Foster Care Redesign
The information in this program outline is provided by the program representative and edited by the CEBC staff. This program has been reviewed by the CEBC in the following Topic Areas:
About This Program
Target Population: Children of all ages, especially minority populations and those with diverse ethnicities, who are at risk of entering the child welfare system; and their families
For children/adolescents ages: 0 – 17
For parents/caregivers of children ages: 0 – 17
Foster Care Redesign is designed to change the culture of removal within the child welfare system to a culture of preventative and diversion services for children and their families. This paradigm shift necessitates both programmatic and organizational changes to redirect the system from a dependence on immediately placing children in foster care to first focusing efforts on managing child safety via in-home Safety Management services until identified danger threats are mitigated and can allow for in-home family-centered services with an ongoing case manager. By providing intense, family-centered services to children and families in their own homes, the program aims to reduce the number of children entering out-of-home care without increasing the number of children who are re-referred for child abuse or neglect. An additional goal is reuniting children taken from homes deemed unsafe more quickly with their parents through the use of behaviorally focused services. Foster Care Redesign is designed to be flexible so that it can meet unexpected challenges for the children and families the program serves.
The goals of Foster Care Redesign are:
- Do everything possible to safely reduce the number of children in foster care by changing the culture of removal to a culture of mitigating safety in order to provide intervention through in-home services By be flexible and responsive and by tailoring services to each family’s needs, strengths, lifestyle, and culture
- Expedite permanency and reduce time in care by identifying diminished caregiver capacities and danger threats meeting child safety threshold through a comprehensive family assessment that focuses on behavioral change services
- Keep children safely in their homes with their families whenever possible through programming in Safety Management, FAST, High Risk Newborn, Health Care Coordination, and STEPS and by using program supports such as FIS (Family Intervention Specialist), Domestic Violence Advocacy Support specialist, Circle of Security infant mental health specialist, and IPT (Integrated Practice Team)
- Reduce lengths of stay in out-of-home care for those children who must be removed by utilizing Innovation Team staffing, condition for return, and in-home safety planning with aftercare supports
- Expedite permanency for all children without a permanent family through the use of a multidisciplinary approach - Permanency Staffing’s, Team Decision Making
- Provide as an immediate response to referral as possible
The essential components of Foster Care Redesign include:
- Two phases:
- Phase 1 of Redesign - Family Preservation – Implementing programs and services in an attempt to keep children safely within their families by reducing their risk to abuse and neglect and preventing their entry into the foster care system The Family Preservation service array includes:
- STEPS Program (Strengthening Ties and Empowering Parents): A prevention services program that aims to help empower, strengthen and promote healthy families by offering direct services such as assessments, in-home parent training, behavior management and money-management counseling, and intensive case management. The STEPS Program is intended to be used to link the families to community resources in an effort to prevent abuse and neglect.
- FAST Program (Family Assessment Support Team): The FAST program uses a team to help ensure that children remain safe by way of intensive Safety Management services and change services such as proper parenting, in-home counseling, anger management counseling, substance abuse treatment, and domestic violence counseling. Safety Management Accept referrals 24 hours a day, 5 days a week; with a 2-hour response time. FAST accept referrals 24 hours a day, 5 days a week; with a 24-hour response time with established cases having access to on-call staff 24 hours a day, 7 days a week.
- IPT (Integrated Practice Team): A multidisciplinary team that staffs cases with the family present to assist with the development of a comprehensive family services plan with innovative ideas based on the family’s voice and choice and team members’ areas of expertise. The IPT tries to ensure the individual needs of a family in crisis are met while safely maintaining children in their homes.
- HRNB (High-Risk Newborn): This program provides family support and education while modeling responsive caregiving, assessing emotional development, and providing direct services in home for ages birth to 5 years old with the goal of strengthening the caregiver/child bond by incorporating brain development research and relationship-based practices into the family’s daily life.
- HCC (Health Care Coordinator): The HCC serves as a consultant and also reviews referrals by medical and mental health providers for accurate coordination of intervention services with the goal of assessing, coordinating, monitoring, educating, documenting, and tracking client health care needs of children ages 0-3 and their caregivers. The HCC ensures cross-system integration and interdisciplinary support by conducting screenings such as domestic violence, depression, social emotional development, and substance abuse.
- Phase 2 of Redesign – Through increased emphasis on a holistic approach, implementing initiatives that focus on quality of care and permanency, including:
- The Transitional Trauma Therapist
- FIS (Family Intervention Specialist)
- DV (Domestic Violence) advocacy support
- Circle of Security - parenting bonding and attachment infant mental health specialist
- A focus on family engagement
- Doubling the number of foster parent trainings
- Targeted foster parent recruitment
- Separate adoption recruiting efforts
- Trained experts in Trauma Informed PS - MAPP (TIPS-MAPP) and PRIDE Model of Practice (Parent Resource for Information, Development, and Education) classes
- Trained experts in assessment and screening tools including Ages and Stages (ASQ/ASQ-SE), Depression Scale (CES-D), Adverse Childhood Experiences (ACEs), Domestic Violence Conflict Tactic Scale, Structured Decision Making (SDM), Screening Brief Intervention Referral to Treatment (SBIRT), Parent-Infant Relationship Global Assessment (PIR-GAS), Structured Assessment for STEPS-Involved Families (SASIF), and Adult-Adolescent Parenting Inventory (AAPI)
- A 5-star rating program for group
- A separate Kinship Caregiver Program
- A Medical Home Program provides a medical home and comprehensive medical, behavioral, dental, and vision care to children, ages birth to 17, in or at-risk of out-of-home care. Children are engaged with a mental health Transitional Trauma Therapist (TTT) at the removal event. All children are seen within 72 hours for an initial assessment at a pediatric practice. If concerns are identified, the child is referred for specialty physical health care, behavior health care, additional assessments and/or interventions. All children are referred for dental and vision screenings.
- Extensive development of Community Centers in communities that are most in need of critical services
- Use of Specialists – Contracting with, and making available to direct service staff, professionals who hold expertise in specific issues frequently affecting families who are referred to child protection services
- Cultural Changes – Focusing on training and skill development for staff designated to instill and operationalize values, norms and competencies that enable the safe maintenance of children within their families
- Leadership Support – Focusing on the roles of leaders from the Department of Children and Families (DCF) and Family Support Services (FSS) in supporting the goals of Redesign and the strategies to accomplish those goals
- Safety of the Child is Paramount – Emphasizing that the safety of the child must be the most important factor in every decision and action by the child welfare staff
- Family-Centered Practice – Focusing on engaging the families of children referred to protective services as partners in assuring the safety of the child
- Community Collaboration – Focusing on efforts to engage the broader community in Redesign in order to draw upon the competencies of diverse segments of the community; develop creative, non-traditional services for families; and gain community support for child protective services and the Redesign efforts through Behavioral and Mental Health Integration.
- Community Planning – Attempting to engage media and thought leaders within the broader community in order to inform the public and stakeholders of the goals and progress of Redesign and to gain the support of the community for child protective services and the new approach introduced through the Redesign efforts
- Specific Components:
- Implement a comprehensive System of Care that includes:
- Family Team Conferences
- Team Decision Making- Innovation Staffing
- Family-Centered Practice
- Constant positive regard for families
- Mentoring and coaching for caseworkers
- Mentoring for youth: Mentors Matter follows a traditional one-to-one model of mentoring where one adult is paired with one young person. The program is intended to provide youth with a volunteer mentor who will help build strong relationships, set and maintain life goals, and be a positive role model. The Mentors Matter coordinator should take great care in matching similar mentor/mentee interests, and offer training, activities, and ongoing support to mentors to help them form nurturing and supportive relationships with their mentees.
- Upfront, research-based assessments
- Wraparound supports for families
- Recognition of the community context for the work
- Develop a strong Fatherhood Engagement initiative
- Create a therapeutic removal team (Transitional Trauma Therapists) integrating child protection and mental health services
- Create Professional Foster Caregivers
- Provide Kinship Caregivers with the same support and services as licensed caregivers
- Create respite for families and providers
- Implement a comprehensive medical/mental health/dental care process for children in care and diversion programs
- Develop multifaceted services for substance abuse, mental health, and domestic violence
- Promote the professional identity of child welfare caseworkers as advocates and agents of change
Foster Care Redesign directly provides services to children/adolescents and addresses the following:
- Living in an unsafe household or where risk for neglect and/or abuse is high and/or has experienced trauma, behavioral/emotional problems, aggression/anger, truancy, and/or running away
Foster Care Redesign directly provides services to parents/caregivers and addresses the following:
- Trauma, family conflict and violence, poor parenting skills, depression, aggression/anger, substance misuse, mental health, child abuse, and neglect
Services Involve Family/Support Structures:
This program involves the family or other support systems in the individual's treatment: The diversion program, FAST, seeks to empower the family by building a partnership with them and their natural network. With a focus on family voice and choice, case managers use Family Team Conferencing to build family engagement and promote commitment and accountability from the family team. The family and their network are involved in co-constructing the safety plan and case plan as well as assessing progress.
Contact with family is made on an as-needed basis as detailed in a Safety Plan and based on the safety finding from a comprehensive Family Functioning Assessment and Structured Decision Making risk rating. The service array is set up in manner to allow for easy flow from low least restrictive into higher levels of intervention and service needs. The services build upon the conviction that most children can be safely protected and treated within their own homes when parents are provided with services and support that empower them to change their lives behaviorally. The Wrap Around Model guides the service system using the 10 principles that result in services that are "wrapped around children and their families in their natural environments."
The Family Preservation programming remains open approximately 3-8 months and closes when behavioral change with parental capacities can show a decrease in child danger threats and indicates risk to child abuse and neglect has been lowered. The FAST case concludes when the parent is assessed as safe with no remaining danger threat and the family has remained stable.
This program is typically conducted in a(n):
- Birth Family Home
- Community Agency
- Foster/Kinship Care
Foster Care Redesign includes a homework component:
Parents are encouraged to practice skills between bimonthly home visits. STEPS homework is conducted through the 123 Parenting program. FAST has a homework component through Active Parenting and Nurturing Parenting
Foster Care Redesign has materials available in a language other than English:
For information on which materials are available in this language, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).
Resources Needed to Run Program
The typical resources for implementing the program are:
The FAST Program serves no more than 20 children to one Certified Child Welfare Case Manager with 5 case managers and 1 therapist per supervisory unit. Safety Managers serve no more than 2 families at a time. The STEPS Program serves no more than 15 families at a time with 5 prevention workers and 1 health care coordinator per supervisory unit. Resources needed are based on the services the family requires and are provided by child welfare workers and providers in the community.
Minimum Provider Qualifications
Must be providers in the community’s child welfare system. Educational level of these providers is up to the agency that hires them.
Education and Training Resources
There is not a manual that describes how to implement this program; but there is training available for this program.
- Sarah Markman-Sayar, Program Director
Training is obtained:
PRISM, Nurturing Parent, Parenting 1234, Family-Centered Practice, Family Functioning Assessment, Structured Decision Making, Supervisory Consultation and Decision Making, Bridges out of Poverty, Motivational Interviewing, Family Engagement, Compassion training and Child Welfare Certification training curriculum are available onsite and FSS is willing to provide training or a formal or informal consultation upon request.
The PRISM training course is designed to strengthen the clinical and direct service skills of those involved with families who come to the attention of the child welfare system. Recognizing that healthy communities can support healthy families and vice versa, the curriculum emphasizes skill building and individual family counseling. FSS provides Prism Training twice a year as a follow-up to the Family-Centered Practice training. All new child protective investigators and case managers are required to complete Family Centered Practice training before completing PRISM training.
Number of days/hours:
Ranges from half-day to multiple days depending on the module
Relevant Published, Peer-Reviewed Research
This program has been reviewed and it was determined that this program lacks the type of published, peer-reviewed research that meets the CEBC criteria for a scientific rating of 1 – 5. Therefore, the program has been given the classification of "NR - Not able to be Rated." It was reviewed because it was identified by the topic expert as a program being used in the field, or it is being marketed and/or used in California with children receiving services from child welfare or related systems and their parents/caregivers. Some programs that are not rated may have published, peer-reviewed research that does not meet the above stated criteria or may have eligible studies that have not yet been published in the peer-reviewed literature. For more information on the "NR - Not able to be Rated" classification, please see the Scientific Rating Scale.
Currently, there are no published, peer-reviewed research studies for Foster Care Redesign.
Casey Family Programs. (2011). Foster Care Redesign in Duval and Alachua Counties: An implementation assessment and research chronicle. Retrieved from http://www.casey.org/resources/publications/duval-alachua.htm
Casey Family Programs. (2014). Using data to drive change: String together enough neighborhoods and you move a county. Solve a few counties and you change a state. Retrieved from http://www.casey.org/using-data-to-drive-change/
Family Support Services of North Florida, & Maystrick, L. (2016). STEPS to tying families together. Retrieved from https://prezi.com/vp11zx9bwmok/steps-to-tying-families-together-fcc-conference-2016/
Date Research Evidence Last Reviewed by CEBC: September 2013
Date Program Content Last Reviewed by Program Staff: March 2018
Date Program Originally Loaded onto CEBC: December 2011