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Koochiching County
Minnesota Child and Family Service Review

Program Improvement Plan


I. General Information
 
 
County Agency Name:

Koochiching County

Address: 1000 Fifth Street, International Falls, MN 56649

Telephone Number: 218 283-7000

 
County Person Primarily Responsible for PIP:

Cindy Ellefson-Oswald

E-mail Address:

cindy.oswald@co.koochiching.mn.us

 
Telephone Number: 218 283-7000

 
DHS Quality Assurance Contact Person:

Steve Johnson

E-mail Address:

Steve.h.johnson@state.mn.us

Telephone Number: 763-497-0156

To be completed by DHS:

Date Draft PIP Submitted by County: September 4, 2007

Date PIP Approved: January 30, 2008

Due Dates for Quarterly Updates: 3/31/08, 6/30/08, 9/30/08 and 12/31/08

Date of PIP Progress Review(s): see dates above

PIP Completion Date: 10/1/08


II: Program Improvement Plan Narrative
*Detailed instructions and additional information on the following narrative is available in the PIP instructions*

Introduction and Performance Summary: Include when the MnCFSR was completed and a summary of performance in outcomes, performance items and national standards.

Koochiching County Community Services participated in the Minnesota Child and Family Service Review in September, 2006. Six cases of children in the county's child welfare system were reviewed. Two in-home and four placement cases were reviewed. The period under review was July 1, 2005, to September, 2006. Koochiching County had ratings of strength on 16 out of 23 performance items. Items rated as areas needing improvement are addressed in this Program Improvement Plan and include items 1, 5, 17, 18, 20, 22 and 23.

Cross Cutting Themes Identified During MnCFSR: Provide a description of crosscutting themes and systemic issues that affect multiple areas of the county’s performance.

The themes that emerged are including all appropriate people in-case planning, including foster parents and children when developmentally appropriate. Health screenings being completed timely for children in placement will be a focus for the county.

Truancy issues is a common theme with no consistent procedures set to address truancy. Truancy problems are not always reported to the county agency.

Description of Overarching Strategies: Provide a description of program improvement strategies and identify strengths or promising practices that can be effective in making improvements in multiple areas. Include discussion on staff orientation/training in relation to the MnCFSR and Program Improvement Plan.

Case planning - Koochiching County will gain knowledge of other case-planning models and possibly format training for social workers. This focus will increase the level of participation in case planning by parents; foster parents; children (when appropriate); service providers, and others. This will include case planning as early as possible after the case is open. Included in case plans will be performance items from the review needing to be addressed.

Description of Methods of Measurement/Monitoring: Provide a description of the evaluation approaches that will be used for measuring improvement, e.g. Qualitative Case Review System and review of relevant SSIS reports.

Koochiching County will use a variety of methods to measure improvement in areas noted throughout the report. Most commonly used will be SSIS reports and suspension case reviews regularly.

Plan for the Development and Dissemination of the PIP: Provide a description of the process used for developing and soliciting input on the PIP, e.g. who was involved, and the plan for dissemination of the PIP to agency staff and community partners.

The Program Improvement Plan has been developed by the Social Service Supervisor with input from child protection social workers. Copies of the plan will be provided to the Koochiching County Child Protection Team; CJI Team; and the Koochiching County Board of Commissioners.


III. Matrix


SAFETY OUTCOME 1: Children are first and foremost protected from abuse and neglect
Item 1: Timeliness of initiating investigations of reports of child maltreatment

Performance at time of review (%): 66.7%

Performance Goal (%): 90%

Issues noted in the final report: There were two traditional investigations and one Family Assessment completed during the period under review. In the two cases rated a Strength, the reports were screened and the assessments initiated the same day, and face-to-face contact with the victims either occurred the same day or within two days of initiating the assessment. In two of three cases, the agency met face-to-face with children within statutory guidelines.

There was one traditional investigation case rated an Area Needing Improvement because the child was not seen within required timeframes. In this case, the assessment was initiated within timeframes, but the child was not interviewed until 11 days after the report was accepted for assessment, which was outside the required guidelines.

Person(s) responsible for implementing action steps and monitoring progress: Cindy Ellefson-Oswald, Social Service Supervisor

Action Steps

Date to be Completed

Methods of Measurement/Monitoring

Quarterly Updates

1. When child protection social workers will make diligent efforts to conduct face-to-face interviews and/or observations with the child(ren) within required time frames. When this contact does not happen, per timelines, the social worker will meet with the social service supervisor to discuss obstacles to contact, and options to overcoming these obstacles. This will all be documented in case notes.

12/31/07

SSIS Report, Time to Initial County Contact with Victim. Review the report on at least a quarterly basis.

QA Toolkit. Review one case, per worker, per quarter.

 


PERMANENCY OUTCOME 1: Children have permanency and stability in their living situation
Item 5: Foster care re-entries

Performance at time of review (%): 26.3%

Performance Goal (%): 15%

Issues noted in the final report: In three cases rated not applicable, the children entered and remained in foster care before the period under review. In the one applicable case rated a Strength, the child entered foster care during the period under review, was reunited with their father after eight months of out-of-home placement, and has not returned to foster care. In this case, the agency facilitated extensive visitation between the child and parent including weekend and overnight visits. The agency was dilligent by providing both reunification and post reunification services to this family. Koochiching County will be required to address this item in their Program Improvement Plan because of not meeting the national standard.

Person(s) responsible for implementing action steps and monitoring progress: Cindy Ellefson-Oswald, Social Service Supervisor

Action Steps

Date to be Completed

Methods of Measurement/Monitoring

Quarterly Updates

Prior to a placement, and when a child returns to placement, a committee of social workers; in-home family based worker; social service supervisor and juvenile probation officer (when appropriate) will meet to discuss reasonable efforts to prevent placement and examine reasons for child’s re-entry into placement.

Supervisor will review case plans to ensure that family needs have been adequately assessed and necessary services provided to alleviate the need for placement and reduce the possibility of re-entry.

Review any child re-entry concerns with the Children’s Justice Initiative Team.

3/31/07

QA Tool Kit (Review one case, per worker, per quarter.

SSIS Charting and Analysis: Review the report on at least a quarterly basis.

 


PERMANENCY OUTCOME 1: Children have permanency and stability in their living situation
Data Indicator: Foster Care Re-Entries

National Standard: 8.6%

County Performance (2005) : 26.3%

Performance Goal (%): 15%

Person(s) responsible for implementing action steps and monitoring progress: Cindy Ellefson-Oswald, Social Service Supervisor

Action Steps

Date to be Completed

Methods of Measurement/Monitoring

Quarterly Updates

Same as Item #5. See prior page.

     


WELL-BEING OUTCOME 1: Families have enhanced capacity to provide for their children’s needs
Item 17: Needs and services of child, parents, foster parents

Performance at time of review (%): 83.3%

Performance Goal (%): 90%

Issues noted in the final report: Issues noted in the final report: In five of six cases, the needs of children, parents and foster parents were adequately assessed; identified needs were addressed through the provision of appropriate services. Identification of needs was achieved through the provision of both formal and informal assessments. Examples of formal assessments included: chemical dependency evaluations, parental capacity evaluations, psychological evaluations and other mental health assessments. The agency caseworkers conducted ongoing informal assessments during their contacts with children, parents and foster parents. Reviewers noted that the caseworkers used the Child Well-being Tool in several cases to assess needs.

In one case, reviewers noted that the agency caseworker organized a treatment team to help coordinate the multiple service providers working with a family, and in another case, the effective teamwork and service coordination through the local drug court played a role in helping a chemically dependent parent achieve sobriety. Multiple services were provided to address the identified needs of children, parents and foster parents. Commonly identified services include both in-patient and outpatient chemical dependency treatment, respite care, out patient mental health, daycare, domestic violence prevention services, money management, transportation, parent education, shared family foster care, adult mental health case management and in-home family based services.

Person(s) responsible for implementing action steps and monitoring progress: Cindy Ellefson-Oswald, Social Service Supervisor

Action Steps

Date to be Completed

Methods of Measurement/Monitoring

Quarterly Updates

1. Social workers will use the SDM Family Strengths and Needs assessment to help determine service needs for the family.

2. “PIP Tips” will be distributed to staff and discussed at staff meetings.

3. On-going evaluation of local services to determine effectiveness of resources available to meet needs and when gaps in services are identified, attempt to develop new and additional resources.

on-going

QA Tool Kit (Review one case, per worker, per quarter.)

 


WELL-BEING OUTCOME 1: Families have enhanced capacity to provide for their children’s needs
Item 18: Child and family involvement in case planning

Performance at time of review (%): 83.3%

Performance Goal (%): 90%

Issues noted in the final report: In all six cases reviewed, there were current case plans in the case files. In five of six cases, parents, and when applicable, children were involved in the development of the case plan. In one case rated Strength, there was a planning team that met and developed the case plan. People involved in developing the case plan included the parents, children, agency caseworker, agency mental health worker and in-home service provider.

In the one case rated an Area Needing Improvement, there was excellent input and engagement of the mother, but the non-custodial father was not engaged or involved in the development of the case plan even though the father played a role in his child's ongoing safety plan.

Person(s) responsible for implementing action steps and monitoring progress: Cindy Ellefson-Oswald, Social Service Supervisor

Action Steps

Date to be Completed

Methods of Measurement/Monitoring

Quarterly Updates

1. Social workers will invite all relevant parties to participate in the development of case plans.

2. Social workers will attempt to locate all persons who should be involved in case planning and invite them to participate.

Engagement of children and parents in case planning will be discussed at staff meetings.

“PIP Tips” will be distributed to staff and discussed at staff meetings.

Supervisor will discuss “non-custodial parent involvement” and legal authority for placement at all pre-placement screenings.

on-going

QA Tool Kit (Review one case, per worker, per quarter.

SSIS reports (Run quarterly): Service Plan Report, Workgroups Without open Service Plans, and Placements Without Open Out-of-Home Placement Plans.

 


WELL-BEING OUTCOME 1: Families have enhanced capacity to provide for their children’s needs
Item 20: Worker visits with parent(s)

Performance at time of review (%): 83.3%

Performance Goal (%): 90%

Issues noted in the final report: Five of the six cases were rated Strength

Person(s) responsible for implementing action steps and monitoring progress: Cindy Ellefson-Oswald, Social Service Supervisor

Action Steps

Date to be Completed

Methods of Measurement/Monitoring

Quarterly Updates

1. Social workers will meet with parents and be flexible as to time and place for meetings that are held.

2. Social service supervisor will monitor worker visits with parents.

3. Social service case notes will reflect detail about contacts and meetings with parents.

4. The social service plan will address social worker meetings with parents, ensuring that needs of the family are being met.

5. Social service supervisor will review case file documentation and discuss parental visits during staffing meeting.

on-going

12/31/07

QA Tool Kit (Review one case, per worker, per quarter.)

 


WELL-BEING OUTCOME 3: Children receive adequate services to meet their physical and mental health needs
Item 22: Physical health of the child

Performance at time of review (%): 60%

Performance Goal (%): 90%

Issues noted in the final report: In the three placement cases rated a Strength, the children received timely health examinations during the first 30 days of placement and there were no unmet medical needs.

In one in-home case rated an Area Needing Improvement, a physical health examination of the child was a reasonable expectation due to the parent's methamphetamine use and the unsafe environmental condition of the family home. In one placement cases rated an Area Needing Improvement, the reviewers could not determine if there were initial health screenings, or other medical evaluations provided to the children upon the most recent entry into foster care.

Person(s) responsible for implementing action steps and monitoring progress: Cindy Ellefson-Oswald, Social Service Supervisor

Action Steps

Date to be Completed

Methods of Measurement/Monitoring

Quarterly Updates

1. Children will be referred for health care exams, when appropriate, within 30 days of case management being opened.

2. All children entering foster care will have a health screening within 30 days of placement. Whenever possible, services will be coordinated with the Child and Teen Checkup Coordinator through Koochiching County Public Health.

3. All completed health screenings will be kept in case files. Documented case files will be the reasoning why a health screen was not completed or not needed.

4. The social service supervisor will monitor, through SSIS reports, to ensure health screenings are completed.

5. Foster parents will continue to be educated as to the necessity and timelines of health care screenings.

on-going

on-going

QA Tool Kit (Review one case, per worker, per quarter)

 


WELL-BEING OUTCOME 3: Children receive adequate services to meet their physical and mental health needs
Item 23: Mental/behavioral health of the child

Performance at time of review (%): 83.3%

Performance Goal (%): 90%

Issues noted in the final report: In five of six cases rated as Strengths, the agency implemented formal mental health and psychological evaluations to assess the mental health needs of children and provide services to address those needs.

In the one case rated Area Needing Improvement, the required mental health screening tools were not completed.

Person(s) responsible for implementing action steps and monitoring progress: Cindy Ellefson-Oswald, Social Service Supervisor

Action Steps

Date to be Completed

Methods of Measurement/Monitoring

Quarterly Updates

1. All children receiving child protection case management will receive a CMH screening, when appropriate.

2. Koochiching County Community Services will contract with providers, if necessary, to meet the mental health needs of children.

3. SSIS reports will be reviewed by the social service supervisor to ensure mental health screenings are completed.

4. Children will receive necessary services in a timely fashion.

5. Completed mental health screenings will be in case files.

on-going

SSIS Children’s Mental Health Screening Report will be reviewed on a quarterly basis.

QA Tool Kit (Review one case, per worker, per quarter

 


SYSTEMIC ISSUES:
County Self Rating (from Self Assessment):

Goal:

Issues noted in the final report: Koochiching County lacks a functioning Children's Justice Initiative (CJI) team, which includes well-rounded representation from the community. At the time of the review, there was a lack of collaboration among key parties in the court system. There remain philosophical differences, unresolved conflict, and resultant lack of trust among team members. A number of team members, including the lead CJI team judge, felt that there is a need to look for a new strategy or common ground in order to work more effectively together in the future. Following are some examples of common ground areas to consider:

* Cross training for guardian ad litems and agency social workers, as well as other members of the CJI team

* A thorough examination of community resources, agency practices, and visitation policies and their impact on the safety, permanency and well-being needs of children

* An examination of how educational neglect and truacy reports are responded to by the Koochiching County child welfare system, involving key community stakeholders in the evaluation process.

Person(s) responsible for implementing action steps and monitoring progress: Cindy Ellefson-Oswald, Social Service Supervisor

Action Steps

Date to be Completed

Methods of Measurement/Monitoring

Quarterly Updates

1. The Koochiching County CJI team has begun to meet once again. The focus, to begin with, has been to work on “The County Best Practice Guide” document. Goals will be chosen from this document for the team to work on.

2. Koochiching County is requesting assistance from DHS as to how to proceed with the cross-training of the Agency staff and GAL’s.

3. KCCS has requested a meeting with the newly hired County Attorney to discuss a truancy policy to ensure consistency amongst cases.

on-going

on-going

1) Meeting agenda items and minutes

3) Development of a policy to address the issue of truancy.

 


SYSTEMIC ISSUES:
County Self Rating (from Self Assessment):

Goal:

Issues noted in the final report: Koochiching County has a two-year grant-funded position for recruiting, training and supporting agency licensed foster parents. Stakeholders spoke positively about the support, additional foster homes, and improved communication that have occurred as a result of this position. They also reported that there remains a need for additional local foster care resources. Additional support by the agency could help recruit more foster care providers, and build good working relationships between agency administration, social workers and foster parents.

Person(s) responsible for implementing action steps and monitoring progress:

Action Steps

Date to be Completed

Methods of Measurement/Monitoring

Quarterly Updates

The Agency has received a 2-year grant from the Otto Bremer Foundation to recruit and train local foster care providers. The Agency will be requesting a 1-year extension (through 2008) for this grant.

9/07

* Written request to Otto Bremer written and sent.

* Orientation and monthly foster care trainings will continue to be provided to all foster care providers.

 


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