws & Entitlements • Medicaid • Early Periodic Screening, Diagnosis and Treatment (EPSDT) • Supplemental Security Income (SSI) • Workforce Investment Act (WIA)

6. Key Federal Laws & Entitlements • Individuals with Disabilities Education Improvement Act (IDEA) (2004) • Section 504 of the Rehabilitation Act • McKinney Vento Homeless Education Act • Title II of the Americans with Disabilities Act (ADA)

7. Key Federal Laws & Entitlements • Adoption Assistance and Child Welfare Act (AACWA) & the Adoption and Safe Families Act • Child Abuse Prevention and Treatment Act (CAPTA) • Chaffee Foster Care Independence Act

8. Key Federal Laws & Entitlements • Juvenile Justice and Delinquency Prevention Act (JJDPA) • Health Insurance Portability and Accountability Act (HIPAA) • Federal Family Educational Rights and Privacy Act (FERPA)

9. Knowing the Law Provides Opportunities • Maximizes access to programs, services, and funding • Helps movement from “process” to concrete “outcomes” • Provides clarity to youth, family and agencies • Minimizes “passing the buck” instincts • Lessens likelihood of “reinventing the wheel”

10. The Role of Advocacy in Enhancing Multi-System Collaboration • Grounded in the perspective of children and families • Focused on solutions to meet needs • Assists with ensuring accountability • Provides balance to other interests at play • Helps identify and analyze complex web of relevant state and federal laws • Result and outcome oriented

11. Thinking About Systems Integration from a Youth’s Point-of-View: Protecting Rights and Improving Outcomes

12. What is the potential benefit of system integration for our children? • What are potential unintended consequences? • What can we learn from taking a youth’s point-of-view?

13. The Promise of System Integration: Shared Assumptions about its Value Increased information sharing, improved coordination of services, and a collaborative approach lead to better outcomes for kids and families.

14. How Youth Perceive a Lack of Integration • “I have been in 47 placements with 3 different agencies. I did not have a lot of school options. I kept talking to social workers and eventually got to go to a regular school.” • “For most kids who get out [of detention] community school is the only option, or continuation school because they don’t have enough credits [for regular school]. You just have to connect the dots: all the kids doing negative things get sent to this school.”

15. How Youth Perceive a Lack of Integration • “At shelter school kids go the first 12 grades in one class- there is no way the credits transfer to regular school.” • “When I got out of my group home two years ago, no one offered me any services. Now, two years later, the people who were supposed to help me are helping me with emergency housing and financial aid to go to college. During those two years, I was caught for robbery because I did not have anything else to live on. Maybe it would have prevented me from going to jail if I had these services right out of the group home. The system will make you grimy and cold-hearted.”

16. What are some unintended consequences of system integration? • Confidentiality: Whether information can be shared is a different question than how or whether it should be shared. • Solution: Consider how sharing information will affect the child and family. Get input from the child and family, and if the information must be shared, help them limit any negative consequences.

17. What are some unintended consequences of system integration? • System Coordination and System Accountability: A “team” approach sometimes compromises children’s rights- either because the team members make “deals” regarding service, or because it delays needed services because no one agency or system is clearly responsible. • Solution: Even in the context of collaboration and teamwork, children and families need advocates. We cannot rely on improved collaboration alone to lead to better system accountability

18. What are some unintended consequences of system integration? • Decreased Autonomy: Increased coordination of services may often lead to better service, but it also may make families feel like they have less control over who is working with them. • Solution: Build choice into system integration. Make sure kids and families feel some control over the process

19. Hypothetical John is a 15 year old special education student recently released from a juvenile correctional facility. He has been in foster care since he was 5. Under a new initiative, Juvenile Justice and the Department of Children and Family Services have been coordinating to improve services for foster children leaving the juvenile facilities.

20. Hypothetical As part of that initiative, John’s caseworker and parole officer have met with John’s IEP team at school to plan an appropriate educational program. A couple of weeks after his release, there is a meeting at school. John and his foster parent find out that he is going to finish the last few months of the school year in a home-based tutoring program. He will meet with a tutor twice a week for an hour or so. The principal explains that in light of John’s Assault 2 conviction, he does not feel like it is safe to have John at school until he shows some stability in the community. Besides, it is too late for him to achieve any credit this semester due to his late start.

21. Hypothetical John is upset because he had been looking forward to getting back to a “normal” life after his stay in the correctional facility. He also does not know how his principal found out about his conviction. His foster parent is also upset because she does not think home tutoring will provide John with the structure and supervision he needs while she is at work.

22. Hypothetical In the meantime, John’s parole officer has made a referral to a community mental health agency so John can get counseling. When John calls the agency to set up an appointment, there are no counselors available immediately, but an intake appointment is set for a few weeks later. At the intake appointment, the counselor tells John that it will cost 50 dollars per session because his Medicaid eligibility has been terminated, and he will have to reapply.

23. How do we measure up? “Not everything that can be counted counts, and not everything that counts can be counted.” - Albert Einstein

24. Evaluation is Hot • Active efforts to implement large, system wide reform in child welfare and juvenile justice • Multi-level pressures for accountability – political, fiscal, legal and client-centered • Desire for evidence-based programs

25. Logic Model • Visual representation of planned work and intended outcomes • Draws connections between outcomes, process, and theory • Tool that can be used at both micro and macro levels • Different approaches (theory, outcome and activities) provide flexibility • Gives layout of where and how to assess progress and success of programs or initiatives

26. Logic Model Planned Work Intended Results Resources Activities Outputs Outcomes Impact In order to accomplish activities, we need…. In order to address the problem, we will do …. Once accomplished, we expect to see these indicators of our work…. We expect that if the activities are accomplished, they will lead to the following short and long term changes… We hope the long-term impact of these activities will be …

27. TemChild’s Logic Model Planned Work Intended Results Resources Activities Outputs Outcomes Impact • 3+ attorneys • 2.5 FTE admin support • Youth (12-18 years old) involved in the juvenile justice system • Volunteers (legal interns, social work interns, college students) • Staff screen referred youths’ need for advocacy education, mental health, housing, other social services • Staff provide advice, counsel and/or brief service to resolve presenting issues • Staff represent youth in administrative or judicial proceedings • Staff engage in negotiations or other dispute resolution on behalf of youth • Staff prepare for and provide training for the community • 400 youth are referred and screened to assess legal or other problem • 300 youth receive advice, referral or representation to resolve issues presented by clients • 12 community trainings for juvenile court stakeholders • Youth resolve discipline problems through a due process hearing or negotiation. • Enhanced access to treatment for mental health, drug/alcohol or other health issues • Enhanced access to education • Enhanced access to housing and social service support • Enhanced access to due process • Increased access to information about the rights of young people to education, transition services, medical care, and housing support. • Reduction in juvenile violence and criminal activity • Youth involved in or at risk of being involved in the juvenile justice system have more support and do not fall into the gap between the juvenile justice system and community support • Increased capacity within the juvenile justice system to better recognize and address the underlying needs of youth in the juvenile justice system

28. Logic Model Planned Work Intended Results Resources Activities Outputs Outcomes Impact • 100% of eligible youth apply for and are eligible for Medicaid • Youth obtain mental health treatment and service without delay • Youth receive appropriate treatment • Youth are healthier • Reduction in the use of incarceration • Reduction in youth violence

29. Logic Model Planned Work Intended Results Resources Activities Outputs Outcomes Impact • Youth transitioning out of secure detention experience no delay in reenrollment in community based school. • Youth with special needs receive appropriate special education services. • Youth are healthier • Reduction in the use of incarceration • Reduction in youth violence

30. Resources • W.K. Kellogg Foundation (Program Evaluation Manual and Logic Model Resource Guide) http://www.wkk.org/ • United Way Evaluation Resources http://national.unitedway.org/outcomes/