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November 20, 2013 California - Child and Family Services Review County Self-Assessment JUNE, 2013 – SEPTEMBER 2013 ---PAGE BREAK--- STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES 1 California - Child and Family Services Review Table of Contents INTRODUCTION PAGE 2 C-CFSR PLANNING TEAM & CORE REPRESENTATIVES. PAGE 3 DEMOGRAPHIC PROFILE PAGE 18 PUBLIC AGENCY CHARACTERISTICS PAGE 18 STATE AND FEDERALLY MANDATED CHILD WELFARE/PROBATION INITIATIVES PAGE 23 BOARD OF SUPERVISORS DESIGNATED COMMISSION, BOARD OR BODIES PAGE 24 SYSTEMIC FACTORS PAGE 25 PEER REVIEW SUMMARY PAGE 29 STATE-ADMINISTERED CWS/CMS SYSTEM CASE REVIEW PAGE 32 OUTCOME DATA MEASURES PAGE 32 SUMMARY OF FINDINGS PAGE 35 ATTACHMENTS C-CFSR SIGNATURE SHEET ATTACHMENT A ---PAGE BREAK--- 2 California - Child and Family Services Review Introduction Alpine County Department of Health and Human Services (ACHHS) is the designated agency to facilitate the development of Alpine County’s Child and Family Services Review (C-CFSR), both its County Self-Assessment (CSA) and the System Improvement Plan (SIP). ACHHS implemented the CSA process in close collaboration with the Child Abuse Prevention Council), the Children’s Trust Fund Commission, representatives of the Washoe Tribe, parent/consumers and virtually all responders and service providers, including both private and public agencies and department representatives who have a role in the prevention, early intervention, and prosecution of child abuse and neglect in Alpine County. The purpose of the C-CFSR, overseen by California Department of Social Services (CDSS), is to conduct a system-wide assessment to inform priority needs and outcome improvement efforts over the next five-year cycle to support continuous quality improvement in local child welfare efforts. Alpine County’s CSA report describes the results of its county-wide assessment process which solicited input from core representatives across the service and response spectrum and comprehensive data from public and private service agencies. As one reads Alpine County’s CSA report, it is important to keep in mind the county’s extremely small population size of approximately 1,000 residents, and its commensurately small and statistically insignificant number of child welfare cases. The small service population makes it difficult to support a robust set of providers and services. It ensures each service category will comprise a very small number of clients relative to larger counties. Alpine’s small population size also means that statistically significant demographic and service outcome changes are slow to emerge, and virtually impossible to demonstrate except over a period of many years. ---PAGE BREAK--- STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES 3 California - Child and Family Services Review C-CFSR Planning Team & Core Representatives Alpine County’s Family Support/Child Abuse Prevention Council (CAPC) functions as Alpine County’s Self-Assessment team to oversee, with DHSS, the C-CFSR assessment and planning processes and to help ensure continuous quality improvement throughout the 5-year plan period. The CAPC is comprised of many of the required core members and agencies, and was augmented for assessment and planning purposes with additional representatives of the community and service population. In its role as the C-CFSR Planning Team, the CAPC helped examine and provide input regarding Alpine’s at-risk populations and service needs by assisting with the planning for the CSA Stakeholder’s meeting, encouraging community participation at the meeting, providing extensive input by its members during the Stakeholder’s meeting, initiating and providing additional input during its own CSA focus group and Strategic Planning Sessions. In addition, CAPC reviews and provides feedback on both the CSA Findings and SIP reports. Working with Alpine County DHHS, CAPC will take major responsibility for SIP implementation. This will include recommending programs/services for funding based on the CSA findings and SIP, and assisting with the monitoring of service outcomes. The full roster of Alpine County’s community representatives and service providers involved in the CSA feedback sessions and processes is comprised of the following: Washoe Tribe Geoff Ellis, Hung-A-Lel-Ti Community County, Chairman, Washoe Tribe Rhonda Medicine Crow, Truancy Officer, Washoe Tribe Dinah Pete, Hung-A-Lel-Ti Community member, Washoe Tribe Donna Miller, Case Manager, Washoe Tribal TANF Richard Varner, Captain, Washoe Tribe Police Department Suzanne Garcia, Assistant Counsel, Washoe Tribe Alpine County Department of Health and Human Services (DHHS) Janel Morales, Fiscal & Technical Specialist Becky Thornburg, Public Health Nurse Lynette Bennett, Nurse David Hathaway, Social Work III Mathieu David, Social Worker III Elyse Niemann, Workforce Development Specialist Nichole Williamson, Director ---PAGE BREAK--- 4 California - Child and Family Services Review Alpine County Behavioral Health Services Amy Broadhurst, Mental Health Services Act Coordinator Kim Kilgore, Clinician Nick Agnason, AOD Counselor Alpine Office of Education Cheri Warrell, Program Coordinator; Director, Alpine Early Learning Center; Chair Alpine CAPC Probation Department and District Attorney’s Office Sara Center, Victim-Witness Coordinator Alpine County Board of Supervisors Ron Hames, Supervisor Mary Rawson, Supervisor Community-based Partners John Fisher, Executive Director, First Five Rachael Brothers, Program Coordinator, Choice for Children Betty Hathaway, Mentor Coordinator, Tahoe Youth and Family Services Alissa Norse, Executive Director, Tahoe Youth and Family Services Heather Knox, Advocate, Alpine Live Violence Free Bear Valley Parents Group Consumer/Parent Representatives Anna Brit Spears, Consumer/Parent, Alpine County CAPC and Mental Health Board Adelina Osorio, Alpine County Mental Health Board Members of Washoe Tribal Council and Community CDSS staff and Peer Reviewers David Brownstein, Outcomes and Accountability, CDSS Patricia Harper, Program Consultant, OCAP Sandra Villapardo, Social Worker II, Mono County Patty Moley, Program Manager, El Dorado County Health & Human Services ---PAGE BREAK--- STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES 5 California - Child and Family Services Review THE CSA PLANNING PROCESS & PARTICIPATION OF CORE REPRESENTATIVES For its CSA process, Alpine County gathered input from across the spectrum of core representatives (listed above) and various service agencies generating new and extant data from both public and private partner agencies to develop a comprehensive picture of Alpine County’s child welfare system. Input from county-wide core representatives and existing data were collected via six methods, including: 1) Three focus groups convened between July 17 and August 5, 2013, one each with the Washoe Tribal Community, Bear Valley Community, and the Child Abuse Prevention Council which serves as the C-CFSR Planning Team; 2) A full-day, facilitated CSA Stakeholder’s Meeting on June 5, 2013 to garner county- and discipline-wide input regarding assets, challenges, and potential improvement strategies for Alpine’s child welfare and probation services from core representatives; 3) Collection of current demographic data; 4) Collection of 2010 census data, and state and local child welfare and juvenile delinquency-related data; 5) Comparison analysis of the demographics, needs and strategies identified during the 2013 CSA process with outcomes identified in the 2010 CSA and SIP reports; 6) In collaboration with CDSS, peer review of child welfare and probation practices and potential improvements in same. AGGREGATED FINDINGS – ASSETS, NEEDS, GENERAL COUNTY DEMOGRAPHICS, CHILD MALTREATMENT INDICATORS, AND CHILD WELFARE AND PROBATION POPULATION DATA The following aggregated findings derive directly from the six data collection methods described in the above section, including four CSA input sessions. These sessions were designed and facilitated to generate county-wide, multi-disciplinary input regarding Alpine County’s assets and unmet needs, and potential solutions to address challenges mitigating the welfare of its children. Original data and input to inform the CSA were collected from a total of 71 participants, comprised of 42 community members and 31 core representatives of Alpine County. The first CSA Stakeholder s’ Feedback Session was held on June 5, 2013. It took the form of a full-day county-wide, cross-disciplinary meeting in Markleeville, facilitated by an independent consultant and attended by 31 participants from across the county responders and service providers from both private and public agencies, elected officials and community leaders, program administrators, and parents/consumers from both the general community and key members of the Washoe Tribal Council and Community. In addition, three Focus groups were held one each with the Washoe Tribal Council and Hung-A-Lel-Ti Community (August 5, 2013; attended by 27); Bear Valley Community and Parents Group (July 15, 2013; attended by 15); and the Child Abuse Prevention Council August 7, 2013; attended by eight members) which utilized the preliminary CSA findings as a basis for its input and strategic planning. In addition, CAPC members ---PAGE BREAK--- 6 California - Child and Family Services Review participated actively in the Stakeholder’s meeting in June, greatly informing the conversation and their own understanding of the key issues. CAPC’s feedback is incorporated along with the other Stakeholder’s in the following aggregated findings regarding Alpine’s CWS-related assets and challenges. ASSETS AND SERVICES Alpine County’s small population size of approximately 1,000 residents (2010 Census; CA Department of Finance, 2012) offers the potential of being able to get “arms around the problems”, to identify and reach virtually every child and family in need. From the perspective of CWS professionals and their partners, its small population size provides Alpine County an opportunity for meaningful collaboration and timely identification and resolution of both system- and client-related issues and challenges. CWS and law enforcement are on a first name basis and routinely join together via simple phone call for response and investigation purposes.) [Its small size also poses considerable resource and access-related challenges to optimal service provision.] The few numbers of staff comprising each department tend to wear multiple hats, making it feasible (albeit, sometimes necessary) for them to understand issues comprehensively, and intercede cross-disciplinarily. The Washoe Tribal Community possesses a strong, cultural heritage of caring for one another. The Washoe Tribe’s Woodfords Indian Education Center offers integrated services under a one roof, through a single point of access – after-school tutoring, library, gardening, summer food programs. Washoe Community is recipient of a Family Justice Center grant. A strong Tribal Council leadership is in place. AA meetings are available for the Washoe Community at the Healing Center in Dresslerville. Neighbors (and CWS clients) throughout the county have some potential to rely on one another for transportation and support car pool system). CWS and partner staff do attempt to provide services and outreach at the point of need when feasible go to the client, rather than vice-versa). “Dial-a-Ride” transportation provided by Alpine County for Washoe Tribe members from Gardnerville, Nevada to Alpine County health and social services is available on a limited basis three days a week (Mon, Tues, and Wed) from 9am-5pm. Collaboration and relationships among ACHHS and county-wide public and private service providers have never been better. Relationships and collaboration with the Washoe Tribe have improved greatly since 2010. The potential for continued progress is excellent. ACHHS has hired an outside legal expert to facilitate resolution to Tribal and federal obstacles that often block services for abused and neglect children and their families due to jurisdictional constraints. The resolution is intended to result in a Jurisdictional MOU between the Tribe and ACHHS to guide and support enhanced prevention, intervention, and healing services for Tribal members. ---PAGE BREAK--- STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES 7 California - Child and Family Services Review New county leadership at numerous levels– elected officials, ACHHS/CWS executives, Washoe Tribe , CAPC, and several community-based organizations – provides fresh opportunity and expertise to further the well-being of Alpine’s children and families. ACHHS’s recently-developed CWS Multi-disciplinary Team now reviews every child abuse and neglect report, monitors each case over-time, provides consultation and resources to the case social worker, offers a venue for county- wide case collaboration, and a key vehicle for continuous quality improvement. The responding social worker is an experienced, skilled social worker who has been with the department for three years, and has over ten years’ experience in King, Tulare, and El Dorado Counties. With support from ACHHS, Child Abuse Prevention Council and its mission to focus attention on prevention and early intervention of child abuse and neglect has been re-energized over the past two years. All members of the MDT, except the Adult Protective Services Social Worker, are members of the CAPC. NEEDS AND CHALLENGES - CORE REPRESENTATIVE INPUT, COUNTY DEMOGRAPHICS, AT-RISK POPULATIONS, CHILD MALTREATMENT INDICATORS, AND CHILD WELFARE AND PROBATION POPULATION DATA The following categories and descriptive bullets describe Alpine County’s challenges and needs, including those related to county demographics and child maltreatment indicators. They derive from the four CSA feedback sessions (focus groups and Stakeholder’s meeting), as well as from 2010 Census data, Alpine County agency data and input. DEMOGRAPHICS When reviewing the CSA report – its process and findings, as related to demographic and other data, it’s essential to consider that Alpine County is entirely rural and home to a scant 957 residents living across 738 square miles. It is the least populated county in the State of California. Given that context, and a lack of adequate data, its demographics are almost imperceptible when viewed on a year-to-year basis. As indicated in the introduction of this report, Alpine County’s small population of less than 1,000 persons makes trend analysis, the meaningful tracking of changes in demographics, risk factors, and outcomes virtually impossible except over significant periods of time. ACHHS attempted to utilize the Annie E. Casey Foundation data collection program Kids Count for the CCFS, however many of the fields were listed as “N/A” due to lack of data. ---PAGE BREAK--- 8 California - Child and Family Services Review General Population and geographic factors Alpine County is located in the Central Sierra Nevada mountain range and straddles both the east and west slopes of the Sierra Nevada mountain range. The County encompasses 738 miles. According to Alpine County QuickFacts from the U.S. Census Bureau (http://qucikfacts.census.gov) the population in 2010 was 1,175 in 2010. In 2012 it was estimated at 957 - 1,129, depending on the source. Regardless of the precise population number, Alpine County remains the county with the smallest population in California. With a population of less than two persons per square mile, it is still considered a “frontier” county. Ninety-six percent (96%) of the county’s territory is designated “public land”, managed by the U. S. government’s Department of Agriculture, Forest Service, and Bureau of Indian Affairs. Alpine County has no incorporated cities; instead, it comprises five distinct communities: On the eastern slope are communities of Hung-A-Lel-Ti (Southern Band of the Washoe Tribe) with a population that varies seasonally from 175 to 204; Markleeville, which is the county seat, with a population of 200; Woodfords, population 170; and Kirkwood recreation and ski resort, with a population of 96. On the western slope is the Bear Valley community, with a population of 133. The three most populated areas of Alpine County – Markleeville, Kirkwood, and Bear Valley are geographically distant and isolated from one another; it is virtually impossible to share or access services among the three communities, especially during the winter months. Alpine County has no stoplight, no grocery store, no bank, no hospital, and no pharmacy. All highways have but two lanes, except for an occasional passing lane. All of the major highways in Alpine County were originally Native American foot paths. According to the 2010 Census, the ethnic composition of Alpine County’s total population is: Caucasians 68%; Native Americans 22.5%; Latino’s 8.4%; and “other” 4.5%. Alpine County Office of Education reports that currently (September 2013) a total of 90 students are enrolled in the three schools in Alpine County. Forty two percent (42%) of the students are Native American and fifty eight percent (58%) are Caucasian. This indicates a higher child Native American population when compared to the general population. English is the predominate language in Alpine County with few members of the Washoe Tribe speaking Washoe, but it is not their primary language. The average median income in Alpine County is $32,159 which is comparable to the state average of $29,188. In August 2013, the California Employment Development Department reported that the unemployment rate was 10.9% with a total labor force of 410 workers with 370 employed and 50 unemployed. ---PAGE BREAK--- STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES 9 California - Child and Family Services Review Washoe Tribal Community Profile, History, and CWS Jurisdictional Challenges The Southern Band of the Washoe Tribe is the only federally recognized Native American tribe in Alpine County. It is a tribe with a long history of significant trauma at the hands of Caucasian settlers whose tactics disbursed and destroyed families and the Tribe’s community structure. Hung-A-Lel-Ti Washoe Tribe community of Alpine County comprises 80 acres of 30 single housing units, a community center and recreational facility. It is under the jurisdiction of the Washoe Tribe of California and Nevada and the Bureau of Indian Affairs. However, Public Law 280 does impact the Hung-A-Lel-Ti community. Public Law 280 was mandated to six states, including California, in 1953. Because the mandate did not include federal funding for mandated services other states disputed the mandate. As a consequence, Public Law 280 is optional in other states including Nevada; but remains mandated in California. The Washoe Tribal is comprised of four communities, only one of which is in California. The Hung-A-Lel-Ti community is located in Alpine County the other communities are located in neighboring Nevada. The Nevada communities include, Dresslerville, Carson, Stewart and Reno Colonies. The Washoe Tribal headquarters are located in Dresslerville, Nevada. The Washoe Tribe has occupied areas of Alpine County for hundreds of years; and the Washoe Tribal Community’s impact on Alpine County is difficult to overstate. Alpine County and the Washoe Tribe have a long history of challenging relationships, especially related to historical trauma and child welfare issues. In 1995, the Washoe Tribe petitioned the federal government for exclusive jurisdiction of Washoe children in Alpine County and it was granted in 1996. Since that time Alpine County and the Washoe Tribe have not been able to obtain and sustain an operational agreement for services. For the past year, Alpine County and the Washoe Tribe have been working with an Indian Child Welfare Act attorney to create a Memorandum of Understanding. The MOU is currently in draft and awaiting approval by the Woodfords Community Council and Alpine County Board of Supervisors. According to 2012 child abuse report data, of the 34 children reported as potentially abused, 15 or 44% were from the Washoe Community. Washoe children comprise 56% of the county’s children. All Washoe-related referrals were turned over to the Washoe Tribe for follow-up. Cases involving Washoe children must, by law, be referred to Washoe Tribal Social Services. Alpine County CWS has no jurisdiction over those referred children, with no ability to follow up or pursue the outcome of the referral. ---PAGE BREAK--- 10 California - Child and Family Services Review The only notable demographic differences and risk factors among regions in Alpine County are those between the Tribal Lands and the rest of the county. However, as indicated above extant data indicate the proportion of child welfare-related cases is approximately the same for the general Alpine community and the Washoe Tribal Community. The latter represents 56% of the children in the county, and 44% of the total referrals for child welfare-related issues. The pressing challenge remaining is Alpine County’s lack of jurisdiction over Washoe families and children. Forbidden to reach out to them to provide or require follow-up, Alpine County DHHS and other county and community-based services are available to Washoe’s children and families only upon request by a family. The Washoe Tribe has a fully developed Child Welfare Services program and Tribal Court. Additionally, the Washoe Tribe has a Tribal Temporary Assistance to Needy Families (TANF) Program. Family Structure Alpine County does not maintain statistics on the number of homes that are headed by single parents or grandparents for either the general community or the Washoe Tribe. Many households on tribal lands are multi-generational including grandparent, parents, aunts, cousins and children. Because Alpine County has no hospitals, official births do not take place in Alpine County. Teen pregnancy rates for those who reside in Alpine County but give birth elsewhere are not known, however through the Public Health Department data indicates there has been a three hundred percent increase (from none to 3) in teen births since the last County Self-Assessment. Poverty, Unemployment, Under-employment An accurate, official count of the number of children and families living in poverty is difficult to obtain. There are currently only four non-Native families receiving CALWORKS. The Washoe Tribe operates their own Social Services program and members are eligible for Tribal Temporary Assistance for Needy Families. There are 25 families with 67 individuals in 16 households receiving Tribal TANF. There are 87 families and 156 individuals currently receiving CalFresh through ACHHS. Alpine County average household median income $59,018 is relatively close to the California average of $61,632. The average home value in Alpine County is $395,600, with a state average of $421,600. While many Alpine County residents income is equal to the state average, there is major disproportionality of income among many residents. Poverty and unemployment are especially hard-felt in the Washoe Tribal Community. Those living in poverty are often trapped in the high-stress spiral of not having economic resources. ---PAGE BREAK--- STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES 11 California - Child and Family Services Review Professionals who work in Alpine County often live in the adjacent counties in El Dorado County or the State of Nevada taking the benefits of their educational and economic resources with them at the end of the work day. Of the 90 students children registered in Alpine County schools, approximately 63% receive free and or reduced lunch. Few employment opportunities exist in Alpine County outside of public sector work. This is especially true on Tribal Lands. Those few who do find employment, work for the County, the School District, or seasonally at Alpine’s two ski resorts. Seasonal employment in Alpine County, when accessible, usually requires different skill sets to qualify for summer or winter jobs. Accordingly, employment is temporary and unstable those who find employment for a portion of the year will often be unemployed for the rest of it. Education Most of Alpine County’s children have virtually no access to summer educational/recreational enhancement programs which might help enhance their educational experience and outcome, their chances of graduating from high school, and their employment opportunities as adults. Alpine County’s three year average graduation rate (2009 – 2011) is 92.9%, compared to the state average of 95.7%. For the Tribal Community, the rate is 87.5%. Those who do not graduate high-school find it very difficult to be economically viable adults and parents. Of the approximately 90 children enrolled in Alpine County’s three schools, approximately 25% are enrolled in Special Education. 42% of Diamond Valley’s students are Native American; 58% are Caucasian. 20 Alpine County High School students in grades 10- 12 are enrolled at Douglas High School and 12 enrolled in grade 9 at Pau-Wa-Lu Middle School, both located in Gardnerville, NV. An additional ten (10) children, grades K-12, who reside in Bear Valley, attend Calaveras County schools. There are approximately 10 Alpine County children who are reported as being home schooled. California DOE indicates no children are home schooled. We have no data from the Washoe Tribal Community. Alpine Department of Education provides the state preschool program to four children. Housing Alpine County offers little by way of affordable, acceptable housing for the average consumer who lives mainly at subsistence level. There is no Section 8 housing in Alpine County. ---PAGE BREAK--- 12 California - Child and Family Services Review Alpine’s trailer park, located in Woodfords, has historically been considered a “slum”. Now under new ownership and management, it is undergoing significant renovation. A more rigorous screening has resulted in tenants who are employed. Rents have increased. Most of the previous tenants have moved out. There are currently no vacancies. Few houses are for sale in Alpine County. When they are available, houses typically sell in the range of $350,000-$500,000; rents are high for small, run-down housing – averaging, $1100-$1200 for per month. Tribal Community’s housing authority has long wait-lists of three to seven years to access affordable housing. Limited number and high cost of housing often force multiple families to live under one roof. This is especially common in the Tribal Community. Transportation Alpine County’s transportation options and availability are very limited and insufficient to mitigate the isolation of many of its most needy families and children. The virtual lack of public transportation and the long driving distances make it virtually impossible, even for those with private transportation options, for clients to adequately access social services, employment, and other needed support resources. People attempting to access services at the Washoe Tribal Headquarters have some transportation assistance through the County’s Dial-a-Ride program in and out of Gardnerville, Nevada. However, the program only operates three days a week from 9am-5pm, and is often interrupted during the winter months due to poor weather. ---PAGE BREAK--- STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES 13 California - Child and Family Services Review CHILD MALTREATMENT INDICATORS Below is a chart detailing child abuse referrals in Alpine County from 2010-2012. Allegation 2010 2011 2012 Sexual Abuse 6 4 3 Physical Abuse 4 7 4 Severe Neglect 0 0 0 General Neglect 20 15 20 Exploitation 0 0 0 Emotional Abuse 1 2 2 Care taker Absence/Incapacity 1 4 2 At risk, sibling abused 0 0 0 Substantial Risk 0 0 0 Missing 0 0 0 Total referrals 32 32 34 As evidenced by the chart above, utilizing data from CWS/CMS there has been no substantial statistical change in child abuse referrals or the allegations in the past three years. Isolation Isolation of families and their children from community supports and services is a persistent challenge in Alpine County, as it is in most rural regions throughout California. Geographic (and cultural) isolation work against identification and remediation of important family problems. While some choose to reside in Alpine County for its exquisite scenery and the serenity of its wide-open spaces, others are attracted to its built-in isolation seeking a place to keep dark family secrets like substance abuse, domestic violence, and child abuse hidden from outside intervention. Families with child abuse and neglect issues, including those with prior contact with other counties’ CWS, may move to Alpine County to avoid attention and intervention. ---PAGE BREAK--- 14 California - Child and Family Services Review Child Care The Alpine County Office of Education provides the only licensed child care in the county. The ACOE operates a state preschool program at Diamond Valley Elementary School. There are four children enrolled in the preschool for the 2013/2014 school year. Children enrolled in the state preschool program may ride the regular school bus to the program. The program operates on a school schedule, but is not operative during the summer or school breaks. After-school and summer break recreational and educational programs are quite limited in Alpine County leaving many children of all ages vulnerable to inadequate supervision, educational assistance, opportunity, and protection. The Alpine County Office of Education provides an after school program at Diamond Valley School and an after school tutoring program is available at the Woodfords Indian Education Center. During the summer break of 2013, multiple community organizations collaborated to offer enrichment programs to Alpine County children. Tahoe Youth & Family Services and Alpine County Behavioral Health Services collaborated to provide a weekly activity for all children. The Woodfords Indian Education Center provided a summer meal program for all but three weeks of the summer. Alpine County Health & Human Services, Behavioral Health Services, and Live Violence Free provided a summer food program during the additional three weeks with very short notice. Additionally, the Woodfords Indian Education Center provided a summer gardening program, library program, and math and science enrichment. Alpine County Behavioral Health Services provides a summer art program for youth and a summer reading program at the Alpine County Library. The Bear Valley Parents Group provided a summer camp for 13 children with recreational and educational activities. Licensed child care is virtually unavailable in Alpine County. Families needing child care must usually rely on neighbors or unlicensed day care situations which can be unreliable at best and, at worst, potentially abusive. In Bear Valley, the child care program is located in a county-owned building, made possible through funding from ACHHS. But the child care program must vacate the premises when the building is rented for a special event and three-weeks during the summer for the annual Music Festival. Social Services – prevention and early intervention While parenting programs are offered by several community-based organizations including Tahoe Youth and Families and Bear Valley Parents Group, the community indicates more parenting classes, parent support groups, life skills training for budgeting and employment purposes, home-visiting programs, substance abuse programs, and domestic violence programs are needed throughout Alpine County. Where parenting classes do exist, access may be hindered by limited offerings at limited times inadequate transportation, and lack of child care. Clients of previous parenting programs, such as “Kid Power” and “Transformative Parenting” considered them very valuable, but also indicated a high rate of turn- ---PAGE BREAK--- STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES 15 California - Child and Family Services Review over and transience among counselors and other service providers which made it difficult to maintain consistency of trust and relationships and may have led some clients to drop out of programs. Continual focus on cultural relevance and inter-cultural respect in all response and service-related interactions and programming is needed. Tahoe Youth and Family Services (TYFS) offers a number of services to prevent and intervene in child mal-treatment, including: Individual, family and group mental health counseling; individual and group substance abuse treatment; mentoring; supportive services for RHY and high-risk youth; shelter via host homes, 24-hour crisis line; and several educational outreach programs for males and females offered in schools to prevent AOD use and abuse and relationship violence. Health Care, including low weight births and births to adolescents While the communities of Bear Valley, Kirkwood and Woodfords do have health clinics, most residents must travel out of county for comprehensive health care services. Alpine County does not have a hospital. Hospital emergency room data regarding non-accidental injuries are not available. All Alpine County residents give birth in another county or state. Data on births to teens and low weight births are not available. According to the Alpine County Public Health Nurse, virtually all children enrolled in Alpine County’s three schools receive all their immunizations. Data for children who reside in Alpine County, but attend school outside the county, are not available. Domestic violence, substance abuse, and mental health services are provided for Alpine County residents by Behavioral Health Services, Tahoe Youth and Family Services, and Live Violence Free. However, CSA Stakeholders voiced concern that Alpine County probably needs to expand both services and outreach to reach more persons who suffer in isolation from these issues. MENTAL HEALTH Behavioral Health Services provided mental health counseling services, in both group and individual settings, to 48 clients in 2012. Domestic Violence Live Violence Free served 38 Alpine County clients in FY2012-2013 with a variety of services through its Lake Tahoe facilities, including: emergency shelter for up to 90 days; transitional housing for up to 18 months; advocacy and/or accompaniment through legal and medical proceedings; 24 hour hotline and crisis ---PAGE BREAK--- 16 California - Child and Family Services Review intervention counseling; emergency clothing, food, and transportation; and referral to other service providers. In 2012, Tahoe Youth and Family Services provided 11 male and female high- school students with education and support group discussions to curb relationship violence. Substance Abuse Behavioral Health Services provided substance abuse counseling and out-patient treatment services to eight clients in 2012. In 2012, Tahoe Youth and Family Services provided 35 youth with individual and group substance abuse treatment; and provided school-based AOD prevention education to 10 students through its Project Alert. Child Abuse and Neglect Reporting, Response, and Prevention While under-reporting persists in all counties, it is most prevalent in rural communities for reasons associated with all the challenges listed in this document. There may be significant under-reporting of child abuse and neglect in Alpine County and perhaps the Washoe Tribal Community as well. 34 cases of abuse and neglect were reported in Alpine County in 2012. Reporting throughout the county may be inadvertently discouraged due to lack of knowledge and, until recently, the lack of regular mandated reporter trainings. Reporting is also unintentionally mitigated because, in a small rural county, “everyone knows everyone else” and neighbors, friends, and family are especially hesitant to make reports. It is unclear how much mandated reporter training takes place within the Tribal Community. Tribal social service providers and responders are invited to the County’s annual training sessions. There is concern that under-reporting may be especially significant in the Tribal Community, perhaps linked to cultural isolation issues, county CWS’s lack of jurisdictional access under federal law, and the under-utilization of county social and behavioral health services by residents of the Tribal Community. Alpine’s CAPC is a cross-disciplinary group which serves as the C-CFSR Planning Team. It has undergone considerable development over the past several years. With continued administrative support by Alpine County DHHS, it has expanded its membership to represent the key elements of the child welfare and prevention community and now includes representatives from each of the service-providing agencies, the Office of Education, law enforcement, child care, the community at- large, parents, the Washoe Tribal Nation, county DHHS, and Behavioral Health Services. In the past year, the CAPC has engaged in comprehensive strategic planning, sponsored several important trainings including “Bridges Out of Poverty” and “Father Engagement”, “Mandated Reporter Training”, and initiated a child abuse prevention awareness campaign. The CAPC, based in part on the CSA analysis, makes recommendations to DHHS regarding which prevention and early intervention services are most needed and deserving of funding and support. ---PAGE BREAK--- STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES 17 California - Child and Family Services Review CHILD WELFARE AND PROBATION POPULATION Child Welfare Alpine County’s Child Protective Services social worker has worked in the county for three years. The social worker’s primarily responsibility has long been to provide intensive services to families to avoid referrals or opening a case. With the initiation of the MDT and new leadership at ACHHS, consistent with some of the findings of the CSA Peer Review, this historic emphasis on not opening cases is undergoing scrutiny and may change. Please refer to the chart and analysis on pages 12 and 13 for additional information. Probation Department The Probation Department of Alpine County has only one, part-time officer the Chief Probation Officer, Gordon Morse. There are currently no active probation cases or placements in Alpine County, nor have there been any cases since the last County Self- Assessment. No significant changes in data or trends have been identified since the last CSA was completed in 2010 STAKEHOLDER’S PRELIMINARY RECOMMENDATIONS FOR SIP CONSIDERATION The CSA findings point to a number of major challenges which significantly impact Alpine County’s child welfare services and outcomes for at-risk children and families throughout the County, including the Washoe Tribal Community. These are offered consideration, and potential prioritization and planning by the C-FSR Stakeholder’s Group, as follows: Improve the effectiveness of two-way communication, collaboration, and service delivery among CWS, its partners, and the Washoe Tribal Community to enhance services and improve outcomes for Washoe Tribe’s at-risk children and families. Finalize and implement the Memorandum of Understanding currently under development to remove unwanted constraints on services to at-risk children and families living on Tribal lands within Alpine County. Increase services and enhance strategies to address more effectively the inter-related issues of substance abuse, domestic abuse and poverty. Increase early identification and reporting in school and child-care settings of child abuse and neglect through enhanced education and awareness. Develop and support licensed child care, after-school and summer programs throughout the County. Increase outreach education and services to prevent, identify and heal child sexual abuse throughout the County. Improve access to affordable, acceptable housing. ---PAGE BREAK--- 18 California - Child and Family Services Review Enhance transportation options to support employment, child care access, social service access, and CWS response effectiveness and client compliance. Continue to monitor child and family outcomes and to enhance scrutiny of each child abuse and neglect report and case disposition through continuous and effective utilization of Alpine County CWS’s Multi-disciplinary Team. Demographic Profile COUNTY DEMOGRAPHICS, CHILD MALTREATMENT, CHILD WELFARE AND PROBATION POPULATION All of these data are included in or attended to within the aggregated findings section of this report. Public Agency Characteristics POLITICAL JURISDICTIONS The Board of Supervisors is the only governing entity in the County. There are no incorporated cities or towns. The county seat is located in Markleeville, an unincorporated town. Given the small staffing numbers, commensurately small budgets, and vast geographic are to cover, all Alpine County public agencies are stretched very thin. This is especially problematic for law enforcement and the Probation Department. The County Department of Health and Human Services and Behavioral Health Services are Alpine County’s primary public providers of child welfare services. Considerable progress has been made toward meaningful collaboration between the two agencies since 2010. The Probation Department is a member of the CWS MDT, and called on to participate on a case-by-case basis. Given that the Probation Department has only one officer – the Chief Probation Officer – and no current placements, its engagement in the CWS process is limited. The Probation Department, per Public Law 280, has jurisdiction under the State of California on tribal land in civil and criminal matters. ---PAGE BREAK--- STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES 19 California - Child and Family Services Review Alpine County Sheriff’s Department, with its 13 sworn officers and independently elected Sheriff, works very closely with ACHHS and all aspects of CWS response and investigation. It is very common for the ACHHS social worker and law enforcement to accompany one another on response calls and to share case information as appropriate. The Sheriff’s Department is a member of the CWS MDT, and attends meetings on a case-by-case basis. Alpine County law enforcement and courts have jurisdiction over criminal cases involving Washoe Tribal members that take place off of tribal land. The Alpine County Office of Education (ACOE) and Alpine County School District overseen by its Alpine County School Board, which employs one Superintendent of Schools for both organizations and it is comprised of three schools: Diamond Valley Elementary School, the Opportunity School, and the Community Day School on the Eastern Slope of the Sierras. Diamond Valley is a Kindergarten through 8th grade school, students entering 9th grade transfer to Pau-Wa-Lu Middle School and then attend Douglas County High in Nevada for grades 10 - 12. The 10 students residing in Bear Valley attend school in Calaveras County. These 10 pupils range in age from 5 to 18 and all ride on the same bus. That bus ride takes 45 minutes one-way in good weather up to as much as 2 hours in bad conditions. ACOE staff members are members of the Child Abuse Prevention Council. Currently, the ACOE Program Coordinator who oversees the Student Mental Health Initiative, the Local Planning Council, and the Tobacco Use Prevention Education programs also serves as the CAPC chair. Alpine County Board of Supervisors is comprised of five elected members. Board Members are very supportive of ACHHS and CWS and give considerable attention to matters related to CWS and its partner agencies. Two members of the Board of Supervisors are among the core representatives for this C-CFSR. Another member serves as a Board of Supervisors liaison to the CAPC and Mental Health Board. As discussed previously in the report, the Washoe Tribe of Nevada and California is the only Native American tribe in Alpine County. It is federally recognized and organized according to the Indian Reorganization Act of 1934; it is self-governing and headquartered in Gardnerville, Nevada. The tribal government has jurisdiction over trust allotments in Alpine County comprising 80 acres. The area is home to 175 - 204 members of the Hung-A-Lel-Ti, southern band of the Washoe Tribe; the population fluctuates seasonally. The Hung-A-Lel-Ti Tribal Community Council of Woodfords is comprised of five members who are responsible for the daily operations of the Tribe. The Woodfords Community Council meets to discuss issues, vote on resolutions, and hear from the Washoe people during sessions. It is the governing body for the Woodfords Indian Education Center, a sub-grantee of CBCAP funds through ACHHS. The Council has designated representation on the CAPC. The Washoe Community Council has sole ---PAGE BREAK--- 20 California - Child and Family Services Review jurisdiction over its land and people; it operates a Tribal Court, and both Social Services and Tribal Law Enforcement Departments which adjudicate all civil, criminal, juvenile and probate cases that occur on Washoe Tribal land. The Washoe Tribal Council of Woodfords and several of Washoe’s community members have been an integral part of the C-CFSR process. ACHHS, including CWS, has no jurisdiction over the Washoe Tribe due to the sole jurisdiction over child welfare granted it and two other tribes in 1996. Since that time, ACHHS has made a number of attempts to develop an MOU to allow it to assist the Tribe with its child welfare issues and cases. In March 2013, ACHHS hired an ICWA legal expert to help facilitate this process. Due to past conflicts and the complexity of the issue the process is slow and measured; it has recently gained encouraging momentum. With considerable support from the Woodfords Community Council, Alpine County and the Washoe Tribe are close to reaching the first set of meaningful agreements. These could be translated into the first Alpine County and Washoe Tribe child welfare MOU soon, with the potential to transform the level of safety and service available to the children and families of Alpine County’s Washoe community. COUNTY CHILD WELFARE AND PROBATION INFRASTRUCTURE Child Welfare Services operates under the umbrella of Alpine County Health and Human Services. ACHHS has 13 employees, two of which are social workers, one each for child and adult cases. Supervision has long been problematic given ACHSS’s case load staffing and budget constraints. Both social workers sit on the CWS MDT. The MDT is organized according to a Team Decision Making (TDM) model that involves not only caseworkers and supervisors, but also birth families, community members, resource families and provider representatives, and other service providers on a case-by- case basis as appropriate to maximize understanding of the case and achieve the best outcomes. The MDT meets but can be called into session at any time for input or decision-making. The CWS single social worker holds a Bachelor’s degree in Social Work and has over 10 years of experience working with children and families in CWS settings. His salary range is $52,000 additionally he is compensated $15,000 a year for stand by pay. He averages a caseload of 0-1.He is responsible for all child-abuse related intakes, responses and investigations, case determinations, and case management in Alpine County. ACHHS currently provides administrative support for the CAPC, and with input from CAPC, allocates CBCAP and CAPIT funds to support community-based services and programs, including the Bear Valley Parents Group, Alpine County Office of Education childcare programs and Live Violence Free which addresses domestic violence. Alpine County does not have a Children’s Trust Fund; therefore additional CBCAP funds are ---PAGE BREAK--- STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES 21 California - Child and Family Services Review provided to the County. Due to Alpine not having the capacity to place any children into foster care or adoption within the county, PSSF funds have not been utilized. Children needing such placement are referred to El Dorado County Department of Health and Human Services who handles all foster care and adoptions under contract to Alpine County. THE PROBATION DEPARTMENT The Probation Department has one officer – the Chief Probation Officer. He works on a part-time basis. There are currently no placements; there have been none since the last County Self-Assessment. The Chief Probation Officer is a member of the CWS MDT and the Child Abuse Prevention Council. FINANCIAL/MATERIAL RESOURCES The Family Support Council/Child Abuse Prevention Council made recommendations to ACHHS for funding child abuse prevention and intervention services until 2010 when it was determined that the CAPC required reorganization to better serve State DSS legal mandates and Alpine County’s needs. Since then ACHHS, with input from CAPC, has developed and distributed the RFPs, reviewed proposals, and made funding recommendations to the Board of Supervisors for approval. Alpine County receives the following three prevention/early intervention funding sources: CAPIT $60,000 (fluctuates due to realignment) CBCAP $30,000 PSSF $10,000 The County performs an on-site inspection of its CAPIT and CBCAP grantees at least once per grant cycle. Fiscal review occurs during the invoicing process, as the County requires that its grantees provide all backup documentation when they submit their annual invoice. CHILD WELFARE/PROBATION OPERATED SERVICES All funds are used to prevent, intervene, and build collaborations to assist child abuse prevention efforts; provide mandated reporter trainings; develop, implement and maintain the Multi -Disciplinary Team (MDT), develop and implement Alpine County Child Welfare Policies & Procedures Manual, implement Structured Decision Making and develop a Memorandum of Understanding with the Washoe Tribe for Child Welfare Services. PSSF funds are NOT utilized because no identified subcontractors can guarantee the mandated 20% allocation to adoption promotion and support or foster care services. CAPIT funds ---PAGE BREAK--- 22 California - Child and Family Services Review are utilized to support the Live Violence Free (aka, Women’s Center’s) home visitation services and a Nurturing Parenting Program for families at risk of or experiencing child abuse and/or domestic violence, and Bear Valley Parents Group which provides parenting classes and child care. CBCAP funds are used to support the Alpine County Office of Education State Preschool Program, so that high risk children can attend the program. CAPIT services are performed by Live Violence Free through their Nurturing Parents program. The Nurturing Parents Program is designed to build strong, healthy bonds between parents and their children. The program utilizes the Nurturing Parenting Program curriculum, which provides parents with effective behavior management tools and encourages the development of healthy parent-child relationships. Live Violence Free provides services to persons in domestic violence or other abusive situations. The CBCAP funds are utilized by two different programs. The Bear Valley Parents Group, which provides child care and summer programs for 13 children (4 of whom are identified as “at-risk”) in the very isolated Bear Valley community of Alpine County. Alpine County Early Learning center is a preschool program for children aged 2 to 5. This program operates during the same time as the public school, giving the parents greater flexibility with their work and/or job hunting hours. The CBCAP grant allows for an aide to be present on the bus providing transportation for the preschool students; this aide provides direct communication to and from the parents and the preschool, allowing for a much more open line of communication and support for the at-risk children attending preschool. Since the last five-year System Improvement Plan, the Woodfords Indian Education Center provided the Positive Indian Parenting curriculum, which was supported by CBCAP funds. This was a one year program and has not been offered again. OTHER COUNTY PROGRAMS Alpine County Behavioral Health Services (BHS) is a county department independent of Health & Human Services. BHS occupies the same building as ACHHS, facilitating coordination and collaboration between the departments. It employs 10 staff, including two Clinicians, a Drug & Alcohol Counselor, a Native Wellness Advocate and a Mental Health Services Act Coordinator. The BHS Department focuses on the low-income Medi- Cal population, providing individual and family counseling, outpatient substance abuse counseling, and “wellness” programs under Prop 63 the Mental Health Services Act. CWS and Behavioral Health Services work very closely together on all aspects related to healing child abuse and neglect. BHS is a core member of the MDT. ---PAGE BREAK--- STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES 23 California - Child and Family Services Review There are no licensed foster homes in Alpine County, the County contracts with foster family agencies to provide foster care, including therapeutic foster care. These services are contracted to foster families and adoptive family agencies under the umbrella of El Dorado County Department of Human Services. Alpine County’s responsibility for a child continues until an adoption process is complete Alpine County Probation Department contracts with the South Lake Tahoe Juvenile Treatment Center in El Dorado County. Additionally, Alpine County has an MOU and contracts with El Dorado County Health & Human Services for Adoption Services and Calaveras County Health & Human Services for Emergency Response services in Bear Valley. Alpine County ACHHS is comprised of a Social Services and Public Health Department. Social Services offers eligibility programs including CalWorks, CalFresh, Medi-Cal and CMSP, General Assistance, Senior Meals, and a Workforce Investment Act Program. The Public Health programs include Maternal Child Adolescent Health Programs, Child Health Disability Prevention Program, Immunization Program, Tobacco Education, SNAP Ed, Emergency Preparedness Programs, and Environmental Health Programs. ACHHS provides transportation for its clients to access services on a case by case basis, as well as by funding a bus service to and from Bear Valley. In addition to traditional public health programs, ACHHS operates a family medical clinic with a licensed physician and registered nurse. The clinic is the only provider of regular medical services in Alpine County. State and Federally Mandated Child Welfare/Probation Initiatives Alpine County Health & Human Services and Behavioral Health Services developed the required Katie A Plan for Alpine County. ---PAGE BREAK--- 24 California - Child and Family Services Review Board of Supervisors (BOS) Designated Commission, Board of Bodies THE BOS-DESIGNATED PUBLIC AGENCY Alpine County Health & Human Services is the designated child welfare agency for Alpine County. CHILD ABUSE PREVENTION COUNCIL (CAPC) The Child Abuse Prevention Council is an independent entity operating under the umbrella of the Alpine County Department of Health & Human Services. At the May 4, 2010 Board of Supervisors meeting, the Health and Human Services department was designated as the administering agency for the oversight of the Child Abuse Prevention Council and to administer agreements with service providers, oversee disbursement of child abuse prevention funds and provide required reports to the California Department of Social Services. The purpose of the Child Abuse Prevention Council is to focus on prevention of child abuse by providing a forum for interagency cooperation and coordination. This type of interagency cooperation is very important in such geographically isolated communities that exist in Alpine County. Council members are appointed by the Board of Supervisors, and the CAPC is an independent organization within the County government. As indicated in earlier sections of this report, the CAPC has undergone reorganization over the past two years and is emerging stronger in terms of its membership, clarity of purpose and mission, and plans for the future. On August 7, 2013, the CAPC underwent, with support and in collaboration with ACHSS, an in-depth strategic planning session utilizing CSA data. The resulting Strategic Action Plan established specific priorities to guide its child abuse prevention work for the next three years. CAPC priorities include: furthering the working relationship among the Washoe Tribe, CAPC, and child welfare service partners; addressing the absence of recreation and child care programs; and increasing awareness and outreach regarding the issue of child abuse and neglect and prevention opportunities. CAPC has co-sponsored with support from Alpine HHS/CWS several important prevention trainings over the past two years including: “Bridges Out of Poverty”, “Strengthening Families and Protective Factors”, “Father Engagement”, and an annual Mandated Reporter Training. In addition, CAPC has recently embarked on the development of a county-wide child abuse prevention awareness campaign which will involve as much of the Washoe Tribal Community as possible. CAPC is active in the Sacramento-Sierra CAPC Regional Coalition which helps it build local prevention and ---PAGE BREAK--- STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES 25 California - Child and Family Services Review early intervention capacity and take advantage of special training it would otherwise not be able to easily access. The CAPC serves as HHS/CWS’s eyes and ears in the community, providing input throughout the CSA and SIP development and implementation phases. It acts as the County’s Children’s Trust Fund Commission and PSSF Collaborative, making recommendations to Alpine HHS/CWS regarding how state child abuse prevention and early intervention funds can be used most effectively in Alpine County. COUNTY CHILDREN’S TRUST FUND COMMISSION, BOARD OR COUNCIL The Child Abuse Prevention Council acts as the Children’s Trust Fund Commission and its PSSF Collaborative. ACHHS implemented the Family Development Matrix project, funded by the Office of Child Abuse Prevention and provided free of charge in partnership with California State University Monterrey Bay. The Family Development Matrix program is utilized to collect all data required for OCAP. ACHHS is in the process of completing the annual mandatory OCAP report and after the report is approved, ACHSS will complete an annual report and present it at an Alpine County Board of Supervisors meeting. The report will also be published on the Alpine County website. Systemic Factors MANAGEMENT INFORMATION SYSTEMS ACHHS regularly collects and reviews data on its child abuse cases. All child abuse referrals including date received, allegation, disposition, and risk assessment score are reviewed by the Multi-Disciplinary Team. Additionally, the data is submitted via the CWS/CMS system. Due to the small amount of data entered into CWS/CMS Alpine County does not find the system a useful tool to analyze child abuse data. CASE REVIEW SYSTEM As discussed several times in this report, ACHHS utilizes an MDT process, with written protocol and collaboration and confidentiality agreements to review every case and to monitor every case through every disposition decision phase. The MDT meets by regular schedule and on an ad hoc basis as the need arises. The MDT was created in early 2013 in response to 2010 CSA findings. While it continues to evolve, the MDT has already begun to enhance CWS oversight of child abuse and neglect cases. Improved outcomes are anticipated as its efforts continue over time. ---PAGE BREAK--- 26 California - Child and Family Services Review FOSTER AND ADOPTIVE PARENT LICENSING, RECRUITMENT AND RETENTION At this time there are no approved foster homes in Alpine County. There are several Washoe Tribe approved foster homes licensed by Washoe Tribal Social Services. All training, support and supervision of Washoe Tribally-licensed foster homes are provided by Washoe Tribal Social Services. Washoe Tribal Social Services is encouraged to attend all DHHS’s child abuse prevention and intervention trainings (as listed under the CAPC description above) on a regular basis. STAFF, CAREGIVER AND SERVICE PROVIDER TRAINING ACHHS provides and funds numerous in-county opportunities for staff and provider training. Both the CWS and APS social worker have attended numerous in-county trainings over the past three years as listed in the CAPC section above. In addition, the social workers are provided on-going information about and financially supported to attend professional trainings. Both Social Workers have attended Core I and II trainings and additional trainings through UC Davis. The CWS MDT established over this past year has been, and will continue to be, a good source of professional training information and peer cross-training during case deliberations, and a means of assessing the on-going training needs of Alpine’s two social workers. ACHHS has funded and coordinated, with outreach from the CAPC, a variety of training opportunities for providers and CWS staff in addition to the annual Mandated Reporter training. In the past year, this has included “Bridges Out of Poverty” training and community follow-up, Strategies-sponsored Protective Factors and Family Strengthening training on September 12, 2013, and Sac-Sierra CAPC Regional Coalition training by Strategies on Father Involvement and Engagement last January. The follow-up Level Three Father Engagement for clinicians and program facilitators to implement evidence- based Father Support Groups locally was attended by a team from Alpine County on October 29, 2013. NATIONAL RESOURCE CENTER TRAINING AND TECHNICAL ASSISTANCE Alpine County is a regularly participating member of the Sacramento-Sierra CAPC Regional Coalition through which it receives on-going technical assistance from peers and the Coalition’s coordinator on issues and programs related to child abuse and neglect prevention and early intervention. Through the Coalition, Alpine County and its partners also have ready access to and benefits from resources and training from the National Resource Center. The Washoe Tribe is currently receiving Technical Assistance from the National Resource Center for Tribes to conduct a community readiness assessment. The ---PAGE BREAK--- STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES 27 California - Child and Family Services Review assessment is to be conducted in the Hung-A-Lel-Ti community in Alpine County in the next month. AGENCY COLLABORATION One of Alpine County’s major a benefit of its small population size, is effective collaboration among its CWS partners. Detailed examples of Alpine’s collaboration in action are provided throughout this report. Among the most important are: the creation of the CWS Multi-disciplinary Team, institutionalized through written agreement, which convenes once a month at minimum to review and monitor each child abuse and neglect report and case disposition; completion of the CAPC Strategic Plan, which is linked to the 2013 CSA assessment data and will help inform SIP priorities and prevention and early intervention efforts for the foreseeable future; the MOU under development between Alpine HHS CWS and the Washoe Tribe which is intended to provide services to children and families living on Washoe land; and the array of collaborative services described in the next section. SERVICE ARRAY As explained previously, Alpine County’s population size translates into a relatively small array of social services, most of which are provided by a small handful of agencies. Due to the small population and size of the County, many services are housed together. Alpine County’s Social Services, Protective Services, Public Health and Public Health Clinic, and Behavioral Health Departments are all housed in the same building. A strong, mutually beneficial working relationship exists between the departments and their staff. Additionally, the majority of the Social Service agencies (Tahoe Youth & Family Services, Live Violence Free, First 5 Alpine, the Early Learning Center, Choices for Children, and the Alpine County Office of Education) are also housed together, less than 2 miles from the County offices. This helps to create a strong working relationship between them and the County staff. When, and if, service gaps become apparent, all of the community agencies work together to ensure that the needs of the client are met. Behavioral Health Services provides comprehensive individual and family mental health services to Medi-Cal eligible and low income residents, including children in foster care with Washoe Tribal Social Services; outpatient substance abuse treatment; and outreach and engagement services. BHS is able to offer their services at their offices, during home visits, or at the school. services are available with a licensed at their main office. Alpine County Behavioral Health has just completed the 3 year MHSA Innovation Plan to increase services to under-served community groups, increase access to services , and ---PAGE BREAK--- 28 California - Child and Family Services Review to promote inter-agency collaboration through a new program entitled Integrated Family Wellness Center to be located at The Learning Center. Tahoe Youth & Family Services provides mental health services to children and adults; outpatient substance abuse treatment; a mentoring program; 24-hour crisis line; teen substance abuse education; and male and female, school-based educational outreach and support groups to reduce relationship violence and other destructive behavior. Supportive services for runaway homeless youth and high risk youth are provided through shelter host homes and a 24 hour crisis line. These youth can also obtain services such as food, clothing, computer use, transportation, and job search assistance at one of their drop-in centers in South Lake Tahoe or Gardnerville. Choices for Children and First 5 Alpine together offer parent education workshops and information and referral for child care. Weekly play groups are also available for children ages 0-5; these playgroups promote socialization for the children as well as the adults. They meet with others in the community facing the same challenges and stressors and can assist each other with emotional and intellectual support. One of the largest challenges faced by parents of young children in Alpine County is the lack of qualified, licensed child care. Since its inception, Choices for Children’s Resource & Referral Program has provided a vital link between families and child care providers in our rural community. Services include support in developing, operating and licensing a quality child care facility; identifying and providing training and education to be a knowledgeable parent and child care provider; guidance in choosing a child care provider and finding financial and family resources; and advocating for families and child care providers. Live Violence Free (LVF) provides domestic violence, sexual assault and child abuse prevention, intervention and treatment programs. Live Violence Free has provided age- appropriate child abuse prevention education in local schools for over 20 years; within this educational program children are taught to recognize the warning signs of violence and what to do if they have experienced violence of any kind. Other services include confidential sheltering and transitional housing for victims of domestic violence; long term individual and group counseling; LVF is the lead agency for the Victim Response Team; LVF has their own Sexual Assault response Team which is mobilized for cases of child sexual assault and/or molestation. Washoe Tribal Community administers a federally funded Educational Resource Center that provides economic and social service assistance for its members. In addition, it has its own Social Services Department with one social worker who counsels families and ---PAGE BREAK--- STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES 29 California - Child and Family Services Review children, and Washoe Native American TANF worker housed at the Alpine County BHS office located at the Community Wellness Center who assists families to access Medi-Cal benefits. The Washoe Community also has its own formal Court system, Medical Clinic, Healing Center, and DV program. QUALITY ASSURANCE SYSTEM ACHHS’s quality assurance system and its critical incident review process are accomplished regularly through its MDT, as described elsewhere in this report. ACHHS implemented the OCAP funded Family Development Matrix (FDM) program to collect data and outcomes related to CBCAP/CAPIT funded programs. The FDM program provides a tool for service providers and their clients to assess the families’ current level within the 20 base indicators and the 10 additional indicators specific to Alpine County. The families and their service provider can then focus on areas that may require intervention or education. Since the program was initiated in October, 2012, the County has seen an overall increase of 3.24% in the indicator scores with the greatest increases in School Readiness and Conflict Resolution Skills. Critical Incident Review Process Peer Review Summary CHILD DEATH REVIEW TEAM Alpine County has not experienced any child deaths in the past five years. If there were a child death, the ACHHS-based multi-disciplinary team would act as the child death review team. The Sheriff/coroner is a member of the MDT. Representatives of the State Department of Social Services – Patricia Harper, Program Consultant, OCAP; and David Brownstein, Evaluation Program Staff designed the peer review process and conducted the Peer Review with assistance from Mono and El Dorado County Child Welfare Services social workers in discussion with the Alpine County CWS social worker. David Brownstein then prepared the following summary of findings. ---PAGE BREAK--- 30 California - Child and Family Services Review FOCUS AREA – PARTICIPATION RATES AND SAFETY ASSESSMENT Method A three hour question and answer and discussion session among all participants was facilitated by an outside facilitator and DSS, followed by in-depth discussion among DSS and the peer reviewers. The following summary from DSS is based on review of two cases. CDSS SUMMARY OF FINDINGS AND RECOMMENDATIONS Barriers and Challenges Lack of county policies and procedures (there is a rough draft of P & Ps completed. Implementation could be challenging.) o Since the Peer Review in June ACHHS has fully implemented an Alpine County specific Child Welfare Policies & Procedures Manual. In many areas Alpine County policies, such as response time exceed the minimum state requirements Individual providing supervision has no CWS background and is unfamiliar with Division regulations. Small community makes managing confidentiality difficult. o The Behavioral Health Director is no longer the supervising Social Worker. ACHHS Director supervises the Social Workers and the team decision making model is utilized when making difficult decisions Peers/county employees wear multiple hats in the community that influence understanding and decisions being made that affect services for children and families. County Counsel was not consulted on either case. Counsel was consulted on the case which resulted in a voluntary placement. Hard to determine if this was due to lack of relationship between CWS and the Court or a training issue for social worker for not collaborating and not seeing collaboration as useful. o During the period of the review ACHHS contracted with an attorney independent from County Counsel for consultations involving Child Welfare cases, since the review Alpine County has retained a new County Counsel, Cota Cole Ltd., and they employ a CWS specific attorney who is available for consultation and will represent Alpine County in all court proceedings. Families are isolated, especially during the winter months. Very limited mental health and substance abuse services in the County. Heavy reliance on and need for dependable transportation. Inconsistent use/incomplete safety and risk tools. Training Needs Placement and family finding Safety Risk Assessment – when and how to use the tool to guide case planning ---PAGE BREAK--- STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES 31 California - Child and Family Services Review Review of Division 31 regulations completed 9/6/13 Review of court process/filing a petition completed 9/6/13 Concurrent planning completed 9/6/13 Child assessment Review of CWS/CMS Review of mandated reporting for county employees and community provided 8/2012 to all County employees and scheduled for 11/2013 Case documentation that will stand up in court Thorough CWS investigation that includes how to use prior family history and referrals in current investigation Identify Systematic/Policy Changes Background check done for all adults living in the home during investigation; and a phased CLETS was done on all adults at intake and throughout the case. All children in the home will be assessed, not just the child identified on referral. Are there county policies that address social worker having continued contact or assisting clients, giving them ride or bus passes for example, once a referral or open court case closes? o Implemented 9/6/13. No supervisor with CWS/CMS and case planning experience. Incomplete case file, missing mandated documents no signed voluntary agreement by birth parent); no formal case file review process. Incomplete/inappropriate case notes written by social worker. Many notes written that cite laws to justify his decision for either acting or not acting on certain matters. Identify Resource Issues Technical and clinical supervision for social worker. No licensed foster homes for emergency and ongoing placements. No foster parent training or ongoing support outside of case-carrying social worker. Peer Promising Practices Close working relationship with Behavioral Health agency and Public Health department. Social worker’s small case load allows more time to be spent with children and families. Social worker has ability to respond quickly to all referrals; there is no need for a “10 day” referral Every attempt is made to keep children in their homes with parents. Social worker is skillful in engaging families and establishing good working relationships with them. ---PAGE BREAK--- 32 California - Child and Family Services Review State-Administered CWS/CMS System Case Review The two cases reviewed by CDSS are addressed in the Peer Review summary above. Outcome Data Measures As mentioned earlier in this report, Alpine is the smallest county in the state with a population of approximately less than 1000 people. Its small population, with a commensurately small number of child abuse reports and cases (approximately 40 per year) make it virtually impossible for Alpine County to identify meaningful demographic trends or demonstrate changes in outcomes measures over a time period of less than 5- 10 years. In addition, Alpine’s small size means that many of the services needed by its population– e.g., foster care, adoption, health care, family maintenance – are not applicable except as accessed outside the county. [For data on maltreatment rates and referrals, please refer to that sub-section within the Aggregate Findings Section.] S1.1 NO RECURRENCE OF MALTREATMENT These data and analysis are presented on page 16 of this report under the child maltreatment heading. There has been no recurrence of maltreatment during the period of review January 1, 2010 – December 31, 2012. S2.1 NO MALTREATMENT IN FOSTER CARE Not applicable. Alpine County has no in-county foster care or adoption services. C1.1 REUNIFICATION WITHIN 12 MONTHS (EXIT COHORT) Not applicable. There are and have been for over three years no open, non-voluntary cases in Alpine county. C1.2 MEDIAN TIME OF REUNIFICATION (EXIT COHORT) Not applicable C1.3 REUNIFICATION WITHIN 12 MONTHS (ENTRY COHORT) Not applicable C1.4 REENTRY FOLLOWING REUNIFICATION Not applicable ---PAGE BREAK--- STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES 33 California - Child and Family Services Review C2.1 ADOPTION WITHIN 24 MONTHS (EXIT COHORT) Not applicable C2.2 MEDIAN TIME TO ADOPTION (EXIT COHORT) Not applicable C2.3 ADOPTION WITHIN 12 MONTHS (17 MONTHS IN CARE) Not applicable C2.4 LEGALLY FREE WITHIN 6 MONTHS (17 MONTHS IN CARE) Not applicable C2.5 ADOPTION WITHIN 12 MONTHS (LEGALLY FREE) Not applicable C3.1 EXIT TO PERMANENCY (24 MONTHS IN CARE) Not applicable C3.2 EXITS TO PERMANENCY (LEGALLY FREE AT EXIT) Not applicable C3.3 IN CARE 3 YEARS OR LONGER (EMANCIPATION/AGE 18) Not applicable C4.1 PLACEMENT STABILITY (8 DAYS TO 12 MONTHS IN CARE) Not applicable C4.2 PLACEMENT STABILITY (12 MONTHS TO 24 MONTHS IN CARE) Not applicable C4.3PLACEMENT STABILITY (AT LEAST 24 MONTHS IN CARE) Not applicable 2B PERCENT OF CHILD ABUSE/NEGLECT REFERRALS WITH A TIMELY RESPONSE One hundred percent of referrals received a timely response from the period analyzed January 1, 2010- December 31, 2012 ANALYSIS N/A, one hundred percent of referrals received a timely response 2C TIMELY CASEWORKER VISITS WITH CHILDREN Not Applicable ---PAGE BREAK--- 34 California - Child and Family Services Review 4A SIBLINGS PLACED TOGETHER IN FOSTER CARE Not Applicable 4B LEAST RESTRICTIVE PLACEMENT (ENTRIES FIST PLACEMENT) Not Applicable 4B LEAST RESTRICTIVE PLACEMENT (POINT IN TIME) Not applicable 4E ICWA & MULTI-ETHNIC PLACEMENT STATUS Not applicable 5B RATE OF TIMELY HEALTH EXAMS Not applicable 5B RATE OF TIMELY DENTAL EXAMS Not applicable 6B INDIVIDUALIZED EDUCATION PLAN Not applicable 8A COMPLETED HIGH SCHOOL OR EQUIVALENCY Not applicable 8A OBTAINED EMPLOYMENT Not applicable 8A HOUSING ARRANGEMENTS Not applicable 8A RECEIVED ILP SERVICES Not applicable 8A PERMANENCY CONNECTION WITH AN ADULT Not applicable ---PAGE BREAK--- STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES 35 California - Child and Family Services Review Summary of Findings The summary of Alpine County’s 2013 CSA aggregated findings is found toward the front of this report. All findings resulted from the six-part CSA process employed over the past several months with core representatives across the county. Those findings led to the identification by the Stakeholders of 11 priority recommendations detailed at the end of the aggregated findings section which, along with all the CSA-generated data, will be deliberated within and further inform the SIP process. While all the priority needs have relevance for the well-being of Alpine County’s children and families, some may not fall within the purview of the ACHHS and its service partners to affect directly.