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September/October 2011Vol. 12, No. 7New Hampshire Uses Practice Model to Build PIP

The New Hampshire Division for Children, Youth and Families (DCYF) and the Division of Juvenile Justice (DJJS) are enthusiastic about implementing their approved Program Improvement Plan (PIP) and bringing about positive change for New Hampshire’s children and families. The PIP outlines child welfare improvements the DCYF and DJJS will implement over the next several years to address issues identified in the State’s recent Child and Family Services Review (CFSR). Staff confidence about the PIP stems from the collaborative development process and the strong connection between the PIP and the DCYF/DJJS Practice Model.

DCYF and DJJS began their PIP planning long before the CFSR. More importantly, PIP planning occurred simultaneously with the development of the Practice Model, a project supported by the Northeast and Caribbean Child Welfare Implementation Center. A variety of stakeholders—including workers, youth, parents, law enforcement, the courts, and residential providers—contributed to the Practice Model design (and later to the development of the PIP). The resulting Practice Model provides both a solid framework and specific strategies for addressing areas needing improvement highlighted in the CFSR while enhancing existing strengths. Both the Practice Model and PIP are centered on enhancing family engagement through their motto of "Family Voice, Family Choice." The following themes resound in both the PIP and New Hampshire’s Practice model:

  • Enhanced family engagement strategies to incorporate both structural and clinical improvements.
    • In an effort to move the Division's assessment process to an evidence-informed Solution-Based Casework (SBC) approach, the Family Assessment and Inclusive Reunification (FAIR) program was created for out-of-home cases. A FAIR meeting is held 10 days after removing a child from the home, and the goal is to engage the family and other team members in an intensive, collaborative discussion regarding the safety, permanency, and well-being of the child or children. Subsequent FAIR meetings are held at scheduled intervals.
    • For in-home cases, Family Team Conferencing has become New Hampshire’s restorative practice approach to achieving permanency through expanded family engagement in case planning.
    • The Youth Action Pool organizes statewide youth advisory meetings for strategy sharing among youth to positively influence DCYF and DJJS adolescent practices. This effort with youth has evolved naturally to join with the Better Together with Birth Parents and the Framework for Collaboration initiative, recently developed to create equal, mutually respectful partnerships between staff, allies, and parents, with the goal of positively changing the child welfare system.
  • Expanded safety and risk assessment mechanisms to include a "Signs of Safety" approach that incorporates strengths-based case planning rooted in family understanding about specific changes required to improve safety. DCYF also will enhance its use of Structured Decision Making to promote consistency across cases and reduce ambiguity for workers faced with difficult decisions.
  • Promoted nurturing of the organizational culture and climate, especially around supervisor standards, leadership, and coaching. Because achieving outcomes in SBC requires significant commitment from supervisors, new training efforts have been employed, and SBC has been incorporated into the revised Supervisory Standards. Once supervisors are trained, they coach field staff to support implementation of the Practice Model and SBC and, ultimately, strengthen the workforce.

An exciting aspect of the Practice Model is that staff from all levels of the organization developed the core beliefs and principles, which apply not only to DCYF, but also its partner DJJS. Under the umbrella of the New Hampshire Department of Health and Human Services, both DCYF and DJJS serve children and families. While the two divisions are autonomous, they collaborate in important ways, including sharing a case management information system.

"The structure of our partnership is considered unique, but it's no secret that the kids in the juvenile court system overlap with the kids in the child welfare system," commented Christine Tappan, DCYF Administrator. Her sentiments were echoed by Nancy Pickett, Child Welfare Program Specialist with the Federal Administration for Children and Families (ACF): "From a Regional Office perspective, ACF and other States have an opportunity to learn from the work New Hampshire is doing with DJJS."

Both groups know the importance of data systems and data tracking for demonstrating outcomes. DCYF's quarterly case review process actually mimics, on a smaller scale, the Federal CFSR process by collecting and analyzing data at sites across the State. At each review, 20 to 30 random cases are pulled  and reviewed by a team of staff from different areas of the State. The weeklong process involves interviews with stakeholders and families and standard questions for stakeholder focus groups. There are two levels of quality assurance:

  • The Bureau of Organizational Learning and Quality Improvement (BOLQI) staff evaluate rating tools to ensure that case ratings are justified.
  • Field administrators from both DCYF and DJJS focus on practice issues and trends in specific offices or regions that would improve outcomes.

Preliminary performance outcome data are reported to the District Office supervisors and Field Administrators on the last day of the onsite review. Finally, DCYF- and DJJS-led debriefs provide regions with a look at their strengths and challenges, as well as data comparisons to their previous review and to the State’s CFSR ratings. At that point, BOLQI staff use an Appreciative Inquiry process to work with the staff and stakeholders in the region to create a picture of changes they would like to see.

Processes like the quarterly case reviews will be vital as New Hampshire prepares to implement its PIP. Armed with its Practice Model, DCYF and DJJS feel confident and equipped to complete the PIP process. Noted Tappan, "This PIP will truly be a tool to drive change. It won't be left on the shelf. Everyone knows the PIP content because it mirrors our Practice Model. That's why we're so confident this time around."

To learn more about New Hampshire's child welfare programs, visit the Department of Health and Human Services website:

http://www.dhhs.state.nh.us/dcyf/index.htm

Many thanks to the following individuals for providing the information for this article: Christine Tappan, DCYF BOLQI Administrator; Kimberly Crowe, CFSR Coordinator; Sherri Levesque, Quality Improvement Supervisor; and Nancy Pickett, Child Welfare Program Specialist, ACF, U.S. Department of Health and Human Services
 

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