Using a NIATx based local learning collaborative for performance improvement

Local governments play an important role in improving substance abuse and mental health services. The structure of the local learning collaborative requires careful attention to old relationships and challenges local governmental leaders to help move participants from a competitive to collaborative environment. This study describes one county's experience applying the NIATx process improvement model via a local learning collaborative. Local substance abuse and mental health agencies participated in two local learning collaboratives designed to improve client retention in substance abuse treatment and client access to mental health services. Results of changes implemented at the provider level on access and retention are outlined. The process of implementing evidence-based practices by using the Plan-Do-Study-Act rapid-cycle change is a powerful combination for change at the local level. Key lessons include: creating a clear plan and shared vision, recognizing that one size does not fit all, using data can help fuel participant engagement, a long collaborative may benefit from breaking it into smaller segments, and paying providers to offset costs of participation enhances their engagement. The experience gained in Onondaga County, New York, offers insights that serve as a foundation for using the local learning collaborative in other community-based organizations.     

Quality care for ill children: AIDS-specialized foster family homes

Children with AIDS and related complexes present a new and serious challenge to the child welfare field's foster care system. At this stage of the world's knowledge of AIDS and treatment capacity for its victims, the children are stigmatized as plague bearers, their viability is unknown, and few, if any, will ever have a home to return to. This article describes a special foster care demonstration in behalf of AIDS infants.     

Perceived self-stigma in the utilization of mental health services in foster care and post foster care among foster care alumni

Foster youth experience higher rates of mental health disorders and receive higher rates of mental health services in comparison to the general population. Yet, upon foster care exit, mental health service use drastically declines. Little is known as to the reasons for mental health service decline after foster care exit. However, research studies in the mental health literature have consistently shown that self-stigma and public stigma are significant in mental health service receipt. Studies have also shown that self-stigma affects an adolescent's self-identity, self-efficacy, and interpersonal relationships, which impact self-sufficiency once youth leave foster care. This study explores self-stigma in the utilization of mental health services while in foster care, and whether the stigma developed while in foster care impacts mental health service use upon foster care exit. The role of public stigma in the utilization of mental health services post foster care is also examined. Thirteen former foster youth with a mental health treatment history while in foster care were interviewed. Results show that foster youth experienced self-stigma, which increased the negative impact of mental health service receipt while in foster care. After foster care exit, youth who identified experiencing self-stigma while in foster care tended to discontinue mental health services after foster care exit. In contrast, foster youth who did not identify self-stigma in the receipt of mental health services while in foster care continued accessing services upon foster care exit. Public stigma was not identified as influencing mental health service use post foster care, but was coupled with negative labels, stereotypes, and negative perceptions. Implications for preventive and intervention measures are also discussed/proposed.     

Are services to prevent foster care effective?

The prevention of foster care became an important issue for child welfare services during the 1970s. Two main types of prevention models have emerged: crisis intervention programs intended to prevent imminent placement and intensive service programs designed to avert those crisis situations that precipitate placement. A critical analysis of several project evaluations leads to the conclusion that neither model has been markedly successful. Low nominal project placement rates seem attributable to inability to predict placements and to client selection biases. From a strictly financial perspective, preventive services have been considerably more expensive than regular services, including temporary family foster care. Data from a new demonstration project in New Jersey illustrate various problems in providing and evaluating preventive services to families referred to protective service agencies. Implications of the findings for prevention programs and policies are discussed, and a new direction focused on truly early intervention with children and families is proposed.     

The training process of the Maryland Guardianship Assistance Project: a collaborative model for kinship foster care

Understanding models of multidisciplinary collaborations in child welfare has become essential for policy development, program success, and improving outcomes for children in foster care. The authors present the state of Maryland's Guardianship Assistance Project (GAP) as a model of multidisciplinary collaboration in child welfare and describe the training process that supported the development of the model. Key components for effective collaborative practice, lessons learned, and recommendations from the GAP collaboration are presented.     

Promising practices and strategies for using trauma-informed child welfare practice to improve foster care placement stability: a breakthrough series collaborative

This paper will provide information on a recent Breakthrough Series Collaborative (BSC) conducted by the National Child Traumatic Stress Network on Using Trauma-Informed Child Welfare Practice to Improve Foster Care Placement Stability. Information on this particular BSC will be provided, followed by initial findings gathered from an evaluation of the BSC and metrics gathered by each of the nine participating teams throughout the BSC process. Specific trauma-informed promising strategies adopted by teams are presented along with recommendations for next steps.     

Financial therapy in foster care

The introduction of prevention-oriented financial therapy in foster care is presented. Consideration of emotional demands in financial literacy and therapy is examined and remedies provided that address them. Revisions to the five-step model of financial therapy are considered in terms of the needs of foster care client populations. A pared down prevention model provides aging out foster children with a means of successfully navigating lifestyle challenges. The need to empirically evaluate the prevention model is advised to demonstrate its value with this population.     

Alcohol control and foster care

Parental alcohol consumption is often associated with an increased likelihood of child abuse. As consumption is related to price, the purpose of this paper is to investigate the propensity for increases in the full price of alcohol to influence entry rates and the length of time spent in foster care. Using alcoholic beverage prices and a measure of availability in combination with data on foster care cases, we find that higher alcohol prices are not effective in reducing foster care entry rates; however, once in foster care, the duration of stay may be shortened by higher prices and reduced availability.     

Adolescent emancipation from foster care

This demonstration project tested the degree to which a short-term, competence-oriented service delivery model prepared 31 older adolescents to move into responsible independent living upon termination of foster home placement. The adolescents achieved significant growth as measured by independent living, employment, and social network skills but not in level of psychosocial functioning.     

Predisposition to seek mental health care among Black males transitioning from foster care

This study examined the predisposition to seek mental health care in the future for personal and mental health problems among Black males transitioning from the foster care system (n=74). Results of simultaneous multiple regression analysis showed that custody status, diagnosis of a DSM-IV psychiatric disorder, and emotional control contributed significantly to the prediction of Black male's predisposition to seek mental health care. Specifically, Black males who were still in foster care were more predisposed to seek mental health care, whereas those diagnosed with a DSM-IV psychiatric disorder and who adhered more to the norm of emotional control were less predisposed to seek mental health care. Implications for mental health service delivery are discussed.     

The market for foster care: an empirical study of the impact of foster care subsidies

When parents are suspected of child abuse or neglect, their children may be placed with foster families. We estimate the relationship between the monthly subsidies paid to foster families and the quantity of foster care services provided. The empirical model uses variation in subsidies and foster care populations within 37 states and the years 1987–1995. One innovation in our approach is that we exploit the idea that states do not appear to set market clearing rates, as evidenced by a foster home shortage during this time period. In this case of excess demand, variation in the monthly subsidy traces out the supply curve. Our results show that states with high demand may be able to use economic incentives to recruit foster families.

Family to family: reconstructing foster care in the US

The public child welfare system in North America is faced with growing deprivation, rising numbers of children who need out-of-home placements for increasingly lengthy periods, and a shortage of foster carers. The Family to Family initiative offers public agencies funds and tools to help them strengthen family support services within the communities from which children enter the system, improve the quantity and quality of neighbourhood-based foster carers and develop the capacity to collect and analyse outcome data.     

Children's participation in foster care placements

This article presents results from a study of the birth children of foster carers and their experiences of growing up with foster siblings. Data were gathered from focus groups (17 participants), discussion groups (16 participants), a questionnaire (684 responses) and eight individual interviews. The children's participation in the fostering placements is in focus. Accounts from the children show that several of them participate in care-giving activities in everyday life. Their participation in the official assignment is however limited and can lead to children taking on responsibility with no support from adults. The tension between children's agency and position in society is addressed. The study shows how power relations between children and adults come into play, how both children and adults (re)-produce positions where children's rights to have a say in questions that concern them are not reflected within fostering processes.     

The gift of kinship foster care

This study examines kinship foster care as a gift relationship. Reunification rates and replacement rates into non-related foster care are analyzed within the statistical framework of competing risks to examine the effects of reciprocity, payment, empathy, and duty on the dynamics of kinship foster care. The study makes use of a unique set of survey data on 983 kinship foster children in Cook County, Illinois. Survey responses are linked to computerized administrative records from the Illinois Department of Children and Family Services to create a 5-year longitudinal file on placement changes from June 30, 1994 to June 30, 1999. Children whose parents were reported as regularly visiting and working toward regaining custody (reciprocity) were more likely to be reunified and less likely to be replaced than children whose parents were reported as non-cooperative with visitation and service plans. Controlling for reciprocity, children were also less likely to be replaced if caregivers retained the full foster care subsidy (payment), reported a good relationship with the child (empathy), and grew-up in the American South and attended church regularly (duty). The sensitivity of these findings to alternative specifications of the competing risks of foster care replacement and kinship transfers is reported.     

Obstacles to employment among mothers of children in foster care

This article reports on a study of obstacles to employment among mothers with children in foster care. The study relies on standardized measures, has a cross-sectional design, and includes a sample of 158 mothers. The analysis shows a high prevalence of obstacles; identifies three co-occurring obstacles, each involving substance abuse, that are related to a low probability of employment (p < or = .05); and reveals that employment and access to transportation are related to higher income relative to mothers' needs (p < or = .05).     

Mentors for adolescents in foster care

Significant numbers of adolescents in foster placement plan to live independently following discharge. Mentoring is increasingly being used as a support service to assist older foster youths to make the transition to adult living. A survey of 29 child welfare programs indicate that a variety of mentoring models are in use. The main models are transitional Life Skills Mentors, Cultural-Empowerment Mentors, and Corporate-Business Mentors. Mentoring connects foster wards with a cross-section of community citizens who provide a bridge to higher education and employment, and serve as a resource for transitional problem-solving. Information is needed on the impacts of mentor-mentee matches and efforts to sustain mentor-mentee relationships.Based on a paper presented at the Second National Child Welfare Conference, Division of Child Welfare Research, Arlington, Virginia, 1994. The research is supported by Research Grant #90CW1026 entitled Mentors as Resources for Preparing Foster Youths for Independent Living, from the Department of Health and Human Services, Administration for Children and Families, Washington, D.C.the Principal Investigator, Foster Youth Project and Adolescent Mentor Project.     

The foster care system in India

The author has undertaken the difficult task of giving us an overall view of the foster care picture of all India, the first such panorama we have received.     

Using GIS to enhance programs serving emancipated youth leaving foster care

This article describes a GIS prototype designed to assist with the identification and evaluation of housing that is affordable, safe, and effective in supporting the educational goals and parental status of youth transitioning from foster care following emancipation. Spatial analysis was used to identify rental properties based on three inclusion criteria (affordability, proximity to public transportation, and proximity to grocery stores), three exclusion criteria (areas of high crime, prostitution, and sexual predator residence), and three suitability criteria (proximity to health care, mental health care, and youth serving organizations). The results were applied to four different scenarios to test the utility of the model. Of the 145 affordable rental properties, 27 met the criteria for safe and effective housing. Of these, 19 were located near bus routes with direct service to post-secondary education or vocational training programs. Only 6 were considered appropriate to meet the needs of youth who had children of their own. These outcomes highlight the complexities faced by youth when they attempt to find affordable and suitable housing following emancipation. The LEASE prototype demonstrates that spatial analysis can be a useful tool to assist with planning services for youth making the transition to independent living.