Objectives. History and Background 10/12/2015. Trauma Focused Treatment Foster Care A New Approach to Child Welfare

Transcription

1 Trauma Focused Treatment Foster Care A New Approach to Child Welfare Objectives Participants will learn about Arrow Maryland s Treatment Foster Care Model Participants will learn about the transition plan established to become trauma-focused Participants will learn about progress made towards outcomes set for this program History and Background Licensed in Maryland for treatment foster care since 1996 Two locations Metropolitan Baltimore (Central Maryland) and Lower Eastern Shore (Rural) Regulations require additional training hours for treatment families; more intensive case management and services vs. basic foster care 1

2 Original Program Model Case Management provided by Maryland licensed social workers only Admissions referral screening and matching conducted by a licensed social worker only Family Home Developer recruits, trains, interviews and assesses, and certifies foster families/homes; maintains foster family compliance Place Matters In 2008, the Department of Human Resources launched a statewide initiative to reduce the number of children in congregate care simultaneously, increasing the use of basic and treatment foster care Youth traditionally served in high intensity residential programs were being stepped down to TFC with greater frequency Permanency and decreasing the number of children in child welfare custody became the focus system wide 2

3 Implications for Providers Foster families were stretched beyond their experience level to support, parent, and provide stability to children with greater behavioral health needs. Providers were challenged to creatively provide services for high intensity youth with fewer resources, in a community/home based model. Crisis management increased significantly, impacting programs ability to strategically work towards permanency, safety, and positive wellbeing for children in care. Our Response January Arrow CFM TFC submitted a proposal to the state, requesting a higher per diem rate in order to better meet the system s present need Proposed to serve highly traumatized youth in a community setting by providing a more comprehensive Trauma-Focused Treatment Foster Care Model Designed to serve special needs children in a home based, community setting: with more significant supports in the home more intensive training of staff and foster parents support and treatment for co-occurring disorders increased treatment services and case management educational supports for the youth and family Our Proposal Targeted recruitment of families Use of Trust Based Relational Interventions (a traumafocused, relationship-driven, evidence-informed philosophy and practice) to guide service delivery and training Family-Centered Treatment Approach with all families Use of the Child and Adolescent Needs and Strengths Assessment (CANS) Intensive case management services Dedicated education liaison (Family Intervention Specialist) to support service provision in the schools, advocacy, IEP coordination, and foster parent education Individualized support for families using a Menu of Services Trauma informed staff including nurse, psychiatrist, and therapist 3

4 Trauma Focused TFC Proposed Arrow Treatment Foster Care Organization Chart BOARD OF DIRECTORS Senior Vice President Associate Vice President Program Director Social Work Supervisor (2) Family Home Trainer Family Home Developer Intake Coordinator Program Assistant Ambassador Family Specialist (7) Intake Assistant Family Interventionist Specialist (1) Therapist (1) The Transition Hire new staff Build out a new workspace Re-design operations (new roles) Identify benchmarks Make everybody (staff and parents) TRAUMA INFORMED Staffing Position/Role Expectations and Results Clinical Supervisor 1. Client systems (foster child and foster family) have face-to-face contact at least weekly. 2. Client systems have access to additional inhome support services. 3. AFS s and Therapists collaborate about the clinical needs of the client system. 4. Treatment and care management services are coordinated, collaborative, and traumafocused. Family Home Development Trainer 1. Families who are adept at the delivery of TBRI interventions in the home, individualized to the children in their care. 2. Families who embrace a trauma-focused philosophy. 3. A decrease in the number of Request for Removals. 4

5 Staffing Position/Role Expectations and Results Treatment Specialist 1. Demonstrated improvement in CANS scores for clients receiving intensified services. 2. Decrease in the number of critical and reportable incidents. Family Intervention Specialist 1. Improved educational outcomes for foster children 2. Greater foster family satisfaction with Arrow TFC services. 3. Decrease in the number of critical and reportable incidents. 4. Decrease in the number of sub-moves. 5. Client systems have face-to-face contact at least weekly. Staffing Position/Role Expectations and Results Ambassador Family Specialists Client systems have face-to-face contact at least weekly. Greater foster family satisfaction with Arrow TFC services. Decrease in the number of critical and reportable incidents. Decrease in the number of sub-moves. Demonstrated improvement in CANS scores for clients receiving intensified services Foster Parent Incentives Client Well Being Stability and Permanency Foster parents (families) are only eligible for incentives if they are compliant with trainings, paperwork, and other requirements at the time of the incentive payment. For the incentive initiatives, the AFSs are the cheerleaders for the family. They are constantly encouraging the family to work towards the incentive(s). 5

6 TBRI Trust-Based Relational Interventions (TBRI), a trauma-focused, relationship-driven, evidence-informed philosophy and practice, lays the foundation for our therapeutic and nurturing environment Recognizes that children in out-of-home care possess a greater risk for psychiatric and mental health challenges, learning and executive functioning problems, and social and emotional deficits as a result of the severe impact of traumas endured earlier in development Creates a clinically nurturing environment that seeks to repair and replenish the child s capacity to feel safe; Enhance his or her capacity to function with confidence and security within the greater environment. TBRI Clinical training and program integration Foster family/afs co learning: The Connected Child TBRI Professional Training Program October 2015 Arrow s Alphabet Soup (TBRI, PBIS, PCM) Benchmarks STABILITY: Reduction in substitute moves and placement disruptions (unplanned discharges) SAFETY: Reduction in critical and serious incidents CHILD WELLBEING: Reduction in overall CANS scores; improved school attendance and performance PROGRAM GROWTH: Increased capacity for TFC and Community Services 6

7 Preliminary Results Family/Client Contact Greater than Required 4/mo: Increase from 113 to 293 Requested Removals: Decreased from 13 (Qu2) to 6 (Qu4) Substitute moves: Decreased from 10 to 2 Disruptions: Decreased from 14 to 4 Incidents: Increased from 34 to 56 (why?) Incentives to date: 8 New Foster Homes: 12 Lessons Learned Challenges with staffing had to look at recruitment efforts and social worker salary ranges Managing foster family compliance Managing AFS caseloads with limited staff Timeline for implementation Internal accountability with minimal external accountability THANK YOU Maisha Davis, LCSW C Associate Vice President, Treatment Foster Care and Clinical Development Janee Deline, LCSW C Program Director, Treatment Foster Care Jennifer McGlothlin Renault, MA, M.Ed. Associate Vice President, Operations Arrow Child & Family Ministries 1605 Cromwell Bridge Road Baltimore, MD