(OLA # 030-03)

LEGISLATIVE ANALYST REPORT

To: Members of the Board of Supervisors

From: Adam Van de Water, Office of the Legislative Analyst

Date: February 23, 2004

RE: Foster Parent Recruitment and Retention (File # 031413)

Summary and Scope of Request

Supervisor Maxwell requested that the Office of the Legislative Analyst (OLA) research successful foster care system models in municipalities similar to San Francisco particularly identifying incentives and support programs that have proven successful for foster parents. The report should also examine the scope of services provided, the number of children/youth served, and the cost of funding resources for such programs.

Executive Summary

The number of foster children in the San Francisco foster system has remained stable at approximately 2,400. However, increasingly complex foster children needs coupled with the reality of small homes, high costs of living, and fewer families in San Francisco, continue to challenge the Family and Children Services (FCS) division's ability to recruit and retain qualified foster parents. FCS is currently revising its recruitment strategy to better align with national research that promotes targeted research over more traditional forms of general recruitment and retention. This presents an opportunity to review recruitment and retention efforts in other jurisdictions to help guide this process.

The Office of the Legislative Analyst surveyed foster programs across California and the nation and interviewed the FCS division in search of innovative ideas to promote foster parenting in San Francisco. The result was a series of five recommendations to improve foster parent recruitment and six recommendations to improve retention. All of the recommendations are offered in recognition of the current state of the city's budget and therefore can be implemented by the Board or the division without significant changes in staffing or organization.

Recommendations range from simple but effective outreach, access, communication, technical assistance, community services, and acknowledgment strategies to more difficult questions of funding, performance measurement, housing, and childcare. These recommendations are offered for the Board's consideration.

Background

The Department of Human Services' Family and Children Services (FCS) division provides services designed to protect children from abuse, neglect, exploitation or abandonment. If their safety demands that a child must be removed from their home, FCS works with parents and the court system to make the home safe and to reunify the family, meanwhile assuring that the child's needs are met through foster care or with relatives who agree to be caregivers. For their part, foster parents agree to perform all the functions of birth parents while the child is in their care, including meeting the child's health, school and parental guidance needs. The foster care system pays basic health care costs through Medi-Cal, provides licensed foster parents with reimbursement for childcare, and provides living expense stipends to foster parents. Stipends range from approximately $400/month up to approximately $1,000/month depending on the age and special needs of the foster child.

In May 2003 there were 2,399 children in the San Francisco foster care system, or approximately two percent of all San Francisco children. This is expected to decline in coming years as large numbers of teenage foster children `emancipate' from eligibility at age 18¹. Foster children are placed with relatives (48%)², out of family (46%), or are on court probation within their own homes (6%). Nearly three in four foster children are African-American (72%, though the percentage of new African-American enrollees has declined), nearly half are placed outside of San Francisco (48%)³, and FCS estimates that over 80 percent are abused and neglected due to parental substance abuse.

While the goal at FCS is to reunite children with their parent or guardian once it is deemed safe, less than half of the approximately 85 foster cases closed per month (123 of the 270 cases closed from March to May 2003) result in reunification. The remaining 147 cases were closed for court-ordered termination (24%), adoption (12%), `emancipation' (6%), or other reasons (12%).

Recruitment

One of the many difficulties of providing foster care is the recruitment and retention of foster parents. This is especially true in San Francisco, where the demographics (fewer families, more single adults, smaller living quarters, and a higher cost of living) hinder traditional foster parent recruitment efforts. However, the challenge of recruitment is by no means unique to San Francisco. Nationwide, foster parent recruitment is hampered by:

These challenges help to explain why, according to the state Department of Social Services, only approximately five percent of those prospective foster parents who initiate contact with their county foster program statewide receive foster child placement (see Graph I at right) ⁵.

In an effort to improve the effectiveness of recruitment, foster associations have begun to recreate their foster systems to be more family, neighborhood, and culturally focused. One of the larger such efforts is the Annie E. Casey Foundation's national Family to Family Initiative (F2F) launched in 1992. According to F2F, there are three kinds of recruitment: general (television, radio, billboards, booths, and fairs), targeted (matching child demographics and needs to appropriate community outlets), and child-specific (seeking specific friends, relatives, or individuals capable of meeting a child's special needs). F2F recommends counties "use all three kinds of recruitment techniques, but stress and invest in the targeted approach" by allocating "perhaps 60 percent of the agency recruitment budget" to it.

Over the last few years, FCS has worked with the F2F Initiative to transition away from general recruitment and toward more targeted and child-specific recruitment programs. According to David Turk, FCS Operations Section Manager, FCS is currently in the process of developing a more comprehensive recruitment strategy consistent with these goals. FCS already produces quarterly reports with excellent demographic data on the foster care system that is then used to target efforts to specific neighborhoods, organizations, and individuals. The Stuart Foundation has also provided support to target recruitment within the faith-based community in southeastern San Francisco where fully one-third of all citywide foster children originate.

HHS uncovered two innovative techniques in a nationwide survey of state foster parent recruitment efforts. They found one state that pays foster parents $10 per hour to staff foster parent event booths and another that provides them with $300 stipends for each successful foster parent referral. These low-cost recruitment methods could replace portions of the more expensive and less effective methods of advertising in major television and radio outlets.

However, there are a number of steps that FCS and the Board could take to further improve recruitment of foster parents in San Francisco.

Recommendations to Improve Recruitment

Some actions the Board may wish to consider taking to support foster parent recruitment include:

1. Access - Helping to identify and provide access to community-based organizations (CBOs) and civic groups - particularly in the Bayview/Hunter's Point and Mission neighborhoods where the need for foster parents is greatest.

2. Outreach - Utilizing techniques proven effective in other California counties such as encouraging referrals from other foster parents (as indicated by Mr. Turk, "the best recruiter is a happy foster parent"), discussing foster care opportunities in community meetings, and/or posting information on specific children in need of foster homes.

3. Funding - Providing recruitment funds to pay foster parents hourly rates to attend orientations, trainings, and events or moderate stipends for every successful foster parent referral. The Board may also wish to pass a resolution encouraging DHS to quickly fill the second training position vacated by a retirement earlier this year.

4. Technical Assistance - Providing in-kind technical assistance and mediation to two existing nonprofit foster parent associations in San Francisco struggling to establish rules of procedure, ethics, and organizational structure.

5. Performance Measurement - Working with FCS and the Controller's Office to develop benchmarks and goals to assess the effectiveness of different recruitment techniques.

Retention

Once foster parents have been identified and trained, however, it is often difficult to keep them actively engaged in the foster care system. According to the National Foster Parent Association, "as many as 60 percent of new foster parents quit in the first 12 months - and the primary reason they give is lack of support, communication, or response from the foster care system."

Simple funding can go a long way to aid foster parent retention efforts. In Oregon, the State Children's Services Division conducted a study of 72 foster families in order to determine the effects of enhanced support and training of foster parents on retention and outcomes for children. They divided the participating families into three groups: Group 1 received enhanced support and training plus an increased payment of $70/month; Group 2 received the $70 but did not receive the increase in services; and Group 3 received no extra support.

Compared to the state average of 40 percent discontinuation of care, the results reflect the positive effect of additional support (training, money, and other services) on foster parent retention. Of participating families, 9.6 percent of Group 1, 14.3 percent of Group 2, and 25.9 percent of Group 3 discontinued care.

In addition to providing financial support, foster parents need resources and recognition to keep involved. In Los Angeles County, the Children and Family Services Division partners with area community colleges to provide continuing education to foster parents, 99 percent of which, according to Shirley McNeal, are provided for free. The County also regularly provides special "Angel Heart" recognition to foster parents in each of Los Angeles County's twelve districts.

In San Rafael in Marin County, Full Circle Program psychologists use a new technique called "parent-child interaction therapy" to teach parents how to be more supportive and encouraging. County family and child psychologists observe parents interacting with their children from behind a one-way glass mirror and coach them via hidden transceivers in the parent's ear.

FCS currently provides several resources for foster parents and relatives including:

Recommendations to Improve Retention

Some actions the Board may wish to consider taking to support foster parent retention include:

1. Communication - Ensuring better communication between and among caseworkers and foster parents by, a) establishing a mentoring program for new foster parents to be paired with those with more experience, and b) implementing the lessons learned from a spring 2003 foster parent survey and an anticipated February retreat between caseworkers and foster parents.

2. Acknowledgement - Attending and supporting the annual foster parent dinner in May, hosting dedicated events for foster children and their foster parents, and recognizing and commending outstanding foster parents and caseworkers for their contributions to the community on a monthly rather than an annual basis. This could include a foster parent or caseworker of the month program, a foster parent mentorship program, prizes donated by the City or local businesses, or other low-cost means of improving foster parent morale.

3. Childcare - Providing childcare to unlicensed potential foster parents as they attend the initial orientation, complete the training courses⁷, and/or attend foster parent events.

4. Funding - Increasing funding, staff, and/or hours of the respite program (providing foster parents with up to 20 hours of free childcare per month) and the foster parent resource room, advocating for increased foster parent payments from the state, and/or establishing a City-run liability insurance program to protect foster parents from catastrophic events.

5. Housing - Providing housing incentives to licensed foster parents such as a) subsidized rents on Treasure Island or at the Presidio, or b) establishing criteria with the San Francisco Housing Authority to prevent moving foster parents in public housing into smaller units if they do not have a foster placement at the time of the Authority's semi-annual census.

6. Community Services - Exploring interactions with day care providers, CBOs, schools, and Big Brother/Big Sister programs to support foster parents with after school programs, day care, tutoring, mentoring, or other services for foster children. The Board could also provide reduced cost or free access to parks, MUNI, and other city activities for foster children and their foster parents.

¹ 12/19/03 telephone interview with Dan Kelly, San Francisco Department of Human Services.

² DHS has made it an explicit policy to emphasize placement with relatives to reduce the child's trauma, build on the strengths of extended families, and minimize the number of placement moves a child has to endure.

³ FCS staff explains that the City's relatively high out-of-county placement rate is due to an emphasis on placement with family as well as the small geographic area of San Francisco.

⁴ "Recruiting Foster Parents." U.S. Department of Health and Human Services, Office of the Inspector General. Janet Rehnquist, May 2002.

⁵ "Foster and Adoptive Parent Recruitment, Training and Retention Annual Report." California Department of Social Services. August 2003.

⁶ Meeting with David Turk, FCS Section Manager, November 21, 2003.

⁷ Either eight, three-hour weeknights or five Saturdays.