Agency leadership and experts convened for a roundtable on February 21, 2020 in Ottawa at the Institute of Fiscal Studies and Democracy (IFSD), to refine a measurement framework based on the work of First Nations child and family services (FNCFS) agency leadership in 2018.

The original vision had four components to well-being: safety, child, family and community well-being.

 

Building from this commonly held vision for thriving First Nations children, families and communities, the roundtable helped to translate this vision into a future focused measurement framework: Measuring to Thrive (see Appendix 1 for the full framework).

The intent of Measuring to Thrive, is to provide FNCFS agencies with a portrait of the people they serve and the context in which they operate to support enhanced decision-making and eventually, to better inform funding approaches.  This framework is a tool to promote better understanding of community in order to ensure an agency has the resources required to meet the needs of the people it serves.  Measuring to Thrive is a vision to promote better results; it is not about measuring an agency’s individual performance. 

What we heard

1. Context matters: The experiences and needs of individual agencies and their communities differ, e.g. urban, rural, remote, etc.  The measurement framework must abstract to a common collective vision of well-being.
2. Culture is key: Culture, language and land are crucial elements of belonging.  Opportunities for children and families to connect with their community are important.  The measurement framework must be read through the lens of individual cultural practices, traditions and languages.
3. Safety is an element of well-being: Safety is not an independent goal of FNCFS, it is an important element of overall child well-being.  Safety must be a measure within child well-being.
4. Measuring what matters: FNCFS agencies recognize the value of collecting and using their own meaningful data for improved decision-making and funding approaches.  Measuring what matters will take time and will require a period of testing and adjustment to refine the approach.
5. Capacity requirements: Agencies require internal capacity and support to leverage data collection and analysis that reflects them.  A third-party independent and trusted custodian of the data should be established to support this need, along with resources internal to agencies.

The vision in Measuring to Thrive is expressed through three interrelated elements: the well-being of communities, families and children.  Measuring to Thrive is meant to be read in the spirit of holistic well-being.  As such, it is meant to be informed by the unique cultural practices, traditions and Indigenous languages integral to thriving First Nations and their communities. 

The vision in Measuring to Thrive is meant to be universal.  No matter where you reside, there can be agreement on the highest order elements that indicate thriving communities, families and children.  While Measuring to Thrive is an expression of well-being among FNCFS agencies, individual agencies will deliver their mandates in the best interests of the communities they serve.  This means that remote, rural, urban, large and small agencies may have differing needs and approaches to their practice, but may find unity in the pursuit of well-being for thriving children, families and communities. 

Ideally, the Measuring to Thrive framework receives strong and broad-based support and is used in part or in full as a common tool for data development and tracking among federally funded FNCFS agencies.  As proposed and agreed during the roundtable, it would be imperative for FNCFS agencies and for their communities to have any data collected through this framework transferred to a neutral, reliable and trusted third-party who would be a custodian of the data.  This data would belong to FNCFS agencies and their communities.  An institution such as the First Nations Information Governance Centre (FNIGC) could be leveraged or an agency similar in style to the University of Chicago’s Chapin Hall, could be established in Canada at a university to securely house, analyze and support FNCFS agencies in the collection and application of their data. Over time, as increased amounts of data are collected and analyzed, the data’s predictive value would improve making it a helpful planning tool. 

In the current state of FNCFS, there is a lack of alignment between social policy and financial resources.  Social policy research and FNCFS agencies have repeatedly emphasized the importance of prevention-focused approaches to care that empower children, families and communities, rather than focusing on apprehension.  Approaches taken by FNCFS agencies in pursuit of the well-being of their communities are numerous.  There are however, established gaps in their regular funding in areas such as prevention, capital and information technology.  The most significant gap however, was characterized through poverty in the 2018 report Enabling First Nations Children to Thrive.  Poverty was used euphemistically to capture the challenging contexts in which many FNCFS agencies operate.  Such challenges include limited housing and housing in need of major repairs, access to potable water from the tap, access to broadband, etc. 

FNCFS agencies do not operate in a vacuum but are influenced by the realities of the communities they serve.  Ensuring that financial resources are aligned to the realities of their circumstances is necessary to support the well-being of communities.  Achieving alignment between policy and resources requires people, processes and data to deliver operations and promote accountability.

As active organizations in a network of services in their communities, FNCFS agency activities are ideally focused on investing in people and collaborating to support – paraphrasing an Inuit proverb – the development of capable human beings.  Inter-relationality is paramount, as individuals are wholly well with a sense of community.

In the Measuring to Thrive framework, community is a network of belonging and support; family is a collection of people who may have blood relations that support each other almost every day; child is a young person on a journey to adulthood.

In an ideal state, a funding approach for FNCFS would have a guaranteed baseline of required operating resources, supplemented by funding to mediate contextual factors based on the needs of individual agencies.

Circumstantial effects, such as geography and poverty, can be mediated with expenditure.  A common vision for thriving children, families and communities sits above the operational elements and can be a common pursuit of agencies in their service journey. 

Applying the framework

On a quarterly basis, data on the child and family well-being indicators would be collected, while community well-being data would be collected annually for the Measuring to Thrive framework (see Appendix 1).  Data will come from various sources, including case files from the agency, as well as external publicly accessible data, e.g. Regional Health Survey, Statistics Canada, etc.  Any data to complete the framework will not identify individuals.  Measuring to Thrive is designed to collect information in aggregate to protect the privacy of individuals. 

As the agency completes the framework, the data would be accessed by the third-party custodian responsible for scrubbing and analyzing the data.  On a quarterly basis, researchers from the third-party would meet with agency leadership to discuss the analysis and potential applications on the ground. 

Transitioning to a data collection and monitoring system that supports FNCFS agencies is not expected to be seamless.  There will be a period of transition where testing and further refinement will be essential.  It is expected that in order to get to the best possible version of Measuring to Thrive, revisions through use will be necessary.  Testing the framework is the only way to ensure it reliably reflects the realities of FNCFS agencies and their communities.

“We have been researched to death.  We now have to research ourselves back to life.”

FNCFS agencies have an opportunity to leverage the information (data); heart (stories); and resource needs (funding) of their communities to support them.  There are three parts to the Measuring to Thrive framework:

1. Support improved decision-making by collecting relevant data aligned to a common vision;
2. Ensure data is good quality and connected to the realities and stories on the ground;
3. Ensure agencies have the capacity and support required to collect and analyze the data.

Taken together, the parts of the Measuring to Thrive framework can encourage a culture of accomplishment within FNCFS agencies wherein measurement is a tool to promote holistic well-being, supported through requisite resources.

IFSD is researching approaches to funding social policy and service delivery.  There are two main types of funding:

1. Prospective: service delivery agencies receive fixed payments to deliver services;
2. Retrospective: service delivery agencies are reimbursed for specific activities.

Within these two main funding types, various mechanisms exist to deliver resources to agencies.  For child and family services, commonly identified mechanisms include: fee-for-service; block funding; and performance-based contracts.

As with any policy question, there are tradeoffs in funding mechanisms.  Resource guarantees and flexibility in delivery vary among the two funding types (and their associated mechanisms) (see figure below). 

 

Retrospective funding approachces (e.g. fee-for-service), tend to offer better resource guarantees (as funded activities are clearly defined), but tend to limit flexibility in delivery (since fundable activities can be restricted).  Prospective approaches (e.g. block funding, performance-based contracting) by contrast, tend to offer greater flexibility in delivery (as service providers can allocate resources as needed), but service providers are required to work within established resource parameters (supplementary resources may not be guaranteed).

Funding Mechanism	Case Study	Description
Fee-for-Service	Current funding mechanism for FNCFS	Required resources are provided by payment for specific activities by unit cost or by population served.  Funding may be consistent but there is limited flexibility in delivery as reimbursement is defined for specific allowable activities.
Block Funding	West Region’s Child and Family Services Center block pilot funding program	Resources are allocated based on a combination of previous financial data and need.  A set funding amount is allocated, leaving the service provider to determine its best uses.  While flexibility in approach is promoted, the service provider bears the risk of operating within the set funding amount.
Performance-based contracting	State of Tennessee child welfare program	Resources are disbursed by achieving pre-established goals.  Goals are defined through a service provider’s past performance.  This approach promotes flexibility in delivery but requires the service provider to meet expectations to receive funding.

There is no perfect approach to funding social policy, but there are acceptable tradeoffs that support FNCFS agencies in best serving their children, families and communities.  Identifying the critical mix of resources required and leveraging lessons from other cases and jurisdictions will be instrumental in developing an approach that is reliable and focused on a common vision of thriving First Nations children, families and communities that you helped to define. 

We are close to achieving our goal of at least 50% participation in each province/region.  To reach the targeted threshold, we require four more agencies from Alberta, and one from Ontario to complete the survey.  Several provinces have made very good progress in the last month, most especially, Saskatchewan which surpassed the 53% threshold. Thank you!

The information from the questionnaire will help IFSD to ensure alignment to need as a funding approach is developed and more accurately cluster agencies to model the effects of transition. 

By sharing your experience, you’re making this work more representative and reflective of your agency’s reality. 

At its core, performance budgeting is about aligning spending to desired results.  Money can be used as a tool to incentive an outcome.  In our case, we want money to be a tool for agencies to support the development of thriving First Nations children, families and communities. 

In a perfect world, both the amount of funding and the way the funding flows to recipients, would support desired outcomes.  The current First Nations child and family services (FNCFS) system incentivizes the placement of children in care to unlock funding.  While funding for prevention-focused programming and services exists and has been bolstered by the Canadian Human Rights Tribunal (CHRT) rulings, the structure of the funding system has yet to catch up to the need for a prevention-based approach to funding FNCFS. 

Agencies and stakholders made it clear that agency leadership spend time trying to find ways of working around the current funding system, rather than having a system that works for them.  IFSD recognizes the importance of a funding approach that enables agencies to act in the best interest of children and families.  By looking to the experiences of other jurisdictions, IFSD will leverage their lessons and best practices to inform an alternative funding approach for FNCFS in Canada.

In child and family services, notably in the United States, various budgeting models have been adopted to promote permanent placements for children in care.  In jurisdictions such as Tennessee, performance-based contracting has shifted the focus of service providers from system processes (how things are done) toward improved outcomes for children (an accountability for results). 

IFSD had the opportunity to learn about Tennessee’s model from those that developed it for the state.  The State of Tennessee’s approach to child welfare is premised on the goal of timely permanency for children (either through family reunification or adoption).  By reducing the length of stay of a child in care, there are improved outcomes for the child and lower associated costs.

To achieve the goal of permanency, Tennessee adopted a performance-based contracting (PBC) model.  In this model, providers are financially incented to promote the permanent placement of children and are benchmarked against their own performance.  The state pays for a result and bills providers that do not meet their agreed targets.  

There are three core components to the PBC model:

1. Reduce the length of stay of a child in care;
2. Increase rates of permanency;
3. Reduce rates of re-entry of children into the protection system.  

Since its initial implementation in 2006, Tennessee’s PBC model has proven to be cost-neutral for the state and has promoted a reduction in the number of children in care. 

Tennessee’s child welfare system is comprised of state-run apprehension services supplemented by a network of providers.  The providers undertake all maintenance, placement, family-support and care services post-apprehension or contact with the child welfare system.

The program’s financial information suggests that PBC is incentivizing better program practices and more stability for children by focusing on Tennessee’s continuum of care.  Since the start of PBC, Tennessee has been paying out more in reinvestment dollars (to providers meeting their targets), than it has required payment in penalties for not meeting them.  When the model was paired with an increase in prevention-focused funding, the number of children in care dropped (it rose again when those prevention investments were eliminated due to state spending changes).   

IFSD recognizes that there is no single model that be transposed for the unique contexts of FNCFS agencies and the communities that they serve.  There is no plan to adopt Tennessee’s PBC model for Canada.  However, Tennessee offers three useful lessons for consideration as funding approaches are being considered. 

First, Tennessee implemented a significant shift in its child welfare system that went from “buying beds, to buying results.”  We can learn from Tennessee’s experience with transition by encouraging those providers ready to adapt and providing resources and support for those needing more time to adjust to the new system. 

Second, Tennessee benchmarks its services provides against themselves.  Comparing the activities of service providers to their own context and their own practices can be a useful point of departure when introducing a new system.  Providers in Tennessee were only asked to do better than themselves; no one else.  This approach helps to recognize diverse contexts and practices to child and family services. 

Third, Tennessee successfully used money to change outcomes.  Even though a reduction in the number of children in care is not the same goal as enabling First Nations children to thrive, that Tennessee encouraged behavioural changes in its service providers is a helpful lesson for other jurisdictions grappling with change.

IFSD will continue to build assessments of comparative cases that have altered their funding approaches to achieve different results, e.g. West Region Child and Family Services’ block funding experience from the 2000s. 

We are close to achieving our goal of at least 50% participation in each province/region.  To reach the targeted threshold, we require five more agencies from Alberta, and two more agencies each from Saskatchewan and Ontario to complete the survey.  Several provinces have made very good progress in the last month, most especially, Saskatchewan. 

The information from the questionnaire will help IFSD to ensure alignment to need as a funding approach is developed and more accurately cluster agencies to model the effects of transition. 

By sharing your experience, you’re making this work more representative and reflective of your agency’s reality. 

There are a variety of indicators proposed in the performance framework to capture progress across the four sub-strategic outcomes defined in Phase 1 – Enabling First Nations Children to Thrive.  The table below summarizes the linkage between sub-strategic objective, measure and indicators, and includes the feasibility of accessing the data required. 

Green Feasible	Green means feasibly accessible because the data is already being captured or an agency could easily collect the data.
Yellow Somewhat feasible	Yellow implies somewhat feasibly accessible.  While the data may not exist publicly, nor is it likely being captured by agencies, the request falls within the agency’s mandate and the data could be feasibly collected by an agency.
Red Difficult	Red indicates some challenge in accessing the data as it falls outside of a typical agency’s mandate, and may require collaboration with a third party to capture the information.

Sub-objective	Performance Area	Measure	Indicators
Safety	Protection	Protection from all forms of maltreatment	Recurrence of maltreatment
			Serious injuries/deaths
			Recurrence of child protection concerns after ongoing protection services
			Non-accidental child injury
			Child sexual abuse
	Permanency	Permanency status	Out of home placement rate
			Number of moves in care
			Timeliness of family reunification
			Timeliness of adoptions
		Out of home care	Percentage of children placed with kin and/or Indigenous families within their community
			Quality of caregiver and youth relationship
Child well-being	Cognitive development	School readiness	Percentage of 3 and 4-year-olds participating in funded early years education
			Basic literacy score
			Basic numeracy score
			Advanced literacy score
			Interest in literacy/numeracy and memory score
		Educational attainment	Literacy and numeracy test scores (middle childhood)
			Positive attitude towards school/learning
			Youth who intend on going to full-time post-secondary (e.g. college, trade school, university)
	Social relationships	Social support and belonging	Youth who report positive relations with their parents or caregiver
			Youth with 5 or more close friends
			Youth who report positive relations with siblings and extended family
			Youth who report positive relations with non-family adults
			Youth who report strong ties with elders in the community
		Social engagement	Youth who report some involvement, participation or contribution within the community
			Youth who participate in extracurricular activities
	Psychological and emotional well-being	Child behaviour	Anxious and fearful behaviour
			Aggressive behaviour
			Hyperactivity and inattentive behaviour
		Social competence	Communication skills
			Prosocial and helping behaviour
			Social intelligence (e.g. cooperation, conflict resolution, trust, intimacy)
		Subjective well-being	Self-reported happiness/life satisfaction
			Self-reported mental health
		Esteem	Sense of purpose
			Optimism and hope
			Resilience
			Confidence
			Agency
	Cultural and spiritual well-being	Spirituality	Sense of belonging to cultural group
			Pride in Indigenous identity
			Sense of connection to the land
			Participation in spiritual practice/knowledge/ceremony
		Tradition	Speaks traditional language
			Eats traditional foods
	Physical health and well-being	Overall physical health	Low birth weight
			Breastfed for at least 6 months
			Children living with a disability or chronic illness
		Healthy habits	Eating habits
			Level of physical activity
			Sleep habits
		Risk management	Teenage birth rate
			Percentage who report using illicit drugs in the past month
			Percentage who report binge drinking in the last month
			Smoking in the last month
Family well-being	Self-sufficiency	Secure parental employment and parental participation in the labour force	Labour force status
			Job tenure/permanency
		Ability to meet basic needs	Household income sufficient to meet basic needs for transportation, housing and utilities, food, clothing, childcare and other necessary expenses
	Family health and protective factors	Physical health status of parents or caregivers	Chronic conditions
			Eating habits
			Drug use (alcohol, smoking, illicit drugs, prescription medication)
		Mental health status of parents and caregivers	Self-reported mental health
			Symptoms of anxiety and depression
			Thoughts of suicide/self-harm
		Family protective factors	Parental resilience
			Social connections
			Knowledge of parent and child development
			Concrete support in times of need
			Developmental parenting and attachment
Community well-being	Access to basic needs	Access to potable water	Number of long-term drinking water advisories affecting FN water systems
		Access to suitable housing	Percentage of homes that are suitable
			Percentage of homes in need of major repairs
		Access to broadband connectivity	Percentage of homes with internet connectivity
		Community infrastructure	Presence of point of community assembly, health centre, elementary school, recreational space or facility
		Overall poverty level	Median household income compared to provincial or national poverty line
			Mental health and counselling services
			Child and family services/social services
			Health and medical services
			Respite care
			Transportation and accommodation (medical and non-medical appointments)
	Public safety and community health	Health and safety	Rates of reported suicide attempts
			Rates of reported heavy drinking
			Rates of reported drug use
			BMI rates
			Rates of chronic health conditions
			Rates of violent crime
		Educational attainment	High school graduation rate
			Rate of post-secondary education

Manitoba and British Columbia have reached the 50% participation threshold, and the Atlantic region has surpassed it at 55%.  Saskatchewan has more than doubled its participation rate in less than four weeks.  IFSD is grateful for this effort.  To reach the 50% target participation rate per region, we are asking agencies in Alberta, Ontario, Saskatchewan and Quebec to continue to complete the questionnaire if they have not already done so.     

The information from the questionnaire will help IFSD to ensure alignment to need as a funding approach is developed and more accurately cluster agencies to model the effects of transition. 

By sharing your experience, you’re making this work more representative and reflective of your agency’s reality. 

The results framework is designed to ‘flip the current structure on its head’ by defining the end goal (thriving First Nations children) and building out a funding approach that aligns to that outcome.   

The table below is a high-level overview of the overall goal, the means through which it can be achieved and the way in which progress can be monitored by agencies.   

IFSD encourages you to share your input and ideas to enhance the framework.

Strategic Outcome: Thriving First Nations Children The overarching goal, to which all activities contribute.
Sub-Strategic Outcomes Areas of focus to achieve the strategic outcome.	Safety Children are protected from harm and achieve permanency in their living situation.	Child well-being Children reach their full developmental potential and have hope, belonging, purpose and meaning.	Family well-being Families enjoy a safe, stable environment in which to foster healthy relationships.	Community well-being Communities have adequate infrastructure, services, resiliency and belonging to ensure collective safety, stability and well-being.
Performance Areas The lenses through which progress on sub-strategic outcomes can be understood.	Protection Permanency	Cognitive development Social relationships Psychological and emotional development Cultural and spiritual development Physical well-being	Self-sufficiency Family health and protective factors	Access to basic needs Gaps in services to community Public safety and community health
Measures Means of assessing progress in performance areas.	Protection from all forms of maltreatment Emergency mental health Permanency status Out-of-home care	Educational attainment Social support and engagement Child behaviour, mental and social well-being Spirituality and tradition Overall physical health, healthy habits and risk management	Parental employment Ability to meet basic needs Physical and mental health of caregivers Family protective factors	Access to potable water, housing, broadband and community infrastructure Poverty level Gaps in health and social services Overall community mental and physical health status
Examples of key performance indicators The variable measured.	Recurrence of maltreatment Number of moves in care	Sense of belonging to cultural group Literacy and numeracy scores Youth who report positive relations with parents, friends and elders	Parental job tenure and permanency Self-reported physical and mental health Developmental parenting and attachment	Number of boil water advisories Median household income Rates of suicide attempts