In addition to HomeTies, Shelby County has a large number of both in-home and office-based programs that provide counseling and some that provide concrete services. Most of these services are free to families, and few have waiting lists. They are either DCS funded programs or community based programs funded through other agencies, such as the schools. Some require TennCare (Tennessee Medicaid) eligibility, some require private insurance. The programs that front line CPS workers are using in place of, or in addition to HomeTies are:
- Life Coach, also provided by Frayser Family Counseling, is an in-home, case management program with case staffing comprised of one therapist and one supervisor. Service intensity varies depending on family needs. At minimum, there are three face-to-face visits a week. Therapists provide counseling, teaching, and concrete services including transportation. Services are funded through TennCare, the Community Mental Health Agency, (formerly ACCT), and DCS, and self pay on a fee-for-service basis. (While Life Coach is viewed as one of the most viable options for some control group cases, workers note that making a referral to Life Coach also requires considerable paperwork and involves uncertainty about whether cases will be accepted into the program.)
- Homeworks, also provided by Frayser Family Counseling, is an in-home, case management program staffed by one therapist and one supervisor. Less intensive, Homeworks therapists provide counseling and teaching services on average once a week. Services are funded through TennCare, the Community Mental Health Agency (formerly ACCT), DCS, and self pay on a fee-for service basis.
- Frayser Family Counseling Outpatient Therapy is weekly individual, couple, or family therapy. Services are funded through TennCare, Social Service Block Grant, and private insurance.
- The Exchange Club provides office based counseling in parenting and anger management. It is funded by DCS or TennCare.
- Intercept, like HomeTies, provides intensive, home-based services (24 hour availability, four to six cases a worker, service duration of three to six months, minimum of three visits a week) and is offered by Youth Village. The program requires an eight page application form. Intercept is “very expensive” and requires ACCT approval and funding but the program also accepts TennCare and some private insurance. For nearly half of the workers we interviewed, Intercept has replaced HomeTies as the intensive model of choice since the study began. This is partly because in the words of both front line staff and supervisors, Intercept has been coming to DCS to “drum up business.”
- Memphis City School Mental Health offers services for children who have been sexually abused, including child-on-child sexual abuse. While the services are free to families, there is generally a waiting list. Services funded by DCS Social Services Block Grant.
- Child Advocacy Center offers counseling to children and their parents. Services are funded by DCS, private funds, federal grants, and the city and county government.
- The Center for Children in Crises provides comprehensive evaluation (social, medical, psychological, and psychiatric) of all family members in abuse/neglect cases and makes placement recommendations. Services are funded by DCS and TennCare.
- Homemaking Services in-home services provided by the Memphis City Schools. Services are funded by DCS.
- Lakeside Hospitals, in-home service using BSI-trained staff.
- Monitor Prime, in-home services, largely case management, that are sometimes tried before HomeTies.
According to the DCS front line staff interviewed, approximately 50 to 60 percent of substantiated CPS cases are encouraged to accept some services. Jean Taylor, the CPS Program Supervisor, estimated that for control cases, over 50 percent currently go to Community Service Agencies to access services not otherwise funded by DCS. For families in treatment, most of the requests for flexible funds are to support concrete needs like home repair or specialized psychiatric services not otherwise covered by TennCare.