Practice Models Aimed at Engagement and Support of Youth and Families in the

Child Welfare System

Presenters:

Elizabeth Greeno, PhD, LCSW-C

Josh Brusca, MSW

Berenice Rushovich, MSW

Kantahyanee Murray, PhD

Engagement and Support of Youth and Families in the Child Welfare System: A Review of Three

Practice Models

One mid-Atlantic state implemented three programs to enhance engagement and support of families and youth involved with child welfare services.

• These included services to help older youth in foster care establish connections with family members (Family Finding);

• improve involvement of family members at critical junctures in the decision making and service provision process (Family Involvement Meetings);

• and support kinship caregivers in providing for children in their care (Kinship Navigator).

The purpose of this presentation is to 1) describe the three programs, 2) assess staff’s perceptions of practice changes, and 3) understand youth and families’ perceptions of the programs.

3 Practice Models

• Family Involvement Meetings

• Family Finding

• Kinship Navigator

• Funding: Making Place Matter through Family Kin Connections [HHS-2009-ACF-ACYF-CF-0078]

Practice Principles

Engagement

Teaming

Assessment

Planning

Intervening

Monitoring &

Reassessment

Facilitation of Family Involvement Meetings (FIM)

Family Involvement Meetings (FIMS)

• Triggers to convene meeting:

Removal/Considered Removal

Placement Change

Permanency Plan Change

Youth Transitional Plan

Voluntary Placement

• Neutral facilitator or supervisor

0

5

10

15

20

25

30

35

40

45

50

Removal PlacementChange

PermanencyChange

YouthTransition

Plan

VoluntaryPlacements

46

26

1114

3Pe

rce

nta

ge o

f FI

Ms

Pe

r M

on

thFrequency for Type of FIM

FIM Model

• Introduction

• Identifying the Situation

• Assessing the Situation

• Developing Ideas

• Reaching Consensus Decision

• Recap/Evaluation/Closing

Strengths Based

Use of Materials:Dry Erase BoardPostings of Rules

Posting of Purpose

Purpose for FIM Facilitation Study

• Implementation & Fidelity Study of FIM Facilitation

• Engagement of children, youth, & families served through FIMs

Evaluation Plan

How?

Three-Pronged, Multi-Informant Approach

1. Focus Groups & Interviews with FIM Facilitators

2. FIM Observations

3. Quantitative analysis of FIM Feedback Surveys

Evaluation Plan

• Interviews/Focus Groups for Model Fidelity

– Trained as a Facilitator and Facilitating FIMs (part-time or on a rotation)

– Trained as a Facilitator and Not Facilitating FIMs

– Full time/designated FIM Facilitator

• Between Fall 2009 & Spring 2011, 132 Workers were eligible, 54 (41%) participated

• 4 Focus Groups and 30 Interviews

Findings for Interviews & Focus Groups

• Fidelity to the model was perceived as strong

– The most effective FIMs are the ones that follow the outline, even if you go through it quickly. But that you go through each step

• Positive View of the FIM model

– I’m not making decisions for this family…we’re all making them together

Findings for Interviews & Focus Groups

Characteristics of FIM Facilitator

• Excellent Communication Skills

• Patience

• Problem Solving Abilities

• Cultural Competence

• Objectivity

• “Quick on Your Feet”

• Time Management

• Ability to hear the Voices of all Participants

• Group Decision But Adhere to Child Welfare

“You have to have good clinical skills. You have to

be able to remain objective and neutral.

You have to feel comfortable speaking

before a group”

Findings for Interviews & Focus Groups

• Importance of Neutral Facilitator“people [in the meeting] will talk to the facilitator and say, “Well, they don’t understand, whatever”. So it’s working. So they look at them. Even though it’s said in the beginning of the meeting, “I work in the department, but I have nothing to do with this case,” they trust that, and they start chatting with the facilitator and, you know, we’re the enemy. And that’s great. I don’t mind that because I think that’s how it works better. So they don’t look like they’re aligned with the supervisor and the worker and everything.”

FIM Observation Findings

• N = 12

• 5 Main Themes

1. 67% of the Facilitators did not follow the steps in order

2. Variation with Maintaining a Strength-Based Approach, 47% to 75% adherence throughout FIM, most noticeable during youth transition FIMs

FIM Observation Findings

• Assessing The Situation, (range from 58.3% to 91.7%). Most concern was seen with safety assessment and discussing the family’s history

• Engaging Families & Invited Guests, 75% of Facilitators actively engaged non-agency participants

FIM Observation Findings

• Facilitator Characteristics, 92% of Facilitators were neutral. Three clinical skills that were infrequently observed: encouraging others to communicate during each step, exhibit sensitively other others, responding to non-verbal messages

FIM Satisfaction Sheets

• Over a period of 3 Months given to all pilot counties with a Removal FIM

• N = 488

• Majority of Participants:

– 35% (171), parents, youth, relatives

– 25% (117), child welfare caseworkers

– 13.5% (66), child welfare supervisors

– 20% (98), Other supports

– 7% (36), unknown

FIM Satisfaction Sheets• Overall, participants very satisfied with the

project

• Differences between Parent, Youth, Relative, & DSS Staff

– Question 1. The action plan will help the family achieve the identified goals

– Question 5. I felt included in the decision making process

– Question 11. I left the meeting knowing what action steps needed to be taken next and who was responsible for each action

Recommendations

• Overall Findings

– Coaching

– Training for all staff regarding FIMs

– Performance feedback to facilitators

FAMILY FINDING

A Brief Summary of Implementation & Practice

Joshua Brusca, LGSW

Family Finding• Intensive relative search activities

• Target population

– APPLA permanency plan

– Re-entry after adoption disruption

– New cases without identified relative resources

• Specialized training

• Collaboration with caseworkers

• Establish “relational permanence”

• Mobility Mapping

• Blended Perspective Meetings

• After Grant Transition to work with FIMS

Strategies Used during Discovery•Review of Case•Interview with Child Welfare Worker•Google Search•Facebook/My Space•Accurint•Whitepagescom•Ussearch.com•CARES•Interview with Others

•SVES•MVA•Child Support•MD Wage Database•Inmate Information (www.vinelink.com)•Military Records•Obituary•www.familylinks.icrc.org

Implementation• Who does it?• Family Finding in Maryland began in Baltimore County

in 2008. There are currently 12 other jurisdictions in Maryland that have implemented Family Finding programs as well, with the rest of the state slated to come on board by the end of 2015.

• Maryland’s Family Finders are full and part-time staff at their local service offices.

• Maryland Family Finders meet on a bi-monthly basis to discuss programming ideas and share success stories.

• Oversight of Family Finding policy is provided by local jurisdiction’s administrations as well as our parent agency, the Department of Human Resources.

Implementation Cont.• Referrals – Agencies in Maryland have designed

referrals in different ways to suit their agency’s needs. In all jurisdictions though the referral process is collaborative between the caseworker and Family Finder.

• Timeframe: Depends on the case, ideally < 6 months.

• Closure: Also a collaborative process between caseworker and Family Finder. Cases typically end when family involvement has been fully explored and implemented into case management.

Why Family Finding?

• Children in the Child Welfare system have been shown to lose connections as time in foster care progresses.

• Children entering care may have already suffered severance of family ties before coming to our attention.

• Providing for a child’s basic needs (placement, education, safety) is not always enough to allow that child to thrive.

Why Family Finding?

• What if someone else controlled the fate of who was defined as your family…?

Case Types

• Cheers Kids – Older children; typically with a plan of APPLA; have been in care for many years. Often times have lost connections due to amount of time in care.

• Front End Cases – Can be any age; upon shelter it is immediately apparent that parts of the family are not in the picture. Have lost connections due to events prior to agency involvement.

Case Types Cont.

• One Year Check-Ins – Children who have reached one year in care; permanency plans have altered drastically or are realized to not be realistic. Family connections were initially avoided for reasons that have now changed.

• Disrupted Adoptees – Touchy legal subject. Children who have been brought to DSS by an adoptive parent who does not wish to seek reunification. Child may or may not be interested in seeking biological family.

Barriers

• Child may not want or be ready for services.

• Parent/Relative may object to services or refuse to provide information (particularly troublesome with VPA’s).

• Family drama or child’s behaviors may have already burned bridges beyond ability to repair.

Barriers Cont.

• Agency staff may side with one parent vs. another or may feel that “the apple doesn’t fall far from the tree.”

• Reunifications can sometimes lead to digging up of past experiences or emotions that may make engagement more difficult.

• Therapy is highly recommended to go hand-in-hand with Family Finding. Deal with these issues now while supports are available to handle them appropriately.

Results!

• Placement resources, though not the primary goal of the process, can materialize.

• Long-term supports can be implemented for children in care (visitation, holiday visits, phone, advice, material support, information)

Results!

• Freedom to pursue other permanency goals.

• Documentation to court that family resources were explored.

• Reality-testing and exposure to the truth.

Questions?

• I am always happy to answer all inquiries or help staff at your agency launch a Family Finding program.

• 410-853-3122 or josh.brusca@maryland.gov

Family Finding Evaluation

• Database collection

• Interviews/Focus Groups at multiple time points

– 2011

– 2012

– 2013

Family Finders: Demographic Data N=12

Full or Part-time

Full-time 8 67%

Part-time 3 25%

Other (Admin) 1 8%

Ethnicity

African American 4 33%

Hispanic 1 8%

White or Caucasian 7 58%

Age

26 to 30 3 25%

31 to 40 3 25%

41 to 50 3 25%

>51 3 25%

GenderMale 3 25%

Female 9 75%

Education LevelUndergrad (BA/BS/etc) 1 8%

MSW 11 92%

Length of Child Welfare Service

1-5 Years 5 45%

6-10 Years 2 18%

>10 Years 4 36%

Average Length of Case: 1 Year

Average Number of Family Finding Cases: 11

Family Finding Model in MarylandKevin Campbell Family Finding Model Maryland Pilot Jurisdictions Implementation of Family

Finding

Discovery

Engagement

Planning

Decision-Making

Evaluation

Follow-up Support

Referral & Discovery

Engagement

Planning & Decision-Making

Transfer the Case

Evaluation

Follow-up

Support as

needed

Engagement

• Most Important

• Most Time Consuming and lifelong throughout the case

• With friends/family and youth“I bring them all to the table. I have them each say something positive about the youth. I let each of them say what they feel like a need of the youth is. And then we all come together to figure out like what is the biggest need of this youth and what can each one of you do to help that youth meet that need?”

3 to 6 People per Youth

Barriers with Family Finding

• Older Youth/Youth close to aging out

“they're connected with their relatives unbeknownst to the workers because they don't want the workers to know. And a lot of times it's because the relatives don't want to deal with Department of Social Services, and they're just waiting for the kid to age out and then they're going to step up. So I've seen that a bunch of times, too.”

Transfer the Case

When do you transfer the case back to the child welfare worker?

“..we kind of know it’s ending, because everything is in place. It’s been stable for six months. Things are in the same--he’s well-connected to his family, has been for a while. I mean, what more can we do? He has the support from the workers, and they’re doing great, we’re checking in.”

Profile of Youth Served by Family Finders (N=295)

Demographics

Average Age 14 (SD = 4), Range 0-22

Age Breakdown

0 Months-13.11 Years,

32% (n = 95)

14-21 Years,

68% (n = 200)

Gender % Male 52% (n = 153)

Race N(%)

African American 186 (63%)

Latino 18 (6%)

White 77(26%)

Other Minority 14 (5%)

Average Length

of FF ServiceNumber of Weeks 37 (Range 0-168)

Length of Time in Care (months) 18.4 Months (Range 0-192)

Profile of Youth Served by Family Finders (N=295)

Primary Permanency Goal48% (142) Reunification with Family

33% (96) APPLA

Current Placement At Start of

FF Services

46% (136) Non-Relative Foster Home

6% (18)Kinship Placement

14% (42) Group Home

10% (30) RTC

9% (27) Other

Prior Existing Connections

Total Relative, Average 4

Total Non-Relative, Average 1

Biological Mother, 57% (168)

Biological Father, Brother, Sister (each) 39% (114)

Cousin 23% (67)

Maternal Grandmother, Maternal Aunt (each)

21% (63)

Services Provided by the Family Finders (N=295)

Number of relatives found 9 per youth

(Range of 0-70)

Number of family members contacted 6 per youth

(Range 0-45)

Number of family members engaged 4 per youth

(Range 0 -39)

Number of blended perspective meetings

held

20% of cases

Number of FIMS held as a result of Family

Finding

24% of cases

A case plan was developed 38% of cases

Differences in Age GroupsFamily Finding Variable Mean Findings

Number of Relatives Found <14 9 t(292) = .335, p =.738

>14 9

Number of Family Members Contacted <14 5.4 t(293) = -.275, p =.783

>14 5.6

Number of Family Members Engaged <14 3.4 t(293) = -.357, p =.721

>14 3.7

Number of Blended Perspective Meetings Held

<14 1 t(293) = .554, p =.580

>14 1

Number of FIMs held as a result of Family Finding

<14 1 t(293) = -.983, p =.326

>14 1

Length of Family Finding Services(in weeks)

<14 31 t(134) = -1.831, p =.06

>14 40

Findings for Family Finding Services• Youth who did not have paternal connections at the

start of Family Finding had greater numbers of Family Members Found, Family Members Contacted, Family Members Engaged, and had a longer length of service (by 15 weeks) compared to those who had paternal connections at the start of Family Finding.

• Older youth (>14) had less paternal connections when compared to younger youth (X² (1, N = 295) =21.901, p = .0001)

• Youth with APPLA as a starting primary permanency plan had longer lengths of service (by 13 weeks)

Findings for Family Finding Services

• Length of Service predicted the number of Family Members Contacted and Engaged and the Number of FIMS held.

– For each additional week of service 3 additional family members were engaged

– For each additional week of service the total number of FIMs increased by 2

Kinship Navigator Program (KNP)

Practice Model

The Kinship Navigator Model

• Developed to provide support to informal kinship caregivers maintain their kin children safely in their home while at the same time facilitating permanency

• Centerpiece of the program was the Kinship Navigator (KN)

• Core Kinship Navigator components: KN Professional Development; Program Service Delivery and Program Coordination

Kinship Navigator Program Model

Facilitate

Support Group

Provide

Information

and Referral

Services

Offer Intensive

Case

Management

Services

Improved Quality and

Access to Services for

Informal Kinship

Caregivers

Facilitate Advisory

Board

Outreach to the

Community

Information and Support

to Child Welfare Staff

Target PopulationInformal Kinship Caregivers and

Children in their Care

KN Support Group, Technical Assistance and

Supervision

Kinship Navigator Professional Development

Types of Service Interventions

• Information & Referral (Kin Navigator)• “I just need some information! Where do I turn? What

do I do now?”

• Case Management (Case Managers)• Every client is an individual and services should be

specific to meeting the family’s individual needs.

• Consists of engagement, collaboration, advocacy, and closure.

Categories of Services

• Legal

• Educational

• Mental Health

• Senior Services

• Day Care

• Child Support

• Substance Abuse

• Housing

• TANF (TCA—Child Only)

• Food Stamps

• Medical Assistance

• DJJ

• Custody & Guardianship

• Adoption

• Other

Kinship Navigator Program (KNP)

Implementation and Evaluation Methodology

KNP Evaluation Methodology

• Process Evaluation to Understand:

– Who received the services

– What services were provided

– How the services were provided

– How decisions were made regarding level of services provided

– Administrator support for the program

– Worker and caregiver satisfaction

KNP Methodology - Overview

• Outcome Evaluation to understand:

– Worker perceptions of the efficacy of services

– Caregiver perceptions of the efficacy of services

– Impact of the program on the youth and families served

Data Collection

• Kinship Navigator Database

– Information regarding services provided

• Kinship Navigators Perceptions

– 2 focus groups (N=9)and 5 semi-structured interviews (N=6) conducted mid-way and end of grant period

• KN Program Administrators Perceptions

– 1 Focus group (N= 4) at end of grant period

Data Collection

• Kinship Caregiver Survey (N=92)

– Mailed survey regarding services received and perceptions and satisfaction with these services

• Kinship Caregivers Focus Groups (N=22)

– 3 Focus groups conducted 2 years after the start of services

Kinship Navigator Services

• Information reported by 9 Kinship Navigators in 7 jurisdictions

• Services provided between September 2010 and May 2013

• 800 kinship caregivers served

Kinship Navigator Services

• Demographic data on 615 caregivers

– 91% (562) female

– Average age 50 years (range 20-88 years)

– 59% (360) African American

– 29% (179) white

– 27% (163) income below $25,000

– 91% (558) were taking care of grandchildren

Kinship Navigator Services

• Total services provided since project began:

– 2823 contacts with 552 families

– 4 weeks of service average (range 1-24 weeks)

– 4.7 contact per family (range 1 – 28 contacts)

– 65% contacts done by phone

– 14% contacts occurred at support groups

Most Common Kinship Navigator Services Received (N=1,431)

0% 5% 10% 15% 20% 25% 30%

Supportive Listening

Case Management Services

Financial Assistance

Legal Services

Provided Resource Guide

Education

Mental Health Services

Medical Services

Child Care

Recreation

Housing

Kinship Navigator Services

• 29 Advisory board meetings held

• 115 Support Group meetings held, attended by 1057 adults and 723 children

• 5,994 flyers and 445 resource guides distributed

• 33 community partner meetings held attended by 300 adults

• 108 outreach, education and other events held attended by 9137 adults and 5,155 children

Kinship Navigator Perceptions

• Decision regarding level of service provided

– Informally assessed by KN

– A screening tool was used by some

• Type and amount of services provided

– Matched to the level of need

– Options of in-home and other more intensive services were available

Kinship Navigator Perceptions

• Support groups– Reduce isolation

– Provide connections to others in same situation

• Resource guides – Provide vital information for caregivers

• Advisory Councils – Promote the program

• Presenting a different face of DSS– Builds trust with the community

Kinship Navigator Perceptions

• Critical Elements for the program to succeed

– Having the KN as a point person for this population group

– Partnerships and collaboration with community stakeholders

– Financial assistance to offer to caregivers

– Support groups

– Keeping the position funded

Kinship Caregiver Survey

Kinship caregivers served by Kinship

Navigators were mailed surveys asking

about:

•Demographic information

•Information about the kinship relationship

•Frequency of contact with parents and siblings

•Services they received

•Perceptions of the impact of services

340 surveys mailed, 92 (27%) returned

Kinship Caregiver Survey Findings

• Demographics:

– 94% female

– 74% grandparents

– 49% African American

– 44%White

– 45% incomes less than $25,000 per year

Kinship Caregiver Survey Findings

• Relationship between caregiver and children:

– 62% cared for kin children for more than 3 years

– 64% had legal guardianship and/or custody of children in their care

– 35% indicated child had contact with a parent at least once a week

– 48% indicated child had daily or weekly contact with siblings

KNP Service Components Kinship Caregivers Received (N=91)

2%

23%

67%

64%

0% 10% 20% 30% 40% 50% 60% 70% 80%

Missing response

Services in Home

Individual Help from KN

Support Group

Additional Services That Would Help Kinship Families

• Additional financial supports

• Child care for working providers

• Clothing

• Parenting mentoring sessions

• Longer services,

more personal one on

one time

• Better advertizing of

services

• Respite care

• Pulling family in to

help

64%

16%

8% 8%4%

0%

10%

20%

30%

40%

50%

60%

70%

Very satisfied Satisfied Neithersatisfied nordissatisfied

Dissatisfied Verydissatisfied

Satisfaction with Services Received

from the KNP (N=90)

Perceived Impact on Kinship Families

More than 80% of the kinship caregivers (N=90) reported* that

the KNP helped them or their families:

• Learn about services and resources available in community

(82%)

• Feel supported in efforts to care for kin child(ren) (80%)

• Feel they could contact the program or worker when

assistance needed (80%)

• Know where to go to get support to meet kin child(ren)’s

needs (80%)

* Caregivers Strongly Agreed or Agreed with these statements.

Kinship Caregiver Focus Groups

Findings for 2 focus groups (n=22):

• 16 white, 6 African-American

• 19 females

• Ages ranged 51 -60 years of age on average

• Income ranged $25,000-$34,999 on average

• 2 kin children in past 12 months on average

• Nearly all were grandparents (16), most with

legal guardianship (14)

• Primarily learned about KNP through Dept. of

Social Services & Dept. of Aging

Use of KNP & Perceptions of KN

• Help navigating the system and support

group were the most commonly reported

KNP service received

• Several reported having a positive

relationship with the KN and found the KN

easy to contact and helpful

Perceptions of the KNP Support Group

• Caregivers indicated the support group

was helpful. Most prevalent ways helpful:

o Legal referrals beneficial to caregiver

o Children were able to make friends

“They’re loving it, they’ve made

friends…“

Perceptions of the KNP Support Group

o Families shared resources with one

another

"Somebody needed a toddler bed, I had a

toddler bed, here you can use it. You

know it didn’t have to go to you know, I

had a mattress, everything, here you

go, you can have it. You know, going to

Goodwill or whatever."

Satisfaction with KNP

• Many reported being satisfied with KNP

• Most reported desiring the KNP to provide

financial support or advocating to help kinship

caregivers to overcome financial barriers

"And I’m not eligible for anything else because

of my income. I can’t touch nothing because of

my income.”

"If I could change anything [about KNP], I would

even pay for lunches if you pay for daycare.

Because its 262 dollars out of my check every

week and I’m not kidding you, I’m living week to

week."

Caregivers’ Perceived Impact of KNP

• Several caregivers indicated that KNP helped:

– Caregiver know that she/he was not alone in having to care for kin child and experiencing similar challenges

– Caregiver to link with other caregivers to provide mutual help

Caregivers’ Perceived Impact of KNP

"And how we help each other. I mean she stopped by, brung me food you know cause she goes to the food bank you know during the day cause I work those regular shifts and she stops by and bring me food because I can’t you know? And we just help one another. I mean it’s just like a, a community, a family."

Caregivers’ Perceived Impact of KNP

– Improve child well-being

• Child knows that other children live with their grandparents/relative/not with parents

“And I think they have met other kids who don’t have parents and they have um like they say well where’s your daddy, well my daddy doesn’t live with me, my mommy doesn’t live with me. So it has helped them cope on the outside so they say hey there’s other kids who are exactly like me.”

Impact of Kinship Navigator Program

• Examine administrative data indicators

– Placement stability

• Were children able to stay with their kinship caregiver?

– Rates of report of maltreatment

• Were reports of maltreatment received?

• How many of these reports were substantiated?

Placement Stability

Caregivers Children

Before KN

Services

After KN

Services

Before KN

Services

After KN

Services

Placement

Changes

Per Child

Cases with Out of Home

Services 1 1 6 2 1-9

Cases with Caregivers as

Perpetrator

Indicated 9 1 11 1

Unsubstantiated 2 0 2 0

Totals 12 2 17 3

Table 1 Caregivers searched in MD SACWIS System N=455

Current Status of the KN ProgramA Policy statement has been issues and is under review

The role of the kinship navigator shall include:

• Developing information and referral resources

• Facilitating monthly support groups for kinship care providers

• Developing community partnerships and resources to support relative caregivers

• Assessing risk and safety concerns and referring to Child Protective Services when appropriate

• Accept referrals of caregivers who are in need of support and assistance

Thank you!

Contact information:• Elizabeth J. Greeno - egreeno@ssw.umaryland.edu

• Berenice Rushovich – brushovich@ssw.umaryland.edu

• Josh Brusca-josh.brusca@maryland.gov

Questions?