On Their Own Terms:  Supporting Kinship Care Outside of TANF and Foster Care

Chapter V:
Alternative Kinship Care Programs Service Delivery

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Contents

• Program Outreach and Referral Sources
• Financial Assistance
• Services
  • Caregiver Support Services
  • Support Groups
  • Respite Care, Transportation, Child Care
  • Services for Children
• A Different Service Delivery Approach

Endnote

Some alternative kinship programs primarily provide financial assistance, others focus on providing non-financial, supportive services, and still others provide a combination of financial and non-financial services. This section describes how caregivers learn about and become involved in the alternative programs we visited and then describes the types of services they receive through these programs.

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Program Outreach and Referral Sources

The alternative programs visited rely on referrals and outreach to reach relative caregivers and provide their service offerings. Child welfare agencies and, to a lesser degree, TANF agencies are the primary referral sources for the alternative kinship care programs visited. Many programs also receive referrals from other community agencies or from caregivers themselves. Some programs conduct outreach efforts in order to reach a broader group of families.

• Child welfare and TANF referrals. Of the 23 programs identified not providing subsidized guardianship, 22 receive at least some referrals from the child welfare system, and 9 receive referrals from the TANF program. Not surprisingly, programs administered and staffed by either a public or private child welfare agency are most likely to receive referrals from the child welfare system. A Second Chance in Pittsburgh consists entirely of child welfare-referred families. In Kentucky's child welfare alternative program and in Florida's Relative Caregiver program, some families are referred by TANF, though only in cases where the child has been adjudicated as abused or neglected. Additionally, some families with closed child welfare cases self-refer to the programs.

  As part of the initial program start-up and implementation in Florida and Kentucky, it was necessary to identify and recruit kinship families who would be eligible for the new programs. This was handled by training child welfare workers on the new programs' eligibility requirements, followed by identifying and contacting those families which appeared eligible.

  Denver's program is the only TANF-administered alternative kinship care program visited and receives the bulk of its referrals from TANF workers. Child welfare workers receive training about TANF's grandparent program, but the program is still in its infancy and interaction with the child welfare division has yet to be formalized. In San Francisco, the Kinship Support Network receives about half of its referrals from child welfare. Two child welfare workers are on-site at the Edgewood center enabling easier referrals and coordination.

• Role of courts.  The courts play a significant role in referring families to the alternative programs developed largely by child welfare agencies. In Pittsburgh, judges often require A Second Chance to accept kin as foster parents who could not be certified because of past criminal charges or other disqualifying factors. As a result, the county cannot receive state or federal reimbursement on behalf of these placements and has to incur all associated placement costs. In addition, judges are sometimes willing to accept pleas from private kinship caregivers who claim that they are caring for children due to abuse and neglect, even though the child welfare agency was not involved in the placement.

  In two states visited, judicial practices affect how kin are served by alternative programs. In Kentucky's child welfare alternative program, relatives are supposed to assume temporary custody of children placed with them, so the children receive less supervision than children who are in state custody. However, some judges have allowed kin to participate in the kinship program, but have ordered the child welfare agency to assume custody. In some parts of Florida, judges are reluctant to adjudicate children placed with kin, instead allowing the kin to care for a child "voluntarily." These caregivers are unable to obtain the relative caregiver payment.

• Community and self referrals.  In addition to TANF, child welfare and the courts, alternative programs rely on other means to identify potential participants. Some programs utilize schools for outreach efforts while other programs rely on grandparent support groups and word-of-mouth. Of the 23 programs identified not providing subsidized guardianship, 16 receive referrals from community agencies and 7 receive self-referrals.

  Kentucky's support group program uses schools to identify children whose legal guardians are relatives rather than parents. Resource coordinators send out notices of support group meetings and provide information at school open houses to inform relative caregivers of support groups. Some advertise the support group program through radio, television, newspapers and community calendars. A support group in Oklahoma also distributed informational brochures to schools and other organizations as a form of outreach.

  In San Francisco, the Kinship Support Network heavily relies on word of mouth for referrals in addition to referrals from the child welfare agency. The Kinship Support Network is well established and known in the community and its outreach activities include interaction with the schools, churches, community meetings, providing flyers to the county Department of Human Services, and advertising meetings in community newspapers.

  Initially, Denver's program conducted presentations at churches, District and City Attorneys' Offices, and the schools. The program's manager also made local radio and TV appearances. Denver's popular and politically active grandparent support groups are also a source of referrals. At local family resource centers, advocates who receive training on the grandparent program are a source of community referrals.

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Financial Assistance

Thirteen of the 23 alternative programs initially identified as not providing subsidized guardianship do not provide financial assistance. However, financial assistance is a key component in many of the programs we visited (see Table 4). In programs providing a monthly payment, the payment may continue until the child reaches the age of 18 or 21. Some programs, in addition to providing a monthly payment, provide emergency financial assistance or financial assistance targeted for specific items, e.g., furnishings, school clothing.

• Monthly financial assistance. As discussed earlier, the impetus for many of the alternative kinship programs was to provide additional financial assistance and stability to kinship care arrangements. Programs administering a monthly payment include Denver, Florida, Kentucky's child welfare alternative program, and A Second Chance in Pittsburgh. And, while the Kinship Support Network does not administer a monthly payment, the majority of its clients do receive some sort of monthly financial assistance either through receipt of a foster care payment or TANF child-only payment.

  For programs providing a monthly payment, the rates vary along a continuum with the highest equal to the foster care rate and the lowest set at the TANF child-only rate. In Pittsburgh, A Second Chance licenses relatives as foster parents and they receive monthly payments equal to the county's foster care rate. Florida's program provides a monthly payment close to the foster care rate (relatives do not become licensed foster parents). Denver's program provides a supplemental payment in addition to the TANF child-only payment, creating a monthly payment closer to the foster care rate.

• Payments until child is an adult. In the programs visited, monthly financial assistance payments may continue until the child turns 18 or 21. Program planners and administrators view the monthly payments as a way to provide continuing support to families until the child reaches adulthood. Florida's revised child welfare statute creates a new permanency option (i.e., long term relative care) expressly for this purpose. In Kentucky's child welfare alternative program, the child is eligible for the monthly payment until they leave home or turn 19 (as long as they are a full-time student). In Denver, children are eligible for the TANF child-only supplemental payment until they turn 18 (or 19 if full-time student); however, program respondents noted that the TANF-funded supplement is dependent upon the availability of funds.
• Other types of financial and in-kind assistance. Additional financial assistance often takes the form of annual clothing allowances used to purchase school uniforms or school clothes. Other uses of financial assistance include paying for child-related furnishings (e.g., bunkbeds) or children's extracurricular activities. Some programs provide a one-time start-up payment while others provide an annual or quarterly amount.

  Kentucky's child welfare alternative program recipients are eligible for a one-time, start-up payment of up to $500 per child and preventive assistance funds of up to $500 per family per year. In addition, kin served by A Second Chance in Pittsburgh are eligible for a quarterly clothing allowance and may receive financial assistance to meet emergency needs. Denver participants are also eligible for a clothing allowance ($1000 per year per family) and emergency financial assistance (no set limit).

  In San Francisco, the Kinship Support Network has an on-site food bank, and children's clothing, toys and car seats are offered to kinship families. Kentucky's kinship support group program does not provide any direct financial assistance but the support groups are intended to increase grandparents' awareness of and access to financial support programs.

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Services

Financial payments are just one type of service that alternative kinship programs may provide. The programs we visited often include a case management component combined with an array of other types of supportive services. Some programs' service offerings are more comprehensive than others and some focus on providing services primarily designed to meet the needs of the adult caregivers while others focus more on addressing the needs of the children.

• Case management services. The degree to which families receive case management services varies by program and by the needs of the families. While participants in the child welfare administered programs receive traditional child protective supervision, the level of supervision varied. In Pittsburgh, kin served by A Second Chance receive the same if not greater supervision than would otherwise be provided to non-kin foster placements.

  In Florida's Relative Caretaker Program and Kentucky's child welfare alternative program, supervision appears to be less intensive and for a shorter period of time. The goal of Florida's program is to close cases within six months; however, child welfare caseworkers are reluctant to do so when family needs remain unmet. Kentucky's kinship care program initially set a two-month period for case management but has extended this period to six months.

  Denver's program targets TANF child-only kinship families and provides limited case management services to some at-risk families. All relatives in the program who are caring for children involved with child welfare receive case management services from the child welfare worker. The program in Florida and Kentucky's child welfare alternative program are designed to close the child welfare cases after a six- to twelve-month period (though still retain the monthly financial payment to kin)

  "[The support group's] been a god-send, I hear other people's stories and I think, 'That's my story. That's exactly where I am.' And thank God we now have a group, now we have someone to turn to.... If I didn't come to the meet-ings,… I wouldn't know about a lot of things. And it's just [knowing] that we are not alone in all of this, that we all have similar stories."

  In San Francisco, Edgewood's Kinship Support Network provides case management services to families referred by the child welfare agency (as well as other families needing additional supports). Case management includes visiting the relative's home once per month, meeting more frequently with clients if needs or circumstances warrant more intensive interaction, making referrals to other programs and services as needed, and advocating for clients in a variety of settings (e.g. accompanying the caregiver to court or to the child's schools). There is no limit on the amount of time families can receive case management. Case management services are terminated once a family has reached their case plan goals or case management is no longer needed. However, at any time families may request reinstatement of case management services if a crises occurs and they feel they need the additional support. It is also important to note that kinship families involved in the child welfare system receive monitoring and supervision by their child welfare worker in addition to the case management services provided by Edgewood's Kinship Support Network.

• Most programs provide some supportive services to kin families.  Supportive services encompass a broad range of services including support groups, respite care, child care, education/ mentoring programs, and transportation. Of the 23 alternative programs identified not providing subsidized guardianship, 17 provide education services, 14 provide child care/respite care, 11 provide mental health services or counseling, and 7 provide health services.⁽²⁴⁾ In addition, 20 programs refer families for health care services, education services and mental health services; 19 refer families for financial assistance and 18 refer families for child care/respite care needs.

Caregiver Support Services

Alternative programs visited recognize the emotional toll that caregiving takes on many relative caregivers, especially grandparents. Kin are unexpectedly shouldered with the responsibility of taking on a new caregiving role later in life or caring for children in addition to their own. Many of the services provided to relative caregivers (e.g., support groups, transportation, child/respite care) are designed to relieve the isolation experienced by kinship caregivers.

Support Groups

Most of the alternative programs visited organize or facilitate the development of support groups for relatives (particularly grandparents) caring for kin. Support groups offer caregivers a source of emotional support and practical information. Both kinship caregivers participating in the focus groups and program staff considered support groups a valuable and helpful service.

Kentucky's support group program operates 29 groups and uses the groups for distributing information about available services in addition to providing a supportive sharing forum. For example, officials from Kentucky's State Children's Health Insurance Program have presented at several support group meetings. Denver's program contracts with a private provider, Catholic Charities, to organize its relative caregiver support groups. In Denver, group facilitators noted that the support groups initially focused on meeting primary needs such as food and housing by bringing in community partners who donate monthly food baskets. Over time the support groups have evolved to address parenting skills, dealing with the adult children's substance abuse, loss and grief issues, defining roles and legal issues with experts invited to discuss these issues.

Support groups differ by whether they are led by professional facilitators or whether they are more loosely organized. The Kinship Support Network's kinship support groups in San Francisco--known as Grandparents Who Care--are peer run by a caregiver who has received facilitator training. A coordinator oversees all the support groups. Kentucky's support groups are tailored to meet local needs. Some of the groups have developed internal leadership with the grandparents running the program.

The San Francisco Grandparents Who Care support groups are held throughout the community in churches and schools and are held both during daytime and evening hours. There are groups for Latino caregivers and one for Korean caregivers. Pittsburgh's program provides support groups for caregivers, children and birthparents. Denver currently has support groups running in three communities with plans to expand into two largely Latino neighborhoods. A program staff member was also organizing a support group for grandfathers.

Respite Care, Transportation, Child Care

Three important supports which kinship care programs can offer are respite care, transportation assistance and child care assistance. Child care is often provided as a way to enable caregivers to engage in activities which provide respite or attend support groups. In addition, access to child care subsidies can enable caregivers to combine caregiving responsibilities with employment.

Respite care may be provided through a variety of arrangements. Denver's program organizes some group activities which provide needed respite for caregivers. The Kinship Support Network in San Francisco provides organized activities for children, fulfilling the dual objective of providing developmentally appropriate activities for children and affording caregivers a respite period while children engage in these activities. For example, adult caregiver group activities, such as an outing to the mall, are often scheduled to coincide with children's activities. In Pittsburgh, A Second Chance provides both emergency respite (a range of one hour to ten days is offered) as well as a grandparent respite cooperative. Older kinship caregivers in Oklahoma can receive vouchers to purchase respite care services through the Oklahoma Respite Resource Network. This network represents a collaborative state agency, including the Division of Aging Services, to provide funding for respite services. Caregivers may select the respite provider of their choosing so long as the provider is 18 years or older and does not live in the same household.

Some programs attempt to alleviate transportation problems for caregivers. Pittsburgh's A Second Chance program provides extensive transportation to caregivers and children. The program provides transportation for children's visitation with birth parents, medical and other appointments, and for recreation activities. In Denver, the alternative kinship program provides transportation assistance in the form of city bus tokens.

Relative caregivers often have little information on the availability of child care in their community. Several of the alternative programs attempt to provide or coordinate with other programs for child care. In Florida, one of the major benefits of the relative caregiver program is that caregivers can obtain subsidized child care (on a sliding scale) until the child turns 12 years of age. In comparison, state policy requires Florida's TANF program to limit child care assistance to a six-month period for relatives in child-only assistance units. The Kinship Support Network includes after school tutoring three days each week and provides child care during support group meetings. Kinship Support Network families involved with the public child welfare system are also eligible for child care through that agency for one year if the caregiver is working or in school or the child has special needs.

Services for Children

Alternative programs visited are less likely to provide an array of services for children. However, children in kinship families involved with child welfare agencies--Kentucky's child welfare alternative program, Florida's statewide program, and A Second Chance in Pittsburgh--are eligible for many services to address their needs (e.g., Medicaid, mental health). Programs not administered by a child welfare agency are recognizing the needs of children being raised by relatives. Denver's program provides referrals for children's activities including referrals to Big Brother/Big Sister programs and payments for special talents (i.e., music lessons, registering for sports teams). The program is also trying to address children's mental health needs through referrals to therapists.

The Kinship Support Network provides some services specifically for children including recreation activities and an after school tutoring program.

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A Different Service Delivery Approach

Two of the programs visited, A Second Chance in Pittsburgh and Edgewood's Kinship Support Network in San Francisco, offer interesting examples of how community-based organizations can work alongside the traditional child welfare and TANF agencies to provide comprehensive services for kinship care families. Both are private agencies with contracts from public child welfare agencies. In Pittsburgh, A Second Chance employs a strength-based approach, focusing on the positive rather than negative aspects of a child's extended family. Staff also stress the cultural responsiveness of their service delivery model. Staff defer to the kinship triad (the child, birth parent, and kinship caregiver), and build services around the client. For example, staff will modify their workday to accommodate a family's schedule. Staff also stress that kin can make the difference for their own family unit, families are the change agents, staff merely facilitate. A Second Chance program also focuses on reunification with the birth parent; 60 percent of kinship care children in the program return home within six months of placement. The program involves birth parents extensively.

In San Francisco, Edgewood's Kinship Support Network aims to provide services to kinship families that are not intrusive, building upon families' strengths, and involving families in planning for their children. The overriding objective is to keep families together if at all possible. After an assessment of needs, case management is provided if it appears that the caregiver would benefit from the individualized attention and support. The program has no limit on the amount of time caregivers can receive case management and the length of time varies by individual. The Kinship Support Network's model recognizes that caregivers' situations and circumstances are dynamic and there may be periods after case management has ended when it makes sense to reassign a case manager.

Many of the Kinship Support Network's case managers are kin caregivers themselves. In the early years of the program, virtually all of the case managers were kin caregivers who shared the same socioeconomic and demographic characteristics as the participants. This model, in which staff understand what the families are going through because they have been through some of the same experiences, promotes an empathetic and trusting relationship between caregiver and case manager.

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Endnote

24. We have very limited information on the support services provided by subsidized guardianship programs, but do note that many provide some support services beyond finanicial payment.

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Last updated:  10/29/01