Meeting Information

family_violence_council

Family Violence Council: 

Addressing Violence throughout the Lifespan

MINUTES

Thursday, July 16, 2009

3:00 pm – 4:30 pm

Members Present (denoted with x):

I.          CALL TO ORDER/ AGENDA CHANGES               

Kathy Baxter called the meeting to order at 3:10 pm.

Action: Approved the agenda with no changes. (Upton/Evans/All)

II.        INTRODUCTIONS

Members and participants introduced themselves and their agency affiliation.

III.       APPROVAL OF MINUTES             

Action: Approved the meeting minutes from April 16, 2009, with 1 spelling correction. (Twomey/Boyd/All)

IV.       BUSINESS                                                                              

A.        Photo Documentation of Injuries

Dr. Leigh Kimberg organized a training on photo documentation of injuries on April 29, 2009.  Representatives from all the DPH Primary Care Clinics attended.  The UC Davis team that conducted the training offered it for free in order to test it as a pilot.  They taught both photo skills and documentation practices.  Dr. Kimberg offered sample training materials for members of the Council to look through.  UC Davis is able to shape the training for a law enforcement audience needing to document crime scenes or for medical practitioners seeing patients with injuries.  Dr. Kimberg has also been working on developing a protocol for the storage of digital photos within DPH, and will share that once the draft has been circulated internally for approval.  The next step in this project will be for the Department on the Status of Women to work with UC Davis to organize additional training on this topic for both community agencies as well as for law enforcement staff.  A participant urged that CPS workers be included in any training on this topic. 

B.        Report on Family Violence in San Francisco

This topic was postponed until after the Intervention Services discussion in order to include late arrivals. 

C.        Intervention Services

The Council co-chairs explained that the intent of revisiting this discussion is to take what has been learned from 20 years of Batterer Intervention Programs (BIPs) operations.  Mary Twomey explained that though there is no program designed or operated specifically for perpetrators of elder abuse, practitioners in that field see many of the same dynamics as exist in other forms of domestic and family violence, leading to the hypothesis that there could be overlap in intervention programs. 

A participant offered the suggestion that many participants don’t go to programs that are named negatively, like Batterer Intervention, and would be more willing to go to something like “Parenting Education.” Stephanie Romney of the Department of Public Health (DPH) noted that the Triple P (“Positive Parenting Program”) model is focused on changing the conversation around parenting, insisting that ALL parents need some assistance sometimes, though some parents need more than others.

Beverly Upton commented that the need for a certain level of accountability in the criminal justice response to this issue is imperative, and participants agreed that beginning with a criminal justice model of intervention is a good place to start, and such a model could then be expanded to be applied to the Dependency Court and other civil responses. 

1. Stephanie Romney, DPH:  Parent Training Institute

The Parent Training Institute is a collaboration of DPH, Human Services Agency (HSA), and First 5, formed to bring evidence-based practice to parenting programs in San Francisco.  The collaboration targets caregivers of young children with emotional or behavioral problems or who are at risk of developing such problems.  The Institute operates the Incredible Years curriculum and will be rolling out the Triple P curriculum this year. 

Incredible Years:  The Parent Training Institute has been operating Incredible Years in 5 clinics for over a year.  It is offered in English, Cantonese, and Spanish.  The curriculum consists of 12 to 16 2-hour sessions, once each week, of group parenting courses based on viewing and analyzing vignettes, role playing, and homework to practice the skills learned.  Dinner, transportation, and childcare are all provided as a part of the program, and the support parents feel significantly reduces attrition.  The practice that is required with children at home is important to its acceptability for CPS referrals, as work with this group must be timed so that parents have contact with their children while enrolled.  Current participants are volunteers, recruited through public health clinics.  However, this spring Dr. Romney surveyed participants and determined that up to 50% of participants also had CPS cases.  They have worked with HSA to allow those parents to receive credit for their involvement with the Incredible Years program. 

Outcomes: [See attachment for graphs.] The Incredible Years curriculum has been measured for effectiveness through pre and post parental reports of a child’s disruptive behaviors, looking at both the intensity (how often the problem behavior occurs) and the problem (parental distress due to the behavior).  Both the intensity scale and the problem scale showed a reduction below the line for clinical intervention in post tests. 

Triple P:  Developed over many years in Australia, Triple P shows evidence in reducing problem behaviors and impacting child welfare outcomes.  It involves a multi-level parent and family support system, utilizing a public health approach to intervention.  At the highest level, the program targets parental anger and other risk factors.  A CDC trial in South Carolina demonstrated reductions in emergency room visits due to child maltreatment, substantiated reports of maltreatment, and out of home placements.  San Francisco will be rolling out the highest level this fall, with lower levels to be offered at Family Resource Centers (FRCs) in the spring.  This will allow the FRCs to become screeners for families with high need, and to have a program to which those families can be referred.   It will be offered in English and Spanish. 

Funding for Incredible Years in clinics is supported by MediCal, except for certain non-billable components (such as prep work) which are funded through grants.  MediCal will only reimburse if child behaviors meet a clinical level of intensity.  Due to the complex funding sources in use by the collaboration between DPH, HSA, and First 5, the Institute is still figuring out what referral sources will be accepted for these programs. 

2. Kelli Finley, Community Works:  Parenting Inside Out

The Parenting Inside Out (PIO) curriculum is backed by a 5-year study, and has been designed specifically for incarcerated parents, and for adult learners.  The program connects students to larger issues (for example, Delia Ginorio serves as a guest speaker to discuss domestic violence issues).  The program is 108 hours in 36 lessons.  In general, the current program participants are not in jail because of a child abuse conviction, but some have had children removed because of circumstances surrounding that parent’s jail stay.  PIO trainers work closely with the CPS liaisons.

The PIO curriculum tries to break the intergenerational cycle of imprisonment.  It begins with general skills, such as communication and empathy, applying those skills to daily life in jail and other circumstances before helping the parents relate those skills to their roles as parents.  This can translate to their role as children or as caregivers to elderly parents/relatives, as well.  [See attachments for additional information.]

Parents are mandated to attend PIO if they want child visitation at the jail.  Most do the program voluntarily through the charter school, as only 5% of participants are eligible to receive child visits.  Anyone with a CPS case must attend PIO.  Community Works would like to have all incarcerated parents take the class, whether they have a CPS case or want child visits, as they will all likely be released and expected to parent at some point. 

Classes are available at San Bruno. There are 50 students in 2 classes.  It was piloted at the Women’s Jail but the curriculum is approved for men and women.  PIO just graduated its first class for early release made up of men who were released prior to finishing the program, and returned to the program in order to complete the workshops.

3.  General Discussion

Chief Probation Officer Pat Boyd provided some statistics about Probation.  There are 7,000 adult probationers, with 500 within the Domestic Violence Unit.  In a search of probationers charged with child abuse, only 21 appeared in the system.  There are likely more probationers who were charged with child abuse, but were only convicted of a different crime, leading to the small number of probationers that appeared in this search.  Most of these 21 probationers were convicted of physical child abuse, though a small number appear to have been involved in illegal adoption practices.  The Domestic Violence Unit has specialized caseloads and court monitoring, but there is nothing similar for child abuse, either here or in neighboring counties.  Chief Boyd expressed a willingness to work with the community to find appropriate programs to order probationers with child abuse convictions to attend, and to create some standards and policies for supervising this group of probationers.  There is a penal code mandating that counties refer individuals convicted of child abuse to a 52-week program, and currently San Francisco is out of compliance with this code (as are many counties in California).  Ms. Upton cited a review of research that shows that there are no court-mandated child abuse programs in the country right now, indicating that San Francisco could become a leader in this area.  In cases of elder abuse, there is only a behavioral health court to monitor mental health treatment, but no criminal-level intervention options. 

4. Next Steps

The Department will schedule an Intervention Sub-Committee meeting prior to the October Family Violence Council meeting to see what types of programs might be a best practice to recommend as a criminal intervention for child abuse.  This Sub-Committee can then begin to plan strategies for creating a formalized intervention program ready for court and probation referrals. 

B.        Report on Family Violence in San Francisco - Revisited

1. General Discussion

Mary Twomey informed the Council that the First Comprehensive Report on Family Violence in San Francisco, 2009 has been released and is available on the Department’s website.  Dr. Emily Murase, Executive Director of the Department, thanked all the criminal justice departments for their support, and credits them and the Mayor for their willingness to create benchmarks for accountability.  She also encouraged feedback on the Report for improvement in its next iteration. 

Toby Eastman of Larkin Street reported that many emancipated foster youth seen by that program often leave violent homes and then become engaged in violent relationships themselves.  There is a need to track and document this trend. 

The Council discussed its mandated role as an advisory body to the Mayor and the Board of Supervisors.

The 2007 legislation for the re-authorization of the Council, sponsored by Mayor Gavin Newsom and Supervisors Sophie Maxwell and Michela Alioto-Pier, included a directive to create an annual report to be provided to both the Mayor and the Board of Supervisors. This was written into the legislation in order to ensure a forum for the issue of family violence.

Dr. Murase acknowledged that the report painted a sobering picture of family violence in San Francisco. Catherine Dodd of the Mayor’s Office expressed concern that the data could be mishandled and suggested creating a work group to focus on the data and recommendations in the Report.  Representatives from the DA’s Office concurred with Dr. Dodd's concerns and suggestion.

The Council Steering Committee members stated that they are in full support of the departments whose statistics appear in the Report, and that there was an effort to craft forward-thinking recommendations. Dr. Murase indicated that she would like to see the Mayor, the District Attorney, the Police Chief, and all other officials involved in this issue standing up together with the community to come out ahead of the issue and work jointly to address it.

Chief Probation Officer Patrick Boyd pointed out that the Council never voted formally to approve the final Report, and the presentation of the Report at the April meeting indicated that it was in draft form still and was subject to final approval by participating departments. Council members urged the Steering Committee to bring future reports to the full Council for an official vote prior to their release.  This will allow Council members to act jointly and speak with a united voice when faced with questions from the Board of Supervisors, the Mayor, or the press. Karen Roye, Director of Child Support Services, suggested meeting again to have further dialogue about the Report and, in particular, how to improve the next round of data collection and analysis.

Sonia Melara expressed concerns about the Report as visitation services was one of the areas not addressed, though 75% of her clients experience domestic violence. 

2. Next Steps

The Council agreed to have a Report Sub-Committee meeting in late August or September to look at linkages existing in the community that would help the City implement the recommendations in the Report, use the Report as a template for an action plan as the Council moves forward in its efforts, and to suggest improvements for the next Report.

D.        Emerging Issues in Child Visitation Services

This topic was postponed until October due to time constraints.

E.         Current Trends in Family Violence/Announcements

None.   

VI.       PUBLIC COMMENT                                                            

None.                          

VII.      ADJOURNMENT                                                     

The Family Violence Council adjourned at 4:50 pm.

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