NATIONAL EVALUATION OF THE SAFE START DEMONSTRATION PROJECT JANUARY THROUGH DECEMBER 2004 VOLUME II: CASE STUDIES OF DEMONSTRATION SITES FINAL SEPTEMBER 2005 SAFE START DEMONSTRATION PROJECT CHILD PROTECTION DIVISION OFFICE OF JUVENILE JUSTICE AND DELINQUENCY PREVENTION U.S. DEPARTMENT OF JUSTICE TH 810 7 STREET, NW WASHINGTON, DC 20531 Association for the Study and Development of Community 312 South Frederick Avenue Gaithersburg, MD 20877 Phone: (301) 519-0722 Fax: (301) 519-0724 Website: www.capablecommunity.com This project was supported by Grant # 2004-JW-MU-K001 awarded by the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, U.S. Department of Justice. Points of view or opinions in this document are Associationthose of the forauthor the Studyand do and not Development necessarily represen of Communt theity official position or policies of the U.S. Department of Justice. i PREFACE This volume on the case studies was developed by the Association for the Study and Development of Community (ASDC) for the Office of Juvenile Justice and Delinquency Prevention (OJJDP) for the National Evaluation of the Safe Start Demonstration Project for January through December 2004. We would like to recognize Katherine Darke Schmitt, Senior Policy Analyst and Safe Start Evaluation Manager for her leadership and support. We would also like to thank Kristen Kracke, Safe Start Program Manager, and Bill Schechter, Consultant with OJJDP, for their assistance. ASDC staff contributing to this volume include: David Chavis (Project Director); Deanna Breslin (Associate); Larry Contratti (Associate); Mary Hyde (Senior Managing Associate); Inga James (Managing Associate); Kien Lee (Senior Managing Associate); Marjorie Nemes (Associate); Varsha Venugopal (Associate). La’Shaune Barker (Marketing and Production Manager) assisted in the production. ASDC would like to thank the Project Directors and Local Evaluators of the 11 Safe Start Demonstration sites for their assistance with their respective case studies. These case studies would not be possible without the collaboration of many people from among the Safe Start Demonstration Project sites, including each site’s partners. TABLE OF CONTENTS CHAPTER I. BALTIMORE CITY SAFE START INITIATIVE 1 CHAPTER II. BRIDGEPORT SAFE START INITIATIVE 20 CHAPTER III. CHATHAM COUNTY SAFE START INITIATIVE 35 CHAPTER IV. CHICAGO SAFE START INITIATIVE 54 CHATPER V. PINELLAS COUNTY SAFE START 70 CHAPTER VI. PUEBLO OF ZUNI SAFE START INITIATIVE 93 CHAPTER VII. ROCHESTER SAFE START 109 CHAPTER VIII. SAN FRANCISCO SAFESTART 124 CHAPTER IX. SITKA SAFE START INITIATIVE 146 CHAPTER X. SPOKANE SAFE START INITIATIVE 166 CHAPTER XI. WASHINGTON COUNTY SAFE START INITIATIVE 183 I BALTIMORE CITY SAFE START INITIATIVE 1. INTRODUCTION To develop a full understanding of the Baltimore City Safe Start from January through December 2004, the National Evaluation Team (NET) visited the Baltimore City site on September 7 and 8, 2004, and conducted follow-up telephone interviews with key individuals in September 2004 and again in January 2005. The NET also reviewed existing documents about the Baltimore City SSI, including strategic, implementation, initiative overview, and progress reports. The NET interviewed ten Safe Start participants, including staff members, point-of- service providers, collaborative members, representatives of mental health and other services, and the local evaluator. Key questions included the following: • What were the milestones reached, goals attained, and other indirect impacts of the Baltimore City Safe Start (BCSS) in the past year? • How did the composition and process of the collaborative in each site influence the types of strategies implemented, and as a result, the system change outcomes? • How has the BCSS changed the service delivery system for children exposed to violence and their families? • What organizational, point of service, and collaborative capacities (knowledge, skills, resources, relationships) are required for successful implementation and sustainability of the system changes? • What strategies were developed to respond to external changes (e.g., fluctuations in the economy, political changes, etc.) that affected the successful implementation and goal achievement of the BCSS? • How did the BCSS handle anticipated or unanticipated critical changes at the program level when they occurred? • What strategies are being used to achieve sustainability in policies, procedures, and practices? • What are the lessons learned about the implementation and replication of a national initiative such as Safe Start? This report covers the period from the start of the Baltimore City Safe Start in January 2004 through December 2004. Organized according to the Safe Start Demonstration Project logic model, it describes the economic, political, and social context of the Baltimore City; the technical assistance the initiative received; the collaboration among different community organizations and agencies participating in BCSS; the system change activities (i.e., development of policies, procedures, and protocols; service integration; new, expanded, or enhanced programming; community action and awareness; and resource development) by BCSS; the Association for the Study and Development of Community 1 September 2005 initiative’s institutionalization of changes; and the challenges faced and lessons learned by the participants. A timeline of major milestones is included in Attachment A. 2. CONTEXTUAL CONDITIONS 2.1 Local Contextual Conditions: Background Baltimore City lies on the Patapsco River in the state of Maryland. The 2003 1 population was estimated at 629,000, with the population on the decrease since 1990. African Americans comprise the majority of the population (64.3%); European Americans, 31.6%; Latinos, 1.7%; and Asians and Asian Americans, 1.5%. Children five years and younger represent 6.4% of the total population. The median household income in the city in 2000 was $30,078. 2 Baltimore has long been known as one of the most violent cities in the country, with crime rates exceeding national averages for all violent crimes except forcible rape. Although site visit participants repeatedly commented on the impact of the level of violence on community attitudes, crime has begun to decline in Baltimore; for the period 1999 to 2001, the city boasted the highest two-year reduction in violent crime of any city in the nation. 3 Site visit participants characterized Baltimore City’s municipal leadership as territorial and unwilling to genuinely collaborate; moreover, leadership changes at the state and local level have failed to facilitate new and productive partnerships. At the state level, Maryland installed a new governor in 2003. The Governor, in turn, appointed a new Secretary to the Department of Juvenile Services (DJS). Although DJS serves as the lead agency for the BCSS, the BCSS had to convince the new DJS leadership of the connection between the Department’s mandate and the issue of children exposed to violence, following the appointment of the new Secretary. At the local level, the Baltimore City Schools and Police Department each have had three different leaders since the inception of the BCSS; in the fall of 2004, the Baltimore City Police Commissioner changed again, when the incumbent was fired as a result of controversy over allegations of domestic violence by his fiancé. In both organizations, each new leader brought on a new managerial staff, disrupting relationships with BCSS staff and organizational knowledge of the BCSS. With respect to the mental health system in Maryland, a diagnosis is required for mental health providers to receive reimbursement for services; currently, diagnoses do not exist for children six years and younger. Although some states reimburse V Codes, which identify parent- child problems that do not reach the threshold of a DSM-IV diagnosis, Maryland does not. In addition, Maryland’s mental health system does not reimburse providers for service linkage or family support services. This is a serious limitation in the system of care given that several site visit participants emphasized the vital role these services play in engaging families in mental health services initially. 1 US Census projections, 2003. 2 US Census, 2000. 3 Baltimore Police Department; http://141.157.54.34/bpdmaps/police.htm Association for the Study and Development of Community 2 September 2005 2.2 Local Contextual Conditions: Specific to 2004 In 2004, the Governor requested that agencies such as the Department of Human Resources, DJS, and the Department of Health and Mental Hygiene devise ways to cut spending by an additional 12%. Baltimore City’s Department of Social Services (BCDSS), therefore, suffered budget cuts that compounded the effects of prior (2003) cuts. Staff had to be released, leaving fewer personnel to address social services and even fewer resources for the BCSS. The BCDSS experienced additional staff turnover in 2004 due to a prolonged political dispute between the Mayor of Baltimore and the Governor of Maryland regarding the agency’s oversight. After this extended period of disagreement, a new Director was appointed to the BCDSS in the fall of 2004. These changes and disruptions made it difficult for BCDSS decision- makers to sustain attention to the BCSS in 2004, in spite of the fact that the BCDSS is a key partner on the Safe Start Council. A high profile BCDSS case involving the death of infant twins further beleaguered this central collaborative