Investing in Culturally Responsive Services: Lessons from Washington State

Highlights

• Washington DCYF launched two procurement pilots designed to reduce barriers for service providers and intended to allocate nearly $3 million for new services focused on Black and Native families.
• The pilots were launched after DCYF engaged with community providers and learned that families wanted more culturally responsive and specific services delivered by proximate providers who reflect their communities.

Introduction

In 2019, leaders in the Washington State Department of Children, Youth, and Families (DCYF) analyzed their child welfare intake data and identified that Black children and American Indian/Alaskan Native children were being removed from their homes at disproportionately high rates. DCYF offered services such as substance use treatment and mental health support, which were meant to address problems that often led to removals; however, Black and Native families were not using many of these services, and leaders did not know why.

With a decade of experience in addressing service gaps, the Harvard Kennedy School Government Performance Lab (GPL) worked with DCYF to interview state-level staff and local service providers, including tribal providers, to identify contributing factors to and possible solutions for racial disproportionalities in child removals.

These conversations suggested that DCYF could address service gaps and potentially reduce racial disproportionalities by taking two related steps: 1) offer more culturally responsive and specific services, and 2) contract with proximate providers who reflect their communities.

With these insights, DCYF launched two procurement pilots designed to reduce barriers for service providers — including barriers related to evidence-based-program requirements — and intended to allocate nearly $3 million for new services expected to reach more than 400 families through 2025.

In this case study, we detail how DCYF used community engagement to shape its approach to addressing service gaps that may contribute to racial disproportionalities in child removals. For child welfare and jurisdictional leaders, the DCYF story offers lessons on how to collect and elevate insights from service providers and community members — and then act.

“A provider who looks like you is likely to set you up for success. The work of understanding is already done.” – Washington service provider

Context: Racial Disproportionalities in Washington

DCYF leaders knew there were significant racial disproportionalities in their child welfare system, a common problem across the United States. These racial disparities date back to intentional efforts to separate poor children, particularly children of color, from their families. In the mid-to-late 1800s, for example, Native American children were intentionally forced out of their communities into boarding schools, and Black families were excluded from supportive social services.

In Washington, Black and Native children were significantly overrepresented in out-of-home care. DCYF’s 2019 analysis found that American Indian/Alaska Native (AI/AN) children were 2.6 times more likely to enter foster care compared to their representation in the general population, and Black children were nearly 1.4 times as likely to enter. DCYF knew that systemic factors (e.g., racial bias in reporting, poverty) as well as potential gaps in DCYF’s service array contributed to these disparities.

Another factor DCYF had to consider, even as they were already working on this issue, was two legal decisions regarding Native families. In 2020, the Washington State Supreme Court ruled that during child custody proceedings if a court has a “reason to know” a child’s tribal heritage, the court must ensure that child is protected under the Indian Child Welfare Act and the Washington State Indian Child Welfare Act. In 2021, the Court reiterated DCYF’s responsibility to engage in “active efforts to prevent the breakup of the Indian family” through child removals. Those efforts must be “thorough, timely, consistent, and culturally appropriate.” With DCYF leaders already focused on addressing racial disproportionalities in child removals, the court rulings underscored the urgency of testing new solutions.

Diagnose Challenges Through Research and Interviews

Leaders at DCYF knew they needed to adjust their service array to better serve Black and Native families but were not exactly sure where to begin. They determined they needed to hear from the community and asked the GPL to help with community outreach efforts.

To avoid overburdening providers through repeated interviews and surveys, the GPL and DCYF began their outreach by interviewing staff from DCYF’s Office of Tribal Relations and then other DCYF leadership and staff. During these interviews, staff frequently reiterated that they knew Black and Native families wanted culturally relevant services, but staff were not sure what programs and services existed beyond the few already in the DCYF service array.

These answers confirmed that talking with providers was an important next step. DCYF and the GPL began to design interview questions that would help them see from a provider’s perspective why existing services, with the potential to reduce child welfare involvement, were not effectively meeting Black and Native families’ needs, and what providers would recommend instead. (See appendix for a list of questions.) DCYF and the GPL structured the questions in ways that would allow them to identify detailed and actionable next steps, rather than elicit a broad “wish list” from providers.

DCYF and the GPL also knew it was important to speak with a range of providers, beyond those who were already known to DCYF, or those who were already providing services within the DCYF service array. In addition to casting a wide net to identify providers and organizations working with Black and Native families, the GPL also concluded each interview by asking the interviewee to recommend another provider they could speak with.

In total, the GPL conducted 17 interviews with service providers, program directors, tribal workers, non-profit founders, family support specialists, and home visitors. Several of these providers were people with whom DCYF had not previously interacted, but who were eager and willing to share their thoughts about new services they believed could benefit their community.

Listen to Insights from Community Providers

As DCYF interviewed the providers, they found that comments generally reflected one of two sentiments. The first sentiment was that clients wanted more specific services — such as prenatal support, fatherhood and adolescent mentorship services, and basic-needs support — that were also culturally responsive. Providers shared that services often do not exist or are inaccessible due to geographic or transportation barriers. If services did exist, they were often not tailored for Black and Native families. The following are quotes shared by providers, which have been lightly edited for clarity.

“Families of color are not prioritized in DCYF’s current service structure. You can’t address the needs of Black or Native families without targeted outreach.”

“Transportation is huge. Coming to tribal community offices is very hard. In many areas, the bus system is not good.”

“We’re in Spokane, which is around 90% white, low diversity. It’s hard to make services tailored to these families. We have great providers locally that are serving these families. Finding culturally relevant services is big challenge.”

“It’s hard to find a therapist who is multi-lingual.”

The second sentiment was that clients wanted more providers who reflect their community, such as more professionals with tribal heritage. Providers shared that clients prefer working with service providers who are trusted members of the community. In situations where such providers are not available, families may be less willing to participate in services offered by those they perceive as outsiders. The following are quotes shared by providers, also lightly edited for clarity.

“A provider who looks like you is likely to set you up for success. There is a shared understanding when talking to Black families. The work of understanding is already done.”

“Parents say, ‘Staff are judging me. They don’t understand how I discipline my child.’”

“We have eight staff members: four African Americans and four who are white. We lost four to five Hispanic staff because of COVID. It’s hard to find male providers and men of color. We tried word of mouth. It’s hard to find someone who does this work.”

Proximate Providers

As DCYF and the GPL analyzed interviews, they found that contracting with more “proximate providers” could help address gaps in the services for Black and Native families. A “proximate provider,“ as defined by the GPL and DCYF, is a person or organization who is “physically close to the communities they serve, has shared lived experiences with their clients, and greater cultural awareness as a result of those shared experiences.” DCYF determined that to adequately address provider input, any solution would need to prioritize both the services and the providers offering those services, as illustrated below:

Expanding the Array of Potential Services

Providers also elevated another opportunity for DCYF to close service gaps: consider contracting with providers and smaller community-based organizations that are already offering culturally responsive and specific services, even if those services do not meet current evidence-based requirements.

In 2018, Congress passed the Family First Prevention Services Act (FFPSA) to enhance prevention services and provide funding to help more children stay in their homes. However, this funding can only cover costs associated with evidence-based programs (EBPs). These programs have been evaluated using methods such as randomized controlled trials and well-designed, quasi-experimental studies in order to measure their impact on individuals, “relative to the status quo.” These evaluations generally require a significant investment of time and money, yet often produce disappointing results. “The evidence base behind many ‘evidence-based’ programs is quite weak, even before considering external validity,” GPL Director Jeffrey Liebman wrote. “This means it can be a mistake to prioritize a national ‘evidence-based’ provider over a strong local provider.”

It is important for jurisdictions to allocate funding in a way that maximizes the expected impact of taxpayer dollars and makes the most progress on improving outcomes for children and families. Often, that can mean prioritizing programs with the strongest evidence base. But in a world in which community-designed services may be able to better meet a specific community need and in which the evidence base rarely includes evidence of impacts for Black and Native families, investing in local providers can be another promising strategy to consider.

Example: Hummingbird Indigenous Family Services is a community-based organization in Washington. Their Pilimakua Family Connections is a voluntary, home-visiting program serving pregnant and postpartum Native mothers and their babies in three Washington counties. The program, which began in 2019 and has been full since it launched, emphasizes caregiver mindfulness and self-compassion, stages of infant and child development, and culture and language reclamation. The program was created through community input, and all staff at Hummingbird are eligible for its services. Yet because the program has not been formally evaluated, it does not meet federal criteria necessary to be defined as an “evidence-based program.”

Use Provider Feedback to Shape Future Contracting Processes

After hearing providers’ ideas and concerns, especially regarding the requirements for evidence-based programs, DCYF leaders resolved to adjust their contracting processes. Their goal was to increase the flexibility for providers who were already committed to serving Black and Native families and make it easier for new proximate providers to enter the service array. Several of the key changes DCYF made are described below:

Change 1: DCYF will double the response period for request for applications (RFAs), from 3045 days to 60-90 days. Establishing longer timelines may give tribal governments and community providers — who may have extensive internal approval processes or limited staff capacity to respond to time-intensive applications — increased opportunity to produce competitive bids.

Change 2: DCYF will allow flexible scopes of work that enable proximate providers to propose new services that are responsive to their clients’ unique needs. Providers had elevated a concern that existing scopes of work were often designed for widespread service delivery, which meant that some existing state services were not responsive to the needs of Black and Native families.

Change 3: DCYF will circulate preliminary materials to generate interest and increase awareness about funding opportunities before the application response period. DCYF released a concept paper among tribes and Native-serving organizations six months before launching the RFAs. This was in response to the concern that some proximate providers may not be aware of opportunities to contract with the state, because DCYF funding announcements often only reach the same providers who have previously contracted with DCYF.

Where Proximate Providers Fill a Gap:

“When I ask pregnant tribal moms to engage in a substance-use treatment program, they tell me they are not comfortable disclosing their prenatal substance use to a nontribal woman.”- Washington proximate provider

Change 4: DCYF will provide upfront lump-sum payments for program startup and capacity building, not just for costs associated with service delivery. These payments are intended to reduce financial barriers for community-based providers who may want to set up new programs, or significantly expand existing ones, but cannot due to prohibitive upfront costs.

Change 5: Finally, DCYF will expand service-array eligibility to include community-based services aimed at reducing child placements, even if they are not yet evidence based. Providers had expressed concern that rigid scopes of work only allowed them to propose evidenced-based services, which may not be what their community needs. Additional steps that jurisdictions can take to improve procurement processes are described in greater detail in other GPL publications, such as “Using Government Procurement to Advance Racial Equity,” and “What is Procurement Excellence?”

Two Procurement Pilots

DCYF incorporated the adjustments named above into two contracting pilots: one for Black families and one for Native families. These pilots were designed to observe how these procurement adjustments impacted proximate providers’ ability to learn about, apply for, and successfully obtain contracts with the state to provide culturally responsive and specific services.

Pilot 1: Programs and services to reduce child removals among Native families

• November 2022: DCYF releases a concept paper about increasing the number of culturally responsive services through contracting adjustments. The concept paper was released six months before the contract application window opened to ensure tribal providers had sufficient time to become informed and apply.
• May 2023: DCYF launches the first request for application (RFA), seeking providers who are offering services intended to reduce out-of-home placements of American Indian/Alaska Native children in Washington by promoting child well-being and safety, and by building upon family strengths and resilience. Both the concept paper and the RFA emphasize that services do not have to be “evidence-based models” nor a program the applicant is currently providing.
• September 2023: DCYF awards contracts to five providers (of which Hummingbird Indigenous Family Services was a recipient) ranging from $120,000-$200,000 to cover both start-up and ongoing costs with a possibility of renewal for a second year.
• April 2024: DCYF launches the second RFA round.

Family Haven, a working partner with the Tulalip Tribes child welfare program, beda?chelh, responded to the RFA by proposing a new pilot program. Program leaders want to address the problem of placements breaking down for teens in out-of-home care. They proposed weaving together curricula from two existing programs, Positive Indian Parenting and Triple P, to create a new program that focuses on supporting older Native American caregivers who are taking care of teenagers. The community-based organization, which was awarded a DCYF contract, will focus on mentoring youth who are dealing with depression, anxiety, suicidal thoughts, or substance use disorder, while also helping caregivers better understand the modern challenges teens face. The program will also focus on improving communication and building positive relationships between teens and their older caregivers.

“Most of the state-offered programs are heavy on reading/teaching and even the concept of completing homework. Over time, we have seen how difficult this approach is for tribal elders and others that struggled with school who may have many years between them and their teen.“ — Alison Bowen, Manager, Tulalip Tribes-Family Haven

Pilot 2: Programs and services to reduce child removals among Black/African American families

• September 2023: DCYF releases a request for information (RFI) to gather community input on ways to increase applications from providers who offer “culturally responsive services that keep Black/African American children safe and supported at home with their families.”
• April 2024: Guided by what they learned from the RFI, DCYF releases a request for proposals (RFP) that specifically encourages small and diverse businesses to apply. Services should focus primarily on families involved with DCYF and should offer help with navigating the child welfare system and meeting basic needs, such as respite care, child care, housing, food, and transportation. Providers are encouraged to identify what services their communities need, even if those services are not “evidence-based models” or already in use.
• Summer-Fall 2024: DCYF anticipates contracting with up to six agencies in year-long contracts ranging from $100,000 to $200,000 to cover both start-up and ongoing costs, with the possibility of renewal for a second year. To help providers prepare for the application window, DCYF hosted a webinar and two different technical assistance sessions.

Service Providers’ Responses to Questions in the RFI

What other opportunities, challenges, or factors should DCYF consider when making future investments in services to reduce out-of-home placements for Black/African American families?

“Consider contracting with community-based organizations to provide the prevention and voluntary services side of the work so that the agency that removes children is not the same agency seeking to prevent removal. There is an inherent issue of trust and perceived conflict of interest when DCYF tries to persuade Black/African American families that they can do both. DCYF can offer technical assistance in support of the work of community-based providers who have the cultural background and appropriate level of trust to serve in this role within their communities.”

“Invest in early intervention and prevention services that are specifically tailored to the unique needs and challenges faced by Black/African American families. Focus on addressing the root causes of child welfare involvement and provide support to families before they reach a crisis point.”

What could DCYF do to better support proximate providers in winning contracts for culturally specific and culturally responsive services?

“Reduce the administrative burden (or pay a realistic indirect cost rate) that mitigates the impact of start-up costs, training, required agency meetings, and administrative time spent invoicing, reporting, and completing agency-required paperwork. Small agencies cannot absorb these costs in the same degree as larger organizations.”

DCYF’s Path Forward

Guided by providers’ insights, DCYF leaders made significant changes to the way they contract for social services. DCYF leaders said they believe that decreasing contracting barriers and increasing contracting flexibility may contribute to an increase in the number of proximate providers in the community, and the number of culturally responsive and specific services, which may ultimately contribute to fewer Black and Native children being removed from their homes.

With that goal in mind, DCYF has also established a community of practice with the five pilot providers and DCYF’s Division for Partnership, Prevention, and Services. Through monthly debriefs and quarterly check-in meetings with DCYF staff and other contracted providers, service providers can share promising practices, receive technical assistance, and troubleshoot challenges together. The data and insights they share will help DCYF continue to refine their processes to better meet the needs of both providers and families.

Appendix: Provider Interview Questions

DCYF and the GPL interviewed providers to identify gaps in services available for Black and Native families in Washington. They used these questions, with additional follow-up or clarifying questions as needed.

1. What are the biggest challenges and needs facing the families you serve?
2. Can you share an example of these challenges?
3. What services exist in your community to meet the needs of Black or Native American families?
4. Which organizations in the community are offering those services?
5. Has your organization ever designed new services or interventions to try and meet these families’ needs?
6. How have funding issues affected the availability of services for Black or Native families in your community?
7. What additional barriers may be preventing you or other providers from offering services to these families?
8. What would you need in order to offer these types of services in your community?
9. We know that governments can play a big role in removing some of the barriers facing providers. How do you think Washington state could better support providers?
10. Other providers have told us that their clients are more likely to engage in services when the provider is from their community. Tell us how your organization and staff reflect your community.