DUALLY INVOLVED YOUTH INITIATIVE

DUALLY INVOLVED YOUTH INITIATIVE
 DUALLY INVOLVED YOUTH INITIATIVE: IMPROVING OUTCOMES FOR DUALLY INVOLVED YOUTH Santa Clara County Fall 2013 TableofContents
I. Introduction A. Background/HistoryofJurisdiction‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐5
B. ReasonsforInvolvement‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐6
II. Mobilization A. IdentificationofPrimaryLeadership‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐8
B. DescriptionofStructureandGovernance‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐10
C. CommitmenttoCollaboration‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐10
III. Target Population A. Definition‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐12
B. DataScan‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐13
C. DescriptionofProcess‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐13
IV. Study and Analysis A. Legal&Policy‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐15
1. Contextualizingtheissues
2. Mapping
3. Improvingtheinformationsharingprocess
formandatoryreferralstotheDistrict
Attorney
4. LegalAspectsofYouth&FamilyTeamMeetings
5. OneJudgeModel
6. InformationSharing
B. Data‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐23
1. DataCollectionforTargetPopulation
2. JointSystemMap
3. AddendumtoIntakeForms
4. MeasuringoutcomesdelineatedinMOU
5. Indepthcasereview
6. Datacollectionproposal
7. Dataanalysistoinformplansfornewunit
servingduallyinvolvedyouth
C. Practice&Resource‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐30
1. Resourceinventory
2. AssessmentInventoryandAnalysis
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3. TrainingDevelopment
4. Traumatrainings
5. Youth&FamilyTeamMeetings
a. DecisionMakingTool
b. Needs&StrengthsGrid
c. MockYFTM
V. Practice Area Reforms A. ReformedPracticesImplemented‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐38
VI. Family & Youth Engagement ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ 40 VII. Culture Change A. Historicalcontextofcrosssystempracticeculture‐‐‐‐‐‐44
B. Effortstoenhancecollaborativeculture‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐47
C. TraumaInformedSystemChange‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐49
VIII. Summary & Conclusion A. NextSteps‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐51
B. Successes&Challenges‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐51
C. FinalComments‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐54
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Appendix Organizational Chart & Committee Rosters Project Overview Memorandum of Understanding January 2013 Data Report Community based perspective on review of flow charts Maps: Probation, Child Welfare & Joint Map 241.1 Protocol Draft Youth & Family Team Meeting Documents a. Overview of plans b. Letter to families c. Confidentiality Agreement d. Self Incrimination Standing Order e. Info Sharing Standing Order 9) Memo on San Diego Dual Status Pilot Project 10) Dr. Herz’ presentation on baseline and intake data 11) Joint System Map and Accompanying Narrative 12) Addendum to Intake Form & Preliminary Results 13) Summary of literature on immigrant families 14) MOU Outcome Goals: Identifying Key Tracking Indicators 15) Case Review Tool 16) Select Information from Case Review Files 17) Recommendation regarding child welfare checks on probation referrals 18) Bibliography of Literature on Dually Involved Youth 19) Resource Inventory 20) Assessment Tools Inventory & Analysis of Assessment Inventory 21) Select Probation Cross Training Materials 22) Select Child Welfare Cross Training Materials 23) Documents from April Convening 24) Vignettes used for Trauma Training 25) TARGET Overview 26) YFTM Decision Making Tool 27) YFTM Needs and Strengths Grid 28) Group Home Survey 29) SVCN Memo 1)
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I. Introduction It has always been clear to the leaders of this Initiative that what we seek is a paradigm shift, not simply a tweaking of existing, flawed policies and practices. How we achieve the paradigm shift we seek, however, has not always been clear. The path we have traveled over the past year has both been marked by moments of confusion and frustration as well as by moments of clarity and nascent mutual understanding. We recognize that true paradigm shift necessarily involves not just a deeper understanding of each other’s systems, but a more holistic understanding of the issues we confront. It involves a sincere appreciation for and acknowledgment of the social, political and economic forces that impact children and families. Acknowledging this will help to create solidarity with those “serving” and those being “served” and diminish the imagined spaces between us. Cross‐system collaboration can only take us so far if we continue to operate in a manner that diverges from the reality that the families we serve face and continue to operate as though there is an “us” and “them.” Finally, it is worth noting that in bringing together a diverse group of stakeholders, we have not always shared the same perspectives on the issues we confront. We begin at times from divergent vantage points. While we share a broad based vision of “improving outcomes for dually involved youth” and while our views may intersect at various points along the path, we have had a multitude of perspectives on how to reach our desired end goal. Although we have certainly not reached a state where we all agree on every issue – nor do we seek to do so, as our healthy debate has been a constructive force in our work—
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we have reached a state where we have a deeper appreciation for each other’s perspectives and the arenas in which our perspectives overlap have expanded. Ultimately, the success of our efforts is contingent upon broadening our perspectives in every direction so that each stakeholder can better understand the other, this includes the youth, families, and communities, as well as judges, social workers, and probation officers. A. Background/ History of Jurisdiction Santa Clara County (SCC), California, is located at the southern end of the San Francisco Bay and encompasses 1,312 square miles. The County is a major employment center for the region, providing more than a quarter of all jobs in the greater Bay Area. SCC also has one of the highest median family incomes in the country, a wide diversity of cultures, backgrounds and talents and attracts people from all over the world to visit, work and live. The County's population of nearly 1.8 million is one of the largest in the state, following Los Angeles, San Diego and Orange Counties, and is the largest of the nine Bay Area counties. There are 15 cities in the county; San Jose is the largest city, with a population of nearly one million and is the administrative site of County Government. While a significant portion of the county's land area is unincorporated ranch and farmland, the area is urban and nearly 92% of the population lives in cities. Although the median income of SCC is high, there are many who live in extreme poverty. The County is also home to many recent immigrants from Mexico, Central American and many Asian countries. There are approximately 176,000 youth ages 10‐17 in the County. Latino youth represent about 31% of the youth population, Anglo youth represent 36% and African 5
American youth represent 3% (the remainder are mostly of Asian descent and are underrepresented in both child welfare and juvenile justice). There are approximately 10,000 arrests and 2,000 bookings of youth into juvenile hall each year. In Fiscal Year 2011, of the 10,117 arrests, 63% are Latino, 18% are Anglo, and 8% are African American youth, showing clear overrepresentation of youth of color. The Department of Family and Children’s Services (DFCS), has an average of over 12,000 referrals annually and a one day snapshot shows 1,825 total open cases. Of the 1,825 open cases, 58% are Latino, 20% are Anglo and 11% are African American, also demonstrating clear overrepresentation of youth of color and a similar population to the juvenile justice youth. B. Reasons for Involvement In spite of numerous strengths that our jurisdiction possess; we face complex problems for which we have been unable to find adequate solutions. We have all of the ingredients to make this a successful project: clear identification of the problem, political will at all levels, exceptionally strong leadership from every partnering agency, sustained collaboration with many proven outcomes, collaborative structures firmly in place that ensures continued access to all critical partners, no known strong opposition to the project, passion for the issue and for the creation of effective solutions, and leaders and staff who are eager and willing to learn and try new strategies to help our systems’ most vulnerable youth. There is a firm commitment to make as substantial changes as are needed and we recognized early on that outside expert assistance would benefit us greatly. 6
In spite of the strengths referenced above, our systems have used traditional solutions to serve youth and families with complex risks and needs, causing great harm to certain youth and families. While there are many examples that we could describe, one in particular became an impetus for moving forward with more sophisticated solutions: “Alisa” was a 16 year old girl who was brought to Juvenile Hall for possession of trace amounts of methamphetamine found in a pipe in her pocket. She admitted to using the drug several times a week and was pregnant. She was adjudicated dependent after the early death of both of her parents. She also had an abundance of strengths, including being very bright and successful in school, demonstrated mature insight into her substance abuse, and proven periods of successful sobriety. She was kept in Juvenile Hall, even though she did not meet the criteria for secure detention, because she was a chronic run away from her placements. Her case was filed and there were strong opinions from the staff at Probation and DFCS that she should be treated by the other system. The true dilemma was there simply was not a better solution available. We tried a slight modification from traditional practice and probation served her “informally” while she remained a dependent. She had a relapse after being returned to placement, became scared of being locked up again, and ran away. She called the Probation Officer and said she would not come back because being locked up was such a horrific experience. Several months later, while still a run away, she delivered a baby who was methamphetamine addicted and then fled the hospital. By anyone’s account, this was one of the worst outcomes possible and a clear illustration that simply “tweaking” current practices is not successful when addressing these very complex situations. 7
II. Mobilization A. Identification of Primary Leadership In Juvenile Justice, the project is led by Deputy Chief Probation Officer Laura Garnette with full support from Probation Chief Sheila Mitchell. Under the leadership of both Chief Mitchell and DC Garnette, there have been vast reforms implemented over the past years. The detention population is at an all‐time low and there has been a 52% decrease in the number of youth placed in out of state or county group homes and a 533% increase in the number of youth who are receiving intensive wrap‐around services in their homes in an effort to avoid more restrictive environments. On the child welfare side, Lori Medina, the DFCS Director and Jaime Lopez, the DFCS Assistant Director, have been leading this Initiative and other reform efforts that complement this work. Under the leadership of Ms. Medina and Mr. Lopez, DFCS successfully closed their Children’s Shelter program, which was operationally a licensed group home, and transitioned to a Receiving Center. This was significant because they moved from a system that initially detained all children at the Shelter to a system that prioritizes placing children in the community with relatives or other family‐based settings. Early during implementation of the project, the Social Services Agency underwent a Leadership change, bringing in Director Bruce Wagstaff to lead the agency, of which child welfare is a part. As a new director, entering the agency with the project already underway, he quickly embraced and promoted the change efforts being planned, personally participating in decision making and reform efforts. This rapid and full immersion of top leadership into the project was critical to the success of the efforts. 8
The Courts have strong leadership from two judicial officers. Judge Shawna Schwarz, Supervising Judge of Juvenile Dependency Court, has over eight years of experience in Juvenile Dependency Court and for more than four years, a case load that is primarily teenagers. She presides over “Teen Court,” a specialty court that is a unique and innovative forum for juvenile dependent teenagers who would like additional support from the Juvenile Court. This voluntary program affords teens in the dependency system the opportunity to talk directly to the Judge about issues that are important to them. The goal is to motivate, guide and support the teen’s transition to adulthood. Judge Schwarz also presides over the Middle School Education Court and works with dual status youth on the dependency side. Additionally, the Dependency Court System has integrated therapeutic court models into practice in Santa Clara County, having a strong history with Drug Dependency Treatment Courts, and Family Wellness Court. The success of these models has led to the integration of these practices to a sustainable Drug Dependency Wellness Model. Judge Patrick Tondreau is the Presiding Judge of Juvenile Court and the Supervising Judge of Juvenile Justice Court. He has over eight years of experience between Dependency and Juvenile Justice Courts. He works with all of the dual‐status youth on the Juvenile Justice side and is on numerous Court committees. The Juvenile Court, Probation and DFCS have worked collaboratively on crossover issues since 1990 when a Dual Status Protocol was first adopted creating the Dual Status Court, over which Judge Tondreau currently presides. 9
B.
Description of Structure and Governance The Dually Involved Youth Initiative is guided by the Executive Steering Committee and comprised of three subcommittees: Legal & Policy, Data, and Practice & Resource. See Appendix 1 for the organizational chart and rosters from each committee. On an as needed basis, subgroups from each of the Subcommittees came together to focus on particular projects. Additionally, a small management group comprised of the both Judges, the Director of the Child Welfare Department, the Deputy Chief Probation Officer, and Project Manager met with the T.A. Advisors before every site visit, to address questions and challenges that have arisen throughout the course of the work. C.
Commitment to Collaboration Early on in our process, the Executive Steering Committee invested a fair amount of time into clarifying what specific issues the Initiative should address, how the issues should be addressed and what values should guide the work. These discussions led to the creation of a Project Overview, which has since been used to educate others about the Initiative. See Appendix 2. After a number of Executive Steering Committee members expressed a strong desire for further clarification about the desired outcomes for this Initiative, and the need to memorialize our commitment to cross‐system collaboration, the group decided to develop an MOU. See Appendix 3. Much time was spent deliberating over the “desired outcomes” of the Initiative to be listed in the MOU. Although the Executive Steering Committee brainstormed the initial lists of “desired outcomes” the Practice & Resource Committee took over the work of 10
refining the outcomes. The “desired outcomes” were separated into two lists: Youth, Family & Community Outcomes, and System Outcomes. Some committee members felt strongly that Community Outcomes should be listed as a distinctive list, and although no one disagreed with the importance of listing community outcomes, ultimately the group decided to integrate community outcomes with youth and family outcomes. 11
III. Target Population A. Definition (1) Dependent youth upon whom a delinquency petition has been filed. (2) A youth currently under the jurisdiction of the juvenile justice court or with a pending petition, for whom there is reason to believe youth is at risk of abuse or neglect. (3) A dependent youth between the ages of 10 and 14, who has received two or more citations within one year. The Executive Steering Committee deliberated at length over the scope of the target population. The first and second categories were straightforward, as they represent the youth that currently fall within the purview of the Dual Status calendar. There was a strong appetite from the committee to focus attention on early intervention efforts. Since there was no preexisting local data on which younger youth in the child welfare system were most susceptible to entering the juvenile justice system, the committee had a number of rich discussions regarding how to gain insight into this population. Thus, the category three represents an attempt to capture a group of youth that may be at risk of penetrating the juvenile justice system. The goal of identifying these youth is to calibrate programming to better serve this population in hopes of diverting the youth away from the juvenile justice system. When the Executive Steering Committee originally debated what the parameters should be for this “early intervention” category, the group was operating under a misimpression that the numbers of these youth were higher than they in fact are. In effort 12
to keep the data collection to a manageable size, the group decided to limit the third category further, to youth who are using substances on a weekly basis. Once we began running the numbers, it became apparent that it was not necessary to limit the category with the substance abuse criteria, and therefore that clause was eliminated from the definition. Even with the broadening of the target population, we were surprised to find how small our numbers were. Ideally our target population would have been broader and yielded a larger data set. B. Data Scan The Data Subcommittee developed a report that summarizes the data and analysis used to inform the Target Population definition. See Appendix 4. C. Description of Process 1) All youth with a new request for a 241.1 assessment were included in the target population. These youth are already regularly identified so capturing the first two categories of our target population did not require the development of a new process. 2) The third target population refers to youth with open child welfare court cases who get referred to Probation. To identify these youth: a. A data extract from the Dependency Court’s database is drawn at the beginning of each month to identify youth ages 10 to 14 with open court cases. Older youth and those receiving voluntary services are presently excluded. b. This list is then run against the juvenile justice database to cull youth who received two or more referrals to Probation in the past 12 months. c. These youth make up the third target population – that is, youth who have formal court cases in the child welfare system but who have not yet deeply penetrated the juvenile justice system. The names of youth identified in the third target population are shared with key child welfare staff. This process then seeks to not only identify the third target population, but 13
also to develop a method for alerting social workers about the whereabouts and juvenile justice involvement of youth in their case loads. This information can better inform social workers how to engage youth and their families in case planning services and supports. 14
IV. Study and Analysis A. Legal & Policy Subcommittee 1. Contextualizing the Issues Thanks to the consistent and compelling voices of community representatives, early on in the work of the Legal & Policy Subcommittee, the importance of providing holistic context to the issues we discuss, was stressed. The heart of these discussions is summarized below: Paradigm shift begins with an acknowledgment of the context in which we are operating. The environment that we, and the families that are the focus of our work, exist in is profoundly unequal. It should come as no surprise that the greater the level of inequality prevalent in a society, the greater the level of poverty and violence. We cannot fully understand and grapple with the challenges faced by the youth we serve without acknowledging the uncomfortable realities that shape our environment. At a minimum, we must fully acknowledge that system induced trauma, past and present, shape the way youth and families respond to system involvement. We must acknowledge that historically, systems have perceived, characterized and talked about the families they serve through a deficient lens. Just as importantly, we must acknowledge that discrimination and oppression actively work in small and large ways to create and perpetuate the problems presented to us in the work that we do. In order create informed and effective practices that move us closer to the outcomes we seek, we must shift our paradigm and consider every issue we discuss through this broader, more holistic lens. See Appendix 5 for document developed by a key community representative that framed our initial discussions. Throughout the year, these themes have woven through our discussions and have, hopefully, influenced the way we approach the work that the subcommittee has been tasked with. As we move forward with the Initiative and look to the future of building a dedicated Dually Involved Youth Unit, we hope to build from this foundation and continuously reinforce the paradigm shift that has begun. 15
2. Mapping Both JPD and DFCS had detailed maps depicting their respective processes. The Legal & Policy Subcommittee reviewed the following maps :  Juvenile Justice o Citation to Jurisdiction Flow Charts different directions a citation may go (including diversion, dismissal and informal handling) up through point of jurisdiction. o Jurisdiction to Disposition Flow Charts potential avenues case can go once juvenile justice jurisdiction has been established, including all potential dispositional outcomes.  Child Welfare o Juvenile Dependency Court Process Charts what happens throughout legal process once petition is filed. o Dependency Process Flow Chart (narrative) Narrative tracking child abuse report through post‐permanency hearing, includes applicable statutory citations. o Dependency Flowchart Extensive flow chart beginning with abuse or neglect incident, charts the numerous different potential trajectories of a case.  Joint map: Juvenile Justice, Child Welfare & Court System o Process for Identifying and Serving Dual Jurisdiction Youth Flow chart from the Data Subcommittee that provides macro overview of the child welfare, juvenile justice and court system processes. See Appendix 6 Presentation of the maps served as a useful springboard for cross system dialogue and training. Both the juvenile justice and the child welfare system already had detailed maps of their respective system. Ultimately, the Data Subcommittee developed a joint map (discussed in Chapter IV, B, 2) which provided a general overview of how the juvenile justice, the child welfare, and the court system and how the three intersect. 16
3. Improving the Information Sharing Process for Mandatory Referrals to the District Attorney Probation is statutorily required to refer certain cases to the District Attorney for review; these cases are known as “mandatory referrals.” Early in the course of the Initiative, the District Attorney indicated a desire to have information that paints a more comprehensive picture of a youth upon whom a mandatory referral has been made, so he is better positioned to make an informed decision about whether to file charges. This request led to an examination of current ad hoc practice and the development of a more systematic protocol. Historically, the District Attorney has had only the youth’s police report upon which to base his decision and would informally ask for input about the youth from the social worker and/or the probation officer. In an effort to systematize the process and to build in a strength‐based approach that mitigates some of the inherent subjectivity, the following proposal was developed: Once a mandatory referral has been made to the DA’s office, the DA’s office will email the following questions to the Probation Officer (PO), Social Worker (SW) and Mental Health (MH) provider/ CBO representative (and/or social worker for dependency attorney). 1.
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What strengths/ supports does the youth have in his/her life? What are your immediate concerns about this youth? How would the youth be helped/ harmed if I decide to file? Will the youth receive a Youth & Family Team Meeting?  PO, SW and MH provider/ CBO rep will be asked to “Respond all” to the email.  If possible, the PO will schedule a conference call for the DA, PO, SW, MH provider/ CBO representative to discuss the case. This practice is actively being developed and will be completed by January 2014 as some concerns continue to be addressed – specifically, how do we create this process while also 17
ensuring a high level of objectivity when the response has to be immediate. Although this process already occurs in an informal manner, formalizing the process allows all partners to provide the critical information needed by the District Attorney as their office weighs the options, while also addressing fairness and equity barriers that have long existed in all of our systems. 4. Legal Aspects of Youth and Family Team Meetings (YFTM) Historically, the child welfare and juvenile justice systems came together to discuss their recommendations for a dually involved youth only when there was a disagreement regarding which system should serve the youth. See Appendix 7 for 241.1 Protocol. By this juncture, both systems had already formed strong opinions about the youth’s needs and which system could meet those needs. Often each system felt that the other system could better serve the youth. Waiting to meet until there was an impasse has been inherently problematic. Therefore, there was a strong desire to meet earlier on in the process where both sides could assess the case jointly and jointly develop recommendations. Youth and family participation was a fundamental component of the vision for these meetings. Youth and Family Team Meetings (YFTM) were developed to address these priorities and concerns. See Appendix 8. The goal of the YFTM is as follows: To partner with the youth and family in identifying what supports are needed in order to be able to function safely, ultimately free of system involvement. The YFTM will involve three phases: 18
(1) The Youth & Family Teaming process will begin with a youth advocate building a relationship with the youth and family, and conducting an assessment of the youth’s most salient needs. (2) Subsequently, a Youth & Family Team Meeting will be held with a variety of system and non‐system participants to discuss the strengths and needs of the youth and explore ways to capitalize on the strengths and more effectively respond to the needs. (3) Finally, a separate meeting will take place without the youth and family to discuss specific joint recommendations that will go into the 241.1 report. Numerous aspects of the YFTM have been vigorously debated. The primary areas of debate include:  When should the YFTM meetings take place (for example at what stage(s) of proceedings?)  Which youth should receive a YFTM?  How do we ensure that the youth and family feel supported during the meeting, that they have a voice and feel safe openly disclosing their challenges? How do we balance out the inherent power imbalances so that youth and family feel comfortable? How do we balance the value of youth/ family engagement with protecting rights of youth?  Who should be invited to each phase of the YFTM? o Should attorneys be involved?  If not, how do we protect incriminating statements of youth?  If so, how do we prevent this from becoming a quasi courtroom like experience for the families? o Should youth/ families be part of discussions surrounding which system should serve the youth? o Should managers be part of Phase III?  If not, how can we empower the line workers to feel comfortable and supported in making “out of the box” recommendations?  What information should be exchanged in advance of Phase II? o Who should receive this information? o How do we ensure that the information is appropriate to share (assessing for both legal and policy considerations)  How should the meeting be structured?  How do we schedule meetings so that it is convenient for youth/ families to attend, while still ensuring that the critical players (including the facilitator, social worker, probation officer are available)?  What should the outcome of each phase be?  Should we be developing joint reports in all cases? 19
The Legal & Policy Subcommittee developed several documents related to the YFTM, including:  Letter to families explaining purpose of the meeting  Confidentiality Agreement  Self‐Incrimination Standing Order  Information Sharing Standing Order o Note: A subgroup of the subcommittee will be meeting to explore information‐sharing issues. The group may end up revisiting this Order. See Appendix 8. 5. One Judge Model Currently Santa Clara County has a dedicated docket for dually involved youth. As we explore “best practices” identified for dually involved youth, we are weighing the benefits and challenges of implementing a One Judge model in our county. Our initial discussions led us to exploring the model implemented in San Diego. See Appendix 9. Broadly speaking, several goals have been articulated in arguments for the One Judge model, each of which has a counterargument: 1. Simplifying process for youth/ families a. Given the logistical challenges our county faces with two separate courthouses and different staffing, a combined court could create more complexity for families. 2. Enabling one judge to have a more holistic understanding of youth/ family and therefore be better positioned to make good decisions. a. Currently the dependency and delinquency judge communicate about joint cases. It is not clear whether a One Judge model would lead to more informed decision‐making. 3. Avoid conflicting orders between dependency and delinquency judge. a. Conflicting orders have not been raised as an issue in our county. That said, anecdotally having two open cases has led to orders while not directly contradictory, are overwhelming for the youth and family to manage. 20
We have also begun discussions with a researcher from University of Maryland who has evaluated whether there is empirical evidence that supports the use of the One Judge model. Although there is limited literature on the subject of One Judge courts used for dually involved youth, there is a body of literature regarding related initiatives. We will be reviewing this literature and drafting a memo that summarizes the literature and offers recommendations on how we should proceed. Both the Legal & Policy Subcommittee as well as the Executive Steering Committee have engaged in spirited debates around the One Judge model. A number of logistical and philosophical considerations have been raised. These include:  How do we safeguard against net widening? If we are now going to be keeping youth under the jurisdiction of both systems when previously they were only under the jurisdiction of one, this raises serious questions about net widening.  Given that the dependency and delinquency courthouses are in different physical locations, how do we coordinate and resource this so that attorneys, including dependency counsel and parent’s counsel, are able to appear at all relevant hearings? o Parents’ attorneys are particularly stretched already and often are required to be in multiple courtrooms within a courthouse at the same time. If they are asked to cover hearings in an entirely separate courthouse, they will require additional staff.  How do we determine which cases would fall within the purview of this model? How many youth do we start with and how do we decide which youth? o Should siblings be included? If so, how are sibling defined? Are half siblings included? Where would cases of siblings be heard? Is it appropriate to have very young siblings in the juvenile justice courtroom? o Should youth in informal services be covered? o How many youth do we anticipate will be part of the pilot?  How do we design a more trauma‐informed court process for this population?  Does the Juvenile Justice Courthouse lend itself to dependency matters being heard? o Is there sufficient private interview space for parents and children to meet with counsel? Accommodations for incarcerated parents? 21
o Are there interpreters readily available? o Is there a children’s waiting area or any space available for younger siblings?  What processes will be put in place to evaluate the pilot project? What will the process be for creating necessary adjustments? How will decision be made to expand beyond a limited pilot group of youth? While we are cognizant of the concerns, Santa Clara County is committed to working through the challenges and piloting a One Judge model for a distinct population. Prior to the launch of the pilot, these questions will be addressed. 6. Information Sharing Questions regarding information sharing practices were raised early during the project year but were not seen by the committee as a particular concern given the Standing Order that governs certain information exchanged between agencies. As the work progressed, more legal and policy questions arose regarding information sharing. Given that historically social workers and probation officers exchanged little to no information, this topic has not been relevant until recently. With the development of the Youth and Family Team Meetings and plans for a Dually Involved Youth Unit, there are numerous emerging policy and legal questions surrounding what information can and should be exchanged. A subgroup of the Legal Subcommittee will soon be meeting to review work done in other jurisdictions on this topic and more thoroughly examine existing practice in Santa Clara County. 22
B. Data Subcommittee 1. Data Collection for the Target Population Forty‐eight dually‐involved/crossover youth were identified. Following are highlights from an analytic presentation by Dr. Denise Herz. See Appendix 10. (Note: When interpreting these findings, keep in mind that the sample size is small).  Pathways by which youth entered dual‐status: o Pathway 1: 30 youth had an open child welfare case with a subsequent delinquency charge o Pathway 2: 14 youth had a delinquency charge with previous child welfare involvement o Pathway 3: 1 youth had a delinquency charge with no prior child welfare history, but where investigation led to child maltreatment concerns o Pathway 4: 2 youth had no caregiver identified at time of release o Unknown: 1  A majority of youth (46%) were residing in congregate care at time of arrest. However, 31 percent were living at home.  Detention at time of arrest was high (56%). This may be explained by one of the following reasons: First, the selected target population was higher risk than the norm. It was not surprising, then, that 54 percent of the target population had felony charges. Secondly, the majority of detained youth did not have a placement option.  Location of the offense: Forty percent of the charges were related to the place the youth was living. In these cases, 47 percent occurred in congregate care settings, and 42 percent occurred at home. When charges occurred at school, it was more likely that the charge would be for a Latino youth (71%) and for youth residing in congregate care (43%). This trend has been observed in other jurisdictions as well.  Forty‐four percent of dually‐involved youth were either not enrolled or not attending school.  Fifty‐two percent of youth had an IEP; 60 percent were for either emotional or behavioral issues. Strikingly, only 10 percent of IEPs were for learning disabilities or developmental challenges.  All dually‐involved youth had a mental health and/or an alcohol/drug related problem. 23
A 9‐month post intake form will be completed for all target population youth to measure programmatic outcomes. The 9‐month outcome data will serve as the baseline data for this initiative. 2. Joint System Map In the early stages of the Dually‐Involved Initiative, various process maps from child welfare and juvenile justice were offered to understand how referrals and cases move through each system. While these process maps were comprehensive, they included many decision points that were not directly relevant to the conversation on how to better serve dually‐involved youth. Thus, the Data Subcommittee developed a synthesized Joint System Map to illustrate the path and decision points by which referrals or cases move through each system: child welfare, juvenile justice, and court. See Appendix 11. Development of the Joint System Map included feedback from key experts across systems: probation officers, social workers, the Dual Status Liaison, and the Executive Steering Committee. The final process map reflects baseline practice, as well as information on potential areas for programmatic revision. For example, team meetings, an important practice strategy are depicted throughout the process map in terms of where they always or sometimes occurs, as well as potential decision points to explore the use of team meetings. The synthesized Joint System Map was very useful in system partners’ understanding of how youth move within and across systems, as well as an understanding of how each system works to support dually‐involved youth and their families. System partners, at first, had some misconceptions about the legal and or best practice obligations of partners in other systems. Simply coming together was very useful in bridging cross‐
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system gaps in understanding, but the visual map made system processes and practices concrete in people’s minds. 3. Addendum to Intake Forms The Data Subcommittee was interested in tracking additional client characteristics not included in the initial intake form that were viewed critical to our understanding of system‐involved youth and their families. In an addendum data form, the following indicators were tracked for youth, mothers, fathers, and other parents: a) Geographic location (i.e., zip code of residence); b) Immigration and linguistic indicators such as legal status, and primary language c) Parental involvement in child welfare case plan services. See Appendix 12 Part of this dialogue also included review of the literature on the role that stress, fear, loss, isolation, and uncertainty play in the lives of immigrant families. See Appendix 13. This literature review will be used to guide analysis and interpretation of the findings, as appropriate. As plans are being developed for the Dually Involved Youth Unit there is a commitment to serve the whole family, as it is incontrovertible that the well being of a youth is intrinsically linked to the family’s well being as a whole. This in turn requires consideration of whether the youth’s parents have unmet legal needs for example, regarding immigration status. Many of the youth served by our systems come from mixed status families, in which some or all of the children are U.S. born and therefore citizens, however at least one primary caregiver is undocumented. Lack of status for a caregiver may lead to instability and insecurity around basic needs. Unless we start to understand youth in the context of the families, communities and cultures they come from, we will be 25
unable to meaningfully address their holistic needs. Culturally‐informed practice and service provision is a critical element of improving outcomes for youth. While concrete indicators were identified for the first two areas: geographic location and immigration indicators, deciding how to operationalize and track parental involvement in child welfare case plan services was not easily resolved. There was deep interest in tracking, for each parent: services offered, services received, and whether the service was offered in the parent’s primary language. The decision was made to only track whether each parent was offered child welfare case plan services and the father type. This decision was made because it would have been extraordinarily resource intensive to gather data for each parent on services offered, services received, and whether services were culturally and linguistically appropriate. The final indicators on the addendum tracking form would serve to offer a starting point by which to understand key characteristics of the target population and how it correlates with youth’ experiences and outcomes (taken from the intake and 9‐month post intake forms). Analytic findings from this initial exploratory investigation could point to areas for deeper investigation or qualitative examination. By the end of the grant period, all target cases had an Addendum to Intake Form completed. Next steps include pulling the initial intake and addendum data together to identify significant relationships. For example, is there a particular zip code from which youth come from? What are the characteristics of the neighborhoods that compose the area of the zip code? How does a youth’s legal status constrain access to needed assessments and services? Is legal status related to a particular set of outcomes? Were the language needs of parents met by service providers? To what degree are fathers offered child welfare case plan services? 26
4. Measuring Outcomes Delineated in MOU The data subcommittee is using the goals delineated in the MOU as a foundation for identifying key data indicators to track. See Appendix 14. Next, indicators tracked by the DFCS Dual Status Liaison in her reporting of youth with 241.1 court orders will be reviewed to identify missing data elements and how they link to specific business questions. The guidebook for Juvenile Justice and Child Welfare System Coordination and Integration by Wiig and Tuell (2008) is also being reviewed to ensure that key indicators are not missed. Finally, lessons learned from an in‐depth qualitative analysis of two dually‐involved youth will inform the breadth and depth of the data to track. Concurrently, the data subcommittee will work with the Legal and Policy Subcommittee to take steps to address information sharing barriers. Once the Executive Steering Committee finalizes the recommended list of key process and outcome indicators to track, and significant progress has been made on data sharing agreements, the data subcommittee will approach IT for guidance and leadership on providing a viable solution and to evaluate the feasibility of implementing the solution. 5. In Depth Case Review A subset of the Data Subcommittee came together to conduct in depth case reviews in effort to distill what information would be most important to capture by an integrated data system. The subgroup discussed at length how our current data collection systems are not fully equipped to efficiently track and use information from a family systems perspective. For example, when a youth comes to the attention of the Juvenile 27
Justice system, how do we use our data systems to understand or track the family history of this youth and its potential impact on his or her behavior? How do we consider the full impact that trauma, child neglect or abuse, poverty and other factors play on behavior and the treatment services that we consider for the youth? See Appendix 15 for Case Review Tool. The case studies confirmed what we already know ‐‐ the lives of these youths are very complex and deeply rooted in traumatic family experiences that often precede the birth of the child. See Appendix 16 for select information from cases reviewed. 6. Moving forward: Data collection proposal The Data Subcommittee persuaded the Executive Steering Committee to endorse its recommendation that the Probation Department track the child welfare involvement, present and historical, of all youths referred to Probation. See Appendix 16 for Data Subcommittee’s proposal. Although this suggestion had been made by DFCS for years, Probation had felt in the past that it was inappropriate, unnecessary and unduly resource intensive to conduct child welfare checks on the almost 9,000 referrals that come into Probation each year. Of even greater concern than the resources required to conduct these checks, was how the information would be used. There has been a longstanding concern that this information could inadvertently push dependent youth into the juvenile justice system who would not have normally penetrated further based on their level of criminality. This project provided capacity building regarding how to use information concerning child welfare history to focus the service response, in concert with child 28
welfare, without formally pushing the youth deeper into the Juvenile Justice system. If we can recognize the driving forces of the youth’s behavior, Probation will be better positioned to match the appropriate services to the youth and family. This match in services will likely be provided outside of our formal systems, thus allowing for the recognition of need without confusing it with criminality. 7. Data Analysis to Inform Plans for a New Unit Serving Dually‐Involved Youth Plans are being developed to launch a Dually Involved Youth Unit, with co‐located probation officers and social workers. There have been preliminary discussions regarding which youth specifically the unit will serve, however, we are hoping to have analysis grounded in our data to provide insight into which youth would most benefit from being placed in the new unit. The Data Subcommittee suggested conducting an exploratory analysis on a random sample of 200 youth referred to Probation in the past year and their present and historical involvement in the child welfare system. In addition, a second dataset was identified for younger youth, 12 years and under, that also includes child welfare involvement. Both datasets will be used to identify characteristics of these youth and how they correlate with child welfare involvement. This information will inform how to use cross‐system data to identify dually‐involved youth that would most benefit from early intervention. Presently, these datasets are being cleaned for analysis. As we began exploring these questions, we were approached by San Jose State Professor Dr. Emily Bruce who has offered her assistance in exploring issues around dually involved youth. We have initiated a partnership with her which could lead to more in‐
29
depth exploration of these datasets to identify complex relationships using more sophisticated statistical tools. Dr. Bruce has also shared a very helpful dually‐involved youth bibliography. See Appendix 18. This partnership is in its early stages and it is hoped that it will lead to many fruitful endeavors in service to dually‐involved youth. C. Practice & Resource Subcommittee 1. Resource Inventory Using a template provided by the technical assistance advisors, the subcommittee began compiling a list of resources early in the project year. See Appendix 19. A subgroup met to refine the inventory by identifying needs by several areas of work: safety, health, success in learning, success in life, including career/vocation, independent living, life skills, financial literacy, cultural connection. This led to a list with over 100 individual need areas such as GED support or creating a resume. This list of needs, while more specific was also overwhelming and there was not a clear path of how to go about gathering this detailed information from the dozens of providers in Santa Clara County. See Appendix 19. Given the enormity, depth and breadth of the second version of the resource list, the ad‐hoc subcommittee met again to narrow down our initial resource‐mapping. The decision was made to focus on the following two resource areas:  Supports that strengthen families with the goal of preventing children and youth from entering the child welfare system.  Supports for youth who are feeling hopeless and are beginning to express that hopelessness by disengaging from school, engaging in substance abuse and other high‐risk activities. However, after that decision was made, several other projects dominated the time and energy of the committee and the resource inventory took a back seat to the higher priority 30
work of the committee. What the activity did do, however, was create the basis for system, youth, family and community outcomes being defined and incorporated into an MOU with all the system partners. Now that we are poised to launch the Youth & Family Team Meetings, we will discuss whether it is time to reprioritize the resource inventory. 2. Assessment Inventory & Analysis The committee developed an inventory of the assessment used by child welfare, juvenile justice, mental health and the drug and alcohol department. See Appendix 20. Subsequently, an analysis of the inventory was conducted which demonstrated the areas of similarities and conflicts among the four systems. See Appendix 20. The analysis revealed opportunities for the systems partners to come together to share information and discuss results from their respective assessment tools. It also identified the focus areas and areas of similarities and differences. Initially, the Committee mistakenly believed that the suggestion for us to conduct “Joint Assessments” involved the development of a new assessment process integrating existing assessments. Once we received clarification from the T.A. Advisors regarding the meaning of “Joint Assessment” the subcommittee shifted the nature of its discussions around this topic. The work around the assessment inventory opened up constructive dialogue around the differences between how the systems view the same behavior. For example, what might be characterized as low‐level criminality by Probation, may be seen as serious criminal activity by Child Welfare. In addition to looking closely at our internal assessment process, the committee also closely reviewed materials from other jurisdictions that the T.A. Advisors shared with us. 31
3. Training Development Throughout the year, the committee had numerous preliminary discussions about the need to develop ongoing, cross system trainings but as other items dominated the work of the Subcommittee, the group has not yet delved deeply into this arena. That said, the subcommittee devoted several meetings to internal cross training in which child welfare and probation each presented on their respective mandates and assessments to the group. These internal trainings proved extremely valuable and generated rich dialogue between the systems. The presentations both helped to clarify misconceptions each system had about the other, as well as offer a broader understanding of the work that each system does. See Appendices 21 & 22 for select materials presented by probation and child welfare, respectively. Additionally, the subcommittee worked to develop the content of a large open forum which was held in April 2013 to update the system partners and the community about the work of the Initiative and generate ideas about how to move forward. This forum provided participants with an appreciation for the complexity of issues surrounding dually involved youth. The event was extremely well attended and well received. It informed and energized the community and served to propel momentum to move forward. Following the event, leaders of this Initiative received positive feedback from a variety of stakeholders. Highlights of the event include:  Powerful opening remarks from a youth representative to the Executive Steering Committee, who spoke about his personal experiences of being dually involved.  Substantial participation from all stakeholder agencies, the community and consumers. 32
 Panel discussion of case study which provided opportunity for audience to hear how a youth, two community representatives, a social worker, probation officer, district attorney and public defender all view the same case through their respective lens.  An opportunity for audience members to work in groups to help generate answers to some of the hardest questions this work involves. See Appendix 23 for case study discussed at the convening and summary of ideas generated in break out groups. A subgroup of the Practice & Resource Subcommittee is being formed to develop long term, ongoing, cross‐system training. 4. Trauma Trainings The Santa Clara County Cross Agency Service Team (CAST) was chartered by the Board of Supervisors to study the interdepartmental activities that could improve access and outcomes for the families involved in the child welfare system. CAST is comprised of leadership from relevant child serving agencies in the county. In the past few years, CAST has been focused on developing plans to promote “trauma informed” and culturally relevant practices across child‐serving departments and agencies. Given the enormity of this goal, CAST decided to pilot its efforts within the Dually Involved Youth Initiative (DIYA), as this Initiative encompasses broad cross system representation. CAST has been working with a leading expert in the field of childhood trauma, who has conducted numerous trauma trainings in the county over the last several years. The trainer came together with several key representatives from the DIYI to adapt her training to the dually involved youth context. This group developed vignettes of dually involved 33
youth that could be used for training purposes. See Appendix 24. Additionally, during the planning meetings, the group had extensive discussions regarding how we make the content of the training feel accessible and relevant to the diverse group of stakeholders involved in the DIYI. We anticipated that participants would be eager for practical information that can be easily applied to their day‐to‐day work. While this is absolutely the ultimate goal of the trainings, it also became clear through working with the trainer, that we would need to first lay a common foundation so that we had consistent language, across disciplines that can be used to discuss trauma. These initial trainings were conducted to help lay the groundwork for more in depth, discipline specific work that will translate theory into practice. We are now at the stage of identifying how best to move this effort forward and ensure that the content shared at the initial trainings informs how we serve dually involved youth. As the appetite for practical application of trauma concepts grew, we began exploring what trauma informed interventions exist for dually involved youth. This exploration led us to TARGET which was originally designed for juvenile justice youth but has since been adapted for use in child welfare systems. See Appendix 25 for overview of the TARGET model. We are in discussion with the psychiatrist that developed this model and are actively exploring the possibility of bringing TARGET to our county. 5. Youth & Family Team Meeting a. Decision Making Tool The Decision Making Tool, developed for YFTM (See Appendix 26) has several goals: 34
 Joint assessment o Have each party document the youth’s needs, corresponding strengths and services that respond to that need. o Identify where there is agreement/ disagreement about key needs.  Exploring dispositional options o Provide a methodical approach to assessing:  What dispositional options are available (with emphasis first on non system responses, and then on joint agency options)  The benefits and drawbacks of each dispositional option.  Which system can best serve each identified need o Provide a methodical approach to developing system recommendation and documenting reasons underlying recommendation. A number of considerations were accounted for in developing this tool. These include the importance of:  individualized decision making  considering the consequences of each recommendation (for example, collateral consequences related to involvement with the juvenile justice system)  considering the safety of child/family and community in decisions  having recommendations regarding which system will serve the youth be driven by best interest of minor  jointly assessing the youth’s needs (recognizing the each system has a different approach to this assessment) and coming to a joint recommendation by the end of Phase III The subcommittee has raised several concerns and questions regarding this document such as, the tool is too cumbersome and laborious; the document does not lend itself to a final written product for families; and the process does not ensure that a joint recommendation will be reached. We have discussed each concern raised at length and at this point we plan to implement this tool, monitor how it operates in practice and modify it as needed. b. Needs & Strengths Grid This grid (See Appendix 27) was developed as a response to several concerns: 35
 In the past, workers have not understood each other’s professional disciplines enough to appreciate the way in which they assess a particular situation.  Workers on both sides have focused a disproportionate amount of attention on certain issues while neglecting to examine other relevant domains.  In the past, both agencies have used information about youth that was arguably misleading, embellished or inaccurate to drive decisions. Use of this grid was intended to elicit an accurate, detailed appraisal of the needs facing a youth in every domain of life. Rather than a vague conclusion that “substance use” was an issue, this grid would help specify the specific nature of the issue, for example, how often does the youth use, what substances are used and with whom). c. Mock Youth and Family Team Meeting The Practice & Resource Subcommittee recently conducted a “mock” YFTM, assigning the roles of youth, DIYA, youth’s sibling, PO, SW, managers for both PO and SW, and community provider to committee members. Using a closed case, we developed a vignette that provided an overview of the youth’s child welfare and juvenile justice history. The group spent a significant amount of time debriefing after the mock YFTM. Participants and observers of the mock had a number of strong reactions to what worked and what did not. One of the significant questions that arose was whether we had succeeded creating an environment in which the youth felt comfortable to speak. The mock forced the group to acknowledge that given the inherent power balance present in the room during these meetings and in spite of everyone’s best intentions, the environment can feel very intimidating to the youth. The debate lies in whether the value of transparency and youth engagement outweighs the possibility that the experience may be uncomfortable for 36
youth. As of now, we have concluded that we are committed to piloting these meetings with youth involved and we will revisit the issue as necessary. Another primary concern that emerged from the Mock was that the purpose of the meeting felt unclear as the meeting played out. Although the group had identified a goal of the meeting and developed a loose structure, we have also tried to allow for the flexibility and space for the meeting to be an organic process for the youth and family to share their concerns. Although it may seem unrealistic to think that youth would feel comfortable enough to speak freely, we are hopeful that the Dually Involved Youth Advocate will be able to forge a connection with youth and open up space for meaningful dialogue. 37
V. Practice Area Reforms A. Reformed Practices Implemented Many of the areas of practice reform have been discussed above in the previous chapter. These include the following:  Youth & Family Team Meeting (launching October 2013) o Dually Involved Youth Advocate (hired September 2013) o Expanded dispositional options (already being used), reflected in Decision Making Tool o Joint 241.1 Reports (used once thus far and will be used more regularly once YFTM launched)  One Judge Model (launching January 2014)  Dually Involved Youth Unit (launching January 2014), staffed by both agencies, sharing responsibility for cases in a coordinated service delivery model. In addition, leadership has been engaging in ongoing dialogue with County Counsel for child welfare and County Counsel for Probation regarding “risk reduction” and sharing risk and success for these cases. These discussions are critical to the broader culture change, and will eventually inform practice area reforms. This process has illuminated that current policy and practice is based on risk or perceived risk aversion rather than on addressing the root cause of behavior. For example, we now know that many of these youth are, “whereabouts unknown” for lengthy periods of time. A warrant is issued and when the youth re‐enters our systems, he or she is often placed back in a congregate care group home and absconds again (usually to the home from which they were removed). When neither system can locate the youth, we are not providing public safety or protecting the youth. By reframing the discussion, we can determine what is truly the more risky path – placing youth where we know they will likely flee, or placing them with families who may 38
not be as cohesive or compliant as we would like. As we launch the integrated unit, we are developing our responses within this framework; how we can best reduce risk and have the youth in a place where they will most likely access the supports and services provided. Finally, several months ago we began holding monthly meetings with managers from both agencies. The decision to initiate these regular meetings stemmed in part from a recognition that “messaging” the work, having the direction set from above penetrate down through line staff, required the investment and involvement of mid‐level management. These meetings have proved to be an extremely valuable forum for relationship building, informal cross system training, and joint brainstorming. We hope that team building and enhanced decision‐making will be a natural outgrowth of this process. 39
VI. Family & Youth Engagement Family and youth engagement has been a priority since the inception of this Initiative. The Executive Steering Committee includes two vocal and articulate youth representatives that have played a significant role in the work. One of the youth representatives has also been a consistent member of the Practice & Resource Subcommittee. As is often the case, however, the two youth representatives are youth that are consistently asked to participate in the county’s reform work. We recognize the importance of diversifying the pool of youth we draw from, and we hope to engage youth moving forward that have not previously been engaged in reform efforts. While the Executive Committee started out with parents’ representatives as well, unfortunately these members have not continued to participate. Although there was an initial attempt to reengage them, there has not been consistent follow up from our end and this is an area where we need a renewed effort. The importance of family and youth engagement is perhaps best reflected by leadership’s unwavering commitment to include youth and family in the Youth and Family Team Meetings. This commitment has not come without its challenges, as including youth and family in these meeting introduces a multitude of complex issues regarding confidentiality, information sharing and self‐incrimination. Recognizing that merely having youth and family at the table does not ensure that youth and family have a meaningful voice in the process, committee members have discussed at length how we build in support and protections so that youth and family have a sincere opportunity to feel comfortable and heard. These discussions led to the hiring of a Dually Involved Youth 40
Advocate whose role is dedicated to supporting the youth and helping them feel empowered to advocate on behalf of themselves. It was important to the search committee to find a candidate who would be able to relate to the youth we serve. We were fortunate to find a bilingual young adult, who was formerly in foster care and has a particular passion for advocating on behalf of system involved youth. The Legal Subcommittee also discussed ways to help support the youth’s caregivers and decided that amongst other things, we will encourage the caregiver to bring a support person of their choosing (for example a friend, neighbor, clergy) to the Youth and Family Team Meetings. As part of our effort to better understand the experience of dually involved youth, we conducted several rounds of interviews with youth. One of the youth we interviewed has been involved with the child welfare system for the entirety of her life and with the juvenile justice system for much of her adolescence. Her case exemplifies the reality that in spite of numerous well‐intentioned, hard working professionals supporting her in the best way they were able to, the system has failed in countless ways. This youth revealed many disturbing details about her experience with both systems, but above all what permeated her comments was the sense that she felt completely unsupported, misunderstood and alienated by both the child welfare and juvenile justice systems. In addition to one on one interviews, we conducted a focus group with several youth that have been dually involved. The youth made a number of stark comments throughout these discussions including the following:  No one explained what was happening while things were happening (for example/ why they were being removed, why they were going to court, what their options were, etc). This was particularly true when the youth were younger. 41
 The quality of staff at group homes was poor. Youth were aware of situation in which staff members bet on fights between youth and situations in which staff had inappropriate sexual interactions with girls in the home.  The clinicians they were referred to for therapy, anger management, etc. were “horrible.” It felt like they had a cookie cutter approach to each kid and they were just checking off their boxes to complete paperwork.  There was a lack of cultural sensitivity and understanding throughout their interactions with the system. Youth also discussed how they grew up hearing how evil the “system” was and how they should never trust system involved people and never disclose information to them. One youth spoke at length about the intense anger that grew inside of him because he was placed far away from his siblings. Years of therapy and anger management did not address this anger. Finally, in discussing the common experience of AWOLing from placement, youth articulated that if there was someone they felt connected to, who could discuss options with them and not be obligated to turn them in, then they would have reached out while on the run. The Executive Committee was deeply concerned by the feedback generated from these interviews with youth. In particular, the comment regarding inappropriate sexual interactions between group home staff and girls in the group home became the centerpiece of intense discussion amongst the committee. There was consensus that this comment was to be further explored in order to verify whether this is in fact occurring and to understand the nature and scope of this issue, assuming that is in fact an issue. One of the youth representatives on the Executive Committee led an effort to develop a survey to be circulated to youth. See Appendix 28. 42
Statement from youth representative to the Executive Steering Committee, Robson Nkomo I was very grateful to be a part of the Dually‐Involved Youth Initiative. This Initiative is the most progressive example of system reform I have yet to see. I was pleased to find that the committee actually walked the talk. It was my expectation that this would just be something people blew steam about but would not go anywhere. What I found was a group dedicated to ensuring better outcomes for our youth, something I believe we all seek, yet often gets lost in the politics. System integration and fostering good relationships amongst organizations is the only way we can ever hope to do this work well. For too long youth, and anyone else interacting with the system, had to play a “game” in accordance to standing politics. Rather than working together, organizations often duplicate work and act rather territorial with their youth populations. That’s why I was so proud to be a part of this committee. It aims at doing our work with this population better and more effectively than we have in the past. My involvement with the project has included offering input in meetings, giving oral presentations and being an advocate for this project. All the while, I felt as if I was truly being heard. My input in meetings was incorporated into the final product. It is such a progressive act for Santa Clara County to incorporate youth in high‐level meetings. What surprises and elates me though is my county’s willingness to accept our experience within the system for what it’s worth and truly listen as we work together to improve outcomes for our youth still in care. This workgroup has essentially created a model, fully sustainable and impressively progressive. I am proud to have been given the opportunity to do this work and improve conditions for transition aged foster youth. We may not have gotten it right or even figured out all of the details yet but we are definitely headed in the right direction with this. It’s our jobs to protect, serve and empower these youth. This is the start of something major and hopefully one day soon, all youth who encounter the foster care or juvenile justice system end up better off because of the efforts of this systems integration model. 43
VII. Culture Change A. Historical Context of Cross‐System Practice Perspective from Deputy Chief Probation Officer, Laura Garnette: As a relatively new employee to Santa Clara County, I had a unique perspective. The strengths and challenges of each of our agencies and of our collaboration with one another and with the Courts, quickly became apparent. Since I was not involved in the history of what had created the current climate, it was easy to be objective and non‐defensive when tasked with challenging the status quo. The reality in most jurisdictions, including Santa Clara County, is that there is a rich history of both successes and challenges – including some tragedies, that continue to plague many partners. While this can add to the richness of systemic change, it can also add to the dependence on past practice and to a resistance to change if not challenged. I was both surprised and heartened to be met with openness to exploration of our practices and commitment to change by almost all of the stakeholder leaders. Many reform efforts are viewed through the lens of, “we didn’t work together before and now we do,” as if by collaboration alone, you can change systems long entrenched in harmful practices. Santa Clara leaders took a much broader view of their own and other systems instead of relying on the easy answers that produce quick, but not sustainable change. One cross over area that surfaced as “low hanging fruit” was the lack of administrative oversight of the staff and court processes for these cases. Line staff assigned to the calendar were used to having significant control over the outcomes of their cases and often recommendations were made without staff from either agency truly understanding the unintended consequences of the recommendation. There was mounting frustration from staff members who often believed the other agency was not fulfilling their obligations. Social Workers voiced concern that Probation Officers were not “holding kids accountable” and treating DFCS youth more leniently than other youth and Probation Officers voiced concern about net widening and the demonization of youth and families by Social Workers. Management was not part of the conversation until there was an impasse on the line level, and by that point, there was rarely a good solution still available. On some of the more difficult cases, staff from both sides claimed that the other agency was remiss in their obligations to the youth and family and admitted that they sometimes just, “gave in” to the recommendation, even when they felt it wasn’t the right one. This appeared as an area of concern for leading Judges in both Juvenile Justice and Dependency. There was a clear plea from the bench to make substantial changes to our processes, coupled with what appeared to be mounting frustration about the lack of high‐level attention to the issue. That frustration led to the two leading Judges working together in an attempt to improve the process and dispositional options for this population without full partnership from the management of DFCS and Probation. 44
In spite of these challenges, Santa Clara County also had many strengths: Staff from both agencies and the Courts are smart, hardworking and have a demonstrated passion for working with youth and families; there was strong leadership from the bench and a joint desire among the leaders to improve the current system; there had already been ample improvements to the entire 241.1 process the past several years; and the county has robust resources from which to draw. The opportunity for the technical assistance provided by this project surfaced just as we were at a critical crossroad in our path, making the decision to seek guidance an obvious prudent choice and one that provided the necessary framework to make systemic changes. Perspective from the Director of Department of Family & Children’s Services, Lori Medina Santa Clara County has had a long history of innovation and willingness to embrace new practice approaches. Both agencies have strong committed staff who take pride in delivering a high level of service and expertise in their respective arenas. This initiative affords us the opportunity to leverage resources, do joint problem solving in a way we never had before, and reduce duplication of efforts. Our County has been one that routinely brings partners and stakeholders to the table to discuss and problem‐ solve system issues. In the area of Dually Involved Youth, however, this has not always been the case, and there were very little collaborative efforts in this regard. The County has had an established Dual Status Protocol for years that had been updated periodically, but required a choice to be made between the systems. Historically, The Dual Status Process has been one fraught with tension and conflict. When Probation and DFCS leadership began meeting and working on how we would address Dually Involved Youth, we really had to educate each other on some basic understanding about the functions of our two systems, philosophical similarities and differences. Having those foundational discussions and understandings at the leadership level really assisted us in moving forward in a more committed way than I have experienced in my eleven years with the County. We also gave a strong message to our staff and stakeholders that we are going to work together jointly and break down the barriers that result in poor outcomes and needs not being fully addressed. The challenge still remaining is supporting our systems and staff through a much needed change process with implicit permission to do something different than what we have always done, and modeling the change we expect as a result. Each Department has a great deal of system improvement efforts in progress, and when approaching this system integration work, we are constantly struggling against perceptions that this is just another “flavor of the month.” We are really striving to demonstrate that this system integration work is aligned, meaningful, and supports all of our change efforts to improve outcomes for youth and families. Solutions 45
reside within family and community systems, and our work should be focused on supporting families’ and communities’ ability to be self‐directed and self‐ sufficient. Perspective from Presiding Judge of the Juvenile Court & Supervising Judge of the Juvenile Justice Court, the Honorable Patrick Tondreau When I took over the Dual Status Calendar in 2007, I was told everything was working just fine. What I discovered was a practice dominated by six "C's": Collaboration, Choice, Chambers (as in underground), Communication, Culture and Cross Training; which is to say, little collaboration, poor choices, psychological and physical silos, poor communication, formal systems with a significant lack of cross cultural understanding, and the absence of people trained to work and think in different worlds from multiple perspectives. It is not an understatement that Probation and DFCS had very little communication and understanding with each other. As one significant partner stated to me when we started this project: "Why would I want my social workers talking to probation?” It is also true that Dependency and Juvenile Justice largely saw themselves working in two different worlds with a significantly different population. This bifurcated world was reinforced by a Dual Status Protocol that essentially required the Court to put the minor into either Dependency or Juvenile Justice, with a few being designed as True Dual Status, which allows the Court to suspend the 300 action and potentially reinstate it at a later time. In practice this often meant I brought either the 300 action to a halt, or dismissed the 600 action when the minor clearly could benefit from probation services. This bifurcation allowed the systems to continue to think and work in their own distinct cultures. We began to rethink these premises. It initially began with a conference a team of juvenile justice participants attended at Georgetown University focused on crossover youth. We began to see two facts, first, that these populations resembled each other much more than we had assumed, and two, Courts across the nation had developed working models for co‐jurisdiction over these families. With time and much discussion we gradually began to see that we needed to create a new protocol, which encouraged both DFCS and Probation to work simultaneously with families. This requires a systems commitment, which we have achieved with an MOU, and the creation of a “one family one judge” court, which will take place in Department 77 at the Juvenile Justice Court. DFCS and Probation have agreed to create a new unit of probation officers and social workers to specifically handle these cases. The use of Youth and Family Team meetings will be a focal event at the front end of a case. This meeting will be facilitated by a Dually Involved Youth Advocate, who will have specialized training and skill in advocating for youth and facilitating the team meeting. We hope to start January 1, 2014. We will simultaneously continue to meet as an executive team to monitor the protocol, 46
make appropriate changes and review outcomes. The goal of this project is to build stronger families, rehabilitate youth, and keep our community safe. By addressing the families' entire needs we increase the chance of successful outcomes. B. Efforts to Enhance Collaborative Culture Many of our efforts towards culture change have been discussed previously throughout this Manual. These include the large community forum held in April, the monthly joint managers’ meetings and the inclusion of non‐traditional partners in subcommittees and on the Executive Steering Committee. Additionally, we have been adjusting the way that we work with community based organizations. Recognizing the importance of incorporating community based organizations into the philosophical and logistical discussions regarding our work, we have the Executive Director of the organization that represents provider agencies on our Executive Steering Committee. In January 2013, we presented on the Initiative to 18 provider agencies. This was an opportunity to both share information about the work we are doing, and just as importantly, to solicit ideas from the community based agencies that serve dually involved youth. See Appendix 29 for Memorandum drafted by Silicon Valley Council of Nonprofits summarizing recommendations from provider agencies that attended the presentation. This meeting and prior and subsequent conversations illuminate systemic challenges even on the services side. It became apparent that the providers were not given enough direction regarding the system’s expectations for serving these specific youth and families and were left to develop these themselves. Words like “culturally competent” were ill defined and it was easy to criticize the service delivery that the system had failed 47
to clearly define. Just as we saw in our own systems, some of the child serving agencies had developed a culture that was inflexible and routine. This Initiative has allowed the providers to work in concert with the system leadership to fashion more responsive solutions. Just as the system began taking some responsibility for the lack of success of our clients, the providers re‐evaluated their delivery system from a “meet them where they are “ approach. Central to this shift was the risk reduction principle. We challenged the providers to build in a safety net where there was substantial risk. For example, a parent might not be ready to quit abusing alcohol yet, but could agree to keep it locked away from their children and have an agreed upon safety plan for when they are impaired. Having the directors from the Mental Health and Drug and Alcohol departments involved in this process was necessary to create “out of the box” solutions that have a increased chance of working. The directors from both agencies provided bold and consistent messaging that youth can reside with parents who are still struggling with mental health or substance abuse issues if the right protections are put in place to reduce the risk to the child. This process also showed where there are gaps in services. There has been vigorous discussion about cultural responsiveness not just as it relates to ethnicity, but also to age, class, learning differences, sexual orientation and gender identity. It is clear that central to the success of this Initiative is the engagement of non traditional partners to this work – including smaller, ethnically centered providers, family partners who resemble and can relate to the families they are serving, linkages with faith communities and engagement of other natural helpers and community resources that reduce risk and increase protective factors rather than focus on the unrealistic task of avoiding risk entirely. Undoubtedly, 48
increasing community capacity is one of the more difficult areas of system reform but also the place where we believe the solutions live. C. Trauma Informed System Change As our county as a whole moves toward a “trauma informed” system of care, we have been exploring what specifically this means for our approach to dually involved youth. The Executive Steering Committee has discussed the importance of minimizing system‐induced trauma. We hope to move to a place where we are able to understand, anticipate and appropriately respond to the distinctive needs that a youth who has been traumatized may have. This requires us to come to terms with trauma in our own lives, as well coming to terms with how unprocessed trauma in the youth we serve may manifest in an unpleasant, destructive manner. Although much has been written on “trauma informed” approaches for social workers and mental health professionals, there is far less guidance for other critical stakeholders in our work, such as Judges, probation officers and prosecutors. As we roll out our Trauma Trainings, we have been sensitized to the importance of finding ways to make this body of knowledge directly relevant and applicable to all the stakeholders involved in our work. Additionally, other questions have arisen about trauma in the context of information sharing. Although many view a youth’s trauma history as a source of mitigating information, this information may be seen by prosecutors as an aggravating factor given the connection between delinquency and unprocessed trauma. Additionally, attorneys’ representing parents may be uncomfortable having trauma history included in 49
the juvenile justice case, if this may implicate the case for parental reunification as well ‐ particularly if one judge is overseeing both the dependency and delinquency cases. Although there is consensus around the desire to become “trauma informed” in our approach to dually involved youth, we continue to grapple with how to make this term come alive in the context of the day to day work, the way we approach live cases, and the broader lens through which we view youth, families and communities. Ultimately, a thoughtfully coordinated approach to dually involved youth is a precursor to a truly “trauma informed” response. If systems continue to operate in their historically based silos, significant potential for system induced trauma will persist. 50
VIII. Summary & Conclusion A. Next Steps Much of the work described throughout this Manual is very much still work in progress. As mentioned above, the Youth & Family Team Meetings will be formally launched in October 2013. The Dually Involved Youth Unit and the One Judge model are scheduled to launch in January 2014 with the expectation that it will take several months for the Unit to become fully operational (anticipated by March 2014). Although the details are currently being worked out for the Unit, the intention to create an integrated unit that serves the youth and family holistically is clear. This will require shared responsibility of case management and outcomes. The design details will be critical, and just as important, if not more so, will be the way in which the culture of the Unit is established and fostered. Each of the subcommittees still has substantial project work underway. The Legal & Policy Subcommittee is embarking upon a deeper exploration of the information sharing issues that have emerged. The Practice & Resource Committee will soon be fleshing out plans for ongoing, cross system training. And the Data Subcommittee is turning its focus to plans for a long term data collection process. B. Success and Challenges Successes: Stakeholder Participation:  Santa Clara County had the right people at the table from the beginning of the project and unwavering leadership supporting it.  Project involvement went beyond the usual participants and had meaningful youth and community voice as part of every decision made. While this might seem obvious or simplistic, it was a cornerstone to what we believe will be 51
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multi‐system change that is responsive to youth and families, acknowledges the systemic harm many have endured and is sustainable over time. Leadership in the county was resolved to cease gate‐keeping and begin solution building. Communication was open and free flowing, and responsibility was shared at the highest levels of the organizations. Our community and stakeholders were engaged, excited, and committed from the start. It seemed they were hungry for the changes we are moving toward. Each stakeholder group brought to the table expansive expertise and knowledge to problem solve and create suggestions for alternative interventions. There is broad commitment to creating a more accountable county system, with a sense of shared ownership for outcomes. Culture Change:  While success is difficult to define, one indicator is that the majority of people who have been part of this work all year are consistently using a shared language and expressing shared values.  As a steering committee, we have been nimble and responsive to new information. We have piloted innovations and quickly acknowledged their unintended consequences and recalibrated. We have a team of leaders who respect one another and who have opened their hearts and minds over the past year. It seems that every leader on this project has had profound changes in the way they view this work and their understanding of different points of view.  We have both accepted and embraced the complexity and magnitude of the work. Just as it took a lot of time and effort to create systems, it takes an equal amount of tenacity to change them.  Even though we often get entangled in the complexity of the work, everyone at the table seems to grasp that in the end, we are talking about children and their families and the profound effect our actions have on them. The leadership has taken this responsibility seriously and when stuck, returned to the guiding values of being facilitators to youth and families, and not assuming that we know what is best for them. 52
 As change agents, we have remained value based at every turn, even when it would have been easier to hide behind traditional shields that have allowed the status quo to prevail regardless of the harm it causes.  Early on, system leaders recognized and embraced that the way in which we approached working with the dually involved population was going to have to change, and that the respective agencies were going to have to lead that change. Resources:  Early in the process, there was the acknowledgement that we were not resourced to successfully complete this project and the solution to hire a Project Manager was made. The Project Manager had the skill set, vision, energy and tenacity to keep the project moving forward during times of chaos and dissipation of focus. General:  Our system also recognized that to develop meaningful interventions, we had to be realistic about our current state and work toward plans that included reasonable tolerance for risk, as opposed to denial. Challenges: Stakeholder Participation:  We were unable to maintain parental representation.  There was at least one key representative who was not brought in until the end of the year, the office who represents the parents of children in the dependency court.  While our community involvement was one of our greatest successes, it proved difficult for the representatives to keep up with the pace of the project. They were not resourced to be part of the project, so every hour they spent on this work, took away from their already busy schedules.  We still are challenged with how to successfully engage education partners, who play a critical role in identifying these youth to our systems. 53
Culture Change  This was a difficult project due to the complexity and size of the jurisdiction and participating agencies. The Probation Department has about 500 staff members who serve youth and families and DFCS has 550. Getting a consistent message to all staff continues to be daunting.  Much of the work and discussion remained youth focused instead of looking at the entire family as a unit.  The leadership team had to continue to re‐focus energy into the larger goal of system reform versus a limited term project to be completed.  Staff continue to gravitate toward doing things the same way they always have. The level of management and supervision required is dramatic. Resources  This project and the work in general is tremendously resource intensive. It has been and continues to be difficult to devote the amount of time needed to the project while attending to all other aspects of the job. General  There were many times when each of the leaders wanted to walk away – the work was difficult and the magnitude of change required overwhelming. Luckily, this seemed to go in phases and we were good at supporting one another when it seemed impossible to prevail. C. Final Comments There are a number of ingredients that are critical to undertaking this endeavor including leadership that prioritizes the work in spite of balancing countless competing demands, and dedicated staff that have the time and resources to devote to this. Just as important is the appetite to combat a resistance to change, the patience to wait for messages to penetrate down to line staff, and the ability to stomach the messy chasm that exists between where you started from and where you hope to end up. * 54
In all of the technical, logistical discussions that this Initiative entails, it can be easy to lose focus on what is truly at issue. This work is not about “fixing” the youth we serve, it is about reimagining and reforming the way we approach our work. It requires understanding the issues our youth and families confront in the broader context of the economic, political, racial and class disparities that persist. It is about seeing the youth we work with as part of families, who are part of communities that have a tapestry of cultures and histories and stories they bring with them. It requires our being able to acknowledge and manage our trigger points, our defensiveness, our egos and our natural tendency to preserve the status quo. Above all it requires us to be able to look through the lens of another and see the world and ourselves with a radical open mindedness and empathy. 55
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