Youth Advisory Council A Program funded through a five-year cooperative agreement with Department of Health and Human Services, Administration for Children and Families, Children’s Bureau in partnership with: Spaulding for Children, The University of Texas at Austin, The University of Wisconsin-Milwaukee, and The University of North Carolina at Chapel Hill Youth Advisory Council

QIC-ag Leadership team QIC-AG is funded through a five year cooperative agreement with Department of Health and Human Services, Administration for Children and Families, Children’s Bureau. Spaulding for Children University of Texas at Austin University of Wisconsin-Milwaukee University of North Carolina at Chapel Hill Entering year 5 of the 5 year project this September.

Partnership The QIC-AG will work in partnership with 8 sites (state, county or tribal child welfare systems), to develop system capacity and implement and evaluate interventions that promote and support adoption and guardianship. The sites that have been selected include: Illinois Catawba County, North Carolina New Jersey Tennessee Texas Vermont Wisconsin Winnebago Tribe of Nebraska Wisconsin is one of 8 sites participating.

Qic-ag goal QIC-AG will develop evidence-based models of support and intervention that can be replicated or adapted by other child welfare systems across the country to achieve long-term, stable permanency in adoptive and guardianship homes for waiting children as well as for children and families after adoption or guardianship has been finalized.

Continuum of Services: A PREVENTION STRATEGY Post-Permanence Pre-Permanence F I N AL Z A T O Prevention Stage Setting Preparation Focused Services Universal Selective Indicated Intensive Services Maintenance Explain how WI selected Indicated Level Stages that are capacity building only are in grey. Areas where the QIC-AG will build capacity AND implement and evaluate interventions are blue (pre-permanence) and green (post-permanence).

INDICATED INTERVAL Characteristics: Families identified through outreach or have contacted agency directly. Families asking for help as problems have become evident. Currently experiencing issues that put them at heightened risk of discontinuity of instability.

Discontinuity Instability that occurs after an adoption or guardianship has been finalized The situation in which an adoption or guardianship ends after being legally finalized.

GOALS OF INDICATED INTERVENTIONs Prevent escalation to crisis Reduce family stress, promote stability Increase caregiver skills Strengthen caregiver commitment Stabilize behaviors Strengthen social support

ADOPTION and GUARDIANSHIP Enhanced Support (AGES) Wisconsin’s QIC-AG project developed the Adoption and Guardianship Enhanced Support (AGES) Program Based on similar programs in Pennsylvania (Statewide Adoption and Permanency Network Case Advocacy) and North Carolina (Success Coach) Supported by feedback from adoptive and guardianship families in Wisconsin AGES offers families: individualized assessment of emerging needs and their strengths, identification of family-specific goals, personalized assistance with navigation of pre-existing resources and services, and targeted advocacy in the areas as requested by the family The Wisconsin QIC-AG project will develop and implement the Adoption and Guardianship Enhanced Support (AGES) Program. AGES is based on similar programs serving post-adoption and guardianship families in Pennsylvania (http://www.adoptpakids.org/CaseAdvocacy.aspx) and North Carolina (http://www.cssp.org/reform/child-welfare/youth-thrive/ei-profiles/Child-Wellbeing-Profile-2-27.pdf ). The program is also informed by adoptive and guardianship families in Wisconsin who stated that they would welcome help with the day-to-day challenges they face parenting children with significant trauma and abuse histories.   Wisconsin’s Theory of Change states that adoptive parents and guardians felt “ill-equipped and unsupported because there are emerging issues that, at the time of finalization may have been within the caregiver’s capacity to address, were not present, or were not causing familial stress.” The AGES Program recognizes that families formed through adoption and guardianship have unique challenges and needs. The intervention seeks to serve as an adoption and guardianship competent, trauma-informed support for families facing emerging needs post-permanence. AGES will offer families an individualized plan with specific goals, needed supports and targeted advocacy based on the assessment of the child and family’s needs and strengths. The AGES worker will work with the family to increase the their capacity to manage stressors by offering support, resources, and advocacy. AGES is designed to help families in the Indicated Prevention Interval. Families in this interval reach out for help due to the emergence of challenging issues or behaviors. These emerging issues may be triggered by a change in the family as a result of the child's age or behaviors, a change in family functioning, or a parent's weakened commitment to permanence. Services delivered to families in the Indicated Interval seek to support the family, reduce family stress, stabilize the placement and increase the family's skills in managing challenging behaviors.

Program Eligibility Eligibility criteria Exclusionary criteria Lives in NE Region of WI Has adopted or assumed guardianship of a child Meets criteria based on referral questions (indicated level) Exclusionary criteria Child is in OHC or not living in the home Family has open child welfare case and receiving services Family has open CPS or YJ case Licensed Foster Parent Expressing the child must be moved or placed in OHC Discuss reasons for NE region selection

Program entry Referral and Screening process (3 days) Family contacts an Entry Point Foster Care and Adoption Resource Center, DCF Central Office, NE Region Post Adoption Resource Center AGES Referral Tool completed Obtain consent to proceed with evaluation Screened by Regional Permanency Supervisor AGES worker is assigned within 3 days of the call and begins offering services Discuss entry point selection Discuss

Who are the AGES workers? What does the AGES workers do?

Ages worker “AGES workers are certified Social Workers that are assigned to a family once the screening process is complete and the family meets eligibility requirements. An AGES worker will discuss the components of AGES and gather necessary information to best support the family driven plan. The AGES worker will offer support in assessing the family needs and strengths, navigating and coordinating services that could benefit the family, as well as assisting the family in building a network of formal and informal supports.”

Information gathering The AGES worker gathers: Relevant and significant information Circumstances surrounding request for AGES Family’s story Child’s history Family’s trauma history Collateral information Observations of interaction with client

Assessment tools and purpose Measures frequency of behaviors and captures change over time Behavior Problem Index (BPI): Assesses child’s belonging to family Belonging and Emotional Security Tool (BEST): Assesses cohesion and flexibility Family Adaptability and Cohesion Evaluation Scale (FACES): Measures strength of family’s social supports Duke Functional Social Support Questionnaire: Measures caregiver stress Caregiver Strain Questions Identifies strengths and needs Wisconsin CANS:

Support types Social Support Supportive emotional, information, relational resources. Social Support Navigation and coordination of supports. Case Management Support to develop strategies and skills to enhance attachment, empathy, and communication. Parenting Services/Education Support and advocate for families with school challenges and questions. Educational/School

Risk and Protective Factors

Child factors for discontinuity Age of the child at time of placement Behavioral issues Number of prior placements Length in out of home care Prior maltreatment Attachment Race Sibling placement

Family Factors for discontinuity Caregiver demographics Marital status Relationship to the child (relative caregiver) Higher education Employment status Caregivers age

Caregiver Characteristics for discontinuity New placement Unrealistic expectations Lack of caregiver commitment Lack of parental sensitivity Placement with relative

Agency factors for discontinuity Inadequate subsidy Inadequate child information provided Inadequate preparation and training before and after legal finalization Inadequate support Availability of pre adoption and post adoption services

Common Themes Found 8-15 year olds, older children Ineffective parenting responses Lack of knowledge regarding child development Lack of trauma informed parenting Frustration with the system and ineffective services Feelings of being misunderstood and helpless Inflexibility Lacking maintenance (always in crisis mode)

Common Themes Found Strong commitment level Willingness to reach out for help and feel a sense of relief They “show up” Passionate about the adoptive process They want kids to be the best they believe their kids can be

Wisconsin AGES Data (March 13, 2017 – July 24, 2018) 56 calls from families 30 referred 25 screened in 22 currently open 3 closed 5 screened out 26 not referred* 3 family wants child to move 7 open case (CW, JJ, CPS) 10 foster parent license** 3 other reasons*** 9 child living away Not referred: * Reasons for not referring are not mutually exclusive; there can be multiple reasons for one family ** Foster parent license was the only reason for not referring in one family *** Other reasons included: 1 was involved in stakeholder group and did not feel it was appropriate to participate; 2 felt that AGES was not what they needed

QIC-AG Project Status: Call sources: 15/56 (27%) DCF Central Office 4/56 (7%) FCARC 37/56 (66%) PARC Adoption/Guardianship Type Referred: 35 public adoptions 3 private domestic infant adoption 5 international adoption 6 private guardianship 2 public guardianship 5 tribal (private/public adoption and guardianship) Adoption/Guardianship Type Not Referred: 17 public adoptions 1 private domestic adoption 2 international adoptions 12 unknown

QIC-AG Project Status: Parents are saying: “At the time, we were under so much stress that it helped tremendously that she [AGES worker] came here… we could not go places without him having a severe meltdown…It also has been helpful for her to see his behaviors…he is cute as button until he is raging. She got to see that because she was in the home. Now that we have everything under control, I go there [to the office]…” “When we first contacted AGES we were in a valley. Since then, we are back on a mountaintop…” “I can see the stress is less…Things have improved in the family in general. I don’t feel so overwhelmed. I feel like I have help.” “We have a whole list of resources, but we will use them when and if we need them. Right now, we are on a mountaintop so we don’t need them. We know that things can change anytime. It is comforting to know that we have them should we need them.” “This program is absolutely necessary!” “AGES is needed. I can tell you, it is needed!” “Also thanks for allowing us to participate in the AGES program.  Finding out our son has Asperger's on top of everything else we went through this Spring with him would have been unbearable without our AGES worker helping us through it.” 

AGES Family Voice What would or should have been done differently prior to your family achieving permanency through adoption or guardianship? What caused you to reach out to the AGES program and what has been the most helpful to you while AGES has been involved? What do you need more of to assist your family moving forward?

QUESTIONS Additional Information on the QIC-AG can be found at: www.qic-ag.org Funded through the Department of Health and Human Services, Administration for Children and Families, Children's Bureau, Grant #90CO1122-01-00. The contents of this presentation do not necessarily reflect the views or policies of the funders, nor does mention of trade names, commercial products or organizations imply endorsement by the U.S. Department of Health and Human Services. This information is in the public domain. Readers are encouraged to copy and share it, but please credit Spaulding for Children.