On Thursday, October 29, 2020, CWLA hosted a webinar titled, “The Case for Case Management in DC: Motivational Interviewing as a Tool to Enhance Case Practice & Improve Service Utilization.” The District of Columbia Child and Family Services Agency (DC CFSA) shared its strategy for incorporating case management as a foundational piece of its approved Title IV-E Prevention Plan.
Presenters included the District of Columbia Child and Family Services Agency Director, Brenda Donald, Jay Murphy, Program Manager of the Federal Revenue Unit, and Natalie Craver, Administrator for the Community Partnerships Administration. They provided an overview of how they approached the planning and plan-drafting process: from the implementation process, which included the training of agency staff and community partners to embed Motivational Interviewing in the agency’s case practice model, and to establishing a claiming framework to draw down Title IV-E dollars under the Family First Prevention Services Act (Family First).
DC CFSA Family First Plan, “Putting Families First in DC,” is prioritized by a four pillars agenda. It is a values-based framework that guides the agency. The four pillars are:
- Front door: Children grow up best with their families. We remove children only when necessary to keep them safe.
- Temporary safe haven: Foster care is temporary. We start planning for permanence the day a child enters care.
- Well-being: Every child is entitled to a nurturing environment that supports healthy growth and development, good physical and mental health, and academic achievement.
- Exit to permanence: Every child exits care as quickly as possible for a safe, supportive family or life-long connection. Older youth have skills for successful adulthood.
By using these four pillars, CFSA has been able to focus on best practices and prioritizing prevention. CFSA has seen a significant decrease in the number of children in foster care since increasing their focus on prevention.
Since the enactment of the Family First, CFSA has gone through an extensive process to plan and implement a new strategy best to meet children’s needs in the District of Columbia. This process included internal planning meetings, research, focus groups, identifying target populations, working with sister agencies, and more to establish the best plan of action to implement the Family First Act. DC submitted the Motivational Interviewing (MI) proposal in their prevention plan in March 2020 and received approval in September 2020 to use MI as a cross-cutting evidence-based treatment modality to increase positive outcomes for children and families.
Motivational Interviewing is “designed to clarify goals, address barriers, and facilitate personal change processes.” It is evidence-based and has been proven effective in engaging parents, building trust, empowering them to discern appropriate services, and helping them to understand the rationale for why these services will help them to succeed. It would be implemented by caseworkers specifically trained to directly engage with the candidate’s caregiver.
Some core elements of the MI proposal to gain approval identified by CFSA were:
- Empirical evidence of MI’s effectiveness beyond substance abuse
- Citations from MI manual asserting that MI is designed to be used to bring about diverse change goals
- Clear vision and theory of change for MI
After discussing the process and selection of using MI, the panel spoke on the financial side of using MI. CFSA has been able to “leverage existing infrastructure and current front-door investments to bring in Title IV-E prevention dollars.” MI is also a “key to helping the District maintain its upstream focus and investment.” They have been able to identify a plan to fund MI through a per candidate/per month rate.
Although DC CFSA recently received federal approval of their plan in September, they have been implementing Motivational Interviewing prior to approval. In FY2020, they focused on training and the buildout of the system by operationalizing the plan. DC CFSA plans to focus on training, fidelity monitoring, and CQI in FY 2021. They anticipate continuing virtual operations (dependent on the impact of COVID-19) and collaborating with sister agencies. They are also planning to have a complete claiming infrastructure and have case management activities and evidence-based programs underway in CCWIS.
The recording will be available on CWLA’s Members-Only site!