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House | June 9, 2016 | Chamber | House Families

Full MP3 Audio File

[BLANK_AUDIO] Good morning, we don't have a full quorum yet but we're gonna start with a webinar, so we can start that . And so we're gonna welcome you to the children, youth and families meeting. We have our sergeant at arms helping us out today we have Bill Bass Mark Coden/g, James Crook and Russel Salsberry/g. I couldn't see Mark cuz he's behind me and not letting me play with buttons. So the first thing we're gonna do today is we have a webinar, which is why we really needed to get on the net at this time and in this place. So we'll get set up. This is on the Neice Program. It's National Electronic Interstate Compact Enterprise and so where gonna have that. There will be the opportunity to ask questions and we certainly invite questions. This is a program out of Washington DC that has been called to our attention as being a very special program. We do have a little Information and presentation present in our folder as well. So we'll wait for staff to get us set up and like I said, please feel, I'm sorry, and Representative Jordan will like to make a comment on it while we're getting him connected up. [SOUND] Representative Jordan, the floor is with you. Thank you Sharon Stevens, [SOUND] I thought I'd make a quick comment that we're looking at At this because this was suggested to me by our Guardian at Light Em Program and our Districit and it may help us with a situation with placing foster children when you have to go take a look at a foster placement especially with family in another State instead of Ash County right the Virginia Line even if they're right across Across of the line, we'll have to send something to O'reilly to get it looked at, it has to go to Richman and then to that county. This kind of system would make it work quicker and we might be able to take care of those placements quicker and cost us less money and then we can get to the one's harder to deal with, so I thought we should take a look at this and see what this is all about. >> And I think we have Miss Mercy Roth on the line Line with us is that correct Miss Roth, can you hear us. [BLANK_AUDIO] >> Okay, hello everyone. Thank you for having me today. >> Thank you and you are free to proceed. The floor is yours. [SOUND] Wonderful. Well thank you again - >> Wow we just saw spy him a minute. >> N.E.I.C.E >> Probably because of the Bell. >> We're anarchy. >> The bell went off and it will go off with more time. [BLANK_AUDIO] Seems it might be good step for you and happy to answer any questions you might have. >> Do we have any questions for the committee. So Representative Avala and then we'll get the question repeated to her. >> I guess it could be answered on her and I'm just curious to know to what degree the Department of DHHS has been discussing this prostility/g and if there are discussions where they see it going, and that's one thing. >> And you can convey that question to her and Mr. Kelley? >> Thank you my name is Kevin Kelley in the section cue for Child Welfare Services in the Division Social services obviously in DHHS, we are currently evaluating this the primary consideration and driver for our consideration as you had was the development of our system known as NC fast, we believe there's a lot of efficiencies to be gained by corking collectively in consideration of needs with the Development of what empty fast [INAUDIBLE] project for which will do the child welfare programs and services [BLANK_AUDIO] >> We lost her. >> Hold on. [BLANK_AUDIO] Hold on You hear me now? >> Yes. >> Okay I was just saying that I can't I couldn't here the question from the broader audience, but I can hear your voice can you tell me what the question is again. [BLANK_AUDIO] >> In terms of other child [INAUDIBLE] that are joining or other types of programs that are connected. >> Just out state. >> Just within North Carolina? >> Yes. >> I haven't spoken yet via email or person with your folks there in North Carolina, I did change emails already this week. You can name us Kevin Kelly and so know that need to be considered that your State is considering it right now and that we're eager to talk more. >> Thank you. Other questions? And I will be happy to to open the question up to our questioning to the audience cuz you

probably have more experience or more knowledge than we do. So does anyone have a question they'd like to ask about N.E.I.C.E. Okay. No questions. So Teller thank you for a very thorough presentation and we didn't have any additional questions. [SOUND] >> That's perfect, thank you. Thanks for your interest and I wish you all a really great day. >> [BLANK_AUDIO] All right, and members we will put this on our website so that you can see the colors in terms of the different things she's talking about. And then maybe you can play and see about maybe the 39 steps and get it enlarged. So it is something we're looking at and figure out whether we got the need for it. So I do appreciate that presentation. Next on our agenda, we're gonna take up PCS for senate bills 29, which will be counted in Genex compensation authority and Representative Stern has the floor with the PCS without objection. Does anybody object? PCS before Stam. Representative Stam. Floor is yours. Yes sir. >> Madame Chair. >> Yes sir. >> You want me up there or can I sit here? >> Well the committee you're fine there, if everybody is fine. >> Its been a long week. >> [LAUGH] >> First of all all this Bill only applies to Wake, Meckelenberg, Guiford and Forsyth, and we object with all the House members from those counties who either do not object or very much support it. Actually five members of the committee are absent who are from those counties but you said they support it, so. You remember the States' Eugenics Program for 10 million dollars it was passed, I believe in 2013. Some of it's still on appeal because some people who had claimed to be qualified and the Industrial Commission, determined that they were not qualified and so therefore the final payments can't go out to the people who are determined to be qualified. Because they're dividing the money, that's unfortunate. But at least in some cases the reason they were found not to be eligible is because they we're I was about to say youth and hass/g but that's not right, right word, asexual, as for sterilized involuntarily under the authority not of the State but of the County. That would, like of those in that category, as they slip through the cracks of our Bill there, we intended to cover for people who just happen to involuntarily but we didn't realize that in some cases this was by the county. And I'm not going to go into a long discussion of the background of that Bill and what happened but especially in Mecklenberg County would probably be the most people who slip through the cracks because the head of social services in Mecklenburg County was a crime pusher, advocate of eugenics. You can't have a local bill on this subject because of constitution article two section 24 rights to have health, but you cant have a reasonable qualification based on population of counties and in my opinion just having studied this for several years this four counties would probably account for 90 to 99% of all the people who may have slipped through the cracks. Wake county because Dorothy Vicks was here and it would have been the default place of residence of people who didn't maybe have a fixed place of residence. And the idea is that they are just as entitled to be compensated as the ones who don't know the authority of the state. So this would be permissive for those four counties, if the County Commissioners do it. They can either choose to have this run through the Industrial Commission like the state program did, which worked fine. In that case they would compensate the Industrial Commission for any of its expenses which should be minimal but because it would be reimbursed the fiscal memo I have shows no expense for the state whatever, or they can do their own program in which case any appeal would be to the spirit cord of that county so I don't think this is going to involve many people, I don't think it's going to involve much money but it is a matter of justice for those people, just like the state program it does not apply to the estates of people who have already died, instead they would Have to be alive at the time they make their claim if they happen to die during the clemency of the claim,

then their stake could get some funds this tend to be the elderly people, so with that madam chair and that I say that the house members from all four of this counties have given their approval for it to go forward even though that's not required by any rule, we thought that that would be a good idea in a sort session. >> I just have a couple of questions as the chair this county compensation is there a limit on it or you just don't know how to try to prove damages or court or they just set their own ordinance how they wanna do it? >> The county could set its own the actual amount that turned out to be for the under the state program ended up at about 50,000 because much few Fewer people qualified than they were expecting and so I'm guessing that the counties would probably wanna do something at that maximum we don't set a limit on it but the county and setting up the program could do that, I'm about to offer an amendment foster here, the correct one technical issue but then also he'd give us foster. >> Well do members wish to way having a copy of the amendment or do we get a copy made and we'll take questions now. Members. Okay. >> Yep. >> So Miss Foster will explain In the amendment to us and if anybody got concerns just please express them and we'll let you look at the amendment. Miss Foster, could you explain the amendment. >> Good morning. It's Wanda Foster, Legislative Analysis Division. The one technical change which occurs on page one line 29 through 32 Those sentences are now being broken into two separate sub sections, the first to be D1 to read, if any claimant dies during the claimant of a claim or after being determined to be a qualified recipient, compensation payment will be made to the State of the decited. No No changes there we just re numbering it to be D1 and then the second sentence will then renumbered to be D2 and it will read, compensation received under this section may be deposited into an Inter vivo trust established for the benefits of the qualified recipient. So we just add Inter vivo there to make it clear Clear, and that the trust is for someone who is still alive. >> And is that all the change. >> No. >> No, there is one other change that is occurring by adding a sub section K in between lines 30 and 31, to add language from the original Bill The language will read nothing in the section shall revive or ascend any statute of limitations that may otherwise have expired prior to July 1, 2013. The County's liability arising from any cause of action related to any a sexualization or sterilization performed pursuant to an order by A county shall be limited to the compensation authorized by this section. >> Okay. >> Again just to out limit liability and make clear that there's nothing about this act that would revive any old claims or anything that has already expired under the section of limitation. >> Representative Stan. >> Yep. If I could just Explain that, that's the same under the state program, this is not saying that this people have a cause of action against the county, but the county chooses to operate the program then they can be a recipient of that, but they can't if the county does not Decide to do the program they have no right to sue. >> Representative Jayden/g are you on the amendment or you're on the Bill? >> If it's appropriate I can make a motion to approve the amendment >> Okay. So we have a motion before us to approve the amendment, any discussions? Any debate? So the vote is on On the amendment as proposed by Representative Stan, all in favor say aye? >> Aye >> Oppose say no. The ayes have it and the amendment shall be engrossed. Now we're back on the Bill. Representative [UNKNOWN] >> Thank you madam chair, I just have a curiosity question, when you limited bids for counties, Was that simply because of their size or did you see that tendency in the claims that came forward? >> Yes so - >> Representative Stan >> Yes so, Mecklenburg because it's where the vast majority of the cases will be, wanted to be in it the most of the I won't call it agitation but most of the requests to do this came from Mecklenburg and because Wallace Carole was head of social

services there my guess is that the vast majority case be Mecklenburg, then wake because it's the location of Dorothy Dix Then if you recall the media support for this came from Forsyth County. Mr Railey I believe this his name a reporter there and if you recall Larry Wamble, and Earline Parmon were the prime, so it's sort of in memory of them I don't really think they'd be many from Forsyth, but to get the Forsyth you also have to have Gilford. So, the house members from Gilford were kind enough to join in. >> Representative Deter do you have additional questions? >> I'll motion when appropriate. >> All right thank you. Thank you. Representative Jordan. >> Thank you madam chair. Question for representative Stam. >> Representative Stam. >> I do. >> Just step back I think I understand what you said in the very beginning, but let me just confirm. This is because when the state program was going on people who this was done to under the authority of a County board were not eligible for the state program and there were a number done actually by the county not by the state board of whatever this was >> My numbers were approximate, but let me give you my numbers. 6 or 700 people applied less than 300 were found to be qualified. Some of them were found not to be qualified for various reasons but some of them who were disqualified were disqualified because there was no record that the State Board of Eugenics did it, but that rather whatever happened under the authority Of some county court or county board, and at least one of the cases that is on appeal to the court of appeals involved someone in that category I believe. So there's at least an unknown number in that category. Representative Gitter. >> If I can piggyback on representative Stan's answer senator Jackson had done a great deal of research on this issue and had talked to some of the attorneys that were handling this stuff in Mecklenburg County. He estimated the number of cases in Mecklenburg County and this would in fact be somewhere between 10 and 20 individuals. >> Representative Adams. >> Thank you madam chairman. A question for representative Stam. >> Yes sir. >> I've read the series of articles that were written by the Winston-Salem journal and it's been several years but weren't most of these operations performed at what's now Baptist Hospital? >> I don't think so but I don't know. I think a great many of them were done at Dorothea Dix but they could have been done anywhere but they would not have necessarily been residents of Forsyth, just because they were performed at Baptist Hospital. >> Followup. >> You may followup. >> My recollection is that the Hings family in Winston-Salem was very much involved in this Eugenics board and um I would ask that you consider looking into I believe that's correct, emerging hospital laws, locations, many of this operations >> If I could respond to that >> Representative - >> I've also written history of it which is almost a website in the sort of history of the suppose good people who are involved in this in the 20s, 30s and 40s and even into the Into the 50s and 60s, made your hair curl >> It did make my hair curl >> Any additional questions by members of the community? Any additional comment s by stuff? Okay. Do we have any questions from members of the public or comments from members of the public? Seeing non representative Gitter you're recognized for a motion >> Madam Chair, I will move for approval to senate bill 29, as amended rolled into a new committee substitute >> The motion is before us, any further discussion on the motion? All in favor say aye? >> Aye >> Any oppose, no? They ayes have it and the motion carries >> Thank you madam Chair >> Thank you. And the last item on our agenda, we've asked the department of health and human services to give us sort of an overview of the federal report that came out indicating that there were perhaps some problems and what they are doing to improve that. Mr.Kelly? >> If you'd come forward, floor is yours. Thank you for being with us today [BLANK_AUDIO]

You have a PowerPoint do you need to, we need the screens [BLANK_AUDIO] [BLANK_AUDIO] Committee's with you. >> Thank you madam chair, members of the committee, my name is Kevin Kelly of the serves as a section for child welfare services in the division of social services which of course is part of the department of health and human services. I'm gonna try to provide as much information as I can about a very complex review known as the child and family services review that North Carolina received the third round in 2015 The previous two rounds that occurred in 2001 and 2007, the child family services review, is a federally defined and driven process, I will say that the children's bureau federal agency is responsible, works hard to make it a collaborative effort between the federal government and the state government nd the intent is to promote a continuous quality improvement system and philosophy in child welfare. And when I use the term child welfare we can primarily think about that as Child Protective Services, Foster Care Services and Adoption services, although as we've heard a minute ago it may include more activities as well. And it really is And it really is designed to try to highlight what areas are needing improvement. The first and foremost philosophical part of that bout that Child and Family Services Review and I'll begin probably again slipping in the acronym CFSR, is it isn't an audit and it isn't intended to states to ever have the term pass or fail. Fail. In fact no state or jurisdiction has ever met substantial conformity in all seven outcomes, or any of the seven systemic factors. So it is designed to find areas needing improvement, and again not be as an audit or something that can be seen as something that should be passed. As I said the last review was in 2007 since that second round in 2007 the Children's Bureau made several revisions to the process. After receiving a great deal of feedback not only from the states but private advocates and partners in Child Welfare as well. And in many of those helped North Carolina position this review in search a way we could really begin to better absorb the information and then ultimately take that information and begin in making improvements. It does require the development of a program Improvement plan North Carolina is currently developing that program improvement plan again in conjunction with the Children Bureau staff. To give you an example we have at least weekly two hour phones calls with the children's bureau of staff. Well actually since the the review in March in 2015. So we're Very tightly connected with the Children's Bureau of staff. As imagined its the third round and to give you some sense of why it's not something you could see is, passing of family. The example have given here is to achieve substantial Only on the seven outcomes than 95% of the cases must meet all of the items under that outcome, and the samples size is fairly small, so you can see we are just a couple of cases that don't need the very high level of conformity than a state would not meet that outcome area. There are seven outcomes as I talked about, two under the heading of safety, two under the heading of permanency, and three under heading of well being, and you see on the slide just a really brief description of what each of this safety and permanency outcomes are defined as. I can tell you that if you really wanna What's really behind them, we would need a whole day to really go through all of the details. Because that's exactly the time it takes to review a case using the federal instrument and protocol for determining and individual case whether or not it met these standards for substantial conformity or strength so the case will Cover that this seven outcome area address. It's also true that, as I look at this three well being outcomes, that they inter lap and overlap in terms of how they're been measured. So in some instances in case not meeting the 95 or the criteria for strength. In for example permanency two therefore also would not need the strength criteria for meeting well being one, so often times I'm

being unable to contact a none resident father for example means that you don't need two of the seven outcome areas for that case right out of Evaluation and 2015 we were able to review a 105 cases, 59 came from foster care services and 46 came from what we call in home services and just give you briefly those are children who have been found to be abused or neglected by their parent or caretaker but the risk is such that We believe that we can manage the case and provide services leaving the child in a home and strengthening those parental capacities so that that maltreatment doesn't continue to occur, this is one of the areas that really changed dramatically between round two and round three, in the first two rounds the Children's Bureau staff conducted the case reviews and And they conducted 65 cases in only 3 counties, and that was intended to represent the entire State of North Carolina's practice across all 100 counties. In this round we got that sample up to 105, and we were able to poll cases from 10 different counties. That's still far from anywhere near where we would call statistical Statistically significant. To give you an example we polled 59 cases from a population that was around 14,000 cases served. On the in home side you see the number smaller. We were just under 11,000 cases that were served again during the same time period from which those cases were selected. So its still a very Very small sample size that's tried to represent the state of North Carolina, in terms of the systemic factors this is an area that's really hard to talk about because often times people wanna go ask the question of mayors, what was the criteria the children's bureau uses to determine a state A substantial conformity on the systemic factors and there is no document I can point you to they derive that from a two step process. The first step is that the State of North Carolina submitted to the children's bureau a description of our programs and activities. Whenever possible using data to describe those try to help the Children's Bureau understand the actual performance of these items. And then the second part, the Children's Bureau staff conducted what they refer to as stakeholder interview's. So North Carolina was responsible for scheduling various constituent stakeholder groups such as foster parents, at a given point and time over the telephone and then the Children's Bureau staff ask the participants in that stakeholder interview, a series of questions framed very carefully for the neutral, and apply to all states and with the exact same wording. So as you can imagine, sometimes the language became real problematic and based on their responses and the information the Children's Bureau received They determine whether or not we were/g substantial conformity on these. Both in terms of the outcomes and the systemic factors, they're broken down a little bit to what they refer to as items. And North Carolina was rated as the strength on some of the items, but in terms of the overall outcome of systemic packers/g, we were not found to be substantial conformity. So the systemic factors continue on this slide. Just gives your roll brief idea of the kinds of things they're looking for. The Children's Bureau staff believes that when the system's items are in place and operating well then that will in fact in terms support better outcomes for children and families. [BLANK_AUDIO] Some [INAUDIBLE] spent a little bit more time, we received our final report on February 2nd of this year. And we immediately began, actually prior to receiving the formal report began pulling together our stakeholders to engage them in figuring out what we thought we needed to do and what activities we could conduct to really help us make the improvements that we knew were coming and that would be in that final report. What we didn't wanna do is what sort of happened in the first two rounds and that is conduct some activities, get through if you will. The program on improvement period and then return to normal. We really wanted to spend some time with these stakeholders thinking about what were the underlying root causes that led to these results of this evaluation of North Carolina's system. And you see we held two day of [UNKNOWN] to start that process off. We elicited a lot of really good feedback. And from that we decided that we needed to dig a little deeper. We formed five different work groups and asked for a smaller number of participants cuz obviously it was very hard to manage what was 300 people in a room or under the sun talking and trying to figure out get their input. Each of these theme work groups that we conducted Each one took one full day to conduct and we limited the participation to no more than 50. We had a couple of examples where we were slightly over that number.

So we could really get some time with people that we fully had a vast of interest in these areas and we were able to really informed about how the system across North Carolina was functioning. That was very fruitful and we were able to move forward with drafting our Program Improvement Plan. The other change that the Children's Bearer made between round two and round three, is that they provided a structure, for states to develop their Program Improvement Plans. And round two, the North Carolina Improvement Plan was over 100 pages long. And it became a very unwieldy task, simply to manage the activities of those improvements we wanted to make and it became a challenge Bureau quite honestly, for them to track, and see where our actions were gonna lead to improvements. So this round, they've structured the program improvement plan into goals, strategies and activities. I'm going to walk through the highlights of where we are now. What I wanna make sure everyone understands is that, our program Our program improvement plan is very much influxed, and in development. We have not yet landed on what the plan, that the children's bureau believes needs to address the report. And that's really a recent clarification that the children's bureau staff has made, that we were thinking very Broadly about all the range of improvements, and system changes that we'd like to make in North Carolina. And instead more recently the children's bureau has challenged us, and tasked us with to be more specific, and more targeted with our goals, strategies and activities, to specifically Typically address what the report said. And in fact every activity must identify something within the Charm Family Services, read final report, in order to be considered part of the Program Improvement Plan. So the first goal that we have set out, and that we believe is part of the results of that report, is to improve the outcomes of safety permits in well building, to the establishment of clear performance expectations. And the reason that is underlined, is that we've heard from the field, particularly for new social workers learning how to do child welfare social work, that it's very difficult to navigate the range of policies, and technical systems, and other training materials, that the state provides to those county employees in a clear, concise, and easily accessible manner. We think we have it all. But again it's very hard to access in a, what is often times a rather emergent situation, they may They may have a new situation present itself to them, after initiating or beginning toperative/g of services assessment. And therefore, we think we can provide an easier way for them to access that information. The goal here is to strengthen the policies, and other written guidelines, and to provide additional training, and technical assistance to all 100 counties. And again, across the board I've mentioned that with an example, and I hope that's not limited to that. It goes all the way through permanency activities such as adoption. And I will say, probably a couple of times throughout this, that we have a set, obviously a very limited capacity today. And to be able to do the activities that we outline, we put forward a request that was included in the governor's budget. The House also included that, and the Senate has some of that. It is a little bit troubling, and quite frankly, very concerning Concerning for us that it is currently marked as non-recurring, because the program improvement period is two years. And obviously we would need to build on all of that, moving forward. We also know that our training system needs enhancements. County staff were very clear that we do not currently have the capacity to meet even the current training system, and needs that we have. And as you can imagine, when you factor turn over of workforce into the equation, then that training system has to be able to keep up with that workforce turnover. And it was very clear to everyone that we currently do not have that capacity. In addition, we need to update as I said earlier, how we provide that training to counties. And one example that we have proposed, is to develop a supervisor academy. And that area is really what we think, is a very efficient way to deliver those clear expectations Expectations and understandings and instructions is if the direct supervisor has that then he or she can translate that to the four, or five, six social workers that that individual supervises, so

really that's a very efficient way to go about it, we began some of the work already in that with the resources that we have we envisioned a collaboration Between both public and private universities, some counties have also suggested that perhaps the community college system can be of assistance in that and that will help spill that in even from the beginning with a individuals social work career if that's the academic program they're in We know we need to strengthen our capacity to provide technical assistance, the polices and training material cover most of the situations that arise, but as we all know, families come to us in very unique circumstances and being able to identify those complex issues and access technical Technical systems is very important and in budget request, we asked for additional for very specific roles who would provide emergency technical assistance, as this individuals we currently have six right now, so we wanna bring that number up to ten. Most of their duties, Answering the phone when counties have a very problematic situation on their hands that they feel they need to address safety of children and families but aren't sure exactly the best way to think about that and to move forward. We've also understood and really realized that we need to improve our quality assurance system And when the Children's Bureau refers to quality assurance system they really place almost complete reliability and emphasis on the case review tool that they used in the assessment process in the CFSR process itself. That's what I mention about a minute ago about it takes one full day to review one case That's obviously a pretty significant investment of time and trying to figure out how the quality of services provided to one case, and we know we need to have a big a sample as we possibly can, we also know that aggregate data can really help us drive a quality assurance system, so we're very excited to To move forward with NC Fast Project Four for Child Welfare. The Children's Bureau Staff did not want us to specifically put the NC Fast system in our Program Improvement Plan because the Program Improvement Plan is structured by congress/g in such a way the schedule cannot be adjusted. And the Children's Bureau of Staff The many years knew that we have a business plan with our county department services that said we will not implement NC Fast until they say it's ready, ultimately that system needs to be usable and accessible by the front line social worker who is responsible for entering that data into that system. Another big goal that we set out is to improve outcomes with collaboration through the judicial system, once a child is brought into the foster care system obviously the court system becomes involved in that, we have a lot of good partnerships at the state level, with not only regarding the light on program but also the court and permit project Who can really leverage their resources they have an automated system known as JYs and we're gonna use that systems data analytics to target areas where permanency isn't being achieved timely enough, and then to have conversations with the judges because they must make findings of fact that relate back to the services that the social worker provides So in some ways we'll be asking the court system to sort of increase their level of oversight of all counties to make sure cases were provided with the right services um as appropriate for the court to weigh in and ask those sometimes very difficult questions. [COUGH] we'll quickly Go forward, and over in a turn, is to improve our cross-system collaboration. I've highlighted the LME/MCOs, because so often our families that we come in contact with, have behavioral health issues, both even for the children, and their parents, and caretakers. We recently did some number crunching. And of the children who were entering care during the past year, 75% of those cases, a family member had an identified substance abuse disorder issue addressed, that contributed to the child coming into care. So that tells you, we're dealing with a lot of overlap between our LME/MCO population. And we also know the LMEMCOs have a lot to say in terms of therapeutic family foster care. Research is pretty clear. The children who need to be in substitute care, do best in family like settings. When they have complex behavioral health needs, therapeutic foster care is there for that. And that's part of the LME/MCO system. The fifth and final goal is really, to improve our state wide data collection. This does touch on a little bit of NC FAST. We're also very grateful for the General Assembly, and others prior involvement in a system, that was originally claimed the CPS Pilot Project.

We've now given that term this Child Welfare Assist System. And that's where child welfare social workers can easily, and quickly access additional datasets, that might help understand what's going on in that family's life. One of the key datasets that we're working to access, is the Criminal Justice Information. As you can imagine, there's also huge overlap between parents who are struggling to care for their children. Might also have some challenges in violating the law, and it certainly has a safety connection in many instances. Not only for the children, and that's first and foremost, but in some senses for the social worker as well. I can tell you, every social worker has a story where they Before they got to a point they had to make that tough decision, and file a petition to bring children into care. With that you always contact law enforcement. Every social worker will tell you that a law enforcement officer will say, it's a good thing you called me, you should never be going to that home alone. And those social workers have probably been doing that for weeks. The other couple of parts of the Program Improvement Plan that will need support from the General Assembly, is more additional positions to really be able to use our data, to drive those systems. Data is often thought about as an extract or an Excel spreadsheet That you can put together in child welfare, data is often very qualitative. And trying to assess what is often times written in narrative format, and to aggregate those cases up, requires a great deal of person time. We believe that with three more positions, we can begin to do that, and we can also collect New information through web based surveys and we've set some success with that in a very limited basis currently as I talked about you know we need to strengthen the training system, we also need to work with our partners to provide those good quality services that also [INAUDIBLE] we are really talking about is changing parental behavior And that's a tough thing to do. So there's a couple of examples I put up here. One is of the intensive family preservation services. Those are services to keep children in their own home, when it looks like removal from the home is eminent [UNKNOWN] today. And that's why we thought we could get a jump start on the program in [UNKNOWN]plan and a longer term. And permits that we know we know we need to b made by asking for additional investments in there. In doesn't meet the need, these dollars were designed around what the system could absorb quickly. The weren't designed around what the need is. When we looked at the need it wouldn't have worked for anybody right now. [LAUGH]. And the system Couldn't be able to adopt, and change that quickly. So this is just what the system can absorb, not what our long term needs or what the population data indicates we do need. And then another program that is in North Carolina is Triple P. This has actually five levels of Triple P. And evidence, and research shows that when all five levels are present, you can actually positively impact your child welfare data outcomes that have been seen. And we'd like North Carolina to get to that state as well. We do have some delays in the process of licensing family foster homes. We know those individuals have generously opened up their heart and homes to these children. And we owe it to them to process them as quickly as possible. I talked about more technical assistance, and more training needs. The last piece is not directly tied to the child and family services review, but we think it's very important for us, to be more on top of those very unfortunate situations, when a child has died, and that family had involvement with TSS, and In the year proceeding that child's death. Currently, we have two positions that do that work. And I can tell you, the retention rate of those individuals is just really tough to keep. And as you can imagine, doing that work day in and day out becomes very difficult. We have a vacancy rate of nearly 50% with those two positions, which means we just can't keep up with that. And we're certainly not able to follow up, and to really do a better job of tracking how the system could adjust, to those recommendations that are made at those local teams. The last thing I wanna make sure I touch on is, how is the Children's Bureau gonna determine whether or not we made the necessary improvements? And they're gonna keep doing those case reviews, using that federal instrument known as the Onsite Review Instrument or OSRI. They're again saying, that is the means by which they determine, whether or not a state is in conformity on the seven outcomes where they place most of the emphasis so we will continue to use that instrument again in partnership with those 10 counties, and we've had some ability to increase our capacity. So you saw that we did 105 cases last year, we are proposing that

beginning July 1st that we will get that number to 213. Every year for the first able future. Because again we believe that knowing how those services are being provided is the key to continuing to improve our system even beyond the program period, Improvement Plan Period. So that's another 100 cases that we'll be doing and we're gonna extract a random sample for all 90 cases. Where wanna make sure every county understands this. Your case will be looked at and we will help your improve cuz we know in child Welfare there is no such thing as perfection, you always have improvement. Thank you. >> All right. Members of the Committee does anyone have a question? I've written down a lot, how about you You Representative Jordan. >> Yes. >> Alright. Representative Jordan? >> [COUGH] And It may be broad, but, and you may have started the answer, on your last part about the Onsite Review Instrument, because my question was gonna be on all the goals that talk about improve, enstrengthen, and so forth. So give me an idea of how this system looks, in order to show how you've improved, where you were before, where you are now? How does it show that kinda progress? Is it statistics? Is it anecdotes? I mean, how does that work? Give a little bit of that. >> Thank you for the question. The Onsite Review Instrument is, again, the primary or the only way the Children's Bureau will acknowledge improvements in the system. The good news is, the amendment/g change the Children's Bureau made is, they developed a web-based system which that information is entered into, and North Carolina can access, and pull out from there down to the question level, but certainly at the Outcome level, determine and compare that to the prior cases that were reviewed. One of the challenges we have obviously, is the timing of that work. So a case is reviewed for work that has already been executed, so as we start to do more of the case reviews using the OSRI. We will be looking at casework that was performed in the most recent year. State fiscal year for example. Obviously we haven't implemented/g the true improvements. We've drawn lot of attention to this, but the activities that we are proposing haven't been executed yet. So the Children's Bureau has a third year of measurement, again using [INAUDIBLE] comparing that to the cases that were reviewed during this CSFR period. >> Follow up. >> [INAUDIBLE] >> So you're looking at case work so what kind of things come up from a previous case you are comparing to a sample I guess of a new cases what are the things that are looked at a few examples of things that are looked at. In those cases to see if we've improved the operation or strengthen the protection of children or whatever the goal is. >> I'm gonna do my best because it looks at so much. It's hard to give you overall view of that but a couple of examples that come to my mind is that review instrument asks the reviewer again his or her understanding of the protocol, is did the social worker provide good ongoing assessment of the risk and safety to the children? We look at the risk and safety of children during the initial assessment period. But again if the child was found to meet the legal definition of abuse neglect or dependency then we provide services. Part of the services is on going assessment of risk and safety. So with a social worker for example allows a week to go by without somehow checking in if you will with that child and family then Then that reviewer might say mm-hm doesn't look like that worker had on going risk assessment activities. I'm going to rate this item as an area needing improvement, that would be one question or one area that this very large instrument looks at. Another example I wanna highlight because this are I know them because they came out in several instances. As you can imagine we often have parents who do not live together, and that it's relatively easy to engage the parents with whom the child lives, but that child may have contact with a non resident parent. And trying to access and engage the non-resident parent in not only assessing his or her ability to parent their child, but provide actual services if they're found to need services is a huge challenge for our workforce. And if a time period goes by where that worker could not locate that non-resident parent or could not find a way to contact that non-resident parent that case on one of the items under well being might be rated as an area needing improvement. So looking it across these are just a couple of quick examples. Again it's an 82 page instrument that takes a day to complete. As you can imagine its somewhat subjective. They've tried to provide as much guidance and clarity as possible

round there. But ultimately the reviewer has to be somebody who knows what child welfare is like in order to know whether or not that case worker provided the necessary services. So some children can go a week without a contact. Depending on what's going on in that child and family's life. But that there's a lot of risks earlier noted. And you allow a week to go by, that might be seen as too risky and therefore not continually assessing risk and safety to that child. >> Any additional questions? Staff do you have any questions before I. [INAUDIBLE] >> Thank you. As Chair I've got a couple of questions. I was looking at slide five, the permanency number two. The continuity of relationships and connections being preserved for children. And you talked bout non-contact by the father or you could even have non-contact by the mother. And we tried to address that in House Bill 6.69 for the court improvement that if parents weren't involved we could just move toward termination. Is that a factor that hurt you or is that a factor we pass the law help you in moving forward? I guess I'm just concerned about that factor and what impact w might have on it. >> Thank you I would say neither helpful and certainly isn't harmful again the Children Bureau expectations are that you will engage everybody in the family caretakers, parents up until the time that there rights are terminated by the court. If that parents rights haven't been terminated then the Children's Bureau expectation is that the agency the Child Welfare Agency will continue to engage that parent in changing their behavior accessing services and certainly in accessing risk or safety to the child by that parent's actions. >> Okay. And I was looking at Foster Care, you were talking about having four new state positions to help with Family Foster Life's Insure. I'm assuming that the per position cost is 55,000. Or is that for all four positions? >> Actually that's for all four positions. One of the reasons that's such a low figure is because we are able to leverage federal grants primarily titled for E in a cost allocation approved methodology. So those are the state dollars that's leveraging additional grants. I've mentioned one there are many others. So that's how that number is so low. >> Okay. And is that the same thing for the state For review cases, perhaps five new state positions is 103,000 that's the state grant get that, okay and back to the foster parents how far behind are we in approving our licence, how long is it taking to get a licence out to someone once they file the application. >> From that time the application is received In our office until it leaves our office we are under 60 days that processing, the more complicated part to that question is we have discovered that almost half of the applications whether they are new or for renewal of the licences family foster Nearly half of them have some error or missing information that prevents us from making a final decision on that application packet, so the main reason that's taking so long is that we are having to go back to the supervising agency could be accounting partners or services or could be a licence top placing agency And asking them where is this information or if there is inconsistency across the various documents that are required which one is the right spelling of the name for example, so the delay is really figuring out how to help those agencies do it more correctly from the very beginning and that's how we'll deploy this for additional positions if approved Approved is that we will send the mountain to the field working with first the largest agencies that submit the most applications and getting them to do it to a higher degree of quality. >> And so you are telling me that you are getting this applications out within 60 days some are not getting completely the 60 days because They have errors is that my understanding? >> The average is 60 days some of them actually take longer to try to fix the errors, the ones that are done without errors or happening undoubtedly shorter period than that but 60 days is the average for all applications. >> And if you find that error early on in an application You still review everything so you can find all errors at once? >> If we are able to obviously we can't find an error on a missing piece of paper but what the processes that we've developed is that the consultant who does the review will make a list of everything that they see either missing or incorrect or have questions about

And then if maybe send that back to that supervising agency here is three or four or five hopefully not more than that things we need you to address what is often the case is that they will indicate that there's an issue with that family and that they'll elaborate enough for us to know whether or not it's a situation that needs more Is more elaboration. >> Representative [INAUDIBLE] >> Thank you Madam Chair, You've referenced several times the phrase the children's bureau expectations and you've also mentioned that in some of their interpretations there is a degree of subjectivity How are you able to effectively and accurately to get the news through if you've got that level of kind of wishy washy sort of analysis of what we're doing. >> You may answer. How we get through it is the easiest way for me to answer is through a lot of discussion, I mentioned in the very beginning that we have weekly phone calls with the children bureau of staff and we often raise that concern that it sounds like we're still learning at it we've been having these calls for well over a year now, the response that we often get [INAUDIBLE] child welfare is not making widgets you have to take the situation the families are obviously very complex even the whole general issue of child maltreatment isn't well defined, families have child maltreatment for a wide range of underlined situations So it's just a matter of us working through that and talking through that and then doing the same thing with our field's leadership. And down to the work force, the front line workforce to really to be able to understand. Yes this work is super complicated. >> Representative [INAUDIBLE] >> A comment please. >> Go ahead. >> I'm not sure Mr Kerry referenced this but I would like to make the observation and let people know that this work to correct this report didn't start the day after we got it. There have been a lot of work that had already been put in place because of the previous report. So we were very well aware of some of our areas of deficiency and the department was right on target with a lot of curing of those problems. And I just wanted to give them at least one kudos for that and encourage them to continue the good work >> Thank you. Any additional questions or comments from the committee? From stuff? >> Representative Stam? >> [LAUGH] Can I ask a question, it's somewhat of topic but very related [LAUGH] >> Certainly >> How is the child fine program going involving children's home society? [BLANK_AUDIO] >> Okay. You may answer >> Great question than you for bringing the family funding up as well and we believe Family funding services that are provide by Children's Homes Society, is greatly impacting the well being, and I mean that in a broad sense not necessarily it would show up on the child payment services review, on site review instrument. We are currently working with Children's Homes Society to do more evaluation, to even dig a little deeper in that, we're very excited about that, county departments of social services find that that we worked through some of the challenges and how we manage cases between the count and that agency, And what I will tell you is we receive tremendously positive feedback from the children and their family members as well. We haven't seen a statistical significant increase in the rate of permanency for the children who have received family finding services. But that might be simply an anomaly of that we haven't had enough time for that to show up in the data. >> Representative Stam. >> I know Representative Idler so she helped getting it going if you just take one minute, what it is. >> I'd love too. Family funding is a national model that was developed by an individual who wanted to respond to natural emergencies. So as we all know when there's something like hurricane Katrina that's the one that comes to my mind, families get scattered across a wide range of geography. And sometimes lose contact with one another and as you can imagine in other situations that might even be more profound. And doing research particularly starting with the Advance of that the world wide web has provided where you can search for individuals and then perhaps follow once you have some information follow up with them. And the same idea occurs when children are in the foster care program. Obviously their immediate parents probably aren't real eager to share their bad news with their extended family Family members,

maybe that family was also already ahead of time not tightly connected so when a child receives family finding services it's a six step process. And one of the early steps is to do a search and find out all possible individuals who not only are biologically related to that child but may have been a major factor in that child's earlier time period. And by reaching out to those individuals, engaging them in a very careful way cuz you don't wanna scare off anybody who you're kinda cold calling with what sounds like a very, obviously a very emotional issue, that's why Why it's very carefully done and when the time is right ask those individuals to what degree can you remain in this child's life, even before introducing that member to that child, cuz the child may not have that memory, and very carefully thinking through how they can be An asset to that child. They don't have to make a commitment to permanency, it isn't an all or nothing thing, many of the family members aren't in a position to take care of the child directly on a day to day basis but they can make commitments to assist that child particularly for older children as we all know need a lot of assistance As they reach and work through that transition from childhood to adulthood. So real briefly I hope that helps- >> Representative Stan? >> Like for example you might find the third cousin who would like to take care of a child if they'd known about it? >> If they'd only known about it, and that's really With a common reaction that we hear is that they may have known a little bit but they didn't know [INAUDIBLE] and know what to ask and other individuals have no idea whatsoever and that's why it is a process you need to work through that you need to find out where they are in there life and what again what level ultimately Placement is a great option but is not the only one for this children. >> Representative [INAUDIBLE] >> I just like to add in terms of the analysis this is actually a two year old program but they are beginning the development of an evaluation set up to look Look at the numbers I can say that the very modest of goals that we set for ourselves when we began the project have been beyond our expectation actually in some areas and they have shown some very positive results across the board we are having a meeting on the 17th of Week from tomorrow and we'll get an update on where we are and some evaluation indications in terms of how we are gonna be building that. To be able to show strong statistical evidence based to be able to continue this. But it's looking good. >> Thank you I'm glad to hear that. One of the concerns I have is when I first got here I asked for a manual how do you train new social workers and eventually I got a stuck of papers this thick, and I kept saying is there anything we can do away with? Is there any way we can simplify some of this not make it so overwhelming. Is there any of the paper work we can do without. Is there some way we can do this. So I hope we are looking at that. Sort of my last comment if nobody has one is you've got one? Go ahead Representative Jordan. >> Your goal one mentions improvements of outcomes of permanency and I know at one point state policy was permanency within one year is that still the policy and how do we kind of stuck up? Against that policy? >> That's a great question in fact that's driven by federal regulations known as ASFA or the Adoption and Safe Families Act. The federal government as you probably won't be surprised words it a little differently. They say that permanency goal should be meet within the 15th The 15 of the most recent 22 months so we say it's easier just to say one year one of the challenges North Carolina has is with our current data system without the advantage of NC first is the children's bureau basically set our date is insufficient quality to generate a measure we went ahead and Measure anyway we do no quite meet what they refer to as the National Standard for Permanency within the first 12 months of entering care, but we're very very close to the National Standard. See that's how we assume comparison, we're a little below but very close to the National Standard, it could be roughly equated to the National Average. I'll say that when you start looking down the road of the health frequently to children meet permanency if they've been in care longer. The measures are between 12 and 24 months and longer than 24 months, and on those two measures we do meet the national standard. And one of the things that we learn in child welfare is that the quicker you return children to their homes the more likely that

child is to re-enter care again in a later day. And that's obviously something we wanna work to avoid. >> Follow up. >> Certainly. >> So the federal goal then is 15 most recent 22 months what does the national average look like? Is it on that scale somewhere? >> I'm sorry I'm not able to follow up in my memory where the national measure is I think it's roughly 40% of all children in union care in a given year exit within the 12 month period All right, thank you. Sort of my last comment is I saw in the presentation the request for additional money, additional positions. But beyond that, what can we do policy-wise that would be beneficial to Health and Human Services, particularly in this arena of Healthcare and Child Protection? >> I would need a little bit of time to better answer that question. I don't know of any specific Legislative level policy changes that we need to make. But I appreciate the question and we can take a second look at that. Again what we're really trying to do is think strategically about what we can implement quickly. Also then also understand that the more long-term needs of the system need to be planned through carefully and thought through as implementation for future requests. >> Because the honest response is, we're here from the government and we're here to help. We really are trying to get this thing in expedited. If there are no other questions, Representative Stam has a comment. >> Before you adjourn, I have a real quick- >> Yes Sir. >> But not on this. I retrieved my six page paper on the State Program Eugenics. If I could just provide it for the minutes so that historians would know why we're doing this. >> Yes Sir. There being no further business we're adjourned.