The Kinship Treatment Foster Care Initiative: Creating a ...files.constantcontact.com/730d1246001/1c1c9476-01...• There are barriers within public agency policy and practice that

In 2014, the Family Focused Treatment Association(FFTA) received a grant from the Annie E. CaseyFoundation to explore how foster care agencies areengaging kinship families for Treatment Foster Care.The purpose of the grant was twofold: first, to betterunderstand the barriers to providing Treatment FosterCare with kinship families; and second, to help memberagencies develop concrete strategies to meet the treatment needs of children in kinship care.

This article shares the lessons learned from the KinshipTreatment Foster Care (TFC) Initiative, specifically, whatFFTA learned about the barriers to kinship TFC and howagencies can overcome some of these barriers by follow-ing the steps to creating a “kin first” agency culture—important steps for both public and private agencies asthey continue to make progress on engaging kinship families as criticalresources for children and youth who have experienced trauma.

Key Developments for the Kinship TFC Initiative The first goal for the Kinship TFC Initiative was to gauge the extent to

which agencies were providing Kinship Treatment Foster Care and to learnmore about the barriers they were encountering. FFTA conducted an onlinesurvey of members and held phone interviews with select agencies to learnabout best practices and ongoing challenges. Project staff also reviewed theliterature to better understand the research base for kinship TFC.

Common themes about the state of the field emerged from this inquiry:• A review of the relevant research confirmed that kinship care is goodfor children. Kinship care helps reduce trauma, provide stability, andreduce behavioral problems for children in foster care. Although the project team did not find any research specifically about kinship TFC, the positive research helped establish the importance of further exploringopportunities to provide TFC in kinship homes.

Newsletter of the Family Focused Treatment Association

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The Kinship Treatment Foster Care Initiative:Creating a "Kin First"Agency Culture —by Jennifer Miller, MSW

A on Kinship Treatment Foster CareThe Kinship Treatment Foster Care Initiative:

Creating a “Kin First” Agency Culture

Editor’s Column

Evaluating Innovative Interventions:Three Steps to Preparing for Evaluation of

Treatment Foster Care With Kin andNon-Kin Families

Public Policy Update

Virginia Chapter Update

Supporting Rhode Island’s KinshipFoster Homes

What Does It Take to SupportKinship Placements?

FOCUS

• Kinship TFC is being implemented but not on a largeenough scale to draw any major conclusions about best practices. The interviews revealed that some child welfaresystems, such as Connecticut and some counties inPennsylvania, are working with their private agencies to provide kinship TFC, but most kinship TFC is happeningcase by case, not as a regular way of doing business.

• There are barriers within public agency policy and practicethat impede more widespread use of kinship TFC. Public sys-tems leaders don’t often encourage their private agencies towork with kin and view kinship care as a public agency func-tion. Barriers include the process for licensing kin families,which is typically a public agency function and not as flexi-ble as it needs to be for kin families, as well as the reality thatmany public systems place children with kin as an alternativeto foster care, creating challenges to securing funding tomeet treatment needs.

• Many private agencies that provide kinship TFC are accus-tomed to recruiting foster parents from the community andproviding them with in-depth training and preparation tostep in as Treatment Foster Care providers. Many of theseprivate agencies have not built the capacity of their staff toidentify kin and engage them in a way that is different fromthe agencies’ engagement of non-kin.

One of the overarching findings was that implementation ofkinship TFC requires a strong public-private partnership, onein which public and private agencies work together to identifykinship caregivers who can step in as treatment foster parentsand to provide the training, preparation, and support kinshipcaregivers need to provide specialized care for children withsocial, emotional, and behavioral challenges.

Armed with a better understanding of the state of KinshipTreatment Foster Care across the country, FFTA sponsorednine summits across the country in partnership with public andprivate agencies. The summits provided an opportunity forearly adopters of kinship TFC to share their lessons learnedand help summit jurisdictions explore opportunities for imple-mentation. Several summits resulted in ongoing dialogue abouthow public and private systems can work more closely togetheron kinship care and TFC, and several agencies began to focusmore intentionally on kinship care in their ongoing work.

continued on pg. 3

The Kinship Treatment Foster CareInitiative: Creating a "Kin First" Agency Culture | continued from pg. 1

EDITOR’S COLUMN

— by Beverly Johnson, LCSW

continued on pg. 3

Kinship foster care is certainly not a newservice, but its status as a viable service optionfor children removed from their homes hasincreased in recent years. This is especially truewhen you factor in federal, state, and tribalchild welfare policies that prioritize the place-ment of children, who are in state custody,with relatives or kin whenever safe; theresearch showing that children and youth gen-erally do best when placed with kin rather thannon-kin; the challenges of recruiting new non-kin foster homes; and the removal of childrenfrom their homes at a higher rate due to theopioid epidemic. The reality, though, is that any child removed

from his home suffers a traumatic event. Manyof these children also have other significantsocial, emotional, behavioral, developmental, ormedical challenges. Although placement with arelative or kin caregiver is most often consid-ered the best option, the child’s treatmentneeds are in no way reduced simply becausethat child is now connected to her family, hercommunity, and her cultural identity. There are tens of thousands of kinship foster

families doing the best they can with the bestintentions, but because they aren’t considereda treatment home, they often lack access to theappropriate training, resources, support, andtreatment services they and their children need. Five years ago the Family Focused Treatment

Association (FFTA) began asking what it can doto bridge the service gap that exists betweenkinship foster care and Treatment Foster Care.FFTA embraced a kinship philosophy that “allchildren belong in families, preferably theirown families. When children cannot safely livewith their parents, they should have everyopportunity to live safely with relatives or thosewith whom they have a family-like relationship.”

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One idea that was repeatedly discussed in the kinship sum-mits was the potential to use kinship TFC to help children andyouth transition from residential treatment back into a familysetting. Given the high cost of residential treatment and otherforms of group care, kinship TFC is seen as a much less expen-sive option and one that helps children maintain family connec-tions that are critical for healthy development. Kinship TFCcan also help prevent the needfor residential treatment in the first place. By equippingcaregivers with the knowl-edge, skill, and support needed to manage difficultbehaviors and complexmedical issues, agenciescan help stabilize situationsthat, in the past, might haveresulted in disruptions.

Finally, FFTA created aKinship Treatment Foster CareInitiative Toolkit (www.ffta.org/kinship) that includes tools, case studies, and other information to help agencies learn more about kinship care and kinship TFC. The toolkit is a practical set of resources that can help agencies become moreimmersed in the idea of kinship TFC and includes strategies for engaging public partners in dialogue about how kinshipTFC can help improve safety, permanency, and well-being outcomes for children and youth in foster care.

Next Steps for the Kinship TFC Initiative: Becoming a “Kin First” Culture

The Kinship TFC Initiative has helped elevate the dialoguebetween FFTA members and their public partners about how towork together to ensure that children have their needs met inkinship settings. Although the grant with the Annie E. CaseyFoundation has ended, FFTA remains committed to supportingagencies that want to do more work with kinship families. Inthe next phase of the initiative, FFTA will continue to supportmembers in engaging their public partners as well as buildingtheir internal capacity to work with kinship families. Agencieshave expressed interest in family search and engagement, newmodels of training kinship caregivers, and help for their staff tobecome more “kinship competent.”

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FFTA also created a vision for kinshipTreatment Foster Care that “all childrenin out-of-home care with treatmentneeds can have those needs met by rela-tives or those with whom they have afamily-like relationship, with access to the full array of training, services, andsupports available through TreatmentFoster Care to help them stay safe,achieve permanency, and thrive.” FFTAthen launched a three-year initiative toengage in a variety of activities to pro-mote Kinship Treatment Foster Care to itsmembership and other key stakeholdersin the public and private sectors. We begin this issue of FOCUS with an

article by Jennifer Miller that highlightssome of what FFTA has accomplished andwhat we’ve learned during our KinshipTreatment Foster Care Initiative. AlthoughFFTA has been working hard to study,promote, and support kinship TFC, ourmembers are doing remarkable work aswell. Lilliput Families, an agency that hasbeen providing kinship care services forthe past 20 years in California, explainswhat it believes is essential to supportingkinship placements. No program imple-mentation is complete without an evalua-tion of its effectiveness, and the BairFoundation’s evaluation of itsTherapeutic/Treatment Foster Care (TFC)program with kin and non-kin familiesprovides insight into one agency’s experi-ence with preparing for evaluation.Devereux Advanced Behavioral Health’s

Treatment Foster Care program in RhodeIsland shares that a contract with the staterequired the agency to work with kinshipfamilies to complete the home studyprocess within a short period. This was afeat in itself, but there were a number ofchallenges to overcome. In particular,

Editor’s Column| continued from pg. 2

continued on pg. 4

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The Kinship Treatment Foster CareInitiative: Creating a "Kin First" Agency Culture | continued from pg. 2

FFTA will continue to

support members in

engaging their public

partners as well as

building their internal

capacity to work with

kinship families.

Editor’s Column| continued from pg. 3

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Agencies that are interested indoing more work with kinship families may consider how closelyaligned their agency culture is withthe steps that have been outlined ina new resource developed by threenational organizations: the AmericanBar Association’s Center on Childrenand the Law, ChildFocus, andGenerations United. The publica-tion, wikiHow for Kinship Foster Care,(www.grandfamilies.org/wikihow-for-kinship-foster-care) outlines keysteps that are needed to reflect anagency culture that truly values kin. Although these steps weredeveloped in close consultation with public agency stakeholders,many of the steps are also relevant to the work of private agenciestogether with their public partners.

• Step 1. Lead with a “kin first” philosophy: Leadership mustconsistently reinforce the value of kinship care to improvechild welfare outcomes and align agency resources withthis value.

• Step 2. Develop written policies and protocols that reflect equityfor children with kin and recognize their unique circumstances:Child welfare agencies must recognize the unique waysthat kinship caregivers experience placement and the differences between kin and non-kin caregivers.

• Step 3. Identify and engage kin for children at every step:Adopt strategies that combine engagement of parents,youth, and the community in identifying a child’s extendedfamily network and technological resources to help youthreengage lost family connections.

• Step 4. Create a sense of urgency for making the first placementa kin placement: Create the teamwork needed for first-timeplacement with kin and ensure that it’s harder to make anon-kin placement than a kin placement.

• Step 5. Make licensing kin a priority: Ensure that there isflexibility for kin families to meet non-safety licensing stan-dards and that training is relevant to the experiences of kin-ship families. This step also helps ensure that any red flagsabout safety are fully addressed.

continued on pg. 5

some families who already had kin liv-ing in their home were not preparedfor the invasive nature of the homestudies, were skeptical of the child wel-fare system, and were resistant toreceiving outside support services. Thisis a common theme that we’ve heardfrom FFTA members across the countrythat are working with kinship families. Also in this issue, find an update

from our Virginia Chapter, which isdetermined to build the foundation fora kinship Treatment Foster Care pilotprogram with the chapter’s publicagency partner in Norfolk. As always,check in with our Public Policy Director,Laura Boyd, PhD, for an update on ourwork shaping public policy. Kinship families are resilient and ded-

icated to doing what is best for thechildren and youth they care for. It’shard to ask for help, and some kinshipfamilies need more time to build trustin the professionals and agencies thatare trying to support them. Many kin-ship families are dealing with multiplefamily dynamics and are unaware ofthe significant treatment needs theirkin have. FFTA members are wellequipped and trained to address allthese issues. This issue of FOCUS high-lights some of the ways that agenciesare supporting kinship families andhelping them thrive.

Beverly Johnson, LCSW, is the Chief Program Officer ofLilliput Children’s Services. She is a member of theFFTA Board of Directors and serves as the Chair of theFFTA Editorial Committee. She will present on kinshipcare competency at the FFTA 31st Annual Conference.

The Kinship Treatment Foster CareInitiative: Creating a "Kin First" Agency Culture | continued from pg. 3

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• Step 6. Support permanent families for children: Ensurethat kinship families are presented with a range ofpermanency options, including reunification, subsi-dized adoption, and subsidized guardianship, andthat they understand the differences between theoptions when children can’t return home.

• Step 7. Create a strong community network to supportkin families: Ensure that kinship families have access tocommunity resources to support them in their care-giving role, including support groups, access to bene-fits, educational advocacy, and the like.

Traditionally, child welfare systems and agencies werebuilt with non-kin in mind. Agencies that recognize theimportance of helping children maintain family connec-tions must fully incorporate a different perspective about

what it means to truly engage kinship families. Thisrequires a fundamental shift in understanding about whatkin families are going through when they partner withchild welfare agencies and some of the unique and chal-lenging family dynamics they experience when they step infor their relative or kin children. Taking the time to ensurethat the steps to creating a “kin first” culture are fullyengrained in the agency is difficult work, but it is work thatis essential to ensure that whenever possible, children andyouth can maintain the family connections that promotetheir well-being.

Jennifer Miller, MSW, is a partner with ChildFocus Inc., a national consultingfirm that helps nonprofit organizations, foundations, and government agen-cies support America’s children and families. She is a consultant to FFTA onits Kinship Treatment Foster Care Initiative. She will present on becoming akin first agency at the FFTA 31st Annual Conference.

31ST ANNUAL CONFERENCEHYATT REGENCY

CHICAGO, IL JULY 16-19, 2017

VISIT: FFTA.ORG/CONFERENCE

The Kinship Treatment Foster Care Initiative: Creating a"Kin First" Agency Culture | continued from pg. 4

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Treatment Foster Care (TFC) is apowerful intervention designed tomeet the specialized needs of childrenin foster care. TFC programs providean array of services to children whosesocial, emotional, and behavioral healthneeds cannot be met in a traditionalfoster care program. TFC programsoften depend on a public-private part-nership in which private agencies placechildren in family settings with 24/7support in order to meet the special-ized needs of these children. TFC pro-grams are designed to work with publicsystems to prevent placement disrup-tions, avoid placements in higher levelsof care that can be very costly, andplace children in family settings. Data-driven and evidence-based practices areessential to the longevity of TFC pro-grams because data show programmaticeffectiveness based on the improvedoutcomes for children and families.

In 2015–2016, the Annie E. CaseyFoundation funded a study with theBair Foundation to better understandhow Bair has developed and imple-mented Structured Intervention

Treatment Foster Care (SITFC) withboth kin and non-kin families to meas-ure outcomes for children in kinshipTFC. Dr. Sarah Kaye worked with theBair team to develop an evaluation planbeginning with the collection of thepreliminary data and ending with thefull product outcomes of an evaluation.

Following are the three steps to takewhen preparing for a similar type ofevaluation in your agency.

Step 1: Articulate YourTheory of Change

Your theory of change is a concisedescription of the outcomes your pri-vate agency seeks to achieve anddemonstrates how this work will helpchildren and families. When develop-ing your theory of change, generate alist of practice activities and intendedoutcomes for children and families;interview agency leadership, staff, andstakeholders; connect specific practiceactivities with specific outcomes; andseek feedback on early drafts of yourtheory of change in order to haveexplicit and focused connections.

In identifying its theory of change,the Bair Foundation developed a pre-liminary list that linked specific prac-tices with specific outcomes. Bair’s lead-ership team reviewed the preliminarylist and clarified connections, and themodel was revised until a consensuswas reached regarding what the theoryof change should be.

Step 2:Operationalize CoreComponents of Practice

Operationalizing your core compo-nents involves explicitly defining whatworkers, foster parents, resource par-ents, clinicians, and others should bedoing and saying with regard to theidentified theory of change as well asdescribing service delivery in a specif-ic and measurable way. Practices mustbe defined specifically enough toobserve and measure progress. Corecomponents will be measured throughforms, checklists, and data systemsand by assessing the reliability andaccuracy of documentation. In thisstep you should explore whether state

Evaluating Innovative Interventions:Three Steps to Preparing for Evaluation of

Treatment Foster Care with Kin and Non-Kin Families

continued on pg. 7

—by Sarah Kaye, Ph.D. and Jennifer Miller; summary by Keisha Bryan, LCSW-C

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and local systems can use data to createa more comprehensive picture of howinterventions have impacted outcomesin the child welfare system.

To operationalize the core practicecomponents, the Bair Foundation collected weekly logs completed bythe treatment or resource parent, performed monthly monitoring ofpaperwork completed by foster careworkers, developed individual serviceplans, and undertook supervisory andperformance quality reviews. Whenaccessing these data, Bair took intoaccount the fairness and accuracy ofthe data, whether the data were considered critically important inachieving outcomes for children,and whether the data could be efficiently collected and analyzedfor every child in the study.

Step 3:Operationalize Childand Family Outcomes

Operationalizing outcomes meansdefining the safety, permanency, andwell-being outcomes that children will experience as a result of being apart of your program. The theory ofchange is critical because measuresmust be related to the practice activi-ties that directly result in the outcomemeasures. For example, if the localdepartment of social services maintainsprimary responsibility for permanency-related activities, then a private agencywill not want permanency outcomes asa measure. Instead, this private agencywould focus on placement stability and improvements in child function-ing. When operationalizing outcomes,consider the outcomes that childrenand families should achieve and howthose outcomes will be measured.When defining the outcomes that your program will achieve, keep thefollowing at the forefront:

• Engage stakeholders to promote clari-ty, transparency, and discussion ofshared priorities.

• Define specific and measurable out-comes that children and families willachieve as a result of the core compo-nents of practice.

• When defining how to measure out-comes, keep the following in mind:-Identify data sources, measurementperiods, and comparison groups.

-Request access to public agency datato allow comparisons to be madewith other child welfare studies.

To operationalize child and familyoutcomes, the Bair Foundation primarilyused the SITFC model, which includedthe enhancement of child strengths,reduction of child needs, and attainmentof safe and stable placements. Bair usedthe Child and Adolescent Needs andStrengths (CANS) tool to assess thestrengths and needs of children age 5and older. Bair did not have access tothe state child welfare data to enhanceits outcome measure. Instead, proxieswere developed using data that Bair hadavailable and then results were present-ed with caveats.

Public agencies can play a significantrole in the evaluation process by granti-ng access to statewide administrativedata for key variables of interest. Thisaccess can be given while protecting theconfidentiality of all children and theirfamilies. If sharing of comprehensivedata is impossible, private agencies canrequest specific pieces of informationabout the children and families that are

most important to their outcomes. Forinstance, if placement stability is criticalin the theory of change, then importantdata points would include the numberand type of all placements prior toreferral to the TFC program and thenumber and type of all placements afterleaving your TFC program.

It is important to ensure the use ofquality data. Before their use in an eval-uation, data sources must be assessed for quality. Data quality standards arerequired to ensure that data are reliableand valid so that the conclusions drawnare trustworthy. Data quality standardsinclude completeness, consistency, and

timeliness.Using assessment data from

standardized assessments can provide invaluable insight into thewell-being or clinical outcomes ofchildren served in TFC programs.

The following are two critical consider-ations for using assessment data:

• Assessments must be consistentlyadministered at defined points in timefor all children in care to ensure comparable results across children.

• Different assessments have differentscoring and monitoring procedures;analysis of data must be clearlydefined and consistent with recom-mendations of the developers of theassessment.

The full article by Sarah Kaye andJennifer Miller can be found athttps://media.wix.com/ugd/93eeb7_5a989a89212d458b8a01cf713f225963.pdf.

Keisha Bryan, LCSW-C, is the Director of theTreatment Foster Care Program with e Children’sGuild in Baltimore, Maryland. She also serves onthe FFTA Editorial Committee and is the Secretary/Treasurer of the Maryland Chapter of FFTA.

Evaluating Innovative Interventions: Three Steps to Preparing for Evaluationof Treatment Foster Care with Kin and Non-Kin Families | continued from pg. 6

Data quality standards include completeness,

consistency, and timeliness.

I write this column with an inspired spirit, expanded mind, grateful heart, and tired feet! Together we have justcompleted the 14th Annual FFTA Public Policy Institute and TFC Advocacy Day.

CEOs, service providers, supervisors, and agency board members covering Treatment Foster Care (TFC) servicesin 26 states convened in Washington, D.C., on May 1 and 2. As we headed to the capitol, 84 individual meet-ings with members of Congress or their staffers had been confirmed! Add at least a dozen more “drop-by” visitsfrom especially industrious TFC leaders and WOW!

Offices in both the House and Senate and Republicans as well as Democrats were welcoming and overwhelm-ingly positive. Several staff members stated that finding common agenda items between both parties is a prior-ity . . . and our TFC definition bill just might fill that need! More members of Congress and Senators than everbefore met personally with our attendees. Indeed, there is a heightened importance of and responsiveness tocitizen involvement and concerns.

The Institute Day of workshops and discussions was stimulating and conducted by national leaders and speak-ers who graciously contributed their time and resources. We received specific ideas on expanding our partner-ships with the National Governors Association (NGA) and our state governors’ offices back home, and we sharedwith NGA the richness and resources of FFTA and TFC. We had to-the-minute updates from the administrationand the Assistant Secretary for Planning and Evaluation (ASPE) as well as from key legislative staff from the Hill.We expanded our knowledge of effectively responding to immigrant families under stress and the importanceof becoming “adoption competent.” Our opportunity to extend relationships back home for homeless and disconnected youth was discussed. And, most potently, our responsibility to listen to and include parent andcaregiver voices was reaffirmed.

One attendee remarked that he passes up other conferences because he gets more out of our one-day training,and it is brought to him so timely. Attendees who are agency board members encouraged us to expand invita-tions to all our boards and offered to “testify and mentor” new board attendees next year.

As for an update on the TFC definition bill, House Bill 2290 was filed on May 2nd with four bipartisan originalsponsors: DeLauro (D-CT), Cole (R-OK), Mullin (R-OK), and DeGette (D-CO). The Senate version will be filed with-in the next two weeks. With the urgency of the health care debate and passage of the House American HealthCare Act, we encountered a slight delay. Our prior original sponsors Baldwin (D-WI), Portman (R-OH), andStabenow (D-MI) and a new original sponsor, Sen. Roy Blunt (R-MO) are on board, giving us two Republicanand two Democratic original sponsors in the Senate as well.

Join us next year, “pros” and “newbies”! Who knows what 2018 will provide or challenge us on? Our week in2017 was smack-dab in the middle of promoting family-based care and the TFC definition, having conversa-tions about protecting kids in the federal budgets that were released while we were there, and pleading forMedicaid access and responsible health care reform, which is morphing daily. Never a dull moment!

Finally, a shout-out to the FFTA board members for their leadership at the Institute and on the Hill, to FFTA stafffor all their work on Institute details and support of attendees, and to our national colleagues who participatedas presenters or as guests as we all move forward together in strong partnership on behalf of those we serve.

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By Laura Boyd, Ph.D.

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VIRGINIA

FFTAChapterSpotlight

Virginia’s Emerging Kinship Pilot ProgramIn April 2010, only 279 out of 6,329 children in foster care in Virginia were placed in a kinship-type foster place-ment, putting Virginia last in the nation in the use of kinship care. The Virginia Chapter of FFTA has been work-ing on a kinship program for several years, and, with an anticipated start date of July 1, 2017, things are movingright along. Although Virginia was very interested in the grant to promote kinship when it was originallyreleased, it was not until the offer came around the second time (2015) that the Virginia Chapter was able toapply for and was awarded the grant. This was the support that the Virginia Chapter needed to begin movingtoward a much-anticipated pilot kickoff.The first step was hosting a 2-day summit on March 30 and 31, 2016. The goal of day 1 was to provide a forumfor public and private providers to learn about existing and emerging Kinship Treatment Foster Care models. Thegoal for day 2 was to establish work groups to assess current systems and create the plan of action for movingforward.Day 1 was a training day designed to provide knowledge about kinship care as well as information for public andprivate agencies about how other states implemented Kinship Treatment Foster Care programs in their commu-nities. The goal was to elicit buy-in from state and local public agencies (the Virginia Department of SocialServices, the local departments of social services, and other child welfare agencies and programs) as well as pri-vate Treatment Foster Care providers for the idea that “kinship care” is essential to Virginia’s communities andultimately a missing necessity.Each of these work groups then reported the information they collected, and a plan of action was set in motion.The first step was to develop a needs assessment that was sent to vital organizations that would be directlyinvolved in the success of this program. The goal was to assess the status of using kinship providers, barriers toimplementing a formal kinship TFC program in local communities, and overall feelings about the program.Following the summit and data collection from the survey, the City of Norfolk agreed to pilot a Kinship FosterCare program. This step brings Virginia to where we are today: gathering Treatment Foster Care providers thatare willing to participate, writing the pilot program with assistance from FFTA National, and assessing the bestway to train kinship foster parents in a cost-effective manner. Initially, we will be targeting kinship placementsfor youth being discharged from congregate care and then expanding the program as appropriate.It has taken the Virginia FFTA Chapter over two years to lay the foundation for a Kinship Treatment Foster Careprogram. Many hours have been spent by chapter members, the board, and community affiliates to prepare thisprogram for implementation in our communities. We hope our pilot will be of help to other states seeking tomove forward with a formal Kinship Treatment Foster Care program. The process has not always been easy, butwe are excited to see how this pilot transforms our Treatment Foster Care programs to be even more person centered and family focused than before.By Angela Edmonds, LCSW, Secretary of the FFTA Virginia Chapter and COO of Embrace Treatment Foster Care

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Within the state of Rhode Island, there has been an ongo-ing need to increase the number of kinship homes availableto children involved with the Department of Children,Youth and Families (DCYF). Kinship homes include bothbiological relatives and other individuals known to the child orfamily. Placement for children in kinship homes has beenunanimously identified in best practice standards as havingmore optimal long-term outcomes for children.

Rhode Island DCYF has a standard requiring all kinship fosterhomes to be licensed within six months of placement. This stan-dard proved to be difficult for the state to adhere to, resulting inwidespread negative media attention. DCYF responded with aplan to contract with four private agencies in Rhode Island toassist with licensing these kinship homes. As a well-knownprovider with a history of quality care in Rhode Island, DevereuxAdvanced Behavioral Health was selected for this assistancethrough contracts that were awarded by the state in 2016.

The contracts were a natural extension of Devereux’sTherapeutic Foster Care (TFC) program that was already work-ing with children and families throughout the state, ensuringthat the values of compassion, accountability, respect, excel-lence, and safety were being met through intensive foster careservices. The first contract focused on the preparation of kin-ship home studies. The second contract focused on supportingkinship foster parents who currently have children placed intheir homes.

It was evident from the beginning that most of the kinshiphomes requiring home studies had been maintaining placementof children without support services for significant periods oftime. These homes were not aware of the complex child wel-fare system, community supports and resources, and licensingregulations. While preparing home studies, Devereux TFCquickly learned that these kinship families required much moresupport, but due to the minimal support these kinship familieshad been receiving, some initially presented as hesitant toengage in the home study process.

Because the contract specified 60 days and 20 hours to com-plete the home study process, Devereux TFC had to work dili-gently to establish a rapport with the families and help themrebuild trust in the child welfare system. The home studyprocess is an invasive, personal experience for all, particularlyfor those whose family members are involved in the child wel-

fare system. When TFC staff started working with these fami-lies and establishing a relationship of trust, staff members foundthe families receptive to engaging in the home study processand eager to receive additional services to further support theplacement. Through this work, Devereux TFC identified somekinship homes with safety issues that could not be mitigated,and licensure had to be denied. Although these situations weredifficult, the outcome was in the best interest of the children.In other cases, Devereux TFC was able to provide support tohelp kinship families voice their own needs and concerns toDCYF. Throughout the process, Devereux TFC has found that,in most cases, families showed great resilience and unwaveringdevotion to the children placed in their homes.

The second contract for kinship support allows Devereux tosupport a wide range of needs for kinship foster families, fromhousing to employment to behavior management. This short-term service is intended to last no longer than 90 days, duringwhich time TFC completes a minimum of weekly face-to-facecontact, monthly strengths and needs assessments, monthlytreatment planning, and monthly reviews and necessary assess-ments. Intrinsic to this work is the need to orient the familiesto the DCYF system and the resources available to them whilehelping them identify natural supports to further aid their long-term placement success.

Through this experience, Devereux has found kinship fosterparents to be a very valuable yet underserved population.Although these families have demonstrated adaptability anddevotion by opening their homes to their relative children,often unexpectedly, they have done so with minimal supportand recognition. Devereux is honored to be able to serve thispopulation and offer them the support and services theyrequire to reach their highest potential.

Devereux is currently tracking outcome data for this service,specifically the length of time services were used and case out-comes. Although it is still very early in the contract, we have hadonly one discharge, and we intend to evaluate the efficacy of ourservices. We look forward to monitoring these data and adjust-ing our service delivery as needed to ensure successful outcomes.

Danielle Imbornone Gallagher, MEd, is Regional Manager, Rhode Island Operations,and Jennifer Young, MA, is Assistant Regional Manager, Rhode Island Operations,at Devereux Therapeutic Foster Care.

SUPPORTING RHODE ISLAND’S KINSHIP FOSTER HOMES—by Danielle Imbornone Gallagher, MEd, and Jennifer Young, MA

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“Are kinship caregivers inthe role of service provider orservice recipient?” Six yearsago during an FFTA workshop,a provider posed this veryquestion. At the time, kinshipcare was being widely recog-nized as a viable foster careoption. What many providersof treatment foster care weredebating was how familiescould get through the process of paperwork, interviews, andtrainings. We all could agree that placement with family wasbest for kids, but we also realized that many of these familiesrequired resources while fulfilling the same requirements asother foster parents that we considered “professionals.” Manyproviders doubted whether some families could pass the initialprocess and whether these families would be receptive to train-ing. These considerations are important and address the initialassessment and subsequent interventions needed in kinshipplacement. Kinship families are uniquely different fromunmatched families who come to this process from a differentplace and have more time to adjust to the process. Equally,given the strength of family connection, kinship caregivers areuniquely positioned to therapeutically support children in theircare and, with proper support, are often more committed toseeing this process through.

Lilliput has spent the past 20 years of our 37-year historysupporting kin caregivers throughout California to assist publicagencies in moving kids to permanency primarily throughguardianship or adoption. More than 50% of the 7,000 adop-tions completed since that time were with relatives. We con-tinued to build in supports for kinship caregivers through fami-ly resource centers tailored to kin, family finding effortsfocused on kids entering care, and foster certification for rela-tives. We have been very excited to see the progress in sup-porting placements with kin nationally and specificallythroughout northern California. Strong kin-ship communities invest in family finding andkinship resource navigation and supports thatare equal to those that foster parents receive.Currently in California, kinship caregivers go

through the same process as anon-related family—a big step forkinship care.

What is essential on macro andmicro levels to support our kidswho are placed in kinship care?Support begins with creating akinship-friendly agency and iden-tifying needed resources that areavailable from public agencies andtheir respective communities.

Strong private-public collaborations are key, and systemstransformation is necessary at all levels. Such transformationstarts at the top but has to be integrated at all levels to be suc-cessful. Bias must be checked consistently, and policies andprocedures require consistent refinement to ensure success.Gatekeeping at critical pathways is key. Once leadership sup-port is established, the practices and procedures to ensure kin-ship care can follow.

Once a system is in place to consistently address bias indi-vidually and systemically, what practices are necessary to sup-port this work? Team members and their supervisors need touse a different lens when working with kin as opposed to non-related caregivers. Kinship caregiving is usually born out of cri-sis and is unplanned. Families usually have little to no time toprepare and are being asked to make some major shifts in theirlives—rearranging work schedules to complete necessary train-ings, enrolling children in school, making necessary healthappointments. Reevaluating our expectations of families is nec-essary—families often need assistance navigating systems andcan feel overwhelmed by the process. At the same time, familysystems are in crisis, and families are reexperiencing trauma.Thorough training and supervisory support related to traumaand family dynamics are necessary to create a therapeutic envi-ronment in which children can thrive. Clinical supervisionbecomes a central aspect of highly effective kinship work.

Support begins with creating a kinship-friendly agencyand identifying needed resources that are available frompublic agencies and their respective communities.

continued on last page

What Does It Take to Support Kinship Placements?—by Beverly Johnson, LCSW

TOOLBOX

FFTA FoundersAction Youth Care, Inc.Ripley, WV

Alternative Family ServicesSanta Rosa, CA

Beech BrookCleveland, OH

Boys TownBoys Town, NE

CONCERNFleetwood, PA

EMQ/FamiliesFirstCampbell, CA

Family Alternatives, Inc.Minneapolis, MN

Lilliput Children’s ServicesCitrus Heights, CA

The MENTOR NetworkBoston, MA

National Youth Advocate ProgramColumbus, OH

PATH, Inc.Fargo, ND

People Places, Inc.Staunton, VA

Pressley RidgePittsburgh, PA

Seneca Family of AgenciesSan Leandro, CA

Specialized Alternatives forFamilies and YouthDelphos, OH

Volunteers of AmericaNew Orleans, LA

FFTA PatronsBluewater Family Support ServicesParkhill, Ontario

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Newsletter of the Family Focused Treatment Association

The Family Focused Treatment Association strengthens agencies that provide family focused treatment services.

Families are complex, as is the world of kinship—fraught with issues and not forthe weary or unprepared. Many kinship families are quite resourceful but strugglefrom time to time like all families. Providers must realize that kinship caregiversmore often than not are simultaneously providing and receiving services, and agen-cies need to be prepared in a myriad of ways to adequately support these placements.

Beverly Johnson, LCSW, is the Chief Program Officer of Lilliput Children’s Services. She is a member of the FFTA Board of Directors and serves as the Chair of the FFTA Editorial Committee. She will present on kinship care competency at the FFTA 31st Annual Conference.

What Does It Take to Support KinshipPlacements? | continued from pg. 11

Addressing bias Recognizing that kin placements are

more likely to be born out of crisis Recognizing our intrusion into the family Helping families navigate systems Valuing the importance of familial bonds

and family dynamics Understanding safety concerns versus

“good enough parenting” Valuing cultural differences Understanding that the motivation

for placement is unique

8 Critical Factors forSupporting Kinship Care