Permanency and Normalcy What disability rights advocates need

Permanency and Normalcy What disability rights advocates need to know about the child welfare system Natane Eaddy and Lisa Swaminathan May 18, 2017 Todays Agenda Introduction Purpose of webinar Child Welfare 101 Basics of the child welfare system Normalcy What is it?

Barriers to achieving normalcy Strategies for supporting and informing normalcy efforts Permanency What is it? Barriers to achieving permanency Strategies for supporting and informing permanency efforts 2 Who We Are Lisa Natane 3

Overrepresented in care 2nd Qtr; 40; 40.00% 60%: 60% receive receive special ed; 60; 60.00% special ed services 2nd Qtr; 33; 33.33%

90%: at least one medical health condition 1st Qtr; 66; 66.67% 2/3: MH or BH needs 4 Poor Outcomes Compared to peers, youth with disabilities exiting the child welfare system exhibit:

Lower levels of educational attainment Worse self-esteem Less likely to be economically self-sufficient Less likely to achieve permanency Higher rates of homelessness More likely to enter juvenile justice system 5 Protection & Advocacy Teams Natural Partners with Child Welfare Advocates 6 Todays Agenda

Introduction Purpose of webinar Child Welfare 101 Basics of the child welfare system Normalcy What is it? Barriers to achieving normalcy Strategies for supporting and informing normalcy efforts Permanency What is it? Barriers to achieving permanency Strategies for supporting and informing permanency efforts 7

Child Welfare Overview Foster Care: full time substitute care where the state is responsible for the child Foster care sometimes refers to a foster family, but generally refers to any out of home placement Guiding Purpose & Standards: Childs needs and welfare Preserve family unity when possible

Time-limited involvement 8 The Child Child is central to proceeding Represented by some adult advocate o Guardian ad litem (GAL)/Attorney ad litem (AAL) o Client-directed counsel o Court appointed special advocate (CASA) 9

The State Department of social services, public welfare, human services, or child and family services sometimes referred to as the Department or the Agency Department/Agency contracts with private child welfare agencies and community-based organizations to provide services to children and families Role: o Investigate reports of possible child abuse and neglect o Provide services to families that need assistance in the protection and care of their children o Take custody of children who cannot safely live at home

o Develop and execute permanency plans for children in their custody 10 The Parent May or may not have custody of child May retain rights to make decisions on childs behalf All rights may be terminated 11 How Children Enter Child Welfare System Child maltreatment Harm that parent does not or cannot

prevent Absence of parents Delinquent behavior or juvenile status offense (very young) 12 How a Child Welfare Case is Initiated CPS report & investigation Agency files petition Possible shelter care Adjudication Disposition 13

Case Planning Requirements Must be in writing Updated every 6 months Generally created when child is placed in care, case is opened for services, or child is adjudicated dependent Components include: o Health care planning o Placement planning o Permanency planning o Transition planning 14 Meeting Health Care Needs States must meet health care needs,

including mental health, of youth in care Case plan must include childs health records Fostering Connections imposes specific requirements for individualized health care plan 15 Placement and Service Obligations Family: Placement should be a safe setting that is the least restrictive (most family like) and most appropriate setting available. Youth-Centered: Services should be provided to find a placement resource who is skilled in meeting the youths needs.

Community: Services should be provided to meet treatment needs in the community based setting. 16 Placement Options for Youth with Disabilities Medical/ Therapeuti c Foster Care Relative/ Kinship Care

Residential Treatment Facility Foster Care Supervisio n Only/ In Home Group Home Supervised Independe nt Living

17 Permanency Hierarchy Reunification Adoption Guardianship Placement with fit & willing relative AP Permanency refers to the youths final disposition PL A

Agency must make reasonable efforts to finalize permanency plan 18 Transition Planning Child Welfare System Successful Adulthood Plan must include specific options on housing,

health insurance, education, local opportunities for mentors and continuing support services, and work force supports and employment services 19 Court Oversight Status of each child in placement must be reviewed at least once every 6 months Parties, including the youth, must receive notice and opportunity to be heard Courts have broad dispositional authority to enter orders in youths best interest 20

Todays Agenda Introduction Purpose of webinar Child Welfare 101 Basics of the child welfare system Normalcy What is it? Barriers to achieving normalcy Strategies for supporting and informing normalcy efforts Permanency What is it? Barriers to achieving permanency Strategies for supporting and informing permanency efforts 21

NORMALCY 22 What is Normalcy? Typical or routine age- and developmentally activities that encourages healthy development and growth of children and youth in care Examples of normalcy activities include, but are not limited to, social, cultural, enrichment, and extracurricular activities, such as: Going to the movies or the Participating in a school trip

mall unsupervised Working or volunteering Learning to drive Joining a school club or Attending the prom or extracurricular sports teams sleepovers at a friends home 23 Poll What barriers do your clients face when

seeking to participate in normalcy activities? A: My client is told that they cannot participate in activities B: Accommodations have not been arranged to permit my clients participation in activities C: There is a fear about being held liable if my client is injured D: Staff do not have the knowledge to help my client engage in activities E: All of the above F: Other 24 Why Normalcy? Normalcy helps youth Build social networks, which: Facilitates the achievement of permanency Develops healthy relationships and support systems Promotes a healthy transition to adulthood

Develop skills and talents, which: Builds confidence Promotes positive decision-making Supports engaging in healthy risk-taking 25 Normalcy Legal Requirements In addition to providing youth with ongoing opportunities to participate in age- and developmentallyappropriate activities, the law requires that: A designated adult, including facility staff, must be trained and given the authority to use the reasonable and prudent parent standard to make decisions about

normalcy activities Normalcy must be addressed in case plan and at every status and permanency review hearing 26 Poll Do you know the facility staff member designated to use the reasonable and prudent parent standard to permit your client to participate in normalcy activities? A: Yes B: No 27 Normalcy

Reasonable and Prudent Parent Standard Requires the use of careful and sensible parental decision-making when determining whether to permit a child or youths participation in extracurricular, enrichment, cultural, and social activities The standard was developed to: o Maintain the health, safety, and best interests of the child or youth o Encourage the emotional and developmental growth of the child or youth 28

Normalcy Caregivers and the Reasonable Prudent Parent Standard Factors that caregivers may use to help guide their decisions under the reasonable and prudent parent standard include, but are not limited to: The potential risk factors to the child or youth and others The history of the child or youth and his or her ability to safely participate in the proposed activity Encouraging the child or

youths formation of healthy age- and developmentallyappropriate relationships Supporting the child or youth in developing skills to successfully transition to adulthood 29 Promoting Normalcy Caregiver Liability Provisions States are required to provide liability protection to caregivers who use the reasonable and prudent parent standard appropriately Liability provisions encourage caregivers to permit children and youth participation in normalcy activities without fear of being held legally

responsible if an injury results from such activity 30 Promoting Normalcy Agency Responsibilities Offer opportunities to engage in normalcy activities to all children and youth in care Provide reasonable accommodations for children and youth to access activities to the greatest extent possible Help enhance a child or youths participation in activities by consulting and partnering with service providers 31

Promoting Normalcy P&A: Tips for Advocacy Investigations Intervene when necessary File grievances in individual cases Individual Advocacy Work directly with the child or youth, caregivers, and the agency to obtain accommodations Empower youth to advocate for themselves Work with the child or youths lawyer to draft orders that promote and address barriers to participation 32 Normalcy

Questions to ask Are reasonable accommodations available to support the child or youths participation in activities in the community? Have reasonable accommodations been requested by the caregiver and provided by the agency? If opportunities are not being provided or taken advantage of, what are the barriers? When necessary, can a court order address and resolve the barriers to the child or youths participation in the activity? 33 Normalcy

FACTS: 19 years old currently living in a group placement setting, where she has lived for the past several years Remains connected with and is very close to her biological aunt, whom she visits on weekends Registered with local Intellectual

Disability Services agency and receives support coordination Likes to sew and is interested in pursuing a degree in fashion design Developed a friendship with the local fabric store owners and has been offered an internship at the store Case Example: Alisha

34 Normalcy Case Example: Alisha BARRIERS: No reliable transportation to the fabric store Alisha does not know which staff member at the group placement has been designated to make decisions SUPPORTS: Alisha is familiar with the local bus routes because she rides the bus with her aunt on the weekends

Biological aunt and fabric store owners believe the internship will help Alisha pursue her interest and 35 develop skills Normalcy Case Example: Alisha What are some creative ways you can advocate for Alisha to participate in the internship? Speak with Alisha to determine: Who helps or works with her at the group facility The type of accommodation she would need to fully

participate in the internship Whether her aunt or the fabric store owners would be willing to transport her to the fabric store Reach out to the facility, Alishas caseworker, or her attorney to find out who is designated to act using the reasonable and prudent parent standard Other ideas? 36 Normalcy

P&A Engagement FACTS: 14 year old client currently living in a residential placement Wants to play basketball The activity has been determined to be age- and developmentally- appropriate There is a staff member on-site who is designated to make decisions based on the reasonable and prudent parent standard BARRIER: The facility does not have the staff to supervise the activity 37

Normalcy P&A Engagement ADVOCACY: How does the Strengthening Families Act help you advocate for your client? What are some ways you can work to ensure that your client can participate in this normalcy activity? 38 Normalcy Creating Opportunities for Youth Resource Highlights:

Teen Success Agreement Document created by youth for older youth, caregivers, and social workers to provide older youth age-appropriate activities and opportunities www.jlc.org/sites/default/files/publication_pdfs/ TeenSuccessAgreementFINAL_0.pdf Advancing SFA: Normalcy Provisions Toolkit to help child welfare practitioners implement SFAs normalcy provisions http://www.aecf.org/resources/advancing-sfa/ 39

Normalcy Creating Opportunities for Youth Well-Being Safety Permanency The primary goals of the child welfare system each support the principles of normalcy

40 Todays Agenda Introduction Purpose of webinar Child Welfare 101 Basics of the child welfare system Normalcy What is it? Barriers to achieving normalcy Strategies for supporting and informing normalcy efforts Permanency What is it?

Barriers to achieving permanency Strategies for supporting and informing permanency efforts 41 PERMANENCY 42 What is Permanency? Youth have a stable living environment that is the least restrictive possible Youth establish a network of relationships that provide the support of family All special and general needs are met Older youth are prepared for adulthood

43 Right to Permanency Agency must make reasonable efforts to: Prevent removal; and Return child home; or Achieve another permanency plan. 44 Permanency Hierarchy Reunification Adoption Guardianship Placement

with fit & willing relative AP PL A 45 Examples of Permanency Services Reunification Services Family Therapy Parent Skill Building FGDM Services to Address: Grief and Loss

Trauma Behavior or Mental Health Issues Inhibiting Trust and Formation of Connections Family Finding Cultivation of Identified Family/Kin File Mining Child Profile Child Interview/Life Map Child Specific Recruitment

Local Permanency Meetings with Project Family Permanency Roundtables Permanency Subsidies Caregiver/Resource Training and Connection w/Community Resources Post-Permanency Support and Advocacy 46

Permanency Challenges for Youth with Disabilities Youth with disabilities may be labeled early on as unadoptable Family may require more or costly services to keep child safely at home Child welfare team may confuse placement with permanency 47 Achieving Permanency for Youth with Disabilities

Judicial review of permanency plan is required for finalization and at each permanency hearing Discuss treatment needs separately from permanency needs Participation in normal activities promotes permanency 48 Avoiding APPLA Prohibited for youth under age 16 Court must find that: o Compelling reasons rule out other permanency plans o Agency documents intensive, ongoing, unsuccessful efforts to achieve another permanency plan

o APPLA is in youths best interest Court must also: o Ask youth about desired permanency outcome o Confirm that agency is taking steps to ensure normalcy Child welfare team must engage in concurrent 49 planning Making APPLA Work Youth must have other permanent connections Youth must be connected to resources before exiting child

welfare system Take advantage of extended foster care, care re-entry, and extended permanency subsidies where available 50 Permanency Planning Child Welfare Strategies for Achieving Permanency Placement in Most Family-Like Setting Part of Case Plan at Age 16, at Least Progressively More Concrete Goals Concurrent Permanency Planning

No Discharge if No Plan 51 Case Example: Monique 16-year-old Spinal muscular atrophy requires a wheelchair, sometimes has seizures, needs ventilator at night No cognitive/developmental limitations; doing well in school Placed with grandmother until she passed away 2 years ago Now in institution for adults with serious developmental limitations Extremely unhappy; desperately wants to return to the community

What advice can you offer that could help Monique meet her goals? 52 Case Example: Monique 16-year-old Spinal muscular atrophy requires a wheelchair, sometimes has seizures, needs ventilator at night No cognitive/developmental limitations; doing well in school Placed with grandmother until she passed away 2 years ago Now in institution for adults with serious developmental limitations

Extremely unhappy; desperately wants to return to the community What advice advice would can you offer that What you offer could help caseworker Monique meet Moniques whoher has

goals?an adoptive family? found 53 Multiple Service Systems Service Availability EPSDT Through age 21 if Medicaid eligible IDEA Transition Planning

While enrolled in school (through secondary) if eligible for special education 504 Plan While enrolled in school (through post-secondary) if disability limits major life function Vocational Rehabilitation Beginning at age 14; No upper age limit Disability impacts ability to prepare for, get, or keep a job

SSI No age limit for individuals with disabilities; Infrequently paid directly to youth in care. Apply before leaving care Chafee Education and Training Grant Program Through age 23 for current or former foster youth attending post-secondary educational institution Medicaid Through age 26 for former foster youth

54 Resources to Support Permanency Supplemental Security Income Additional income may support youth in a family-like environment Foster youth can now apply for SSI up to 6 months (180 days) before they leave care SSA policy applies to: o Foster youth of any age o Leaving care for any reason One year pilot program (began 8/1/16)

Citation: Program Operations Manual System (POMS) SI 00601.011 55 Resources to Support Permanency Medicaid Waivers Medicaid waivers can transition a successful foster placement into a life share arrangement that lasts into adulthood Individuals with significant cognitive, developmental, and/ or physical disabilities. Access services

beyond those traditionally covered by MA Avoid institutionalization 56 Permanency Planning How to Support Permanency Use your personal knowledge of the youth Identify services to support resource families Promote normal activities and community engagement Engage in aftercare planning

Attend case planning meetings and permanency hearings Advocate on systemic level to ensure appropriate placements 57 Upcoming Webinars Tuesday, May 18: Planning for a Quality Education in the Child Welfare System: What Disability Rights Advocates Need to Know Tuesday, June 13: Achieving the Least Restrictive Setting in the Child Welfare System: What Disability Rights Advocates Need to Know Thursday, July 6: Navigating Adult-Serving Systems after the Child Welfare System: What Disability Rights Advocates Need to Know

58 Questions? 59 Natane Eaddy Staff Attorney [email protected] Lisa B. Swaminathan Staff Attorney [email protected]

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