February 2008Vol. 9, No. 1Print issueSpotlight on Family Engagement

Issue Spotlight

• Healthy Families America: Positive Impacts of Home Visiting

  Healthy Families America: Positive Impacts of Home Visiting

  For 15 years, Healthy Families America (HFA) programs around the country have promoted positive parenting and the prevention of child maltreatment through home visits to new and expectant parents who may be at risk for child abuse. The HFA initiative has grown to include programs in more than 450 communities. While there is a great deal of flexibility in implementation, all HFA programs adhere to a series of critical elements involving service initiation, service content, and staff characteristics.

  A recent article explored the effectiveness of HFA programs by reviewing 33 evaluations of HFA sites, including 15 studies with comparison groups. Despite the diversity of the sites and the variability in implementation, program quality, and family risk level, overall findings were positive for the impact of the home visiting program. HFA sites showed improvements in parenting attitudes, the home environment, birth outcomes, maternal depression, and in many cases, child maltreatment rates. Data from two large-scale programs illustrated the benefits of communitywide and statewide HFA programs.

  "Healthy Families America Effectiveness: A Comprehensive Review of Outcomes," by Kathryn Harding, Joseph Galano, Joanne Martin, Lee Huntington, and Cynthia Schellenbach, was published in the Journal of Prevention & Intervention in the Community, Volume 34, and is available from Haworth Press:

  http://haworthpress.com/store/ArticleAbstract.asp?ID=105641

  Related Items

  • For more information about Healthy Families America, including access to the new self-assessment tool, visit:
    www.healthyfamiliesamerica.org/home/index.shtml
  • Children's Bureau Express wrote about the Healthy Families New York site, which was recognized by RAND as a "Promising Program That Works," in "Recognition for Healthy Families New York" (April 2006).
  • The Children's Bureau recently awarded 5-year grants to three agencies to provide nurse home visitation to low-income first-time mothers at risk for child abuse and neglect. The Yakima Valley Farm Workers Clinic in Toppenish, WA, the Nurses for Newborns Foundation in St. Louis, MO, and the Spokane Regional Health District in Spokane, WA, will implement nurse home visitation in combination with healthy marriage and responsible fatherhood curricula.
• Engaging Families Through Intensive Family Preservation Services

  Engaging Families Through Intensive Family Preservation Services

  A new report illustrates the effectiveness of Intensive Family Preservation Services (IFPS) in preventing out-of-home placements of children. Researchers reviewed both IFPS and a variation for children already in out-of-home care, Intensive Family Reunification Services (IFRS), using case-level data from State or private contract agencies in seven States.

  The IFPS model includes frequent face-to-face contact with families in their homes or communities, as well as small caseloads, rapid response, 24/7 availability, time-limited services, and provision of both clinical and concrete (e.g., financial) services. While there were some variations among the sites and some differences in the types of families served by programs, all the sites showed a high degree of fidelity to the IFPS model and delivered "intensive" services.

  Researchers found that the IFPS programs achieved a 93 percent placement prevention rate (children living with a biological or adoptive parent or relative, with 85 percent living with the biological parent). Family preservation was associated with increased parenting skills and family functioning and was not dependent on the type of maltreatment.

  The reunification rate for families that received IFRS was 69 percent (children reunited with biological or adoptive parents, relatives, or guardians). In the case of IFRS, race and maltreatment type appeared to be factors in the rate of reunification. Child well-being and readiness for reunification were two factors associated with successful reunification.

  These results show promise for child welfare agencies seeking new strategies for achieving permanency and well-being for children and families.

  The report, An Examination of Intensive Family Preservation Services, was prepared by Raymond S. Kirk and Diane P. Griffith of Independent Living Resources, Inc., in cooperation with Priscilla Martens of the National Family Preservation Network (NFPN). Funding was provided by the Annie E. Casey Foundation. The report is available on the NFPN website:

  www.nfpn.org/images/stories/files/ifps_research_report.doc

• Engaging Dads: The National QIC on Non-Resident Fathers and the Child Welfare System

  Engaging Dads: The National QIC on Non-Resident Fathers and the Child Welfare System

  Fifth in a series of articles on the Children's Bureau's Quality Improvement Centers

  How are child welfare outcomes affected by nonresident fathers' involvement in their children's lives? This question is the focus of one of the newest Children's Bureau Quality Improvement Centers, the National Quality Improvement Center on Non-Resident Fathers and the Child Welfare System (QIC NRF). In 2006, the Children's Bureau funded the American Humane Association and its partners, the American Bar Association Center on Children and the Law and the National Fatherhood Initiative, to develop and implement the QIC NRF.

  The QIC's first year was spent conducting a national needs assessment to determine the current state of nonresident father involvement in the child welfare system. Research—including findings from the first round of the Child and Family Services Reviews—showed that many children are not living with their fathers when they enter foster care, and a tenuous father-child relationship may become even more difficult to maintain once a child is placed in out-of-home care. Five substantive areas for research by the QIC NRF were noted:

  • Identification of nonresident fathers
  • Location of fathers' residence or workplace
  • Contact between child welfare systems and nonresident fathers
  • Engagement of fathers by working with them or offering services
  • Interagency collaborations that make identification, location, contact, and engagement possible

  The QIC NRF explored father involvement from three perspectives: social work/child welfare, the courts, and private provider practice, with special attention to cross-system issues involving child welfare, child support enforcement, and judicial and other systems. A number of reasons for noninvolvement of nonresident dads with their children were found by the QIC NRF, including:

  • Gaps in policy, procedures, or professional training that particularly affect contacting and engaging nonresident fathers
  • Inequitable treatment of fathers and paternal kin by child welfare and judicial systems compared to the perceived essential role of the mothers
  • Personal, relationship, and material and economic barriers encountered by the fathers

  During 2007, as a result of their needs assessment and research, QIC staff compiled an extensive literature review on nonresident dads and the child welfare system. In addition, staff prepared for Phase II, which will involve administering grants to fund demonstration projects on nonresident father involvement. The grants will be awarded early in 2008, so that the funded projects can begin to determine how the involvement of nonresident fathers impacts the safety, permanency, and well-being of children in the child welfare system. One of the activities in progress to support the work of the grantees is an additional literature review on male help-seeking behaviors.

  During this next phase, which will take place over 4 years, the QIC NRF will provide technical assistance to the demonstration projects and conduct cross-site evaluations to assess outcomes. The QIC NRF will continue to develop knowledge and a network among the grantees and other agencies and service providers, courts, and the Children's Bureau so information can be shared easily and disseminated quickly.

  To find out more about the QIC NRF, its initial findings, and the upcoming demonstration grants, visit the website:

  www.fatherhoodqic.org

  Or, contact Principal Investigator Sonia Velazquez at soniav@americanhumane.org or Project Director Karen Kessen at karenk@americanhumane.org.

• Involving Families in the CFSRs

  Involving Families in the CFSRs

  Outcomes from the first round of the Child and Family Services Reviews (CFSRs) have helped States extend family engagement efforts beyond case planning, and some States are now engaging families for their input into agency policy and management. A November teleconference sponsored by the National Child Welfare Resource Center for Organizational Improvement (NRCOI) featured presenters from North Carolina and Oregon discussing strategies used in their States to involve children and families in the CFSR process. The presenters outlined promising practices for involving families in such areas as assessing agency performance and planning program improvements. Associate directors from the NRCOI and the National Resource Center on Family-Centered Practice and Permanency Planning also participated.

  The NRCOI has made this presentation available on its website as an audio file for MP3 players. Also included are links to the handouts used in the presentation, including manuals, information packets, PowerPoint slides/presentations, and more. Visit the NRCOI website to access these materials. Scroll down the page to the November 29 presentation at this link:

  http://muskie.usm.maine.edu/helpkids/tele.htm

• Resources for Group Decision-Making

  Resources for Group Decision-Making

  Family engagement is increasingly recognized as an essential ingredient for the safety, permanence, and well-being of children involved with the child welfare system. A number of strategies for engaging families involve group decision-making through team meetings or family conferences. While team approaches vary and each has its own set of techniques, all stress the importance of including family and kin as partners who can contribute to finding the best safety and permanency solutions for children.

  Recent resources and articles on different types of group decision-making include:

  • "Enhancing Child and Family Team Meetings," Children's Services Practice Notes, from the North Carolina Division of Social Services and the Family and Children's Resource Program, Volume 13(1), at www.practicenotes.org/v13n1/cspn-v13n1.pdf (PDF - 488 KB)
  • "Using Family Group Conferencing to Achieve Permanency for Youth," by Lisa Merkel-Holguin et al., in American Humane's Protecting Children, Vol. 22(1), at www.americanhumane.org/site/DocServer/PCarticle.pdf?docID=6041
  • "Seen But Not Heard? Children and Young People’s Participation in Family Group Decision Making: Concepts and Practice Issues," by Paul Nixon, in American Humane's Protecting Children, Vol. 22(1), at www.americanhumane.org/site/DocServer/PCNixonarticle.pdf?docID=5721
  • National Center on Family Group Decision Making website, sponsored by American Humane, at www.americanhumane.org/children/programs/family-group-decision-making/national-center
  • The Facilitator, a new national newsletter from the Annie E. Casey Foundation for team decision-making facilitators and supervisors, at www.aecf.org/upload/PublicationFiles/TDM_Newsletter_Issue2.pdf (PDF - 224 KB)
  • Resources for team decision-making for supervisors and social workers, including examples of county materials and brochures, from Family to Family California, at www.f2f.ca.gov/team.htm
  • Family Group Conferencing webpage on the website of the National Resource Center for Family-Centered Practice and Permanency Planning at www.hunter.cuny.edu/socwork/nrcfcpp/info_services/family-group-conferencing.html
  • Family Group Decision-Making Approaches webpage on the Child Welfare Information Gateway website at www.childwelfare.gov/famcentered/overview/approaches/family_group.cfm
• Family to Family: Implementation Update

  Family to Family: Implementation Update

  One of the most longstanding programs to endorse family engagement in child welfare is Annie E. Casey's Family to Family model, which promotes a family-centered, neighborhood-based network of care for children by specifying certain organizational and practice changes for child welfare agencies. Begun in 1992, the Family to Family initiative has been implemented in more than 60 locations in 19 States.

  A recent report drew on interviews and focus groups with agency staff, community partners, and families at five sites to explore challenges and solutions experienced in implementing the Family to Family initiative. The results are discussed in terms of the four core components of Family to Family:

  • Team decision-making—Respondents pointed out the benefits of team decision-making, including greater engagement of families, more knowledge of and access to resources to support children and families, and shared responsibility for placement decisions. Challenges were related to the time involved, logistics, and follow through.
  • Community partnerships—Agency leadership and respectful dialog were cited as the two factors that promoted good community partnerships. A number of respondents noted that agencies need to target partners who actually live in the community where children and families are being served.
  • Resource family recruitment and support—Respondents noted that resource families, birth families, and agency staff worked together as a team as a result of the Family to Family initiative.
  • Self-evaluation—Staff cited some difficulties in involving community partners in collecting data, although most reported positive results when sharing data with community partners.

  While each site had issues unique to its population, there were common challenges and solutions that cut across the all locations. Some of the common strategies for implementing Family to Family included strong leadership, community-based practice, and a focus on developing relationships. As Family to Family continues to evolve, the four core strategies will become more integrated with each other; this is apparent in sites where Family to Family has been in place the longest. This integration should help agencies and stakeholders take the initiative to a new level of service for engaging and serving children and families.

  To read the full report, Implementing Family to Family, by Marno Batterson et al. and published by the University of North Carolina at Chapel Hill, visit:

  www.unc.edu/~lynnu/ImpleF2F.pdf (PDF - 514 KB)

  To read more about the Family to Family initiative and to access related resources, visit the Annie E. Casey website:

  www.aecf.org/MajorInitiatives/Family%20to%20Family.aspx

• Mentoring Kinship Caregivers-An Interview With Tiffany Hesser

  Mentoring Kinship Caregivers-An Interview With Tiffany Hesser

  The Caring Communities Demonstration Project in Clark County, NV, includes a kinship care program with some special features. Anchored in a systems of care approach, the program operates out of neighborhood family service centers that serve as the workplace for staff and specialists from a number of systems and disciplines. A relatively unique component is the use of kinship liaisons to mentor kinship caregivers. These liaisons are former or current kinship caregivers who have been hired and trained by the Department of Family Services (DFS) to link kinship caregivers with important resources, provide networking opportunities, and help support stable placements for children in care.

  Clark County's experience with kinship caregivers was recognized by Casey Family Programs in 2004 when the county was selected to participate in the Casey Breakthrough Series Collaborative to support kinship care. This involved the rapid testing and evaluation of new practices for supporting kinship caregivers and their children.

  Children's Bureau Express (CBX) spoke with Tiffany Hesser, Project Director, Caring Communities, about the county's experiences in developing the kinship support program and being part of the Casey Breakthrough Series Collaborative.

  CBX: How is your Children's Bureau Systems of Care grant helping you support kinship caregivers in Clark County?

  Hesser: When we applied for the grant in 2003, kinship caregivers in our area were a population with a great deal of unmet need. Unlike foster parents who choose to take in children and receive training and prepare their homes, most grandparents and other kinship caregivers aren't prepared to take in children. The call they may receive in the middle of the night to pick up a child is usually a surprise, and they may need a number of resources and a great deal of support. This support hasn't always been available to them through the DFS.

  As a result of the grant, the mentoring program was begun in 2005, and since that time, we've refined the program and made the kinship liaisons paid DFS staff members. These four staff all have personal experience as kinship caregivers; that experience is what makes them valuable mentors to other kinship caregivers. Our liaisons contact the kinship caregivers, mail out packets of resource information, and explain their roles. Sometimes, a caregiver might not choose to draw on that support until a crisis arises. In other cases, caregivers are looking for a sympathetic listener who can understand what they're going through. Our liaisons are able to offer all those levels of support. That's part of the systems of care individualized approach. They can even explain and assist with the licensing procedure, if a caregiver is interested in becoming licensed.

  CBX: Tell us about some of the stakeholder involvement in Caring Communities.

  Hesser: We were very lucky because, at the time we received the grant, the University of Nevada was already in the middle of a study of kinship caregiver needs in the State. We were able to use the information from that needs assessment to do our initial planning. We also had the benefit of the knowledge of a number of stakeholders who were involved in children's mental health systems of care. Some of that involvement carried over to this systems of care grant for child welfare, and some did not. For instance, the use of neighborhood centers for staff was an idea that came from mental health systems of care.

  Our kinship caregivers—both our liaisons and our families—have been involved stakeholders from the beginning. They are involved at every level. We have kinship caregivers review every brochure, resource guide, and evaluation tool we produce, and they sit on every committee and attend all our meetings. At times, for instance, during teleconferences with other systems of care grantees, some of the kinship caregivers have been reluctant to speak out, but we've convinced them of the value of their stories and the importance of sharing their experiences.

  CBX: How do the kinship liaisons function as part of the DFS inhouse staff?

  Hesser: It has been overwhelmingly positive to have the kinship liaisons work for DFS. Regular staff have come to realize their value and to regard the kinship liaisons as a resource for information and for referrals. And they're busy! Our most recent data show that the four kinship liaisons received approximately 500 relative referrals in 6 months. The kinship liaisons are also good at retaining the resource families that we need so badly. This focus on retention has become one of the most important parts of their job.

  CBX: Clark County was 1 of 25 teams that participated as part of the Casey Breakthrough Series Collaborative on Supporting Kinship Care. What did you learn from that experience?

  Hesser: Being part of the Casey series was great, because it gave us permission to go ahead and try lots of different strategies on a small scale and in a short timeframe. At the same time that we were working on the long-term systems of care approach, we also had the freedom to try some of the short-term "fixes" that were part of the Casey approach. For instance, we had the idea of using the National Crime Information Center to run criminal background checks on potential kinship caregivers beyond traditional work hours. Using this database allowed relatives to receive clearances and take children into their homes more quickly. We also enhanced our efforts at "diligent search," that is, the systematic search for relatives who could provide homes for children coming into care.

  CBX: What do you see for the future of kinship liaisons?

  Hesser: While we're just beginning our evaluation, we know anecdotally that kinship caregivers in our county have more support and better access to resources as a result of our program. We're now focusing on measuring and reporting outcomes that demonstrate this. Hiring kinship liaisons as DFS staff has worked well, and I'd like to see them continue their focus on retaining kinship caregiver families. Supporting and retaining these families will always be important for the permanency of children.

  Tiffany Hesser can be reached at HesserTi@co.clark.nv.us.

  The Breakthrough Series Collaborative report, Supporting Kinship Care: Promising Practices and Lessons Learned, is available on the Casey Family Programs website:

  www.casey.org/Resources/Publications/pdf/BreakthroughSeries_Kinship.pdf (PDF - 839 KB)

• How Systems of Care Grantees Engage Families

  How Systems of Care Grantees Engage Families

  A new series of issue briefs reports on findings from the nine grantees participating in the Children's Bureau's Improving Child Welfare Outcomes Through Systems of Care demonstration initiative. Developed by the National Technical Assistance and Evaluation Center (NTAEC), A Closer Look debuts with a report on "Family Involvement in Public Child Welfare Driven Systems of Care." The issue brief draws on insights from the grantees to address the challenges of and strategies for involving families in meaningful ways in such areas as agency policy development and management.

  Four challenges to family-agency partnership were identified by the grantees:

  • Agency readiness to partner with families
  • Training and professional development for families
  • Recruitment and retention of family partners
  • Funding

  The report summarizes multiple strategies employed by the grantees to overcome each challenge. Some of the suggestions include working with parent advocacy organizations, developing mentoring programs, partnering with faith-based organizations, and providing partial reimbursements for parents. In accord with their systems of care focus, the grantees' strategies emphasize collaboration across many groups.

  Future issues of A Closer Look will explore grantees' findings in such areas as strengths-based care, interagency collaboration, cultural competency, and accountability. The series will be posted on the Child Welfare Information Gateway website. The grantees and NTAEC are supported under the Children's Bureau discretionary grant program.

  www.childwelfare.gov/management/reform/soc/communicate/initiative/closerlook