6.5 Alternatives to reduce the need for congregate care
Reducing reliance on congregate care requires development of a continuum of enhanced forms of family foster care. Jurisdictions including New York City and select counties in California and Washington have achieved significant success moving children out of congregate care directly into the homes of caring kin or foster families. In 2003, the New York City Administration for Children’s Services (ACS) began implementation of its Congregate Care Reduction Initiative, designed to end the City’s over-reliance on group and residential care as placement resources for older children and youth. Family-based placements were developed, and more than 48 facilities were closed, eliminating 535 congregate care beds. [i]
Evidence-based outpatient treatment
. For some children, family foster care together with outpatient treatment for medical, mental health and other disabilities allows movement out of congregate care. In Denver, multi-systemic therapy has helped reduce the length of stay in congregate care for some young people (See Policy Area 2.6
Home and community-based services for families and children with mental illness: Children with Mental Health Problems, Evidence-based, home and community mental health services).
Therapeutic foster care
. Highly trained foster families who provide intensive supervision and case management and receive higher payments are effective alternatives for children with emotional, behavioral and mental health problems. In addition to the child’s basic needs for shelter and care, therapeutic foster care includes services and treatment tailored to meet the child’s unique needs.
[ii]
Evidence-based models of enhanced foster care
. Program evaluations support specific models of enhanced family foster care that provide comprehensive supports for both children and foster care providers.
The Mockingbird Family Model (MFM) places foster youth in the center of a community of four to ten foster or kinship homes in a given neighborhood. At the center of the constellation is a Hub Home operated by licensed foster parents who coordinate special events, youth activities and emotional resources to support foster youth and other parents in the cluster. [iii] The model includes respite, placement of siblings together, cultural/ethnic consideration (for example, foster parents with the same background), respite care, crisis respite, and family social activities. Initial, small scale evaluation results are positive, and participating foster families are enthusiastic. Eighty-four percent of children remained in one foster home consistently over the period evaluated. According to foster parents, placement disruptions were prevented by the availability of MFM respite and support. [iv]
In the Neighbor to Family Program, foster caregivers strive to enable siblings in foster care to live together close to home in their own communities, while efforts are made to reunite them with their families. Caregivers are trained and salaried staff members who act as mentors with biological parents and receive 24-hour support and benefits. They are part of specialized multidisciplinary teams that offer case management, therapeutic and counseling services, permanency planning and other related services. Between 1998 and 2002, Neighbor to Family served 42 sibling groups with 143 children, with high rates of joint sibling placement and placement stability. Programs are located Daytona Beach, Fort Lauderdale, Orlando and Gainesville, Florida; as well as Baltimore, Maryland; Norfolk, Virginia; and 4 counties in Georgia. [v]
Policy Options: States can reduce reliance on congregate care by authorizing and funding 1, 2, or 3 of the following placement alternatives:
·
Evidence-based out-patient treatment
·
Evidence-based therapeutic foster care
·
Evidence-based models of enhanced family foster care.
[i]
Making Permanence a Reality for Children and Youth in Foster Care: Strengthening Policy at the Federal Level Casey Family Services; Children’s Defense Fund 2006 available at: http://www.aecf.org/upload/PublicationFiles/CFS3622H5061.pdf
[ii]
Chamberlain, P. & Reid, J.B. 1998, Comparison of two community alternatives to incarceration for chronic juvenile offenders. Journal of Consulting and Clinical Psychology, 66 (4), 624-633.
[iii]
Mockingbird Family Model Project Evaluation Year Three Evaluation Report Northwest Institute for Children and Families School of Social Work University of Washington
http://www.mockingbirdsociety.org/mfmeval.php
[iv]
The Mockingbird Family Model, The Mockingbird Society.
http://www.mockingbirdsociety.org/model/index.php
Northwest Institute for Children and Families, University of Washington, (2007),
Mockingbird Family Model, Project Evaluation, Year Three Evaluation Report
(2007). http://www.mockingbirdsociety.org/pdf/mfmreport5.pdf
[v]
Hegar, R.L. 2005. Sibling Issues in Child Welfare Practice. In Mallon, G.P. and Hess, P.M., Eds. Child Welfare for the Twenty-First Century: A Handbook of Practices, Policies, and Programs, pp. 536-557. New York: Columbia University Press.