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Young Adults Transitioning From Group Care to Self-Sufficiency Version 1.0, 9/18/12

Young Adults Transitioning From Group Care to Self-Sufficiency Version 1.0, 9/18/12. Paul Gibson, LCSW Bay Area Academy. Course Objectives. To review exit outcome and group home data on child welfare and juvenile probation youth in out of home care

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Young Adults Transitioning From Group Care to Self-Sufficiency Version 1.0, 9/18/12

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  1. Young Adults Transitioning From Group Care to Self-SufficiencyVersion 1.0, 9/18/12 Paul Gibson, LCSW Bay Area Academy

  2. Course Objectives • To review exit outcome and group home data on child welfare and juvenile probation youth in out of home care • To discuss the emerging role of group homes under AB 12 • To review the role of child welfare and juvenile probation in working with young adults and group homes in extended care • To review group homes services for young adults that prepares them for transition from congregate care • To review the placement options and transition resources for youth and young adults exiting congregate care

  3. Child Welfare Dynamic Report SystemCalifornia 2011 Exit Outcomes 2212 Total Child Welfare Youth Exited Care • 1272 (57.5%) Completed a High School Diploma or GED • 603 (27.3%) Obtained Employment • 2012 (91%) Secured Housing 448 Total Probation Youth Exited Care • 244 (54.5%) Completed High School Diploma or GED • 99 (22.1%) Obtained Employment • 398 (88.8%) Secured Housing

  4. Child Welfare Dynamic Reporting SystemYouth Living in Congregate CareJanuary 1, 2012

  5. Child Welfare Dynamic Report SystemGroup Home Characteristics Child Welfare Youth • 52% ages 16-18 were prescribed psychotropic medications compared to 21% of other youth in out of home care • 24% ages 16-18 had an IEP compared to 16% of other youth in out of home care • 95% ages 16-17 in care for at least 24 months had 3 or more previous placements • 20% ages 17-18 reunified with family and 68% emancipated Juvenile Probation Youth • 54% ages 16-17 in care for at least 24 months had 3 or more previous placements • 48% ages 17-18 reunified with family and 24% emancipated

  6. Child Welfare Youth in Group Homes • Group home placements are often used as a last resort when other types of out of home care have failed • Most youth have an extensive history of multiple placements with family members, foster homes and congregate care • Youth often have limited family and permanency options • Youth frequently have mental health, emotional and behavioral issues that interfere with achieving positive outcomes • Budget cuts have reduced residential treatment options resulting in more youth with mental health issues placed in group homes • Most youth have academic deficits, have not completed high school and have limited or no work experience • Some youth have had sudden changes in living situations that necessitated short term group home placement

  7. Probation Youth in Group Homes • Group homes are the most frequently used type of out of home care • Youth are removed from their community due to their behavior • Family issues include lack of supervision, abuse and neglect, or criminal involvement • Budget cuts have reduced other placement options including ranches, camps and the youth authority • Youth often have mental health, substance use and behavioral issues that interfere with positive outcomes • Group homes provide better supervision and more services for probation youth than other out of home care • Probation youth often have more family permanency options

  8. The Emerging Role of Group Homes • Education support with a focus on youth completing high school or obtaining their GED and learning college resources • Permanency support for youth with involvement of families and other significant adults to develop permanent connections • Behavioral interventions and skills building to help youth address emotional and behavioral issues impeding their progress • Intensive treatment services to help youth address past trauma, mental health, substance use, and unresolved family issues • Life skills development to support youth in learning self sufficiency, social skills, work readiness, and gaining work experience • Preparing youth for transition to a lower level of care including families, transitional housing, foster care and their communities

  9. The Impact of AB 12/212 on Group Homes • Allows youth to remain in congregate care after turning 18 years of age as a Non-Minor Dependent (NMD) youth • Decision on group home placement for youth is a voluntary, youth driven, team based planning process • Continued group home placement needs to be in the best interest of the youth in order to complete high school or a GED • Once the young adult completes high school or turns age 19 they are expected to exit congregate care • Young adults with medical and mental health conditions can continue in short term placement in group homes after high school or age 19 • Treatment strategies in extended group home placement should prepare them for a less restrictive and more family like setting

  10. Potential Benefits of Group Home Care Group homes can provide young adults with the safety, support and additional time needed to • Complete high school or their GED • Participate in interventions to change behaviors to facilitate moving to a lower level of care • Access mental health and substance abuse treatment • Develop family and permanency connections • Obtain a job and start saving money • Enroll in vocational training or post secondary education • Prepare for transitional housing

  11. Group Discussion • What are the characteristics and challenges of young adults you have worked with in congregate care? • What service needs did they have in order to make a successful transition to adulthood? • What are the characteristics and service components of the group homes that you have worked with? • What are strengths and weaknesses of congregate care? • How can you work with young adults and group homes to achieve positive outcomes and successful transitions from congregate care?

  12. Extended Care Partnerships • AB 12 extended care requires all of us to work together to achieve positive outcomes with young adults • These partnerships include the young adult, social worker or probation officer, group home placement, & adult community services • The SW or DPO maintains frequent contact with the youth in extended care to monitor their progress • The SW or DPO and group home work closely together to ensure the young adult transition goals are met • The SW or DPO & group home actively support the youth in developing permanent connections with family & other significant adults • The SW or DPO & group home work with adult community resources and engage them as partners

  13. Engaging Young Adults • Extended care is a collaborative, youth-centered process that includes treating the youth as an adult • This involves a change in role from a person in authority making decisions for them to a support person providing them with guidance • Include young adults in the development of their independent living, service and treatment plans • Recognize and respect their adult status in making decisions about their education, health, mental health treatment and other services • Encourage the NMD to assume greater responsibility for participating in the activities of their independent living plan • Balance supporting the developmental needs of the young adult with providing them with a safety net for the experience of independence • Promote a relationship with young adults based on respect, positive regard and genuineness • Providing young adults with a supportive environment so they can enhance their life skills and experience positive outcomes as they leave care

  14. Case Manager Responsibilities To Young Adult • Meet with the youth six months prior to age 18 to discuss option and benefits of extended care • Discuss placement options with youth including remaining in group home care • Complete SOC 161 – Six Month Certification of Extended Foster Care Participation • Complete SOC 162 – Mutual Agreement for Extended Care (except for 602 probation youth) • Complete updated Transition Independent Living Case Plan with youth including 6 month goals and activities • Complete updated Transition Independent Living Plan and Agreement with youth • Meet with the young adult at least monthly to monitor progress with 51% of meetings at their placement

  15. Extended Care Participation Conditions • Complete high school or a program leading to an equivalent credential • Enroll in post secondary or vocational education • Participate in a program/activity that removes barriers to employment • Be employed for at least 80 hours a month • Be unable to consistently do one of the other conditions due to a verifiable medical or mental health condition

  16. Transition Independent Living Case Plan (TILCP) • The TILCP is a continuation of the same case plans that were developed prior to age 18 and is the AB 12 case plan • There is no longer a focus on family re-unification, parental rights termination, or establishing legal guardianships • The focus is on permanent connections and independence • Must include at least one of the participation condition for extended care eligibility • Continues efforts to identify and develop permanent connections with committed and caring adults and family members • Identifies goals and services to support youth in education, employment and development of independent living skills to be successful adults

  17. Transition Independent Living Plan (TILP) • The TILP is part of the Transition Independent Living Case Plan and is developed with the youth or young adult • The purpose of the TILP is to identify the goals the young adult agrees to achieve over the next six months • The TILP includes at least one goal that meets a participation condition for extended care and a back up goal that meets a second condition • The TILP includes a goal to develop permanent connections with committed and caring adults • The TILP includes a goal to transition to a lower level of care • The TILP is reviewed with the young adult and the group home to identify the activities, responsible parties and timeline for completing each goal

  18. Sample Transition Independent Living Plans For Youth in Group Homes General Goal. Develop a permanency connection with a supportive adult. • Activity. Identify family members and other adults who can provide permanency support. • Activity. Meet with family members and other adults to discuss future support they can provide. Condition 1 Goal. Complete the course requirements for high school graduation. • Activity. Meet with counselor to identify classes needed to graduate. • Activity. Identify and access supports needed for success. Condition 2 Goal. Enroll in Post Secondary Education • Activity. Research post secondary education options including college and community college. • Activity. Apply for college, financial aid, and available services for foster youth.

  19. Sample Transition Independent Living Plans For Youth in Group Homes Condition 3 Goal. Remove Barriers to Employment • Activity. Participate in ILP work readiness. • Activity. Volunteer at a community program Condition 4 Goal. Obtain Paid Part Time Employment • Activity. Research and apply for supported employment opportunities (i.e. Summer Employment Programs, WIA Youth Programs). • Activity. Participate in ILP employment counseling. Condition 5 Goal. Participate in Mental Health Treatment • Activity. Obtain information about your mental health diagnosis and treatment. • Activity. Attend individual therapy on a weekly basis.

  20. Youth Transitioning From Congregate Care Prior to Age 18 • Meet with youth at least six months prior to turning age 18 and discuss the benefits of extended care • When possible, efforts should be made to transition youth from group homes to less restrictive settings • Review housing options and discuss where they would want to be placed in extended care • Develop the TILCP and TILP with the youth to support transition from the group home by age 18 • Have a transition planning meeting with the group home to work with them on activities to ensure successful transition • Wraparound services may be used to support addressing the goals and services of the TILCP including transition from group home

  21. Developing a Transition Independent Living Plan with a Young Adult

  22. Group Home Case Plans • Why the group home is the best placement to meet the needs of the young adult • How the placement will assist the young adult’s transition to independent living • Treatment strategies the group home will use to prepare the young adult for discharge to a less restrictive or family like setting • A target date for group home discharge • Periodic review of the placement to ensure it is the best option and review progress towards achieving independent living goals

  23. Case Manager ResponsibilitiesTo the Group Home • Complete SOC 154 B Group Home Agreement for Non Minor Dependent (a new agreement is not needed for youth who remain in the same placement at age 18) • Provide the group home with knowledge of the background and needs of the youth including their Transitional Independent Living Plan • Assist the group home in developing a transition plan consistent with the TILP and support them in providing the services needed to achieve their goals • Provide a Medi-Cal card or other medical coverage for the youth • Work with the group home to maintain permanency connections with youth family members, siblings and significant adults in their lives • Maintain ongoing contact with the group home and include them in transition planning meetings to support the young adult • Work with the group home and NMD on discharge planning towards a lower level of care or transitioning to adult services

  24. Group Home Responsibilities • Develop an initial transition plan with the young adult consistent with their TILP (within 30 days for new placements) • Provide the young adult with care, supervision, treatment arrangements and services based on their TILP to ensure they achieve their goals • Notify the placing agency within 24 hours of significant changes in the young adult’s situation including their health, school, work or absence • Complete a Shared Living Agreement with the young adult • Support identifying and developing permanent connections with family members, siblings and significant adults • Participate in transition planning meetings with the SW or PO, young adult, permanency options and community providers as appropriate • Provide periodic updates of the transition plan progress every six months or more frequently as needed

  25. Young Adult Responsibilities • Meet with my SW or DPO once a month and update them on progress towards my TILP and permanency goals • Work on completing the goals of my TILP and the participation condition for being in extended care • Comply with the terms of the Shared Living Agreement that I make with my group home placement • Inform my group home and case worker about any problems I am having in my placement and work with them to find solutions • Notify my case worker with 24 hours if I move to a new placement or out of my current placement for any reason

  26. Shared Living Agreements • Group homes should review potential issues in housing non-minor dependent youth and minors together and develop specific policies to address them • The Shared Living Agreement (SLA) is considered a best practice for the group home to develop with non-minor dependent youth living with minors • Shared Living Agreements should respect the adult status of the youth including the following areas • Personal time • Health care decisions • Food shopping and preparation • Computer access • Shared Living Agreements with youth should respect the policies for minors in program areas that include • Keeping medications secured • No smoking cigarettes • Quiet after bedtimes

  27. Shared Living Agreements SLA Components • Skills and Resources Wanted • Health and Safety Concerns • Household Agreements • Household Chores and Responsibilities • School / Work Attendance and Performance • Financial Issues • Drugs and Alcohol • Conflict Resolution 3. Household Agreements • Schedules / Curfew • Noise • Language • Cigarette Smoking • Guests • Shared Space • TV/Computer/Video Games • Furnishing/Decorating

  28. Community Care Licensing RegulationsNon Minor Dependents in Group Homes • Complete a Pre-Placement Appraisal to ensure the safety of all residents, review health history, identify special needs and confirm the program can meet the needs of the youth • Ensure the youth receives needed health care services & assist them in developing skills needed to being self sufficient in obtaining health care • Ensure the youth has access to three meals per day & is involved in planning meals, food shopping, & preparing meals • Assist the youth in developing independent living skills & assist them in obtaining information on employment, career options, & attending college • The non-minor dependent youth can share a bedroom with a minor who is a sibling or who they were roommates with prior to turning age 18 or with another non-minor dependent

  29. Community Care Licensing RegulationsNon Minor Dependent Youth Personal Rights The NMD has the same personal rights as minors plus additional rights as legal adults • Have personal items including furnishings, supplies for their living space, and an automobile • Select, obtain or decline health care and related services • Have a personal telephone or computer for internet access • Leave or depart the program at any time • Participate in activities of their own choosing • Provide their own releases for confidential information

  30. Group HomeTransition Service Components • Education Support • Mental Health Treatment • Family and Permanency Connections • Employment and Vocational Training • Independent Living Skills • Transition Preparation

  31. High School Completion • A primary reason for young adults to remain in group home care is to complete their high school education • Supporting youth in completing their secondary education • Working with Special Education Departments to coordinate IEPs and transition planning and ensure youth obtain needed services • Working with Foster Youth Services to ensure youth get the additional support needed including tutoring and advocacy • Ensuring youth are enrolled and participate in adult education classes to obtain their GED if high school is not a viable option • Ensuring youth are aware of their educational rights and their rights are honored

  32. Post Secondary Education Support • Community Care Licensing requires group homes to assist young adults with the steps to attending college at their request. • Encouraging young adults to explore post secondary options including community colleges, universities, vocational and career technical education • Assisting young adults in completing college and financial aid applications, college enrollment and orientation, course planning, and payment of fees • Providing access to college resource programs including the Foster Youth Success Initiative (FYSI), Extended Opportunity Programs and Services (EOPS), Disability Support Programs and Services (DSPS), and Guardian or Renaissance Scholars

  33. Employment Support • Youth need support to maintain employment or remove barriers to employment • Build positive relationships with youth, encouraging them to set and achieve relevant goals • Support youth with transportation and other resources to get to work or meet goals for removing barriers • Work with community organizations to connect youth to services, programs and supports • Help youth identify and access volunteer and internship opportunities

  34. Medical and Mental Health Treatment • Providing young adults with interventions to support them in changing difficult or negative behaviors • Ensuring young adults have access to treatment to address medical needs and unresolved trauma, mental health and substance use issues • Assisting young adults who meet disability criteria with completing applications for Supplemental Security Insurance • Educating young adults about their diagnosis and medications while teaching them to advocate for themselves • Educating young adults about the differences between the adolescent and adult mental health systems • Ensuring young adults have access to continuity of care in health and mental health treatment through EPSDT and Medi-Cal

  35. Supplemental Security Income (SSI)State Supplementary Payment (SSP) • SSI benefits are an important safety net for youth with serious disabilities • SSI benefits are available to youth regardless of AFDC-FC eligibility (SSI and AFDC-FC benefits may be offset – youth will receive amount of whichever benefit is greatest) • Every youth in care must be screened for SSI eligibility between the ages of 16.5 and 17.5 and applications must be made on behalf of youth determined likely eligible • The goal is to have SSI in place by age 18 • Non minor dependents can participate in extended care and receive SSI • Young adults may be awaiting SSI approval while in extended group home care • SSI may qualify youth for permanent housing and social security has programs to help youth work and pursue their education • The placing agency must ensure that youth receiving SSI suspend payment and receive state funded AFDC-FC for one month each year to maintain SSI eligibility

  36. Family and Permanency Connections • It is important to continue to have a philosophy that family and permanency is important • Help young adults form mutually supportive and stable attachments with adults and expand their concept of family • Search for and strengthen relationships with family members and significant adults that have been disrupted • Encourage youth to identify adults in their lives who are allies including their friends, partners and their families • Adult mentors can be an important permanency option and have been effective in helping probation youth make positive changes in their lives • Family therapy may be appropriate with some young adults and some parents who experience change and growth • Help young adults to understand, accept and manage their relationships with their family members

  37. Wraparound Services • Wraparound services can help youth transition from group homes to a lower level of care • Wraparound services uses a team approach brings together friends, family, and other important individuals in the youth’s life • Services areas include transition planning; lack of supports; impaired functioning; and social, communication, and living skills • Wraparound services are intensive, individualized, strengths based and focused on supporting youth in identifying and developing permanent connections • Eligibility is for youth currently placed in a group home and transitioning to a lower level of care within 3 months of their discharge date

  38. Employment and Vocational Training • Exit and outcome studies consistently show at least half of former foster youth are unemployed • Education and employment goals are not mutually exclusive and should both be part of transition planning • Supported employment provides youth with job readiness and retention skills, work experience and employer support • Group homes can support young adults in gaining work readiness skills and work experience before transitioning to lower levels of care • Community Care Licensing requires group homes to assist young adults in obtaining information about trade, vocational, or professional careers as well employment-related programs at their request • Some youth will benefit more from employment and vocational training than from pursuing post secondary education

  39. Employment and Vocational Training • Community after school and summer youth employment programs provide work experience with a 2.0 GPA usually required • WIA (Workforce Investment Act) Youth Programs, One Stop Centers and EDD (Employment Development Department) programs provide work training and experience for youth • Workability programs and the Department of Rehabilitation provide employment services for youth with disabilities • ROCP (Regional Occupational Centers and Programs) and Adult education schools provide career technical education for young adults • Local employers and the business community can be engaged as partners to expand employment opportunities for young adults

  40. Independent Living Skills • Group homes can provide young adults with a supportive environment to learn and practice independent living skills • Ansell-Casey Life Skills Assessments can help young adults and group homes to identify specific areas and skills to focus on • Youth engaged in employment can learn skills related to job retention, budgeting, paying bills, and money management • Programs can teach daily living skills including grocery shopping, preparing meals, self care and transportation • Youth can also learn skills related to problem solving, decision making, stress and anger management, and living with others • These skills are essential for young adults to learn in transitioning to a lower level of care

  41. Independent Living Programs Services Include Access to Transitional Housing Case Management Post Secondary Education Support Employment Services Life Skills Workshops Transportation and Financial Assistance • ILP services are available to both child welfare and juvenile probation youth in out of home care until age 21 • Youth in extended care should be encouraged to participate in ILP • Participation in ILP meets Eligibility Condition 3 for extended care

  42. Evidence Based and Promising Practices General • Positive Youth Development • Motivational Interviewing • Cognitive Behavioral Therapy Trauma • Trauma Focused Cognitive Behavioral Therapy • EMDR (Eye Movement Desensitization Reprocessing) Supportive Services • Wraparound • Mentoring • Multidimensional Treatment Foster Care

  43. Evidence Based and Promising Practices Transition • Supported Employment • Permanent Supportive Housing • Transition to Independence Process Model • Independent Living Programs (Unrated) Mental Health • Interpersonal Psychotherapy – Adults / Adolescents • Mindfulness-Based Cognitive Therapy • Intensive Short-Term Dynamic Psychotherapy

  44. Transition Planning Meetings • Transition planning meetings include the young adult, SW or DPO, and group home provider • Transition meetings can also include family members, mental health providers, potential care providers, and other significant adults • They also meet the case manager requirement of meeting with youth at their place of residence more than half of the time • An initial transition meeting at the beginning of the six month extension can be used to develop and sign the Transition Independent Living Plan • TILP goals and activities can be reviewed with the young adult and group home to clarify the responsibilities of all parties

  45. Transition Planning Meetings • A transition planning meeting is recommended at the mid point of the six month group home agreement • Progress in developing permanency connections with family members and other caring adults can be reviewed • Viable housing options for transitioning from group home care with the steps involved, assigned activities and community resources needed can be identified • Social workers and probation officers need to ensure that youth are on the waiting lists for supported transitional housing • The need for extending group home care after the six month period can be reviewed including reasons (i.e. medical or mental health) and time frame involved • This meeting can include preparing the 90 day transition plan for youth wanting to exit foster care

  46. Young Adults Who Have Dual Service StatusWith Adult Providers • Adult service providers who have a dual status in working with youth should be included in the transition planning process • Adult dual service providers may include the regional centers, mental health services, vocational rehabilitation, special education and health care providers • The SW or DPO should ensure that youth are receiving case management services from adult dual service providers when appropriate • Transition to supportive housing available through regional centers, mental health, and others should also be considered if it ensures site specific services or increases permanency

  47. Housing Options For Young AdultsTransitioning From Congregate Care • Transition Housing Placement Program • Transition Housing Program Plus Foster Care • Family and Foster Care Options • Post Secondary Education Housing • Supervised Independent Living Setting • Transition Housing Program Plus • Transitional Living Programs

  48. Transition Housing Placement Program (THPP) • Youth ages 16-18 are currently eligible • There is a period of transition as THP-Plus FC comes online, and existing THPP providers can currently serve non-minor dependent youth beyond age 19 or beyond HS • THPP includes living in apartments with roommates, communal living situations in a house, or in family settings • Case management is required for all housing models • Communal living situations have staff supervision • Short term housing option for youth or young adults transitioning from congregate care

  49. Transition Housing Program Plus Foster Care • Currently being developed as AB 1712 • Young adults in out of home care ages 18-21 are eligible • Young adults will be under the supervision of their SW or DPO and meet with them monthly • THP-Plus Foster Care is a Title IV-E eligible placement and will be under the authority of Community Care Licensing • Housing will include both site based apartments and host family options • Case management and wrap around services will be available to support the young adult • It is important for THP Plus Foster Care to provide continuity of mental health treatment and other specialized services for many non-minor dependent youth exiting group homes

  50. Family and Foster Care Options • Young adults can transition from group homes to living with family members, non-related family members (NREFM) or a non-related legal guardian • These providers can receive foster care payments directly or the young adult can also live with them as a roommate using SILP funding • Foster family homes, foster family agency (FFA) homes and small family homes can also be use as placements for young adults transitioning from congregate care • Shared Living Agreements can help young adults transition to living with family members, non-relative family members, and foster homes • Non-minor dependent youth in these placements remain eligible for specialized care increment, dual agency rate, intensive treatment foster home rates (if applicable), etc.

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