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Administration for Children and Families US Department of Health and Human Services

FAMILY PRESERVATION AND FAMILY SUPPORT (FP/FS)

SERVICES IMPLEMENTATION STUDY

EXECUTIVE SUMMARY

 

The 1993 Family Preservation and Family Support (FP/FS) legislation (title IV-B, subpart 2 of the Social Security Act) authorized nearly $1 billion over five years in new federal funding for services to strengthen and support families' efforts to provide a safe and nurturing environment for their children. FP/FS funds were to be administered at the federal level by the Administration on Children, Youth and Families and at the state level by the child welfare agency responsible for administering child welfare services funds under title IV-B, subpart 1.

In September 1994, the Administration for Children and Families (ACF) awarded a five-year contract to James Bell Associates (JBA) to conduct the "Family Preservation and Family Support Services Implementation Study." The purpose of this study is to evaluate how states and communities implemented the legislation, the ways in which implementation altered the pre-existing service delivery system, and the effects on service delivery. This interim report is based on: (1) A review of the FP/FS applications, state plans and 1996 plan updates submitted by each of the 50 states; (2) site visits to 10 states conducted between November 1995 and July 1996; and, (3) site visits to 20 communities between September 1996 and June 1997.

Throughout the study activities to date, it became evident that there was no single story of FP/FS implementation -- each state and locality's implementation effort reflected their unique history of family preservation and support services, problems and issues facing their child welfare system, and their unique strategy toward decentralizing decision-making authority for government programs. The degree of flexibility provided to states and localities by the federal government promoted the diversity observed in this study.

Consistent with federal expectations, FP/FS funds have been used to launch new community-based programs and encourage broad-based participation in the planning and service delivery process. Many sites developed innovative and promising approaches to service delivery. They provided comprehensive services, bridged existing gaps in service delivery, maximized the use of available resources, attracted other funding sources, involved consumers in the service delivery process, supported safe and nurturing environments for children whose parents were transitioning from welfare to work, and reduced tensions between public institutions (especially child welfare agencies) and the communities these agencies serve.

In 1994 and early 1995, when states were engaged in FP/FS planning, several factors slowed FP/FS implementation. States noted the following federal issues: proposals before Congress calling for a child welfare block grant; the shut down of the federal government; delays in issuing final program regulations; and anticipated welfare reform legislation. Other factors at the state and local levels further delayed the start of service delivery. These included changes in the political structures; the challenge of establishing new collaborative planning bodies; and desire to further decentralize decision-making authority to counties and communities.

As a result, most programs in the 10 case study states had just begun operations at the time of the site visits in 1996-97. Since the programs were still in their infancy, it was too soon to accurately describe detailed program operations or draw conclusions about the results they might achieve. Nevertheless, there was sufficient information to examine the lessons learned to date, explore areas where further federal guidance and support would be beneficial and identify promising service delivery program designs. Despite the unique nature of each state and locality=s approach to FP/FS implementation, some common issues in planning, management and service delivery emerged. These issues are described below.

A. Planning

Most states took advantage of the opportunity afforded under the federal legislation to emphasize planning efforts, spending up to $1 million of their first-year federal funds on these activities without having to allocate state matching dollars. States enthusiastically followed federal guidance in many aspects of the planning process, including: non-supplantation of funds, collaboration, needs assessment, consumer involvement, and approaches to decision making.

 

1. Non-Supplantation of Funds

As required in the legislation, FP/FS funds do not appear to have supplanted pre-existing monies for family preservation and support programs. States created new programs, replicated promising program models in new geographic areas, and added new and more comprehensive service components to existing program models.

 

2. Collaboration

Most states made considerable efforts to implement a broad-based collaborative planning process. Both state and local collaborative planning bodies were formed. These planning bodies were comprised of representatives from other human service agencies, including health, mental health, substance abuse treatment, public assistance, domestic violence, education, developmental disabilities, and juvenile justice. Membership included both public and private service providers, as well as advocates, academics and consumers. Furthermore, some states, such as Arizona and Texas, required service providers interested in applying for FP/FS funds to join together to develop more comprehensive and collaborative service delivery projects.

 

3. Needs Assessment

States followed federal guidance and engaged in a variety of formal and informal needs assessment efforts. States conducted surveys, held focus groups, examined existing statistical data and conducted public hearings. However, the success of the needs assessments varies depending upon the criteria used to judge their effect.

 

! Needs assessment as a catalyst: The assessments often engaged a broad array of stakeholders and encouraged them to review the problems facing children and their families. The assessments also prompted stakeholders to examine existing resources and consider ways to use them effectively. In this regard, state needs assessment efforts were largely successful.

 

! Needs assessment as a targeting tool: Acknowledging that funds were limited, some states used needs assessment data to target funds to specific counties (or communities). Some states used existing data on such measures as poverty, abuse/neglect rates and teen pregnancy rates to select counties and communities that had the greatest need for additional services.

 

! Needs assessment as a technical planning tool: One weakness in the planning process in many states was that needs assessment data were seldom used to establish program priorities and determine which program models might best address the most pressing gaps in the existing service delivery system. It appears that a lack of time (some planning decisions were made prior to needs assessment completion), and the effects of other contextual factors played a greater role in making these funding and service delivery decisions. In this regard, needs assessment efforts were less useful than they might have been.

 

4. Consumer Involvement

Most state and local planning groups included consumers in the planning process, often securing input from consumers through focus groups and public hearings. Although states and localities made considerable efforts to appoint consumers to the planning bodies, several states noted that their early efforts had not been as successful as they had hoped. Two issues pertaining to consumer involvement emerged:

 

! Definition of a consumer: While planning groups typically sought to include parents in the process, there was a tendency for consumer participation to be limited to parents who were active in civic affairs (e.g., a PTA president) or who were experienced advocates (e.g., parents of children with disabilities). Few planning groups focused on involving parents who had received public assistance or services from the child welfare agency, had substance abuse problems or were teenage parents. One notable example of efforts to reach a more diverse consumer population occurred in Phoenix, Arizona, where a member of the planning group visited local unemployment and public assistance offices and talked with individuals in the waiting rooms about their service needs.

 

! Efforts to attract consumers: Planning groups attempted to attract consumers primarily by providing child care and transportation services. Despite these efforts, non-traditional consumers typically came to only one or two meetings and then dropped out. Whether or not consumers attend all meetings may be less important than their active participation at critical junctures in the planning process. For example, in Broward County, Florida, special efforts were made to include residents in reviewing provider proposals to establish service programs in their neighborhood.

 

Although child care and transportation assistance may be important, it appears equally important to create a welcoming environment for families by: educating other members of the group to be sensitive to cultural differences and non-judgmental about issues facing consumers (e.g., substance abuse); helping consumers understand technical and bureaucratic terminology; keeping in contact with consumers between scheduled meetings; and bringing them up-to-date when meetings are missed.

 

5. Locus of Decision Making

Although most states formed collaborative planning bodies, there was considerable variation in the composition of the planning groups and the extent of their role in the decision-making process. In turn, these differences affected the nature of the decisions reached as a result of the planning process.

Three decision-making models were identified in the case studies: state child welfare agency model in which the child welfare agency (with some input from other stakeholders) made at least one key decision concerning the use of FP/FS funds; state-level collaborative body model in which decisions were made by the entire planning body; and local jurisdiction model under which the state delegated planning authority to a local agency or planning body.

The type of decision-making model used affected the following:

 

! Allocation of significant funds for FP and FS programs: States employing the child welfare agency decision model set aside funds for both FP and FS programs. While they involved other stakeholders in the decision-making process (especially as it related to family support programs), these states had a clear vision of the types of programs they wished to develop. In contrast, stakeholders who were most knowledgeable about family support programs tended to predominate on the collaborative planning bodies. Often child welfare administrators or front-line staff did not participate actively in this process. As a result, the collaborative planning bodies allocated relatively fewer dollars for intensive family services or reunification programs targeted to the child welfare population.

 

! Geographic allocation of funds: States that delegated authority to the local level divided their FP/FS funds proportionately among all districts or counties. In contrast, states using the child welfare agency decision model targeted funds to selected counties. Some of the sites using state-level collaborative bodies also targeted funds.

 

! Size of service delivery projects: Funding allocations for programs were also affected by the size and diversity of the planning bodies. Large, diverse planning groups tended to achieve consensus by "giving everyone something." This resulted in numerous projects with few resources to achieve the often far-reaching goals that were established.

B. Linking Plans to Service Delivery

Several activities necessary to support and enhance service delivery were undertaken. These include program financing, monitoring and training.

 

1. Financing

The federal government recognized that FP/FS funds alone would be insufficient to address the range of needs experienced by children and families. One expected outcome of collaboration was that it would lead to agencies and programs blending funding streams or jointly funding programs. Although several positive examples of blended and joint funding were noted, collaboration in the planning process did not necessarily lead to blended or joint funding. Stakeholders in several states noted the need to continue working on efforts in this area.

Successful examples of blended or collaborative funding at the state level include both Missouri and West Virginia. Both states blended FP/FS monies with other federal and state funds to create a larger and more flexible pool of funds to support locally-determined service delivery programs.

At the program level, some FP/FS programs were successful in attracting funds from other sources, gaining access to other agencies' facilities, and having staff from other programs outstationed at their centers. This proved especially true for programs that received sizeable FP/FS grants (i.e., over $300,000). Programs receiving small grants (under $50,000) appeared less able to generate the level of interest necessary to attract support from other sources.

One example of collaborative funding at the local level is the Family Service Center in Houston County, Alabama. The site received an initial $50,000 FP/FS planning grant and $305,000 in FP/FS funds in 1995. In addition, the Center received $100,000 from a local foundation to support a child care center; the school district provided a building, and funds from the Community Development Block Grant were utilized for renovation and facilities operations. Other program funds originated from the Governor's High Risk Youth program, the Alabama Civil Justice Foundation, and the United Way. State and federal education funds were used to provide adult education classes. The city government paid for the building's maintenance and utilities.

2. Monitoring

Federal guidance requested that states identify outcome objectives for families and children, select measures and benchmarks, and monitor progress toward these objectives.

 

! Establishing measurable objectives: States encountered considerable difficulties in establishing measures that were realistic and appropriate for the service delivery efforts funded. Many states had plans to use aggregate data available through existing management information systems. However, the size of most programs made it unrealistic to expect that programs serving a small number of families could dramatically affect statewide or even countywide rates of foster care, teenage pregnancy or high school graduation. States acknowledged problems in this area and the need for assistance.

 

! Monitoring: Some of the planning groups retained a role as an oversight committee once implementation began; however, in this capacity they met on a limited basis and focused almost exclusively on allocation of the next year's FP/FS funds. To more adequately monitor existing programs, collaborative oversight bodies needed staff assigned to periodically review programs, collect program data, analyze and interpret findings, and report to the oversight group on a regular basis. Although a few states specifically charged staff with these functions (e.g., Arizona and Florida), most did not. While a portion of each state=s FP/FS allocation was allotted for planning and service delivery, only 10 percent could be used for administrative purposes. States varied considerably as to whether they considered management and monitoring to be administrative costs. Without sufficient funds designated for this purpose, states did not appear to invest in creating management and monitoring structures.

 

 

3. Training in the Principles of Family-Centered Practice

Federal guidance to states stressed the importance of developing service strategies that operationalized the principles of family-centered practice: services should address the needs of the entire family; there is an emphasis on assessing family strengths; families are actively involved in developing service plans; services are flexible, accessible, and coordinated; and there is respect for community and cultural strengths. Although stakeholders believed that their programs were based on the principles of family-centered practice, some stakeholders did not appear to fully understand these principles or know how to operationalize them. Additional training is needed in this area for stakeholders at all levels in the implementation process.

 

C. Service Delivery Design

Although federal legislation defined both Afamily preservation@ and Afamily support@ programs, the programs reviewed in the case studies did not fall neatly under the labels provided in the legislation. The FP/FS legislation required states to spend a significant amount of funds on both family preservation and family support programs (defined in federal guidance as at least 25 percent of funds in each category or a justification if fewer dollars were allocated). Analysis of the national data indicated that approximately 64 percent of FY 96 funds were used for family support; however, an examination of the application of these terms to specific programs suggests that the actual allocation of funds to family support programs is even greater. In several instances, programs identified as family preservation programs served families who were unknown to the child welfare agency. While these families often had serious problems, child abuse and neglect was not typically an issue.

In order to more accurately distinguish among the major program models identified through the case studies, a more detailed classification was developed for this study that reflects the variety found in the 36 major FP/FS programs reviewed. As shown in Exhibit A, programs are divided into four major categories: in-home service delivery programs; center-based programs; networks; and mini-grant programs.

Within each of these categories, many promising and innovative programs were established. Examples include:

!C Family Continuity Program, Pinellas County, Florida (In-home service delivery): This program provides intensive family preservation services for mothers who are part of a welfare reform demonstration and who have had some involvement with the child welfare agency. In addition, staff from this program act as advisors and provide technical assistance to some of the community-based family support programs in their district.

 

! Caring Communities, St. Louis, Missouri (School-based center): This school-based family center provides a comprehensive continuum of services that range from broadly based community-level prevention efforts, cultural and recreational activities, and tutoring and after-school programs, through more targeted assessments of child and family needs, drug counseling, case management and intensive family services.

 

Exhibit A

Classification of FP/FS Program Models

 

 

 

Program Category

 

 

Subcategories/Description

 

 

1. In-Home Service Delivery Programs

 

 

Intensive Family Services: Includes programs traditionally considered family preservation. Programs primarily serve families known to the child welfare system, and are intended to prevent foster care placement or facilitate reunification when placement has occurred. Staff typically have master's or bachelor's degrees in social work. Workers have small caseloads and may visit families several times per week. Services are typically of limited duration (4 weeks to 12 weeks, although some may serve families for 6 months).

 

Parent Training Programs: Typically intended for teen parents or new mothers with other risk factors. Like intensive family service programs, most are professionally staffed. Most use a formal assessment and protocol that determines the frequency of visits and the duration of service. Typically, home visits occur less frequently than they do in intensive family services programs, but often continue for a longer period of time (e.g., up to three years).

 

Case Management Programs: Unlike the other home-based service programs, these serve a broader target population. Although programs tend to be situated in communities with high rates of poverty and other risk factors, any family in the targeted community can access services. Programs are often staffed by individuals who reside in the community. Frequency of services varies considerably, and there is typically no limit on service duration. Services focus on resolving a specific conflict or emergency. Services are of a brief duration, although a family may return for services when other problems arise.

 

 

2. Center-Based Programs

 

 

School-Based Centers: Mostly targeted to children with behavior or learning problems, although the array of services available are intended to meet the needs of both children and their caregivers. Programs tend to rely on professional staff and include a formal assessment process. Nature and intensity of services vary.

 

Community-Based Centers: Typically accessible to all members of a targeted community. Varies considerably as to the type of services provided and the staff employed. While some centers have a central intake and assessment component, others do not.

 

 

3. Networks

 

 

Collaborative entities encompassing multiple service providers -- "centers without walls." Although programs vary in terms of target populations and services provided, they represent a common approach to service delivery fostered by FP/FS. FP/FS funds are used to strengthen the relationships among existing service providers, adding case management services and improving referrals among providers.

 

 

4. Mini-Grant Programs

 

 

Programs award small grants to several community-based service providers. Services funded vary considerably, but most are intended to provide primary prevention services and expand community involvement in service delivery. Programs are intended to attract new community-based service delivery providers to the process and often have simplified administrative and procurement procedures.

 

 

!C The Healthy Grandparents Program, Atlanta, Georgia (Network): This program represents an example of the formation of an inter-disciplinary network of health, social work, education and law professionals, as well as students and volunteers, who provide multi-disciplinary services to both relative caregivers and the children in their care. Services are provided both in the home and at various other locations. They include health screenings for caregivers and children, parent training, legal services, tutoring, counseling and support groups.

 

!C Youth and Family Impact Center, Dallas, Texas (Community-based center): This center-based program serves children ages 4 through 19 who have been identified by the school, child welfare or juvenile services as needing additional services. A staff of five case managers and a supervisor work with children and youth assessing both child and family needs, establishing a service plan, conducting home visits, arranging services and providing transportation to services, as well as monitoring and tracking their progress. Through agreements with approximately 20 public and private sector providers, the Center offers psychological testing, individual and family counseling, tutoring, mentoring programs, a parent involvement program, access to a food bank, and cultural and recreational activities. Typically, services are provided at the Center, and service providers meet quarterly to discuss specific cases and generally maintain a collaborative relationship.

 

! Great Start, San Antonio, Texas (In-home services-parent training): This in-home services program provides parent training to new mothers screened to be at especially high risk of abuse/neglect. Mothers who have given birth (at an area hospital with the largest number of publicly-assisted births) are assessed for life stressors and parenting skills. With their consent, the two screeners contact one-of-three participating social service agencies who provide home visiting until the child is at least three years of age: Avance, which serves the area=s poorest Hispanic neighborhoods; Child Abuse Prevention Services, a licensed Healthy Families America provider that specializes in assisting abused teens and pregnant and parenting teens; and Family Services Association, an established social service agency.

 

D. Next Steps

In addition to the many innovative and promising approaches to planning and service delivery, states and localities also noted several issues and challenges that need be addressed as their programs mature. These include:

 

! Child welfare agency involvement: Historically, child welfare agencies and community-based family support programs rarely interacted. Federal guidance on FP/FS attempted to facilitate a greater degree of collaboration among stakeholders who had not traditionally worked together. This has proved to a challenging goal that has not yet been achieved. Child welfare staff in some localities appeared largely unaware of the family support programs that were developed with FP/FS funds. Linkages between child welfare and family support programs in some communities appear weak and a sense of distrust persists between the child welfare agency and other programs.

 

! Centralized intake and comprehensive assessment at family centers: Some family centers established a centralized unit that was responsible for intake and assessment functions, while others chose not to do so. Centers that had such units practiced the principles of family-centered practice by emphasizing family strengths in their assessment process, ensuring that families were involved in developing their service plan and providing only those services that a family wanted to receive. In contrast, several centers believed that centralized intake and assessment activities were contrary to the principles of family-centered practice. They did not want to be perceived as intrusive or judgmental by asking questions that might not relate to the reasons a family contacted a center, or that might be perceived as requiring families to accept services that they did not want. However, centers without centralized intake and assessment units may miss the opportunity to comprehensively explore and address family needs.

 

! The role of case managers and family advocates: Though program planners defined these positions as brokers of community services needed by families, some case managers or advocates focused on directly providing services. Further, some of these staff expressed distrust of public agencies and were reluctant to make referrals. While the case management and family advocate positions were intended to provide a bridge between communities and public agencies, in some instances they appeared to reinforce client fears of public agencies.

 

! Influence of welfare reform: Virtually all of the family centers offered some support for family members who were seeking their GED. However for some, welfare reform issues such as adult education and job training were their paramount concern. The question should not be whether FP/FS should support welfare reform, but how it can do this most appropriately. Programs that support families' abilities to provide for the safety and healthy development of their children as they transition from welfare to work are consistent with the goals of FP/FS. Given the limited amount of FP/FS funds, programs need to work with TANF (Temporary Assistance to Needy Families) agencies to provide family services that enhance and complement the education and work-related programs funded through TANF and other job training programs. Use of FP/FS funds largely as a supplemental funding source for education and training does not appear to reflect the definitions of FP and FS services provided in the legislation.

 

The description of the planning and early implementation of FP/FS, and the identification of issues requiring future attention, point in a common direction. Collectively, they suggest the focus of FP/FS to date has been on establishing broad-based preventive services programs that are accessible to a diverse population within a community. The types of programs funded appear to reflect trends toward devolving program design and implementation to the community level and increasing community ownership of human services programs. Also, the limited amount of FP/FS funds available may have encouraged the development of less costly (and therefore less intensive programs) than those targeted toward families already facing problems of abuse and neglect.

As the administrators of the FP/FS funds, this is an appropriate time for state child welfare agencies to examine the balance between the service delivery approaches funded and the needs of the target populations served. It is also important to review the realism of some program objectives in light of the funds allotted, to consider the optimal relationship between welfare reform and FP/FS funds, and to examine approaches which provide comprehensive, family-centered assessments of needs and linkages to appropriate services.

FP/FS implementation takes place within a complex and dynamic context. There are inherent tensions among the various factors that influence FP/FS implementation and limited resources create considerable challenges for states in meeting the diverse needs of children and their families. However, given the flexibility provided in the legislation, there is also the potential to resolve, or at least lessen, the effects of competing influences. Some programs have demonstrated this ability. Using these examples as a basis for providing technical assistance, along with improved oversight and monitoring efforts, will aid the future development of FP/FS programs.

 


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