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County shares model of care

First Lady leads Norwegian delegation

By Angie Landsverk

A delegation from Norway visited Waupaca County’s Department of Health & Human Services earlier this month to learn how the Trauma-Informed Care approach changed the department.

“I think it’s very interesting we’re back in this room. About six years ago, the First Lady (Tonette Walker) did listening sessions. Waupaca (County) was one of them chosen,” said Chuck Price, the department’s director.

He said it is great to see where things have gone at the state, national and international levels during the last six years.

The First Lady and Elizabeth Hudson, director of Wisconsin’s Office of Children’s Mental Health, asked the department to be one of the hosts because of its culture and practice shift in the area of Trauma-Informed Care (TIC).

Walker and Hudson accompanied the governmental delegation from Oslo, Norway to highlight how TIC has been applied in Wisconsin, and to also discuss the First Lady’s Fostering Futures initiative.

Fostering Futures started in 2011 as an initiative of the First Lady to raise awareness about how childhood trauma may shape a person’s life.

Their stop here was followed by trips to the Menominee Tribal School District and to Sojourner Family Peace Center, in Milwaukee.

Trauma-Informed Care
TIC is a movement in the field of child welfare.

It is about asking a child “What has happened to you?” instead of “What is wrong with you?”

The approach lessens the blame on children who experience Adverse Childhood Experiences (ACEs), acknowledging it may not be their fault they are behaving badly.

The First Lady was introduced to the science of ACEs through Lauri Gramling Lambach, president and CEO of SET Ministry, and Dr. Angela Carron, a pediatrician.

The ACE Questionnaire is about the first 18 years of ones life.

ACEs include physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect, intimate partner violence, mother treated violently, substance misuse within a household, household mental illness, parental separation or divorce and an incarcerated household member.

ACEs are related to the development and prevalence of a range of health problems throughout a person’s life, including those associated with substance misuse.

Walker said she could relate to the science.

That moment resulted in a series of listening sessions in the state.

Price had just become the new health and human services director when Waupaca County hosted one of them in April 2012.

When he heard the principles that day, it was the first time he heard about TCI.

Price wanted to use the approach to change the department.

That is because turnover was high in the department, and burnout was high among employees.

“The culture of any organization is shaped by the worst behavior the leader is willing to tolerate,” he said.

County’s story
There are between 120 and 130 employees in the department, and they started training staff in TCI about five years ago.
All staff members have received the training.

Price said they also had the staff look at the ACEs calculator.

“Some staff came forward and said they had ACEs, too,” he said.

That was the point where the lines start to blur between them and their clients, he said.

“We knew it would be great for our clients,” Price said. “But we also saw the impact it had with the staff. We knew we had to look at the staff as well.”

Staff members were bringing their own ACEs to work, and there had to be a talk about the well-being of the staff, he said.

A member of the staff became a master ACEs trainer, and they started a book club as well.

“Maybe that sounds odd, but it was about developing leadership,” Price said of the book club.

He said they even started mentioning TCI during the recruitment process to attract those familiar with the process.

Shannon Kelly is the department’s deputy director.

“When you are trauma-informed, you are able to support people in a whole different way is what we found,” she said.

Before, the approach was punitive and heavy handed, Kelly said.

Today, they work with people, growing trust and relationships and helping them move through the bumps on the road, she said.

TCI impacts
Kelly shared where the department is now following the implementation of the TCI approached.

From 2012 to 2015, the average time it took to reunify youth with their families dropped from 11.5 months to 7.7 months.

In 2013, 21 percent of youth were reunified within 12 months.

In 2015, 67 percent of them were reunified within 12 months.

Since 2012, the county’s overall out of home placement rate dropped 17 percent, and in 2016, there were no children living in residential care placements.

In 2012, 31 percent of the youth re-entered foster care after they went home from placement.

In 2016, that figure was 13 percent.

Kelly said TCI has also impacted how staff members interact with each other in the hallways.

When they see a performance or behavior issue in the workplace, it now puts them in the position to ask the staff member what is going on and how the person can be supported instead of moving to disciplinary action.

Price said there have been different tools they have used along the way.

Their goal is to help people in Waupaca County be safe and connected.

Next for the department is looking at child welfare and using what it known about child brain development to build a child welfare system in a way it should function today, he said.

“At the point in my career, where I’m a bit tired of the system the way it is,” Price said. “I’m going to spend the next six to nine months with another two to three cohorts across the country, using TCI as the principles.”

The First Lady said there are communities throughout the state embracing TCI.

“It’s getting harder and harder to not find folks who don’t know what it is,” Price said.

Tone Tellevik Dahl, vice mayor of Oslo for primary health and social services, said the delegation hoped to learn how organizations implemented the approach.

“It’s interesting how they did it here, the self realization,” she said. Often, professionals think they know best.”
She said they should think about how there may be a crisis behind a behavior.

“I think this particular method is maybe the right one,” Dahl said. “They are having good results.

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