19, No. 2
"We Need a Sense of Urgency"
Interview with Kevin Kelley, Chief of Child Welfare Services, NC Division of Social Services
To get a statewide perspective on time to permanence, why it matters, and what's being done to improve it, Practice Notes spoke with Kevin Kelley, Chief of the Child Welfare Section of the NC Division of Social Services. (This interview has been edited for style and length.)
Why is achieving timely permanence for children important?
We need to achieve permanence to ensure children's well-being, both now and in the long run.
Is there a child who comes to mind when you think about why permanence matters?
I saw many in my time as a foster care services worker. One example was a young man of 12 or 13. He had a lot of developmental work that needed to be happening with him that wasn't happening. I have to admit that as a worker at that time I was comfortable dealing with his health needs, but not the cause of those challenges, which probably had something to do with the amount of time he was in foster care and the fact that permanency wasn't even on the horizon.
The longer a child is in care, the more comfortable everyone gets. On the surface it appears to be an acceptable situation. But it's not.
We need to have a sense of urgency about this. Our urgency must actually intensify the longer a child is in care. We have to somehow build our system to continue that sense of urgency because it may not seem to be a crisis, but it is and it needs to be addressed.
What's going well in North Carolina with regard to time to permanence?
In the past several years the number of children in foster care in our state has been reduced. This is due primarily to the declining rate at which children enter care. All of this has positioned us to have a smaller caseload, which is very desirable.
Another bright spot is that, compared to the national average, we have a fairly small number of children in foster care. That is creeping back up, but it is still true. We've done a good job reducing the total number of children in care. We are bringing only those children into care who truly need to be protected by the system. (Note: see the next article for more on NC's performance in this area.)
Our ability to achieve timely permanence depends a lot on our partners. What can DSS agencies do to influence key partners on this issue?
Although we don't have direct control over other systems, child welfare agencies can help drive improvement. Obviously the performance of the behavioral health system, and I mean both the Division of Medicaid Assistance (DMA) and the NC Division of Mental Health (DMH), is strongly connected to permanence for children. The Division of Social Services is actively forming partnerships to help them see the needs.
For example, we are trying to communicate to the folks who oversee Medicaid that it is worthwhile to devote resources in certain ways that not only help children but that make the most sense fiscally in the long run. We are taking part in regular meetings with DMH, DMA, and their vendor, Community Care of North Carolina (CCNC).
Going forward, we want to be a better player at the table of the managed care system. There is a lot to learn and things change frequently, but we are making a difference by being involved.
Workers and their agencies can help by communicating with service providers when they see needs that aren't being met. When we can help providers serve families and children quickly, effectively, and efficiently, everyone benefits.
At the local level managed care organizations continue to evolve. They are being more selective about who they engage as providers. County DSS agencies can help the system make those decisions. DSS can also help providers get the attention of MCOs. Help your MCO understand which providers are using evidence-based practices that are important and valuable to you.
What about the courts?
The Administrative Office of the Courts has an information system (JWISE) we think will help shed light on how the court system could improve the rate at which court cases are continued. Continuances seem to be the lynchpin. If we want timely permanence, we need the court to have timely hearings.
Having more conversations with attorneys and judges might be another way we can improve the system.
We hear about the need to use data to track and improve performance. Are there performance measures related to timely permanence that are especially helpful to follow?
While we all have to pay attention to confidentiality, sharing data with providers is very helpful, particularly if you have a service provider that is serving multiple children for your agency. Looking at their data and sharing your data with them, you can start to see patterns of performance. Use this data to have conversations about how those who do the work at the client level can improve results.
Like many states, NC has seen a steady rise in youth aging out of care without permanence. How are we addressing this trend?
We have the Generally Assembly's permission to develop a guardianship assistance program. The target population for this program will be kids for whom adoption has been ruled out as a permanent plan and who are currently placed with a relative licensed to provide foster care. This program is needed because some relatives hesitate to adopt because they don't want to taint relationships with the child's parents or other relatives. At the same time, we are asking the relative to assume full financial responsibility for the child, which may be difficult or impossible for them. Assisted guardianship is a way to overcome this barrier to permanence.
And of course we need to continue to work to find adoptive homes for children who need them--especially older children. Youth who belong to [the youth advocacy group] SaySo will tell you "Don't say a 16-year-old can't be adopted, because they can!" We can't ever forget that.
Any final words for county DSS staff about timely permanence?
Don't feel bad if you don't have a solution to the permanency question for every youth. I'm not saying you should stop trying, but achieving timely permanence for every child in foster care is a collective responsibility. I hope you make this clear to every one of your current and potential service providers.
Permanence is a multifaceted problem. We need to own it collectively. Partnerships and collaborations are very, very important to improving time to permanence.