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Roanoke County innovates foster care program to save on Children's Services Act costs

Roanoke County innovates foster care program to save on Children's Services Act costs

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Erika Stinnett shuffled her stack of papers and looked up at the 17-year-old sitting across the table. She asked the girl about her plans for when she turns 18: where she will work, where she will live, and what support to expect from the social services department.

“You do very well communicating what you want and stating what you want, and you need to keep that in you,” Stinnett said. “Not even talking about you aging out of foster care, but no one’s going to have your back like you. And at the end of the day, you have to do what’s best for you.”

Stinnett is a mentor with Youth Advocate Programs, a national nonprofit focused on community based alternatives for at-risk children and support for foster care youth. Youth Advocate Programs teamed up with the Roanoke County and Roanoke City social services departments in 2010 to administer the STARS program — an extra layer of support for children and families involved in foster care.

Stinnett met with the foster child, whose name has been withheld to protect her identity and privacy, multiple times per week to support both her and her foster parents, Andy and Sandee Szabo.

At one of their meetings in April, Stinnett talked with her about her new job at Walmart and how she was balancing the new commitment with her last few weeks of high school. And they strategized how to budget her money so she could afford rent when her time with the Szabos came to an end.

The young woman came into the care of the Roanoke County Department of Social Services in the summer of 2020. And as a teenager in foster care, she was immediately placed in the STARS program, which focuses on families who are fostering teenagers or fostering children with severe disabilities or emotional needs.

The additional services, such as a therapist for the foster parents, a mentor for each foster child, and parent support groups, has helped retain and support foster families in the area. That retention, and being able to train its own specialized foster care homes, saved Roanoke County more than $1 million in potential Children’s Services Act costs over a two year period.

The Children’s Services Act was implemented in the early 1990s and pooled money from different child-serving agencies across the state, including juvenile justice, social services, behavioral health and education. Those funds are used to provide services for at-risk children, including all children in foster care.

The idea of the legislation was to eliminate duplication and use funds more efficiently to realize better outcomes for children, but the legislation has, at times, fallen short.

Recently, the state has been studying ways to reform the act after costs have continued to rise year after year without a proportional increase in the number of children being served. As costs have increased, localities have been forced to innovate with new programs like STARS to lower their CSA costs and fill needed service gaps across the state. But these programs can be difficult to replicate in smaller, rural or more resource-strapped areas.

“Why doesn’t everybody do this? Because it’s above and beyond what is required,” Roanoke County foster care supervisor Ben Jones said. “In child welfare, you often don’t have what you need to do what’s required.”

Help from STARS

The Szabos’ foster daughter came to their home after a transient period living with her uncle locally and then with her mom in eastern Virginia. She ran away from home, but was picked up by child protective services and spent a few nights in a group home. She arrived at the Szabo house with just the clothes on her back and a small bag.

“When you first come in, it’s kind of hard because you have, especially when you’ve been on your own, like so many rules that have to come along,” she said. “Before I knew them fully, I wanted to go back to the group home.”

Sandee said the timing of her foster daughter’s arrival coincided with the anniversary of Sandee’s father’s death and just a few months after Sandee’s mom’s funeral.

“I think in the beginning that really caused her and I to butt heads a lot, because I was in such an emotional state,” Sandee said. “And then all of a sudden, here we have this 17- year-old who thinks she knows everything and wants everything her way.”

Sandee and her foster daughter both describe themselves as stubborn and said they consistently fought for the first few months. But the STARS program set Sandee and her husband up with their own therapist to work through the transition and also provided respite care, when another family takes care of a foster child for a short period of time. Sandee said respite gave her and her husband needed breaks and kept their own relationship strong.

The STARS mentor, Stinnett, helped them establish house rules and enforce them because it was their first time fostering. And Stinnett offered suggestions on how to get the young woman ready for her adult life: they established one night per week where she would budget, grocery shop and prepare a meal for the entire family on her own.

“Without STARS we probably would have said please come get her,” Sandee said. “Because we really needed those STARS workers and the therapists to help us all. I think it really helped us get a handle on how to do it. Without STARS, we would have had a lot more difficulties.”

Sandee said the program provided her foster daughter with three different workers: a medication counselor, a private therapeutic counselor and her mentor. These are in addition to the workers she has access to through the social services department.

“Since I’ve been in counseling and been on medication, I’ve actually been better attitude-wise,” the young woman said. “Because when I got here, I was a raging dog. I’ve actually calmed down in counseling. I can really see a difference.”

The STARS program provides many services to foster families, but is able to save the localities money by mimicking therapeutic foster care homes. Therapeutic foster homes are typically run by private agencies that recruit and train their own foster parents and contract their services to local social services departments, which pay a high rate to use them.

Therapeutic homes receive a larger stipend from the state because the children in these homes typically have needs that go above and beyond what a normal foster family would be expected to provide. And the private agencies often have more resources and a higher paid staff that can provide additional support to foster parents who may be struggling to adjust to their new role.

The Roanoke County and Roanoke City social services departments have been able to create their own therapeutic foster care program with STARS, where they train therapeutic foster parents themselves, and with the help of YAP, provide the extra support that retains families and helps them avoid burnout from the social services system.

Jones said his department is able to provide the same service for less than one tenth of the cost that a private agency would charge.

“It turns out that with these additional supports, our families are able to be more sustainable, more professional,” Jones said. “We look at what a family needs and utilize multiple funding sources to make it happen. Our outcomes are better and we’re able to train families to a higher level right off the bat.”

Jones said the two localities copied the idea from Portsmouth, which ran a similar program for a few years before it fizzled out. When Jones became the foster care supervisor in 2012, he inherited the program. At the time there were fewer than 10 families involved.

Jones and his counterpart in Roanoke began to grow the program slowly — looking for families who had fostered before and done well. Eventually, they expanded the program to new families who had never had a foster child. Now, there are 33 STARS families in the city and county combined.

The program requires the same 30 hours of training, background checks and approval process as a regular foster family. But the STARS program adds 12 more hours of training and additional assessments to make sure families can handle the added difficulty of a child with severe needs.

“All of this is about keeping placements stable so kids don’t bounce from one home to another, providing a better stewardship of county and state funds, and we want our foster homes to be safe and stable,” Jones said. “We don’t want the families to break under the pressure of the system.”

Filling a gap

The Children’s Services Act provides funding for more than 5,000 foster children in Virginia — about $117 million was spent in 2020, according to data from the Office of Children’s Services.

CSA has been experiencing cost increases overall since about 2015 and increases in foster care costs since at least 2017 without a proportional increase in the number of children served.

The Joint Legislative Audit and Review Commission released a report in November about these trends and attributed some of that cost increase to the need for more services in many areas of the state.

These service gaps, in which a locality may not have access to a particular service a child needs, mean kids are sometimes sent to a higher-than-necessary level of care, such as a residential facility. This leads to cost increases and worse outcomes for the children being served.

Therapeutic and regular foster care homes have been repeatedly identified as one of the largest areas of need across the state for years, according to surveys conducted by the state Office of Children’s Services.

Each year the office surveys localities about barriers that exist to overcoming these service gaps. In fiscal year 2021, a lack of service providers was identified by 50% of localities.

Part of the reason the STARS program is so successful is because the local governments have partnered with Youth Advocate Programs to help run it.

Jones, who coordinates the program as part of his regular duties, said high caseloads, turnover and a litany of responsibilities would make it difficult for his staff to run the program without a dedicated partner separate from the social services department.

But in counties where a partner organization or service provider doesn’t exist, replicating the STARS program would be difficult, if not impossible.

Smaller localities often serve fewer children in CSA programs and can have difficulty attracting a provider to the area if there isn’t a financial incentive to open there. The smallest local CSA programs serve fewer than 10 children per year while the largest serves more than 1,000. Some regions have been successful in attracting a provider to serve multiple localities at once, but the time-consuming collaboration and development process can be a barrier for areas without the staffing or resources.

Rebecca Morgan, director of the Middlesex County social services department, said her area faced a gap with special education services. Her agency is now working with multiple localities to create a new special education school. Currently, the closest private special education school is about 30 minutes away, and the closest one that served children with autism is anywhere from 60 to 90 minutes away.

Morgan said the group has been working to create the new school for a few years now and has partnered with a service provider that will run the program. They are currently in the process of selecting a location.

“You have to have somebody to step up and say they’re going to lead it,” she said. “That’s how everything got off the ground for us.”

The local community services board stepped up, applied for grant funding and took the lead on the project. Finding that leader can often be the barrier holding localities back from making progress, Morgan said.

“Where is your time going if you aren’t waking up every day, going to work and thinking of how you can improve the life of the latest child who’s come through child protective services?,” she said. “It has to be a community effort, stepping outside of the day to day and at least trying something new.”

According to JLARC, some smaller localities lack the financial leverage, resources and expertise to negotiate terms and rates with providers. The report recommended the state step in and help negotiate these agreements.

Funding is also among the largest factors in maintaining service gaps. According to a survey from the Office of Children’s Services, close to one-third of localities said a lack of funding has greatly inhibited their ability to develop services.

Jones said the STARS program did not take a large investment to start, but replicating it would require buy-in from the local CSA office and a small amount of funding to hire a coordinator who could track the training, appointments and other requirements of the program and its families.

“Most of the infrastructure to run a successful program already exists within your local DSS because the state has already provided for it,” Jones said. “The enhancements are what you need to fund and they are surprisingly affordable compared to what we’re spending in private agency reimbursement.”

Even so, extra funding can be hard to come by in social services departments that operate on strict budgets and are already struggling with increased costs.

Brian Carter, director of finance and human services in Franklin County, said the locality has had discussions about replicating the STARS program, but hasn’t been able to because of staffing and budgeting issues.

Years ago, legislators created a grant program of $750,000 to help address the funding issue experienced in localities wanting to start new programs. A 2006 JLARC report on CSA recommended the program be expanded, but the recommendation was never implemented and the grant eventually expired.

Taking on teens

The Szabos lived in Northern Virginia for decades before deciding to retire in Salem. They never had children of their own due to medical issues and considered adopting and fostering, but didn’t pursue it until they moved to the Roanoke area.

Sandee said she had always thought about fostering children because her aunt and uncle in Maryland fostered children for more than 30 years and adopted some of her cousins from foster care.

“I’ve always been exposed to it,” she said. “It was always open.”

The Szabos took foster parent training classes in the fall of 2019 and were approved the following spring after the required home visits and background checks were complete.

The same day the department certified them as foster parents, they received a call for emergency respite placement for a 15-year-old boy. The Szabos took care of him for about two weeks while his foster parents took a break.

A few months after that, their 17-year-old foster daughter arrived.

The Szabos said they specifically volunteered for teenagers because it’s a foster care population that is often overlooked.

Jones said the county has a significant need for foster parents willing to take teenagers, who are often sent to group homes or residential care because there is no family who can, or is willing to, take them.

“They need to grow up in a family environment to see people interact and argue and work things out together and be in a relationship because that’s what you take into your adult life,” Jones said. “If they lose that and they go to a group home or a residential situation, then we are preparing them for jail or the army. Because that’s where those relationships are transitory and you are in a bunk and you don’t get those family dynamics you’re supposed to have.”

Many families sign up to foster with the expectation they will care for an infant or a toddler. Convincing them to take on an older child, with more life experiences and potential trauma, can be difficult.

“I think if more people knew how much support is actually out there through the STARS program, I think a lot more would probably consider doing teens,” Sandee said.

Under the radar

Currently, innovative programs like STARS can go unnoticed by state officials and other localities that are not aware of the success.

Morgan, social services director in Middlesex County, said it would be helpful if localities had a chance to share ideas and successful programs with one another. She said the Office of Children’s Services could take on the role to facilitate best practices, feature new programs and help localities replicate them.

“If everyone was committed to moving the system forward and trying something different, trying a new approach, talking to someone who’s developed a new program and taking the time to build it up, you could really do something transformative,” Morgan said. “Many communities are doing this, many programs are partnering together, but I don’t know that there’s a spotlight on that.”

Each year, the service gap surveys are sent out to each locality and respondents simply check boxes on a form with categories that can include close to 10 different services. The needs over the years have remained consistent and such broad categories prevent the ability to drill down into actual service gaps experienced by children and families.

A more thorough look at exactly what each locality needs would be a more effective way to evaluate and fill service gaps.

Del. Kenneth Plum introduced a bill, which was passed last regular session, that requires the Office of Children’s Services to monitor performance measures, use data to identify localities that are underperforming and develop corrective action plans.

The legislation required the office to hire an additional staff member who would develop an approach to the data analysis and review of local CSA programs.

Sen. Barbara Favola, who serves as a member of the Commission on Youth, said she hopes these reports and data points will help the state see where gaps exist across the Commonwealth and what can be done to address them.

“My overall goal would be to make the state a really strong partner in funding creative solutions that would work for their families and their children,” Favola said. “You have to look at this as an investment, not a cost. You have to ensure that localities have the support they need to make these programs work.”

Alison Graham is The Secular Society Investigative Fellow at The Roanoke Times.

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Alison Graham covers Roanoke County and Salem news. She’s originally from Indianapolis and a graduate of Indiana University.

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