Beyond these reunification tools that are implemented in many foster care agencies, many states and counties have developed special reunification programs. These specialized programs are designed to serve families or children with particular needs, or for programs designed as an alternate approach to traditional reunification practices in foster care systems. Some of these are structured as managed care or performance contract efforts. Some emphasize concurrent planning. Others are community oriented efforts while still others make use of other approaches such as "wrap-around services" (intensive efforts to provide extensive community supports for the family) and court-based services. The concepts of permanency, time limits for making decisions, and use of community resources pervade these programs. The importance of ongoing contact between children and their parents is generally recognized, so visitation is a part of all programs directed at return home, although it is handled in various ways in different programs. In other respects, there is great variation in the ways common goals are pursued.
Specialized or innovative reunification programs can be classified into four categories:
- Programs for substance abusing parents;
- Programs for children with severe problems;
- Community-based programs; or
- Family preservation model intensive in-home services.
Programs for Substance Abusing Parents. Programs for substance abusing parents focus on working with a population recognized as one of the most difficult to reunify, particularly under the constraints of the ASFA timelines. Long-term substance abuse is a difficult behavior to eradicate. Even when parents are motivated to change, repeated relapse is common before they are ultimately free of drugs. Two types of programs developed to combat substance abuse among parents are drug courts and residential treatment programs.
Drug courts represent an approach to treatment of drug abusers that includes sanctions enforced by the court. One such program is the Drug Court Recovery Project in San Diego County, California. When a custody petition is entered and the caseworker has identified substance abuse as a contributing factor to the abuse or neglect of the child, the parent is referred for inpatient or outpatient substance abuse treatment and regular drug testing. Parents' failure to comply with treatment may result in the court exercising a number of sanctions including 3-5 days in custody and/or a monetary penalty for contempt of court, and upon the third failure to comply a referral is made to the Dependency Drug Court Program. Participation in the program is voluntary and subject to the approval of the court judge. In this program, parents continue to receive treatment for substance abuse, but must make frequent court appearances to report their progress to the judge during phases of the program. Phase 1 of the Dependency Drug court requires a court appearance once a week for 90 days; phase 2 requires a court appearance once every two weeks for 90 days; and phase 3 requires a court appearance once a month for 90 days. The Dependency Drug Court hopes to encourage compliance through the heightened supervision of the court and through peer support. Parents receive praise for compliance and are given tokens for the number of days of sobriety maintained. Failure to comply results in sanctions of up to 5 days in custody or dismissal from participation and evaluation for TPR.
Another specialized approach to working with substance abusing parents is the development of residential treatment programs for drug dependent women and their children. Mothers Making a Change (MMAC) in Cobb and Douglas Counties in Georgia is a comprehensive program that includes community outreach, early intervention, family preservation and support services, and substance abuse treatment services. MMAC's services are based on a non-threatening treatment model that is family-centered, community-based, and encompasses a holistic approach to treatment. MMAC recognizes that substance abuse is usually one of many family problems, and addresses not only the addiction but education, health, housing, and employment in a holistic fashion. The program recognizes that to keep a parent and child together requires resolving the problems of the parent. Therefore, services are mother and family focused rather than child focused. The hallmark of the MMAC program is a residential substance abuse treatment service. Clients receive intensive services to conquer addiction for 90 days in the Ready to Work program at the Cobb County facility. In the second phase of the program women are transferred to the Douglas County facility, (a complex of apartments rented by the program) where they spend 9 months receiving services focused on anger management, child development, parental skills, nutrition, and education. Most women are reunified with their children during this phase. In the final phase, clients receive 6 months of aftercare focused on support to minimize the risk of relapse and on finding employment.
Programs for Children with Severe Problems. While the drug courts and residential substance abuse prevention programs target parents whose problems make them among the most difficult to reunify, other innovative programs target children whose severe problems make reunification difficult. Children with severe mental health problems who end up in the child welfare system are difficult to reunify as their parents' problems with parenting are exacerbated by the children's serious mental health needs. Finding a way to reunify children who have been institutionalized due to their mental illness is a real challenge. Wraparound services were mentioned by several states as an effective way to reunify emotionally disturbed children with their parents. Wraparound services refers to an approach whereby an extensive array of services are individualized and "wrapped around" the family unit to support their strengths and meet all their needs with respect to personal and community safety, education, emotional and physical health, family life recreation and legal issues.
Wraparound services are used by the Santa Clara County California Department of Family and Children's Services for emotionally disturbed children who have been placed -- or are at risk of being placed -- in their highest level of care residential placement facilities. Through the efforts of two wraparound programs in the county, children and their families are provided with an individualized array of program services to maintain the child in a more normalized setting outside of an institution. The program uses a team approach with a variety of specialists within the agency working with parents to make decisions about what services the family needs to keep the child within the home. A crisis line is available with program specialists on call 24 hours a day to go to the family's home to intervene as necessary. At times, as many as 12 staff members may be assigned to work with one family. Although these intensive wraparound programs are costly in terms of resources, workers report the services are successful in returning children to their homes who would otherwise stay institutionalized until they reached the age of majority.
Community Based Models. Across the country, community based models for providing foster care and reunifying families have become more prevalent. The Annie E. Casey Foundation's Family to Family Initiative is one of the more widely used community-based models. This model seeks to reform foster care systems so that 1) there is better screening of cases to determine if out-of-home placement is necessary, 2) children in institutional settings are returned to their communities, 3) foster families are used as team members to facilitate family reunification, and 4) family-centered neighborhood-based services are developed to strengthen the communities from which foster children come.
Community-based reunification programs try to recruit foster families to serve children in the communities where the children reside so that there are no unnecessary disruptions of school and peer friendships. The Lucas County Ohio Community Development Department adopted the Family to Family model to help facilitate reunification. Six neighborhood community centers have been given subcontracts from the department to provide space for family visitation, parenting classes, and family conferences. The families find the community centers more convenient and less intimidating than the Department's downtown offices. In addition to providing space for Department use, the community centers themselves are multi-service agencies that provide recreation, family counseling, health services, and after-school programs. Community advocates from the Department are linked with families shortly before a child is to return home. Their job is to provide intensive in-home services to parents and children to prepare them for the transition and to stabilize the reunified family. The community advocates introduce families to the community centers so that the community centers can serve as a resource for families once services by the community advocate end. The goal of the program is to use the community centers as a resource that troubled families can draw upon to prevent abuse and neglect and another out-of-home placement.
Family Preservation Intensive In-Home Services. A fourth widespread approach to specialized reunification services are programs that use the family preservation model of short-term intensive in-home services. Caseworkers assigned to these cases have small caseloads of 2 to 5 families, are available to the families 24 hours a day, seven days per week and go to the home to provide services to the families. Typically the families start to receive services a few weeks before the child is to return home and the services last for 8 to 12 weeks until the family is stable and the child has been reintegrated into the family. The amount of service is intensive with families typically receiving between 10 and 20 hours of services per week, depending on the families' needs.
A variation of this family preservation model is the Natural Parent Support Program which operates in central New Jersey. Like family preservation programs, the program provides home-based services to families whose children are soon to be returned home. The services are typically less intensive than family preservation services and workers work with families in their homes an average of 5 to 7 hours per week. However, families receive services for 6 months, a much longer period of time than families are usually served by family preservation programs.
The services are family-focused with an emphasis on trying to support the parents' ability to be successful parents through behavior modeling, mentoring, advocacy for school and other services, and family counseling. The program also provides concrete services such as transportation to appointments, child care, and help finding housing and employment. Workers have caseloads of five to seven families. This program occupies an important niche between family preservation programs which provide more intensive services but can only serve a few families as caseloads are limited to 2 or 3 families per worker and traditional reunification services where caseworkers have much larger caseloads and provide families with much more limited attention.
While the special reunification programs described represent different approaches to reunification and serve different populations, these programs, with the exception of the drug courts, share several elements in common. First, they are predominantly family-focused rather than child-focused or parent-focused. They stress working with the entire family to provide the support and resources necessary for the family to function effectively as a unit. Second, they develop a well delineated case plan with the parents that identifies what is necessary to return and keep children in the home. Also, there is an emphasis on active work with the parents to make sure that the goals of the case plan are met. Reunification services provided within the context of standard social service practice typically put much more of the onus on the parents to comply with the case plan and, given the size of their caseloads, can rarely provide the intensive one-on-one attention that is evidenced in these specialized programs. Third, these programs are comprehensive efforts to address a range of issues that effect the parent's ability to be a good parent. They focus on much more than remedying the problems that brought the child into the system but on making sure families are stable with respect to housing, employment, and networks of support. Fourth, services are individualized and customized to meet the unique needs of the families. Finally, these reunification programs start their intensive reunification efforts once a decision has been made to return the child. These programs help parents and children prepare for and then make the transition to home and then expend considerable time and resources to stabilize the family so that the child can remain home permanently.