Children's Bureau -- Child and Family Services Reviews CFSR Final Report: New Hampshire

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Children's Bureau -- Child and Family Services Reviews
CFSR Final Report: New Hampshire

Region: I
State/Territory: New Hampshire
Document Type: CFSR Final Report
Review Period: 2nd Round CFSR
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EXECUTIVE SUMMARY

Final Report: New Hampshire Child and Family Services Review November 2010

INTRODUCTION


This document presents a summary of the findings of the Child and Family Services Review (CFSR) for the State of New Hampshire. The CFSR is the Federal Government’s program for assessing the performance of State child welfare agencies with regard to achieving positive outcomes for children and families. The CFSR is authorized by the Social Security Amendments of 1994 requiring that the U.S. Department of Health and Human Services (HHS) promulgate regulations for reviews of State child and family services programs under titles IV-B and IV-E of the Social Security Act. The CFSR is implemented by the Children’s Bureau of the Administration for Children and Families within HHS.

The New Hampshire CFSR was conducted the week of August 2, 2010. The period under review for the onsite case review process was from April 1, 2009, to August 6, 2010. The findings were derived from the following documents and data collection procedures: The Statewide Assessment, prepared by the New Hampshire Department of Health and Human Services (DHHS), Division for Children, Youth and Families (DCYF), and Division for Juvenile Justice Services (DJJS)

The State Data Profile, prepared by the Children’s Bureau, which provides the State’s child welfare data for the 12-month CFSR da ta period ending September 30, 2008

Reviews of 65 cases (40 foster care and 25 in-home services cases) at three sites: 17 cases in Littleton and Conway (Littleton/Conway), 31 cases in Manchester, and 17 cases in Portsmouth Interviews and focus groups (conducted at all three sites and at the State level) with stakeholders including, but not limited to, children, youth, parents, foster and adoptive parents, all levels of child welfare agency personnel, collaborating agency personnel,

se

rvice providers, court personnel, child advocates, Tribal representatives, and attorneys

Background Information

The CFSR assesses State performance with regard to its substantial conformity with seven child and family outcomes and seven systemic factors. For the outcome assessments, each outcome incorporates one or more of the 23 items included in the review, and each item is rated as a Strength or Area Needing Improvement based on the results of the case reviews. An item is assigned an overall ra

ting of Strength if 90 percent or more of the applicable cases reviewed were rated as Strengths. The evaluation options for these outcome

s are “substantially achieved,” “partially achieved,” or “not achieved.” For a State to be in substantial conformity with a particular outcome, 95 percent or more of the cases reviewed must be rated as having substantially achieved the outcome. Two outcomes—Safety Outcome 1 and Permanency Outcome 1—also are evaluated based on State performance with regard to six national da

ta indicators. For a State to be in substantial conformity with these outcomes, both the national standards for each data indicator and the case review requirements must be met.



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There are 22 items that are considered in assessing the State’s substantial conformity with the seven systemic factors. Each item reflects a key Federal program requirement relevant to the Child and Family Services Plan (CFSP) for that systemic factor. An item is ra

ted as a Strength or an Area Needing Improvement based on whether State performance on the item meets the Federal program requirements. A determination of the rating is based on information provided in the Statewide Assessment and from interviews with stakeholders held during the onsite CFSR. Additional information may come from other Federal reports or assessments.

Overall performance on each systemic factor is based on the ratings for the individual items incorporated in the systemic factor. For any given systemic factor, a State is rated as being either “in substantial conformity” with that factor (a score of 3 or 4) or “not in substantial conformity” with that factor (a score of 1 or 2). Specific requirements for each rating are shown in the table below.

Rating the Systemic Factor

Not in Substantial Conformity In Substantial Conformity

1 2 3 4

None of the CFSP or program requirements is in place. Some or all of the CFSP or program requirements are in place, but more than one of the requirements fail to function as described in each requirement.

All of the CFSP or program requirements are in place, and no more than one of the requirements fails to function as described in each requirement.

All of the CFSP or program requirements are in place and functioning as described in each requirement.


A State that is not in substantial conformity with a particular outcome or systemic factor must develop and implement a Program Improvement Plan to address the areas of concern associated with that outcome or systemic factor.

Because many changes were made in the CFSR process based on lessons learned during the first round and in response to feedback from the child welfare field, a State’s performance in the second round of the CFSR is not directly comparable to its performance in the first round. Key changes in the process that make comparing performance difficult across reviews are the following: An increase in the sample size from 50 to 65 cases

Stratification of the sample to ensure a minimum number of cases in key program areas, resulting in variations in the number of cases relevant for specific outcomes and items Changes in criteria for specific items to increase consistency and to ensure an assessment of critical areas such as child welfare agency efforts to involve noncustodial parents

The specific findings regarding the State’s performance on safety and permanency outcomes are presented in table 1 at the end of this Executive Summary. Findings regarding well-being outcomes are presented in table 2. Table 3 presents the State’s performance with regard to the seven systemic factors assessed through the CFSR. In the following sections, key findings are summarized for each outcome and systemic factor. Information also is provided about the State’s performance on each outcome and systemic factor during the Federal fiscal year 2003 CFSR.

Key CFSR Findings Regarding Outcomes

The 2010 CFSR identified the following areas of high performance with regard to the State’s performance in achieving the outcomes assessed during the review: Items pertaining to foster care reentry, proximity of placement, visiting with parents and siblings in foster care, preserving connections, and physical health of child were rated as Strengths for the State.

The State met the national standards for the data indicators pertaining to (1) absence of maltreatment recurrence, (2) absence of maltreatment of children in foster care by foster parents or facility staff, (3) timeliness of adoptions, and (4) placement stability. Although the State’s performance on Permanency Outcome 2 (children have permanency and stability in their living situations) did not meet the required 95-percent level for substantial conformity, performance on this outcome was fairly high, with the outcome

being substantially achieved in 87.5 percent of the cases. Although the State’s performance on Well-Being Outcomes 2 (children receive services to meet their educational needs) and 3 (children receive services to meet their physical and mental health needs) did not meet the required 95-percent level for substantial conformity, performance on these outcomes was fairly high, with the outcomes being substantially achieved in 91.7 and 84.4 percent of the cases, respectively. Although the State’s performance on the items pertaining to repeat maltreatment; services to protect children in the home;

reunification, guardianship, and placement with relatives; other planned permanent living arrangement (OPPLA); placement with siblings; caseworker visits with the child; and educational needs of the child did not reach the level required for an overall rating of Strength, these items were rated as Strengths in over 85 percent of the cases.

In addition to these positive CFSR findings, HHS acknowledges the efforts New Hampshire has made since 2003 in focusing its work on improving permanency planning for children. For example, some of the initiatives implemented by the State include the establishment of Permanency Planning Teams (PPTs), the passing of permanency legislation, the establishment of the Voluntary Mediated Adoption Program, the establishment of the Finding Connections Program, and the establishment of the Relative Care Specialist position. HHS would like to acknowledge the commitment and dedication of both DCYF and DJJS in establishing a successful collaboration to prioritize improvements in permanency. New Hampshire has made considerable and continuous efforts to strengthen the services provided to children and families involved in the child welfare system through this focus on permanency and through efforts to individualize services for children.

For example, the Individual Service Option program provides resources to purchase specific services to target individualized service needs, including intensive therapeutic, social, and community-based services. In addition, the State’s commitments to data-informed continuous improvement, cross-system collaboration, and policy reform are clear strengths in New Hampshire.


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The CFSR also identified the following key concerns with regard to the State’s performance in achieving the desired outcomes for c hildren and families:

The State was not in substantial conformity with any of the seven outcomes. Some of the lowest performing areas included achieving adoption, assessing and addressing the needs of parents and foster parents, involving the child and parents in case planning, and ensuring caseworker visits with parents. The State did not meet the national standards for the data indicators pertaining to (1) timeliness and permanency of reunification,

and (2) permanency for children in foster care for extended time periods.

The State’s low performance with regard to these CFSR outcomes and national data standards may be attributed in part to the following key factors: There are areas of the State that do not have access to the full range of services. Caseworkers carry high caseloads in some areas inhibiting their ability to meet the needs of children and families effectively.

The State has not made consistent, concerted efforts statewide to locate and engage fathers in case planning, assessment, and service provision.

Key CFSR Findings Regarding Systemic Factors

With regard to systemic factors, New Hampshire is in substantial conformity with six of the seven systemic factors: Statewide I nformation System; Quality Assurance System; Staff and Provider Training; Service Array and Resource Development; Agency

Responsiveness to the Community; and Foster and Adoptive Parent Licensing, Recruitment, and Retention. However, New Hampshire is not in substantial conformity with the systemic factor of Case Review System.


I. KEY FINDINGS RELATED TO OUTCOMES


Safety Outcome 1: Children are, first and foremost, protected from abuse and neglect

Safety Outcome 1 incorporates two items. One pertains to the timeliness of initiating a response to a child maltreatment report (item 1), and the other relates to the recurrence of substantiated or indicated maltreatment within a 6-month time period (item 2). Safety Outcome 1 also incorporates two national data indicators for which national standards have been established. These data indi

cators measure the absence of maltreatment recurrence and the absence of maltreatment of children in foster care by foster parents or facility staff.

New Hampshire is not in substantial conformity with Safety Outcome 1. The outcome was substantially achieved in 71.4 percent of the applicable cases reviewed. This percentage is less than the 95 percent required for a determination of substantial conformity.
The outcome was substantially achieved in 100 percent of applicable Littleton/Conway cases, 50 percent of applicable Manchester cases, and 78 percent of applicable Portsmouth cases. In addition, the State met the national standards for the data indicators pertaining to (1) the absence of maltreatment recurrence, and (2) the absence of maltreatment of children in foster care by foster parents or residential facility staff.

The 2010 CFSR case reviews indicated that, in 87.5 percent of the cases reviewed, there was no maltreatment recurrence within a 6-month period.

In addition, in 75 percent of the cases reviewed, the agency initiated a response to a maltreatment report within the timeframes established by State policy. However, the 2010 CFSR case reviews also identified concern that, in some cases, investigations of maltreatment reports were not initiated in a timely manner.
New Hampshire was determined to be in substantial conformity with this outcome in its 2003 CFSR. Therefore, New Hampshire was not required to address the outcome in its Program Improvement Plan.

Safety Outcome 2: Children are safely maintained in their homes when possible and appropriate

Performance on Safety Outcome 2 is assessed through two items. One item (item 3) assesses State efforts to prevent children’s removal from their homes by providing the family with services to ensure children’s safety while they remain in their homes. The other item (item 4) assesses efforts to manage safety and reduce risk of harm to children in their own homes and in their foster care placements.

New Hampshire is not in substantial conformity with Safety Outcome 2. The outcome was substantially achieved in 73.8 percent of the applicable cases reviewed. This percentage is less than the 95 percent required for a determination of substantial conformity. The outcome was substantially achieved in 59 percent of applicable Littleton/Conway cases, 77 percent of applicable Manchester cases, and 82 percent of applicable Portsmouth cases.

The 2010 CFSR case reviews found that the agency was effective in providing services to the family to prevent the child’s removal from the home in 85 percent of the cases reviewed, and the agency conducted initial and ongoing risk and safety assessments to ensure the child’s safety in 75 percent of the cases reviewed. However, the 2010 CFSR case reviews also identified concern that, in some cases, risk and safety were not assessed or managed consistently.

New Hampshire also was not in substantial conformity with this outcome in its 2003 CFSR and was required to address the outcome in its Program Improvement Plan.

The key concern identified in the 2003 review was that, in some cases reviewed, the assessments conducted were not sufficient to address the safety issues in the home, which resulted in some children remaining at risk.



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To address the identified concern, the State implemented the following strategies in its Program Improvement Plan: Strengthened the assessment process through reevaluating intake criteria and the assessment policy Developed the Second Level Screening process/staff training via Leadership Meetings Developed the Reference Guide for Early Domestic Violence Identification & Referral and accompanying Domestic Violence Indicators Improved the use of Structured Decision Making (SDM) by reviewing the current use of the tool and establishing an SDM Core Team to oversee the application of SDM during intake and assessment Established regular and ongoing review of practice issues relative to assessment and family services Established risk assessment procedures within DJJS Improved the array of and staff’s knowledge of prevention services

The State met its goals for this outcome by the end of its Program Improvement Plan implementation period.

Permanency Outcome 1: Children have permanency and stability in their living situations

Six items are incorporated in the assessment of Permanency Outcome 1, although not all of them are relevant for all of the foster care cases reviewed. The items pertain to State efforts to prevent foster care reentry (item 5), ensure placement stability for children in foster care (item 6), and establish appropriate permanency goals for children in foster care in a timely manner as well as seeking termination of parental rights (TPR) in accordance with the requirements of the Adoption and Safe Families Act (ASFA) (item 7). Depending on the child’s permanency goal, the remaining items focus on an assessment of State efforts to achieve permanency goals (such as reunification, guardianship, adoption, or permanent placement with relatives) in a timely manner (items 8 and 9), or to ensure that children who have a case goal of OPPLA are in stable long-term placements and are adequately prepared for eventual independent living (item 10).

New Hampshire is not in substantial conformity with Permanency Outcome 1. The outcome was substantially achieved in 70.0 percent of the cases reviewed.

This percentage is less than the 95 percent required for an overall rating of substantial conformity. The outcome was substantially achieved in 70 percent of Littleton/Conway cases, 60 percent of Manchester cases, and 90 percent of Portsmouth cases. In addition to case review findings, New Hampshire met the national standards for the data indicators pertaining to (1) timeliness of adoptions, and (2) placement stability. However, the State did not meet the national standards for the data indicators pertaining to (1) timeliness and permanency of reunification and (2) permanency for children in foster care for extended time periods.



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The 2010 CFSR case reviews determined the following achievements: In 93 percent of cases reviewed, there was no foster care reentry. In 80 percent of cases reviewed, children experienced stability in their foster care placements. In 80 percent of cases reviewed, children had an appropriate goal established in a timely manner. In 86 percent of cases reviewed, the agency made diligent efforts to achieve the goal of reunification, guardianship, or permanent placement with relatives or the goal of OPPLA, as appropriate.

However, the 2010 CFSR also identified the following concerns in the cases reviewed: In some cases, the permanency goal for the child was either not appropriate or not established in a timely manner. In some cases, the agency had not sought TPR in accordance with the requirements of ASFA. There were delays in achieving adoptions in a timely manner, identifying an adoptive resource, and in the TPR process.


New Hampshire also was not in substantial conformity with this outcome in its 2003 CFSR and was required to address the outcome in its Program Improvement Plan.

The following key concerns were identified in the 2003 review: The State did not meet the national standards for the data indicators pertaining to the percentage of children reentering foster care within 12 months of a prior foster care episode, the percentage of reunifications that occurred within 12 months of the child’s entry into foster care, and the percentage of children who were discharged to finalized adoptions within 24 months of entry into fostercare. DCYF was inconsistent in its efforts to ensure that children experienced placement stability while in foster care. DCYF was inconsistent in its efforts to establish appropriate permanency goals. DCYF was inconsistent in its efforts to file for TPR in a timely manner, and there were numerous agency- and court-related delays

pertaining to TPR and adoption finalization. DCYF was inconsistent in its efforts to achieve reunifications or adoptions in a timely manner. DCYF was inconsistent in its efforts to assist youth in achieving independence.

To address the identified concerns, the State implemented the following strategies in its Program Improvement Plan: Added a Permanency and Adolescent caseworker in each district office to specialize in permanency-related issues; specifically to provide consultation on all cases in which the permanency goal is no longer reunification Created a PPT in each district office to provide an opportunity for cooperative case planning to begin at the onset of a case Provided intensive reunification services in the five district offices that have the Permanency Plus Program, which provides timelimited, intensive family reunification services for children in first-time, out-of-home placements, and expanded this program to
four additional district offices Improved data accuracy in reporting of foster care reentries



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Focused efforts on recruitment of dual-purpose resource homes that work intensively with the birth family toward reunification and, if reunification is not possible, are prepared to become the permanent placement Increased collaboration on cases managed by DCYF and DJJS together and implemented review of these cases by the PPT Monitored all children in out-of-home placements to ensure that each has the most appropriate and least restrictive placement and the most

appropriate permanency goal Monitored the number of cases and courts where TPR decisions were not received within 30 days of the final hearing to ensure that TPR proceedings are in accordance with ASFA, and reviewed findings with each district office and judge to resolve issues Worked with the Court Improvement Project (CIP) to assess and address reasons for delays in TPR proceedings—reviewed court files, surveyed judges and stakeholders, and expanded the Division of Family Courts statewide to address delays in filing TPR petitions in those areas in which the case had to be transferred from district court to probate court

The State met its goals for this outcome by the end of its Program Improvement Plan implementation period.

Permanency Outcome 2: The continuity of family relationships and connections is preserved for children

Permanency Outcome 2 incorporates six items that assess State performance with regard to (1) placing children in foster care near their parents and close relatives (item 11); (2) placing siblings together (item 12); (3) ensuring frequent visitation between children and their parents and siblings in foster care (item 13); (4) preserving connections of children in foster care with extended family, community, cultural heritage, religion, and schools (item 14); (5) seeking relatives as potential placement resources (item 15); and (6) promoting relationships between children and their parents while the children are in foster care (item 16).

New Hampshire is not in substantial conformity with Permanency Outcome 2.

The outcome was substantially achieved in 87.5 percent of the cases reviewed. This percentage is less than the 95 percent required for a determination of substantial conformity. The outcome was substantially achieved in 100 percent of Littleton/Conway cases, 90 percent of Manchester cases, and 70 percent of Portsmouth cases.
The 2010 CFSR case reviews determined that the State was effective with regard to placing children in close proximity to their parents, placing children with their siblings when appropriate, ensuring that children had the opportunity to visit with their parents and siblings in foster care, preserving important connections for children in foster care, and promoting the relationship of the child in foster care with parents. However, the 2010 CFSR also identified concern that, in some cases, the agency had not made concerted efforts to search for either maternal or paternal relatives as potential placement resources.

New Hampshire also was not in substantial conformity with this outcome in its 2003 CFSR and was required to address the outcome in its Program Improvement Plan.



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The following key concerns were identified in the 2003 review: DCYF was inconsistent in its efforts to facilitate visitation between children in foster care with their siblings and parents. DCYF was inconsistent in its efforts to seek and assess relatives as placement resources, particularly paternal relatives. DCYF was inconsistent in its efforts to support or strengthen the parent-child relationship, particularly with respect to fathers.


To address the identified concerns, the State implemented the following strategies in its Program Improvement Plan: Revised SDM Case Contact Guidelines to improve practice to ensure consistency regarding visits between children in foster care and their parents and siblings Through the use of the Permanency Plus Program, focused efforts on early identification of relative resources within 30 days of

placement Through the use of the Permanency Plus Program, used a team approach, including the birth family and the foster family, to promote a strong and consistent relationship between the parent and child Focused efforts on identifying fathers, paternal relatives, and/or other appropriate parties in a timely manner

The State met its goals for this outcome by the end of the Program Improvement Plan implementation period.

Well-Being Outcome 1: Families have enhanced capacity to provide for their children’s needs

Well-Being Outcome 1 incorporates four items. One item pertains to State efforts to ensure that the service needs of children, parents, and foster parents are assessed and that the necessary services are provided to meet identified needs (item 17). A second item examines State efforts to actively involve parents and children (when appropriate) in the case planning process (item 18). The two remaining items examine the frequency and quality of caseworker contacts with the children in their caseloads (item 19) and with the children’s parents (item 20).

New Hampshire is not in substantial conformity with Well-Being Outcome 1.

The outcome was substantially achieved in 52.3 percent of the cases reviewed. This percentage is less than the 95 percent required for a determination of substantial conformity. The outcome was substantially achieved in 57.5 percent of the 40 foster care cases and 44 percent of the 25 in-home services cases. In addition, the outcome was substantially achieved in 53 percent of Littleton/Conway cases, 58 percent of Manchester cases, and 41 percent of Portsmouth cases.

The 2010 CFSR case reviews determined that the State was effective with regard to ensuring frequent and high quality caseworker visits with children, ensuring that the needs of children were assessed and addressed consistently, and involving children in foster care in case planning. In addition, in many cases the State was effective with regard to ensuring that the needs of foster parents were assessed and addressed consistently.

However, the 2010 CFSR case reviews identified the following concerns in many of the cases reviewed:


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The agency did not make concerted efforts consistently to assess and address the service needs of parents, and especially of fathers. The agency did not make concerted efforts consistently to involve children in in-home services cases, mothers, and fathers in case planning. The frequency and quality of caseworker visits with parents were not consistent or sufficient to monitor the safety and well-being
of the child or promote attainment of case goals.

New Hampshire also was not in substantial conformity with this outcome in its 2003 CFSR and was required to address the outcome in its Program Improvement Plan.

The following key concerns were identified in the 2003 review: DCYF was inconsistent in its efforts to assess children’s and parents’ needs and provide appropriate services to meet those needs. DCYF was inconsistent in its efforts to involve children and families in case planning. DCYF was inconsistent in its efforts to ensure that contact among caseworkers and the children and parents in their caseloads was of sufficient frequency and quality to meet the needs of the family.

To address the identified concerns, the State implemented the following strategies in its Program Improvement Plan: Updated the Foster Parent Handbook and developed the Child Information Sheet to ensure that all foster parents have relevant, current, and complete information relative to their children in care Implemented the SDM Family Strengths, Needs Assessment, and Needs Review to assess families’ needs Identified and enrolled providers of specialized services needed by children and families, including substance abuse counselors and mental health professionals Focused efforts on increasing the number of parents and age-appropriate children/youth who attend and participate in case planning at the Administrative Case Review (ACR) meetings Revised case plan form, policy, and procedures and provided training to ensure that supervisors provide clinical supervision and oversight of the development of the case plan Improved the agency’s capacity to meet the needs of children by reducing caseworker caseloads with the addition of the Permanency and Adolescent caseworker in each district office Focused efforts on improving the consistency of visitation between the caseworker and the child as specified in the case plan Established consistent practices related to the frequency and quality of staff visits with both parents

The State met its goals for this outcome by the end of the Program Improvement Plan implementation period.



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Well-Being Outcome 2: Children receive appropriate services to meet their educational needs

Only one item is incorporated under Well-Being Outcome 2. It pertains to State efforts to assess and meet the educational needs of children in foster care and, when relevant, children in the in-home services cases (item 21).

New Hampshire is not in substantial conformity with Well-Being Outcome 2.

The outcome was substantially achieved in 91.7 percent of the applicable cases reviewed. This percentage is less than the 95 percent required for a determination of substantial conformity. The outcome was substantially achieved in 94 percent of the 31 applicable foster care cases and 88 percent of the 17 applicable inhome services cases. In addition, the outcome was substantially achieved in 70 percent of applicable Littleton/Conway cases, 96 percent of applicable Manchester cases, and 100 percent of applicable Portsmouth cases.

The 2010 CFSR case reviews determined that in 92 percent of cases reviewed, the educational needs of children were being appropriately and adequately assessed and addressed. In addition, children in foster care were more likely to have their educational needs met than children in the in-home services cases.

New Hampshire was in substantial conformity with this outcome in its 2003 CFSR and was not required to address the outcome in its P rogram Improvement Plan.


Well-Being Outcome 3: Children receive adequate services to meet their physical and mental health needs

This outcome incorporates two items pertaining to State efforts to assess and meet the physical health (item 22) and mental health (item 23) needs of children in foster care and children in the in-home services cases, if relevant.

New Hampshire is not in substantial conformity with Well-Being Outcome 3. The outcome was substantially achieved in 84.4 percent of the applicable cases.

This percentage is less than the 95 percent required for a determination of substantial conformity. The outcome
was substantially achieved in 92.5 percent of the 40 foster care cases and 71 percent of the 24 applicable in-home services cases. In addition, the outcome was substantially achieved in 88 percent of Littleton/Conway cases, 90 percent of applicable Manchester cases, and 71 percent of Portsmouth cases.

The 2010 CFSR case reviews determined that the State was effective in assessing and meeting the physical and dental needs of children and, in many cases, the State was effective in assessing and meeting the mental health needs of children. In addition, the 2010 CFSR found that children in foster care were more likely to have their physical, dental, and mental health needs assessed and addressed than children in the in-home services cases.

The key concern identified in the 2003 review was that DCYF was inconsistent in its efforts to assess and address children’s mental health needs.



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To address the identified concern, the State implemented the following strategies in its Program Improvement Plan: Collaborated with a subgroup of Community Mental Health Center children’s directors to ensure that all children/youth in court-ordered placement receive a mental health and developmental assessment within 30 days of placement Assigned a family therapist to each child/youth during his/her first out-of-home placement Committed to making available home-based therapeutic services to all children/youth at home Provided training for all district office staff relative to protocols regarding accessing mental health services

The State met its goals for this outcome by the end of the Program Improvement Plan implementation period.


II. KEY FINDINGS RELATED TO SYSTEMIC FACTORS


Statewide Information System

Substantial conformity with the systemic factor of Statewide Information System is determined by whether the State is operating an information system that can provide accurate and timely information pertaining to the status, demographic characteristics, location, and case goals for the placement of every child in foster care.

New Hampshire is in substantial conformity with the systemic factor of Statewide Information System. The 2010 CFSR determined that New Hampshire Bridges is an information system that can readily identify the status, demographic characteristics, location, and goals for every child in foster care.

New Hampshire also was in substantial conformity with this systemic factor in its 2003 CFSR and was not required to address the factor in its Program Improvement Plan.

Case Review System

Five items are included in the assessment of State performance for the systemic factor of Case Review System. The items examine development of case plans and parent involvement in that process (item 25), the consistency of 6-month case reviews (item 26) and 12-month permanency hearings (item 27), implementation of procedures to seek TPR in accordance with the timeframes established in ASFA (item 28), and notification of foster and pre-adoptive parents and relative caregivers about case reviews and hearings to be held regarding the children in their care and about their right to be heard in those proceedings (item 29).



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New Hampshire is not in substantial conformity with the systemic factor of Case Review System. The 2010 CFSR determined the following :

The State provides a process for the periodic review of each child at least once every 6 months. In addition, the court schedules review hearings for each child every 3 months. The State ensures that permanency hearings occur when a child has been in out-of-home care for 12 months and at least every 12 months thereafter.

The State provides a process for TPR proceedings that is in accordance with the provisions of ASFA.

However, the 2010 CFSR also identified the following concerns: Although the State provides a process that ensures that each child has a written case plan, this plan is not developed jointly with the child’s parents consistently. Although the State consistently provides caregivers with notice of and an opportunity to be heard in administrative reviews, with regard to court hearings, the State is inconsistent in its efforts to ensure that foster parents, pre-adoptive parents, and relative caregivers are notified.

New Hampshire also was not in substantial conformity with this factor in its 2003 CFSR and was required to address this factor in its P rogram Improvement Plan.

The following key concerns were identified in the 2003 review: DCYF was not consistent in its efforts to involve parents in the case planning process. DCYF was not consistent in its efforts to ensure that permanency hearings were held for children in foster care or for adjudicated delinquents in a timely manner due in part to court hearing delays.


To address the identified concerns, the State implemented the following strategies in its Program Improvement Plan: Reviewed and improved the current case plan form, policy, and procedures to ensure that every child has a case plan developed with his/her family and with his/her primary caseworker Increased the number of parents who attend and participate in case planning at ACR meetings Provided satisfaction surveys to assess the parents’ involvement in the development of the case plan In partnership with CIP, examined reasons for delays in adjudicatory hearings which could result in delays in permanency hearings Adopted policy, developed forms and instructions, and provided training on permanency hearings for DJJS staff to ensure that these hearings would be held consistently in all DJJS cases where children/youth are in foster homes or residential placements

The State met its goals for this systemic factor by the end of the Program Improvement Plan implementation period.



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Quality Assurance System

Performance with regard to the systemic factor of Quality Assurance (QA) System is based on whether the State has developed standards that ensure the safety and health of children in foster care (item 30) and whether the State is operating a statewide QA system that evaluates the quality and effectiveness of services and measures program strengths and areas needing improvement (item 31).

New Hampshire is in substantial conformity with the systemic factor of QA System. The 2010 CFSR determined that the State has standards to ensure that children in foster care are provided quality services that protect their safety and health, including certification standards for service providers. In addition, the State’s QA system, the Case Practice Review, identifies the strengths and needs of the service delivery system, provides relevant reports, develops improvement plans, and evaluates program improvement measures implemented.

New Hampshire also was in substantial conformity with this systemic factor in its 2003 CFSR and was not required to address the fa ctor in its Program Improvement Plan.

Staff and Provider Training

The systemic factor of Staff and Provider Training incorporates an assessment of the State’s training provided to new caseworkers (item 32), the ongoing training provided to agency staff (item 33), and both initial and ongoing training provided to foster and adoptive parents (item 34). This systemic factor does not assess the training of service providers other than child welfare agency staff unless the service providers are private agency caseworkers, operating under a contract with the State, who have full case management responsibilities.

New Hampshire is in substantial conformity with the systemic factor of Staff and Provider Training. The 2010 CFSR determined that the State is operating an effective pre-service training and ongoing training program for DCYF and DJJS staff. In addition, the State requires and provides initial training for prospective adoptive parents and initial and ongoing training for foster parents and residential facility staff.

New Hampshire also was in substantial conformity with this systemic factor in its 2003 CFSR and was not required to address this factor in its Program Improvement Plan.

Service Array and Resource Development

The assessment of the systemic factor of Service Array and Resource Development incorporates answers to three questions: Does the State have in place an array of services that meets the needs of children and families served by the child welfare agency (item 35)?


Are the services accessible to families and children throughout the State (item 36)? Can services be individualized to meet the unique needs of the children and families served by the child welfare agency (item 37)?

New Hampshire is in substantial conformity with the systemic factor of Service Array and Resource Development. The 2010 CFSR determined that the State has an appropriate array of key services to assess the strengths and address the needs of children and families. In addition, the State effectively uses case planning mechanisms and flexible funds to individualize services to meet the unique needs of children and families. However, the 2010 CFSR also identified concern that there are barriers to accessing key services, such as mental health and substance abuse treatment services, in many parts of the State due to the rural nature of the State and a deficiency of service providers.

New Hampshire was not in substantial conformity with this systemic factor in its 2003 CFSR and was required to address this factor in its Program Improvement Plan.

The following key concerns were identified in the 2003 review: The services available in the State were not adequate to enable children to remain safely with their parents when reasonable and help children in foster and adoptive placements achieve permanency. Existing services were not consistently available throughout the State. Key services noted to be lacking were substance abuse treatment and mental health services.

To address the identified concerns, the State implemented the following strategies in its Program Improvement Plan: Conducted a service resource and needs assessment in each district office that included regular monitoring of all family services cases for adequacy and accessibility of needed community services Improved the array of prevention services, dental services, and treatment services for domestic violence, substance abuse, sexual

abuse, and mental health Improved the access to transportation services for families connected to DCYF and/or DJJS Established wraparound teams to work with DCYF and DJJS to ensure access to local services

The State met its goals for this systemic factor by the end of the Program Improvement Plan implementation period.

Agency Responsiveness to the Community

Performance with regard to the systemic factor of Agency Responsiveness to the Community incorporates an assessment of the State’s consultation with external stakeholders in developing the CFSP and producing Annual Progress and Services Reports (APSRs) (items 38 and 39) and the extent to which the State coordinates child welfare services with services or benefits of other Federal or Federally- assisted programs serving the same population (item 40).



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New Hampshire is in substantial conformity with the systemic factor of Agency Responsiveness to the Community. The 2010 CFSR de termined that the State engages in ongoing consultation with key stakeholders in developing the goals and objectives for the CFSP and in preparing the APSRs. In addition, the State’s coordinates its services with those of other Federal or Federally-assisted programs.

New Hampshire also was in substantial conformity with this systemic factor in its 2003 CFSR and was not required to address the factor in its Program Improvement Plan.

Foster and Adoptive Parent Licensing, Recruitment, and Retention

The assessment of this systemic factor focuses on the State’s standards for foster homes and child care institutions (items 41 and 42), the State’s compliance with Federal requirements for criminal background checks for foster and adoptive parents (item 43), the State’s efforts to recruit foster and adoptive parents who reflect the ethnic and racial diversity of foster children (item 44), and the State’s activities with regard to using cross-jurisdictional resources to facilitate permanent placements for waiting children (item 45).

New Hampshire is in substantial conformity with the systemic factor of Foster and Adoptive Parent Licensing, Recruitment, and R etention. The 2010 CFSR determined the following:

The State has standards for foster family homes and child care institutions and reviews licensing records to ensure that licensing requirements are being met. In addition, the State ensures that licensing standards are applied equally statewide and to all licensed foster family homes and child care institutions.

The State complies with Federal requirements for criminal background clearances in licensing foster and adoptive placements. The State has developed a collaborative process with community and faith-based organizations to ensure the diligent recruitment of potential foster and adoptive families who reflect the ethnic and racial diversity of children in the State. The State has a process to use cross-jurisdictional resources to facilitate timely permanent placements for waiting children.

New Hampshire also was in substantial conformity with this factor in its 2003 CFSR and was not required to address this factor in its Program Improvement Plan.



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Table 1. New Hampshire 2010 CFSR Ratings for Safety and Permanency Outcomes and Items Outcomes and Indicators Outcome Ratings Item Ratings

In Substantial Conformity?

Percent Substantially Achieved*

Met National Standards?



Rating**


Percent Strength

Safety Outcome 1: Children are, first and foremost, protected from abuse and neglect

No


71.4


Met 2 of 2


Item 1.


Timeliness of investigations ANI 75
Item 2. Repeat maltreatment ANI 87.5

Safety Outcome 2: Children are safely maintained in their homes when possible and appropriate

No


73.8


Item 3. Services to protect children in home ANI 85

Item 4. Risk of harm ANI 75

Permanency Outcome 1: Children have permanency and stability in their living situations

No


70.0


Met 2 of 4


Item 5. Foster care reentry Strength 93

Item 6. Stability of foster care placements ANI 80

Item 7. Permanency goal for child ANI 80

Item 8. Reunification, guardianship, and placement with relatives

ANI


86

Item 9. Adoption ANI 68

Item 10. Other planned living arrangement ANI 86

Permanency Outcome 2: The continuity of family relationships and connections is preserved

No


87.5


Item 11. Proximity of placement Strength 97

Item 12. Placement with siblings ANI 88

Item 13. Visiting with parents and siblings in foster care Strength 91

Item 14. Preserving connections Strength 92

Item 15. Relative placement ANI 70

Item 16. Relationship of child in care with parents ANI 83

* 95 percent of the applicable cases reviewed must be rated as having substantially achieved the outcome for the State to be in substantial conformity with the outcome. ** Items may be rated as Strengths or as Areas Needing Improvement (ANIs). For an overall rating of Strength, 90 percent of cases must be rated as Strengths.



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Table 2. New Hampshire 2010 CFSR Ratings for Child and Family Well-Being Outcomes and Items Outcomes and Indicators Outcome Ratings Item Ratings

In Substantial Conformity?

Percent Substantially Achieved*



Rating**


Percent Strength

Well-Being Outcome 1: Families have enhanced capacity to provide for children’s needs

No


52.3


Item 17. Needs/services of child, parents, and foster parents ANI 57

Item 18.Child/family involvement in case planning ANI 66

Item 19. Caseworker visits with child ANI 86

Item 20. Caseworker visits with parents ANI 61

Well-Being Outcome 2: Children receive services to meet their educational needs

No


91.7


Item 21. Educational needs of child ANI 92

Well-Being Outcome 3: Children receive services to meet their physical and mental health needs

No


84.4


Item 22. Physical health of child Strength 98

Item 23. Mental/behavioral health of child ANI 82

* 95 percent of the applicable cases reviewed must be rated as having substantially achieved the outcome for the State to be in substantial conformity with the outcome. ** Items may be rated as Strengths or as Areas Needing Improvement (ANIs). For an overall rating of Strength, 90 percent of the cases reviewed for the item (with the exception of item 21) must be rated as Strengths. Because item 21 is the only item for Well-Being Outcome 2, the requirement of a 95-percent

Strength rating applies.

Table 3. New Hampshire 2010 CFSR Ratings for Systemic Factors and Items

Systemic Factors and Items

Substantial Conformity?

Score*

Item Rating**

Statewide Information System Yes 4

Item 24. The State is operating a statewide information system that, at a minimum, can readily identify the status, demographic characteristics, location, and goals for the placement of every child who is (or, within the immediately preceding 12 months, has been) in foster care



Strength

Case Review System No 2

Item 25. The State provides a process that ensures that each child has a written case plan to be developed jointly with the child’s parent(s) that includes the required provisions

ANI

Item 26. The State provides a process for the periodic review of the status of each child, no less frequently than once every 6 months, either by a court or by administrative review

Strength

Item 27. The State provides a process that ensures that each child in foster care under the supervision of the State has a permanency hearing in a qualified court or administrative body no later than 12 months from the date the child entered foster care and no less frequently than every 19

Systemic Factors and Items

Substantial Conformity?

Score*

Item Rating**

12 months thereafter Strength

Item 28. The State provides a process for termination of parental rights proceedings in accordance with the provisions of the Adoption and Safe Families Act

Strength

Item 29. The State provides a process for foster parents, pre-adoptive parents, and relative caregivers of children in foster care to be notified of, and have an opportunity to be heard in, any review or hearing held with respect to the child



ANI

Quality Assurance System Yes 4

Item 30. The State has developed and implemented standards to ensure that children in foster care are provided quality services that protect the safety and health of the children

Strength

Item 31. The State is operating an identifiable quality assurance system that is in place in the jurisdictions where the services included in the Child and Family Services Plan (CFSP) are provided, evaluates the quality of services, identifies strengths and needs of the service delivery system, provides relevant reports, and evaluates program improvement measures implemented




Strength

Staff and Provider Training Yes 4

Item 32. The State is operating a staff development and training program that supports the goals and objectives in the CFSP, addresses services provided under titles IV-B and IV-E, and provides initial training for all staff who deliver these services


Strength

Item 33. The State provides for ongoing training for staff that addresses the skills and knowl- edge base needed to carry out their duties with regard to the services included in the CFSP

Strength

Item 34. The State provides training for current or prospective foster parents, adoptive parents, and staff of State licensed or approved facilities that care for children receiving foster care or adoption assistance under title IV-E that addresses the skills and knowledge base needed to carry out their duties with regard to foster and adopted children




Strength

* Scores range from 1 to 4. A score of 1 or 2 means that the factor is not in substantial conformity. A score of 3 or 4 means that the factor is in substantial conformity. ** Items may be rated as Strengths or as Areas Needing Improvement (ANIs).



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Systemic Factors and Items

Substantial Conformity?

Score*

Item Rating**

Service Array and Resource Development Yes 3

Item 35. The State has in place an array of services that assess the strengths and needs of children and families and determine other service needs, address the needs of families in addition to individual children in order to create a safe home environment, enable children to remain safely with their parents when reasonable, and help children in foster and adoptive placements achieve permanency





Strength

Item 36. The services in item 35 are accessible to families and children in all political jurisdictions covered in the State’s CFSP

ANI

Item 37. The services in item 35 can be individualized to meet the unique needs of children and families served by the agency

Strength

Agency Responsiveness to the Community Yes 4

Item 38. In implementing the provisions of the CFSP, the State engages in ongoing consultation with Tribal representatives, consumers, service providers, foster care providers, the juvenile court, and other public and private child- and family-serving agencies and includes the major concerns of these representatives in the goals and objectives of the CFSP




Strength

Item 39. The agency develops, in consultation with these representatives, Annual Progress and Services Reports delivered pursuant to the CFSP

Strength

Item 40. The State’s services under the CFSP are coordinated with services or benefits of other Federal or Federally-assisted programs serving the same population

Strength

Foster and Adoptive Parent Licensing, Recruitment, and Retention Yes 4

Item 41. The State has implemented standards for foster family homes and child care institutions that are reasonably in accord with recommended national standards

Strength

Item 42. The standards are applied to all licensed or approved foster family homes or child care institutions receiving title IV-E or IV-B funds

Strength

Item 43. The State complies with Federal requirements for criminal background clearances as related to licensing or approving foster care and adoptive placements and has in place a case planning process that includes provisions for addressing the safety of foster care and adoptive placements for children




Strength

Item 44. The State has in place a process for ensuring the diligent recruitment of potential foster and adoptive families that reflect the ethnic and racial diversity of children in the State for whom foster and adoptive homes are needed



Strength

Item 45. The State has in place a process for the effective use of cross-jurisdictional resources to facilitate timely adoptive or permanent placements for waiting children

Strength

* Scores range from 1 to 4. A score of 1 or 2 means that the factor is not in substantial conformity. A score of 3 or 4 means that the factor is in substantial conformity. ** Items may be rated as Strengths or as Areas Needing Improvement (ANIs).


Final Report

New Hampshire Child and Family Services Review November 2010
U.S.

To Read the More of NH's failings go to:

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