May marks National Foster Care Month. How does the state system work, generally?
It’s administered by the Department of Human Services (DHS). The age range is birth to age 18, with infants representing the largest segment. Also, DHS has a wonderful program called Imua Kakou, which supports young adult former foster youth through their transition to adulthood.
DHS collaborates with us in the Department of Health. We at Child & Adolescent Mental Health Division (CAMHD) provide a service where youth live with specially trained “therapeutic” foster parents and receive intensive mental health treatment.
Could you elaborate on CAMHD’s role?
Children who have been abused or neglected frequently suffer from mental health difficulties as a result. Foster children often are referred to CAMHD by Child Protective Services (CPS) for mental health treatment. CAMHD provides an array of services for youth with severe emotional and behavioral difficulties.
A transitional family home (TFH), also known as a therapeutic foster home, is utilized both by foster youth who are in CPS custody and by non-CPS youth who need intensive help. CAMHD contracts for TFH services with Hawaii agencies including: Child and Family Service, Hale Kipa, Hawai‘i Behavioral Health, Catholic Charities Hawai‘i, Hale Na‘au Pono, Hale Opio Kauai, and Maui Youth and Family Services.
TFHs admit youth ranging in age from about 4 to 18 and care for up to two CAMHD youth at a time, providing a family setting that’s well-structured and feels safe for youth. The TFH agency provides intensive individual and family therapy to the youth and their families.
The treatment service is billed to health insurance, and it’s designed to help youth transition back to their family or to a more permanent CPS resource home after a stay of around six months.
TFH parents are provided with a great deal of training and support in order to work with youth who can be very challenging. They’re our heroes — especially now during COVID-19 social distancing, they’re working with these youth all day every day in their homes.
Another type of foster parenting — one that does not involve intensive therapy concerns — is resource caregiving?
Yes, DHS contracts with the Partners in Development Foundation to recruit, train and assess families who wish to become “general licensed” resource caregivers. Some of the basic requirements include: desire to accept a foster child into your home with the goal of reuniting the child with their birth family; space in your home for the child; and income that can cover usual household expenses. In addition, all adult household members undergo background checks for crime, child abuse and neglect.
Similar requirements apply to TFH families in addition to committing to regular training and coaching.
In both types of foster homes, parents need a lot of patience and empathy. They need to provide structure without being overly rigid, and they need to be ready to forgive when youth are uncooperative or hurtful. I think it’s important to understand that love alone will not heal the hurts some of these children bring into foster care, and that some youth will have a hard time accepting love.
Being willing to risk loving a child who may not give love back easily — and who is going to leave you soon for a more permanent home — is a big part of the challenge. Despite that, many foster caregivers love the work and find it very rewarding.
Has demand for foster care undergone significant change since you began working at CAMHD in 2003?
DHS data suggests a drop in the state’s foster care population from almost 4,000 youth in care per month in 2004 down to a current level that hovers at about 1,500. This reflects Hawaii’s success in complying with more recent national legislation that requires states to more quickly move youth out of foster care and back to birth families or into other permanent homes.
How are CAMHD’s operations affected by the coronavirus outbreak?
CAMHD staff have maintained all normal duties, with most of our direct services being provided via telehealth. We have been working hard with our contracted agencies that provide out-of-home care to find safe ways to continue treating youth in their care and admit new youth who need their services.
Direct care workers in our residential programs are also heroes in the pandemic crisis as they work on their own version of the “front line.” CAMHD case managers have been trying to connect our families with a range of resources to help them cope, and our public communications section has done a wonderful job making sure our websites provide excellent resources.
Parents worried about their child’s adjustment to changes in everyday life due to COVID-19 should check out our website, www.helpyourkeiki.com, which also explains how to apply for admission to CAMHD services.
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THE BIO FILE
>> Job title: Chief psychologist at the DOH’s Child & Adolescent Mental Health Division
>> Personal: I was born and raised in Connecticut. I have lived in Hawaii for almost 17 years. I came here to take my job at CAMHD during the era of the Felix Consent Decree (1994) — the upshot of a class-action lawsuit that forced the state to dramatically overhaul the way it provided special education services to students in need of them.
>> Education: Tufts University, bachelor’s degree in psychology; University of Vermont, Ph.D. in clinical psychology
>> A favorite non-work activity: I am very fortunate to study hula with Kumu Hula Hiwa Vaughan-Darval and Halau Hula Kalehua Tuahine.
