EPISODE:
How Will the FFPSA Change My Work With Families?
GUESTS:
Chris Groeber & David DeStefano
00:00:07
Pryce
SEASON 3 INTRO - Welcome to the third season of the Florida Institute for Child Welfare Podcast. I am Jessica Pryce, your host. In this season, we’re exploring perspectives on the Family First Prevention Services Act. We are talking with child welfare leaders and community advocates about how Family First will impact our state. Let’s get started. EPISODE 2 INTRO - Today on the Florida Institute for Child Welfare Podcast, we are discussing how the Family First Prevention Services Act could shift child welfare culture and values and improve outcomes for families. I would like to welcome Chris Groeber, faculty in the School of Social Work at the University of South Florida, and David DeStefano, the Chief of Strategy at Kids Central. Thank you both for being here. Chris, can you tell the listeners how you got into child welfare policy and practice?
00:00:58
Groeber
00:01:32
Pryce
00:01:36
DeStefano
*Laughs* Yeah sure! About 35 years ago, I got interested in child welfare kind of accidentally, and through my career, one of the things that became very important to me was to understand where the money came from, the flow of money. And so, you can’t understand that without learning a little bit about policy. And I had some phenomenal mentors throughout my career who really taught me the importance of singing for your supper and knowing how you’re paid. So, I became kind of a policy wonk who’s also a practitioner.
And what about you David, what got you into child welfare policy and practice?
My entry into child welfare policy and practice was actually quite accidental. It started about thirty years ago when I went to work in human service, non-profit agency, working with adults with disabilities, transitioning to work, TANF Welfare to Work. And then from there, move into consulting doing federal claiming and background for eligibility practice. At that time, Title IV-E was one of the big eligibility issues around the country. I learned Title IV-E eligibility. And then, backed my way into the practice side of child welfare. From there, I uh began learning about best practice implementation of child welfare, evaluation
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of child welfare outcomes, frontline practice, federal evaluation on *email notification* services and-and outcomes. And have really built my last twenty years of work around that, working with multiple states, multiple jurisdictions in states, large non-profit organizations on everything from strategic planning to program implementation, service design, outcome evaluation, a proposal development, and I’ve really enjoyed the work and enjoyed the impact that we’re able to make with children and families.
00:02:47
Pryce
Wow, I am really excited to get into this topic with the both of you. We have an array of experience on the podcast today. So, as we all know, Florida is expeditiously moving toward implementing the Family First Prevention Services Act but there’s still lots of questions and there’s still lots of demystifying, in my opinion, of the entire process. So, you used the term “best practices” a moment ago, so I wanted to start discussing practice, in particular, evidence-based practice. This word is the buzzword now, right? So, people are trying to understand what that really is. So, I’m curious, either one of you can start off, is evidence-based practice just another fad or should we be gearing up for this for the long haul?
00:03:30
Groeber
I’ll start and then David, please fill in! I think it’s here to stay. Now, what constitutes that is where the jury’s still out on. You know- as you know, Florida picked up the evidencebased practices that-that were set aside by the new evidence-based clearing house. We’ve got the California clearing house, and then we have the one in D.C.-- that’s looking at these child welfare practices, they don’t always agree. So, what constitutes evidence is up to the folks that are actually reviewing that. However, that said, we do know some things, right? We know that trauma-informed care is really important. We know that there are some standards that we’ve utilized like the Home Builder’s model for intensive in-home services. We are learning some of these things and some of these things we’ve known for quite awhile. So, some of the evidence that’s been the evidence will remain so, but I think we’re going to see more and more evidence-based practices as they’re designated. Things that are now promising practices, come into the forefront, and come into the mainstream. David I- you probably have something to add to that?
00:04:37
DeStefano
I really think evidence-based practice is here to stay for the long-haul. I think it is future of child welfare and of human services, in general. Approaching services from a front-end prevention sense, is imperative in the work we do. That said, looking at that through an evidence-based lens of what is proven to work is critically important. I- we wouldn’t go to a doctor and let them perform a procedure on us if that procedure hadn’t been tested. There’s no difference in child welfare, and the whole impotence of FFPSA and evidencebased practice is really to move not only to front end of the system, but use proven techniques that match the needs of the child and families we serve.
00:04:19
Groeber
To continue David’s analogy, you wouldn’t let a surgeon do an assessment on you that was evidence-based and then saying something, “Well we kind of used this in the past, and this kind of worked.” You know that equivocating will have to stop, we-and we
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equivocate a lot of times in practice. We’ll read something and we’ll layer something on, and we’ll do something different, and I think that’s where we’ve got to really learn how to do evidence-based practice. We keep talking about this term “fidelity to the model.” And that’s what we mean when we talk about fidelity to the model. It’s not adding something because it feels right or feels good, it’s sticking to the evidence-based model that’s out there with the full complement of resources that are supposed to come with it. Whether that’s a certain degree, a certain training, a certain certification, a certain set of trainings, whatever that is, and they vary. You don’t have to be a masters-level therapist to be able to do all of this, but there are certain requirements that people have to go through to be able to do this practice. So, when we talk about fidelity to the model, we’re just talking about sticking close to the intent of the model and the way it was designed so it can remain an evidence-based practice.
00:06:35
Pryce
Thank you! That’s really helpful, and one thing that’s sticking out to me is the idea of the surgeon analogy, right? This idea of bringing a level of focus, this is how I’m kind of translating it. A level of focus, a level of proven efficacy to the work that we do in child welfare. So you pretty much answered my next question because I was going to say, “Why should child welfare practitioners care about this?” So I would say, number one, is what you all just said. The idea that we need to bring a level of evidence to our field. Is there anything else that you would add to that question, “Why else should someone pay attention to this?”
00:07:10
Groeber
Well I-I think it goes to heart, if you do what you’ve always done, you’ll get what you’ve always got. And we’ve limped along for a lot of years in child welfare. I mean we’ve stayed at sea level, we’ve had some bad moments, we’ve had some good moments, but all the while, you hear it all the time, you here it in the field, you hear it in the administrative meetings, and you would hear it from families for heaven’s sakes, people want more! People deserve better. You know, we hear these things talked about all the time in schools of social work, and all the different places that we have these discussions. “We’ve got to better. We’ve got to change what we’re doing to make it better because where we’re at is not satisfactory.” The statistics on kids graduating from care and not being super successful are way too detrimental to our community as a whole. And I think the overrepresentation of black and brown children in the system is way too high to not address it. The sheer culture and organization where frontline workers are so demeaned and so tired and so frustrated with the processes and all of the stuff we’ve added to their to their place to work, and the caseloads, we have to have this discussion. I think that we’re way pass time, I just think it’s really important from a practice standpoint, and also from a research and outcome standpoint.
00:08:29
DeStefano
You know to follow up on that, Chris, too it goes back to- we’re working with a very, often with a young workforce that uh needs the tools to be successful in the job they have. We wouldn’t expect a carpenter to go build a house, to use another analogy, with just a screwdriver and say, “go build that house.” We would give them all the tools, teach them when to use those tools, teach them why these use those tools, and allow them and give them the ability to be successful in their job. It’s the same in what we do, by using evidence-based interventions and interactions, we’re not only giving children and families
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the best opportunity to be successful, we’re giving our workforce the best opportunity to successfully intervene and work with families, and help those families be successful.
00:09:16
Pryce
What I really appreciate about this conversation, is it really brings it down to eye level because a lot of EBP talk is so connected to funding. And I think that frontline workers are saying, “Are we just doing this to be able to draw down, and be able to get paid or reimbursed?” But no, what you both are saying is, “This is how you fully engage in an effective way with families. This is going to change how you interact with families, and it’s going to give you a level of confidence that you’re making a meaningful impact because you have the right tools.” So, I really appreciate you know those caveats. Something keeps coming up in this conversation, Title IV-E. So, I would love to kind of expound on that for the listeners, what is it? And what does that mean for someone’s dayto-day in the field?
00:09:58
DeStefano
At the simplest level, Title IV-E is the funding- the federal funding mechanism that states are able to use to pay for, primarily, out-of-home care for children. Meaning if the states wanted to draw down, with the bulk of child welfare funding was that were to support children in crisis the only way you could do it, and the biggest federal funding mechanism, was for out of home care. What FFPSA does is opens the use of Title IV-E to front-end diversion prevention services that can be used with families that are in crisis, where the child’s at risk of coming into care before that child moves into out-of-home care, which opens, again, the toolbox of services we can provide.
00:10:42
Groeber
Yeah I-I think that one of things that we’ve got to remember, right now, it’s an uncapped entitlement. So, it’s open-ended. We can draw in as much as we- and you have to match it. So, you’ll hear people talk about IV-E match and there’s lots of different ways to do that. But there’s also a front door to this piece, that I think people don’t understand and they just think it’s just a stupid administrative task, but that’s establishing IV-E eligibility. And that’s making sure that that child meets the criterion to enter that system, which has changed a little bit with FFPSA and it kind of opens the gates to say, “any child that is at potential risk of coming into the system could be IV-E eligible.” It used to be, as David said, really primarily focused on the out-of-home care population but now it’s opened up. So, we’re having very interesting conversations about moving kids’ potential eligibility further and further upstream to where we have first touch with them, maybe it’s through a family resource center, maybe it’s through when they come in to ask for clothing or shelter or food, but establishing that eligibility sooner rather than later so that we can actually utilize that IV-E money, that money that flows through the state to the communities earlier rather than later- I will say this, Jessica- we haven’t cracked that nut yet. Those of you listening, I would say to you, “Be patient with us all as we try and figure that out,” but it will change probably how we practice. And some of you front door providers, it will change who are partners might be, right? So, it may move it to a hospital setting where a drug-exposed infant and mother are, it may move it to a health department setting where
5 a drug-exposed infant and mother are, it may move it to a health department setting where you’re doing early childhood, it may move it to a CBC who’s doing early childhood interventions. And the other thing that I want to say Jessica, that I think is really important- it is that we’ve got to really rethink prevention. I want to challenge us to think about programs that we haven’t thought about yet. I want to challenge us to think about ways to prevent that we really haven’t gone there, and say to ourselves, “If we look at a family’s story, if we look from the inception of a family, right? Where can we move prevention to so it really is prevention? Where can we move so it really is primary, so that we’re not doing the traditional secondary and tertiary prevention that we like to rest in and call ‘prevention’. But how far back on the continuum can we move it?” And I think part of doing that goes to listening to families’ stories and letting families tell us where that first touch would have made a difference. Where our intervention really could have impacted. I was talking with a former foster child this past week, and she was saying to me, “Man, if we could have gone clear back to the hospital when I was born, my mom might have had a chance, and our family may have had a chance.” But it started then, and I thought, “Wow, that really refocuses me on how we think about prevention, and how we talk about prevention and what we do when we prevention, right?” And so, I think those are conversations that we haven’t had yet. But I think we let the family take the lead, the families that have experienced us good, bad, and different, and let them tell us where those pressure points are that really would have taken the pressure off them and maybe prevented removal.
00:14:13
Pryce
You know the prevention conversations is always fascinating to me because, like we said, Title IV-E, for so long, was after a child was in our system and already really entangled in foster care. And now we have this opportunity, through Family First, to you know move it upstream a bit. But I do have a question about that because I- when I think about evidence-based practice, a lot of people think about treatment modalities and things like that, but we know that over 61 percent of the cases, I believe it was in 2019, were neglect-focused. What are your thoughts around EBP, Family First, and families that are struggling with neglect, which Iof course, is correlated with poverty, is there room for them to also get help through EBP, folks that are struggling financially?
00:14:59
DeStefano
The financial help to families is going to possibly be difficult through FFPSA unless that concrete supports maybe built into some of the modalities that are eventually approved under FFPSA. But that’s yet to be seen. That said, as a system, so often you know neglect, in addition to poverty, is also based on the fact- uh mental health, substance abuse, parenting skills and the three first areas that FFPSA is looking at to support families that are in that situation are to address that. I think the parenting skills classes, the in-home interventions can also potentially help with poverty but it’s going to be critical we link families through those programs to the external supports and services that they need to enhance job skills, to enhance employability, to enhance their ability to access daycare and those types of service supports. It’s going to mean-mean a lot of cross system navigation, and I’m actually fortunate enough to be working on a project in Mississippi right now that’s looking at just that, using community
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navigators to work with at-risk families, to see how to best connect them with services like FFPSA funded services to prevent child a-abuse and neglect, like community employment-based services to address those other issues. Chris?
00:16:32
Groeber
Well, I think one of the other issues, one of the dreams with FFPSA is we will eventually save money on the deep end services so that we can slide those resources to the front end or other resources that we’re currently expanding on that into the front end. And I think all of us are a little nervous about our out-of-home care population, particularly our kids who are still in some sort of residential type setting. And even though FFPSA’s provided for that at some level, that’s a different group of kids being in that setting than some of us currently have now. So, in other words, you may have three or four kids that don’t meet the criteria, the FFPSA criteria for what they call “qualified residential treatment program,” or QRTP. You know, but there’s some rules around them and who can use them. But some kids won’t be eligible, so that means the CBC, and ultimately, the state are on the hook for the full cost of the kids that don’t meet that criteria. There will be no federal money on that. FFPSA has opened up the opportunity to talk about prevention and I think, “Is it complete? Is it an ideal law?” Absolutely not. But we’ve got to look at the system that we’re in. And so, one of the things that I want to encourage everybody to think about is, I think the changes have to be incremental. I don’t think this is necessarily a “go big or go home” kind of opportunity. I think we have to get smarter about how we use resources and where we put them so that we can slide them to the front end in that Maslow’s Hierarchy kind of need, you know, whether it’s food, shelter, and the sustainability of those things. And so, as we get better at the deep end, ideally, we have more money at the front end. I- but that’s not going to happen overnight, Jessica, because our population didn’t just magically change. So, we’ve got- we’ve got two focus areas now. We’ve got this front end and we’ve still got all these kids on the deep end that, sadly in many cases, we as a system built. There’s a short game and a long game here, if you will. I think the short game is to figure out what our quick wins are and how- some of these evidence-based practices and getting them in and getting return on our money on those evidence-based practices. But the other one you talked about, in the way you asked your question, was building capacity, so that we can expand. And some of that, like I mentioned earlier, may require different degrees, it may require a master’s degree, which for some people, may be two or three years away. So, the longer game is about capacity building. It’s also working with frontline staff to understand why fidelity’s important, why filling out this form is important. The other thing is it’s thinking about the things that I mentioned earlier that we haven’t thought about. So, what does prevention at the hospital, in the neo-natal unit look like? How is that different than what it is now? And how do we integrate that into our systems of care because we’ve never thought about that before? So, I think it’s how we think about things, which shifting that culture’s also a long game.
00:19:34
DeStefano
And Chris, to follow up on that, I think you’re right in that in that uh in the long game it’s really that shift to the front end services, which hopefully are less expensive to provide
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than out-of-home care. And the reinvestment of those funds from the back end to the front end of the system to not only support the provision of these services but address some of those concrete needs of families, and housing, and food instability, and insecurity. And that reinvestment is going to be critical over the long term.
00:20:03
Groeber
Well and so often, David, I think that we’re willing to do it when the kids are in out-of-home care. Why shouldn’t we be willing to do it in a birth family that actually birthed and loved this child and you know wants this child as opposed to bringing it- them into a system which is ah- makes them an outcome? And so, how do we enhance that that stuff on the front end? But, I think it goes back to listening to what families ha- and being willing as a system to not be the expert all the time. Families are experts on themselves. And so, asking a family, “Well, what would work best you?” As opposed to telling them what we think would work best for them.
00:20:45
Pryce
I agree, and this is making me think about this idea of- we’ve heard the statement, “We need to work ourselves out of a job.” And when people say that, some people get a little nervous because they say, “Wait, we need jobs.” So now, I’ve started saying, “We’re going to work ourselves out of this job.” Because there’s room for us in this new system that we’re trying to build through Family First. There’s room for us in the Prevention Era, you know for frontline workers. So that’s where I wanted to take the next part of the conversation. You know, when you’re a frontline worker--and we’re talking about being family-focused or child-centered--you know, let’s have a conversation about, again, we’re working ourselves out of our other job where we sprung into action once a child was in foster care, but how do we reorient our frontline to say we’re going to be prevention focused now and more family focused? What are your thoughts around that?
00:22:31
DeStefano
I think that, though we all like the thought of “we’re gonna work ourselves out of a job,” I don’t think FFPSA necessarily does that for us. I think changes the job we have, um very significantly, because prevention is, in my mind, a much higher risk and a much higher intervention-based way of working with families, something that we haven’t done. Does it change the skill set of a case manager? Does it change the mix of case management to in-home staff that are working directly with families? It does. I remember having a conversation several years ago, with an organization that ran group home and residential facilities and they straight out asked me, “What do you think the future of residential facilities will be?” And I said, “Well, you know, there’s always going to be a subset of kids who are gonna need intensive treatment, that are gonna need the type of services that you provide, but that subset of kids is going to look a little bit different, the mix of kids is gonna look different then it does now.” And I followed up with them by asking, “How many buggy whips do you ha- do you own?” And he ask me, “Well, what do you mean?” I said, “Well, if this was 1850 we’d all have buggy whips and horses and harnesses sitting outside, but we all have automobiles sitting outside.” So, there was a point, that that the buggy whip was absolutely critical as an industry. Those industries had to change, and change what they do, and maybe change the focus of what they do over time to move into other types of work.
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And that is what we need to do. We need to look at how we look at this on- at the residential side, instead of just providing residential care, and follow along supports and services to help the child re-return home to become an active part of that reunification, and how do you support that reunification even once that child goes home? How do you look at working in the community to provide prevention-based services? Expand what you do, change what you do, and work with families in different ways. It doesn’t mean that what we do now is gonna completely go away but it will change.
00:23:31
Groeber
You said something, David, that I think is really important and I think that goes to heart of me as an individual case manager, me as the individual investigator. My relationships, then, in the community, are one of most important resources I have to make a difference in the lives of my families. So, it goes to the heart of how I partner in the community, how I am viewed in the community. What is my reputation in the community as a case manager and investigator, or heck, a PA or regional administrator? If I’m viewed negatively, that in turn hurts not only the people that work with me but also hurts the families that I’m serving. I totally believe that.
00:24:09
Pryce
I wanted to follow up on something you said, David. I think, you know, taking this route with Family First you know could be considered more risky. So, that term “risk” I think is a really interesting conversation because I talk about risk aversion versus risk tolerance, and I’m curious, your thoughts around, again, we’re talking about the frontline and folks are reactive and often make decisions for CYA, right? But how do we juggle the risk aversion versus risk tolerance with the Family First Prevention and Services Act?
00:24:42
DeStefano
You know, at the end of the day, uh we are in a family risk business. And no matter what we do there is always going to be something that that occurs outside of the expected norm even when using an evidence-based service. Remember, evidence-based doesn’t always work in 100% of the cases. We all know right now, especially with COVID as we go get our vaccine that that’s supposedly been based on evidence, that it works, but there are still people that are going to get sick even after they become vaccinated. So, we have to, as an industry, find out what we can do to minimize those risks, take the appropriate steps. Is an appropriate safety plan in place? Do we have appropriate safety measures to be able to keep that child at home? Do we have backup plans for parents to reduce the opportunity for recidivism or to put protections around that child if they think that they can’t handle things for a night, or a day, or a weekend. Can grandma take the kids? So that how we can manage the risk, we’ll never completely eliminate it. And I think that’s gonna be an important lens to look at this whole process through, as we go forward not only from a practice side but from administrative and legislative side. Chris?
00:26:01
Groeber
I absolutely agree. To me, it goes back to trust and relationships and engagement. And if a family can trust me as their case manager, their investigator, or the person that that’s involved in their lives- and I’ve got enough relationship with that family that I can have these conversations and strike when the iron is cold, not in the middle of crisis. But that we can safety plan, when we talk about it, and make plans for, “Well, what if, what if, what
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if?” I think one of the other things that’s really important for us to realize, so many of our families have so many crises around them that they “crisis think.” And crisis thinking is fundamentally different, survival thinking’s fundamentally different than cause-effect thinking. And so, I think it’s incumbent upon us as a system and as individual practitioners to give family thinking space. To give family these places where that they can come and they can safely think, “Well, if this then that.” And to facilitate those discussions and so people can make legitimate decisions based on what is best for their family because I believe most families ultimately know what’s best for them. From a macro standpoint, we need to- we need to give some relief to the front end so that they can help facilitate the creation of these spaces where families can begin to regain the authority over their own family and regain the trust and of the system and the system regain the trust of the families. I think part of this is this kind of emergency room kind of frenetic approach to these families. We don’t have time. A lot of the reason we have turnover is for these very things that we’re talking about. I mean really do think if we can just breathe and relieve some of this pressure on the front end of the system, whether it’s through prevention, whether it’s through case load reduction, we will begin to see the kinds of outcomes or start to see the kinds of outcomes or at least outputs that we’re talking about and hoping for.
00:28:05
Pryce
So many layer, right? I mean I heard words like “trust.” I heard words like “turnover” and the workforce. So, I I appreciate the conversation because I think that when people start talking about keeping families together and strengthening them and providing support, sometimes people hear, “So, you’re leaving kids in an unsafe environment?” Or they start to you know start to create their own narratives around our system becoming more neglectful. But I tell folks, “Trying to keep families together doesn’t mean we’re gonna shirk on our work and not do comprehensive investigating and comprehensive you know service provision. So, that’s why I wanted to really discuss that idea of risk and I love the idea of trust and really co-creating a path forward with the family because they’re really the full authority over how they want to live and where they want to go.
00:28:53
DeStefano
To follow up on what Chris said, is if we can intervene and work with families or partner with families early in a crisis or at the point they come to our attention, in a true prevention sense the risk is going to be much less. And if we can catch and work with the family at that point, then it reduces the burden on the caseworkers because the family may not have to go into a court ordered situation where the case manager has to spend a lot of time in court uh every month giving detailed updates to the judge because that family hasn’t gotten involved with the formal dependency system as yet. So that’s that whole idea, move it up front, we shift and change our system. We don’t continue with the status quo.
00:29:37
Groeber
And how we refer and where we refer also matters at that point, and so again having those community partners. And I think we need to look at our friends in the school system who are taking massive cuts right now, where school social workers and people that are involved in the social aspect of people’s educations are being cut. You know, there’s some of our first responders when it comes to who our families aren’t coming to the attention.
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I think we have to broaden our-our list of concerns to any family serving system and when any good family serving system is cut we all take a cut. We all suffer because of that. For me, this all goes back to values and what we value. And societally, we complain about children not having rights and not valuing children and not valuing families. Well, we say “the system,” the system is us. And so, I think we have to groundswell up and say, “No, I’m gonna drive a stake in the ground and this family’s story matters. I’m going to listen to it. I’ve got a relationship with them. They trust me, I trust them and I believe we can go forward with that together.” And so, I-I think you’re exactly right. I’m gonna feel safer going home if I know Mom and Dad are bought into the safety plan that they know that they know, you know, that that they’ve got a plan if that child does something, or if somebody comes into that home or there’s a crisis in that home. I don’t think we’re talking mutually exclusive when we talk about being child-centered and family-focused. Well, if that’s the case, then we should be family focused.
00:31:11
Pryce
We talked about you know that broad theme of “what is evidence-based practice?” And then we went into a conversation of “how does EBP and that implementation process impact the frontline?” But I’m curious now, for the listeners that our leaders and running agencies or service providers, implementation is on the horizon, transitions are already starting, and I know that this could be an entirely you know new podcast, but what broad types of things would you offer for service providers and lead agencies as they prepare for what’s coming?
00:31:43
DeStefano
Wow, that’s a timely and pointed question to ask; you know it, it’s at the at the frontline level as the agencies that that work with the communities, you need to understand your communities, the families you serve, what their needs are, align those needs with the evidence-based services that-that are approved or through the clearinghouse and most likely to be able to, hate to put it this way, but draw down those federal funds. So, look at the family needs, look at what your funding mechanisms are, look at your available programming, and start aligning those things and start preparing yourself to transition to that ability to provide those services. What training do- does your staff need? Not only the staff that are going to provide the interventions, but what training does your other staff need--your case management staff, your child protective investigators in the field to connect the families with that? What type of community partnerships do you need to help fill concrete needs and supports for families? Um, how does all that interact and play together? That planning needs to be well in process and I know I know the state of Florida and the um coalition have been working very, very hard on those things together, in partnership with the CBCS and the universities to implement that. On a claiming side, what do we need to be doing to get ready to federally draw down the funding for those services? Eventually, half of the services we offer will have to be evidence based. Half of those half of those evidence-based services must be well
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supported and to provide those services we have to plan now. That also draws down the ability to be able to do- and get trained. Right now to get training, to get those evidencebased programs to come in and work with staff to train staff, is becoming increasingly difficult. They only have so much capacity. So, getting on their schedules to work. Who do you partner with? Can you work with uh organizations to get that training? Do they have a train the trainer model? Do you have- can you have new staff go through retraining? Those are all things that have to be strategically thought through now.
00:33:56
Groeber
I wanna add to what David said or enhance by saying, “do we have the capacity in our communities to do X, Y or Z? What does that look like? Who has to be licensed? Do we have to have a Medicaid license to do it? Is it best to have a Medicaid license? Do we have a relationship with our M.E. that’s seamless and we can just say, ‘You know, we need you to step up here, we see this is a gap?’” I think, have we talked to our care leavers? Have we talked to the individuals who have left care and said to them, “You guys are experts on this, where are the pressure points for you? Where could we have stopped this trip to a SIP? Where could we have stopped this Baker act? If we could do it all over again and wave a magic wand, where would those places have been for you?” And start to build some information into our system like that. I think we need to look at evidence-based practice in terms of minorities and black and brown children and building some evidence base that includes them in the giant “in” which we haven’t done to this point because we’re flying blind with some of our evidencebased practices ‘cause they have been normed uh-uh in families of color and families of different cultures and things like that. So, I think we- just because its evidence based doesn’t mean that all the evidence is there? So, and some of y’all doing promising practices, I think you need to do a cost benefit analysis if you’re getting good outcomes out of your promising practice, it may be cheaper for you to stay with that promising practice than to take on one of these evidencebased practices that you currently don’t have in your complement. But who do you need to get to evaluate that so it can move up the food chain as well? What do you have to do to advance that discussion? So it goes the heart of who’s not at the table? Who are our partners that we need to have that we don’t have? I mean, who’s talking with health departments? Who’s talking with the hospital, NICU units and the the pediatric units, and the obstetrics units? You know who’s talking to the health equity centers? Who’s talking to the universities? Are are we going to put enough LCSWs out there? Is there a way to create more LCSW’s or LMFTs? All of these discussions need to be having- being had simultaneously and it’s a lot. So, uh we gotta lead too. We can’t just manage.
00:36:11
Pryce
And one thing that I’m hearing from you Chris is values. You know, that’s how you put your stake in the ground, “What are your values?” So, you’re not reverting back to that reactionary position that we’ve been in for so long.
00:36:21
Groeber
It’s all you have. It’s all we have, Jessica. I mean outcomes are going to change over time. Tools are going to change over time, but the values that we hold really are what give us the impetus to decide, “I want to learn about that. I’m going to be a learner. I’m going-
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I’m going to be somebody who’s going to make a difference.” And I think the other piece that’s important on this is when we talk about empathy, which we do a lot, it’s empathy with a capital ‘E’, that means everyone. It’s not selective empathy. It’s not strategic empathy. It really is being empathic for the whole family system and taking everybody along and- because I think a lot of times empathy has gotten very wea- weaponized. So, we have worthy poor and unworthy poor. And I, I think we’ve got to have these really uncomfortable discussions about what our values are and build some scaffolding around us as a system, so that as we build, we can start to take scaffolding down and we can grow in new areas.
00:37:20
DeStefano
You know, and I, I think systematically and systemically we need to make sure that our values across different aspects of our of our system of care and need to align. For instance, achieving permanency in 12 months is-is going to be increasingly difficult if we’re working with more and more families who have substance abuse related issues. We need to make certain that that the timelines of treatment on a mental health, substance abuse side align with the timelines on a child welfare side and make those two things come together. And if we can work with families and keep them together without that child coming into out of home care, we are more able to do that where we’re more flexible in our ability to do that. But on the deep end of the system, we need to make certain that, number one, once a child gets there, if there’s any chance of them going home, our systems, our timelines, and our approaches align.
00:38:14
Groeber
Absolutely, and I think it goes to the heart of, “Do I value that individual and that family or do I value our outcome?” And if they’re mutually exclusive, we gotta do something about that. You know, one of DCS- DCF’s values is courage, professional courage. And that’s where the professional courage lies. The professional courage lies between that frontline practitioners going, “This is crap! What you’ve got me doing with this family is not helping the family and that policy or that procedure.” And having the professional courage to go, “Enough!” We need to have a discussion about how this is a detriment to my practice. We’ve got to be there and those discussions need to be allowed to occur it in ways that are solutionfocused and that people can learn from and that have that they’re change-making. I think there has to be some disruption, and instead of silencing the disruptors, I think we probably ought to spend a little more time saying, “Well, tell me more about that. Tell me more about how that affects your practice.” As opposed to just saying, “Get back in line!”
00:39:15
Pryce
No, I love this conversation, and what I’m really pulling from what David said earlier and what you just said, Chris, is understanding the community. And it sounds really simple but I think, for many years, we’re told to know what community resources are out there. And to “know” is different than to “understand” certain communities and certain subgroups. And the first thing that you said, David, a few moments ago, was agencies and CEOs and organizations, “Understand your community so then you have a strategic plan on building capacity to meet those needs.” I think that’s an incredible first step for folks.
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00:39:53
DeStefano
It’s so difficult to do and you know it’s one of the things I’ve appreciated here, recently, in the last year with the state of Florida and looking at implementing the My Florida, My Families powered by Bertha uh the system, and the ability to use that to connect families with services and supports in the community. It is so difficult on a client consumerbased side to do that. I’m actually going through that right now with a with an elderly father who has some health care needs, broke a hip a few weeks ago, and working with the social workers where he lives and the ability to even know what’s available for him can be overwhelming at times. And that’s me looking at as a family member from the outside, I can’t imagine looking and being in the system and being in crisis myself and having to navigate that. And that’s where our workforce in child welfare needs to be attuned to working with families, helping families and helping them navigate that system.
00:40:46
Pryce
Absolutely. I don’t know if you all do this, but I’ve become this person that everything I read I kind of filter through child welfare. So, I’m reading a book right now, and it’s called Professional Troublemaker. And I wrote a quote, the other day, from the book and it said, “Right your values in cement even if your strategies are written in sand.” And that is really coming up for me as both of you are talking because, especially one of things that you said Chris, “Even though it’s evidence-based it doesn’t mean it has all the evidence for black and brown communities or other BIPOC communities.” So, the idea of making sure our values are cemented, even if interventions may change depending on the relevancies to certain communities, really spoke to me when you said that and it reminded me of that quote. And I just think that it’s so focused on child welfare, and when I read that I said, “That’s what we need to do for Family First!” So I did want to pull this and culminate it by asking you kind of your closing thoughts around Family First, for the listeners?
00:41:45
Groeber
You know it’s- we talk about these evidence-based programs like their one size fits all. I think admitting what you don’t know, you know I, I think and reflecting, what do we know? What do we know to be true? And I think having those values discussions, I think now is the time for every organization to go and look at their value statements, their mission statements and say, “Do they align with what I anticipate our families are going to need? Do the families feel like they align with what they need?” And so, I think bringing a family in to an egalitarian kind of relationship with us, and in these cases in saying, “Is this working for you? What’s could we do differently? How would it be better? Who do we need to put in the mix that’s not here?” And then trusting that what our families tell us is what they really need. Then we begin to shift what we view as priorities based on what the real priorities actually are. I think there’s a lot of work to be done with engagement and how we engage. But I think that work goes the heart of do we value that? Does it really matter to us? And I think we have to have some hard discussions about what we think and what we feel as practitioners, “Do I really have what it takes to take on a true prevention front end system, not just resource-wise but emotionally and all the things that come with it,” which goes to the heart of, “Am I ok with not being the expert?”
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00:43:11
Pryce
00:43:14
DeStefano
Thank you, thank you. And David, what about you?
I really think it comes down to aligning your mission and values with what we believe in what the most in what we’re doing. For instance, uh the majority of the work I do in Florida is with Kids Central and Circuit 5, where I act as their Chief of Strategy. Several years ago, they went- they and their board of directors, went through a-a review of their mission statement and took a lengthy and wordy mission and boiled it down to three simple things: supporting families, protecting children, engaging communities. Very simple, very straightforward and our values are all based around those three simple statements. How do we support those families in their effort to protect children? How do we- how do we help them protect children and what do we do to do those things? And how do we engage communities in helping that? And I think that ties very nicely, not only to the use of evidence-based services in a prevention sense, but with the intent of FFP- PSA and navigating the implementation of that. Is it going to be easy? No. Are there going to be unintended consequences? We’ve already seen some of those unintended consequences of FFPSA at the national level. There’s only, I believe, at this point 12 or 13, Chris, well supported, approved interventions on the clearinghouse, which is making it very difficult to get those types of services implemented. It is very difficult for programs to become and meet the rigor of becoming well supported. Um and working on evaluations, we’re seeing that change at a national level. It’s going to take us time to get there. But if our mission and our values are aligned with what we believe is best for families, and we work with families in partnership with families to achieve that, I think we’ll be successful in the long run.
00:44:59
Pryce
I agree. Thank you both so much! I appreciate this podcast, thank the listeners for joining us as we talk about perspectives on the Family First Prevention Services Act. This episode has really opened my mind to the possibilities and changes that Family First can offer our child welfare system. Thank you so much Chris and David for your perspectives on this policy. I’m looking forward to our listeners learning about how it’s being put into action in future episodes.
DeStefano
00:45:31
Pryce
Well, thank you.
EPISODE 2 OUTRO - I want to give a huge thanks to our guests and we are so appreciative of their commitment to improving our child welfare system. If you want to learn more about this topic or contact these speakers, please visit www.ficw.fsu.edu. Stay safe and well.
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