Focusing on Quality Services for Children

Focusing on Quality Services for Children

The three children entered DSS care days before Christmas. One was in elementary school. One was a preschooler. The baby was in the hospital, just 3 days old.

Social workers with the Cleveland County Department of Social Services had to determine the next steps. Placing the children with a relative wasn’t an option. What was the best placement? Could they stay together with a foster family? What services did they need? Which home had available space?

For the past two years, a unique task force in North Carolina has grappled with ways to help Departments of Social Services make the best decisions for the thousands of children who enter the foster care system each year. Funding from The Duke Endowment supported the work.

The goal was to build effective public/private relationships – to “partner for excellence” – and provide better services for vulnerable children and families.

The System

To understand the task force and its work, it helps first to understand what happens to children after they enter the foster care system.

In North Carolina, each county has a Department of Social Services that receives reports of child abuse, neglect or dependency. In most cases, when the county DSS determines that a child is not safe at home, and a judge agrees, DSS takes custody and is responsible for finding a place for the child to live and receive services.

Across the state, the number of children entering the child welfare system is growing. If the trend continues, the total will soon reach 10,000. The length of stay varies from a few days to much longer.

The minority of children are placed in group care settings, some of which provide a highly structured, therapeutic environment. Most of the children – six of every 10 – are placed with foster families.

Foster families are recruited, trained and licensed to care for abused and neglected children temporarily. Some foster homes are supervised by county DSS offices. The majority, however, are supervised by private agencies. Those private agencies range from very small, with a handful of foster families, to large, such as Eliada Homes or Barium Springs Home for Children.

Departments of Social Services depend on those private agencies to help them place children. But experts say that selecting a home is often based primarily on immediate availability. What’s missing is a resource that would help DSS leaders make the best possible matches based on ability to meet a child’s needs.

Coming Together

With an initial grant from The Duke Endowment in 2012, the N.C. Division of Social Services and Benchmarks an alliance of nationally accredited agencies that work in child welfare, brought together public and private agencies to address the void. Leadership came from the Family and Children’s Resource Program at the UNC School of Social Work.

Partnering for Excellence asked three big questions:

  • How can the system be more discerning about where children are placed and what type of services they receive?
  • How can the system move from “Where is there an available bed?” to “How can key private agencies support DSS by providing quality placement services?”
  • How can strong public/private partnerships move the child welfare system toward higher quality services for children?

Mellicent Blythe, a clinical assistant professor with the Family and Children’s Resource Program, served as one of the facilitators. “If we’re going to improve outcomes for children in foster care,” she says, “we have to make sure the Departments of Social Services are working well with the private agencies that care for those children.”

The group focused on the idea of creating a written set of quality standards and performance indicators that would help Departments of Social Services select providers based on quality, and then make placements based on a child’s needs.

“We looked at the universe of outcomes that we could target and picked the ones that we thought were most meaningful,” says John McMahon, a clinical assistant professor with the Family and Children’s Resource Program. “I think the biggest take-away for DSS was that they can be a driving force in what’s available, rather than feeling they just have to take what they can get.”

The resulting product was a 60-page document, or “toolkit,” that consists of questions that help establish standards for how private agencies perform. It’s divided into sections, with questions about performance and services. The idea is for Departments of Social Services and private agencies to collaborate on expectations.

 “If I’m a social worker and I have a 10-year-old who comes into care at 3 p.m. on a Friday and I start calling private agencies because I need a place to put this child, the situation is somewhat crisis-driven,” Blythe says. “This guide helps create a working relationship between DSS and the private agency, which will help us get to a point where the social worker will have a list of agencies that have agreed to meet a set of standards.”

By tracking and measuring outcomes and identifying which agencies are providing quality services, DSS teams have the means to be more discerning when choosing where to send a child.

Piloting the Product

The toolkit was put to the test with teams in three N.C. counties: Caldwell County DSS and Barium Springs Homes for Children; Cleveland County DSS and Children’s Homes of Cleveland County; McDowell County DSS and Alexander Youth Network. This “learning community” met three times over eight months, with county-specific meetings and coaching between. Funding from The Duke Endowment paid for the Center for Child and Family Policy at Duke University to evaluate the process.

Feedback was positive. In all three counties, participants agreed that using the guide was critical to enhancing outcomes.

“At the first meeting, when all those pages were in front of me for the first time, I thought, ‘I don’t have time to commit to this,’” says Alison Clark, child welfare program manager with Cleveland County DSS. “But it was so beneficial just to come together and look at things differently and focus on what’s best for the kids. I felt really fortunate to be a part of the work.”

Margie Christopher, executive director at Children’s Homes of Cleveland County, agrees.

“The Departments of Social Services are charged with taking care of children to the best of their abilities when those children cannot be in their own families,” she says. “The departments need to make good decisions about where the children are placed and the kinds of services they receive. This tool gives them the information they need to make those good decisions.”

Leaders hope to keep the project moving forward by giving additional counties an opportunity to use and test the guide and, ultimately, making it available in the child welfare field.

Contact Us

Tamika D. Williams
Associate Director, Child Care
704.969.2115 

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Related Work

Area of Work

  • Out-of-home care for youth

Program Area

  • Child Care

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  • Prevention and early intervention for at-risk children

    To equip children and families with skills to ensure that children reach developmental milestones to lead successful lives.

  • Out-of-home care for youth

    To drive child welfare systems toward greater accountability for child well-being.

  • Quality and safety of health care

    Improving the quality and safety of health care delivery

  • Access to health care

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  • Prevention

    Expanding programs to promote health and prevent disease

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  • Congregational outreach

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