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Revisiting Reunification

When the National Family Preservation Network (NFPN) was founded 25 years ago, reunification research was in its infancy. Some of the earliest research on reunification involved Intensive Family Preservation Services (IFPS). IFPS was found to be very successful with reunifying families. Today far fewer families receive reunification services through IFPS; generally under 20% of IFPS services are provided to reunifying families as compared to intact families.

In terms of priority, emphasis, research, and funding, reunification has stalled at the state level. The percentage of families in the child welfare system that reunify has been stuck at 50% for at least the past decade. Only a few states devote funding to programs assisting families to reunify. Research on reunification has also lagged.

One doctoral research study in 2012 conducted a meta-analysis of reunification. The study identified the factors related to reunification failure/success:
• Infants and adolescents are less likely to reunify
• Children with behavior, emotional, cognitive problems, or physical disabilities are less likely to reunify
• After more than one year in care the likelihood of reunification decreases
• The more parental contact and visits, the more likely reunification will occur

To view the meta-analysis study of reunification visit https://kb.osu.edu/dspace/bitstream/handle/1811/52994/24_5_saunders-adams_paper_kb.pdf

Most of the current research and funding for reunification comes from federal laws, policies, and grants. This is in response to the explosion of misuse of prescription drugs and heroin. Half of the babies with exposure to opioids during the mother’s pregnancy are born with withdrawal symptoms. Babies also make up the largest group of the increasing number of children placed in out-of-home care due to parental substance abuse.

Two federally-funded programs are addressing the issue of how to reunify families when parental substance abuse is a factor in removal of children. The Regional Partnership Grant Program and the Children Affected by Methamphetamine Program use a set of common ingredients and strategies including:
• A system of identifying families in need of treatment
• Timely access to treatment
• Recovery support services
• Comprehensive family services
• Increased judicial oversight
• Cross-systems response
• Collaborative structures

The Regional Partnership Program has served over 15,000 families with these outcomes:
• 83% of children discharged from foster care were reunified
• 73% of infants were reunified within 12 months, an astonishing figure considering that infants as a group are less likely to reunify

The Meth Program has provided funding for drug courts which are also proving to be very effective:
• 68% of children were reunified in less than 12 months
• Less than 6% of children reentered foster care within 12 months after being returned home (about a third the national average for reentry with traditional services)

For more information on these programs and opiate misuse visit https://www.finance.senate.gov/imo/media/doc/23feb2016Young.pdf

This post began with research on IFPS reunification and will end with a research study on IFPS reunification published by NFPN in 2014. The study found that IFPS reunification was effective with families involved in substance abuse, domestic violence, and mental health problems. Step-down services and involvement of biological fathers improved the durability of reunifications. Finally, exit instruments designed for both the worker and parents showed very strong alignment in perceptions.

For more information on exit instruments for workers/parents visit http://www.nfpn.org/products/exit-instruments (free with purchase of NCFAS-G+R assessment tool)

Posted by
Priscilla Martens, NFPN Executive Director

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History of Federal Funding for Family Preservation

The National Family Preservation Network (NFPN) was in its infancy when it became one of the chief advocates for passage of the federal Family Preservation and Support Services Act of 1993. The purpose of this legislation was to “develop and establish, or expand, and to operate a program of family preservation services and community-based family support services.” Initial funding of $60 million was allotted to states based on the number of children receiving food stamps. States were required to contribute 25% in matching funds.

In 1997 Congress reauthorized funding through the Adoption and Safe Families Act but changed the name from Family Preservation and Support Services to the Promoting Safe and Stable Families Program. States could also now spend funds on two additional service categories: time-limited reunification (within 15 months from date of removal of a child) and adoption promotion and support. Congress authorized mandatory funding to increase annually, rising to $305 million by FY 2001.

The PSSF program was reauthorized in 2001 with $200 million in discretionary funds added to the $305 million in mandatory funds. The discretionary portion of the funding included set-asides for tribal services, court improvement, and research/training/technical assistance.

In the 2006 reauthorization of PSSF, mandatory funding was increased to $345 million for one fiscal year. New funding of $40 million was allocated to support monthly caseworker visits and to improve outcomes for children affected by parental abuse of meth or other substances. PSSF was most recently reauthorized in 2011.

States are required to report how funds are spent. Currently, states spend about 30% of funds on family preservation, 29% on family support, 21% for reunification, and 20% for adoption promotion and support. States vary in the degree to which they use PSSF funds to pay for Intensive Family Preservation Services (IFPS), ranging from using no PSSF funds for IFPS to using all their PSSF allocation to pay for IFPS. Total mandatory and discretionary funding for PSSF has averaged $382 million in each of the past four fiscal years (FY 2013-FY 2016) with both types of funding reduced over the years due to budget cuts.

In 2016 reauthorization for PSSF was included in the Family First Prevention Services Act. This legislation was not passed by Congress so PSSF operates under a continuing resolution. The Family First Prevention Services Act was reintroduced this year in the House as H.R. 253 and the bill includes extending funding authority for the PSSF program. There could also be other bills introduced to extend authorization.

NFPN gratefully acknowledges reports on PSSF by Emilie Stoltzfus, Congressional Research Service, in preparing this history of federal funding of family preservation.

Posted by Priscilla Martens
NFPN Executive Director

IFPS Nationwide Surveys

When the National Family Preservation Network (NFPN) was founded 25 years ago, the first publication, released in 1994, was a nationwide survey of Intensive Family Preservation Services (IFPS).

The first IFPS survey was at the program level with 223 IFPS programs listed as meeting the following criteria:
• Serve a maximum of 4 families per worker
• Deliver services in the home and community
• Meet at least 15 of the 20 characteristics of IFPS (based on Homebuilders model)

Most of the programs listed were in a dozen states that had a statewide model. The bulk of funding was provided by the states with a small number of programs also receiving federal, county, city, or private foundation funding.

It would be another 13 years before the next IFPS nationwide survey was published in 2007. Twenty states responded to the survey stating that they provided IFPS services. However, there was a wide variation in the models of service and thus limitations on any conclusive findings.

In 2011 NFPN released another IFPS survey and this time exemplary IFPS programs were separated from less intensive programs. Fourteen states met criteria for exemplary IFPS and findings included:
• Safety is a hallmark with few IFPS deaths reported in a five-year period of time
• Key components of intensity are adhered to including 24/7 availability of worker, low caseload (2-4 families), brief length of service (4-6 weeks), and high number of face-to-face hours spent with families (average of 47 hours per IFPS intervention)
• Exemplary IFPS programs have written program standards, monitor compliance, and conduct evaluations
• A clinical model was used by 65% of IFPS programs

To view the 2011 IFPS Survey visit: http://www.nfpn.org/preservation/2011-ifps-survey

In recognition of the 40th anniversary of IFPS, NFPN released a special edition of the IFPS nationwide survey in 2014. A dozen states were listed with exemplary IFPS programs. A comparison of IFPS then and now included a letter from an early supporter of IFPS, Douglas Nelson from the Annie E. Casey Foundation, a side-by-side comparison of IFPS in 1992 and in 2104 for several states, and an IFPS timeline.

To view the special edition IFPS Nationwide Survey visit: http://www.nfpn.org/preservation/2014-ifps-survey

More information about the early years of IFPS and the 40th anniversary are available on the Intensive Family Preservation website: http://www.intensivefamilypreservation.org/

In summary, the four nationwide surveys provide a snapshot view of IFPS during a point in time. There have been 7 states with strong IFPS programs that appeared in all the surveys (KY, MO, CT, MI, NC, ND, WA). Cumulatively, the nationwide surveys provide critical information about both the evolution and consistency of IFPS programs and thus serve as a guide for the future development and expansion of IFPS.

Posted by Priscilla Martens
NFPN Executive Director

Preserving Families for 25 Years

The National Family Preservation Network (NFPN) is celebrating its 25th anniversary this year. Our legal name, Intensive Family Preservation Services National Network, reflects the original purpose of the organization: to promote Intensive Family Preservation Services (IFPS). And we have! From the early days when NFPN served as a clearinghouse for IFPS, conducted the first nationwide survey of IFPS, and developed two videos on IFPS and Mental Health and IFPS and Substance Abuse, to the present where NFPN continues to serve as a clearinghouse for IFPS, has conducted three additional nationwide surveys of IFPS, and has over 30 resources on the website related to IFPS for both intact and reunifying families, NFPN is still promoting IFPS!

NFPN partners with state agencies and private organizations in researching IFPS and developing resources for the field. NFPN has conducted six research studies involving IFPS in the past 15 years. All of them support IFPS as an effective intervention for high-risk families with a wide variety of presenting problems. The most recent study demonstrated that IFPS services are effective with families exhibiting trauma symptoms and indicators.

Resources on NFPN’s website include Request for Proposal (RFP) samples, state annual IFPS reports, practice standards, and training. NFPN has developed a CQI instrument that IFPS programs can use to demonstrate quality assurance. One of the most popular resources is the IFPS ToolKit, a guide for developing and maintaining strong and effective IFPS services that includes the following:
• Definition, history, and benefits of IFPS
• Essential components, standards, and performance measures
• Federal funding sources and payment structure for contractors
• Research and evaluation measures
• A model for Intensive Family Reunification Services

Several state agencies have used the IFPS ToolKit to develop their model of IFPS. To view the ToolKit visit http://www.nfpn.org/preservation/ifps-toolkit.

IFPS is now at a crossroads. Federal and state mandates require that programs meet standards for Evidence-Based Practice. In a study of IFPS programs, Schweitzer et al (2015) report that IFPS does not meet the criteria for the highest level of Evidence-Based Practice because it does not have two random-controlled, published studies of efficacy. However, they do say that IFPS meets a lower standard, that of promising practice. Thus, more studies are needed to fully establish IFPS as Evidence-Based Practice.

NFPN is committing to another 25 years of promoting IFPS, conducting research studies on IFPS, and providing resources, training, and technical assistance to the field.

To view resources on IFPS, visit http://www.nfpn.org/preservation

Posted by Priscilla Martens
Executive Director

Wrapping up 2016

The Preserving Families Blog made its debut in January, the product of two previous blogs that were focused on family preservation. This year we covered the topics of training for in-home services workers, safety, designing an IFPS program, effective prevention programs, changing the child welfare system, and federal legislation.

The Family First Prevention Services Act, federal legislation to expand funding of in-home services, was passed by the House but was not acted upon by the Senate this year. The legislation will need to be re-introduced when the new Congress convenes in January. There will be many other changes at the federal level with new appointments and new policies from the incoming Trump administration. Similar changes will also be forthcoming at the state and local levels.

The new decision-makers may not be familiar with family preservation and in-home services and their critical importance in a continuum of services for families. All of us need to focus on informing, advocating, and providing the best resources and services possible in 2017.

For now, please take a well-deserved rest from all of your hard work this year and spend some wonderful time with your own family. We’ll meet again next year!

Merry Christmas and Happy New Year!

Posted by Priscilla Martens

NFPN Executive Director

Changing the Child Welfare System–2

In the last post, we discussed how the state of Connecticut is changing its child welfare system and the focus was on the back end of the system. This time we’ll look at efforts being made to change the front end of the system.

Joette Katz, Commissioner of the Department of Children and Families, says that the child welfare system has historically viewed families as the source of the problem rather than part of the solution. The system is risk averse so the default option is often the most drastic one: removal of a child from the home.

Commissioner Katz believes that families must be at the center of the solution so she has implemented the Strengthening Families practice model which has family engagement as its foundation. The model emphasizes support services for families, strength-based case plans that are responsive to the family’s needs and values, and a strategy to preserve the family. Connecticut is using the Eckerd Rapid Safety Feedback tool to identify the highest-risk families and then establish an action plan to mitigate safety risks and prioritize tasks.

Connecticut is a leader in trauma-informed practice and was one of the first to screen children in the child welfare system for trauma. Since 2007 more than 50,000 children have been screened for trauma and over 8,600 professionals, including child welfare workers, have received training. Trauma-focused services for school-age children have been expanding over the past decade. Now the focus is turning to children under age 5, of whom 12,000 were included in reports of child abuse/neglect in 2014.

The federal government is funding a five-year Early Childhood Trauma Collaborative that will train 500 people who work with young children on recognizing signs of trauma and connecting children to services. The funding will also be used to help outpatient clinics offer treatments that have been shown to be effective with young children.

Connecticut provides a robust Intensive Family Preservation Services (IFPS) program to prevent the unnecessary placement of children. A higher percentage of families in the child welfare system receive family preservation services in Connecticut than in other states. The state reports a 92% rate in keeping families together that have received IFPS.

Commissioner Katz says that her goal is to change the culture of child welfare from one of blame to one in which we are all members of a team with the goal of making families stronger and children safer. NFPN heartily endorses that goal as reflected in our logo: Safe Children, Strong Families!

Posted by Priscilla Martens
NFPN Executive Director

Changing the Child Welfare System

Ten years ago this month the National Family Preservation Network (NFPN) released a paper, An Effective Child Welfare System, featuring the Allegheny County child welfare system in Pittsburgh, PA. This child welfare system reduced foster care placements, reunified children with family, and placed children with relatives, doing all of these goals at two to three times the rate of other state child welfare systems. In addition, there were no child deaths from abuse or neglect for a period of three years in a population of over 1 million people. Allegheny County is still a model child welfare system and you can view the paper here: http://www.nfpn.org/articles/monograph-an-effective-child-welfare-system

In revisiting effective child welfare systems, this time we’re going to look at Connecticut’s child welfare system. We’ll begin with the back end of the child welfare system and work our way to the front. Connecticut is one of 21 states whose child welfare system is under federal oversight through a court consent decree. When Joette Katz, a former judge, was appointed 6 years ago as Commissioner of the Department of Children and Families, there were 50 group homes statewide in which dependent children were frequently placed and only 21% of children were placed with relatives. Many children were sent out of state for mental health treatment. Commissioners averaged 18 months on the job.

Commissioner Katz adopted a Strengthening Families practice model which has family engagement as its foundation. The goal is to preserve the family unit and minimize the disruption and trauma associated with the removal, placement, and separation of the child from the family. In two years Commissioner Katz reduced out-of-state placements by 97% and congregate care by 67% while doubling the number of children placed with relatives. All of this took place during a time of large cuts to the child welfare budget. The state has met 16 of the 22 outcome requirements from the consent decree and is on track to exit federal oversight. The child fatality rate is the third lowest in the nation.
One of the biggest impacts in the back end of Connecticut’s child welfare system was the dramatic reduction (67%) in congregate care. The Annie E. Casey Foundation has been instrumental in the reduction in use of congregate care. Take a look at their data:
 *57,000 children nationwide are living in group placements
 *4 in 10 children have no medical/mental health diagnosis or behavioral problem warranting group placement
 *Group placement costs 7-10 times the cost of placing a child with a family
 *States range from 4%-35% of children in the child welfare system placed in group care with an average of 14%

Casey Foundation states that one way to reduce group placements is to have the top child welfare administrator approve all group placements as is the case in Connecticut. To read the Casey report on group care visit http://www.aecf.org/resources/every-kid-needs-a-family/

The Casey Foundation also has a report on kinship care noting that 2.7 million children live with extended family, or 1 in every 11 children and about 29% of the children in foster care. Kinship care increases child safety, stability, permanence, and well-being by maintaining familial and community bonds, sense of belonging, and by minimizing trauma. View the kinship report at http://www.aecf.org/resources/stepping-up-for-kids/

Still another report focuses on the increase in the number of children being raised by grandfamilies due to the opioid epidemic. Over 40% of children placed with relatives are removed because of parental drug or alcohol abuse. Shaheed Morris was born with fetal distress due to his mother’s alcohol and drug use during pregnancy. When his mother deserted him at the hospital, his grandmother claimed him although she had little money and only a 5th grade education. Shaheed graduated from university this year with a degree in journalism. He is still close to his 89 year old grandmother. For more stories like Shaheed’s see http://www.gu.org/Portals/0/documents/Reports/16-Report-State_of_Grandfamiles.pdf

In the next post, we’ll see how Connecticut addressed the front end of the child welfare system.

Posted by Priscilla Martens
NFPN Executive Director