California Child Welfare Outcomes and

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					California - Child and Family Services Review
          Peer Quality Case Review
               Alameda County




                    2008

        Carol Collins, Assistant Agency Director,
       Department of Children & Family Services
Hamilton Holmes, Acting Deputy Chief Probation Officer,
                   Juvenile Probation
                            Table of Contents
Acknowledgments                                                                    1
Background                                                                         2
Executive Summary                                                                  3
County Perspective                                                                 6
Focus Area                                                                         7
Agency PQCR Preparation                                                            8
I.     PQCR Methodology                                                            9
       Case Sample/Child Welfare Worker Selection                                   9
       Focus Group Selection                                                       11
       Review Team Composition                                                     11
       Review Process                                                              12
       Data Collection                                                             13
       Interview Tools                                                             13
       Successes and Lessons Learned                                               14
II.    Summary of Data                                                             15
        Characteristics of Child Welfare Workers and Probation Officer Probation
                                                                                   15
Officers
       A. Child Welfare Worker Trend Data                                          16
       B. Probation Officer Trend Data                                             20
       C. Focus Group Trend Data                                                   22
              Child Welfare & Probation
III.   Final Observations and Recommendations                                      24
Appendix A                                                                         28
     Social Child Welfare Worker Interview Tool/ Probation Officer Tool
Appendix B                                                                         49
     Focus Group Interview Tools/Community Partner Tools
Appendix C                                                                         66
     Debrief Matrix for Child Welfare Interviews
Appendix D
                                                                                   69
       Debrief Matrix for Probation Interviews
Acknowledgements
The Alameda County Child Welfare and Probation Departments would like to thank the
Peer Quality Case Review Team members and Planning Team members listed below
for their hard work, commitment and important contributions to this effort. This report
would not have been possible without their expertise, insight, and dedication.


Peer Review Team Members from Other California Jurisdictions

Contra Costa                 Fresno                        San Francisco
Lori Castillo                Marshall Garth                Queen Adu-Poku
Anne Davis                   Kham Hamilton                 Jessica Recinos
Alicia Jackson               Mercedes Medina
Rachelle Jackson

Peer Review Team Members – Community Partner

Ken Porter, Executive Director of Greater New Beginnings

Peer Review Team Members – Alameda County

Ken Shaw, ILSP               Gary Thompson, Mental Health

Bay Area Training Academy (BATA)

Erika Gonzalez               Ventura Cortez

California Department of Social Services

Henry Franklin

Alameda County – Child Welfare & Probation

Vanessa Anderson             Jacqueline Foster             Gumaro Garay
Cerise Grice                 Kirsten Halbrook              Naima Hart
Nathan Hobbs                 Theresa Johnson               Dorothy Lewis
Michelle Love                Beth McAllister               Kimberly McCreary
Nicole Radford               Cindy Rinker                  Budd Seeley
Mary Shean                   Mary Ann Tyler-Sims           Jennifer Uldricks
Sarah Wales

Shared Vision Consultants, Inc.

Stacie Buchanan              Lisa Molinar




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        Alameda County Peer Quality Case Review Draft Final Report November 2008
Background

Pursuant to AB 636, effective January 2004, a new Child Welfare Services
Outcome and Accountability System began operating in California. It focuses
primarily on measuring outcomes in the areas of Safety, Permanence and Child
and Family Well-Being. The new system operates on a philosophy of continuous
quality improvement, interagency partnerships, community involvement, and
public reporting of program outcomes.

This new Outcomes & Accountability system, also known as the California Child
and Family Services Review (C-CFSR), includes three processes which together
provide a comprehensive picture of County Child Welfare practices. Since 2005,
CDSS has aligned the C-CFSR triennial cycle so counties are staggered in their
completion of the C-CFSR process. The Peer Quality Case Review (PQCR) is
the first component of the C-CFSR process. The PQCR replaces the Division 31
compliance audit. The purpose of the Peer Quality Case Review is to learn,
through intensive examination of county social work and probation practice, how
to improve Child Welfare and probation services and practice. Alameda County
completed its first PQCR in May 2006.

The County Self-Assessment (CSA) is the next process in the cycle. The CSA is
driven by a focused analysis of Child Welfare data. This process also
incorporates input from various Child Welfare constituents. Alameda County
completed its first CSA in June 2004

A principal component of the new system is the County System Improvement
Plan (SIP). The SIP serves as the operational agreement between the County
and the State, outlining how the County will improve its system to provide
improved outcomes for children, youth and families. Quarterly County Data
Reports are the mechanism for tracking the County‟s progress. The SIP includes
specific milestones, timeframes and improvement targets. Alameda County
completed its first SIP in September 2004 and most recently the SIP was
updated for the triennial cycle in September 2007 with further revisions in
September 2008. As Alameda County is participating in the Title IV-E Waiver
Capped Allocation Demonstration Project, the projects planning documents have
been aligned with Alameda County‟s SIP.

The first section of this report includes the Executive Summary of the PQCR
findings and describes the PQCR process in Alameda County. The second
section of this report provides a summary of the data collected throughout the
PQCR process. The third section of this report provides final observations and
recommendations from the PQCR process. These sections provide more depth
regarding the PQCR process and report the top five findings for each domain in
Child Welfare and the top three for Probation. In an effort to assure the County
does not lose any of the valuable information obtained during the review
additional attachments have been provided. These documents help convey “the
story” of the PQCR as it unraveled. The appendices include tools used to guide

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       Alameda County Peer Quality Case Review Draft Final Report November 2008
interview and focus group discussions as well as debrief tools that document
information and recommendations from the interviews and focus groups.




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       Alameda County Peer Quality Case Review Draft Final Report November 2008
Executive Summary

Throughout the PQCR process Alameda County demonstrated a belief that the
PQCR is an invaluable tool in drilling more deeply into practice areas exposing
unmet needs of the children, youth and families they serve. It was clear that all
concerned were hopeful that three years from now, families and youth will
experience a noticeable difference in the way engagement, assessment and
service provision are delivered; and that these efforts will positively result in a
reduction of children that re-enter the foster care system. Similarly, it is hoped
that in three years probation‟s improvement efforts will reveal data that indicates
a reduction in the number of youth who exit the system and subsequently enter
the adult criminal justice system. Another indication of how the PQCR is a
continuum of learning is evident in how the counties continue to uncover
information and to develop insights about daily practice from the beginning of
planning through the formal review process.

An example of this belief can be found in “tangible results” which were identified
through the previous PQCR process in Alameda County. Two recommendations
adopted in short order following the 2005 PQCR have allowed social workers to
better serve youth and families. The first included the addition of FasTrak for
County cars, which has enabled Child Welfare Workers to more easily commute
throughout the Bay Area. Second, was the ability for workers to obtain gift cards
for youth to help celebrate noted occasions as well as to provide for the child
when Child Welfare Worker met face to face with child by, for example, taking the
child to lunch, shopping for necessities or enjoying an ice cream cone. Other
results from the previous PQCR processes include a redesign and increase of
the placement program and policies, including the addition of more Child Welfare
Workers; the creation of a parent engagement plan and subsequent work around
parent engagement and the allocation of resources for family finding.

Child Welfare

The overall findings can be found in the attached report, but focus groups and
interviews for Child Welfare revealed four significant themes which may impact
and improve the rates for re-entry of young children into the foster care system.

      There were numerous comments about the legal timeframe limitations for
       parents receiving reunification services and how those time limits often do
       not align with the worker‟s assessment. Every group interviewed noted
       this challenge, especially for families dealing with substance abuse and/or
       mental health issues. Examples include: children being returned home
       under the pressure of time limits when the parents may not be fully
       prepared; workers not taking full advantage of the time available for
       parents to reunify; inconsistent practice throughout agency for returning
       young children home; the necessity for planned transitions from placement
       home.


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        Alameda County Peer Quality Case Review Draft Final Report November 2008
       Recommendations include: planned and uniform reunification/transition
       policies; review to ensure workers are knowledgeable of timeframes;
       coordination with juvenile Court regarding reunification time limits.
      The second theme involved the continuum of support and in-home
       services families receive upon reunification. This again was noted by
       each constituent group interviewed during the PQCR process. This is an
       especially vulnerable time for families and to ensure full support, in-home
       services were thought to be essential for parents of young children as they
       reunify in order to reduce the occurrence of re-entry.
       Recommendations include: expand Parent Advocates to include FM
       cases; contract with EPSDT providers to make available services for all
       families as they transition.
      Another theme continuously identified across the interviews and focus
       groups pertained to training for all groups serving families with children
       ages 0-5 yrs of age. This training for Child Welfare Workers, resource
       parents and Court personnel, would focus on the developmental needs of
       very young children, especially as it relates to reunification, attachment
       and separation. The purpose would be to help each discipline solidify their
       role in recognizing challenges in either parent or child.
       Recommendations include: provide training on mental health and
       development for children 0-5, with an emphasis on services and treatment
       available to service this population.
      and one of the most pronounced was the issue of case transfers. Inherent
       in the Alameda County system are a number of case transfers that can
       disrupt the relationship between worker and family. Also built into this
       system, is the lag time between the time a case leaves one worker and is
       assigned to the next, which can also interrupt service delivery. One major
       transfer point stood out more than others, the transition from FR to FM.
       Recommendations include: vertical case management to maintain the
       integrity of worker and parent relationships; identifying a streamline policy
       to reduce the number of case transfers; expand SEED program (which
       addressees multiple challenges noted); create policy for more planned
       transition of cases.
      Finally, staff and partners involved in the PQCR process recognize the
       utility of structured tools to help guide decisions about first entry,
       reunification,     dismissal    from     FM,      and      subsequent     re-
       entry. Structured Decision Making (SDM) tools can assist in removing bias
       from these decisions, help include best practice and research regarding
       safety factors and risk in decision making, and also help Child Welfare
       staff maintain a documented history of changes or stability in factors over
       time in the circumstances of a family.
       Recommendations include: development of a clear set of guidelines by
       the Department for Child Welfare Workers and TDM facilitators in how and
       when and who will use which specified SDM tools. Also, develop a
       monitoring structure and procedures for supervisors and managers to
       ensure that the appropriate tools are used in the most productive way
       possible.

Probation
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        Alameda County Peer Quality Case Review Draft Final Report November 2008
Throughout the planning process for Probation, there was an openness and
acceptance of the challenges Probation Officers face in providing services to this
vulnerable population. While many practice challenges were known, there was
not a firm concept of how to approach addressing the challenging areas. Clear
themes from the PQCR were identified for Probation to review and to begin to set
out concrete and tangible plans to adopt. Unlike Child Welfare, Probation
struggled with the implementation and spread of the recommendations in the
previous PQCR cycle. New hope has emerged for change regarding this cycle
as Probation and Child Welfare are more closely partnering as a result of the
Title IV-E Waiver project. The following four themes were identified through the
PQCR process:

      The first was the identification of a general lack of knowledge among the
       Probation Officer Probation Officers of the roles and responsibility of Child
       Welfare Workers regarding Independent Living Skills (ILSP) resources.
       Many of the Probation Officers were not able to identify the resources
       available to aid youth in their transition.
       Recommendations include: cross-training between Child Welfare, ILSP
       and Probation to increase knowledge and communication between
       disciplines; a resource guide for all Probation Officers in the Department.
      The previous recommendation focused specifically on the focus area
       selected; however the lack of general/core and advanced training for
       Probation Officers was identified. The Probation Officers noted having
       little knowledge regarding eligibility policy and practice, which has
       prevented them from accessing resources for families and youth they may
       need.
       Recommendations include: provide relevant training to assist Probation
       Officers in building their skill set for field work; training in family finding,
       Medi-cal eligibility, SSI/SSA eligibility, family/youth engagement, Cal-WIN
       training and co-locating an eligibility specialist in the placement unit.
      An overall theme of improving the transfer and referral process within
       Probation to include the provision of full documentation was identified.
       Probation Officers identified that a lack of information regarding a youth
       who has a full family history in the Child Welfare system, can be frustrating
       and it makes it difficult when assessing the youth for appropriate services.
       Recommendations include: adopt a policy for the referral process to
       work with Child Welfare and include full documentation. Additionally,
       explore the idea of holding TDM„s as currently done in Child Welfare.
      The final significant point identified involves the resources available to
       Probation Officers to carry out their day-to-day activities. Probation
       Officers noted using their own personal resources upfront to fund their
       statutory visitation with youth; there is no formal documentation for
       Probation Officers to note their field activities which makes it difficult to
       maintain consistent information regarding the youth‟s progress; the
       Probation Officers stated they have no internet access in the field to check
       warrants, case information, etc.
       Recommendations include:              grant access for Probation Officers
       traveling for business to have a Department credit card for expenses;
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        Alameda County Peer Quality Case Review Draft Final Report November 2008
      provide radios in County cars for safety purposes; and a central and
      uniform database for documentation.

The Reflection Session held on the last day of the PQCR week was filled with a
sense of satisfaction about the wonderful work that had been completed and
excitement at the hope of the work yet to be done. This quote was read aloud
and sums up the entire PQCR purpose and process:

 “The discoveries, breakthroughs, inventions, and masterpieces that profoundly
  change lives (individually and globally), rarely, if ever, require dollars or even
                                      time.”

                      “They just require a little new thinking.”

                                   ~Anonymous~




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       Alameda County Peer Quality Case Review Draft Final Report November 2008
County Perspective1

In Alameda County, the Department of Children and Family Services is the
primary County entity responsible for providing Child Welfare services to families
experiencing child abuse and neglect. Juvenile Probation is the department
responsible for providing Child Welfare services to children involved in the
County‟s juvenile delinquency system. Because Child Welfare and Juvenile
Probation play an important role in providing Child Welfare services to children
and families, both worked in conjunction to plan, co-chair and complete the
PQCR process.

Alameda County is a large county, covering more than 800 square miles,
including waterways. Alameda County is the seventh most populous County in
California, and the second largest County in the Bay Area, after Santa Clara.
With a population of 1.5 million residents, Alameda County has the 21st largest
population among all counties in the United States. Alameda County is one of
the most ethnically diverse areas in the nation. According to the latest census,
the county‟s non-white population is 52.2 percent of the total county population.

Previously the County received specific funding to provide prescribed services,
including room and board to children while they are in the foster care system.
However, that money could only be used while children are removed from their
homes and was not allocated for services to keep children in their homes. To
address this dilemma, the State of California proposed that the Federal
government waive, or put aside, certain Title IV-E funding requirements for five
years for California counties that elect to participate in what is formally known as
the “Title IV-E Waiver Capped Allocation Demonstration Project” (Waiver).
Alameda County and Los Angeles County elected to participate in the waiver
project.
The Alameda County Board of Supervisors approved the County‟s waiver plan
on February 6, 2007. The Waiver means that participating counties can re-invest
federal funding to provide services to children without having to remove them
from their homes. While the Waiver is not new or additional funding, it will allow
for flexibility to re-invest IV-E funds to provide direct services based on each
family‟s individual needs so that children can remain safely with their families, are
reunified sooner, or that an alternative permanency plan is achieved timely. Two
of the operational goals of the County‟s waiver plan are also the focus areas of
the PQCR: reduce the re-entry rates into the foster care system as well as to
provide better support for transitioning youth.

From April 2007 through March 2008, Alameda County Children and Family
Services received referrals on 11,557 children with nearly 7,000 children being
assigned for investigation. During this same time period, 750 children entered
foster care, while 574 children or 52% of the Child Welfare population were


1
    Information from Adult & Aging Services Area Plan Update Report 2008-2009 and CWS/CMS Dynamic Website.
                                                                                                             8
            Alameda County Peer Quality Case Review Draft Final Report November 2008
reunified. As of April 2008, there was a total of 2,396 children in the foster care
system and roughly 23% of those were 5 years and under.
The Alameda County Juvenile Probation Department placement unit supervises
approximately 432 youth which includes approximately 120 youth in placed in
foster or relative care. Of these youth, 79% fall within the ages of 15-18 years of
age and are preparing to transition to adulthood from the Probation system.

Focus Area

For this PQCR cycle the focus area for Child Welfare was Re-entry to Foster
Care (with an emphasis on children 0-5 yrs of age). The focus area for
Probation was Transition to Adulthood.

The Child Welfare measure was chosen by the Management Team after a
comprehensive review of the County‟s Child Welfare data trends reports,
provided by the DISE (Data Integrity Self-Evaluation) Workgroup. This
workgroup supports the management in the identification and analysis of data to
better evaluate the impact of program interventions on child safety, permanence
and well-being outcomes. The information available at that time (Q3-07)
revealed Alameda County‟s rate of re-entry to foster care was 16.0%. The
State average during that same time period was 11.1%, showing neither
Alameda nor the State as a whole meet the federal standard of no more than
9.9%. In numbers of children, for the year April 2006-March 2007 a total of 767
children were reunified with their families and of those a total of 131 re-entered
foster care for a total rate of re-entry for that period being 17.1%.

A review of the data from at least the last two years reveals that despite slight
changes each quarter, the above rates have remained decidedly constant.
Spurred by this information, management was convinced that a thorough
investigation of their case practices around the re-entry to foster care, would
better equip Child Welfare Workers, supervisors and managers to aid families in
crisis.

It is important to note that while Alameda County does demonstrate a higher than
average rate of re-entry, the performance in the rate of reunification has steadily
improved. In three of the measures that make up the Reunification Composite
(C1.1, C1.2, C1.3), Alameda County has made great strides to improve its
outcomes and has successfully reunified children of all ages with their families.
Additionally, the overall reunification composite outcomes performance has risen
from a baseline performance relative to the national goal of 87.2% in 6/2003 to
the currently performance relative to the national goal of 91.1% in 3/2008.

While this measure is not outlined in the previous SIP, it is outlined as an
overarching goal to be improved upon by the work identified through the Waiver
Plan. Through discussion in the PQCR planning meetings and a further
breakdown of the data, County staff made the decision to focus on Alameda
County‟s most vulnerable children, those children ages 0-5. The county staff
wanted to ensure County practices were in line with providing the highest quality
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        Alameda County Peer Quality Case Review Draft Final Report November 2008
of service to these children and families, and acknowledged that there was an
array of services already existing and available for families with young children.

Probation‟s focus was Transition to Adulthood. The area of focus was chosen as
many youth are entering the foster care system at a later age, and often age out
of the system. The majority enter foster care based on their offense and
treatment needs versus a dependency issue. These youth are seen as most
vulnerable to not reunify with their family of origin. Additionally, they need
transitional services to increase their level of independence, if reunification is not
possible. Their offense and probation status create barriers in finding transitional
services for Probation youth, even though they are still considered to be in foster
care. As a result, the challenge of this PQCR is to examine the processes and
resources available for the Probation foster care population. One main goal of
the Probation PQCR is to identify the specific practices of Probation Officers
around the involvement of family and family finding efforts.

Agency PQCR Preparation

Despite the limited time allotted for the planning and preparation for this PQCR,
there were varied opportunities extended to staff in both Child Welfare and
Probation which described the PQCR purpose and process. Division Directors,
Section Managers, and Supervisors were all encouraged to have discussions
with their staff regarding the PQCR and focus area selection. For Probation,
many of the Probation Officers were familiar with the PQCR process as they had
participated in the previous PQCR process. They welcomed the opportunity to
learn more about their practice to have an opportunity to better the outcomes of
the youth they serve.

In September 2008, two newsletters were distributed to all Children & Family
staff providing information regarding the PQCR process; the focus area selected
and also providing some basic information about confidentiality and case
selection. The newsletters gave staff important facts about the PQCR process
and were designed to answer the common questions staff may have regarding
the process and how the case selection process would be completed. The staff
were also directed to two individuals on the PQCR planning committee should
they have any additional questions. Flyers and posters were posted in the North
County and South County Children and Family Services offices and flyers were
also distributed and posted in the Juvenile Probation placement unit.

Staff selected for interviews were given a letter describing the process, a copy of
the interview tools, and were invited to a “Pre-briefing/orientation” session the
first day of the PQCR week. This day was specifically designed for Child Welfare
Workers and Probation Officers to have question and answer time regarding the
process and to give their input regarding concerns and desired results. Ensuring
that staff from both agencies had access to the same information was a key
consideration in preparing for the PQCR interviews. Staff from both the North
and South County offices in Child Welfare participated on the planning
committee, and played in integral role in the selection of cases and in revising the
interview tools. All levels of staff were identified to participate in the process from
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        Alameda County Peer Quality Case Review Draft Final Report November 2008
management to contracted Parent Advocates. This diagonal representation on
the planning committee allowed for decisions to be made promptly by
management and for the voice of staff in the field to be immediately considered.

Probation was active on the same planning committee and while their numbers
are considerably smaller than Child Welfare, they benefitted from the discussions
and experience of Child Welfare staff that had planned the previous PQCR
process. The Probation Placement Unit supervisor was the key person identified
to plan and execute the PQCR on behalf of Probation.

I. Methodology
The PQCR process requires data be analyzed from a variety of sources,
including the CDSS and UC Berkeley CWS/CMS data reports, Business Objects,
and Safe Measures. In addition to interviewing Child Welfare Workers and
Probation Officers, Children and Family Services and Probation elected to
conduct focus groups with different constituent groups to learn from a broad base
of experiences regarding the focus areas selected.

The Methodology for the Child Welfare focus area C1.4 Re-entry Following
Reunification is based on an exit cohort and asks the question, “Of all children
discharged from foster care to reunification during the year, what percent
reentered foster care in less than 12 months from the date of discharge?” This
measure computes the percentage of children reentering foster care within 12
months of a reunification discharge (the child must have been in placement at
least 8 days). The denominator is the total number of children who exited foster
care to reunification in a 12 month period; the numerator is the count of these
reunified children who then reentered care within 365 days of the reunification
discharge date. This measure contributes to the first permanency composite.

Case Sample Selection
The intention of the PQCR is to obtain qualitative data with respect to practice;
therefore, the focus was to obtain an objective agency-wide representation of
cases and workers. An initial sample size of 34 cases was selected for Child
Welfare and 12 cases for Probation. An additional pool of cases was identified
to ensure an adequate number of cases/workers were available as back-ups for
interviews.

The case selection process for Child Welfare was as follows:
    Identification of children who exited the foster care system during fiscal
      year 2006-2007 (493 children). An exit cohort was selected and the
      decision to pull all of the cases from one cohort was made to help ensure
      the families received comparable services;
    The decision to focus on children under the 5 years of age and under
      prompted the next parameter (185 children were 0-5 at exit);
    At this point 23 children were omitted from the sample, because after their
      exit from the system they did not receive any subsequent services from
      Alameda County Department of Children and Family Services. In other
      words these families received Family Reunification (FR) services and later
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       Alameda County Peer Quality Case Review Draft Final Report November 2008
       their cases were closed. The remaining 162 children received Family
       Maintenance (FM) services.
      Since the PQCR process includes a review of the full spectrum of Child
       Welfare practices a decision was made to select both families that
       experienced a re-entry and families who did NOT experience a re-entry.
       The remaining children were divided into two groups, one group who did
       re-enter into foster care within 12 months (47 children); and one group
       who did NOT re-enter into foster care within 12 months (115 children).
      Finally, recognizing there was a difference in the level of services a family
       obtains while receiving Emergency Responses (ER) services versus a
       family who is receiving family reunification services a final division was
       made to delineate the services component at reunification. Among the
       families that experienced a re-entry 21 children were reunified while
       receiving ER services and 26 were reunified after receiving FR services.
       Among the families that did NOT experience a re-entry 48 reunified from
       ER, while 67 reunified after receiving FR services. The final initial sample
       was then selected randomly, 70% or 24 children who experienced a re-
       entry and 30% or 10 who did NOT experience re-entry.
      Some other factors considered were the following: the Child Welfare
       Worker remained employed with the Agency and was not scheduled for
       time off during the PQCR event week; a fair representation from both
       offices within the County; and to interview a Child Welfare Worker only
       once.

A thorough review of the history of each of the remaining cases was done with
the intent to identify which Child Welfare Worker would be able to provide the
most pertinent information regarding the family; had worked with the family for a
substantial length of time; and would best know the services offered to shed
some light on the potential case practices which may have affected the re-entry
to foster care. This review also eliminated cases that were high profile, involved
a worker on the PQCR committee or in general were deemed inappropriate for
the PQCR process in that the substance of the petition would not lend itself to the
focus area selected. This review also eliminated cases which had been
transferred in from local counties, where the disposition and child placement was
determined by that sending County.

Safe Measures was used to identify previous case components and Child
Welfare Workers. A Child Welfare Supervisor, a Program Manager, CWS/CMS
Support Trainer assisted in this review, combing through the remaining cases.
(Note: In screening the cases, there was a striking difference noticed in that the
number of workers assigned to work with the family in re-entry cases was
markedly higher than the number of workers assigned in cases where re-entry
was NOT experienced.)

As a result of this review, Child Welfare Workers from Dependency Investigations
(a component of ER), FM, FP (Family Preservation) and FR were selected. The
PQCR team completed a total of twenty-four 24 interviews reviewing sixteen (16)
cases for Child Welfare. Seven (7) of the cases selected for Child Welfare
involved the interview of more than one worker that had been assigned to the
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        Alameda County Peer Quality Case Review Draft Final Report November 2008
case. For example, in one instance the ER worker who reunified the child with
the family was interviewed, as well as the FM worker who had then subsequently
petitioned the Court to remove the child.


The original case selection parameters for Probation were as follows:
    Probation cases were initially randomly selected for review;
    The youth must have been in a out-of-home/foster care placement (foster
      home, group home or other institution);
    All of the youth must have been between the ages of 15-18 years.

All of the cases meeting the above criteria were also screened with the Case
Screening Tool. This tool enabled the PQCR team to review the initial case
findings for appropriateness. The case screening tool also doubled as a way for
the review teams members to have pertinent case information.

Focus Group Selection
Five (5) focus groups were held between Probation and Child Welfare
constituents. Probation identified Probation youth as the one constituent group
to hear from via a focus group. Child Welfare identified four constituent groups;
Parent Advocates, Court Personnel (Judges, Attorneys, County Counsel); CARI
resource parents (foster parents who specifically care for the very young); and
Child Welfare Supervisors (specifically those who supervise the Child Welfare
Workers selected). All of the focus groups were held in accessible and
convenient locations for the participants. Food and beverages were also
provided.

Review Team Composition
Alameda County‟s Peer Review team consisted of twelve (12) members; two
local County staff; nine (9) staff from other California jurisdictions; and one
community partner. Contra Costa, Fresno, and San Francisco counties were
selected as peer review jurisdictions. Peer Counties were selected with the
following criteria in mind: innovative programming; performance in focus area
outcomes; reciprocity; and location.

In total, there were four review teams consisting of three members each. Child
Welfare had three review teams and had both experienced Child Welfare
Workers from peer counties as well as Child Welfare supervisors each of whom
had experience in both the front-end investigative ER aspect of Child Welfare
and FR/FM experience.

Probation had one four-member review team. Probation included one probation
placement officer from out-of-county, one County Child Welfare supervisor from
the Independent Living Skills Program (ILSP) and community partner who is the
executive director of two local group homes on their review team. The inclusion
of the ILSP supervisor and community provider on the probation team added a
unique experience for both the reviewers as well as provided rich feedback and
perspective for County Probation staff.

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       Alameda County Peer Quality Case Review Draft Final Report November 2008
Each review team was given a packet of information on the first day of the Event
week. This packet included all of the relevant material outlining the week‟s duties
and expectations. A daily schedule was given to each review team member
indicating the time and location of all events. Case material to prepare for the
interviews was also given to the review team members the day prior to the
interviews for their review. (Note: all review team member signed confidentiality
forms and a strict check-in/check-out procedure was followed regarding sensitive
documents). A Child Welfare and Probation - discipline specific acronym list was
provided to all review team members.

All members were available to participate during the review week, of October 13-
17, 2008.

Review Process
The first day of the review week consisted of training for review team members.
Training goals were as follows:

      To provide information to the PQCR Review Teams on tasks and
       responsibilities during the PQCR week
      To provide an orientation to the PQCR process for those being
       interviewed
      To develop a common understanding of the purpose and desired
       outcomes of the PQCR process
      To develop effective working teams
      To practice the interview process
      To develop a plan for creating a safe and supportive interview
       environment for the interviewees.

Interviews were scheduled for Tuesday, Wednesday and Thursday. Each team
performed four interviews the first day, three interviews the second day and two
interviews the third day. On the first day of the interviews, each Child Welfare
team ended the day interviewing a community partner. The probation team
ended with a custodian. Teams were given time each morning to prepare and
review cases and a debrief time after each interview was part of the schedule.
Review team members were provided with the PQCR Case Screening Tool and
Child Welfare provided the latest Court report and pertinent contact notes for
each case. All teams met together each afternoon for a debrief session that
consisted of summarizing daily trends in practice around five areas
(documentation trends, strengths and promising practices, training needs,
resource issues, and State technical assistance). Since there was overlap with
the Probation focus area and the Child Welfare review team members, the
decision to ask Child Welfare reviewers to remain in the room to add to any trend
of comment proved helpful to gathering information. Child Welfare interviews
were debriefed after probation.

100% of the interviews were performed.



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       Alameda County Peer Quality Case Review Draft Final Report November 2008
On Thursday after debriefing for the day‟s interviews, the trends for the week
were summarized and posted around the room. Each reviewer voted for the
three to five top trends under each practice area mentioned above. The top
trends were noted in each practice area and each team was then asked to
fashion possible recommendations to address each of the trends identified.
Friday morning, members of each review team gave a final presentation of the
week‟s themes and trends. Guest reviewers were also asked to identify their
local best practices specific to the focus areas, which they believed may help
Alameda County improve outcomes for children, youth and families.

Data Collection
Individual responses to interview questions were captured on the Child Welfare
Worker or Probation Officer interview tools. At the end of each interview, an
identified review team member entered that information on a debrief matrix. A
spreadsheet was developed for capturing the debrief trend data after each
interview, and was integrated into one document by clerical staff. To protect staff
confidentiality, no case or staff names were documented. Information was
gathered by team name only. To ensure that all information from the interviews
was collected onto the spreadsheet a quality assurance process of review was
employed at the end of each day. The CDSS consultant, one County analyst and
the consultant reviewed each of the completed interview tools and compared
them to the spreadsheet to ensure all information as transcribed.

Interview Tools
Distinct interview tools were developed and utilized for the Child Welfare
Workers, Probation Officers and for the different constituent groups interviewed
through focus groups. Information was collected on practices relevant to the
focus areas as well as family engagement, barriers, systemic issues and
recommendations for improvements. Interview tools are attached in Appendix A.

The Child Welfare Worker Interview Tool was developed to address casework
practice issues relevant to the focus area and contained questions in the
following areas:
     Safety & risk assessment
     Delivery of service
     Family strengths
     Cultural issues and practices
     Utilization of risk and safety assessment tools/TDM/supervision in
       decision-making
     Factors considered to make risk and safety assessment decisions
     Barriers to service provision
     Social work practices they were proud of and other practice observations
     Systemic barriers in working with or assessing families
     Recommendations which would better enable workers to support families
       and reduce the re-entry rates after reunification.

The Probation Officer Interview Tool was developed to identify practices and
services available to support youth as they transition from the probation system

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       Alameda County Peer Quality Case Review Draft Final Report November 2008
to adulthood and self-sufficiency. The Probation Officer Interview Tool contained
questions in the following areas:

      Engagement of youth and assessment of youths needs
      Both youth‟s and family‟s perception of youth needs
      Delivery of transitional living services
      Existing formal services
      Systemic factors – Department policy which supports or is a barrier to
       service provision or practice
      Probation practices they were proud of and other practice observations
      Systemic barriers to engagement and individualization of case plans
      Recommended systemic changes to promote engagement of family and
       the successful transition of youth to adulthood.

The Focus Group Tools were developed with each constituent group in mind.
The questions were designed to spark conversation around the focus areas and
to help pinpoint key areas in practice from the perspective of Court personnel,
Parent Advocates, youth, Child Welfare supervisors, Resource Parents and
others.

All of the interview tools were refined by the PQCR planning team. The interview
tools were reviewed weekly with planning team members and were tested
casually with workers to ensure the flow of the questions was adequate. Mock
interviews were also held two weeks prior to the PQCR event week and the tools
were modified based upon input from the Child Welfare Workers, Probation
Officers and supervisors who tested the tools.

Successes and Lessons Learned
The PQCR event week went smoothly with few challenges. Feedback from
review team members was that the process was well organized and that they
were impressed by the caliber of staff interviewed. Feedback from Child Welfare
workers, Probation Officers and supervisors interviewed was that the process
was positive and that the opportunity to give input and feedback was
appreciated. Contributing to the success of the project were the following:

      Weekly telephone conference calls or in-person meetings with agendas.
      Hosting all PQCR events at one site and central location – hosting focus
       groups in locations convenient to constituent groups
      Review team members who were dedicated and enthusiastic about the
       process
      Thorough screening and identification of cases using available technology
      Child Welfare review team members remaining for Probation debrief to
       allow for cross-training regarding resources for transitioning youth.
      Input from review team members and other agency staff on interview tools
      Mock interviews done to test interview tools with workers and supervisors
      Decorating interview rooms to make them more welcoming
      Providing food for review team members as well as staff interviewed
      Using consultants with experience in the PQCR process
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        Alameda County Peer Quality Case Review Draft Final Report November 2008
      Providing team support from County staff for each of the team members.
      Team building and networking within each of the review teams.

The following measures to improve the process were identified:

      More clearly defined roles and responsibility for County staff in planning
       PQCR. For probation, additional staff to help plan and execute PQCR.
      Early initiation of planning with a highly detailed work plan
      Identifying review team members and screening process to determine if
       appropriately matched for focus area and County needs
      Decreasing redundancy in interview questions – better layout of interview
       tools when interviewing workers from different programs
      Allowing for feedback from peer County review team members regarding
       interview tool.
      Reviewing each question with the peer review team members to get
       clarification regarding meaning of questions and to allow for any need to
       refine the interview tool.
      Reworking or rewording and/or better defining questions regarding State
       Technical Assistance
      Initiating early discussion with managers, supervisors and staff to better
       prepare the entire agency and staff for the PQCR process
      Early identification and invitation of review team members

II. Summary of Data
Characteristics        of   Child   Welfare     Workers     and     Probation     Officers
Interviewed

Child Welfare Workers
A total of 23 Child Welfare Workers were interviewed as part of the PQCR
process. Their characteristics are as follows:

            Average years of Public Child Welfare experience – 8 years and five months
            Average length of time with Alameda County – 8 years six months
            Average length of time in Child Welfare when assigned to this family – 4
             years

Probation Officers
A total of 7 Probation Officers were interviewed as part of the PQCR process.
Their characteristics are as follows:

            Average years of Probation experience – 11 years
            Average length of time with Alameda County Probation Placement Unit – 4
             years three months




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           Alameda County Peer Quality Case Review Draft Final Report November 2008
A. CHILD WELFARE WORKER INTERVIEW TREND DATA2


Strengths and Promising Practices
Clearly defined strengths and promising practices emerged during the interview
week. Trends in identification of strengths and promising practices included:

           Nearly all of the workers identified TDM meetings as a primary resource
            and benefit for engaging families and assessing the on-going placement
            and service needs of the family.
           Many workers identified in-home supportive services for families as a key
            in helping to reduce the re-entry of young children into the foster care
            system. Particularly noted was the SEED program (Services to Enhance
            Early Development) for its unique approach to serving families with young
            children.
           The majority of the workers discussed how they routinely involve co-
            workers in their practice for support and guidance.
           Workers also identified that they receive strong and consistent supervision
            to assist them with difficult assessments.

Barriers and Challenges
Many Child Welfare Workers identified the pressures of trying to meet the varied
demands of administration/ legal mandates and also provide quality social work
practice in working with families. Trends in barriers and challenges included:

           Workers indicated the current legal timeframes for reunification are not
            realistic for parents, especially when parents are contending with
            substance abuse and incarceration. As a result of these barriers, children
            may be returned prior to the parents being prepared to receive the child.
           Workers felt they have a lack of knowledge of developmental needs of
            children ages 0-5. They reported feeling that it is difficult to focus on the
            specific and varied needs of the youngest and most vulnerable on the
            caseload when the ages of the children on their caseloads are so varied.
           Worker‟s discussed the barrier created when a case transfers and how
            that can disrupt the social worker/parent relationship, including the
            problem that the new worker does not know the family history which can
            affect service provision and how the lag time that frequently happens
            when a case is transferred before the family is contacted by a new worker.
            Since Alameda County is set up to with separate FR and FM units, once a
            child is returned home (an especially vulnerable time for the family),
            inherent in the County process is the transfer of the case to a new Child
            Welfare Worker.
           When reunification happens, it happens haphazardly – there is a lack of
            planned transition.
           The lack of time is a barrier to effectively and appropriately use SDM tools
            as outlined in County policy.

2
    For more detailed information see Debrief Matrix in Appendix C
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              Alameda County Peer Quality Case Review Draft Final Report November 2008
Documentation and Use of CWS/CMS
Most Child Welfare Workers discussed the challenges of using CWS/CMS and
the SDM tools and how their usage can enhance or challenge practice. Trends
in documentation included:

      CWS/CMS is reported to be used consistently to document face to face
       contacts, however, it was reported to not be routinely used to document
       other information including narratives with case contacts, due to time.
       Workers also noted that maintaining only basic information in CWS/CMS
       would reduce the possibility of contention in the Court room, keeping
       notations brief was thought to help move the case along in the Court
       process.
      Workers indicated they did not know they needed to document and
       indicate whether the parent signed the case plan in CWS/CMS.
       Accordingly, a few workers did note parent‟s signature.
      Workers found it difficult to seek help from their supervisors when they
       needed guidance around CWS/CMS, and found it difficult to get on-site
       help for immediate needs.
      Workers reported inconsistent use of assessment tool system (SDM), in
       that they only used the tool‟s safety and risk assessment when unsure
       about the assessment. The tool was subsequently used for report writing
       and when transferring cases, not throughout the life of the case.
      Workers indicated the use of SDM tools assisted them in documentation,
       and the use of the safety assessment helped with making better decisions.
      Workers report they have limited time to complete necessary
       documentation, which may lead to scant information.
      There is difficultly in workers‟ ability to easily view other County‟s
       information in CWS/CMS, although it is possible to review the information,
       the process is cumbersome and time-consuming.

Training Needs
Trends regarding training needs identified by review team members included:

      Cross-training between Child Welfare, the Juvenile Court and attorneys, to
       identify roles and responsibilities for each discipline.
      Ongoing regular and advanced training for CWS/CMS.
      Training for Child Welfare Workers and Resource families especially
       regarding developmental ages 0-5 to improve participants‟ understanding
       of the age groups developmental needs including attachment and lack of
       attachment.

Systemic and Policy Changes
Topics in this area largely include the review team members‟ observations as
they interviewed Child Welfare Workers throughout the week. Trends in systemic
and policy changes included:


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        Alameda County Peer Quality Case Review Draft Final Report November 2008
      Caseloads are lower; however, the work impact is still high due to the
       intensity of the cases.
      There is an inherent adversarial relationship between Child Welfare and
       Juvenile Courts, resulting in decisions made that are not always in the
       best interest of the child.
      There is a difference in treatment between North and South County Court
       rooms
      When children are returned home, especially ages 0-5, children are not as
       verbal. If a new worker is assigned, the child/parent may be even less
       comfortable with the new worker making it harder to assess if the child is
       safe.
      There are multiple built-in case transfers in the County process resulting in
       time lapses when a new worker is assigned.
      A few workers indicated that children may be returned home too early as a
       result of the TDM, as the process can be enabling for the parent.


Resource Issues
This topic area encompasses all of the resources identified to enable Child
Welfare Workers to assist families in protecting their children. Trends in
Resources included:

      Families need additional support services after the child is returned home.
      There is a lack of quality substance abuse resources, specifically
       residential treatment for parents with multiple children of varying ages.
      Families need concrete resources, money, furniture, repairs on their
       homes.
      There is a lack of services for parents in jail: substance abuse treatment,
       basic visitation.
      There is a lack of basic services such as language services, child care,
       and transportation.
      There are only two drug testing sites, situated far apart. Families report
       they are able to choose when to test (no random testing) – Workers do not
       always get drug test results in a timely manner.
      Workers need more support around visitation.
      Workers need more resources such as lap tops for use in the field to
       maximize their time and enable them to document information in a more
       timely fashion.
      Families need more transportation resources. Due to size of the County,
       many families have difficulty traveling to needed services and therefore do
       not engage.
      Bi-lingual staff are needed to meet the diverse population needs,
       especially for the SEED program.

State Technical Assistance
Trends in State Technical Assistance included:


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        Alameda County Peer Quality Case Review Draft Final Report November 2008
      Improving the ability to more directly view other County‟s referrals in
       CWS/CMS without the current cumbersome process.
      Assist in maintaining Medi-Cal coverage for children when they return
       home so the children have seamless service delivery.
Other Salient Points
This area includes trends identified that were not directly linked to the focus area
but were found important to note. Trends included:
      Workers identified that few units are updating case plans to meet the
       current needs of the family. It was also noted in some instances, that
       supervisors update case plans during the transfer process.
      There was very little mention of parents involvement in developing the
       case plan – the actual document was often not signed by the parents.
      Review team members noted they did not hear about the use of the SDM
       tool (Family Strengths and Needs Assessment - FSAN) to develop case
       plan, which would identify which services would be priority for the family.
      Despite an initial feeling regarding the Juvenile Court, most often the
       Judge/Commissioner does follow the Agency recommendation regarding
       the assessment and placement of children.




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        Alameda County Peer Quality Case Review Draft Final Report November 2008
B. PROBATION OFFICER PROBATION OFFICER3

Strengths and Promising Practices
Clearly defined strengths and promising practices emerged during the interview
week. Trends in identification of strengths and promising practices included:

           Probation Officers displayed good engagement skills with youth (rapport
            building, honesty around current circumstance and choices, candid,
            empowering youth). One youth quoted “if my probation officer said she
            would be there on Tuesday, she will be there.”
           Many Probation Officers provided early, proactive planning prior to the
            youth‟s transition
           There appears to be a wonderful team effort with group home staff in
            planning the transition for youth, as they either exit the system or return
            home.

Barriers and Challenges
Many Probation Officers identified the challenges of trying to meet the needs of
youth with limited knowledge of available resources. Trends in barriers and
challenges included:

           Probation Officers describe the difficulty in contacting and communicating
            with an Eligibility Worker around Medi-cal and payments. Additionally,
            Probation Officers reported it was a challenge getting the Medi-cal card
            within the first 30 days of placement. Finally, getting payment to group
            homes in a timely manner is a challenge.
           Probation Officers often pay travel expenses related to visitation up front
            and wait to be reimbursed – This procedure hinders the relationship and
            the time that the Probation Officer has to spend with a youth that is placed
            far away and prevents more support for the youth. It is also difficult and
            visitation is hindered, when the Probation Officer can‟t afford to pay
            upfront for travel expenses.
           There can be difficulty with cell phone signal coverage for Probation
            Officers who are travelling throughout the County, and especially when
            alone it can be dangerous.

Documentation
Most Probation Officers discussed the lack of access to computer technology to
document their work which they believe enhances or challenges practice.
Trends in documentation included:

           Probation Officers have only hard copy documentation – there is no ability
            to have anything documented in the computer. Probation Officer‟s stated
            there is no way for them to consistently document their field notes or gain


3
    For more detailed information see Debrief Matrix in Appendix D
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              Alameda County Peer Quality Case Review Draft Final Report November 2008
       access to information on warrants, field notes, etc. There are no laptops
       with internet access so can‟t get pertinent information while in the field.
      When Probation Officers receive a case from another County or Child
       Welfare agency they do not receive adequate documentation or
       information to make a thorough assessment of the youth. The information
       provided rarely informs the Probation Officer of the family social history.
      Probation Officers reported not having enough time to document
       everything they do regarding their work with the youth and family as the
       caseloads are high.

Training Needs
Trends regarding training needs identified included:

      Probation Officers noted there is no formal induction training provided new
       Probation Officers, only on-the-job training which is inconsistent and not
       always relevant to their day-to-day work. In general, the Probation Officer
       officers would like to have more access to relevant training to help them
       improve their skill level.
      There is a need for cross training with Child Welfare to increase the level
       of knowledge regarding roles and responsibilities of Child Welfare in
       serving youth in transition.
      Probation Officers had little general knowledge of ILP/Transitional
       resources, specifically those resources available for after care. Many
       Probation Officers were not aware that it is mandatory to offer ILSP
       services to youth.
      Many Probation Officers requested that specific training be provided on
       the following topics: SSI/SSA eligibility and resources, Family Finding,
       Family Engagement, ICWA, and the training on the use of the CalWIN
       system to have access to basic information contained in the database.
      There was also the identification by Probation Officer officers that training
       on diagnosis and general mental health issues present in the youth
       probation serves would be of great benefit to them.

Systemic and Policy Changes
Trends in systemic and policy changes included:

      The Probation Officers report trouble with maintaining Medi-Cal insurance
       when youth have been moved from placement to placement. There was
       very little understanding of the eligibility process and policy around Medi-
       Cal. Probation Officers would like to gain access to CalWIN system.
      Probation Officers reported out of County ILSP services are inconsistent
       and there is no way to ensure youth are properly being prepared for
       transitioning to adulthood and/or exiting the system.
      Probation Officers report the current caseload numbers are too high to be
       able to maintain the level of relationships with youth and family necessary
       to foster successful transitions.



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        Alameda County Peer Quality Case Review Draft Final Report November 2008
      Once more the fact that Probation Officers must pay for travel up front
       from their own pocket to conduct visits with youth, was reported as a
       systemic/policy challenge to be addressed.

Resource Issues
The resource issues identified for Probation focused around the limited ability to
provide much needed services to youth. Trends in Resource issues included:

      There was a request there be clear identification of the available
       transitional resources for youth ages 15 ½ -24 years of age for Probation
       Officers. This information should be readily available to all officers
       throughout the Department. If possible this should contain resources for
       the most commonly used counties for placement outside of Alameda.
      There is a need for a pool of money/funds to provide enhancement
       activities – These funds could also be used for placement enhancement
       and to provide a safe placement.
      The need for respite was noted as a need for custodians/caregivers, for
       the youth placed in their homes.
      It was suggested by Probation Officers that all caregivers and Probation
       Officer officers should have an understanding of how to receive a special
       care increment, and what is the general structure and policy to obtain this
       resource.

State Technical Assistance
Trends in State Technical Assistance included:

      There is a challenge maintaining medical insurance (Medi-Cal) when
       youth are placed from county to county. This disruption can delay
       necessary medical/mental health services critical to the youth‟s
       functioning.

Other Salient Points
This area includes points identified that were not directly linked to the focus area
but were found important to note. :

      Review team members noted the Transition Independent Living Plan
       (TILP) was seen more as a formality for Probation Officers, as opposed to
       a resource document that should be used to assess youth and be an aide
       in preparing youth for exiting the system.

C. FOCUS GROUPS

Five focus groups were held during September and October of 2008. The focus
groups varied in size, with the smallest including four people and the largest
including eleven. The information below identifies themes and recommendations
from the focus group interviews.

Child Welfare Focus Groups
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        Alameda County Peer Quality Case Review Draft Final Report November 2008
   •   All four of the Child Welfare focus groups identified the legal timeframes
       for reunification as one contributor to the re-entry of young children after
       reunification. The sentiments expressed included that some Child Welfare
       Workers may reunify children early to help preserve the parents right to
       reunification; others noted that the agency may neglect to offer parents an
       extension on services due to budget constraints; another group identified
       that parents may be afraid to state they are not quite ready to have their
       children returned for fear it may impede their right to have the children
       return home at all. All of the groups stated that a closer look at the
       possibility of an extension of time, especially for parents dealing with long-
       term substance abuse may help reduce the risk of re-entry.
   •   Another central theme for the focus groups involved in-home supportive
       services for families who have completed residential treatment and need
       aftercare services. The idea that these families are particularly vulnerable
       to relapse, providing them with in-home support would help to ameliorate
       transportation issues, isolation and it could also potentially identify safety
       and risk factors prior to the situation becoming critical. A recommendation
       for the expansion of EPSDT services for families with young children and
       who receive full-scope Medi-Cal and also additional EPSDT contracted
       providers who may be able to provide the same type of services for
       families who do not qualify for Medi-Cal.
   •   Every focus group identified the necessity to have training regarding the
       developmental needs of children ages 0-5. While many working in this
       field have received basic education and training on child development, the
       mindset that children 0-5 “will be fine” remains a prevalent misconception
       among Child Welfare Workers, Juvenile Court personnel, parents and
       Resource Parents. Training regarding the latest information on the mental
       health of very young children with specific attention given to the impact of
       abuse and neglect on the development of the young child as well as how
       the removal and placement process affects young children‟s development
       should be made available for all working with this population.
   •   Each group spoke of the critical nature of the Child Welfare Worker and
       parent relationship has on reunification and parent engagement. Inherent
       to the Alameda County system are a series of worker transitions which
       can disrupt this vital relationship and hinder a parents progress. Vertical
       case management was mention as a way to avoid the consequences of
       continually severing the relationship building done by parent and Child
       Welfare Worker.

NOTE: Many Child Welfare supervisors indicated a desire to see data more
regularly regarding the re-entry of children after they have been reunified. They
indicated they often do not know if a child has re-entered the foster care system
and that information could help them supervise and hone their assessment skills
and those of their workers much more efficiently. There was a request to have
the data broken down by unit, and to be used purposefully, for advancing skill
and learning not to be used in a punitive manner.



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        Alameda County Peer Quality Case Review Draft Final Report November 2008
Probation Focus Groups

Probation held one focus group involving youth who have been placed in a group
home. The themes identified below correspond with those that were gleaned
through the PQCR interview process.

   •   While all of the youth acknowledged there are good Probation Officers and
       ones they never see, currently each of them could identify their Probation
       Officer and felt they could rely on them for support. They felt they had
       Probation Officers who knew them and cared about their success.
   •   The youth voiced that Probation should attempt to involve family more in
       their planning for the transition. One youth stated “some of our problems
       are because of our family situation”, and another youth stated “while on
       probation, it‟s like your family doesn‟t exist.” The youth would like to have
       their families more a part of their life and especially during the transition
       out of placement and return home.
   •   None of the youth could identify what their Transitional Independent Living
       Plan (TILP) was, nor did they play a part in its creation.
   •   For those who were participating in ILSP services they found them very
       helpful, however they would like to have had them at a younger age and
       not just as they are about to leave the system…it felt too late.


III. FINAL OBSERVATIONS AND RECOMMENDATIONS

Although both Probation and Child Welfare showed a great deal of strength, both
in staff and agency practices, there were areas identified by the interview teams
and focus groups that could make improvements with respect to the focus areas
selected. An advantage of conducting the PQCR is that recommendations for
improvement are made by the staff who are directly working with children and
families. Recommendations are categorized according to the debrief tool in the
following areas:

      Documentation
      Barriers and Challenges
      Training
      Systemic and Policy
      Resource Issues
      State Technical Assistance

Peer Recommendations for Documentation

Child Welfare
   • SDM should be trained to be utilized throughout the life of the case.
   • Supply laptops or PDA‟s with access to CWS/CMS so that Child Welfare
      Workers can take advantage of “down time” in Court and in the field. This
      would help to increase documentation.
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        Alameda County Peer Quality Case Review Draft Final Report November 2008
Probation
   • Have access to CalWIN, CWS/CMS and other databases to help
      improved the flow of information and access for Probation Officers.
   • Have a consistent database for Probation Officers to gather and document
      their case activities.

Peer Recommendations for Barriers and Challenges

Child Welfare
   • Have an Eligibility Worker assigned to units for easier access to Medi-Cal
      and foster care payments.
   • Review current structure to determine if case is moving from FR to FM
      could the FR worker maintain the case to reduce the break in relationship?
      Review other ways to minimize the transfer of workers which may disrupt
      service provision.

Probation
   • Have an Eligibility Worker assigned to units for easier access to Medi-Cal
      and foster care payments.
   • Lower caseloads so Probation Officer‟s have ability to form more
      supportive and consistent relationships with family and youth.
   • Provide car radios, so that Probation Officer‟s always have a way to
      request assistance in dangerous situations.

Peer Recommendations for Training

Child Welfare
   • Specific training for Resource Parents, Child Welfare Workers, Judges
      and attorneys on the developmental needs of children 0-5 years of age
      and how removal and attachment affect the children‟s development.
   • Cross-discipline training for Child Welfare, juvenile Court and Community
      Partners on substance abuse and recovery. This training would be
      specifically designed to help participants understand how recovery does
      not necessarily progress in harmony with the current legal timeframes for
      reunification.
   • Provide and expand training on new              template for standardized
      investigative narratives

Probation
   • Induction training for new Probation Officers that is consistent with the
      specific skill set needed for the work.
   • Provide general training on various relevant topics held on a regular basis
      for Probation Officers and ensure they have the ability to attend. Topics to
      include:      ICWA, mental health, Child Welfare, SSI/SSA, Family
      Finding/Family Engagement; Medi-Cal and eligibility processes.




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       Alameda County Peer Quality Case Review Draft Final Report November 2008
Peer Recommendations for Systemic and Policy Changes

Child Welfare
   • Streamline service delivery in Child Welfare to reduce the number of
      planned transitions of a case.
   • Create a practice and policy to have more of a planned transition of
      children in FR home to a return home. A formalized transitional planning
      process to help prepare families for reunification. Extended visitation plan
      with specific goals, for example as a way to help prepare parents and
      children for the return home.
   • Provide more consistent Agency direction around the decision to reunify
      young children home. There seemed to be no standard practice among
      workers/units within the Agency as far as returning children. One
      suggestion includes holding a weekly formal case conference with
      supervisors and managers and have workers present the case to reunify
      young children for approval.
   • Spread the SEED program to include all children ages 0-5 and require
      weekly contact with families with young children. This weekly contact
      would be specifically for cases where the SDM tool indicates high risk and
      that visitation should be made 3-4 times month to the family. This may
      also require a lower caseload for Child Welfare Workers.

Probation
   • Streamline process for Probation Officers to have access to travel funds
      for their regular monthly visits to youth placed a distance away.
   • Create a fund for Probation Officers to access for enrichment activities
      (SCIAP funding).

Peer Recommendation regarding Resource Issues

Child Welfare
   • Increase the pool of Parent Advocates and expand the program to families
      receiving FM services.
   • Provide more in-home supportive services
   • There is a need for a one-stop aftercare program. Once families leave
      residential treatment and become isolated this is a way to reintroduce
      them to the community and reduce the level of travel throughout the
      County for them to get the needed resources to remain clean and sober.
   • Child Welfare to have their own transitional housing specialist to assist
      families as they make the transition from residential treatment back to their
      community.
   • Recruitment & retention of Bi-lingual staff, especially for the SEED
      program.

Probation
   • Technical Resources for field work
   • Creation and dissemination (Agency wide) of all transitional services
      available for youth ages 15 ½-24.

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       Alameda County Peer Quality Case Review Draft Final Report November 2008
Peer Recommendations involving State Technical Assistance

Child Welfare
   • CDSS to capture and publish the best practices and lessons learned from
      PQCR‟s throughout the state.

Probation
   • Ensure Medi-Cal process becomes more seamless between placement
      transitions, especially between counties.
   • Statewide Medi-Cal eligibility as opposed to County specific.

The PQCR offered staff an opportunity to reflect upon and share their social work
practices as it impacts outcomes for children. While there was not a significant
amount of new information gained through the PQCR, staff appreciated the
opportunity to interact with peers from other Counties, between departments, and
with each other. The PQCR will be used to inform the Title IV-E Waiver CAP
plan. The commitment to the PQCR process is just one of the many steps that
both Departments have put forth in an effort to implement and facilitate change.
These changes have already begun to address the immediate concerns
reported. For example, working in collaboration during the interview week, Child
Welfare agree to assist Probation in streamlining the reimbursement process for
Probation Officers using their own funds to pay for transportation for regular
monthly visits.




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       Alameda County Peer Quality Case Review Draft Final Report November 2008
Appendix A
                           CALIFORNIA CHILD WELFARE
                       OUTCOMES & ACCOUNTABILITY SYSTEM
                           PEER QUALITY CASE REVIEW

                     CHILD WELFARE WORKER INTERVIEW TOOL


INFORMATION

County Name: ALAMEDA                                     Child Name:

Child Welfare Worker Name:                               Date of Interview:

Team/ Interviewer‟s Names:



                                INTRODUCTIONS & BACKGROUND

Child Welfare Worker Background
Introductions:

       Interviewer Team: Briefly identify interviewers and their work experience. Explain each interviewer‟s
        role (time keeper, recorder, and lead interviewer).




       Briefly remind of purpose of the interview.
         Anonymity
         No right or wrong responses
         Qualitative information about practice
         Concentrate responses on the focus topic: Re-Entry into foster care for children ages 0-5.
         Okay to generalize from other cases Feel free to speak in general terms about other case(s) as
            they relate to the focus topic. Do not feel limited if you feel something is important share it.

       Ask CWW for a brief summary of their background:

             Educational background (BSW, MSW, Title IV-E, licensed): ______________________

             Child Welfare experience (e.g., years of experience, which programs such as FR, DI, etc) :
             _________

             Length of time with this County: ______________________

             How long had you been a Child Welfare Worker when you were assigned this case? :
             ___________




Case Background Information

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          Alameda County Peer Quality Case Review Draft Final Report November 2008
1. Please take about 5 minutes to tell us generally about the ___________________family.
Prompt: If the worker didn’t identify the following information regarding the family, please prompt them to
provide the following information:
              Where was the family living? ________________________________________
              Income (yearly and source): __________________________________________
              Transportation: ____________________________________________________
              Employment: ______________________________________________________
              Primary Language: __________________________________________________




2. How did this family come into the system? What were/are the main issues facing the family?
Please include strengths.




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         Alameda County Peer Quality Case Review Draft Final Report November 2008
                                    CHILD WELFARE PRACTICE

Safety & Risk Assessment
3. In your daily practice, how do you utilize the SDM tools to aide your decision-making?




4. How did the TDM process influence your decision-making in this case? If no meeting was held,
please discuss the barriers to holding the meeting.



 5. Were there any cultural considerations regarding this family which factored into your
assessment? If so please share them. (Prompt: language, poverty/social class, life-style or family
tradition).




DI/FR Worker:

6. In assessing the risk factors of this family, was the use of the risk assessment tool helpful? If not
why? (Prompts: over-ride necessary; case didn‟t fit tool questions, profession judgment was
different).




7. If you made an assessment to return the child home in this case, what were the factors you
considered which led you to your decision?




Safety & Risk Assessment (Continued)
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         Alameda County Peer Quality Case Review Draft Final Report November 2008
8. Did you have reservations regarding the disposition of this case? Did the initial case plan reflect
your concerns?




9. In your practice in general, what safety and risk factors do you consider when returning children
to their parent(s) care?




FM/FP Worker:
10. When considering the removal of this child, was the safety assessment tool used? If so, was it
helpful in your assessment process? If not used, why? (Prompts: over-ride necessary; case didn‟t
fit tool questions, profession judgment was different).




11. When you received this case did you have reservations regarding the safety or potential risks for
this child? If so what were they? How did you ameliorate your concerns?




Case Plan


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         Alameda County Peer Quality Case Review Draft Final Report November 2008
12. Did the case plan match the needs of the family? If not, was the case plan updated to reflect
the needs of the family? If the case plan was not updated, why?




13. Describe the participation of the parent(s) in the development of the case plan? (Prompt for
reviewing of case plan with the family, signature and how it was documented in CWS/CMS.




Case Plan (Continued)


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        Alameda County Peer Quality Case Review Draft Final Report November 2008
14. Were the case plan goals met (parenting classes, substance abuse treatment, domestic
violence etc.) Were the safety concerns addressed in this case prior to the children returning to the
parents?




15. What part of the case plan did the family have difficulty completing?




DI workers:
16. How did the Court and or attorneys influence the development or modification of the case plan
for this family?




Reunification/Case Closure


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         Alameda County Peer Quality Case Review Draft Final Report November 2008
17. How did you assess the family‟s progress in meeting case plan objectives towards reunification?




18. Were the reunification timeframes a factor influencing your decision? (If this was a re-entry do
you believe the child was sent home too quickly?)




19. How did or do you utilize supervision in your decision-making process? Can you name three
things your supervisor does to help you in decision-making?




20. What was the frequency and quality of visitation at the time of reunification? Were there any
barriers to the implementation of a visitation plan?




Reunification/Case Closure (continued)


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         Alameda County Peer Quality Case Review Draft Final Report November 2008
DI/FR workers:
21a. Did Juvenile Court order the reunification of the children with the parent(s) against Agency
recommendations? If so, what was the cited reason for such an order?




b. Did having any challenge with foster care placement(s) influence your decision to recommend
reunification?




c. Describe the partnership between Child Welfare and the Legal System (Courts, attorneys and
CASA)? How is it helpful when reunifying families? What are the challenges?




d. In general, what are the challenges you face as you work to assist a family, with children ages 0-
5, towards successful reunification?




Reunification/Case Closure (continued)
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         Alameda County Peer Quality Case Review Draft Final Report November 2008
FP/FM workers:
22a. Describe how in your practice you utilize the perception of the Court to maintain successful
reunification of families?




b. Describe your partnership between Child Welfare and the Legal System (Courts, attorneys and
CASA)? How is it helpful when working to maintain children safely in their homes? What are the
challenges?




c. Did Juvenile Court order the closure of a case against Agency recommendations? If so, what was
the cited reason for such an order?




d. In general, what are the challenges you face as you work to help maintain children, ages 0-5
safely in their home?




Service Delivery


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         Alameda County Peer Quality Case Review Draft Final Report November 2008
23. What were the barriers for the parents in accessing needed services (i.e. location, language,
hours of operation, transportation, financial, childcare)?




24. Were the services the parent(s) were/was referred to appropriate to their identified needs? How
were they effective in meeting the needs of the family?




25. What other services were in place? (probation, mental health, public health, community based
services)




Service Delivery


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        Alameda County Peer Quality Case Review Draft Final Report November 2008
26. Describe your working relationship with service providers? (Prompts: how often and how do you
communicate? Phone, email, in-person; weekly, bi-monthly, every six months)




27. What, if any, challenges did you encounter in connecting this family to community resources?




28. How did you evaluate the effectiveness of the service or services being utilized by the family?




                                 CWS/CMS DOCUMENTATION


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         Alameda County Peer Quality Case Review Draft Final Report November 2008
Interviewers: Please explain to the interviewee that this section of the interview considers the
“mechanics” of the case and how the County can review and make any necessary changes to
ensure proper documentation is occurring.
29. What factors impact your use of CWS/CMS? What supports do you need that would be helpful
to fully utilize CWS/CMS.




30. Describe the training/support you have received that has been helpful in fully utilizing
CWS/CMS. How did your supervisor support you?




                         CHILD WELFARE WORKER REFLECTIONS


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         Alameda County Peer Quality Case Review Draft Final Report November 2008
Over the past three years, what improvements and actual changes within the agency have helped
you provide services more efficiently? (i.e. training, systemic changes(policy and procedures),
resources and caseload size) AND, are there any improvements or changes that you haven‟t already
mentioned that would be useful to help you do your job more effectively? (Training, resources,
supervision, procedures….)




When you face a difficult situation with a case, how do you get the support you need?




Please share some of your social work practices which you are particularly proud of?




Is there anything you would like to add?




                              Alameda County
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         Alameda County Peer Quality Case Review Draft Final Report November 2008
                     Juvenile Probation Department
                 CDSS -OUTCOMES & ACCOUNTABILITY SYSTEM
                        PEER QUALITY CASE REVIEW

                      PROBATION OFFICER INTERVIEW TOOL


                                     GENERAL INFORMATION

Team Name:                                             Case Name/Number:



Probation Officer:
                                                       Interview Time & Date:

                              INTRODUCTIONS & BACKGROUND

Probation Officer Background
Introductions:

     Interviewer Team: Briefly identify interviewers and their work experience. Explain each
      interviewer‟s role (time keeper, recorder, and lead interviewer).

     Briefly explain purpose of the interview.
       Anonymity- your name will not appear on these forms nor will it appear on any document or
          final report to the state
       No right or wrong responses
       Qualitative information about practice
       Concentrate responses on the focus topic: Transition to Adulthood
       Okay to generalize from other cases. Feel free to speak in general terms about other
          case(s) as they relate to the focus topic. Do not feel limited if you feel something is important
          share it.

            Ask Probation Officer for a brief summary of their education background (BS, Title IV-E), any
            specialized training, licenses or certificates, probation experience and length of time with the
            County.




Case Background




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         Alameda County Peer Quality Case Review Draft Final Report November 2008
ASSESSMENT & INDEPENDENT LIVING PLANNING

1.   Please take about 5 minutes to tell us generally about the youth and their family.




2. How did this youth come into the system? What were/are the main issues facing the
     youth/family? Please identify the youth‟s strengths and assets.




Assessment
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         Alameda County Peer Quality Case Review Draft Final Report November 2008
3. How did you determine the services this youth needed to prepare for transition out of placement?




4. How did you develop a relationship with the youth?




5. If you met with the family what steps did you take to engage the family in planning for the youth‟s short
   and long term goals?




6. What did the youth say they wanted for their future?




7. What did the family say was their goal for the youth?




8. Were you able to engage any extended family members, kin or other significant person in the youth‟s
   life, in the transition planning process? If so, how did you utilize them in the planning process? If not,
   what were the barriers that prevented your from engaging these individuals?



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         Alameda County Peer Quality Case Review Draft Final Report November 2008
9. What process did you use to discuss future needs and steps to achieve youth‟s goals?




10. What were the resource gaps identified?




11. What were the services were effective for preparing the youth for transition?




12. In your Department are their certain policies or systems that impact your ability to do what is needed to
    help with the successful transition out of placement for youth?




Delivery of Transitional Living Services
13.      How did you connect the youth to Transitional Living or Independent Living services?
      Which services did the youth identify as helpful for them and which were not?




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           Alameda County Peer Quality Case Review Draft Final Report November 2008
14.       Were there any barriers to accessing needed services (location, language, culture, hours
      of operation, transportation)?




15.       Did the youth have special needs which affected your ability to provide services for
      transition? If so, what were they? (Prompt: Behavioral issues-delinquency, acting out,
      mental health needs)?




16.        Describe the level of involvement of family members, mentors, teachers, staff, CASA
      etc.., or other significant members of the youth‟s community/life. In what ways were they
      helpful?




17.        What (if anything) could have been done to improve the speed and efficiency of service
      delivery for this youth?




18.       How and when did you determine the most appropriate post placement living
      environment for this youth?




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           Alameda County Peer Quality Case Review Draft Final Report November 2008
19. Were you able to identify the youth‟s eligibility for SSI/SSA? If not, what would help you to do
so?




Existing Formal Services
20. What were the steps used for planning for the youth‟s exit from formal services?




21. How do you assess the safety/risk issues in planning for a youth who is exiting formal
services?




PROBATION OFFICER OBSERVATIONS
1. Was there anything about this case that you found especially difficult or challenging?




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         Alameda County Peer Quality Case Review Draft Final Report November 2008
2. What improvements or changes would be useful to help you do your job more effectively?
   (Training, resources, procedures….)




3. Are their resources available to Child Welfare Services (CPS) that are not available to
   Probation that might have been helpful in this case?




4. If this case re-entered the justice system, either as a juvenile, or adult, what were the primary
   factors that lead to it and what in retrospect could have done to better support the Youth?




5. Describe some promising practices that you used in this situation to help to obtain
   permanency or to assist the youth in transition? Which aspects of your work are you most
   proud of regarding transitioning youth?




6. Is there anything you would like to add?




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         Alameda County Peer Quality Case Review Draft Final Report November 2008
Appendix B
                           CALIFORNIA CHILD WELFARE
                       OUTCOMES & ACCOUNTABILITY SYSTEM
                           PEER QUALITY CASE REVIEW

                       FOCUS GROUP INTERVIEW GUIDE – CARI


                                                INFORMATION

County Name: Alameda                                       Date of Focus Group:

Interviewer/Facilitator:
NAME                                                   AFFILIATION



                                INTRODUCTIONS & BACKGROUND
Introductions:

 Briefly identify facilitators and their title/affiliation. Explain each interviewer‟s role.

 Briefly introduce participants (parents and youth give first names only)


Purpose

 Explain general process
   Introductions and logistics (8 min)
   Facilitator to state the issue and why people are gathered here (10mins)
   Questions that guide the conversations (60 min)
   Conclusions, restate what the focus group notes will be used for and share appreciation (8 min)

 What is the reason for doing focus groups?
   Briefly explain PQCR process
   Focus area statement
   Need input to improve how we do our job
   The information will be shared confidentially with managers and staff to improve our services

GUIDELINES & GROUND RULES
Focus Group Guidelines:

 Participants choose guidelines and ground rules in addition to the following :

       Confidentiality-don‟t share what you hear outside of this room, unless someone discloses that
        they will hurt themselves or others
       Facilitators will write down comments (not names of who gave the comment) and share all the
        comments with staff and peers as a review tool for system improvements.
       No right or wrong responses




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          Alameda County Peer Quality Case Review Draft Final Report November 2008
                               FOCUS GROUP QUESTIONS

1. In your opinion, what types of factors (including
resources/services/supports/relationships) affect the re-entry of young children into the
foster care system?




2. What do you believe parents need to have their children safely returned to their care
and to prevent the re-entry of their children to care? What is your role in helping
parents safely reunify with their children and preventing the re-entry of those children?




3. How effective is Alameda County Children & Family Services is preventing the re-
entry of young children into the foster care system once they have been reunified with
their families?




4. Are there any resources, services needs or barriers which affect the re-entry of
children into the foster care system?




5. Are there any County practices or policies which affect the re-entry of young children
into the foster care system?




6. What services have you observed or parents you have worked with find were most
helpful? What services were least helpful?




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        Alameda County Peer Quality Case Review Draft Final Report November 2008
7. In your experience what role does visitation play in supporting successful
reunification of families? Do you have any suggestions that would improve the visitation
process?




8. We also want to hear about practices that have worked well so they can be shared
and possibly spread through the Agency. Can you share some instances when Child
Welfare staff/practice was pivotal in the successful reunification of families? What
specific things did the social worker do to assist the family?




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       Alameda County Peer Quality Case Review Draft Final Report November 2008
                           CALIFORNIA CHILD WELFARE
                       OUTCOMES & ACCOUNTABILITY SYSTEM
                           PEER QUALITY CASE REVIEW

                      FOCUS GROUP INTERVIEW GUIDE – COURT


                                                INFORMATION

County Name: Alameda                                       Date of Focus Group:

Interviewer/Facilitator:
NAME                                                   AFFILIATION



                                INTRODUCTIONS & BACKGROUND
Introductions:

 Briefly identify facilitators and their title/affiliation. Explain each interviewer‟s role.

 Briefly introduce participants (parents and youth give first names only)


Purpose

 Explain general process
   Introductions and logistics (8 min)
   Facilitator to state the issue and why people are gathered here (10mins)
   Questions that guide the conversations (60 min)
   Conclusions, restate what the focus group notes will be used for and share appreciation (8 min)

 What is the reason for doing focus groups?
   Briefly explain PQCR process
   Focus area statement
   Need input to improve how we do our job
   The information will be shared confidentially with managers and staff to improve our services

GUIDELINES & GROUND RULES
Focus Group Guidelines:

 Participants choose guidelines and ground rules in addition to the following :

       Confidentiality-don‟t share what you hear outside of this room, unless someone discloses that
        they will hurt themselves or others
       Facilitators will write down comments (not names of who gave the comment) and share all the
        comments with staff and peers as a review tool for system improvements.
       No right or wrong responses




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          Alameda County Peer Quality Case Review Draft Final Report November 2008
                               FOCUS GROUP QUESTIONS

1. In your professional opinion, what factors (including
resources/services/support/relationships) affect the re-entry of young children ages 0-
5yrs into the foster care system? How do you ensure these factors are in place prior to
reunification?



2. What is the Courts role in ensuring successful and timely reunification of families?



3. What is the Courts role in establishing an appropriate visitation plan?



4. How effective is Alameda County Children & Family Services is preventing the re-
entry of young children into the foster care system once they have been reunified with
their families?



5. Are there any resources, services needs or barriers which affect the re-entry of
children into the foster care system?



6. Are there any County practices or policies which, in your experience, affect the re-
entry of young children into the foster care system?



7. How often would you say child(ren) are returned to the care of their parents against
Agency recommendation? What seems to be the most common reason for this?




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        Alameda County Peer Quality Case Review Draft Final Report November 2008
8. How often would you say child(ren) are returned to their parents prior to completing
the services outlined in their case plan? Would, in most cases, the parents have nearly
completed the case plan prior to the Court ordering the child(ren) returned home? Can
you name the most common services that remain?




9. In your Court experience, what are some of the practices Child Welfare Worker do in
successful reunification cases, where children do not re-enter the Child Welfare system.
Can you identify particular aspects of their work which helped to make a difference for
families?




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       Alameda County Peer Quality Case Review Draft Final Report November 2008
                           CALIFORNIA CHILD WELFARE
                       OUTCOMES & ACCOUNTABILITY SYSTEM
                           PEER QUALITY CASE REVIEW

                 FOCUS GROUP INTERVIEW GUIDE – CWS PARENTS


                                                INFORMATION

County Name: Alameda                                       Date of Focus Group:

Interviewer/Facilitator:
NAME                                                   AFFILIATION



                                INTRODUCTIONS & BACKGROUND
Introductions:

 Briefly identify facilitators and their title/affiliation. Explain each interviewer‟s role.

 Briefly introduce participants (parents and youth give first names only)


Purpose

 Explain general process
   Introductions and logistics (8 min)
   Facilitator to state the issue and why people are gathered here (10mins)
   Questions that guide the conversations (60 min)
   Conclusions, restate what the focus group notes will be used for and share appreciation (8 min)

 What is the reason for doing focus groups?
   Briefly explain PQCR process
   Focus area statement
   Need input to improve how we do our job
   The information will be shared confidentially with managers and staff to improve our services

GUIDELINES & GROUND RULES
Focus Group Guidelines:

 Participants choose guidelines and ground rules in addition to the following:

       Confidentiality-don‟t share what you hear outside of this room, unless someone discloses that
        they will hurt themselves or others
       Facilitators will write down comments (not names of who gave the comment) and share all the
        comments with staff and peers as a review tool for system improvements.
       No right or wrong responses




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          Alameda County Peer Quality Case Review Draft Final Report November 2008
                               FOCUS GROUP QUESTIONS

1. What types of factors (including resources/services/supports/relationships) do
parents need to re-gain custody of their children in a timely manner?




2. How were you or families you work with included in developing case plan services?




3. How would you characterize your relationship with your social worker? How does the
relationship with your Social Worker affect timely reunification and re-entry in to foster
care? How did your relationship with your Social Worker affect your family's reunification
efforts? Do you have a different perspective now than when you were going through
the system?


4. What types of factors (including resources/services/supports/relationships) did you
need to safely maintain children in your home and prevent re-entry in to care? What
worked well? What were some challenges? How is this true for the families you are
working with now?



5. At the point of reunification, did you feel prepared and supported adequately to
provide for your children? Were you aided and supported by your family and
community to care for your children and prevent re-entry? If so, in what ways? If not,
what do you wish had been different?



6. What do parents need to reunify quickly without re-entry that do not currently exist?




7. What services did you or parents you have worked with find were most helpful?
What services were least helpful?




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        Alameda County Peer Quality Case Review Draft Final Report November 2008
8. In your experience what role does visitation play in supporting successful
reunification of families? What did visitation look like in your case? How often did you
see your children, was it supervised? What did the transition from out-of-home care to
the return home of the children look like? Was it helpful? Do you have any suggestions
that would have improved your visitation process?



9. If you had a child to re-enter foster care after re-unification what 3 things would you
change to prevent re-entry? If you had a child to reunify that did not return to foster
care please give 3 reasons why.




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        Alameda County Peer Quality Case Review Draft Final Report November 2008
                           CALIFORNIA CHILD WELFARE
                       OUTCOMES & ACCOUNTABILITY SYSTEM
                           PEER QUALITY CASE REVIEW

         FOCUS GROUP INTERVIEW GUIDE – Child Welfare Supervisor


                                                INFORMATION

County Name: Alameda                                       Date of Focus Group:
Interviewer/Facilitator:
NAME                                                   AFFILIATION



                                INTRODUCTIONS & BACKGROUND
Introductions:

 Briefly identify facilitators and their title/affiliation. Explain each interviewer‟s role.

 Briefly introduce participants (parents and youth give first names only)


Purpose

 Explain general process
   Introductions and logistics (8 min)
   Facilitator to state the issue and why people are gathered here (10mins)
   Questions that guide the conversations (60-90 min depending on timeframe allotted)
   Conclusions, restate what the focus group notes will be used for and share appreciation (8 min)

 What is the reason for doing focus groups?
   Briefly explain PQCR process
   Focus area statement
   Need input to improve how we do our job
   The information will be shared confidentially with managers and staff to improve our services


GUIDELINES & GROUND RULES
Focus Group Guidelines:

 Participants choose guidelines and ground rules in addition to the following:

       Confidentiality-don‟t share what you hear outside of this room, unless someone discloses that
        they will hurt themselves or others
       Facilitators will write down comments (not names of who gave the comment) and share all the
        comments with staff
       No right or wrong responses




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          Alameda County Peer Quality Case Review Draft Final Report November 2008
                               FOCUS GROUP QUESTIONS

1. In your opinion, what factors prevent the re-entry of young children ages 0-5 yrs into the foster
   care system?



2. In your opinion, what factors lead to the re-entry of young children ages 0-5 yrs into the foster
   care system?



3. When a Child Welfare Worker is considering reunification, what key factors do you review with
   them?



4. What are the social work practices which affect the re-entry of young children ages 0-5 yrs into
   the foster care system?



5. Are there systemic challenges and barriers that line staff and supervisors feel which affect re-
   entry of young children ages 0-5 yrs into the foster care system?



6. What would be helpful for you to better support your staff to improve the outcomes of the children
   and families you serve and prevent re-entry?




7. In what way do the SDM assessment tool and TDM process help to prevent the re-entry of young
   children ages 0-5 yrs into the foster care system?




8. Would you please share some of your supervisory practices you are proud of? Please also share
   some practices Child Welfare Workers do in successful reunification cases, where children do not
   re-enter the Child Welfare system? Can you identify particular aspects of their work which helped
   to make a difference for families?




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     Alameda County Peer Quality Case Review Draft Final Report November 2008
                          CALIFORNIA CHILD WELFARE
                      OUTCOMES & ACCOUNTABILITY SYSTEM
                          PEER QUALITY CASE REVIEW

        INTERVIEW GUIDE – CHILD WELFARE COMMUNITY PROVIDERS


                                              INFORMATION

County Name: Alameda                                     Date of Interview:
Team Name:




                               INTRODUCTIONS & BACKGROUND
Introductions:

       Interviewer Team: Briefly identify interviewers and their work experience. Explain each interviewer‟s
        role (time keeper, recorder, and lead interviewer).




       Briefly remind of purpose of the interview.
         Anonymity
         No right or wrong responses
         Qualitative information about practice
         Concentrate responses on the focus topic: Re-Entry into foster care for children ages 0-5.
         Do not feel limited to share any information if you feel something is important share it.



       Ask Community Partner for a brief summary of their background and work with Alameda County
        dependents ages 0-5yrs.




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          Alameda County Peer Quality Case Review Draft Final Report November 2008
                                 INTERVIEW QUESTIONS

1. In your professional opinion, what factors (including
resources/services/support/relationships) affect the re-entry of young children ages 0-
5yrs into the foster care system?




2. How effective is Alameda County Children & Family Services in preventing the re-
entry of young children into the foster care system once they have been reunified with
their families?



3. Have you recognized any changes in the performance or practices regarding the re-
entry of children ages 0-5 yrs., from new initiatives or strategies implemented by the
County over the past three years?



4. Are they any County social work practices or policies that you know of which may
affect the re-entry of children ages 0-5?



5. What County support would you need to help reduce the re-entry of children ages 0-
5 yrs. for the children and families you serve?




6. In your experience, what are some practices Child Welfare Workers do in successful
reunification cases, where children do not re-enter the Child Welfare system? Can you
identify particular aspects of their work which helped to make a difference for families?



7. Is there any additional information regarding the re-entry of young children to the
foster care system that you would like to add?




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        Alameda County Peer Quality Case Review Draft Final Report November 2008
                           CALIFORNIA CHILD WELFARE
                       OUTCOMES & ACCOUNTABILITY SYSTEM
                           PEER QUALITY CASE REVIEW

                 FOCUS GROUP INTERVIEW GUIDE – PROB YOUTH


                                                INFORMATION

County Name: Alameda                                       Date of Focus Group:

Interviewer/Facilitator:
NAME                                                   AFFILIATION



                                INTRODUCTIONS & BACKGROUND
Introductions:

 Briefly identify facilitators and their title/affiliation. Explain each interviewer‟s role.

 Briefly introduce participants (parents and youth give first names only)


Purpose

 Explain general process
   Introductions and logistics (8 min)
   Facilitator to state the issue and why people are gathered here (10mins)
   Questions that guide the conversations (60-90 min depending on timeframe allotted)
   Conclusions, restate what the focus group notes will be used for and share appreciation (8 min)

 What is the reason for doing focus groups?
   Briefly explain PQCR process
   Focus area statement
   Need input to improve how we do our job
   The information will be shared confidentially with managers and staff to improve our services


GUIDELINES & GROUND RULES
Focus Group Guidelines:

 Participants choose guidelines and ground rules in addition to the following:

       Confidentiality-don‟t share what you hear outside of this room, unless someone discloses that
        they will hurt themselves or others
       Facilitators will write down comments (not names of who gave the comment) and share all the
        comments with staff
       No right or wrong responses




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          Alameda County Peer Quality Case Review Draft Final Report November 2008
                              FOCUS GROUP QUESTIONS

   1. How well does Probation provide services to prepare youth fifteen and older to
      be independent? Are the services effective?




   2. How effective is Probation in involving youth (and their parents) in creating their
      own transitional independent living plan or case plan?



   3. How did your Probation Officer link you to services?



   4. Were you given the services you needed or requested while you were in
      placement? (prompts education, employment, skill building, etc)



   5. Did you or do you visit with your family regularly?



   6. How has Probation helped you to link and maintain contact with extended family
      or other people close to you?



   7. Is there anything that could have been done to better support you and your
      family‟s success?



Additional Comments:




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       Alameda County Peer Quality Case Review Draft Final Report November 2008
                             CALIFORNIA CHILD WELFARE
                         OUTCOMES & ACCOUNTABILITY SYSTEM
                             PEER QUALITY CASE REVIEW

                       INTERVIEW GUIDE – PROBATION CUSTODIAN

                                                   INFORMATION

County Name: Alameda                                           Date of Focus Group:
Interviewer/Facilitator:
NAME                                                   AFFILIATION
Stacie Buchanan                                         Shared Vision Consultants, Inc
Erika Gonzales                                          Bay Area Academy

                                   INTRODUCTIONS & BACKGROUND
Introductions:

   Briefly identify facilitators and their title/affiliation. Explain each interviewer‟s role.

   Briefly introduce participants (parents and youth give first names only)


Purpose

   Explain general process
     Introductions and logistics (8 min)
     Facilitator to state the issue and why people are gathered here (10mins)
     Questions that guide the conversations (60-90 min depending on timeframe allotted)
     Conclusions, restate what the focus group notes will be used for and share appreciation (8 min)

   What is the reason for doing focus groups?
     Briefly explain PQCR process
     Focus area statement
     Need input to improve how we do our job
     The information will be shared confidentially with managers and staff to improve our services


GUIDELINES & GROUND RULES
Focus Group Guidelines:

   Participants choose guidelines and ground rules in addition to the following :

       Confidentiality-don‟t share what you hear outside of this room, unless someone discloses that they will
        hurt themselves or others
       Facilitators will write down comments (not names of who gave the comment) and share all the
        comments with staff
       No right or wrong responses




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          Alameda County Peer Quality Case Review Draft Final Report November 2008
                               INTERVIEW QUESTIONS


1. How effective is Probation in helping youth transition to independent adulthood?




2. How effective is Probation in involving caretakers in creating a workable independent
   living plan for youth?



3. How did the youth‟s Probation Officer include you in determining what services would be
   provided to youth in your care?



4. Do you feel the Probation Officer took time to get to know you? Your child? How often
   did you hear from the Probation Officer?



5. Are there any services, resources, or barriers which affect the successful transition of
   youth to independent living?



6. What suggestion for change do you have that the Probation Department could use which
   would better help youth and their families succeed?


7. What is your greatest concern regarding the transition to independent living for the youth
   in your care?




8. We also want to hear about practices that have worked well so they can be shared and
   possibly spread through Probation. Can you share some instances when the Probation
   Officer was pivotal in the successful transition of the youth? What specific things did the
   Probation Officer do to assist the youth?


9. Is there anything you would like to add?




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    Alameda County Peer Quality Case Review Draft Final Report November 2008
Appendix C
                                  PQCR DAILY DEBRIEF
                                     FOCUS TOPIC:
             Re-Entry into Foster Care (ages 0-5)
                                         10/14-10/16
Identify strengths and promising practices:
The use of TDM (involves parent and family‟s support system-and agency other that just SW)
great outcomes for families; having SDM with specific definitions for safety; SEED program;
cultural considerations in case management.
Consistent supervision.
Ability to use peers for support.
Workers saw in-home services a plus for families.
SEED - expansion – continuity of worker – intensive work with family, clinician involved in
decision making – evaluations with both birth parent and in placement – lower caseload
EPSDT – In Home Supportive Services – Therapeutic Visits
SDM – using historical information
DI – 30 day trial visit prior to the dispositional recommendation is made for FM services
Project Pride allows transitional overnight visits
More resources available; bus passes and BART tickets are easier to get, parenting classes in
different languages.
Supervisors know CWS/CMS
Family finding was utilized as a resource by workers.
Email Court reports to attorneys – the availability to have faster access to Court reports.
Identify documentation trends/ Use of CWS/CMS:
Use of SDM, only used the tool in front end when was unsure about assessment (helped with
safety assessment). Tool used when report writing and when transferring cases, not throughout
the life of the case.
Supervisors have limited knowledge of CWS/CMS. CWWs only have initial training and not on-
going. There is no on-site tech support for immediate needs.
CWS/CMS reported to be used consistently, however selective.
Using it minimally – due to lack of time
Using for face to face visits but not entering narrative
Did not know that they needed to document that the parent signed the case plan
PDA or other remote access to CWS/CMS
No documentation of parent‟s signature on case plans – CWWs were not aware of this
compliance issue.
Identify Barriers & Challenges:
Legal timeframes for reunification are not realistic, especially with sub abuse and when parent is
incarcerated.
Time is a barrier to effectively use SDM.
CWW‟s reported lack of supervision. – Use colleagues instead of supervisors in that they had
multiple sups.
Challenge around the transition of cases between units. CWW‟s not understanding case
history.
Beds available for parents and children together in substance treatment – also facility that will
take older children
Lack of knowledge of developmental needs of children ages 0-5 when you have a range of ages
on your caseload
Once the child is returned or once they leave in patient treatment lack of motivation to continue
services, follow case plan and workers couldn‟t do anything
Substance abuse treatment, sometimes when there is a requirement to have a child placed
within 90 days, the children are returned home too early.
6 months is not enough time to undo a long history of substance abuse
When reunification happens, it happens haphazardly – lack of planned transition.



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        Alameda County Peer Quality Case Review Draft Final Report November 2008
Some parents are hesitant to have child placed with them while in substance abuse treatment
because the parents had concerns about the childcare provided in the treatment program.
Location of foster homes far away from Alameda County and lack of Alameda County homes.
Multiple placements leads to trauma could lead to returning a child too early
Parents refuse to engage in services
Families that are so marginal, children are suffering because of marginal state of the family.
Medi-Cal for the parents, getting them enrolled in it so they can take advantage of services.
Parent failed after getting out of residential treatment services because of lack of structure, and
having to go to multiple sites for services outside of their home.
Vicious cycle of parents needing their children to have housing and income and when is the
proper time to reunify so they can have housing.
Breakdown of SDM – the tool doesn‟t address relapse and when was last usage.
Multiple services for families and the difficulty of completing services if on public transportation.

Identify Training Needs:
There is a need for cross-training between CPS and Juvenile Court and Atty‟s, to identify roles
and responsibilities for each discipline.
Ongoing regular training for CWS/CMS, this includes advanced training for both Child Welfare
Workers and supervisors.
There is a need for sensitivity training around English as a second language.
Training around Family cultural needs at the ER level
Provide specific training for foster care families and Child Welfare Workers, especially regarding
the developmental needs of children age 0-5 – and understanding the different age groups
developmental needs. Understanding how critical attachment and lack of attachment is for young
children and healthy development.
Identify Systemic/Policy Changes:
Caseload lower however work impact still high with intense cases
Transition of case between programs can cause a gap in services
Difference in treatment of North and South County Court rooms
Inherent adversarial relationship between Child Welfare and juvenile Court – decisions being
made that aren‟t always in the best interest of the child; each side wants to win, not what is best
for the child.
There are transportation difficulties for CWWs walking several blocks to get a County car. And
few County cars, may or may not be available.
When kids are returned home, especially ages 0-5, kids are not as verbal, new worker less
comfort with new worker therefore harder to assess if the child is safe. Time lapses when new
worker is assigned.
Identify Resource Issues:
Lack of housing. Lack of services in jails (sub abuse, basic visitation).
Lack of language services, child care, transportation.
Lack of quality substance abuse resources.
Child Care
Transportation – Services too far away
Need additional support services after the child is return
Need for concrete resources, money, furniture, repairs on home
Need for more support around visitation.
Drug testing – only two sites, far apart in Alameda County – client able to choose when to test –
CWW did not get drug test results in a timely manner.
Lack of Spanish speaking SEED workers that caused a barrier to engaging with the family.
Identify areas needing state technical assistance:
Gap in Medical coverage when children are returned home
Other Salient Points:
Children returned home too early as a result of the TDM. TDM can be enabling the parent.
Workers identified that other units were doing the case plans and only some are updating the cp
to meet needs.
Parents not involved in developing the case plan – not signed.
Did not hear about the use of the SDM tool (FSAN) to develop case plan
Don‟t become attached to the outcome.

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         Alameda County Peer Quality Case Review Draft Final Report November 2008
Appendix D

                                  PQCR DAILY DEBRIEF
                                     FOCUS TOPIC:
                         Transition to Adulthood
                               10/14-10/16
Identify strengths and promising practices:
Relationship with youth – when they had a good relationship they were consistent with their
contact with the youth
Team effort with group home staff on transitioning youth.
Early, proactive planning done by PROBATION OFFICER prior to transition
Including the parent in the transition – getting verification
Encouraging the youth to expand their horizons – looking into college – take on college tour
Custodian – an equal partner with Probation in discussing services for youth, had support from
Prob. PROBATION OFFICER consistent, developing rapport with youth. “if she said she would
be there on Tues, she would be there".
Motivational interviewing with youth – PROBATION OFFICER encouraged the youth to think
outside the box. Allowed youth to feel comfortable enough to regularly contact the PROBATION
OFFICER.


Identify documentation
Hard copy documentation – nothing in a computer
When received a case from another County or CPS there was not adequate documentation or
information in the case.
Internet access in the field for laptops, so they can check warrants, etc.
Field notes, R & R, TILPs
Sometimes don‟t have enough time to document everything, caseloads high, busy.


Identify Barriers & Challenges:
Out of state placement – unknown resources
Group Home payments in a timely manner
PROBATION OFFICER pay travel expenses up front and wait to be reimbursed – can hinder the
relationship and the time that the PROBATION OFFICER has to spend with a youth that is placed
far away and prevents more support for the youth.
Difficulty with cell phone signal, and especially when alone it can be dangerous. (radios in cars
would help).
Difficulty with getting in touch with ED around Medi-cal and payments. Along with getting Medi-
cal card within the first 30 days of placement.


Identify Training Needs:
No formal Induction training regardless of program that they are placed. 0JT only
Training on Resources that are available to youth through ILSP and after care.
Training not relevant
Training on SSA and SSI eligibility
Training on the use of CalWIN
Training on ICWA as it relates to Juvenile Probation
Training in regards to community resources; or children with MH issues, they would like to have
access to more training. Emancipation issues and basic training to do her job.
PROBATION OFFICER not aware that it is mandatory to offer ILSP services to youth.




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         Alameda County Peer Quality Case Review Draft Final Report November 2008

				
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