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Office of the Child Advocate: Moving Ahead

Office of the Child Advocate: Moving Ahead. Working to ensure children have access to necessary health, educational and family supports. . Priorities of the OCA. 1. Child Fatality Review 2. Response to citizen concerns 3. Advancing critical issue reforms. Child Fatality Review Panel.

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Office of the Child Advocate: Moving Ahead

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  1. Office of the Child Advocate: Moving Ahead Working to ensure children have access to necessary health, educational and family supports.

  2. Priorities of the OCA • 1. Child Fatality Review • 2. Response to citizen concerns • 3. Advancing critical issue reforms

  3. Child Fatality Review Panel • 1. Role of the OCA. • 2. Process. Partnership. • 3. Goals.

  4. Child Fatality Review Panel • 1. Homicides • 2. Suicides • 3. Accidental Passing • 4. Natural Passing

  5. Trends • 2001-2013 child abuse fatalities: 58 children • Over 80 % perpetrators are male • More fathers than boyfriends • Majority are 12 months or under • Almost all are under 36 months of age

  6. Trends NumerousUndetermined Child Deaths Undetermined Death (category used by Office of Chief Medical Examiner)No findings of accident, disease, trauma, or obvious injury. All Undetermined Cases were infants under one-year. Many in sleep environments other than crib (adult bed, chair, couch)Many had extraneous items in sleep environment (blankets, pillows, stuffed animals) In 2012, at least 16 “undetermined” child deaths.

  7. OCA Goals • 1. Work with partner agencies to strengthen and expand engagement and supports for young or first time parents. Example: Nurturing Families Network. • 2. Maximize engagement with fathers. Example: home visiting slots for fathers. • 3. Increase screening opportunities for children and their parents, including developmental screening for children and maternal depression screening. • 4. Increase capacity for evidence-based dyadic mental health interventions that work with both parents and children. Example: Child First. • 5. Increase awareness of unsafe sleep conditions, which, along with numerous factors, increase risk of infant fatality.

  8. Citizen Concerns • In 2012, OCA staff reviewed over 400 casesProvided information, referral and coaching • OCA intervened directly in approximately 15% of the cases of children referred through its ombudsman activities

  9. What Do People Call About? • 1. Concerns regarding children with disabilities • 2. Child welfare concerns • 3. Legal concerns

  10. Citizen concerns • Most child/youth cases involved significant concerns with treatment planning around complex mental health needs, developmental disabilities and social issues transcending the services of multiple state agencies.

  11. How does OCA respond? • 1. Advice and “Coaching” for caller • 2. Referrals to agencies as appropriate • 3. Direct intervention in case • 4. Review of systems/practice issues • 5. Follow up with oversight entities including: • - Agency commissioners- Governor’s office- Legislature- Judicial branch officials

  12. OCA Moving Ahead • 1. New technology to optimally track issues and solutions • 2. Public education mandate tied to citizen concerns • - OCA publications • - OCA forums • 3. Systemic agenda deriving from citizen concerns • - Social/Emotional and educational supports for young children • - Reduction in restraint and seclusion • - Improving outlook for youth aging out of foster care

  13. Facility and Agency Advocacy • Hospitals for adolescents and young adults (DCF and DMHAS) • Treatment Planning • Best Practices • Discharge • Correctional Facilities (DOC) • Conditions of confinement • Developmentally appropriate rules and policies, including visitation policies

  14. OCA Moving Ahead • Encouraging data and outcome driven investment in treatment supports, including facilities • Ensuring educational opportunities in facilities that comport with best practices and legal entitlements • Ensuring access to family for incarcerated youth in developmentally appropriate way

  15. Investigations/Public Policy and Legislative Work Gun Violence 12 Years of Gun Deaths and Injuries in Connecticut Published by OCA Jan 2013 and shared with public and legislature to assist in policy discussions Between Jan 1, 2001 - Dec 31, 2012 94 children died from gunshot wounds 924 children were injured by guns

  16. Investigations/Public Policy • School Suspension of Young Children • OCA responded to parent’s request for assistance regarding exclusion of her young child from school. • Upon investigation, OCA was concerned regarding district’s response to emotional/behavioral health needs of young children. • OCA contacted SDE and further investigation revealed that during the 2011-2012 school year, over 2000 children, ages 6 and younger, were suspended from CT public schools. • Children most likely to be suspended were boys, specifically Black or Latino boys, living in an urban setting.

  17. Suspension. Expulsions. • OCA initiated discussion with SDE executive leadership • SDE committed to examination and intervention where needed • OCA continues to monitor and work with SDE and other key stakeholders to ensure that this is effectively addressed

  18. ‘Scream Rooms’ Seclusion (and restraint) in our schools • Middletown Public Schools: Use of Seclusion in Elementary School • Jan 2012, report to OCA that young children were subjected to lengthy stays in scream rooms (converted cinderblock utility rooms) • Children described experiencing great emotional distress, head banging, urinating on floor • OCA, in partnership with the Office of Protection and Advocacy for Persons with Disabilities (OPA), promptly initiated independent investigation into complaints • OCA and OPA completed investigative report, No More Scream Rooms in Connecticut Schools: An Investigation into Seclusion Practices at Farm Hill Elementary School

  19. OCA Moving Ahead Focus on points where systems collide and partner for children with disabilities, mental and behavioral health needs. Advocate for schools to have appropriate partnerships, resources and expertise to build positive school climate, facilitate effective crisis intervention, and assist children and families with accessing appropriate mental health support services. Sought outcomes: • Meaningful access to effective community and HOME BASED health care supports. • Increase developmental, mental and behavioral health screening for children. • Broaden implementation of evidence-based SWPBIS in schools.

  20. OCA Moving Ahead • Reduce use of restraint and seclusion for children. • Reduce or eliminate use of suspension/expulsion for young children. • Systematize data and needs-driven investment in mental and behavioral health treatment infrastructure. • Reduce and eliminate barriers to enrollment for at-risk populations of children and children with special health care needs. • Specific emphasis on very at-risk infants and toddlers, ensuring safety and access to appropriate developmental supports.

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