Georgia Establishing New Therapeutic Foster Care Program

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Georgia is establishing a therapeutic foster care program to provide specialized treatment for children with an assortment of behavioral, mental and developmental challenges.

The state is providing $6.7 million to begin the program that Tom Rawlings, director of the Division of Family and Children Services, called a pilot initiative that he hopes will expand in the future.  A similar program existed over a decade ago, and Rawlings and other advocates see its return as a major step toward strengthening welfare services for children with intense treatment needs.

“There is this, I believe, very special population of children with very severe emotional issues, often co-occurring autism spectrum and mental health issues, and we as a state really have to develop a more specialized system,” Rawlings said. “And I think that this is a major step toward that.”

Therapeutic foster care differs from traditional foster care in several ways. Children placed in a therapeutic care home have individualized care needs for various behavioral or mental issues that often arise from past trauma. Foster parents in a therapeutic program are highly trained to handle these challenges and provide around the clock care for the child. Children in this program also receive crucial treatment services, usually involving therapy.

Rawlings said the program fills a critical gap in care for children facing difficult challenges. He said it serves as a needed step-down service for a child who may no longer be in need of inpatient care at a psychiatric treatment facility, but would not receive adequate treatment in a traditional foster care setting with less trained caregivers.

Juanita Stedman, executive director of the child advocacy group Together Georgia, said that without the therapeutic option, these children often get moved around in the foster care system or are left without any care at all.

“What I know, and we all know now, is that every time you move a child, the trauma that that it causes is just horrific,” Stedman said. “And you know, you have kids that sometimes have been moved seven or eight times.”

Advocates for therapeutic foster care say the program cuts down on this movement by providing foster parents with training that equips them to handle the many challenges that arise when caring for these children. They say this creates a more stable environment better suited for longer term placement and care. However, the intense nature of the care required can make it a challenge to recruit foster parents for the program.

“It's a lifestyle for our parents. They have to be very dedicated because they are truly the changemakers,” said Sally Buchanon, CEO of Creative Community Services. “You can have therapy, you can have all of our workers in there, but those parents are with them 24/7, so it makes a big difference.”

Buchanon’s agency, Creative Community Services, is one of the only agencies in Georgia that has provided therapeutic foster care since 2007. Prior to 2007, a statewide program existed, but the federal Centers for Medicare & Medicaid Services “unbundled” child placement and child treatment services. In effect, this meant that child placement agencies could not provide therapeutic services with Medicaid dollars, which left most of the agencies without the resources to deliver crucial in-home care.

But Buchanon said dozens of agencies in Georgia have remained interested in providing therapeutic foster care and will jump at the opportunity once the state’s new program is up and running. She said that the specialized care provided for each child limits how many children an agency can take in, so the enthusiasm from many different groups will help make sure any child in need of therapeutic foster care can get treatment.

Division Director Rawlings said he expects the enthusiasm shown by child placement agencies will be matched by community members willing to take on the role of a therapeutic foster care parent.

“In my experience in child welfare over the years, I have seen that there are individuals who have a very special talent for doing this, who really have a heart for this work,” Rawlings said. “And I believe that we'll have plenty of folks who will step up to the plate and do it.”

The program must be approved by the federal government to receive Medicaid funding, but it could be up and running by January, serving as many as 500 children. As the state moves beyond the pilot project, Rawlings said he hopes more than 1,200 in the foster care program could be helped. Currently, the state has 11,000 foster care children.

This prospect has many foster care advocates excited about the future, but there are still some concerns about the state’s overall approach to child welfare. Amy Rene, vice president of clinical programs at Hillside Atlanta, said therapeutic foster care is a step in the right direction, but that Georgia needs to put more emphasis on keeping children united with their families in the first place.

“We need to really look at what kinds of kids really need to be put in foster care,” Rene said. “Are there a set of services that we can put in to teach parents how to parent their child with behavioral health needs?”

Rawlings echoed that sentiment and said he hopes to implement more services to create a “continuum of care” for a child at any level of need. These could range from intensive outpatient services to in-home intervention care aimed at keeping children in parental custody. For now, though, his team is focused squarely on finalizing therapeutic foster care plans and making the program available to children beginning next year.

This story comes to GPB through a reporting partnership with Fresh Take Georgia.