Measuring How Evidence-Based Assessment Leads to Comprehensive Planning: An Example from a Title IV-E Child Welfare Demonstration

Background and Purpose: Evidence-based assessment should guide treatment planning and the provision of evidence-based services. Implementing a new evidence-based assessment into an existing service delivery system creates both practice and evaluation challenges that can impede progress toward agency goals. Understanding the nature of these challenges, and strategies to address barriers, can assist human service agencies to more effectively implement evidence-based assessment in order to inform service planning. In this vein, the results of a statewide Title IV-E Child Welfare Waiver Demonstration will be reviewed, in which an evidence-based assessment (the Child and Adolescent Needs and Strengths; Lyons, 2009) was adapted for use in case planning with children and their caregivers. The importance of using implementation science will be illustrated by comparing results of this implementation effort with a previously unsuccessful attempt at integrating the CANS assessment into agency practice. Methods: An assessment-to-plan review process was designed to examine and guide implementation: To identify the extent to which the adapted assessment informs treatment planning for in-home cases, a review instrument measuring agreement between assessment and service planning was designed. Case reviews were conducted by teams of evaluators, and results were used to generate recommendations to the agency in order to support improved fidelity. Results: Barriers identified include differences in language required on the repsetive assessment and plan, difficulty determining which members to include on the assessment and/or plan (especially for large, complex families), difficulty assessing multiple case types within families, and the need for service plans to be used by audiences/systems outside the agency (especially legal partners). Conclusions and Implications: Other discussion will include the degree to which assessment was found to guide treatment planning in the example evaluation, identification of lower-level fidelity issues, and strategies presented to the agency to increase fidelity. Although challenges occur when implementing a new evidence-based assessment into existing service delivery systems, strategies to address these challenges can effectively support agencies and evaluators to optimally guide implementation.