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Discussion of FTC from staff of NYC agencies participating in the IOC pilot
Improved Outcomes for Children (IOC) Pilot Project
ACS’ Improved Outcomes for Children (IOC) initiative began July 1, 2007. Our agency is among the nine agencies chosen for this project which is intended to serve approximately 40% of the 17,049 children receiving out-of-home care services through the New York City foster care system.
Organizationally, the project is administered centrally through our Quality Management (QM) Department and FBH casework, supervisory and managerial staff from our satellites offices are involved in the day-to-day implementation supported by all areas of the Support Services division of the agency including Fiscal, MIS and Training Units. Progress can best be summarized by a review of four primary aspects of the project:
Family Team Conferencing, Delegated Case Management, Data Management, and Reporting and Outcomes.
Family Team Conferencing
(FTC) is organizationally housed in our QM unit. The administrative staff was identified at the outset and a full complement of full-time FTC Facilitators, as well as Supervisory and 3 support staff were hired and received the requisite ACS training. One of the supervisors in the unit also received ACS Train-the-Trainer designation to allow our agency to provide in-house training as we moved forward. Together the staff ensures that conferences are scheduled, held, and properly documented.
The unit also provided a series of IOC overview presentations to all FBH staff to familiarize them with the details of the project.
Moving forward, the FTC unit, in conjunction with FBH and Training staff further developed and refined internal work processes and procedures used as the basis for ongoing staff training. Together with MIS, the unit also implemented a conference and services database that helps ensure that the outcomes of FTC conferences are tracked and management reports are readily available.
Delegated Case Management
(At the beginning of November, 2007, ACS delegated Case Management to the IOC agencies. This represented a fundamental change in case practice. Essentially, the delegation entails a shift from ACS to the agencies in decision making with regard to a series of case actions including service plan approval and the discharge of children from foster care. It heightens agency responsibility and alters relationships between providers particularly with regard to shared cases. We are still in the
process of working through its full significance and await more details and direction from ACS on work processes and procedures that will presumably come with the new RFP process and system-wide implementation.
Data Management, Reporting, and Outcomes
the involvement of the MIS and Fiscal Departments has been critical to our data management and reporting responsibilities. MIS and Fiscal have and continue to develop and provide necessary data and reports to track the actual and projected outcomes of the project including monthly census, care days, savings, costs, admissions, reunifications, adoptions and step-up statistics on a weekly and monthly basis.
Due to the receipt from ACS of revised definitions and clarification of terms such as Admissions, Reunifications, and Step-Ups which has occurred repeatedly since the beginning of the project, we recently revised our monthly and annual projections for the outcomes of the project. However, in spite of these changes, our actual outcomes to date remain in an acceptable range vis-à-vis the projections and ACS expectations.
In summary, the project is proceeding in an encouraging manner. Casework, supervisory, support and managerial staff have positively responded to the new work load challenges – particularly those involved in the increased number of family team conferences. Thus far, we have been able to find solutions to the problems encountered in the implementation of the project and remain confident that we will be able to continue to do so. Reducing caseloads for caseworkers and supervisors, coupled with increasing ancillary
supports (e.g., crisis social workers, recreation therapists, social workers providing group work to teens, etc.), has been essential to our success in this new initiative.
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