Child Welfare in the 21st Century

  • October 2014
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Courts and other legal partners: An essential collaboration for child welfare public and private

Posted by lboyd544 on October 29, 2014

Last week I had the privilege of presenting a workshop entitled: Therapeutic Foster Care – Exceptional Care for Complex, Trauma-Impacted Youth in Foster Care, to an annual Judicial Conference held in Oklahoma City, OK. This conclave of 250 was sponsored by the Administrative Office of the Supreme Court of Oklahoma. Attendees included Judges, District Attorney’s, private client attorneys (for the youth in care), state child welfare workers, and CASA volunteers. The presentation and discussion created an energetic, informative exchange that both provided questions and answers for services in communities for these youth and also a clear recognition of our overlapping responsibilities, if we are to serve such youth and their families.

I want to reflect on just a few highlights:

1- I hope other states annually have such conferences and opportunities for training in cross-disciplines so that we best meet the needs of vulnerable youth and families. The respect for each other and the willingness to ask and learn permeated the large meeting room for these judges and public servants.

2- Therapeutic foster care (TFC) is a community-based treatment, provided in specially trained foster homes for youth who would otherwise be in group homes or other congregate caring, including an in patient facility. TFC is a medically necessary service, the clinical components of which are paid by Medicaid. It was surprising and most informative for Judges to learn that a youth cannot simply be ‘ordered’ to therapeutic foster care. Instead, a child must be ‘approved’ as meeting medical necessity criteria by the state’s Medicaid authority if reimbursement for services is to occur.

3- Public child welfare workers and court personnel were surprised and pleased to know that kinship and relative placements for youth with child welfare involvement can, and should, be approved for training and services as TFC homes, if the child meets such behavioral and mental health conditions as enumerated in Medicaid criteria. Likewise, TFC agencies can provide services for in-home stabilization in order to divert an out-of-home placement.

4- With the signing on September 29, 2014, of the federal Preventing Sex Trafficking and Strengthening Families Act, states must begin to screen, identify, track and serve minor victims of sex trafficking. Therapeutic Foster Care and specialize congregate care are the only two appropriate treatment resources for this population. We must work quickly and closely with one another to provide specialized responses for trafficked youth.
States vary in their definitions of both “medical necessity” and their understanding of therapeutic foster care. The national

Foster Family-based Treatment Association is hard at work with Congress to create uniform, national definitions and standards for TFC services and professionals. As that effort moves forward, I hope all states will develop or continue the multi-discipline sharing such as provided by the Oklahoma Supreme Court Administrator. Check into what is happening in your state and ask to be involved!


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