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Process Perspectives: Chronicling Ohio’s Alternative Response Pilot Experience Looking Back…..and Forward
Objectives for Today • Describe the purpose and process of chronicling the pilot experience • Present qualitative findings of the chronicling effort • Discuss implications for the future and ongoing systems change
Why Chronicle? If you can’t describe what you are doing as a process, you don’t know what you’re doing.” -W. Edwards Deming
The Role of the Chronicler Documenting the Process, Experiences & the Voices of Participants: • Historical Context • Milestone events • Planning and implementation processes • Challenges or barriers • Successes • Lessons learned • Implications for the future
The Chronicling Process Comprehensive information gathering process: Events • Pre-pilot regional forums • Design Workgroup & Leadership Council meetings • Task Team meetings through Design Phase • Worker and Supervisor meetings • AR training opportunities
The Chronicling Process Comprehensive information gathering process: Interviews • County Stakeholders (Workers, Supervisors, and Administrators) • State Stakeholders • AIM Team • Judicial System Stakeholders
Final Report Content • Process Timeline • Historical Context of the AR Pilot • Pre-Pilot Planning • Planning and Design Phase • Implementation Readiness • Implementation • Process & Milestones • Successes • Challenges • Lessons Learned • Family Stories • Conclusions and Recommendations
Capturing the Voice of Experience “It’s been a great opportunity to learn how system change works –it’s been a good process.” -Franklin County Administrator
Key Lessons Prior to Implementation • State and County Partnership: Building relationships and establishing a parallel process • Process Shift: Collaborative pilot design • Context: It’s all about expectations “This is the first time in a long time that the state and counties are sitting at the table and making decisions together.” -Trumbull County Design Workgroup Member
Key Lessons Prior to Implementation • An imperfect process: We didn’t know what we didn’t know. • Challenges around timing • The lens of experience changes perspective • A fundamental touchstone: • “How is this good for families?”
Design Phase Successes • “Bringing the ten counties together with discussion and voting that resulted in looking at what is best for families and children.” - Clark County Design Workgroup Member • “Creating a broad enough structure that leaves room for some county creativity. -Fairfield County Design Workgroup Member • “Individual transformations at both state and county levels – creating more of a partnership with counties.” -ODJFS Design Workgroup Member • “Relationship building.” • -Licking County Design Workgroup Member
County Implementation: Workflow & Staffing • One Worker/One Family Approach (Fairfield, Lucas, Ross, and Trumbull) • Separated Intake and Ongoing Units (Franklin) • Blended model/Short-term Services Focus (Clark, Greene, Guernsey*, Licking, and Tuscarawas*) *Very few cases in these two counties ultimately transferred to another worker for ongoing services.
County Implementation Other county-specific implementation decisions: • Pathway assignment • Decision making procedures • Use of discretionary considerations • Case initiation procedures • Phone contact • Letter • Face-to-face • Contact timeframes
Implementation Successes “AR has changed the way we gather information and look at strengths.” -Trumbull County AR Worker, February 2010
Implementation Successes Partnership with Families: • Removal of labels • Changes in approach to families • More time to build rapport • Focus on family-driven services “The Family Service Plan helps workers think differently about collaborating with families.” -Clark County Worker, July 2009
Implementation Successes Meeting family identified needs with flexible funding: • Hard services to meet basic needs • Services that contribute to long-term safety or family stability that would not otherwise be accessible, e.g.: • Education • Job training and/or licensure • Transportation
Implementation Successes Partnerships in the Community: • Changing perceptions of community partners over time • Opening new avenues of collaboration with traditional and non-traditional partners • Building workers’ knowledge of community resources and other service systems “We have found that if you ask for help from your community, you will receive it. Through the AR initiative, we have expanded our view of community partners.” -Ross County Supervisor, September 2009
Implementation Successes Intra-Agency Partnership & New Ways of Doing Business: • Coaching and clinical consultation • Internal partnership among units “We discuss and present strengths more, and we discuss cases in a more respectful way.” -Trumbull County Worker, February 2010 “Workers have progressed in their depth of communication and understanding of families.” -Fairfield County Worker, February 2010
Shared Challenges It was overwhelming in the beginning with mixed caseloads. TR cases would have to take priority over AR. We no longer have mixed caseloads unless there is a track change.” -Greene County AR Worker, February 2010
Shared Challenges • Caseload Demands • Size of caseloads needs to be controlled • Dual AR/TR caseloads • SACWIS • Staff Relationships: Promoting system change in a manner sensitive to TR workers • Supervisory Training & Support • Economic Impact
Shared Challenges • Developing new skill sets: Assessment & Intervention • Evolving practice challenges: “Aren’t we already doing this?” • Unintended practice consequences of tying funds to completion of the Family Service Plan “We needed to step back and look at how we defined AR. It is not dependent on services or resources; it is about openness to having families drive the process.” -Franklin County Supervisor, February 2010
Lessons Learned AR is the first thing that I’ve seen come down the pike that has successfully moved us away from incident-driven thinking. AR reinforces strengths-based practice over time.” -Greene County Administrator, February 2010
Lessons Learned • Among the ten pilot counties, there is broad agreement that AR has resulted in positive outcomes for families. • There has been a progressive shift in focus from procedures and system requirements to family-driven interventions and an emphasis on clinical practice skills. • Hands-on experiences and cross-jurisdictional learning opportunities, such as coaching, immersion experiences, and group case consultation, have been instrumental in facilitating this shift.
Lessons Learned “Hands-on consultation was one of the most beneficial things we received through the pilot – one of the most memorable learning experiences was having Russ come to our county.” -Franklin County Supervisor, February 2010
Lessons Learned • Ongoing communication with community partners is important. • Variations in implementation decisions among counties contributed to disparate senses of the degree of change achieved among the counties. • Leadership is critical! • System change is a developmental process and takes time.
Words of Wisdom… “Even though I said two years ago, ‘This is what I do,’ it truly is a different approach.” - Licking County Worker “During training, it’s difficult to understand how AR is different. You need to see the differences in practice and how system change impacts family response.” – Tuscarawas County Supervisor
Words of Wisdom… “Pointing out family strengths and allowing them to be the experts has changed the perspective of families. Families are more likely to come to us for help, rather than wait until they’re in crisis because they’re afraid.” -Ross County Worker “No matter what perspective individuals came from – administrator, policy, or front line staff – it’s been a learning experience. Everybody had something to learn and something to improve upon.” -ODJFS
What Is a MCWIC? • Midwest Child Welfare Implementation Center • Part of federal Training and Technical Assistance Network • Three-and-half-year grant • Support: • Financial • Access to federal resources • Outside consultants • Center support
Elements • Formal Assessment of organizational culture & climate • Development and installation of new technical assistance model • Rule review • Implementation of organizational structure and function to support model • Ongoing fidelity and monitoring
Where Do We Start? • Mission and Vision • Advisory Committee • Operationalize mission and vision • Coordinate communication • Provide guidance to task teams • Provide input and recommendations on the implementation progress to ODJFS Leadership Group • Regional Forum