Department of Health and Human Services
Division for Children, Youth and Families
Child and Family Services Review
Statewide Assessment
July 2010
StatewideStatewide Assessment Instrument
Section I – General Information
Name Of State Agency
New Hampshire Department of Health and Human Services
Division for Children Youth and Families
and
Division for Juvenile Justice Services
Period Under Review
Onsite Review Sample Period
Foster Care Cases
In-Home Cases
4-01-2009 – 9-30-2009
4-01-2009 – 11-30-2009
4-01-2009 – 5-10-2010 (Portsmouth)
Period of AFCARS Data:
Period of NCANDS Data:
FFY07AB08AB09AB
FFY07AB08AB09AB
2007-2008-2009AB
2007-2008-2009AB
State Agency Contact Person For Statewide Assessment
Name:
Kimberly Crowe, LICSW
Title:
CFSR Coordinator
Address:
129 Pleasant Street
Brown Building
Concord, NH 03301
Phone:
603-271-4693
Fax:
603-271-4729
E-mail:
[email protected]
1
TABLE OF CONTENTS
SECTION I GENERAL INFORMATION
1
SECTION II SAFETY AND PERMANENCY DATA
32
SECTION III CHILD AND FAMILY OUTCOMES
50
Safety Policy Overview
51
Safety Outcome 1: Children are, first and foremost, protected from abuse and neglect.
64
Safety Outcome 2: Children are safely maintained in their homes whenever possible and appropriate. 72
Permanency Practice Policy Update
Permanency Outcome 1: Children have permanency and stability in their living situations.
Permanency Outcome 2: The continuity of family relationships and connections is preserved for
children.
81
92
120
Well-Being Policy Update
141
Well-Being Outcome 1: Families have enhanced capacity to provide for their children‘s needs.
145
Well-Being Outcome 2: Children receive appropriate services to meet their educational needs.
161
Well-Being Outcome 3: Children receive adequate services to meet their physical and mental health
needs.
164
SECTION IV SYSTEMIC FACTORS
171
Systemic Introduction
A. Statewide Information System
B. Case Review System
C. Quality Assurance System
D. Staff and Provider Training
E. Service Array and Resource Development
F. Agency Responsiveness to the Community
G. Foster and Adoptive Home Licensing, Approval and Recruitment
172
177
183
209
219
249
265
287
SECTION V STATE ASSESSMENT OF STRENGTHS AND NEEDS
305
2
CFSR Acronym List
ACRONYM
AAU
ACF
ACR
ACTS
ADA
AFCARS
AG
AIP
AITP
ALPP
ANI
APC
APDU
APSR
APPLA
ARM
ASFA
ASQ
ASQ-SE
BBH
B-case
BDS
BIS
BOLAC
BOLQI
BQI
Bridges
BSC
BT/BP
CAC
CA/N
CAPTA
CARE-NH
CASA
CBT
CCDF
CFBI
CFCIP
CFSP
CFSR
NAME
Administrative Appeals Unit
Administration for Children and Families
Administrative Case Review
Adolescent Community Therapeutic Services
Americans with Disabilities Act
Adoption and Foster Care Analysis and Reporting System
Attorney General
AFCARS Improvement Plan
Annual Individual Training Plan
Adult Living Preparation Plan (Process)
Area Needing Improvement
Anna Philbrook Center (State‘s Children‘s Psychiatric Hospital)
Advanced Planning Document Update
Annual Progress and Services Report
Another Permanent Planned Living Arrangement
Accelerated Reunification Model
Adoption and Safe Families Act
Ages and Stages Questionnaire
Ages and Stages Questionnaire-Social/Emotional
Bureau of Behavioral Health
Non court-involved case
Bureau of Developmental Services
Bureau of Information Systems
Bureau of Organizational Learning Advisory Council
Bureau of Organizational Learning and Quality Improvement
Bureau of Quality Improvement
New Hampshire SACWIS system
Breakthrough Series Collaborative
Better Together with Birth Parents
Child Advocacy Center
Child abuse/neglect
Child Abuse Prevention and Treatment Act
Child Abuse Referral Evaluations- New Hampshire
Court Appointed Special Advocate
Competency Based Training
Child Care Development Fund (child care subsidy scholarship)
Community and Faith Based Initiative
Chafee Foster Care Independence Program
Child and Family Services Plan
Child and Family Services Review
3
New Hampshire CFSR Statewide Assessment
July 2010
CHI
CHINS
CHS
CHSS
CIP
CMHC
CoOL
CORE
COT
CPE
CPR
CPR/AED
CPS
CPSW
CRP
CSSP
CT DCF
DCA
DCYF
DHHS
DJJS
DJJS-QI
DO
DOE
DOL
DTIRC
DV
DVS
DYDS
E&TP
ETV
FACES
FAPA
FC
FCDA
FFY
FMLA
FSSR
FTSP
GSC
HBTS
HCBC-DD
HSSCO
ICPC
Community Health Institute
Child in Need of Services—under the supervision of DJJS
Community Health Institute
Child Health Support Services
Court Improvement Project
Community Mental Health Center
Council on Organizational Learning
Initial training for all CPSWs before they can maintain a caseload
Caregiver Ongoing Training
Center for Professional Excellence in child welfare
Case Practice Review
Cardiopulmonary Resuscitation /Automated External Defibrillators
Child Protective Services
Child Protective Service Worker
Citizen‘s Review Panel
Center for the Study of Social Policy
Connecticut Department of Children and Families
Deputy Compact Administrator
Division for Children, Youth, and Families
Department of Health and Human Services
Division for Juvenile Justice Services
Division for Juvenile Justice Services Quality Improvement
District Office
Department Of Education
Department Of Labor
Dartmouth Trauma Interventions Research Center
Domestic Violence
Domestic Violence Specialist
Department of Youth Developmental Services
Educational and Training Partnership
Education and Training Voucher
Foster and Adoptive Care Essentials
Foster/Adoptive Parent Association
Foster Care
Foster Care Data Archive
Federal Fiscal Year
Family and Medical Leave Act
Family Services Supervisors Report
Field Training Services Program
Granite State College
Home Based Therapeutic Services
Home and Community-based Care waiver –Medicaid waiver for
Developmentally Delayed population
Head Start State Collaboration Office
Interstate Compact on the Placement of Children
New Hampshire CFSR Statewide Assessment
July 2010
ICWA
IEP
IHS
IL
IMH
ITNA
ISO
JOLT
JPPI
JPPO
LADC
LAMM
MARE
MCAC
MMIS
MOU
NCANDS
NCIC
NCJFCJ
NCWLI
NEACWCD
New HEIGHTS
NHAIMH
NHCFRC
NHCSW
NHCTF
NH – DHHS - ODTS
NHJB
NHRAPP
NH TRAILS
NRCOI
OJJDP
PAR
PATT
PDSA
PIC
PII
PIP
PPT
PSSF
PUR
QA
RCCT
Indian Child Welfare Act
Individual Education Plan
Institute for Human Services
Independent Living
Infant Mental Health
Individual Training Needs Assessment
Individualized Service Option
Juvenile Offender Locator Team
Juvenile Probation and Parole Institute
Juvenile Probation and Parole Officer
Licensed Alcohol and Drug abuse Counselor
Leadership Academy for Middle Managers
Massachusetts Adoption Resource Exchange
Medical Care Advisory Committee
Medicaid Management Information System
Memorandum Of Understanding
National Child Abuse and Neglect Data Systems
Northeast and Caribbean Implementation Center
National Council of Juvenile and Family Court Judges
National Child Welfare Leadership Institute
New England Association of Child Welfare Commissioners and Directors
New Hampshire Empowering Individuals to Get Help Transitioning to
Self-Sufficiency
New Hampshire Association for Infant Mental Health
New Hampshire Child Fatality Review Committee
New Hampshire Commission on the Status of Women
New Hampshire Children‘s Trust Fund
New Hampshire - Department of Health and Human Services Organization Development and Training Services
New Hampshire Judicial Branch
New Hampshire Relatives as Parents Project
New Hampshire Teen Responsibilities and Independent Living Skills
National Resource Center for Organizational Improvement
Office of Juvenile Justice and Delinquency Prevention
Permanency, Adolescent and Resource staff
Project for Adolescent Trauma Treatment
Plan, Do, Study, Act (Part of the Breakthrough Series)
Parents Information Center
Practice Improvement Initiative
Program Improvement Plan
Permanency Planning Team
Promoting Safe and Stable Families
Period Under Review
Quality Assurance
Residential Counselor Core Training
New Hampshire CFSR Statewide Assessment
July 2010
RFP
RJP
RSA
SACWIS
SAMHSA
SB
SCCH
SDM
SERESC
SFI
SFY
SIU
SORT
SPSS/PC
SYSC
TABS
TANF
TFCBT
TPR
UNH
USNH
VKAP
VNA
WFD
WMG
WWK
YAB
Request For Proposals
Realistic Job Preview
Revised Statutes Annotated
Statewide Automated Child Welfare Information System (NH Bridges)
Substance Abuse and Mental Health Services Administration
Senate Bill
St. Charles Children‘s Home
Structured Decision Making
Southeastern Regional Educational Services Cooperative
Strengthening Families Initiative
State Fiscal Year
Special Investigations Unit
State Office Response Team
Special Program for Social Services -software
Sununu Youth Services Center
Temperament and Atypical Behavior Scale
Temporary Assistance for Needy Families
Trauma Focused Cognitive Behavior Therapy
Termination of Parental Rights
University of New Hampshire
University System of New Hampshire
Vermont Kin as Parents
Visiting Nurse Association
Work Force Development Committee
Watch Me Grow
Wendy‘s Wonderful Kids
Youth Advisory Board
New Hampshire CFSR Statewide Assessment
July 2010
Introduction
Introduction
In New Hampshire, two divisions within the Department of Health and Human Services (DHHS)
share statutory and practice responsibility for the safety, permanency and well-being of the state‘s
children and youth. The New Hampshire Division for Children, Youth and Families (DCYF)
and the Division for Juvenile Justice Services (DJJS) experienced ―
CFSR Round 1‖ in April
2003. The CFSR process was instrumental in moving these agencies jointly forward in direct
practice, systemic integration, and collaboration with partners and stakeholders. Through the
analysis of the State Data Profile, agency leaders and managers learned the importance of having
timely, accurate data to evaluate child and family outcomes. This spurred the development and
improvement of quantitative measurement and data driven service enhancement throughout New
Hampshire. Priority efforts have included working closely with residential and community-based
service providers, staff, parents and youth to enhance data collection and outcomes measurement
that drive vital practice changes.
The DCYF and DJJS operate as distinct divisions under the Department of Health and Human
Services (DHHS). However, the divisions collaborate in real and demonstrable ways. For
example, as a result of the 2003 CFSR, both agencies prioritized improvements in permanency
through concurrent planning, specific practice improvements, collaboration with the courts, and
development of our workforce. Results of these efforts have included:
Developing an integrated Case Practice Review process;
Actively sharing training resources and conducting joint planning;
Use of the same case management information system;
An enhanced, shared service array; and
Joint case-planning policy for families involved with both systems.
Leadership views the upcoming CFSR process as a unifying activity that will coalesce all of the
cultural, operational, practice and quality improvement initiatives of the last several years,
bringing our organizations together to achieve an even higher level of performance – from Good
to Great! That theme has been consistent, is echoed by many senior and middle managers, and
permeates day-to-day activities from administration to the field. This introduction will highlight
several key internal and cross-system initiatives, which have enhanced performance in most
CFSR Items, and are described in greater detail throughout the statewide assessment.
1
Geographic Overview
New Hampshire CFSR Statewide Assessment
July 2010
Introduction
New Hampshire is located within the New England Region of the United States. New Hampshire
is a picturesque state, known for beautiful mountains, lakes, and beaches, making tourism a
significant source of revenue and employment. The population density of New Hampshire
increases from the ―
North Country‖ downward and then east to the southeastern-most part of the
state, which borders Massachusetts and the Atlantic Ocean. The state consists of 236
incorporated areas, with the Office of Energy and Planning classifying only 13 as cities; there
also are 10 counties and 221 towns that comprise the Granite State. The majority of New
Hampshire residents are considered to live in rural areas.
Among the 50 states, New Hampshire ranks 44th in land area, 46th in total area, and 41st in
population at 1,324,575. The median household income is $49,467, seventh highest in the
country. Its agricultural outputs are dairy products, nursery stock, cattle, apples and eggs. Other
industries include machinery, electric equipment, rubber and plastic products and tourism.
Concord is the state capital; Manchester is the most populated city, with 107,006 residents
reported by the 2000 census.
Census Data
At the time of the 2000 census, the State of New Hampshire had a total population of 1,235,786
people. Estimates for 2008 reflected a population increase of 6.4% to 1,315,000. Of those
residents calling New Hampshire their primary home, 1,175,083 (95%) identified themselves as
White alone with no Hispanic or Latino heritage. New Hampshire has no federally recognized
Native American Tribes.
The 2000 census reported 307,665 residents were under the age of 18. However, the population
of children in New Hampshire is estimated to have declined since the 2000 census after having
risen 11% from the 1990 census. Population estimates calculated in 2004 from the American
Community Survey estimated 305,153, children with the largest decline being among children
aged 5 to 10 years old. In 2005, minority children accounted for approximately 6.4% of the child
population. Disproportionality in child welfare involvement is an area in which there could be
changes within the state as our minority population continues to increase. Within the State of
New Hampshire, numbers of minority residents have been too low to determine if
disproportionality statistics are significant, but after the 2010 census results are released, it may
be possible to determine if disproportionality is a concern within the state‘s largest cities of
Manchester and Nashua.
2
New Hampshire CFSR Statewide Assessment
July 2010
Introduction
3
New Hampshire CFSR Statewide Assessment
July 2010
Introduction
Child Welfare Structure
New Hampshire DCYF and DJJS are two of several state agencies that operate under the
administration of the New Hampshire Department of Health and Human Services (DHHS), with
the Division Directors reporting directly to the DHHS Commissioner. DCYF is the agency in
New Hampshire mandated to respond to concerns for child maltreatment while DJJS is the
agency mandated to respond to children in need of services (CHINS) and youth adjudicated
delinquent. The level of partnership between these two agencies is unique both within the state
and across the country. This is in large part due to conscientious recognition by leadership, staff,
and providers of the overlapping mandates of the agencies and related best practices for children,
youth and families. The Divisions maintain a shared vision to assist families in the protection,
development, permanency and well-being of their children and the communities in which they
live. The driving force behind the vision is that this will be best accomplished by working
collaboratively with families, providers and stakeholders across New Hampshire to assure timely,
appropriate and quality interventions.
DCYF was created in 1983 under New Hampshire‘s Governor‘s Commission on Crime and
Delinquency. Legislation resulted from the work of this Commission that created an umbrella
state agency to deal with services for children. DCYF was given the authority and responsibility
to provide services for children, youth, and families in areas that address:
Child abuse and neglect
Foster Care
Adoption
Prevention and Community Services
Child Care and Child Development
Head Start
DCYF manages protection, prevention and child development programs on behalf of New
Hampshire‘s children, youth and families. This is accomplished with approximately 370 staff
and an annual budget of $122 million. The agency serves approximately 20,000 children as well
as their families annually. DCYF staff provides a range of family-centered child protective and
community-based services with the overall goal of meeting the needs of parents and children by
strengthening the family system.
DCYF is organized around nine bureaus targeted on designated program and service support
areas that include: Child Protection, Child Development, Head Start, Community and Family
Support, Administrative Operations, Well-Being, Legal Services, Information Systems, and
Organizational Learning and Quality Improvement. DCYF management philosophy is to operate
as ―Bu
reaus without Borders‖ promoting collaborative program design, oversight and quality
improvement. The intent is to minimize organizational ―s
ilos‖ that can have a detrimental effect
on service delivery and improvement. Services are located in the Administrative State Office, one
central intake unit and twelve district offices located throughout New Hampshire‘s 10 counties.
Figure 1 provides an organizational overview of DCYF bureaus and priority program areas.
DCYF programs, services and key initiatives are summarized in Figure 2.
Historically, community-based JPPOs were under the auspice of the municipal courts in New
Hampshire. In 1988, the closure of the municipal courts resulted in juvenile justice services
4
New Hampshire CFSR Statewide Assessment
July 2010
Introduction
being moved to operate under the DHHS/DCYF umbrella. In 2001, juvenile justice services was
founded as a separate and distinct division from DCYF and was named the Division of Juvenile
Justice Services, and the community-based juvenile probation and parole functions combined
with the Department of Youth Development Services (DYDS).
DJJS is responsible for providing supervision and rehabilitative services to youth adjudicated
under state law as delinquent or as children in need of services (CHINS). DJJS maintains
approximately 80 Juvenile Probation and Parole Officers (JPPO) and provides services to 5500
youth and their families annually. DJJS provides supervision, case management, and an array of
rehabilitative services through its staff of JPPOs and a network of community-based providers
who are licensed and/or certified by DHHS. DJJS field staff also work closely with Diversion
programs and community stakeholders to provide preventative services to youth and families.
DJJS administers programs and services in three organizational and functional areas:
Institutional Services: The John H. Sununu Youth Services Center (SYSC) provides
short-term detention services as well as secure residential placement for youth involved
with the New Hampshire court system.
Community Programs: This unit administers community-based services, both residential
and non-residential.
Probation and Parole: This unit conducts investigations and provides supervision of
delinquent youth and CHINS, as well as providing supervision of committed delinquents
released from the John H. Sununu Youth Services Center on parole.
Residential community-based services include; shelter care, general group homes, and
intermediate and intensive level care. The Juvenile Justice Community Program unit is
responsible for the certification of all community-based residential programs used by DJJS. Nonresidential community-based services include youth tracking services, in-home family
counseling, traditional counseling, and transportation. In some areas of the state JPPO staff
collaborate with coalitions and police departments to provide evening supervision of youth.
Figure 3 provides an organizational overview of DJJS and priority program areas. DJJS
programs, services and key initiatives are summarized in Figure 4.
5
New Hampshire CFSR Statewide Assessment
July 2010
Introduction
Division for Children Youth and Families Organizational Chart (figure 1)
Maggie Bishop
Director
Legal Services
Byry Kennedy
Melissa Wardner
Administrative Asst
Support Unit
Robert Boisvert
Administrator
Business Operations
Personnel
Disaster Response
Workforce Development
Bureau Child Protection
Lorraine Bartlett
Child Protection Field Services
Interstate Compact on the Placement of Children
Permanency Program
Bureau Administrative Operations
Dague Clark
Financial Management
Provider Relations
Revenue Enhancement
Reimbursement Unit
Bureau Well-Being
Erica Ungarelli
Mental Health & Developmental Servcies
Adolescent & Foster Care Health Program
5 year Plan
LADAC Program & Domestic Violence Services
DD Waivers
Special Investigations
Bureau Information Systems
Steve DeGiso
NH Bridges
Automated Case Management
SACWIS Compliance
OIT Systems Development
Bureau Child Development
Ellen Wheatley
Child Development Services
Bureau Organizational Learning
& Quality Improvement
Christine Tappan
Staff Training
Foster Care and Adoptive Parent Training
Service Provider Training
Interns
CFSR & Case Practice Reviews
Data & Research
Bureau Community & Family Support Services
Eileen Mullen
Community Prevention Services (Incentive Funds & Family Support)
Foster Care Program
Post Adoption Program/Kinship Care
Certification
Policy & Rules
Central Registry
Bureau Headstart
Debra Nelson
Headstart Collaboration
6
New Hampshire CFSR Statewide Assessment
July 2010
Introduction
Division for Juvenile Justice Services Organizational Chart (figure3)
William W. Fenniman, Jr.
Director
Philip J. Nadeau
Financial Manager
Business Office
DJJS Advisory Group
Program Specialist
Grants
State Advisory Group
Juvenile Parole Board
Doug Beaton
JDAI Coordinator
Program Specialist IV
Luanne Blais
Administrative Asst. I
Secretarial Support
Eric Borrin
Manager of Field Services
& Quality Improvement
Sandra Ziegra
Sr. Assistant Administrator
Conway DO
David Ball
Assistant Administrator
Concord DO
Michael O'Connor
Assistant Administrator
Littleton DO
Laconia DO
Manchester DO
Claremont DO
Portsmouth DO
Nashua DO
Keene DO
Switchboard
Jeffrey Nelson
Manager of Residential Services
(Facility Administrator)
Philip Nadeau
Permanency Administrator
Medical
Annette Wood
JPPO IV (Parole Board)
Education
Richard Neilsen
Jail Compliance Monitor
Maintenance
Performance Based
Standards
Food Services
Facility Supervisor (3)
Residential Supervisors (2)
Safety and
Security
Classification
Internal Affairs
Hearings
Unit Supervision
Residential Bureau Chief
Residential Units
Clinical
Legislative Liaison
Quality Improvement
& Training
Rochester DO
Interstate Compact
Salem DO
Berlin DO
7
New Hampshire CFSR Statewide Assessment
July 2010
Introduction
Division for Children, Youth & Families
Bureaus, Functions and Key Initiatives
Figure 2
DCYF Bureau
Business
Operations
Child
Protection
Function
Key Initiatives
Workforce Development
Realistic Job Preview (video)
Structured Interviewing
Personnel and Workforce
Development, Disaster Response
Staff Development
Planning.
Mentoring/Advanced
Mentoring
Breakthrough Series
Structured Decision Making
Permanency Program
Permanency Planning
Child Protection Field Services
Teams (PPT)
including Central Intake, Assessment,
Permanency Adolescent
Family Services, Interstate Compact,
and Resource (PAR) worker
Permanency Program.
meetings
Model Court
Frameworks for Collaboration
Budget development, Revenue
enhancement, Parental
reimbursement, Provider relations,
Cost containment. Monitoring
Administrative
including, Collecting, reporting,
Operations
analyzing data
Data analysis and quality
improvement
Residential Care
Prevention Programs
Procurement including services,
supplies, providers, staff, and invoices
Child care scholarship reimbursement,
Customer service to child care
Child
providers and parents, management of
Development child care resource and referral
network
Quality enhancement initiatives
throughout the state, assures
compliance with federal
regulations
8
New Hampshire CFSR Statewide Assessment
July 2010
Introduction
DCYF Bureau
Function
Comprehensive Family Support assists
families through community agencies by
promoting family wellness, decreasing
family stress, and preventing abuse and
neglect. Certification of service providers.
Policy and Rules program supporting field
practice.
Community
and Family
Central Registry - Centralized confidential
Support
listing of perpetrators of abuse/neglect.
Adoption recruitment and subsidy work.
Resource Workers include foster
care/adoptive & post-adopt work. Relative
Care support services.
Head Start
Head Start - Children age birth to three,
toddlers, and preschool age children, and
their parents. Priorities include health
care, child welfare, education, community
services, family literacy services, children
with disabilities, children/families who are
homeless, professional development,
systems building/state policy
development.
Maintains and administers statewide
automated child welfare information
system (SACWIS), and related web billing
applications that include five modules
(workload, resources, claims, training, and
DJJS). Develops detailed business
Information
requirements for applications. Produces
Systems
data reports for National Child Abuse and
Neglect Data System (NCANDS) and
Adoption and Foster Care Analysis
Reporting System (AFCARS).
Key Initiatives
Individual Service Option (ISO)
programs
Pilot transportation program
Watch Me Grow Pilot
Comprehensive Family
Support Program
DCYF flexible funds for gas
cards, grocery cards, bus
passes and car repair
assistance for families to assist
in facilitating reunification by
removing transportation
barriers
Family Resource Centers,
statewide PAR (Permanency,
Adolescent & Resource
Worker) monthly meetings
Watch Me Grow Pilot
Strengthening Families
Continuous Quality
Improvement through the use
of data reports
Expanded use and flexibility of
Bridges
Training Module
9
New Hampshire CFSR Statewide Assessment
July 2010
Introduction
DCYF Bureau
Function
Child and Family Service Reviews,
monthly supervisory reports and specialty
data reports.
Creating and Supporting the
workforce
Competency Based training
Workforce Development Group
Council on Organizational
Learning
Mentoring/Advanced
Mentoring
Practice reports to
administrators and field
supervisors
Case Practice Reviews that
mirror CFSR On-Site Review
Tool and QA process
Adolescent Programs Youth Advisory
Board (YAB), Permanency, Project First
Step Program, Domestic Violence
program, Foster Care Health Program,
Special Investigations Unit that
investigates incidents of abuse/neglect for
children in out-of-home care (e.g. facilities,
foster homes, etc), Mental Health &
Developmental Services, DD Waivers
Accelerated Reunification
Model
Health Plan
Foster Care Health
Advisory Committee
Medicaid Data
Youth Advisory Board
PAR Meetings (Permanency,
Adolescent & Resource
Worker) monthly meetings
Core, Specialized and Advanced Staff
Training; Mentoring and Advanced
Mentoring; Student intern programs,
including IVE. Training for foster/adoptive
parents, relative care givers, residential
providers, CASA
Organizational
Learning &
Case Practice Reviews monitoring
Quality
outcomes and driving new practice
Improvement
initiatives
Well-Being
Legal
Services
Key Initiatives
Track legislation, attend public hearings
and report to administration
Staff attorneys in the field offices
provide legal representation in
abuse/neglect court proceedings,
offering legal services at each
point in court processes
Collaboration with CIP, Model
Court
10
Figure 4
DJJS Bureau
New Hampshire CFSR Statewide Assessment
July 2010
Introduction
Function
The John H. Sununu Youth Services
Center (SYSC) provides short-term
Institutional
detention services as well as secure
Services
residential placement for youth involved
with the New Hampshire court system.
Key Initiatives
Risk Needs Assessmentfocusing on critical decision
making points and improving
effectiveness of child protection
interventions through
increasing decision making
consistency, targeting
resources
Comprehensive rehabilitative
treatment programs
This unit administers community-based
services, both residential and nonCommunity
residential.
Programs
Risk Needs Assessment
Targeting resources
Permanency Protocols
Model Court
Framework for Collaboration
Community Supervision
Conducts investigations and provides
supervision of delinquent youth and
CHINS, as well as providing supervision of
Probation
committed delinquents released from the
and Parole
John H. Sununu Youth Services Center on
parole.
Risk Needs Assessment
Targeting resources
Permanency Protocols
Model Court Protocols
Framework for Collaboration
Community Supervision
11
Court Structure
New Hampshire CFSR Statewide Assessment
July 2010
Introduction
In order to fully see the context in which child welfare and juvenile justice services are delivered in New
Hampshire, it is critical to understand the court structure and judicial environment. In 2004, legislation
was signed into law to consolidate jurisdiction for all family-related matters, which had been handled in
the Superior, District and Probate Courts, into a single statewide Judicial Branch Family Division. There
are currently 24 Family Division locations in nine counties in New Hampshire that deal with matters
impacting families. The Family Division has jurisdiction to hear cases involving divorce, parenting
disputes, child support, domestic violence, termination of parental rights, child abuse and neglect, child in
need of services, delinquencies, and adoptions. There are currently 10 full-time judges, 9 full-time marital
masters and 10 part-time judges who work regularly in the Family Division. Approximately 1000 children per
year are alleged, in court records, to be victims of abuse or neglect.
Cases involving minors are handled in Family Division and District Courts.
Three types of cases involve minors:
Delinquency: A juvenile delinquent is a person under age 17 who has done something that would
be a crime if committed by an adult.
Child in Need of Services (CHINS): Children under age 18 who repeatedly refuse to attend
school, run away from home, or are found uncontrollable.
Neglected and abused children: Children under age 18 who have not been provided with proper
care, supervision, or financial support, or who have been sexually, physically or psychologically
abused.
In New Hampshire an out-of-home placement requires a court order. This court action was identified in
2003 as a barrier to permanency due to timeframes for hearings and the court‘s lack of focus on
permanency issues.
CASA volunteers are the court appointed guardian ad litem for most child protection cases. In New
Hampshire, CASA is a private, non-profit organization that is responsible for advocating for the best
interests of the child in child welfare and juvenile court matters.
Court and Agency Collaboration
The New Hampshire District Court, Family Division, Probate Court and Superior Court, as well as DCYF
and representatives from the New Hampshire Bar, Legislature, CASA, Judicial Council, law enforcement
and the Attorney General‘s Office continue to partner in addressing solutions to child safety, permanency
and well-being when families are involved in the Court system because of child abuse or neglect, child
delinquency or status offenses.
DCYF and DJJS partnered with the court on two specific statute changes, the creation of Voluntary
Mediated Adoptions and the inclusion of a Permanency Statute to assure improved outcomes for children
who enter out-of-home placement. Through assistance of the New Hampshire Court Improvement
Project, protocols have been created and adopted by courts and statutes changed to assure that children
and youth have timely permanency and that the court barriers identified in 2003 were addressed.
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New Hampshire CFSR Statewide Assessment
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Introduction
Court Improvement Project
In New Hampshire, DCYF and the Court Improvement Project (CIP) Coordinator have maintained
meaningful, ongoing collaborations that have clearly resulted in each system being able to successfully
identify and work toward shared goals and activities. New Hampshire engages in multidisciplinary work
to plan and carry out cross-system training. Through this collaboration we have created the ability and the
structure to provide ongoing training across the state, as needed, to assure that future staff within any
system receive training on the court guide.
There are and have been many joint statewide learning opportunities and program initiatives that are
based on the collaborative efforts of DCYF and the CIP, including grant applications and strategic plans.
In New Hampshire there is a true partnership between DCYF and the CIP Coordinator that has resulted in
improved practices and improved relationships between DJJS and DCYF Directors and the courts. These
relationships have enhanced current initiatives and program activities by assuring a continued
commitment to permanency for children and families.
The Protocols Relative to Abuse and Neglect Cases and Permanency Planning were made possible
through a federal grant received by the New Hampshire Administrative Office of the Courts from the
United States Administration for Children and Families. This exciting grant opportunity allowed the New
Hampshire District Court to develop and oversee the Court Improvement Project (CIP). In addition to
solution-based collaboration among the key partners listed above, foster parents and service providers
also contributed to this endeavor.
In 2007 the Court Improvement Project received a grant to improve data collection and outcome
measurement. The DCYF Director, Director of CASA and Bureau of Quality Improvement (BQI)
Administrator worked collaboratively with CIP staff to develop performance indicators related to the
timeliness of court hearings.
In 2008, the CIP Coordinator established a large multidisciplinary committee to develop protocols for use
in cases that involve CHINS and delinquents. That committee included participation by four Family
Division and District Court judges as well as a Family Division Administrator, the Director,
Administrator, Assistant Administrator and Permanency Specialist from DJJS, three attorneys from the
New Hampshire Bar and DCYF‘s Director, Legal Counsel, Administrator, Permanency Specialist and a
field attorney.
Permanency Legislation
Our more recent goals and activities have clearly been aimed at addressing New Hampshire‘s
commitment to permanency and the comprehensive legislative changes that became law on January 1,
2008. There is a true appreciation for the fact that the Federal CFSR process is a review of not only the
child welfare agency, but of New Hampshire.
Both the DCYF and DJJS Directors participated with New Hampshire State Supreme Court Judge
Broderick to establish a Permanency Committee. This committee reviewed timelines for court hearings
in both child protection and juvenile justice cases in Family/District /Probate courts appeals and legal
aspects of adoption, to ensure New Hampshire practices are in compliance with ASFA mandates. Judge
Edwin Kelly, of the New Hampshire Administrative Office of the Courts, and the two agency Directors
committed to address specific objectives related to timelines. The biggest accomplishment was the
commitment of both the Chief Justice and the Administrative Judge to make the Court Improvement
Protocols mandatory, which has helped to assure timely adjudicatory hearings and improved permanency
outcomes. In addition, this committee collaborated on putting forth permanency legislation.
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New Hampshire CFSR Statewide Assessment
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Introduction
Model Court Project
In July 2008, the CIP‘s Coordinator was asked by the supervisory judge of the Concord Family Division
to develop and submit an application to the National Council of Juvenile and Family Court Judges for two
courts, Concord and Franklin Family Divisions, to become Model Courts. The application resulted in
New Hampshire being selected in August 2008 to become a Model Court site.
Work began in October of 2008 by a committee made up of stakeholders in Merrimack County, which
convened to develop new protocols for termination of parental rights and adoption. Parents‘ attorneys
and CASA have also collaborated on the Model Court Project and been active members of the
subcommittees working on the new protocols for TPR and Adoption. Their voices have been essential in
the discussions of more timely permanency outcomes. Mental health providers and educators have also
been represented on the Model Court Committee.
Draft protocols went into effect in the Model Court sites in May of 2010 following training for
stakeholders in Merrimack County.
Permanency MOU
A major change has been the requirement for permanency hearings and concurrent planning in DJJS
cases. In 2008, the Court Improvement Coordinator established a large multidisciplinary committee to
develop protocols for use in cases that involve CHINS and Delinquents. This committee included four
judges, as well as the Directors and Administrators from DJJS and DCYF. A DJJS Permanency
Administrator position was created to ensure permanency standards and timeframes are met within DJJS.
In 2009, the Directors of DJJS and DCYF signed a Memorandum of Understanding between the two
Divisions that provides for an active collaboration of the Divisions in permanency planning. The
involvement of the PPT‘s in all DJJS cases where the goal is something other than reunification is
available and strongly encouraged. Each DJJS office participated in training for staff regarding the
Memorandum of Understanding guidelines and some DCYF staff attended to support this collaborative
effort.
Ongoing CIP, DCYF and CASA Collaboration
The CIP‘s Coordinator has a strong working relationship with DCYF and CASA and throughout 2008
had regular meetings with representatives from both organizations. This resulted in the identification of a
need to bring together DCYF and CASA to discuss each system‘s roles and expectations, as well as issues
related to visitation. The result was an important collaboration by the CIP, DCYF and CASA on a oneday Summit held for seventy-five staff from DCYF and CASA staff and guardians ad litem. The Summit
was led by DCYF‘s Director and CASA‘s Executive Director and resulted in overwhelmingly positive
evaluations. Another Summit of a similar scope was held in February 2010.
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New Hampshire CFSR Statewide Assessment
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Introduction
VISION & COMMITMENTS
Since the CFSR in 2003, the two Divisions have accomplished a significant, multi-faceted cultural shift in
organizational leadership, management, and practice. The agencies have successfully implemented
several major initiatives relating to safety, permanency and well-being that have included rapid and
substantive changes in both internal operations and practice in the field. Additionally, considerable
efforts have been put forth to recruit, retain and prepare a competent and skilled cadre of staff, caregivers
and providers. In an effort to evolve towards a learning organization, staff at all organizational levels,
providers, families and youth have been highly involved in these profound and continuous efforts.
The leadership within DCYF and DJJS have clearly articulated a vision that at its core nurtures and
cherishes children, youth, families and their communities. Both DCYF and DJJS identify as their priority
a unified effort to ensure that children and youth involved with either system receive priority attention
through cross-system efforts. Both Division‘s leadership credit their focus and commitment to
relationship building, transparency and assuring that they function as learning organizations for the
successful transformation that has taken place over the past five years. This transformation may not be
obvious from the outside looking in; therefore, this statewide assessment provides an opportunity to
broadcast the collaborative work, culture shift, and practice improvements that New Hampshire has
undertaken.
Our work with families, the courts, public and private agencies, faith-based organizations, elected
officials, businesses and community advocates, is part of an intentional effort to truly transform practice.
In order to identify priorities, target resources, and redesign the way in which services are delivered in
New Hampshire we knew we could not do it alone. We are proud of the work that is going into
establishing cross-system relationships and activities that promote a common vision and mission.
The Directors of both DCYF and DJJS are committed to a deliberate partnership to engage
simultaneously in ongoing practice improvements. This is illustrated by the creation of a Permanency
Administrator for Juvenile Justice mirroring an operational function within DCYF. Additionally, both
DCYF and DJJS maintain administrative staff for quality improvement and training. Individuals in these
positions have developed a collaborative, team approach and are dedicated to strengthening these
partnerships to move both agencies forward.
Each Division‘s leadership has been committed to human service endeavors that require continuous selfassessment, critical review, and adaptation to new methods of best practice, legal mandates, and collective
social need. They share a strategic plan that provides the direction and focus needed to move practice and
policy in a purposeful and positive direction.
In particular, over the last five years, both Divisions have identified permanency planning as equally
critical in child welfare and juvenile justice because nationally too many children fall through the cracks
of each system. In the absence of focused planning, many children have and will continue to spend their
entire lives without permanent connections, experiencing inconsistent and changing placement settings,
and constantly moving to new schools and communities. While children may enter placement for a
variety of reasons, they sometimes end up staying longer than necessary due to inefficiencies in the
system. New Hampshire is steadfastly committed to a cultural shift that emphasizes permanency planning
across both juvenile justice and child protection.
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New Hampshire CFSR Statewide Assessment
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Introduction
DCYF is proud to have a juvenile justice partner that truly understands and values the need for
permanency and has created a systemic vision intent on maximizing the benefits for youth, families, staff
and communities. Initiating quality permanency work in juvenile justice required an extensive paradigm
shift in the way staff do business. The focus historically has been on the juveniles themselves.
Permanency planning in New Hampshire now allows the opportunity for a broader look at the entire
family unit to achieve better and more long-term outcomes through facilitated and planned treatment and
services. The ultimate focus must be on life-long connections. We know our system needs to assure that
every youth has at least one healthy connection to count on when transitioning out of state care. We want
and accept nothing less for our youth.
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New Hampshire CFSR Statewide Assessment
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Introduction
KEY INITIATIVES: SYSTEMIC & CROSS-SYSTEM
New Hampshire DCYF and DJJS have engaged in several key ―s
ystemic‖ (internal) and ―Cros
s-system‖
initiatives intended to respond to findings from the last CFSR. The following sections will describe these
initiatives, highlighting the major intention and accomplishments in each area.
SYSTEMIC INITIATIVES
Establishing the Culture
In order to accomplish the agencies‘ missions, goals set forth after the last CFSR, and evolving legal
mandates, while pursuing excellence in practice, DCYF and DJJS have undertaken a significant
organizational culture shift. As mentioned previously the values of transparency, collaboration and
integration of service design, delivery and evaluation have become the hallmarks of our cultural
―r
/evolution‖. These values have led to substantive shifts in the way we do business, including how staff
view their role with families, communities and co-workers, their openness to change, and expectations for
learning and leadership. Partnership now defines the daily modus operandi and drives all elements of
practice. There is a primacy to involving the voice of youth, parents and relatives in all aspects of agency
operations including training, policy development, and practice improvement.
Maintaining Transparency in a public bureaucracy is particularly challenging due to a variety of factors,
but it is essential to the foundations of a parallel process of honest engagement with families. Over the
last several years, DCYF and DJJS have enhanced organizational transparency by speaking openly about
potential practice, policy and legal changes before decisions have been made. This has included intensive
dialogue with staff at all levels of the organization and stakeholders, including parents, youth, relative
caregivers, foster/adoptive parents, provider partners and extended constituencies. A few examples of
this include: the New England Breakthrough Series on Risk & Safety, the Framework for Collaboration,
the second annual CASA/DCYF Summit, the Youth Advisory Board (YAB), the Model Court Project and
the Council on Organizational Learning (CoOL). In each of these efforts, preparation, planning and
transformation have been done collaboratively, with ―
joined‖ leadership, facilitation and decisionmaking. Although time intensive, the results have proven that a collaborative, transparent, and integrative
approach is fruitful both in the product developed and the relationships made or enhanced.
Enhancing the Workforce and Learning
DCYF and DJJS believe that well educated employees, caregivers and providers deliver higher quality,
more efficient, effective and proactive services to children and their families, which support the
department‘s mission and guiding principles. The DCYF Bureau of Organizational Learning & Quality
Improvement (BOLQI), previously known as the Bureau of Staff Development & Training, is responsible
for leading and providing an array of learning opportunities for DCYF/DJJS staff, foster and adoptive
parents, relative caregivers, CASA staff and volunteers, residential staff, and providers. Additionally, the
BOLQI leads the Council on Organizational Learning (CoOL) and co-leads, with the Business Operations
Administrator, the DCYF Workforce Development Committee.
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New Hampshire CFSR Statewide Assessment
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Introduction
During the 2003 CFSR, the staff development and training program for DCYF employees, foster/adoptive
parents and relevant community stakeholders, was deemed a strength. Given the agency mindset however,
of always striving to enhance practice through learning, the BOLQI has put forth numerous efforts to
ensure the staff recruitment, training and organizational development process kept pace with the vision,
mission and practice of the agency. This has included the BOLQI leading agency efforts to establish a
―l
earning organization‖ culture built on Senge‘s five disciplines of: Systems Thinking, Shared Visioning,
Mental Models, Team Learning and Personal Mastery, and emphasizing that learning is valuable,
continual and most effective when shared.
Additionally, research has clearly proven that recruiting, retaining and developing a quality workforce is
critical to positive outcomes for children, youth and families in child welfare and juvenile justice.
Therefore, in 2005, DCYF created a Workforce Development Committee (WFD) to lead, implement and
monitor workforce initiatives. Since its inception in 2005, the WFD, comprised of CPSW, supervisory,
administrative, fiscal, and staff training representatives, has worked determinedly to design and
implement cutting edge workforce strategies. These strategies are intended to promote excellence in staff
training and performance from the moment an individual engages in the hiring process throughout their
career through program design and evaluation, and include:
extensive student internship opportunities throughout the agency, including the IVE funded
Education & Training Partnerships with two USNH schools,
a Realistic Job Preview (RJP) for individuals interested in becoming CPSWs,
implementation of a Structured Hiring Process for CPSWs,
operation of Competency-Based training system,
mentoring for new and seasoned employees,
extensive opportunities for advanced training,
employee Exit interviews and questionnaires that are used for program improvement, and
a statewide advisory council (CoOL) to support the mission of promoting a learning
organization culture throughout child welfare and juvenile justice in New Hampshire.
Of the above initiatives, perhaps most significant has been adjusting the current system to operate as a
true Competency-Based Training program (CBT) and curriculum, with a heavy emphasis on skill
building. Training is sequential, building theory, practice and skill as appropriate for each employee
(workers and supervisors). Using a competency-based model from the Institute of Human Services,
DCYF developed and implemented a new Core Training Academy for new workers and a Supervisory
Core training series, which has run consistently since 2005.
Proven in the literature to be critically important to prepare and retain staff has been the process of
mentoring. DCYF initiated a mentoring program for all new staff in 2000 and has continued this program
to the present with great success. In 2009, DCYF added a mentoring program for seasoned staff –
Advanced Mentoring.
The Advanced Mentoring Program has been modeled after an evidence-based mentoring program
developed by the Connecticut Department of Children and Families (DCF), in conjunction with Fordham
University. The ambitious goals of the program include opportunities to improve organizational
understanding, build leadership capacity, increase retention of quality employees and enhance
professional navigation within DCYF and the community. Through a structured application process,
employees are matched with mentors who have been quality employees for 10 years or more. A Team
Leader who is a member of the agency‘s Workforce Development Committee supports each match.
The Advanced Mentoring Program is a significant partnership between mentors and mentees with a focus
on interpersonal support, guidance, sharing of ideas and, expertise, and role modeling. Program outcomes
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New Hampshire CFSR Statewide Assessment
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Introduction
include a broader understanding of the mission of the agency, exposure to different departmental
programs, opportunities to demonstrate best practice, increased professional development through
participation in projects and presentations, and enhanced awareness of management styles in various
settings. The first group of mentees is targeted for graduation in November 2010.
Enhancements in Field Practice and Service Delivery
Safety, Risk and Needs Assessment
Since the last CFSR, both DCYF and DJJS have engaged in intense efforts to enhance operational and
practice processes that ensure thorough and consistent safety, risk and needs assessments are done
throughout service delivery. Utilizing technical assistance, DCYF implemented Structured Decision
Making (SDM) in December 2001 in the Intake and Assessment program areas. DCYF expanded SDM
to the Family Services area in March 2002. SDM includes a set of research-based tools designed to
identify safety and risk factors, which guide staff at critical service decision points. SDM can improve the
effectiveness of child protection interventions by:
Focusing on critical decision points
Increasing the consistency and validity of decision-making
Targeting resources to families at highest risk
Improving the effectiveness of child protection interventions
SDM reduces ambiguity by providing consistent, reliable information and a clearly defined methodology
for making decisions related to the safety, permanency, and well-being of children. After implementation,
representatives from each district office formed a CORE team to share information and resolve barriers to
effective use. All staff were trained in the use of SDM, and training continues for new staff. While the
CORE team is no longer meeting regularly, DCYF field staff continue to be involved in the refinement
and implementation of SDM through discussions at leadership meetings, and through an
Intake/Assessment workgroup, and a Family Service workgroup.
To monitor implementation, the SDM supervisory case read process was established in October 2004.
BQI (now BOLQI) randomly selects one case or assessment per worker per month in each district office.
Supervisors use the Case Reading tools on each of the selected cases and assessments to ensure the
workers are using the SDM tools correctly. For several years, completed Case Reading tools were
returned to BQI staff for aggregate analysis and reporting. In addition, BQI coordinated, with members of
the SDM Core Team and the respective CPS assistant administrator, a periodic, random quality check of
the supervisor‘s case read to ensure consistent and correct use of the SDM tools by supervisors across the
state. BQI, the Core Team members and the CPS assistant administrator then met with the district office
supervisors to review findings and identify remediation, if needed. This process is now being integrated
into the ongoing monitoring of district offices.
Since the last CFSR, DJJS has also undertaken a process of enhancing safety and risk, as well as needs
assessment. In 2003, DJJS selected and implemented statewide a Risk/Needs Assessment Tool. This
evidence-based tool is designed to assess the safety and risk factors of each youth and family enabling
staff to make more timely and effective decisions about safety, permanency and well-being. Additionally,
DJJS developed the Community Supervision Plan.
The ―Ri
sk/Needs Assessment‖completed by the JPPO uses the Community Supervision Plan to determine
the needs and expectations of the juvenile and family and to identify protections for the community. The
youth also uses this plan as a guide to assure successful completion of ―Cond
itional Release‖. It provides
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New Hampshire CFSR Statewide Assessment
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Introduction
confidential information to parents/caregivers to help ensure safety, permanency and well-being for the
youth.
DJJS believes that the safety of the youth, family and the community are the most important concerns of
the Division for Juvenile Justice Services. Court ordered interventions and services are utilized and
documented to address supervision and safety concerns.
Prevention Programs
New Hampshire child welfare and public policy makers have expanded the traditional mission and
mandates of a public child welfare agency. This unified voice has allowed DCYF to continue to engage
in projects and initiatives that expand the typical roles of child welfare agencies and move it towards a
―f
ront door approach‖ to providing prevention and intervention services to reduce the number of children
in out-of-home placement.
New Hampshire has made a commitment to reduce the number of children in out-of-home care. We
recognize that in an effort to reduce the number of children in foster care placement, services have to be
available to all families in their home communities. Services have to be primary prevention and wellness
focused and available to all families to either prevent or forestall child protective intervention services. If
placement services are necessitated, then family reunification efforts are rapid, timely, and time limited.
Comprehensive Family Support
Since 2005 contracts have been awarded for statewide comprehensive family support programs covering
all twelve district office catchment areas. Through the Comprehensive Family Support Program, DCYF
contracts with community-based agencies to provide support services to approximately 500 families
annually. The programs assist families and children by promoting family wellness, decreasing family
stress, and preventing abuse and neglect. The social service agencies identify and assist families with
multiple stressors by providing multivariate services that encourage and promote the development of
healthy families.
Strengthening Families Through Early Childhood Education
Developed by the Center for the Study of Social Policy (CSSP), Strengthening Families is an approach to
preventing child abuse and neglect through building five Protective Factors in families: parental
resilience, social connections, knowledge of parenting and child development, concrete support in times
of need, and children‘s social and emotional development. Research shows that these factors reduce the
incidence of child abuse and neglect by providing parents with what they need to parent effectively, even
under stress. By building relationships with families, programs can recognize signs of stress and build
families‘ protective factors with timely, effective help.
In 2005, the CSSP designated New Hampshire as one of the seven states in the country for its
Strengthening Families Initiative (SFI). Designated as the lead agency, DCYF has partnered with the New
Hampshire Children‘s Trust Fund (NHCTF) in building protective factors for New Hampshire‘s families,
thus promoting the safety and well-being of children in their homes and reducing incidents of child abuse
and neglect. Some of the approaches New Hampshire is currently using to achieve its mission are to:
Incorporate Protective Factors curriculum into collegiate and advanced learning early
childhood education courses
Provide training and technical assistance on Strengthening Families and Self-Assessment to
childcare programs through the Childcare Resource and Referral Network‘s contract with
DCYF
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New Hampshire CFSR Statewide Assessment
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Introduction
Add Strengthening Families models to the Bureau of Child Development Professional
Development System
Participate in the Zero to Three‘s State Partnerships for Prevention
New Hampshire has designated twenty-seven childcare centers, which, combined, serve 21% of the
children receiving Child Care Scholarship (CCDF Subsidy), to be Strengthening Families Centers. These
programs will build protective factors for enrolled families.
DCYF supports the New Hampshire Association for Infant Mental Health (IMH) and regional Early
Childhood Mental Health Teams. The New Hampshire Association for Infant Mental Health (NHAIMH)
is an organization comprised of professionals in the field of infant mental health, community providers,
and representatives of partnering programs and family support and advocacy organizations. Infant mental
health addresses all systems of development for children birth to six years, emphasizing the interaction of
factors that affect social/emotional health and development. The organization‘s mission is to identify and
disseminate information, research, and best practices that promote interdisciplinary efforts on a
community level in order to strengthen relationships in families with infants and young children.
NHAIMH supports public policy initiatives that promote positive child outcomes and enhance continuity
of care for children and families throughout the early years.
Focus on Permanency: Making and Sustaining Change
DCYF has responded to the many challenges in the area of permanency noted in the 2003 CFSR. The
approach was to ―hi
t it from all sides‖ with a comprehensive set of initiatives and programs. Many of
these initiatives will be described in more detail later in this document. Some highlights include:
Specialized Permanency and Adolescent CPSWs in each district office
Implementation of Permanency Planning Teams (PPT)
Implementation of ―Fi
nding Connections‖ in each district office
Development of a Relative Care Specialist position
Implementation of the Accelerated Reunification Model (ARM)
Legislative changes: Mediated Adoptions
Legislative changes: timely permanency
Improved use of SACWIS data to monitor case outcomes and PPT meetings
Evaluation of residential programs through treatment plan driven outcomes
Collaboration with community and residential service providers
With regard to service delivery, DCYF and DJJS have undergone substantial changes over the past five
years. Changes in DCYF practice are notable, and have had a significant impact on the attainment of
timely permanency, while not dramatically increasing re-entries into foster care. Within DJJS the culture
shift is in process as the agency embraces the reality that the ultimate goal for all agencies must be to
create specific planning and practices that will assure all children, regardless of which system maintains
case management, achieve timely permanency.
The Permanency CPSW
Prior to 2003, Family Services CPSWs traditionally focused on working with birth parents and
reunification plans, Foster Care CPSWs located, evaluated and supported foster families, Teen
Independent Living workers created adult living plans, and Adoption CPSWs worked with children and
adoptive families following the termination of parental rights. Real, efficient and effective concurrent
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New Hampshire CFSR Statewide Assessment
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Introduction
planning and permanency practice demanded a different organizational model and realignment of
resources.
DCYF was committed to breaking down the boundaries among Child Protection, Foster Care,
Independent Living and Adoption CPSWs and, as its first step, was able to acquire additional staff. In
2003, a new position of Permanency CPSW was created in each district office along with an Adolescent
CPSW, both of which were additions to the existing Family Services and Foster Care licensing staff.
Permanency workers function as a resource to staff in the district offices in all matters pertaining to
permanency. Carrying reduced caseloads, Permanency CPSWs are available to consult with staff, to meet
with families and to facilitate Permanency Planning Team meetings (PPT). The DCYF Permanency
Program Specialist is responsible for oversight of the program with direct supervision being provided by a
District Office Supervisor or Assistant Supervisor. In line with our joint mission, in 2008 DJJS also
added a Permanency Administrator.
Permanency Planning Teams
Beginning in 2005, Permanency Planning Teams (PPT) were established in each district office. Each
PPT is comprised of the same core group of staff: the Permanency CPSW, Adolescent CPSW, Foster
Care Worker, Administrative Case Reviewer and supervisor. Other PPT participants, depending on the
case, could include the Foster Care Health Program nurse, other specialists such as the Domestic Violence
Specialist (DVS), the Licensed Alcohol and Drug Counselor (LADC), the Connection Specialist and/or
the Juvenile Probation and Parole Officer (JPPO). The strength of the PPT is derived from the ongoing
consultation and cooperative case planning among the team members and the case‘s primary CPSW.
Both DCYF and DJJS have implemented the use of Permanency Planning Teams (PPT) and have worked
collaboratively with the courts and residential providers to focus on timely permanency. Data from the
Foster Care Data Archive show substantial improvements in both length of stay and placement with
relatives in more recent entry cohorts.
The Adolescent Worker
The Adolescent Program is designed to ensure that current and former DCYF and DJJS youth obtain the
preparation, resources, and positive youth development they need to establish permanent connections and
become healthy, self-sufficient, and successful adults. During the past five years (2004-2009) the
Adolescent Program has steadily increased its effectiveness in meeting the needs of current and former
youth in care. Most significant to this evolution has been the growth and development of the Adolescent
Worker position, created in 2003.
The Adolescent Workers use their specialized training to lead, educate and collaborate with youth,
colleagues and the community to ensure best practice on the local level for adolescents. They are leaders,
consultants and resource specialists when it comes to DCYF‘s work with adolescents. The group has
established a mission statement as well as specific roles and responsibilities. In addition to carrying an
adolescent caseload, they are active members in their office Permanency Planning Team (PPT) and their
local youth vision teams. They assist in the coordination of the DCYF Youth Advisory Board, the DCYF
Teen Conference and the creation of youth-in-care panels for new foster/adoptive parents.
Implementation of Finding Connections
Soon after creating a permanency and adolescent focus at the local district offices DCYF partnered with a
private agency provider to create a program option targeted on finding connections for children and youth
in placement. Through an internal review of all children and youth in care New Hampshire identified a
number of youth who were remaining in residential care because ―t
hey were doing well‖. This led to an
intensive effort to transition every child in residential care to a family setting if they had been succeeding
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New Hampshire CFSR Statewide Assessment
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Introduction
in residential services. Consequently, a need to establish connections for some children who did not have
available family resources followed.
The contract established was subsequently enhanced to include the capacity for ―c
ase mining‖ in
instances where youth connections were lost or forgotten while they were in care. The Connection
Specialist established an expertise in researching a child‘s case file (case mining) to identify relatives and
other supports, and he/she works collaboratively with the child‘s caseworker and Permanency Planning
Team (PPT) to identify positive resources for the child. As the agency has worked towards breaking
down barriers to permanency, this new collaborative effort has elicited optimism in helping to reach
permanency goals for children in care.
The Finding Connections Program was implemented in all of the district offices by September 2007.
Each office received focused training related to the need for connections in every child/youth‘s life and
specific information about the Finding Connections Program, the Connections Specialist‘s role, referrals
and the case planning process.
Initial results from SFY 08 were very positive. Sixty-five percent of cases serviced by the Connection
Specialist had at least one ―
new adult‖ located. Further, 86% of those cases had ―i
ncreased face-to-face‖
contact with their adult connections. The performance indicators of greatest significance were linked to
the ―
APPLA‖ permanency plan cases. The success of this initiative reinforces the importance of relatives
and other community supports in all aspects of case practice.
With the success of the Finding Connections Program, this initiative has been moved to the front door.
Children entering care with no relative or natural resources identified are now referred immediately to a
Connections Specialist to assist in quickly locating connections. Overall, the program has had a major
impact on decreasing reliance on foster care, supporting children leaving care sooner or moving toward
another permanent goal. The premise is that children are more likely to remain stable with caregivers that
have a pre-existing relationship. This proved true as placements seldom disrupted, resulting in fewer
children moved to group or residential care.
The Relative Care Program
In an ongoing effort to support kinship placements, DCYF hired a part-time Relative Care Specialist in
April 2008.
The role of the Relative Care Specialist is to:
develop knowledge of all relative and community services available in New Hampshire and
develop a database of DCYF relative care providers,
create and assist relatives to complete a ―ne
eds assessment‖ of relative care in New Hampshire,
develop a newsletter specifically targeted toward relative care, and
revise and keep current the DCYF Relative Care policy
As a result of a collaborative effort with NHRAPP (Relatives as Parents Project), New Hampshire‘s first
annual Kinship Conference took place in October 2008. A second conference occurred in October 2009
in Lebanon, New Hampshire in collaboration with Vermont Kin as Parents (VKAP).
Accelerated Reunification Model
In New Hampshire we have made concerted efforts to improve our practice at the ―f
ront door‖ especially
in court-involved cases. Child protection in New Hampshire has traditionally been a litigious process.
Consequently, a majority of staff time upon entry of a family into the child protection system has been
focused on the legal process. This means staff may be wasting valuable time and energy that could and
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New Hampshire CFSR Statewide Assessment
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Introduction
should be spent with the family to expedite reunification. In response, the Accelerated Reunification
Model (ARM) was crafted and based on the philosophy that in some cases, if reunification efforts were
constant and intense, children could reunify within 30 days.
In October 2008 DCYF developed a service model called the ARM in collaboration with Casey Family
Services. The service goal is to conduct a comprehensive assessment with the family that focuses on
identifying and strengthening protective factors, and taking concrete action to enable timely and safe
reunification. The concept behind intensive reunification work with parents is to improve parenting and
to overcome any barriers to reunification. Accelerated services include immediate parent-child contact,
home visits and family meetings, supportive counseling and advocacy. This work involves immediate
engagement of the child's parents, the extended family, and the community to support the child's return
home.
ARM is currently being rolled out statewide. Preliminary findings noted in the Casey Family Services
mid-year program review indicate that although initially skeptical of having ―a
nother social worker tell
me what to do‖, families have felt supported and included as part of the team in the goal of bringing their
children home. When reunification has not occurred, families report a sense that genuine efforts were
made to reach that goal and that they were included in the planning and decision-making.
Emphasis on the Use of Data
From the last CFSR until February 2010, DCYF maintained a distinct Bureau of Quality Improvement
(BQI) that blended evaluation and oversight with research and development, policy and rules. Recently,
DCYF integrated the Bureau of Organizational Learning and the Bureau of Quality Improvement into one
bureau – BOLQI. The intent is to recognize the inextricable link between quality improvement and
training activities and support continuous organizational and practice enhancement. The groundwork laid
over the past several years to solidify a multidisciplinary approach to quality improvement activities will
be maintained and is now being infused into several bureaus and program areas. Critical quality
improvement activities since the last CFSR have included ensuring successful completion of the Program
Improvement Plan, designing and implementing a new statewide Case Practice Review (modeled after the
CFSR) and establishing a cycle of continuous quality improvement through a heightened knowledge and
use of data throughout the agency.
Together BOLQI and the Bureau of Information Systems (BIS) staff provide timely program data to
managers and, more importantly, work to break down the barriers between data and practice. Over the
past five years, New Hampshire has truly embraced the use of data at all levels of management. Staff, at
times, are overwhelmed by the amount of data available and need support with technical skills necessary
to turn ―
data‖ into ―
information‖. The BOLQI is now the ―
data broker‖ that provides a bridge between
simply having the data and actually using it. The agency‘s use of data has matured in recent years from a
reliance on ―c
ompliance‖ to a focus on ―ou
tcomes.‖
In 2008, the New Hampshire Bridges case management system, within the BIS, was determined to be
fully compliant with Federal SACWIS requirements. In order for this significant achievement to come
about, major enhancements and revisions to the system were undertaken over the last several years. New
Hampshire Bridges can now capture, store and display eligibility results including clients‘ individual
eligibility history. Also, due to enhancements of IV-E determination results, DCYF is able to report and
analyze trends with greater accuracy. In 2005, a training module was created and added to New
Hampshire Bridges that collects and maintains training related data for both DCYF and DJJS.
On an ongoing basis, BIS coordinates with the Child Protection Bureau and the BOLQI to develop
significant enhancements aimed at supporting permanency planning. This particular project has been split
into several phases, the first of which was completed in December 2008. This included:
24
New Hampshire CFSR Statewide Assessment
July 2010
Introduction
A new navigator tree section added called Permanency Planning to allow Permanency workers
to enter pre-adopt information.
The ―c
urrent placement willing to adopt‖ date history was added to the Recruitment General
Screen.
Changes to the TPR/Surrender screens to improve data collection related to children who are
legally available for adoption.
Other significant enhancements during the last several years included work on the AFCARS
Improvement Plan (AIP). The AIP is derived from the assessment review performed by the
Administration for Children and Families and provides requirements to be incorporated into the Bridges
case management system and AFCARS extract criteria. This plan is being implemented in phases and the
last phase will be completed in 2010. The changes to both the case management system and the
AFCARS extract criteria are designed to improve the quality and integrity of the data being reported,
provide more accurate measures in the State Data Profile to be used in the CFSR and depict a
comprehensible view of New Hampshire protection and prevention outcomes.
Several key processes have resulted in DCYF‘s status as a data-driven agency and a model for other
agencies within New Hampshire‘s Department of Health and Human Services. First, district office
supervisors are key in any effective systems change. It is vital that this group understand the benefits of
using administrative data to monitor and improve practice. To accomplish this, BQI developed a ―
data
managers‖ group in 2003. The group includes both analysts and program managers. Throughout 2004
and 2005, the data managers gathered information from field staff and supervisors to develop a set of
supervisors‘ reports.
The supervisors‘ reports were designed as tools for local supervisors, reinforcing the philosophy that state
office operates first and foremost to support the field. The intent of the supervisors‘ reports was to show
supervisors, staff, and managers that data from Bridges can be used to improve the efficiency and quality
of staff supervision, guide caseload and staffing decisions, and identify areas of strength and challenge in
office practice. By observing differences across offices, program administrators can appropriately target
improvement initiatives. Additionally, district office supervisors can support one another by sharing
successful strategies.
As a result of these ongoing efforts, DCYF now maintains over fifteen standard reports that are accepted
as reliable sources of information. District office supervisors and state office program managers have
begun using these reports to begin new initiatives in their offices. Requests for additional data are
common as staff at all levels learn how useful the information can be. Data integrity improved rapidly as
the reports began to be widely used. Staff and supervisors have realized the value in data entry and are
willing to invest the time in accurate documentation. This shift from data indifference to data competence
has allowed DCYF to explore the use of data in additional areas; the supervisors‘ reports have become
one component of the larger data system.
The Case Practice Review (CPR):
As a direct result of New Hampshire‘s participation in the federal Child and Family Services Review
(CFSR) in June 2003, the former Bureau of Quality Improvement (BQI) restructured its case practice
review system to mirror the CFSR process. Held quarterly, the Case Practice Reviews (CPR) identify
strengths and areas needing improvement in each district office focusing on outcomes for children and
families in the areas of safety, permanency and well-being.
25
New Hampshire CFSR Statewide Assessment
July 2010
Introduction
In the Ongoing Case Component of the CPR, reviewers use the federal CFSR review instrument to review
twelve randomly selected ongoing cases, eight from DCYF and four from DJJS.
In addition to the review instrument designed for ongoing cases, the New Hampshire CPR also includes
two new, additional review instruments, one specifically designed to evaluate the assessment phase of
child protective services, and another to assess compliance with fiscal policies and procedures. The new
instruments were developed and implemented in 2007.
The Assessment review instrument allows BQI to evaluate risk assessment and safety management in a
random sample of twenty completed assessments. These include both substantiated and unsubstantiated
referrals.
The fiscal review instrument allows BQI and the DCYF Fiscal Unit to identify strengths and challenges
regarding implementation of fiscal procedures. This tool also assesses the quality of services provided by
the fiscal specialist and DCYF /DJJS staff.
The Adolescent Review Instrument
In addition to initiatives driven by the Bureau of Quality Improvement, DCYF program managers have
begun to request assistance in developing their own internal QA processes. Due to the success of the
Case Practice Reviews, program managers have approached BQI for assistance in evaluating their own
efforts.
The development of a new Adolescent Case Review Instrument highlights this successful collaboration.
This review instrument builds on successful components of the CPR process such as the use of peer
review, a structured review instrument, and a strengths-based approach. In addition to determining
whether specific agency policies were followed, the main goal of this tool is to evaluate from the youth‘s
perspective, how well the involved agencies worked to meet their needs for positive youth development,
permanent connections, and adult living skills. Input from the Youth Advisory Board, a group of youth
currently in out-of-home placement through DCYF or DJJS, was essential to this process. The youth
themselves determined which outcomes were truly important for their successful transition to adulthood.
The Adolescent Review Instrument was finalized in 2009 and will be used in the next round of CPRs.
Assessing Outcomes
DCYF/DJJS have recognized that it is critical to have in place the ability to monitor statewide changes of
high-level outcomes such as length of stay in care. We are committed to assessing whether policy
changes and new initiatives have the desired effect on case outcomes. To guide our practice in this way,
the agencies make use of the NCANDS and AFCARS data and the State Data Profile. Additionally,
DCYF relies on a subscription to the Foster Care Data Archive for the analysis of program outcomes.
Finally, the DCYF Fiscal Unit has moved toward a system of performance-based contracting. Contracts
now include requirements for measuring case outcomes in residential, home-based, and preventative
services.
The Case Practice Reviews result in local Practice Improvement Initiatives (PII) as well as statewide
policy changes such as the implementation of Permanency Planning Teams and the Finding Connections
program. The PII includes specific action steps to be taken to improve practice in areas identified through
the onsite review as in need of improvement. The PII can also include action steps related to systemic
issues such as improved collaboration with community stakeholders if such Items are warranted.
Management from both Divisions work with BOLQI and the district office staff to monitor improvement
initiatives and report on program outcomes. This process continues until the next onsite review.
26
New Hampshire CFSR Statewide Assessment
July 2010
Introduction
CROSS-SYSTEM INITIATIVES
DCYF and DJJS have recognized and embraced the importance of collaboration among the two divisions,
the courts, CASA and other community stakeholders. Below are some examples of key cross-system
initiatives that have been developed over the past seven years. The impact of these relationships has
resonated in many areas of practice as written in this Statewide Assessment, especially in the area of
permanency, due to the extraordinary focus of leadership at both DCYF and DJJS.
Breakthrough Series Collaborative On Safety And Risk Assessments
As a member of the New England Association of Child Welfare Commissioners and Directors
(NEACWCD), DCYF is participating in an innovative project to improve safety and risk assessments in
the child welfare system. In partnership with Casey Family Services, The Breakthrough Series
Collaborative (BSC) on Safety and Risk Assessments is a twenty-nine month long project, beginning in
April of 2008, that will plan, field test, evaluate, and quickly disseminate new tools and strategies in an
effort to transform child welfare practice1. The methodology uses small-scale, rapid tests of change,
which are closely monitored and measured in almost real-time so that successes can be expanded
promptly and under-performing strategies can be learned from and discarded.
This Breakthrough Series Collaborative involves four teams from New Hampshire. Teams are comprised
of discreet participants that include representation of State Office administration, District Office
Supervisors, front line supervisors and staff, birth parents, youth, and cross-system partners. The district
offices represented are: Nashua, Manchester, Laconia and Rochester.
The Breakthrough Series is challenging DCYF to look at how to improve outcomes in the seven key
practice areas, which are:
Engagement:
Respecting and responding to race, ethnicity and culture; and
Engaging the child/youth and family.
Decision-making:
Using safety and risk assessment tools; and
Making sound decisions on safety and risk.
Integrated Practice
Practicing with an integrated and comprehensive assessment;
Maintaining focus on permanency and well-being; and
Collaborating with cross-system and community partners.
The four teams went through multiple self evaluation processes to identify and target priority areas to
focus the work of the development of small changes to then review using the Plan, Do, Study Act cycle
(PDSA). This resulted in numerous small practice changes being implemented and tested. This testing
resulted in several practice changes that are ready for spread throughout the jurisdictions.
1
http://www.jbcc.harvard.edu/publications/cg_08S.pdf
27
New Hampshire CFSR Statewide Assessment
July 2010
Introduction
Each office solicits youth voice and birth parent input relating to practice. The Manchester District Office
has a parent member who is sending out a letter to new birth parents involved with DCYF to offer
insights and support. Additionally, Manchester has generated a non-custodial parent letter to engage the
birth parent in the process at the start of a family‘s involvement with DCYF. As a result of the
discussions that occur at the monthly leadership meetings, this practice is spreading statewide, thus
indicating further efforts to get absent parents involved early in the case and in the case planning
surrounding permanency for their children. Nashua has instituted transition meetings that occur within
thirty days of a case opening. During these meetings to which the parents bring their natural support
system, the case planning process is initiated incorporating the input and supports of individuals already
invested in the safety, permanency and well-being of their children. These meetings have received
positive reviews from the families impacted.
Residential Provider Forums
In June 2008, DCYF and DJJS convened a meeting with statewide representatives from residential
facilities to present data on the status of children and youth in residential treatment. This data included
information on:
Current lengths of stay for children and youth in residential placements
Where they were living
What the youth said they needed to be prepared for independent living
Residential Providers were invited to join DCYF/DJJS in an initiative aimed at developing and
implementing a collaborative system for delivery of services in residential treatment focusing on shorter
lengths of stay while achieving permanency for the youth who were placed in their programs. The
culmination of this work was the creation of A Framework for Collaboration to achieve improved
permanency outcomes for children and youth placed in residential programs.
Since 2008, a core work group of agency staff, residential providers, community partners and a youth,
have been meeting regularly to articulate a framework to achieve improved permanency outcomes for
children and youth placed in residential programs. The purpose of these meetings has been to design a
plan for establishing new models of residential care and inter-agency collaboration, which facilitate
access for referred children to the least restrictive placement and assist in achieving timely permanency.
The shared goal is to increase the number of DCYF/DJJS involved children in permanent homes through
safely reducing the number of children in residential care.
The Framework for Collaboration includes:
A Vision Statement
Core Values
Key Definitions
Guiding Principles
Permanency Outcomes
Standards of Practice
Progress Indicators
This framework will serve as the basis for achieving effective, quality service provision at all levels of
intervention and support with children/youth and families.
In an effort to gather feedback on the framework, Casey Family Programs retained an independent
consultant to moderate focus groups in three locations with four essential groups who have experience in
the child welfare system: residential care staff, DCYF/DJJS staff, parents and youth. The focus group
28
New Hampshire CFSR Statewide Assessment
July 2010
Introduction
report was then used to inform final edits to the Framework for Collaboration. Future steps in this
process include continued technical assistance from Casey Family Programs and establishing a strategic
plan for integrating practice and policy changes statewide.
Better Together with Birth Parents
DCYF has begun to work with Casey Family Programs to bring Better Together with Birth Parents, a
training curriculum of Casey Family Programs, to New Hampshire as part of our continued
implementation of the Framework for Collaboration. This is a two-phase project. First, a birth parent
facilitator and staff facilitator will be brought to New Hampshire to train six birth parents and six
staff/agency providers in the Better Together Model. The second phase involves these twelve individuals
forming teams of two and over the next year facilitating a Better Together two-day workshop of birth
parents and staff/agency providers from different regions across the State. The Better Together with Birth
Parents training is based on empowering birth parents to be more deeply involved in child welfare
systems by honoring a guiding set of principles including shared decision making, respectful
communication and acknowledging shared purposes and common values.
The New Hampshire Bridge project
The New Hampshire Bridge Project reflects a true partnership between DCYF, DJJS the Family Courts and
Dartmouth Trauma-informed Research Center (DTIRC). The goal of this project is to enhance the level of
trauma-informed services and integration of care among the three agencies of key importance in the lives
of abused and at-risk children and youth in New Hampshire, DCYF, DJJS and the New Hampshire
Family Court Division.
DCYF, DJJS and the Family Courts have been acutely aware of the challenges of service provision among
community mental health providers. Consequently, the state agencies have reached out in a variety of ways to
gain education and training to become trauma-informed, and to better integrate and coordinate their activities
with the community mental health system to collaboratively and effectively serve children, youth and families
who have experienced trauma. The Bridge Project will enhance those efforts by bringing trauma-informed,
culturally sensitive perspectives, knowledge, systems change and practices to our statewide systems.
The New Hampshire Bridge project will initially be targeting four identified regions of the state. These
regions have been chosen due to promising approaches and practice atmosphere that will support the
rapid integration of trauma-informed services.
In January 2010, New Hampshire Bridge Project staff and leadership from DCYF attended the
International Conference on Child Abuse and Neglect in San Diego, California in order to assess training
curriculum and initiate relationships critical to shifting the system. As a result, DCYF and DJJS clinical
and administrative leadership will be involved in finalizing curriculum for foster parents and assisting in
the development of curriculum for juvenile justice staff. Now that the project is fully underway, on June
17, 2010, a kick-off event including a series of workshops was held at Dartmouth for DCYF/DJJS
administrators, staff, mental health providers, and the courts from the four designated project areas.
There are three key components to the New Hampshire Bridge Project, a training component, a systems change
component, and a direct services enhancement component. The training component includes education, training
and consultation/supervision on the implementation of trauma-informed services.
At the systems change level, children and families served by the three agencies will benefit from the education
and systems change process. It is anticipated that over 7300 trauma-exposed children per year may receive
benefit from the New Hampshire Bridge Project. This benefit should be reflected in improved client satisfaction,
improved retention in services, fewer placements out-of-home or in restrictive environments, and better
29
New Hampshire CFSR Statewide Assessment
July 2010
Introduction
functional outcomes. The systems change components at DCYF and DJJS will be largely integrated into the
existing staff education and quality improvement functions administered by the Center for Professional
Excellence in Child Welfare, whose staff is committed to working in collaboration with child protection and
juvenile justice services.
At the direct intervention level, this project will also focus on improved referral and case coordination for
approximately 1,000 children per year. Outcomes expected include therapist competence in evidence-based
treatment, symptom reduction in clients as well as improved functional outcomes and satisfaction with care.
30
New Hampshire CFSR Statewide Assessment
July 2010
Introduction
NEXT STEPS
As a system striving to be a learning organization, New Hampshire is looking towards the upcoming
CFSR as an opportunity to engage in an intensive systemic assessment, reflection, and process of
continued improvement. Moving towards a model of organizational effectiveness, New Hampshire is at a
crossroads, or convergence, of extensive efforts to enhance permanency practices. Data indicates that
much success has been gained, while some areas, particularly consistency in practice, remain challenging.
For this reason, New Hampshire‘s is conscientiously engaged in the development of a Practice Model.
Through a transparent and collaborative Practice Model design endeavor, a set of core beliefs and
principles will emerge that will establish a conceptual map for child welfare and juvenile justice practice
in New Hampshire. As a set of ―t
ouchstones‖, these beliefs and principles will guide all staff, providers
and stakeholders in ensuring consistency in quality service to children, youth and families, while ensuring
“family voice, family choice”. The expectation is that New Hampshire will use information derived from
the CFSR in conjunction with the visioning process the agency has been engaged in for several months to
develop a scope for services enhancements that will likely include:
Enhanced family engagement strategies and tools across all phases of service delivery; from
prevention through case closure;
Expanded mechanisms for assessment of safety and risk that build upon the Structured
Decision-Making framework and more comprehensively inform case decision-making and
planning practices;
Matured critical thinking capacity of staff and supervisors that supports consistent key
decision-making in assessment and case planning;
A broadened understanding and framework for prevention within the context of the agency‘s
mission and service array; and
Nurturing the culture and climate of the organization to support implementation and
sustainability of evidence-based or informed practices and strengthen the workforce.
New Hampshire is eagerly looking forward to the opportunity to complete the CFSR in order to further
develop the vision of the Practice Model and shift towards a new paradigm. As it has been stated by the
Director, the Practice Model is not a new initiative; “It will be our way of life”.
31
New Hampshire CFSR Statewide Assessment
July 2010
SECTION II SAFETY AND PERMANENCY DATA
New Hampshire Data Profile April 9, 2010
32
New Hampshire Child and Family Services Review Data Profile: April 9, 2010
CHILD SAFETY PROFILE
I. TOTAL CA/N REPORTS
DISPOSED1
Reports %
6,834
Fiscal Year 2007ab
Duplic. %
Unique %
Childn.2
Childn.2
9,958
8,631
Reports %
8,031
A
New Hampshire CFSR Statewide Assessment
July 2010
Fiscal Year 2008ab
Duplic. %
Unique %
Childn.2
Childn.2
11,868
Reports %
10,063
7,880
Fiscal Year 2009ab
Duplic. %
Unique
Childn.2
Childn.2
11,649
%
9,848
II. DISPOSITION OF CA/N
REPORTS3
Substantiated & Indicated
649
9.5
912
9.2
873
10.1
831
10.3
1,129
9.5
1,063
10.6
676
8.6
984
8.4
924
9.4
5,672
83
8,293
83.3
7,155
82.9
6,643
82.7
9,916
83.6
8,351
83.0
6,745
85.6
9,961
85.5
8,396
85.3
513
7.5
753
7.6
603
7.0
557
6.9
823
6.9
649
6.4
459
5.8
704
6.0
528
5.4
III. CHILD VICTIM CASES
OPENED FOR POSTINVESTIGATION SERVICES4
912
100
873
100
1,129
100
1,063
100
984
100
924
100
IV. CHILD VICTIMS ENTERING
FOSTER CARE BASED ON CA/N
REPORT5
228
25
221
25.3
252
22.3
228
21.4
226
23.0
205
22.2
2B
0.2
0B
0
1B
0.1
434 of
453
95.8
342 of
371
92.2
Unsubstantiated
Other
V. CHILD FATALITIES
RESULTING FROM
MALTREATMENT6
STATEWIDE AGGREGATE DATA USED TO DETERMINE SUBSTANTIAL CONFORMITY
VI. ABSENCE OF
MALTREATMENT
Recurrence7
[Standard: 94.6% or more; national
median = 93.3%, 25th percentile =
91.50%]
VII. ABSENCE OF CHILD ABUSE
AND/OR NEGLECT IN FOSTER
CARE8 (12 MONTHS)
[Standard 99.68% or more; national
median = 99.5, 25th percentile = 99.30]
409 of
419
97.6
1,660 of 99.94C
1,661
1,614 of 99.88C
1,616
1,474 of
1,475
99.93C
The Permanency Data for FFY 2009 was based on the annual file created on 2-24-2010. The FY2009 NCANDS Child File was submitted on 1-29-2010, and the Agency File was submitted on 3-4-2010.
33
New Hampshire Child and Family Services Review Data Profile: April 9, 2010
New Hampshire CFSR Statewide Assessment
July 2010
Additional Safety Measures For Information Only (no standards are associated with these):
Fiscal Year 2007ab
Hours
VIII. Median Time
to Investigation in
Hours (Child File)9
IX. Mean Time to
Investigation in
Hours (Child
File)10
X. Mean Time to
Investigation in
Hours (Agency
File)11
XI. Children
Maltreated by
Parents While in
Foster Care.12
Unique
Childn.2
Fiscal Year 2008ab
%
Hours
Unique
Childn.2
Fiscal Year 2009ab
%
Hours
<24
<24
<24
18.7
19.4
19.1
60.1
49.9
40.5
5 of
1,661
6 of
1,616
0.30
0.37
CFSR Round One Safety Measures to Determine Substantial Conformity (Provided for informational purposes only)
Reports
XII. Recurrence of
Maltreatment13
[Standard: 6.1%
or less)
XIII. Incidence of
Child Abuse and/or
Neglect in Foster
Care14 (9 months)
[standard 0.57% or
less]
%
Fiscal Year 2007ab
Duplic.
%
Unique
Childn.2
Childn.2
10 of
419
0 of
1,540
%
2.4
0.00
Reports
%
Fiscal Year 2008ab
Duplic.
%
Unique
Childn.2
Childn.2
19 of
453
2 of
1,511
%
Reports
%
Unique
Childn.2
%
6 of
1,475
0.41
Fiscal Year 2009ab
Duplic.
%
Unique
Childn.2
Childn.2
4.2
0.13
%
29 of
371
7.8
1 of
1,349
0.07
The Permanency Data for FFY 2009 was based on the annual file created on 2-24-2010. The FY2009 NCANDS Child File was submitted on 1-29-2010, and the Agency File was submitted on 3-4-2010.
34
New Hampshire Child and Family Services Review Data Profile: April 9, 2010
New Hampshire CFSR Statewide Assessment
July 2010
NCANDS data completeness information for the CFSR
Description of Data Tests
Fiscal Year 2007ab
Fiscal Year 2008ab
Percent of duplicate victims in the submission [At least 1% of victims should be associated with multiple
reports (same CHID). If not, the State would appear to have frequently entered different IDs for the same
4.12
5.2
victim. This affects maltreatment recurrence]
Percent of victims with perpetrator reported [File must have at least 95% to reasonably calculate
100
100
maltreatment in foster care]*
C
Percent of perpetrators with relationship to victim reported [File must have at least 95%]*
86.7
86.4C
Percent of records with investigation start date reported [Needed to compute mean and median time to
100
100
investigation]
Average time to investigation in the Agency file [PART measure]
Reported
Reported
Percent of records with AFCARS ID reported in the Child File [Needed to calculate maltreatment in
foster care by the parents; also. All Child File records should now have an AFCARS ID to allow ACF to
100
100
link the NCANDS data with AFCARS. This is now an all-purpose unique child identifier and a child does
not have to be in foster care to have this ID]
*States should strive to reach 100% in order to have maximum confidence in the absence of maltreatment in foster care measure.
Fiscal Year 2009ab
5.95
100
78.68C
100
Reported
100
FOOTNOTES TO DATA ELEMENTS IN CHILD SAFETY PROFILE
Each maltreatment allegation reported to NCANDS is associated with a disposition or finding that is used to derive the counts provided in this safety profile. The
safety profile uses three categories. The various terms that are used in NCANDS reporting have been collapsed into these three groups.
Disposition
Category
A
Safety Profile Disposition
Substantiated or Indicated
(Maltreatment Victim)
NCANDS Maltreatment Level Codes Included
―Subs
tantiated,‖ ―Indicated,‖ and ―Alt
ernative Response Disposition
Victim‖
B
Unsubstantiated
C
Other
―Unsubs
tantiated‖ and ―U
nsubstantiated Due to Intentionally False
Reporting‖
―Clos
ed-No Finding,‖ ―Alternative Response Disposition – Not a Victim,‖
―Othe
r,‖ ―No A
lleged Maltreatment,‖ and ―Unk
nown or Missing‖
Alternative Response was added starting with the 2000 data year. The two categories of Unsubstantiated were added starting with the 2000 data year. In earlier
years there was only the category of Unsubstantiated. The disposition of ―Noalleged maltreatment‖ was added for FYY 2003. It primarily refers to children who
receive an investigation or assessment because there is an allegation concerning a sibling or other child in the household, but not themselves, AND whom are not
found to be a victim of maltreatment. It applies as a Maltreatment Disposition Level but not as a Report Disposition code because the Report Disposition cannot
have this value (there must have been a child who was found to be one of the other values.)
Starting with FFY 2003, the data year is the fiscal year.
The Permanency Data for FFY 2009 was based on the annual file created on 2-24-2010. The FY2009 NCANDS Child File was submitted on 1-29-2010, and the Agency File was submitted on 3-4-2010.
35
New Hampshire Child and Family Services Review Data Profile: April 9, 2010
New Hampshire CFSR Statewide Assessment
July 2010
Starting with FFY2004, the maltreatment levels for each child are used consistently to categorize children. While report dispositions are based on the field of
report disposition in NCANDS, the dispositions for duplicate children and unique children are based on the maltreatment levels associated with each child. A child
victim has at least one maltreatment level that is coded ―s
ubstantiated,‖ ―i
ndicated,‖ or ―a
lternative response victim.‖ A child classified as unsubstantiated has no
maltreatment levels that are considered to be victim levels and at least one maltreatment level that is coded ―u
nsubstantiated‖ or ―un
substantiated due to
intentionally false reporting.‖ A child classified as ―
other‖ has no maltreatment levels that are considered to be victim levels and none that are considered to be
unsubstantiated levels. If a child has no maltreatments in the record, and report has a victim disposition, the child is assigned to ―o
ther‖ disposition. If a child has
no maltreatments in the record and the report has either an unsubstantiated disposition or an ―o
ther‖ disposition, the child is counted as having the same disposition
as the report disposition.
1.
The data element, ―
Total CA/N Reports Disposed,‖ is based on the reports received in the State that received a disposition in the reporting period under
review. The number shown may include reports received during a previous year that received a disposition in the reporting year. Counts based on
―r
eports,‖ ―dup
licated counts of children,‖ and ―un
ique counts of children‖ are provided.
2.
The duplicated count of children (report-child pairs) counts a child each time that (s)he was reported. The unique count of children counts a child only
once during the reporting period, regardless of how many times the child was reported.
3.
For the column labeled ―Re
ports,‖ the data element, ―D
isposition of CA/N Reports,‖ is based on upon the highest disposition of any child who was the
subject of an investigation in a particular report. For example, if a report investigated two children, and one child is found to be neglected and the other
child found not to be maltreated, the report disposition will be ―
substantiated‖ (Group A). The disposition for each child is based on the specific finding
ubstantiated‖ (Group A) and the other is
related to the maltreatment(s). In other words, of the two children above, one is a victim and is counted under ―s
not a victim and is counted under ―uns
ubstantiated‖ (Group B). In determining the unique counts of children, the highest finding is given priority. If a
child is found to be a victim in one report (Group A), but not a victim in a second report (Group B), the unique count of children includes the child only as
a victim (Group A). The category of ―o
ther‖ (Group C) includes children whose report may have been ―
closed without a finding,‖ children for whom the
allegation disposition is ―u
nknown,‖ and other dispositions that a State is unable to code as substantiated, indicated, alternative response victim, or
unsubstantiated.
4.
The data element, ―Ch
ild Cases Opened for Services,‖ is based on the number of victims (Group A) during the reporting period under review. ―O
pened for
Services‖ refers to post-investigative services. The duplicated number counts each time a victim‘s report is linked to ongoing services; the unique number
counts a victim only once regardless of the number of times services are linked to reports of substantiated maltreatment.
5.
The data element, ―Ch
ildren Entering Care Based on CA/N Report,‖ is based on the number of victims (Group A) during the reporting period under
review. The duplicated number counts each time a victim‘s report is linked to a foster care removal date. The unique number counts a victim only once
regardless of the number of removals that may be reported.
6.
The data element ―Ch
ild Fatalities‖ counts the number of children reported to NCANDS as having died as a result of child abuse and/or neglect.
Depending upon State practice, this number may count only those children for whom a case record has been opened either prior to or after the death, or
The Permanency Data for FFY 2009 was based on the annual file created on 2-24-2010. The FY2009 NCANDS Child File was submitted on 1-29-2010, and the Agency File was submitted on 3-4-2010.
36
New Hampshire Child and Family Services Review Data Profile: April 9, 2010
New Hampshire CFSR Statewide Assessment
July 2010
may include a number of children whose deaths have been investigated as possibly related to child maltreatment. For example, some States include
neglect-related deaths such as those caused by motor vehicle or boating accidents, house fires or access to firearms, under certain circumstances. The
percentage is based on a count of unique victims of maltreatment for the reporting period.
7.
The data element ―Abs
ence of Recurrence of Maltreatment‖ is defined as follows: Of all children who were victims of substantiated or indicated
maltreatment allegation during the first 6 months of the reporting period, what percent were not victims of another substantiated or indicated
maltreatment allegation within a 6-month period. This data element is used to determine the State‘s substantial conformity with CFSR Safety Outcome #1
(―Chi
ldren are, first and foremost, protected from abuse and neglect‖).
8.
The data element ―Abs
ence of Child Abuse/or Neglect in Foster Care‖ is defined as follows: Of all children in foster care during the reporting period, what
percent were not victims of substantiated or indicated maltreatment by foster parent of facility staff member. This data element is used to determine the
State‘s substantial conformity with CFSR Safety Outcome #1 (―Chil
dren are, first and foremost, protected from abuse and neglect‖). A child is counted as
not having been maltreated in foster care if the perpetrator of the maltreatment was not identified as a foster parent or residential facility staff. Counts of
children not maltreated in foster care are derived by subtracting NCANDS count of children maltreated by foster care providers from AFCARS count of
children placed in foster care. The observation period for this measure is 12 months. The number of children not found to be maltreated in foster care and
the percentage of all children in foster care are provided.
9.
Median Time to Investigation in hours is computed from the Child File records using the Report Date and the Investigation Start Date (currently reported
in the Child File in mmddyyyy format). The result is converted to hours by multiplying by 24.
10.
Mean Time to investigation in hours is computed from the Child File records using the Report Date and the Investigation Start Date (currently reported in
the Child File in mmddyyyy format). The result is converted to hours by multiplying by 24. Zero days difference (both dates are on the same day) is
reported as ―unde
r 24 hours‖, one day difference (investigation date is the next day after report date) is reported as ―
at least 24 hours, but less than 48
hours‖, two days difference is reported as ―a
t least 48 hours, but less than 72 hours‖, etc.
11.
Average response time in hours between maltreatment report and investigation is available through State NCANDS Agency or SDC File aggregate data.
"Response time" is defined as the time from the receipt of a report to the time of the initial investigation or assessment. Note that many States calculate the
initial investigation date as the first date of contact with the alleged victim, when this is appropriate, or with another person who can provide information
essential to the disposition of the investigation or assessment.
12.
The data element, ―Ch
ildren Maltreated by Parents while in Foster Care‖ is defined as follows: Of all children placed in foster care during the reporting
period, what percent were victims of substantiated or indicated maltreatment by parent. This data element requires matching NCANDS and AFCARS
records by AFCARS IDs. Only unique NCANDS children with substantiated or indicated maltreatments and perpetrator relationship ―P
arent‖ are selected
for this match. NCANDS report date must fall within the removal period found in the matching AFCARS record.
13.
The data element, ―Re
currence of Maltreatment,‖ is defined as follows: Of all children associated with a ―
substantiated‖ or ―
indicated‖ finding of
maltreatment during the first six months of the reporting period, what percentage had another ―
substantiated‖ or ―
indicated‖ finding of maltreatment within
The Permanency Data for FFY 2009 was based on the annual file created on 2-24-2010. The FY2009 NCANDS Child File was submitted on 1-29-2010, and the Agency File was submitted on 3-4-2010.
37
New Hampshire Child and Family Services Review Data Profile: April 9, 2010
14.
New Hampshire CFSR Statewide Assessment
July 2010
a 6-month period. The number of victims during the first six-month period and the number of these victims who were recurrent victims within six months
are provided. This data element was used to determine the State‘s substantial conformity with Safety Outcome #1 for CFSR Round One.
ncidence of Child Abuse and/or Neglect in Foster Care,‖ is defined as follows: Of all children who were served in foster care during
The data element, ―I
the reporting period, what percentage were found to be victims of ―
substantiated‖ or ―i
ndicated‖ maltreatment. A child is counted as having been
maltreated in foster care if the perpetrator of the maltreatment was identified as a foster parent or residential facility staff. Counts of children maltreated in
foster care are derived from NCANDS, while counts of children placed in foster care are derived from AFCARS. The observation period for these
measures is January-September because this is the reporting period that was jointly addressed by both NCANDS and AFCARS at the time when NCANDS
reporting period was a calendar year. The number of children found to be maltreated in foster care and the percentage of all children in foster care are
provided. This data element was used to determine the State‘s substantial conformity with Safety Outcome #2 for CFSR Round One.
Additional Footnotes
A.
For FFY2008, New Hampshire provided the following comment: New Hampshire saw an increase in reports during the last fiscal year, and therefore an
increase in the number of investigations. There are a number of possible factors contributing, including the economic downturn, and a couple of highprofile child abuse cases that may have spurred people to make reports when they might otherwise have dismissed their concerns.
B.
In FFY2007, New Hampshire reported 3 fatalities in the Agency File. In FFY2008 and FFY2009, New Hampshire did not report any additional fatalities
in the Agency File.
C.
The New Hampshire SACWIS does not automatically associate relationships, and the NCANDS extract does not currently report the perpetrator's
relationship to the victim when only the victim's relationship to the perpetrator is documented in the SACWIS. This will be corrected for the FFY2010
NCANDS data submission.
The Permanency Data for FFY 2009 was based on the annual file created on 2-24-2010. The FY2009 NCANDS Child File was submitted on 1-29-2010, and the Agency File was submitted on 3-4-2010.
38
New Hampshire Child and Family Services Review Data Profile: April 9, 2010
POINT-IN-TIME PERMANENCY PROFILE
I. Foster Care Population Flow
1
Children in foster care on first day of year
Admissions during year
Discharges during year
Children discharging from FC in fewer than 8 days
(These cases are excluded from length of stay
calculations in the composite measures)
Children in care on last day of year
Net change during year
II. Placement Types for Children in Care
Pre-Adoptive Homes
Foster Family Homes (Relative)
Foster Family Homes (Non-Relative)
Group Homes
Institutions
Supervised Independent Living
Runaway
Trial Home Visit
Missing Placement Information
Not Applicable (Placement in subsequent year)
III. Permanency Goals for Children in Care
Reunification
Live with Other Relatives
Adoption
Long Term Foster Care
Emancipation
Guardianship
Case Plan Goal Not Established
Missing Goal Information
Federal FY 2007ab
# of Children % of Children
1,089
572
566
25
4.4% of the
discharges
1,095
6
New Hampshire CFSR Statewide Assessment
July 2010
Federal FY 2008ab
# of Children % of Children
1,045
571
585
35
6.0% of the
discharges
1,031
-14
Federal FY 2009ab
# of Children % of Children
983
492
558
32
5.7% of the
discharges
917
-66
0
147
666
237
19
4
0
0
22
0
0.0
13.4
60.8
21.6
1.7
0.4
0.0
0.0
2.0
0.0
0
159
624
201
21
2
0
0
24
0
0.0
15.4
60.5
19.5
2.0
0.2
0.0
0.0
2.3
0.0
0
173
536
152
17
0
0
0
39
0
0.0
18.9
58.5
16.6
1.9
0.0
0.0
0.0
4.3
0.0
284
20
299
165
0
23
282
22
25.9
1.8
27.3
15.1
0.0
2.1
25.8
2.0
340
12
273
153
0
22
207
24
33.0
1.2
26.5
14.8
0.0
2.1
20.1
2.3
352
8
254
124
0
11
129
39
38.4
0.9
27.7
13.5
0.0
1.2
14.1
4.3
The Permanency Data for FFY 2009 was based on the annual file created on 2-24-2010. The FY2009 NCANDS Child File was submitted on 1-29-2010, and the Agency File was submitted on 3-4-2010.
39
New Hampshire Child and Family Services Review Data Profile: April 9, 2010
POINT-IN-TIME PERMANENCY PROFILE
Federal FY 2007ab
New Hampshire CFSR Statewide Assessment
July 2010
Federal FY 2008ab
Federal FY 2009ab
# of
Children
% of
Children
# of Children
% of
Children
# of
Children
% of
Children
402
266
145
87
45
150
0
36.7
24.3
13.2
7.9
4.1
13.7
0.0
362
275
143
68
53
127
3
35.1
26.7
13.9
6.6
5.1
12.3
0.3
314
232
124
73
48
120
6
34.2
25.3
13.5
8.0
5.2
13.1
0.7
One
Two
Three
Four
Five
Six or more
Missing removal episodes
768
171
49
15
8
5
79
70.1
15.6
4.5
1.4
0.7
0.5
7.2
728
154
57
18
6
2
66
70.6
14.9
5.5
1.7
0.6
0.2
6.4
665
128
48
12
3
2
59
72.5
14.0
5.2
1.3
0.3
0.2
6.4
VI. Number of children in care 17 of the most recent 22
months2 (percent based on cases with sufficient
information for computation)
297
58.0
282
51.5
294
53.6
IV. Number of Placement Settings in Current Episode
One
Two
Three
Four
Five
Six or more
Missing placement settings
V. Number of Removal Episodes
VII. Median Length of Stay in Foster Care
(of children in care on last day of FY)
19.3
VIII. Length of Time to Achieve Perm. Goal
# of Children
Discharged
Reunification
Adoption
Guardianship
Other
Missing Discharge Reason (footnote 3, page 16)
Total discharges (excluding those w/ problematic dates)
Dates are problematic (footnote 4, page 16)
16.5
# of Children
Discharged
298
138
25
93
10
Median
Months to
Discharge
7.7
35.4
19.0
32.9
23.2
564
2
18.6
285
165
16
108
8
Median
Months to
Discharge
6.0
31.1
8.9
40.0
9.4
# of
Children
Discharged
285
145
12
103
8
Median
Months to
Discharge
5.8
31.8
15.3
26.3
46.8
17.7
582
15.7
553
14.9
N/A
3
N/A
5
N/A
The Permanency Data for FFY 2009 was based on the annual file created on 2-24-2010. The FY2009 NCANDS Child File was submitted on 1-29-2010, and the Agency File was submitted on 3-4-2010.
40
New Hampshire Child and Family Services Review Data Profile: April 9, 2010
New Hampshire CFSR Statewide Assessment
July 2010
The Permanency Data for FFY 2009 was based on the annual file created on 2-24-2010. The FY2009 NCANDS Child File was submitted on 1-29-2010, and the Agency File was submitted on 3-4-2010.
41
New Hampshire Child and Family Services Review Data Profile: April 9, 2010
New Hampshire CFSR Statewide Assessment
July 2010
Statewide Aggregate Data Used in Determining Substantial Conformity: Composites 1 through 4
IX. Permanency Composite 1: Timeliness and Permanency of Reunification [standard:
122.6 or higher].
Scaled Scores for this composite incorporate two components
National Ranking of State Composite Scores (see footnote A on page 12 for details)
Component A: Timeliness of Reunification
The timeliness component is composed of three timeliness individual measures.
Measure C1 - 1: Exits to reunification in less than 12 months: Of all children discharged from
foster care to reunification in the year shown, who had been in foster care for 8 days or longer,
what percent was reunified in less than 12 months from the date of the latest removal from home?
(Includes trial home visit adjustment) [National median = 69.9%, 75th percentile = 75.2%]
Measure C1 - 2: Exits to reunification, median stay: Of all children discharged from foster care
(FC) to reunification in the year shown, who had been in FC for 8 days or longer, what was the
median length of stay (in months) from the date of the latest removal from home until the date of
discharge to reunification? (This includes trial home visit adjustment) [National median = 6.5
months, 25th Percentile = 5.4 months (lower score is preferable in this measureB)]
Measure C1 - 3: Entry cohort reunification in less than 12 months: Of all children entering
foster care (FC) for the first time in the 6 month period just prior to the year shown, and who
remained in FC for 8 days or longer, what percent was discharged from FC to reunification in less
than 12 months from the date of the latest removal from home? (Includes trial home visit
adjustment) [National median = 39.4%, 75th Percentile = 48.4%]
Component B: Permanency of Reunification The permanency component has one measure.
Measure C1 - 4: Re-entries to foster care in less than 12 months: Of all children discharged
from foster care (FC) to reunification in the 12-month period prior to the year shown, what percent
re-entered FC in less than 12 months from the date of discharge? [National median = 15.0%, 25th
Percentile = 9.9% (lower score is preferable in this measure)]
Federal FY
2007ab
Federal FY
2008ab
Federal FY
2009ab
State Score =
98.7
State Score =
101.1
State Score =
102.8
40 of 47
39 of 47
39 of 47
64.4%
70.5%
70.6%
Median = 8.2
months
Median = 7.2
months
Median = 8.1
months
39.3%
35.7%
40.1%
17.0%
19.5%
21.3%
The Permanency Data for FFY 2009 was based on the annual file created on 2-24-2010. The FY2009 NCANDS Child File was submitted on 1-29-2010, and the Agency File was submitted on 3-4-2010.
42
New Hampshire Child and Family Services Review Data Profile: April 9, 2010
X. Permanency Composite 2: Timeliness of Adoptions [standard: 106.4 or higher].
Scaled Scores for this composite incorporate three components.
National Ranking of State Composite Scores (see footnote A on page 12 for details)
Component A: Timeliness of Adoptions of Children Discharged From Foster Care. There are
two individual measures of this component. See below.
Measure C2 - 1: Exits to adoption in less than 24 months: Of all children who were discharged from
foster care to a finalized adoption in the year shown, what percent was discharged in less than 24 months
from the date of the latest removal from home? [National median = 26.8%, 75th Percentile = 36.6%]
Measure C2 - 2: Exits to adoption, median length of stay: Of all children who were discharged from
foster care (FC) to a finalized adoption in the year shown, what was the median length of stay in FC (in
months) from the date of latest removal from home to the date of discharge to adoption? [National
median = 32.4 months, 25th Percentile = 27.3 months (lower score is preferable in this measure)]
New Hampshire CFSR Statewide Assessment
July 2010
Federal FY
2007ab
State Score =
96.0
24 of 47
Federal FY
2008ab
State Score =
125.7
3 of 47
Federal FY
2009ab
State Score =
121.4
6 of 47
11.7%
20.0%
20.8%
Median = 35.4
months
Median = 31.1
months
Median = 31.8
months
22.7%
27.1%
26.6%
8.4%
18.5%
10.9%
64.3%
74.4%
78.2%
Component B: Progress Toward Adoption for Children in Foster Care for 17 Months or
Longer. There are two individual measures. See below.
Measure C2 - 3: Children in care 17+ months, adopted by the end of the year: Of all children in foster
care (FC) on the first day of the year shown who were in FC for 17 continuous months or longer (and who,
by the last day of the year shown, were not discharged from FC with a discharge reason of live with
relative, reunify, or guardianship), what percent was discharged from FC to a finalized adoption by the last
day of the year shown? [National median = 20.2%, 75th Percentile = 22.7%]
Measure C2 - 4: Children in care 17+ months achieving legal freedom within 6 months: Of all
children in foster care (FC) on the first day of the year shown who were in FC for 17 continuous months
or longer, and were not legally free for adoption prior to that day, what percent became legally free for
adoption during the first 6 months of the year shown? Legally free means that there was a parental rights
termination date reported to AFCARS for both mother and father. This calculation excludes children who,
by the end of the first 6 months of the year shown had discharged from FC to "reunification," "live with
relative," or "guardianship." [National median = 8.8%, 75th Percentile = 10.9%]
Component C: Progress Toward Adoption of Children Who Are Legally Free for Adoption.
There is one measure for this component. See below.
Measure C2 - 5: Legally free children adopted in less than 12 months: Of all children who became
legally free for adoption in the 12 month period prior to the year shown (i.e., there was a parental rights
termination date reported to AFCARS for both mother and father), what percent was discharged from
foster care to a finalized adoption in less than 12 months of becoming legally free? [National median =
45.8%, 75th Percentile = 53.7%]
The Permanency Data for FFY 2009 was based on the annual file created on 2-24-2010. The FY2009 NCANDS Child File was submitted on 1-29-2010, and the Agency File was submitted on 3-4-2010.
43
New Hampshire Child and Family Services Review Data Profile: April 9, 2010
New Hampshire CFSR Statewide Assessment
July 2010
Federal FY 2007ab
Federal FY 2008ab
Federal FY 2009ab
State Score = 101.7
State Score = 107.2
State Score = 118.7
40 of 51
35 of 51
19 of 51
27.2%
25.6%
27.8%
Measure C3 - 2: Exits to permanency for children with TPR: Of all children who were
discharged from foster care in the year shown, and who were legally free for adoption at the
time of discharge (i.e., there was a parental rights termination date reported to AFCARS for
both mother and father), what percent was discharged to a permanent home prior to their 18th
birthday? A permanent home is defined as having a discharge reason of adoption,
guardianship, or reunification (including living with relative) [national median 96.8%, 75th
Percentile = 98.0%]
94.8%
98.8%
97.9%
Measure C3 - 3: Children Emancipated Who Were in Foster Care for 3 Years or More.
Of all children who, during the year shown, either (1) were discharged from foster care prior
to age 18 with a discharge reason of emancipation, or (2) reached their 18th birthday while in
foster care, what percent were in foster care for 3 years or longer? [National median 47.8%,
25th Percentile = 37.5% (lower score is preferable)]
64.2%
61.9%
46.3%
XI. Permanency Composite 3: Permanency for Children and Youth in
Foster Care for Long Periods of Time [standard: 121.7 or higher].
Scaled Scores for this composite incorporate two components
National Ranking of State Composite Scores (see footnote A on page 12 for details)
Component A: Achieving permanency for Children in Foster Care for Long
Periods of Time. This component has two measures.
Measure C3 - 1: Exits to permanency prior to 18th birthday for children in care for 24
+ months. Of all children in foster care for 24 months or longer on the first day of the year
shown, what percent was discharged to a permanent home prior to their 18th birthday and by
the end of the fiscal year? A permanent home is defined as having a discharge reason of
adoption, guardianship, or reunification (including living with relative). [National median
25.0%, 75th Percentile = 29.1%]
Component B: Growing up in foster care. This component has one measure.
The Permanency Data for FFY 2009 was based on the annual file created on 2-24-2010. The FY2009 NCANDS Child File was submitted on 1-29-2010, and the Agency File was submitted on 3-4-2010.
44
New Hampshire Child and Family Services Review Data Profile: April 9, 2010
XII. Permanency Composite 4: Placement Stability [national standard: 101.5
or higher].
Scaled scored for this composite incorporates no components but three individual
measures (below)
National Ranking of State Composite Scores (see footnote A on page 12 for details)
Measure C4 - 1) Two or fewer placement settings for children in care for less than 12
months. Of all children served in foster care (FC) during the 12-month target period who were
in FC for at least 8 days but less than 12 months, what percent had two or fewer placement
settings? [National median = 83.3%, 75th Percentile = 86.0%]
Measure C4 - 2) Two or fewer placement settings for children in care for 12 to 24 months.
Of all children served in foster care (FC) during the 12-month target period who were in FC for
at least 12 months but less than 24 months, what percent had two or fewer placement settings?
[National median = 59.9%, 75th Percentile = 65.4%]
Measure C4 - 3) Two or fewer placement settings for children in care for 24+ months. Of
all children served in foster care (FC) during the 12-month target period who were in FC for at
least 24 months, what percent had two or fewer placement settings? [National median =
33.9%, 75th Percentile = 41.8%]
New Hampshire CFSR Statewide Assessment
July 2010
Federal FY 2007ab
Federal FY
2008ab
Federal FY 2009ab
State Score = 96.6
State Score =
101.6
State Score = 101.1
21 of 51
11 of 51
11 of 51
81.1%
84.0%
85.7%
65.4%
67.5%
62.8%
41.1%
44.3%
44.6%
Special Footnotes for Composite Measures:
A.
These National Rankings show your State‘s performance on the Composites compared to the performance of all the other States that were included in
the 2004 data. The 2004 data were used for establishing the rankings because that is the year used in calculating the National Standards. The order of
ranking goes from 1 to 47 or 51, depending on the measure. For example, ―
1 of 47‖ would indicate this State performed higher than all the States in
2004.
B.
In most cases, a high score is preferable on the individual measures. In these cases, you will see the 75th percentile listed to indicate that this would be
considered a good score. However, in a few instances, a low score is good (shows desirable performance), such as re-entry to foster care. In these
cases, the 25th percentile is displayed because that is the target direction for which States will want to strive. Of course, in actual calculation of the total
composite scores, these ―
lower are preferable‖ scores on the individual measures are reversed so that they can be combined with all the individual scores
that are scored in a positive direction, where higher scores are preferable.
The Permanency Data for FFY 2009 was based on the annual file created on 2-24-2010. The FY2009 NCANDS Child File was submitted on 1-29-2010, and the Agency File was submitted on 3-4-2010.
45
New Hampshire Child and Family Services Review Data Profile: April 9, 2010
PERMANENCY PROFILE
FIRST-TIME ENTRY COHORT GROUP
Federal FY 2007ab
# of Children
% of
Children
New Hampshire CFSR Statewide Assessment
July 2010
Federal FY 2008ab
# of Children
% of Children
Federal FY 2009ab
# of Children % of Children
196
76.3
168
74.3
153
74.6
0
38
131
24
3
0
0
0
0
0
0.0
19.4
66.8
12.2
1.5
0.0
0.0
0.0
0.0
0.0
0
38
101
24
5
0
0
0
0
0
0.0
22.6
60.1
14.3
3.0
0.0
0.0
0.0
0.0
0.0
0
34
95
18
5
0
1
0
0
0
0.0
22.2
62.1
11.8
3.3
0.0
0.7
0.0
0.0
0.0
Reunification
Live with Other Relatives
Adoption
Long-Term Foster Care
Emancipation
Guardianship
Case Plan Goal Not Established
Missing Goal Information
107
2
17
2
0
2
66
0
54.6
1.0
8.7
1.0
0.0
1.0
33.7
0.0
102
0
11
3
0
7
45
0
60.7
0.0
6.5
1.8
0.0
4.2
26.8
0.0
115
0
2
2
0
0
34
0
75.2
0.0
1.3
1.3
0.0
0.0
22.2
0.0
IV. Number of Placement Settings in Current Episode
One
Two
Three
Four
Five
Six or more
Missing placement settings
109
45
26
8
3
5
0
55.6
23.0
13.3
4.1
1.5
2.6
0.0
84
53
22
8
1
0
0
50.0
31.5
13.1
4.8
0.6
0.0
0.0
77
52
10
7
3
0
4
50.3
34.0
6.5
4.6
2.0
0.0
2.6
I. Number of children entering care for the first time in
cohort group (% = 1st time entry of all entering within first 6
months)
II. Most Recent Placement Types
Pre-Adoptive Homes
Foster Family Homes (Relative)
Foster Family Homes (Non-Relative)
Group Homes
Institutions
Supervised Independent Living
Runaway
Trial Home Visit
Missing Placement Information
Not Applicable (Placement in subsequent yr)
III. Most Recent Permanency Goal
The Permanency Data for FFY 2009 was based on the annual file created on 2-24-2010. The FY2009 NCANDS Child File was submitted on 1-29-2010, and the Agency File was submitted on 3-4-2010.
46
New Hampshire Child and Family Services Review Data Profile: April 9, 2010
PERMANENCY PROFILE
FIRST-TIME ENTRY COHORT GROUP (continued)
V. Reason for Discharge
Reunification/Relative Placement
Adoption
Guardianship
Other
Unknown (missing discharge reason or N/A)
VI. Median Length of Stay in Foster Care
New Hampshire CFSR Statewide Assessment
July 2010
Federal FY 2007ab
# of Children
% of
Children
Federal FY 2008ab
# of Children
% of
Children
61
0
3
2
0
55
1
2
1
2
92.4
0.0
4.5
3.0
0.0
Federal FY 2009ab
# of
% of
Children
Children
90.2
1.6
3.3
1.6
3.3
60
0
1
3
2
Number of Months
Number of Months
Number of Months
16.4
16.0
not yet determinable
AFCARS Data Completeness and Quality Information (2% or more is a warning sign):
N
File contains children who appear to have been in
care less than 24 hours
File contains children who appear to have exited
before they entered
Missing dates of latest removal
File contains "Dropped Cases" between report
periods with no indication as to discharge
Missing discharge reasons
File submitted lacks data on Termination of
Parental Rights for finalized adoptions
Foster Care file has different count than Adoption
File of (public agency) adoptions (N= adoption
count disparity).
File submitted lacks count of number of
placement settings in episode for each child
90.9
0.0
1.5
4.5
3.0
Federal FY 2007ab
As a % of Exits
Reported
N
Federal FY 2008ab
As a % of Exits
Reported
N
Federal FY 2009ab
As a % of Exits Reported
0
0.0 %
0
0.0 %
4
0.7 %
2
0.0 %
3
0.0 %
1
0.0 %
0
0.0 %
0
0.0 %
0
0.0 %
0
0.0 %
0
0.0 %
0
0.0 %
10
N
1.8 %
As a % of adoption exits
8
N
1.4 %
As a % of adoption exits
8
N
1.4 %
As a % of adoption exits
4
2.9 %
3
1.8 %
4
2.8 %
3
2.1% fewer in the foster
care file.
2
1.2% fewer in the foster
care file.
10
6.9% fewer in the
adoption file.
N
Percent of cases in file
N
Percent of cases in file
N
Percent of cases in file
0
0.0 %
3
0.3 %
6
0.7 %
* The adoption data comparison was made using the discharge reason of ―
adoption‖ from the AFCARS foster care file and an unofficial count of adoptions finalized during the period of interest that were ―
placed by public
agency‖ reported in the AFCARS Adoption files.
The Permanency Data for FFY 2009 was based on the annual file created on 2-24-2010. The FY2009 NCANDS Child File was submitted on 1-29-2010, and the Agency File was submitted on 3-4-2010.
47
New Hampshire Child and Family Services Review Data Profile: April 9, 2010
New Hampshire CFSR Statewide Assessment
July 2010
Note: These are CFSR Round One permanency measures. They are provided for informational purposes only.
IX. Of all children who were reunified with their parents or caretakers
at the time of discharge from foster care, what percentage was
reunified in less than 12 months from the time of the latest removal
from home? (4.1) [Standard: 76.2% or more]
X. Of all children who exited care to a finalized adoption, what
percentage exited care in less than 24 months from the time of the
latest removal from home? (5.1) [Standard: 32.0% or more]
XI. Of all children served who have been in foster care less than 12
months from the time of the latest removal from home, what
percentage have had no more than two placement settings? (6.1)
[Standard: 86.7% or more]
XII. Of all children who entered care during the year, what percentage
re-entered foster care within 12 months of a prior foster care episode?
(4.2) [Standard: 8.6% or less]
Federal FY 2007ab
# of
% of
Children
Children
Federal FY 2008ab
# of
% of
Children
Children
Federal FY 2009ab
# of
% of
Children
Children
197
65.9
206
72.0
211
73.3
16
11.6
33
20.0
31
21.4
522
80.9
545
83.6
494
85.2
78
13.6
(65.7%
new entry)
97
17.0 (65.0%
new entry)
78
15.9 (68.1%
new entry)
The Permanency Data for FFY 2009 was based on the annual file created on 2-24-2010. The FY2009 NCANDS Child File was submitted on 1-29-2010, and the Agency File was submitted on 3-4-2010.
48
New Hampshire Child and Family Services Review Data Profile: April 9, 2010
New Hampshire CFSR Statewide Assessment
July 2010
FOOTNOTES TO DATA ELEMENTS IN THE PERMANENCY PROFILE
1
The FY 07, FY 08, and FY 09 counts of children in care at the start of the year exclude 14, 13, and 13 children, respectively. They were excluded to avoid
counting them twice. That is, although they were actually in care on the first day, they also qualify as new entries because they left and re-entered again at some
point during the same reporting period. To avoid counting them as both "in care on the first day" and "entries," the Children's Bureau selects only the most recent
record. That means they get counted as "entries," not "in care on the first day."
2
We designated the indicator, 17 of the most recent 22 months, rather than the statutory time frame for initiating termination of parental rights proceedings at 15 of
the most 22 months, since the AFCARS system cannot determine the date the child is considered to have entered foster care as defined in the regulation. We used
the outside date for determining the date the child is considered to have entered foster care, which is 60 days from the actual removal date.
3
This count only includes case records missing a discharge reason, but which have calculable lengths of stay. Records missing a discharge reason and with noncalculable lengths of stay are included in the cell ―Dat
es are Problematic‖.
4
The dates of removal and exit needed to calculate length of stay are problematic. Such problems include: 1) missing data, 2) faulty data (chronologically
impossible), 3) a child was in care less than 1 day (length of stay = 0) so the child should not have been reported in foster care file, or 4) child's length of stay
would equal 21 years or more. These cases are marked N/A = Not Applicable because no length of stay can legitimately be calculated.
5
This First-Time Entry Cohort median length of stay was 16.4 in FY 07. This includes 0 children who entered and exited on the same day (who had a zero length
of stay). Therefore, the median length of stay was unaffected by any 'same day' children.
6
This First-Time Entry Cohort median length of stay was 16.0 in FY 08. This includes 0 children who entered and exited on the same day (who had a zero length
of stay). Therefore, the median length of stay was unaffected by any 'same day' children.
7
This First-Time Entry Cohort median length of stay is Not Yet Determinable for FY 09. This includes 4 children who entered and exited on the same day (they
had a zero length of stay). If these children were excluded, the median length of stay would still be Not Yet Determinable. The designation, Not Yet
Determinable occurs when a true length of stay for the cohort cannot be calculated because fewer than 50% of the children have exited.
The Permanency Data for FFY 2009 was based on the annual file created on 2-24-2010. The FY2009 NCANDS Child File was submitted on 1-29-2010, and the Agency File was submitted on 3-4-2010.
49
New Hampshire CFSR Statewide Assessment
July 2010
Safety Policy Overview
SECTION III CHILD AND FAMILY OUTCOMES
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SECTION 3: NARRATIVE ASSESSMENT OF CHILD AND FAMILY OUTCOMES
Safety Policy Overview
RSA 169 identifies statutes that are created by the New Hampshire Legislature and are published in the
New Hampshire Revised Statutes Annotated, which serve as legal authority for DCYF and DJJS to serve
families. The policies outlined below are derived from these statutes.
New Hampshire through the Division for Children Youth and Families (DCYF) and the Division for
Juvenile Justice Services (DJJS) has nine key policy Items that impact safety. As outlined below these
Items identify the process and requirements of how the agency receives and responds to reports of child
maltreatment, while manageing safety and risk factors.
Item 680 Child Abuse & Neglect
Item 680(e) Second Level Screening
Item 681Transfer of Referral from Central Intake
Item 681(a) Required Timeframes for Commencing and Assessment
Item 682 Planning the Assessment
Item 682(b) Safety Assessment
Item684 Risk Assessment
Item685 Interventions for Children and Families
Item FS 662 DJJS Field Services Risk Needs Assessment
RSA 169-C: Child Protection Act. The purpose of this chapter, through the mandatory reporting of
suspected instances of child abuse or neglect, is to provide protection to children whose life, health or
welfare is endangered and to establish a judicial framework to protect the rights of all parties involved in
the adjudication of child abuse or neglect cases. Each child coming within the provisions of this chapter
shall receive, preferably in his own home, the care, emotional security, guidance and control that will
promote the child's best interest and, if the child should be removed from the control of his parents,
guardian or custodian, adequate care shall be secured for the child. This chapter seeks to coordinate
efforts by state and local authorities in cooperation with private agencies and organizations, citizens'
groups and concerned individuals.
This chapter shall be liberally construed to the end that its purpose may be carried out, to wit:
a)
To encourage the mental, emotional, and physical development of each child coming within
the provisions of this chapter, by providing him with the protection, care, treatment,
counseling, supervision, and rehabilitative resources which he needs and has a right to receive.
b) To achieve the foregoing purposes and policies, whenever possible, by keeping a child in
contact with his home community and in a family environment by preserving the unity of the
family and separating the child from his parents only when the safety of the child is in danger
or when it is clearly necessary for his welfare or the interests of the public safety and when it
can be clearly shown that a change in custody and control will plainly better the child; and
c)
To provide effective judicial procedures through which the provisions of this chapter are
executed and enforced and which recognize and enforce the constitutional and other rights of
the parties and assures them a fair hearing.
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Safety Policy Overview
169-D: Children in Need of Services: This chapter shall apply to children in need of services as
hereinafter defined and shall be construed and administered in accordance with the following purposes
and policies:
I.
To recognize that certain behaviors occurring within a family or school environment indicate
that a child is experiencing serious difficulties and is in need of services and corrective action
in order to protect the child from the irreversibility of certain choices, and to protect the
integrity of the family and the authority it must maintain in order to fulfill its responsibilities to
raise the next generation. To further provide the child with the treatment, care, guidance,
counseling, discipline, supervision, and rehabilitation necessary to assist him in becoming a
responsible and productive member of society
169-B: Delinquent Children: This chapter shall apply to delinquent children as defined in RSA 169-B:2.
This chapter shall be liberally interpreted, construed and administered to effectuate the following
purposes and policies:
I.
To encourage the wholesome moral, mental, emotional, and physical development of each
minor coming within the provisions of this chapter, by providing the protection, care,
treatment, counseling, supervision, and rehabilitative resources which such minor needs.
Centralized Intake
New Hampshire has an established centralized Intake Unit, which maintains responsibility for responding
to all initial contacts for inquiries, information and referral and determining whether reports of
maltreatment meet DCYF criteria regarding suspected child abuse or neglect. It also establishes how
these contacts are to be classified, documented, and referred for further action or services, if appropriate.
The Intake Unit is located in Concord at a separate location from the twelve district offices. Ten Child
Protective Service Workers (Intake CPSW) and two Supervisors are available during work hours to
receive contacts regarding abuse and neglect. DCYF Central Intake hours are Monday to Friday, 8 AM to
4:30 PM.
Local law enforcement agencies provide coverage for contacts made after DCYF work hours, on
weekends, or on holidays.
For all classifications of contacts, the Intake CPSW must:
Encourage the caller to provide all information about the situation under consideration;
The Intake CPSW should ask questions of the caller until the response becomes clear or the
referent has no further information. If the response to a question is not known, the Intake
CPSW must respond in the most protective way;
Obtain accurate and complete information concerning the specific, descriptive facts of the
situation under consideration and enter the data on the referral screens on New Hampshire
Bridges;
The Intake CPSW should attempt to ascertain as much information as possible about the
whereabouts and identity in regards to a potential absent parent.
All contacts must be processed according to the classification assigned by the Intake CPSW.
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Safety Policy Overview
A Child Protective Service Worker (CPSW) and Supervisor must review all information received, obtain
prior history on New Hampshire Bridges SACWIS System, apply the screen-in criteria, and determine the
response priority level.
Classification of Contacts
"Information and Referral" means a request for information about the availability of a service or criteria
that may qualify a person to receive a service. This contact does not constitute a referral of suspected
abuse or neglect. An attempt is made to refer the source to the local, county, state, federal, or private
agency for services.
For contacts classified as Information and Referral, the Intake CPSW must:
Respond to the request for information and refer the source to the local, county, state, or
federal agency with jurisdiction or another service to respond to the need for service; and
Complete the "Intake and Referral Log" (Form 2200).
"Inquiry" means the caller provides information about a suspected incident of child abuse or neglect, but,
after completion of the Child Abuse and Neglect Screen-In Criteria this information does not meet DCYF
criteria for child abuse and neglect assessment, no further assessment will occur because intervention by
DCYF would cause an intrusion into family life that is not warranted by the child‘s need for protection.
For contacts classified as Inquiry, the Intake CPSW must:
Respond to any request for information;
Encourage the reporter to identify themselves, or facts that would identify the child in question
in order to enable a further review of the situation and for the Intake Unit to re-contact the
reporter for additional information;
If the contact does not require DCYF assessment refer the reporter to the local, county, state, or
federal agency with jurisdiction to respond to the need for service;
Notify law enforcement by telephone with a written report to follow, pursuant to RSA 169-C:
38, via the Referral to Law Enforcement Letter; and
Complete the referral screen on New Hampshire Bridges and forward the referral electronically
to the Intake Supervisor for review and approval.
For credible reports of Child Abuse and Neglect that do warrant an investigation of child maltreatment
DCYF has clear policy as to how investigations are to be initiated. As per Policy 681(a) Required Time
for Commencing an Assessment following the receipt of a child abuse or neglect referral from central
intake to the district office, an assessment must commence within 72 hours per RSA 169-C: 34. The time
period for commencing an assessment excludes weekends and holidays. Within the required timeframes,
the alleged victim will be interviewed in person or observed by a Child Protective Service Worker
(CPSW).
Agency Policy identifies conditions that constitute child abuse and neglect. This is based on specific
definitions as outlined in RSA 169-C.The major definitions are as follows:
"Neglect" means a child who has been abandoned by his parents, guardian or custodian; or who is without
proper parental care or control, subsistence, education as required by law, or other care or control
53
New Hampshire CFSR Statewide Assessment
July 2010
Safety Policy Overview
necessary for his or her physical, mental, or emotional health, when it is established that his or her health
has suffered or is very likely to suffer serious impairment; and the deprivation is not due primarily to the
lack of financial means of the parents, guardian, or custodian; or whose parents, guardian or custodian are
unable to discharge their responsibilities to and for the child because of incarceration; hospitalization or
other physical or mental incapacity.
“Physical abuse" means a child who has been intentionally physically injured or injured by other than
accidental means or psychologically injured so that said child exhibits symptoms of emotional problems.
When a parent or caregiver does not control his or her reaction by stopping the punishment before it
causes injury, this constitutes an abusive act.
―
Sexual abuse," means the following activities under circumstances which indicate that the child‘s health
or welfare is harmed or threatened with harm; the employment, use, persuasion, inducement, enticement,
or coercion of any child to engage in, or having a child assist any other person to engage in, any sexually
explicit conduct or any simulation of this conduct for the purpose of producing any visual depiction of
this conduct; or the rape, molestation, prostitution, or any other form of sexual exploitation of children, or
incest with children.
Response Priority
The time period for commencing an assessment excludes weekends and holidays. Within the required
timeframes, the alleged victim will be interviewed in person or observed by a Child Protective Service
Worker (CPSW). Timeframes for responding to the priority levels are:
Level I assessments require face-to-face contact with the alleged victim within 24 hours.
Level II assessments require face-to-face contact with the alleged victim within 48 hours.
Level III assessments require face-to-face contact with the alleged victim within 72 hours.
The Structured Decision Making (SDM) intake tools clearly identify the factors that determine a Level I,
II or III (See SDM Response Priority Tree). The use of the SDM tools results in greater consistency
among workers. The decision tree incorporates and prioritizes critical factors and leads staff to a decision
about the speed of the response. These factors are outlined in more detail in the SDM policy manual. The
Response Priority Decision Trees are completed on every new Child Protective report that is accepted for
assessment, including credible reports accepted for assessment on open cases.
A supervisor has the discretion to grant an extension of the timeframe requirements on Level II and III
assessments to interview or see the alleged victim within the required timeframe under specific
circumstances outlined in policy, and when there are no immediate safety concerns. The allowable
reasons to grant an extension are outlined in policy and include the following:
(1)
The alleged victim cannot be located;
(2)
The family did not cooperate with scheduled appointments or refused to meet with the
CPSW;
(3)
The CPSW has made numerous unsuccessful attempts to locate the family and there is no
other access to the child;
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New Hampshire CFSR Statewide Assessment
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Safety Policy Overview
(4)
DCYF agrees to law enforcement requests for no contact or law enforcement requests an
interview at a time outside the 72-hour parameter but not to exceed 5 business days over the
response level;
(5)
Language barriers exist that require interpreter services;
(6)
The victim will be interviewed at a local Child Advocacy Center and the interview is
scheduled for a timeframe that is outside of the required 48 or 72 hours;
(7)
To meet with the family within timeframes would present a documented hardship to the
family, however the family is cooperative;
(8)
There is no named perpetrator and the allegations involve sexual activity between children
12 and under, or;
(9)
Child is safe and the alleged perpetrator has no current access.
The supervisor is responsible for assuring the safety of the child and that the face-to-face contact occurs
within the revised timeframe agreed upon.
RSA 160-C the statute in New Hampshire that authorizes and mandates the Division‘s response to child
abuse and neglect states that ―i
f it appears that the immediate safety or well-being of a child is
endangered, the family may flee or the child disappear, or the facts otherwise so warrant, the department
shall commence an investigation immediately after receipt of a report. In all other cases, a child protective
investigation shall be commenced within 72 hours of receipt of the report‖. The statute does not specify
the type of contact that is required and it does not identify different responses for various priorities.
It should also be noted that the policy outlined above goes beyond the response timeframe outlined in
statute. The agency policy directs face-to-face contact where the law states the agency must only
―c
ommence‖ an investigation without addressing the type of contact that warrants commencement. The
Division‘s policy not only identifies the importance of a face-to-face contact but that in certain
circumstances those contacts must occur within 24 and 48 hours.
Safety and Risk Assessments
New Hampshire Policy Item 685 Interventions for Children and Families outlines the assessment
process that involves the completion of a Structured Decision Making (SDM) safety assessment, the
findings of which determine immediate action and/or services needed to protect the child. Prior to closure
of the assessment an SDM risk assessment is completed to determine whether to open a case for services,
identify appropriate contact requirements, and to inform the case planning process.
Policy Item 684 Risk Assessment provides direction regarding the action a CPSW is to take when
planning for a new assessment and we have had prior involvement with the family. Upon receipt of a
new report the CPSW must identify and review prior reports (if any) or any other history the family may
have with DCYF. The CPSW also checks the names of adult family members versus the names of
founded adults in the Central Registry. If there is a prior founded referral, the assigned CPSW must
consult with his/her direct supervisor prior to making a determination of unfounded to the current
assessment. If there are a total of three or more prior unfounded referrals, the assigned CPSW must
consult with the supervisor prior to making a determination of unfounded in regard to the current
assessment. A statement documenting the significance of the prior founded or unfounded referrals to the
55
New Hampshire CFSR Statewide Assessment
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Safety Policy Overview
current assessment must be included in the conclusion summary screen on Bridges and approved by the
supervisor.
In addition to the initial check of the Central Registry during the planning stage of the assessment, prior to
making a determination that a referral is unfounded and/or founded, the CPSW must determine whether
the alleged perpetrator is listed in the Central Registry.
DCYF assesses safety and manages risk through formal and informal assessment tools that drive
recommendations for services. In considering the causes of abusive and neglectful behavior on the part of
the parents or caregivers, and the various forms of family dysfunction, the CPSW must explore the
underlying dynamics of the harmful behavior. Any intervention offered must address these identified
issues by providing targeted services and interventions, such as the following:
(1)
When the causes of child maltreatment or neglect are mental illness, mental retardation, or
physical handicap or illness, assistance for the family from a behavioral health or medical
service provider must be sought.
(2)
When the causes of child maltreatment or neglect are inadequate parenting or stress,
intervention is guidance provided by the CPSW and a referral may be made to a child health
support agency.
(3)
When the causes of child maltreatment or neglect are emotional illness, marital conflict, family
conflict, or alcohol/drug abuse, the decision to refer for treatment or to provide guidance by the
CPSW is based on the severity of the condition:
If the condition is severe and directly impacting the child‘s safety, a referral must be
made to a behavioral health service provider;
If the condition is moderate or mild, and in the supervisor‘s judgment the CPSW has the
skills to intervene, the worker may provide the direct services.
When Domestic Violence is occurring or is the cause of the child maltreatment, the CPSW must refer the
victim to the Domestic Violence Specialist located within the district office. When documenting any
information specific to the children‘s or alleged victim of domestic violence safety, relative to identified
domestic violence, the CPSW must not include locations of potential "safe places" that the child and nonoffending parent might use in a crisis situation.
When a child under age 3 is involved in a founded assessment, the child and his or her parent or guardian
must be referred to Family-Centered Early Supports and Services for a developmental screening, funded
by Part C of the Individuals with Disabilities Education Act.
When the child‘s safety cannot be secured, the child must be placed outside the home. Placement may be
with a relative, foster parent, or residential care provider.
Disposition
If there is a prior founded referral, the assigned CPSW must consult with the direct supervisor prior to
making a determination of unfounded to the current assessment. A statement as to the significance of the
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New Hampshire CFSR Statewide Assessment
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Safety Policy Overview
prior founded to the current assessment must be included in the conclusion summary and approved by the
Supervisor.
If there has been any "additional information" added to the assessment the information must
have been addressed and information documented in the Bridges contact log.
If there are a total of three or more prior unfounded referrals, the assigned CPSW must consult
with the supervisor prior to making a determination to the current assessment of unfounded. A
statement documenting the significance of the prior unfounded referrals to the current
assessment must be included in the conclusion summary screens on Bridges and approved by
the supervisor.
The assessment, including the decision regarding the outcome and notification to the family regarding this
outcome, must be completed no later than sixty calendar days from the date that the referral was
originally received at the district office.
Assessment Outcome Categories Include the Following:
(1)
"Founded, Problem Resolved" means there was a preponderance of the evidence to believe the
alleged incident of abuse or neglect did occur, however, the issues, which led to the abuse or
neglect, have been resolved during the assessment to the extent that the child is no longer unsafe.
This category may include referrals to community resources, which will end the need for
continued DCYF involvement.
(2)
"Founded, Services Only," means there was a preponderance of the evidence to believe the
alleged incident of abuse or neglect did occur and a case will be opened without court
involvement. In these cases, it has been determined by the CPSW and the family that court
interventions is not necessary to ensure the safety of the child because the parent or caregiver is in
agreement that the incident did occur and is willing and motivated to correct the situation that led
to the maltreatment of the child.
(3)
"Founded, Court Action," means there was a preponderance of the evidence to believe the alleged
incident of abuse or neglect did occur, a case is opened, and court intervention is necessary to
ensure the safety of the child.
(4)
"Assessment Not Complete" means the CPSW was unable to complete the assessment and make
a determination due to uncontrollable issues:
(5)
"Unfounded" means a report of child abuse or neglect for which DCYF finds that there is no
preponderance of the evidence to believe the child is abused or neglected. However these
assessments may result in referrals to preventative services.
(6)
―Unfound
ed, Finding Overturned" means that there was a reason to believe that the assessment
was founded, however due to an appeal to the Administrative Appeals Unit (AAU) the finding
has been overturned and the person‘s name does not go on to the Central Registry.
The Assessment CPSW completes Family Strengths and Needs Assessment to identify critical family
strengths and needs and to help develop effective case plans any time there is a founded determination.
When the assessment outcome is "Founded, Services Only" or "Founded, Court Action" a case is opened
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New Hampshire CFSR Statewide Assessment
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Safety Policy Overview
on Bridges for services. When the assessment outcome is "Founded Problem Resolved" no case is
opened on Bridges.
The next two pages illustrate New Hampshire‘s Intake and Assessment process.
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New Hampshire CFSR Statewide Assessment
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Safety Policy Overview
DCYF
Intake
Process
Central Intake
1-800-894-5533
Consult
Referral to
Law Enforcement
For Alleged
Stranger Abuse
No
Further
Action
Community
Referrals
Requested
DCYF Assist
Referral Accepted
for Assessment and
Risk Level Assigned
No
DCYF
Assist
Assigned to DO
Assessment Supervisor
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New Hampshire CFSR Statewide Assessment
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Safety Policy Overview
DCYF
Assessment
Process
Assessment
Supervisor reviews and assigns risk
level, consults with worker
regarding approach with family
Assessment worker meets with
parent/caretaker and child(ren),
gathers information from other sources
Joint Law Enforcement
investigation/DCYF
Assessment are
required when
allegations are related
to sexual abuse,
intentional and/or
severe physical abuse
or when the assessment
indicates the child(ren)
are otherwise the victim
of a crime
Supervisor and worker review all facts and
information to make a case determination
Unfounded
Community
Referrals
No
Further
Action
Founded
Problem Solved
Due Process: Client
may appeal finding
to Administrative
Appeal Unit
Founded
Case Open
Court
Case
Non-Court
Case
60
The Division For Juvenile Justice Services
New Hampshire CFSR Statewide Assessment
July 2010
Safety Policy Overview
The New Hampshire Division for Juvenile Justice Services (DJJS) policy identifies and outlines the use
of a Risk and Needs Assessment, which is designed to serve as a case-planning guide for strengths-based
intervention, anticipation of level of need for services, and safety management.
The Youth Status Report and Risk Needs Assessment tool guide the Juvenile Probation and Parole
Officer (JPPO) through a brief but comprehensive review of the current behavioral and offense status, as
well as the key risk factors, potential strengths and protective factors for each youth referred to the
Division. The Youth Status Report ratings of offense severity and current behavior problems will assist
in determining a preliminary level of supervision, will inform compliance with workload guidelines, and
will guide the JPPO in development of a Community Supervision and Case Plan.
These assessments are incorporated into the dispositional investigation, and enable monitoring of youth
outcomes.
Procedure
The JPPO shall complete the Youth Status Report and Risk and Needs Assessment within thirty days of a
summary disposition or before the disposition hearing. The JPPO may update the Youth Status Report
and Risk and Needs Assessment whenever the juvenile status with the Division changes.
The JPPO will use the tools to collect accurate and detailed information, which identifies the youth‘s
behavior, offense status, and family history. This information will guide the JPPO in developing
appropriate services through the Community Supervision Plan or Case Plan.
The New Hampshire-DJJS Risk and Needs Assessment is based on the Brief Resiliency Checklist, and
documents most of the known risk and protective factors for youth at risk for delinquent or criminal
involvement. It is designed to serve as a guide for JPPOs to come to an efficient, and thorough
understanding of the crucial factors involved in each youth‘s case. Like any case assessment, it requires
review of agency records, interview with the youth and family, contact with school personnel, and any
other community contacts known to the case. At the completion of the Assessment and Youth Status
Report, ample information will be known for case planning and presentation at the dispositional hearing.
Conducting the interviews
In most cases, a youth and his/her family are interviewed as part of any initial intake process. This is the
best time to ask and answer the questions about early developmental risks, childhood problems, family
stresses, traumatic experiences, early developmental strengths, family strengths, involvement and
supports, social skills, and positive perceptions and outlooks. It is important to ask the family and youth
the questions relating to Youth Current Behavioral Ratings. Agency records may contain some of this
information, especially for some of the early developmental risks, childhood problems, and Youth
Offense Severity Scale, but rarely contain enough information to document all the required risk and
protective factors.
It is necessary to interview the youth alone in order to obtain information such as traumatic experiences,
family stresses and strengths, involvement and supports and positive perceptions and outlooks.
61
New Hampshire CFSR Statewide Assessment
July 2010
Safety Policy Overview
Prompting Questionnaire for the New Hampshire-DJJS Risk and Needs Assessment
In an effort to assure standardized risk and needs assessments DJJS policy outlines a ―
Prompting
Questionnaire‖ for DJJS staff. This questionnaire is designed to help prepare for court and for the needs
of the child. They review some past history, including early life and family history, as well as ask about
recent functioning, strengths, and positive factors for the child and the family.
Early developmental risks and strengths
Childhood problems
Family strengths and stresses
Youth protective factors
School skills and supports
Social skills
Joint Case Planning and Case Management
DCYF and DJJS policies are in place to support best practices relative to safety and risk management for
children and youth involved with either/or both systems. Whenever a family is a recipient of DCYF and
DJJS services, it is essential that an integrated process of case planning, implementation and monitoring
take place.
To avoid duplication of effort and services, the case managers (CPSWs and/or JPPOs) must strive for
clear and open communication with one another, with the client family and with community stakeholders.
The case managers must sustain goals of safety for the child and the community. Policy Item 712 Joint
Case Planning establishes the protocols for determining and implementing joint case planning and case
management responsibilities of the assigned CPSW and/or JPPO, which include:
Schedule, attend and participate in a joint case-planning conference with one another and their
immediate supervisors within 10 days of the identification of a joint case.
Prepare a written agreement that documents the assigned roles and responsibilities of the
assigned case managers; this should be integrated into the case plan (Form 2240 MPR) when
the latter document is prepared.
Maintain child and community safety as the primary goals throughout the case planning and
case management process.
Strive for maximum communication and collaboration with each other.
Clearly communicate their specific roles and responsibilities to the family, service providers,
community stakeholders and the court.
Special Investigations
New Hampshire established policy and procedures for conducting investigations of alleged abuse and
neglect of children in residential care and for conducting reviews of programs when a child may have
been injured in a residential setting.
The purpose is to provide direction and guidance to the staff regarding allegations of abuse or neglect
involving residential care facilities, and foster homes. A Special Investigation Unit (SIU) was created to
provide standards intended to achieve statewide consistency.
62
New Hampshire CFSR Statewide Assessment
July 2010
Safety Policy Overview
When investigating an allegation of maltreatment of a child in a children‘s residential care facility, a
child care setting or foster home a determination will be made about whether the allegation require a
CPSW, law enforcement or licensing response. Referrals determined to be possible abuse, neglect or
a crime, follow the same procedure as outlined in policy for all suspected reports. However, instead
of going to the local district office the referral will be made to the Special Investigation‘s Unit
located in state office.
When the child named in the allegation is in the custody of the Division, Special Investigation‘s staff
will coordinate with the worker responsible for the child‘s ongoing case management.
The SIU worker must investigate assigned assessments of alleged child abuse and neglect occurring in
out-of-home placements, determine the child‘s immediate safety needs, determine ongoing risk of
maltreatment and coordinate services to secure the child‘s safety. The responsibilities, as outlined in
policy, apply to all investigations.
63
New Hampshire CFSR Statewide Assessment
July 2010
Safety Outcome 1
Safety Outcome 1: Children are, first and foremost, protected from abuse and neglect.
Item 1: Timeliness of initiating investigations of reports of child maltreatment. How
effective is the agency in responding to incoming reports of child maltreatment in a timely
manner?
New Hampshire continues to make progress in responding timely and effectively to reports of
child maltreatment. In FFY 07, the average response time was 60 hours; in FFY 08, the response
time had declined to 49.9 hours. The response time was even more improved in FFY 09, with the
average being 40.5 hours.
Policy Considerations
New Hampshire has an established centralized Intake Unit, which maintains responsibility for responding
to all initial contacts for inquiries, information and referral and determining whether reports of
maltreatment meet DCYF criteria regarding suspected child abuse or neglect. It also establishes how
these contacts are to be classified, documented, and referred for further action or services, if appropriate.
DCYF‘s Central Intake Office receives between 19,000 and 20,000 calls annually regarding concerns of
child maltreatment and requests for child welfare related information and service referrals.
CFSR Findings Round 1
In 2003, Item 1 was assigned an overall rating of Strength based on the finding that in 89 percent of the
applicable cases, the agency had initiated an investigation of a child maltreatment report in accordance
with the State‘s required timeframes.
A key CFSR finding with regard to this Item is that DCYF initiates child maltreatment investigations and
establishes face-to-face contact with alleged child victims in accordance with State-established
timeframes. However, only 9 (18%) of the 50 cases were applicable for an assessment of this indicator.
Stakeholders commenting on the issue of timeliness of initiating investigations expressed the opinion that
the agency responds to child maltreatment reports in a timely manner. Stakeholders reported that the
police and the child welfare agency collaborate in responding to maltreatment reports effectively.
Changes Since Round 1
As indicated in the chart below, New Hampshire has experienced an increase in the overall number of
calls, as well as the number of actual protective reports received and screened in for assessment over the
past five years. This is likely due in part to changes in the economy and increased efforts by DCYF to
educate the community on reporting.
64
New Hampshire CFSR Statewide Assessment
July 2010
Safety Outcome 1
CALENDAR REPORTS
CALLED IN
YEAR
2005
2006
2007
2008
2009
16472
16413
16786
17164
17631
REPORTS
SCREENED IN
PERCENT
SCREENED IN
6819
6954
7550
7880
7906
41.4
42.4
45
45.9
44.8
Since 2003 New Hampshire has continued to focus attention on documentation of commencing
investigation activity and assuring staff understand and adhere to agency timeframes. This is being
accomplished mainly through the use of ―
supervisors‘ reports‖, discussions at monthly Leadership
meetings and direct supervision of field staff.
In 2004 and 2005 the Bureau of Quality Improvement data managers gathered information from field
staff and supervisors to develop a set of ―s
upervisors‘ reports‖. The Assessment Supervisor‘s report
provides aggregate data at the district office level and has ―d
etail‖ tabs where results are available at the
supervisor, caseworker, and client level. The Supervisor is able to monitor by individual worker the
timeframe between date of assignment and first face-to-face contact with the child. New Hampshire has
made concerted efforts over the past three years to improve timeliness of initiating assessments through
the use of these monthly supervisory reports. Using data management tools has helped New Hampshire
provide a focus on the timeliness of initiating assessments. The use of these reports helps to identify
successful practices, as well as staffing needs.
New Hampshire has consistently improved in meeting response timeframes even while there has been an
increase in the number of protective assessments assigned to the district offices. The chart below
illustrates the improvement in the timeliness of initiating assessments with an assigned response level.
Timeliness of Initiating Assessments
CALENDAR
YEAR
ASSESSMENT ASSESSMENTS
ASSIGNED
# INITIATED WITHIN
% PERCENTAGE INITIATED
2005
2006
2007
2008
2009
6400
6649
7459
7643
7636
3266
3431
3996
4248
5273
51
51.6
53.6
55.6
69.1
TIMEFRAMES
TIMELY
In addition, DCYF added a review tool to the Case Practice Reviews (CPR) that are conducted in each
district office. In 2007, two new review instruments were developed and implemented, one specifically to
evaluate the Assessment phase of Child Protective Services.
The Assessment review instrument allows DCYF to evaluate risk assessment and safety management in a
random sample of twenty completed assessments. These include both substantiated and unsubstantiated
referrals. Adding this component to the ongoing internal review of district office practice assures that the
agency has ongoing information as to the success and barriers in meeting the requirements of this Item.
The trend clearly demonstrates that this focus has indeed led to improved timeliness across the state.
65
New Hampshire CFSR Statewide Assessment
July 2010
Safety Outcome 1
In addition New Hampshire has maintained ongoing efforts to identify and eliminate barriers to timely
responses to maltreatment that are identified during the review process. The Division noted that the
requirements of 169-C: 34 II Duties of the Department of Health and Human Services are detailed in
statute and take effect once a report has been screened-in for assessment. The statute states that for each
report it receives, the department shall promptly perform a child protective investigation to:
(i)
determine the composition of the family or household, including the name, address, age, sex
and race of each child named in the report, and any siblings or other children in the same
household or in the care of the same adults, the parents or other persons responsible for their
welfare, and any other adults in the same household;
(ii) determine whether there is probable cause to believe that any child in the family or household
is abused or neglected, including a determination of harm or threatened harm to each child, the
nature and extent of present or prior injuries, abuse or neglect, and any evidence thereof, and a
determination of the person or persons apparently responsible for the abuse or neglect;
(iii) determine the immediate and long-term risk to each child if the child remains in the existing
home environment; and
(iv) determine the protective treatment, and ameliorative services that appear necessary to help
prevent further child abuse or neglect and to improve the home environment and the parents'
ability to adequately care for the children.
DCYF determined that after an initial contact, some reports do not warrant a complete assessment as
outlined in statute. Therefore, in 2006 DCYF piloted a ―s
econd level‖ screening process. In February
2007 a new policy, Item 680(e) Second Level Screening, was adopted and rolled out statewide. The
purpose was to establish policy and procedures for the district office to determine whether a referral
received from Central Intake warrants a DCYF assessment. The philosophy behind this change was to be
minimally intrusive to families and assure thorough screening of referrals of child abuse and neglect. As
a result, staff resources were able to assure a more timely focus on the legitimate protective reports
requiring a full assessment.
Data Considerations
The Case Practice Reviews (CPR) conducted in each district office between June 2006 and August 2009
found the results for Item 1 rated Strength in 73% of the cases statewide. It should be noted that initially
during Case Practice Reviews it was found that often the safety Items were not applicable because of the
period under review. The implementation of the assessment instrument assured that Safety Item 1 was a
substantial element reviewed between 2007 and 2009. The chart below indicates the ratings by office on
this Item.
Item 1: Timeliness of initiating investigations of reports of child maltreatment
Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester Salem
Jun-07 Dec-06 Jun-08 Jun-06 Dec-07 Sep-07 May-09 Dec-08 Aug-10 Sep-08
May-07 Mar-09
100
66.7
80
n/a
100
66.7
100
60
75
33.3
60
100
The Portsmouth District Office review in 2008 continued to identify challenges with timely responses to
reports of maltreatment. This office had a history of allowing families to have discretion in determining
not only where interviews with children occurred but also when they occurred. Since the review in 2008
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New Hampshire CFSR Statewide Assessment
July 2010
Safety Outcome 1
Portsmouth staff have shifted their practice in this area standing firm with the expectation that if the
circumstances warrant a report of maltreatment, families must be held to the timeframes in policy.
The most recent supervisor reports identify that the Portsmouth District Office efforts to assure more
timely responses to reports of maltreatment have resulted in improved timeframes for all levels of
response priorities. In particular, they meet timeframes 98% of the time for reports with a Level 1
response priority.
Strengths
In working with the data and tracking the timely initiation of child abuse reports, and eliminating policy
barriers, DCYF has improved the ability to respond timely and effectively. Delays in response times are
now mostly attributed to the child or parental refusal to cooperate and/or allow access to the child. These
are documented as failed attempts.
The other factor for a delay in timeframes is coordinating an assessment with local law enforcement. If
commencing the assessment within 72 hours would result in repeated interviews to the child, or if the
child is not at imminent risk and the alleged perpetrator will not have unsupervised access, the timeframe
to commence an assessment is discussed with the Supervisor. We believe this is consistent with good
practice, as it effectively serves the child and the family in the least intrusive manner.
Overall, the data and reviews of specific cases support the premise that New Hampshire is consistently
responding to safety concerns in a timely and appropriate manner, consistent with policy. In fact,
supervisor reports indicate that in 90% of the Level 1 reports DCYF fulfills the 24-hour response
requirement.
Opportunities For Improvement
New Hampshire sees the focus on establishing consistent practices within all aspects of the assessment of
child maltreatment as the most important opportunity for improvement. As we establish a practice model
that identifies our beliefs, values and practice approaches in initiating, as well as completing, assessments,
DCYF is confident that we will be able to demonstrate even more improved and timely responses.
67
New Hampshire CFSR Statewide Assessment
July 2010
Safety Outcome 1
Safety Outcome 1: Children are, first and foremost, protected from abuse and neglect.
Item 2: Repeat maltreatment. How effective is the agency in reducing the recurrence of
maltreatment of children?
New Hampshire has been above the national standard of 94.6% for Absence of Recurrence of
Maltreatment in FY 2007 and 2008 as reported in the NCANDS data. In FY 2009 the data
showed New Hampshire‟s performance as slightly below the standard at 92.9%.
Policy Considerations
As outlined in the Safety Policy Overview New Hampshire requires thoughtful planning of a child abuse
or neglect assessment in order to assess the safety of the child and to minimize future risk of harm to the
child and other family members.
The updates to policy were specifically identified to assure consistent use of the SDM risk assessment and
if there was a history with the family, the history is reviewed as part of that new assessment. Nationally
there are practice tendencies for staff to be incident-focused when assessing reports of maltreatment. The
policies outlined in New Hampshire shift practice to be holistic and to look beyond the current incident
and assure a thorough family assessment.
DCYF policy has had a direct impact on the practice in the field. Staff are identifying risk and
minimizing repeat maltreatment by consistently using both formal and informal risk and safety
assessments. The adoption of formal tools that are embedded into case planning has helped to improve
the overall safety and risk assessments resulting in less repeat maltreatment.
The same policies are being applied to assessments conducted by our Special Investigations Unit. This
unit responds in collaboration with the District Office to reports of maltreatment in foster homes, as well
as childcare or residential settings.
The key to minimizing repeat maltreatment is the practice of identifying those issues requiring not only an
investigation of maltreatment, but also a licensing response. This has brought about a practice that
focuses on licensing issues and concentrate on the difficult conversations that need to occur even if an
allegation is not substantiated.
It has been determined that the consistent implementation of licensing expectations relative to the
standard of care being provided in placement is vital to minimizing future maltreatment of children.
CFSR Round 1 Findings
Safety Item 2 was an Area Needing Improvement during New Hampshire‘s CSFR Round 1. Despite the
case review finding of no maltreatment recurrence as it is measured for the CFSR (Item 2), the
maltreatment recurrence data reported in the State Data Profile indicate that New Hampshire did not meet
the national standard for this measure.
Although the State did not achieve substantial conformity with Safety Outcome 2, a key finding of the
CFSR was that in most of the cases reviewed, DCYF provided appropriate services to families to prevent
the removal of children from their homes and made concerted efforts to address the risk of harm to
68
New Hampshire CFSR Statewide Assessment
July 2010
Safety Outcome 1
children. However, in some cases, reviewers determined that the assessments conducted were not
sufficient to address the safety issues in the home, which resulted in some children remaining at risk.
This latter finding was consistent with the opinions of some stakeholders that DCYF is not as effective as
it needs to be in assessing for underlying problems in the family, such as domestic violence, sexual abuse,
and substance abuse.
Changes Since Round 1
Since 2003 New Hampshire has focused on a more consistent use of the formal risk assessment and
family strengths/needs tools to determine the service needs of the child and family prior to closing an
assessment. It is expected that the CPSW also share information about concerns with other service
providers involved with the family. This direct intervention by the CPSW is intended to prevent future
maltreatment even when none has been substantiated.
New Hampshire has a 60-day assessment period in which to address reports of child maltreatment. Since
2003 the Division has focused on providing early and ongoing comprehensive family assessments,
training staff and supervisors to identify underlying issues and address them with the right intensity of
response and interventions. We continue to address the value of a ―
family‖ assessment rather than an
incident specific assessment. Families in cases that are open for services, receive ongoing risk reassessments to determine the family‘s progress toward achieving case plan goals.
The SDM supervisory case read process was established in October 2004 because SDM was not being
implemented consistently in the field. The case read process involved the random selection of one case or
assessment per worker per month in each district office. This process was successful in shifting practice
to consistenly use SDM tools. Currently, supervisors use the case reading tools on selected cases and
assessments to ensure the workers are using the SDM tools correctly. Supervisors use this information as
a clinical tool, not a tracking tool. The case read process is viewed as a ―
tool in the tool box‖ to ensure
consistency with SDM case practice. Since 2004, 4500 assessments have been selected for a supervisory
case read.
Unlike many states New Hampshire has a relatively lengthy assessment period. Reports of child
maltreatment are to be completed within 60 days of the District Office receiving the report. Historically,
more than two-thirds remained open for more than 120 days, and 33% remained open for more than eight
months. These assessments were deemed ―
unfounded‖ by the worker and the delay was in the actual
completion of the closing documentation.
Although DCYF has clearly improved in assuring timely closing of assessments, the ability to complete
assessments in a timely manner is a remaining factor that impacts the data, implying repeat maltreatment.
Delays in closing assessments with an ―
unsubstantiated‖ finding impacted data on this Item. When a
subsequent referral would come in warranting a ―
substantiated‖ finding, the worker would then make a
substantiated finding on both reports, giving the impression that there was repeat maltreatment.
The timely completion of assessments is beneficial to children and families and indicates a more
effective, less cumbersome workflow for DCYF staff. Interestingly, the practice of ―s
ubstantiating‖ on
two separate reports continues to impact repeat maltreatment data. Multiple reports of maltreatment can
be received for similar allegations over the sixty-day assessment period. Instead of making one finding of
maltreatment, some staff continue to make multiple findings. This practice is not truly reflective of the
issues relative to repeat maltreatment and skews the data.
69
New Hampshire CFSR Statewide Assessment
July 2010
Safety Outcome 1
The impetus behind Item 2 is that once a finding of child maltreatment is made the agency wants to
minimize the likelihood that a child will experience repeat maltreatment after the agency intervenes. New
Hampshire is working with supervisors and staff to standardize the practice of closing out multiple reports
(with the same allegations) with just one finding. Multiple findings should only occur if indeed the child
experienced continued or different maltreatment after DCYF involvement.
Data Considerations
New Hampshire conducts quarterly Case Practice Reviews (CPR) in district offices that mirror the CFSR
process. A CPR was conducted in each district office between June 2006 and August 2009. Statewide,
repeat maltreatment was rated as Strength in 95.6% of those cases reviewed and nine of the twelve offices
scored 100 % on this Item.
The chart below indicates the ratings by office on this Item. The data from the reviews align with what is
happening in practice and what is reflected in the data profiles.
Item 2: Repeat Maltreatment
Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester Salem
Jun-07 Dec-06 Jun-08 Jun-06 Dec-07 Sep-07 May-09 Dec-08 Aug-09 Sep-08
May-07 Mar-09
100
100
100
100
100
100
100
80
*
100
50*
*In Rochester 10 cases were not applicable, one was rated strength, one ANI. In Nashua,
eleven were not applicable and 1 was ANI.
100
In the 2008 Manchester Review the rating dropped from a previous 100% to 80%. The challenge in
Manchester for this Item focused upon assessments with three or more reports concerning similar
allegations. The data and the practice demonstrate a continued challenge of accepting multiple reports
and then making multiple findings giving the appearance of repeat maltreatment. As mentioned
previously, this is a practice we are changing and monitoring to assure that the timing of multiple findings
is the issue and not the lack of appropriate referrals for services to these families to prevent recurrence.
Strengths
The utilization of data is a clear strength in minimizing repeat maltreatment. Monthly supervision reports
have enabled supervisors to review monthly staff activity relative to documentation of face-to-face
contacts, meeting timeframes and closing assessments. The use of this information has helped to assure
timely initiations and completion of investigations as well as closings. Case practice demonstrates that at
the close of every assessment DCYF staff make referrals and document in the case record which are
reviewed by supervisors.
Assessment documentation issues have been resolved, which has also positively impacted repeat
maltreatment data. Historically, delays in closing assessments without a finding entered skewed the data
on this Item. The changes in this practice have helped to improve not only the data but also the actual
practice involved with timely completion of assessments for the agency as well as the family.
New Hampshire has been able to utilize data as a supervision tool and has seen the positive impact data
can have on practice. Supervisors and staff use data to identify resource needs, successful practices and
practice issues. This was clearly the case in improving outcomes in Item 2.
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New Hampshire CFSR Statewide Assessment
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Safety Outcome 1
Opportunities for Improvement
Practice regarding review of prior assessments of maltreatment and documenting as well as incorporating,
their significance in relation to the current assessment varies statewide. In the fall of 2008 assessment
revitalization discussions were initiated with supervisors at monthly Leadership meetings to examine
practice related to the assessment process. One of the Items discussed was review of prior reports and
what action was being taken to assure CPSWs were acting in accordance with policy. It was determined
that CPSWs routinely reviewing prior assessments. However, the agency recognized the significance of
not just reviewing prior reports but factoring the information into the closing decision. Supervisors
continue to discuss this and see it as an opportunity for New Hampshire to improve practice, regardless of
the disposition of the assessment.
In addition, some staff/offices continue to make duplicative findings on families where we have received
and accepted more than one report within a 30-day period, giving the appearance of repeat maltreatment.
New Hampshire is focusing on these two areas for continued efforts to improve practices in assuring our
continued strength in this Item.
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New Hampshire CFSR Statewide Assessment
July 2010
Safety Outcome 2
Safety Outcome 2: Children are safely maintained in their homes whenever possible and
appropriate.
Item 3: Services to family to protect children in the home and prevent removal or reentry
into foster care. How effective is the agency in providing services, when appropriate, to
prevent removal of children from their homes?
The State‟s performance for absence of maltreatment recurrence in 2008 was 95.8%, which was
above the national standard of 94.6% but has dropped slightly to 92.2%. New Hampshire‟s
performance on Absence of Child Abuse and/or Neglect in Foster Care has continued to improve
and in 2009 was 99.93%, which is above the national standard of 99.68%.
Policy Consideration
As outlined in the Safety Policy Overview the immediate safety of the victim is of paramount importance.
For reports of child maltreatment, workers respond according to mandated timeframes and conduct
interviews of all child victims, siblings, the non-offending parent, the alleged perpetrator, and collateral
contacts. The Safety Assessment is completed on all assessments within 24 hours of face-to-face contact
with the alleged victim to guide decisions about services or removal.
This policy identifies the expectations and as a result, has impacted practice in this area. Even though
there may be times when children must be removed from their home to assure safety, the practice of
safety planning with specific interventions in situations such as domestic violence, has played out as a
viable option that is being applied more consistently across the state.
CFSR Round 1 Findings
This Item was rated as strength during the 2003 CFSR. There were 26 cases for which an assessment of
Item 3 was applicable. Item 3 was rated as Strength in 22 (85%) of the 26 applicable cases (6 of which
were foster care cases).
Most stakeholders commenting on this Item indicated that there are a number of community-based
services and home-based services available in the State to prevent children‘s removal from their homes or
their re-entry into foster care after reunification. Stakeholders also expressed the opinion that the in-home
services available are usually successful in maintaining children safely in their own homes.
Changes Since Round 1
On January 1, 2008, Governor Lynch signed into law a comprehensive piece of permanency legislation,
Senate Bill 152. The goal of the new permanency legislation is to reduce the length of time until
permanency is achieved for all children involved with DCYF or DJJS. The new law significantly changes
New Hampshire‘s Child Protection Act (RSA 169-C) and statutes for Children in Need of Services (RSA
169-D) and Delinquent Children (RSA 169-B).
This law significantly impacts permanency items, as well as the expectation that the agency will safely
maintain children in their homes whenever possible. The law requires the court to make ―
contrary to the
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New Hampshire CFSR Statewide Assessment
July 2010
Safety Outcome 2
welfare‖ and ―
reasonable efforts” (to prevent the removal) findings in abuse and neglect cases as well as
cases that involve delinquents and CHINS. The purpose for adding this to New Hampshire statute was to
emphasize the importance of efforts to prevent removal, as well as the court‘s active role in assuring that
the agencies provide services and planning prior to removal if at all possible.
Other changes since Round 1 include:
As indicated in Item 2, New Hampshire has focused on establishing consistent use of
Structured Decision Making (SDM) since 2003. The SDM tools assist workers in improved
identification, assessment and response to the safety, risks, and strengths of children and
families. As a result, workers are able to identify service needs and incorporate those needs
into the services identified in case planning with families.
Core Training for child protection staff has been revised to include enhanced focus on
engaging families in the assessment and case planning process. As a result of this shift in
approach and practice when working with families New Hampshire has seen an increase in the
number of in-home cases.
In 2005 DCYF contracted with community-based agencies for twelve statewide regions to
provide support services to approximately 500 families annually. The Comprehensive Family
Support programs assist families and children by promoting family wellness, decreasing family
stress, and preventing abuse and neglect. The social service agencies identify and assist
families with multiple stressors by providing multivariate services, which encourage and
promote the development of healthy families. The data show that the changes across all family
support programs were statistically significant at the .0001 level. These outcomes are used to
inform program practice and public policy.
Since 2005 the Bureau of Organizational Learning provided 223 staff with the Learning Core
Module 1: A Family-Centered Approach to Child Protection, 209 staff with Core Module 2:
Engaging Families in Family-Centered Child Protection and 189 staff with Core Module 2
Learning Lab.
In April 2008 training was provided on the Zero to Three Preventing Child Abuse and Neglect
curriculum and included child protective service workers, child care resource and referral
coordinators, early childhood education full time and adjunct faculty, child care consultants
and a UNH cooperative extension early childhood trainer. The child protective service workers
and early childhood professionals teamed up to provide 75 trainings within 15 months
including all District Office regions for child care and other early childhood professionals and a
full-day track at the DCYF annual conference in 2008. The trainers continue to provide
trainings throughout New Hampshire and the target audience has expanded to include early
intervention and home visiting professionals.
DCYF has contracted with the ten child care resource and referral agencies to provide at least
three of these trainings per year. Professionals who receive training are expected to implement
strategies to support parents of young children to develop protective factors known to prevent
child abuse and neglect, for example, access to material supports in times of need, reliable
social networks, and enhanced knowledge of parenting and child development.
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Safety Outcome 2
DCYF contracts with community-based agencies for twelve statewide regions to provide support services
in an effort to assure a focus on sustaining children in their own homes. The programs assist families and
children by promoting family wellness, decreasing family stress, and preventing abuse and neglect.
Data Considerations
The Case Practice Reviews shown in the chart below conducted in each District Office between June
2006 and August 2009 have found that Item 3 was consistently rated as Strength. 91.9% of the cases
reviewed were found to have appropriate and timely services put into place to maintain the children in the
home or prevent removal. New Hampshire has also seen a significant decrease in the number of children
in out-of-home care from 1100-1400 in SFY 2003 to approximately 950 at the current time. The decrease
allows staff caseloads to remain at a manageable ratio.
Item 3: Services to family to protect children in the home and prevent removal or re-entry into
foster care
Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester Salem
Jun-07 Dec-06 Jun-08 Jun-06 Dec-07 Sep-07 May-09 Dec-08 Aug-10 Sep-08
May-07 Mar-09
100
100
100
75
100
77.8
100
100
83.3
100
87.5
100
DCYF contracts with community-based agencies for twelve statewide regions mentioned above to
provide support services to approximately 500 families annually. Data from tracking the graduating class
following discharge from a comprehensive support program for three successive years, 2007-2009,
shows: 33% of the children first entering a program were referred by DCYF during an assessment of the
family. Of those families 92% did not have a DCYF case opened for at least two years following
completion of the program.
The data trends align with the shift in practice demonstrating that the more we provide ongoing
assessment of safety needs and early interventions to address those specific needs, the less likely children
are to experience re-entry into care.
During the case practice reviews in Conway the data for this Item demonstrated an area needing attention
and focus. The review identified the need for improvements in assessment documentation and up front
services. Since this review in 2006 Conway has worked to shift its practice to engage families more at the
―f
ront door‖. Utilizing community resources prior to removal and engaging families in non-court
interventions has been the focus for the past five years. As a result, Conway staff have identified an
increase in voluntary cases and non-court cases.
Current data for Conway has shown a consistent decrease in the percentage of children being removed
and placed in out-of-home care. In 2007, 57% of children served in Conway were in placement. In
2010, only 39% were in placement. This data reflects the change in up front practices, demonstrating a
decrease in placements with improved efforts to provide services and prevent removals.
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New Hampshire CFSR Statewide Assessment
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Safety Outcome 2
#
#
%
2010
92
36
39%
2009
94
39
41%
2008
81
43
53%
2007
54
31
57%
CONWAY
CHILDREN CHILDREN CHILDREN
IN OPEN
IN
IN
CASE
PLACEMENT PLACEMENT
Strengths
New Hampshire has made and continues to make progress in improving assessment of service needs and
planning with families and providers, as noted in case practice reviews. In addition, New Hampshire has
made concerted efforts through training and other statewide meeting opportunities to address the way we
provide services and to emphasize that we have an obligation to monitor the effectiveness of services. In
a State that has a litigious process for child protection, New Hampshire values the importance of keeping
services that address needs and not services that are a compliance issue for court. This is a shift in
practice and change in focus from a court-driven process to a family needs-driven process.
We believe we have accomplished this through venues including but not limited to the following:
New Hampshire has focused on establishing consistent use of Structured Decision Making
(SDM) since 2003. The SDM tools assist workers in improved identification, assessment and
response to the safety, risks, and strengths of children and families. As a result, workers are
able to identify service needs and incorporate those needs into the services identified in case
planning with families.
Incorporating ‗reasonable efforts‖ language into statute has helped to assure a focus on services
and needs assessment for the agency and the court at every hearing.
Through the Court Improvement Project (CIP) and the creation and training on protocols for
the court to use in child protection cases the Division Director and other leaders continue to
meet and identify service delivery and culture changes that need to happen in all systems
including the courts. The creation of court guides for cases of co-occurrence of domestic
violence and child maltreatment and the generic CIP protocols have been key in creating
change to the way child protection cases move forward. Taking a litigious process and making
it family and child specific focusing on reunification and rehabilitation, rather than just
compliance with orders, has been a successful shift in practice.
New Hampshire has created prevention programs and community resources across the State
that provide an array of early intervention opportunities for families that can address service
needs without agency or court intervention.
The ability to provide agency case management and services to families in less intrusive ways
through the creation of ―
Voluntary Service‖ and Non-Court case options for working with
families at risk.
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Opportunities For Improvement
New Hampshire CFSR Statewide Assessment
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Safety Outcome 2
Item 3 is of particular interest to us in New Hampshire as we have worked diligently over the years to
improve our prevention and community services. The intent is to make it easier to serve families without
court intervention. The creation of Non- Court (B) cases and a Voluntary services statute in 2001 enabled
the Division to offer services to families in a less intrusive manner. This has led to only the more critical
cases or imminent danger cases being brought to court for removal and placement services. We want to
assure, however, that this does not diminish our efforts to prevent removal even in those very high-risk
cases.
New Hampshire has clearly demonstrated improvement in providing services to children in their homes,
with the resulting reduction of initial removals and overall number of children in care. The opportunity to
assure consistency in practice statewide will assure continued improvement in this area.
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Safety Outcome 2
Safety Outcome 2: Children are safely maintained in their homes whenever possible and
appropriate.
Item 4: Risk assessment and safety management. How effective is the agency in reducing the
risk of harm to children, including those in foster care and those who receive services in their
own homes.
New Hampshire continues to successfully focus on reducing the risk of harm to children, as
evidenced by the data on repeat maltreatment and the absence of maltreatment in foster care.
NCANDS Data for the Absence of Recurrence of Maltreatment was at 92.2% in 2009 and
exceeded the National Standard (99.68%) for absence of maltreatment in Foster Care at 99.93%
Policy Consideration
As previously indicated New Hampshire uses a Structured Decision Making model that includes both a
Safety Assessment tool and a Risk Assessment tool based on national research that is designed to indicate
the likelihood of future maltreatment. These tools are incorporated into Bridges (the Statewide
Automated Child Welfare Information System), and required to be completed on every case within
twenty-four hours of the first contact with the child and before the close of the assessment.
New Hampshire policy and practice focuses on assuring that staff identify safety issues and the services
or resources that are needed to respond and mitigate safety concerns.
The efforts to consistently use SDM and informal assessments of risk have been an additional focus of
policy and practice initiatives. New Hampshire wanted to assure through case practice that policy and
trainings clearly identify the differences between safety and risk and the importance of identifying and
managing both effectively and distinctly.
A particular policy and data consideration that needs to be noted here is that New Hampshire has a 60-day
assessment period. This timeframe can be conducive to efforts to assess safety/risk and the provision of
services. However, when the agency receives multiple reports on the same issues within a 30-day period,
there has been a tendency for staff to make multiple findings on those reports. This led to the appearance
of repeat maltreatment when in reality the same allegation was triggering multiple findings. This is not
fair or productive practice for families or the agency. This issue has been identified but still occurs
sporadically and is being addressed during case practice reviews.
CFSR Round 1 Findings
In 2003 this Item was assigned an overall rating of Strength in 85.3% of the applicable cases. Reviewers
determined that DCYF had made diligent efforts to address the risk of harm to children.
Stakeholders commenting on this Item were in general agreement that once a report is substantiated or a
child is removed from the home, the agency is effective in addressing risk of harm issues. However, they
also expressed concern that, because of the State‘s requirement that a pattern of maltreatment be
established for a determination of substantiation, children are at high risk of harm prior to the agency
making a determination of substantiation and often enter foster care with a long history of ―un
founded‖ or
―s
creened out‖ maltreatment reports. In addition, a few stakeholders noted that the DCYF is not
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New Hampshire CFSR Statewide Assessment
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Safety Outcome 2
consistently effective in responding to the underlying issues in a family that tend to put children at risk of
harm. Stakeholders also reported that delayed adjudication can negatively impact the provision of
services in a case.
Changes Since Round 1
Major changes since 2003 include the combined efforts of DCYF and DJJS to coordinate practice
initiatives relative to safety and risk assessments and service planning. We are aware that the way both
agencies manage safety and risk in the beginning of the case process impacts the success of permanency
planning for children and youth. The following are highlighted initiatives from both divisions that have
impacted change over the past several years:
New Permanency Legislation was signed into law in 2008 that has the main focus of
expediting permanency for children and youth in New Hampshire. This law will be discussed
in more detail in the permanency section; however a key component of this statute is the
requirement that the court will hold an adjudicatory hearing within 30 days of the filing of a
petition. As this was cited as a barrier during the first round we knew that expedited
adjudicatory hearings would lead to more timely services as well.
The Division for Juvenile Justice Services adopted the Risk/Safety Management Tool in an
effort to assure that the agency is effectively managing risk with juveniles involved with
Juvenile Justice as well. All JPPOs, youth and families are required to complete this tool postadjudication. Services are recommended to the court based on the results of this tool.
DJJS also utilizes NHJB-2581 (03/09/2009) Detention Assessment Screening Instrument to
assess the risk and needs for safety.
Since September of 2008 DCYF has participated in the Breakthrough Series Collaborative on
Safety and Risk Assessments, sponsored by the New England Association of Child Welfare
Commissioners and Directors, Casey Family Programs and Judge Baker Children‘s Center.
This Breakthrough Series Collaborative is a two-year commitment that involves four teams
from New Hampshrie. Teams are comprised of discreet participants that include representation
of state office administration, district office supervisors, front line supervisors and staff, birth
parents, youth, and cross-system partners.
Since 2003 DCYF and DJJS have worked to assure that policy and practice reflect the value of ongoing
assessment of safety and risk for children in and out of the foster care system. As we improved our ability
to assess, identify and manage risk we also saw a decline in the number of children in placement and the
length of time children were placed in out-of-home settings.
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Data Considerations
The Case Practice Reviews demonstrate consistent risk assessments and safety management occurring in
the district offices.
Item 4: Risk assessment and safety management
Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester Salem
Jun-07
82.0
Dec-06
100
Jun-08
91.7
Jun-06 Dec-07 Sep-07 May-09
87.5
83.3
83.3
100
Dec-08
83.3
Aug-10
66.7
Sep-08
100
May-07
66.7
Mar-09
91.7
The Rochester and Nashua offices have had challenges engaging families in conversations relative to the
need for services and the practice of referring families for services, especially as it relates to domestic
violence and counseling services for children. They have been and continue to work on improveing
documentation of these practices as well as more timely use of the SDM tools. Through their program
improvement initiatives each office has identified improved supervisory monitoring of SDM and case
reads.
Monitoring data trends illustrated below show movement toward fewer removals, which demonstrates
more efforts to provide services and prevent removal in those two offices.
% Children in Placement
Nashua
Rochester
2007
60 %
66%
2008
57%
51%
2009
55%
44%
The data demonstrates a significant link between offices that use SDM timely and refer timely to services
and the rating on this Item. Continued focus in the two identified offices has begun to show improvement
in this area. In the chart below statewide data also demonstrates a decrease in the removals indicating an
improved ability to maintain children in their home. The alignment of data showing that fewer children
are being placed and the continued ability to minimize repeat maltreatment demonstrates overall
improved practices in this area.
July 2005
January 2006
July 2006
January 2007
July 2007
January 2008
July 2008
January 2009
July 2009
January 2010
# Children in
Open Case
1747
1710
1680
1738
1792
1816
1874
1670
1650
1688
# Children in InHome Case
667
636
608
689
744
803
867
760
820
897
% Children in InHome Case
38.2
37.2
36.2
39.6
41.5
44.2
46.3
45.5
49.7
53.1
# Children in
Placement
1080
1074
1072
1049
1048
1013
1007
910
830
791
% Children in
Placement
61.8
62.8
63.8
60.4
58.5
55.8
53.7
54.5
50.3
46.9
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Safety Outcome 2
Strengths
New Hampshire has continued to work on practice that impacts our ability to manage risk and safety
issues. The following strengths have been identified.
The number of children entering care is lower, the rate of placement has lessened, and the
stability in placement indicates that we are able to manage risk effectively for children in care.
Managing caseloads is the first priority in reducing risk. Vigilance regarding caseload capacity
is the primary ingredient in addressing the needs of children, as it gives workers time to engage
in quality contacts with children and families, addressing risk and protective factors.
The Division for Juvenile Justice Services focuses on formal Risk/Safety Management Tools to
assure that the agency is effectively managing risk with juveniles involved with the Juvenile
Justice System.
Participation in the Breakthrough Series opens the door to improve outcomes in the seven key
practice areas.
SDM Tools are used consistently to assess and manage safety and risk.
Opportunities For Improvement
The lack of consistent ratings in this area identifies the opportunity to standardize numerous aspects of
risk and safety assessments. Nine of the twelve offices rated higher than 80% for this Item, which
demonstrates overall improvement, but the need to focus on practice and documentation in this area will
provide even more opportunity for improvement.
DCYF and DJJS have been able to demonstrate through more timely formal and informal risk
assessments that there is a value to both tools. Standardizing the way the field uses the tools and follows
policy is the focus for the future.
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Permanency Overview
Permanency Practice Policy Update
The past several years have brought dramatic changes in Permanency Planning within the New
Hampshire Division for Children, Youth and Families and the Division for Juvenile Justice. Permanency
has been the focus of much of the system wide re-structuring that has taken place since 2003, in an effort
to respond to permanency issues identified in the first round of federal reviews that highlighted a need to
focus on timeliness to permanency. New Hampshire has continued to work on enhancing policies that
will drive practice and maintain a focus on permanency and permanency planning for children, youth and
their families. The policies address the need for children to have stability in their living situations and
specifically when in out-of-home placements. Policy is meant to guide changes that reflect efforts to
achieve case goals and maintain connections with the child‘s family and community.
During a safety assessment reasonable efforts are made to secure services and implement protective
strategies. If services or resources which are sufficient to keep the family together while keeping the
children safe, cannot be identified, removal must be considered. When placement is warranted, DCYF
meets with the family, whenever possible, to engage them and their support system before placement
occurs.
In New Hampshire an out-of-home placement requires a court order. Court action must be initiated for
both DCYF and DJJS placements to occur. This court action was identified in 2003 as a barrier to
permanency due to timeframes for hearings and the courts lack of focus on permanency issues.
DCYF and DJJS partnered with the court around two specific statute changes, the creation of Voluntary
Mediated Adoptions and the inclusion of a Permanency Statute to assure improved outcomes for children
who enter out-of-home placement. Through assistance of the New Hampshire Court Improvement
Project, protocols have been created and adopted by courts and statutes changed to assure that children
and youth have timely permanency and the court barriers identified in 2003 were addressed.
On January 1, 2008, Governor Lynch signed into law a comprehensive piece of permanency legislation,
Senate Bill 152. The goal of the new permanency legislation is to reduce the length of time until
permanency is achieved for all children involved with DCYF or DJJS. The new law significantly changes
New Hampshire‘s Child Protection Act (RSA 169-C) and statutes for Children in Need of Services (RSA
169-D) and Delinquent Children (RSA 169).
Highlights of these changes are as follows:
Court Findings: The law requires the court to make ―
contrary to the welfare‖ and ―r
easonable
efforts to prevent the removal‖ findings in abuse and neglect cases, as well as cases that
involve delinquents and CHINS.
Adjudicatory Hearing: The law requires that the adjudicatory hearing in a child protection case
be commenced and completed within thirty calendar days of the filing of the petition absent a
written finding of extraordinary circumstances. If the court, due to extraordinary circumstances
continues the adjudicatory hearing, the hearing is required to be held, completed and a court
order issued within, sixty calendar days of the filing of the petition.
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The law also requires that any adjudicatory order that includes a finding and provides for outof-home placement of a child set a date for a permanency hearing within 12 months of the
finding.
The law also requires that at each review hearing the court must determine whether DCYF has
made reasonable efforts to finalize the permanency plan that is currently in effect for the child
and to consider, ―wh
ether services to the family have been accessible, available and
appropriate‖. This finding is also required at all review hearings held for CHINS cases.
Permanency Hearing: The law establishes in statute a requirement for a permanency hearing
for abuse and neglect cases, as well as cases that involve delinquents and CHINS.
In addition to legislative changes, DCYF and DJJS addressed improving internal practices. Traditionally,
the roles of staff had been defined in a way that had not been conducive to timely and effective
permanency planning: Child Protection staff worked with birth parents to develop plans leading to
reunification; Foster Care Licensing staff would find, evaluate and support foster homes; and Adoption
staff worked with children and adoptive families following the termination of parental rights.
It was evident that genuine concurrent planning and permanency efforts demanded a different
organizational model. This necessitated no longer compartmentalizing the roles of Child Protection,
Foster Care Licensing, and Adoption staff. By creating permanency and adolescent workers in each
office and establishing ―Pe
rmanency Planning Teams‖ (PPT) staff could share case responsibilities from
the outset, rather than becoming involved in a child/youth‘s life sequentially.
To this end, certain specific casework steps needed to be taken to identify and nurture permanent family
connections for children in each district office and concurrent planning needed to become an active part
of practice. These changes and polices have impacted the following outcomes:
reducing the number of placements,
reducing the length of time in care,
an increase in voluntary relinquishments, and improving the long-term adjustments of the child
by an increase in the degree of openness,
providing better outreach and support to extended families in making decisions,
recruiting and supporting foster-adopt families, both before and after placement, and
conducting early searches for extended family resources.
The policies listed below identify the importance of focusing on permanency even prior to removal and
that family connections be maintained and that children/youth reside in the least restrictive settings.
Item 729 Placement Options,
Item 729(a) Placing Siblings Together/Maintaining Connections,
Item 700 Parent/Child Visitation,
Item 701 Worker Child Visits,
Item 703 Permanency Options for Children and Youth in Foster Care, and
Item 721 Voluntarily Mediated Agreements In Adoptions.
When a child or youth requires out-of-home placement, the worker must first consider relatives and close
family friends who may be willing and able to provide substitute care. Policy requires a search for
relatives as soon as placement is being considered. Significant efforts have been made through policy and
trainings to look at the natural resources children and families have when first entering the system.
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Permanency Overview
In 2007, a new initiative Finding Connections was launched, to assist in the identification of relatives and
other lifelong connections for a youth. DCYF contracted with Easter Seals to place a Connection
Specialist in each district office to research a child‘s case file (case mining) and work collaboratively with
the caseworker and PPT to identify positive resources.
In an ongoing effort to support relative placements, DCYF hired a Relative Care Specialist in April 2008.
The Relative Care Specialist revised the Relative Care policy and shall keep it current. In addition, the
specialist works on the development of programs and supports for relative care providers.
When placement with a relative or friend is not possible, the least restrictive licensed foster home is then
considered. DCYF has shifted their activities with recruitment and retention of foster parents to focus on
stability of children‘s placements. We advertised the need for ―
resource families‖, first placements being
last placements for children. This shifted the way foster homes were recruited. The need to take the
uncertainty of ―f
oster care‖ off the backs of children and put it on the adults who are more able to deal
with it was identified. Foster homes were recruited to be short- term placements for children pending
reunification. However, if reunification could not occur, that same family would be willing to adopt.
This was a paradigm shift for New Hampshire but one that needed to occur. Today, resource homes are
readily available and this has clearly improved timeliness to permanency.
Permanency Options for Children and Youth in Foster Care
Within policy we guide best practice for staff to achieve a safe, stable and permanent environment for
every child or youth in the timeliest way possible. A permanent relationship with a nurturing caregiver is
necessary to establish the foundation for a child‘s healthy development.
Permanency Options include:
The most preferred permanent placement for a child is a safe and permanent reunification with
the family of origin.
Permanent placement with extended family is preferred when it is not possible to reunify with
the family of origin.
For children who cannot be reared by their birth parents or within their extended family,
adoption is the preferred permanent placement.
A permanent placement includes the following characteristics:
It is legally intended to be a permanent relationship to last throughout the child‘s minority and
to establish family relationships that will last for the child‘s lifetime.
It is legally secure from modification.
When pursuing permanency for a child, a diligent search for relatives must be made.
If adoption is not appropriate for a child unable to return home safely, DCYF/DJJS will
establish another legally sanctioned permanency plan including guardianship or Another
Planned Permanent Living Arrangement (APPLA).
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Case Plans and Permanency Planning
New Hampshire has maintained a clear focus on permanency believing that children need permanent
families as quickly as possible for their emotional well-being. A priority of the agency is to assure that
families will be provided with the services they need to allow for safe reunification whenever possible.
As a result, in October 2008 DCYF developed a service called the Accelerated Reunification Model
(ARM) in collaboration with Casey Family Services. The goal is to conduct a comprehensive assessment
with the family that focuses on identifying and strengthening protective factors, and taking concrete
action to enable timely and safe reunification. An initial contact is made with the family within 24 hours
of the referral for service. Frequent in-home and face-to-face contacts are provided to maintain the
urgency of creating the changes necessary for children to be reunified and for families to demonstrate the
ability to keep their children safe.
In addition, the agency recognizes the need to identify, early on in a child‘s placement, appropriate
permanency goals. The early identification of an alternative permanent plan is vital to ensuring that, in
the event reunification is unsuccessful, work has begun on the alternative goal. Within thirty days of the
child‘s placement, a primary and secondary goal for the child must be established.
Sustained focus on concurrent planning has occurred through the creation of Permanency Planning Teams
in every district office. This assures a process that provides a system for frequent and structured reviews
of a child‘s status in order to ensure the agency has established appropriate and concurrent case goals for
the child and continues to make progress.
The "Permanency Planning Team" (PPT) is a group of DCYF/DJJS staff that meet, at least monthly, to
develop permanency action plans for children and youth in out-of-home care and to provide consultation
and planning to CPSW/JPPO case managers concerning permanency issues.
The PPT, at least monthly, conduct reviews of selected cases with district office staff in order
to facilitate permanency planning for children in out-of-home care prior to the permanency
hearing but not later then nine months from the date of the child‘s removal from his/her home.
The PPT review all cases with the goal of APPLA at least once per year and six months prior
to the youth turning 18 years of age.
The PPT review cases where there is a shared case management responsibility between a
CPSW and a JPPO.
PPTs are a resource for JPPOs to use when they need assistance with achieving permanency
goals for juveniles.
Youth in secure detention facilities are not eligible for review by the PPT but permanency is
addressed as part of the discharge planning for each youth by DJJS. (The resources of the
Permanency Worker and the PPT are available to the JPPO and youth at all times; however,
they are not typically utilized until there is an anticipated discharge).
Over the past two years, the Child Protection Administrator has taken the initiative to meet with
incarcerated women involved with DCYF to listen to their struggles to maintain connections with their
children, keep apprised of case status and planning, and communicate with the CPSW assigned to the
case. These listening sessions have prompted a response by DCYF to develop a system in which
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Permanency Overview
incarcerated mothers of children involved with DCYF can have a voice and participate in the case
planning process. The CPS Administrator also holds quarterly meetings at the State women‘s prison.
These meetings are aimed at providing the women with information about services available to them from
DCYF and DHHS including services for family members that are caring for their children.
Concurrent Planning
New Hampshire stands committed to the underlying belief that children need permanent families as
quickly as possible. A guiding principle of this belief is that families will be provided the opportunities
they need to allow for safe reunification whenever possible. As a result, we recognize the need to
identify, early on in a child‘s placement, appropriate permanency goals for children. The early
identification of an alternative permanency plan is key to ensuring that, in the event reunification is
unsuccessful, work is begun on the alternative goal. Within thirty days of the child‘s placement, a
primary and secondary goal for the child must be established.
Concurrent Planning is referenced in several DCYF policies including:
632 Foster Care Administrative Case Review
To establish requirements for periodic case review for children who reside in out-of-home
placement and for whom DCYF has placement and care responsibility.
(d)"Concurrent Plan" means the alternate plan for the child in out-of-home placement,
which will achieve another permanent plan if reunification with a parent is not possible.
698 Dispositional Hearings
(b)Prior to and in preparation for the initial dispositional hearing, the CPSW must consult
with his or her Supervisor to review the case plan, the permanency plan, including the
concurrent plan, and the report to be submitted to the court.
703 Permanency Options for Children and Youth in Foster Care
This policy guides best practice for staff to achieve a safe, stable and permanent
environment for every child or youth in the timeliest way possible. A permanent
relationship with a nurturing caregiver is necessary to establish the foundation for a child‘s
healthy development.
Concurrent Planning is identifying and working toward a child's primary permanency goal (such as
reunification with the birth family) while simultaneously identifying and working on a secondary goal
(such as adoption or guardianship with a relative). This practice shortens the time to achieve permanency
because progress has already been made toward the secondary goal if efforts toward the primary goal
prove unsuccessful.
Voluntarily Mediated Agreements In Adoptions
Following a statutory change, New Hampshire enacted policy for voluntarily mediated agreements to
provide an opportunity for all parties to actively participate in creating a timely permanency plan of
adoption for the child (ren). When it‘s in the best interest of the child, an ongoing connection with the
birth parent(s) is invaluable to children growing up in an adoptive family.
Only cases involving the DCYF/DJJS where the agency has legal custody or guardianship of a child can a
voluntarily mediated agreement be legally binding or enforceable under law.
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Permanency Overview
Prospective adoptive parents and birth parents may voluntarily participate in a court-approved
mediation program.
Voluntarily mediated agreements are completed prior to the surrender of parental rights and no
later than the entry of any adoption decree when reunification is no longer a permanency
option.
Voluntarily mediated agreements for ongoing communication or contact must be in the child‘s
best interest.
Examples of connections can be; yearly letters or pictures shared between adults, other
contacts, or visits according the child‘s age.
Once the court approves the Voluntarily Mediated Agreement documentation of the agreement
is then included in the case file.
Adoption
Adoption is the preferred permanency outcome for children in care for whom reunification efforts have
been unsuccessful. To achieve this goal the agency is responsible for the filing of Termination of Parental
Rights (TPR), adoption home recruitment, adoptive placement, and adoption supervision.
At the time of the 2003 CFSR, several different staff provided these services in a way that was not
conducive to timely and effective permanency planning. Traditionally, Child Protection staff worked
with birth parents and developed plans leading to reunification; Foster Care Licensing staff recruited,
evaluated and supported foster homes; and Adoption staff worked with children and adoptive families
following the termination of parental rights. Real concurrent planning and permanency work demanded a
different organizational model. Therefore, we eliminated the silos among Child Protection, Foster Care
Licensing, and Adoption staff, creating permanency workers in each office and establishing
―Per
manency Planning Teams‖. Staff now share case responsibilities from the outset, rather than
becoming involved in a child‘s life sequentially. So, in essence, Adoption staff became Permanency
Workers and are an integral part of the PPTs. DCYF now has ―Po
st Adoption‖ staff located in state office
that provides post adoption services as needed for families.
DCYF, in partnership with community providers, has worked collaboratively to establish an array of
recruitment resources for adoptive families for children in care. The list below illustrates the myriad of
available resources:
Community and Faith Based Initiative: As a result of a national 2004 summit attended by
DCYF and New Hampshire faith leaders, the Community and Faith Based Initiative (CFBI),
with oversight and coordination from Bethany Christian Services, was formed in 2005. In its
first year, the CFBI‘s work started in six New Hampshire regions covered by DCYF district
offices. By the fall of 2006, the initiative had expanded to all twelve catchments areas,
providing support for DCYF and foster/adopt families statewide. Through this collaboration,
many faith based leaders and churches have participated in recruitment and retention events
across the state. Some of the recent recruitment events have included performances by the
Saving Grace Dance Ensemble where information on foster care adoption was available and
presented to families as well as funds being raised to assist supporting children in foster care to
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participate in enrichment activities. A Discover Adoption and Foster Care event was held at
the Manchester Christian Church. The CFBI also support foster/adoptive families through
Camper ships, backpacks for back to school, clothing give always, Christmas gifts for children
in care, and renovations to homes to help make them meet licensing requirements. The CFBI
also collaborated to provide labor and supplies to add a two-bedroom renovation to a home
with several special needs children.
Wendy‟s Wonderful Kids: Starting in December 2007, DCYF partnered with Bethany
Christian Services in another recruitment project, Wendy‘s Wonderful Kids (WWK) through
the Dave Thomas Foundation for Adoption. Bethany is the recipient of a WWK grant that
funds an adoption recruitment position to focus on those children considered hard to place.
This position carries a caseload of approximately eighteen to twenty children throughout the
state. WWK, in partnership with the CFBI, has also sponsored our 2008 and 2009 adoption
parties.
AdoptUSKids: Ongoing site training is provided by New Hampshire trainers to assist local
social workers in their efforts to recruit permanent homes for waiting children.
Post Adoption Services Program: This program is managed by a Post Adoption Support
Specialist that families can access directly and that include referral to various services
throughout the state, advocacy for adoptive families, short term case management, in-home
supportive services and consultation with professionals working with adoptive families.
Workers have been identified in each district office and have been provided with additional
supports to help work with local families.
Foster/Adopt Parent Association (FAPA): Statewide monthly support groups for
foster/adoptive parents.
Heart Gallery: DCYF has partnered with the New Hampshire Professional Photographers
Association and some individual volunteer photographers to take photos of children waiting to
be adopted. There are currently over twenty photographers who are volunteering their time
and services for this project. A printer has agreed to donate the 20x24 photos needed for the
gallery. In addition each child will receive a framed 8x10 portrait. The permanent Heart
Gallery created in collaboration with the Massachusetts Adoption Resource Exchange (MARE)
remains displayed at Jordan‘s Furniture in Nashua. New Hampshire DCYF has created a
traveling Heart Gallery that is used for statewide recruitment and retention events. Portraits of
waiting children have also been displayed in several locations throughout New Hampshire such
as the Whittemore Center at UNH, the McAuliffe/Shepard Discovery Center, the Capitol
Center for the Arts, Dartmouth Hitchcock in Manchester, the Manchester Christian Church,
and the Southern New Hampshire Regional Medical Center in Nashua etc.
Each year the division creates a DVD of "waiting children” which is distributed to our
District Offices and our community-based partners for use with public presentations,
recruitment events and foster/adoption celebrations throughout the state. The DVD highlights
waiting children, children who had been waiting but placement or matching has been done and
children and families with finalized adoptions. Adoptive parents are asked to submit pictures
of children they have adopted within the past year. Often, the pictures include families in
probate court at the time of finalization. Each year this DVD has been unveiled during May,
Foster Care Month. It is also a part of all FACES graduation classes held throughout the year.
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Waiting Children brochure: A listing of all New Hampshire children who are legally free for
adoption, which is disseminated through all our recruitment venues.
National Adoption Month activities: This includes a proclamation event involving the
Governor of New Hampshire, local activities within the district offices showing appreciation to
adoptive families, as well as interagency events.
St. Charles Children‟s Home: (SCCH) The Division has been working with the Director of
St. Charles Children‘s Home in Rochester New Hamshire, an intermediate level children‘s
congregate care environment. SCCH is renovating the third floor of their expansive Victorian
style home as part of a plan to provide weekend retreats for birth, relative, resource or adoptive
families of children placed in their care. SCHH has experienced very successful positive
outcomes for children in their care. The concept behind the model is to provide families who
have children placed at St. Charles an opportunity to work with the staff and their children in a
therapeutic milieu so that behavioral interventions may be practiced and utilized before a child
leaves the group home to live with their adoptive family or reunite with their birth family. The
Division also supports this model as part of the continuum of care and normalizing adoptive
and reunification efforts for other children who may be placed at SCCH.
SCCH also offers the use their home for respite care weekends for children and their parents
who may need a break from the day-to-day challenges of parenting. The staff at SCCH is
committed to help support reunification, post adoption services and other types of services in
an effort to avoid placement disruption.
Guardianship
For children who can not return home and adoption is not the preferred option, there is a statutory ability
for relatives to provide permanent care for a child by becoming ―l
egal guardians.‖ New Hampshire
provides for payment through the TANF Relative Payee program to support such placements when
guardianship is the appropriate disposition.
Another Planned Permanent Living Arrangement -APPLA
APPLA is the least preferred permanent plan for youth; however, when it is the appropriate goal it must
be a significant well-designed plan. Outlined in New Hampshire Policy Another Planned Permanent
Living Arrangement (APPLA) is a living arrangement intended, designed, considered, premeditated or
deliberate that includes: the physical placement of the child, the quality of care, supervision, nurture and
permanent connections to the family of origin and/or other families/individuals important to the child.
APPLA is only considered when all other permanent options including reunification, adoption,
guardianship or permanent placement with relatives have been exhausted. The courts adopt the
permanency goal recommendations of the agency including an APPLA goal.
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DCYF After Care Services-Independent Living
The DCYF Adolescent Program helps youth plan for their future and prepare for a successful transition
out of care and into adulthood through the Adult Living Preparation Process (ALPP). There are
Adolescent Workers in every office who have the responsibility to impact the work we do for and with
youth in both Divisions. DCYF now requires staff to initiate independent living preparation at 14 instead
of 16 years of age to better meet the transition needs of younger youth. (This change occurred in the fall
of 2009).
The DCYF Aftercare Services Program is a voluntary program that provides continued case management,
future planning and financial assistance designed to meet the needs of former foster care youth pursuing
educational, employment, housing and other goals. Young adults receiving DCYF Aftercare Services
may receive Chaffee and/or ETV funds depending on their eligibility status. Eligible youth are informed
about Aftercare Services by their CPSW or JPPO during the Adult Living Preparation Process. They can
sign up for Aftercare Services after the closure of their DCYF or DJJS case through their CPSW or
through the DCYF Adolescent Worker from their current or former DCYF office.
During an aftercare case, it is expected that the young adult maintain regular contact with their CPSW,
update them on progress and provide receipts for any and all financial assistance provided. Aftercare
Services may continue until the young adult turns 21 or until they turn 23 if the young adult is enrolled in
college or a vocational training program and receiving assistance on their 21st birthday. Youth's
participation in aftercare is reflected in the case contact logs and in their Self Sufficiency plan.
The Protocols Relative to Abuse and Neglect Cases and Permanency Planning
The New Hampshire District Court, Family Division, Probate Court and Superior Court, the Division for
Children, Youth and Families, representatives from the Bar, Legislature, CASA, Judicial Council, law
enforcement and the Attorney General‘s Office continue to partner in addressing solutions to child safety,
permanency and well-being when families are involved in the court system because of child abuse or
neglect, child delinquency or status offenses.
The Protocols are the result of a significant collaboration among the District Court, Family Division,
Probate Court and Superior Court, as well as representatives from the Bar, Legislature, CASA, the
Division for Children, Youth and Families, Judicial Council, law enforcement and the Attorney General's
Office. Foster parents and service providers also contributed to this endeavor.
For years the focus of New Hampshire‘s Court Improvement Project (CIP) has been on abuse and neglect
cases and the development and training of the Protocols Relative to Abuse and Neglect Cases. In
addition, the CIP has developed Permanency Planning Protocols and standard court order forms for abuse
and neglect cases. The actual protocols identify the policies and procedures that the courts and the agency
must follow to assure best practices in permanency planning. All systems were trained on the protocols,
which have helped to sustain improved practices. All Judges have copies of the protocols and they have
been incorporated into the division‘s policy. The most significant feature of the Protocols is the focus on
timeliness to permanency and what each system should be doing relative to best practice.
In 2007 the Court Improvement Project received a grant to improve data collection and outcome
measurement. The DCYF Director and Director of CASA worked collaboratively with CIP staff to
develop indicators related to the timeliness of court hearings.
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Court performance measures will be based on:
Length of time to finding as alleged in the abuse/neglect petition;
Number of de novo appeals;
Length of time to permanency court order;
Length of time to Termination of Parental Rights (TPR) or Surrender final order;
Length of time to final adoption order;
Duration of an open case; and
Reason for case closure.
New Hampshire was one of six communities across the country selected to take part in a federal initiative
known as the Greenbook Project. Greenbook‘s goal was to improve how child protection, the courts, and
domestic violence coalitions work together when responding to the co-occurrence of domestic violence
and child abuse and neglect. The result was a court guide for best practices for judges.
While the Greenbook Project officially ended in the fall of 2006, efforts to ensure the sustainability of the
work continue. Family Court Judges and agency staff took part in a statewide, multidisciplinary training
on the Greenbook Court Guide for Co-Occurrence Cases in the fall of 2007. This court guide is in
response to New Hampshire‘s recognition that there is overlap between child abuse and domestic violence
in families. Further, partnerships between child protection, domestic violence, and the courts must be
developed to address the multiple, complex, and often conflicting needs of these families as this is critical
in making families safe for children.
The courts, DCYF and DJJS have made significant paradigm shifts in each systems‘ policies and
practices. The commitment from within all levels of each agency to focus on permanency planning for all
children and youth has moved New Hampshire forward in practice and has had an unprecedented impact
on the way children enter and exit care.
Community Prevention Services and Programs
An overarching focus in New Hampshire is the value of prevention as it is a critical factor in a family‘s
ability to sustain reunification without agency involvement. Of further benefit to families is that the
provision of prevention services also facilitates timely reunification.
Strengthening Families Through Early Childhood Education was developed by the Center for the
Study of Social Policy. Strengthening Families is an approach to preventing child abuse and neglect
through building five protective factors in families: parental resilience, social connections, knowledge of
parenting and child development, concrete support in times of need, and children‘s social and emotional
development. Research shows that these factors reduce the incidence of child abuse and neglect by
providing parents with what they need to parent effectively, even under stress. By building relationships
with families, programs can recognize signs of stress and build families‘ protective factors with timely
and effective help.
In 2005, the CSSP designated New Hampshire as one of the seven states in the country for their
Strengthening Families Initiative (SFI). Designated as the lead agency, DCYF has partnered with the
New Hampshire Children‘s Trust Fund (NHCTF) in building protective factors for New Hampshire‘s
families thus promoting the safety and well-being of children in their home and reducing incidents of
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child abuse and neglect. Some approaches New Hampshire is currently using to achieve its mission
include:
Incorporate Protective Factors curriculum into collegiate and advanced learning early
childhood education courses
Provide training and technical assistance on Strengthening Families and Self-Assessment to
childcare programs through the Childcare Resource and Referral Network‘s contract with
DCYF
Adding Strengthening Families models to the Bureau of Child Development Professional
Development System
Participate in the Zero to Three‘s State Partnerships for Prevention
Taking it a step further, in June of 2008, the New Hampshire SFI provided a train-the-trainer two-day
event for childhood and child protection professionals in the Zero to Three Strengthening Families
curriculum. During the last year, New Hampshire has designated twenty-seven childcare centers, which
combined; serve 21% of the children receiving Child Care Scholarship (CCDF Subsidy) to be
Strengthening Families Centers. These programs build protective factors for enrolled families.
Comprehensive Family Support is a statewide initiative where DCYF contracts with community-based
agencies for comprehensive family support programs that cover all twelve-district office catchment areas.
Through the Comprehensive Family Support Program, agencies provide support services to
approximately five hundred families annually. The programs assist families and children by promoting
family wellness, decreasing family stress, and preventing abuse and neglect. The social service agencies
identify and assist families with multiple stressors by providing multivariate services, which encourage
and promote the development of healthy families.
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Permanency Outcome 1: Children have permanency and stability in their living situations.
Item 5: Foster care re-entries. How effective is the agency in preventing multiple entries of
children into foster care?
New Hampshire has seen an increase in re-entry of children and is currently above the national
median (15%). We have seen an increase from 17.0% in 2007, 19.5% in 2008 and 21.30% in 2009.
Policy Considerations
New Hampshire is committed to assuring that children do not enter foster care unnecessarily, and that
they do not leave our system without a permanent and stable family living situation. Both DCYF and
DJJS work to ensure that families be provided with the services they need to allow for safe reunification
whenever possible.
However, historically in New Hampshire children remained in foster care for a long period of time. The
lack of focus on reunification was preempted by what is a litigious child protection system. Since the
majority of child protection interventions are driven by the court process the focus was often on
compliance with orders rather than the outcome of safety and rehabilitation. We have worked diligently to
re-focus our efforts and the court process on more effective case planning with attention to the needs for
service and early intervention to assure timely reunification.
As we increased the number of children who reunify timely, the expectation was that our re-entries could
also increase. Although this was an expected outcome we remain committed to maintaining both practice
and policy that assures children leaving our system have the security and services in place to minimize the
likelihood of re-entry.
The majority of practice and policy changes previously outlined focus on the premise that permanency
begins for children and youth the moment they are known to our system. An effort to maintain children
safely in their own homes is our first priority. If removal is necessary we remain focused on providing
the most stable, safe transition home as possible. Following reunification the agency stays involved and
provides services to assure a sustained reunification.
CFSR Round 1 Findings
During the 2003 CFSR this Item was rated as an area needing improvement. The data from the State
Data Profile indicated that New Hampshire‘s re-entry rate for FY 2001 (13.3%) did not meet the national
standard of 8.6 percent or less.
Stakeholders commenting on this issue expressed the opinion that the agency is effective in preventing reentry into foster care through its use of risk assessment tools, trial home visits, and community-based
services that support reunification.
Changes Since Round 1
Although New Hampshire continues to see increases in re-entries it is an expected outcome resulting from
significant practice changes. We can use the CFSR findings and current data to drive other questions such
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as, are reunifications that occur within two or three months more likely to result in re-entry, than
reunifications occurring after six months. The data may tell us that some types of maltreatment may
impact the success of an expedited reunification as well. We would like to see if there is a correlation of
increased re-entries over time from this practice shift, and if so, will we also see a decline during the
period under review or post review.
As indicated previously, New Hampshire historically had not produced timely achievement of
permanency goals. Reunification or adoption took much longer than the national average. The agency has
worked over the years to implement more proactive efforts to achieve these goals including reunification.
The following are initiatives the agency has identified that have shown positive results in achieving more
timely permanent goals and the ability to sustain those goals and minimize the likelihood of re-entries.
The use of Structured Decision Making (SDM) tools has strengthened workers ability to assess
capacity of the family system. In particular, the use of strength and needs assessments for
families, as well as reunification assessments allows workers to weigh the presenting
conditions, appropriateness and prospects for successful reunification.
The inclusion of Permanency Workers and Adolescent Worker is in every office and the
increased staffing since 2003 has improved caseloads and placed the focus for permanency at
the local level. Both have allowed workers to have the time and resources to assure focused
case planning and service delivery. The adolescent worker provides the local office with an
expertise in working with youth and assures more stable exits from care.
The creation of Permanency Teams in every office. The strength of the PPT is derived from the
ongoing consultation and cooperative case planning among the team members and the case‘s
primary CPSW. Both DCYF and DJJS have implemented the use of Permanency Planning
Teams (PPT) and have worked collaboratively to focus on timely permanency.
The Finding Connections Program places a contracted Connection Specialist in each of the
District Offices. As the agency worked towards breaking down barriers effecting permanency,
this new collaborative effort elicited optimism in helping to reach permanency goals for
children in care.
The changes in service array, to include a focus on services aimed to address a specific need
has been another major change in New Hampshire. New Hampshire Collaborative, redesign of
Individualized Service Options and transformative work with residential service providers are
examples of those changes.
Improved case planning at the time of removal to assure timely efforts are in place to expedite
reunification. In October 2008 DCYF developed a service model called the Accelerated
Reunification Model (ARM) in collaboration with Casey Family Services. The service goal is to
conduct a comprehensive assessment with the family that focuses on identifying and
strengthening protective factors, and taking concrete action to enable timely and safe
reunification. An initial contact is made with the family within 24 hours of the referral for
service. Frequent in-home and face-to-face contacts are provided to maintain the urgency of
creating the changes necessary for children to be reunified and for families to demonstrate the
ability to keep their children safe.
DCYF and DJJS contract with community-based Family Resource Centers located and
operating within the state of New Hampshire. These entities provide a range of support
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services to families and children that focus on strengthening, supporting and building on the
strengths and skills of individuals. Family support services adhere to a nationally recognized
set of values and principles centered on the empowerment of individuals, families and
communities. DCYF continues to hold the belief that families should have services provided to
them in the most non-intrusive, non-categorical and most efficient manner possible. This
model of service delivery lends itself toward a single point of entry and comprehensive
services delivery model for families prior to and following involvement with either DCYF or
DJJS.
The co-location of Domestic Violence Specialists and Licensed Alcohol and Drug Abuse
Counselors into district offices helped improve our practice. A shift in practice approach is that
now when DCYF responds to families where there is either domestic violence or substance
abuse (or both) these specialists are available for assistance. This approach minimizes the
number of children entering foster care, as these issues can be addressed and ameliorated while
we safely maintain the children in the home.
Collaborative redesign of Individualized Service Options and transformative work with
residential service providers has occurred. Residential providers are changing the way they
work with children and families to include transitional services by the residential provider to
assure a sustained reunification.
DCYF continues to see an increase in the number of children exiting care to a finalized
adoption. DCYF demonstrated commitment to supporting adoptive families through the
provision of post-adoption services, and a commitment to community agencies who provide
supports to all families by creating a Post Adoption Unit to help sustain successful adoption
goals.
Data Considerations
The Case Practice reviews conducted since 2007 (as demonstrated below) show improvement on this
Item. However, New Hampshire expects to see some increase in re-entries just by the nature of improving
our practices in reunifying families more timely. The chart below demonstrates continued efforts in this
area. The Concord number reflects the small number of applicable cases, which limits the validity of this
measure, however, focus group participants commented on the need for more community-based supports
for families to access. In particular, it was cited that by providing more supports for those families
working with substance abuse issues, it would help maintain the family unit and prevent the child from
entering or re-entering care.
Item 5: Foster care re-entries Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester Salem
Jun-07
100
Dec-06
N/A
Jun-08
66.7
Jun-06 Dec-07 Sep-07 May-09
100
100
100
100
*Claremont and Nashua DO’s had N/A for all cases
Dec-08
100
Aug-10
N/A
Sep-08
100
May-07
100
Mar-09
100
In the Concord DO, 2 cases were rated a strength, 1 an ANI, and 9 were N/A. Since 9 out of 12 cases
were rated as not applicable it is difficult to determine what the accurate rating for this office would be on
this Item.
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As New Hampshire focuses efforts on achieving reunification in a timely manner, we know it is important
to monitor rates of re-entry into the foster care system. New Hampshire data has shown decreases in
length of stay, particularly as children approach the 12-month point. At the same time, re-entries into care
have increased slightly. It is our intent to continue efforts to sustain reunification and minimize re-entries.
However, the data and monitoring of re-entries can and should help with efforts to revise and learn from
the new practices around expedited reunifications. We do not want to stop new initiatives focusing on
accelerated reunification because re-entries increase. However, we do need to watch and clarify what the
data is telling us.
We know from our own history here in New Hampshire that longer stays in foster care are not the answer.
Interventions that have varying intensity of services, the length of time that services are provided, the
point in a case when reunification services begin, and the extent to which post-reunification services are
available to families will most definitely improve outcomes.
To target services effectively, we need to use the information on which services work best for which
families and under which circumstances. It is very important for us to track the effects of these policy
changes and respond to what we learn. New Hampshire has invested staff resources in not only improving
our agency outcomes but the provider agencies as well. Site visits and monitoring family outcomes for
service providers that work with our families is also relevant to the overall improved practices in New
Hampshire.
Strengths
Since 2003 New Hampshire has changed practice to assure more timely efforts to reunify children and
families. A particularly valuable initiative in New Hampshire, the Accelerated Reunification Model has
recently been rolled out statewide.
The ARM model was developed because we believed there are a number of children who could be
returned home quickly, but due to competing priorities within the state child welfare system, historically
would wait for three to six months or more before active pursuit of the goal, including any significant
efforts made to reunify them with their families. This is important given the fact that research indicates
that there is an inverse correlation between the length of time in foster care and the chances of a
successful reunification.
Because the New Hampshire child protection system is a litigious process, CPSW staff must file petitions
to obtain court orders for removal. The agency then focuses the next 30-60 days on adjudicating the case,
and in the past, made minimal efforts to reunify until post adjudication. With this new model we focus
immediate attention to reunifying children as the court process proceeds, instead of waiting on the court
process.
When children are removed because of an immediate threat to their health or safety, the family is linked
to a contracted agency that provides intensive in-home services. Individually tailored to each family‘s
unique needs, these services may include helping the family with budgeting, time management, parenting
responsibilities, and meeting basic tangible needs (food, clothing, baby equipment and supplies, or
furniture).
The Division believes this model as well as other improved case planning and permanency initiatives are
helping families reunify who otherwise may not have had that experience. Knowing that systems ―
raise
the bar‖ for reunification as time passes, New Hampshire had to provide better and more timely
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opportunities for families to reunify. Knowing this could increase our re-entry statistic we still believe it
is best-case practice for children and their families.
Also important to note and reiterate, is that since the 2003 CFSR, DCYF and DJJS have accomplished a
culture shift in relation to permanency and successfully implemented major initiatives. These have
included rapid and substantive changes in both policy and practice and have involved and affected all
levels of staff throughout the divisions.
Our major goals have focused on and produce changes in the following areas and will over time result in
a decrease in re-entries:
Expedited permanency for children
Improvement of case plans and the case planning process
Increased effectiveness of court hearings
Improved community-based Comprehensive Family Support programs to prevent child
maltreatment and sustain reunification.
Improved efforts in finding connections, utilizing relatives, and community and faith- based
supports
Opportunities for Improvement
Knowing that service delivery and service array impact the ability to address needs for children and
families we will continue to evaluate the services provided to families to support reunification, as well as
those post-reunification services to assure stabilization. Focusing on post reunification and post agency
involvement provides an opportunity to learn what works and how to sustain those practices consistently
and statewide.
New Hampshire is looking at creating a post-agency case plan for families leaving the system in an effort
to assure the likelihood of success, to support self- sufficiency and minimize re-entries.
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Permanency Outcome 1: Children Have Permanency and Stability in their Living Situations
Item 6: Stability of foster care placement. How effective is the agency in providing
placement stability for children in foster care?
New Hampshire continues to improve in placement stability, rating slightly below the National
Standard (101.5) with a score of 101.1. It is important to note that in the last three years New
Hampshire has demonstrated improvement in placement stability and ranks as the 11 th highest
scoring state in the 2009 AFCARS data profile.
Policy Considerations
As discussed in Item 5 and in the policy update, the decision on removal, the use of Structured
Decision Making tools, permanency planning and permanency teams also impact this Item. In
addition, New Hampshire has done a lot of work with recruiting and re-training foster parents as
―
resource parents‖ to be considered as a first and last placement option for children coming into their
care.
We focused on foster parents as key ―r
esources‖ in working to achieve permanency for children in foster
care. It is critical for foster parents to work with birth parents and support reunification efforts. However,
we also want them to consider adopting the children if they cannot return home. This was a significant
shift in practice, changing ―f
oster‖ homes to realistically becoming a ―
resource‖ home for our children
and youth. Previous practice and policy was not to recruit adoptive families as foster homes. This shift in
policy and practice repositioned the instability and trauma of foster care off the child, and on to the adults
who are more prepared to handle it. As the children's primary caretakers, foster parents have significant
roles in carrying out the tasks in the permanency plan.
In line with the shift in utilizing foster homes as ―
resources‖ for children we redefined policy to reflect the
change in practice. An example of this is the renaming of the position of foster care licensing worker to
resource worker.
In situations where the foster parent is not committed or willing to adopt the child we knew it was critical
that DCYF practice and policies not diminish the child‘s right to permanency for the sake of stability of
the placement. Our practice became focused on children deserving and having the right to a permanent
family and to assure that commitment, and not settle for the temporary stability of a current placement
provider instead of more secure long-term permanency.
New Hampshire believes that selecting the most appropriate family for a child who cannot safely return
home can reduce the trauma of separation and loss for the child, can increase the probability of a
successful placement and ideally, can create a lifelong connection or permanent home for the child.
CFSR Round 1 Findings
During the 2003 CFSR this Item rated as an area needing improvement. Reviewers commented on how
multiple placement changes for children did not promote attainment of their goals or meet their treatment
needs.
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Stakeholders commenting on this issue expressed the opinion that most children are in stable placements,
although a few stakeholders suggested that DJJS children in foster care might experience greater
placement instability than other children in foster care.
The more current Case Practice Reviews identify continued improvement in this area and reviewers
commented that in many of the cases, children remained in the same placement the entire period under
review. In some instances, this placement was the pre- adoptive home, demonstrating the importance of
providing the child with permanency as soon as possible. In instances where a placement change did
occur, reviewers cited that this change was made in accordance with the child‘s case plan goal in an effort
to transition him back into his home and community.
Changes since Round 1
As part of the overall focus on permanency New Hampshire has worked diligently to avoid conditions
that lead to disruptions in foster care and result in multiple placements. Extensive work has been done to
improve practice in this area:
By decreasing the number of children in placement through better
identification/targeting of children who truly need placement
Since 2003 New Hampshire has done an analysis of children and youth placed in residential facilities
across the state. Part of this process surveyed why the child was residing in a group home/residential
setting. We determined that a number of children were in group-care because they ― weredoing well‖
there. This sparked concern and we initiated immediate transition plans for a child doing well in
residential services and a focus was put on locating less restrictive/family settings. This reality combined
with other permanency initiatives started New Hampshire on a road that re-focused our efforts on children
in residential placements. We focused all our services, as appropriate, including individualized service
options, to assist children in returning home. If this was not an option for safety reasons then a transition
was planned to a lesser restrictive placement. Our caseworkers and residential program staff worked
collaboratively to transition children as quickly as possible.
We implemented formal and informal policies that monitored children entering residential care. One way
this was done was to establish criteria that children referred for residential care must demonstrate
behavioral problems that cannot be managed in a less structured, and less restrictive environment. The
goal of placement in a residential service program was more clearly defined as remediation of the
behaviors preventing the child from residing in a community setting, and to assist the child in making the
changes necessary to allow them to return to a family setting.
Conducting placements in a planned way utilizing natural resources that come with
children and families
Both DCYF and DJJS have adopted a practice and policy shift that assures that the agency utilizes the
natural resources of children and families. This allows for children to be placed with relatives or other
caregivers that have an established investment in the child and the family. This minimizes the likelihood
that a child will disrupt or be asked to move, with the premise being that caretakers are less likely to
disrupt a placement of a relative or family friend.
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Adjusting recruitment efforts to assure stability of placements for children who cannot be
returned home.
New Hampshire shifted their activities with recruitment and retention of foster parents to focus on
stability of children‘s placements. We advertised the need for ―
resource families‖, first placements being
last placements for children and researching relatives immediately at removal.
Providing after hours support for foster parents in an effort to minimize disruptions
New Hampshire historically did not have 24hr availability for foster parents. The need to assure foster
parents have supports with challenging behaviors was key in stabilizing placements. The Division
developed an on-call system that provides foster parents with after hours contact with an Administrator to
provide direction and support.
Expand ISO (Individualized Service Options) for children in placement.
"Individual Service Options" was originally designed for foster family care in which a variety of intensive
therapeutic, social, and community-based services are provided or coordinated to meet the individual
needs of a child and his or her family. In an effort to expand the services available to transition children
more effectively from residential care, we extended this service to the residential provider community.
Families served by In-Home ISO include those who demonstrate the willingness to cooperate with the
provision of the service and who will benefit from treatment and who require an array of service options
in order to maintain or transition the child/children.
The implementation of the Framework for Collaboration
DCYF and DJJS have partnered with the residential providers across the state to ensure that a sustained
and uniform focus is applied towards ensuring that children and youth who need residential treatment
services in the future will experience shorter lengths of stay, placement stability and realize permanency
at a higher rate. As our practice shifts began to take hold, census in all residential programs declined.
Some facilities closed but others began to transform their services to provide a continuum of care for
children and are now providing in-home services as children exit group care.
We believe establishing a common focus and guiding principles that each system commits to and to have
all providers collaborate and share resources will not only assure a continued service array, but will also
provide timely permanency for children. This effort is taking the lead on evaluating and transforming the
way children receive residential services in New Hampshire.
Data Considerations
DCYF internal Case Practice Reviews (CPR) have found that overall the agency continues to do
relatively well in placement stability. It should be noted that there has been a significant drop in DCYF
placement numbers through the years going from a range of 1100-1400 in 2006 to fewer than 900
currently. As indicated in the chart below most offices across the state are managing placement stability
and are assuring the placement changes are driven by treatment need and not disruptions in placement.
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Item 6: Stability of foster care placement
Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester Salem
Jun-07 Dec-06
Jun-08 Jun-06 Dec-07 Sep-07 May-09
Dec-08
Aug-10
Sep-08
May-07 Mar-09
50
88.9
77.8
80
88.9
88.9
88.9
88.9
77.8
88.9
66.7
100
In the 2007 review in Berlin and Rochester, Item 6 was rated significantly low and an ―
area needing
improvement‖. Both the reviewers and focus group participants stated that this Item is related to systemic
barriers. Focus group participants remarked that increased recruitment of foster parents including
enhancing support networks for them would help encourage stability for children. One of the issues that
illustrated the challenges in this Item was not having pre-adoptive homes available. Children needed to
change placements when such homes became available. Another issue that came up was the need for
better communication between the worker and foster families regarding planned moves that are necessary
and in accordance with the child‘s case plan.
Since the review in 2007, Berlin has been focused on improving communication with foster parents. The
service array, in this case adoptive homes, is an ongoing challenge for the northern parts of the state.
Recruitment efforts are intensely focused in this area. The overall data continues to show improvement in
Item 6.
The chart below represents the numbers of youth placed at in-state residential treatment programs for both
DCYF and DJJS from 2007-2009. The declining numbers demonstrate the efforts made by DCYF/DJJS
to focus on treatment planning for youth in residential programs, and on making sure that those youth
receive the services that they need.
Trends in In-State Residential Placements
DCYF/DJJS Point-in-Time Census
In-State Residential Placements 2007-2009
400
350
308
323
319
316
314
318
338
323
300
301
324
291
271
250
200
182
180
175
162
161
161
150
142
135
123
122
97
100
93
50
0
Jan-07
Apr-07
Jul-07
Oct-07
Jan-08
Apr-08
DCYF
Jul-08
Oct-08
Jan-09
Apr-09
Jul-09
Sept-09
DJJS
The data definitely demonstrates that the practice shift of utilizing natural resources that children and
families have, as well as, expedited permanency timeframes have resulted in less children in care and less
children moving to residential care. The obvious result being a
Left DCYF care within two
much more stable placement experience for children and their
years
families.
In addition, when comparing children who entered out of home
care in 2000 to those who entered in 2004 or later, we see
faster exits from care (shorter length of stay) among the more
100%
80%
60%
53%
63%
60%
68%
40%
100
20%
0%
2000
Cohort
2004
Cohort
2005
Cohort
2006
Cohort
New Hampshire CFSR Statewide Assessment
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recent cohorts. The majority of children in out-of-home placements have only one or two placement
settings. In FFY 2007, 79 percent of children who had been in the state‘s care less than 12 months had no
more than two placement settings compared to only 67% in 2005.
Strengths
New Hampshire is extremely proud of the changes in every aspect of the placement process
and permanency experience, from initial removal to concurrent planning. As these changes are
being embedded into daily practice, we expect continued improvement in stability.
Data trends continue to show positive progress as fewer children actually enter care. The Data
Profile on stability shows that New Hampshire is close to the national standard.
Improvements in the area of foster/ ―r
esource‖ home recruitment, and the expansion of
individualized services have strengthened our ability to support and maintain placements,
improving stability.
Opportunities for Improvement
The ability to standardize practice will show promise for making better placements and managing the
placement experience more carefully and completely. New Hampshire‘s significant improvements in
permanency and permanency planning must be consistent from worker to worker and office to office. It is
our expectation that the 2010 CFSR will reveal where the consistencies and inconsistencies in practice
occur and provide us with an opportunity to create a framework for consistent permanency practice as a
key factor in future improvement.
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Permanency Outcome 1: Children Have Permanency and Stability in their Living Situations.
Item 7: Permanency goal for child. How effective is the agency in determining the
appropriate permanency goals for children on a timely basis when they enter foster care
DCYF continues to emphasize the importance of establishing timely and appropriate permanency
goals for children and families. The State Data Profile shows that 81.6% of all children in New
Hampshire have an identified permanency goal. It also demonstrates an increase in the
permanency goals of reunification from 25.9% to 38.4% from the FFY 2007 to FFY 2009.
Policy considerations
A number of key policy and practice changes, discussed earlier in the Permanency Policy update, have
contributed to improvement in goal timeliness and appropriateness:
Permanency Teams
Concurrent Planning
Case Plan and timeframes
Permanency Statute
Court Improvement Protocols
The permanency/case plan goal must be identified within 30 days of placement for all cases.
The case plan policy is used by DCYF staff and the family to ensure the continued safety, permanency
and well-being of children. Effective case planning is achieved when done in collaboration with families;
is based on family strengths, and resources; and is time-limited, goal-oriented, and solution-focused.
CFSR Round 1 Findings
During the 2003 CFSR this Item rated as an Area Needing Improvement. Item 7 was assigned an overall
rating of Area Needing Improvement based on the finding that in 35 % of the applicable cases, reviewers
determined that the agency had not established an appropriate goal for the child in a timely manner.
Some stakeholders commenting on the issue of permanency planning reported that the agency and the
courts emphasize establishing permanency goals early in a case. However, other stakeholders suggested
that the emphasis on permanency planning varies across judges and DCYF workers, particularly with
regard to the willingness to seek TPR in a case. Several stakeholders reported that concurrent planning is
taking place in the agency and is effective in promoting permanency; however, there were no cases
reviewed during the CFSR that involved active pursuit of concurrent permanency goals.
Changes since Round 1
Since 2003 DCYF and DJJS have accomplished a culture shift in relation to permanency and have
successfully implemented major initiatives. These have included rapid and substantive changes in both
policy and practice and have involved and affected all levels of staff throughout the divisions.
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The findings of the 2003 CFSR indicated that the traditional practices had not been as effective as they
could have been in ensuring that each child‘s permanency goal is achieved within timeframes that are
appropriate for his/her circumstances and case plan. The following activities and initiative outline the
major changes since the first round.
Creating Permanency workers as a resource to staff in the district offices in all matters
pertaining to permanency has definitely helped assure a needed focus on permanency. Carrying
reduced caseloads, Permanency CPSWs are available to consult with staff, to meet with
families and facilitate ongoing Permanency Planning Team meetings (PPT).
We created a DCYF Permanency Program Specialist who is responsible for oversight of the
program statewide with direct supervision being provided by a District Office Supervisor or
Assistant Supervisor.
In 2008, DJJS also added a Permanency Program Specialist. The Permanency Program
Specialists from DCYF/DJJS communicate regularly, provide joint trainings and make DO
visits together. In addition, they serve as resources for all staff.
Both DCYF and DJJS have implemented the use of Permanency Planning Teams (PPT) and
have worked collaboratively with the courts to focus on timely permanency. DCYF and DJJS
established internal mechanisms to regularly review timely permanency for children in out-ofhome placement.
The creation of Permanency Planning Teams (PPT) have been identified in policy and
established in each district office. The strength of the PPT is derived from the ongoing
consultation and cooperative case planning among the team members and the case‘s primary
CPSW. The PPT team lends expertise and provides consultation to ensure timely
determination, development and implementation of permanency and concurrent planning for
children in out-of-home placement.
We established a new mandate to have a PPT meeting for every child in out-of-home
placement within 30 days of placement. A PPT form is required at this initial meeting where
the permanency goal and concurrent goal is documented and reviewed by the PPT team
members.
Starting in January 2007, DCYF contracted with Easter Seals to establish the Finding
Connections Program that places a contracted Connection Specialist in each of the District
Offices. The Connection Specialist has expertise in researching a child‘s case file (case mining)
to identify relatives and other supports and works collaboratively with the child‘s caseworker
and Permanency Planning Team (PPT) to identify positive resources for the child.
Within DJJS we are in the midst of a significant culture shift that embraces the concepts of true
permanency starting with the fact that Adoption needs to be seen as a viable and positive
option for youth. Clearly, adoption within DJJS is considered an unusual and difficult
endeavor, but we are committed nonetheless to it being culturally viewed as an option.
Permanency planning is supported philosophically and provided with adequate resources and
training for DCYF and DJJS and the courts. The Division Directors and the courts provided
and still provide ongoing training for permanency planning and concurrent planning for Judges
and agency staff.
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In an ongoing effort to support kinship placements, DCYF hired a Relative Care Specialist in
April 2008. The role of the Relative Care Specialist includes revising and keeping current the
DCYF Kinship policy and developing programs and supports for kinship providers.
The Adolescent Program was designed to ensure that current and former DCYF and Division
for Juvenile Justice Services (DJJS) youth obtain the preparation, resources, and positive youth
development they need to establish permanent connections and become healthy, self-sufficient,
and successful adults. During the past five years (2004-2009) the Adolescent Program has
steadily increased its effectiveness in meeting the needs of current and former youth in care.
Most significant to this evolution has been the growth and development of the Adolescent
Worker position, created in 2003.
The Adolescent Workers use their specialized training to lead, educate and collaborate with
youth, colleagues and the community to ensure best practice for adolescents. They are leaders,
consultants and resource specialists when it comes to DCYF‘s work with adolescents. The
group has established a mission statement as well as specific roles and responsibilities. In
addition to carrying an adolescent caseload, they are active members in their office
Permanency Planning Team (PPT).
In June 2008, residential providers were invited to join DCYF/DJJS in an initiative aimed at
developing and implementing a collaborative system for delivery of services in residential
treatment that focused on shorter lengths of stay and achieving permanency for the youth who
were placed in their programs. Over the past eight months a core work group of DCYF/DJJS
staff and residential providers have been meeting regularly to create a New Hampshire
framework to achieve improved permanency outcomes for children and youth placed in
residential programs.
Data Considerations
The Case Practice Reviews have identified inconsistency in New Hampshire‘s rating on this Item. As
indicated below, district offices range from 44% to 100% success in this area.
Item 7: Permanency goal for child
Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester Salem
Jun-07 Dec-06
Jun-08 Jun-06 Dec-07 Sep-07 May-09
Dec-08 Aug-10 Sep-08
May-07 Mar-09
100
55.6
66.7
100
100
77.8
77.8
66.7
44.4
88.9
77.8
55.6
As reported in the case practice review, Salem DO‘s greatest challenge in Item 7 was related to systemic
challenges in filing TPR‘s in court and also establishing permanency goals in a timely manner. For the
Claremont DO, their greatest challenge in this area was systemic issues with the courts and the courts
changing recommended permanency goals. The Nashua DO struggled in terms of timeliness of both
establishing permanency goals and filing TPR‘s.
When reviewing stakeholder information and on-site case specific barriers from the offices that rated low
on this Item the following were identified as areas needing to improve moving forward.
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When reunification is not the identified permanency goal, there needs to be ongoing work and
contact with parents to reassess permanency options.
One of the challenges in this area is the need to timely document in a child‘s case plan the
primary permanent goal as well as the concurrent goal.
That the concurrent plan needs to remain active and efforts made trying to achieve it, if
reunification is unsuccessful.
The reviews also determined that offices are improving in their efforts to explore connections and this has
helped with the completion of more appropriate goals for children and youth.
The Manchester District Office, as the largest agency jurisdiction, has had ongoing and substantial
involvement of the Family Court Judge in working on improved permanency outcomes over the past three
years. The focus and involvement of the Court Improvement Project in Manchester has helped to improve
practices in this office. More current practice changes and improved staff retention have helped to impact
positive changes with this and other Items in Manchester. We currently see more timely documentation of
goals, but still need to address concurrent-planning activities sooner and in more detail.
The Permanency Team (PPT) meetings held to review the permanency goal and concurrent plan have
helped each office to ensure the establishment of timely permanency goals and address barriers, if any.
From calendar year 2005 to 2009, DCYF held a total of 5,794 PPT meetings at the local district offices to
review the local efforts to ensure timely permanency and concurrent planning for all children. Since 2005
we have held 5,794 PPT meetings. This demonstrates that at least that many permanency goals have been
reviewed to assure they were timely and appropriate. Since siblings are often reviewed at the same
meeting the reality is this number reflects many more children and permanency goals have actually been
reviewed.
Strengths
All the initiatives and practice changes in New Hampshire are based on the core belief that we can and
should assure that all children and families involved in the child protection and juvenile justice system
have timely permanency planning.
As a result of these initiatives, stakeholder relationships have been created and strengthened, and agency
practice has improved.
The development of community-based Comprehensive Family Support programs to prevent
child maltreatment,
The co-location of Domestic Violence Specialists and Licensed Alcohol and Drug Abuse
Counselors into district offices,
Implementation of Family Court, participation in the Model Court and Court Improvement
Projects,
Cross-training opportunities with Court Appointed Special Advocates (CASA),
The addition of Permanency and Adolescent specialized Child Protective Service Workers,
The implementation of Finding Connections, a Relative Care program, and a Community and
Faith Based Initiative
The implementation of Permanency Planning Teams,
Passage of Mediated Adoption and Timely Permanency legislation,
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The development of a Post Adoption Services Unit,
Transportation and ARM (reunification pilot programs),
Participation in the Breakthrough Series Collaborative for Safety and Risk Assessment
The development of an internal Case Practice Review and a system of continuous quality
improvement utilizing both qualitative information and administrative data,
Since the Findings Connections Program was implemented in all of the District Offices and staff received
training around the need for connections and specific information about the Finding Connections
Program, a culture shift has taken place.
Initial results from SFY 08 were very positive. 65% of cases discharged by the Connection Specialist with
a completed connections plan have ―
new adults‖ located. Further, 86% of those cases had ―
increased
face-to-face‖ contact with their adult connections. The performance indicators of greatest significance
were linked to the ―
APPLA‖ permanency plan cases. The success of this initiative reinforces the
importance of kin and other community supports in all aspects of case practice. Both agencies began to
see the benefits of a connection for children and began to eagerly seeking out relatives and other
connections for children.
Stories of youth finding lost relatives and supports months before potentially ―a
ging out‖ of the system
began to spread statewide. Staff became invested in the success of connections and adoptions for older
youth began to occur, suddenly workers began to appreciate the value of permanency efforts. Over time
this process moved to the front door and both Divisions embrace concurrent planning as part of the
establishment of effective goals and overall case planning.
Data analysis shows a dramatic reduction of the number of children in out of home placement (see chart
in Item 6) through shorter lengths of stay and increased exits to permanency.
Opportunities for Improvement
The culture and practice shift relative to permanency planning in New Hampshire has been evolving over
the past several years. The agency vision and focus has been consistent and clear. The opportunity for
improvement lies with consistency in the fieldwork being done every day. A unified approach to practice
will ensure consistency in the establishment of appropriate and timely permanency goals.
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Permanency Outcome 1: Children Have Permanency and Stability in their Living Situations
Item 8: Reunification, guardianship, or permanent placement with relatives. How effective
is the agency in helping children in foster care return safely to their families when appropriate?
New Hampshire has worked diligently to improve outcomes relative to timely reunification. We
continue to show improvement in this area as noted in the Permanency Composite for Timeliness
and Permanency of Reunification [standard: 122.6 or higher] and New Hampshire is at 102.8.
Although New Hampshire is not yet at or above the standard, the data continues to demonstrate a
trend that is consistently moving toward achievement of that standard.
Policy Considerations
Permanency practice and policy described in the Permanency Policy Update section applies to Item 8. In
the hierarchy of permanency alternatives, reunification and adoption are placed ahead of Guardianship,
which does not require the Termination of Parental Rights.
In our work to shift the culture and practice around permanency planning for children in New Hampshire,
DCYF specifically identified reunification as a challenge based on local and systemic barriers. Most of
those have been addressed through the previously discussed Permanency Legislation and the Court
Improvement Protocols and practice initiatives. The court process had a tendency to drive casework
decision relative to reunification. The agency and the court would focus on ―c
ompliance‖ driven activities
rather than actual safety and risk factors or changes in behaviors.
For years the scope of New Hampshire‘s Court Improvement Project has been on abuse and neglect cases
and the development of and training on the Protocols Relative to Abuse and Neglect Cases, Permanency
Planning Protocols and standard court order forms. The success of these efforts, including a strong
collaboration with DCYF, CASA and other system participants, served as a model for expansion. In 2007
the CIP broadened its scope to include cases that involve delinquents and CHINS.
The other significant policy consideration for this Item is the Accelerated Reunification Model that DCYF
has adopted over the past two years. This clearly defines a shift in practice that requires a focus that is
constant and intensive immediately upon removal. The New Hampshire child protection system is a
litigious court process that takes at least 90 days to adjudicate and provide dispositional orders for case
planning. This has become a barrier to timely reunification. The development of this model directs staff in
certain cases to provide that intensive effort through contract providers concurrent to the court process.
CFSR Round 1 Findings
During the 2003 CFSR this Item rated as an Area Needing Improvement based on data from the State
Data Profile for FY 2001 revealing the percentage of reunifications occurring within 12 months of entry
into foster care (48.8%) did not meet the national standard of 76.2 percent or more. In addition, case
reviewers determined that the agency had not made diligent efforts to attain the goals of reunification or
guardianship in a timely manner in 37 percent of the 8 applicable cases.
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Stakeholders commenting on this issue noted that DCYF engaged in several practices to assess a family‘s
readiness for reunification such as the following: (1) use of Structured Decision Making tools, (2) team
decision-making, and (3) court reviews. However, several stakeholders also identified barriers to timely
reunification including high caseloads and a lack of appropriate services to bring about the necessary
changes in the family. Also mentioned, was the fact that in some cases the court will order reunification
over the objection of DCYF.
Changes since Round 1
The significant changes relative to timely reunification have been embodied in the overarching
permanency planning improvements within New Hampshire‘s philosophy, practices and initiatives. The
following highlights some of those and additional initiatives:
Permanency Legislation- requires more timely permanency efforts for the court and the
agency.
Creation of Permanency staff and Permanency Teams- To maintain a focus on timely
permanency goals and concurrent planning at the local level, permanency workers heighten the
focus on every aspect of permanency in the office.
Residential Providers- In June 2008, residential providers were invited to join DCYF/DJJS in
an initiative aimed at developing and implementing a collaborative system for delivery of
services in residential treatment that focused on shorter lengths of stay and achieving
permanency for the youth who were placed in their programs.
New Hampshire framework-Over the past year a core work group of DCYF/DJJS staff and
residential providers have been meeting regularly to create a framework to achieve improved
permanency outcomes for children and youth placed in residential programs.
Incarcerated Parents-Over the past two years, the Child Protection Administrator has met
with incarcerated women involved with DCYF to listen to their struggles to maintain
connections with their children, keep apprised of case status and planning, and communicate
with the CPSW assigned to the case. These listening sessions have prompted a response by
DCYF to develop a system in which incarcerated mothers of children involved with DCYF can
have a voice and participate in the case planning process.
The CPS Administrator maintains a seat on the Senate Council New Hampshire Executive
Council to the Governor‘s Commission on the Status of Women (NHCSW).
The Greenbook Project - Grafton County, New Hampshire was one of six communities
across the country selected to take part in a federal initiative known as the Greenbook Project.
Greenbook‘s goal was to improve how child protection, the courts, and domestic violence
coalitions work together when responding to the co-occurrence of domestic violence and child
abuse and neglect. The result was a court guide for best practices for Judges.
Strengthening Families Through Early Childhood Education Developed by the Center for
the Study of Social Policy, Strengthening Families (SFI) is an approach to preventing child
abuse and neglect through building five Protective Factors in families. In 2005, the CSSP
designated New Hampshire as one of the seven states in the country for their SFI. Designated
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as the lead agency, DCYF partnered with the New Hampshire Children‘s Trust Fund (NHCTF)
in building protective factors for New Hampshire‘s families thus promoting the safety and
well-being of children in their home and reducing incidents of child abuse and neglect.
Comprehensive Family Support- DCYF contracts for statewide comprehensive family
support programs covering all twelve-district office catchment areas. Through the
Comprehensive Family Support Program, DCYF contracts with community-based agencies for
12 statewide regions to provide support services to approximately 500 families annually. The
programs assist families and children by promoting family wellness, decreasing family stress,
and preventing abuse and neglect. The social service agencies identify and assist families with
multiple stressors by providing multivariate services, which encourage and promote the
development of healthy families.
Accelerated Reunification Model- In 2008 DCYF developed a service model ―A
ccelerated
Reunification Model‖ (ARM) in collaboration with Casey Family Services. The service was
created in direct response to a barrier to timely reunification that results from the court process
the agency engages in with families under RSA 169 C. The goal is to conduct a comprehensive
assessment with the family that focuses on identifying and strengthening protective factors, and
taking concrete action to enable timely and safe reunification.
Data Considerations
The Case Practice Reviews conducted in our district offices demonstrates New Hampshire‘s continued
improvement in achieving timely reunification for children and youth.
Item 8: Reunification, guardianship, or permanent placement with relatives
Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester Salem
Jun-07
100
Dec-06
N/A
Jun-08
80
Jun-06 Dec-07 Sep-07 May-09
100
71.4
100
100
Dec-08
100
Aug-10
66.7
Sep-08
80
May-07
83.3
Mar-09
75
The Nashua District Office continues to display inconsistent reunification practices. Extensive office
reviews have identified training and practice issues that are being addressed relative to achieving more
consistent approaches. Nashua has a history of being more compliance focused than other offices and this
is being included in their ongoing practice improvement initiatives, as it is not consistent with the
performance in other offices.
Reviewers also noted in some offices the documentation of changes in goals or the reasoning for
extending the goal of reunification in a timely manner is problematic. Despite this, overall the data
demonstrates improvement and significant practice efforts in this area.
Strengths
The ability to engage in active reunification efforts immediately following removal as outlined
in our Accelerated Reunification Model is seen as one of the stronger improvements to
practice. Knowing the inclination of child welfare systems to raise the bar for reunification the
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longer a child is in placement makes this practice change the most significant for New
Hampshire.
The ongoing Court Improvement Protocol work that not only identifies best practices for the
agency and the court, but assures cross-system trainings and review for sustainable practice
improvement.
Permanency Teams and Permanency Staff that assure that permanency is a focus from the
time of removal and that reunification is the best and most appropriate identified goal being
actively pursued in every case.
The Provision of Community Prevention Services and Programs that focus on families‘
ability to sustain reunification without agency involvement. The focus on prevention in New
Hampshire is not only to support the prevention of children and families from coming into the
children protection or juvenile justice system but also to facilitate and sustain reunification.
Examples include Strengthening Families Through Early Childhood Education and
Comprehensive Family Support programs.
A major strength in New Hampshire is the commitment to partnering and collaborating with all
stakeholders and providers to assure a common focus and commitment to serving families in
their communities. The work with the Residential Provider network to assure that all children
and families regardless of placement type can have a common focus on reunification
demonstrates how these relationships can impact the work with children even in the most
intensive programs.
Opportunities For Improvement
As much as New Hampshire has truly focused on timely reunification the opportunity to engage parents
more in our policy development and practice initiatives is an area we are excited about improving.
Better Together with Birth Parents –a training curriculum of Casey Family Programs. DCYF has
begun to work with Casey Family Programs to bring BT/BP to Ne Hampshire as part of our continued
implementation of the Framework for Collaboration developed with residential providers. This is a twophase project. First, Casey Family Programs will bring to New Hampshire a birth parent facilitator and
staff facilitator to train 6 birth parents & 6 staff/agency providers in the Better Together Model. The
second phase involves these 12 individuals forming teams of 2 and over the next year they will facilitate a
Better Together 2-day workshop made up of 12 birth parents/12 staff/agency providers in different
regions across the State. The Better Together with Birth Parents training is based on empowering birth
parents to be more deeply involved in child welfare systems by honoring a guiding set of principles
including shared decision making, respectful communication and acknowledging shared purposes and
common values.
The prospect of engaging with parents and utilizing their input more effectively is an exciting opportunity
for improved policies and practices in New Hampshire.
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Permanency Outcome 1: Children Have Permanency and Stability in their Living Situations
Item 9: Adoption. How effective is the agency in achieving timely adoption when that is
appropriate for the child?
New Hampshire„s efforts to improve its adoption practice has resulted in some notable
achievements in the numbers of adoptions as well as a decrease in median length of stay for
children exiting to adoption. Based on the Permanency Composite 2: Timeliness of Adoptions
(standard: 106.4 or higher), our state score for FFY 2009 is 121.4, which is well over average.
New Hampshire has made significant improvements in most areas, specifically:
The length of time to achieve adoption has decreased from 35.4 months in FFY 2007 to 3.8
months in FFY 2009.
New Hampshire exits to adoption in less than 24 months is at 20.8% for FFY 2009 compared
to the national median of 26.8%.
In FFY 2009, 78.3% of legally free children were adopted in less than 12 months compared to
the national median of 45.8%.
Policy Consideration
Adoption offers children and youth the highest level of permanency. DCYF strives to achieve timely
adoption for children for whom it is appropriate. Several new policies identified below have stemmed
from the need to achieve timely adoption as the best permanency option for children who cannot return
home.
―Per
manency Options for Children and Youth in Foster Care‖
―V
oluntarily Mediated Agreements in Adoptions‖
―Chil
d Matching Process for Adoption and Placement of Children‖
―Pl
acing Siblings Together/Maintaining Connections‖
DCYF is also in the process of developing policy for the delivery of Post Adoption Services that supports
the Division‘s commitment to provide ongoing assistance to families who have adopted children from our
child welfare system.
As outlined in the Permanency Policy Update, several policy changes within the agency and the courts
have addressed the adoption process, from the initial placement and concurrent planning process, to the
specific actions that follow the permanency hearing. Most importantly, policy has been developed that
assigns specific timeframes to promote more timely adoption.
CFSR Round 1 Finding
During the 2003 CFSR this Item was rated an area needing improvement because reviewers determined
that the agency had not made concerted ongoing efforts to explore more permanent options and to
develop permanent relationships for children with a goal of long-term foster care.
Most stakeholders commenting on the issue of adoption finalization expressed the opinion that the agency
is making a concerted effort to pursue adoptions in a timely manner and to observe the ASFA timelines
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for permanency. However, stakeholders voiced concern about existing agency and court policies and
procedures that result in delaying adoptions. For example, stakeholders reported, DCYF workers do not
recruit an adoptive resource or transfer a case to the adoption unit until TPR is granted. In addition, delays
in scheduling the adjudication hearings impacts case planning, service delivery, and scheduling the
permanency hearing within the 12-month timeframe.
Changes since Round 1
Following the 2003 CFSR, DCYF committed to permanency by identifying and initiating many practice
and statutory changes that were barriers to permanency. Many of these have been previously discussed in
other Items. The impact of the Permanency Workers and Permanency Teams and Connection Specialists
in each District Office has had major influence on practice. The intent was to assure a local and constant
focus on permanency. It helped New Hampshire to breakdown the barriers in our own structure cited in
2003 and facilitated more timely adoption activities.
The local focus on permanency and the system changes brought on by the permanency legislation has led
to the most obvious improvements in the agency‘s outcomes in this area. However, in its mission to
achieve timely adoption, New Hampshire collaborates and utilizes the following as means for recruitment
and retention of adoptive families as well as for expanding support to adoptive families:
Community and Faith Based Initiative: The Community and Faith Based Initiative (CFBI)
were formed in 2005 and provide support to DCYF foster/adopt families statewide. Through
this collaboration many faith based leaders and churches have participated in recruitment and
retention events across the state. The CFBI also support foster/adoptive families through
Camper ships, Backpacks for back to school, clothing give always, Christmas gifts for children
in care, and renovations to homes to help make them meet licensing requirements.
Participating churches work with the district offices to provide appreciation events for foster
parents.
Wendy‟s Wonderful Kids: A recruitment project through the Dave Thomas Foundation for
Adoption that focuses on those children considered hard to place. WWK, in partnership with
the CFBI, has also sponsored our 2008 and 2009 adoption parties. Overall, WWK has been
involved with several matches and placements of older youths waiting for adoptive families.
AdoptUS Kids: Provides in state training and technical assistance. Ongoing site training is
provided by New Hampshire trainers to assist local social workers in their efforts to recruit
permanent homes for waiting children.
Post Adoption Services Program: This program is managed by a Post Adoption Support
Specialist that families can access directly and that include referral to various services
throughout the state, advocacy for adoptive families, short term case management, in-home
supportive services and consultation with professionals working with adoptive families.
Workers have been identified in each of our district offices and are provided with additional
supports to help work with families from their local areas
Foster/Adopt Parent Association (FAPA) Monthly support groups for foster/adopt parents.
Heart Gallery: DCYF has partnered with the New Hampshire Professional Photographers
Association and some individual volunteer photographers to take photos of children waiting to
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be adopted. The permanent Heart Gallery created in collaboration with the Massachusetts
Adoption Resource Exchange (MARE) remains displayed at Jordan‘s Furniture in Nashua.
New Hampshire DCYF has created a traveling Heart Gallery that is used for statewide
recruitment and retention events
Each year the division creates a DVD of "waiting children” which is distributed to our
District Offices and our community-based partners for use with public presentations,
recruitment events and foster/adoption celebrations throughout the state. Each year this DVD
has been unveiled during May, Foster Care Month. It is also a part of all FACES graduation
classes held throughout the year.
Waiting Children brochure: A listing of all New Hampshire children who are legally free
for adoption, which is disseminated through all our recruitment venues.
National Adoption Month activities: This involves local activities within the district offices
showing appreciation to adoptive families, as well as interagency events. A highlight of the
month is a proclamation event at the state capitol with the Governor of New Hampshire,
St. Charles Children‟s Home: The Division has been working with the Director of St.
Charles Children‘s Home in Rochester New Hampshire, an intermediate level children‘s
congregate care environment to provide weekend retreats for resource families, relatives, birth
or adoptive families of children placed in their care. The concept behind the model is to
provide families who have children placed at St. Charles an opportunity to work with the staff
and their children in a therapeutic milieu so that behavioral interventions may be practiced and
utilized before a child leaves the group home to live with their adoptive family or reunite with
their birth family.
DCYF partnered with the court and providers in writing legislation to implement ―
voluntary
mediated adoption‖ for children in the care of DCYF. The goals were to facilitate voluntary
surrenders rather than complete lengthy termination of parental rights proceedings, and to
encourage older children to consider adoption if contact with birth parents could continue. The
bill was presented to the legislature and passed effective January 1, 2006.
The intent of the Post-Adoption Program is to support and promote healthy, stable families where
adoptive children can flourish. DCYF advocates for and provides a leadership role in educating the
community toward an increased understanding of post-adoption issues. DCYF envisions being a resource
for ongoing information and services related to adoption. Post-adoption services are provided in a variety
of ways, including individual and group contact and work with community-based agencies. Since its
inception, the Post-Adoption Program efforts have included:
Development of a Post-Adoption Services brochure
Meeting with District Office staff to assess post-adoption needs and planning activities to
address those needs
Providing information to adoptive families through the foster/adoptive newsletter
Development of support groups easily accessible to adoptive families
Creation of an adoption mentoring program for families
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Data Considerations
The results of our case practice reviews conducted in each DO between June 2006 and August 2009 are
listed below. We have found that although New Hampshire has been successful in getting children
adopted out of foster care, the timeliness to adoption still needs to improve.
Item 9: Adoption
Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester Salem
Jun-07 Dec-06 Jun-08 Jun-06 Dec-07 Sep-07 May-09 Dec-08 Aug-10 Sep-08
May-07 Mar-09
100
50
50
100
100
50
50
66.7
25
100
100
25
As a result of the previously mentioned initiatives the number of adoptions in New Hampshire has
steadily increased. There has also been an increase in adoptions of children age 12 or older from 17% in
2007 to 22 % in FFY 2009. Last year 16 children were featured on the "waiting children‖ DVD initiative
and of those, 12 were placed or matched in permanent homes.
From 01/01/06 – 12/31/2009 mediated adoptions were completed for 205 children.
33 mediated adoptions completed in 2006
50 mediated adoptions completed in 2007
54 mediated adoptions completed in 2008
68 mediated adoptions completed in 2009
The data reflects numerous efforts and practice shifts that have led to more adoptions and particularly
more adoptions for older children. We have been extremely successful in moving children and youth to
more permanent adoptive settings than ever before. This data is clear in identifying those successes,
however, the time it takes to achieve the adoptions although better, is not good enough.
The charts below also demonstrate the adoption trends in New Hampshire and a point in time picture of
adoption.
New Hampshire clearly wants to identify the successes in adoption but we also want to make sure that we
do not minimize the value of more timely adoptions. The length of time to achieve adoption has decreased
from 35 months in FFY 2007 to 32 months in FFY 2009. However we know this is a struggle that we
DCYF Finalized Adoptions by Federal Fiscal Year
Adoptions have increased over 200% since 1998
Age of Children Adopted from DCYF in
FFY 2009
200
173
180
160
# of Children Adopted
120
99
100
99
112
143
136
125
0 to 3
32%
103
72
80
60
142
138
140
12 and
over
22%
45
40
8 to 11
21%
20
0
FFY 98
FFY 99
FFY 00
FFY 01
FFY 02
FFY 03
FFY 04
FFY 05
FFY 06
FFY 07
FFY 08
FFY 09
4 to 7
25%
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need to monitor both within our agency and with the courts. The system barriers are identified and the
work is being done to improve this outcome; watching the data from court to court and office to office
will be key moving forward.
Strengths
As in other areas of practice, DCYF identifies its successful collaboration internally and externally
including stakeholders and providers as our biggest strength. The ability to partner and roll out initiatives
like the ones listed below is clearly an asset to the positive outcomes we are determined to obtain.
Continued Court Improvement Project activities expanding permanency initiatives with DJJS
court cases.
Statutory changes for permanency timeframes and voluntary mediated adoptions
Recruitment changes that identify foster parents willing and able to be the first and last
placement for children.
Finding Connections program that locates and engaging children and youth with new health
adult connections as permanent placements
Community and Faith Based Initiative (CFBI)
Foster and Adoptive Parent Association (FAPA)
Child Placing and Private Adoption Agencies collaboration in planning the development of an
Adoption Consortium to promote timeliness and practice consistency
Child Profile, Recruitment list
Waiting Children brochure and
Waiting Families list.
Opportunities for Improvement
As a result of permanency remaining the focus, DCYF has begun the process of developing a Practice
Model that will provide consistency throughout the state in all areas of child welfare including adoption
timeliness. In addition, we plan to continue to enhance our Post Adoption services in an effort to address
any barriers in relation to adoption due to children‘s needs and/or service array. The continued work on
the court improvement protocols for DJJS is also a significant opportunity for improvement.
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Permanency Outcome 1: Children have permanency and stability in their living situations.
Item 10: Other planned permanent living arrangement. How effective is the agency in
establishing planned permanent living arrangements for children in foster care, who do not have
the goal of reunification, adoption, guardianship, or permanent placement with relatives, and
providing services consistent with the goal?
New Hampshire continues to improve in the efforts to assure the most appropriate permanency
goal for children and youth. The data shows improved timeliness in establishing and obtaining
effective goals all of which impact this Item. The Data Profile shows improved numbers of
reunification and adoption permanency goals, which means less APPLA goals.
Policy Considerations
DCYF has made significant policy updates to assure appropriate APPLA goals are established when
appropriate and that we provide solid transition plans for youth. DCYF staff ensure the youth is provided
with the opportunity to build relationships with adults such as relatives, school staff, foster parents,
employers, coaches, community agency staff members, mentors, etc. who may become a permanent part
of the youth‘s post placement support network. This includes having ongoing discussions with older
youth regarding adults in their life that may provide long-term care support and guidance.
CFSR Round 1 finding
During the 2003 CFSR this Item received a rating of area needing improvement. Reviewers determined
that the agency had not made concerted ongoing efforts to explore more permanent options and to
develop permanent relationships for children with a goal of long-term foster care.
Stakeholders noted that the agency seeks alternative planned living arrangements for young children who
have special needs or older youth with exceptional circumstances. For special needs children,
stakeholders noted that use of co-guardianship as a permanency goal enables the child to receive needed
services and remain in a stable foster home while the agency retains custody. However, some reported
that DCYF is moving away from agency guardianships and co-guardianships to pursue more permanent
goals, such as adoption, when adequate supports and services can be secured.
Changes since Round 1
Since 2003 New Hampshire created Adolescent Workers in each district office. Following the same
concept behind the creation of Permanency Workers the agency wanted to assure a local focus and
expertise influencing everything adolescent, including but not limited to, the use of APPLA as an
appropriate and timely goal.
The Adolescent Worker is a core member of the Permanency Teams (PPT). Teams meet a
minimum of once a month in each district office to review each and every placement case to
ensure that all children and youth achieve permanency prior to exiting the DCYF system.
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When the PPT reviews a goal of APPLA, members will challenge the CPSW and their
supervisor to make sure that APPLA is the best plan for the youth and that all other
permanency outcomes have been exhausted. The result has been a significant decrease in the
number of APPLA plans since the last CSFR (See Data Considerations below).
The PPT provides oversight and direction regarding the CPSW‘s efforts to create a post care
support network for APPLA youth. Adolescent Workers are specially trained CPSW‘s who
lead, educate and collaborate with youth, colleagues and the community to ensure best practice
for adolescents. Adolescent Workers assist CPSW‘s to find permanent connections for youth,
along with providing consultation regarding adolescent development, case management
strategies and access to resources through the DCYF Adolescent Program.
Data Considerations
The results of the DCYF Case Practice Reviews (CPR) conducted in each DO between June 2006 and
August 2009 showed this Item rated strength in 80% of the applicable cases reviewed. Internal reports
reflect a decline in the percentage of children in our state with a primary goal of APPLA.
Reviewers noted challenges in this area were ensuring consistent documentation reflecting the goals
agreed upon in a transition plan as well as documenting these planning discussions during worker visits
with the youth. The offices struggling with this Item are working on more timely documentation
strategies as part of their improvement plans.
Item 10: Other permanent planned living arrangement
Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester Salem
June 07 Dec 06 June 08 June 06 Dec07 Sept 07 May 09
Dec08 Aug 10 Sept 08
May 07 Mar 09
100
100
50
50
100
75
75
75
75
100
50
100
In January 2005, 29.5% of children in placement had a primary goal of APPLA. This has dropped over
the years, with our January 2010 data reflecting only 18% of children in placement having APPLA as a
primary goal.
In 2008, 40 youth in DCYF/DJJS care received services from the Finding Connections Program. In 70%
(28) of the cases, the Case Connection specialist found new adult connections previously unknown to
DCYF or DJJS. In 75% (30) of the cases, the youth‘s adult connections increased their face-to-face
contact as a result of the work of the Case Connection specialist. Demonstrating further progress in 2009,
45 youth referred to the ―
Finding Connections ―Specialist received new adult connections increasing to
71% and face-to-face contacts with connections increasing to 78%. The data is identifying improvements
in practice and that the policy and practice changes are impacting practice for youth who have APPLA
goals.
Strengths
The DCYF Adolescent Program helps youth plan for their future and prepare for a successful transition
out of care and into adulthood through the Adult Living Preparation Process (ALPP). In the fall of 2009
DCYF began requiring staff initiate independent living preparation at 14 instead of 16 years of age to
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better meet the transition needs of younger youth. In addition, the DCYF Adolescent Program has several
components to assist transitioning youth including;
New Hampshire Trails, a curriculum that helps foster parents and residential providers teach
adult living skills, a career assessment and future planning tool and financial assistance to help
youth reach their Adult Living Plan goals.
Through DCYF Aftercare Services eligible young adults, ages 18-21, who age out of foster
care are provided with continued case management, support and financial assistance to meet
their basic needs, and support for their pursuit of education, employment, housing and wellbeing goals. This includes Education and Training Voucher (ETV) funds and a tuition waiver
program for college bound youth.
In January 2007 DCYF established the Finding Connections Program that places a contracted
Connection Specialist in each of the District Offices. The Connection Specialist has expertise
in researching a child/youth‘s case file (case mining) to identify relatives and other supports
and working collaboratively with the child/youth‘s caseworker and Permanency Planning
Team (PPT) to identify positive resources for the child/youth. Increasing the connections
available to children and youth in care has greatly enhanced the post care support networks.
DCYF has started utilizing alternative housing arrangements for older youth with a plan of
APPLA. Working in partnership with provider agencies and on a case-by-case basis, DCYF
has created independent living type independent service options (ISOs). The arrangement
allows youth age 17 and older to live in a supervised and supported apartment or adult living
preparation oriented foster placement while still in an open DCYF case. These environments
allow the youth to practice living on their own while maintaining the support and services
available through DCYF.
Staff utilizes the Permanency Pact created by FosterClub. The pact contains a list of 45
suggested supports that a foster parent or other caring adult can provide to an exiting youth. In
APPLA cases, CPSW‘s have used the list to define the roles and responsibilities of each
member of the youth‘s support network and to identify where there are gaps. Starting in
October of 2010, the support list will be integrated into our SACWIS system so that staff can
complete it on an ongoing basis and review it at each PPT meeting.
In May of 2009 DCYF created a hard copy and online version of a Young Adult Resource guide to be
provided to all APPLA youth as they exit care. It contains statewide resources and practical tips related
to housing, education, employment and well-being.
Opportunities for Improvement
A standardized method to determine if APPLA has been successfully achieved would further improve
DCYF practice in this area. It is DCYF‘s intention to better define a permanent connection and APPLA
criteria in the future.
Stakeholder information still indicates that many youth are not as aware of their permanency plan as is
desirable. Clearly we see an opportunity for improvement is to consistently demonstrate appropriate
APPLAs to ensure permanency for all youth in care. DCYF intends to continue to address this through
education and training for staff, youth and community partners through our Framework for Collaboration
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initiative aimed at improving permanency outcomes for youth in residential care. In addition we are
excited to use the opportunity that a practice model will bring to the APPLA goal for not just DCYF but
DJJS as well. New Hampshire plans to embark on the first permanency practice model for Juvenile
Justice in New England if not nationally.
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Permanency Outcome 2: The continuity of family relationships and connections is
preserved for children.
Item 11: Proximity of foster care placement. How effective is the agency in placing foster
children close to their birth parents or their own communities or counties?
New Hampshire continues to demonstrate successful efforts to place children closer to their
families and community, as demonstrated by a consistent decline in out of state placements. In
2007, DJJS and DCYF had a combined total of 45 children in residential out of state placements.
DJJS had 34 and DCYF had 11. Currently DJJS has only 11 and DCYF has only 2 children in
residential out of state placements
Policy considerations
As indicated in the Permanency Policy Update, when placing children, staff pursues the least restrictive
setting available, in close proximity to the parents‘ home, consistent with the best interest and special
needs of the child. Staff work closely with the family to identify placement resources. A relative or a
close family friend is the preferred resource, followed by a non-relative family, and then a congregate
care setting as necessary. When placement with a relative has been explored and is either not found or not
appropriate for the child, DCYF seeks a foster home that is in close proximity to the child‘s parent‘s
home.
In 2007, DCYF contracted with a provider to establish Connection Specialists as a resource to assist staff
in both DCYF and DJJS in finding connections for children that enter foster care. Connection Specialists
were initially created to ―m
ine‖ or research case files to locate previous or lost connections for children
and youth who were in placements and were not moving toward a permanent goal. Seeking out and
utilizing families‘ natural resources as children first enter care helps us place children in close proximity
of their parents and preserves existing relationships.
CFSR Round 1 Findings
During the 2003 CFSR, Item 11 was assigned an overall rating of Strength because in 100 percent of the
cases, reviewers determined that DCYF had made diligent efforts to ensure that children were placed in
foster care placements that were in close proximity to their parents or relatives, or were necessary to meet
their special needs.
Stakeholders commenting on this Item were in general agreement that most children are placed in close
proximity to their parents or relatives. Stakeholders reported, however, that youth entering foster care as
CHINS or as delinquents are more likely to be placed outside their community or out-of-State for
residential treatment and services than children entering foster care through child protective services.
Changes since Round 1
Partnering with the community and families is a fundamental philosophy of both DCYF and DJJS. The
community has a role and responsibility in supporting children in care. Community placements can also
increase the probability that the parents and children will be reunified. In recognition of this, since the
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2003 CFSR New Hampshire has worked diligently to establish programs and resources that assist DCYF
and DJJS staff in securing appropriate and needed placement resources for children and youth in their
communities. These include:
Finding Connections Program
In January 2007, DCYF contracted with Easter Seals to establish the Finding Connections Program that
places a contracted Connection Specialist in each of the District Offices. When a child is removed from
his or her parent‘s care and no relative has been identified as a possible resource for the child, a referral is
made to the Connection Specialist. The Connection Specialist reaches out to the parent to further explore
with them the names and contact information for relatives or others who may be a connection for the child
(ren). The Connection Specialist then begins the process of locating and contacting those potential
resources to determine the extent to which they may be a positive connection for the child (ren). When it
is determined a resource is available this information is shared with the assigned CPSW or JPPO and their
Supervisor to make an informed decision about how this individual can be utilized as a viable placement
or other supportive resource for the child (ren).
The Findings Connections Program was implemented in all of the District Offices by September 2007.
DCYF and DJJS staff in every office received training regarding the need to establish, maintain and
sustain connections for children. Initial results from SFY 2008 were very positive, 65% of cases
discharged by the Connection Specialist with a completed connections plan have ―
new adults‖ located.
Further, 86% of those cases had ―
increased face-to-face‖ contact with their adult connections. The
success of this initiative reinforces the importance of kin and other community supports in all aspects
of case practice.
Foster Care Recruitment and Retention
Foster and adoptive parents are linked closely to the neighborhoods, and cultural, ethnic, and religious
groups that make up the community. Development of the plan by local recruitment and retention teams in
each District Office is grounded in the belief that keeping children in their own communities in close
proximity to their parents, schools, and other significant people in their lives will enhance the safety and
well-being of children.
New Hampshire DCYF staff develops a local plan with a Recruitment and Retention Team that consists
of the DCYF Office supervisor, the resource worker, assessment worker, family service worker, the
permanency and adolescent workers, foster and adoptive parents, community representatives and others
as appropriate. A needs assessment is conducted by reviewing staff requests, community needs and
monthly statistics that assist the Team in targeting the recruitment and retention efforts to produce desired
outcomes. In addition, the number of inquiries, the number of home studies in process that will result in
licensed homes in the local community, and identification of retention practices in the local office is
reviewed. The plan includes a local needs assessment and review of the children and youth referred for
foster home placement and adoptive placements in the previous year. The safety, well-being and
permanency issues are considered in the development of new recruitment goals and objectives.
The Statewide Recruitment and Retention Plan compliments the twelve District Office plans and provides
support and cohesiveness to the local activities. In a standardized format, plans are submitted by the Team
to a review panel for approval annually.
Relative Care Program
In April 2008, in an ongoing effort to support relative placements, DCYF hired a part time Relative Care
Specialist. The Relative Care Specialist is responsible for a number of initiatives being developed to
support relative caregivers in order to keep children placed in proximity to their birth parents and
community. These include developing and maintaining knowledge of relative and community services
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Permanency Outcome 2
available in New Hampshire, working with the Family Resource Centers to develop programs and
supports for relative caregivers and serving as a liaison for relative caregivers who need access to
information and support. As a result of a result of a collaborative effort with New Hampshire RAPP
(Relative as Parents Project), New Hampshire held annual Kinship Conferences in 2008 and 2009.
Relative caregivers who attended these conferences report that having the ability to come together as a
group and share their successes as well as discuss their needs was beneficial for them as well as the
children they are caring for. Recent data collected from New Hampshire BQI show that the proportion of
children placed with relatives has increased from 15% to more than 20%.
Cultural Competency
Although New Hampshire‘s diversity is not as readily apparent as in other states, New Hampshire
continues to review performance outcome data by race, ethnicity, tribal affiliation, gender, presence of
disabilities, children‘s age, and other important demographic variables whenever possible.
Training has been provided to enhance the understanding of the importance of securing placements in
proximity to the child‘s community and culture. In the fall of 2006, a Supervisory training entitled ―
Child
Abuse & Culture: Working with Diverse Families‖ was held. The Office of Minority Health arranged for
a representative from the Manchester-based Somali Development Center to speak at this training about
the experiences of Somali refugees resettled in New Hampshire communities.
Subsequent to this training an agency wide Cultural Competency Self Assessment was completed by
child protection workers across the State in early 2008. Over 90% of frontline staff completed the survey.
Preliminary findings indicate that staff understand and respect cultural differences but would benefit from
opportunities to learn about specific populations, such as recent refugees from Sudan or Somalia. Staff in
more urban offices indicated a need for additional bilingual resources.
In April 2008, and again in 2009, field staff and supervisors from several DCYF district offices attended
the New Hampshire Diversity Conference sponsored by Casey Family Services. The conference is
designed for human service professionals, foster and adoptive parents, educators, policymakers, and other
interested members of the community to expand their knowledge of diversity issues.
In December 2009 the Court Improvement Project sponsored day long training on ―Court
s Catalyzing
Change‖ which was attended by DCYF Administrators, head Supervisors and Attorneys and CASA
representatives from across the State. The training focused on the impact of race, disproportionately and
implicit bias on outcomes for children and youth in foster care placement and the importance of
maintaining cultural connections for them.
Individualized Service Options (ISOs)
New Hampshire recognizes that at times placing children and youth in proximity to their parents, relatives
and community is not possible due to the specialized behavioral or mental health needs of the child (ren).
In an effort to address this in 2005, New Hampshire implemented the ISO Program. This program is
designed to provide specialized care and intensive therapeutic treatment for children in a family foster
home or provide intensive in-home support services to relatives caring for children in their home
community. ISO homes provide opportunities for children to reside in the least restrictive communitybased setting and allow for normalized environments and experiences for children. Since the inception of
the ISO program several residential treatment facilities and mental health agencies have expanded their
array of services and become certified to provide ISO services. Upon discharge from a residential
treatment facility, children and youth who are not yet ready for reunification have been transitioned from
the facility to an ISO foster home either in their community of origin or within close proximity to the
facility allowing for continuity of support and treatment in a less restrictive setting.
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Data Considerations
New Hampshire CFSR Statewide Assessment
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Permanency Outcome 2
The Case Practice Reviews (CPR) findings illustrate that Proximity of out of home placement is an area
where New Hampshire continues to do well. 94.7% of all cases reviewed are rated as strength as
evidenced by the chart below:
Item 11: Proximity of out of home placement
Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester Salem
Jun-07 Dec-06 Jun-08 Jun-06 Dec-07 Sep-07 May-09 Dec-08 Aug-09 Sep-08
May-07 Mar-09
100
100
85.7
100
100
100
100
100
88.9
100
100
100
Strengths
New Hampshire is confident that the policies and programs put in place since the last CFSR
have enabled us to demonstrate a strong commitment to maintaining connections to parents,
relatives and community for children and youth placed in out-of-home care.
DCYF works closely with community members that represent different cultural, racial or
ethnic backgrounds to build and support cultural competency within resource families. DCYF
recruits and trains resource families whom are culturally responsive to child (ren)‘s needs
regardless of whether they have different backgrounds.
Data trends continue to show sustained efforts in placing children in close proximity to their
parents and communities. For example in 2007, DJJS and DCYF had a combined total of 45
children in residential out of state placements. DJJS had 34 and DCYF had 11. Currently DJJS
has only 11 and DCYF has only 2 children in residential out of state placements thus in closer
proximity to their parents and community.
In anticipation of the upcoming 2010 CFSR, Foster and Adoptive parent stakeholders provided
feedback for this Item. They agreed that DCYF makes concerted efforts to place children
within proximity of their parents and that this practice is the best way to facilitate and support
reunification.
Opportunities for Improvement
New Hampshire needs to continue the focus on providing support to relative caregivers and on
recruitment efforts to build the pool of needed resource homes, particularly for children and youth with
special needs. Increasing our resources in this area is necessary to permanency efforts, as we know that
proximity is critical to maintaining the sufficient level of connection and contact that is needed to
effectively support reunification.
New Hampshire continues to demonstrate through coordinated efforts, that it is possible to place
children in close proximity to their birth families, relatives and community. We have done well in
establishing and documenting the foundation for this practice. Further development of a standard
statewide practice will provide opportunities for improvement in this Item.
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Permanency Outcome 2: The continuity of family relationships and connections is preserved for
children.
Item 12: Placement With Siblings. How effective is the agency in keeping brothers and sisters
together in foster care?
The Division for Children, Youth and Families (DCYF) recognizes that sibling relationships are
emotionally powerful and critically important not only in childhood but over the course of a
lifetime.
Policy Considerations
Children and youth who must be placed away from their families are placed together unless the serious
specific needs or the safety of one or more siblings justifies separating them. The decision to separate
siblings is based on a carefully documented and reviewed determination that such separation is necessary.
When that is not possible, strong connections between siblings are maintained.
The decision about placing siblings together is made when the child first comes into care. If placement
together does not occur at this time, the sibling placement and visitation is revisited at each point in the
case until placement together is made or the permanency plan is achieved.
Staff make key decisions about placing siblings together and maintaining connections when the case plan
is developed, the permanency planning team meets and at the dispositional and permanency hearings.
CFSR Round 1 Findings
During the 2003 CFSR, Item 12 was rated as strength in 16 (94%) of the 17 applicable cases.
Stakeholders commenting on this Item observed that the agency makes diligent efforts to place children
with their siblings. Although a key CFSR finding was that DCYF makes concerted efforts to place
siblings together in foster care, stakeholders recognized the need for more foster homes that can provide
for large sibling groups.
Changes Since Round 1
As mentioned in previous Items New Hampshire re-defined the roles of staff in a way that would be more
conducive to timely and solid permanency planning. Identifying Permanency, Adolescent and Resource
Workers at the local office resulted in more consistent practice and a unified focus at the onset of
involvement with children and youth. Concurrent Planning and foster care recruitment were two areas
identified for improvement to keep siblings together when the need to enter out- of- home placements
becomes necessary.
Created ―
Permanency Teams‖ that mandated core membership from the Permanency,
Adolescent and Resource (PAR) staff that share case responsibilities from the outset, rather
than becoming involved sequentially as the case progresses. This has improved continuity in
case planning and provided valuable expertise in each District Office.
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The Community and Faith Based Initiative has enhanced our foster home recruitment efforts to
assure more resources to place siblings together.
The Division has expanded its use of DHHS Website as an informational and recruitment tool.
Links to training and other resources for both foster and adoptive families are easily found.
New Hampshire DCYF developed a local Recruitment and Retention teams process.
Membership consists of the DCYF Office supervisor, the resource worker, assessment worker,
family service worker, the permanency and adolescent workers, foster and adoptive parents,
community representatives and others as appropriate. The Recruitment and Retention plan
includes a local needs assessment and review of the children and youth referred for foster and
adoptive home placements in the previous year. The permanency issues such as sibling
placements are considered in the development of new recruitment goals and objectives.
In an ongoing effort to support kinship placements, DCYF hired a part time Relative Care
Specialist in April 2008.
Data Considerations
Case Practice Review data demonstrates New Hampshire maintains a strong practice in placing siblings
together. As shown in the chart below 10 of the 12 offices rated 100% on this Item.
Item 12: Placement with siblings
Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester Salem
Jun-07 Dec-06 Jun-08 Jun-06 Dec-07 Sep-07 May-09 Dec-08 Aug-10 Sep-08
May-07 Mar-09
100
100
100
100
100
85.7
100
100
75
100
100
100
In the Nashua office where the rating was 75% stakeholders reported that the agency is improving in this
area and if they do not initially place siblings together they do ultimately move them together if
appropriate.
The positive data obtained during the New Hampshire case practice reviews demonstrate that staff are
making concerted efforts to maintain sibling connections either through actual placements or case
planning efforts that assure quality contact.
Strengths
PAR staff from across the state, meet on a monthly basis to discuss ways we can sustain or improve
existing practices. The group meets jointly for a morning discussion, leaving the afternoon reserved for
breakout time where the individual specialties meet with their Program Specialist to fine tune practices
unique to them. As a result of the relationships, networking opportunities, and shared philosophies that
are derived from participation at the PAR meetings, a level of statewide collaboration has been developed
that includes the sharing of resource homes, when necessary, for a variety of reasons including to keep a
sibling group together.
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Established strong relationships with the New Hampshire Foster and Adoptive Parent Association
(NHFAPA) strengthen DCYF‘s practice. DCYF values the hard work and commitment of the parents
actively involved with this association who offer peer support to fellow families. The Division recognizes
and appreciates that the best recruitment tool for new foster and adoptive families is a well-supported
current foster or adoptive family.
Partnering with the community and families is a fundamental philosophy of the Division. The community
has a role and responsibility in supporting children in care. Foster and adoptive parents are linked closely
to the neighborhoods, communities and cultural, ethnic, and religious groups that make up the
community. They work and perform daily activities and contribute to the vitality of the community while
serving children in care. Development of the plan by local recruitment and retention teams in each
District Office makes operational the belief that we need to keep siblings together whenever possible and
creating the resources willing and able to provide care for siblings has been a key strategy.
Community placements can also increase the probability that siblings will be placed together and can
enhance the ability to maintain natural and lifelong connections.
Opportunity For Improvement
New Hampshire is proud of the efforts and increased percentages of siblings placed together. Continued
efforts in recruiting foster homes and relatives to assure enough resources across the state is our area for
continued opportunity to provide the best options and resources for placements.
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Permanency Outcome 2: The continuity of family relationships and connections is preserved for
children.
Item 13: Visiting with parents and siblings in foster care. How effective is the agency in
planning and facilitating visitation between children in foster care and their parents and siblings
placed separately in foster care?
New Hampshire has worked to improve our approach to visitation.
Policy Considerations
New Hampshire acknowledges that when children are placed in out-of-home care, it is essential that they
maintain contact with their family. Family visitation practice is as ―
least restrictive‖ as possible and takes
into consideration what type of visitation is safe and appropriate given any ongoing risk factors.
As noted previously, child protection in New Hampshire can be a litigious process and the decisions
around visitation cannot and should not be a part of that litigiousness. When a child is placed in out-ofhome care, the CPSW or JPPO and supervisor make the determination about the level and frequency of
visitation after consultation with the parents, children, the guardian ad litem, and mental health providers
currently involved with a family.
Compliance or non-compliance with the case plan should is not the sole deciding factor regarding
visitation, and visitation should never be punitive. Visits are only supervised when the CPSW or JPPO
and supervisor determine that the child may continue to be unsafe if left unsupervised with the visiting
parent. When siblings are placed separately, a visitation plan includes the frequency of contact between
them.
CFSR Round 1 Findings
During the 2003 CFSR, this Item was rated am area needing improvement because reviewers determined
that the agency had not made concerted efforts to ensure that visitation between parents and children and
between siblings was of sufficient frequency to meet the needs of the child.
Stakeholders commenting on this Item reported that the agency strongly encourages and facilitates
visitation between parents and children. They also noted that foster parents are primary catalysts in
supporting visitation and are receptive to visits in the home. Stakeholders cited a lack of transportation as
a barrier to more frequent or regular visitation.
Changes since Round 1
Significant improvements have been made to the Case Plan since 2003. The current version of
the DCYF/DJJS Case Plan (Form 2240) went into effect in March 2006. In the Case Plan,
CPSW‘s and JPPO‘s are required to enter information regarding their efforts to maintain child
and family connections. The Instructions to the Case Plan [Form 2240 (i)], instruct CPSW‘s
and JPPO‘s to identify the measures taken to encourage contact between a child and their
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family members including parents, guardians, siblings, extended relatives, former placement
providers, friends, and close community people involved in the child‘s life.
New policy regarding Placing Siblings Together/Maintaining Connections was finalized in
February 2010. When the decision to separate siblings is imperative, strong connections
between siblings must be maintained. These connections can be established or maintained
through a variety of options including visitation, phone calls, email, joint respite and placement
within close proximity to each other.
The Creation of an Absent Parent Affidavit was established in 2006 to address the need to
assure and monitor efforts to locate absent parents. Through the CIP activities DCYF and the
courts created this affidavit, which outlines at every hearing the agency efforts to locate
parents.
In December of 2008, DCYF launched a pilot transportation program in the Manchester district
office. The Transportation-To-Reunification Pilot explored hiring independent transportation
providers to be located in the district office and work in coordination with staff in scheduling
and providing transportation for children and families served by the Manchester office through
an open placement case.
Since September of 2008 DCYF has participated in the Breakthrough Series Collaborative on
Safety and Risk Assessments, sponsored by the New England Association of Child Welfare
Commissioners and Directors, Casey Family Programs and Judge Baker Children‘s Center.
Two practices have been identified for statewide implementation in upcoming months, which
will have a positive impact on maintaining family relationships immediately upon removal of a
child from their home.
The first practice change allows children to telephone their parents at bedtime on the
night of removal. This allows contact between the child and parent to know that they
have some time in the near future when they will speak and has shown to alleviate some
of the unknowns during the time of removal.
The second practice change ensures that the child and parent have a visit within 24 hours
of the placement. The phone call and 24-hour visit are both arranged by the CPSW
during conversations with the parent and child during removal, and set the tone for the
important role that ongoing and consistent family contact will play.
Many of the State Prisons in New Hampshire now have video conferencing abilities. This
technology has been expanded to allow parents who are incarcerated to have contact with their
children in care via web cameras. This is especially helpful when parents are incarcerated in a
prison that is a great distance away from their children and when the frequency of contact
would be diminished without this capability.
The Incarcerated Parents program involves ongoing meetings between DCYF Administration
and incarcerated women involved with DCYF to listen to their struggles to maintain
connections with their children, keep apprised of case status and planning. These listening
sessions have prompted a response by DCYF to develop a system in which incarcerated
mothers of children involved with DCYF can have a voice and participate in the case planning
process.
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Data Considerations
New Hampshire has made numerous changes both in practice and systems to address the known barriers
to visitation. The challenging part of this Item is for workers to promote and maintain connections with
the child‘s father and paternal relatives. In addition, Case Practice Reviews pointed out the systemic
challenge of working with the corrections system.
Reviewers discussed the excellent work done with mothers and siblings insuring regular and frequent
visitation. However, in several offices identified below efforts need to be made to reach out to the child‘s
father to engage him in visitation and the child‘s progress. Although improvements have been made the
data as indicated below does not yet demonstrate a significant impact statewide.
Item 13: Visiting with parents and siblings in foster care
Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester Salem
Jun-07 Dec-06 Jun-08 Jun-06 Dec-07 Sep-07 May-09 Dec-08 Aug-10 Sep-08
May-07 Mar-09
66.7
57.1
66.7
100
77.8
77.8
87.5
55.6
55.6
62.5
55.6
71.4
Strengths
The involvement with the Breakthrough Series and the opportunity to spread practice
initiatives that positively engage parents and children immediately is a clear strength in New
Hampshire‘s effort to improve in this area.
The creation of the Absent Parent Affidavit has proven to be valuable in locating and engaging
absent parents in case planning for their children.
Listening sessions with incarcerated mothers of children involved with DCYF have provided
them with a voice and the ability to participate in the case planning process.
Opportunities For Improvement
In New Hampshire resources are not consistently available statewide, some District Offices are faced with
limited options for some services and that could impact visitation including transportation and Parent
Aide services. CPSW‘s make every effort to provide some of the direct intervention themselves when it is
needed and other options are unavailable.
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Permanency Outcome 2: The continuity of family relationships and connections is preserved for
children.
Item 14: Preserving Connections: How effective is the agency in preserving important
connections for children in foster care, such as connections to neighborhood, community, faith,
family, tribe and friends?
Policy Considerations
New Hampshire has incorporated the Fostering Connections to Success and Increasing Adoptions Action
(HR 6893) which was passed to provide New Hampshire‘s children support by increasing connections
through relative involvement. It is New Hampshire‘s belief that by identifying, locating and engaging
relatives or supportive connections, it can greatly impact the well-being of children in care and
significantly enhance permanency outcomes.
In November 2009, New Hampshire implemented a 30-day relative notification policy where CPSW‘s
work with the birth parents to identify all relatives and send a letter to the reported relatives within 30days of the child‘s removal from the home. This notification gives relatives timely notification of
placement and to explore the opportunity to work with the parents and the Division to become involved in
the child‘s life. The Division will look at all relatives as placement options for the child.
CFSR Round One Findings
During the 2003 CFSR this Item was rated strength because in 90 percent of the cases, reviewers
determined that the State had made diligent efforts to preserve children's connections. Stakeholders
commenting on this issue expressed the opinion that the agency is generally effective in preserving
connections to family and schools.
Changes since Round One
New Hampshire has continued to remain focused on the need for children to have relative involvement or
other permanent connections.
In 2007, the Division implemented the Finding Connections program, which is a contracted service
through Easter Seals to increase connections for children who have been removed from their home
through DCYF or DJJS. Each district office in the state is assigned a Connections Specialist and the
office assesses the needs of the children in their office. If a child is in need of additional supportive adults,
a referral is made to the Connections Specialist to assist in case mining or efforts to locate or re-involve
connections for the child. Some examples of connections work includes, reaching out to parent‘s whose
parental rights were terminated, locating and engaging absent parents and looking at community
connections such as teachers, neighbors or other important people identified by the child or family.
Trainings about the Finding Connections program and the importance of maintaining connections were
held for all DJJS/DCYF staff in 2007 as part of the rollout.
Since the last CFSR, DCYF implemented a Permanency Program Specialist Position, as well as a
Relative Care Specialist position at the state level, to focus on policy oversight of policy, training and
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provide consultation to district office staff regarding connections work with relatives or other permanency
planning needs of families. DCYF also had CPSW positions designated as Permanency Workers. There
is currently a CPSW assigned to every district office to monitor each child‘s permanency plan.
Data Considerations
A Case Practice Review (CPR) was conducted in each district office between June 2006 and August
2009.
Item 14: Preserving connections
Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester Salem
Jun-07 Dec-06 Jun-08 Jun-06 Dec-07 Sep-07 May-09 Dec-08 Aug-09 Sep-08
May-07 Mar-09
83.3
77.8
100
100
88.9
77.8
87.5
75
55.6
100
88.9
88.9
The results of the most recent CPR indicated that 85% of the cases reviewed were rated as strength as
they successfully maintained connections for the child in the community. This is also reflective in the
State of New Hampshire‘s success in placing children in, or close to their community of which they were
removed.
The positive outcomes for preserving connections were also reflected in the data collected through the
Finding Connections program. The utilization of this program increased for DJJS and DCYF from 2008
to 2009. The cases for DJJS increased from 11 cases in SFY 2008 to 38 cases in SFY 2009. For DCYF,
the cases increased from 74 cases in SFY 2008 to 109 cases in SFY 2009.
In SFY 2009, all discharged cases from DCYF/DJJS in the Finding Connections Program, 74% of the
referrals had ―ne
w adults‖ located and 79% of the cases discharged had an ―
increased face-to-face‖
contact with their existing adult connections.
Challenges were voiced during CPR‘s in several district offices. In Laconia, lack of placements for
adolescents in the community, in particular therapeutic options for teens, was mentioned as a challenge to
preserving connections. In Nashua, focus group participants indicated DCYF/DJJS staff were aware that
maintaining connections with family and their community was an issue in some cases but staff were
working to improve in this area.
Strength
DCYF has utilized the Permanency Planning Team (PPT) process to review cases at 30-days, 6 months
and 11 months from the child‘s initial removal. The PPT meeting looks at permanency options for the
child and ensures that relatives and other supportive adults are engaged to ensure children have permanent
connection and that community support is maintained. These connections identified are documented on
the PPT form to include the frequency of the contact.
When the Finding Connections Program was first implemented, a majority of the referrals were made for
cases that had been open for an extensive period of time. Referrals are often made to the Finding
Connections Program at the 30-day PPT meetings, which has helped to shift the focus from the older
cases, to looking at establishing permanent connections soon after initial placement. This shift will help
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identify connections earlier on and therefore, ensure better permanency planning for children who have
been removed from their home.
Each Connections Specialist and Permanency Worker has access to a search engine, Accurint, which is a
paid service to help locate persons identified as possible connections.
New Hampshire does not have any federally registered tribes. When DCYF has an applicable ICWA
case, the CPSW/JPPO assigned to the case works with the attorney in their district office to ensure that
appropriate ICWA procedures are met.
The relative notification policy that addresses relative placement brings families together from the initial
removal in order to plan around the ICWA provisions required. Conversations are had with the birth
parents regarding ICWA eligibility at initial placement and during the social study. The Social Study is
provided to the Court at the Dispositional Hearing, at which time the Court will order a finding of fact and
specify whether ICWA is applicable for the child. For all ICWA eligible children entering or leaving
New Hampshire through an ICPC, the interstate compact paperwork will reflect this information and
information regarding tribal approval for placement, if applicable.
Opportunities for Improvement
Consistency in case practice relative to preserving connections is an opportunity for improvement as we
look to develop a case practice model. The practice model will help ensure that each office in the state is
utilizing the Finding Connections program when appropriate. The Finding Connections program is a
service that is started by a referral process from the CPSW/JPPO in coordination with the supervisor. At
this point, there is no tracking process in place to ensure that all cases needing connections are referred to
the Finding Connections program.
Birth parents or children may sometimes create challenges to preserving connections, especially for DJJS
who has a different legal relationship with children in care. In some cases, parents or children may not
want to have the State engage additional connections. This may create an adversarial dynamic between
the Divisions and the parent or child. It is important for the involvement of connections to be a
collaborative partnership with all parties to the case to help minimize risk factors and to help the child
manage any possible outcomes from the efforts to explore connections.
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Permanency Outcome 2: The Continuity of Family Relationships and Connections is Preserved
for Children.
Item 15: Relative Placements: How effective is the agency in identifying relatives who could
care for children entering foster care, and using them as placement resources when appropriate?
New Hampshire has focused on the use of relatives as placement resources with positive results in
placement, stability, and permanency. Data for first time cohorts in 2009 shows that 90% of
children discharged are reunified or in a relative home. To date, New Hampshire has a total of
155 relative homes serving children in DCYF custody.
Policy Considerations
As of November 2009 DCYF developed new policy addressing this Item in conjunction with the Foster
Connections Legislation in 2008. This new policy requires due diligence to identify and locate relatives
for placement by the Child Protection Social Worker (CPSW) as early as possible at the time of the
child‘s removal and throughout the first 30 days of the child‘s removal. CPSWs are directed to continue
to make efforts beyond the first 30 days of removal to identify and locate all adult relatives until all
appropriate adult relatives have been given notice. All correspondence and efforts to identify and locate
relatives is to be documented in the case contact logs in Bridges. Due to the timeframes in which this
policy was released, efforts to locate relatives may or may not be reflected in the documentation during
the period under review.
The CPSW is to engage both maternal and paternal parent or guardians as early as possible whenever
placement becomes a possibility and for in-home cases to identify family members using the Family
Inquiry Tool (Form 2264). The tool is to be transferred to the joining caseworker and kept in the file for
reference.
Relatives are notified in writing of a child‘s removal. Workers are required to send each identified
relative Form 2263, The Relative Notification letter along with a self addressed stamped envelope to
assist the ease of response from the relative. Bridges is to be used to document the CPSWs effort to
identify relatives with family members as well as all correspondence.
According to DCYF's relative care policy #734, placement with a relative care provider, who does not
pursue licensure, may be approved under the following conditions: the relative care provider meets the
definition of relative; meets all safety needs of the child or youth; provides for the child‘s educational,
financial, physical and emotional needs; completes the Relative Care Agreement (RCA, Form 2273); and
Resource Care Enrollment Form (Form 2104); completes central registry and criminal background checks
of all household members age 17 and over; participates in a home study; and cooperates by providing any
additional information as deemed appropriate by the Resource Worker e.g. fire and health inspection.
Relative Caregivers are required to apply for Healthy Kids Gold for the child (ren) and are eligible for a
―c
hild only‖ TANF grant through the Division of Family Assistance.
In 2009 New Hampshire changed the policy terminology from Kinship to Relative Care. As policy
revision and implementation was underway it became apparent that ―
relative‖ was the right terminology
for New Hampshire Culture and Child welfare. This deliberate change is reflected in an article in the
January 2010 Issue of the Common Ground, a newspaper of the New England Association of Child
Welfare Commissioners and Directors.
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CFR Round 1 Findings
During the 2003 CFSR, relative placements were found to be an area of strength in 76% of cases. This
Item was assigned an overall rating of area needing improvement because reviewers determined that
DCYF had not made diligent efforts to locate and assess relatives as potential placement resources. The
key concern pertained to inconsistent efforts on the part of the agency to seek paternal relatives as well as
maternal relatives
Changes Since Round 1
Starting in January 2007, DCYF contracted with Easter Seals to establish the Finding Connections
Program that places a contracted Connections Specialist in each District Office. The Connection
Specialist has expertise in researching (case mining) a child‘s case file to identify relatives and other
supports and working collaboratively with the child‘s caseworker and Permanency Planning Team (PPT)
to identify positive resources for the child.
New Hampshire hired a Relative Care Specialist in April 2008. In 2009 the Relative Care Policy Item 734
was revised along with Form 2162 Guide to Home Study for Relative Care and Form 2273 the Relative
Care Agreement. Item 697 Notification of Relatives was written and implemented, along with Form 2264
the Family Inquiry Tool, Form 2263 the Notification Letter, and a ―W
elcome Letter‖ to be sent to new
relative care providers.
Relative Care Training has been provided to leadership staff and all Permanency, Adolescent and
Resource workers. Issues surrounding relative placement; including trust, engagement, beliefs and values
has taken place among administration and leadership staff and with relative caregivers.
Searches for both paternal and maternal relatives
Due diligence is required in all efforts to identify, locate and notify all adult relatives of each child that
comes into care. CPSWs may contact schools and medical offices to request any identifying information
provided by the parent. The use of advanced search engines and other technology has been implemented
within DCYF.
The Notification of Relatives‘ policy directs the field to consult with the Finding Connections Specialist
under certain conditions when; the parents are resistant or do not know the information about their
relatives; there is minimal or no response to the Relative Notification Letter (Form 2263); relatives do not
follow through after their initial response to the CPSW; or there is a Permanency Planning Team meeting
and the CPSW requests assistance.
Before a child in DCYF custody is placed with a relative the relative must complete a local criminal
record check and sign form 2273, the Relative Care Agreement. They are also required to sign a Resource
Provider Enrollment, Form 2104. The CPSW must conduct a home visit and contact the local police
department to determine if there is any criminal activity. Policy requires a home study to be written within
30 days of the child‘s placement in the relative‘s home. If the child‘s first placement is with a relative,
notification letters must still be sent to other identified adult relatives within the first 30 days, and after if
necessary.
Upon placement of a child with relative caregivers paperwork regarding the licensing process is provided
and families are encouraged to become licensed foster parents, although this is not required. Becoming
licensed often allows the State to provide additional supports to relative caregivers, including a higher
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reimbursement rate for board and care, which is beneficial when they have more than one child in
placement. Becoming licensed also connects relative caregivers with other resources that they might not
be eligible for otherwise. When licensed the provider becomes a member of the New Hampshire Foster
Adoptive Parent Association and a monthly newsletter consisting of news, events and announcements.
To become a licensed foster home, relative providers must complete the basic application process
required by all licensed foster parents. This includes 26 hours of foster parent training, references,
medical statements, financial information, an autobiography, copies of birth certificates and a marriage
certificate if applicable. Criminal background checks and fingerprinting is also required. The home must
be deemed safe, and pass both a town health and fire inspection. Landline phones are also required.
The resource worker is responsible for maintaining a file on the relative family with a minimum of the
signed Relative Care Agreement and Provider Enrollment Form in the file. The resource worker also
sends a ―
Welcome letter‖ to the relative caregiver in an effort to support the placement and provide
additional information regarding agency and community services.
The CPSW is responsible for documenting all correspondence to the identified relatives within the
required timeframes. In the event a relative cannot be located the CPSW is responsible for documenting
in Bridges the efforts that took place to locate. CPSWs are required to review with their supervisor or
team members at the three, six or nine month court or administrative reviews, existing relative
connections and potential placements. Case contact logs should include documentation detailing relatives
who were contacted for placement or connection purposes and the reason placement did or did not occur
at these times.
Data Considerations
Item 15: Relative placement
Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester Salem
Jun-07 Dec-06 Jun-08 Jun-06 Dec-07 Sep-07 May-09 Dec-08 Aug-10 Sep-08
May-07 Mar-09
100
77.8
80
40
80
87.5
100
37.5
33.3
100
60
65
A Case Practice Review (CPR) was conducted in each district office between June 2006 and August
2009. In our most recent CPR‘s, the strength of this Item, relative placements, had a varied range
between DO‘s from, 33.3% to 100%, with the state average being 76.1%.
As noted in the chart above, Manchester and Nashua have struggled with consistent practice around the
identification of extended family and placement with relative caregivers. Historically both offices would
locate relatives but then take up to 30 days to assess them as a placement resource. Current practice is to
do conduct an initial assessment of the home in an effort to determine the appropriateness of an
immediate placement. This has led to an increase in relative placements as demonstrated by recent data;
the proportion of children placed with relatives in New Hampshire has increased from 15% to more than
20%.
To date, the number of open relative care homes that are both licensed and unlicensed on the Bridges
System is 159. 111 are categorized as Relative Homes, leaving the remaining 48 to be open for fostering
or adopting. Using manual reporting methods, we have been able to determine that of the 48 licensed
homes, 12 are providing care to a total of 18 children in the custody of the State of New Hampshire. The
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other 36 have no placements at this time or are providing homes to children from out-of -State. There are
currently 166 children in relative care in New Hampshire 18 are in a licensed relative home. As
mentioned above, relative caregivers are not required to become licensed but must meet DCYF relative
care policy requirements.
Strengths
The Fostering Connections to Success and Increasing Adoptions Act of 2008 was timely and instrumental
in the development of new and improved policy and practice for relative placements.
DCYF‘s Relative Care Specialist has worked diligently on projects targeting relative caregivers with the
New Hampshire Relative as Parents Program (NH RAPP) and Vermont Kin as Parents, along with New
Hampshire‘s Bureau of Elderly and Adult Services, Division of Family Assistance and Easter Seals.
An improved tracking system has been implemented in order to effectively monitor and track relative
placements within Bridges. A provider enrollment process was developed and all relative placements are
identified with a provider number and a relative care service credential.
Two statewide committees were established within DCYF to focus on improving the practice and policy
of relative placements and implementing the Fostering Connections to Success and Increasing Adoptions
Act of 2008. Committee members included field staff and leaders from the various district offices
throughout the State. Involved in policy planning was a representative from the Finding Connections
Program, a TANF Specialist from the Division for Family Assistance and a representative from the
Bureau of Elderly and Adult Services.
As a result of collaborated efforts with New Hampshire Relatives as Parent Program (NHRAPP)
Administrators and State officials have had the opportunity to hear about needs directly from relative
caregiver.
A pilot program with the Portsmouth Office in collaboration with the Administrative Case Review
process has been implemented to review cases within the first 10 days of placement at which point
parents, relatives and other parties to the case will come together to support reunification and look at the
availability of relative placements.
As of December 2009, identifying Information received by the CPSW is to be recorded on Form 2264 the
Family Inquiry Tool. Calls are made to relatives identified with a phone number and the CPSW assesses
first by a phone interview and later with a face-to-face interview the availability and appropriateness of
placement.
Opportunities for Improvement
The Fostering Connections Legislation makes way for the expansion and implementation of more
programs that will benefit relative caregivers. Many states have implemented a Kinship Navigator
program and Family Decision Making has become an increasingly popular approach to identify and
involve relatives in case planning at the beginning of a child‘s placement.
Advanced training in Relative Care practice and policy is currently being developed for all CPSW
positions and will be conducted this year.
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Barriers to identifying and locating relatives as placement resources are most often attributed to the birth
parents‘ inability or refusal to cooperate and provide information to the CPSW at the time of removal;
often times this is due to the parents‘ lack of trust. If a child is placed in traditional foster care at the time
of removal, the likelihood of the child being placed with a relative may be reduced. Factors such as the
age of the child and the length of time in non-relative placement play a role. A parent may identify a
relative for placement at the time of permanency. It may be determined that removal of a child from a
foster home to place with a relative is not in the child‘s best interest.
The recent release of the Notification of Relatives Policy has changed current practice in that it requires
the use of additional forms, documentation and timeframes that have not previously been practiced by
field staff. The ability to sufficiently monitor and track this data within the District Offices is being
researched.
The state‘s ability to track the number of unlicensed relative care homes in New Hampshire Bridges
system has improved this past year with the implementation of the Resource Provider Enrollment Form
2104. However, a challenge still exists in Bridges for tracking the number of relative care homes.
Specifically, when a home becomes licensed for foster care regardless if it is a relative home, the resource
category that must be selected in Bridges is fostering. When a relative home or foster home adopts a
child, the resource category becomes adopting. Both the fostering category and the adopting category
replace the relative home category. This issue has been brought to the attention of the DATA
Management team for resolution.
Training for all field staff regarding the implementation and practice of new and revised policy has yet to
take place. At this time training has been provided to supervisors and Adolescent, Resource and
Permanency Workers. However the majority of assessment and family service workers have not received
training.
Finally, another area that warrants attention is inconsistent practice regarding the level of involvement of
relatives. In some cases, extensive efforts are made to locate, involve and maintain involvement with
parents and relatives for placement however; these measures are not consistently practiced statewide.
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Permanency Outcome 2: The continuity of family relationships and connections is preserved for
children.
Item 16: Relationship of child in care with parents. How effective is the agency in promoting
or helping to maintain the parent-child relationship for children in foster care, when it is
appropriate to do so?
New Hampshire has been focused on efforts to maintain the parent-child relationship for children
in foster care. Initiatives have are in place to assure improved practices at initial removal and
throughout the life of a case.
Policy Considerations
DCYF has addressed policy and practices that work toward maintaining the parent/child relationship
while children are placed in foster care. They include worker visits, child and parent visits, searches for
missing parents and researching connections as a placement resource. We recognize that the role of the
parent in their child‘s life should continue to be of great importance during the time that a child is in outof-home care.
Per DCYF policy (Item 700), when children are in placement, one of the most important opportunities for
them to maintain connection with their parents, siblings and other family members are through visitation.
From the onset of placement, DCYF works toward the development of a visitation plan that allows for
ongoing and consistent contact that is as least restrictive as possible. When a child enters placement, the
CPSW and supervisor make the determination about the level and frequency of visitation. This decision
is made after consultation with the parents, children, the guardian ad litem, and mental health providers
currently involved with a family. A family‘s compliance or non-compliance with the case plan should not
be the sole decision factor regarding visitation, and visitation should never be punitive.
There are circumstances that warrant the need for supervised contact between the parent and child.
However, visits are supervised only when the CPSW and supervisor determine that the child would
continue to be unsafe if left unsupervised with the visiting person.
DCYF makes efforts throughout the life of a case to locate absent parents. From the initial Court Hearing
and every Review Hearing thereafter, DCYF completes an Absent Parent Affidavit, which outlines the
efforts made to find missing parents. DCYF Permanency Workers within each District Office have
access to a database that conducts thorough people-searches. Positive matches will provide critical
contact information in order to reach out to an absent parent. Each District Office also has a Connections
Specialist to which a CPSW can make a referral in order to have a person dedicated to searching out
names and contact information for people who might serve as a connection to a child in some way. This
includes absent parents.
CFSR Round 1 Findings
During the 2003 CFSR, Item 16 was rated as an area needing improvement because reviewers determined
that the agency had not made concerted efforts to support the parent-child relationships of children in
foster care. In particular, reviewers noted agency had not made sufficient efforts to promote the fatherchild and that in some instances, when a worker was rebuffed by a parent, or the parent was resistant to
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services, the agency did not continue to make adequate efforts to support that parent‘s relationship with
his or her child. However, this Item was rated strength when reviewers determined that the agency
promoted the parent-child relationship by facilitating and encouraging frequent visitation/contact or
continued involvement of the parents in the child‘s life.
Changes Since Round 1
Like the other New England States, DCYF has been involved in a Breakthrough Series on Safety and
Risk Assessment for the past 18 months, which will be coming to a close in April 2010. Through that
process, DCYF has developed two practice changes that have a positive impact on maintaining parentchild relationships immediately upon removal of a child from their home.
The first practice change allows children to telephone their parents at bedtime on the night of removal.
This serves to allow the child and parent to know that they have some time in the near future when they
will speak and has shown to alleviate some of the unknowns during the time of removal. The second
practice change ensures that the child and parent have a visit within 24 hours of the placement. The
phone call and 24-hour visit are both arranged by the CPSW during conversations with the parent and
child during removal, and set the tone for the important role ongoing and consistent family contact will
play.
The most significant change, however, is in our practice philosophy. In 2003 DCYF practice was to use
visitation as a reward for compliance with court orders and treatment. This has been significantly changed
to a philosophy that the parent- child relationship is significant and needs to be maintained regardless of a
parents compliance and should only be limited for safety concerns.
In addition, DCYF worked with numerous Court Improvement activities and used that forum to align
court practices with our shift in philosophy relative to visitation and compliance.
Data Considerations
A Case Practice Review was conducted in each district between June 2006 and August 2009. These
reviews found that staff continues to struggle with maintaining consistent practice in promoting and
maintaining children‘s relationships with parents. The CPR findings related to this Item as documented
below.
Item 16: Relationship of child in care with parents
Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester Salem
Jun-07 Dec-06
Jun-08 Jun-06 Dec-07 Sep-07 May-09
Dec-08
Aug-10
Sep-08
May-07 Mar-09
66.7
71.4
57.1
80
77.8
77.8
87.5
36.4
55.6
83.3
50
75
The data shows Manchester and Rochester as ranking lowest in this area. Manchester focus groups
indicated that improvements could be made with increased visitation and contact with parents to keep
them ―i
n the loop‖. Distance and proximity of placement to family were also identified as challenges to
maintaining contact between youth in care and their parents in both of these offices. The Rochester focus
group participants noted finding quality foster homes and their limited availability as a factor to being
able to place children in close proximity to their parents to promote connections. The participants
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recommended that work could be done to include families as in addressing solutions as a way of
empowering them.
Both offices have worked diligently over the past 3 years to improve practices and to assure that we work
to enhance the parent-child relationships. Many initiatives such as the ARM program and permanency
activities have helped to shift practice in this area. In addition, the Manchester District Offices has been
involved with the Breakthrough Series and implemented initiatives around improved parent child contact.
Strengths
The Accelerated Reunification Model provides opportunities to for families where a child has been placed
to receive intensive services with a focus on immediate reunification.
In collaboration with the Court Improvement Project, Protocols Relative to Abuse and Neglect Cases and
Permanency Planning were developed. From the protocols came the utilization of an Absent Parent
Affidavit. When DCYF does not know the location of a parent, efforts are made throughout the life of a
case to locate them. From the initial Court Hearing and every Review Hearing thereafter, DCYF
completes an Absent Parent Affidavit, which outlines our efforts to find missing parents.
At Administrative Case Reviews, Permanency Planning Team (PPT) meetings, and Court Hearings, the
level of contact and visitation between the parent and child in placement is discussed.
The Breakthrough Series resulted in new practice initiatives that enhance and maintain the parent –child
relationship from the time of removal.
Domestic Violence Specialists located in each office provides a consistent practice of responding to cases
of co-occurrence that also assures a focus on maintaining the parent child relationship, without safety
concerns.
DCYF has also engaged in work with the incarcerated women to assist them in maintaining quality
contact with their children.
Although the Southern half of the State has some public transportation options, Northern New Hampshire
offers no opportunity for public transit. DCYF makes efforts to eliminate this barrier to visitation and
contact with parents and their children. We are able to provide gas cards to those parents who have
access to a reliable vehicle or friend to drive them but lack the funding to purchase fuel. DCYF will also
purchase transportation services from a provider agency when all other options have been exhausted.
Opportunities For Improvement
We anticipate seeing improvements through more support for connections to family and friends. The
shift in practice that assures the consistent valuing of the parent-child relationship will be key to our
creation and roll out of a practice model and is a key opportunity for improvement across the state on this
Item.
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Well-Being Policy Update
New Hampshire policies that impact child well-being indicators focus on assessing and responding to
health status, cognitive functioning, social and emotional status and educational opportunity. Policy
demonstrates the need to make concerted efforts to assess the needs of children, parents, and foster
parents not only at the child's entry into foster care, but on an ongoing basis, to identify the services
necessary to achieve case goals and adequately address the issues that led to the need for our involvement
with the family, and provided the appropriate services.
Meeting the service needs of children, youth, parents and foster parents is a core component of the work
we do in New Hampshire regardless of what petition type may bring a family to the agency. Policy
outlines the basis for case planning, the preparation for and development of case plans, as well as the
frequency required for updating plans. Policy requires that every effort will be made to make this process
and the development of the plan inclusive. Children, parents and all appropriate service providers will be
given the opportunity to participate.
In New Hampshire we realize that in order for families to have an enhanced capacity to provide for their
children the agency needs to be responsible for the following:
Establish a working relationship with the family
Adequately assess and identify service needs
Develop a realistic plan with measurable outcomes
Appropriate service array
Consistent contact and communication regarding progress, and
The ability to adapt and revise services as needed
The function of the case plan is the opportunity to identify in a time-limited and goal-oriented road map to
address the needs and services for all involved participants, the description of reasonable efforts to
prevent placement or reunify children, the mutual responsibilities of the parties to achieve the identified
goal and the evaluation of case progress towards goals. However, the initial contact a family has with the
agency through the assessment process is key to identifying and assessing the initial issues or concern.
Therefore, our SDM policy is key in assuring accurate safety and risk assessments as well as the as the
strengths and needs of both children and caregivers. Policy requires that, in preparation for developing an
effective case plan, the worker complete SDM Caregiver and Child strengths and needs assessments. For
in-home cases, the safety, family risk assessment, and family risk re-assessment (as appropriate) will be
completed. For placement cases, the out-of-home placement assessment and reunification assessment are
completed.
Case Plans and Planning
Policy requires that a case plan be completed if the Division provides any service to the family, including
case management, and that the plan must be developed by the Division representative in conjunction with
the family and service providers, who collectively determine which services are needed to meet the
family's needs.
The case plan is used by DCYF staff and the family to ensure the continued safety, permanency and wellbeing of children. It is also designed to motivate and measure changes in child and family behaviors; and
encourage stability and permanence for children. Effective case planning is achieved when done in
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collaboration with families; is based on family strengths, and resources; and is time-limited, goaloriented, and solution-focused. Federal laws and regulations have been incorporated into sections of this
policy and the case plan form to further guide case practice and meet regulatory requirements.
Parent-Child Visitation
Safety, respect, empowerment, and partnership of children and their families are the basic elements of our
family-centered philosophy and policies. When children are placed in out-of-home care, one of the most
important opportunities for them to maintain connection with their parents, siblings and other family
members is through visitation. Visitation needs to be as "least restrictive" as possible. It is essential
when considering what type of visitation is safe and appropriate that the potential of ongoing risk factors
to children be considered.
Since 2003 our policy has been revised to ensure that once the CPSW and the family have developed the
Family-Centered Services Plan, progress towards goals are assessed continuously by the CPSW in
conjunction with the family. The focus of intervention is to facilitate a time-limited service process,
which consistently addresses the safety of the children. Case planning must always be progressive, that
is, moving toward a permanent plan for the child and family.
Worker Visits
The staff assigned to a family services case in which the child is placed in an in-state foster home or with
a relative must visit the child in the foster home at least once during a calendar month and DCYF staff
shall follow the SDM Child(ren) in Placement Case Contact
The staff assigned to a family services case must visit a child placed in an in-state residential facility at
least once during the calendar month and DCYF staff shall follow the SDM Child(ren) in Placement Case
Contact Policy
Staff assigned to a family services case must visit at least once during a calendar month a child placed in
an out-of-home placement in Massachusetts, Vermont, or Maine that is reasonably accessible from New
Hampshire and shall follow the SDM Child(ren) in Placement Case Contact Policy.
Staff assigned to a family services case in which the child remains at home must visit the child and family
with whom the child resides a minimum of once every calendar month or more often as determined in the
case plan and the SDM Child(ren) In Home Case Contact Policy.
Worker visits with children living at home and in foster care are necessary: to prevent unnecessary
placement; to achieve permanency for each child in a timely manner; to evaluate progress towards
reunification; to understand the child‘s adjustment to living with another family (including a relative) or
in a residential facility; to support connections to family and friends; to monitor progress in school; and to
identify and monitor health needs and safety issues. The more quality visits a worker can make, the
greater probability each child will be safe, permanency will be achieved and the child‘s needs will be met.
Courts and Well-Being Outcomes
As part of our work with the courts and the creation of permanency legislation DCYF intentionally
included ―r
easonable efforts‖ into the statute to assure that the responsibility to provide targeted services
to families to prevent removal, expedite reunification and or other permanency plans is always
paramount.
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Through our work with CIP and other court initiatives we have outlined expectations regarding visitation
in an effort to shift from a compliance focus to a reunification focus. Court guides (including the 2006
Greenbook Court Guide for Co-occurrence Cases) and initiatives now identify that in the context of a
child abuse and/or neglect case, safe and successful visitation of a child with a parent from whom the
child has been removed is one of the primary predictors of reunification. The safety of the child can be
promoted by enhancing the safety of the parent/alleged victim. The Court should focus on what is safe
and appropriate for the child given the nature of the alleged child abuse and/or neglect the child has
suffered, the age of the child, and the child‘s relationship with each parent.
New Hampshire was selected to take part in a federal initiative known as the Greenbook Project.
Greenbook‘s goal was to improve how child protection, the courts, and domestic violence coalitions work
together when responding to the co-occurrence of domestic violence and child abuse and neglect. While
the Greenbook Project officially ended in the fall of 2006, efforts to ensure the sustainability of the work
continue. Family Court Judges took part in a statewide, multidisciplinary training on the Greenbook
Court Guide for Co-Occurrence Cases in the fall of 2007. Another statewide training on the Court Guide
was held in September for DCYF supervisory and legal staff, DV Advocates, and Court Appointed
Special Advocates (CASA) to better understand the recommended practice change for each system
working with co-occurrence cases.
New Hampshire has also established court procedures for educationally handicapped children as it relates
to residential/educational placements. When the court contemplates a residential /educational placement,
DCYF/DJJS staff petitions the court to join, as a party to the proceedings, the legally liable school
district. The school district determines if the child is educationally handicapped, as defined in RSA 186C, or reviews the services offered or provided under RSA 186-C if the child has already been determined
to be educationally handicapped.
Once joined, the legally liable school district has full access to all records maintained by the district court
and must make a recommendation to the court as to where the child's educational needs may best be met.
DCYF and DJJS must make its best efforts to ensure that a child who is removed from his or her home:
Is provided with a placement which allows continuation of the child's current educational
program in his or her own school district whenever possible and when it meets the child‘s best
interest,
Is immediately enrolled in school (if it‘s a new school) in compliance with New Hampshire
Law and Rules regarding compulsory education attendance,
Is provided with timely educational planning and educational services, and
Is encouraged to achieve his or her highest education potential.
Reports to the Courts and other parties include information on the child‘s educational progress, as well as
the efforts made by DCYF /DJJS and the school district(s) to maintain the student in the original school
district, or if this was not in the child‘s best interest or feasible, efforts made to minimize educational
disruption. This information is reviewed at Administrative Reviews or multidisciplinary team meetings
that are regularly convened to review cases.
Health Care Planning
DCYF policy outlines that children must receive health care planning and health care services to meet
their needs while in placement. This includes a "Health Care Plan" (Form 2270B), which is based on the
needs of the child and the recommendations of the child‘s medical providers, dentist, or mental health
specialist made at or submitted in writing prior to the Health Care Planning Meeting.
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The "Health Care Plan" identifies the child‘s health needs and describes how and by whom services will
be provided. The delivery of health care services to children in placement is a shared responsibility
among DCYF and DJJS staff, parents, foster parents, and other substitute care providers.
Each child must receive medical and dental examinations consistent with the following
Medical Examinations:
(1)
(2)
(3)
(4)
Neonatal Examination;
Six examinations through age one;
Two examinations between age 1 and 2; and
Yearly exams at age 2 through 17.
Dental Examinations:
(1)
(2)
(3)
Beginning at age 3, one visit every 6 months up to age 12. Includes prophylaxis, fluoride and
oral hygiene instructions,
After age 12, one visit every 6 months. Includes prophylaxis and oral hygiene instructions, and
Bitewing x-rays taken yearly for both age groups.
For many years New Hampshire had in each office, as part of our Foster Care Health Program, Nurse
Coordinators, to serve children in foster homes and relative homes and assist the CPSW or JPPO by:
(1)
(2)
(3)
Coordinating health care visits, exams, and treatment;
Obtaining and reviewing health care histories and reports; and
Documenting health care planning activities and meetings.
In the past year we have decreased the Nurse Coordinator staff to 2 statewide. The practice of engaging
staff and foster parents in health planning has become embedded into our practices. The two remaining
Nurse Coordinators monitor statewide the provision of routine medical care and case manage the
medically needed cases directly. One Nurse Coordinator is located in Concord to manage the children
who are in DCYF Guardianship as well, to assure timely medical services for those children.
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Well-Being Outcome 1: Families have enhanced capacity to provide for their children‟s
needs.
Item 17: Needs and services of child, parents, foster parents. How effective is the agency in
assessing the needs of children, parents, and foster parents, and in providing needed services to
children in foster care, to their parents and foster parents, and to children and families receiving
in-home services?
New Hampshire continues to work on its assessment capabilities, through the application of
Structured Decision Making tools and through policy. We also have invested substantially in
services to meet the needs of children, families, and caregivers.
Policy Considerations
New Hampshire has enhanced the use of Structured Decision Making tools in the assessment of safety,
risk, strengths, and needs throughout the life of the case. We worked diligently to assure that policy
identifies the need for individualized case plans to be developed collaboratively with the family, within 30
days. This is particularly necessary in New Hampshire due to the litigious court process. Policy focuses
on the importance of engaging families and identifying only those services that are needed to address
specific needs. This lessen the tendency to engage in ―
compliance‖ monitoring and keep the focus on the
needs we are trying to address.
CFSR Round 1 Findings
Item 17 was assigned an overall rating of Area Needing Improvement because in 40 percent of the cases,
reviewers determined that the State had not adequately assessed and/or addressed the service needs of
children, parents, and foster parents. A key concern identified for in-home services cases pertained to a
lack of assessment of underlying issues that present a risk of harm.
Stakeholders commenting on the issue of assessment and service provision expressed the opinion that the
skill and experience of workers is a critical variable in assessing family needs, and that not all workers
have the necessary skills. In addition, some stakeholders suggested that the provision of appropriate
services might be hindered by staff turnover as well as by a lack of available services in some areas.
Since the first round, the case practice reviews that have been held still support the need to focus on this
item, however, stakeholders have found improvement in the staffs‘ assessment and provision of services.
It is the area of identifying and then assessing service needs of fathers that continues to be an area of
focus in New Hampshire.
Changes Since Round 1
The first round of the CFSR and the state‘s ongoing Case Practice Reviews has provided clear evidence
of the link between frequent, high quality caseworker visits and positive outcomes for children and
families. As such, DCYF Supervisors and staff have responded positively to the requirements for
monthly caseworker visits.
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DCYF updated the caseworker visit policy in June 2008. In addition, the Division developed
training and reporting systems to monitor caseworker visits and provide updated data to the
district offices on a monthly, quarterly, and annual basis. To date, all benchmarks for
performance improvement have been met. At statewide Leadership meetings, district office
supervisors share techniques that have led to their success in this area.
Core Training for child protection staff has been revised to include enhanced focus on
engaging families in the assessment and case planning process. As a result of this shift in
approach and practice when working with families New Hampshire has seen an increase in the
number of in-home cases.
DCYF expanded the use of Structured Decision Making SDM to the family services area.
SDM includes a set of research-based tools designed to identify safety and risk factors, which
guide staff at critical service decision points. SDM can improve the effectiveness of child
protection interventions by:
Focusing on critical decision points;
Increasing the consistency and validity of decision-making;
Targeting resources to families at highest risk; and
Improving the effectiveness of child protection interventions.
Policy was updated to include that when a child under age 3 is involved in a founded
assessment, the child and his or her parent or guardian must be referred to Family-Centered
Early Supports and Services for a developmental screening.
New Hampshire was one state selected to take part in a federal initiative known as the Greenbook Project.
Greenbook‘s goal was to improve how child protection, the courts, and domestic violence coalitions work
together when responding to the co-occurrence of domestic violence and child abuse and neglect.
When domestic violence is occurring or is the cause of the child maltreatment, the CPSW must
refer the victim to the Domestic Violence Specialist located within the district office. When
documenting any information specific to the children‘s or alleged victim of domestic violence
safety, relative to identified domestic violence, the CPSW must not include locations of
potential "safe places" that the child and non-offending parent might use in a crisis situation.
DCYF has worked since 2005 to enhance our "Individual Service Options" (ISO) service
which is a service specifically created for children in placement or in their own home in which
a variety of intensive therapeutic, social, and community-based services are provided or
coordinated to meet the individual needs of a child and his or her family. This service
demonstrates the increased focus on individualizing the services provided in order to meet the
specific needs of the children and families and not trying to fit the needs into the existing
services.
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Data Considerations
Item 17: Needs and services of child, parents, foster parents Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester Salem
Jun-07 Dec-06
Jun-08 Jun-06 Dec-07 Sep-07 May-09
Dec-08
Aug-09
Sep-08
May-07 Mar-09
50
66.7
50
87.5
58.3
50
75
50
33.3
75
58.3
58.3
A Case Practice Review (CPR) was conducted in each district office between June 2006 and August
2009. Findings from the case practice reviews are noted in the table above.
The Nashua District Office rating was particularly concerning. The results of the 2009 CPR in Nashua
identified several areas needing improvement. Services must be clearly linked to an identified need and
family‘s capacity and preferences. Practice changes are necessary regarding staff questioning the
appropriateness of services when things aren‘t going well rather than simply attributing the problem to the
family. Staff needs to be more concrete in identifying supports/services to families proactively to avoid
removal. Also identified was the need to improve documentation significantly to adequately reflect the
work that is being done to identify and provide for the needs and services of families and youth.
During the debriefing sessions and stakeholder interviews in most offices, it was noted that the needs and
services for children were being assessed and provided, but not always for the child‘s biological parents
and in some instances foster parents. Focus group participants discussed the need for support of the entire
family and not just the child who is in care.
The major challenge of this item for both DCYF and DJJS staff was found to be the lack of involvement
of fathers and minimal efforts of the CPSW and JPPO to pursue avenues to try and engage with fathers.
For most offices the tasks for improvement include utilizing creative methods to work with fathers and
insuring documentation of these efforts are located in the case file. Through individual practice initiatives
every office has identified this area to continue to focus on for program improvements.
Strengths
New Hampshire has made and continues to make some progress in improving assessment and planning
with families and providers, as noted in case practice reviews. In addition New Hampshire has
implemented a number of initiatives to address this area. These items are as follows:
New Hampshire has focused on establishing consistent use of Structured Decision Making
(SDM) since 2003. The SDM tools assist workers in improved identification, assessment and
response to the safety, risks, and strengths of children and families. As a result, workers are
able to identify service needs and relate those needs to the services identified in case planning
with families.
Incorporated ―
reasonable efforts‖ language into statute helped to assure a focus on services and
needs assessment as an ongoing focus for the agency and the court at every hearing.
Developed the Finding Connections program that uses skilled providers in each district office
to work with families to identify and find any relatives, including absent parents that can
become a resource for the child in care.
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Developed and are using Absent Parent Affidavits at every court hearing to outline efforts
made by the Division to locate any absent parent.
The use of Accurint, a search engine that each Permanency Worker uses to search for absent
parents.
Changes to the special investigation unit that investigates reports of abuse or neglect in foster
homes, residential care facilities and state run facilities. Changes made to the program includes
assessing the needs of foster parents and making recommendations to the CPSW or JPPO as
well as the Resource Worker or Child Placing Agency for services and supports to strengthen
that foster home and hopefully preserve the placement, when abuse and neglect is not found.
Developed a risk assessment tool for children involved in Juvenile Justice cases to determine
needs and the appropriate level of care for children.
Changed policy requiring the Adult Living Preparation Process (ALPP) to begin when a child
is 14 years of age instead of 16 to better meet the transition needs of younger youth. This
change has helped to assure children are assessed earlier and provides needed time to ensure
needs are met.
The implementation of Permanency Planning Teams, although designed to monitor
permanency goals, has provided another level of review for service needs and the provision of
timely services.
Changes made to the In Home Support Services and the ISO rules requiring providers of these
services to perform a psychosocial assessment on the child and family within the first thirty
days of service in order to accurately identify strengths and the needs of the family for the
service provision and treatment planning purposes.
Changes made to the In Home Support Services Rule to include the language that allows the
use of all of these services in foster homes to assist in strengthening the placement and prevent
placement disruption.
Implemented the Foster Care Mental Health and Physical Health Assessments which requires
each child that comes into care for the first time to have a comprehensive mental health or
developmental screening by the local Community Mental Health Centers, as well as a
comprehensive medical assessment performed by the child‘s primary care provider. The
results of both assessments are then used to determine appropriate services and supports to be
provided to the child while in care.
The development of ARM, Accelerated Reunification Model, which is used in cases where
safety concerns, can be mitigated by very intensive and focused service delivery. ARM allows
for reunification to occur within thirty days after placement. This model uses a parenting
assessment to identify a couple of key areas that the service delivery needs to address in order
to mitigate the safety concerns.
Developed a process to ensure that all families with risk indicators of substance abuse or
domestic violence are immediately referred to either the district office LADC, where
applicable, or the district office Domestic Violence Specialist.
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Developed multiple forums for practice discussions regarding needs assessments and service
delivery. These forums include, monthly leadership meeting with all district office supervisors
and state office specialists, intake and assessment and family services statewide workgroups,
assessment team meetings and family services team meetings at the district office level and the
monthly permanency, adolescent and resource meetings.
Opportunities For Improvement
New Hampshire has clearly demonstrated ongoing efforts in providing services to children in their homes,
with the reduction of initial removals and number of children in care. Like many practices, moving
forward, the opportunity to assure consistency statewide will continue to show real improvement.
A Practice Model will provide an opportunity to address item 17 in more detail. Standardizing the
assessment and delivery of services statewide is a massive challenge, but one that we have already started
and see the opportunity to solidify through a model of practice. The core values and beliefs that drive an
agency‘s practice should have the biggest impact on this item. An agency‘s guide for how it wants to
work with children, families, the community and each other to achieve desired outcomes impacts the way
we assess service need and the provision of services. The Practice Model provides the most critical
opportunity for standardizing assessment and delivery of services into the future.
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Well-being Outcome 1: Families have enhanced capacity to provide for their children‟s needs
Item 18: Child and family involvement in case planning. Were concerted efforts made to
involve parents and children (if developmentally appropriate) in the case planning process on an
ongoing basis?
New Hampshire has made progress in developing capacity to engage families in case planning.
Data collected through Administrative Case Reviews (ACR) related to case plan compliance
shows New Hampshire staff are providing timely case plans and engaging parents in that
planning and continue with compliance steadily increasing from 96% to 98% to 99% in 2009.
Policy Considerations
New Hampshire believes that families need to be a part of the development of the case plan in order for
the best possible outcomes to be achieved. We strive to have our staff and the family work together to
develop the case plan after identifying the strengths of the family as well as the needs that the case plan
will address. The goal of the case plan and case planning process is to ensure the continued safety,
permanency and well being of children. It is also designed to motivate and measure changes in child and
family behaviors; and encourage stability and permanence for children.
The case planning process begins once the Division opens a case. Case plan, is a template completed
with every family and child. Case plans are maintained in the case file in addition to the electronic version
stored in Bridges (SACWIS system) and the permanency/case plan goal must be identified within 30 days
of placement for all cases.
The case plan must be completed within 30 days from the date a non-placement case is assigned and 60
days from the date of removal for placement cases. The case plan is developed with the family and
reviewed and updated every 6 months.
CFSR Round 1 Findings
During the 2003 CFSR this item was rated overall an area needing improvement based on the finding
that, in 41 percent of the cases, reviewers determined that DCYF had not made diligent efforts to involve
parents and/or children in the case planning process. Prior to the CFSR in 2003 the Division completed
case plans but with limited input or collaboration from the families and children.
Changes since Round 1
Since 2003 New Hampshire has developed a new case plan form, policy, procedures and training. These
enhancements to case planning were successfully completed and implemented in April of 2006.
In essence our goal was that this would be the starting point for case planning practice change. Next, arework on the court report was done so it wasn't redundant with the case plan and court forms.
In November 2009, the newly formatted social study and dispositional court report was
completed and the field began testing these forms which will be incorporated into future policy.
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An enhanced case planning process emphasizes very straight forward conversations with the
family about concerns that have been identified by DCYF and the strengths that can be built on in
order to facilitate the change for children to be safely cared for in their home. The case planning
process is designed to be a very collaborative process wherein each family member has a voice
relating to the needs identified as well as the means to address that need.
Also reviewed with the family is the information sheet, health care plan and educational plan (if
special education) or report card of the child in order to update the educational and health needs
of the child. Copies of the case plan are provided to the family, foster parents; residential care
providers, CASA, and guardian ad litem in all cases.
Absent Parent Affidavits Template was created and is now required at every court hearing when a
parent‘s whereabouts are unknown.
Achieving and sustaining manageable caseloads specifically in our largest metropolitan
office has provided workers with more opportunity to engage families in case planning.
The implementation of Supervision Reports has enhanced supervisor‘s ability to track worker
visits.
Data Considerations
The Case Practice Review data below identifies inconsistency in New Hampshire‘s rating of this item.
Item 18: Child and family involvement in case planning
Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester
Salem
Jun-07
75
Mar-09
83.3
Dec-06
90.9
Jun-08
58.3
Jun-06
87.5
Dec-07 Sep-07
58.3
50
May-09
91
Dec-08
50
Aug-10
50
Sep-08
63.6
May-07
50
CPRs in the Concord, Keene, Laconia, Manchester, Nashua Rochester and Portsmouth Offices showed
low scores primarily due to lack of engaging fathers in the case planning process. It was also noted in
Keene that staff do not engage as well in case planning with incarcerated parents.
The Administrative Case Review process is a quality assurance measure that examines both DCYF‘s and
DJJS‘ case planning efforts and the case plans of children and families in cases where children are in
temporary out-of-home placements. Monthly reports are produced that identify the review status of cases,
those that are due or overdue and includes the date for future review of children recently removed from
their homes. The Administrative Case Review Satisfaction Surveys assess the parent(s) and child‘s
involvement in the development and modification of the case plan. The data collected by the ACR
contractor related to case plan compliance between 2006 and 2009 demonstrates that compliance
improved from 96% to 98% to 99% in 2009.
Strengths
DCYF/DJJS have implemented some promising approaches in order to seek out and encourage
uninvolved parents to participate in the case planning process. These efforts include the following:
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Monthly attempts to locate absent parents through searches and the engagement of family
connections specialists. Monthly letters are sent to uninvolved parents in order to get them reinvolved in their plan and lives of their children.
Monthly family service worker groups discuss and develop consistent practices statewide
relating to responsibilities a family service worker has including the case planning process.
Recently, the work group has been focusing on developing a consistent form for social studies
that is the process by which a parent is able to share their lives, strengths, needs, relationships
and any information that could be helpful in moving the case planning process forward.
Modification to the administrative case review process involve changing the timeframes and
content to promote a process where the family and their identified supports are engaged in the
initiation of the case plan process, particularly surrounding placement, including the
identification of relatives, parenting opportunities and other issues relating to attaining the goal
of reunification at the start of the case. These meetings are held at the location that is most
supportive of the family. This process began in the Portsmouth District Office and will be
expanding to the Rochester District Office in May 2010 with a long-term goal of statewide
implementation in be the end of 2010.
More concerted efforts to involve and maintain involvement of individuals who are
incarcerated.
The use of Absent Parent Affidavits at every court hearing that outline ongoing efforts to locate
parents whose whereabouts are unknown.
Opportunities for Improvement
What we have learned through Case Practice Reviews, file scrubs and other informal reviews in each field
office is that the case plan process is not consistent throughout the state. We are looking forward to the
development of a practice model that we believe will assist with insuring that case practice is consistent
statewide. While policy has been clear around the case planning process, practice varies depending on the
office. Case plans are often created by the worker and then shared with the family and other parties
instead of discussed and developed collaboratively.
In an effort to insure that this process is being done consistently there have been both formal and informal
trainings on how to engage families around case planning , as well as how to document the level of
participation individual family members have in the process. We are always striving to improve training
to promote best practice and family case planning continues to be a high priority.
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Well-Being Outcome 1: Families have enhanced capacity to provide for their children‟s needs.
Item 19: Caseworker visits with child. How effective are agency workers in conducting faceto-face visits as often as needed with children in foster care and those who receive services in
their own homes?
Policy Considerations
DCYF has made a concerted effort through training and policy development to assure staff understands
the importance of establishing relationships with the children they work with and sustaining those
relationships through consistent and regularly scheduled contact with them.
Visits with children in foster care and in their own homes are necessary in order to evaluate progress
toward goals; to understand the child‘s adjustment to living with another family (including a relative) or
in a residential facility; to support connections to family and friends; to monitor progress in school; to
identify and monitor health needs and safety issues and to achieve permanency for each child in a timely
manner.
Worker Visit Guidelines
The staff assigned to a family services case in which the child is placed in an in-state foster home or with
a relative must visit the child in the foster or relative home at least once during a calendar month and
DCYF staff shall follow the SDM Child(ren) in Placement Case Contact.
The staff assigned to a family services case must visit a child placed in an in-state residential facility at
least once during the calendar month and shall follow the SDM Child(ren) in Placement Case Contact
Policy.
Staff assigned to a family services case must visit at least once during a calendar month a child placed in
an out-of-home placement in Massachusetts, Vermont, or Maine that is reasonably accessible from New
Hampshire and shall follow the SDM Child(ren) in Placement Case Contact Policy.
Staff assigned to a family services case in which the child remains at home must visit the child and family
with whom the child resides a minimum of once every calendar month or more often as determined in the
case plan and the SDM Child(ren) In Home Case Contact Policy.
Worker visits with children living at home are crucial to prevent unnecessary placement. Regular worker
and family contact is essential to achieve permanency for each child in a timely manner; to evaluate
progress towards reunification; to understand the child‘s adjustment to living with another family
(including a relative) or in a residential facility; to support connections to family and friends; to monitor
progress in school; and to identify and monitor health needs and safety issues. The more quality visits a
worker can make, the greater probability each child will be safe, permanency will be achieved and the
child‘s needs shall be met.
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CFSR Round 1 Finding
During the 2003 CFSR, item 19, worker visits with child, was rated an area in need of improvement. This
item finding was based on, in 26 percent of the cases; reviewers determined that caseworker visits with
children were not of sufficient frequency and/or quality.
A key concern raised was that the contact between the worker and the child often did not occur in the
child‘s home. Some stakeholders commenting on this issue noted that workers visit children at least
monthly and make concerted efforts to see the child alone. Other stakeholders, however, expressed the
opinion that workers are not visiting children in foster care with sufficient frequency, although they
acknowledged that the frequency of contact is driven by the size of the worker‘s caseload and worker
turnover or reassignment.
Changes Since Round 1
In response to concerns raised in the 2003 CFSR regarding worker‘s caseloads and worker turnover or
reassignment, additional positions were created which resulted in reduced caseloads. In addition, two
―s
pecialists‖ were placed in each district office, a Permanency Specialist and an Adolescent Specialist to
focus on achieving improved outcomes in permanency. Reduction in caseloads enabled CPSW staff to
increase their focus on the quality and value of their visits with children.
DCYF was also able to acquire assistant supervisor positions for the three North Country offices, Berlin,
Conway and Littleton. Prior to this the district office supervisor was responsible for providing case
supervision and consultation for staff that conducted protective investigations, staff that managed family
service cases and the staff that did foster care recruitment and retention activities. The addition of
assistant supervisors in these offices has increased the opportunity for staff to have regular clinical
supervision that promotes consistency and quality casework practice. This in turn has played a critical
role in assisting staff in evaluating safety and risk of children during worker visits and making progress in
achieving positive outcomes for well-being and permanency.
In January 2008 a State Office Response Team (SORT) was created. The team consists of state office
staff that have volunteered and will be appointed by the Director to provide needed resources to a specific
office due to staffing issues (shortage) or a crisis that requires additional staff be available to meet the
needs of children and families. The individuals who serve on this team represent staff commitment to
quality practices. The skill sets of team members provide a wide variety of child welfare competencies
and experiences in multiple child welfare programs. This array of staff resources enables us to access and
design specific responses to support the field, including sustaining our efforts to maintain regular monthly
contacts with children in open cases.
In 2005, supervisors‘ reports were developed to monitor workload activity including caseworker visits.
Reports provide aggregate data at the district office level, but also have ―
detail‖ tabs where results are
available at the supervisor, caseworker, and client level. The monthly Family Services Supervisors
Report (FSSR) provides updated data to the district offices on the number of children in open cases, the
number of children in placement seen in their residence each month and the number of children in their
own home seen each month.
DCYF updated the caseworker visit policy in June 2008. In addition, the Division developed training and
reporting systems to monitor caseworker visits and provide updated data to the district offices on a
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monthly, quarterly, and annual basis. To date, all benchmarks for performance improvement have been
met. The table on the following page describes these activities in more detail:
ACF Requirements for Caseworker Visits: DCYF and DJJS placements (excludes detention)
Actual
Target
Actual
Actual
Target Performance
FFY 2007
Baseline
FFY 2008
FFY 2008
FFY 2009
FFY 2009 FFY 2010
% Visited
each/every month
28%
30%
45%
63%
60%
75%
% In residence
71%
>=50%
81%
87%
>=50%
>=50%
Activities
Review Bridges to determine ability to capture
required elements
Run baseline data
Change existing Family Service Supervisors Report
(FSSR) to capture visits on monthly basis
Discuss changes to policy and reporting at DCYF
Leadership
Monitor reports/discuss barriers at DCYF
Leadership meeting
Revise existing DCYF visitation policy
Status
Completed August 2007, screens capture visits
date, type, location, reason and participants
Completed October 2007, submitted to ACF on
10/31/07
Completed August 2007
Completed August 2007
Ongoing
Completed, distributed June 2008
Local office visits to provide overview of CFSR,
focus on connection between monthly visits and
CPSW/Supervisor training/education on
improved outcomes completed last district office in
importance of entering contacts and outcomes
April 2008 Themes incorporated into ongoing Case
associated with caseworker visits
Practice Reviews and trainings
Ongoing ―doc
umentation‖ training in district
Additional training as required
offices
Inform DCYF and DJJS Administrators of financial Completed with ongoing discussion and monitoring
implications and targets
of reports
Discussed quarterly report at Data Managers
meeting/educate new DJJS data analyst
Completed 7/31/2008
Provide DCYF and DJJS administration with FFY
2008 performance
Completed October 2008
Update/congratulate staff on improved performance
exceeding goals!
Completed at Leadership meeting in January 2009
The CFSR and ongoing Case Practice Reviews have provided clear evidence of the link between frequent,
high quality caseworker visits and positive outcomes for children and families. As such, DCYF
supervisors and staff have responded positively to the requirements for monthly caseworker visits.
Data Considerations
The Case Practice Review (CPR) conducted in each district office between June 2006 and August 2009
found 79.2% of cases reviewed were rated Strength. The CPR revealed that visits are occurring
frequently and regularly; however, the documentation did not always clearly reflect that case plan goals
were being discussed during visits. Internal reports reflect improvement in worker visits with children.
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In FFY 07, only 27.5% of children were seen each and every month throughout the year. The percentage
increased to 45% in FFY 08 and to 75% in FFY 09 as indicated below.
Item 19: Caseworker visits with child
Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester Salem
Jun-07
87.5
Dec-06
75
Jun-08
75
Jun-06 Dec-07 Sep-07 May-09
100
83.3
58.3
92
Dec-08
75
Aug-10
75
Sep-08
83.3
May-07
75
Mar-09
58.3
Performance on this item has steadily improved, however; the Laconia and Salem offices had scores that
warranted attention.
During the 2007 Laconia CPR, this item was rated a Strength in seven out of the twelve cases determined
applicable, resulting in a percentage rating of 58%. This rating shows a slight decline from the 64%
rating found in the 2004 CPR. Reviewers found that one of the main challenges for this Item was the
high rate of worker turnover. During the debriefing sessions, it was noted that challenges in this area
centered on consistent worker visits, ensuring these visits are insightful and helpful to the child and
articulating the outcome of visits through effective documentation.
During the Salem review in 2009, this Item was rated Strength in seven out of twelve applicable cases
(58%). This rating shows a significant decline in performance from the 2005 CPR that resulted in a rating
of 100%. The reviewers commented that employee turnover impacted the outcome for the second round
in 2009. There were instances illustrating the lack of monthly visits occurring as a result of a change in
assigned CPSWs. Also JPPOs were not visiting the youth in placement on a monthly basis and were not
documenting the quality of the visits that did happen. Reviewers noted that there seemed to be a reliance
on providers as a substitute for worker visits.
Stakeholder comments during the 2006 through 2009 Case Practice Reviews varied by district office but
the general themes were:
In three DOs the workers discussed distance as a challenge for face-to-face contacts. For
example, if the DO has large geographic area to cover travel can take a significant amount of
time. Also, when the child had to be placed outside a district office catchment area particularly
in the rural DOs, such as Conway, visiting the child every month was challenging.
In three DOs caseload size was mentioned specifically; too many cases per worker though
better than years ago, and CPSWs have done a better job because of lower caseloads.
Contact with families and providers by JPPOs were well coordinated and ―e
xcellent‖.
Strengths
DCYF expanded SDM to family services in March 2002. SDM includes a set of research-based tools
designed to identify safety and risk factors, which guide staff at critical service decision points. The
family service components include:
Case contact guidelines to determine the minimum number of contacts with the child (ren) and
family based on risk level changes;
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Family service status which documents service referrals that address the identified priority
needs of the family and tracks the status of each service;
Family risk reviews to guide decisions about whether to keep a case open or to close with
community supports; and
Family strengths and needs review to assess changes in family strengths and needs which may
influence frequency of contacts.
In 2005 supervisors‘ reports were developed to monitor workload activity including caseworker visits.
This data along with SDM is used as a tool in supervision.
In Leadership meetings the consistent presentation of data related to worker visits and sharing techniques
used in offices to track individual worker visits with children have led to improvements.
In 2008 DCYF updated the caseworker visit policy providing clarification and specific requirements for
caseworker face-to-face contact. This policy correlates to and is linked with the SDM Case Contact
Policy.
The Division developed documentation training and reporting systems to monitor caseworker visits that
have been very well received in the field.
Opportunities for Improvement
New Hampshire sees the future focus to be on establishing consistent practices within all aspects of
family services. As we establish a practice model that identifies the beliefs, values and practice
approaches guiding worker visits with children living at home and in foster care we will improve our
overall ability to engage families and provide needed services. The more quality visits a worker can
make, the greater probability each child will be safe, permanency will be achieved and the child‘s needs
shall be met.
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Well-Being Outcome 1: Families have enhanced capacity to provide for their children‟s needs.
Item 20: Worker visits with parents. How effective are agency workers in conducting faceto-face visits as often as needed with parents of children in foster care and parents of children
receiving in-home services?
Policy Considerations
New Hampshire uses the Structured Decision Making (SDM) model to improve case decisions and the
delivery of services for families and children with whom we are involved. The Family Risk Assessment
provides reliable, valid information on whether a family is more or less likely to have another abuse or
neglect incident if there is no intervention. For family services cases, the risk levels are used to determine
the minimum number of contacts that should occur with the children and their caregivers. Staff assigned
to a family services case in which the child remains at home must visit the child and family a minimum of
once every calendar month. Staff use their professional judgment in each case to determine whether more
contacts are needed to assess the safety of the child, to observe interactions between the caregiver and the
child (ren), to facilitate implementation of the case plan and to monitor developments in the case.
Because New Hampshire courts hold many court hearings to monitor cases, CPSWs are provided with
ample opportunities to engage with the birth parents before or after hearings are held.
The new case planning process, that went into effect in 2006, includes the CPSW having very straight
forward conversations with the family about the concerns and family strengths that have been identified
by DCYF to facilitate the change that has to happen in order for their children to be safely cared for in
their home. The case planning process is designed to be a very collaborative process wherein each family
member is encouraged to identify needs as well as potential means (services, family resources,
community support) to address their needs.
A new Dispositional Social Study (form 2208) was developed in September 2009, by the Family Services
Workgroup, which encourages thorough and difficult conversations with birth parents as soon as the court
has determined that abuse or neglect has occurred. Information from birth parents help shape the case
plan for the parent‘s work to address the problems that resulted in abuse or neglect of their children. This
Social Study must be reviewed and approved by the Supervisor prior to its submission to the court.
CFSR Round 1 Finding
During the 2003 CFSR, Item 20 was assigned an overall rating of area needing improvement because in
35 percent of the applicable cases, reviewers determined that the frequency and/or quality of caseworker
visits with parents were not sufficient to monitor the safety and well-being of the child or promote
attainment of case goals.
Stakeholders commenting on the issue of worker contacts with parents expressed concern that workers
were not visiting parents as frequently as is necessary to attain case goals.
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Changes Since Round 1
In 2005 supervisors‘ reports were developed to monitor workload activity including caseworker visits.
This data along with SDM is now used as a tool in supervision.
In 2006 the new Case Plan was introduced and trainings held to encourage workers to be collaborative
with parents in developing time limited goals. The case plan must be developed with the family and
reviewed and updated every 6 months. It must also be revised, updated, and reviewed when placement
changes or other emergencies arise that require a change to the current permanency/case plan goal.
In 2009 a new Social Study was developed by the Family Services Workgroup, which facilitates difficult
conversations with birth parents as soon as the court has determined that a child has been abused or
neglected.
The Division developed documentation training and reporting systems to monitor caseworker visits that
have been very well received in the field. During Family Service Committee meetings, participants have
discussed worker visits with parents in an effort to ensure we have a standardized practice and philosophy
around meeting with parents.
The DCYF Child Protection Administrator acts as a liaison to the Women‘s Prisons in New Hampshire
and is a strong advocate for ensuring that these parents who have open cases with the agency continue to
be seen by the assigned CPSW and that they continue to participate in the case planning process.
Data Considerations
Item 20: Worker visits with parents
Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester Salem
Jun-07
33.3
Dec-06
75
Jun-08
20
Jun-06 Dec-07 Sep-07 May-09
87.5
41.7
50
81
Dec-08
36.4
Aug-10
50
Sep-08
60
May-07
54.5
Mar-09
54.5
A Case Practice Review (CPR) was conducted in each district office between June 2006 and August
2009. Worker visits with parents is a struggle statewide and was our lowest scoring Item in the most
recent CPR round. Only 55% of cases reviewed were rated as strength, mostly due to a lack of visits with
bio-fathers but there is documentation that workers had frequent phone and/or e-mail contact with parents
where case plan goals were discussed.
Strengths
The Division has made improvements with regard to worker visits with parents, and additional work
continues to be warranted both in the area of identifying barriers when the visits do not happen as well as
improving our efforts to effectively document the work that is occurring. CPRs conducted in each office
have focused on each CFSR Item including Item 20 so that DCYF can ensure attention is paid to this
critical area of practice.
There are a number of initiatives currently operating that will demonstrate increased efforts with regard to
visits with parents including the new Administrative Case Review process that is being piloted in two
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district offices: Portsmouth and Rochester. This process calls for an initial review with the family and
other key individuals within ten days of the placement. In Nashua, they have initiated a practice where
the family service worker and assessment worker meet with the family together and identify family and
community supports within 30 days of placement at a transition meeting.
New Hampshire continues to offer, as part of CORE, an engaging families training, which introduces the
key concepts of engagement and rapport building between the child welfare caseworker, and the family
being served. This training was revised in 2009. Participants explore the child protective services
casework approach as an integration of engagement and protective authority; explore the dynamics of
resistance; and are introduced to interviewing strategies that promote engagement in child protective
services.
Through the Breakthrough Series Collaborative, DCYF has developed an increased recognition of the
importance and value of having the input and participation of birth mothers and fathers in not only their
case, but in the system changes proposed by the agency as a whole. We are committed to soliciting the
feedback of birth parents in many new initiatives, including the development of our Practice Model.
Opportunities for Improvement
The Division has made improvements with regard to worker visits with parents, and additional work
continues to be warranted both in the area of identifying barriers when the visits do not happen as well as
improving our efforts to effectively document the work that is occurring.
Increased use of team meetings with parents as a participant is another opportunity for improved
collaboration with parents, the agency and providers. As DCYF is working on improving permanency
outcomes for children and youth in residential settings, the importance of parents being active participants
in the process is crucial.
In cases where the permanency goal has been changed to APPLA, we need to make better efforts to have
regular contact with parents who are active with their children as well as those who are absent or
unavailable. We need to improve our interactions with the Men‘s State prison system and overcome
barriers to working with fathers.
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Well-Being Outcome 2: Children receive appropriate services to meet their educational
needs.
Item 21: Educational needs of the child. How effective is the agency in addressing
the educational needs of children in foster care and those receiving services in their own
home.
Policy Considerations
During the 2003 review the agency was still operating under a federal court order known as the James O.
decree. Mandates from that court order were aimed specifically at children with educational disabilities,
or who may have education disabilities and included requirements regarding school notifications and
trainings. The James O. decree expired in 2003 and, although the agency is no longer under an active
court order, it has decided to continue the mandates and have included them as part of policy and practice.
Any time there is a concern that a child with whom we are involved may have an educational need; policy
dictates a referral to the local school district for assessment and evaluation.
CFSR Round 1 Findings
Item 21 was assigned an overall rating of Strength because in 95 percent of the applicable cases,
reviewers determined that DCYF, through the efforts of both caseworkers and foster parents, had made
diligent efforts to meet the educational needs of children.
Case review findings and stakeholder interviews indicate that foster parents have assumed primary
responsibility for advocating for children with the educational system and for ensuring that children‘s
educational needs are being addressed. In addition, the agency has both a formal relationship with the
Department of Education, through the James O. consent decree, and informal relationships between
DCYF staff, educational specialists, and the Department of Education that contribute significantly to
meeting children‘s educational needs.
Changes since Round 1
Exploration of educational needs and referral to resources is part of case plans on all open cases. To
assist in the process, the agency‘s two Education Specialists have been available statewide for advocacy,
as liaisons to the local school district, attendance at IEP and other educational, meetings, trainings,
support for families, and a resource to all staff.
The DCYF expects foster parents will be educationally involved with the child, including enrolling the
student and, as available, attending school meetings and functions. Within the foster parent training
requirement is a module on education and further educational training is available at no cost.
In 2004, the DCYF created the position of Adolescent Worker in each district office recognizing those
adolescents, and especially those placed outside their homes, have specific challenges. These Workers
have specialized training and work with the adolescent population addressing a number of issues that
arise, including difficulties in school. In addition, they also help students plan for adult living and assist
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them in creating a plan to acquire self-support skills within the high school program and any postsecondary education.
In 2007 DCYF applied for and acquired a Title I (IV-D) grant. The purpose of the grant was to establish
a state wide protocol amongst the school districts, residential providers and the New Hampshire
Department of Education that would address credits earned at the residential placement; specifically,
credits earned in placement would earn the same credit regardless of what school district is the ―s
ending
district‖. New Hampshire is a state where the local school district has a lot of authority. DCYF
recognized that loss of credit(s) by a student when placed outside the school district had a strong
detrimental effect on the student‘s ability to graduate with their class. The grant was awarded to the
Southeastern Regional Educational Services Cooperative, (SERESC). SERESC was established in 1974,
when fourteen New Hampshire school districts pooled their resources to create a collaborative non-profit
agency. Originally chartered to establish services and programs to implement the Individuals with
Disabilities Education Act (IDEA), SERESC has since expanded its focus areas to include: Education,
Professional Development and Technology services. The mission of this organization is to engage,
support and inspire learning. The project has been linked to DCYF/DJJS and the New Hampshire Court
Improvement Project to learn the outcomes of students affected by Court orders as well as developing the
capability of sharing child specific information with providers. For example, sharing how the student is
doing in school is now possible on a weekly basis with DCYF and DJJS staff.
Data considerations
A Case Practice Review was conducted in each district office between June 2006 and August 2009.
Below is a chart indicating the statewide average results for Item 21, which was rated Strength in 95.3%
of cases reviewed.
Item 21: Educational needs of the child
Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester Salem
Jun-07 Dec-06
Jun-08 Jun-06 Dec-07 Sep-07 May-09
Dec-08
Aug-10
Sep-08
May-07 Mar-09
100
100
90.9
85.7
100
100
100
91.7
81.8
100
100
90
The Nashua DO received an 81.8% rating during their 2010 case practice review. Stakeholders
commented that educational needs of the child get overlooked and parents don‘t know how to advocate
for their children. In addition, stakeholders noted that in general, staff and foster parents struggle with
school districts when a foster child‘s placement changes and they move to another school district.
The cities of Manchester, and to a lesser extent Nashua, have the most diverse population in New
Hampshire, as immigrants have tended to gravitate toward larger cities. Some schools have up to halfdozen or more students whose primary language is not English. The New Hampshire Dept. of Education
has recognized the extra challenges and have been assisting and monitoring the Manchester school
system.
Strengths
The agency has a family-strength approach to case management and birth parents are invited to meetings,
receive report cards, and are part of all case planning.
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Parents are encouraged to share their knowledge of the history and needs of the child, including
educational needs.
When children are members of in-home cases parents are encouraged and expected to be a strong
advocate for their child with the school district. This is the same for children in foster care. The agency
believes that just because a child is in foster care does not mean that parents are unable to advocate for
their child‘s educational needs, although they may need more support or education from the agency staff
as to how to perform these responsibilities. In foster care placements, DCYF staff continually monitors
and review the child‘s education. If the parents are unable or unwilling to advocate properly for their
child DCYF staff will step in.
The Administrative Review process includes specific inquiry regarding educational advancement and
needs.
The local district offices work closely with the local school district, and the New Hampshire Department
of Education. Parents are frequently referred to the Parent’s Information Center (PIC) for training and
support. The New Hampshire court system, through its Court Improvement Project has also been
working with the DCYF. Since the last review the courts have modified certain forms to assure that
school districts are joined as parties on a regular basis.
DCYF requires full day training on special education issues for new staff within one year of hire. Staff
also attend a yearly refresher educational training workshop in their respective district offices.
Opportunities for Improvement
In 2009, the State of New Hampshire changed its education laws so that students no longer can ―dr
opout‖ at age sixteen. Instead, they have to wait until age 18 to end their compulsory education
requirements. Schools are challenged to create new programs to keep this 16 through 18-age population
in school, as well as finding new ways to educate and award credit. This should have a positive impact on
children in foster service care or living in their own homes.
DCYF will sustain the emphasis on meeting the educational needs of children we serve through the
Department of Education‘s Education Consultants. Consultants serve as a resource for DCYF in regards
to special education services and process.
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Well-Being Outcome 3: Children receive adequate services to meet their physical and
mental health needs.
Item 22 Physical health of the Child: How effective is the agency in identifying and
addressing the physical health and medical needs, including dental needs, of children receiving
in-home and foster care services?
Policy Considerations:
The Foster Care Health Program Policies implementation is the responsibility of the CSPW, foster parents
or other substitute caregiver, and biological parents. The nurse coordinators are available for consultation
with the CPSWs and JPPOs and foster parents relative to any medical concerns, as well as assistance with
the management and quality of the each child‘s medical, dental and mental health information.
CFSR Round 1 finding
During the 2003 CFSR this item was assigned an overall rating of Strength based on the finding that in 89
percent of the applicable cases, reviewers determined that the agency adequately addressed children‘s
physical health needs.
Changes since Round 1:
There have been three significant changes in the Foster Care Health Program since 2003. Prior to the last
CFSR there were 10 Nurse Coordinators and a Nurse Supervisor to manage this program. New
Hampshire now has 2 nurses that monitor medical care for our youth and provide consultation statewide
as maintaining the health, needs of youth has become embedded into daily business and sustained by the
ongoing case management by CPSWs and JPPOs.
The second change since 2003 is the development of a data based management tool that assists the Nurse
Coordinators and the DCYF/DJJS Supervisors and Administrators in managing the health care needs of
every child in out of home care.
The Foster Care Health Program has formed an Advisory Committee. This Advisory Committee is
comprised of both medical and non-medical professionals. This advisory group will review the foster
care health management reports, policies and practices and make recommendations relative to improving
screening and coordination of services and identifying any gaps in medical services for children and
youth in foster care in New Hampshire.
Dental Care has improved as well. According to the Medicaid Management System there are a number of
new Medicaid Providers in New Hampshire statewide. In 2009 alone, there are four dentists or dental
groups that have been certified by DCYF, including one in the northern part of the state. There are
currently 636 individually enrolled dental providers in the New Hampshire Medicaid system as of January
of 2010 as compared to 544 to March in 2005.
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Data considerations:
Item 22: Physical health of the child
Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester Salem
Jun-07 Dec-06
Jun-08 Jun-06 Dec-07 Sep-07 May-09
Dec-08
Aug-10
Sep-08
May-07 Mar-09
85.7
90.9
78
83.3
90.9
80
100
75
100
100
100
100
A CPR was conducted in each DO between June 2006 and August 2009. Physical health is another Item
where New Hampshire did very well in during the last round of district office case practice reviews. Of
the cases reviewed, 90.6% were rated as a Strength. Although improved since 2003, dental care still
presents a challenge for the state, based upon findings from the CPRs. In particular, both Manchester and
Concord District Office ratings were low due to the lack of enrolled dental providers in these DO
catchments. Since the CPRs in 2008 two large dental clinics, which include The Easter Seals Society and
Small Smiles, have been enrolled in Manchester alone and two practices in the Concord catchment have
been enrolled. .
Stakeholder comments in the Berlin and Conway Offices indicated the lack of Medicaid providers was a
challenge however it did not impact the children‘s ability to receive dental care. Rather, it is just a more
time consuming and difficult process for caregivers to access dental care services.
Strengths
DCYF‘s Foster Care Health program has been cited as a promising practice on ACF‘s website. This
program has allowed DCYF to have a sustained focus on the physical, dental and behavioral health needs
of children in foster care. The use of nurses in every District Office allowed the Division to prioritize and
embed this focus into everyday practice.
The main components of the Foster Care Health Program consist of an immediate initial physical and
behavioral health or developmental screening for every child upon entry into the foster care system. The
results of these initial assessments are then used to develop a health care plan for every child in foster
care. The implementation of the health care plan is then the responsibility of the CPSW, substitute
caregiver and biological parents.
A strength and promising approach relative to the Foster Care Health Program has been Health Care
Policy. DCYF started to develop a two-phase management and oversight report for the Foster Care
Health Program to assist in the oversight of the implementation of the Health Care Policy. In 2009, phase
one of this report has been completed. The report collects data from the New Hampshire Bridges system
in regards to mandated, routine medical and dental care for kids in out of home care only. This
information is then organized into usable reports for the district office supervisors, child protection
administrators and the Foster Care Health Program nursing staff to ensure that children and youth in
DCYF's care are receiving routine medical and dental care. The information for medical and dental care
is organized according to Pediatric and Dental care guidelines, as described in policy.
The second phase of this report has begun. DCYF is working with Medicaid data specialists to
incorporate Medicaid data into this report. This will enhance the Division‘s ability to track all medical
care for children in foster care as well as to help us monitor the medications being prescribed to this group
of children. The Medicaid information will include every medical event. The uses for this information
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will not only track the ongoing medical care for children and youth but will allow the Division to follow
trends for issues such as psychotropic medication use by service group and provider as well as help
identify any gaps in medical services.
The Foster Care Health Program has formed an Advisory Committee, which will assist in the oversight
and program improvements in the area of medical, dental and behavioral health of children in care.
Opportunities for Improvement
New Hampshire has made gains to enroll more Medicaid providers to meet the physical health needs of
our foster care population however, there is still a need for more Medicaid providers particularly dentists.
In addition, we will diligently monitor the change from nursing staff to field staff assuming medical case
management responsibilities to ensure quality care is provided to meet the physical health needs of our
foster youth.
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Well-Being Outcome 3: Children receive adequate services to meet their physical and mental
health needs.
Item 23: Mental/behavioral health of the child. How effective is the agency in identifying,
assessing, and addressing the behavioral, emotional, and mental health needs of children?
Policy Consideration
The Foster Care Health Program Policies implementation is the responsibility of the CSPW, foster parents
or other substitute caregiver, and biological parents. The nurse coordinators are available for consultation
with the CPSWs and JPPOs and foster parents relative to any medical concerns, as well as assistance with
the management and quality of the each child‘s medical, dental and mental health information.
CFSR Round 1 finding
Item 23 was assigned an overall rating of Area Needing Improvement based on the finding that in 79
percent of the applicable cases, reviewers determined that DCYF had not made sufficient efforts to
address the mental health needs of children.
Changes since Round 1:
Since Round 1 DCYF has placed a lot of attention on accurately assessing a child‘s mental health needs.
These changes include:
Implementation of The Foster Care Behavioral Health Program, which mandates a
comprehensive behavioral health assessment for every child‘s first out-of-home placement
into, foster or relative care, or upon placement in a general group home. Both DCYF and DJJS
utilize this program. CPSWs and JPPOs are responsible for making the initial referral to the
Community Mental Health Center and the Foster Care Health Nurse documents the assessment
outcome.
The implementation of consultation times with a senior clinician from each Community Mental
Health Center at all the district offices. This consultation time is a couple of hours every
month.
Incorporation of psychosocial assessment requirements in all of DCYF/DJJS Community
Based In Home Services array and Group Home Care, as well as individualized treatment plans
identifying child and family needs and the services to be provided to support those needs.
Data Considerations:
Item 23: Mental/behavioral health of the child
Percent Rated as a Strength
Berlin Claremont Concord Conway Keene Laconia Littleton Manchester Nashua Portsmouth Rochester Salem
Jun-07
75
Dec-06
90.9
Jun-08
91.7
Jun-06 Dec-07 Sep-07 May-09
75
90
81.8
91.7
Dec-08
91.7
Aug-10
63.6
Sep-08
100
May-07
87.5
Mar-09
100
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The District Office Case Practice Reviews between June 2006 and August 2009 found that meeting
mental health needs of children continues to be a challenge in several offices in the state because of a lack
of nearby providers; however, the most recent CPR round found that even with that challenge, 88.1% of
cases reviewed were rated as a Strength. In the Nashua DO, the 63.6% finding was due to lack of
documentation of the follow up efforts of the CPSW (For example, no contact log notation of follow up to
mental health providers recommendations.). Participants in the focus group for the Berlin CPR remarked
at the increasing need for more mental health services in this geographic location. Currently, the group
commented on the difficulty of not having consistent long-term treatment programs for addicts and the
need for drug and alcohol counselors for youth.
The Conway CPR showed that although it was felt that the behavioral health needs of children were being
met, the DCYF and DJJS staff needed to engage the Residential and ISO providers to ensure children‘s
behavioral health needs are being met and that the DCYF and DJJS staff are then documenting that in
their case contact logs.
Strengths:
The Foster Care Behavioral Health Program has created a relationship between child welfare and
community mental health that provides an opportunity for Bureau of Behavioral Health (BBH), DCYF,
and DJJS to collaborate in better serving families. The assessment identifies crucial needs of children
entering the child welfare system early on, by providing a baseline for mental health and developmental
growth along with specific recommendations for interventions to be provided by foster and biological
families and other service providers.
Key Points of this program include:
Not all children will need mental health treatment;
Not all treatment must be provided by the Community Mental Health Centers (CMHC);
If a child is connected to a private therapist the mental health assessment information must be
provided to the current therapist;
CMHC‘s have designated senior children‘s clinicians to do these assessments;
Two hours of consultation provided by a CMHC therapist in each district office for all cases
and assessments and not just first time placements; and
The process is flexible enough to meet local needs while still supporting the team collaboration
that insures better planning for children and families.
In 2005, the Dartmouth Trauma Interventions Research Center (DTIRC) developed the New Hampshire
Project for Adolescent Trauma Treatment (PATT). The mission is to implement, evaluate and
disseminate best practice for severely emotionally disturbed adolescents who are served by the
community mental health system (CMHC) in New Hampshire. This has been accomplished through
education, training, and supervision of community mental health providers to:
Screen for and assess the emotional sequelae of trauma exposure;
Increase outreach to traumatized adolescents and their families; and
Implement best practices of trauma treatment across the New Hampshire mental health system.
PATT chose to work with CMHC clinicians and administrators using Trauma-Focused Cognitive
Behavioral Treatment (TFCBT), which is an evidence-based treatment model. As of March 2007, the
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PATT team had trained over seventy-five clinicians from all ten CMHCs across the state and the Anna
Philbrook Center, New Hampshire‘s acute psychiatric hospital for children. In 2009 DCYF used funds to
continue this effort by providing two days of training to 100 private, residential and community mental
health therapists on TF-CBT and assisted 18 individual providers to purchase consultation time with the
trainers in order to be certified in this evidenced based treatment.
DCYF also has been working with DTIRC to continue this work by providing training on the screening of
trauma in children and adolescents to both Divisions‘ field staff, supervisory staff, foster parents and
program specialists.
In order to address the issue of the lack of Mental Health Services in the Berlin District Office, DCYF
expanded the First Step Program by adding a part time Licensed Alcohol and Drug Abuse Counselors
located in the District Office.
In 2009 the certification rule for the Behavioral Health Services was revised. The revisions included an
emphasis on the use of evidenced based or promising practices as well as an emphasis on quality
assurance activities. Through DCYF and DJJS‘s certification process, each private therapist is screened
for the proper credentials. Through the certification process, providers identify if they are using an
evidenced based treatment or if they have a specific specialty. This information is then used to make an
appropriate match of provider to client‘s needs.
Training was developed for DCYF and DJJS staff called Navigating the Mental Health System, which
trains staff on mental health issues and how to access services for clients they serve within the New
Hampshire Behavioral Health System.
Opportunities for Improvement:
Over the past few years, there have been a number of studies conducted in regards to children‘s mental
health in the State of New Hampshire. These reports and studies are providing the Division an
opportunity to identify specific areas of need.
These studies include:
The prevalence of mental illness and psychotropic medication use among the low income
Medicaid group as compared to children in residential group home care and children in foster
family care;
The status of New Hampshire public Mental Health system; and
The status of New Hampshire‘s Child and Infant Mental Health system.
In response to these comprehensive reports, DCYF is partnering with external stakeholders to address the
needs identified.
Some of these projects include:
The New Hampshire Department of Health and Human Services (DHHS) is partnering with the
Community Health Institute (CHI) for a year-long planning process to implement a
wraparound approach to care management and blended funding to better address the mental
health needs of children in state care. The project is expected to transition to a piloting of the
operations plan in one of DHHS‘ district offices in 2010.
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The Watch Me Grow Pilot (WMG) is an opportunity to develop a system to ensure that
families with children birth to six years in New Hampshire are consistently able to access
developmental information, support, health and developmental screenings.
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SECTION IV SYSTEMIC FACTORS
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Section IV – Systemic Factors
Systemic Introduction
Since 2003, DCYF and DJJS have made several breakthroughs with how each agency operates on a
systemic level. Throughout this section are examples of how DCYF and DJJS engage with children,
youth, families, providers and community stakeholders alike. Over the years, DCYF and DJJS have
shifted the mindset in how we serve families. The agencies no longer prescribe to a practice of directing
families what to do, rather how can we do things better with the family‘s involvement. As indicated in
this section, both agencies have had their struggles in executing this shift, with consistency in practice
being a significant factor, however steps are being taken in the right direction.
An important systemic shift since the last CFSR has been how DCYF and DJJS have intertwined data and
the systemic factors with advancements made in case practice. Not only has DCYF and DJJS embraced
the usage of data as a way to measure outcomes, but more importantly, as a way to inform practice.
Internal mechanisms such as Permanency Planning Teams and Case Practice Reviews have been
instrumental in shifting practice forward; evaluating the work we have done and inform areas that we
must improve upon.
As a result of the 2003 CFSR, DCYF and DJJS recognized the benefit of a thorough examination of our
child welfare system. The results of the CFSR led to several changes with how we conduct best-case
practice. We understood that substantial shifts in permanency practice needed to occur. Such shifts have
occurred and have had a very positive impact on practice.
As this CFSR approaches, DCYF and DJJS has re-focused attention on our front door servicing of
children and families. As mentioned in this document, the revitalization of assessment, the Accelerated
Reunification Model and the modifications to the Administrative Case Review process all are playing
critical roles in how DCYF and DJJS engage with families from the beginning of our respective
involvement.
Below are some of the systemic highlights and key initiatives that DCYF and DJJS have achieved or are
moving forward with in alignment with the development of our practice model.
Statewide Information System
Bridges
NH Bridges is the DCYF and DJJS SACWIS system of record. All required information is recorded in
this application. The system is actively used by all case carrying staff and their supervisors, as well as
administrative staff.
New Hampshire understands that Bridges is the principle tool to aid management in monitoring practice
and is therefore a key to improving service delivery and practice. Therefore, DCYF and DJJS
management use data from this automated system to augment case management, workload management,
planning, budgeting and resource management.
Bridges can identify the status, demographic characteristics, goals for placement, and location of every
child in foster care, including the actual address as well as the placement agency. Other benefits of the
system identified by stakeholders included the following:
The system provides immediate access to information on a statewide basis
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The system is stable
The information is available for children that are in ―u
npaid‖ (i.e., unlicensed relative care) as
well as ―p
aid‖ placements
The system includes ticklers for administrative reviews and permanency hearings
Recent modifications to Bridges to address many past concerns have made it more user
friendly
On November 13, 2008 the State received a letter from ACF regarding the final determination of the
SACWIS review. ACF noted that the Bridges SACWIS system is fully compliant with Federal SACWIS
requirements. These requirements included the system‘s ability to identify the status, demographic
characteristics, location, and goals for the placement of every child who is (or within the immediately
preceding 12 months, has been) in foster care.
Case Review System
The Division is incorporating the voice of birth parents and youth in the development of the practice
model and throughout a number of initiatives that have developed through the Breakthrough Series
Collaborative of which DCYF is a part. Four district offices are involved and each office solicits youth
voice and birth parent input relating to practice. The Manchester District Office has a parent member
who is sending out a letter to new birth parents involved with DCYF to offer insights and support.
Additionally, Manchester has generated a non-custodial parent letter to engage the birth parent in the
process at the start of a family‘s involvement with DCYF. As a result of the discussions that occur at the
monthly leadership meetings, this practice is spreading statewide, thus indicating further efforts to get
absent parents involved early in the case and in the case planning surrounding permanency for their
children. Nashua has instituted transition meetings that occur within thirty days of a case opening.
During these meetings to which the parents bring members of their natural support system, the case
planning process is initiated incorporating the input and supports of individuals already invested in the
safety, permanency and well being of their children. These meetings have received positive reviews from
the families impacted.
Administrative Case Review Process
DCYF, DJJS and the contract agency are currently in the process of modifying the Administrative Case
Review (ACR) process. This includes changing the timing; instead of the first ACR occurring at the sixmonth point where the child has been in out-of-home care, the first ACR occurs within ten days, the next
within four months and then every six months thereafter. Timeframes may look different for DJJS cases
given the needs of their cases. In addition to the change in timeframes, the content of the ACR is being
modified to promote a process through which the family and their identified supports are engaged in the
initiation of the case planning process particularly surrounding placement including the identification of
relatives, parenting opportunities and other issues relating to attaining the goal of reunification at the start
of the case. These meetings are held at the location that is most appropriate and is most supportive of the
family and children. This process began in the Portsmouth District Office in January 2010 and expanded
to the Rochester District Office in April 2010 with a long-term goal of its implementation in all District
Offices by the end of 2010.
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Quality Assurance System
Case Practice Review
As a direct result of New Hampshire‘s participation in the federal Child and Family Services Review
(CFSR) in June 2003, BQI (this bureau is now the Bureau of Organizational Learning and Quality
Improvement) restructured its case practice review system to mirror the CFSR process. Held quarterly,
the Case Practice Reviews (CPR) identify strengths and areas needing improvement in each District
Office focusing on outcomes for children and families in the areas of safety, permanency and well-being.
The Case Practice Review is an interactive process, which includes the entire office being reviewed, staff
from around DCYF and DJJS who participate as reviewers, as well as stakeholders who participate as
reviewers or in key stakeholder focus groups facilitated by DCYF that occur concurrent to the on-site
review.
As a result of the review, DCYF‘s BOLQI creates a final report for the office under review. With the
findings of the report, a Practice Improvement Initiative (PII) is developed in collaboration with BQI and
the District Office Supervisors for DCYF and DJJS. The goal of the PII is to not only address areas found
as needing improvement during the review, but to foster continuous quality improvement within that
office. The PII not only addresses practice issues, but also various systemic issues within that particular
office. DCYF and DJJS Administration then monitor progress made with the PII.
In 2003, as a result of a major DHHS reorganization, DJJS created its own Quality Improvement Unit. In
2009, DJJS developed a working partnership with the University of NH-Manchester to accept interns
from the Computer Science Department to assist in developing a Data Mart to hold DJJS Bridges client
data that can be queried quickly. As a result of this collaboration, the efficiency and accuracy of DJJS
data reports have greatly improved. Reporting capability has been improved and workloads have been
reduced.
Staff and Provider Training
Training (Center for Professional Excellence)
NH DCYF operates a staff development and training program that supports the goals and objectives in the
CFSP, addresses services provided under titles IV-B and IV-E, and provides initial training for all staff
that deliver these services. DCYF and DJJS believe that training is a critical systemic factor in achieving
quality outcomes for children and families. Thus, it must be fully integrated into and aligned with all
agency activities. DCYF/DJJS recognizes the inextricable link between continuous quality improvement
and training as a staff and organizational development strategy, and therefore strives to be a learning
organization. Within DCYF, the Bureau of Organizational Learning & Quality Improvement (BOLQI)
oversees efforts to recruit, prepare, grow and retain a competent and committed workforce. Within DJJS,
the Training and Professional Development Unit, lead by a designated Manager, oversees training
coordination and quality improvement. These two agents lead a highly collaborative process between the
Divisions regarding the training and preparation of new staff.
Since July 2009, DCYF has contracted with the University of New Hampshire - Center for Professional
Excellence in Child Welfare (CPE) for provision of staff trainings.
Since the last CFSR, DJJS efforts to enhance training have focused on organizing training around the
needs of both new and seasoned Juvenile Probation Parole Officers, state law, NH DHHS Rule, DJJS
Policy and Procedures, federal mandates, and best practices. This has caused DJJS to re-evaluate their
training delivery model and establish new training cycles that have been in effect since 2008.
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A very important change regarding the training system operation since the last CFSR has been the design
and implementation of a new training database within the NH Bridges System. In October 2005, a
module specific to the training function was implemented within the NH Bridges system in order to track
and maintain training related data.
Service Array and Resource Development
Individualized Service Options (ISO)
In 2007, DCYF and DJJS re-designed their Individualized Service Options (ISO) Program to meet a child
and families unique and individual needs. This program was expanded from three provider agencies to
currently 12 agencies that are certified to provide this unique and individualized service. Two of these
ISO agencies serve unique populations of children with behavioral health issues and multiply
handicapped children. Two other agencies are also certified to provide ISO services to the adult
developmental population and can serve older youth who will be transitioning from the DCYF and DJJS
system to Adult Developmental Services without having to change agencies and sometimes foster homes.
ISO in-home and ISO foster care have a wide array of services that are to be provided by the certified ISO
agency as needed. Through the assessment and treatment planning process, the service needs of each
family are identified and documented in the treatment plan. The service array can range from childcare to
crisis stabilizations, parent education and counseling services. Each family is provided with case
management from the ISO agency. The case manager coordinates all the services for each family.
Agency Responsiveness to the Community
Collaboration with the Courts, CASA and DJJS
NH has benefited from a strong collaborative relationship with the Courts through the Court Improvement
Project, the Model Court Project, and the development of Protocols relative to Abuse and Neglect Cases
and Permanency Planning. These protocols, which were revised in 2003, were the result of the work of a
large multidisciplinary group of stakeholders including CASA. The current protocols for TPR and
Adoption are currently being revised through the work of the Model Court.
DCYF and DJJS have collaborated in numerous ways, including a joint Case Practice Review process, the
use of the same case management information system, a shared service array, and a joint case-planning
policy for families involved with both systems. As a result of the 2003 CFSR, both agencies have
prioritized improvements in permanency through concurrent planning, specific practice improvements,
and collaboration with the courts. This work will be strengthened through the development of the DCYF
practice model.
The CIP‘s Coordinator has a strong working relationship with DCYF and CASA. This relationship
resulted in the CIP, DCYF and CASA identifying a need to bring together DCYF and CASA to discuss
the roles and expectations of DCYF and CASA as well as issues related to visitation. The result was an
important collaboration by the CIP, DCYF and CASA to collaborate on a one-day Summit held for
seventy-five staff from DCYF and CASA staff and guardians ad litem. The Summit was led by DCYF‘s
Director and CASA‘s Executive Director and has occurred twice since 2007.
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Systemic Factors
Residential Frameworks
In June 2008, residential providers were invited to join DCYF/DJJS in an initiative aimed at developing
and implementing a collaborative system for delivery of services in residential treatment that focused on
shorter lengths of stay and achieving permanency for the youth who were placed in their programs. Since
June 2008, a core work group of DCYF/DJJS staff and residential providers have been meeting regularly
to create a New Hampshire framework to achieve improved permanency outcomes for children and youth
placed in residential programs.
Foster and Adoptive Home Licensing, Approval and Recruitment
Recruitment
New Hampshire believes that selecting the most appropriate family for a child who cannot safely return
home can reduce the trauma of separation and loss for the child, can increase the probability of a
successful placement and ideally, can create a lifelong connection or permanent home for the child, if
needed. New Hampshire uses a diligent recruitment model for potential foster and adoptive families that
reflects not only the ethnic and racial diversity of the children in our care, but families that are naturally
linked to the neighborhood and communities where children reside.
While efforts are made to diligently recruit foster and adoptive parents who reflect the diversity of the
children who need foster and adoptive homes, practice does not delay the selection of a family for the
purpose of finding a racial or ethnic match. DCYF staff as well as providers and caregivers participate in
on-going training to promote cultural competency. Through training and on-going support, the Division
makes efforts to ensure that resource families are culturally responsive to child(ren)‘s needs regardless of
whether they have different backgrounds.
Community and Faith Based Initiative (CFBI)
The Community and Faith Based Initiative grows stronger every year. Because the CFBI has been so
successful in supporting foster and adoptive families, the new CFBI contract includes an additional goal
of providing support and assistance to NH Family Resource Centers. It is hoped that this support will
increase prevention at a community level as well as provide assistance for identified families who are at
risk.
New Hampshire Foster and Adoptive Parent Association (NHFAPA)
DCYF enjoys a strong relationship with the New Hampshire Foster and Adoptive Parent Association
(NHFAPA). DCYF values the hard work and commitment of the parents actively involved with this
association who offer peer support to fellow families. The Division recognizes and appreciates that the
best recruitment tool for new foster and adoptive families is a well-supported network of current foster,
adoptive families and licensed relative caregivers.
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Item 24
A. Statewide Information System
Item 24: Statewide Information System. Is the State operating a statewide information system
that, at a minimum, can readily identify the status, demographic characteristics, location, and
goals for the placement of every child who is (or within the immediately preceding 12 months,
has been) in foster care?
In Round 1 of the CFSR, New Hampshire was in Substantial Conformity with the systemic factor
of Statewide Information System.
New Hampshire submitted the Advance Planning Document (APDU) for the NH Bridges application to
ACF that was approved in March 2009.
With this approval, the New Hampshire Department of Health and Human Services has completed the full
cycle of planning, design, development and implementation of a Statewide Automated Child Welfare
Information System (SACWIS) to federal compliance standards.
The DCYF Bureau of Information Systems (BIS) coordinates ongoing improvements, training, and
technical assistance for DCYF‘s Statewide Automated Child Welfare Information System (SACWIS),
known as New Hampshire Bridges.
From July 16, 2008 to July 18, 2008, a SACWIS on-site review, led by an ACF team, was held to perform
an audit of the pending SACWIS requirements and a review of the entire system to include all completed
elements.
During the review, the ACF team performed a comprehensive audit of the Bridges application to review
all SACWIS requirements to validate that the entire New Hampshire SACWIS system was in compliance
with ACF.
On November 13, 2008 the State received a letter from ACF regarding the final determination of the
SACWIS review. ACF noted that the Bridges SACWIS system is fully compliant with Federal SACWIS
requirements. These requirements included the system‘s ability to identify the status, demographic
characteristics, location, and goals for the placement of every child who is (or within the immediately
preceding 12 months, has been) in foster care.
Policy Considerations
New Hampshire Bridges is the DCYF and DJJS system of record. All required information is recorded in
this application. The system is actively used by all case carrying staff and their supervisors, as well as
fiscal and administrative staff.
Bridges provides the input capability and data structures necessary to capture and store essential data.
This includes demographic data for victims of alleged abuse and neglect as well other individuals
involved in referrals, assessment and family service cases. Bridges documents interviews, assessments,
findings, and authorizations for placement and other services and payment records.
As a matter of policy and practice, New Hampshire‘s child abuse/neglect investigations are called
assessments. If a referral is accepted for assessment, this is done on the basis of a reasonable belief a
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New Hampshire CFSR Statewide Assessment
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Item 24
child may have been maltreated. As a part of the assessment of allegations of abuse or neglect, risk,
family safety and family strengths and needs assessments are completed. Requests for information are
not assessed past the Intake Referral stage. New Hampshire Bridges‘ produces the documents, notices,
and reports required for assessments.
CFSR Round 1 Findings
During the 2003 CFSR, this item was rated as an area of Strength, because the system has the capacity to
identify the status, demographic characteristics, location, and goals for the placement of every child in
foster care, and this data are consistently entered and available in the system.
Stakeholder comments during the 2003 on-site CFSR indicated that Bridges could identify the status,
demographic characteristics, goals for placement, and location of every child in foster care, including the
actual address as well as the placement agency. Other benefits of the system identified by stakeholders
included the following:
The system provides immediate access to information on a statewide basis
The system is stable
The information is available for children that are in ―u
npaid‖ (i.e., unlicensed relative care) as
well as ―p
aid‖ placements
The system includes ticklers for administrative reviews and permanency hearings
Recent modifications to Bridges to address many past concerns have made it more user
friendly
Changes since Round 1
Since Round 1 of the CFSR, many significant enhancements have been made to the Bridges system.
These changes have been driven by the 2004-2009 Five Year Plan, the statewide Program Improvement
Plan (PIP), the AFCARS Improvement Plan (AIP), requirements of the Child Care Development Fund
(CCDF), and other changes to state and federal laws and policies.
One major enhancement to New Hampshire Bridges occurred with the launch of the IV-E Eligibility
Project in 2008. This project required coordination with the New Hampshire Division of Family
Assistance and the eligibility system New HEIGHTS. In order to comply with federal standards, Bridges
and New HEIGHTS enhanced the existing interface between the two applications. Specifically, the two
applications are now able to exchange Title IV-E related data.
With this release, Bridges can now capture, store and display eligibility results including clients‘
individual eligibility history. Also, due to enhancements of IV-E determination results, DCYF is able to
report and analyze trends with greater accuracy.
Other enhancements to New Hampshire Bridges occurred during the June and December 2008 releases.
These included:
Significant updates to the Childcare Development Fund (CCDF) provider payment system
New Hampshire House Bill 2 - removing counties‘ liability for services
Provider Web Billing - enhanced to support a wider ranged of claims
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New Hampshire CFSR Statewide Assessment
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Item 24
Preparation for the upcoming interface with the new Medicaid Management Information
System (MMIS)
Enhancements to support DCYF‘s new Parental Reimbursement Unit
In addition to these changes, BIS has coordinated with the Child Protection Bureau and the Bureau of
Organizational Learning and Quality Improvement to develop significant enhancements aimed at
supporting permanency planning. This project has been split into several phases, the first of which was
completed in December 2008. This included:
A new navigator tree section added called Permanency Planning to allow Permanency workers
to enter pre-adopt information
The ―c
urrent placement willing to adopt‖ date history was added to the Recruitment General
Screen
Changes to the TPR/Surrender screens to improve data collection related to children who are
legally available for adoption
Other significant enhancements during the last several years included work on the AFCARS
Improvement Plan (AIP). The AIP is derived from the assessment review performed by ACF and
provides requirements to be incorporated into the Bridges case management system and AFCARS extract
criteria. This plan is being implemented in phases and the last phase will be completed in 2010. The
changes to both the case management system and the AFCARS extract criteria are designed to improve
the quality and integrity of the data being reported, provide more accurate measures in the State Data
Profile to be used in the CFSR and depict a comprehensible view of New Hampshire protection and
prevention outcomes.
Data Considerations
The State implemented the New Hampshire DHHS data warehouse in 1998. It is updated on a daily basis
with a full refresh from the New Hampshire Bridges database. The New Hampshire Bridges data
warehouse provides the data and tools for ad hoc management report generation in all functional areas of
the application. Standardized reports can be designed and implemented to augment reports automatically
generated by NH Bridges. For example, the State generates statistical reports through the New
Hampshire DHHS data warehouse for quarterly submission to the New Hampshire legislature.
Additionally, the annual Foster Care Report is generated with New Hampshire Bridges data available in
the New Hampshire DHHS data warehouse. The creation of additional statistical reports is a continuing
focus of the New Hampshire Bridges development process.
New Hampshire Bridges maintains a Helpdesk specific to the application. The helpdesk is available from
8 a.m. until 4:30 p.m. on business days and is staffed by two fulltime Business Systems Analysts who
address user support needs in addition to their Analyst duties.
Helpdesk tickets are prioritized in a range of 1 – 6 (1 being of critical priority such as unable to access the
system, 6 is typically a training or report request of lower urgency). Priorities are determined by scripts,
created by the Bridges Helpdesk, that define urgency, turnaround time and assign a priority accordingly.
Bridges also provides checks for licensed providers.
In the calendar year of 2009 the Bridges Helpdesk received and resolved 2416 tickets with an average
resolution time of 26 minutes (based on 8-hour work days – not accounting for weekends and holidays).
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New Hampshire CFSR Statewide Assessment
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Item 24
Breakdown of Bridges Tickets by Priority
70
56
1
92
2
547
3
1512
139
4
5
6
The Bridges user community has been deriving assessment information from the Bridges Enterprise Data
Warehouse on a regular basis to support field and management assessment decision-making. The
Enterprise Data Warehouse is populated via the Bridges System on a nightly basis. Since Bridges is the
SACWIS (Statewide Automated Child Welfare Information System), it will capture, store and display
eligibility results including clients‘ individual eligibility history. Also, due to enhancements of IV-E
determination results, DCYF will be able to report and analyze trends with greater accuracy. Two Federal
Reporting projects are key to the data for the CFSR and State Data profile. The two projects, AFCARS
and NCANDS are outlined below.
Adoption and Foster Care Analysis and Reporting System (AFCARS) Assessment Reviews are
conducted in order to verify the State information system‘s capability to collect, extract and transmit
AFCARS data accurately in accordance with ―
The Federal regulations and ACF‘s policies.‖2 The
submission of this data is also a requirement of the Statewide Automated Child Welfare Information
System (SACWIS) compliance. AFCARS regulations are found at 45 CFR 1355.40 and provide the
guidelines for collection of uniform and reliable information on children who are under the placement and
care responsibility of the State title IV-B/IV-E agency and children adopted under the auspices of the
State public child welfare agency. States failing to meet the standards detailed in 45 CFR 1355.40(a-d)
are considered out of compliance with SACWIS requirements.
In calendar year 2009, SACWIS reported a total of 28,109 children were served by DCYF/DJJS. Of this
number, 20,997 children were counted as open in assessment, 4,852 were open DJJS cases and 2,260
were open DCYF cases.
National Child Abuse and Neglect Data System (NCANDS) is a national data collection and analysis
system created in response to the requirements of the Child Abuse Prevention and Treatment Act (Public
Law 93-247) as amended. This data is input for Child and Family Service Review. The report extract
must be corrected to provide accurate data.
Reporting Capability
New Hampshire Bridges supports the generation of reports from the initiation of a referral through the
assessment process and through the opening, management and closing of a case. These reports include
referral summaries, full documentation of all interviews and case contacts, risk, safety and family
strengths and needs assessments, and all client information.
2
Excerpted from the USDHHS/ACF/ACYF/Children‘s Bureau, State Guide to an AFCARS Assessment Review
dated December 2003.
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New Hampshire CFSR Statewide Assessment
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Item 24
New Hampshire Bridges provides the data required for ad hoc management report generation from all
functional areas of the application. Users can generate reports using the MS Office suite of tools or Info
Reports, a third party report generation applications. Additionally, any standardized reports can be
designed and implemented through the use of the data warehoues to augment reports automatically
generated by New HampshireBridges. Currently, there are over 50 standard reports generated on a
regular basis through the Data warehouse. DCYF management staff utilizes a set of reports to determine
the location of all children in care. An example is the ―
Emergency Placement Report‖ that can be run
upon request to determine the current location of all children in the agency‘s care.
Ad hoc reports in particular will enable users to transfer aggregate data from Bridges to other platforms
such as Access, Excel, or SPSS/PC. Once there, the data can be analyzed, charted, graphed, and
interpreted. The ability to move data between platforms is a tremendous improvement to program
management. It is our goal to increasingly move to electronic reporting, and eventually reduce printed
reports to a minimum.
Quality Assurance
ACF has supplied and the State has consistently employed the Data Quality Utility and the Frequency
Utility and will continue to do so. In fact, the State now runs the AFCARS reporting programs monthly
and uses the utilities to analyze the output. Records failing the validation process are reported to district
office supervisors who in turn route them to the applicable district office for review and correction.
In addition, the State is developing other techniques for monitoring the accuracy and timeliness of data
entry. It plans to continue to enhance monitoring analysis in place by utilizing a variety of queries to
interrogate the database for specified conditions.
Strengths
Tracking Capability
New Hampshire Bridges provides a series of screens, which guide intake workers and supervisors through the
process of collecting basic information about reporters, subject families and allegations, as well as recording
contacts with collateral parties. The system guides staff through the process of accepting a referral for further
assessment or recording the reasons a referral is not accepted. Finally, the Central Intake supervisor uses the
system to transfer the referral to a local district office for further assessment. The system keeps a log of all
contacts and transfers, as well as providing a utility for freezing the information recorded in the system at the
point that key decisions are made. All children under care are recorded and tracked in the NH SACWIS
application. Since New Hampshire Bridges is fully compliant with ACF as a SACWIS system, it is the
system of record and there are no other alternative systems for tracking children. For example, children in
different geographical areas throughout the State or for different groups in out-of-home care are recorded
and tracked through the same system.
New Hampshire Bridges provides for a case planning process, including a family services planner. In
addition, there is a separate placement planning process to specify the placement plans for children placed
out of their homes. This process begins with an assessment of needs and strengths of the child and the
family, and proceeds through setting goals and determining services needed to reach goals. The planning
process then feeds into a service authorization process, which allows the worker to match the child to
needed services (based on child and service provider characteristics). Supervisory approvals are required
at various points along the way. Should legal action be required as part of the case plan, NH Bridges
provides for tracking that process as well.
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Opportunities for Improvement
New Hampshire CFSR Statewide Assessment
July 2010
Item 24
The New Hampshire SACWIS application (Bridges) is fully compliant with federal requirements since
2009. However, the system has been in production for 12 years and at some point will require a ―r
eplatforming‖ of the application. One objective would be to take advantage of more modern technology
for a mobile work force. Utilizing the State‘s new financial system for provider billing could be another
opportunity for improvement. The existing SACWIS application could be streamlined if claims
processing in Bridges are moved to a central financial system.
Additionally, field staff often report concerns with certain aspects of Bridges. While Bridges is fully
compliant and performs all tasks necessary to complete job function, many of our field staff are
technologically savvy and express their frustrations with how long Bridges modifications and upgrades
can take to complete compared to other forms of modern technology. Bridges modifications are
conducted every six months through new Bridges releases. Additionally, maintenance can be done offcycle during the year for changes that do not require a full release.
182
B. Case Review System
New Hampshire CFSR Statewide Assessment
July 2010
Item 25
Item 25: Written Case Plan. Does the State provide a process that ensures that each child has a
written case plan, to be developed jointly with the child, when appropriate, and the child‘s
parent(s), that includes the required provisions?
In Round 1 of the CFSR, New Hampshire was Not In Substantial Conformity with the systemic
factor of Case Review System.
DCYF believes that families need to be a part of the development of the case plan in order for the best
possible outcomes to be achieved. We endeavor to have our staff and the family work together to develop
the case plan after identifying the strengths of the family as well as the needs that the case plan will
address. The goal of the case plan and case planning process is to ensure the continued safety,
permanency and well-being of children. It is also designed to motivate and measure changes in child and
family behaviors; and encourage stability and permanency for children. Effective case planning is
achieved when done in collaboration with families; is based on family strengths, and resources; and is
time-limited, goal-oriented, and solution-focused.
Policy Considerations
The case planning process as indicated in policy begins once DCYF opens a case. Case plan, Form
2240MPR, is a template completed by the CPSW with every family and child who has an open case on
Bridges. Case plans will be maintained in the case file in addition to the electronic version stored in
Bridges, and the permanency/case plan goal must be identified in Bridges within 30 days of placement for
all cases. Bridges does not provide specific notification for entering the permanency goal into Bridges,
however Bridges does require the CPSW to enter the permanency goal into Bridges before completing the
initial case plan. The case plan must be developed with the family and reviewed and updated every 6
months.
The process of case planning includes some preliminary work by the CPSW in that prior to meeting with
the family, the Family Services CPSW will review the assessment file and consider the recommendations
made by the Assessment CPSW. The Family Service CPSW will review the assessment finding and any
existing service referrals with the family and determine the family‘s progress since the case was
transferred. If services have already begun, the Family Services CPSW will conduct a brief review of the
family‘s situation and include the family‘s perceptions and needs in considering any changes in services.
The Family Services CPSW (hereafter referred to as the ―
CPSW‖) then conducts a social study in order to
obtain historic and current information about the parents and family that can include strengths as well as
needs that can be used in the development of the case plan. A family ecomap or genogram are useful
tools to use when discussing these issues with the family.
The CPSW will review with the family both those strengths that have been identified as well as the needs
identified in the SDM Family Strengths and Needs assessment and the Risk assessment. Once these
strengths and needs are identified and discussed with the family they will be documented in the case plan,
in the contact logs, and/or in reports to the court. The worker and family also discuss any financial,
educational, and emotional resources or needs of the family to ensure the plan and identified services are
reasonable.
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New Hampshire CFSR Statewide Assessment
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Item 25
Once the CPSW and the family have developed the case plan, progress towards goals will be assessed
continuously by the CPSW in conjunction with the family and documented in this plan. The focus of
intervention must always be to facilitate a time-limited service process, which consistently addresses the
safety and well-being of the children. Case planning will always be progressive, that is, moving toward a
permanent plan for the child and family. If stagnation in case planning occurs, the worker must meet with
the family to re-assess the goals in conjunction with the family strengths, capabilities, and resources.
DCYF, in conjunction with the family, has the primary responsibility for the management of a case
involving child protection. The CPSW is responsible for ensuring that the services provided to families
are the best quality possible. Therefore, the CPSW needs to remain in frequent contact with the family
and the service providers to facilitate focused and timely goal achievement. If it is determined that the
service being provided is not meeting the family‘s needs, the CPSW and the family must review the goals
in the case plan and consider other alternatives.
The case plan must also be revised, updated, and reviewed every six months and when placement changes
or other emergencies arise that require a change to the current permanency/case plan goal. CPSW's will
review the case plan during regular meetings with the family, and to end date the accomplished objectives
and add new objectives, and document the meetings in the Bridges contact log. Attached to the paper
copy of the case plan is a copy of the completed child information sheet, Health Care Plan and
educational plan (if there are special education needs) or report card in order to document the known
educational and health needs of the child. CPSW‘s also provide copies of the case plan to the family,
foster parents; residential care providers, CASA, and guardian ad litem in all cases.
CFSR Round 1 Findings
During the 2003 CFSR, this item was rated as an Area Needing Improvement, because although case
plans are generally kept up to date, there are delays in developing initial case plans and parents and
children are not consistently involved in the case planning process.
Stakeholders commenting on case plans during the onsite CFSR noted that all children have case plans,
and that they are usually ―i
n place‖ by the time of the child‘s first 6-month review. Stakeholders
commenting on the case planning process during the onsite CFSR provided contrasting opinions. Some
stakeholders reported that DCYF makes concerted efforts to involve parents in the case planning process
while other stakeholders noted that the extent of parent involvement in the case planning process varies
across workers and depends on a worker‘s experience and knowledge. Some stakeholders suggested that
parents have difficulty participating in case planning through administrative case reviews, because they
are overwhelmed with other appointments and find it difficult to attend.
In addition, some stakeholders reported that JPPO‘s involve parents in the case planning process, while
other stakeholders indicated that this is the exception rather than the rule for JPPO workers. Several
stakeholders indicated that in juvenile justice cases, there is little focus on the parents or on case plans in
general. Finally, stakeholders noted that the case plan, which is used for both juvenile justice and child
welfare cases, is very lengthy (28 pages) and not family friendly.
Changes since Round 1
Prior to the CFSR in 2003 the Division completed case plans but often with limited input or collaboration
from families and children. Since then the actions that the Division took in conjunction with the Program
Improvement Plan included the development of a new case plan form, policy and procedures and training
on the new process, which was successfully completed and implemented in April of 2006.
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New Hampshire CFSR Statewide Assessment
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Item 25
The new case planning process that went into effect in 2006 includes the CPSW having very straight
forward conversations with the family about the concerns that have been identified by DCYF and the
strengths that we believe we can build on in order to facilitate the change that has to happen in order for
their children to be safely cared for in their home. The case planning process is designed to be a very
collaborative process wherein each family member has a voice relating to the needs identified as well as
the means to address those needs.
In implementing new case plan policy and procedure; DCYF recognized that there also needed to be
changes made to court reports and social studies in order to complement the case planning process. In
November 2009, the newly formatted social study and dispositional court report was completed and the
field began testing these forms to be implemented into policy. The DCYF Family Services Workgroup is
still amending review hearing court reports.
A number of the CPR‘s that were conducted indicated that while case plans are being developed, the
process by which they were created did not always include a collaborative process with the birth parents
and the participation of youth or children that were age and developmentally appropriate. Additionally,
the six month task of updating the case plan that was designed for the purpose of ensuring the tasks, goals
and services identified were appropriate as well as a more formalized discussion with the birth family
seemed to be an occasion where the dates of the case plans were changed and signatures obtained. As a
result concerted efforts were initiated including further training on case planning, and engaging families
and discussions indicating the value of reviewing a case plan at the six-month point as an opportunity to
ensure it was an effective plan toward the identified permanency and concurrent goals. Supervisors
increased discussions relating to the process of engaging with a family in order to collaborate around the
development a case plan versus developing a plan and directing the family to comply with the plan.
Such a shift has been met with mixed responses and the work to incorporate the collaborative process
continues. While policy has been clear around the process by which case plans are to be developed in
collaboration with families, the individual practices of CPSW‘s vary depending on the office, the beliefs
that are held in that office, as well as individual beliefs of supervisor and worker. Case plans are
completed based on the timeframes indicated in policy but more often than not the case plans are created
by the worker and shared with the family and other key parties. This information has been captured in
monthly supervisory reports that supervisors receive and review with staff. What has not been captured
in the documentation has been the evidence of the worker collaborating with the family.
Data Considerations
Data from Administrative Case Reviews, Supervisory Reports, Court Reviews, Case Practice Reviews,
and Scrubs indicate that the Division is developing case plans for children in out-of-home care. Scrubs
are an internal process that involves review of a case file and Bridges for key documentation of the
casework that conforms to federal review standards. According to the SFY 2009 Administrative Case
Review Annual Report chart below, 98 percent of DCYF and DJJS cases had case plans that were in
compliance with the timeframe requirements. The plans go to court at the dispositional hearing, which
typically occurs within two months of the child being placed in out-of-home care. Case practice reviews
(CPR) were implemented as a peer review process that mirrors the review conducted during the CFSR.
The Administrative Case Review Satisfaction Surveys assess the parent(s) and child‘s involvement in the
development and modification of the case plan. As a follow-up, the contractor‘s data analyst also
provides monthly reports that track the number of reviews, the attendance, the evidence of a case plan and
other compliance issues. In addition, a comprehensive annual report that provides an extensive analysis
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New Hampshire CFSR Statewide Assessment
July 2010
Item 25
of the year‘s activities is distributed among both divisions‘ administration, quality improvement bureaus
and the district offices, as are the data analysts‘ monthly reports. The Permanency Planning Team is
another avenue in which a team of experts including the Permanency CPSW, Adolescent CPSW,
Resource CPSW, Permanency Supervisor, Administrative Case Reviewer, Family Connections Specialist
and the CPSW and their supervisor discuss the current permanency goal, concurrent goal and the case
plan as well as any barriers impeding progress toward the goal. DCYF does not monitor in-home cases
through the ACR or PPT process. However, in-home cases are selected and reviewed as part of each
office‘s Case Practice Review and are also reviewed at court.
The chart below indicates how many PPT meetings were held statewide during each calendar year since
2005:
PPT meetings held per calendar year
CY 2005
CY 2006
CY 2007
CY2008
CY 2009
Grand Total
Total
662
1029
1320
1388
1395
5794
ACR Annual Report Case Planning Statistics Shown as Percent “Yes” for DCYF and DJJS for SFY06 - SFY09
Compliance Needs
Current Case Plan
Medical Auth in File
Medical Records in File
Ed Code
Current IEP in File
Behavioral Health Records
DSM-IV Code
Services for Child
Services to Parents
Appropriateness of Services
Case Documentation
Provider‘s Progress Reports
SFY06
97%
85%
83%
52%
43%
64%
54%
98%
64%
98%
97%
71%
SFY07
99%
88%
83%
50%
41%
66%
50%
99%
70%
99%
98%
61%
SFY08
97%
91%
85%
47%
41%
70%
55%
95%
67%
97%
96%
74%
SFY09
98%
94%
93%
50%
47%
73%
67%
95%
70%
97%
99%
67%
The Division has incorporated a number of reviews to ensure that each family has a case plan including
the Administrative Case Review Process, Court Hearings, Supervisory Reports and Supervision. The
case planning has also begun to be discussed during the reviews done at the Permanency Planning Team
(PPT) meetings particularly during the 30-day PPT meeting. Family service supervisors are responsible
for overseeing the development of the case plans. The supervisors provide clinical supervision and
problem solving when barriers impede the case planning process. Each CPS Area Administrator also
assesses the practice and plans for improvement are developed as needed. The case practice review is the
process that monitors the adequacy of case plans and appropriateness of permanency goals.
The Administrative Case Review process examines both DCYF‘s and DJJS‘ case planning efforts and the
case plans of children and families in cases where children are in temporary out-of-home placements.
This process is described in more detail in Item 26. Monthly reports are produced that identify cases that
are due, are overdue or are due for future administrative case reviews because of children having recently
186
New Hampshire CFSR Statewide Assessment
July 2010
Item 25
been removed from their homes. The Administrative Case Review Satisfaction Surveys assess the
parent(s) and child‘s involvement in the development and modification of the case plan.
While the Division has not incorporated a formal method of teaming, a number of supports and initiatives
have ensued including a transition meeting within thirty days of a case opening in one district office.
Another significant initiative that will result in a statewide practice change is the re-design of the
Administrative Case Review that includes a review with key team members and family supports that is to
occur within ten days of children entering out-of-home placement. Staff are permitted and encouraged to
offer meeting times that accommodate the youth‘s school schedule and the birth family‘s work schedule,
as well as holding meetings at locations that are amenable to the needs of the families that are served by
the Division.
New Hampshire has been enhancing our collaboration with a number of community stakeholders over the
past few years with the intention of increasing our ability to engage families. Key collaborators relating
to ensuring that each child has a written case plan that was developed jointly with the child and child‘s
parents includes the agency with which the Division contracts to conduct the external administrative case
reviews, birth parents, providers, community members, foster parents, and youth and children when
developmentally appropriate.
Strengths
As mentioned above, data is showing that case plans are being completed for children in out-of-home
care. CPR‘s and Scrubs are additional processes that measure the effectiveness of DCYF and DJJS case
planning in relation to CFSR standards.
We are making efforts through a number of avenues including the Breakthrough Series Initiative,
individual experience of workers with the families they are serving, staff are learning and experiencing
that by engaging and involving the families in the case planning process goals are more readily achieved
and staff feel more fulfilled in their work experiences. In addition, a family service workgroup convenes
monthly to discuss and develop consistent practices statewide relating to responsibilities a family service
worker has including the case planning process. In the past eight to ten months the workgroup has been
focusing on developing a consistent form for social studies that is the process by which a parent is able to
share their lives, strengths, needs, relationships and any information that could be helpful in moving the
case planning process. Although this is not a new idea and for many CPSW‘s, for some the
―c
ollaboration‖ vs. ―
directing‖ is a paradigm shift with which they struggle. As the process continues
with the appropriate supervision and supports CPSW‘s will be successful with the shift, but without them
they may default back to the way they have always directed children and families. Therefore, efforts are
also being made to ensure that supervisors have the skills and tools to support and provide coaching
opportunities for staff to learn and be accountable to this process. Supervisors review the original case
plan that is hand written by the worker and family, in addition to the updates and modifications until the
goal has been achieved or changed resulting in the creation of a new case plan.
In an effort to ensure that this process is being done consistently there have been both formal and informal
trainings on how to engage families around case planning process, as well as how to document the level
of participation individual family members have in the process. A number of promising approaches have
been implemented statewide in order to engage uninvolved parents in the case planning process including
the following: monthly attempts to locate absent parents through searches, family connections specialists
and monthly letters are being sent to uninvolved parents in order to get them re-involved in their plan and
lives of their children. Additional efforts have been made to increase involvement of individuals who are
incarcerated.
187
New Hampshire CFSR Statewide Assessment
July 2010
Item 25
In 2009, DCYF worked with 26 incarcerated mothers and 73 incarcerated fathers. The total number of
children impacted by the absence of one or both parents in these cases is 152 children. Eighty-one of
these children resided in foster care or were receiving residential treatment services. The remaining
children are with the other parent or residing with a relative or court appointed guardian. Incarcerated
parents are encouraged and supported by the assigned CPSW to participate in case planning, including
concurrent planning, for their children to assure that permanency is achieved.
DCYF makes a concerted effort to assure that when appropriate, incarcerated parents have some type of
contact with their children. Most have visits at least one or more times per month. Others are able to
maintain contact via phone or letter, and in at least one case the parent is able to visit via video sessions.
A child health support provider, foster parents, relative caregivers or the assigned CPSW bring children to
visits at the women‘s prison. Visitation at the County Correctional facilities is complicated and often
difficult to arrange due to hours of visitation, willingness of House of Corrections personnel to support
access and the lack of appropriate visiting space.
In those areas where visitation in county facilities has presented a challenge, a DCYF Supervisor has
reached out to the facility in an effort to bring the matter to resolution so that children can maintain a
connection with their parents.
Opportunities for Improvement
What we have learned through our Case Practice Reviews, file scrubs, Bridges, and other informal
reviews in each district office, is that the process for developing a case plan is not consistent throughout
the State. We are in the process of developing a practice model that we believe will assist with ensuring
that practice is consistent statewide. While policy has been clear around the process by which case plans
are to be developed in collaboration with families, practice varies statewide.
Case plans are completed based on the timeframes indicated in policy but more often than not the case
plans are created by the worker and shared with the family and other principal parties. This information
has been captured in monthly supervisory reports that supervisors receive and review with staff. What
has not been captured has been the evidence of the worker collaborating with the family other than what
is indicated in the surveys that accompany each review held.
Policy dictates that in-home case plans must be reviewed at least every six months while a case is opened.
Family Service Supervisors are also responsible for ensuring that case plans are reviewed and updated.
As noted above, however, the measures taken for placement cases, such as PPT meetings and
Administrative Case Reviews, to assist in ensuring timely completion of case plans, are not in place for
in-home cases.
Another area that we could improve on is the manner in which data specifically relating to the case plan is
completed. Currently, in order to assess the collaboration with the birth parents and foster parents we can
look at the last page of the case plan that states how the parent participated in the case plan as well as the
signature page on the hard copy to see if the participants signed the case plan.
188
New Hampshire CFSR Statewide Assessment
July 2010
Item 26
Item 26: Periodic Reviews. Does the State provide a process for the periodic review of the
status of each child, no less frequently than once every 6 months, either by a court or by
administrative review?
DCYF maintains a contract for the provision of Administrative Case Reviews (ACR) for children
and youth who are in the care and custody of DCYF or DJJS and are placed in out-of-home care
for six months or more by qualified child welfare professionals who are not responsible for direct
case management. Subsequent reviews are conducted every 6 months thereafter for as long as the
child remains in care. The reviewers serve as an objective, yet highly qualified third party. The
role of the ACR is to ensure case planning activities achieve the best possible outcomes for
children and families.
Reviews are tracked through the NH Bridges SACWIS database to ensure that reviews are held
every 6 months. Notification of meetings is a joint effort between the CPSW/JPPO and the
administrative case reviewer. Attendees of the review are sent invites 10 days in advance.
Policy Considerations
Policy 632
Foster Care Administrative Case Review
Establishes the requirements for periodic case review for children who reside in out-of-home placement
and for whom DCYF has placement and care responsibility. A contract provider, who reports directly to
the Family Preservation Grants Administrator and maintains direct communication with the statewide
Administrators for Child Protection Services and Juvenile Justice Services, manages the foster care
Administrative Case Review program. For each child who resides in out-of-home placement, the assigned
CPSW is required to prepare the record for review, schedule the review and notify the child‘s parents and
other involved individuals of the date, time, and place that each case review will be held, via the "Notice
of Foster Care Case Review" (Form 2272).
CFSR Round 1 Finding
During the 2003 CFSR, this item was rated as an area of Strength, because the State provides for the
administrative case reviews of the status of each child in foster care at least every 6 months and these
reviews are held in a timely manner and facilitate substantive discussion of the status of each child.
There was general agreement among all stakeholders commenting on the topic of the 6-month case
reviews during the onsite CFSR that a case review of each child in foster care occurs at least once every 6
months, and usually more often. However, stakeholders expressed differing opinions regarding the
relative value of court reviews compared to administrative reviews. Although some stakeholders indicated
that the court reviews are successful in promoting permanency because they ensure that services are in
place and because parents usually attend them, other stakeholders suggested that the administrative
reviews are more productive than court reviews because they last longer and can involve an open
discussion of relevant issues, which sometimes is difficult in a courtroom setting.
Stakeholders noted that Easter Seals has the contract to implement the administrative reviews across the
State and that this agency has been very effective in meeting the requirements of the contract.
189
Changes since Round 1
New Hampshire CFSR Statewide Assessment
July 2010
Item 26
Starting in January 2007, DCYF increased the scope of the ACR to establish the Finding Connections
Program. This program places a contracted Connection Specialist in each of the District Offices. The
Connection Specialist has expertise in researching a child‘s case file (case mining) to identify relatives
and other supports and works collaboratively with the child‘s CPSW and Permanency Planning Team
(PPT) to identify positive resources for the child. As the agency works towards breaking down barriers
affecting permanency, this new collaborative effort has elicited optimism in helping to reach permanency
goals for children in care.
The Findings Connections Program was implemented in all of the District Offices by September 2007.
Each office received training around the need for connections and specific information about the Finding
Connections Program and referral process. The training clarified the role of the Connections Specialist
and other related services around this program.
The Division and the contract agency who conducts the Administrative Case Review (ACR) are currently
in the process of modifying the ACR process including changing the timing – instead of the first ACR
occurring at the six month point from when the child entered out-of-home care, the first ACR occurs
within ten days, the next within four months and then every six months as long as the child remains in
out-of-home care. In addition to the change in timeframes, the content of the ACR is being modified to
promote a process through which the family and their identified supports are engaged in the initiation of
the case planning process particularly surrounding placement including the identification of relatives,
parenting opportunities and other issues relating to attaining the goal of reunification at the start of the
case. These meetings are held at the location that is most appropriate nd supportive of the family and
children. This process began in the Portsmouth District Office in January 2010 and expanded to the
Rochester District Office in April 2010 with a long-term goal of its implementation in all district offices
during 2010.
Data Considerations
Results from SFY 09 were very positive. According to the Easter Seals Administrative Case Review
Annual Report, 74% of cases discharged by the connection specialist with a completed connections plan
have ―
new adults‖ located. Further, 79% of those cases had ―
increased face-to-face‖ contact with their
adult connections. The performance indicators of greatest significance were the many adult and relative
connections that have provided support through visits, placement or even adoption. The success of this
initiative reinforces the importance of kin and other community supports in all aspects of case practice.
The ACR Program was initially designed to enable DCYF and DJJS to assure that cases were in
conformity with the federal child welfare requirements. An important area where the ACR program has
evolved has been with data collection. The contracted agency employs a data analyst for the ACR
Program. The analyst develops ACR monthly reports and an overall program annual report, both of
which serve to inform DCYF and DJJS of data collected, recent trends and provide recommendations in
order to assess the State‘s progress toward meeting its goal of permanency for all children in care.
ACR‘s are consistently occurring every 6 months throughout the State. In SFY 09, only 11 children who
met the criteria for Administrative Case Review did not have a review. Five of those were closed in SFY
09 before a review was done; two were completed at the beginning of SFY 10. Two other cases had been
assigned to State Office and one of these was a voluntary case. Increased focus on permanency by DCYF
and DJJS is noted in recent data as placement with relatives, reunification and adoption are the exit
reasons for the majority of the children and youth leaving care.
190
Below are charts to support the information provided:
R2 = 0.7447
300
250
200
150
100
50
0
SFY03 SFY04 SFY05 SFY06 SFY07 SFY08 SFY09
500
R2 = 0.114
400
300
200
100
0
SFY03 SFY04 SFY05 SFY06 SFY07 SFY08 SFY09
1400
# DCYF Placements
# Delinquency Placements
# CHINS Placements
New Hampshire CFSR Statewide Assessment
July 2010
Item 26
R2 = 0.8732
1200
1000
800
600
400
200
0
SFY03 SFY04 SFY05 SFY06 SFY07 SFY08 SFY09
191
New Hampshire CFSR Statewide Assessment
July 2010
Item 26
The table below from the SFY 09 ACR Annual Report illustrates the number and characteristics of the
children served through the Administrative Case Review process.
SFY09 Characteristics of Children Placed
*Total Unduplicated Count of Children
GENDER
Male
Female
** AGES
0–5
06 – 12
13 – 17
18+
PRIMARY ETHNICITY
American Indian/Alaskan Native
Asian
Black - (Inca Hispanic)
White - (Inca Hispanic)
Hispanic Only
Native Hawaiian/Other Pacific Islander
More than One Race
Blank
In-State
Out-of-State
Undetermined in Bridges
****CASE TYPE
Abuse
CHINS
Delinquency
Neglect
Other: Adoption, Guardianship,
IL Aftercare
***TYPE OF PLACEMENT
Foster Family Care (FC)
Group Home (GH)
Therapeutic Foster Care & ISO (TFC)
Residential (RES)
Other (Unpaid)
Average Number of Placements
Median Number of Placements
Median Length of Stay (Years)
All Ages
0–5
06 – 12
13 – 17
18+
Average Length of Stay (Years)
All Ages
0–5
06 – 12
13 – 17
18+
DCYF
DJJS
CHINS
DJJS
Delinquency
997
167
321
513
484
51%
49%
91
76
54%
46%
221
100
69%
31%
285
300
265
146
29%
30%
27%
15%
0
7
134
26
0%
4%
80%
16%
0
4
284
33
0%
1%
88%
10%
6
3
52
819
9
3
33
72
1%
0%
5%
82%
1%
0%
3%
7%
96%
4%
1
0
9
157
0
0
0
0
4
3
21
287
1
0
3
2
0%
158
9
0
1%
0%
5%
94%
0%
0%
0%
0%
95%
5%
0%
306
13
2
1%
1%
7%
89%
0%
0%
1%
1%
95%
4%
1%
69
0
0
778
150
7%
0%
0%
78%
15%
0
167
0
0
0
0%
100%
0%
0%
0%
0
0
321
0
0
0%
0%
100%
0%
0%
1400
435
258
78
74
3.0
2.0
62%
19%
11%
3%
3%
26
254
17
18
9
2.4
2.0
8%
78%
5%
6%
3%
95
484
34
56
5
2.8
2.0
14%
72%
5%
8%
1%
953
44
0
2.1
1.5
2.0
2.6
4.6
1.0
0.0
1.0
1.0
1.9
1.0
0.0
0.9
1.0
1.9
3.0
1.8
2.5
3.7
5.4
1.6
0.0
1.0
1.4
2.7
2.0
0.0
1.1
1.7
2.8
192
New Hampshire CFSR Statewide Assessment
July 2010
Item 26
When exploring the data further, recent improvements regarding DCYF‘s push towards permanency are
supported. As indicated in the table above, during SFY09, a total of 1,485 children were in placement.
This is compared to 1,632 children in SFY08. These two past years represent a significant decrease from
SFY07 when 1,727 children were in out-of-home placement for six months or more.
Furthermore, During the SFY09, a total of 620 children exited care compared to 636 children exiting care
in SFY08. During the SFY07, 630 children exited care. The most frequent reason for exit was
reunification, which accounted for 211 children compared to 214 in SFY08.
Number of Children Exiting
Placement with relatives was the second most frequent category with 150 youth in SFY09 compared to
161 in SFY08. It is significant to note that there were 135 children leaving care due to adoption in SFY09
and 139 children leaving care due to adoption during SFY08. This compares to 114 in SFY07, 113 in
SFY06, and only 94 leaving care due to adoption in SFY05.
Overall, there has been continuous improvement across the board to achieve permanent outcomes for
children. This improvement has been clearly documented since Easter Seals began using this data in
SFY04. The Division‘s focus on permanency can be noted in this data as placement with relatives,
reunification and adoption are the exit reasons for the majority of the youth leaving care as shown below:
160
140
120
100
138
112
93
96
80
60
40
20
135
114
94
80
70
68 70
58
44
37
17
10
59
86
58
52
42
9
11
5
8
18
9
44
11
10
0
SFY05
SFY06
SFY07
SFY08
SFY09
DCYF: Reason for Exit
Adoption
Aged Out
Independent Living
Placement w ith Relative
Reunification
Runaw ay
Additional findings are important to highlight for SFY09. Overall, there is increased emphasis on quality
indicators such as placement with relatives when reunification is not possible, keeping siblings together in
placement when possible and when that is not possible, providing opportunities for visits to maintain the
family connection. For example, in DCYF during SFY09, 67% of siblings who were placed out of home
were placed in the same home with siblings. This is a dramatic improvement from SFY 05 when only
47% of siblings who were placed out of home were placed with siblings.
The Administrative Case Review process examines both DCYF‘s and DJJS‘ case planning efforts and the
case plans of children and families in cases where children are in temporary out-of-home placements.
Monthly reports are produced that identify cases that are due, are overdue or are due for future
193
New Hampshire CFSR Statewide Assessment
July 2010
administrative case reviews due to children having recently been removed from their homes. The Administrative Case Review Satisfaction Surveys assess the
parent(s) and child‘s involvement in the development and modification of the case plan. (See chart below)
ACR Annual Summary Report for SFY09 ............................................................................................ JJS
District
Office
Berlin
Claremont
Concord
Conway
Keene
Laconia
Littleton
Manchester
Nashua
Portsmouth
Rochester
Salem
Totals
Total
JJS
Total #
Compliant
(Form 2240)
Case Plan
(Form 2240)
Compliance %
Total #
Compliant
(Form 2272)
Review Notice
(Form 2272)
Compliance% (1)
Number of
Parents
Attending
Number of
Parents Invited
Percent of
Parents
Attending (3)
Reviews w/
Parent(s)
Attending
Reviews w/
Parent(s)
Invited
Review % w/
Parent(s)
Attending (4)
18
36
37
8
47
60
11
83
47
35
66
28
476
18
36
37
8
47
60
11
81
46
35
65
28
472
100%
100%
100%
100%
100%
100%
100%
98%
98%
100%
98%
100%
99%
18
35
36
8
47
55
11
82
43
34
61
27
457
100%
97%
97%
100%
100%
92%
100%
99%
91%
97%
92%
96%
96%
13
22
35
2
34
23
6
32
13
26
24
17
247
31
57
53
10
62
70
18
88
60
46
78
39
612
42%
39%
66%
20%
55%
33%
33%
36%
22%
57%
31%
44%
40%
10
15
24
2
28
19
5
27
11
20
21
13
17
34
37
6
46
55
11
74
39
33
62
28
195
442
59%
44%
65%
33%
61%
35%
45%
36%
28%
61%
34%
46%
44%
Total
CPS
Total #
Compliant
(Form 2240)
Case Plan
(Form 2240)
Compliance %
Total #
Compliant
(Form 2272)
Review Notice
(Form 2272)
Compliance% (1)
Number of
Parents
Attending
Number of
Parents Invited
Percent of
Parents
Attending (3)
Reviews w/
Parent(s)
Attending
Reviews w/
Parent(s)
Invited
Review % w/
Parent(s)
Attending (4)
82
123
131
74
138
163
68
237
223
93
138
65
0
81
122
127
74
135
160
68
237
222
92
136
65
0
99%
99%
97%
100%
98%
98%
100%
100%
100%
99%
99%
100%
N/A
82
113
123
74
138
161
68
237
223
88
137
64
0
100%
92%
94%
100%
100%
99%
100%
100%
100%
95%
99%
98%
N/A
37
50
43
37
75
49
30
62
64
29
33
25
0
92
178
142
103
179
154
72
199
201
80
129
63
0
29
41
37
29
56
39
24
50
55
23
29
22
0
54
108
101
61
108
107
41
136
132
53
87
43
0
1535
2011
1519
534
1592
40%
28%
30%
36%
42%
32%
42%
31%
32%
36%
26%
40%
N/A
34%
434
1031
54%
38%
37%
48%
52%
36%
59%
37%
42%
43%
33%
51%
N/A
42%
Reviews w/ Child
Reviews w/Child
of Age to Attend
Attending (2b)
(2a)
18
35
37
8
47
59
11
83
46
35
65
28
472
Item 26
Review %
w/Child
Attending (2c)
10
13
12
5
25
10
6
34
9
13
17
12
166
56%
37%
32%
63%
53%
17%
55%
41%
20%
37%
26%
43%
35%
CPS
District
Office
Berlin
Claremont
Concord
Conway
Keene
Laconia
Littleton
Manchester
Nashua
Portsmouth
Rochester
Salem
State Office
Totals
99%
1508
Overall State Total
98%
Reviews w/ Child
Reviews w/Child
of Age to Attend
Attending (2b)
(2a)
Review %
w/Child
Attending (2c)
29
45
69
42
83
64
35
109
93
55
57
33
0
2
19
18
14
19
12
8
32
30
32
15
14
0
7%
42%
26%
33%
23%
19%
23%
29%
32%
58%
26%
42%
N/A
714
215
30%
1= Compliance in this category now also includes was the review notice timely
2a= Number of Reviews involving a case with a child of age 12 or older.
2b= Number of Reviews with a child age 12 or older attending.
2c= Percentage of Children Attending Reviews now includes only those reviews that involve children at the recommended age of 12 or higher.
3=Percent calculated as number of parents attending review divided by total number of parents invited to review.
4=Percent calculated as number of reviews with parents attending divided by number of reviews with parents invited.
194
New Hampshire CFSR Statewide Assessment
July 2010
Item 26
As a follow-up, the contractor‘s data analyst also provides monthly reports that track the number of
reviews, the attendance, the evidence of a case plan and other compliance issues. In addition, a
comprehensive annual report that provides an extensive analysis of the year‘s activities is distributed
among both divisions‘ administration, quality improvement bureaus and the district office, as are the
monthly data analyst‘s reports.
At each ACR, the reviewer completes a Form 2272C ―
Administrative Case Review‖. This form contains
case identifying information as well as safety, permanency and well-being sections. At the end, there is a
section to document activities needing to be completed over the next 6 months in order to achieve the
permanency plan. The form is provided to the CPSW to use in developing their case plan and their work
with the family. This form is then reviewed at the following review 6 months later to ensure that progress
is being made.
As noted above, DCYF is rolling out an entirely different format that is strictly focused on the reviewer
being a permanency facilitator and bringing the family together early in the case to achieve timely
permanency. In the first 3 months of the Portsmouth Pilot, DCYF has noticed dramatic improvements in
the results of the ACR meetings. Since January 2010, over 90% of parents have attended the first
administrative case review held within 10 days of placement. 100% of age appropriate children have
attended their reviews. As of March 2010, 31% of children who have entered out-of-home placement in
the Portsmouth District Office since January 1, 2010, have been reunified.
Strengths
In recognizing the importance of meaningful participation of all team members involved, both Divisions
have worked with the contracted agency to improve this outcome. Recent efforts have included more
careful, community-based site selection in order to reduce travel barriers and make the site environment
more engaging toward families and providerssuch as hosting review meetings at foster homes, schools or
team meetings rather than the DCYF or DJJS Office.
DCYF, DJJS and the contract agency are currently in the process of modifying the ACR process
including changing the timing – instead of the first ACR occurring at the six month point where the child
has been in out-of-home care, the first ACR occurs within ten days, the next within four months and then
every six months thereafter. Timeframes may look different for DJJS cases given the needs of their cases.
In addition to the change in timeframes, the content of the ACR is being modified to promote a process
through which the family and their identified supports are engaged in the initiation of the case planning
process particularly surrounding placement including the identification of relatives, parenting
opportunities and other issues relating to attaining the goal of reunification at the start of the case. These
meetings are held at the location that makes sense and is most supportive of the family and children. This
process began in the Portsmouth District Office in January 2010 and expanded to the Rochester District
Office in April 2010 with a long-term goal of its implementation in all District Offices by the end of
2010.
Opportunities for Improvement
While data and overall practice support the positive trends listed above, there are barriers to further
success of the ACR Program. Since the last Statewide Assessment, parent and youth attendance and
participation at the reviews remains an issue statewide. In addition to the issues with parent and child
attendance, stakeholder attendance was 49% statewide in SFY 09.
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Item 26
In addition to improving the attendance and participation of children, parents and key stakeholders,
DCYF recognizes that we needed to change the whole structure of the ACR process. The statistics shown
above in relation to the Portsmouth Pilot indicate substantial improvements in all categories measured and
show great promise as to the potential for success of this new initiative both with engaging families and
facilitating permanency.
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Item 27
Item 27: Permanency Hearings. Does the State provide a process that ensures that each child
in foster care under the supervision of the State has a permanency hearing in a qualified court or
administrative body no later than 12 months from the date that the child entered foster care and
no less frequently than every 12 months thereafter?
Policy Considerations
NH statute RSA 169-C:24-b requires that ―Fo
r a child that has been in out-of-home placement for 12 or
more months, the court shall hold and complete a permanency hearing within twelve months of the
finding. For a child that enters an out-of-home placement subsequent to a finding, the court shall hold
and complete a permanency hearing within 12 months of the date the child enters the out-of-home
placement‖.
RSA 169-C:24-b was enacted with new Permanency Legislation that was requested by the New
Hampshire Supreme Court after collaboration with key stakeholders. The goal of the new permanency
legislation is to reduce the length of time until permanency is achieved for all children and youth with
DCYF or DJJS.
New Hampshire‘s Permanency Legislation, SB 152, which was implemented on January 1, 2008, resulted
in modifications to New Hampshire‘s Child Protection Act (RSA 169-C) and statutes for Children In
Need of Services (RSA 169-D) and Delinquent Children (RSA 169-B).
SB 152 establishes a statutory requirement for a 12-month permanency hearing for abuse and neglect
cases. For those cases that involve delinquents and CHINS a permanency hearing must be held within 12
months of a finding or if the child has been in placement for fourteen months, whichever is earlier.
Additionally, the law requires the court to determine whether reasonable efforts have been made to
finalize the permanency plan that has been in effect and to consider ―whe
ther services to the family have
been accessible, available and appropriate‖.
This legislation strengthened stringent timeframes in which the permanency hearing must be held with
continuances granted only after a court determination with written findings that support all continuances.
RSA 169-C:24-c requires that the court hold and complete a post-permanency hearing within 12 months
of the permanency hearing and every 12 months as long as the child remains in out-of-home care. In New
Hampshire, review hearings within the first 12 months of placement are typically held every three
months; with post-permanency reviews scheduled depending on the needs of the specific case and the
progress being made in achieving the permanency goal.
CFSR Round 1 Findings
During the 2003 CFSR, this item was rated as an Area Needing Improvement, because in New
Hampshire, the courts convene the initial permanency hearing 12 months from the time of the
adjudication hearing instead of 12 months from the time of the child‘s entry into foster care. Because
adjudication hearings can be delayed, sometimes for several months, not all children in foster care have a
permanency hearing 12 months from the date that they entered foster care. In addition, permanency
hearings also are not being held on a consistent basis for cases involving Children in Need of Supervision
(CHINS) or adjudicated delinquents.
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Item 27
During the 2003 CFSR, stakeholders were in general agreement that permanency hearings were not
taking place in a timely manner. Stakeholders in Manchester, however, noted that the hearings are
beginning to occur in a timelier manner because of the CIP protocols. One primary reason for delays
noted by stakeholders was that permanency hearings are scheduled 12 months from adjudication rather
than 12 months from the time of the child‘s entry into care. Because an adjudication hearing can be
delayed for several months, depending on the court‘s calendar, the permanency hearing also is delayed.
Some stakeholders also expressed concern that permanency hearings were not being held at all for
CHINS cases or for cases involving adjudicated delinquents. They noted that in juvenile justice cases,
there often is a presumption of reunification so no permanency planning is done. As a result, stakeholders
are concerned that children who cannot be reunified often end up ―a
ging out‖ of DJJS at the age of 17 and
entering DCYF, and then eventually age out of that system as well. This problem was attributed to a
DJJS and court philosophy that does not promote alternative permanency plans for these children.
Changes since Round 1
Since the PIP implementation, there has been a significant focus on concurrent planning. The new
permanency legislation has formalized the courts inquiry regarding what efforts have been made in regard
to the concurrent plan and the PPt‘s are required to review the viability of the concurrent plan. If
adoption were the concurrent plan the PPT would be overseeing the work of preparing the resource family
and assessing whether or not the current caregiver is willing or able to adopt. Any time a child is
removed from his or her parent‘s care, and prior to the permanency hearing, there would also be a focus
on relatives as to whether they are available and willing to assist with the reunification efforts or to
become a permanent home or connection for the child or youth.
In January of 2006, NH passed legislation allowing for Voluntary Mediated Adoptions. RSA 170-B:14
allows for voluntary mediated agreements for post-adoption contact between birth parents and the
adopted child, with these agreements being enforceable by the Court. The possibility of mediation is
discussed at the permanency hearing if the agency is recommending adoption as the goal.
Another major change has been the requirement for permanency hearings and concurrent planning in
DJJS cases. In 2008, the Court Improvement Coordinator established a large multidisciplinary committee
to develop protocols for use in cases that involve CHINS and Delinquents. This committee included four
judges, the Director and administrators from DJJS and DCYF. A DJJS Permanency Administrator
position was created to ensure permanency standards and timeframes were being met within DJJS. In
2009, the Directors of DJJS and DCYF signed a Memorandum of Understanding between the two
Divisions that provides for an active collaboration in permanency planning. As part of this
understanding, the involvement of the PPT‘s in all DJJS cases where the goal is something other than
reunification is available and strongly encouraged. Each DJJS office received training for their staff
regarding the Memorandum of Understanding guidelines. Some DCYF staff attended these trainings to
support this collaborative effort.
In July of 2008, the CIP coordinator was asked by the supervisory judge in the Concord Family Division
Court to develop and submit an application to the National Council of Juvenile and Family Court Judges
(NCJFCJ) to become a Model Court Site. This application was accepted and the work began in October
of 2008. The courts in Concord and Franklin were selected as Model Courts. A committee made up of
stakeholders in Merrimack County began meeting to develop new protocols for termination of parental
rights and adoption. Parents‘ attorneys as well as CASA have also collaborated on the Model Court
Project and been active members of the subcommittees working on the new protocols for TPR and
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Item 27
Adoption. Their voices have been essential in the discussions of more timely permanency outcomes.
Mental health providers as well as educators have also been represented on the Model Court Committee.
During the course of this work it became very apparent that in order to streamline the permanency process
it was necessary to review the procedures and practice earlier in the process, particularly with concurrent
planning and the court‘s inquiry at every hearing leading up to the permanency hearing. Draft protocols
went into effect in the Model Court sites in May of 2010 following training for stakeholders in Merrimack
County.
DCYF supervisors are encouraged to meet regularly with the judges and clerks in their local catchment
area in order to discuss any logistical or practice issues that are of concern by the courts or the agency.
This has fostered a strong working relationship with the courts on the local level.
Protocols have also been established pertaining to the participation and roles of children, parents and
foster parents in permanency hearings. Parents and foster parents both receive notice of permanency
hearings and are strongly encouraged to attend. Parents are represented at all court hearings by courtappointed counsel. All participants at permanency hearings are encouraged to speak by the judge and
have their opinion heard regarding the permanency planning for the child in care. Children are also
encouraged to attend their permanency hearing, however this remains a barrier. While there are instances,
when developmentally appropriate, children attend and meaningfully participate in their permanency
hearings; this is not consistent throughout the State. Since the last CFSR, there has been a culture shift in
the importance placed upon child participation, but improvement still needs to be made. A noted strength
has been the increased collaboration between parents and foster parents before, during and after
permanency and other court hearings, especially during mediation and reunification cases. Additionally,
DCYF has worked diligently to remove transportation barriers for parents in order for them to attend their
child‘s permanency hearing. Transportation has been provided more often by the CPSW either directly or
through a transportation provider.
Data Considerations
In 2007 The Court Improvement Project received a grant to improve data collection and outcome
measurement. The DCYF Director, Director of CASA and BOLQI Administrator worked collaboratively
with CIP staff to develop performance indicators related to the timeliness of court hearings and to
measure outcomes. There has been difficulty with collecting this information through Bridges as we are
able to track the numbers of petitions filed and court orders but not specific to hearing type.
Since January of 2008, DCYF has been tracking the timeliness of the adjudicatory hearing, which is tied
to the date that the permanency hearing must be held. SB 152 requires that an adjudicatory hearing be
held within 30 days of the filing of the petition or 60 days if there is a judicial determination of
―e
xtraordinary circumstances‖. If this determination is made, the hearing must occur and be completed
with written findings within 60 days. The permanency hearing date is set for 12 months from this order.
DCYF tracking for 2008 and 2009 included 1012 petitions filed and all but 314 cases (31%) were
adjudicated or came to a consent agreement within 30 days. Of those 314 cases, 120 cases (38%) were
found to have a determination of extraordinary circumstances as indicated below.
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Item 27
Timeliness of Adjudicatory Hearings
314
Petitions Filed in
2008/2009
120
Not Adjudicated
within 30 days
1012
Not filed due to
Extraordinary
Circumstances
Other data is demonstrating that permanency is being achieved more timely and that in 2008, 175 children
were adopted from DCYF custody. Both the recent increase in the number of adoptions, as well as
decreases in the length of stay in care are largely due to the focus on permanency both in the court and
within DCYF.
Strengths
As stated previously, the collaboration that exists among stakeholders has been the most important factor
in improving the court process and the agency‘s ability to do effective permanency planning. Statewide
leadership meetings with all District Office Supervisors have been an important step in working towards
consistency across the state and highlighting promising practices. The Family Services workgroup is cochaired by three Assistant Administrators, andis composed of the Policy Supervisor and field staff, and
has focused on establishing standards for consistent court report templates to be used in every court.
Permanency Court Reports are submitted to the court five days prior to the hearing and these reports
include comprehensive information regarding the parents‘ efforts and progress towards reunification and
any barriers that remain. There is a recommendation on whether the permanency goal needs to be
changed from reunification to one of the alternate permanency goals including TPR/adoption,
guardianship or APPLA. The social study on each parent is updated so that if the recommendation is
adoption, the social study that accompanies the petition to terminate parental rights is prepared for the
permanency hearing, thus significantly reducing delays in filing the termination petition.
Opportunities for Improvement
Barriers to holding timely permanency hearings sometimes exist due to limitations of the courts
scheduling and dockets. This has been further exacerbated by the recent implementation of furlough days
by our courts. If an adjudication hearing requires several days, it sometimes cannot be scheduled on
consecutive days thus causing a delay in an adjudicatory finding. This then may result in a delay in
scheduling the permanency hearing. Occasionally, in a contested permanency hearing the court will hold
an evidentiary hearing in order to make a determination on the permanency goal. This can also cause
delay in the implementation of the concurrent plan.
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Item 27
Another area that needs improvement is the linkage on data of how well permanency hearings promote
timely achievement of permanency for all children in foster care. Currently, reliable, quantitative data is
not readily available.
As stated previously, DCYF is continuing to work on improving children‘s participation and attendance at
their permanency hearing. The necessary shifts in mindset have largely occurred as to the importance of
their attendance. Over time as we continue to see the benefits of children participating in their own
permanency hearings, we anticipate progress in this area.
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Item 28
Item 28: Termination of Parental Rights. Does the State provide a process for Termination
of Parental Rights (TPR) proceedings in accordance with the provisions of the Adoption and
Safe Families Act (ASFA)?
Policy Considerations
New Hampshire statute RSA 170-C:1 to RSA 170-C:15 provides for the ―
involuntary termination of the
parent-child relationship by a judicial process which will safeguard the rights and interests of all parties
concerned and when it is in the best interest of the child.‖ The statute is based on the presumption that
whenever possible, families should be strengthened and preserved and that termination of the parent-child
relationship is to occur only when the adoption of that child is contemplated.
New Hampshire Court Improvement Protocols, Chapter 13, provide the procedural and practice standards
for the Termination of Parental Rights (TPR). If the permanency order results in a change in the goal to
adoption, the district or family court will order DCYF to file a TPR. The Protocols state that the best
practice is to file the TPR within 60 calendar days of the permanency order but in all cases, the petition
shall be filed within 90 calendar days.
Pursuant to RSA 170-C:5, a TPR petition could be filed on one or more of seven grounds. The vast
majority are filed on failure to correct the conditions that led to a finding of abuse or neglect within 12
months of the finding despite reasonable efforts under the direction of the court; or the parent has
abandoned the child for a period of six months
Although the agency has the ability to file a TPR absent an order of the court, the most common practice
is to file as a result of the permanency order. The recent permanency legislation, SB 152, resulted in
stringent requirements for timeframes for adjudicatory hearings which directly impact the timeliness of
the permanency hearing in that they are required to be held at 12 months following a finding of abuse or
neglect or when the child has been in out-of-home placement for 12 months, or for 15 of the past 22
months.
The TPR statute in New Hampshire requires that in filing a TPR, contemplation of adoption is a factor to
be considered, not a prerequisite. Therefore, if the child is not currently placed with an adoptive family,
the agency could still proceed with TPR if it is determined to be in the child‘s best interest. The court will
then continue to monitor the progress in recruiting an adoptive family in post-TPR review hearings.
According to New Hampshire statute, for the court to grant a petition to terminate a parent‘s rights, they
must first find that the grounds have been met and the standard of evidence is ―be
yond a reasonable
doubt‖. The court must also find that it is in the child‘s best interest for the parent‘s rights to be
terminated.
CFSR Round 1 Findings
During the 2003 CFSR, this item was rated as an area needing improvement, because reviewers found
TPR proceedings were frequently delayed and compelling reasons for exceptions are not consistently
documented or reviewed.
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Item 28
Stakeholders who commented on this topic were in general agreement that although there is a process in
place for filing for TPR, there are delays and problems associated with both the filing for TPR and the
attainment of TPR. With regard to filing, stakeholders suggested that in a majority of applicable cases,
TPR is not being filed. Stakeholders reported that compelling reasons for making exceptions to filing for
TPR were not presented by the agency nor reviewed by judges during court hearings. Some stakeholders
noted that sometimes workers do not file for TPR because (1) it requires a ―t
oo high‖ burden of proof, (2)
the judge has a reputation for not granting TPR‘s; (3) they do not have an adoptive placement for the
child; and/or (4) the child is an adolescent and does not want to be adopted. A few stakeholders noted
that DJJS workers are discouraged from filing for TPR because of the belief that older children are not
likely to be adopted.
Changes since Round 1
Several factors have impacted performance regarding this Item. One of those is logistical, in that
subsequent to the last statewide assessment, the internal approval process for a TPR petition has been
streamlined. The Child Protection Assistant Administrator that oversees a district office reviews the
petition and supporting documents on-site rather that having the packet sent to state office. The courts are
ordering TPR‘s to be filed within 30, 60 or 90 calendar days of the permanency order.
Prior to 2003, the TPR social studies were contracted out to providers to write; now they are completed at
the time of the dispositional hearing, updated by the CPSW for the permanency hearing and then filed
with the TPR petition. This has reduced the length of time for filing a petition.
A major practice shift resulted in the enactment of legislation allowing for Voluntary Mediated
Adoptions. This is now an option available to parents as an alternative to a termination of parental rights
proceeding unless there are conditions which cause the agency not to recommend this option such as a
safety concern or if the prospective adoptive family is not willing to mediate. RSA 170-B:14, which
allows for Voluntary Mediation went into effect on January 1, 2006. For the years 2006-2008 there have
been a total of 139 mediated adoptions.
In those cases where reunification has not been successful, the agency will recommend an alternate
permanency plan to the court. Once the court approves the plan or orders another plan, the case will
continue to be reviewed by the court at least every twelve months until permanency is achieved or the
case is closed.
The courts have been more active in their inquiry regarding the concurrent plan in review hearings both
prior to the permanency hearing and beyond. The court‘s expectation is that the agency will report on any
permanency planning efforts that have occurred including the recruitment of a prospective adoptive home
and discussions with birth parents regarding the option of voluntary mediation and/or surrender of
parental rights.
As has been stated previously in Item 27, Merrimack County was chosen as the site of a Model Court
after being awarded a grant through the National Council of Juvenile and Family Court Judges.
(NCJFCJ). The project began in the fall of 2008 with the first year goal being the development of revised
protocols for TPR and Adoption. The new protocols require that a TPR petition be filed immediately
following the permanency hearing if the recommendation is to change the goal to adoption and the court
adopts that goal. The termination hearing would be scheduled 45 days from the permanency order.
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Data Considerations
New Hampshire CFSR Statewide Assessment
July 2010
Item 28
Bridges is able to provide reports that identify those children who have been in care for 15 of the past 22
months. The Permanency Report tracks the length of time that children have been in care and when PPT
meetings have occurred to ensure that these cases are reviewed according to the established timeframes.
The length of time to achieve adoption has decreased from 35 months in FFY 2007 to 32 months in FFY
2009. New Hampshire exits to adoption in less than 24 months are at 20.8% for FFY 2009 compared to
the national median of 26.8%. While the 20.8% is below the national average, it represents a substantial
increase for New Hampshire as FFY 2007 data shows only 11.7% of children exited to adoption in less
than 24 months.
In FFY 2009, 79.1% of legally free children were adopted in less than 12 months compare to the national
median of 45.8%. The 79.1% is a sharp increase from FFY 2007 data, which showed 64.5% of legally
free children being adopted in less than 12 months in New Hampshire. This indicates that New
Hampshire‘s permanency initiatives implemented since 2003, such as allocating a Permanency CPSW
and Supervisor within each district office and PPT meetings, along with increased collaboration with the
Courts and CASA have had a very positive impact on facilitating timely permanency for children who are
legally free for adoption.
The data below llustrates that more adoptions are occurring each year, in part due to improved efforts to
assure an adequate TPR process.
More recent preliminary data from FFY 2009 and 2010 indicate that the rate of finalized adoptions has
steadied. This is understandable as fewer children are in placement compared to recent years. The
following data represents the number of children adopted since September 2008 in the offices selected for
the 2010 CFSR.
Manchester: 38
Portsmouth: 19
Conway: 14
Littleton: 8
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Item 28
Strengths
The collaboration that has existed among the courts, DCYF/DJJS and CASA has been a major strength in
moving practice forward in this area. To achieve timely permanency through Termination of Parental
Rights, systemic changes have been needed in order to reduce barriers regarding the scheduling of court
hearings and timely decisions.
Another strength has been in the structural changes within the agency, which has allowed for more
proactive permanency planning. The availability of voluntary mediation has also eliminated the number
of cases that require TPR, thus less time needed on court dockets for TPR trials. Permanency Planning
Teams have assisted staff with concurrent planning so that the process of terminating a parent‘s rights is a
shared responsibility of the team rather than one CPSW and supervisor.
Lastly, the Model Court Project is a new endeavor that has allowed for a fresh look at the standards and
procedures related to TPR and an opportunity to test new initiatives.
Opportunities for Improvement
One of the challenges has been the court‘s ability to schedule TPR hearings in a timely manner. Space on
the court docket for a TPR trial that may need to be scheduled over several days is a challenge. The
appellate process for TPR also creates challenges in that a parent has 30 days from the TPR order to file
an appeal and then the case is heard in the New Hampshire Supreme Court. It can take many months for
the case to be heard and then to have a decision issued. There have been efforts to address this concern
with the courts to prevent lengthy delays however, with budgetary limitations imposed on the judicial
system, there is a strong likelihood that this challenge will continue to be an issue for the foreseeable
future
.
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Item 29
Item 29: Notice of Hearings and Reviews to Caregivers. Does the State provide a process for
foster parents, pre-adoptive parents, and relative caregivers for children in foster care to be
notified of, and have an opportunity to be heard in, any review or hearing held with respect to
the child?
New Hampshire provides a process for foster parents, pre-adoptive parents, and relative
caregivers of children in foster care to be notified of, and have an opportunity to be heard in, any
review or hearing held with respect to the child.
Policy Considerations
In April 2003 the New Hampshire District Court Improvement Project in cooperation with the Family
Division and New Hampshire Probate Court released revised Protocols Relative to Abuse and Neglect
Cases and Permanency Planning. New Hampshire has since adopted these protocols as policy and
procedure related to court proceedings involving an abused and neglected child.
PROTOCOL 10-2: Necessary parties at the Court hearing.
The judge must identify the necessary parties to each proceeding and instruct the clerk to provide notice
of the review hearing to those parties. Pursuant to Protocol 10-2 the following parties must receive notice
and should be in attendance at the review hearing:
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Offending parent;
Non-accused parents, including household and non-household parents;
Putative father(s);
Attorney for the offending parent;
DCYF attorney;
DCYF caseworker (with a copy of the notice sent to her/his supervisor);
GAL or CASA GAL;
Relatives with legal standing or representatives of placement facilities, or other custodial
adults; and
Foster parents, pre-adoptive parents or relative caregivers.
Consistent with the Adoption and Safe Families Act of 1997 (ASFA), foster parents, pre-adoptive parents
or relative caregivers must receive notice of the review hearing and should be strongly encouraged to
attend the review hearing and present information on the status of the child. Foster parents, pre-adoptive
parents or relative caregivers should be invited to offer information about the child, rather than to advance
a particular position. Although vitally important, they are not "parties" to the case and, as such, do not
have legal standing. They are not entitled to counsel, may not file pleadings, and may not offer or crossexamine witnesses. If a party does not believe it is appropriate for a foster parent, pre-adoptive parent or
relative caregiver to attend the hearing, the party should raise it with the judge for the court to decide.
If not already provided at the dispositional hearing or previous review hearing, DCYF shall provide the
court (or the clerk's office) with the current name, address, and telephone number of the foster parents,
pre-adoptive parents or relative caregivers. In the court's discretion, if the child has recently been in
placement with a different foster family, those persons may also be invited to participate. It is presumed
that all such persons will be invited to the review hearing and will attend the entire hearing unless the
court finds good cause to excuse anyone from any portion of the hearing. If the court finds such cause,
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Item 29
the court should structure the review hearing so that those persons who will be excused from the hearing
may address the court early in the hearing, rather than having to wait until the end.
Policy 632
Foster Care Administrative Case Review
This policy is described in detail in Item 26. In advance of each Administrative Case Review the
assigned CPSW is required to prepare the record for review, schedule the review and notify the child‘s
parents and other involved individuals, including foster parents, pre-adoptive parents, and relative
caregivers of the date, time, and place that each case review will be held, via the "Notice of Foster Care
Case Review" (Form 2272).
CFSR Round 1 Findings
During the 2003 CFSR, this item was rated as an area of Strength, based on findings that foster parents,
pre-adoptive parents, and relative caregivers were notified of reviews and hearings. In general, they were
given the opportunity to attend reviews and provide input in person or, if they are unable to attend, they
may provide input in written form.
Stakeholders commenting on this Item indicated that they were routinely notified of Administrative Case
Reviews. However, stakeholders also noted that notification of court hearings varied across the sites
being reviewed and that notice was less timely when the responsibility transferred from the agency to the
court system. Stakeholders further noted that the extent to which foster parents, relative caregivers and
adoptive parents were given the opportunity to be heard or submit written information when they could
not attend depended on the presiding judge and varied by jurisdiction.
Changes since Round 1
DCYF values the participation of foster parents, pre-adoptive parents, and relative caregivers at court
reviews. However, court proceedings in abuse and neglect cases are often lengthy and very litigious.
Review hearings are scheduled every three months following the Dispositional Hearing. Court protocols
state that foster parents and relative caregivers must receive notice and should be at review hearings.
While this assertive approach to scheduling hearings has been instrumental in consistent monitoring of
progress towards permanency for children in care, it has the unintended consequence of limiting the
ability of foster parents and relative caregivers who work or have other personal or professional
obligations to attend. To that end foster parent and relative caregivers are strongly encouraged to submit
a letter or report to the court whether or not they plan to attend the review hearing.
In an effort to increase attendance of foster parents, pre-adoptive parents and relative caregivers at
Administrative Case Reviews in collaboration with the ACR program staff, we have sought to increase
the participation of all collaterals, including foster parents, pre-adopt parents and relative caregivers,
through flexible scheduling, use of conference calling and site selection for reviews. ACR reviewers have
been proactive in working with us to combine treatment team, educational and ACR meetings so that they
may occur at the same time whenever possible. Reviews have been held at foster homes and in
residential facilities in an effort to improve the attendance of caregivers, as well as parent‘s attendance.
Written notice to foster parents, pre-adopt parents, and relative caregivers of a scheduled Administrative
Case Review is now accompanied by an ―
invitation‖ brochure. Created in 2005 the brochure provides
detailed information about what a case review meeting entails, who else is invited to the meeting, and
why it is important for all individuals who care about the child and his/her future to attend the meeting.
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Item 29
Data Considerations
The table below indicates that the number of foster parents and relatives invited to attend reviews
increased between SFY 08 to SFY 09. However, the percentage attending ACRs has decreased. As
stated above we believe that the number of scheduled court hearings foster parents and relative caregivers
are required to attend impacts their ability to attend those hearings as well as participate in Administrative
Case Reviews.
Attendance Rates for Foster Parents and Relative Caregivers at Administrative Reviews
Role
SFY 08
SFY 08
SFY 08
SFY 09
SFY 09
SFY 09
Total
Total
Percent
Total
Total
Percent
Invited
Attended
Attended
Invited
Attended
Attended
1064
520
49%
1321
636
48%
Foster
Parents
220
138
63%
283
164
58%
Relative
Caretaker
Strengths
New Hampshire has processes and tools in place to assure that foster parents, pre-adoptive parents and
relative caregivers receive notice of hearings and reviews, are oriented to their role, and have the
opportunity to participate in person, or to provide information if unable to participate in person.
New Hampshire has seen increased numbers of foster parents, pre-adopt and relative caregivers being
invited to Administrative Case Reviews. We believe their involvement early on leads to more focused
permanency planning on behalf of the child. This can expedite reunifications as well as achieve timely
consensus regarding permanency alternatives.
Opportunities for Improvement
In order to ensure that resource families receive notice of the appropriate proceedings, the court must
have current contact information for caregivers. DCYF is working to improve practice to be more
consistent and timely in notifying the court when a child‘s placement changes or a resource family
changes their address. We will continue to work with the Courts to ensure they have the information they
need to provide notice as required.
We believe a strong foundation has been set for involving foster parent, pre-adoptive and relative
caregivers in case reviews. New Hampshire will continue to work in collaboration with the court and
Administrative Case Review staff to identify and implement strategies to improve and sustain foster
parent, pre-adoptive and relative caregiver participation at review meetings.
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C. Quality Assurance System
New Hampshire CFSR Statewide Assessment
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Item 30
Item 30: Standards for Ensuring Quality Services. Has the agency developed and
implemented standards to ensure that the children in foster care are provided quality
services that protect the safety and health of the children?
In Round 1 of the CFSR, New Hampshire was in Substantial Conformity with the
systemic factor of Quality Assurance System.
Policy Considerations
DCYF has worked diligently to ensure that children in foster care receive quality services that
protect their health and safety by utilizing administrative rules He-C 6446
He-C 6352.
According to administrative rules, licensed foster homes are subjected to re-licensing standards
every two years and are required to follow the same regulations, HeC-6446, to become licensed
and to maintain a license.
The agency operates under statute RSA 170-G and administrative rule He-C 6352, ―Cer
tification
for payment standards for Community-Based Providers‖. All community-based service providers
who receive Medicaid or financial reimbursement from the Department of Health and Human
Services (DHHS) for services provided to children and families must adhere to these rules.
Certification for payment standards for community-based service providers identifies the
qualifications and performance requirements to become a provider for the agency and to be recertified for payment as required by RSA 170-G: 4, XV III. The certification for payment
standards were recently revised and received final legislative approval in September 2009.
CFSR Round 1 Finding
During the 2003 CFSR, this item was rated as an area of Strength, because standards for foster
parents and foster care providers to protect the health and safety of children in their care had been
established and were actively monitored.
Stakeholder feedback from Round 1 of the CFSR indicated that home studies, training, and
licensure had been put together in a more structured way to ensure standards. Stakeholders
reported that licensing and certification requirements, including health and safety standards, were
stringently upheld. Maltreatment reports regarding children in foster care were investigated by
DCYF‘s Special Investigations Unit, which stakeholders credited with addressing health and
safety issues for foster children. Stakeholders also commented that the licensing standards had
been revised several times with input from child placing agencies, adoptive parents, and others.
However, stakeholders noted that foster parents did not always receive medical records, which
may have a negative impact on their ability to address the health issues of the children in their
care.
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Changes since Round 1
New Hampshire CFSR Statewide Assessment
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Item 30
Many changes regarding foster family licensing have occurred since the 2003 CFSR. The Fire
Department Inspection Form 2361 was updated in December 2004 and done in conjunction with
the New Hampshire State Fire Marshall. In October 2005, the Foster and Adoptive Family Home
Health Inspection Report Form 2360 was updated which included higher standards for checking
safety issues regarding backyard pools and wells. The implementation of the Adam Walsh Act to
fingerprint applicants for licensing was implemented on July 1, 2007. Foster family licensing
rules were re-drafted and finalized in September 2009.
A foster care license issued in New Hampshire is valid for no more than two years. Part of the
renewal process includes a home visit by the licensor, as well as, updated criminal check, central
registry check, and fire inspection. In addition, the licensor must visit the home annually and if
the foster parent is serving a child/youth, the caseworker must meet with the foster parent in their
home on a monthly basis to assess the child‘s safety, permanency and well-being.
Each town in the state adopts the National Fire Association Code Standard to use when
completing the Fire Inspection form. Most towns have adopted the 2004 standards but some may
use a previous version while others will use a more recent standard. Due to this, it is difficult to
predict the structural needs of a home when licensing is sought. For example, the 2004 code
requires hard-wired smoke detectors and a specific window size for bedroom exits and egress.
The 2002 fire code did not have these same requirements. The 2006 code requires that the home
be outfitted with a water sprinkler system. Some towns have already stated that in 2011 they will
be using the 2006 fire code standards. Additionally, the current standards are not applied equally
from town to town within the state.
Data Considerations
Providers are monitored for compliance by periodic re-certification processes as well as from
scheduled and periodic site reviews. Licensing, registrations and approvals from other New
Hampshire licensing bodies, and if required by law, are verified at the time of the initial or recertification process. Generally, the community-based provider groups are classified as adoption,
behavioral health, childcare, child in-home care, foster care, in-home services, interpreter, legal,
therapeutic community-based adolescent services, recreation and transportation services. DCYF
and DJJS staff may only access certified providers for services for children and families.
Teams comprised of staff from DCYF and DJJS conduct residential care provider site reviews.
Residential services are designed to meet the needs of children and families being served by both
agencies. The programs are provided to children in the least restrictive community-based settings
and progress, by design, to more restrictive and secure settings. All facilities are certified in
accordance with He-C 6350, Certification for Payment Standards for Residential Programs.
DCYF and DJJS staff placement decisions based upon the needs of the children and families in
need of residential services. Residential facilities are generally categorized as: Independent living
homes, General group homes, Intermediate homes, Intensive residential treatment, Therapeutic
foster care, Individualized Service Options, Experiential/wilderness programs, Shelter care and
Nursing homes. Each program has varying levels of treatment for rehabilitation, substance abuse,
psychiatric, therapeutic and education services.
Residential services census reports, consumer surveys and site review results are shared between
DCYF and DJJS. Results of the comprehensive services review are shared with all staff and
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New Hampshire CFSR Statewide Assessment
July 2010
Item 30
posted on the Department‘s shared computers drives. Non-compliance with the certification
standards triggers corrective action plans and more frequent provider reviews. The follow-up
reviews address the areas deemed as non-compliant and look at progress made since the last
review.
The agency may contract for services that are needed in a specific region of the state. The need
for a specific service is identified by field staff and developed by the appropriate staff within the
agency. Depending upon the type of service that needs development, DCYF collaborates with
appropriate community-based partners as well as other department staff.
The agency meets regularly with community-based providers to ensure that quality services are
being delivered as well as to ensure communication flow and children and family needs are met.
Strengths
Due to the size of the State of New Hampshire and the vigorous requirements and oversight of the
foster care system; New Hampshire is able to ensure that children in foster care are provided with
quality services.
Opportunities for Improvement
Given that New Hampshire is engaging in the development of a practice model, DCYF and DJJS
staff will have more ability to ensure that monthly visits with children and families in their home
setting will be more productive and practice informed.
Having the ability to provide site review information and notice of deficiencies in service
provision in an electronic communication would enhance the agencies ability to address quality in
a more timely process
.
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New Hampshire CFSR Statewide Assessment
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Item 31
Item 31: Quality Assurance System. Is the State operating an identifiable quality
assurance system that is in place in the jurisdictions where the services included in the
Child and Family Services Plan (CFSP) are provided, evaluates the quality of services,
identifies the strengths and needs of the service delivery system, provides relevant
reports, and evaluates program improvement measures implemented?
Policy Considerations
DCYF‘s Bureau of Organizational Learning and Quality Improvement (BOLQI) blends
evaluation and oversight with research and development, policy and rules. This multidisciplinary
team is the hub that connects DCYF‘s Program Improvement Plan, the statewide Case Practice
Review, Workforce Development and Training Unit in a cycle of continuous quality
improvement.
BOLQI provides timely program data to managers and, more importantly, works to break down
the barriers between data and practice. Over the past several years, New Hampshire has truly
embraced the use of data at all levels of management. However, staff are sometimes
overwhelmed by the amount of data available and may lack the technical skills needed to turn
―da
ta‖ into ―i
nformation‖. BOLQI has become the ―
data broker‖ that provides a bridge between
simply having the data, and actually using it. The agency‘s use of data has matured in recent
years from a reliance on ―c
ompliance‖ to a focus on ―
outcomes.‖
CFSR Round 1 Findings
During the 2003 CFSR, this item was rated as an area of Strength, because the State‘s quality
assurance (QA) system evaluates the quality of services, identifies strengths and needs for
improvement through quality review reports, and monitors follow-up to the reports.
Stakeholder feedback from Round 1 of the CFSR indicated a general agreement that the State has
a statewide quality assurance system. Stakeholders noted that DCYF conducts reviews of district
offices and that district offices follow up on the recommendations resulting from the reviews.
These reviews include interviews with staff and clients as well as case reviews to examine
outcomes for children and parents. Stakeholders at the local level reported that there is a quality
assurance unit that conducts sample case reviews and provides feedback. A few stakeholders,
however, expressed concern about the lack of clear policy regarding supervisory review of cases.
Changes since Round 1
As a direct result of New Hampshire‘s participation in the federal Child and Family Services
Review (CFSR) in June 2003, DCYF restructured its case practice review system to mirror the
CFSR process.
Held quarterly, the Case Practice Reviews (CPR) identify strengths and areas needing
improvement in each District Office focusing on outcomes for children and families in the areas
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New Hampshire CFSR Statewide Assessment
July 2010
Item 31
of safety, permanency and well-being. The table below is the schedule of CPR‘s since the 2003
CFSR.
Case Practice Reviews 2004-2009
District
Office
Berlin
Claremont
Concord
Conway
Keene
Laconia
Littleton
Manchester
Nashua
Portsmouth
Rochester
Salem
Date of CPR
2004
June
May
March
(pilot)
August
January
(pilot)
Cancelled
February
(pilot)
2005
July
2006
December
September
September
January
May
2008
2009
June
June
March
November
2007
June
December
March
May
December
March
September
August
September
(rescheduled)
March
In the ongoing case component of the CPR, reviewers use the federal CFSR review instrument to
review twelve randomly selected ongoing cases, eight from DCYF and four from DJJS.
reviewers are volunteers from other district offices throughout the state. Past reviewers have
included front line field staff from intake, assessment, and family services, juvenile justice, field
supervisors, program specialists, education specialists, and foster care health nurses.
Additionally, at least one community stakeholder is recruited to participate as a reviewer. The
table on the next page illustrates one of the CPR reports that BOLQI generates to inform the field
and leadership of the findings.
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New Hampshire CFSR Statewide Assessment
July 2010
Item 31
Outcome or Performance Item
Item 1:
Item 2:
Timeliness of initiating investigations
Repeat maltreatment
Outcome S1: Children are, first and foremost,
protected from abuse and neglect.
Percent Rated as a Strength or Substantially Achieved
Berlin Claremont
Jun-07
Dec-06
100
66.7
100
100
Concord Conway Keene Laconia Littleton
Jun-08
Jun-06 Dec-07 Sep-07 May-09
80
n/a
100
66.7
100
100
100
100
100
100
Manchester
Dec-08
60
80
Nashua
Aug-09
75
0
Portsmouth
Sep-08
33.3
100
Rochester Salem
May-07
Mar-09
60
100
50
100
Statewide
Over 3 years
73
95.6
100
91.7
80
100
100
66.7
100
40
75
33.3
60
100
79.6
Item 3:
Services to family to protect child(ren) inhome and prevent removal or re-entry into
out of home placement
100
100
100
75
100
77.8
100
100
83.3
100
87.5
100
91.9
Item 4:
Risk assessment and safety management
81.8
100
91.7
87.5
83.3
83.3
100
83.3
66.7
100
66.7
91.7
85.3
Outcome S2: Children are safely maintained in their
homes whenever possible and appropriate.
Item 5:
Out of home placement re-entries
Item 6:
Stability of out of home placement
Item 7:
Permanency goal for child
81.8
75
50
100
100
n/a
88.9
55.6
91.7
66.7
77.8
66.7
87.5
100
80
100
83.3
100
88.9
100
83.3
100
88.9
77.8
100
100
88.9
77.8
75
100
88.9
66.7
66.7
n/a
77.8
44.4
100
100
88.9
88.9
66.7
100
66.7
77.8
91.7
100
100
55.6
83.9
90
81.7
76.1
Item 8:
Item 9:
Reunification, guardianship, or permanent
placement with relatives
Adoption
100
100
0
50
80
50
100
100
71.4
100
100
50
100
50
100
66.7
66.7
25
80
100
83.3
100
75
25
80.9
62.9
Item 10:
Other planned permanent living
arrangement
100
100
50
50
100
75
75
75
75
100
50
100
80
Outcome P1: Children have permanency and stability
in their living situations.
Item 11: Proximity of out of home placement
Item 12: Placement with siblings
80
100
100
55.6
100
100
44.4
85.7
100
100
100
100
77.8
100
100
66.7
100
85.7
55.6
100
100
66.7
100
100
22.2
88.9
75
75
100
100
66.7
100
100
55.6
100
100
63
94.7
93
Item 13:
Item 14:
Item 15:
Visiting with parents and siblings in out of
home placement
Preserving connections
Relative placement
80
90
88.9
57.1
77.8
77.8
66.7
100
80
100
100
40
77.8
88.9
80
77.8
77.8
87.5
87.5
87.5
100
55.6
75
37.5
55.6
55.6
33.3
62.5
100
100
55.6
88.9
60
71.4
88.9
65
71
85
76.1
Item 16:
Relationship of child in care with parents
85.7
71.4
57.1
80
77.8
77.8
87.5
36.4
55.6
83.3
50
75
71.6
Outcome P2: The continuity of family relationships
and connections is preserved for children.
80
66.7
77.8
80
77.8
66.7
88.9
58.3
55.6
88.9
62.5
77.8
72.9
Item 17:
Needs and services of child, parents, and
foster parents.
66.7
66.7
50
87.5
58.3
50
75
50
33.3
75
58.3
58.3
56.3
Item 18:
Item 19:
Item 20:
Child and family involvement in case
planning
Worker visits with child
Worker visits with parents
83.3
91.7
60
90.9
75
75
58.3
75
20
87.5
100
87.5
58.3
83.3
41.7
50
58.3
50
91
92
81
50
75
36.4
50
75
50
63.6
83.3
60
50
75
54.5
83.3
58.3
54.5
66.9
79.2
55
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New Hampshire CFSR Statewide Assessment
July 2010
Item 31
Outcome WB1: Families have enhanced capacity to
provide for their children's needs.
Item 21: Educational needs of the child
66.7
100
66.7
100
25
90.9
87.5
85.7
63.6
100
50
100
55.8
100
58.3
91.7
33.3
81.8
58.3
100
58.3
100
50
90
52.1
95.3
Outcome WB2: Children receive appropriate services
to meet their educational needs.
Item 22: Physical health of the child
Item 23: Mental/behavioral health of the child
100
90.9
87.5
100
90.9
90.9
90.9
78
91.7
85.7
83.3
75
100
90.9
90
100
80
81.8
100
100
91.7
91.7
75
91.7
81.8
100
63.6
100
100
100
100
100
87.5
90
100
100
95.3
90.6
88.1
Outcome WB3: Children receive adequate services to
meet their physical and mental health needs.
81.8
83.3
66.7
75
100
72.7
91.7
83.3
66.7
100
90
100
85.9
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New Hampshire CFSR Statewide Assessment
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Item 31
In addition to the review instrument designed for on-going cases, the New Hampshire CPR also includes
two new, additional review instruments, one specifically designed to evaluate the Assessment phase of
Child Protective Services, and another to assess compliance with fiscal policies and procedures. The new
instruments were developed and implemented in 2007.
The Assessment review instrument allows DCYF to evaluate risk assessment and safety management in a
random sample of 20 completed assessments. These include both substantiated and unsubstantiated
referrals.
The fiscal review instrument allows the BOLQI and the DCYF Fiscal Unit to identify strengths and
challenges regarding implementation of fiscal procedures. This tool also assesses the quality of services
provided by the fiscal specialist and DCYF /DJJS staff. In a 2009 telephone conversation with the
National Resource Center for Organizational Improvement (NRCOI), it was noted that New Hampshire
was the first state to develop and conduct a fiscal review in conjunction with a quality review of practice.
In addition to the on-site case review process, representatives from BOLQI also facilitate a communitybased stakeholder focus group. The focus group is held offsite and involves a variety of human service,
education, behavioral health, and law enforcement professionals from the communities serviced by the
district office under review. The focus group questions are designed to solicit feedback regarding the
effectiveness of the Child Welfare System.
After the on-site review and stakeholder focus group, BOLQI develops a confidential report for each
district office. The report explains the findings of the case review and includes a summary of the focus
group findings. In order to facilitate continuous quality improvement and address specific areas of
challenge identified in each district office, BOLQI assists the supervisors with the development of the
Practice Improvement Initiative (PII).
The PII includes specific action steps to be taken to improve practice in areas identified through the onsite review as in need of improvement. The PII can also include action steps related to systemic issues
such as improved collaboration with community stakeholders if such items are warranted. Administration
from both Divisions work with BOLQI and the district office staff to monitor improvement initiatives and
report on program outcomes. This process continues until the next on-site review.
In addition to initiatives driven by the Bureau of Quality Improvement, DCYF program managers have
begun to request assistance in developing their own internal QA processes. The development of a new
Adolescent Case Review Instrument highlights this successful collaboration. This review instrument
builds on successful components of the CPR process such as the use of peer review, a structured review
instrument, and a strengths-based approach. In addition to determining whether specific agency policies
were followed, the main goal of this tool is to evaluate, from the youth‘s perspective, how well the
involved agencies worked to meet their needs for positive youth development, permanent connections,
and adult living skills. Input from the Youth Advisory Board, a group of youth currently in out-of-home
placement through DCYF or DJJS was essential to this process. The youth themselves determined which
outcomes were truly important for their successful transition to adulthood.
DJJS created its own Quality Improvement Unit in 2003 as a result of a major DHHS reorganization. The
mission of the DJJS Quality Improvement Unit is:
To facilitate and improve data collection and data quality by producing monthly caseload data
quality reports for supervisors and managers;
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New Hampshire CFSR Statewide Assessment
July 2010
Item 31
To provide data analysis and reports to enhance management and program decision-making;
To improve communications;
To measure program outcomes in order to improve the quality of services to our youth;
To provide aggregate and record level detailed caseload reports to Juvenile Probation and
Parole Supervisors; and
To provide accurate reporting at the federal, state and local levels on the DJJS populations in
New Hampshire
In 2009 DJJS developed a working partnership with the University of NH-Manchester to accept interns
from the Computer Science Department to assist in developing a Data Mart to hold DJJS Bridges client
data that we can query quickly. This project has greatly improved the efficiency and accuracy of our data
reports. The DJJS/UNH collaborative data project will also be the foundation for a larger Data Mart
project that will eventually have a Cognos front end is currently in the requirements phase at the DHHS‘s
Enterprise Data Warehouse. To date, Interns from UNH-Manchester have worked on several data
initiatives within DJJS and the QI Unit to assist us in developing custom data collection and reporting
solutions that have improved our efficiency, reporting capability, and reduced workloads. As a result, our
data quality has dramatically improved and continues to improve each month.
The DJJS QI Unit also has a seat in the DHHS Data Managers Group where ideas are shared with other
Division representatives.
Data Considerations
The Case Practice Reviews result in local Practice Improvement Initiatives as well as statewide policy
changes such as the implementation of Permanency Planning Teams and the Finding Connections
program.
In order to monitor statewide improvements on high-level outcomes such as length of stay in care and
assess the effectiveness of policy changes on case outcomes, DCYF makes use of NCANDS and
AFCARS data and the State Data Profile. Additionally, DCYF relies on a subscription to the Foster Care
Data Archive (FCDA). Finally, the DCYF fiscal unit has moved toward a system of performance-based
contracting. Contracts now include requirements for measuring case outcomes in residential, home-based,
and preventative services.
Public oversight groups such as the Citizen‘s Review Panel, the Child Welfare Committee, and the DCYF
Advisory Board are also a fundamental part of the quality assurance process. Their membership includes
representation from community members, CASA, foster parents, attorneys, group home staff,
representatives from prevention programs, and other professionals who have involvement with or
knowledge of DCYF and DJJS. DCYF has the same liaison to each of these panels that serves as a
conduit between DCYF Management and these DCYF Oversight Panels to facilitate appropriate quality
assurance measures. Members of these groups have also participated in past CPR‘s as stakeholder
reviewers.
Strengths
Several key processes have resulted in DCYF‘s status as a data-driven agency and a model for other
agencies within NH‘s Department of Health and Human Services. First, district office supervisors are key
in any effective systems change. It is vital that this group understand the benefits of using administrative
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New Hampshire CFSR Statewide Assessment
July 2010
Item 31
data to monitor and improve practice. To accomplish this, BOLQI developed a ―d
ata managers‖ group in
2003. The group includes both analysts and program managers. Throughout 2004 and 2005, the data
managers gathered information from field staff and supervisors to develop a set of supervisors‘ reports.
The supervisors‘ reports show supervisors, staff, and managers data gleaned from BRIDGES that is used
to improve the efficiency and quality of staff supervision, guide caseload and staffing decisions, and
identify areas of strength and challenge in office practice. District office supervisors support one another
by sharing successful strategies that are initiated after analysis and discussion of the data in the reports in
monthly Leadership meetings and other forums.
As a result of these on-going efforts, DCYF now maintains numerous standard reports that are accepted
as reliable sources of information. District Office supervisors and State Office program managers have
begun using these reports to begin new initiatives in their offices. Requests for additional data are
common as staff at all levels learn how useful the information can be. Data integrity improved rapidly as
the reports began to be widely used. Staff and supervisors now see the value in data entry and are willing
to invest the time in accurate documentation. This shift from data indifference to data reliance has
allowed DCYF to explore the use of data in additional areas – the supervisors‘ reports have become one
component of the larger data system. The Data Managers group continues to meet as needed, with a focus
on information sharing, improving data collection, and reviewing outcomes data. Information from the
reports is shared among Supervisors from all offices at the monthly Leadership meetings.
Opportunities for Improvement
Continuous quality improvement is a broad term that means the ongoing process of identifying problems,
recommending solutions, and evaluating follow-up action plans directed toward improvement of services
and programs. The shared DCYF/DJJS vision is that excellence in practice results in safe, healthy
children and adolescents who are nurtured by permanent families and secure communities.
As mentioned in the introduction, DCYF management philosophy is to operate as ―Bure
aus without
Borders‖ promoting collaborative program design, oversight and quality improvement. The upcoming
CFSR process is viewed by leadership as the ultimate quality assurance tool that will join together all of
the cultural, operational, practice and quality improvement initiatives of the last several years to achieve
an even higher level of performance.
From the last CFSR until just February 2010, DCYF has maintained a distinct Bureau of Quality
Improvement (BQI) that blends evaluation and oversight with research and development, policy and
rules. As a response to the commitment placed on quality improvement across all realms of practice and
operations, DCYF integrated the Bureau of Organizational Learning and the Bureau of Quality
Improvement into one Bureau – BOLQI. The intention is to recognize the inextricable link between
quality improvement and training activities and support continuous organizational and practice
enhancement. The groundwork has been laid over the last several years to solidify this multidisciplinary
approach to quality improvement activities and is now being infused into several bureaus and program
areas.
218
D. Staff and Provider Training
New Hampshire CFSR Statewide Assessment
July 2010
Item 32
Item 32: Initial Staff Training. Is the State operating a staff development and training
program that supports the goals and objectives in the CFSP, addresses services provided
under titles IV-B and IV-E, and provides initial training for all staff that deliver these
services?
In Round 1 of the CFSR, New Hampshire was in Substantial Conformity with the
systemic factor of Training.
The DCYF and DJJS believe that well-educated employees, caregivers and providers deliver
higher quality, more efficient, effective and proactive services to children and their families,
which support the department‘s mission and guiding principles. The DCYF Bureau of
Organizational Learning & Quality Improvement (BOLQI), previously known as the Bureau of
Staff Development & Training, is responsible for providing both long-term training for DCYF
staff and a wide variety of short-term training options for DCYF/DJJS staff, foster and adoptive
parents, relative caregivers, residential and system of care providers.
The BOLQI has an annual training plan that supports the goal(s) set forth in the agency five-year
Child and Family Services Plan and guides curriculum enhancements, training design, delivery
and scheduling. In order to support cross-systems coordination, integration and effective use of
training resources, agency staff, stakeholders, training partners and contractors participate in a
newly formed statewide Council on Organizational Learning (CoOL). The role of CoOL is to
provide input into the development of the annual training plan to ensure content from various
disciplines and knowledge bases relevant to child and family services policies, programs and
practices is included. The DCYF training plan is updated annually and evaluated by the BOLQI
Administrator and DCYF Director.
Training is required for both new and seasoned staff, as explained in detail in Items 32 and 33.
Training opportunities increase employees‘ competence and morale through professional growth,
development, and increased job effectiveness to ensure the safety, permanency and well-being of
the children and families served. In addition to the regularly scheduled staff and provider
trainings, an annual conference attracts an even broader audience for skill building, networking,
celebration and recognition of peers and colleagues who have rendered outstanding service to
New Hampshire children and families.
New Hampshire DCYF operates a staff development and training program that supports the goals
and objectives in the CFSP, addresses services provided under titles IV-B and IV-E, and provides
initial training for all staff that deliver these services. The New Hampshire Division for Children,
Youth & Families (DCYF) and Division of Juvenile Justice Services (DJJS) believe that training
is a critical systemic factor in achieving quality outcomes for children and families. Thus, it must
be fully integrated into and aligned with all agency activities. DCYF/DJJS recognizes the
inextricable link between continuous quality improvement and training as a staff and
organizational development strategy, and therefore strives to be a learning organization. Within
DCYF, the Bureau of Organizational Learning & Quality Improvement (BOLQI) oversees efforts
to recruit, prepare, grow and retain a competent and committed workforce. Within DJJS, the
Training and Professional Development Unit, lead by a designated manager, oversees training
coordination and quality improvement. These two agents lead a highly collaborative process
between the Divisions regarding the training and preparation of new staff.
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New Hampshire CFSR Statewide Assessment
July 2010
Item 32
Policy Considerations
Per DCYF Policy 46 (i) Professional Development and Learning, and DJJS Policy C-004
Training and Professional Development, the pre-service or initial training program includes
classroom (with pre and post activities), on-the-job training, mentoring and supervision for all
new DCYF/DJJS employees. Both agencies operate a new worker training academy, DCYF Core
Academy (123 hours) and DJJS Juvenile Probation & Parole Institute (JPPI) (150 hours), that
includes a comprehensive array of competency-based courses designed to prepare each new direct
care employee and supervisor with the critical knowledge, skills and abilities they need to be
effective in their job. These courses are all required within the first 6–12 months of employment
and prior to assignment of a full caseload and independent work authority.
All new DCYF and DJJS employees are ―o
riented‖ to their jobs in two primary ways. First, a
broad organizational overview is provided through the New Hampshire Department of Health and
Human Services (DHHS) in a one-day orientation. Each agency then provides more intensive
job-specific training to new employees.
DCYF staff receives a one-day condensed agency orientation entitled ―I
ntroduction to the New
Hampshire Practice Model‖. This day is initiated by a welcome and presentation from the agency
director who sets the tone for new staff regarding the agency vision, mission, values and
principles that drive practice. Next, each of the agency bureau administrators presents an
overview of their bureau‘s role in striving towards the outcomes of safety, permanency and wellbeing by presenting the primary policies, procedures, programmatic and fiscal practices that are
encompassed with the agency Practice Model. The intent is to create a comprehensive and
integrated picture of the organization for each new employee and develop connections for staff
within and across the Division.
Once JPPOs complete DHHS orientation, they transition immediately into the DJJS Professional
Foundation Curriculum Academy, a 150-hour training curriculum, or the Field Training Services
Program (FTSP), depending upon their hire date. The Academy is delivered on-site at the
Sununu Youth Services Center in Manchester, New Hampshire.
DJJS courses included for new staff:
Orientation Training Includes (40 Hours):
Orientation to the DJJS purpose, goal, policies and procedures
Working Conditions
Employee Rights and Responsibilities
An Overview of the Juvenile Justice System
Job Requirements
Additional Training Includes (120 Hours):
Family Strengths-Based Practice in Juvenile Probation
Ethics in Juvenile Probation
Adolescent Development
Special Education & James O Consent Decree
Adolescent Mental Health Issues
Case Planning and File Management
Revenue Enhancement
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Domestic Violence & Juvenile Justice
Substance Abuse & Juvenile Justice
Overview of Residential Services
Community Networking, Wrap-Around, and Continuum of Services
CPR/AED
Upon entering the FTSP, DJJS staff are matched and mentored by an experienced JPPO or JPPO
Coordinator. The purpose of the FTSP is to ensure transfer of knowledge from the Academy and
to support standardized field operations. FTSP curriculum includes topics such as safety
awareness, legal mandates, court hearings and procedures, connections between child protection
and juvenile justice, permanency planning, and professional behavior in the workplace. All
JPPOs must complete the DJJS Professional Foundation Curriculum and the FTSP prior to being
assigned a caseload or acting independently.
All new DJJS employees also participate in the Juvenile Justice Mentoring Program. In this
program a new Juvenile Probation and Parole Officer (JPPO) is assigned to a seasoned JPPO for
overall guidance and assistance completing a mentoring log. The goals of mentoring are to
familiarize the new employee with good case management skills, procedures, policies, best
practice and the culture of the agency. All DJJS pre-service training including Orientation,
Academy, FTSP and Mentoring are currently funded through non-IV-E state and federal sources
such as the Office of Juvenile Justice and Delinquency Prevention (OJJDP). These learning
opportunities have been described above in order to set a context for the professional
development continuum for juvenile justice staff. In summary, all JPPOs must complete 150
hours of classroom training and field mentoring prior to have a full-independent caseload.
Attendance at individual training session as, as well as individual staff‘s overall compliance with
new worker training requirements is rigorously tracked and monitored by the DJJS Training Unit
Coordinator. This information is then regularly reported to the Training Unit Manager and
supervisor.
All new DCYF CPSW‘s complete the Core Academy (123 hours, 20.5 days), and the
Introduction to the New Hampshire DCYF Practice Model within their first six months of
employment. The focus of the CPSW Core Academy curriculum is to ensure basic competency
for new staff in relation to the basic knowledge, skills, abilities and behaviors necessary to
implement the agency mission and achieve targeted outcomes for Safety, Permanency and WellBeing. There are eight Core Academy Modules, which include:
Core Module I: Family-Centered Approach to Child Protective Services (2 classroom days),
Core Module II: Engaging Families in Family Centered Child Protective Services (1 classroom
day, 1/2 learning lab day)
Core Module III: Legal Issues in Family Centered Child Protective Services (1 classroom day, 1
1/2 learning lab day)
Core Module IV: Assessment in Family Centered Child Protective Services (2 classroom days, 1
learning lab day)
Core Module V: Investigative Process in Family Centered Child Protective Services (2
classroom days)
Core Module VI: Casework Process and Case Planning in Family Centered Child Protection
Services (3 classroom days)
Core Module VII: The Effects of Abuse and Neglect on Child Development (3 classroom days)
Core Module VIII: Separation, Placement and Reunification in Family Centered Child
Protective Services. (3 classroom days)
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All Core Academy modules are delivered via in-class instruction and classroom or ―r
eal-life‖
setting learning labs. Subject matter is arranged sequentially to build a logical progression of
information sharing and skill-building as one completes the Academy.
Since July 2009, DCYF has contracted with the University of New Hampshire - Center for
Professional Excellence in Child Welfare (CPE) for provision of Core Academy trainings.
These trainings are offered two to three times per fiscal year in a centralized location in Concord,
depending upon the hiring needs of the division. All new CPSW‘s are assigned as ―s
econdary‖
workers on a reduced caseload (no more than four cases) during the pre-service training period.
The intent is for new staff to transfer their learning, i.e. new skills, knowledge, abilities and
competencies, into their workload under the guidance of their supervisor, mentor and peers in a
controlled environment.
Several supports are provided to CPSW‘s during the pre-service training period. These include
learning labs within specific Core Academy modules such as Module II: Engaging Families in
Family-Centered Child Protective Services, reading and skills tracking tools, collegial,
supervisory and logistical support.
Mentoring is also a critical support provided to staff during their first year. All new CPSW‘s are
matched with a certified mentor who is at least a CPSW II, with more than 1 year of experience,
and is typically located within the same District Office. The mentoring process includes the
completion of a Mentoring Log, which coincides with the Core Academy Learning Workbook
and must be completed within the first year of employment, signed off by the CPSW, their
mentor, and supervisor. A copy of the Mentoring log is maintained in the employees training file.
A Core Academy Learning Workbook is provided to all new CPSW‘s. Mentors and supervisors
review the workbook in detail with new CPSW‘s before, during, and after training. New CPSW‘s
are expected to complete all elements of the Core Academy Learning Workbook prior to
graduating from Core. An important aspect of the Core Academy is to ensure strategic placement
of the number of days out of the office for training and in the office for application of learning
that a new CPSW attends classes provides an additional support. This supports the transfer of
learning process and allows new CPSW‘s to be coached through the application of new
knowledge, skills and abilities. Via the New Hampshire Bridges System - Training Module,
Center for Professional Excellence in Child Welfare (CPE) staff maintains employee-training
data for both DCYF and DJJS. Further, CPE closely monitors employee training attendance and
completion of the CPSW Core Academy and ensures supervisors have the information they need
to monitor training compliance. Once the Training Liaison from CPE has confirmed that all Core
Academy requirements have been met, they communicate this information to the supervisor and
schedule the new worker for Core Academy Graduation, which is attended, by the worker, their
mentor, and the supervisor.
CFSR Round 1 Findings
During the 2003 CFSR, the DCYF/DJJS training program was rated as an area of Strength.
Stakeholder comments related to this finding included that the core training is available to new
workers and had recently shown some improvement. Many stakeholders also commented that the
mentoring program was well liked by participants. Additionally, stakeholders confirmed that new
workers do not take on a caseload until training is completed. Finally, training for new JPPOs is
provided every 6 months and this degree of frequency met the needs at the time of the CFSR.
Since the last CFSR, DCYF/DJJS has strived to continue to promote excellence in learning for
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Item 32
new staff in several ways while maintaining its solid foundation particularly in those areas noted
as in need by stakeholders such as, training for staff on family engagement and hands-on
experience prior to core training classes.
Changes since Round 1
In October 2005, an enhanced Core Academy described above was designed and fully
implemented. The design process included direct involvement from CPSW staff and supervisors
who chose to implement a competency-based, family-centered child welfare training system
developed by the Institute for Human Services. Implementation of this curriculum increased the
number of hours attended by new staff during the Core Academy to 123 hours and included
several new modules with Learning Labs where staff have the opportunity for hands-on
experience to practice new skills and knowledge and be observed, before returning to the field.
Additionally, a consistent time period for completion of Core Academy was established, as well
as enhanced requirements for new staff to have a specifically identified reduced caseload, no
more than four cases assigned and must be assigned as a secondary, not a primary caseworker,
until completion of all Core Academy requirements. There is a multi-step waiver process for
seasoned staff that comes to the agency with experience from another child welfare system, as
long as the supervisor, assistant administrator for their area and the BOLQI Administrator agree
that prior training documentation proves that required competencies have been met.
A second enhancement to new worker training was the design and implementation of a series of
Related Trainings totaling 60 hours/10 days that new staff generally takes within their first year
of employment, some of which are required. Examples include: Staying Safe During Home and
Office Visits, Structured Decision Making, Art of Mentoring I and Interstate Compact. These
topics focus on critical work management techniques, such as worker safety, cultural
competency, assessment of family safety, as well as specialty topics related to planning and
addressing family and youth needs. Related Training topics include:
Staying Safe During Home and Office Visits
Impact of Domestic Violence
Structured Decision-Making, two-day Cultural Competency,
Overview of Residential Services
The Art of Mentoring I
Revenue Enhancement
Prevention of Disease Transmission
Adolescent Toolbox
Working with Families with Mental Health Issues
Interstate Compact
Special Education and James O Consent Decree
Also, in June 2006, the Workforce Development Committee (WFD) created an Exit
Questionnaire. The Exit Questionnaire is given to the departing employee with an addressed,
stamped envelope so that it may be completed and mailed back to the agency at a later date.
Information and data is compiled and reviewed by both the WFD and Bureau of Child Protection
to address culture trends in certain offices, as well as training and retention issues. In regards to
training, four key questions are asked which give an indication of the role training and education
played in recruiting, training and retaining new staff. Results of the questionnaires are reviewed
by the WFD and are used to inform future training needs assessments, design and
implementation. Questionnaires are distributed via hard copy to every staff person when they
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Item 32
leave the agency. At this time, DCYF is looking into the benefit of electronically conducting
these questionnaires, as the return rate of these questionnaires and data tracking of these
questionnaires is inconsistent. These questions include, on a scale of 1 – 5, with 5 being Strongly
Agree and 1 being Do Not Agree answer the following questions:
The following questions related to training scored favorably on the scale:
A.
What interested you in this position?
Several items such as “Opportunity to make a difference”, “Work with children”, and
“Education/training opportunities” are asked. In calendar year 2009, the mean response
for the question ―c
. Education/training opportunities‖ was a favorable 3.50.
B.
How helpful was the training you received while you were in this position?
In calendar year 2009, the mean response for this question was a favorable 3.75.
C.
Which, if any, of the following factors, i.e. “Difficulty of the work”, “Emotional impact
of the work”, “Not enough opportunities for training”, contributed to your decision to
leave your position?
In calendar year 2009, the mean response for this question related to training was a
favorable 3.75.
D.
What have you liked about this position?
Options for this question included; “Positive Peer Support”, “Benefits and Pay”,
“Opportunity to Make a Difference‖, and “Education/Training Opportunities”. In
calendar year 2009, the mean response for the question related to education and training
opportunities was 3.25. A somewhat favorable response; however, in part this response
rate may have been impacted by the state‘s decision to terminate tuition assistance for
staff.
E.
And finally, which, if any, of the following factors contributed to your decision to
leave your position?
In calendar year 2009, the mean response for these questions was a favorable 2.00.
Which indicates that staff did not agree that “Not enough opportunities for training”
were a contributing factor in their decision to leave the agency.
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Item 32
Do Not
Strongly
Agree
Agree
______________________________________________________________________________
2
E
1
3
4
5
D A B
1
1
C1
1
Since the last CFSR, DJJS efforts to enhance training have focused on organizing training around
the needs of both new and seasoned Juvenile Probation Parole Officers, state law, New
Hampshire DHHS Rule, DJJS Policy and Procedures, federal mandates, and best practices. This
has caused DJJS to re-evaluate their training delivery model and establish new training cycles that
have been in effect since 2008.
A very important change regarding the training system operation since the last CFSR has been the
design and implementation of a new training database within the New Hampshire Bridges
System. In October 2005, a module specific to the training function was implemented within the
New Hampshire Bridges system in order to track and maintain training related data. This Bridges
module is maintained and operated by the Training Support Assistant within the CPE. This
position is different from the CPE training liaison position. The three CPE training liaisons who
support training activities within the field, the CPE Program Director, DCYF BOLQI
Administrator and Training Specialist, as well as administrators, supervisors and staff, can all
access the system to monitor training records and attendance on a regular basis. From the system,
CPE also generates and forwards a monthly report to supervisors and staff regarding individual
training attendance and compliance. Further, a proactive role of the Training Support Assistant is
to identify missing training components and make recommendations regarding upcoming
trainings to meet requirements based upon the progression of the training calendar.
Data Considerations
The BOLQI collects data related to initial staff training in several ways. These include,
quantitative data tracking through the New Hampshire Bridges system, participant training
evaluations, monitoring, surveys and informal feedback through training liaisons. All of this data
indicates that the implementation of a Family-Centered Core Academy curriculum, which is
competency-based, has been highly successful. For example, since Core Academy was
implemented in October 2005, 141 staff have attended and completed all Core Modules. For
each Module, attendance since full implementation in October 2005 has been:
Core Module I: Family-Centered Approach to Child Protective Services = 223
Core Module II: Engaging Families in Family Centered Child Protective Services = 209
Core Module III: Legal Issues in Family Centered Child Protective Service = 216
Core Module IV: Assessment in Family Centered Child Protective Services = 217
Core Module V: Investigative Process in Family Centered Child Protective Services = 213
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Item 32
Core Module VI: Casework Process and Case Planning in Family Centered Child Protection
Services = 238
Core Module VII: The Effects of Abuse and Neglect on Child Development = 235
Core Module VIII: Separation, Placement and Reunification in Family Centered Child
Protective Services = 202.
Additionally, every participant conducts evaluations on each training module, as well as Core
Academy overall. Participants are asked to rate their overall satisfaction with the training and
accomplishment of the learning objectives identified on a scale of 1 to 4, with 1 = Extremely
Dissatisfied, 2=Unsatisfied, 3=Satisfied, 4=Extremely Satisfied. The results for FY 2008 - 2010,
are presented in the table below.
NH DCYF CPSW Core
Academy – FY Year
2008
2009
2010*
% Participants Satisfied/Extremely Satisfied
NH DCYF CPSW Related
Trainings – FY Year
2008
2009
% Participants Satisfied/Extremely Satisfied
*Year to date
95%
99%
100%
SOURCE: Staff Development Partnership (SDP) Year End Reports
SOURCE: SDP Year End Reports
97%
98%
In the spring on 2009, the National Resource Center for Organizational Improvement (NRCOI)
was engaged by New Hampshire DCYF to assist with an assessment of the training system.
DCYF utilized the survey instrument developed by Kanak and Maciolek (2008) ―
Building
Effective Training Systems‖ and ―
New Hampshire-ized‖ and distributed the instrument via
survey monkey to staff, supervisors, specialists, managers, and Training Steering Committee
members across both DCYF and DJJS. A response rate of 64% was achieved with responses
from:
164
80
70
11
CPSW‘s & JPPOs
CPSW & JPP Supervisors
Program Specialists and Managers
Training Steering Committee Members
The data gathered regarding the training system was rich and extremely informative and used in a
variety of ways including developing a new proposal for staff training delivery through a Center
for Professional Excellence in Child Welfare with the University of New Hampshire. In regards
to initial training for new workers, Question # 10 on the survey specifically asked:
“Does the training system provide new hire training in skills and
knowledge needed to understand and implement the full practice
model?”
75% of respondents
AGREED or STRONGLY AGREED that it did.
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Item 32
Strengths
A primary strength of both the DCYF and DJJS initial pre-service training systems is that they are
highly structured, comprehensive, competency-based training programs which are closely
managed and monitored to ensure successful preparation of new staff to assignment of a fullcaseload. Both systems have training liaisons/coordinator assigned to each new worker, and in
DCYF‘s case, the new worker‘s office, to ensure follow through on transfer of learning related
activities such as Action Plans, pre and post assignments and the mentoring activities. As the
training systems assessment survey conducted in March 2009 indicated, 75% of staff surveyed
believes the initial training systems are sufficiently preparing new workers for their jobs.
The mentoring program for new workers has historically been a very strong component of the
DCYF new worker training process. The following table shows the historical attendance of staff
at both Mentoring I and II trainings for SFY 2004 – 2009. The need for mentoring training
depends upon the number of new staff being hired into CPSW positions. On average, about 58
new staff receives mentoring training each year. In 2008, there was an increase in staff receiving
mentoring training due to an increase in hiring for newly opened CPSW positions.
DCYF New Worker Mentoring Training
SFY 2004 2005
5
4
Mentoring I
Training
3
3
Mentoring II
Training
5.5
Total Training 6.5
Days
89
42
# Of
Attendees
Unduplicated
2006
4
2007
4
2008
4
2009
2
4
4
4
2
6
6
6
3
56
48
75
42
SOURCE: SDP Year End Reports
Recent changes to the training system brought about by the newly formed Center for Professional
Excellence in Child Welfare with UNH include expansion of the Learning Management System.
One of the most important changes for new staff is the ability for staff to access 24 hours a day
the training calendar, learning materials including curriculum, and a knowledge bank of links to
state, national and international child welfare information.
Opportunities for Improvement
In October 2005, as mentioned previously, a new module of the New Hampshire Bridges system
focused on training was designed and implemented. Although a significant step forward from the
previous system used to track training data, deficiencies in the design of the training module have
impacted the CPE and DCYF staffs‘ ability to accurately track training attendance and
compliance. The DCYF BOLQI and Bureau of Information System have worked closely over the
last year to make adjustments to the Bridges Training module that will correct data collected
related to staff hire dates, identification of training workshop information (title and description),
as well as accuracy in counting number of hours of actual attendance. These corrections are
planned and approved for a Bridges system Upgrade in September 2010. In the meantime, CPE
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Item 32
management and staff have worked with DCYF supervisors to develop a data-reporting
alternative to ensure all are informed of staff training attendance and compliance in a timely and
accurate manner. CPE maintains this data and sends it out to supervisors on a monthly basis.
DJJS also tracks their training data via Bridges. The changes discussed above will assist them
also in managing training data more effectively; however, DJJS has also experienced staff
reductions which have impacted their ability to maintain and track training data. With CPE‘s
assistance however, the expectation is that the data entry activities will be supported and
maintained in the future.
An unusual area of challenge for the new hire training system has been a state imposed freeze on
the hiring of new employees. This has presented challenges in delivery of training content,
sustaining a consistent flow in the training schedule and has affected the breadth of and continuity
of course offerings. The primary reason for this is that training curricula is built on an
expectation of an average course attendance of 7 – 15 participants. The DCYF Core Academy
has been run as many as four times annually in order to accommodate the flow of new hires being
trained in a timely manner. At this point, due to the trickle of new hires - one to two individuals
every other month, course delivery, content and scheduling, has had to be re-designed to
accommodate the potential of only 1 – 3 staff in need of a Core Academy module. Seasoned staff
are typically also available and encouraged to attend Core Academy courses for a refresher;
however, with staff reductions in the field, seasoned staff are only attending courses that are
identified as most critical within their Annual Training Plan.
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Item 33
Item 33: Ongoing Staff Training. Does the State provide for ongoing training for staff that
addresses the skills and knowledge base needed to carry out their duties with regard to the
services included in the CFSP?
New Hampshire DCYF operates a staff development and training program that supports the goals and
objectives in the CFSP, addresses services provided under titles IV-B and IV-E, and provides ongoing
training that addresses the skills and knowledge base necessary for all staff that deliver these services.
The New Hampshire Division for Children, Youth & Families (DCYF) and Division of Juvenile Justice
Services (DJJS) believe that training is a critical systemic factor in achieving quality outcomes for
children and families. Thus, it must be fully integrated into and aligned with all agency activities.
DCYF/DJJS recognizes the inextricable link between continuous quality improvement and training as a
staff and organizational development strategy, and therefore strives to be a learning organization. Within
DCYF, the Bureau of Organizational Learning & Quality Improvement (BOLQI) oversees efforts to
recruit, prepare, grow and retain a competent and committed workforce. Within DJJS, the Training and
Professional Development Unit, lead by a designated manager, oversees training coordination and quality
improvement. These two agents lead a highly collaborative process between the divisions regarding the
training and preparation of new staff.
Policy Considerations
Per DCYF Policy 46 (i) Professional Development and Learning, DCYF staff who deliver services
directly to children and families are required to attend 30 hours of ongoing training annually. Per DJJS
Policy C-004 Training and Professional Development, staff are required to attend 40 hours. Each year an
annual staff-training calendar is developed to meet the ongoing/advanced training needs of DCYF/DJJS
seasoned staff.
Aggregate data from Annual Individual Training Plans (AITP) (DCYF) or Annual Training Surveys
(DJJS) are used, as a starting point to identify potential training needs statewide. The Center for
Professional Excellence in Child Welfare Training Liaisons and the DJJS Training and Professional
Development Unit staff meet with individual district office teams and supervisors to ensure specific needs
for ongoing/advanced training are available and aligned with training system principles: accessible, needs
based, locally delivered, and outcomes focused. If necessary, when a specific area of training need is
identified through supervisory evaluation, the DJJS Professional Standards Bureau or CPE training
liaisons will identify or develop appropriate curriculum and provide training at an individual level for the
employee.
Each year DJJS provides 5 cycles of 12 advanced trainings derived from the Annual Training Surveys.
DCYF offers at least 12 days (72 hours) of ongoing/specialized trainings annually through contract and
state partners. Over the last year, more than 100 hours of specialized training has been provided to
seasoned DCYF staff on a wide variety of topics. IV-E funds are used to support a portion of ongoing
(in-service) training activities for DJJS.
As policies or protocols shift or are newly created, staff are provided with detailed training to ensure
competency in procedural application. For example, in 2008 the New Hampshire Attorney General‘s
Task Force on Child Abuse & Neglect finalized changes to the statewide abuse/neglect protocols. In
response, the DCYF BOLQI supported the delivery of several regional trainings on the new protocols
coordinated throughout the state for staff and other critical cross-system partners to ensure full
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Item 33
compliance with the new procedures. Additionally, in December 2008 changes in the abuse/neglect
Central Registry procedures prompted a statewide, locally delivered teleconference training. Finally, a redesign of the Child Care Development Fund necessitated design and delivery of a timely and accessible
training for staff across the state in order to understand how to best support and collaborate with
biological, foster and adoptive parents, and kinship caregivers in accessing child care resources in their
community.
DCYF or DJJS seasoned staff may also be referred to attend new worker Academies and DCYF Related
trainings as part of their professional development identified in their AITP, or as referred by their
immediate supervisor. Additionally, staff have access to trainings outside the division provided by other
state agencies, community and higher education partners across the state, regionally and nationally.
Finally, DCYF holds an annual conference that offers a diverse array of workshops and networking
opportunities. In 2008, over 200 staff attended 35 workshops and 8 information sessions. Due to
budgetary constraints, an annual conference was not held in 2009, but one is scheduled for May 14, 2010,
and will include 18 workshops, 9 information sessions and is expected to have a total attendance of 350 –
400 staff, caregivers, providers and stakeholders from across the state and region.
Supervisors within DCYF/DJJS have access to numerous opportunities for supervisory training. Both
DCYF and DJJS run agency specific supervisor training programs. All DJJS supervisors within their first
year of promotion must attend the DJJS Supervisor Training held at the Sununu Youth Services Center in
Manchester, New Hampshire. This training is held over five days (37.5 hours) includes topics such as:
Fundamentals of Supervision, Understanding and Appreciating Individuals Styles, Managing Authority,
Supervisory Communications through Change and Conflict, Performance Management for Success and
Best Practice for Performance. These activities are currently funded through non-IV-E state and federal
sources.
DCYF holds an intensive, in-depth supervisory training on a bi-annual basis. This 10-day training is
delivered over a 3 – 4 month period and was developed specifically for DCYF supervisors. The program
is based on the Institute for Human Services competency-based training curriculum. Training topics are
derived from best practices in the field of child welfare management and leadership science. The goal of
this training is to equip district office supervisors with the management, clinical and case practice
knowledge needed to guide their staff to consistently support the vision, mission, guiding principles, and
goals of the agency through best practices. Training modules include: Managing within a Child and
Family System, Managing Diversity, Effective Casework Supervision, Supporting Transfer of Learning,
Developing Work Groups and Teams, and Leadership in Child Protection. This training was last
completed in June 2009. It is anticipated that the Workforce Development Institute on-line training for
supervisors will be accessed in the future to assist New Hampshire DCYF in meeting the training needs of
supervisors.
DCYF/DJJS supervisors also have access to the New Hampshire DHHS ODTS Certified Public
Supervisors program. This program trains supervisors in agency specific human resource policies and
procedures, supervision techniques, effective communication and facilitation of workplace issues.
Finally, several DCYF supervisors have attended the National Child Welfare Leadership Institute
(NCWLI) for mid-level managers. This experience has greatly enhanced our District Office Supervisors
capacity to build the human capital needed in child welfare organizations in order to improve outcomes
for children and families. Another accomplishment was that, 5 mid-level supervisors/managers were
selected and attended the Leadership Academy for Middle-Managers (LAMM) in New York City in
January of 2010. Additionally, the CPE is intending to access the new Leadership Academy On-Line
Training for Child Welfare Supervisors through the National Child Welfare Workforce Institute, which
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Item 33
has recently become fully available. This exciting opportunity solidly aligns with DCYF‘s intention to
provide accessible, eLearning options for all staff.
As mentioned previously, DCYF operates and maintains a fully SACWIS compliant information system
known as Bridges. A module for coordinating training and maintaining records in order to support
training compliance was designed and implemented within Bridges in 2006. The BOLQI collaborates
with the CPE and the agency‘s Bureau of Information Systems to enhance and maintain the training
module on an ongoing basis. Enhancements to the system to improve tracking of training related data are
scheduled for September 2010.
The use of technology to support and enhance training is in transition at DCYF. Currently, all
DCYF/DJJS staff training is scheduled, advertised and tracked through the Bridges Information System.
Staff and supervisors can access and monitor their own training records and register for internal agency
trainings via Bridges. Center for Professional Excellence in Child Welfare Training Liaisons are assigned
to each District Office and directly assist staff and supervisors in ensuring Annual Individual Training
Plans are completed, aligned with required competencies, and completed in a timely manner. Liaisons
also ensure that staff are aware of all training resources and are thus able to plan in advance which
trainings they would like to access in order to support their individual professional growth. With the
initiation of the new CPE Learning Management System and website, staff can access training related
information 24 hours a day such as curriculum, training calendars, and a research rich knowledge bank.
Additionally, DCYF staff will soon be able to monitor their training records and annual hours on-line 24
hours a day.
CFSR Round 1 Findings
During the 2003 CFSR, the DCYF training program was rated as an area of Strength. Stakeholder
comments in support of this determination included that workers have annual individualized training
plans, supervisors review training records prior to annual employee evaluations and workers are expected
to complete action plans stating how they will use skills acquired during training in their practice. Since
that time, DCYF has strived to continue to promote excellence in learning for staff in several ways while
maintaining its solid foundation. This has included addressing areas of need noted by stakeholders in the
last CFSR such as, specialized training for foster care nurses, cultural competency training, family
engagement and permanency planning training, ongoing training for agency attorneys and staff on court
protocols, and training for supervisors.
Changes since Round 1
One significant change in regards to ongoing training has been the expansion of specialized/advanced
trainings available to both DCYF & DJJS staff. This has included expansion of the topics, format, length
and level of the training (i.e. advanced). For example, for DCYF staff the number of specialized trainings
has expanded from just 7 days in SFY 2006, to 61 days in SFY 2009. For DJJS a primary reason for this
has been the evolution of the needs assessment process conducted by the training staff from both DCYF
and DJJS, as well as our contracted training partners. Needs assessments are now conducted through
several means including the Individual Training Needs Assessment for each staff member, training liaison
assessments that are District Office/team specific, regular surveying of staff, supervisors and
stakeholders, input from youth, and involvement of the training staff in the DCYF and DJJS Case Practice
Review Process.
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Efforts continue to ensure staff are culturally competent and abide by ICWA. ICWA competencies are
specifically addressed in Core Academy Module I and DCYF continues to partner with specific expert
trainers for ongoing staff training and organizational consultation as needed. Through support from the
New Hampshire Court Improvement Project, DCYF received the ICWA Guide books in 2008 and they
are accessible to staff within each District Office for continual reference as needed.
In the fall of 2009, in an effort to offer advanced professional development opportunities for employees
who have been with the agency for approximately five or more years, DCYF began implementation of an
Advanced Mentoring Program. It has been modeled after an evidence-based mentoring program
developed by the Connecticut Department of Children and Families (DCF), in conjunction with Fordham
University. Connecticut‘s DCF is now successful into its third year of Seasoned Mentoring program and
is reporting continued success.
The New Hampshire DCYF Advanced Mentoring Program began in November 2009 with the primary
goals to improve participants organizational understanding and leadership capacity, increase retention of
quality employees and enhance professional navigation within DCYF and the community. Through a
structured application process, eight employees who have been with the agency for five or more years
have been matched with mentors who have been quality employees for 10 years or more. Matches that
began last fall will last one year and typically have contact two to four times per month via face-to-face,
phone or e-mail. Mentees work with their mentors to identify specific professional goals they would like
to accomplish over the year, and design an agency-based project that targets enhancing quality in practice.
Each match is supported by a Team Leader who is a member of the DCYF‘s Workforce Development
Committee. Quarterly meetings are held for matches involved in the program to share match progress
and receive advanced training on topics related to leadership, communication, team building, critical
thinking, and career development. Some expected outcomes for participants include, an enhanced
understanding of the agency DCYF mission, exposure to different departmental programs, opportunities
to demonstrate best practice, increased professional development through participation in projects and
presentations, and enhanced awareness of management styles in various settings. Both formative and
summative data has been collected throughout the program development and implementation.
Participants complete surveys via survey monkey after each quarterly meeting and prepare session
recordings after each mentoring contact. This information is reviewed by the Advanced Mentoring
Committee on an ongoing basis to plan and prepare additional trainings and provides support to matches.
Currently, several upper level administrators, including the agency Director, are successfully serving as
mentors.
The Foster Care Health Program has been an important initiative for DCYF/DJJS. Ensuring nursing staff
are well trained, competent and confident has been a focus for the BOLQI since the last CFSR. Since
2005, 10 nurses have been a part of the Foster Care Health Program. For these staff, a total of 2,368
hours of training has been provided since 2005. On average, since 2005 nurses have received 43 hours of
annual training, exceeding the 30 hours per year annual requirement. This achievement has been
accomplished by ensuring nurses have access to DCYF provided specialty training, expert support and
training from the DHHS Division of Public Health, as well as opportunities to attend specialized training
in the health care field.
Data Considerations
Each year, the DCYF BOLQI contracted training partner, currently the University of New Hampshire,
Center for Professional Excellence in Child Welfare (CPE) and previously the Staff Development
Partnership with NFI, Inc., are required to provide at least 12 specialized trainings per year to assist staff
in meeting their ongoing training needs. These are trainings, which are chosen based upon the expanded
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needs assessment described above. In SFY 2009, 263.8 hours, totaling 44 days, of advanced/specialized
training was provided.
In 2009, specialized training topics included:
Safe Homes, Safe Families
Voluntary Mediated Adoption I and II
Youth Suicide Prevention Overview – Frameworks Model
Effective Child Welfare Documentation
Living Through the Termination of Parental Rights Process
Making More Powerful Choices: Team Building in Child Welfare
Making More Powerful Choices: Ethics, Boundaries and Professionalism in Child Welfare
Reunification and Closure in Child Sexual Abuse Cases
Advanced Training on Working with Batterers
Over the last several years, participant satisfaction with ongoing trainings has risen steadily.
Staff Satisfaction with Specialized Training
Specialized Trainings – FY
% Participants Satisfied/Extremely Satisfied
Year
80%
2008
97%
2009
99%
2010*
SOURCE: SDP Year End Report & CPE
DCYF and DJJS staff may also request to attend ongoing specialized or advanced training outside of the
agencies. For more seasoned staff, this is particularly important way for them to get the in-depth content
they need to grow in their skills and knowledge. Historical data demonstrates that access for staff to
outside trainings as an option for meeting their training needs has also expanded significantly over the last
several years. From SFY 2006 to 2009, the request for attendance at outside trainings increased by 25%.
Staff Use of Outside Training
Requests Submitted
Number of Individuals
SFY 2006
394
219
SOURCE: SDP Year End Report
SFY 2007
395
248
SFY 2008
291
196
SFY 2009
527
287
DCYF has been providing Supervisor Training since 2004. In 2005, DCYF adopted a multi-module
Supervisor Core Training curriculum series from the Institute for Human Services, which is uniquely
aligned with the Core Academy curriculum also developed by IHS. This curriculum is a series of
competency-based trainings designed and trained by IHS certified trainers. Upon adoption of the new
supervisor training curriculum, an individualized assessment approach to each supervisor‘s training needs
was used and the number of modules required to ―c
omplete‖ the Supervisor Core Training varied
depending upon whether someone was a new or experienced supervisor, and what previous trainings they
had attended. Due to the longevity of DCYF Supervisors, the original intention was to hold Supervisor
Core Academy every other state fiscal year, which would sufficiently meet the need. This did occur,
however, some delivery of modules within a given series occurred across fiscal years. From 2005
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through 2009, 309 supervisors attended one or more of the supervisor Core Modules. The following
number of Supervisor Core trainings were held in SFY‘s 2005 – 2009.
Supervisor Trainings
Supervisor
SFY 2005
Core
2
Trainings
5
Days
23
Attendees
SFY 2006
SFY 2007
SFY 2008
0
0
0
15
25
278
2
2
70
SOURCE: SDP Year End Report & CPE
SFY 2009
3
8
36
There are currently 93 JPPO‘s and Supervisors in the Field Services Bureau of DJJS. By ensuring
consistent scheduling of the training cycle, DJJS has maintained a high level of compliance with training
requirements for all field services staff, 96 – 99% compliance. The only exceptions to training attendance
over the last 3 years have been in regards to staff that have experienced leave due to FMLA. Staff
returning from FMLA are assigned to the Professional Standards Bureau until they have completed all
training missed. Upon completion of all training requirements, then they return to their field position.
The following chart summarizes training for DJJS staff for the last three years.
DJJS Ongoing Training by Year
2008
2009
2010*
*Year to date
# of hours
3720
3640
712
% of staff in attendance
99
98
96
SOURCE: DJJS Bureau of Professional Standards
# of staff FMLA
1
2
4
DJJS monitors the quality of training through several means including the DJJS training steering
committee; peer review of lesson plans, testing of students and participant evaluations. In 2008,
participant satisfaction rate for was 86.5% and in 2009, it was 83.2%. To date in 2010, the satisfaction
rate is 94.3%.
As mentioned in Item 32, the WFD monitors conducts Exit Interviews with staff who depart the agency in
order to assess the culture and climate of the organization and the impact of training on employee
retention. The quote below is from a staff member who recently retired from the agency.
“I'm not interested in doing an exit interview, I'm retiring, not quitting
and I am fresh out of ideas as to what would make the system better. I
think the work that is being done now is amazing compared to what we
did when I started 25 years ago. We do a much better job of listening to
people and engaging youth and families to help them reach their goals. I
have found the work I do with youth exciting and challenging. I have
several youth that keep in contact after they leave DCYF care and it's
good to see how the work we have done is paying off for them.
Especially when they are able to break the abuse/neglect cycle they came
from. This has been a tremendously rewarding job and I'm certainly
going to miss the families and my co-workers. Thank you for the
opportunity to express myself and for your support of us in the work we
do. It has been a pleasure to work for DCYF”.
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An important activity for DCYF/DJJS over the last two years has been the integration of quality
improvement and training activities. In an effort to ensure training supports DCYF‘s mission and the
requirements of the CFSP, the BOLQI has embarked on a quality assurance process that includes a
component into the Case Practice Review. BOLQI‘s plan is to collect information from this instrument as
a data point to begin the process of evaluation training needs and collecting data in an effort to
demonstrate consistent training methods with positive CPR results. While the CPR reviewers are meeting
with the CPSW or JPPO, as well as providers in the case being reviewed, the worker and provider are
asked to answer five questions related to training they have received, and any specific trainings that
would be helpful for the specific case under review.
In December 2008, DCYF/DJJS began a pilot process of including training staff as participants in the
Case Practice Review. To date, training staff have participated in the CPR processes in three district
offices, Salem, New Hampshire - December 2008, Littleton, New Hampshire – May 2009, and Nashua,
New Hampshire – August 2009. In May, pilot questions during case specific interviews included:
Questions to CPSW‟s/JPPO‟s:
Have you received training from the DCYF/DJJS System? Briefly describe
When and where did you receive this training?
How has training supported you in your role with this child and family in this case?
Are there other training needs you have as it relates to your work with this particular case/ or
similar case?
Do you have any training recommendations as it relates to this case?
Questions to Providers & Stakeholders:
Have you received training from the DCYF/DJJS System? Briefly describe
When and where did you receive this training?
How has training supported you in your role with this child and family in this case?
Are there other training needs you have as it relates to your work with this particular case/ or
similar case?
Do you have any training recommendations as it relates to this case?
Feedback from these questions has been informative; all CPSW/JPPO and providers reported having
received training and all felt the training was helpful in their casework. Questions related to training
needs or recommendations relative to the specific case under review yielded a diverse range of needs,
including interviewing skills, how to empower women, navigating the adult system for transition to
developmental disabilities services, and treatments for those addicted to substances, specifically heroin.
Strengths
The DCYF/DJJS training systems have many strengths that impact the provision and quality of ongoing
staff training. These include:
Establishment of the Center for Professional Excellence in Child Welfare built on four guiding
principles: Accessible, Local, Needs Based, and Outcomes Focused,
Training Liaisons/Coordinators that support staff in District Offices,
Enhanced ability to be responsive to staff training needs,
Establishment of a single statewide Learning Advisory Council to guide an integrated system
of learning/training in child welfare and juvenile justice,
Support for systemic partnerships – establishment of the CASA Training Partnership.
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Since the last CFSR, the training systems at DCYF/DJJS have evolved greatly. As mentioned previously,
the systems were founded on a competency-based curriculum, solidly aligned with the agency mission.
In the last two years, with founding of the Center for Professional Excellence in Child Welfare (CPE)
with the Department of Social Work at the University of New Hampshire, and the restructuring of
training delivery at DJJS, the training systems are now moving towards increased support to the agencies‘
Practice Model and best practices in the fields of child welfare and juvenile justice. The CPE specifically
adds two critical elements to the DCYF/DJJS training systems 1) an enhanced research to practice
capability and 2) a comprehensive Learning Management System, including a website and distance
learning expertise and capabilities. The CPE is able to do this via partnerships with several centers,
institutes and departments at UNH and nationally including:
Social Work Outreach Center
Center for Excellence in Teaching and Learning
Browne Center for Innovative Learning
Institute on Disability (A Center of Excellence)
Granite State Distance Learning Network
Crimes Against Children Research Center
Justiceworks
Tennessee Center for Child Welfare
Institute for Human Services
Further, new principles regarding training being accessible, needs based outcomes oriented and local, are
driving training design and delivery. This has specifically impacted ongoing training for staff by
increasing 1) the number of advanced training offerings, 2) the speed and flexibility in which ongoing
trainings are developed and delivered, 3) the targeting of ongoing trainings to specific individual, team,
office and agency needs, 4) and the development of distance learning options for staff.
The pace of practice changes in both child welfare and juvenile justice has increased dramatically. This
dynamic has created the necessity for training development and delivery to be rapid and flexible to adjust
to the ever-changing needs of staff in the field. Therefore, DCYF and DJJS have both expanded the needs
assessment process to become multi-faceted. First, training liaisons/coordinators are assigned to district
offices to support ongoing assessment of the individual training needs of CPSW‘s/JPPO‘s and supervisor,
as well as district office teams and local regions. Second, needs assessment focused on programmatic and
organizational goals is also conducted via surveys, focused discussions with staff and stakeholders, and
the Learning Advisory Council. The purpose of these needs assessments are to ensure training activities
are aligned with the agency Practice Model and targeted outcomes of Safety, Permanency and WellBeing. Third, training and quality assurance functions have become highly integrated at both DCYF and
DJJS and are overseen by a single Administrator at each agency. Training staff from both DCYF and
DJJS participating in agency quality assurance processes such as Case Practice Reviews to ensure training
development is targeted to specific needs identified in the CPR‘s and support practice improvements for
individual staff, teams, offices and regions.
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Another strength of the training system is the establishment of the Learning Advisory Council. In July
2009, with the establishment of the CPE, DCYF and DJJS decided to embark on a process of integrating
the training system ―a
dvising‖ process through eliminating separate steering committees for each training
contractor and establishing a single statewide Advisory Council. The vision and mission of the Learning
Advisory Council are:
Vision Statement
We envision an inspired, confident and
skilled cadre of caregivers and professionals who
positively impact the lives of children, families and each other.
Mission Statement
The mission of the BOLAC is to ensure training has a positive impact on the
outcomes of children and families. To accomplish this, the BOLAC will guide the
provision of innovative and engaging learning opportunities that are
collaboratively designed and delivered, and consistent in supporting best practice.
Family and youth voice will guide prioritization of emerging learning needs, while
training design will be grounded in both theory and practice.
Membership on the Learning Advisory Council includes 40 individuals from across the state including
DCYF/DJJS staff and supervisors, specialists, and administrators, as well as representatives from state
agencies, such as the Department of Education, DHHS Bureau of Drug and Alcohol Services, New
Hampshire Court Improvement Project, Attorney General‘s Office, training contractors, several
institutions of higher education, New Hampshire CASA, New Hampshire Foster and Adoptive Parent
Association, and New Hampshire Relatives as Partners. Additionally, adolescents from the Youth
Advisory Board and birth parents are being engaged as members of the Learning Advisory Council or
participants in training design, delivery and evaluation. The Learning Advisory Council and its
subcommittees meet on a quarterly basis.
DCYF/DJJS recognizes that ensuring functional and effective systemic partnerships, especially between
the courts, court personnel, attorneys, court appointed special advocates, and DCYF staff, support best
practices for children and families. With this in mind, DCYF actively participates in and support several
training related activities that strengthen systemic partnership.
The New Hampshire Court Improvement Project has the basic training and data grants to help support the
improvement of court policies and practices in juvenile cases. The CIP has focused much of its efforts on
the development of protocols and court tools to improve permanency outcomes for children in out-ofhome placements. The CIP Training Grant is specifically focused on providing training to judges,
masters, court staff, DCYF attorneys, attorneys who represent parents, and other system stakeholders such
as CASA and DCYF staff. The training support comes in several ways, both financially supporting
training programs, coordinating the logistics of training opportunities, and planning with other system
trainers for multidisciplinary training events. The DCYF Training Administrator participates in the CIP
Training Steering Committee, and the CIP Training Coordinator is actively engaged in planning training
for DCYF staff and a member of the Learning Advisory Council.
An example of this is the planning and implementation of two annual statewide summits in 2008 and
2009 that focused on building the practice partnerships between CASA and DCYF. DCYF and the Court
Improvement Project, along with CASA, have brought together over 100 staff and volunteers from across
the state to facilitate enhanced practice and communication. These daylong events are focused on
establishing commonalities within each agency‘s programs and missions. The Directors of DCYF and
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CASA have led the events and set forth the expectation that local regional teams will set annual goals that
will address misconceptions between agencies, enhance communication and practices that support
children, families and communities. The intention is for an annual DCYF/CASA Summit to be held and
collaboratively sponsored each year by DCYF, CASA and the CIP to sustain this important process.
Another example of supporting systemic partnerships regarding training that improve outcomes for
children and families is the establishment of the CASA Training Partnership in August 2009. Under P.L.
110-351 amended section 474 (a)(3)(B), DCYF has established a contractual relationship with New
Hampshire CASA, the statewide agency for court-appointed special advocates. Through the CASA
Training Partnership, IVE training funds are being used to support both pre-service and in-service training
of court-appointed volunteers and staff. New CASA volunteers receive 40 hours of pre-service training
prior to being assigned a case.
Pre-service training consists of 40 hours of comprehensive adult participatory training, which prepares the
CASA guardian ad litem to perform their role within the child protection system and juvenile court in an
effective and thorough manner. This core training curriculum has been developed by the National CASA
Association, with necessary revisions made by CASA of New Hampshire, in an effort to have specific
portions comply with New Hampshire child protection laws (169c), New Hampshire Supreme Court
Guardian ad litem rules, and general court and child protection practice. Training for new volunteers is
delivered at the CASA central office in Manchester, New Hampshire or other designated locations.
Volunteers and staff are then required to complete 12 hours of ongoing training per year.
All curriculum is delivered by qualified and trained CASA of New Hampshire staff, as well as
professional/trainers who practice in various areas of the Juvenile court and child protection systems, such
as judges, attorneys, foster parents and child protection workers.
Opportunities for Improvement
With the founding of the CPE in July 2009, there has been a transition period, which has affected resource
utilization moving from the previous long-term training provider, NFI, Inc. There have been a reduced
number of ongoing/specialized trainings available to staff since July 2009. Throughout SFY 2010, the
emphasis for the CPE has been on creating the Learning Management System and website which has
absorbed a significant amount training development time for CPE staff. The CPE website was
successfully completed on time in January 2010, and it is expected that the final elements of the Learning
Management System to support distance learning will be completed in the summer of 2010. With these
steps accomplished, CPE will begin regular offerings of on-line courses, which will enhance staff access
to a larger number of trainings in varying formats, lengths and topics.
DJJS would also like to be able to provide additional training on specific topics as requested in a number
of training surveys. To that end, DJJS is looking at creating a series of monthly, optional in-service
training sessions that would be responsive to the requests of staff and easily accessible.
In October 2005, as mentioned previously, a new module of the New Hampshire Bridges system focused
on training was designed and implemented. Although a significant step forward from the previous system
used to track training data, deficiencies in the design of the training module have impacted the CPE and
DCYF staffs‘ ability to accurately track training attendance and compliance. The DCYF BOLQI and
Bureau of Information System have worked closely over the last year to make adjustments to the Bridges
Training module that will correct data collected related to staff hire dates, identification of training
workshop information (title and description), as well as accuracy in counting number of hours of actual
attendance. These corrections are planned and approved for a Bridges system upgrade in September
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Item 33
2010. In the meantime, CPE management and staff have worked with DCYF supervisors to develop a
data-reporting alternative to ensure all are informed of staff training attendance and compliance in a
timely and accurate manner.
DJJS also tracks their training data via Bridges. The changes discussed above will assist them also in
managing training data more effectively; however, DJJS has also experienced staff reductions which have
impacted their ability to maintain and track training data. With CPE‘s assistance however, the
expectation is that data entry may be updated and maintained on a regular basis
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Item 34: Foster and Adoptive Parent Training. Does the State provide training for current
or prospective foster parents, adoptive parents, and staff of State-licensed or State – approved
facilities that care for children receiving foster care or adoption assistance under Title IVE?
Does the training address the skills and knowledge based that they need to carry out their duties
with regard to foster and adopted children?
As stated previously, DCYF and DJJS believe that well educated caregivers and providers deliver higher
quality, more efficient, effective and proactive services to children and their families, which support the
department‘s mission and guiding principles. Through an array of contracts the BOLQI provides training
for foster and adoptive parents, relative caregivers, residential and system of care providers. Currently,
DCYF contracts with Granite State College through the Education & Training Partnership to provide
training to foster and adoptive parents, relative care givers and residential care providers. The mission of
this partnership is:
To enhance the quality of care for children living outside of their own homes by providing the
knowledge, skills, ability and mutual support necessary to address the daily issues that confront
substitute caregivers and case managers who work with children and youth in placement. In
support of this goal, the Education and Training Partnership provides competency based
training, statewide, to foster/adoptive parents, kin caregivers, DCYF staff, and residential care
providers working with children in placement due to abuse/neglect.
DCYF staff are encouraged to join caregivers in training as a matter of best practice, to promote
collaborative relationships between social workers and caregivers. The E&TP partners with DCYF in
assessing training as it relates to the principles of accessibility, needs based, outcomes oriented and local,
and in alignment with DCYF‘s Practice Model. Members of the E & TP participate in the Learning
Advisory Council to guide the design, delivery and evaluation of training for new and experienced
caregivers and residential care providers.
Policy Considerations
As it is written in state regulations He-C 6446.11 and He-C 6446.19, all applicants for foster home
licensing must attend 21 hours of pre-service training and either 16 or 32 hours of ongoing training to
renew their license. Proof of training can be found in the foster home file. Each record contains a copy
of the certificate of completion of the pre-service training (original is given to the participant). When a
foster parent renews their license they submit a list of trainings that they have attended to meet the
requirement. Specialized foster parents need to have half of their training hours devoted to becoming
more competent in meeting the needs of the child in their care.
Foster and adoptive parent attendance at training is tracked through the E & TP and forwarded to
Resource Workers in the field who document training completion in the foster home file and in Bridges.
Training for foster parents contracted as Individual Service Providers is maintained by the child-care
placing agency and is documented in the agencies annual report. The Foster Care Program Specialist
under the Bureau of Community and Family Support Services monitors these contracts.
Pre-service training
In 1999, the E & TP began delivering Foundations For Fostering to prospective foster parents statewide.
In 2004, Adoption Essentials was created and delivered to individuals wishing to adopt through DCYF.
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In response to changing practice, the E & TP worked with DCYF to merge both trainings into one.
Starting in 2005 and continuing into 2006, the E & TP staff along with a committee made up of DCYF
staff, instructors and foster/adoptive parents began working to blend the two curricula. The result, Foster
and Adoptive Care Essentials (FACES), is now available to individuals interested in providing
foster/adoptive care and consists of 21 hours of training that promotes a better understanding of working
with children, families and child-placing agencies connected with DCYF. This shift is consistent with the
shift of foster parents to resource families and goals for permanency for children.
The FACES training assists in preparing individuals to be skilled caregivers and professional team
members. Foster and adoptive parents who have been recruited and trained as instructors with Granite
State College primarily instruct courses. This series of seven 3-hour modules is delivered statewide and
fulfills NH state training licensing requirements. One hundred and eighty modules of training are
provided each year.
Developed in 2005 and piloted in 2006, Residential Counselor Core Training (RCCT) is offered to
residential care staff to support their work with children, youth in care and their families in any of New
Hampshire‘s residential facilities. A 30-hour competency-based training series, RCCT provides
generalized training that addresses the basic knowledge, skills and abilities essential to the position of
residential counselor, regardless of the facility in which they are employed. In SFY 2009, 15 modules of
training were provided statewide.
In-service training
Initiated in 1996, the Caregiver Ongoing Training (COT) is a program of over 60 competency-based
courses designed in collaboration with DCYF staff, foster parents and residential childcare staff. The
intent of the program is to provide the skills and mutual support necessary to address the daily issues
confronting caregivers and case managers. Foster parents are required to have 9 hours of ongoing
training per year. The COT program is the primary vehicle for foster parents to meet this requirement.
Classes are open to eligible caregivers, staff and providers, including relative caregivers, and are intended
to provide the skills and mutual support necessary to address daily issues and the challenges of working
with children in placement, and their families. Approximately 160 training courses are offered statewide
in local communities each year in content areas such as: Adolescence, Behavior Management, Child
Development, Communication, Education, Health, Neglect and Abuse, and Collaborating with Families
and Providers. The E & TP partners with CPE who provides funding for registration and child care
services to support foster parent attendance at training including the annual DCYF, NH FAPA, NH RAPP
and New England Foster and Adoptive Care Conferences.
In all E & TP programs, both formal and informal training needs assessment is performed on a regular
basis. Methods for assessing need include: surveys, focus group studies, participating at foster parent
support group meetings and the Foster and Adoptive Parent Association, attending monthly DCYF foster
care meetings and ongoing dialog with residential facilities and New Hampshire Partners in Service, a
coalition of New Hampshire residential care providers.
New non-credit and college credit courses are developed in response to identified needs in collaboration
with DCYF staff and stakeholders through a process that begins with: a rationale, guiding principles and
the identification of desired learning outcomes. Subject matter experts are guided through the
development and stakeholders review progress at regular intervals. Training design is grounded in adult
learning theory. Revisions occur on a regular basis to reflect DCYF practice changes.
Delivery methods and duration are assessed and determined by the Curriculum Development Specialist in
consultation with the Subject Matter Experts, stakeholders and the BOLQI. Handouts and/or manuals
used in each training session are also prepared by the E&TP.
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The E&TP provides publicity and registration for the training sessions. Publicity includes: brochures,
flyers, a catalog of courses, and web page updates that provide the registration function for all training
programs and include the ability for caregivers, providers and staff to register on-line. Materials are
distributed to approximately 900 licensed foster homes, 550 residential care workers, and 360 DCYF
staff, as well as to New Hampshire DHHS Division of Finance staff who distribute to identified relative
care providers.
Training is delivered in traditional classrooms, and community sites (approximately 40 local community
sites including GSC Centers, libraries, police/fire stations, hospitals, schools, community centers and
residential facilities). All facilities are assessed for safety and ADA accessibility. Distance learning is
also offered for specific courses and includes, workbooks, audio, and on-line modalities.
Instructors are community practitioners qualified to teach specific courses based on their resume, vitae, a
personal interview, academic credentials, expertise, years of experience in their field, and philosophical
compatibility with the DCYF. They are engaged in professional development through various venues
including a newsletter publication called Partnership Press.
The E&TP has designed a system that promotes continuous quality improvement. It includes the
quarterly analysis of significant quantitative and qualitative data elements, and class observation reports.
An annual report representing a compilation of the data is presented to stakeholders.
Beginning July 1, 2009, the E & TP also has a part-time staff member who provides support to the New
Hampshire Foster and Adoptive Parent Association by providing training and technical assistance to
complete its goal of self-sufficiency and sustainability. An important aspect of E & TP‘s support to
FAPA is collaboration with the FAPA Conference Committee to coordinate the annual NH Foster and
Adoptive Parent, statewide conference.
CFSR Round 1 Findings
During the 2003 CFSR, the training system was rated as an area of Strength. As in all training areas, the
agency has continued with consistent efforts to evolve the system in alignment with best practices. One
specific area of need related to training for foster and adoptive parents, relatives and residential care
providers mentioned by stakeholders in the last CFSR pertained to parenting behaviorally challenging
children. In relation to this, the E & TP has enhanced content in several courses to ensure practical
suggestions for ways to deal with difficult behaviors in youth and they have also developed two specific
courses in consultation with DCYF Severe Behaviors of Youth in Placement and Parenting Children who
Exhibit Sexualized Behavior.
Changes since Round 1
First, as discussed above, training curriculum for new foster and adoptive parents underwent significant
changes in 2006 and is now delivered via FACES curriculum. Additionally, the RCCT training for
residential providers was developed in 2005 and implemented in 2006. This curriculum is being further
updated as DCYF/DJJS in alignment with development of the Practice Model. Additionally, the ongoing
training courses offered for foster/adoptive parents and relative caregivers has expanded greatly both in
numbers, content, format and location. In regards to curriculum development, there has been a specific
focus on engaging births parents and relatives in permanency and partnering for healthy connections for
children and youth in care.
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July 2010
Item 34
Our contract partner, E & TP, has played a strategic role in supporting training for relatives of children in
care. First, all E & TP courses are open to relatives. As mentioned in Item 15, in the spring of 2009, a
survey of relatives and staff was conducted in an effort to learn more about training needs. This
information, as well as information from the Relative Care Committee focused on policy, practice and
training development has assisted in the development of a training plan focused on the needs of Relative
caregivers. This has included assisting with the design, implementation and funding of the NH RAPP
conference in the fall of 2009, as well as enhancing current course offerings.
Data Considerations
Each year the E & TP summarizes data regarding the delivery and quality of training for foster and
adoptive parents, relatives, and residential care providers and submits to the DCYF BOLQI an annual
report.
The number of FACES classes required to be offered by E & TP around the state each year is 180.
Classes are not run however, if registration is less than 15. Throughout the contract period, E & TP has
consistently offered and run the required number of courses to train and prepare new foster and adoptive
parents. In 2009, 665 prospective foster parents, 20 prospective adoptive parents, 25 relatives, 7 DCYF
staff and other providers attended FACES training.
FACES Training
# of Classes Run
# of
Registrations
Average Class
Size
SFY 2006
179
686
SFY 2007
180
708
SFY 2008
180
811
SFY 2009
170
717
15
16
17
16
SOURCE: E & TP Year in Review Report 2009
E & TP conducts course evaluations in all FACES modules. With a course evaluation satisfaction score
of 95%, training participants indicated that:
The course met their needs given their role/position,
The coverage of the subject was completed in the time allotted
The instructor was sufficiently prepared, knowledgeable, and encouraged students‘ questions
and opinions.
The facility was accessible and the room was conducive to learning.
When the last CFSR occurred in 2003, 55 COT courses were offered foster and adoptive parents, relatives
and residential care providers. In 2009, 170 courses were offered while an outstanding satisfaction rate
was maintained. In 2009, the satisfaction rate of attendees at FACES modules was 97%.
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New Hampshire CFSR Statewide Assessment
July 2010
Item 34
Caregiver Ongoing Training
# of Classes Run
# of Registrations
# of foster parents
# of adoptive parents
# of relatives
# of residential care staff
Average Class Size
SFY 2006
112
634
326
52
1
200
9.5
SOURCE: E & TP Year in Review Report 2009
SFY 2007
116
783
325
66
6
326
10.4
SFY 2008
112
764
350
75
5
274
11.3
SFY 2009
112
816
415
119
2
221
11.3
The table above shows that the number of foster and adoptive parents attending caregiver ongoing
training has increased. A primary reason for this has been the expansion of COT on-line courses. In
2006, Distance Learning made up approximately 12% of all COT classes and in SFY 2009, more than
30% of all COT courses were Distance Learning. This is particularly significant for foster and adoptive
parents in rural areas where distance to training can be a challenge.
One of the COT courses that has had a highly positive impact on the ability of foster, adoptive parents and
staff to interact effectively with youth has been the Guiding New Hampshire Teens through New
Hampshire TRAILS. This course focuses on building independent living knowledge, skills, and abilities
in youth through a structured and interactive curriculum. After taking this course, one participant‘s
feedback to their instructor was:
“I recently took the NH TRAILS course through Granite State College, E
& TP, and I worked with one of our girls here at the shelter and wanted
to report that she is doing FANTASTIC! After she left us and moved into
her foster home she enrolled into the Manchester School of Technology
in the Graphic Design Program. This is the program we had worked on
together helping her find what she wanted to do with her future, located
a school, received enrollment information, and contacted her JPPO to
help her get started. She started the program several months ago and
just contacted me that her recent report card was straight B’s. Thought I
would share with you how we were able to help this one girl work
towards her goals and a positive future. Thanks for all your guidance.”
In 2006, the E & TP was contracted to provide six series of RCCT across the state to support the needs of
residential care providers. With the emphasis on permanent family connections and least restrictive
environment, the number of children in residential care and the number of residential care providers
across the state has decreased. As a result, the number of annual offerings of RCCT by E & TP has been
reduced to three. As the data shows below, the average class size has remained conducive to the learning
environment while this shift has occurred.
RCCT Training
# of Classes Run
# of Registrations
Average Class Size
SFY 2006 SFY 2007 SFY 2008 SFY 2009
28
30
25
16
145
77
86
57
14.1
9.0
9.7
13.1
SOURCE: E & TP Year in Review Report 2009
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New Hampshire CFSR Statewide Assessment
July 2010
Item 34
An important part of training for foster and adoptive parents, relatives, residential care and DCYF staff is
the annual NH FAPA conference. This one-day event is held on a Saturday and typically offers eight
dynamic workshops, a keynote and an opportunity for networking, support to caregivers and resource and
referral information. The table below shows data related to the conference attendance and satisfaction of
participants.
NH FAPA Conference
Conference Theme:
Total Workshops
Total Conference Registrants
Foster Parents
Adoptive Parents
Foster & Adoptive Parents
DCYF Staff
Community Providers
Others
Satisfaction rate
SFY 2008
―Adv
ocacy: Making
Connections, Finding
Answers‖
8
92
Unavailable
Unavailable
71
8
6
7
90%
SFY 2009
―Chal
lenges Today,
Opportunities Tomorrow‖
8
134
51
11
44
9
3
16
88%
SOURCE: E & TP Year in Review Report 2009
In 2008, a facilitated panel of adults who grew up in foster or adoptive care provided the keynote
presentation. The panel members shared their experiences and the impact foster care and adoption made
in their lives. A quote from one conference participant sums up the value of the panel presentation:
“The panel discussion was really and truly eye-opening. Now I
will try to establish a relationship with my son’s bio family so that
he will never wonder about his connections”
E & TP Total Individuals Served Across All Programs
Type
SFY 2004
SFY 2005
SFY 2006
SFY 2007
All
3640
4347
5193
6098
Caregivers
Foster
2749
3174
3700
4326
Parents
Residential
644
787
987
1181
Care Staff
Adoptive
85
185
277
301
Parents
DCYF
103
138
162
179
Staff
Non0
0
1
19
Licensed
Relatives
SFY 2008
6987
SFY 2009
7755
4928
5488
1344
1463
335
357
209
225
71
94
SOURCE: E & TP Year in Review Report 2009
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New Hampshire CFSR Statewide Assessment
July 2010
Item 34
As mentioned in Item 33, within the CPR process a set of pilot questions are being used to assess the
effectiveness of training in meeting the needs of foster and adoptive parents, relatives and residential care
providers. This includes questions to Providers & Stakeholders such as:
Have you received training from the DCYF/DJJS System? Briefly describe
When and where did you receive this training?
How has training supported you in your role with this child(ren) and family in this case?
Are there other training needs you have as it relates to your work with this particular case/ or
similar case?
Do you have any training recommendations as it relates to this case?
Feedback from these questions has been informative; all CPSW/JPPO and providers reported having
received training and all felt the training was helpful in their casework and efforts to support children and
families. Questions related to training needs or recommendations relative to the specific cases under
review yielded a diverse range of needs, including how to empower women, navigating the adult system
for transition to developmental disabilities services, and treatments for those addicted to substances,
specifically heroin.
When a foster parent chooses not to renew their license an exit survey is sent to them from State Office.
Data collected from 2003 through 2009 shows that most people stop fostering due to changes in their own
family. Trainings provided are typically mentioned in a positive light.
In March 2010, a series of regional focus groups were held around the state facilitated by the Foster Care
Program Manager, Administrator for the Bureau of Community and Family Support Services, and the
Child Protection Administrator in which foster/adoptive parents and relatives were asked four key
questions regarding training accessibility, availability and quality. They included:
1.
2.
3.
4.
How well did training prepare you for being a foster parent?
Have you taken any ongoing training?
Has ongoing training supported your needs as a foster or adoptive parent?
Have the types of training you need been available and accessible?
Results from the focus groups indicated that 87% of the foster/adoptive parents felt that initial training
prepared them ―W
ell‖, ―Good‖, or ―Gre
at‖ for their role as foster parents.
Relatives have different training needs and as such, some current training offerings for foster/adoptive
parents are not helpful. Eighty-seven percent of the parents had taken ongoing training, two foster parents
were new and had not yet taken ongoing training and one was a relative who hadn‘t received notice of
trainings available. For those who had taken ongoing training, when asked about how training supported
their needs, feedback included:
“Excellent curriculum, which met my needs”
“Wonderful training available”
“Met my needs most of the time”
Finally, in response to the question regarding whether training has been available and accessible, 70% felt
the types of trainings they needed were available and delivered in accessible formats. Some suggestions
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New Hampshire CFSR Statewide Assessment
July 2010
Item 34
for improvement included delivering more localized trainings, providing more training for relatives, and
for long-term foster parents, have more varied topics.
Strengths
A primary strength of the training system for foster and adoptive parents, relatives and residential care
providers is the longevity and quality of the partnership with Granite State College and the E & TP
program. The E & TP curriculum is competency- and learning outcome-based for prospective and current
foster and adoptive parents and offered to child-placing agency staff. This supports the provision of
consistency across the state in foster parent training – both private and state agency licensed foster
parents.
The E & TP has received numerous awards including:
E&TP 2003 American Pubic Human Services Associate Award (National)
E&TP 2004 New Hampshire Partners in Service, Provider Partnership Award
DCYF with GSC 2005 Campus Compact for New Hampshire, President‘s Community Partner
Award
E&TP 2007 Campus Compact for New Hampshire, President‘s Community Partner Award
Over the last several years, the E & TP has greatly expanded access to training for foster parents via
geographically spreading their training delivery and offering more courses on-line. Now more than thirty
percent of training is delivered through distance learning modalities, promoting accessibility.
All training opportunities through the E & TP are available to relative caregivers across the state.
There is development and ongoing delivery of training courses specifically designed to meet the unique
needs of families who have adopted. These trainings are delivered regionally, with local supportive
resources available to address their identified need for services.
The E & TP provides training opportunities to residential staff to join with foster and adoptive parents in
60 training courses related to the care and well-being of children in placement due to abuse and neglect.
Residential facilities determine their own training needs and training is delivered responsively, often at
the facility, to meet those needs. Curriculum in the administration of medications was designed in 2006
specifically to address New Hampshire‘s residential caregivers' required competencies and is delivered
regularly and rotated through out the state. A 30-hour training curriculum, Residential Counselor Core
Training (RCCT), was collaboratively designed by DCYF staff, Residential providers and E&TP staff to
enhance training that is provided by individual facilities and delivered as a series three times/and rotated
regionally.
Opportunities for Improvement
The five year plan regarding training for foster, adoptive parents, relatives and residential care providers
emphasizes the continued expansion of accessibility, local design and delivery, ensuring training is needs
based and focused on the outcomes of safety permanency and well-being. With these in mind, there is an
intention to move towards a proactive assessment of foster parent training needs prior to renewal of the
foster care license. The system currently reviews the past two years of training taken but does not address
future trainings needed. A standardized template for writing foster parent re-licensing updates needs to be
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New Hampshire CFSR Statewide Assessment
July 2010
Item 34
developed and be enhanced to include suggested areas of training related to foster parents' needs and the
specific needs of the children they serve.
Additionally, E & TP, along with DCYF staff focused in the areas of foster care, adoption, relative and
residential care, are all members of the statewide DCYF/DJJS Learning Advisory Council. As mentioned
previously, the primary goal of the Council is the integration of training resources, planning and processes
statewide to ensure alignment with the agencies‘ evolving Practice Model and best practices in the fields
of child welfare and juvenile justice. The five areas currently being focused on within the Learning
Advisory Council include: Needs Assessment, Recruiting and Retaining Quality Trainers, Curriculum
Development, Technology and Evaluation.
E & TP has had in place throughout its contract a continuous quality improvement process, which ensures
quality delivery of each E & TP course. An opportunity for improvement is to expand evaluative
techniques to further link foster, adoptive, relative and residential care provider training with the
outcomes of children and families.
248
E. Service Array and Resource Development
New Hampshire CFSR Statewide Assessment
July 2010
Item 35
Item 35: Array of Services. Does the State have in place an array of services that
assess the strengths and needs of children and families, that determine other service
needs, that address the needs of families in addition to individual children to create a
safe home environment, that enable children to remain safely with their parents when
reasonable, and that help children in foster and adoptive placements achieve
permanency?
In Round 1 of the CFSR, New Hampshire was Not In Substantial Conformity with the systemic
factor of Service Array and Resource Development.
Policy Considerations
Administrative Rule He-C 6339 ―Ce
rtification for Payment Standards for Community-Based InHome Service Providers, Child Health Support, Home-Based Therapeutic, Therapeutic Day
Treatment, Adolescent Community Therapeutic Services and Individual Service Options – InHome‖ apply to all services described in Item 35.
As indicated in the Rule, the goals of these in-home community-based services are to:
Ensure the safety of children, families and communities;
Improve interpersonal relationships and communication within the family;
Prevent the placement of a child in out-of-home care;
Reduce the recurrence of juvenile delinquent or status offenses;
Improve each child‘s well-being in the home and community;
Stabilize the child and family by providing therapeutic support prior to a court-ordered
or voluntary placement; and
Assist in preparing the family and child for reunification if the child is in out-of-home
placement by:
Supporting the permanency plan of the youth; and
Supporting and enhancing the youth‘s positive community connections.
Each service is designed to meet both DCYF‘s and DJJS‘s children, youth and families needs as
they entered the systems. Each community-based service was designed to address needs around
home stability and risk management and placement avoidance, reunification of children and
youth with their families, placement stability and preservation as well as permanency
preparedness.
All services can be uniquely designed to meet the child or families needs through the assessment
and treatment planning process that is mandated of all service providers. An assessment is done
within the first thirty days of service that serves as the tool to identify child and family needs.
DCYF is currently working with our providers and CPSWs on ensuring that assessments and
treatment plans from our home-based service providers are being routinely shared and distributed
to all treatment team members as appropriate. The treatment planning process uses the results of
the assessment to present details regarding the direct and indirect service being provided by the
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New Hampshire CFSR Statewide Assessment
July 2010
Item 35
agency. The treatment plans are then signed by youth who are old enough to participate, parents
and CPSW and JPPOs, all as members of the treatment team.
Policy and rule considerations since the last CFSR include: DCYF adding transportation and onsite diagnostic evaluation requirements to shelter care contracts, adjusting the child health support
services rate to include more transportation provided by the vendor, re-writing our behavioral
health rule to address and improve efficiency in certifying our local mental health centers and
implementation of a certification rule based on local need.
CFSR Round 1 Finding
During the 2003 CFSR, this item was rated as an Area Needing Improvement. Reviewers found
that available services were not adequate in keeping children with their families and facilitating
permanency for children in out-of-home care. The most notable service gaps identified pertained
to substance abuse treatment, mental health services and transportation in order to access
services.
Stakeholders commenting on the topic of service array generally expressed the opinion that the
range of available services is not sufficient enough to enable children to remain safely with their
parents, or to help children in foster and adoptive placements achieve permanency. The most
frequently cited service gaps pertained to substance abuse treatment (for both adolescents and
women with children), mental health services (families can wait four to six months for a mental
health evaluation), and transportation to access services. In addition, several stakeholders
commented on the lack of coordination among agencies in providing services.
Changes since Round 1
Since Round 1 of the CFSR, DCYF has made numerous efforts to address the areas of concern
noted above. The updated ISO rule has identified coordination of community services as a core
component of service. This is aimed at addressing the concern from Round 1 on the lack of
coordination among agencies in providing services. A systemic improvement is the transition of
the fiscal agent of flexible spending funds (flex funds) transition from being county-based to the
management by the New Hampshire Children‘s Trust Fund (NHCTF), our CBCAP designated
agency. This has markedly improved DCYF‘s ease of access to these funds, which better enables
DCYF to meet the varying needs of our children and families in a more timely and broader
fashion. Examples of how we are able to utilize our flex funds include: providing families with
gas cards to help with transportion to appointments, grocery gift cards, and bus passes for
families in urban areas. Flex funds have also been utilized to provide families with monetary
assistance toward car repairs so they can maintain reliable transportation after DCYF
involvement.
To date, DCYF has out-sourced transportation services to independent agencies throughout the
State. Accompanied transportation, which is transportation services used primarily for activities
and services, is one of DCYF‘s largest expenses. Continuous efforts have been made to reduce
these expenditures, including accommodating parents‘ schedules to meet outside of business
hours, scheduling meetings in parents‘ homes or locations convenient to them, however, aligning
improvements in combining cost efficiency with access to service to promote time-limited
reunification and permanency remainsa challenge.
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New Hampshire CFSR Statewide Assessment
July 2010
Item 35
In December of 2008, DCYF launched a pilot transportation program in the Manchester district
office. This pilot explored hiring independent transportation providers to be located in the district
office and work in coordination with DCYF staff in scheduling and providing transportation for
children and families served by the Manchester office through an open placement case. This pilot
is geared at not only testing the efficiency of this concept, but to test the feasibility of spreading
the initiative statewide.
Community-Based In-Home Services
The array of Community Based In-Home Services includes:
Child Health Support Services (CHSS) – In-home support services for children and
families through the provision of supportive counseling, health assessment, health
education, behavioral health management, referral.
Home-Based Therapeutic Services (HBTS) – Intensive, short-term, therapeutic
interventions in the home setting in order to strengthen the family and prevent
placement of the child.
Adolescent Community Therapeutic Services (ACTS) – Implementation, coordination,
and maintenance of cases involving children in need of services and delinquents, which
include intensive monitoring, counseling and supervision of juveniles.
Individual Service Options (ISO) In-Home – Variety of intensive therapeutic, social,
and community-based services provided or coordinates to meet the individual needs of
a child and his or her family in their residence to prevent placement or to provide postplacement family support, or in a DCYF general foster care setting.
The chart below illustrates how many DCYF and DJJS clients have been served by various
community-based in-home services for each SFY between 2004 and 2008:
SERVICE PROVIDED BY:
DCYF
Child Health Support
Home Based Therapy Services
ISO - In Home
ISO Daily Rate (Foster Care)
FY04
FY05
FY06
FY07
FY08
CLIENT # CLIENT # CLIENT # CLIENT # CLIENT #
526
367
6
68
FY04
DJJS – CHINS
FY05
ISO - In Home
ISO Daily Rate (Foster Care)
FY08
14
10
7
10
169
194
202
193
7
3
11
18
40
11
9
14
14
16
FY04
Home Based Therapy Services
FY07
465
348
127
249
17
ISO Daily Rate (Foster Care)
Child Health Support
FY06
413
281
70
249
188
ISO - In Home
DJJS - DELINQUENCY
436
295
53
203
CLIENT # CLIENT # CLIENT # CLIENT # CLIENT #
Child Health Support
Home Based Therapy Services
499
320
21
138
FY05
FY06
FY07
FY08
CLIENT # CLIENT # CLIENT # CLIENT # CLIENT #
41
35
29
25
33
448
385
341
333
299
9
15
31
77
104
11
16
25
38
47
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New Hampshire CFSR Statewide Assessment
July 2010
Item 35
As shown in the chart, CHSS and HBTS have been used consistently since 2004. However, there
has been a drastic increase statewide in the utilization of ISO In-Home and ISO Foster Care
services.
In 2007, DCYF and DJJS redesigned their Individualized Service Options (ISO) Program to meet
a child and families unique and individual needs. This program was expanded from three
provider agencies to currently twelve agencies that are certified to provide this unique and
individualized service. Two of these ISO agencies serve unique populations of children with
behavioral health issues and multiply handicapped children. Two other agencies are also certified
to provide ISO services to the adult developmental population and can serve older youth who will
be transitioning from the DCYF and DJJS system to Adult Developmental Services without
having to change agencies and sometimes foster homes. With the significant increase in ISO
agencies, services were spread more substantially throughout New Hampshire. The increase in
agencies coupled with DCYF‘s shifts in permanency away from residential care have greatly
attributed to the elevated number of children and families being served by ISO agencies. ISO is
discussed further in Item 37.
In recognizing the shortcomings of accessible substance abuse services throughout the State,
DCYF has expanded our Licensed Alcohol and Drug Counselor (LADC) program to the northern
part of our State (Berlin District Office) in order to increase access and better meet the substance
abuse needs of our consumers. The LADC‘s assist with substance abuse evaluations and serve as
counselors for families until appropriate community-based substance abuse treatment is arranged.
Although only 3 DCYF district offices have an on-site LADC (Manchester, Nashua and Berlin),
they are available for consultation to the other offices across the state.
To better meet the needs of children as they enter care, DCYF has implemented a comprehensive
mental health assessment for children coming into placement for the first time. DCYF has also
purchased consulting time from each of our local mental health centers. This allows for a mental
health provider to consult and correspond with our staff on mental health needs for any of the
children and families we serve.
Since 2003, there has been a drastic increase in the number of dental providers who accept
Medicaid, which allows better access and facilitation of dental services for children in care.
DCYF also ensures that children entering care receive physical health screenings within thirty
days of placement. This information is monitored through monthly reports completed by the
Bureau of Well-Being.
The Accelerated Reunification Model (ARM) has been utilized by DCYF since October 2008.
ARM was piloted in two district offices, Concord and Laconia. ARM has since expanded to the
Manchester and Nashua District Offices. Casey Family Services and Lifeshare Inc. are the two
partners providing these voluntary services through our Child Health Support Services (CHSS)
array. This initiative has proven to be very successful as it is focused on facilitating reunification
and engaging with families as soon as possible after removal of a child. It is a ―f
ront door‖
focused, comprehensive service that is geared towards identifying critical safety factors and
utilizing evidence-based therapeutic interventions to mitigate safety concerns and utilize family
supports so that reunification can occur quickly and safely.
According to Casey Family Services, statistics have supported the promise of this Model. As of
March 17, 2010, there have been 28 placement cases referred to ARM. Of those cases, 16 have
achieved reunification with ARM service, 7 did not achieve reunification and 5 cases still have
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New Hampshire CFSR Statewide Assessment
July 2010
Item 35
ARM services involved. Of the 16 cases where reunification occurred, the average length of time
until reunification occurred was 48 days. In those cases, ARM was involved for an average of 59
days post-reunification for continued support.
Another initiative implemented since the 2003 CFSR is the Watch Me Grow Pilot (WMG).
WMG is a system developed to ensure that families with children birth to six years in New
Hampshire are consistently able to access developmental information, support, health and
developmental screenings.
The purpose of the pilot is to identify the processes and procedures necessary to administer a
statewide screening system in all regions/districts/communities of the state and to collect data and
information necessary to inform statewide model development and replication.
WMG Program Goals
To provide all families with young children, aged birth to six years, with access to
information about their child‘s health and development.
To help families enhance their children‘s development.
To support families in their home communities by providing information about
appropriate community-based resources, supports and services for their child and
family.
To improve the process in New Hampshire for keeping all potential referral sources
and screeners knowledgeable about comprehensive screening systems, their standards
and protocols, and available community resources
To establish a program model for statewide implementation of a standardized
comprehensive screening system
Guidelines
Services (screenings) are voluntary (Families are not obligated to participate)
Services are provided with the recognition that the parent knows the child best
Services are provided without cost to the family
Referrals are provided in the areas including but not limited to oral health, physical
health, vision, hearing, social emotional (trauma treatment), communication, gross and
fine motor, cognition, self-help, nutrition, comprehensive health, sensory integration
In collaboration with DCYF, the New Hampshire Association for Infant Mental Health
(NHAIMH) produced the first-ever report on the state of mental health concerns among very
young children, and the availability, accessibility and equality of services to address them. The
report, entitled, ―Fr
om Peek-a-boo to Parenthood: A Look at Early Childhood Mental Health in
New Hampshire,‖ inventoried early childhood mental health supports and services for New
Hampshire‘s youngest children (ages birth to six years) and their families.
Family Resource Centers in New Hampshire are also an important component of communitybased support. Family Resource Centers are non-profit, community-based programs available
and accessible to all families in a particular community. Family Resource Centers serve
individuals, families and children through a wide range of programs that promote family health
and well-being. Services offered by Family Resource Centers are ongoing, evidence and
outcome-based, effective, and measurable through participants‘ voluntary engagement in program
evaluation.
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New Hampshire CFSR Statewide Assessment
July 2010
Item 35
An innovative approach for increasing successful permanent placement opportunities for children
in care has been designed by St. Charles Children‘s Home, a licensed residential provider with
DCYF. The St. Charles program is open to families of pre and post-adopted children through
DCYF. Families have the opportunity to stay at St. Charles Children‘s Home for an intensive 2½ day overnight on weekends with staff assistance to learn to help their children set behavioral
goals, explore other methods of parenting and receive support through difficult behavioral issues.
DCYF has obtained a software license for a variety of geomapping techniques. The Agency‘s
quality improvement data analyst has the ability to use this technology to assess statewide trends
on various issues including but not limited to, removal rates of children across the state and the
number of foster homes in each city and town. This tool can also be used for determining service
array throughout the State and become a useful asset in determining how DCYF develops and
implements services.
Data Considerations
DCYF has intertwined the use of several data and evaluative measures in order to determine the
effectiveness of services provided. A comprehensive service utilization matrix completed by our
Well-Being Bureau Administrator articulates the parameters for each service we provide and how
to use each service to meet the needs of our families. The matrix provides all of the information a
CPSW would need to choose the most appropriate service including: the funding source, service
description, case management provisions, frequency of contact or services, population served,
availability of agency staff, service length, administrative approval process, certified providers
and staff descriptions and qualifications.
DCYF has become more involved with residential providers in communicating the changing
needs of our agency and our families. Since 2003, many residential providers across the state
have become certified for more home-based services and have addressed their overall service
delivery mechanisms to be more community-based.
In June 2008, residential providers were invited to join DCYF/DJJS in an initiative aimed at
developing and implementing a collaborative system for delivery of services in residential
treatment that focused on shorter lengths of stay and achieving permanency for the youth who
were placed in their programs. Since June 2008, a core work group of DCYF/DJJS staff and
residential providers have been meeting regularly to create a New Hampshire framework to
achieve improved permanency outcomes for children and youth placed in residential programs.
This initiative is discussed in more detail in Item 38.
DCYF also engages with its community partners through the use of focus groups during our Case
Practice Reviews to address service needs. As Case Practice Reviews are held in all areas of the
state, this forum provides an excellent opportunity to gather feedback from the community on
statewide and regional service needs. Additionally, the Case Practice Review itself is composed
of DCYF staff and community partners. The review has proved to be a very beneficial tool used
in evaluating practice and systemic needs in the particular region being reviewed.
The Case Practice Review focus groups have confirmed much of the information as to DCYF‘s
strengths and areas needing improvement regarding service array. Two significant themes have
been lack of availability of services in certain areas of the State and also inconsistency among
CPSW‘s, JPPOs and providers as to their understanding of the services available.
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New Hampshire CFSR Statewide Assessment
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Item 35
Other evaluative techniques DCYF utilizes are the certification process of our providers, on-site
review of the services each provider has in their array, fiscal reports developed by DCYF which
indicate trends and usage of each service, outcome measures applied to community-based
services and service utilization discussions with staff. The on-site review process occurs at the
provider‘s central office and consists of a random sample of cases reviewed by DCYF State
Office staff. The review also provides the opportunity for the staff and management team of the
provider agency to share feedback with DCYF staff regarding strengths and barriers in working
with the Division and the effectiveness of the services provided.
Strengths
DCYF‘s service array is uniquely tailored to meet the changing safety, permanency and wellbeing needs of the children and families we serve. More children are being served in the
community and with their families than before. In order to meet their needs in the community,
DCYF‘s service array must include community-focused solutions aimed at building a network of
support around the family and be available to the family before, during and after DCYF
involvement.
DCYF has recognized and embraced the importance of using comprehensive data and evaluative
measures in assessing the effectiveness and outcomes of the services delivered to our consumers.
Noted throughout this item are areas we believe DCYF has improved upon in its ability to
provide quality, evidence-based community services.
Opportunities for Improvement
Like other states, New Hampshire has felt the tremendous impact of the recent economic
downturn. The challenge faced by DCYF is to provide an improved array of services to an
increasing amount of consumers with fewer resources.
An ongoing need for our consumers has been consistent and timely access to local community
mental health services. While waiting lists vary across the state, it is still a statewide issue.
While this issue can be attributed to several long standing causes, such as staff turnover,
fluctuations in economy, etc., one cause could also be more children are being served in the
community than ever before.
Housing, employment, childcare availability and transportation still remain areas of need in New
Hampshire. As mentioned above, DCYF has made significant strides in addressing our statewide
transportation needs. However, much of the State is rural, and access to natural, community
sources of transportation is extremely limited. Sustained attention on transportation challenges is
needed in order to continue to alleviate this on-going issue.
New Hampshire is a mostly rural state. Aside from the southeastern quadrant of the state, which
contains 6 of our 12 district offices, the rest of New Hampshire is very rural. Not only is the rural
nature of the northern and western parts of the state an impact on service array, but also the
current economic downturn has further exacerbated this problem. Jobs have become increasingly
scarce in the north, which limits the abilities of existing businesses, including our service
providers. By having fewer service providers, there are fewer identified specialists who can meet
the unique needs of children in care. In addressing this, DCYF has taken steps during
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certification to better identify what specialties each provider possesses so that we can make more
efficient and effective referrals for services.
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Item 36: Service Accessibility. Are the services in item 35 accessible to families and
children in all political jurisdictions covered in the State‘s CFSP?
Policy Considerations
In DCYF, all services, within our service array outlined in Item 35, must be accessible statewide
in order to ensure the safety, permanency and well being of the children we serve.
Administrative Rule He-C 6339 ―Ce
rtification for Payment Standards for Community-Based InHome Service Providers, Child Health Support, Home-Based Therapeutic, Therapeutic Day
Treatment, Adolescent Community Therapeutic Services and Individual Service Options – InHome‖ applies to Item 36.
CFSR Round 1 Finding
During the 2003 CFSR, this item was rated as an Area Needing Improvement due to services not
consistently being available throughout the State and ―t
ransportation challenges relative to the
location of services impedes access‖.
Stakeholders commenting on this issue were in agreement that the service array varies across the
State and that there are areas of the State that are without reasonable access to services. A key
problem is the lack of transportation and the need in many communities to travel long distances to
access basic services. Keene has achieved some success improving access to services through
community collaboratives, such as arranging for dental care for foster children with two local
dentists.
Changes since Round 1
Historically, families have had to drive to different agencies in the community in order to access
any number of therapeutic, emergency or supportive services. A crucial component of the ISO
program model is that all services are provided in-home. This completely removes transportation
as an access barrier for families. Part of the discharge planning is to work with the family on how
to continue to meet their ongoing needs in the community after ISO involvement. This proactive
planning often assists families with removing potential barriers that may impede their ability to
access services in the future. Additionally, many of the in-home services have 24/7 on-call
emergency supports for families to help alleviate after hours crises.
Home-based services have become increasingly accessible in practically all areas of New
Hampshire. As the demand has increased, the number of agencies getting certified to provide
ISO services has increased. While an increase has been noted in providers located all over the
State, there are still fewer agencies in the northern and western parts of New Hampshire.
Community-Based Comprehensive Family Support Services
In 2005, contracts were awarded for statewide comprehensive family support programs covering
all twelve-district office catchment areas. Through the Comprehensive Family Support Program,
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community-based agencies provide support services to approximately 500 families annually. The
programs assist families and children by promoting family wellness, decreasing family stress, and
preventing abuse and neglect. Agency staff identifies and assist families with multiple stressors
by providing multivariate services, which encourage and promote the development of healthy
families. The program seeks to intervene before the occurrence of abuse or neglect on behalf of
all families and also serves families in the process of reunification.
Services offered by the contract agencies include:
Home Visiting
Short-term Child Placement
Child Development Education
Parent Education and Support
Quality Early Care and Learning
Health Education
Adult Literacy and Higher Education
Life Skills Training
Child Care Resource and Referral
Family Empowerment
Information and Referrals to other community based agencies
A unique facet of the family support programs is the ability to evaluate outcomes. This was made
possible through the utilization of Title IV-B, subpart 1 funds, provided to the New Hampshire
Children‘s Trust Fund to conduct an in-depth analysis of the needs of families participating in
family support programs across New Hampshire and of the impact of the programs serving them.
The Family Support Outcomes Evaluation measures the impact of strengthening protective
factors in all counties in the state. These data, from 455 parents in 2005, 1,200 in 2006, 918 in
2007, and 532 in 2008 provide demographic information as well as reliable information about the
impact of family support programs.
Transportation Pilot Program
In December of 2008, DCYF launched a pilot transportation program in the Manchester district
office. This pilot enabled the hiring of independent transportation providers to be located in the
district office and work in coordination with DCYF staff in scheduling and providing
transportation for children and families served by that office with an open placement case.
As of April 2009, over 27 children and parents were assisted with their transportation needs.
Over 225 individual trips were made; these trips included parental visitation, medical
appointments, various therapy visits, and general transport needs.
The pilot enabled a more uniform system of transport with consistency provided to children by
having the same driver provide their transport needs. This built a level of comfort and familiarity
for the children that they might not have had by using a contracted transporting company. By
utilizing a driver who was stationed out of the district office and coordinated by a district office
staff member, it enabled more flexibility for changes to be made should the need arise. In
addition to these qualitative outcomes, preliminary results of cost analysis indicate that, for short
frequent trips, the transportation pilot is more cost effective than using outside transportation
providers.
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This pilot is still in progress. The goals are to test the effectiveness of the pilot while testing the
feasibility of implementing this pilot on a statewide level.
In recognizing the shortcomings of accessible substance abuse services throughout the State,
DCYF has expanded our Licensed Alcohol and Drug Counselor (LADC) program to the northern
part of our State in order to increase access and better meet the substance abuse needs of our
consumers. The LADC‘s assist with substance abuse evaluations and serve as counselors for
families until appropriate community-based substance abuse treatment is located. Although only
three DCYF district offices have an on-site LADC (Manchester, Nashua and Berlin), they are
available for consultation to the other offices across the State.
Data Considerations
As part of the statewide on-site compliance reviews outlined in Item 35, DCYF gathers feedback
and compliance percentages, based on administrative rule, to determine not only the effectiveness
of the service but also service usage. This information is considered when developing new pilot
initiatives, regional access to services, and service quality to families. The information also is
valuable in the continual evaluation of the administrative rule and policies governing the services
offered by our providers.
DCYF strives to include community partners in the ongoing evaluation of service accessibility.
Avenues for this information includes participation in case practice reviews, focus groups,
monthly advisory committees and panels where key decisions are made regarding the
accessibility of DCYF‘s services to families. Input is shared between the community partners
and DCYF through a DCYF staff liaison that represents DCYF on each oversight panel and
brings information back to the DCYF Leadership Team. Additionally, annual reports are created
by the advisory committees and shared with DCYF Leadership.
Stakeholder feedback on the Divisions‘ service accessibility has provided valuable input and
noticeable trends. As part of the Statewide Assessment process, DCYF asked stakeholders to
provide feedback on service array and accessibility. Stakeholders have expressed that service
accessibility is not equal across New Hampshire; there is notably fewer resources and services
available in the North Country and Southwestern part of the state. Stakeholders also commented
on statewide budget restraints as a cause of perceived reduction in overall service accessibility.
Additional stakeholder feedback indicated that services are more accessible to children and
families with highly dedicated team members who are strong advocates for them and understand
what services are at their disposal.
Strengths
DCYF has been developing of a system of community-based services accessible to families that
are evidence and outcome-based, provide a range of support services that promote family health,
well-being and education and use families in evaluating the service throughout the State.
DCYF has forged critical partnerships with Dartmouth and the Anna Philbrook Center (APC),
New Hampshire‘s inpatient child psychiatric unit to fill the gap in readily accessible statewide
child psychiatric services.
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Another strength for DCYF is utilizing improved technology along with the skills of our data
analysts to map the service accessibility gaps and to assess changes and needs as they relate to a
particular region of the State.
Opportunities for Improvement
An important area of improvement remains addressing the statewide accessibility to community
mental health services, as it is inconsistent across the State. Wait lists continue to present
problems for families trying to access timely mental health services. This problem has been
compounded by the budget restraints and high staff turnover in the local mental health agencies,
which impacts the community mental health centers on a statewide level.
Despite advanced trainings of mental health counselors and spreading our LADC services,
stakeholders often report that services are not equally accessible across the State. The rural
Northern and Southwestern parts of the State often cite not having the amount of services
available to serve their families that the more populated areas of our State possess. All areas do
have mental health centers, however, the amount of specialized psychiatric and substance abuse
care is limited, especially in these rural parts of the State. As mentioned above, DCYF does have
solid relationships with Dartmouth and the Anna Philbrook Center in Concord. With that said,
those psychiatric facilities are in the Southern part of New Hampshire. If a child needs to be
admitted for inpatient psychiatric care in the North Country, there is a significant distance to
travel to access care.
Standardization of practice and the services we deliver to our consumers is a significant factor in
DCYF‘s development of a statewide practice model to ensure consistency of practice across the
State. Stakeholders have often reported that, while many services are accessible to families,
knowledge of the services available varies greatly from CPSW to CPSW. DCYF‘s goal is to
alleviate this discrepancy in knowledge and understanding of service availability through training
and standardization of case practice expectations across the State.
The issue of service accessibility will continue to be a focus of DCYF/DJJS strategic planning.
While specific issues related to certification have been addressed, DCYF will continue to assess
community needs and service availability at the local and state level. DCYF is involved in a
regional analysis of state-sponsored service delivery driven by the DHHS Commissioner and will
utilize this information to make improvements as it becomes available.
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Item 37
Item 37: Individualizing Services. Can the services in Item 35 be individualized to
meet the unique needs of children and families served by the agency?
Policy Considerations
The in-home community-based service array was designed to meet children, youth and families
needs as they enter the system. Each community-based service was designed to address needs
around home stability, risk management and placement avoidance, reunification of children and
youth with their families, placement stability and preservation as well as permanency
preparedness.
All services can be uniquely designed to meet the child or families needs through the assessment
and treatment planning process that is mandated of all service providers. The assessment that is
done with in the first 30 days of service serves as the tool to identify child and family needs. The
treatment planning process uses the results of the assessment to provide details regarding the
direct and indirect service being provided by the agency. The treatment plans are then signed by
youth who are old enough to participate, parents and CPSW and JPPOs, all as members of the
treatment team.
CFSR Round 1 Finding
During the 2003 CFSR, this item was rated as Strength, because services are regularly selected
and tailored to meet the individual needs of children and families.
Stakeholders commenting on this topic generally expressed the opinion that DCYF makes
concerted efforts to tailor services to the needs of children and families. There are wraparound
services available in many communities, and efforts to respond to the cultural needs of changing
communities. In addition, there are specialized programs that focus on meeting the unique needs
of children and families, such as the Permanency Plus program, the Family Strengths program,
and the CARE-New Hampshire program. A few stakeholders suggested that there is a need for
greater individualization of IL services. Stakeholders in Portsmouth indicated that flexible funds
are available at county administrator discretion to provide some services not available through
existing providers.
Changes since Round 1
The CARE NH Program as well as the Permanency Plus program is no longer operating as they
were back in 2003, as funding for both programs became an issue. However, the local wrap
around teams are still in operation and available to families. The local wrap around teams are
available for all families in the community that may have multi-systemic issues that one agency
cannot address alone, and not just for families involved with either DCYF or DJJS. Some
components of the Permanency Plus Program have been integrated into practice through the
development of the Permanency workers and a Permanency Specialist as well as the creation of
the Permanency Planning Teams (PPT).
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The Accelerated Reunification Model (ARM) is the last piece of Permanency Plus to be
incorporated into standard practice statewide. This service addresses the need to partner with
parents immediately upon the removal of their children by an outside agency in order to address
specific safety criteria so that the child can be reunified quickly and safely. The ARM Model
looks at reunifying children within 30 days of removal and then providing 60 days of post
reunification services and supports. This service uses the North Carolina Parenting assessment to
identify, and prioritize the areas of greatest need as a way of individualizing the services and
supports to meet each family‘s unique needs.
In 2007, DCYF and DJJS re-designed their Individualized Service Options (ISO) Program to
meet a child and families unique and individual needs. This program was expanded from three
provider agencies to currently twelve agencies that are certified to provide this unique and
individualized service. Two of these ISO agencies serve unique populations of children with
behavioral health issues and multiply handicapped children. Two other agencies are also certified
to provide ISO services to the adult developmental population and can serve older youth who will
be transitioning from the DCYF and DJJS system to Adult Developmental Services without
having to change agencies and sometimes foster homes.
The Domestic Violence Specialist program has been in implementation for many years. The colocation of Domestic Violence Specialists in every district office has provided immediate access
to Crisis Center Services for DCYF families experiencing domestic violence. The collaboration
between each district office and the local crisis centers has been invaluable in identifying and
meeting the unique needs of each community. The Portsmouth District Office has developed The
Coalition for Domestic Abuse Recovery, which is a multi-agency collaboration of the local Crisis
Center, the Community Mental Health Center, and DCYF. At the request of the Portsmouth
District Office, these agencies came together to create a concurrent treatment group for mothers
and children who have experienced trauma as a result of domestic abuse.
Data Considerations
Stakeholder input indicates that DCYF and DJJS have significantly improved the individualizing
of services to meet the unique needs of the children in care, specifically over the past three to five
years.
The stakeholders cited individualized budgets and service plans for children allow for creative
thinking and planning more appropriately for youth. Additionally, stakeholders stated that
referrals that are made are much more comprehensive and effective than they used to be.
Some areas of improvement mentioned by the stakeholder group were that there was an
inconsistency across the state in areas of service extension approvals and information given at
times of referrals. There was also some systemic issues mentioned in regards to DCYF/DJJS
service providers demonstrating more flexibility and willingness to work with resistant families
continually where community resources have rigid limitations on things like missed
appointments, which causes difficulty when transitioning families from DCYF/DJJS service array
to community resources.
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Strengths
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Item 37
DCYF‘s in-home community-based service array was designed to meet children, youth and
families needs particularly related to home stability and risk management and placement
avoidance, reunification of children and youth with their families, placement stability and
preservation as well as permanency preparedness. As mentioned previously, ISO in-home and
ISO foster care programs offer a wide array of services. Through the assessment and treatment
planning process required of ISO agencies, the service needs of each family is identified and
documented in an individualized treatment plan. Services can range from childcare to crisis
stabilizations, parent education and in home counseling as well as case management. The ISO
provider case manager coordinates all the services for each family.
ISO in-home services are provided to biological families for the purpose of safety reduction, risk
management and placement avoidance. Additionally, this service may also be used for DCYF
general foster homes to achieve placement stability and to avoid placement disruption.
ISO foster care has taken an array of services that are available in ISO in home services and
provides those services to foster parents who are recruited and trained by the ISO agencies to
meet a child‘s need for therapeutic foster care. Services are provided to both the child as well as
the foster parents. These ISO foster care placements are individualized to meet each child‘s
therapeutic and behavioral needs in order to prepare them to achieve their permanency plan. For
children with a particularly high need of support, an individualized budget and service plan can
be created by the treatment team for that child and are all reviewed and approved by the
Administrator for the Bureau of Well-Being.
ISO foster care agencies have also been providing Independent Living ISO placements to meet
the unique needs of older adolescents who may have a permanency plan of APPLA and need to
practice being independent in a supportive setting. Examples of Independent Living ISO‘s are, an
independent apartment with staff checking in daily and phone calls for curfews, a foster home
that is dedicated in assisting youth to be as independent as possible and assisting the youth in
acquiring all the skills needed to be on his or her own, and lastly a roommate situation that has a
youth living with another young adult in order to gain independence without being alone in an
apartment.
DCYF meets quarterly with all the ISO providers in the state as well as a representative from
each district office. The ISO Quarterly meeting is an opportunity for the group to discuss any
issues with the program, as well as program enhancements and accessibility. Recently, DCYF
and DJJS has begun to have special ISO matching meetings where field staff from the district
offices can come and present children and youth who are in need of ISO foster care in order for
them to step down from residential care and better prepare them for their permanency plan.
There have been three meetings and a number of children who have been in residential care for a
while have been matched to prospective ISO level foster homes.
For many years DCYF and DJJS has had a unique relationship with the Bureau of Developmental
Services (BDS). This relationship consists of an interagency agreement that allows DCYF and
DJJS to access developmental services for children in our care that would not normally be
available to them until the age of 21. These services are the Home and Community Based Care
Medicaid Waiver for the Developmentally Delayed population (HCBC-DD). This arrangement
allows access to services specific to the unique needs of children and young adults with
developmental disabilities.
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Item 37
Opportunities for Improvement
Substance abuse issues remain a challenge when working with families. The prevalence of
substance abuse co-occurring with child abuse and neglect is not met by the development of
available services in every community in the State. DCYF has expanded our First Step Program
by having a LADC in three offices. The LADC in Berlin District Office is part-time but meets
the need for that district office.
In areas where there are substance abuse services available, the services are not designed with
individual family needs in mind. Nashua District Office has been partnering with Harbor Homes
to look at how the community can better respond to the unique needs of families with cooccurring issues. One of the desired outcomes is to better address the needs of parents who
continue to parent their children while going through a treatment program.
The services designed and developed by DCYF and DJJS have changed over the past few years to
better serve the individual. The challenge remains that community-based services that these
families will be accessing after DCYF involvement are not as flexible, which causes issues when
transitioning families.
Another area in regards to individualizing services that is currently being explored is allowing
youth who have left DCYF care, to come back and be supported for a period of time when they
are experiencing difficulties with the transition.
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F. Agency Responsiveness to the Community
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Item 38
Item 38: State Engagement in Consultation With Stakeholders. In implementing the
provisions of the CFSP, does the State engage in ongoing consultation with tribal
representatives, consumers, service providers, foster care providers, the juvenile court,
and other public and private child- and family-serving agencies, and include the major
concerns of these representatives in the goals and objectives of the CFSP?
In Round 1 of the CFSR, New Hampshire was in Substantial Conformity with the systemic factor
of Agency Responsiveness to the Community.
Policy Considerations
New Hampshire DCYF is committed to the establishment of effective, meaningful collaborative
relationships with our numerous partners and stakeholders throughout the State. Since New
Hampshire‘s last statewide assessment in 2003, DCYF has maintained several long-standing
relationships with consumers, providers and other community advocates and stakeholders, while
recognizing the areas where DCYF must establish or further develop connections with additional
members of the community while ensuring that the feedback from providers is implemented into
the goals and objectives of our CFSP.
Partnering with the community and families is a fundamental philosophy of the Division. The
community has a role and responsibility in supporting children in care. Foster parents make up
an integral part of the DCYF community. The DCYF Foster Care program provides foster family
homes and a family experience for children who cannot be safely cared for in their own homes.
There is at least one Resource Worker in each district office who works to recruit, train and
license foster families and match children in need of foster care with a foster family best suited to
meet the child's specific needs.
CFSR Round 1 Finding
During the 2003 CFSR, this item was rated as an Area Needing Improvement, because although
DCYF staff participate in a variety of state level interagency committees and advisory boards, the
major concerns of local stakeholders, consumers, foster care providers, the courts, and other
public and private child-and family-serving agencies are not frequently included in the goals and
objectives of the CFSP.
Local stakeholders reported active consultation at the case level and awareness of statewide
advisory groups, but little knowledge of how local stakeholder concerns are considered by DCYF
and DJJS in developing their goals and objectives. Stakeholders at the state level reported that
private family service agencies have some involvement, but not enough, in developing the state‘s
child welfare goals. At the time of the CFSR, there was not an active youth advisory board.
Stakeholders reported that the Child Welfare Committee, responsible for consulting with
stakeholders to develop the 2005-2009 CFSP, is undergoing reorganization designed to improve
its connections with the DCYF Advisory Board, the Citizen‘s Review Panel, local family services
agencies, foster and adoptive parents, and adolescents in foster care.
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Item 38
Changes since Round 1
In the Manchester District Office, the Foster Care program was committed to actively
participating in community programs that would reach a diverse, broad range of ethnic and
cultural groups. This includes participation in the city's annual, PeopleFest, which is organized
and run by multicultural groups representing a variety of cultures. The Resource Worker‘s staff a
DCYF table, which shares Division information, and information on being a foster parent with
the hopes of recruiting a diverse group of foster parents in order to meet the diverse needs of
children in DCYF care.
The DCYF foster care program has also participated in the annual Women's Expo. This event
highlights women's issues and provides important information about services and programs. The
foster care program has participated each year of the Expo, as it is an opportunity to show the
need for qualified, caring families to provide good home to children in need.
In attempt to further galvanize the foster care program and address the needs of the children in
care and the community, DCYF develops a local plan with a Recruitment and Retention (R+R)
Team that consists of the DCYF Office supervisor, the Resource worker, other staff, foster and
adoptive parents, community representatives and others as appropriate. Needs assessments are
completed and foster care data relating to the recruitment and retention of foster homes is
gathered. Identification of recruitment and retention practices for the local office is reviewed.
Safety, permanency and well-being for children and youth who have been recently referred for
foster home placement is strongly considered in the development of new recruitment goals and
objectives. The DCYF Statewide recruitment and retention plan compliments the twelve district
offices plans. In a standardized format, plans are submitted by the local R+R Team to a review
panel for approval prior to October first of the planning year.
In July 2004, DCYF and New Hampshire faith leaders attended a national summit on recruiting in
the faith community as part of the "Answering the Call" initiative. As a result, representatives
from different faiths, community members and DCYF developed an advisory board for faithbased initiatives. In response to this collaboration, the Community and Faith-Based Initiatives
(CFBI), with oversight and coordination from Bethany Christian Services, was formed in 2005.
Currently, four CFBI representatives throughout the State are serving all twelve DCYF district
offices and provide support for DCYF and foster families statewide.
The New Hampshire District Court, Family Division, Probate Court and Superior Court, the
Division for Children, Youth and Families, representatives from the New Hampshire Bar,
Legislature, CASA, Judicial Council, law enforcement and the Attorney General‘s Office
continue to partner in addressing solutions to child safety, permanency and well being when
families are involved in the court system because of child abuse or neglect, child delinquency or
status offenses.
The Protocols Relative to Abuse and Neglect Cases and Permanency Planning were made
possible through a federal grant received by the New Hampshire Administrative Office of the
Courts from the U. S. Department of Health and Human Services, Administration for Children
and Families. This exciting grant opportunity allowed the New Hampshire District Court to
develop and oversee the Court Improvement Project (CIP). In addition to solution-based
collaboration among the key partners listed above, foster parents and service providers also
contributed to this endeavor.
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In 2008, the CIP Coordinator established a large multidisciplinary committee to develop
Protocols for use in cases that involve CHINS and delinquents. That committee includes
participation by four Family Division and District Court judges as well as a Family Division
administrator, the Director, Administrator, Assistant Administrator and Permanency Specialist
from DJJS, three attorneys from the Bar and DCYF‘s Director, Legal Counsel, Administrator,
Permanency Specialist and a field attorney.
In July 2008, the CIP‘s Coordinator was asked by the supervisory judge of the Concord Family
Division to develop and submit an application to the National Council of Juvenile and Family
Court Judges for two courts, Concord and Franklin Family Division, to become Model Courts.
The application resulted in New Hampshire being selected in August 2008 to become a Model
Court. The CIP‘s Coordinator continues to play an active role in the Model Court Project and
CIP funds will be used to support this exciting opportunity, which will include the development
of Protocols for termination of parental rights and adoption cases.
The CIP‘s Coordinator has a strong working relationship with DCYF and CASA and throughout
2008 had regular meetings with representatives from both organizations. These discussions
resulted in the CIP, DCYF and CASA identifying a need to bring together DCYF and CASA to
discuss the roles and expectations of DCYF and CASA as well as issues related to visitation. The
result was an important collaboration by the CIP, DCYF and CASA to collaborate on a one- day
Summit held for seventy-five staff from DCYF and CASA staff and guardians ad litem. The
Summit was led by DCYF‘s Director and CASA‘s Executive Director and resulted in
overwhelmingly positive evaluations. Another Summit of a similar scope was just held in
February 2010.
In 2003, the New Hampshire Executive Council to the Governor requested the New Hampshire
Commission on the Status of Women (NHCSW) to conduct a survey about training and education
programs available to incarcerated women. The findings of the report estimated that 85-90% of
the women were mothers of whom many were the sole providers for their children prior to
incarceration. Yet, there were no formal visitation or parenting support groups offered. Many
women reported fighting to keep their parental rights with no legal assistance or guidance and
losing custody of their children altogether. In response, Senate Bill 262, an act establishing the
position of an Administrator of Women Offenders and Family Services within the Department of
Corrections and establishing an Interagency Coordinating Council on Women Offenders was
passed in March of 2006.
The Child Protective Administrator serves on this council on behalf of DCYF. Over the past
couple years, the Administrator has met with incarcerated women involved with DCYF to listen
to their struggles to maintain connections with their children, keep apprised of case status and
planning, and communicate with the CPSW assigned to the case. These listening sessions have
prompted a response by DCYF to develop a system in which incarcerated mothers of children
involved with DCYF can have a voice and participate in the case planning process. The CPS
Administrator holds quarterly meetings at the State women‘s prison with incarcerated women.
These meetings are aimed at providing the women with information about services available to
them from DCYF and DHHS including services for family members that are caring for their
children.
Starting in 2004, DCYF has been meeting and partnering with the Departments of Juvenile
Justice (DJJS), Education (DOE), Labor (DOL) and Vocational Rehabilitation, to better serve
our shared youth. The Department of Vocational Rehabilitation and Bureau of Behavioral Health
came on board in 2005 and 2006 and since 2008, the Division of Family Assistance, the 21st
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Item 38
Century Learning Programs and the New England Migrant Farm Workers Council have joined
what is now known as the New Hampshire Youth Vision state level team.
In October of 2005 the committee conducted the New Hampshire Youth Vision Forum, which
involved over 150 representatives of the above-named agencies. Attendees were given the
history and purpose of the US Department of Labor‘s initiative to better serve what the White
House‘s 2003 Task Force identified as the youth with the most needs. Everyone was then divided
into teams depending on the community in which they worked. These local youth vision teams
worked with a volunteer facilitator to: 1) Get to know what each person‘s agency did for youth;
2) Determine at least one youth-related need in their community; and 3) Create an action plan to
address the problem. Group leaders were chosen to report out their identified youth need and to
lead their team‘s effort going forward.
Local youth vision team leaders have met with the state level Youth Vision team on a regular
basis for additional guidance and support for their community change efforts. Each local team
has a chair and a co-chair who attend yearly trainings conducted by the state level team.
New Hampshire Teen Voices is the Youth Advisory Board and it has provided a great
opportunity for DCYF and DJJS youth to meet each other, network and advocate for positive
change for youth in out-of-home care. The board is made up of approximately 25 current foster
care youth from across New Hampshire. It is a youth/adult partnership supported by staff and led
by a youth president, vice president, secretary and activities coordinator. New Hampshire Teen
Voices has been actively involved in the New England Collaborative, an advocacy group made
up of youth leaders from across the region. The board‘s accomplishments include the
development and passage of tuition waiver legislation, four statewide teen conferences, attending
a national conference, raising money for disabled youth and adults and for current youth in care
and having their voices heard regarding numerous practice and policy issues.
Another important initiative has been the implementation of Strengthening Families. Developed
by the Center for the Study of Social Policy (CSSP), Strengthening Families is an approach to
preventing child abuse and neglect through building five Protective Factors in families: parental
resilience, social connections, knowledge of parenting and child development, concrete support in
times of need, and children‘s social and emotional development. Research shows that these
factors reduce the incidence of child abuse and neglect by providing parents with what they need
to parent effectively, even under stress. By building relationships with families, programs can
recognize signs of stress and build families‘ Protective Factors with timely, effective help.
In 2005, the CSSP designated New Hampshire as one of the seven states in the country for their
Strengthening Families Initiative (SFI). As the lead agency, DCYF has partnered with the New
Hampshire Children‘s Trust Fund (NHCTF) in building protective factors for New Hampshire‘s
families thus promoting the safety and well-being of children in their home and reducing
incidents of child abuse and neglect. Some of approaches New Hampshire is currently using to
achieve its mission are to:
Incorporate Protective Factors curriculum into collegiate and advanced learning early
childhood education courses
Provide training and technical assistance on Strengthening Families and SelfAssessment to childcare programs through the Childcare Resource and Referral
Network‘s contract with DCYF
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Adding Strengthening Families models to the Bureau of Child Development
Professional Development System
Participate in the Zero to Three‘s State Partnerships for Prevention
DCYF combines CAPTA and PSSF funds with other funding streams to support the New
Hampshie Association for Infant Mental Health (IMH) and regional Early Childhood Mental
Health Teams. The New Hampshire Association for Infant Mental Health (NHAIMH) is an
organization comprised of professionals in the field of infant mental health, community providers,
and representatives of partnering programs and family support and advocacy organizations.
Infant mental health addresses all systems of development for children birth to six years,
emphasizing the interaction of factors that effect social/emotional health and development. The
organization‘s mission is to identify and disseminate information, research, and best practices that
promote interdisciplinary efforts on a community level in order to strengthen relationships in
families with infants and young children. NHAIMH supports public policy initiatives that
promote positive child outcomes and enhance continuity of care for children and families
throughout the early years.
Also supported by Title IV-B and CAPTA funds, the Watch Me Grow Pilot (WMG) is an
opportunity to develop a system to ensure that families with children birth to six years in New
Hampshire are consistently able to access developmental information, support, health and
developmental screenings.
In 2009 Phase I, three WMG pilot programs were started in Family Resource Centers, each
receiving $5,000.00 to build self-sustaining infrastructure for, enhance the capacity and promote
usage of, early childhood screening. During late 2009 – early 2010, Phase II began, bringing on
two more pilot sites, each receiving $5,000.00 to again build self-sustaining infrastructure for the
screening program. During 2010, Phase III, the remaining seven Family Resource Centers were
brought into the program, one at $5,000.00 and the last six at $4,000.00 due to budget
adjustments.
In June 2008, residential providers were invited to join DCYF/DJJS in an initiative, now called
the Framework for Collaboration, aimed at developing and implementing a collaborative system
for delivery of services in residential treatment that focused on shorter lengths of stay and
achieving permanency for the youth who were placed in their programs. From the beginning, a
core work group of DCYF/DJJS staff and residential providers have been meeting regularly to
create a New Hampshire framework to achieve improved permanency outcomes for children and
youth placed in residential programs. The framework includes a vision statement, core values,
key definitions, guiding principles, outcomes, and standards of practice that emphasize outcomes
and positive results. This set of values and commitments provides for more effective
collaboration between all stakeholders: child welfare professionals, parents and relatives, youth,
providers and community alike. The framework will serve as a guide and helps everyone to hold
themselves and each other accountable to common ways of working together.
Policies, both by the child welfare agency and by providers, can be created to formalize parts of
the framework so that professionals and programs operate in a consistent manner. This
framework will serve as the basis for achieving effective, quality service provision at all levels of
intervention and support with children/youth and families.
Data Considerations
According to the 2000 United States Census, the total New Hampshire population was 1,235,786.
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7,885 residents, or 0.6% of the population reported being American Indian/Alaskan Native,
increasing from 0.2% reported in the 1990 Census. While the indigenous people of this state
include Abenaki people, American Indian/Alaskan Native residents of the state reported over
4,000 tribal affiliations with federally recognized tribes. A representative of the DCYF Child
Welfare Committee is the director of Wijokadoak, Inc., a New Hampshire based non-profit
organization advocating for individuals who are of Abenaki and other tribal descent. This
representative began consultations with DCYF in 2005 regarding development of a revised
training curriculum, a contracted instructor, and specific materials and training goals to be
utilized regarding ICWA. As a result of this partnership, staff training on (ICWA) is incorporated
into DCYF‘s Core training curriculum for new employees. Further, a workshop on ICWA has
been offered at several of the annual conferences.
DCYF also engages with its community partners through the use of focus groups during our Case
Practice Reviews to address service needs. As Case Practice Reviews are held in all areas of the
State, this forum provides an excellent opportunity to gather feedback from the community on
statewide and regional service needs. Additionally, the Case Practice Review itself is composed
of DCYF staff and community partners. The review has proved to be a very beneficial tool used
in evaluating practice and systemic needs in the particular region being reviewed.
The Case Practice Review focus groups have confirmed much of the information as to DCYF‘s
strengths and areas needing improvement regarding service array. Two significant themes have
been lack of availability of services in all areas of the State and also inconsistency among
CPSW‘s, JPPOs and providers as to their understanding of the services available.
All 12 focus groups, 1 representing each district office cited varying levels of concerns with
service array in their respective community as it relates to DCYF and DJJS. It is of note that the
Southern (Manchester and Nashua) and Seacoast (Portsmouth) regions experience less difficulties
with service array, but it is still an issue. Multiple focus groups also indicated concerns with the
consistency of knowledge amongst CPSW‘s and JPPOs of the services available in their
respective areas.
Strengths
DCYF supports the functions of a variety of oversight panels including the Citizen‘s Review
Panel (CRP), the Child Welfare Committee, and the DCYF Advisory Board. In combination,
these groups meet the requirements of CAPTA and Title IV-B, in addition to New Hampshire
statutory requirements. Their membership is diverse and includes representation from
community members, youth in care, CASA, foster parents, attorneys, group home staff,
representatives from prevention programs, and other professionals who have involvement with or
knowledge of DCYF and DJJS.
The DCYF Director attends each group's meetings as often as possible, and DCYF provides a
liaison to each meeting. The role of the liaison is not to drive the agendas of any group, but to
provide information on DCYF programs, including identified areas needing improvement or
issues that a particular group may be interested in addressing.
The board writes an annual report, which is presented to the DHHS Commissioner and the
Governor of New Hampshire.
Memoranda of Understanding have been developed connecting the Advisory board with two
other oversight groups, the Citizen‘s Review Panel, and the Child Welfare Committee. DCYF
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staff has worked in conjunction with these groups to ensure good communication between the
three. It was decided that the Advisory Board would send one member to each of the other
boards to facilitate communication and reduce duplication of effort. This has worked very well as
each group has taken on different roles and responsibilities.
The Child Welfare Committee has a membership including service providers and DCYF staff
from different program areas. The group's role is to foster communication between communities,
DCYF, and agencies providing services to promote safe and stable families. As such, this group
has been very involved in DCYF‘s Cultural Competency Self-Assessment and in the development
of the Five-year Plan.
As the panel with the most case-driven oversight capacity, the CRP is particularly involved in the
case practice review process and has been reviewing data and outcomes from those reviews.
With this knowledge, the CRP has decided to focus specific attention over the past two years on
youth aging out of care and educational transition stability for youth in care. The CRP also
completes an annual report. In addressing the needs of the report and implementing them into
practice, DCYF prepares responses to each recommendation of the report and how those
recommendations will be incorporated into practice.
In addition to the three groups described above, DCYF also supports the Youth Advisory Board,
Child Fatality Review Committee and the Medical Care Advisory Committee.
DCYF is represented on the New Hampshire Child Fatality Review Committee (CFRC). The
mission of the Committee is to reduce preventable child fatalities through systemic
multidisciplinary review of child fatalities in New Hampshire; through multidisciplinary training
and community-based prevention education; and through data-driven recommendations for
legislation and public policy. The Committee membership is comprised of representation from
the medical, law enforcement, judicial, legal, victim services, public health, mental health, and
child protection and education communities. The Committee provides the recommendations to
the participating agencies and asks them to take actions consistent with their own mandates. The
Committee publishes the recommendations and the agency responses to those recommendations
in an Annual Report.
The Medical Care Advisory Committee (MCAC) is a federally mandated committee to provide
guidance, feedback and oversight to the Medicaid Program. Each Division is represented at the
MCAC as each Division has specific Medicaid programs that are used to support their specific
populations. The committee is comprised of multiple stakeholder groups as well as consumer
representatives. DCYF and DJJS have a representative attend these monthly meeting to share any
pertinent program information or clarification the committee may need.
In 1988, a local foster family support group formally organized as a non-profit corporation. This
association was approached by DCYF to assist with efforts to promote specific supportive
activities and opportunities for foster parents statewide and to ensure the representation of the
foster parent point of view in policy and practice development and implementation. As a result
the New Hampshire Foster Parent Association was formed. In 1997, the name was changed to
the New Hampshire Foster and Adoptive Parent Association (NHFAPA) and membership was
expanded to include families who adopted New Hampshire foster children.
The New Hampshire Foster & Adoptive Parent Association is committed to enhancing the lives
of youth in care and the families who serve them. The mission of New Hampshire Foster and
Adoptive Parent Association is to support foster and adoptive parents and remain a consistent,
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strong voice on behalf of all children. NHFAPA supports twelve local associations across the
state. These local groups provide direct support, networking, and fun activities for foster and
adoptive families across the state. NHFAPA partners with New Hampshire DCYF, local child
placing agencies, community organizations and local businesses to provide opportunities so
families can thrive. NHFAPA provides technical assistance to DCYF in the development of
foster care policy and programs.
In addition to our collaboration with NHFAPA, DCYF meets quarterly with all the ISO providers
in the state as well as a representative from each District Office. The ISO Quarterly meeting is an
opportunity for the group to discuss any issues with the program, as well as program
enhancements and accessibility. Recently, DCYF and DJJS has begun to have special ISO
matching meetings where field staff from the district offices can come and present children and
youth who are in need of ISO foster care in order for them to step down from residential care and
better prepare them for their permanency plan. There have been three meetings and a number of
children who have been in residential care for a while have been matched to prospective ISO
level foster homes.
Since 1997, New Hampshire has benefited from having co-located Domestic Violence Specialists
(DVS) in each district office. The DVS program is an ongoing partnership with the New
Hampshire Coalition Against Domestic and Sexual Violence who provide staff from local crisis
centers to work in the district offices providing case consultation, direct services, and referrals for
families experiencing the co-occurrence of domestic violence and child maltreatment. These
ongoing efforts ensure the sustainability of the work completed during the Greenbook Project.
The Division for Children, Youth & Families (DCYF) and the Division for Juvenile Justice
Services (DJJS) operate as distinct divisions under the Department of Health and Human Services
(DHHS). However, the divisions collaborate in real and demonstrable ways, including a joint
Case Practice Review process, the use of the same case management information system, a shared
service array, and a joint case-planning policy for families involved with both systems.
Opportunities for Improvement
New Hampshire has made tremendous strides over the past several years in developing networks
and relationships with our community partners, foster parents and courts. With that said,
stakeholder and focus group feedback still indicate that the level of support and collaboration that
New Hampshire has focused on developing has not resonated in all parts of the state. There are
still gaps in how we as agency respond to the dynamic needs of our community. The steps taken
since Round 1 are necessary ones in order to shift practice from directing people to collaborating
with people. As part of the development of our statewide Practice Model, New Hampshire will
include the use of current stakeholder groups in addition to new focus groups in order to gain a
higher-level stakeholder engagement and collaboration around the future direction of practice.
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Item 39: Agency Annual Reports Pursuant to the CFSP. Does the agency develop,
in consultation with these representatives, annual reports of progress and services
delivered pursuant to the CFSP?
Policy Considerations
DCYF has continued to embrace the importance of the collaborative community response in
developing our Child and Family Services Plan (CFSP) and Annual Progress and Services Report
(APSR) and has set up the internal structure to accomplish community collaboration. New
Hampshire develops annual reports of progress in consultation with its system partners, using
both direct and indirect feedback from children, families, providers, and other parties to inform
the reports.
Each year DCYF produces an Annual Progress and Service Report (APSR) on progress of the
CFSP. Report content is prescribed by the Administration for Children and Families is developed
in two sections described below, and includes:
Child and Family Services Plan
Promoting Safe and Stable Families
CAPTA State Grants
Description Of Services And Training Provided Under CAPTA
Activities for children adopted from other countries, including the provision of
adoption and post-adoption services
Chafee Independent Living Skills / Education and Training Vouchers
Court Improvement Project
Progress made in the areas of training, technical assistance, evaluation, or management
information systems in support of the goals and objectives
Preventive Community Services, Safety and Well-Being
Progress made with regard to ICWA compliance and the coordination of the
permanency provisions afforded to Indian children
Progress made with regard to the diligent recruitment of potential foster and adoptive
families that reflect the ethnic and racial diversity of children for whom foster and
adoptive homes are needed
Caseworker Visits
DCYF Oversight Panels
Collaborative Responses To Multiple Family Issues
Decision Making Tools And Evaluation
Community Education And Awareness Building
Financial and Statistical Information
Disaster Preparedness Plan
Section one provides an overview of child welfare services, including substantial changes in
systemic issues and direct practice occurring during the five-year period. This includes activities
and services provided under: Title IV-B, including both subpart 1, the Stephanie Tubbs Jones
Child Welfare Services Program and subpart 2, Promoting Safe and Stable Families (PSSF); the
Child Abuse Prevention and Treatment Act (CAPTA); Adoption Incentive Funds, and the Chafee
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Foster Care Independence Program (CFCIP) and Education and Training Voucher Program
(ETV). Section two contains a summary and status update on each goal, objective, and action
step from the five-year strategic plan.
DCYF supports the functions of a variety of oversight panels including the Citizen‘s Review
Panel, the Child Welfare Committee, and the DCYF Advisory Board. In combination, these
groups meet the requirements of CAPTA and Title IV-B, in addition to New Hampshire statutory
requirements. Their membership is diverse and includes representation from community
members, youth in care, CASA, foster parents, attorneys, group home staff, representatives from
prevention programs, and other professionals who have involvement with or knowledge of DCYF
and DJJS.
The DCYF Director attends each group's meetings as often as possible, and DCYF provides a
liaison to each. The role of the liaison is not to drive the agendas of any group, but to provide
information on DCYF programs, including identified areas needing improvement or issues that a
particular group may be interested in addressing. In addition, the liaison will coordinate
presentations at these meetings by various DCYF Administrators and Program Specialists in
order to inform the groups on current updates in all areas of DCYF practice. DCYF‘s Child
Development Administrator, Legal Services Administrator, Well-Being Administrator and
Practice Model Coordinator have conducted recent presentations. These presentations allow each
group to make informed decisions and recommendations to DCYF.
The DCYF Advisory Board is a requirement of the New Hampshire Legislature, RSA 170-G: 6.
This board has a required membership of two citizens per county and has historically taken a
systemic view of agency practice and policy. The board writes an annual report, which is
presented to the DHHS Commissioner and the Governor of New Hampshire.
The Child Welfare Committee has a membership that meets the requirements of Title IV-B
including service providers and DCYF staff from different program areas. The group's role is to
foster communication between communities, DCYF, and agencies providing services to promote
safe and stable families. As such, this group has been very involved in DCYF‘s Cultural
Competency Self-Assessment and in the development of the CFSP.
The Citizen's Review Panel (CRP) meets every other month to provide advice and oversight on
DCYF practice and policies. The purpose of the CRP is to determine how DCYF is effectively
discharging its child protection responsibilities.
The CRP is required to review the compliance of DCYF in the discharge of its duties with respect
to the following: The state CAPTA Plan, coordination with Title IV-E foster care and adoption
programs, activities associated with CFSP, participation in the DCYF case practice review
process, participation in debriefings on Quality Assurance Specific Case Reviews and other
criteria the panel considers important. In the event that a fatality or near fatality occurs that is
connected to a DCYF case or assessment, the DCYF Child Protection Administrator engages in a
critical incident review. The results of this review are shared with the CRP upon request.
In addition to the three groups described above, DCYF also supports the Youth Advisory Board
and the Child Fatality Review Committee.
The NH Child Fatality Review Committee (CFRC) was created by Executive Order in 1991. The
mission of the Committee is to reduce preventable child fatalities through systemic
multidisciplinary review of child fatalities in New Hampshire; through multidisciplinary training
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and community based prevention education; and through data-driven recommendations for
legislation and public policy.
The Committee membership is comprised of representation from the medical, law enforcement,
judicial, legal, victim services, public health, mental health, child protection and education
communities. The Committee began reviewing cases of child fatalities in January of 1996. After
each review the Committee identifies risk factors related to the death and makes
recommendations aimed at improving systematic responses in an effort to prevent similar deaths.
CFSR Round 1 Finding
During the 2003 CFSR, this item was rated as an area of Strength. DCYF was noted for
developing annual reports of progress and services in consultation with its advisory groups and
other stakeholders. Additionally, the Citizen‘s Review Panel was also noted for developing an
annual report.
Stakeholders reported that DCYF develops its Annual Progress and Services Report (APSR) in
consultation with the Child Welfare Committee (formerly Child Welfare Advisory Board) and a
variety of other DCYF advisory boards, interagency committees, and service networks.
Changes since Round 1
New Hampshire continues to use the same level of collaboration with representatives that were
identified in Item 38 in developing the Annual Report of Progress and Service (APSR). The
Citizen‘s Review Panel continues to complete its annual report. Upon completion of the annual
report, DCYF reviews the report and prepares responses indicating how the Division would
implement the Panel‘s recommendations into practice. Many of the Panel‘s recommendation
from recent reports have been included in New Hampshire‘s 2010-2014 Child and Family
Services Plan.
Memoranda of understanding have been developed connecting the DCYF Advisory Board with
two other oversight groups, the Citizen‘s Review Panel, and the Child Welfare Committee.
DCYF staff has worked in conjunction with these groups to ensure good communication between
them. It was determined that the Advisory Board would send one member to each of the other
boards to facilitate communication and reduce duplication of effort. This has worked very well as
each group has taken on different roles and responsibilities.
Created in 2004, the Youth Advisory Board, known as NH Teen Voices, is a panel composed of
young adults in out-of-home care. The board‘s mission is ―
making a difference for youth in care
by voicing opinions for positive change‖ and it meets monthly to work on a variety of projects.
DCYF solicits feedback from NH Teen Voices for policy and program development. The Board
also provides leadership experience to youth who participate in panel discussions and trainings
provided to peers, DCYF staff, placement providers, and community professionals.
Data Considerations
DCYF utilizes the Panel‘s annual reports as a mechanism for ensuring that community
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Item 39
driven oversight capacity, the CRP is particularly involved in the case practice review process
and has been reviewing data and outcomes from those reviews. With this knowledge, the CRP
has focused specific attention over the past two years on youth aging out of care and educational
transition stability for youth in care.
The CRP has just completed its 2010 Annual Report. As highlighted in the report, the two
primary areas of focus for the 2009-2010 fiscal year have been the DCYF Practice Model and
educational transition stability for youth in care. The following is taken from the CRP Annual
Report in regard to its involvement with the two areas mentioned above:
The first area of focus for the CRP was the DCYF Permanency Practice Model. This is the
practice model New Hampshire will be using as the framework that will drive DCYF business. A
clear definition of terms and practices will be developed by staff to ensure everyone operates with
the same framework. There currently are 7 teams: Executive; Project; Design; Training Work
Group; Policy Work Group; Evaluation Group; and Communication. The definition of each team
was presented to the CRP. The New Hampshire CRP involvement will be that of feedback on the
framework for the Permanency Practice model.
Currently, the Design Team, which consists of representation of all DCYF Bureaus and Offices
and staff from DJJS, is internally developing the framework by crafting the agency's beliefs and
guiding principles for the practice model. Once the framework is completed the team will bring it
to the key stakeholders, one of which is the CRP. This overall project is to be completed in 2
years. The CRP suggests that DCYF continue keeping the panel informed of the project's
progress and time line in order for the panel to provide timely feedback.
The second area of focus for the CRP was the issue of Foster Care, as it relates to the importance
of educational stability/standardization process for foster care student transitions between school
systems. The CRP designed a survey for foster parents to provide feedback on their experiences
and knowledge of the foster care system as it relates to the educational system. NH Foster and
Adoptive Parent Association (FAPA) sent out the survey to about 800 foster parents in NH. The
panel is currently in the process of compiling the data results and identifying needs. The CRP is
looking forward to sharing the survey results with DCYF and the Foster Parent community. The
CRP suggests that DCYF, with CRP input, will develop a plan of action that addresses the needs
identified as outcomes of the survey.
Strengths
As mentioned above, DCYF provides a liaison to each of the three oversight panels. The liaison,
historically, has been the same person who is charged with completing DCYF‘s Child and Family
Services Plan and subsequent Annual Progress and Services Report. This continuity allows for
substantial, on-going collaboration with the DCYF Advisory Board, Citizen‘s Review Panel and
Child Welfare Committee in developing a comprehensive CFSP and APSR.
Opportunities for Improvement
While DCYF‘s collaboration with the three oversight panels has played a significant role
in DCYF developing its CFSP and APSR, continued improvement is needed. Recently,
DCYF‘s Director and Liaison had a conversation with the DCYF Advisory Board about
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the possible merging of the three panels into one panel. The purpose would be to
galvanize the backgrounds, expertise and influence of each panel into one. While the
scope of each panel is a bit different, the focus is the same, to improve New Hampshire‘s
child welfare system. Members from each panel have recently shared some concern with
the influence each panel has with DCYF and the development of policy and practice
procedures.
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Item 40
Item 40: Coordination of CFSP Services With Other Federal Programs. Are the
State‘s services under the CFSP coordinated with the services or benefits of other
Federal or federally assisted programs serving the same population?
Policy Considerations
DCYF is the designated agency with responsibility for IV-B and IV-E funded services. These
services are provided either directly by the DCYF, through contracted providers, or by system
and community partners. Each year DCYF produces an Annual Progress and Service Report
(APSR) to report on progress of the CFSP.
New Hampshire has the structure to ensure coordination of services. Within the Department of
Health and Human Services (DHHS), DCYF coordinates services with the Division of Juvenile
Justice Services (DJJS), the Bureau of Behavioral Health and Bureau of Developmental Services.
DCYF also coordinates services with agencies and departments external to DHHS. Examples
include the New Hampshire Children‘s Trust Fund (NHCTF), the Department of Education, the
New Hampshire Coalition Against Domestic and Sexual Violence, the Family Resource Centers,
the University of New Hampshire via the Center for Professional Excellence and IV-E training
program.
CFSR Round 1 Finding
During the 2003 CFSR, this item was rated as an area of Strength, because services were
coordinated with a range of Federal and Federally assisted programs through interagency
collaboration.
In Round 1 it was noted that DCYF coordinated with a range of programs and providers,
including:
The New Hampshire Coalition Against Domestic and Sexual Violence,
The Greenbook demonstration,
New Hampshire Children‘s Trust Fund,
The Department of Education,
Other New Hampshire DHHS divisions, including the Division of Behavioral Health
and DJJS,
University of New Hampshire Family Research Lab, and
The Court Improvement Program.
The Statewide Assessment also noted that DCYF and DJJS finalized a Memorandum of
Agreement in 2002 for DJJS to place CHINS and delinquent youth into title IV-E funded foster
care placements. The agreement addresses case planning, case reviews, permanency hearings, and
termination of parental rights.
Stakeholder input on this topic identified a number of efforts on the part of DCYF to coordinate
services with other agencies, including the State‘s Behavioral Health Provider agency, DJJS, the
Bureau of Special Education, and the foster parent association. Stakeholders noted that staff from
the mental health division provides training for DCYF at an annual conference and DCYF district
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Item 40
offices commit time for workers and supervisors to participate. Stakeholders noted that DCYF
shows a strong interest and willingness to collaborate, but sometimes workers are unable to
follow through due to high caseloads.
Changes since Round 1
The Greenbook Project
Seven years ago, Grafton County, New Hampshire was one of six communities across the country
selected to take part in a federal initiative known as the Greenbook Project. Greenbook‘s goal was
to improve how Child Protection, the Courts, and Domestic Violence Coalitions work together
when responding to the co-occurrence of domestic violence and child abuse and neglect. While
the Greenbook Project officially ended in the fall of 2006, efforts to ensure the sustainability of
the work continue. Family Court Judges took part in a statewide, multi-disciplinary training on
the Greenbook Court Guide for Co-Occurrence Cases in the fall of 2007. Another statewide
training on the Court Guide was held in September 2007 for DCYF supervisory and legal staff,
DV Advocates, and Court Appointed Special Advocates (CASA) to better understand the
recommended practice change for each system working with co-occurrence cases. Prior to these
statewide trainings, DVS Program Coordinators provided five regional trainings on the Court
Guide for DCYF field staff.
Comprehensive Family Support
During 2005, contracts were awarded for statewide comprehensive family support programs
covering all twelve-district office catchment areas. Through the Comprehensive Family Support
Program, DCYF contracts with community based agencies for 12 statewide regions to provide
support services to approximately 500 families annually. The programs assist families and
children by promoting family wellness, decreasing family stress, and preventing abuse and
neglect. The social service agencies identify and assist families with multiple stressors by
providing multivariate services, which encourage and promote the development of healthy
families.
Strengthening Families Through Early Childhood Education
Developed by the Center for the Study of Social Policy, Strengthening Families is an approach to
preventing child abuse and neglect through building five Protective Factors in families: Parental
resilience, social connections, knowledge of parenting and child development, concrete support in
times of need, and children‘s social and emotional development. Research shows that these
factors reduce the incidence of child abuse and neglect by providing parents with what they need
to parent effectively, even under stress. By building relationships with families, programs can
recognize signs of stress and build families‘ Protective Factors with timely, effective help.
In 2005, the CSSP designated New Hampshire as one of the seven states in the country for their
Strengthening Families Initiative (SFI). Designated as the lead agency, DCYF has partnered with
the New Hampshire Children‘s Trust Fund (NHCTF) in building protective factors for New
Hampshire‘s families thus promoting the safety and well-being of children in their home and
reducing incidents of child abuse and neglect. Some of approaches New Hampshire is currently
using to achieve its mission are to:
Incorporate Protective Factors curriculum into collegiate and advanced learning early
childhood education courses
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Provide training and technical assistance on Strengthening Families and SelfAssessment to childcare programs through the Childcare Resource and Referral
Network‘s contract with DCYF
Adding Strengthening Families models to the Bureau of Child Development
Professional Development System
Participate in the Zero to Three‘s State Partnerships for Prevention
Head Start State Collaboration Office
The Head Start State Collaboration Office (HSSCO) seeks to improve long-term outcomes for
children in families with low incomes by promoting collaboration among the Head Start
community, state policy makers, program administrators, professionals from early childhood and
related fields and family representatives. Toward this outcome, resources from the Collaboration
grant are used to create, support and sustain collaborative relationships and initiatives among
Head Start and its natural state and community partners in eight priority areas established by the
Head Start Act. These areas include: health care; education; services to families who are
homeless; services to children with special needs; child care; welfare reform (child and family
assistance); family literacy and community services.
Infant Mental Health
DCYF combines CAPTA and PSSF funds with other funding streams to support the NH
Association for Infant Mental Health and regional Early Childhood Mental Health Teams (IMH).
The New Hampshire Association for Infant Mental Health (NHAIMH) is an organization
comprised of professionals in the field of infant mental health, community providers, and
representatives of partnering programs and family support and advocacy organizations. Infant
mental health addresses all systems of development for children birth to six years, emphasizing
the interaction of factors that effect social/emotional health and development. The organization‘s
mission is to identify and disseminate information, research, and best practices that promote
interdisciplinary efforts on a community level in order to strengthen relationships in families with
infants and young children. NHAIMH supports public policy initiatives that promote positive
child outcomes and enhance continuity of care for children and families throughout the early
years.
NHAIMH has successfully provided an annual statewide conference for the past 13 years as a
means of increasing available infant mental health expertise in NH. NHAIMH has provided ongoing community education and awareness through offering round tables and making
presentations at conferences, including those sponsored by the NH Association for the Education
of Young Children, NH Association for Family Child Care Providers, the Early Education and
Intervention Network of NH, NH DHHS DCYF Child Development Bureau, and DHHS Division
of Children Youth and Families. The Association also provides as a community service, a bimonthly e-mail brief addressing early childhood issues of concern.
In 2008, NHAIMH received a grant from the NH Endowment for Health to implement a rigorous,
one-year data collection and planning process that results in a state plan to improve mental health
services for young children and their families (aged birth to six years) throughout the state. The
final report, entitled Mental Health Services for New Hampshire’s Young Children and Their
Families: Planning to Improve Access and Outcomes, was released in May 2009.
NHAIMH and their partners have already begun to implement many of the recommendations
developed through this research. For example, the Watch Me Grow pilot was initiated to meet the
need for early childhood screening, evaluation and referral, and to build capacity for early
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childhood mental health within the existing behavioral health system. Additional ongoing efforts
have been incorporated into the DCYF 2010-2014 Child and Family Services Plan.
Watch Me Grow
Also supported by Title IV-B and CAPTA funds, the Watch Me Grow Pilot (WMG) is an
opportunity to develop a system to ensure that families with children birth to six years in New
Hampshire are consistently able to access developmental information, support, health and
developmental screenings.
In 2009 Phase I, three WMG pilot programs were started in Family Resource Centers, each
receiving $5,000.00 to build self-sustaining infrastructure for, enhance the capacity and promote
usage of, early childhood screening. During late 2009 – early 2010, Phase II began, bringing on
two more pilot sites, each receiving $5,000.00 to again build self-sustaining infrastructure for the
screening program. During 2010, Phase III, the remaining seven Family Resource Centers were
brought into the program, one at $5,000.00 and the last six at $4,000.00 due to budget
adjustments.
Domestic Violence and Substance Abuse
Since 1997, New Hampshire has benefited from having co-located Domestic Violence Specialists
(DVS) in each district office. The DVS program is an ongoing partnership with the NH Coalition
Against Domestic and Sexual Violence who provide staff from local crisis centers to work in the
district offices providing case consultation, direct services, and referrals for families experiencing
the co-occurrence of domestic violence and child maltreatment. These ongoing efforts ensure the
sustainability of the work completed during the Greenbook Project.
Similarly, in a project called the First Step Program, NH has co-located Licensed Alcohol and
Drug Abuse Counselors (LADC) in three district offices. What began as a Title IV-E
demonstration project from 1999 to 2004 has been maintained through Title IV-B and CAPTA
funds. The original project included only two district offices and was evaluated using random
assignment of assessments to experimental and control groups. The project resulted in
significantly positive outcomes for families in the enhanced group including increased access and
participation in mental health treatment, substance abuse treatment, in-home family support
services, and vocational or educational training. Further, children from the enhanced group
demonstrated declines in anxiety and depression, withdrawal, reports of somatic and attention
problems, and aggression.
In 2007, DCYF expanded this program to the Berlin District Office in collaboration with the
Community Mental Health Center. This program has proven to be an asset in early identification,
assessment and case planning for families who have alcohol or substance abuse as a significant
factor in their DCYF involvement.
New Hampshire Bridge Project
The NH Bridge Project reflects a true partnership between DCYF, DJJS the Family Courts and
Dartmouth Trauma Informed Research Center. The goal of this project is to enhance the level of
trauma informed services and integration of care among the three agencies of key importance in
the lives of abused and at-risk children and youth in NH, DCYF/DJJS and the NH Family Court
Division.
DCYF, DJJS and the Family Courts have been acutely aware of the challenges of service provision
among community mental health providers. Consequently, the state agencies have reached out in a
variety of ways to gain education and training to become trauma informed, and to better integrate and
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coordinate their activities with the community mental health system to collaboratively and effectively
serve children, youth and families who have experienced trauma. The Bridge Project will enhance
those efforts by bringing trauma-informed, culturally sensitive perspectives, knowledge, systems
change and practices to our statewide systems.
The NH Bridge project will initially be targeting four identified regions of the state. These
regions have been chosen due to promising approaches and practice atmosphere that will support
the rapid integration of trauma informed services.
In January 2010, NH Bridge Project staff and leadership from DCYF attended the International
Conference on Child Abuse and Neglect in San Diego, California in order to assess training
curriculum and initiate relationships critical to shifting the system. As a result, DCYF and DJJS
clinical and administrative leadership will be involved in finalizing curriculum for foster parents
and assisting in the development of curriculum for juvenile justice staff. Now that the project is
fully underway, on June 17, 2010, a kick-off event including a series of workshops will be held at
Dartmouth for DCYF/DJJS administrators, staff, mental health providers, and the courts from the
four designated project areas.
There are three key components to the New Hampshire Bridge Project, a training component, a systems
change component, and a direct services enhancement component. The training component includes
education, training and consultation/supervision on the implementation of trauma informed services.
At the systems change level, children and families served by the three agencies will benefit from the
education and systems change process. It is anticipated that over 7300 trauma-exposed children per year
may receive benefit from the New Hampshire Bridge Project. This benefit should be reflected in
improved client satisfaction, improved retention in services, fewer placements out of home or in
restrictive environments, and better functional outcomes. The systems change components at DCYF
and DJJS will be largely integrated into the existing staff education and quality improvement function
administered by the Center for Professional Excellence in Child Welfare, whose staff is committed to
working in collaboration with us.
At the direct intervention level, this project will also focus on improved referral and case coordination for
approximately 1,000 children per year. Outcomes expected include therapist competence in evidencebased treatment, symptom reduction in clients as well as improved functional outcomes and satisfaction
with care.
The New Hampshire Project for Adolescent Trauma Treatment (PATT)
In 2005, using funds from the U.S. Substance Abuse and Mental Health Services Administration
(SAMHSA), the Dartmouth Trauma Interventions Research Center (DTIRC) developed the New
Hampshire Project for Adolescent Trauma Treatment (PATT).
PATT‘s mission is to implement, evaluate and disseminate best practice for severely emotionally
disturbed adolescents who are served by the community mental health system (CMHC) in New
Hampshire. This has been accomplished through education, training, and supervision of
community mental health providers to:
Screen for and assess the emotional sequelae of trauma exposure;
Increase outreach to traumatized adolescents and their families; and
Implement best practices of trauma treatment across the NH mental health system.
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To accomplish these objectives, PATT chose to work with CMHC clinicians and administrators
using Trauma-Focused Cognitive Behavioral Treatment (TFCBT), which is an evidence-based
treatment model. The TFCBT framework is time-limited (12-18 sessions) and includes:
education, relaxation training, affect identification, cognitive coping, trauma narrative, cognitive
processing, and behavior management.
Since 2005, PATT‘s mission to expand evidence-based trauma treatment throughout the NH
community mental health system has been successful. As of March 2007, the PATT team had
trained over seventy-five clinicians from all ten CMHC‘s across the state and the Anna Philbrook
Center, NH‘s acute psychiatric hospital for children. Supervision and consultation by PATT has
continued to expand with the launch of videoconferencing technology with seven CMHC‘s and
the Anna Philbrook Center.
The DCYF Well-Being Bureau worked with DTIRC to train and provide ongoing supervision for
DCYF and DJJS Residential Providers and private therapists in the use of TFCBT. This will
allow DCYF and DJJS youth experiencing symptoms and behaviors related to trauma, better
access to this effective treatment.
Currently, DCYF is involved in two key statewide initiatives. First, we are collaborating with
others in the Court Improvement Project‘s Education Protocol subcommittee. DCYF is also
involved in developing and implementing a three-year project using Title 1 Part D funding called
the DHHS Statewide Standardization Project. This collaborative project‘s goal is to ultimately
develop and recommend an effective Statewide Standardization Process to help ensure that all
court placed New Hampshire students are provided with equal educational opportunities. This
includes establishing effective and compatible electronic record keeping systems, consistent
expectations for curriculum delivered and credits earned and proactive student-centered transition
planning.
Youth Vision State and Local Team
Starting in 2004, DCYF has been meeting and partnering with the Departments of Juvenile
Justice (DJJS), Education (DOE), Labor (DOL) and Vocational Rehabilitation, to better serve our
shared youth. The Department of Vocational Rehabilitation and Bureau of Behavioral Health
came on board in 2005 and 2006 and since 2008, the Division of Family Assistance, the 21st
Century Learning Programs and the New England Migrant Farm Workers Council have joined
what is now known as the NH Youth Vision state level team.
In October of 2005 the committee conducted the NH Youth Vision Forum, which involved over
150 representatives of the above-named agencies. Attendees were given the history and purpose
of the US Department of Labor‘s initiative to better serve what the White House‘s 2003 Task
Force identified as the youth in greatest need. Everyone was then divided into teams depending
on the community in which they worked. These local youth vision teams worked with a volunteer
facilitator to: 1) Get to know what each person‘s agency did for youth; 2) Determine at least one
youth-related need in their community; and 3) Create an action plan to address the problem.
Group leaders were chosen to report out their identified youth need and to lead their team‘s effort
going forward.
Local youth vision team leaders have met with the state level Youth Vision team on a regular
basis for additional guidance and support for their community change efforts. Each local team has
a chair and a co-chair who attend yearly trainings conducted by the state level team.
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Tuition Waiver for Foster Children Program
On July 17th 2007 Governor Lynch signed into law NH House Bill 168, which created the
Tuition for Foster Children Program. The program provides up to 20 youth a year, who were
adopted or aged out of DCYF or DJJS care, with the opportunity to attend NH state colleges free
of tuition and fees. The NH Teen Voices (DCYF Youth Advisory Board) led the charge of this
historic effort. Members of the NH Teen Voices developed the legislation in collaboration with
the bill‘s sponsor and then provided key testimony instrumental to the bill‘s passage. From the
fall of 2007 to the spring of 2009, 45 youth applied for the tuition waiver and 17 received it. The
majority of youth who did not receive the waiver did not need it as they already had sufficient
grants and scholarships. As word has spread about the waiver program so has the level of interest.
56 youth applied for the waiver for the 2009-2010 year.
The Family Resource Connection
The Family Resource Connection is a clearinghouse and library service for children with special
needs, thus filling a significant gap in NH‘s early intervention; disability, foster care and child
care systems. The clearinghouse is designed to address a statewide need on the part of
professionals, parents, family members, students, and the general public for information,
resources and materials related to child care, child development, parenting and children with
special needs.
Through this collaborative effort, the Family Resource Connection prevents the duplication of
services and expenditures by consolidating current statewide information and referral services for
child care, foster care, health, child abuse and neglect prevention and treatment and early
intervention resources and services.
In operation since the spring of 1996, the Family Resource Connection is receiving increasing
requests for information and materials as more people have learned about the service. The lending
library has grown to a collection of over 5,000 books and videos specially chosen to be helpful to
New Hampshire families and children. Additionally, an online website features a complete listing
of books, videos, and other materials available for loan from the Family Resource Connection; a
statewide directory of services pertaining to families with children; and a directory of statewide
calendars listing workshops, conferences and other events geared to children‘s development, care,
health, welfare and other special needs.
Training Program
NH DCYF operates a staff development and training program that supports the goals and
objectives in the CFSP, addresses services provided under titles IV-B and IV-E, and provides
initial training for all staff that deliver these services. The New Hampshire Division for Children,
Youth & Families (DCYF) and Division of Juvenile Justice Services (DJJS) believe that training
is a critical systemic factor in achieving quality outcomes for children and families. Thus, it must
be fully integrated into and aligned with all agency activities. DCYF/DJJS recognizes the
inextricable link between continuous quality improvement and training as a staff and
organizational development strategy, and therefore strives to be a learning organization. Within
DCYF, the Bureau of Organizational Learning & Quality Improvement (BOLQI) oversees efforts
to recruit, prepare, grow and retain a competent and committed workforce. Within DJJS, the
Training and Professional Development Unit, lead by a designated Manager, oversees training
coordination and quality improvement. These two agents lead a highly collaborative process
between the Divisions regarding the training and preparation of new staff.
Since July 2009, DCYF has contracted with the University of New Hampshire - Center for
Professional Excellence in Child Welfare (CPE) for provision of staff training. This highly
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collaborative endeavor includes partnerships with several centers and institutes at the University
of New Hampshire including the Institute on Disability, the Center for Teaching Excellence, and
the Crimes Against Children.
Data Considerations
Family Resource Connection: Receives more than 3,000 inquires per year for information and
resources to assist families and children.
Training Program: Please refer to training section of Statewide Assessment for more data.
Tuition Waiver: As indicated above, interested amongst DCYF and DJJS youth has increased
since the Waiver‘s inception. A record 56 youth has applied for the Waiver during this fiscal
year.
Comprehensive Family Support: Through the Comprehensive Family Support Program,
community-based agencies provide support services to approximately 1,070 families annually.
Strengthening Families Initiative: During the last year, New Hampshire has designated 27
childcare centers, which, combined, serve 21% of the children receiving Child Care Scholarship
(CCDF Subsidy) to be Strengthening Families Centers. These programs will build protective
factors for enrolled families. Currently, DCYF is recruiting and providing technical assistance to
additional child care providers across the state.
Watch Me Grow: Each pilot site has an evaluation plan that includes indicators collected
throughout the course of the contract period. DCYF will use the self-evaluation material during
the quarterly review of the program outcomes. Pilot sites use common screening tools and
reporting forms and data are collected to facilitate monitoring on the individual, agency and
statewide level.
NHAIMH: NHAIMH and their partners have already begun to implement many of the
recommendations developed through this research that resulted in the May 2009 report mentioned
above. For example, the Watch Me Grow pilot was initiated to meet the need for early childhood
screening, evaluation and referral, and to build capacity for early childhood mental health within
the existing behavioral health system.
Strengths
Foster Care Behavioral Health Program
The relationship between child welfare and community mental health provides an opportunity for
Bureau of Behavioral Health (BBH), DCYF, and DJJS to collaborate in better serving families.
This program provides an opportunity to identify crucial needs of children entering the child
welfare system early on, by providing a baseline for mental health and developmental growth
along with specific recommendations for interventions to be provided by foster and biological
families in a way that supports a child‘s strengths utilizing natural supports that exist for them in
their communities. Calling upon the expertise of New Hampshire‘s Community Mental Health
Centers (CMHC) provides these vulnerable children and families an opportunity to receive the
help they need to move children more quickly into stable family situations. Early identification
of mental health and developmental needs will lead to a more efficient, cost effective provision of
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core services to the family and more timely reunification or, if that cannot occur, other permanent
living situations for children.
For many years DCYF and DJJS has had a unique relationship with the Bureau of Developmental
Services (BDS). This relationship consists of an interagency agreement that allows DCYF and
DJJS to access developmental services for children in our care that would not normally be
available to them until the age of 21. These services are the Home and Community-Based Care
Medicaid Waiver for the Developmentally Delayed population (HCBC-DD). This arrangement
allows access to services specific to the unique needs of children and young adults with
developmental disabilities. The ISO service plans are individually created with a unique budget
for each child and youth. These service plans and budget are reviewed and approved by State
Office. This arrangement allows for a more seamless exit from the child welfare system into the
developmental system serving adults.
The Practice Model
The overarching goals of the DCYF/DJJS 2010-2014 five-year Child and Family Services Plan
are centered on the development, implementation, and evaluation of a system-wide Practice
Model.
In accordance with the National Resource Center for Organizational Improvement (NRCOI), NH
defines a practice model as ―…aconceptual map and organizational ideology of how agency
employees, families, and stakeholders should unite in creating a physical and emotional
environment that focuses on the safety, permanency, and well-being of children and their
families.‖
To meet the goals set forth in this plan, DCYF has applied for, and received an intensive
implementation grant from the Northeast and Caribbean Implementation Center (NCIC). New
Hampshire is using this assistance to establish a Practice Model. This Practice Model will outline
the agency‘s beliefs and guiding principles and create a framework for decision-making and a
practice structure to guide work within all levels of the agency.
New Hampshire‘s DCYF and DJJS have been identified as leaders among child welfare agencies
in the country. The state would like to continue to improve on its existing best practices in order
to remain on the cutting edge of human service delivery. The development and implementation
of our Practice Model will provide many benefits including a shared vision, consistency in
practice and policies statewide and improved accountability. As our organizational
―t
ouchstones,‖ the Practice Model will remind us what we are supposed to be doing in relation to
human service delivery and assist us with our decision-making.
Opportunities for Improvement
As a result of the economic downturn, DCYF has had to make difficult budgetary and staffing
decisions. The impact of these decisions has been felt in DCYF‘s day-to-day practice. The loss
of some positions played pivotal roles in DCYF‘s collaboration in the community with other
federally funded programs and initiatives. With that said, DCYF has embraced the challenge of
sustaining these partnerships and programs and will continue to support many of these initiatives
in different capacities.
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G. Foster and Adoptive Home Licensing, Approval and Recruitment
Item 41: Standards for Foster Homes and Institutions. Has the State implemented
standards for foster family homes and child care institutions that are reasonably in
accord with recommended national standards?
In Round 1 of the CFSR, New Hampshire was in Substantial Conformity with the systemic factor
of Foster and Adoptive Parent Licensing, Recruitment, and
Retention.
Policy Considerations
Foster Family Care Licensing Requirements (He-C 6446) reflect the intent of the NH statute to
ensure a safe and nurturing environment for children in out of home care. Adoptive homes, which
receive a child before an adoption is finalized, must meet the Foster Family Care Licensing
Requirements. Child-placing agency Licensing Requirements (He-C 6448) establishes guidelines
and standards to become a child-placing agency in New Hampshire. Child Care, Residential, and
group home institutions are required to meet the licensing standard and certification for payment
standards in order to care for children placed by the Department of Health and Human Services
(DHHS) per the following rules: He-C 6350 Certification for Payment Standards and He-C 4001
NH Child Care Facility Licensing and Operating Standards. These rules set minimum standards
for health and safety, programmatic and clinical services.
CFSR Round 1 Finding
During the 2003 CFSR, this item was rated as an area of Strength, because foster family homes
and child care institutions are uniformly required to meet the State‘s licensing and certification
standards, as well as participate in initial and on-going training.
Stakeholders commenting on this issue noted that existing standards take into consideration
children‘s safety and health and are adhered to fairly stringently. A few stakeholders noted that
the local fire officials have inconsistent interpretations of fire code provisions for foster homes
(e.g. applying sprinkler systems requirements for institutions rather than that of private homes).
DCYF and the Foster and Adoptive Parent Association (FAPA) have had some success working
with State fire officials to establish consistent requirements among localities. Stakeholders noted
that children are not placed in homes until they are fully licensed, unless it is a relative home.
Changes since Round 1
He-C 6446 was revised and readopted in June of 2006 with some changes. Applicants still need
to be at least 21 years of age to apply for a foster care license but they no longer need to be under
the age of 65 to apply for an initial license. In the 2006 requirements, revisions were made to
incorporate ―
staffed foster homes‖ as an alternative to residential placements. In an attempt to be
more inclusive of other cultures, the requirement to ―r
ead and write‖ in English was reworded and
the applicant must now be able to ―
communicate‖ in English. In an attempt to clarify reasons
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why a license would be denied or revoked, the wording in the regulations was changed to identify
the types of felonies that would prevent a person from becoming licensed.
Data Considerations
Licensing records are reviewed to ensure that the necessary requirements are being fulfilled. A
recent Federal IV-E audit was held in December 2009. The report results indicated ―a
ll foster
homes and childcare institutions licensing records were available for review and contained the
required foster care provider license information for the PUR (period under review).‖ It was also
reported ―Cr
iminal record checks were consistently completed on foster family homes and
childcare staff employed in childcare institutions for all of the cases reviewed.‖
Strengths
All individuals applying to foster in the State of NH follow the same regulations. This would
include those people being licensed through a local district office and those applying through a
child-placing agency.
The schedule on which all licensing standards are reviewed and updated is described in the NH
Administrative Procedure Act RSA 541-A: 3 Procedure for Adoption of Rules by which all
agencies are bound. Specifications include drafting, style, and notice to stakeholders, public
hearing and a timeframe for filing. A rule adopted under RSA 541-A: 14, IV expires after the last
day of the eighth year following its becoming effective, unless sooner amended, readopted, or
repealed.
New Hampshire completes one home study for the purposes of fostering and adopting. This
practice was instituted in May 2000. Foster Care Licensing regulation, He-C 6446.06 (i) requires
that a decision on each completed application must be made by the licensing agency within 120
days from the date of the completed application. This would include that the home study must be
completed prior to the 120-day requirement.
All licensed foster homes throughout the State of NH meet the same requirements. The only
variable throughout the state that may vary are the requirements to pass the local fire and health
inspections because towns adopt the building code standards that they choose to follow.
Prior to June 2006, the date of the latest revision to the NH Licensing Regulations, meetings were
held with key collaborators throughout the State. These groups included the 12 District Office
Resource Workers, the 14 Child-Placing Agency Licensing Workers and the New Hampshire
Foster and Adoptive Parent Association. Input was sought, issues were discussed and when
appropriate, changes were made.
Communication is the key factor to ensure that all individuals in the state use the same licensing
standards. Monthly meetings are held with all Resource Workers from the district offices and this
group meets with all licensors from child placing agencies on a quarterly basis. On an annual
basis, training is held for all of these individuals to review the regulations to ensure consistency.
The Statewide Resource Worker, a position held at DCYF State Office, is in constant contact
with all staff that license foster homes and is available for on-site support and training.
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The most promising approach in this area is the use of monthly statewide meetings that include
Permanency, Adolescent and Resource Workers (known as PAR) from all district offices. These
meetings are currently addressing the issue of increasing the quality of home studies being
completed. This forum provides input from all areas of the state to address issues of concern.
Opportunities for Improvement
The State faces the challenge of working with the various requirements set forth by the different
towns in New Hampshire. State law requires that the local fire inspector approve all foster
homes. Meetings were held with the State Fire Marshall in 2004 to rewrite the ―F
ire Inspection
Form‖ (#2361). Input was sought to include the general requirements based upon the Fire Safety
Code of 2004. Since that time, some towns in the state have begun to adopt the 2006 Fire Safety
Codes, which creates a higher standard of approval. This issue continues to be a challenge and
will require additional collaboration.
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Item 42: Standards Applied Equally. Are the standards applied to all licensed or
approved foster family homes or childcare institutions receiving title IV-E or IV-B
funds?
Policy Considerations
The State of NH issues general and specialized foster care licenses according to He-C 6446
―Fost
er Family Care Licensing Requirements.‖ The initial license issued is General but with
additional training and experience a Specialized Foster Care License will be issued. Based upon
the needs of a child, a child will enter a General or a Specialized Foster Home. There are times
when a Permit to foster will be issued. This is only done when the most appropriate placement
for a child/youth is found and the home is not currently licensed. A Permit is time-limited and
not to exceed 6 months. Approval from a Child Protection Assistant Administrator is needed
prior to a home being permitted. This time limit is provided to allow the parents to meet all
requirements to become licensed, including training. The same standards apply to all people
seeking a foster care license. The only non-health and safety issue that is waived to obtain a
license is the initial training program for a relative who wishes to be licensed. Any waiver
requests by relatives are made to the Relative Care Program Specialist. Reasons for waiver
request vary, some examples are: relative already has a well-established relationship with the
child, transportation barriers and timeliness of placement.
Child Care, Residential, and group home institutions are required to meet the licensing standard
and certification for payment standards in order to care for children placed by the Department of
Health and Human Services (DHHS) per the following rules: He-C 6350 Certification for
Payment Standards and He-C 4001 NH Child Care Facility Licensing and Operating Standards.
These rules set minimum standards for health and safety, programmatic and clinical services.
CFSR Round 1 Finding
During the 2003 CFSR, this item was rated as an area of Strength, because the State‘s licensing
and certification standards were applied to all foster family homes and childcare institutions.
According to the Statewide Assessment DCYF applies the same standards to all applicants.
Stakeholders commenting on this issue were in general agreement that the State‘s standards apply
to all foster homes and child placing agencies, including relatives serving as foster parents.
Changes since Round 1
He-C 6446 was revised and readopted in June of 2006 with some changes. People still need to be
at least 21 years of age to apply for a foster care license but they no longer need to be under the
age of 65 to apply for an initial license. In the 2006 requirements, revisions were made to
incorporate ―
staffed foster homes‖ as an alternative to residential placements. In an attempt to be
more inclusive of other cultures, the requirement to ―r
ead and write‖ in English was reworded and
the applicant must now be able to ―
communicate‖ in English. In an attempt to clarify reasons
why a license would be denied or revoked, the wording in the regulations was changed to identify
the types of felonies that would prevent a person from becoming licensed.
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Data Considerations
Federal funds are only claimed for foster family homes and childcare institutions that meet the
full licensing standards set forth by the State. This is evidenced by the results of the December
2009 Federal IV-E audit, which showed that all foster homes reviewed were in compliance.
Fiscal staff throughout the State maintains copies of foster care licenses for all cases they
monitor. All claims that are processed in Bridges look at the Bridges Resource Section to make
sure the license is in effect. If the child is IV-E eligible, and the license is in effect, the claim will
be paid out of IV-E. If the license expired in Bridges, the claim is paid out of settlement.
Monthly meetings for key stakeholders, including DCYF Resource Workers throughout the State,
ensure consistency in licensing foster homes.
Strengths
In 2008, a Relative Care Program Specialist was hired to develop, revise and create policy and
methods to increase the use of relatives for children and youth entering care. This person assists
in educating staff of the importance of placing children with relatives and assisting relatives to
receive needed supports and services.
Opportunities for Improvement
DCYF understands the importance of improving the education of relatives of the benefits of
becoming a licensed foster parent. In part by utilizing the Relative Care Program Specialist
position, DCYF has begun welcoming relatives to local support groups for foster and adoptive
parents, as well as, including them in the statewide newsletter. By doing this, DCYF is moving in
the right direction.
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Item 43: Requirements for Criminal Background Checks. Does the State comply
with Federal requirements for criminal background clearances related to licensing and
approving foster care and adoptive placements, and does the State have in place a case
planning process that includes provisions for addressing the safety of foster care and
adoptive placement for children?
Policy Considerations
The New Hampshire ―Fos
ter Family Care Licensing Requirements‖ includes the need to
complete local and statewide criminal background checks. He-C 6446.06 addresses the issue of
criminal record checks and He-C 6446.07 addresses the issue of central registry checks for a
history of abuse and neglect for all members of a household age 17 and older. There are no
exceptions to this regulation. All individuals seeking to adopt a child in the State of New
Hampshire follow the same rules. Criminal record and central registry checks are only valid for
two years. A foster care license expires prior to reaching the 2-year mark. These checks must be
completed again in order to renew a foster care license.
The following checks are required for each applicant and every household member age 17 and
older prior to licensing the home:
Live Scan FBI fingerprint check done through the NH Department of Safety for the
applicant;
NH Criminal record checks for all members of the household age 17 and older;
Central Registry checks for all members of the household age 17 and older; and
Local police checks for all members of the household age 17 and older
Foster and adoptive applicants undergo Live Scan fingerprinting with the NH Department of
Safety. The applicant calls a specific telephone number to make the appointment. Fingerprinting
results are sent via a currier to the Department of Health & Human Services/Division for
Children, Youth and Families. Results are copied, tracked, and filed at State Office. One copy of
the results is sent to the licensing office or agency to be maintained in the applicant‘s file.
CFSR Round 1 Finding
During the 2003 CFSR, this item was rated as an area of Strength, because criminal background
checks and reviews of child maltreatment histories were consistently completed for foster
families and child care institution staff.
Stakeholders reported that criminal background checks are conducted at the State and local levels
and child maltreatment histories are checked out through the Central Registry.
Changes since Round 1
On July 1, 2007, FBI Live Scan fingerprint checking began as the State complied with the Adam
Walsh Act. All applicants seeking a foster home license needed to be fingerprinted. A procedure
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Item 43
was set in place to have this be accomplished. Foster parents who became licensed prior to July
1, 2007 do not need to be fingerprinted. However, if these foster parents are planning to adopt
their foster child, they need to be fingerprinted prior to being approved.
Data Considerations
In December 2009, a Federal IV-E review was held. Results of the review showed that all foster
and licensed relative homes records contained the necessary criminal background and fingerprint
checks that are required. Unlicensed relative homes require criminal background and central
registry checks, but do not require fingerprint checks.
These requirements are completed prior to issuing a license. Therefore, no child is placed in a
home prior to these checks being completed. This is also true if a home will initially be a
permitted foster home. Periodic checks, Federal IV-E reviews and approval of a license by the
local office all ensure that these requirements are being met.
Strengths
State regulation He-C 6446.27 Denials and Revocations is very clear as to the types of felonies
committed that would prevent the issuing of a foster care license. This regulation has not been
appealed by an applicant nor waived for an applicant. If a felony, as defined in He-C 64466.27, is
committed by a member of the household during the time that a child is placed in the home, the
child would be moved to another home to ensure safety of the child as described in Regulation
He-C 6446.25 Orders to Comply and Immediate Removal of Child In Care.
These regulations apply to all areas of the state with no exceptions. The State of NH was able to
implement Live Scan fingerprinting in a timely fashion. Initially, all individuals needing to be
fingerprinted needed to travel to the state capitol, Concord, to have this done. This was a barrier
for some people. The NH State Police have now added additional locations for fingerprinting to
be done in the Northern and Western part of the State.
Opportunities for Improvement
There is a continued need to increase locations throughout the State of NH that would be able to
provide Live Scan fingerprinting services. Communication with the Department of Safety
regarding this issue needs to be on going and collaborative.
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Item 44
Item 44: Diligent Recruitment of Foster and Adoptive Homes. Does the State have
in place a process for ensuring the diligent recruitment of potential foster and adoptive
families that reflect the ethnic and racial diversity of children for whom foster and
adoptive homes are needed in the State?
Policy Considerations
Foster Family Care Licensing Requirements (He-C 6446) reflect the intent of the NH statute to
ensure a safe and nurturing environment for children in out-of-home care. Adoptive homes,
which receive a child before an adoption is finalized, must meet the Foster Family Care Licensing
Requirements.
Policy 723 Child Matching Process informs practice regarding the selection of the family for a
child in out-of-home care who cannot safely return to their family of origin and who may not be
currently in a family placement that can assure permanency for the child.
Policy 730(b) Individual Service Options (ISO) Foster Care defines the requirements for
Individual Service Options in Foster Family Homes. "Individual Service Options" means foster
family care in which a variety of intensive therapeutic, social, and community-based services are
provided or coordinated to meet the individual needs of a child and his or her family. The ISO
provider must be an agency that is: Enrolled as a Medicaid provider; and Certified for payment by
DHHS, pursuant to He-C 6351, Certification for Payment Requirements for Foster Family Care.
Policy 746(b) Recruitment and Retention Plan defines the requirement for DCYF to
developing a strategic, annual plan for continuous recruitment and retention of foster homes in
each District Office. Recruitment and retention of foster family homes is an integral part of
licensing homes to care for children. Continuous recruitment and retention of foster homes
enables DCYF to have a sufficient number and types of foster homes to match children‘s needs to
the foster family‘s skills.
CFSR Round 1 Finding
During the 2003 CFSR, this item was rated as an area of strength, because DCYF conducts
recruitment activities throughout the state and works with community partners to help recruit
foster and adoptive homes that reflect the racial and ethnic diversity of the children in care.
Stakeholders reported that DCYF makes efforts to recruit and retain foster and adoptive families
from backgrounds that reflect the racial, ethnic and other types of diversity found in the state.
Stakeholders also recognized the support of current foster parents as an important recruitment and
retention strategy. They cited Casey Family Services‘ support of the Foster and Adoptive Parent
Association under a contract with DCYF as instrumental in promoting a renewal of the
association at the state and local levels over the past year and a half. The association was credited
by stakeholders as contributing to the retention of 80 percent of foster homes over the past year.
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Changes since Round 1
New Hampshire CFSR Statewide Assessment
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Item 44
An internal shift in DCYF Administration and practice has occurred since the last CFSR. The
Bureau of Community and Family Support has joined the Foster and Adoption Programs into one
entity. Recruitment and Retention responsibilities are now equally shared. The training for foster
and adoptive parents has been merged into one program (FACES) and more participants apply to
be foster-to-adopt homes. All foster homes for DCYF have been informed that the expectation of
fostering for New Hampshire includes engaging with birth families. DCYF foster homes are
required to work with the birth family when children are placed into their care and when the
permanency plan for that child is reunification with their own family. When it is determined that
a child cannot safely return home, it is a desired outcome that the foster family is willing and able
to provide that child with long-term stability and permanency through adoption.
A committee to address the implications for relative caregivers of the Fostering Connections to
Success and Increasing Adoptions Act of 2008 was created and a 30-day relative notification
process has been established as new policy for the Division (Refer to Item 15 for more details).
More relatives are being found and utilized as natural placements and supports for children who
are at risk of removal from their own families. This is beginning to reduce the need for nonrelative foster care.
In July 2004, DCYF and New Hamshire faith leaders attended a national summit on recruiting in
the faith community as part of the ―
Answering the Call‖ initiative. As a result, the Community
and Faith-Based Initiative (CFBI) were formed in 2005 and have continued to grow and expand
over the last six years. This statewide initiative provides recruitment and retention support for
DCYF and foster/adoptive families. Starting in December 2007 DCYF partnered with a faithbased contractor in another recruitment project; Wendy‘s Wonderful Kids (WWK) through the
Dave Thomas Foundation for Adoption. This grant funds an adoption recruitment position to
focus on those children considered hard to place and carries a caseload of approximately 8-10
children throughout New Hampshire.
Data Considerations
The overall statistics for foster homes have remained steady over the last six years. The merging
of the Foster Care and Adoption programs has resulted in more families who are willing to foster
to adopt. A growing percentage of the closed foster homes are a direct result of the foster to
adopt program.
2006 2007 2008 2009
Number of DCYF foster home (April)
650 612 645 637
Number of child specific foster homes
Adoption only foster homes
Number of Inquiries in year
Initial Training completed in year
Number of new foster homes licensed
Number of homes closed
72
33
982
338
147
171
95
43
981
320
175
157
93 90
56 49
1161 1048
448 370
126 107
132 139
The majority of children in out-of-home placements have only one or two placement settings. In
FFY 2007, 79 percent of children who had been in the state‘s care less than 12 months had no
more than two placement settings. Per the 2000 US census report, 95% of New Hampshire
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Item 44
residents were reported to be White. New Hampshire is anticipates this percentage may shift with
the results of the2010 census. A recent survey done with the twelve district offices showed that
there is more cultural diversity in the larger, more metropolitan areas of the State. The Northern,
more rural areas of New Hampshire have not yet experienced that type of growth or population
change. Placement data available from February 2009 reports the following racial-ethnic
composition of New Hampshire children in care: 85.3% White, 4.3% Black, 7.1% Hispanic, 2.7%
Multi-Racial, 0.5% Asian and 0.1% American Indian. A recent review of homes in the state
showed that 7% of the provider families are documented as being multi-racial or of a minority
background. As you will see, Hispanic is not identified. When the data is entered, the foster
parent applicant (or other adult in the home) chooses a primary race and then either a ―Yes‖ or
―No‖ for the question of Hispanic ethnicity. Of 930 licensed homes, 33 chose ―Ye
s‖ for
Hispanic, 1 chose unknown, 865 chose ―No
‖ and 31 chose not to answer.
The chart below includes all licensed homes, including those licensing by child placing agencies.
As of March 2010
Total of licensed homes
White
Black
American Indian
Asian
Natural Pacific Islander
#
930
868
36
18
5
3
%
93.3%
3.9%
1.9%
0.5%
0.3%
The chart below provides further detail of the breakdown between DCYF licensed Foster Family
Homes and Foster Family Homes licensed by Child Placing Agencies. As the chart indicates, the
number of DCYF licensed foster homes has gradually decreased over the past several years,
while the number of Child Placing Agency licensed foster homes has gradually increased.
Licensed Foster Homes
As of April 2008, there were 939 licensed foster homes in New Hampshire.
As of April 2010, there were 896 licensed foster homes in New Hampshire.
As of April 2008, 31% of the licensed homes were from Child Placing Agencies.
As of April 2010, 37% of the licensed homes were from Child Placing Agencies.
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Item 44
DCYF Licensed Foster Homes by District Office
DO
April 2006
April 2007
April 2008
April 2009
April 2010
Berlin
53
44
46
55
47
Claremont
52
46
41
34
34
Concord
54
42
37
38
39
Conway
28
29
31
39
39
Keene
71
64
71
72
64
Laconia
51
50
50
58
57
Littleton
28
23
33
26
25
Manchester
71
80
82
68
57
Nashua
76
77
89
84
72
Portsmouth
71
68
72
63
52
Rochester
50
41
45
51
54
Salem
45
48
48
49
52
Total
650
612
645
637
562
April 2007
10
60
3
4
7
70
74
32
11
3
1
2
2
1
April 2008
15
58
2
3
6
74
68
38
11
11
9
4
2
1
1
1
280
294
April 2009
25
50
2
3
8
106
50
38
10
12
18
3
3
1
0
0
0
0
329
Foster Homes Licensed by Child Placing Agency
Child Placing Agency
Child & Family Services
Easter Seals of NH
NFI North
NHS
Casey Family Serv. VT
Casey Family Serv. NH
Lutheran
LifeShare Inc.
Spaulding
ISN
NH Mentor
Adoptive Families
Catholic Charities
Lakes Region
Wide Horizons
Bethany Christian Services
Crotched Mountain
NE Center
Total
April 2006
5
47
2
11
76
62
27
5
2
2
238
April 2010
20
47
3
3
10
104
42
41
20
12
17
3
4
1
0
3
3
1
334
Strengths
Partnering with the community and families is a fundamental philosophy of the Division. The
community has a role and responsibility in supporting children in care. Foster and adoptive
parents are linked closely to the neighborhoods, communities and cultural, ethnic, and religious
groups that make up the community. They work and perform daily activities and contribute to the
vitality of the community while serving children in care. Development of the plan by local
recruitment and retention teams in each District Office makes operational the belief that keeping
children in their own communities in close proximity to their parents, schools, and other
significant people in their lives will enhance the safety and well-being of children. Community
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New Hampshire CFSR Statewide Assessment
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Item 44
placements can also increase the probability that the parents and children will be reunified and
can enhance the ability to maintain natural and lifelong connections.
New Hampshire believes that selecting the most appropriate family for a child who cannot safely
return home can reduce the trauma of separation and loss for the child, can increase the
probability of a successful placement and ideally, can create a lifelong connection or permanent
home for the child, if needed. New Hampshire uses a comprehensive recruitment model for
potential foster and adoptive families that reflects not only the ethnic and racial diversity of the
children in our care, but families that are naturally linked to the neighborhood and communities
children are from.
While efforts are made to diligently recruit foster and adoptive parents who reflect the diversity
of the children who need foster and adoptive homes, practice does not delay the selection of a
family for the purpose of finding a racial or ethnic match. DCYF staff as well as providers and
caregivers participate in on-going training to promote cultural competency. Through training and
on-going support, the Division makes efforts to ensure that resource families are culturally
responsive to child(ren)‘s needs regardless of whether they have different backgrounds.
The Community and Faith Based Initiative grows stronger every year. Because the CFBI has
been so successful in supporting foster and adoptive families, the new CFBI contract includes an
additional goal of providing support and assistance to NH Family Resource Centers. It is
anticipated that this support will increase prevention at a community level, as well as provide
assistance for identified families who are at risk.
In April 2008, and again in 2009, field staff and supervisors from several DCYF district offices
attended the NH Diversity Conference sponsored by Casey Family Services. The conference is
designed for human service professionals, foster and adoptive parents, educators, policymakers,
and other interested members of the community to expand their knowledge of diversity issues.
The Division has expanded its use of the DHHS and the UNH Center for Professional Excellence
in Child Welfare websites as informational and recruitment tools. Pictures of Waiting Children in
the state are available on both sites to viewers. Links to training and other resources for both
foster and adoptive families are easily found. DCYF has had a partnership with AdoptUsKids for
child specific recruitment since 2005.
New Hampshire also participates annually in both the national Adoption Celebration month of
November and the national Foster Celebration month of May through gubernatorial proclamation.
Finally, DCYF enjoys a strong relationship with the New Hampshire Foster and Adoptive Parent
Association (NHFAPA). DCYF values the hard work and commitment of the parents actively
involved with this association who offer peer support to fellow families. The Division recognizes
and appreciates that the best recruitment tool for new foster and adoptive families is a wellsupported network of current foster or adoptive families.
Opportunities for Improvement
DCYF is working on the creation of a Practice Model; an effective practice framework that will
provide staff with a moral imperative for practice that goes beyond compliance with policy and
rules. Once established, practice will be consistent with common underlying principles that will
be more likely to be sustained over time. DCYF believes the development, implementation, and
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Item 44
evaluation of a statewide Practice Model will improve communication between all internal and
external partners involved with the New Hampshire Child Welfare system.
As the responsibilities of the Resource Workers have expanded, there has been less time for them
to dedicate to broad recruitment tactics. The larger community of New Hampshire has not been
receiving a clear and consistent message about the need for and role of foster and adoptive
families on a statewide basis.
Foster/Adoptive parent recruitment will continue to be a focus of DCYF/DJJS strategic planning.
DCYF was not successful in obtaining the Diligent Recruitment grant written in 2008, so the goal
of developing a centralized inquiry system to inform and track potential provider families has not
yet been met. A new request for proposals (RFP) for foster/adoptive parent recruitment and
retention will explore new techniques to increase the availability of resource families, relative
caregivers, respite care providers and foster/adoptive parents. This supplements on-going work
with ISO and residential care providers. Specific goals related to this area are included in the
2010-2014 five-year plan.
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Item 45
Item 45: State Use of Cross-Jurisdictional Resources for Permanent Placements. Does the
State have in place a process for the effective use of cross-jurisdictional resources to facilitate
timely adoptive or permanent placements for waiting children?
Policy Considerations
The Interstate Compact on the Placement of Children (ICPC) promotes cooperation and collaboration
among the states in the interstate placement and determination of possible placement resources for
children. The NH ICPC policy reflects federal legislation governing the Safe and Timely Interstate
Placement of Foster Children Act effective October 1, 2006. DCYF policy requires that all ICPC
referrals be entered into Bridges, the NH SACWIS system.
The Safe and Timely Interstate Placement of Foster Children Act of 2006 included an amendment to
encourage timely home studies. A home study is considered timely if ―w
ithin 60 days after the state
receives from another state a request to conduct a study of a home environment for purposes of assessing
the safety and suitability of placing a child in the home, the state shall, directly or by contract:
Conduct and complete the study; and
Return to the other state a report on the results of the study, which shall address the extent to
which placement in the home would meet the needs of the child.‖
In response to this legislation DCYF revised policies and procedures to outline:
How to effectively evaluate families who are referred by another state for an ICPC Home
Study, and;
What is required by the CPSW for supervision of this home, if a placement is made.
DCYF also created a monthly report that provides data on ICPC referrals received into New Hampshire.
This report allows the ICPC Administrator to track the timeliness of these home studies.
Policy 734(a) “Home study and Supervision of ICPC Placements when NH is the Receiving State”
describes the process and sets the timeframes when NH is the receiving state in an ICPC request. This
policy sets the procedures to be followed when completing a home study to ensure that the proposed
placement would meet the child‘s safety, permanency, health and well-being needs. This policy also sets
the guidelines for supervision and quarterly reports once a placement is made.
Policy 734(b) “ICPC when NH is the Sending State” describes the requirements and procedures for
requesting an out-of-state placement. DCYF must elicit the assistance of another state in providing
specific information and in evaluating a possible resource when considering a cross-jurisdictional
placement.
DCYF, through its ICPC office, processes several hundred referrals each year. Improved training
provided to the CPSW‘s and supervisors has resulted in more complete referrals and shorter time frames
in completing home studies6. DCYF has been able to track the timeframes for pending requests to assist
the district offices in meeting their timely completion dates.
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Item 45
During the 2003 CFSR, this item was rated as an area of Strength, because the State uses a variety of
methods to facilitate the placement of children with adoptive families across jurisdictional lines.
Stakeholders commenting on this issue noted that the State makes use of multiple cross-jurisdictional
resources to ensure that appropriate placements are found for children in a timely manner. They cited
AdoptUsKids as one resource, as well as listing of children on the website. Stakeholders also described
the statewide structure of the DCYF adoption unit, which facilitates adoptive placements across county
lines. A few stakeholders noted that when the agency explores placements outside of the local
jurisdiction, it is usually a placement with a relative or parent who has moved. However, stakeholders
reported that adoptive placements have been found in other States for two waiting children with complex
special needs through a contract with Downey Side for Children.
Changes since Round 1
Since the last CFSR, DCYF has implemented several changes to practice for interstate cases. First, in
2005, ICPC cases became part of NH‘s SACWIS system, which allows referrals to be assigned
electronically to the district offices, and monitored to make sure time frames are being met. The system
also tracks monthly face-to-face visitation to be recorded in the quarterly reports. Second,
ICPC home study requests are now generally assigned to the Resource Workers in each district office,
which has shown more consistency in evaluating potential resources for children. Third,
DCYF now provides a monthly tracking report of ICPC requests by state, district office, and type of care
and length of time to completion of a home study. These reports assist the ICPC Deputy Compact
Administrator (DCA) in tracking home studies that may become overdue. Finally,
DCYF implemented new ICPC policy effective October 1, 2006 that describes the process for completing
both sending and receiving ICPC referrals. This policy also sets timeframes for completing home studies
within the federal guidelines.
DCYF utilizes several mechanisms described throughout this item for recruitment of families for waiting
children some of which may come from other states. If a family were then found, the ICPC office would
be the entity to access the information on the potential out-of-state resource. Some of the recruitment
activities that may reach across state lines are as follows:
Community and Faith based Initiatives (CFBI). A grant funded contract with Bethany
Christian Services that has brought together many faith-based leaders and churches that
participate in recruitment activities;
Starting in December 2007 DCYF has also partnered with Bethany Christian Services in
another recruitment project—Wendy‘s Wonderful Kids (WWK) through the Dave Thomas
Foundation for Adoption. Bethany is the recipient of a WWK grant that funds an adoption
recruitment position to focus on those children considered hard to place. This position carries a
caseload of 8-10 children throughout the state. WWK, in partnership with the Community and
Faith-Based Initiative also sponsored NH‘s first adoption matching party in November 2008.
Overall, WWK has been involved with several matches and placements of older youth waiting
for adoptive families;
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Data Considerations
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Item 45
Since 2005 when ICPC was put into the NH SACWIS system, DCYF has been able to report data on the
number of ICPC referrals sent to other jurisdictions and received from other jurisdictions. Timeframes for
completing ICPC home studies and types of placements requested are also being reported on.
Reporting period 10/1/06 to 9/30/07
168 incoming requests
166 accepted and referred to district offices for completion
25.6% (43) completed within 30 days
41.07% (69) completed within 31-60 days
13.10% (22) completed within 61-75 days
19.05 % (32) completed over 75 days
.60% (1) not completed
Reporting period 10/1/07 – 9/30/08
178 incoming requests
170 accepted and referred to district offices for completion
24.72% (44) completed within 30 days
32.58% (58) completed within 31-60 days
14.04 % (25) completed within 61-75 days
24.16% (43) completed over 75 days
3.93% (7) not completed
Reporting period 10/1/08 – 9/30/09
263 ICPC referrals were received in to NH and reviewed by the Deputy Compact Administrator.
104 remained in the state office under the ICPC Admin (Private adoptions and residential
placements)
159 were referred to district offices for completion
Of the 159 referred to district offices:
25.16% (40) completed within 30 days
32.08% (51) completed within 31-60 days
15.72% (25) completed within 61-75 days
25.16% (40) completed over 75 days
1.89% (3) not completed
DCYF record destruction policy regarding ICPC cases is to maintain the record of information received
from the sending state for one year after closing. Hence, a complete analysis of the reasons why the
extended compliance period was needed was not always possible.
The DCYF ICPC Administrator conducted a comprehensive review of those files that had not been
purged. For SFYs 2007 and 2008, approximately 43% (75) of the requests for home studies needed the
extended 75-day period to be completed and the extension did result in resolution of the circumstances
that necessitated the extension. The primary justification for extending the time frame to complete the
study was to obtain necessary corroborating information from the foster/relative or adoptive family or
collateral resources in order to determine whether the home study could be approved.
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The following circumstances impacted the timely completion of home studies within 60 days:
Child was already living with the foster/relative family at the time the request was received and
the caregiver delayed submission of requested paperwork for a NH foster care license to be
issued;
Child was already living in the pre-adoptive home in New Hampshire at the time the request
for study was received, and the family did not submit paperwork at the time it was requested;
Significant information was not received at time the request for home study was received from
the sending state; e.g., criminal record history of proposed caregiver, certain evaluations,
information regarding the type of study needed, etc. As a professional courtesy, the DCYF
ICPC Administrator held onto the request until the information was received thus reducing the
number of days the local office had to complete the home study once it was assigned;
DCYF requested a mental health and/or substance abuse evaluation be completed to assess
parental capacity to care for the child and was awaiting the outcome and recommendations
prior to approving the home study;
Availability of staff resources in a local office impacted assignment and timely completion of
home study
DCYF has taken the following action in an effort to assure timely completion of home studies:
Requests for home studies that are lacking necessary information to assign to the local office
will be returned to the sending state rather than held by the ICPC Administrator;
Increased oversight by the Assistant Administrators assigned to the local offices including
follow up with the Supervisor and assigned staff to address issues related to incomplete studies
Strengths
In addition to the recruitment activities listed above, DCYF also supports several more recruitment
initiatives:
The Heart Gallery is a project initiated by the New Mexico Department of Youth and Families
as a way to recruit adoptive families for waiting children. DCYF partnered with Jordan‘s
Furniture and the Massachusetts Adoption Resource Exchange (MARE) in creating the
permanent New Hampshire Heart Gallery in the Jordan‘s Furniture store in Nashua;
NH DCYF has also created a traveling Heart Gallery that will be used for statewide
recruitment and retention events. Approximately $5,000 of PSSF Adoption Recruitment and
Retention funds has been dedicated to this activity. The traveling display has been featured at
various locations throughout the state, including the Dartmouth Hitchcock Medical Center in
Lebanon and the Capitol Center for the Arts in Concord. The traveling display was posted
throughout the 2009 federal fiscal year. A poster-sized version of the display is available to the
District Office staff for use at local events;
DCYF has partnered with the NH Professional Photographers Association and some individual
volunteer photographers to take photos of waiting children. There are currently 19
photographers who are volunteering their time and services for this project. A printer has
agreed donate the 20x24 photos needed for the gallery. In addition, each child will receive a
framed 8x10 photo;
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Item 45
Additional recruitment efforts utilized by NH DCYF include: AdoptUSKids offers training and
assistance to NH, working with MARE and a waiting children brochure
While these recruitment efforts are not tracking their effectiveness in locating cross-jurisdictional
resources, the on-going focus on permanency has resulted in a continuing rise in the number of annual
adoptions. Since 1998, the number of children adopted through DCYF has increased by over 200%.
DCYF works through the ICPC office to take all necessary steps to evaluate potential resources for
waiting children that may reside in other states. The ICPC DCA has open communication with other
compact offices to resolve interstate issues related to permanency for children.
NH does not have any border agreements with any other state or jurisdiction.
There are no influences or issues specific to a particular region of NH regarding this item.
DCYF has recently collaborated with the CIP, NH Judges, CASA and NCJFCJ to complete the NH
Interstate Compact on the Placement of Children Court Guide. This is a comprehensive guide that
includes ICPC procedures to be addressed by the court at each hearing. Best practice recommendations
are included in the guide. Upon final revisions this guide will be distributed to the courts and other
stakeholders. There are also plans for a shorter, quick reference bench guide for ICPC cases.
Opportunities for Improvement
DCYF has begun the process of developing a Practice Model that will provide consistency throughout the
state in all areas of child welfare including cross-jurisdictional placements to and from NH.
Unfortunately, timeframes in obtaining ICPC home studies from other states continues to be an issue.
In 2009, the NH Supreme Court decided the case, Alexis O, which does not allow NH to request ICPC
home studies on parents who live in other states. This can be a barrier to achieving permanency through
reunification with a parent.
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Section V
SECTION V STATE ASSESSMENT OF STRENGTHS
AND NEEDS
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Section V
Section V – Statewide Assessment of Strengths and Needs
Across the country, state child welfare agencies are engaged in comprehensive and significant reform of
their practices to improve the way they protect children and engage families. Such changes do not come
easily or quickly. In New Hampshire we have maintained a sustained focus for change that was a direct
result of our 2003 Child and Family Services Review. The Review provided helpful information about
both our outcomes for families and the underlying systems that affected those outcomes.
That review set the stage for New Hampshire‘s reform efforts and our commitment to creating and
sustaining an environment that promotes learning and leadership at all levels and to make our
organization more accountable for its actions and individuals more readily responsible for their actions.
New Hampshire is proud of its multiple and intricate networks of relationships, which are sustained
through communication and a common vision for change. Throughout this document there are examples
of successful and significant initiatives relating to safety, permanency and well being. These have
included rapid and substantive changes in both policy and practice and have involved and affected all
levels of staff throughout both Divisions and major community partners.
While the Divisions many accomplishments provide a fertile ground for innovation, it is the partnership
and commitment from internal and external stakeholders that is our strength and key to our success. The
major systems (Court, CASA, DCYF, DJJS, Residential Providers) know the importance of impacting
each system‘s practices in order to improve practice outcomes. The ability to sustain practice and
philosophy changes is because the leadership from each systemic partner has been committed to crosssystem planning and training. Each system hears directly from their leadership as well as the leadership
within the other systems and this has role modeled the critical commitment to best practices. This
amazing collaboration and communication is unique to New Hampshire and is critical to assure
consistency in servicing families across the state.
Similar to many other states around the country, New Hampshire has been experiencing some significant
budget deficits. Both agencies already had to address layoffs, and continued budget shortfalls are adding
another level of uncertainty and concern for staff and providers. Although we are experiencing difficult
times, they will not diminish leadership and staff enthusiasm and commitment toward improving
outcomes for the children and families we serve.
Question 1: Determine and document which of the seven outcomes and systemic factors
are primary strengths, citing the basis for the determination.
Safety Outcome 2: Children are, first and foremost, protected from abuse and neglect.
New Hampshire has demonstrated exceptional performance on the standard for Absence of Child Abuse
and/or Neglect in Foster Care and exceeded the national standard in 2009. The use of SDM tools has
improved identification, assessment and response to the safety, risks, and strengths of children and
families and led to better case planning. Core Training for child protection staff has been revised to
include enhanced focus on engaging families in the assessment and ongoing case planning. As a result of
this shift in approach and practice when working with families, New Hampshire has seen an increase in
the number of in-home cases. And lastly, the expansion of community-based support programs that
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promote family wellness, decrease family stress, and ultimately contribute to the prevention of abuse and
neglect have led to positive outcomes.
Permanency Outcome 1: Children Have Permanency and Stability in their Living Situations
The findings from the 2003 CFSR were a driving force behind many significant changes and a
commitment to permanency that has initiated a culture shift within both DCYF and DJJS. Consequently,
the agencies have successfully implemented major initiatives relating to permanency.
Our commitment to improved outcomes included identifying and initiating extensive practice and
statutory changes that were barriers to permanency. DCYF leadership made bold changes to the
infrastructure through the reorganization of positions, creating specialty focuses and expertise of staff.
This helped New Hampshire breakdown the compartments of service delivery in the field, which led to
the facilitation of more focused and timely permanency activities. Notable achievements are illustrated in
the adoption data; New Hampshire scores are well above the national standards. There is also evidence of
a significant decrease in median length of stay for children exiting to adoption.
The traditional roles of the CPSWs had not been as effective as they could have been in ensuring that
each child‘s permanency goal was achieved within timeframes appropriate for his/her circumstances and
case plan. Prior to 2003, Family Services CPSWs traditionally focused on working with birth parents and
reunification plans, Foster Care CPSWs located, evaluated and supported foster families, Teen
Independent Living workers created adult living plans, and Adoption CPSWs worked with children and
adoptive families following the termination of parental rights. Real, efficient and effective concurrent
planning and permanency planning demanded a different organizational model.
As its first step in enhancing the infrastructure, DCYF was able to acquire additional staff. A new
position of Permanency CPSW was created in each district office along with an Adolescent CPSW, both
of which were additions to the existing Family Services and Foster Care licensing staff.
Both DCYF and DJJS have implemented the use of Permanency Planning Teams (PPT) and have worked
collaboratively with the courts and residential providers to focus on timely permanency.
Residential providers joined DCYF/DJJS in an initiative aimed at developing and implementing a
collaborative system for delivery of services in residential treatment that focused on shorter lengths of
stay and achieving permanency for the youth in their programs.
The fact that New Hampshire has seen a dramatic decrease in the number of children in out-of-home care
is a significant demonstration of our commitment and success.
Permanency Outcome 2: The continuity of family relationships and connections is preserved for
children.
One of the first and most significant permanency initiatives in New Hampshire was the creation and roll
out of the Finding Connections Program that placed a contracted Connection Specialist in each of the
district offices. The Connection Specialist has expertise in researching a child‘s case file (case mining) to
identify relatives and other supports; and works collaboratively with the child‘s caseworker and
Permanency Planning Team (PPT) to identify positive resources for the child. As DCYF and DJJS work
towards breaking down barriers effecting permanency, this new collaborative effort has elicited optimism
in helping to reach permanency goals for children in care.
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The Findings Connections Program was implemented in all of the district offices by September 2007.
Each office received training around the need for connections and specific information about the Finding
Connections Program and referral process. The training clarified the role of the Connections Specialist
and other related services around this program.
Initial results from SFY 08 were very positive. Of the discharged cases 65% of cases by the Connection
Specialist with a completed connections plan have ―
new adults‖ located. Further, 86% of those cases had
―i
ncreased face-to-face‖ contact with their adult connections. The performance indicators of greatest
significance were linked to the ―
APPLA‖ permanency plan cases. The success of this initiative reinforces
the importance of relatives and other community supports in all aspects of case practice.
Well-Being 2: Children receive appropriate services to meet their educational needs
New Hampshire has a history of excellent results in ensuring that children and youth have appropriate
services to meet their educational needs. An overall rating of Strength in the 2003 CFSR reviewers
determined that, through the efforts of both caseworkers and foster parents, New Hampshire makes
diligent efforts to meet the educational needs of children.
Exploration of educational needs and referral to resources is part of case plans on all open cases. The
agency also expects foster parents to be educationally involved with a child placed in their home,
including enrolling the student and, as available, attending school meetings and functions. Within the
foster parent training requirement is a module on education and further educational training is available at
no cost.
In addition, the Adolescent Worker in each district office recognizes that adolescents, especially those
placed outside their homes, have specific challenges. These Workers have specialized training and work
with the adolescent population addressing a number of issues that arise, including difficulties in school.
In addition, they also help students plan for adult living and assist them in creating a plan to acquire selfsupport skills within the high school program and any post-secondary education.
New Hampshire has worked to improve a family-strength approach to case management and birth parents
are invited to meetings, receive report cards, and are part of all case planning. Parents are encouraged to
share their knowledge of the history and needs of the child, including educational needs.
When children are in-home parents are encouraged and expected to be a strong advocate for their child
with the school district. This is the same for children in foster care. DCYF and DJJS believe that just
because a child is in foster care does not mean that parents are unable to advocate for their children‘s
educational needs, although they may need more support or education from staff to carry out these
responsibilities. If parents are unable or unwilling to advocate properly for the educational needs of their
child DCYF and DJJS staff may fill this role.
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Statewide Information System
In an era of increasing emphasis on accountability in child welfare, information management is becoming
critical to sound child welfare practice. This push for accountability coincides with New Hampshire‘s
increased attention to data in an effort to know what is happening, identify strengths and challenges at the
local level and recognize changes that can be made as a result of these strengths and challenges. We have
embraced the value of analyzing and using data to verify and measure the effectiveness of services to
make informed policy and practice decisions, with the ultimate goal of improving outcomes for the
families.
In New Hampshire the Bureau of Information Systems (BIS) coordinates ongoing improvements,
training, and technical assistance for the Statewide Automated Child Welfare Information System
(SACWIS), known as NH Bridges.
Over the past five years, many significant enhancements have been made to the Bridges system. These
changes have been driven by the 2004-2009 Five Year Plan, the statewide Program Improvement Plan
(PIP), the AFCARS Improvement Plan (AIP), requirements of the Child Care Development Fund
(CCDF), and other changes to state and federal laws and policies.
In 2008 the State received the final determination of our SACWIS review. ACF noted that the Bridges
SACWIS system is fully compliant with Federal SACWIS requirements.
We have worked diligently in New Hampshire to ensure that our automated system helps with our efforts
to improve practice. For example, BIS has coordinated with the Child Protection Bureau, and the Bureau
of Quality Improvement to develop significant enhancements aimed at supporting permanency planning.
Several key processes have resulted in New Hampshire‘s shift to a data-driven agency. First, district
office supervisors were key to the systems change. It was vital that this group understood and embraced
the benefits of using administrative data to monitor and improve practice. To accomplish this a ―da
ta
managers‖ group was developed in 2003. Throughout 2004 and 2005, the data managers gathered
information from field staff and supervisors to develop a set of supervisors‘ reports.
As a result, DCYF now maintains over fifteen standard reports that are accepted as reliable sources of
information. District office supervisors and state office program managers have begun using these reports
to begin new initiatives in their offices. Requests for additional data are common as staff at all levels
learn how useful the information can be. Data integrity improved rapidly as the reports began to be
widely used. Staff and supervisors now see the value in data entry and are willing to invest the time in
accurate documentation. This shift from data indifference to data reliance has allowed DCYF to explore
the use of data in additional areas, utilizing the supervisors‘ reports as one component of the larger data
system.
B. Staff and Provider Training
New Hampshire believes that well-educated employees, caregivers and providers deliver higher quality,
more efficient, effective and proactive services to children and their families, which support the
department‘s mission and guiding principles. The DCYF Bureau of Organizational Learning & Quality
Improvement (BOLQI), previously known as the Bureau of Staff Development & Training is responsible
for providing both long-term training for DCYF staff and a wide variety of short-term training options for
DCYF/DJJS staff, foster and adoptive parents, relative caregivers, residential and system of care
providers.
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The first and most significant change in the training system involved adjusting the current system to
operate as a true Competency-Based Training program (CBT) and curriculum, with a heavy emphasis on
skill building. Training is sequential, building theory, practice and skill as appropriate for each employee
(workers and supervisors). Using a competency-based model from the Institute of Human Services,
DCYF developed and implemented a new Supervisory Core training, which has run consistently every
other year since 2005. Also included in the training were those Child Protective Services Workers who
were seen as having the skills, desire and the potential to be future supervisors.
In addition, a series of advanced and specialized trainings have been developed and implemented with the
intent to build higher level knowledge and skills in the areas of domestic violence, substance abuse,
sexual abuse, mental health and cultural competency. In addition to stand-alone workshops, the issues of
domestic violence, cultural competency, mental health issues, and substance abuse have been fully
integrated into the Core training modules. These efforts were completed and have continued since 2007.
New Hampshire has embarked on a new partnering relationship with the University of New Hampshire
that created the Center for Professional Excellence in Child Welfare. This new training system is based
upon four core principles related to training. They are, training must be 1) accessible, 2) locally designed
and delivered, 3) needs based and 4) outcomes driven.
Quality Assurance System
DCYF‘s Bureau Of Organizational Learning and Quality Improvement (BOLQI) blends evaluation and
oversight with research and development, policy and rules. This multidisciplinary team is the hub that
connects Program Improvement Plan, five year Child and Family Services Plan, the statewide Case
Practice Review (modeled after the CFSR), and administration of key grants and new initiatives in a cycle
of continuous quality improvement.
BOLQI provides timely program data to managers and, more importantly, works to break down the
barriers between data and practice. Over the past five years, New Hampshire has truly embraced the use
of data at all levels of management. We have been able to turn ―da
ta‖ into ―
information‖. The BOLQI
has become the ―
data broker‖ that provides a bridge between simply having the data, and actually using it.
DCYF‘ use of data has matured in recent years from a reliance on ―c
ompliance‖ to a focus on
―out
comes.‖
New Hampshire has been conducting regular Case Practice Reviews (CPR) in each local office to identify
strengths and areas needing improvement, focusing on outcomes for children and families in the areas of
safety, permanency and well-being.
The Case Practice Reviews have become embedded into our practice and serve a dual purpose. Staff
reviewers from other offices learn the value of good casework through the case review process and also
develop an appreciation of what their own work should look like. The philosophy of the CPR mirrors that
of the federal CFSR, that is to focus on improving practice and has played itself out in this process. Staff
at all levels of the organization, not only understand and embrace the benefits of reviews, they have begun
to celebrate it.
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Agency Responsiveness to the Community
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We have a long history in New Hampshire of successfully promoting comprehensive and quality
community responsiveness by engaging leadership from various systems to ensure commitment to the
process and inter-agency collaboration. Through these collaborative efforts New Hampshire is in a
position to lead nationally in improved outcomes for children and youth involved with not only Child
Protection, but Juvenile Justice as well. System partners have collaborated on several fronts to strengthen
practices in Safety, Permanency and Well-being.
The New Hampshire District Court, Family Division, Probate Court and Superior Court, the Division for
Children, Youth and Families, representatives from the New Hampshire Bar, Legislature, CASA, Judicial
Council, law enforcement and the Attorney General‘s Office continue to partner in addressing solutions to
child safety, permanency and well-being when families are involved in the court system because of child
abuse or neglect, child delinquency or status offenses.
Since 2008, residential providers have also joined DCYF/DJJS in an initiative aimed at developing and
implementing a collaborative system for delivery of services in residential treatment that focused on
shorter lengths of stay and achieving permanency for the youth who were placed in their programs. A
core work group of DCYF/DJJS staff and residential providers have been meeting regularly to create a
New Hampshire framework to achieve improved permanency outcomes for children and youth placed in
residential programs.
Many significant statewide initiatives have occurred that not only demonstrate responsiveness to the
community, but actual relationships and cross-system collaboration and a shared vision that ensures
continued responsiveness across systems. Some examples are listed below:
Legislative changes: Timely permanency,
Legislative changes: Mediated Adoptions,
The development of community-based Comprehensive Family Support programs to prevent
child maltreatment,
The co-location of Domestic Violence Specialists and Licensed Alcohol and Drug Abuse
Counselors into district offices,
Implementation of Family Court, participation in the Model Court and Court Improvement
Projects,
Cross-training opportunities with Court Appointed Special Advocates (CASA),
The completion of revised Domestic Violence Protocols,
The completion of AG‘s Protocols and trainings,
The addition of Permanency and Adolescent specialized Child Protective Service Workers,
The implementation of Finding Connections, a Kinship Care program, and a Community and
Faith Based Initiative,
Training in the 357 model, and
Development of a post-adoption services unit.
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Question 2: Determine and document which of the outcomes and systemic factors
present primary Opportunities for Improvement, citing the basis for determination.
Well-being Outcome 1: Families have enhanced capacity to provide for their children‟s needs
New Hampshire has made progress in developing capacity to engage families in case planning.
In an effort to insure that this process is being done consistently there have been both formal and informal
trainings on how to engage families in case planning as well as how to document the level of participation
individual family members have in the process. We are always striving to improve training to promote
best practice and family case planning continues to be a high priority.
We have worked with the courts and created absent parent affidavits to assure continued efforts to locate
parents who are not actively engaged in planning. The challenge lies in the next steps, ensuring that all
parents once located are engaged in case planning in a significant and meaningful way.
New Hampshire is currently engaged with Casey Family Programs and Judge Baker Children‘s Center on
an exciting project, the Breakthrough Series Collaborative. This collaborative is a two-year commitment
that involves four teams from NH, comprised of discreet participants that include representation of state
office administrators, district office supervisors, front line supervisors and staff, birth parents, youth, and
cross-system partners. The Breakthrough Series is challenging DCYF to look at how to improve
outcomes in the seven key practice areas one of which is family engagement.
Permanency Outcome 1: Children have permanency and stability in their living situations.
New Hampshire continues to improve and is extremely proud of its efforts to assure the most appropriate
permanency goal for children and youth. The data shows improved timeliness in establishing and
obtaining effective goals.
A key component to success in achieving permanency is the understanding that permanency planning is
equally critical in child welfare and juvenile justice. In the absence of focused planning, many children
have and will continue be without permanent connections, experiencing inconsistent and changing
placement settings, and constant changes to new schools and communities. Despite the variety of reasons
children enter placement in New Hampshire, we see an opportunity to assure that permanency goals and
concurrent goals are identified early and worked on concurrently.
In New Hampshire we continue to work to collaboratively address issues affecting youth and families in
the juvenile justice system. New Hampshire has begun to establish consisitent case planning, casework
practices, policy and law that are a part of each system‘s responsibility regardless of petition type or
agency case manager responsible for case management. It should not matter if a child is in out of home
care due to a child protection or juvenile justice factors. What should matter is that similar permanency
planning occurs for every child as soon as they are removed from their home of origin. Every child and
youth deserves a permament lifelong connection.
As both Divisions move forward with permanency planning efforts we know the value of consistent
practice statewide. Our opportunity to create a model of practice that drives the consistent practices in
both divisions will be key to our continued success in assuring permanency and connections for all
children and youth.
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Termination of Parental Rights
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New Hampshire‘s termination of parental rights statute has been historically a well-known barrier to
meeting ASFA timeframes for permanency. The collaboration that has existed among the courts,
DCYF/DJJS and CASA has been a major strength in moving practice forward and closer to meeting those
timeframes. To achieve timely permanency through Termination of Parental Rights, systemic changes
were needed in order to reduce barriers regarding the scheduling of court hearings and timely decisions.
The Permanency Legislation enacted in 2008 was significant and we anticipate this will improve
timeframes for cases that go to termination of parental rights. Before the permanency law went into effect
there were numerous discussions about the law with judges, a Family Division Administrator, DCYF,
legal Counsel and CASA. Of particular interest were the challenges faced by courts, DCYF and parents‘
attorneys to meet the new statutory requirements of timely adjudicatory hearings and the issuance of
adjudicatory court orders.
In response to these discussions, and an interest in monitoring the implementation of the permanency law,
the CIP Coordinator established a committee to study the permanency law and consider systemic change
that may be necessary to successfully meet the new requirements of state law.
In addition, the Concord and Franklin Family Division Courts are approved Model Court sites. The focus
is on identifying and addressing barriers to the TPR process. New Hampshire‘s structure has historically
been a systemic barrier to meeting ASFA timeframes. The courts and DCYF are committed to analyzing
and addressing barriers to improve outcomes in this area.
Service Array
New Hampshire continues to invest in creative and individualized service options, from prevention to
safety to permanency to well-being services. Like other states, New Hampshire has felt the tremendous
impact of the recent economic downturn. The challenge faced by DCYF is to provide an improved array
of services to an increasing amount of consumers with fewer resources.
New Hampshire has focused on creating individualized service options and home-based services, which
have become increasingly accessible in all areas of NH. As the demand has increased, the number of
agencies coming on board to provide ISO services has increased. Agencies are located all over the State,
which allows families everywhere to have better access to ISO programs. With that said, there are still
fewer agencies in the Northern and Western parts of NH and logistics still can be difficult.
An on-going need for our consumers has been consistent and timely access to local community mental
health services. While waiting lists vary across the State, it is still a statewide issue. While this issue can
be attributed to several long standing causes, such as staff turnover, fluctuations in economy, etc., one
cause could also be more children are being served in the community than ever before.
Question 3: Recommend two additional sites for the onsite review activities
In considering options for site selection for our upcoming Child and Family Services Review, the New
Hampshire Division For Children Youth and Families (DCYF) reviewed our available data and weighed
the relative strengths and challenges of our twelve District offices. In recommending these sites, the
leadership of DCYF hopes to better understand and identify the impact of practice changes and barriers to
best practice across all offices including the smaller North Country offices. These offices provide unique
challenges in both geography and service array. The information used as the basis for these
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recommendations are from our Federal Data Profile, SACWIS management reports, Practice Initiatives
and our own internal Case Practice Reviews.
New Hampshire DCYF provides child welfare services through twelve District offices, each covering a
geographic area that coincides, but also crosses over, Family Court jurisdictions. In addition to the
available data, geographic locations and district office caseload sizes, we have considered personnel
changes within each office in our site selection recommendations.
Manchester is our largest metropolitan site. This office, like every other office in New Hampshire has
embraced significant practice changes that have impacted our permanency and well-being outcomes.
However, due to long standing practice struggles typical to the larger metropolitan sites, we have
strategically engaged in significant personnel changes. This leads us to question whether the anticipated
outcomes of the CFSR in Manchester will be reflective of practice changes or personnel changes. This
brought us to the recommendation of the Portsmouth District Office for our second site selection.
The Portsmouth District Office was a site in the first round of CFSRs, and unlike Manchester, Portsmouth
has the majority of the same staff that were present in 2003. Therefore, Portsmouth provides us with
opportunity to see if the actual practice initiatives and changes result in improved outcomes during the onsite review. Since the 2003 CFSR, DCYF and DJJS have successfully implemented major systemic
initiatives relating to safety, permanency and well-being. The Divisions have made rapid and substantive
changes in both policy and practice. These changes have involved and affected all levels of staff
throughout the Divisions. Therefore, if the on-site review in Portsmouth identifies improved practices
from 2003 we will know that those are reflective of the substantive changes in practice and not in staff
changes.
The third and final recommended site is a combination of two small North Country Offices (Littleton and
Conway). This site needs to encompass two district offices in order to have an appropriate sample size.
The caseloads in the Northern offices are smaller and we need to merge two offices to produce one site.
This site is representative our most rural and isolated areas. This translates to a vast geographic area with
low populations, which impacts the delivery of services because of the distance between clients and the
actual array of available services. Clearly it is almost impossible to provide the multitude of services
available in the more highly populated areas. In addition, there was not a North Country site selected
during the 2003 CFSR. It is important for us to identify and measure practice in all areas of our state and
we want the CFSR process to be reflective of this approach.
Manchester District Office
Although included because it is the largest metropolitan area, Manchester will demonstrate some
significant changes since 2003. The restructuring and focus on staff, caseloads and the supervisory
structure in this office should reflect significant changes to practice and community responsiveness. It is
still our largest site and with that comes common challenges, associated with larger staffing patterns and
―i
nner city‖ challenges.
The Manchester Office serves the city of Manchester and is the largest city in the state.
Manchester is located in Hillsborough County.
According to the 2000 census, Manchester‘s population has risen to 107,006; an increase of
7439 residents from the 1990 census.
Manchester has lower than the state average of children living in married-couple household,
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Manchester staff does well in services to family to protect child(ren) in-home and prevent
removal or re-entry into out of home placement.
They provide strong on –going assessment of risk to children in and out of their homes. They
also have minimal re-entries in to foster care.
Manchester has consistently provided for sibling connections and placements, as well as,
maintaining placements in close proximity of parents.
Portsmouth District Office
The Portsmouth DO is located in the thriving seacoast town of Portsmouth.
The catchment area includes the region of the state known as the seacoast as well as some
towns that are more inland.
The seacoast region is a fairly affluent part of the state.
The population of the Portsmouth DO catchment area is approximately 135,000 and is
predominantly white.
Poverty in the catchment area is lower than the state average and the median household income
for the area exceeds that of the state.
The seacoast has a very active tourist season in the summer though the economy is not as
service driven as the Littleton and Conway areas.
The Portsmouth District Office has had very little staff turnover and therefore been able to
achieve consistency in their assessment and family service workforce.
Portsmouth does well in preserving family connections, making relative placements, keeping
siblings together and maintaining close proximity of out of home placements to family.
Portsmouth demonstrated significant improvement in establishing an appropriate permanency
goal in a timely manner and excellent use of concurrent planning.
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The Conway Office is located in a 100% rural part of the state.
The population of the Conway DO catchment area is about 45,000 (compared to a state
population of approximately 1.3 million).
The Conway catchment area is tourist driven and many of the residents are also employed by
the service industry.
The city of Conway is home to a large outlet mall. There are many second homes in the
Conway DO area. The vast majority of the residents in the area are white.
Conway Office documentation and organization of information in case records is high quality.
Conway staff demonstrates strong practice in engaging both parents and children. They work
diligently to monitor families and youth to assure safety through home visits, meetings, and
phone support.
The Littleton DO is located in the small city of Littleton (population 6000), though the city feels much
larger than it is due to the extreme rural nature of the surrounding towns.
The economy of the Littleton DO area is also largely tourist driven, with destinations for all
seasons.
Employment can vary significantly by season. The population of the Littleton catchment area
is approximately 23,000; just 2% of the total state population.
Littleton staff provide strong educational services and coordination of services.
Both the Littleton and Conway offices face the challenge of a limited service array for DCYF/DJJS cases.
Question 4: Provide comments about the State‟s experience with the Statewide Assessment
Instrument and process.
New Hampshire‘s approach to addressing the statewide assessment was similar to how we have
approached all our efforts aimed at creating and supporting an environment that promotes improvement.
Our efforts were based on an inclusive evaluative approach; not just to present data and information but
also to ascertain the factors that influence New Hampshire‘s performance.
In each section of the Statewide Assessment we attempted to use descriptive and honest language to
provide context, and hopefully used evaluative language to explain our performance. Believing that the
purpose of the CFSR is to generate improvement, the focus of our statewide assessment was to reflect on
our achievements and practice initiatives while acknowledging a need for continued focus on areas
needing improved outcomes for children and families.
New Hampshire truly views the CFSR as something that should be integrated into normal work efforts,
including the on-going and realistic assessment of practice both from the field and systemic perspective. It
was our intent to have the Statewide Assessment reflect current routine aspects of our business and
identify information as it compares to the CFSR Round 1.
We elected to establish several groups and work teams for the Outcome and Systemic Factors. The teams
were coordinated by our state CFSR Coordinator and led by the individual Bureau Chief responsible for
the particular area. Each Bureau also involved stakeholders, internal and external, who were able to bring
information relative to an Item or area. As part of this process we sought additional input from colleagues
in their respective stakeholder areas to broaden the expertise and perspective.
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Bureau staff considered the basics, identified historical actions, policy adjustments, analyzed relevant data
affecting safety, permanency and well-being outcomes, and then sought out stakeholders. This strategic
and thoughtful development of the statewide assessment provided staff with insight into our practice,
which led to the ability for each group to frame questions for stakeholders to clarify or fill gaps in
information, and offer feedback about New Hampshire‘s child welfare and juvenile justice system.
Additionally, we advocated for more general and open-ended discussions so as not to diminish the quality
and creative flow of these opportunities. Previously established stakeholder groups such as the Advisory
Board and Citizen Review Panel were engaged separately in this process.
The statewide assessment has been simply one part of the on-going process and commitment to
examining our own capacity and performance. It is a critical part of our journey toward improving
outcomes for children and families. It has enabled us to gather and document information that is critical
to analyzing that capacity and performance, setting the stage for the on-site review. The statewide
assessment like the on-site review includes a broad representation from within and outside the child
welfare agency.
The entire CFSR is a review of ―NewHampshire‖ and it is truly a state process not just an agency
process. As indicated many times New Hampshire is proud of its multiple and intricate networks of
relationships, which are sustained through communication and a common vision for change. Throughout
this document there are examples of successful and significant initiatives relating to safety, permanency
and well-being. These have included rapid and substantive changes in both policy and practice and have
involved major community partners.
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Contributors
CFSR STATEWIDE ASSESSMENT CONTRIBUTORS
The following individuals and groups contributed through participation in a focus group, survey
or by discussion in a regular meeting on CFSR Outcomes and Systemic Factors to frame
responses.
Amy Finkele, Littleton Child and Family Services
Angela Nuzzi, Curriculum & Training Coordinator, DCYF Practice Model
Child Care Advisory Council
Child Care Resource and Referral Network of NH
Child Fatality Review Committee
Christie Davis, Program Director, UNH, Center for Professional Excellence in Child Welfare
Child Placing Agency, ISO Group
Christine Rine, Assistant Professor, IV-E Coordinator, Plymouth State University
Cynthia Moniz, Plymouth State University, Department of Social Work
Community Providers, ISO Quarterly Meeting
Danielle Snook, Department of Justice, Attorney General‘s Office
David Viliotti, Nashua Children‘s Home, Residential Provider Network
DCYF Child Development Bureau Staff
DCYF Fiscal Staff
DCYF Program Specialists
DCYF and DJJS Administrators
DCYF and DJJS Field Staff
DCYF and DJJS Field Supervisors
Deirdre Dunn, Early Childhood Special Projects Coordinator, DHHS Division of Public Health
Services Maternal and Child Health
Debra Coe, Chairperson, Child Welfare Committee
Derek Luke, Educational Program Coordinator, UNH Center for Professional Excellence in Child
Welfare
Diane Valladares, CASA NH
Dorothy Whittaker, Nashua Child and Family Services
Ellie Tsetsi, Good Beginnings of Sullivan County/VNA,
Eric Borrin, DJJS
Francisca Mathes, Granite State College, Education and Training Partnership
Gail Thomas, Granite State College, Education and Training Partnership
Glenn Quinney, Chair, State Advisory Group on Juvenile Justice
Greg Burdwood, The HUB, Family Resource Center
Greg Burdwood, Family Support NH
Jackie Cowell, Executive Director, Early Learning NH
Jackie Sparks, Children Unlimited, Family Resource Center
Jane Fletcher, Project Director, Granite State College
Jane Whitney, Systems Analyst, DCYF Bureau of Information Systems
Jeannie Agri, President New Hampshire Head Start Directors Association
Jeff Caron, Becket Family Services
Jen Guillmette, Director New Hampshire Foster and Adoptive Parent Association
Jerry Marx, Chair of Social Work Department, University of New Hampshire
JoAnn Cobb, Program Director, Child and Family Services
Joan Valk, Franklin Child and Family Services
Jon Eriquezzo, Crotched Mountain, Residential Provider Network
Karen Kregl, Executive Director, NH Children‘s Trust Fund
Karen Welford, Family Resource Center of Central New Hampshire
318
New Hampshire CFSR Statewide Assessment
July 2010
Contributors
Katie McDermott, NH Partners in Service
Kimberly Bavaro, Executive Director, The Upper Room, Family Resource Center
Kim Kelsey, University of New Hampshire
Krista Lampe, Recruitment and Training Coordinator, CASA
Kristie Palestino, Director, New Hampshire Network of Child Advocacy Centers
Kristy Lamont, Coordinator, Court Improvement Project
Linda Compton, Chairperson, Citizen‘s Review Panel
Lisa Sanchez, Manchester Child and Family Services
Lisa Shauney, Granite State College
Lisa Strout, Executive Director, New Hampshire Association for the Education of Young
Children
Lucinda Sadler, Justice, New Hampshire Judicial Branch
Marty Sink, Director, CASA of New Hampshire
Mary Stewart-Gile, Chairperson, New Hampshire Child and Family Law Committee, New
Hampshire House of Representatives
Melissa Kelly, Program Assistant, Family Resource Connection
Michelle Lewis, Parents as Teachers, Parent Information Center
Michael Adamkowski, Chairman, DCYF Advisory Committee
Misty Kennedy, Educational Program Coordinator, UNH Center for Professional Excellence in
Child Welfare
Nancy Childress, New Hampshire Department of Education
Nancy Cristiano, Coordinator, Family Resource Connection
New Hampshire Foster and Adoptive Parent Association Chapters Statewide.
New Hampshire Teen Voices Advisory Board
Noel Sullivan, Easter Seals, Residential Provider Network
Pamela French, Systems Analyst, DCYF Bureau of Information Systems
Pamela Seufert, UNH Center for Professional Excellence in Child Welfare
Patricia Reed, Easter Seals.
Paul Desmarais, President, New Hampshire Foster and Adoptive Parent Association
Rachel Kelly Concord Child and Family Services
Residential Provider Network
Robert Fusco, Monadnock Family Services, Family Resource Center
Sandra Matheson, Liaison, New Hampshire Department of Justice, Attorney General Office
Sarah Fox, Training Specialist, New Hampshire Court Improvement Project
Shannon Quinn, New Hampshire Bureau of Drug and Alcohol Services
Sheri Simpson, Concord and Manchester Child and Family Services
Sheryl Tedford, Program Development Specialist, Educational and Training
Sue Schick, Project Coordinator, The Upper Room, Family Resource Center
Sue Watson, Family Resource Center at Gorham
Susan Hallett-Cook, Program Specialist, DCYF
Thom Linehan, New Hampshire RAPP (Relatives as Parent Providers)
Tricia Neville, Granite State College, Education and Training Partnership
Wanda McDonough, Families First Health and Support Center
319