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Family Success: Achieving Outcomes by Promoting Accountability. Presenters: Bret Stockton, Director of Business Development Catherine Adams: Business Development Manager. Workshop Overview: Video Introduction Youth Villages’ Overview Increasing Family Accountability
Family Success: Achieving Outcomes by Promoting Accountability
Presenters: Bret Stockton, Director of Business Development Catherine Adams: Business Development Manager
Workshop Overview: Video Introduction Youth Villages’ Overview Increasing Family Accountability Intensive In-Home Services: Intercept Intercept Outcome Data Questions/Answers & Discussion
Youth Villages’ Mission and Values OUR MISSION Youth Villages helps children and families live successfully. OUR VALUES Kids needs come first…Always. Children are raised best by their families. We provide a safe place. We strive to achieve positive, lasting results. We are committed to our staff. We are each responsible for providing the highest level of service to our customers. We constantly improve our performance to achieve excellence. We create new programs to meet the needs of children, families and the community. We do what we say we do.
Quick Facts Youth Villages’ Daily Program Census as of 7/31/11 The Youth Villages Specialized Mobile Crisis program in Tennessee received 9,862 calls in FY 2010 and conducted 6,921 face-to-face assessments. Across the state, over 65% of these youth were diverted from hospital placement. Youth Villages’ Mentoring Program currently has over 325 mentors.
Goals of Intensive In-Home Services: Achieve long-term, successful outcomes for youth in the home Empower families to be accountable to and for their children and to resolve problems independently whenever possible Ensure services rendered focus on providing families with the resources needed to address current and future mental health and behavioral issues Reduce the overall cost of services through reduced overall length of stay per youth and treatment in the least restrictive environment Decrease number of unnecessary out-of-home placements Prevent disruptions from home-based setting resulting in placement in detention centers or hospitals Increase the number of youth served by reducing the overall cost per youth Provide cost effective, successful services to states and localities Increase service capacity to ensure that all children and families have access to the most appropriate level of service they need
Recommendations for Promoting Accountability: Before any child is committed to state custody, or if necessary at the moment the child is committed to state custody, families should be assigned an intensive in-home service provider. States should build in a mechanism to intensely monitor every single child who is entering custody, to ensure that all appropriate efforts are being made to provide the most appropriate service(s). States should marshal all resources needed to do whatever it takes to resolve family problems so that children can safely stay or return home if at all possible, and monitor to ensure that resources are properly used to their fullest extent.
Youth served July 2000 through May 2011Youth Served by Program Youth may be served in multiple programs.
In-Home Services ProgramsAdmissions by Fiscal Year October 1994 through March 2011 Youth may have multiple admissions to the program. * Represents the first three quarters of the fiscal year Fiscal Year – July 1 to June 30
Intensive In-Home Services: Intercept
History of Promoting Family Accountability History of providers’ role in promoting accountability: Take responsibility for outcomes Philosophical change: Seeing families as the solution Reasons families don’t accept responsibility and accountability: What is the fit? Role of alignment: Can’t speak about families in the ways that you wouldn’t speak to them
Organizational Practices for Promoting Family Accountability Emphasize our accountability Describe what accountability looks like for each family, identify what stands in the way of that, then hold ourselves accountable for addressing those things. Eliminate language like “resistant” or “not ready for change.” If the family just needed to be told what to do, we wouldn’t be needed. Often need to do non-traditional things to earn trust and communicate a non-judgmental relationship. Address alignment as a developmental target with staff.
Why Treatment in the Home is Necessary Natural Environment - Resolve problems in the natural environment. Present Focused - Address current behaviors relating to: Family Peers School Individual Community “Fit” - Understand the fit. Family Responsibility - Encourage the family to take responsibility. Generalization - Develop long-term solutions in the community. Realistic Setting - Teach youth to function in realistic setting. Effective Treatment – Treatment based on research is most effective. Research - Research indicates that restrictive out-of-home placements may do more harm than good. Engage Entire Family – Need to treat entire family.
Intercept Program Overview Youth Villages developed the Intercept Program to serve a broader population of youth and families Serves youth from infant to age 17 Utilized with a combination of child welfare, mental health, and juvenile justice systems Currently serving AL, FL, GA, MA, MS, NC, NH, OR, and TN Ability to divert youth from placement, thus keeping families together safely Ability and experience in transitioning youth home from out-of-home placements (detention, RTC, acute hospitalizations, foster homes, etc.) even after extended time out-of-home (more than 3 months)
Program Key Components Youth Villages' Intercept program offers the following: Extremely high levels of staff training and supervision Intensive services conducted in the child's home and community by a single Intercept family intervention specialist Caseloads of only 4-5 youth/families per Intercept family intervention specialist Family sessions conducted 3 times per week 24/7/365 on call support to families Accountability for success is with the Intercept family intervention specialist and program
Program Key Components (cont.) Average 4-6 months per case for diversion and up to 6-9 months per case for reunification Involvement in all systems affecting youth and family Assistance with concrete needs such as housing, healthcare, and employment Nurturance of long-term support from extended family and other natural support systems Masters level counselors preferred or Bachelors level with experience working with target population
OngoingEvaluation of Cases Daily Updates and Red Flag E-mails Weekly Individual Counselor Development Critical Event Reviews Supervisor field visits Tape reviews
Typical Youth Referral Issues • Youth Villages, Inc.
Typical Parent Referral Issues • Youth Villages, Inc.
Initial and Ongoing Communication With Key Stakeholders Community Stakeholders: Case Managers Current provider (if applicable to reunification cases) Agency Staff (child welfare, juvenile justice, and/or mental health) Court Staff (including Judges, GALs, and POs) Schools (including teachers, principals, guidance counselors) Mental Health Centers (including psychiatrists) Communication includes: In addition to the youth and family, Youth Villages’ Intercept includes key stakeholders in the assessment and treatment planning process. Youth Villages provides documentation such as monthly updates, detailed assessments, weekly treatment plans, discharge plans, and safety plans. Youth Villages provides ongoing updates as often as requested.
Intervention Targets Identification of the primary risk factors associated with referral problems Services are all-inclusive Services are focused on strengths of the family & child Family Members are full partners in the treatment process Interventions take place within the multiple systems occurring within the natural ecology
Intercept Program:Common Interventions Work with family to design and implement an individualized safety plan Work with family to design and implement an individualized behavior plan Work with family and support network to design and implement a supervision plan Work with family to meet basic needs (housing, health care, transportation, employment, etc. Work with family on how to manage medications Work with family to increase and utilize their support network Find respite with extended family or other supports, as necessary Engage stakeholders, including caseworkers and courts to find appropriate relative/support placements when it is necessary to remove a child from the home
Intercept Specialist Characteristics Total Commitment to Model Intense Critical Thinker Creative Flexible Open to High Levels of Supervision Outcome Driven
How Intercept Can Help Diversion Diversion/Stabilization Assessments on all youth entering care Adoption Stabilization Birth to Four Reunification Assessments and intensive family searches Short-term Reunification Long-term Reunification Residential Partnerships
Intercept Program Outcomes Youth Served July 2006 through December2010 Includes youth served through the Intercept Program in Alabama, Florida, Georgia, Massachusetts, Mississippi, New Hampshire, Tennessee and Virginia.
Outcome Evaluation Process Research Dept. led by Dr. Sarah Hurley and 14 full time staff Follow-up surveys administered to all youth/families who received at least 60 days of Youth Villages’ services (a “full dose”) at 6, 12, and 24 months post-discharge.
Intercept ProgramDemographics Youth served July 2006 through March 2011N = 9,461 Gender Race/Ethnicity
Intercept ProgramAge Group Youth served July 2006 through March 2011N = 9,461
Intercept ProgramPresenting Issues Youth served July 2006 through March 2011N = 9,461 90% of youth have multiple presenting issues.
Intercept Program History of Family DifficultiesYouth served July 2006 through March 2011 N = 9,461 50% of families have multiple difficulties
Intercept ProgramAdmissions by Fiscal Year Youth served July 2006 through March 2011 Youth may have multiple admissions to the program. *Represents the first three quarters of the fiscal year Fiscal Year – July 1 to June 30
Intercept ProgramAdmissions by Region Youth served July 2006 through March 2011 Youth may have multiple admissions to the program.
Intercept ProgramDischarge LocationYouth discharged July 2006 through March 2011N = 7,683 Only includes youth who received at least 60 days of service; 16.1% (1,469 out of 9,152) of admissions ended prior to 60 days. *includes placements such as group homes, runaway, foster care and rehab centers
Intercept Program Parent Satisfaction at DischargeParents surveyed July 2006 through March 2011 Note: Figures include only youth who received at least 60 days of service.
Intercept ProgramSuccess at Follow-upFollow-ups conducted through March 2011 Success is defined as living at home with family or living independently. Note: Figures include only youth who received at least 60 days of service.
Intercept ProgramYouth reporting NO Trouble with the LawFollow-ups conducted through March 2011 Note: Figures include only youth who received at least 60 days of service.
Intercept ProgramSchool StatusFollow-ups conducted through March 2011 Indicates the number in school, graduated from high school, or in GED classes at the time of follow-up. Note: Figures include only youth who received at least 60 days of service.
Intercept ProgramOut of Home PlacementsFollow-ups conducted through March 2011 Note: Figures include only youth who received at least 60 days of service.
Intercept Program Youth in State Custody at Follow-upFollow-ups conducted through March 2011 Nearly a quarter (20.7%) of youth were in state custody during enrollment. Please note: Most youth in parental custody who are admitted to Intercept are at substantially increased risk of placement into state custody, either through the child welfare or juvenile justice system. Note: Figures include only youth who received at least 60 days of service.
About our Response Rates Surveys are conducted by research staff via phone with letter surveys to non-respondents. Please note: Surveys are completed with youth/families who have discharged from YV services altogether. If a youth re-enters YV services, the survey cycle is reset and begins again at their discharge. Parent Satisfaction surveys are only conducted with families who were involved in the youth’s treatment. • Internet search of public records (Lexis-Nexis) is completed to locate accurate contact information • While no consensus exists regarding adequate response rates, 40% - 60% has been identified as appropriate for surveys of this type and size1. • Rate of re-entry into YV services: 6-Month Follow-up – 5.3% (334 out of 6,339) 12-Month Follow-up – 9.6% (501 out of 5,211) 24-Month Follow-up – 14.2% (432 out of 3,050) 1PWGSC (Public Works and Government Services Canada). (2008). Advisory Panel on Telephone Public Opinion Survey Quality: Standards and Guidelines for Response Rate.
Questions Answers Discussion
Contact Information: Bret Stockton: 901-338-6097 Bret.Stockton@youthvillages.org Catherine Adams: 901-283-1728 Catherine.Adams@youthvillages.org