In Connecticut, government services for children and youth, which include public education, cash and housing assistance, health care, prevention and diversion programs, services for those with disabilities, advocacy, juvenile justice; and community-based corrections, are not consolidated within one agency.  Rather, services for those under age 18 are provided by more than a dozen state agencies, the judicial branch, and over 200 public and private facilities and programs, both in- and out-of-state.  

            This section provides an overview of the services provided to persons under 18 by entities other than DCF.  Each one's role in serving children, which may not be its primary mandate, is highlighted below.  Many agencies and providers do not have a formal or direct relationship with DCF, despite its broad role as the state's children's agency.  Current working relationships and mechanisms for coordinating children's services among agencies and providers are also described below.  

State Agencies with a Role in Children's Services  

The state agencies with a role in providing children's services were categorized by the program review committee according to the type of service provided.  Services were broadly classified as: social/welfare; mental health; health; education; juvenile justice; substance abuse; prevention; and advocacy.  Table VI-1 shows the state agencies other than the Department of Children and Families that have a role in providing services to persons under 18.  

Table VI-1. State Agencies (Other than DCF) Providing Children's Services
Social/Welfare	Department of Social Services* Department of Mental Retardation	Board of Education and Services for the Blind*
Mental Health	Department of Mental Health and Addiction Services*
Health	Department of Social Services Department of Public Health
Education	State Department of Education State Board of Education	Department of Mental Retardation Board of Education and Services for the Blind
Juvenile Justice	Judicial Branch Department of Corrections	Board of Parole Division of Criminal Justice
Substance Abuse	Department of Mental Health and Addiction Services
Prevention	Children's Trust Fund
Advocacy	Office of Child Advocate Office of Protection and Advocacy	Commission on Children Commission on Deaf and Hearing Impaired
*Denotes an agency with responsibility for more than one type of service category.

As the table indicates, some agencies, like the Departments of Social Services and Mental Retardation, provide more than one type of children's service.  Each state agency's responsibilities for children's services are briefly described below.  

·       State Department of Education and State Board of Education are responsible for the general supervision and control of the state's public educational interests including preschool, elementary and secondary education, special education, and vocational education.  Public school education is the primary service provided by the state to all children.  The SDE also supports Youth Service Bureaus that provide community-based prevention, intervention, treatment, and follow-up services for children and youth. 

·       Board of Education and Services for the Blind (BESB) is responsible for providing a comprehensive, community-based continuum of individualized educational, rehabilitation, and social services to legally blind and visually impaired children.

·       Department of Social Services is responsible for a number of programs that directly or indirectly provide goods and services to low-income families, youth, and children.  The programs include: Temporary Family Assistance (formerly AFDC); Food Stamps; Medicaid; and General Assistance program. DSS is also the state's lead agency for child support enforcement activity. 

·       Department of Public Health (DPH) is the state's lead agency for public health policy and advocacy.  DPH operates or funds a number of programs that serve children and youth, including maternal and infant care projects, adolescent pregnancy prevention programs, supplemental nutrition programs, and school-based primary health care services.  The department also licenses a variety of health and behavioral health (mental health and substance abuse) facilities that serve children, and it also regulates child day care facilities.

·       Department of Mental Retardation is responsible for planning, developing, and administering complete, comprehensive, and integrated state-wide services for persons with mental retardation, diagnosed as having Prader-Willis syndrome, or who are autistic.  DMR administers the Birth-to-Three program, a system of early intervention services for all infants and toddlers under age three with any types of disability or significant developmental delay.

·       Office of the Child Advocate is responsible for: the evaluation and review of the delivery of children's services by state agencies and state-funded organizations; investigation of complaints regarding the actions of any state or local agency or state-funded organization providing children's services; and reviews juvenile delinquency facilities.  Furthermore, the advocate can recommend changes in children's policies, conduct public education programs, propose legislative changes, or take formal legal action.  The child advocate is also a member of the state's child fatality review board.

·       Judicial Branch is responsible for the state's court system.  The Superior Court's Family Division hears all criminal and civil matters involving children under 16 and all other matters involving a youth between the ages of 16 and 18 are heard by the (adult) criminal or civil divisions of the court.  The criminal section adjudicates delinquency and Family With Service Needs cases and the civil section disposes of cases involving dependent, neglected, and uncared for children, termination of parental rights, and emancipation of minors.  The judicial branch also operates court support services that include juvenile intake, assessment, and referral services and probation supervision services that are provided to juvenile delinquents and FWSNs.  In addition, the judicial branch administers the state's three juvenile (pre-trial) detention facilities for children up to the age of 16.

·       Division of Criminal Justice is responsible for all state criminal prosecutorial functions including juvenile delinquency matters.

·       Department of Correction (DOC) is responsible for providing fair, safe, humane, and secure care of individuals placed in its custody, and intervening to reduce the likelihood of recidivism and criminality of those sentenced to its jurisdiction.  The department incarcerates all adjudicated offenders, including male and female youth who are at least 16 years old and 14- and 15-year-old juveniles who have been adjudicated in the adult criminal court.

·       Board of Parole (BOP), in accordance with the state's sentencing statutes, is responsible for determining when adjudicated inmates, including those between 16 and 18, serving sentences greater than two years should be granted parole and under what supervision conditions.  As a result of the 1995 Juvenile Justice Reorganization Act, which authorized the transfer to adult court of juveniles charged with specific crimes, the parole board will soon be considering the release of parole-eligible juveniles who are between the ages of 14 and 16.  The board will also be required to provide community-based parole supervision to these youth.

·       Department of Mental Health and Addiction Services is responsible for administering client-based mental health treatment and substance abuse services to persons who are at least 18.  The department's prevention programs serve all children and adults. DMHAS and DCF began a three-year pilot program, in 1998, for youth leaving DCF care who have pervasive developmental disorders or predatory sexual disorders.  To be eligible for the DMHAS services the youth must be between 18 and 21 and enrolled in school or training program.  The program is intended to ease the transition to the adult system and provide comprehensive and individualized services.

·       Commission on Children, a legislative agency, is responsible for studying the status of children and recommending improvements to programs, policies, or legislation aimed at improving the development of children and strengthening of families.

·       Children's Trust Fund was established by the General Assembly in 1983 to receive public and private monies to be used to support families in raising healthy and capable children.  Its primary focus in on prevention of abuse and neglect.  It is directed by a council comprised of the commissioners of the departments of children and families, public health, social services, and education and representatives of the business community, child abuse prevention field, parents, and a pediatrician.

·       Commission on the Deaf and Hearing Impaired is responsible for advocating for deaf and hard of hearing individuals, including children.  It oversees and provides interpreter services and provides personal and family counseling services.

·       Office of Protection and Advocacy is responsible for advocating for all citizen's with disabilities.  It provides information and referral services, investigates allegations of abuse or neglect of disable persons, provides public education and training, and pursues legal and administrative remedies for disability-related discrimination.

Interagency coordination.  Over the years, several organizations have been created to coordinate the activities of human service agencies, including their responsibilities related to children.  Most notable were the Council of Human Services, established in the 1970s, and later the governor's  Human Services Cabinet.  The council was comprised of commissioners of all the state human service agencies and was mandated to coordinate planning, policy, and resource utilization among them.  It was in effect from 1973 to 1977.  A human service cabinet with a mandate similar to that of the council was informally established during the administration of Governor Weicker.  

More recently, a common mechanism for achieving interagency collaboration is a written document signed by the parties involved called a memorandum of agreement (MOA) or memorandum of understanding (MOU).  The Department of Children and Families has entered into written agreements with other state agencies and with the judicial branch to either transfer a responsibility or clarify roles in providing a service.  Table VI-2 provides a brief description of 14 MOUs/MOAs currently in effect between DCF and other state agencies.              

As shown, eight of the memoranda clarify the responsibilities of the agencies.  For example, the department has entered into four agreements with DSS to define roles and procedures related to: processing children eligible for Title IV-E and for the Connecticut Access medical program; conducting background checks on unlicensed persons legally providing child care; and depositing and spending funds from the federal social services block grant.   Another agreement outlines DCF's responsibility for the educational costs for children it places in residential facilities.  The remaining agreements shift responsibility for a particular service or target population from DCF to another agency or clarify procedural issues between the agencies.  

Private Providers of Children's Services  

The Department of Children and Families relies on a network of private, typically nonprofit, community-based service providers for much of the treatment and care its clients require.  About half the agency's total expenditures each year between FY 91 and FY 99 have paid for contracted services that range from prevention and diversion to foster care and residential treatment.   The main types of direct services purchased by the agency are shown in Table VI-3.   They are grouped according to the service categories DCF uses, which are based on a child's placement (i.e., in- or out-of-home).  

Table VI-2. Written Agreements Between DCF & Other State Agencies
Department	Description of Agreement:
Education	To develop & implement a plan to prevent, identify, and treat child abuse & neglect, and to train education professionals in detection & reporting. (1986) To continue the inclusion of students, who are not enrolled in a public school district that is financially responsible for the child's education ("no nexus"), within DCF Unified School District #2 whenever the child is placed by DCF in a residential facility & DCF will assume responsibility for educational costs. (1993)
Social Services	To establish procedures for effective & timely processing of medical eligibility for Title IV-E children and state-funded children.<![endif]> To improve medical services to children in DCF care through DSS Connecticut Access program by coordinating, integrating, and defining responsibilities of DCF & DSS. (1997)   To clarify DSS will deposit federal social services block grant funds & DCF will provide designated services to target populations as per grant plan. (1998) To cooperatively implement a process for screening unlicensed persons legally providing child care in their home or in a child's home to determine a record of substantiated abuse or neglect. (1998)
Public Health	To clarify and define functions of DPH and DCF regarding health care institutions providing inpatient care to infants & reports of medical neglect of infants. (1992)
Mental Retardation	To expedite DCF referrals to Birth-to-Three program. (1996) To establish intake, investigation, & reporting processes for DMR to follow to ensure children with mental retardation are free from abuse & neglect, and establish DMR & DCF responsibilities regarding mentally retarded children under 18. (1992)
Mental Health & Addiction Services	To coordinate services and transition of clients under 21 who are enrolled in education or training program from DCF to DMHAS adult mental health system.  DCF will fund services until the youth reaches 21 or ceases to be a student and then DMHAS will pick up funding. (1997) To collaborate, coordinate, implement, & report on joint issues regarding substance abuse services for children, youth, & families, and to review DMHAS model of service networks.  CT Alcohol & Drug Policy Council is forum for collaboration. (1996) To work collaboratively on substance abuse services for children & families with particular attention on creating a "seamless system of care" for women & children at-risk. (1997)
Judicial Branch	To reserve 20 inpatient beds at DCF's Riverview Hospital for: (1) court-ordered evaluations of children pending before the court as FWSN or delinquent; and (2) children awaiting placement but who do not need continued hospitalization.  Judicial Branch will provide part-time intake & discharge staff.  Both agencies will pursue funding to develop a joint treatment unit at Riverview. (1998) To establish protocol to maximize effectiveness of DCF and Judicial resources to serve FWSN cases. (1998) To develop a process for transferring non-delinquency FWSN cases needing residential treatment or placement from juvenile probation to DCF. (1999)
Source of Data: DCF

Table VI-3.  Direct Client Services Purchased by DCF
In-Home Services	Out-of-Home Services
	Family Model	Residential
·        Intensive Family Preservation/Reunification ·        Parent Aide ·        Foster and Adoption Placement Preservation ·        Parenting Education ·        Respite Care (Biological Parents) ·        Child Care ·        Therapeutic Child Care ·        Extended Day Treatment ·        Crisis Counseling (Emergency Mobile Psychiatric) ·        Substance Abuse -- Supportive Housing ·        Substance Abuse -- Primary Caregiver Outpatient ·        Substance Abuse -- Adolescent ·        Individual and  Family Counseling ·        Outreach and Tracking (“parole” services)	·        Safe Homes ·        Foster Care ·        Foster Family Recruitment ·        Foster Family Retention ·        Specialized Foster Care ·        Adoption	·        Temporary Shelter Care ·        Independent Living Programs ·        Residential Programs

At present there is no single, complete inventory of all providers with whom the agency contracts for direct services to children and families.  The department is currently working to develop, in computerized form, a resource directory as required by the consent decree.  

Not counting licensed foster families, DCF estimates it purchases services from more than 200 providers.  Individual providers include a variety of care and treatment facilities as well as cities and towns, local family or youth services agencies, hospitals, community action agencies, community mental health centers, and other community organizations such as YMCAs and the Salvation Army.  Some contractors are very specialized, serving a limited population or geographic area; others provide a full spectrum of services to children and adults and are a statewide resource for DCF as well as other state agencies.  

In general, DCF regional offices and institutions carry out the contracting process -- defining needs, designing requirements, procuring the services, managing the contract, and evaluating the services provided -- for outside services their clients need.  If a program or service is needed statewide, programmatic staff in the central office responsible for the area usually will handle these contracting functions.  All contracts, however, are subject to review by the central office financial bureau staff.  The bureau's contract staff must ensure that funding is available initially for the contracted service and approve any subsequent changed in the contract's spending plan.  The central office staff who oversee consent decree implementation also participate in the financial bureau's review to make sure the proposed contracts do not conflict with the resource allocation (PARA) plan approved by court monitor.  

In compliance with consent decree requirements and state and federal initiatives, the department is instituting a performance-based contract process for purchasing services from private providers.  The first performance-based contracts were developed in 1994 and used for some of the agency's major provider groups including residential treatment facilities, child guidance clinics, and family preservation programs.  As shown in Table VI-4, they are currently used for 23 categories of service and apply to over 300 individual provider contracts.  

Table VI-4.  DCF Providers Subject to Performance-Based Contracts
Contract Category	No. Providers
Alcohol and Drug Prevention	29
Child and Adolescent Respite Care	5
Child Guidance Clinics	27
Clinical Pediatric Liaisons	22
Day and Extended Day Treatment	16
Early Childhood Programs	4
Emergency Mobile Psychiatric Services	18
Emergency Shelters	11
Family Support Centers	7
Family Violence Outreach	9
Group Homes	18
Independent Living	13
Intensive Family Preservation	24
Juvenile Case Management Collaborative	3
Outreach Tracking and Reunification	5
Parent Aide Programs	28
Parent Education and Support Centers	16
Residential Treatment	15
Safe Homes	14
Specialized Foster Care	18
Substance Abuse Services	12
Substance Abuse Services for Families At Risk	10
Therapeutic Child Care	15

The existing performance-based  contracts contain workplans developed by the providers and DCF staff that specify goals, objectives, and activities.  Each quarter, providers must submit to the department workplan status reports along with performance-based criteria data and financial data.  As noted in an earlier chapter, the central office, through its quality management bureau, is responsible for compiling and analyzing the data gathered from the agency's  performance-based contracts.  The department intends to use the contract data as a basis for deciding whether to continue funding a provider as well as to help evaluate the effectiveness of programs and services and identify needs.  

Advocacy  

            During the past 20 years, there has been growing political and public interest in improving the lives of and services for children.   Much of the attention has been the result of increased and improved advocacy for children.  

            Advocacy strategies vary with the specific issue and focus of the preferred outcome.  The focus can be on making service systems or bureaucracies more effective and efficient, reforming existing statutes or enacting new laws, assisting an individual access a service or benefit, or bringing class action litigation to challenge unlawful or harmful patterns and practices.  

            Most typically, advocacy is carried out by persons and organizations outside of the systems that either provide, fund, or monitor services or enact legislation and appropriate resources.  Beyond provider groups that have organized to improve children's services and strengthen their working relationships with DCF, a number of groups that lobby and advocate around children's issues have evolved over the past decade.  Among the more prominent are: Connecticut Voices for Children which focuses on advocating for policy and procedural changes and improvements; the Center for Children's Advocacy, affiliated with the University of Connecticut (UCONN) School of Law, which serves the legal needs of poor children; and the Connecticut Association of Human Services, which publishes research on the condition of children in the state and provides education and outreach services.