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Family Preservation (continued)
Rossi (1992) also postulates that much of the research on FPS is flawed; most studies are too small to generalize to other FPS programs. And not only are the sample sizes too small, but FPS programs vary from one to another in many ways: how long the services are provided, whether or not the services are provided in the home or in the office, how many hours child welfare workers are actually involved with a family, and some services are largely educational while others are more concrete. These variations make the sample sizes, where several different FPS programs are included into one study, not related to the overall group and "because the sites differ markedly in the version of family preservation used, the effective N's [sample sizes] are those for individual sites" (Rossi, 1992, p. 93) rather than FPS, overall.
Shared Family Care
Shared family care (SFC) is a relatively new approach in the United States, for dealing with children who are at risk of being separated from their parents. The program "helps families become self-sufficient. Both parents and children are placed in the homes of people in the community who mentor them, and help provide the skills and discipline they need to become responsible citizens" (Mikkelson, 2002). The troubled family simply lives with, and is guided by a host family. An advantage to having both the parent and the child live in one home is that in essence, both people in the troubled family simultaneously receive the benefit of assistance.
One of the goals of SFC is to keep birth families together while a foster parent teaches birth parents how to keep a home clean, how to be a good parent, how to find childcare, and how to keep a job. In Milwaukee, where a pilot program was started in 2002, shared family care is just taking shape. But in other states, such as California, where SFC is in its fifth year, Mikkeslon (2002) reported that it is showing favorable results; desired outcomes of the program are 1) shortened length of stay (compared to a traditional foster care placement), 2) reduced recidivism (fewer children coming back to foster care once they leave), and 3) cost neutrality (equal expenses related to traditional foster care costs).
But there are similar programs in other states that are much older. One program, the Texas Baptist Children's Home (TBCH), started in 1979 working in a pre-SFC approach using a group home setting where three or four single parents live together with their children and one staff family. As a group the families work at learning good parenting skills, discipline techniques, meal preparation, obtaining employment, and continuing education. In a six-year period TBCH served 185 families. In 1996, 99% of the families remained intact after graduation from the program; 92% found employment (Barth & Price 1999, p. 93). Other states have SFC programs as well. Illinois started a SFC program for teen mothers in 1989 and in 1984 New Jersey started a similar program. The New Jersey program helped 96 families over the course of a seven-year period and the program reports a near 85% success rate in keeping mother and child together (Barth & Price, 1999, p. 95).
Probably the biggest issue with shared family care programs is the cost. SFC tops the foster care daily rate, but remains cheaper than the more restrictive residential group home placement rates. For some SFC programs the monthly cost per family, can be as much as four and a half times higher than traditional foster care rates (Barth & Price, 1999, p. 102); and even when the rates are figured out based upon the average length of stay (5 months for SFC compared to 14 months for traditional foster care) there is still a higher cost for shared family care. Additionally, while the median length of stay for SFC services is reported by Barth and Price (1999) to be only five months, one program lasts up to 18 months, while another lasts up to 24 months, and a third program can run the course of three years. If one family stayed in SFC for 36 months, compared to one child in foster care for 14 months, the cost difference would be more than $50,000. But quite possibly, when one considers treatment costs of a family compared to the treatment costs of one child, there may in fact be a savings, even while initially the costs are comparatively higher with SFC. It would make sense that treating a family in SFC, costs more than treating one child in foster care.
Other more recent studies however, actually reveal that SFC is more cost effective than foster care. There is an evaluation process underway by the School of Social Welfare from the University of California at Berkeley that began in 1996 to help establish and evaluate seven SFC programs. The goal, according to Barth and Price (1999), is "to determine if shared family foster care can…become a viable alternative to traditional family foster care in the 21st century" (p. 99). The outcomes of the Berkeley studies culminate in annual reports from the years 1999, 2000, 2001, and 2002. The evaluation process, that began in 1997, shows that SFC is proving to be more cost effective than traditional foster care, and substantially more affordable than treatment foster care, when looking at actual placement costs per child (Clovis, Price, & Wichterman, 2002).
Other cost savings and positive outcomes of SFC, compared to traditional foster care, being realized by Clovis, Price, and Wichterman (2002) include: 1) SFC families are less dependent on the system, 2) they have better employment rates, 3) they have higher income, and 4) there are fewer children who re-enter foster care (p. 52). "Therefore, although SFC involves many additional costs (e.g., for start-up, mentor recruitment and support, and intensive services), it may be worth the up-front investment" (Clovis et al, 2002, p. iii).
One problem with SFC is that the program does not work for families who are not still together or reunified. That means that many children in foster care cannot take advantage of SFC services, simply because they no longer live with their natural parents. And the research is showing that even for intact families, SFC is not for everyone. Parental motivation, family size, and active drug use prevents some families from participating in SFC (Simmel & Price, 2000, p. 6).
Another issue facing the shared family care movement is that very limited research exists to show how effective the program is. Some of the research that has been reported here is either for programs that are similar to SFC, but not the same (TBCH), or the research only evaluates a few SFC programs (Berkeley). And while Illinois and New Jersey (and the Berkeley studies) can tout a high level of success, the results only reflect the accomplishments of a few programs making generalizations nearly impossible. It would be very difficult to ascertain the programs' likely outcomes, and in the case of Milwaukee, program infancy makes research results virtually impossible to obtain.
Family Drug Courts
It has already been stated that alcohol and other drug (AOD) usage is a problematic factor in the majority of child abuse cases. In any event it is worth restating: an estimated 80% of all child abuse cases are linked to alcohol and other drug usage (Lavato & Mack, 2003). It is a particularly interesting idea to factor into child abuse cases a treatment component for the substance abusers. If it is true that AOD's are contributing culprits of abusive episodes, then addressing AOD usage seems fitting in resolving at least a portion of the familial problems. Family drug courts, believed to have first appeared in a Florida court in the early to mid 1990's (Family Courts, 2001), do just that.
Sometimes simple communication and goal agreement between all parties involved in a given abuse/neglect/AOD case can help move families to reunification and/or prevent the need to remove children from homes altogether. Family drug courts (FDC's) have been helping in recent years to bring a wide range of different agency staff together in order to assess a family's needs and move toward meeting those needs. Judges in FDC's can be instrumental in putting together teams that involve the police, social workers, alcohol treatment professionals, child protective services, public defenders, and the AOD parents (Lavato & Mack, 2003). With everyone being involved in a case the unanimity adds to the ability of everyone to promote long and short-term goals. Together the FDC team can look at the children's interests, the state's interests, and the parents' interests. "This coordination reduces the trauma families experience when faced with multiple systems, policies, and competing timelines" (Lavato & Mack, 2003, para. 2).
The successes of FDC show how a comprehensive view of family issues serves children and families well. The use of services that include practical support and firm and directed accountability, common components to FDC, are reportedly working. In Suffolk County, New York, family drug courts were started in 1997. Since that time, the length of time for children in foster care has been reduced from 2.5 years down to 16 months (Lavato and Mack, 2003).
Lavato and Mack (2003) describe some FDC norms: specific goals and timelines are established; parents receive AOD counseling and treatment; FDC team members arrange care for the children; referrals are made for jobs and housing assistance; parents attend court hearings, undergo drug testing, and perform community service. With noncompliance, parents get increased drug treatment or spend time in jail, and positive behavior is rewarded with reductions in program requirements or gift certificates (para. 10). It is noteworthy that the FDC program includes both rewards and sanctions for parents.
However not all sanctions and consequences are good ones in the FDC program. An FDC in Kansas City, Missouri tried to reduce parental visitation time with children as one of its sanctions and later realized that doing so simply was not in the best interests of the child (Lavato & Mack, 2003). And logically it makes sense that, even while a parent may not be compliant with program guidelines, the children themselves have not done anything wrong, and the children may not easily understand missed visitations.
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