hsa

Yesterday I attended a Core Team Meeting for the System Improvement Plan (SIP) for San Francisco’s Human Services Agency (HSA). According to law, each country must submit their data to a statewide system (http://cssr.berkeley.edu/ucb_childwelfare/), analyze the outcomes and then compare the data to federal measures. If San Francisco does not achieve the federal standards, those areas needing improvement will be addressed in the SIP.
The SIP is completed ever 3 years and has several phases of self and external peer assessment. The 2010 SIP is the second SIP San Francisco has developed. Counties have 3 years to improve outcomes in selected areas. During the 2009 assessment cycle, San Francisco identified 3-4 issues on which to focus.

• Child Welfare:
o Recurrence of Maltreatment
o Re-entires of Children into Foster Care
o Timeliness to Adoption
• Juvenile Probation
o Utilization of Least Restrictive Placement Options

During the meeting the team learned specifics about these measures and why they were chosen. HSA must prioritize safety over other factors, and need to keep budgets and creative solutions in mind as well. San Francisco is moving towards the implementation of evidence based practices, and considering eliminating older and non-data driven programs. They are looking to improve cross-systems communication and relationships, especially with the dependency courts.
During the meeting, the presenters discussed how the improvement of an issue might actually affect another data point negatively, causing a failure to meet standards. For instance, in order to adopt children as fast as possible, it is necessary to terminate parental rights. However, if a county terminates rights too early, the child can no longer legally reunify with their parents, making reunification measures worse for the county. Also, if parental rights are terminated without a committed adoptive family, or if the adoption fails, a child may be left a legal orphan, which is an unsavory position for both the county and the child. Another seemingly conflicting problem discussed was that while HSA values placement stability, they value permanence more. Therefore, when youth who have been in care over 24 months, HSA attempts to have them ‘step-down’ to less restrictive placements to prepare them gradually for reunification, adoption or other types of permanence. In these cases, an improvement in permanence indicators means a decline in placement stability statistics.
During the next meeting of the SIP Core Team, the focus will be on child welfare and timeliness to adoption. During this meeting, the team plans to discuss strategies to improve this measure, by reviewing current practices and initiatives and considering creative and evidence based solutions. Expect a SIP update next week.