September 7, 2007

DCYF Changes Afoot

Marc Comtois

The ProJo's Steve Peoples reports:

The Department of Children, Youth and Families is about to fundamentally change the way it does business.

The state child-welfare agency is moving forward with an aggressive plan to rely on a handful of private companies to manage care for Rhode Island’s most vulnerable children. By streamlining services and reducing the number of children taken from their homes, state officials say they can improve the state’s troubled child welfare system while living within a budget that was cut by $60 million this year.

“Rhode Island has relied on many residential programs for too long. Kids need to be in the community, provided that you have the right services for the children,” said DCYF executive director Patricia Martinez. “We’re taking the concepts of 30 years of recommendations and really staying true to our mission: keeping kids safe and making sure families have the resources to really support their kids.”

Child-welfare advocates largely agree with the philosophy behind the new plan, which is dubbed the Family Care Community Partnerships. It follows similar moves in recent years by Massachusetts and New York.

However, some are wary:
“Good idea. Great concept. But like anything when you’re dealing with people’s lives, you need to make sure you have everything in place. Something like this should take a year or two to do. It’s not something you do in six months,” [state child advocate, Jametta] Alston said yesterday. “They’re saying let’s do this and work out the kinks later. That’s all well and good if I’m knitting. It’s not good if I’m dealing with someone’s life.”

Nonprofit leaders across the state echoed Alston’s concerns yesterday.

“The dollars are driving decision making, which is unfortunate,” said Margaret Holland McDuff, chief executive officer of Family Service of Rhode Island, which works with 3,000 children across the state. “To do it this way isn’t realistic. The RFP just came out a couple weeks ago.”

Afraid that "dollars are driving" change? Well, what else has worked?! However, it sounds like the cost-savings are secondary and that the real goal is to fundamentally change the way that DCYF does business. The new plan is called "high-fidelity wraparound,” which, on its face, seems to be less about throwing money at the problem and more about really involving families and communities in the process. What is Wraparound (PDF)?
The Wraparound process is a collaborative, team-based approach to service and support planning. Through the wraparound process, teams create plans to meet the needs—and improve the lives—of children and youth with complex needs and their families. The Wraparound team members—the identified child/youth, parents/caregivers and other family and community members, mental health professionals, educators, and others—meet regularly to design, implement, and monitor a plan to meet the unique needs of the child and family...Briefly, the Wraparound process can
be described as one in which the team:
• Creates, implements, and monitors
an individualized plan using a collaborative process driven by the perspective of the family;
• Includes within the plan a mix of professional supports, natural supports, and community members;
• Bases the plan on the strengths and culture of the youth and their family;
• Ensures that the process is driven by the needs of the family rather than by the services that are available or reimbursable.
Wraparound’s philosophical elements are consistent with a number of psychosocial theories of child development, as well as with recent research on children’s services that demonstrates the importance of services that are flexible, comprehensive, and team-based. However, at its core, the basic hypothesis of Wraparound is simple: If the needs of a youth and family are met, it is likely that the youth and family will have a good (or at least improved) life. Much of the early work on Wraparound was focused on children, youth, and their families with very complex needs.

However, it is important to note that the process has been proven useful with children, youth, and families at all levels of complexity of need, including those whose needs are just emerging. The intuitive appeal of the Wraparound philosophy, combined with promising initial evaluation studies and success stories from communities around the nation, has promoted explosive growth in the use of the term "Wraparound” over the last two decades. In fact, it has been estimated that the number of youth with their families engaged in Wraparound could be as high as 200,000 (Faw, 1999).

There are some important things that "wraparound" is not (PDF):
• a “service”
• case management
• simply what occurs with a new funding source or the availability of flexible dollars
• merely any service or support that is not typically reimbursable (e.g., respite care, karate lessons, or transportation)
AND
Wraparound is an Alternative to the Typical “Three-Step” Process:
• Assess problems, assign a diagnosis
• Look around for the services that are available
• Plug services into the family
• Provide what’s available and reimbursable rather than what’s really needed
Now, apparently there is a difference between just "wraparound" and "high fidelity wraparound," with the difference being on the amount of training the providers receive. The core principals of this approach, laying there behind all of the social-scientific jargon, is that the fundamental units of society--marriage, family, community--need to be re-introduced to this troubled portion of our society:
In considering the history of Wraparound, it becomes apparent that the idea it represents is nothing new. Humans have been creative, and effective, in supporting one another for eons. Building on this seemingly simple idea, Wraparound represents a process that has the potential to be extremely efficient and useful in improving the lives of children, youth, and families.
In a perfect world, we wouldn't need the government to teach families and communities how to be, well, families and communities. While a portion of the damage that has already been done is attributable to government enabling in the first place, maybe this approach will help to positively enable individuals and communities to reduce these problems on their own. Call it on the job life-training, if you will.

The cautionary note sounded by Alston should be heeded: do it right, don't rush it. However, so long as the new direction is plotted carefully--and the average DCYF worker buys in--maybe it will help the children and families free themselves from a generational pattern of abuse, neglect and poor choices. "Managing" cases and throwing money at the various problems--no matter how well-intentioned--hasn't worked. It's time to try something different. This may be the first step down that path.

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