A care coordination program for substance-exposed newborns

The Vulnerable Infants Program of Rhode Island (VIP-RI) was established as a care coordination program to promote permanency for substance-exposed newborns in the child welfare system. Goals of VIP-RI were to optimize parents' opportunities for reunification and increase the efficacy of social service systems involved with families affected by perinatal substance use. Findings from VIP-RI's final four years show that by 12 months, 86% of substance-exposed newborns had identified permanent placements and 77% were placed with biological parents or relatives.     

Policy options: early intervention services for substance-exposed infants.

Substance-exposed infants, or babies that have been victims of their mothers' drug use during pregnancy, have reached substantial proportions. Currently, no comprehensive public policy exists to deal with these infants as they enter a society unprepared to respond to an issue increasingly fraught with substantial adverse economic, social, and political ramifications. In order to address the needs of this emerging sub-population, California's governor and state legislature must develop and adopt a concerted interagency policy which outlines: a) uniform criteria for local health care workers, social service agencies, and educators; b) consistent guidelines governing the exchange of information among a range of agencies, including hospitals, schools, and other public and private agencies; and c) increased prevention and early intervention services for these babies and their families. Addressing the needs of these infants requires a bold, comprehensive, interdisciplinary approach from the creators of public policy.     

Learning the hard way: a pilot permanency planning program

California's Family Protection Act (FPA) is a forerunner of Public Law 96-272 and of the state's permanency planning efforts. The mechanisms for implementing judicial and administrative review and delivering new contract and in-agency services are discussed, as well as the criteria for receipt of services and the changing use of preventive services and foster care. The original implications of the chosen mechanisms and their evolution across seven years of permanency planning are reviewed.     

Ambivalences: a challenge to permanency for children

A key to determining a permanent plan for children in placement lies in determining and working with the history and relative intensity of parental ambivalence in the parent-child relationship as it is acted out in the placement experience. A study of cases in a public department disclosed not only indicators of parental ambivalence but also the reinforcement of that ambivalence by agency policy, working conditions, and lack of resources.     

Socioeconomic correlates of current and regular smoking among college students in Rhode Island

Objective: The objective of this study was to determine how sociodemographic variables, in particular socioeconomic status, correlate with current and regular smoking among college students in Rhode Island. Participants and Methods: Over a 4-year period (academic year 2000-2001 to 2003-2004), the authors examined sociodemographic correlates of cigarette use among 3,984 students aged 17 to 24 years from 10 colleges and universities in Rhode Island. Results: One-third of participants (32.0%) had smoked a cigarette in the 30 days preceding the questionnaire. Findings from a pair of logistic regression models indicated that participants from upper-income families were more likely to be current smokers-although not regular smokers-suggesting that the effect of socioeconomic status on smoking is partly dependent on the level of addiction. In addition, freshmen were more likely to be current and regular smokers than were upperclassmen, and white students were most likely to be regular smokers. Conclusions: The frequency of college students who reported that they first tried smoking and first smoked regularly while in college increased from freshman to senior year, indicating that the college years are a vulnerable period for smoking initiation and habituation.     

Socioeconomic Correlates of Current and Regular Smoking Among College Students in Rhode Island

Objective: The objective of this study was to determine how sociodemographic variables, in particular socioeconomic status, correlate with current and regular smoking among college students in Rhode Island. Participants and Methods: Over a 4-year period (academic year 2000-2001 to 2003-2004), the authors examined sociodemographic correlates of cigarette use among 3,984 students aged 17 to 24 years from 10 colleges and universities in Rhode Island. Results: One-third of participants (32.0%) had smoked a cigarette in the 30 days preceding the questionnaire. Findings from a pair of logistic regression models indicated that participants from upper-income families were more likely to be current smokers—although not regular smokers—suggesting that the effect of socioeconomic status on smoking is partly dependent on the level of addiction. In addition, freshmen were more likely to be current and regular smokers than were upperclassmen, and white students were most likely to be regular smokers. Conclusions: The frequency of college students who reported that they first tried smoking and first smoked regularly while in college increased from freshman to senior year, indicating that the college years are a vulnerable period for smoking initiation and habituation.     

Beyond termination: length of stay and predictors of permanency for legally free children

Despite growing awareness of the complex needs of legally free children in child welfare care, relatively little empirical investigation has been done of these children and their experiences. This article reports the results of a study of length of stay and predictors of permanency in a sample of 1,366 legally free children in state custody in Washington state. A Cox proportional-hazards event history model was developed to explore the effects of gender, race, and ethnicity, and age at initial placement, on the likelihood of achieving legalized adoption or guardianship. Results indicate that older children, boys, and African American children were all significantly less likely to achieve a permanent outcome than were Caucasian children. Hispanic children, in the other hand, were significantly more likely to achieve a permanent outcome. The implications of these findings for permanency planning practice and policy development are discussed.     

Expedited permanency planning: evaluation of the Kentucky Adoptions Opportunities Project

This article presents the evaluation findings of a Kentucky Adoptions Opportunities Project (KAOP), a three-year project funded by the U.S. Department of Health and Human Services, Administration on Children, Youth and Families, Children's Bureau. The primary goal of the KAOP was implementation of three permanency planning activities: (1) risk assessment/concurrent planning, (2) one child/one legal voice, and (3) early placement in kinship or foster/adoptive homes. These activities were designed to expedite a permanency placement decision within 12 months for high-risk children. The evaluation of 124 high-risk children in the KAOP revealed that the majority of children had one or both parents coping with multiple risk factors, including mental illness, substance abuse, mental retardation, or family violence. The major barriers to permanency are discussed, as well as the policy and practice implications in the context of Adoption and Safe Families Act of 1997.     

Advocating for the Rights of Vulnerable Nursing Home Residents:

The purpose of this article is to describe how advocates continued to work to effect change after the criminal prosecution of one nursing home corporation (referred to in this article as the Corporation). The impact was felt not only by that company but also by area nursing home providers, policymakers, and regulators in long-term care.     

Profile of children placed in out-of-home care: Association with permanency outcomes

The goals of this study were to explore characteristics and profiles of children who received out-of-home care services and to examine the relationship between their profiles and permanency outcomes. Results of latent class analysis suggest that there are three distinct subgroups of children served in out-of-home care (N = 33,092): Children with Complex Needs (6%), Children in Families with Complex Needs (64%), and Older Abused Children (30%). Of the three identified subgroups Children with Complex Needs consisted of youth who were at greater risk for adverse outcomes. These children were less likely to experience timely adoption, had the longest length of stay in out-of-home care, and were least likely to experience timely reunification. Although permanency outcomes for Older Abused Children are somewhat better than for Children with Complex Needs, they represent a vulnerable population of youth in out-of-home care who have a very low chance of being adopted. Overall, this study suggests that service provision by itself may not improve permanency outcomes for children unless both prevention and intervention efforts address co-occurring family needs and are tailored to specific characteristics of the children being served.     

Use of court-appointed advocates to assist in permanency planning for minority children

Despite federal law on reuniting children in care with their families, minority children remain in dependency longer and are more likely to be placed in long-term foster care than white children. This article describes a program of volunteer, court-appointed advocates to assist in cases of abuse and neglect involving minority families, and an outcome study. Significantly fewer children were placed in long-term foster care and significantly more children were placed in adoptive families than in a comparison group of families.     

Barriers in permanency planning for medically fragile children: Drug affected children and HIV infected children

This article discusses the problems of medically fragile children, drug affected and/or HIV infected. Passage of the Adoption Assistance and Child Welfare Act of 1980 markedly increased the number of these children in foster care. The specific barriers to permanency planning for this group of children are discussed and include interviews with staff people, review of the literature and integration of material from pilot studies of families fostering and adoping children with HIV.Dr. Groze is an Associate Professor, Mandel School of Applied Social Sciences, Case Western Reserve University, Mr Haines-Simeon is a Research Assistant, Univ. of Iowa, School of Social Work.Funding for the project from which this article was derived was provided by the Dept. of Health and Human Services, Abandoned Infants Assistance Programs, contracts #90CB00029.     

Preschoolers entering foster care in New York City: the need to stress plans for permanency.

Analysis of data furnished by a computer system makes clear the need for special programs to plan permanency for infants and young children in foster care. A report on New York upstate data is appended to this article.     

24-month update on the impact of roundtables on permanency for youth in foster care

Although the number of children in foster care has decreased in recent years (U.S. DHHS, 2012), additional strategies are needed to help youth achieve legal permanency before they age out of foster care. One such strategy is the permanency roundtable, which convenes a team of professionals to facilitate the permanency planning process by identifying realistic solutions to permanency obstacles for youth. Nearly 500 youth went through the initial permanency roundtable process in Georgia in 2009. Just over half were male (57%) and over nine in ten (92%) were African American. At the start of the roundtables, the median age was 13, and the median length of stay in foster care was 52 months. Two years after their roundtable, 50% of the nearly 500 children had achieved legal permanency. Analyses, presented separately for three age groups (0–6, 7–12, and 13–18), examine outcomes and predictors of legal permanency. Recommendations, limitations, and areas for future research are discussed.     

The influence of father involvement on child welfare permanency outcomes: A secondary data analysis

Children have a higher risk for poor psychosocial outcomes when their fathers are absent or uninvolved. These children are more likely to live in poverty, drop out of school, and engage in risky behaviors like using alcohol, tobacco, and illicit drugs. Only 54% of nearly a half million children in foster care had contact with their fathers in the past year compared to 72% of children from the general population. Data on the involvement of fathers whose children are in out-of-home placements are scarce and child welfare agency efforts to involve fathers and children's permanency outcomes also are not well documented.     

Program evaluation of the CREST project: empirical support for kinship care as an effective approach to permanency planning

The number of children, especially from ethnic minority groups, in substitute care is growing rapidly even as the number of foster care homes is steadily decreasing. Kinship care has quickly become the permanency planning option of choice. This article describes a model kinship care project and the results of an extensive program evaluation. Results show that the project enhances functioning of relative caregivers and reduces the cost of care. Implications for contemporary permanency planning are presented.     

Preventing risk for obesity by promoting self-regulation and decision-making skills: pilot results from the PATHWAYS to health program (PATHWAYS)

The overall aim of the two school-based pilot studies was to evaluate whether an approach to prevention that focused on changing child impulse control, decision making, and social competence can be effective in changing attitudes toward food intake and physical activity as risk factors for obesity. The strategy used was to translate specific components of one evidence-based program for violence prevention (Promoting Alternative Thinking Strategies: PATHS) into an elementary school curriculum program for obesity prevention. Both studies demonstrated significant changes in positive attitudes toward self-regulation of appetitive behavior. In addition, Study 2 demonstrated positive changes in actual food choices and television viewing patterns. Implications are that comprehensive efforts to prevent youth risk for obesity should include as one component school-based curricula that target self-regulation and decision-making skills.     

Social Capital for Vulnerable Groups: Insight from Employed People Experiencing Homelessness

Abstract

Social capital is a term that has evolved within the social sciences, and has been presented as a mediating factor in how people experience the social environment. In 2008 and 2009 we conducted one-to-one interviews with 61 people experiencing homelessness in an effort to investigate the concept of “pathways” from homelessness. Our findings show that social capital was not just about making positive friends or improving social relationships. Instead, personal issues of identity, self-esteem, and individualization were contributing factors to developing social capital; and social service agency practices could contribute to how these are experienced. Further areas of research are discussed along with the application of research findings to other vulnerable populations.