Designing an IFPS Program

Several agencies have used the IFPS Toolkit produced by the National Family Preservation Network (NFPN) to design an IFPS program. Let’s take a closer look at how the ToolKit and other resources can be used for that purpose.

The IFPS ToolKit is a comprehensive resource that includes:
 Definition and History of IFPS
 Benefits of IFPS
 Essential Components of IFPS
 RFP and Pay Structure for IFPS Contracts
 Reunification Model
 Step-Down Services….and much more!

The ToolKit contains the basics for designing an IFPS program.
To view the IFPS ToolKit, visit http://www.nfpn.org/preservation/ifps-toolkit

While the ToolKit is a good place to start, NFPN has other resources available to further assist in designing an IFPS program. NFPN has conducted several nationwide surveys of IFPS. The surveys provide data on exemplary IFPS programs nationwide including the following service components:
 Caseload
 Timeframe for first visit
 Total hours for intervention
 Length of service
 Clinical models
 Training requirements
 Outcomes
 Cost

As you build your IFPS program, you can comparing your design to the well-established, exemplary programs included in the nationwide survey.

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

Dr. Ray Kirk and NFPN have conducted numerous studies on IFPS. The studies use the North Carolina Family Assessment Scales (NCFAS) as pre/post measures of improvement in family functioning. The NCFAS scales were originally developed with and for IFPS programs. The majority of exemplary IFPS programs use the NCFAS tools. Improvement in family functioning is closely associated with placement prevention and successful reunifications. Thus, you can use the NCFAS scales for multiple purposes: prioritizing needs, goals, services, developing a case plan, data collection, and evaluation.

For an overview of the research on the NCFAS scales, including six studies on IFPS, visit http://www.nfpn.org/assessment-tools/ncfases-scale-development-report

For more information on the NCFAS scales, visit http://www.nfpn.org/assessment-tools

Following development of an IFPS program, it’s critical to ensure ongoing quality. NFPN has developed a Continuous Quality Improvement (CQI) instrument for use with IFPS programs. The CQI-IFPS Instrument and supporting materials include the following:
 Introduction (definition, basis in federal law/policy, and purpose of the CQI-IFPS)
 CQI-IFPS Instrument (10 domains covering a total of 75 items)
 Tally Sheet (checklist for reviewers that allows tallying of up to 5 case files)
 Instructions (preparation, reviewing case files, debriefing, using findings to guide improvement in practice)
 Frequently Asked Questions (F.A.Q.)

You can begin using the CQI with your IFPS program in the second year of operation to establish a baseline.

For more information on the CQI-IFPS instrument visit http://www.nfpn.org/preservation/cqi-ifps-instrument

Finally, NFPN is always available to provide technical assistance for IFPS program design. Call 888-498-9047 or email director@nfpn.org.

Posted by Priscilla Martens, NFPN Executive Director

Advertisements

Family First Prevention Services Act

Federal financing of child welfare is an open-ended entitlement for out-of-home placements whereas funding for prevention (keeping families together) is much more limited and capped. Thus, federal funding is skewed toward placement services with a ratio of 6:1 or perhaps even higher for funding of placement vs. prevention services.

This month ground-breaking legislation has been introduced in Congress to allow foster care funds (Title IV-E) to be used for prevention services. The Family First Prevention Services Act of 2016 (H.R. 5456/S. 3065) is a jointly developed House/Senate bill that is now moving forward in the House of Representatives.

Those eligible for the prevention services include children who are at imminent risk of out-of-home placement, children experiencing disrupted guardianships or adoption, and young people in foster care who are pregnant or parenting. There is no income eligibility requirement.

Criteria for services eligible for federal reimbursement include:

  • substance abuse and mental health prevention and treatment services provided by a qualified clinician
  • in-home parent skill-based programs including individual and family counseling
  • services and programs that are trauma-informed
  • services and programs that are evidence-based (based on criteria from the California Evidence-Based Clearinghouse for Child Welfare http://www.cebc4cw.org)
  • services provided for a maximum of 12 months

The Department of Health and Human Services will provide technical assistance and best practices to states on prevention programs. In addition, the department will establish a clearinghouse of promising, supported, and well-supported practices based on research findings. States must include a well-designed research evaluation for any practice used unless they receive a waiver based on compelling evidence of effectiveness.

The legislation also extends the Promoting Safe and Stable Families Program (Title IV-B, Subpart 2) for another 5 years (FY 2017-FY 2021). Mandatory funding of $345 million is provided each year plus whatever discretionary funding Congress allocates. There are two changes to the PSSF program that currently funds four types of services: family support, preservation, reunification, and adoption services:

  • the definition of “family support services” is amended to include community services that are designed to support and retain foster families
  • eliminates the current 15-month time limit for reunification services

To view the bill, visit http://waysandmeans.house.gov/wp-content/uploads/2016/06/BUCHAN_031_xml2.pdf

A detailed summary of the bill is available here: http://www.childrensdefense.org/policy/welfare/assets/family-first-prevention.pdf

If your organization is interested in signing on to support the legislation, please contact: Stefanie Sprow, Children’s Defense Fund, ssprow@childrensdefense.org

Priscilla Martens, NFPN Executive Director

 

 

Framework for Safety

The National Family Preservation Network (NFPN) was invited to give a workshop on Safety this month. Sheila Searfoss, an NFPN board member, clinician, and trainer, presented the Framework of Safety that she developed to help IFPS therapists and other direct services workers address safety with the families they serve. Here is an overview of the workshop:

Safe is a condition in which the threat of serious harm is not present or imminent or the protective capacities of the family are sufficient to protect the child. Protective capacities refer to the individual and family strengths, resources, or characteristics that mitigate threats of serious harm to the child.

To conduct an effective safety assessment, the worker must answer the following critical questions:

  1. Is there serious harm to the child? If yes, what is the harm?
  2. Is there an immediate threat of serious harm? If yes, describe in behavioral terms.
  3. Is there a vulnerable child?
  4. Are there protective capacities within the family to adequately mitigate any threats of immediate serious harm?
  5. Is there a need for an immediate safety intervention or action?

A decision of “unsafe” requires an immediate safety response to protect the child. It does not necessarily equate with removal of the child from the home but does require a safety plan to protect the child. A safety response also requires interventions. Interventions are specifically employed to control the safety threat and protect a child until more permanent change can take place. Here are some examples of safety interventions if the child remains in the home:

  • Use of family, neighbors, etc. as safety resources
  • Alleged perpetrator leaves the home
  • Family preservation services
  • Emergency medical/mental health services
  • Emergency substance abuse services

The safety plan incorporates all safety interventions and includes the following components:

  • Family involved in developing and implementing the plan
  • A written document prepared by the worker and approved by the supervisor
  • Clear description of the harm, child’s vulnerability, and caregiver’s protective capacities
  • Description of how the caregiver views the situation
  • Description of each intervention, how it will protect the child, who is responsible for implementation, and time frames
  • Details of how the plan’s effectiveness will be monitored

Managing a safety plan involves

  • Regular contacts with the child and all others that have a role in the plan
  • Continuous assessment for new threats of serious harm
  • Continuous work on family engagement
  • Periodic evaluation of the need to alter the safety interventions
  • Inclusion of the safety plan in the case plan
  • Keeping the supervisor informed of the status of the safety plan

Safety reviews provide a formal structure for monitoring and evaluating all the safety issues in a case. The purpose of the safety review is to:

  • Measure the growth in a caregiver’s ability to protect the child
  • Assess whether there have been any changes in the child’s vulnerability that affect safety
  • Decide whether and how to adjust the safety plan (may include increasing or decreasing service intensity)
  • Evaluate the suitability of the safety interventions
  • Consider whether caregiver responsibility and involvement can be increased.

A comprehensive framework for safety guides the worker in assessing harm, developing, implementing and monitoring a safety plan; protects the child from harm; and assists the family with enhancing protective capacities to prevent future harm.

Priscilla Martens, NFPN Executive Director

Engaging Families

The National Family Preservation Network (NFPN) provided webinar courses in March for family preservation and in-home services workers. Sheila Searfoss–an NFPN board member, trainer and clinician–generously donated the curricula.

The first session of the training focused on engaging families. Let’s take a closer look at how we can effectively engage families, beginning with the three essentials of engagement:
 Empathy: the ability to perceive and communicate accurately both the current feelings and experiences of another person and the significance of those feelings
 Respect: consider each individual and family to be a unique human being, not a case; view individuals/families as capable of determining their own fates
 Genuineness: not overemphasizing the professional role, being spontaneous but not uncontrolled or haphazard, open and nondefensive, consistent in values, words, and behavior

These essentials help the worker to establish a good working relationship with families characterized by a sense of reciprocity or mutuality, and good communication. The partnership is facilitated with parents by the worker:
 Treating parents with dignity and respect
 Building a relationship based on honesty and mutual respect
 Acknowledging the expertise parents have about their children
 Responding to parents’ stated needs
 Working in collaboration with parents to define the issues to be addressed and the decisions about possible solutions

Engagement requires effective listening. Here’s why effective listening is useful:
 It builds relationship: people feel closer to someone who cares enough to listen
 It helps the family sort out feelings and desires and may help them to begin making decisions

 It helps families feel understood so that they can be more calm and reflective
 It helps families to hear the point of view of others, including the worker
 By listening, the worker obtains more information without having to question or interrogate families
 Listening models effective communication skills

These are some excellent skills for professionals to use not only when engaging clients but also to use with their own families!

Posted by Priscilla Martens
NFPN Executive Director

Fast Facts About IFPS

The National Family Preservation Network (NFPN) has analyzed, researched, provided resources and training on, and promoted Intensive Family Preservation Services (IFPS) for the past two dozen years. Here are 10 fast facts about IFPS:
 About a dozen states have an exemplary statewide model of IFPS characterized by 24/7 availability of the IFPS workers, low caseloads (2-4 families at a time), brief length of services (4-6 weeks), 40 or more hours of face-to-face services with families, clinical interventions, and 24/7 supervisory support with case consultation.
 Exemplary IFPS programs serve on average about one-third of the families whose children would otherwise enter out-of-home placement.
 The average cost nationwide to provide quality IFPS services to a family is $6,000 while the average annual cost of out-of-home placement of a child is over $30,000.
 At least 90% of families nationwide remain safely together at the close of IFPS services.
 Exemplary IFPS programs assess families using the North Carolina Family Assessment Scales (NCFASes) that were originally designed for use with IFPS services.
 The most prevalent federal funding source for IFPS is the Promoting Safe and Stable Families Program (PSSF) that currently provides $335 million annually for family preservation, family support, reunification, and adoption services.
 The District of Columbia is using a federal Title IV-E waiver to fund IFPS services.
 Research has linked effectiveness of IFPS to the provision of concrete services such as rent, auto repair, utilities, food, etc. While amounts vary across IFPS programs, the average is around $300 per family.
 Exemplary IFPS programs require about 40 hours of initial training for IFPS workers.
 About 75% of exemplary IFPS programs offer step-down services. Some programs offer up to two booster sessions within six months of case closure. Others offer service extensions or less intensive services.
For a more detailed overview of exemplary IFPS programs visit: http://www.nfpn.org/preservation/2014-ifps-survey
For information on how to establish an exemplary IFPS program view the comprehensive IFPS ToolKit: http://www.nfpn.org/preservation/ifps-toolkit
For information on a quality assurance instrument for IFPS, visit: http://www.nfpn.org/preservation/cqi-ifps-instrument

Posted by Priscilla Martens
NFPN Executive Director

IFPS and Safety

From its inception, the top priority for Intensive Family Preservation Services (IFPS) has been the safety of children and all family members.  An early information packet developed by the Edna McConnell Clark Foundation in support of IFPS stated, “First and foremost, intensive family preservation services are not appropriate when children cannot be kept safe at home. In cases of severe abuse or extreme neglect, for example, or where children have been abandoned, they should be removed.”

In the IFPS ToolKit, produced by The National Family Preservation Network (NFPN), the following factors account for the strong safety record of IFPS:

  • Safety of the child is the highest priority.
  • Workers see families within 24 hours of referral and are available to families 24/7.
  • Workers meet with families in the home and are able to observe the home environment, interaction of family members, and any other factors that would jeopardize safety.
  • With only a few cases at a time, workers can spend significant amounts of time to teach new skills to the family, monitor progress, and assess safety.
  • Prior to termination, workers connect the family to other community services. Families are not abandoned at the end of the IFPS intervention.
  • Worker training, supervision, and quality assurance provide additional measures to ensure the safety of families.

While IFPS has an exemplary record of safety, that will only continue through a vigilant and committed effort.  NFPN has included a safety component in a quality assurance instrument: CQI for IFPS (http://www.nfpn.org/preservation/cqi-ifps-instrument).   The criteria require the IFPS worker to develop a safety plan and to address safety during each visit.  How might that look in practice?
An IFPS program (TIES) in Tennessee requires a safety check of all family members within 72 hour intervals.  There are many drug-affected infants and families served through this program and these infants and families must have a safety check within 48 hours.  The required safety checks are incorporated into the goals, plans, and contracts with the family.  If any family members are not present during a safety check, the TIES worker makes every attempt to locate and meet with them. The referral agency is notified if a face-to-face contact is not made.  Safety checks take about 20 minutes and are separate from therapy visits if a back-up worker or supervisor conducts the safety check.  The family’s worker may combine safety checks with regular visits provided the time interval requirements are met.

NFPN’s online courses for in-home services will include training on risk and safety.  The three courses are scheduled for March 10, 17, and 24 at 10:30 a.m. Central Time. The cost is $50 per course or all three courses for $100. You can register by contacting NFPN’s Executive Director, Priscilla Martens, director@nfpn.org. One prerequisite is current use (or purchase) of the NCFAS-G or NCFAS-G+R assessment tool. Participants will receive a Certificate of Completion. 

Posted by Priscilla Martens

NFPN Executive Director

 

Preserving Families Blog Kick-Off

Welcome to the Preserving Families Blog! Formerly the Intensive Family Preservation Blog and before that the IFPS Coast to Coast Blog, this resource is fast approaching its 100th post. The Preserving Families Blog will be published by the National Family Preservation Network (NFPN) along with its sister blog, NFPN News Notes. The blogs will have different content so readers are encouraged to follow both.
The Preserving Families Blog will expand to cover all in-home services, including preventive services, as well as services to avert out-of-home placement and to reunify families following placement.
The blog will kick off with a focus on practitioner training. NFPN is offering online courses to practitioners this year focused on family preservation and in-home services. The trainer, Sheila Searfoss, has a wealth of knowledge and experience providing training in the state of Missouri on IFPS and in-home services.
A series of three courses will be offered with the first set scheduled for March 10, 17, and 24 at 10:30 a.m. Central Time. The cost will be $50 per course or all three courses for $100. You can register by contacting NFPN’s Executive Director, Priscilla Martens, director@nfpn.org. One prerequisite is current use (or purchase) of the NCFAS-G or NCFAS-G+R assessment tool. Participants will receive a Certificate of Completion.

The course descriptions follow:
Overview of Family Preservation and In-Home Services Courses
The three-part training provides participants with the structure of an In-Home Services Intervention and the process for delivering services.
Major areas covered in this three-part training include: engaging families, conducting the initial screening, safety planning, assessment, goal setting; intervention planning, teaching skills to families, termination of services, follow-up planning to maintain the progress families have made during an intervention; therapeutic techniques to use during an intervention, risk management, and ethics of social work.
Objectives of Part I:
• Participants will gain a working knowledge of the structure of an In-Home Services Intervention.
• Participants will learn how to apply selection criteria and develop a safety plan.
• Participants will learn how to conduct a comprehensive, interactive, strength-based, culturally competent assessment utilizing the NCFAS G + R and a variety of systemic assessment tools.
• Participants will be able to develop and write behavioral and measurable intervention goals.
• Participants will learn how to develop an In-Home service plan.
• Participants will learn the techniques of teaching strategies for working with families.
• Participants will gain knowledge of specific skills that can be used with families and individuals.
• Participants will be able to demonstrate how to facilitate a Team Meeting.
• Participants will learn what to do if they get off track in an intervention.
• Participants will gain an understanding of the required documentation and what to include in an In-Home Intervention file.

Objectives of Part II:
• Participants will gain an understanding and be able to utilize techniques for facilitating change.
• Participants will gain knowledge of and be able to demonstrate a number of advanced therapeutic skills that can be used with families and individuals including solution focused, RET, relationship building and other techniques.
• Participants will share and discover creative interventions to be used with families.

Objectives of Part III A:
• Participants will gain an understanding of ethical social work practice and be able to apply them to a variety of situations.
• Explore the challenge of providing in-home services while managing ethical boundaries and confidentiality.
• Identify and explore with participants specific ethical issues that arise when providing in-home services
• Identify protocol and critical thinking problem solving techniques when dealing with ethical issues when providing in-home services
Objectives of Part III B:
• Participants will have an opportunity to increase their confidence when confronted with high risk situations,
• Participants will learn information about certain types of high risk situations.
o Assessing risk or level of danger in certain situations (mental illness, suicide, alcohol/drug, aggressive children/youth, child abuse/neglect, violence)
• Participants will learn options and a problem solving process for managing high-risk situations.
o Determining strategies (options/steps to take)
o Management of a high risk situation (action/inaction, seeking help, what to do until help arrives)
o Documentation (why and how, for our best protection)
o Managing personal safety in high risk situations

Posted by Priscilla Martens
NPFN Executive Director