Final Assessment Human Trafficking in CT

8/13/2019 Final Assessment Human Trafficking in CT

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Current Landscape of Service Delivery Systems

for Identified Survivorsof Domestic Minor Sex Trafficking:

Prepared by:

Cristine !eys" MS#

for

Love$%&

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Table 'f Contents

I( Current Landscape in Connecticut

a. Executive Summary 3b. Interviews with stakeholders 5

II( 'vervie) of Congregate Care Programs in Connecticut

a. Congregate Care Programs or !C Involved "outh #b. Congregate Care Programs $or %on&!C Involved "outh 13c. 'icensing (e)uirements $or Congregate Care Settings 1*

III. 'vervie) of *oster Care Programs in Connecticut1+a. 'evels o$ oster Care Settings,-

b. (e$erral Intake and Placement ,/c. 'icensing (e)uirements $or Child Placing 0gencies ,*

I+( ,ducational Planning for DC* and -on.DC* /out

,+

+( 0reas of *urter ,xploration 33

+I( 1ecommendations 3*

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I( Current Landscape In Connecticut

,xecutive Summary

his 2roect set out to identi$y the current ca2acity within Connecticut to 2rovide sa$e treatmenta22ro2riate housing $or identi$ied survivors o$ domestic minor sex tra$$icking. 4hile thisassessment $ocuses 2redominantly on the work o$ the !e2artment o$ Children and amilies!C6 interviews were conducted with 2rivate residential grou2 home and $oster care agencies7as well as (unaway and 8omeless "outh 2rograms serving non&!C youth. 0ttem2ts to engageservice 2roviders in areas o$ uvenile ustice child advocacy and domestic violence were alsomade. 8owever res2onse $rom such resources has been minimal.

9ver the 2ast several years !C has become the lead agency in identi$ying and addressing theissue o$ !:S. 0s the state child wel$are agency mandated to 2rotect children $rom abuse andneglect !C has established a variety o$ mechanisms to begin meeting the needs o$ this2o2ulation. 0ccording to 4illiam (ivera !irector o$ :ulticultural 0$$airs and co&chair o$ the

8uman 0nti&ra$$icking (es2onse eam 80(6 !C has identi$ied a22roximately 1-- victimso$ !:S since ,--#. Since ;anuary ,-1, there have been ,- identi$ied victims7 1* $emales and3 males. 022roximately +#< had !C involvement at the time o$ identi$ication7 most residingin residential grou2 home or $oster care settings. In ,-1, !C issued =0 Child 4el$are(es2onse to !omestic :inor Sex ra$$icking> which outlines historical current and 2ro2osedinitiatives. see 022endix 06. !es2ite the e$$orts o$ the !e2artment there is a lack o$ ex2ertservice 2rovisions to address the housing and clinical needs o$ this 2o2ulation.

Currently there are $our short&term assessment beds 1-&,1 days6 allocated $or identi$ied victims.here are no treatment s2eci$ic beds or 2rograms at any level o$ care. he licensing 2rocess isarduous and can vary greatly on time$rames. he maority o$ services 2urchased by !C are

re)uisitioned through a (P 2rocess7 however the current !C Commissioner is su22ortive o$innovative and s2eciali?ed community based treatment services. In addition to licensing seekingaccreditation is a critical ste2 in moving towards the develo2ment o$ care $acilities. 4hile thereare several entities that can serve in this role the Council on 0ccreditation C906 is anestablished stakeholder with the develo2ment o$ best case 2ractice standards.

he current trend in 2roviding out o$ home care as designed by the !C Commissioner ;ustice;oette @at? is towards less restrictive congregate settings and greater integration o$ youth into$amily&like community based 2rogramming. It is 2roected that over the course o$ the next 1#months there will be a great reduction in congregate level care or at least a reduction in thelength o$ stay with increased 2lacements in varying levels o$ $oster care. he 2rimary challenge

to meet this goal is in the recruitment and retention o$ $oster care 2roviders. here are twomodels 2resented that re$lect o22ortunity $or 'ove1/A to 2artner andBor develo2 innovative ande$$ective 2rogramming $or the target 2o2ulation.0s !C has become a $orerunner in child wel$are systems in identi$ying and addressing theneeds o$ the !:S 2o2ulation youth i.e. runaway and homeless youth not under the 2urviewo$ !C continue to be an unidenti$ied 2o2ulation. Services are even scarcer long&term sa$ehousing o2tions are minimal and there is limited awareness among runaway and homeless youth(8"6 2roviders. o date there has been no s2eci$ic identi$ication o$ a tra$$icking victim $rom

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the (8" services 2roviders. urthermore there is a lack o$ knowledge in where and how tolocate resources i$ identi$ied. his was voiced by several 2rivate agency 2roviders o$ $oster careand grou2 home care as well.

raining and technical assistance has been an identi$ied need by service 2roviders in all realms as

well as !C. Initiatives have included local 2olice de2artments !C sta$$ and service2roviders at&risk youth and school&based 2resentations. 4hile 'ove1/A had served as the2rimary agency in develo2ing and 2roviding these trainings :y 'i$e :y Choice7 ell "ourriends sta$$ directed curriculum67 $unding im2eded 2rivate agency utili?ation o$ the agencyresources. 0s a result in ,-11 !C and 2rivate agencies sought to im2lement several 2rogramswithout the assistance o$ 'ove1/A. Clinical training and consultation is 2resently beingcoordinated by !C with the assistance o$ ;(I. !es2ite these many e$$orts to educate thecommunity there is a large ga2 in the level o$ skill and knowledge in how to best serve this2o2ulation7 including the develo2ment o$ agency 2olicy and 2rocedures. his is 2articularlyevident in the (8" 2rovider network and at the 2rivate $oster care level. 4ithout con$irmationit may be also lacking in areas that intersect with at risk youth such as domestic violence

networks $amily 2lanning networks and medical 2roviders. here has been no outcome data2ublished to the e$$ectiveness o$ the training e$$orts.

hrough interviews with !C licensed treatment 2roviders and $acilities assessment o$ thecurrent landsca2e with regard to the 2lacement o$ children and a review o$ the literature7 severalo2tions exist to build the ca2acity within the state to 2rovide ade)uate trauma&in$ormedrestorative treatment $or minor victims. Pro2osed 2roects $or develo2ment considerationinclude a com2rehensive case management model that would $ollow the youth regardless o$2lacement7 a continuum o$ sa$e housing that ranges $rom assessment beds to transitional housingto community homes7 and the develo2ment o$ a training and technical assistance 2rogram $or andwith !C ;uvenile ;ustice the ;udicial ranch and community&based 2roviders.A. Interviews with Community Stakeholders

In 2re2aration o$ this re2ort interviews were conducted with !C licensed 2rograms and (8"2roviders. 0lthough most 2artici2ants were eager to discuss their service delivery 2rogrammodel and knowledge o$ subect there were three 2roviders that wished to remain anonymous.See 022endix C $or Duestionnaire6.

our o$ the six 2rograms that serve non&!C youth were interviewed Children and amilies:eriden7 ;anus Center ridge2ort7 he ridge amily Center 4est 8art$ord7 and 'C:anchester. our !C contracted agencies that 2rovide residential grou2 home short termassessment housing andBor thera2eutic $oster care services were interviewed @lingberg amilyCenters %ew ritain7 4heeler Clinic Plainville7 and oys and Firls Gillage :il$ord7 amilyand ChildrenHs 0id !anbury7 and he ridge amily Center 4est 8art$ord. wo additionalresidential agencies were contacted and did not res2ond to in)uiries.4ith the exce2tion o$ he ridge amily Center grou2 home and S0( 2rogram all 2rovidersindicated that they are only ust gaining greater awareness o$ minor sex tra$$icking. hreeagencies ;anus Center @lingberg amily Centers grou2 home and the ridge amily Centersgrou2 home and S0( 2rograms identi$ied that sta$$ had recently been trained or currentlybeing trained by 'ove1/A. 9ne agency had attended a 2resentation through their 2lace o$

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worshi2. he ridge amily Centers has also utili?ed !C resources to 2rovide in&housetraining. wo agencies identi$ied that they had no working knowledge o$ the to2ic but wereaware o$ the issue based on re$errals received $or their 2rograms.oth (8" 2rograms and the maority o$ !C contracted 2roviders did not believe there wasenough training and awareness building o22ortunities a$$orded to them. Several were not aware

o$ the re2orting re)uirements to !C or that !C had established a res2onse 2rotocols2eci$ically $or !:S. 9ne 2rogram stated that =4hile not minimi?ing the realities o$ sextra$$icking I have observed some level o$ hy2er vigilance7 2articularly in the ;uvenile ;usticesystem. Sometimes an 049' is ust an 049'. Providers need to understand the dynamics o$sex tra$$icking and not con$use this with other emotional res2onses to stress.>9$ the (8" 2rograms with the exce2tion o$ the ridge none o$ the agencies had any ex2eriencewith identi$ied victims o$ tra$$icking and had not utili?ed the hotline to re2ort sus2ectedtra$$icking cases. :ost o$ the 2rograms believed that they had worked with victims o$tra$$icking based on their current knowledge o$ the subect. wo !C contracted agencies hadworked with youth that had been at a minimum sus2ected victims o$ tra$$icking at the time o$2lacement. oys and Firls Gillage Program !irector o$ hera2eutic oster Care states that there

has been an increase in the number o$ re$errals with sus2icion o$ or con$irmed tra$$ickinghistories.

0ll 2rograms interviewed had at least one case managerBthera2ist res2onsible $or 2roviding cases2eci$ic treatment or re$erring to community based services. %o 2rogram could identi$y aclinical resource that s2eciali?ed in tra$$icking victims. !C congregate care agencies re2ortedto have ex2ertise in trauma&in$ormed treatment7 several using evidenced based treatment modelssuch as rauma&ocused Cognitive ehavioral hera2y &C6 or !ialectal ehavioralhera2y !6. oster care agencies did not im2lement any evidenced based training althoughone agency was ex2loring the &C model $or their sta$$. oster care agencies had access to acommunity based clinician with trauma ex2ertise. 8owever none recalled utili?ing an ex2ert intreating PS! or evidence&based model o$ treatment. (8" 2rograms o$$er re$erral services $orclinical treatment.

0gencies with a strong working knowledge and have had training $or sta$$ were the onlyagencies re2orting to assess risk $actors s2eci$ic to tra$$icking during the intake 2rocess. %o2rogram had s2eci$ic 2olicies regarding the treatment o$ !:S survivors although the ridgeamily Centers identi$ied a need to integrate a harm reduction model to address 049'Hs i.e.sa$ety 2lanning measures within their 2olicies. Policies that would re)uire revisions toaccommodate the needs o$ this 2o2ulation included 049' re2orting 2olicies restrictions on cell2hone and internet access and unsu2ervised community time.

Survey 2artici2ants were asked about risk and sa$ety concerns as a result o$ their location.Several 2rograms identi$ied that they did not 2ublish the s2eci$ic address o$ their 2rogram. 9necongregate care agency had removed 2ictures o$ their buildings. Several 2rograms did notconsider their residence at risk $or being targeted by tra$$ickers7 this was 2articularly true $or$oster care agencies.

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!C contracted 2roviders indicated that there was a need $or s2eciali?ed treatment and2lacement services com2rehensive case management services that could navigate both thecriminal andBor investigative 2rocess as well as the clinical treatment needs.

rends regarding outreach and re$erral services 2lacement access and length o$ stay were

s2eci$ically targeted to (8" 2roviders as they only acce2t non&!C involved youth. Programmodels are $urther detailed in Section III. (8" identi$ied that re$errals were $rom 2arentsschools and youth. "outh who access their 2lacement services are o$ten re$erred by other youth.Several 2rograms indicated that utili?ation o$ national and statewide switchboards or re$erralservices were o$ten di$$icult to navigate $or youth. Community based networking and street&level outreach were the most e$$ective means o$ raising 2ublic awareness o$ their services.

9ne such exam2le is the establishment o$ the Sa$e Place 2rogram through ;anus 8ouse.Currently there are 3* Sa$e Place sites and ,5 F0 buses that act as mobile sites in the Freaterridge2ort area. :ost o$ these sites are housed at $ire stations libraries and community centersand have trained sta$$ who knows how to hel2 the youth when they accesses them. he Sa$e

Place 2rogram works in conunction with ;anus CenterHs ,/&hour crisis hotline where sta$$ can bedis2atched immediately to hel2 the youth in trouble. ;anus 8ouse sta$$ o$$er the youth access to$ull ;anus Center services which includes advocacy mediation and a tem2orary emergencyshelter o2tion i$ the youth is unable to return home.1Programs in the network dis2lay a brightyellow sign with =Sa$e Place> design $or easy recognition.

0ll (8" 2roviders concurred that length o$ 2lacement regardless o$ tra$$icking identi$icationwas a challenge. Program models 2rovide short&term 2lacements7 most $alling within the rangeo$ 1/&,1 days. 9ne 2rogram 'C while able to acce2t emergency 2lacements is alsodesignated as a grou2 home and can 2rovide long&term 2lacements.

1Council o$ Churches Freater ridge2ort7www.ccgb.org

A
http://www.ccgb.org/http://www.ccgb.org/http://www.ccgb.org/


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II( 'vervie) of Congregate Care in Connecticut:A. Congregate Care Facilities for DCF Involved YouthIt is the 2hiloso2hy o$ ;ustice ;oette @at? Commissioner !e2artment o$ Children and amiliesto 2rovide youth with the o22ortunity to be integrated into $amily settings and 2artici2ate in theircommunities 2roviding normative childhood o22ortunities. In 0ugust o$ ,-11 !C released

=Congregate Care (ightsi?ing and (edesign "oung Children Goluntary Placements and aPro$ile o$ hera2eutic Frou2 8omes>7 a re2ort in the =ostering the uture> series. his AA 2agere2ort 2rovides an in&de2th assessment o$ current congregate care continuum with outlined2ractice and 2rogrammatic changes to restrict 2lacement o$ children under 1, in congregatesettings reduce the length o$ stay and restructure existing 2rograms to accommodate thosechildren in out o$ state 2lacements see 022endix 6.or youth that are involved in the child wel$are system re)uiring out o$ home care 2lacemento2tions vary de2ending on the level o$ clinical need. 0s 2oint in time measure in ;une ,-11there were 1/33 youth 2laced in congregate settings both within and outside o$ the state o$Connecticut.ollowing is a brie$ overview o$ congregate care settings relevant to this 2roect,

Short erm 0ssessment and (es2ite 8omes S0(6

o tem2orary congregate setting7 youth ages 11&1*

o short&term care clinical evaluation and nursing care

o acce2ts 2lacements ,/B* 3A5 days7 no 2re&2lacement transitions

o direct service 2rovided by non&clinical 2ara2ro$essionals

hera2eutic Frou2 8ome F86

o

community based7 neighborhood setting

o serves as ste2&down $rom residential treatment 2rogram or ste2&u2 a$ter multi2le

disru2tions in lower level care i.e. $oster care

o designed by cohort o$ gender age and s2eciali?ed needs

o ,/B* sta$$ing and clinical su22ort7 clinically trained sta$$ing bachelors level6

o scheduled admissions7 2re&2lacement transition

o 2sychiatric services including medication management are 2rovided on&site

o 3&/ hours o$ weekly clinical treatment 2rovided on&site7 includes individual grou2

and $amily when a22ro2riate 2re$erence $or state licensed clinicians6

o social recreational and vocational activities are community based

,Connecticut !e2artment o$ Children and amilies =Congregate Care (ightsi?ing and (edesign "oung Children Goluntary Placement and aPro$ile o$ hera2eutic Frou2 8omes> 2ages 5A&AA.

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o education is 2rovided o$$&site

Psychiatric (esidential reatment acilities P(63

o highly structured sel$&contained milieu

o thera2eutic medical educational and recreational activities within milieu

o intensively sta$$ed7 clinically trained bachelors level and higher6

o /&A hours o$ weekly s2eci$ic clinical treatment including individual grou2 and

$amily7 2rovided on&site

o scheduled intakes7 2re&2lacement transitions

Pass Frou2 8omes

o moderately si?ed homes averaging A&1- beds 2er 2rogram

o sta$$ed with non&clinical 2ara2ro$essionals associatesBhigh school di2loma6

o mild&behavioral health needs

o all clinical and educational services are community based

Su22ortive 4ork Education and ransition Program S4EP6

o community based sta$$ed a2artment 2rogram

o serves adolescents 1A&,1

o not designed as thera2eutic clinical setting

o $ocus on develo2ment o$ building skills $or sel$&su$$iciency

Program Type -o( of Programs -umber of

2eds

Lengt of Stay 3L'S4

S0( 1, *# A- days contracted6

hera2eutic Frou28ome

5, ,A- arget o$ A&+ months

Psychiatric (esidentialreatment acilities

13 ,#- arget o$ + months

P0SS Frou2 8ome / 3/ Estimated 1,&,/ months

S4EP / ,/ 1, months

3here are $our (esidential reatment Centers s2eci$ically to address substance abuse which is not included in the data

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numbers are a22roximated based on $igures $rom ;une 3- ,-119$ the 5, licensed thera2eutic grou2 homes 1, are designated $or 2o2ulation under the age o$1,7 the remaining are designed $or the adolescent 2o2ulation. It is the intention o$ !C toconsider re2ur2osing the existing grou2 homes $or under 1, 2o2ulation to accommodate s2ecial2o2ulations andBor youth being treated out o$ state. here are no mixed&gender thera2eutic grou2

homes $or adolescents. 8al$ o$ the homes are designated $or s2ecial 2o2ulations that include2roblem sexual behaviors develo2ment disabilities andBor 2ervasive develo2mental disorders.

;uvenile ;ustice Programsor youth that are committed !elin)uent there are two sta$$&secured $acilities $or $emales bothrun by %orth 0merican amily Institute %0I Inc.6. ouchstone located in 'itch$ield Countyand Ste22ingStone 4aterbury have a total ca2acity o$ /-. Ste22ingStone has allocated twoemergency beds $or the assessment o$ identi$ied victims o$ tra$$icking. 0verage length o$ stayranges $rom A&1, months7 youth 2laced are 2laced in these 2rograms as an order o$ the uvenilecourt system.hree o$ the 5, F8Hs re)uire uvenile ustice involvement $or 2lacement7 two are s2eci$ically

designed $or $emales on 2arole.(e$erral Process J Intake 2roceduresIn order to access the above 2rograms re$errals are made through !C including the ;uvenile;ustice System6. here must be some level o$ legal involvement or acce2ted into the !CGoluntary Services Program GSP6 a 2rogram designed to assist $amilies who have exhausted allresources $or securing ade)uate behavioral health services. Children in the GSP are notadudicated abuseBneglected or delin)uent7 and 2arents retain their legal status as guardians.he assigned !C Social 4orker Probation 9$$icer or !C Parole o$$icer com2letes a Childand 0dolescent %eeds and Strengths C0%S6 in consultation with !C ehavioral 8ealthConsultants. he com2leted assessment is $orwarded to the C ehavioral 8ealthPartnershi2BGalue 92tions C8P6 reviews and identi$ies the a22ro2riate level o$ care utili?ingstandardi?ed guidelines./

Private 2roviders who meet the criteria $or the identi$ied needs o$ the youth are 2rovided withthe o22ortunity to interview the youth. Programs may deny admission to a youth due to clinicalincom2atibility sa$ety issues or con$lict with the milieu. 9nce an agency acce2ts a youth $or2lacement C 8P issues authori?ation $or 2lacement including a22roved length o$ stay.Fenerally 2lacements occur within a short 2eriod o$ time i.e. 5&15 business days $rom date o$2re&2lacement interview.S0( 2rograms are excluded $rom the above outlined re$erral and 2lacement 2rocess. Suchdecisions are made solely between !C and the 2rovider agency. Placements are acce2ted atanytime and there is no 2eriod o$ transition.'ength o$ Stay0t the time o$ initial authori?ation $or 2lacement C 8P 2rovides a22roval $or a s2eci$iedamount o$ time. or exam2le 2lacement into a thera2eutic grou2 home may be authori?ed $or1#- days. !uring the course o$ 2lacement C 8P will conduct treatment reviews to monitor2rogress towards clinical goals and identi$y barriers $rom achieving such goals. Such reviewsresult in the re&authori?ation o$ 2lacement and increase o$ '9S i$ re)uired. ailure to conduct

/C ehavioral 8ealth Partnershi2 legislatively created collaboration that su22orts oint 2lanning $unding and oversight o$ 2ublicly&$undedbehavioral health services $or 8usky 0 and reci2ients :edicaid6 and !C involved youth . www.ctbh2.org

+
http://www.ctbhp.org/http://www.ctbhp.org/


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reviews may result in non&2ayment to the 2rovider agency during the unauthori?ed 2lacementtime$rame.S0( 2rograms are contracted $or a A- day '9S. here are bi&weekly reviews conducted at the!C local level to assess barriers to achieving discharge 2lan.unding

0ll the above 2rograms are $unded by !C. y2ically 2rograms are under contract with !Cand are 2rocured through the (e)uest $or Pro2osal (P6 2rocess. 9nce agencies are selectedthrough the 2rocurement 2rocess contracts are negotiated to cover sco2e o$ services and ratesetting. See 0ttachment $or a sam2le o$ a hera2eutic Frou2 8ome Sco2e o$ Service.Provider agencies are reimbursed on a monthly basis $or the 2er diem rate $or each youth 2lacedin the 2rogram. or thera2eutic grou2 homes the 2er diem rates vary across 2rograms $romK33A./# to KA31.##. he 2er diem $unds are to cover all com2onents o$ 2rogramming includingsalaries general and administrative costs basic living needs i.e. clothing hygiene items6activities $unds trans2ortation etc.

Program Type 0vg( Per Diem 1ate 5

2eavioral 6ealt

0vg( Per Diem 1ate 5

7uvenile 7ustice

(esidential reatment In&State K,*5 K3*5(esidential reatment 9ut&o$&State K33, K,35

Sa$e 8ome K,#1 nBa

P0SS Frou2 8ome K,A/ nBa

here are several challenges $or 2rivate 2roviders with the current $unding structure. irst therehave not been rate increases in the 2ast three years. Secondly the 2rovider agency will notreceive 2ayment $or an un$illed bed. or exam2le the utili?ation rates $or thera2eutic grou2homes average between #A


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develo2 treatment goals and monitor 2rogress

2rovide ,/B* clinical consultation

Programming

2rogramming services include social recreational and vocational activities

ca2acity building o$ daily li$e skills and 2re2aratory skills towards sel$&su$$iciency

(e2orting (e)uirements(e2orting re)uirements $or $unding 2ur2oses vary de2ending on the level o$ care 2rovided.Fenerally agencies are re)uired to com2lete weekly census re2orts noti$y C8PBGalue92tions within ,/ hours o$ 2lacement date and 2artici2ate in reatment (eviews $or re&authori?ation o$ 2lacement. In addition each contract outlines s2eci$ic outcome measures thatthat are related to 2er$ormance o$ the 2rogram service delivery. Exam2les may include dischargedestinations rate o$ seclusions and restraints and medication errors.

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B. Overview of ousing O!tions for "on#DCF involved Youth in Connecticut$

or youth that are involved with !C including abuseBneglect delin)uency or through GoluntaryServices the a$orementioned 2rograms are available as 2lacement and treatment resources.8owever $or non&!C youth including runaway and homeless youth there are $ew o2tions $orsa$e housing.

In testimony submitted in :arch ,-1- by the ChildrenHs 0dvocacy Center5

in su22ort o$ (aisedill %o. ,+, 0n 0ct Concerning 8omeless "outh it was re2orted thatIn Connecticut, we do not have an accurate number of runaway andhomeless youth. We know that the National Crime Information Center(NCIC), a database maintained by the Federal Bureau of Inesti!ation,re"orted on #ctober $%, $%%& that there were $' actie runaway casesand ,'%% "ur!ed records for runaway cases in Connecticut for $%%&. Wealso know that the National *unaway and +omeless outh -ana!ementand Information ystem re"orted a total of $/ runaway and homelessyouth in Connecticut for fiscal year $%%&0%/.A1 re"ort from the #ffice of2e!islatie *esearch indicates that thou!h the number is difficult to

"recisely count, there are more than '3% unaccom"anied homelesschildren under the a!e of 4& in Connecticut.*5

Sa$e housing o2tions are very limited in numbers accessibility and 2rovision o$ services.Currently there are six 2rograms or a total bed ca2acity o$ ,, throughout the state thatwill 2rovide housing $or youth not re$erred by !C. 9$ these ,, beds 2rogram designincluding re$erral intake consent $or 2lacement service delivery and length o$ stay varygreatly.

Program -ame Service 0rea 8ender90g

e

Program Model of

-on

/ouCouncil o$ Churches ;anusCenter $or "outh in Crisis

Freater ridge2ort :aleBemale11&1*

8ost 8ome,/hr 9utreachBCrisis Intervention

5 bed

@ids in Crisis Southwestern C :aleBemale11&1*

Emergency Shelter,/ hr 9utreachBCrisis Intervention

/ bed

4omen and amilies Center :iddlesex County :aleBemale 8ost 8omeStreet 9utreach

, bed

"outh Continuum %ew 8aven :aleBemale11&,3

Emergency Shelterransitional 'iving8L! 8omes 1#&,3yr old6

/ bed1- be# bed

50uthored byStacey Giolente Cote !irector o$ ChildrenHs 0dvocacy Center een 'egal 0dvocacy Clinic and Chair o$ the C eam on (unawayand 8omeless "outh.

Ahis number is believed to be a $ar underestimate o$ the total number o$ homeless youth in C as it only includes re2orts $rom grantees o$ anational grant to work with runaway and homeless youth.

*=Poverty 8omelessness and Children.> C 9$$ice o$ 'egislative (esearch ;uly * ,--#6.

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ridge amily Centers 4est 8art$ord emale Emergency Shelter 1 bed

'C :anchester :aleBemale ransitional 'ivingBemergency housing A bed

unding

unding $or $our o$ the six (8" emergency and transitional housing is generally $unded through

(unaway and 8omeless "outh 0ct & itle III o$ the ;uvenile ;ustice !elin)uency Prevention 0ctestablished in 1+*/ (8"06. (8"0 has been amended by several subse)uent youth&$ocusedlegislative acts is currently administered through the amily and "outh Services ureau 2art o$the !e2artment o$ 8ealth and 8uman ServicesH 0dministration $or Children and amilies. 0scurrently amended (8"0 authori?es $ederal $unding $or three 2rograms

asic Center Program

o designed to accom2lish three goals immediate sa$e shelter and services $or runaway

youth7 reuni$ication o$ $amilies whenever 2ossible7 and alternative 2lacements o$ theyouth when reuni$ication is not a22ro2riate.

o 2rovide a wide range o$ services to runaway and homeless youth including ,/&hour

access to all 2rogram services emergency shelter $ood and clothing medicalassistance counseling and re$errals to health care and educational systems.

ransitional 'iving Program 'P6

o 2rovides shelter and an array o$ com2rehensive social services $or older homeless

youth.o youth live in a su22orted structured environment in which the overall goal is to

increase their inde2endent living skills and ability to be sel$&su$$icient. 8ousing and arange o$ li$eskills services are 2rovided $or u2 to 1# months to youth ages 1A&,1 whoare unable to return to their homes.

Street 9utreach Program

o Street 9utreach 2rograms 2rovide street&based education and outreach to youth whohave been or who are at risk o$ being sexually abused or ex2loited. he ultimategoal o$ the 2rogram is to move these young 2eo2le o$$ the streets and into shelterswhere they can access other needed services. he Street 9utreach 2rograms 2rovideaccess to medical and mental health treatment counseling and in$ormation andre$erral services.

In ;une the Senate 022ro2riations Committee a22roved " ,-13 legislation that would2rovide K115 million $or (8"0 2rograms.#

wo remaining 2rograms 'C and he ridge amily Centers have varied $unding

sources. 'C is solely $unded by the own o$ :anchester and the :anchester oard o$Education. he ridge amily Centers has one bed within their S0( 2rogram that is2rivately $unded.

#%ational 0lliance to End 8omelessness7 (8"07 www.endhomelessness.org

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8owever consent is re)uired within *, hours o$ 2lacement in 2rogram. I$ a 2arent orlegal guardian is not available within the s2eci$ied time $rame a re$erral to !C is madeas youth is viewed as abandoned.

'ength o$ Stay

0verage length o$ stay is 1/&,1 days $or the host home and shelter models. 0s noted two2rograms o$$er transitional living models to serve homeless youth7 both which haveextended length o$ stay7 however only 'C o$$ers emergency housing within the same2rogram.

!ata (e2orting (e)uirements9utcome data is re)uired o$ all $ederal grantees. See 022endix ! $or sam2le outcome measures.

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c. %icensing &e'uirements for Congregate Settings

6CF is the licensin! a!ency for all con!re!ate care facilities for children and youth

under the a!e of 4& re!ardless of their fundin! source. 7his includes all con!re!ate

settin!s that "roide serices to non86CF inoled youth such as the identified *+

"ro!rams. In addition, facilities which are not "riate family homes may also be

licensed under these re!ulations9 therefore, therefore, an a!ency8owned home that is

"roided as "art of em"loyee benefit may be licensed as a child8care facility. 1!ency

re!ulations a""licable are identified in the re!ulations of #"eration of Child8Carin!

1!encies and Facilities: Children;s +omes or imilar Institutions, *esidential 7reatment

Facilities, for 1!ency

*e!ulations9 2icensin! ?acket 1ttachment)

For a!encies that hae no e=istin! contracts, such as 2oe4, the "roider initiates a

2icensin! In@uiry call to the 2icensin! ?ro!ram u"erisor, reiew the 6CF website

re!ardin! the licensin! "rocess and schedule a technical assistance meetin!+.

Initial 2icensin! ?hase:

a""lication is assi!ned to *e!ulatory Consultant

on8site isit is conducted9 reiew of facility and submitted materials

submission to ?ro!ram u"erisor

?roisional 2icensure:

*eiew of ubmitted materials

6etermination of Fiscal Aiability:

o detailed bud!et submit with eidence of at least four months of fundin! forthe "ro!ram

Ins"ection

"hysical "lant

medication mana!ement

o -edication 1dministration: facility must hae aailable certified staff

*e@uired Certifications:

o *estraint0C?*: each shift has $ certified staff in restraints9 4 certified staff

in C?* ?ersonnel Files

+7he entire licensin! "acket can be iewed as an 1ttachment or ia htt":00www.ct.!o0dcf0cw"0iew.as"a$3DE$/'%%GForms

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am"le Case *ecords

H"on com"liance with the licensin! re@uirements, 6CF may issue a "roisional license.

7he "roisional license allows for a licensed bed ca"acity (2BC) below the intended full

ca"acity of the "ro!ram. Considerations for 2BC are in relation to staffin! hired0trained,

im"lementation "lan for transitionin! new children into the "ro!ram, and how a!ency

will accommodate census increases. 7he im"lementation "lan is a""roed by the

2icensin! Hnit.

?roisional to *e!ular 2icense:

1ssessment of the "ro!ram readiness to increase 2BC9 e=am"les of criteria for

consideration: condition of "hysical "lant, com"liance with re!ulatory mandates, staffin!

com"liance, "roision of s"ecified "ro!ram serices, includin! clinical educational and

medical "ro!rammin!.

Com"liance -onitorin!

>ach licensed a!ency will be isited at least @uarterly by the assi!ned *e!ulatory

Consultant9 reiews consist of condition of "hysical "lan, "ro!ram staffin!, "ro!ram

chan!es9 census and follow8u" to any correctie actions.

7he 2icensin! Hnit may also conduct unscheduled or follow8u" isits without notification

to the licensed a!ency.

*enewal of 2icensin! 1""lication

2icenses are renewed eery two years.

1ccreditation

In addition to the licensin! re@uirement, it is recommended that licensed a!encies beaccredited by one of seeral different entities, includin! but not limited to:

Council on 1ccreditation (C#1),www.coa.or!

7he oint Commission,www.Jointcommission.or!

Commission on the 1ccreditation of *ehabilitation Facilities (C1*F),

www.carf.or!

C90 has engaged in a $ormal collaboration with !C to establish best 2ractice standards tores2ond to !:S in congregate care and $oster care settings.

1*
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III. Foster Care Programming

0s clearly identi$ied there is a growing trend towards $amily&based care settings with both !Cinvolved and non&!C involved youth. In Se2tember ,-11 the second re2ort in the =osteringthe uture> series was released7 =4e 0ll %eed Somebody Su22orting Children amilies andthe 4ork$orce in ConnecticutHs amily oster Care System> 022endix 6. Commissioner @at?

rein$orces that children deserve an o22ortunity to become members o$ a healthy $amily tosucceed in school and 2artici2ate in the community in a 2ositive and character building way. Shecontinues to challenge that there is an over utili?ation o$ congregate settings and an underutili?ation o$ kinshi2 and $oster $amily homes. Challenges to meeting this goal are basic therecruitment and retention o$ )uali$ied non&relative caregivers and ca2acity building o$ kinshi22roviders.or the targeted 2o2ulation these challenges are exacerbated by many o$ the survival behaviorsexhibited such as $re)uent 049' sexuali?ed behaviors and other high risk behaviors such assubstance use. 0dditionally non&kinshi2 $amilies may be $ear$ul o$ ex2osing themselves or theirchildren to the risks that may be involved with a youth who has either not exited the li$e orstruggling with sa$ety and reintegration. @inshi2 2lacement resources may be con$licting in the

healing 2rocess $or the victim. here may be shame involved regarding the tra$$icking historyguilt $or not 2rotecting the youth $rom such harm or in severe cases $amily engagement in thetra$$icking behaviors.In addition to the recruitment o$ $oster care 2roviders retention o$ licensed $amilies is an on&going struggle. In a recent study cited by the =4e 0ll %eed Somebody> re2ort 3-< o$ surveyed$amilies $elt devalued and not res2ected by the !e2artment. amilies o$ten re2ort that they donot $eel they have access to community and agency su22orts7 are have limited access tocommunity su22orts and services when needed7 and sti2ends do not o$ten cover the cost o$ care$or the child es2ecially $or older adolescents.!e$initions o$ oster Care amilies

(elativeB@inshi2 Care & $amily members licensed as $oster 2arents $or the 2lacement

o$ relative child

S2ecial StudyBChild S2eci$ic N non&relatives that 2resent themselves as 2lacement

resources $or a s2eci$ic child

%on&relative oster amily N$amilies that are licensed to acce2t child and youth

unknown to them

A. %evels of Foster Care (rogramming

0s with congregate care settings there are levels o$ $oster care designed to meet the level o$acuity 2resented by the youth.

C9(E oster Care

o !C licensed trained and su22ort $oster care

o (elative S2ecial Study and %on&(elative $amilies are eligible

o asic 2re&service training7 minimal $ocus on trauma in$ormed care

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3- hours $or %on&(elative

A&1# hours $or (elative and S2ecial Study

o 1# hours o$ 2ost&licensing training 2er year

o Child retains assigned !C Social 4orker

monthly visitation standard

!C S4 caseload average 1#&,- cases

o amily assigned Su22ort 4orker

)uarterly visitation standard

o 9n&callB0$ter 8ours su22ort 2rovided by !C Careline or C00P

o 1- days o$ res2ite 2er year

0ge 8roup Per Diem 1ate 0nnual Payment

0ges -&5 ,5.*3 +3+1./5

0ges A&11 ,A.-3 +5--.+5

0ges 1,O ,#.,/ 1-3-*.A-

:edically Com2lex /A.A3 1*-1+.+5

:inor Parent with Child 53.+* 1+A++.-5

reatmentBhera2eutic oster Care C6

o 1# 2rivate 2roviders licensed as Child Placing 0gencies

o agencies are contracted to 2rovide a s2eci$ic number o$ beds

o (elative S2ecial Study and %on&(elative $amilies are eligible

o Pre&Service raining and 0ssessment7 heavy $ocus on trauma

3* hours7 * o$ which are child s2eci$ic when child matched to $amily

all $amilies are re)uired to com2lete hours

o ,#&3, hours o$ 2ost&licensing training 2er year

o sta$$ training re)uired7 annual training 2lan re)uired $or a22roval

o Child assigned Case :anager

weekly $ace to $ace visitation with child

twice a month $ace to $ace visitation with $amily

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once a month minimum o$ grou2 session

caseload si?e ca22ed at +

4(0P $unding allocated to agency to su22ort $oster $amily and child

K3A5- 2er year

covers 1# days o$ res2ite $or $oster $amily

2ayment $or social recreational educational vocational and

clinical services $or which no other $unds are available

o ,/B* on&call coverage 2rovided by 2rivate agencyBC 2rogram

ty2ically a case manager who is known to the $amily

o C 2rograms designed to 2rovide ste2&down care $rom residential setting

thera2eutic grou2 homes or as an intervention $rom re)uiring higher levels o$care

oster Parent Sti2end 0dministrative ee otal 0mount

K55 KA# K133

,--*5 annual ,/#,- annual /#5/5 2aid by !C

Sta$$ing :odel Per Contract

Position Sta$$ing 'evel Education

Case :anagerBSocial 4orker 1E N 1+ youth achelor or higher

(ecruiter .5 E $or 3- contract slots 0ssociates7 ex2erienceProgram Su2ervisor 1.- E :S4

Program :anager .5 E :S4B'CS4

:odels o$ Pre&Service raining and rauma in$ormed training includeP(I!E Child 4el$are 'eague:0PPS(isking Connection raumatic Stress Institute7 C&C basic training $or $oster care 2roviders

here are two other levels o$ $oster care utili?ed within C :ultidimensional reatment oster Care :!C6

o designed $or the uvenile ustice 2o2ulation

o evidence based model7 rigorously evaluated and $ound to be e$$icacious1-

1-on&line atwww.mt$c.comBournalarticles.html

,-
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21/41

o model designed $or s2eci$ic age grou2s

o 2rogram 2rovides close su2ervision 2roviding $air and consistent limits

2redictable outcomes $or breaking rules

o im2lemented in a team model Program Su2ervisor amily hera2ist Individual

hera2ist skills trainer and daily check&in sta$$.

o ehavior is monitored on a daily basis

Pro$essional oster Care

o trained 2aid em2loyees o$ the child 2lacing agency

o receives salary and bene$its in addition to monthly sti2end

o Pros intensive training greater direct care o$ child better 2re2ared to care $or

more behaviorally challenged youth7 case managers are graduate level and higher7

internal access to 2sychiatry services medication management and behaviorists

o Cons $inancial disincentive to move towards 2ermanent goal i$ a22ro2riate7

$undamentally inter$eres with the conce2t o$ $amily

o Several models across the country have shown 2romising results

o unding model exam2le K/---- annual salary to one 2arent who must be

available to the child $ull&time7 co&2arent is not a 2aid em2loyee and may workoutside the home.

o :onthly sti2end 2aid to $oster $amily to cover the cost o$ care $or the child

%0I is the only certi$ied agency to 2rovide the :!C model and $irst introduced the2ro$essional 2arenting model in C in 1++/. here is one other agency Institute o$ Pro$essionalPractice that 2rovides 2ro$essional $oster care services in C. heir $unding rates are unknownat this time.9ther oster Care (elated 9rgani?ationshe Connecticut 0ssociation o$ oster and 0do2tive Parents C00P6 is a non&2ro$itorgani?ation $unded by !C to 2rovide training su22ort and advocacy to the $oster and ado2tive$amilies both !C and 2rivately licensed. 8owever their 2rimary $ocus is assisting the!e2artment with the recruitment and 2ost&licensing training o$ !C C9(E $amilies. hey havea sta$$ o$ 31 em2loyees and an annual budget o$ 1.++:.

Innovative )odel of Foster Care$ )ocking*ird Society:ockingbird Society as a model o$ $oster care or Community 8omes6 is recommended $or$urther ex2loration. hey are not a child 2lacing agency7 they 2rovide technical assistance tochild wel$are and 2rivate $oster care agencies to im2lement the model o$ care.he model is com2rised o$ Constellations with a 8ub 8ome that serves as res2ite on&goingsu22ort and event coordination $or $amilies and youth. 0 constellation is recommended $or u2 tono more than 1- $amilies. 8owever with higher acuity level youth it is recommended that therebe lower numbers o$ $amilies in the constellation.

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8ub 8ome he 8ub 8ome 2arent is ty2ically an ex2erienced $oster 2arent who is 2aid amonthly sti2end $or their role. he monthly sti2end covers their role in 2roviding res2itesu22ort services to constellation $amilies and monthly activities.

o (es2ite (es2ite is the 2rimary $unction o$ the 8ub 8ome. he 8ub 8ome manages a

monthly calendar o$ res2ite re)uests which come directly $rom the $amily. (es2ite may

include days evenings or overnight re)uests.

o 0ctivities Coordination he 8ub 8ome 2arent also coordinates monthly activities to

$acilitate a sense o$ community. 0ctivities may include a cook&out game night 2ot lucketc.

o 9n&going su22ort in addition to the childHs social worker or case manager the 8ub

8ome 2arent 2rovides on&going su22ort to the $amily that may include assisting withtrans2ortation visitation with siblings and 2eer mentoring to constellation $amilies.

he child 2lacing agency is res2onsible $or recruiting training and licensing the constellation$amilies. 8owever the 8ub 8ome is o$ten a collaborative 2artner in this 2rocess. he child

2lacing agency also maintains the case management res2onsibilities addresses clinical needs ando$$ers training to the $amilies and youth.he goal is to create a sense o$ community among the constellation. In discussion with the:ockingbird Society there are o22ortunities $or $amilies and youth to develo2 relationshi2among other members o$ the constellation7 thus im2roving outcomes $or children in the model.In 2romoting 2ositive outcomes $or children data has shown that this model has met or exceedednational standards in the areas o$ sa$ety 2ermanency well&being and caregiver su22ort. In the,--+ :ockingbird amily :odel ::6 :anagement (e2ort the $ollowing outcomes werenoted

Child Sa$ety

o here were ?ero CPS re$errals $or caregivers in the :: Constellations

Permanency

o ,1< o$ youth achieved their 2ermanency goals or made moves that were

consistent with achieving 2ermanency.

o

Child 4ell&eing

o Placement Stability #3< o$ :: youth ex2erienced ?ero changes in

2lacement

o In ,--+ 1< o$ Constellation youth ran away $rom 2lacement

uilding Strong Community Connections

o +1< o$ youth 2artici2ated in 8ub 8ome organi?ed social activities

Caregiver Su22ort

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o (etention o$ :: $amilies at ## re2ort.he :ockingbird Society has been re2licated with 2o2ulations similar to !C C9(E $oster careand C level $oster care. here have not been any sites that re2licated the model s2eci$ically$or !:S although there is one agency is Seattle 40 ex2loring the o2tion.

B. &eferral+ )atching and (lacement (rocesshere are no $oster care beds through !C and the 2rivate 2rovider network that can assumenon&!C involved youth. 0ll youth re$erred must have some level o$ legal involvement or beacce2ted into the Goluntarily Services Program outlined in section IIa.!C is res2onsible $or com2leting all re$errals $or $oster care. I$ there is a )uestion regarding thelevel o$ a22ro2riate care re)uired the !C S4 com2letes a EI unknown acronym6 aninventory o$ 2lacement ex2eriences at risk behaviors clinical interventions academic

2er$ormance and social $unctioning. ased on the scoring a youth may or may not be eligible$or thera2eutic level $oster care C6. 9n occasion the local o$$ice will re)uest a clinicalreview to override the score $or 2lacement into C care. or youth that score exce2tionallyhigh yet still a22ro2riate $or thera2eutic $oster care will be re$erred to the two 2ro$essional2arenting 2rograms and re$erred to as C&Enhanced C&E6.!C has a structured division oster and 0do2tive Services Lnit 0SL6 in each o$ the 1/ localo$$ices. hey 2rovide the recruitment licensing training and su22ort to !C C9(E $oster$amilies. 0dditionally they are res2onsible $or matching re$erred youth to their own homes.or youth that )uali$y $or C or C&E the re$errals along with the EI are submitted to the!C 'iaison and the S0'0 coordinator. In the most recent contract design $or C !Csu22orted the develo2ment o$ the S0'0 Service 0rea 'ead 0gency611. 0 se2arate contract wasawarded to one agency in each o$ the then $ive regions to serve as the gatekee2er $or all C andC&E re$errals. he S0'0 is res2onsible $or gathering data on the number ty2e anddis2osition o$ re$errals. ecause o$ contract language there are time$rames in which youth areex2ected to match and transitioned into their identi$ied $amily. he broader goal is that within /5days o$ the re$erral youth will be matched and 2laced. 0s the acuity level o$ youth beingre$erred increase there is a longer wait time to match youth with a22ro2riate $amilies. 0t the2resent time there is an increase o$ youth 2resented $or C and C&E as the Commissionermoves $orward with the (ightsi?ing and (edesign o$ congregate care settings. Each 2rovideragency 2artici2ates in S0'0Hs that serve their catchment areas. 9n a weekly basis new re$erralsare 2resented unmatched youth are reviewed status u2dates on the 2re&2lacement o$ youth is2rovided and 2resentation o$ any 2ending disru2tions within the !C 2rogram are made. 0syouth are 2resented 2rivate agencies o$$er any $amily resources that may be available ask $ormore in$ormation or decline 2lacement. 0t the time in which a $amily is o$$ered !C reviewsthe $amily 2ro$ile and acce2ts or denies the 2lacement. !enial o$ o$$ered resource re)uiresclinical reasoning7 however it is o$ten noted that !C will re$use a $amily based on location i.e.too $ar $rom community o$ origin. In some circumstances this is an a22ro2riate denial.

11he S0'0 is currently $unded by the 2rivate 2roviders7 rates are established based on the number o$ contracted slots.

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8owever $or this targeted 2o2ulation this would be highly recommended to minimi?e sa$ety andaccess.!uring the licensing 2rocess $amilies com2lete a Ca2acity 0ssessment with the licensings2ecialist. 0t this time the $amily and licensing s2ecialist review all the 2otential behaviorsduring 2lacement. (ecommendations $or age gender behavioral characteristics are develo2ed

into a 2ro$ile to $acilitate the matching 2rocess.9nce 2laced into C or C&E level $oster care the $amily and youth receive a high level o$case management services as outlined in the 2revious section. he ex2ectation $or C $ostercare 2roviders is that they are willing able and ex2ect to manage more behaviorally challengedyouth. here$ore there is a higher ex2ectation that C $amilies will 2roduce lower disru2tionun2lanned discharges6 rates. 0lthough the data has not been released $or " ,-11&,-1,7anecdotally this a22ears to be true in com2arison to !C C9(E $amilies.Intersection with !:S!uring a S0'0 2resentation the !C Social 4orker andBor treating clinician 2rovide a detailedhistory and clinical recommendations $or an a22ro2riate 2lacement. 0s noted by oneinterviewee there has been an increase in the number o$ re$errals identi$ying at minimum risk o$

tra$$icking. 8owever there a22ears to be a lack o$ coordination and sharing o$ in$ormation o$identi$ied or sus2ected tra$$icking victims.In a recent S0'0 2resentation a youth known to one o$ the 2rivate 2rovider agencies hadknowledge that there was an o2en investigation regarding !:S as it is sus2ected that she wasrecruited $rom the 2rivate 2roviderHs $oster home. 4hen asked by the 2rivate 2rovider agenciesthe status clinical needs and recommendation7 there was a dead silence and the 2resentersbecame uncom$ortable. he !C S4 indicated that she had not had any communication with!C 80( and was unaware o$ what clinical and sa$ety measures may be needed. 0s earlierstated among C 2roviders it is re2orted that there has been little e$$ort by !C to include2rovider agencies in the training and ca2acity building to ade)uately serve these youth althoughthey are automatically classi$ied as C due to the tra$$icking. or some C $oster $amiliesthera2y is 2rovided outside o$ the home. Case managers 2rovide clinical su22ort to the youthand the $amily but the delivery o$ individual and $amily work is through out2atient clinics.:any C 2roviders o$$er only basic evidence based trauma a22roaches to their sta$$ andminimally to their $amilies. 9$ the agencies utili?ing clinical services $or their youth there islittle em2hasis on securing a clinician trained in trauma based treatment.

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C. %icensing &egulationsSimilar to congregate care settings 2rivate agencies who wish to 2rovide $oster care servicesmust be licensed by !C. In addition to the regulations $or child 2lacing agencies CP06 $ostercare $amilies are re)uired to be licensed. oth re)uirements are outlined in this section in022endix F. he 2rocess $rom becoming a licensed CP0 is the same as $or congregate care

settings.he regulations set $orth regarding the licensing o$ $oster 2arents are the core com2onents toissues a CP0 license7 however due to the level o$ care re)uired by re$erred youth the assessmento$ $oster 2arent thera2eutic ability is a considered $actor.a( *oster Parent Screening ; 0ssessment Process $or the thera2eutic level $oster care

2rogram and will adhere to !C 2olicies and Connecticut Feneral Statutes. Pros2ective

$amilies are engaged in the screening and assessment 2rocess to determine their suitability

$or 2roviding $oster andBor res2ite care. @lingberg views this as an o22ortunity $or mutualassessment. he ste2s $or a $amily seeking licensure are7 Initial screening o$ basic

re)uirements $or eligibility and 2rogram descri2tion7 8ome 0ssessment with 'icensing

S2ecialists to assess and review the 022lication $or oster Care7 interview o$ $amily

members $or motivation7 eligibility $or licensure or identi$ication o$ 2otential barriers7licensing 2rocess and commitment7 clinical needs o$ youth re$erred to C7 and Casey

oster 022licant Inventory. here is a $ocus on each $amilyHs availability to 2rovide ,/B*su22ort to the youth in its care and ability to engage in intensive clinical service delivery

and weekly 2artici2ation in clinical skills training i$ re)uired. 0ssessment $or suitability $or

licensure continues throughout the 2re&service training and licensing 2rocess.

b( 0gency Licensing Process" 6ome Study" and Practices9Policies

7he licensin! "rocess is one of mutual assessment, that includes9

Pros2ective amilies are re)uired to attend a minimum o$ 3* hours o$ 2re&service

training and 2arenting skills education.

Concurrent with the 2re&licensing training re)uirements all $amily members

engage in a series o$ 2ersonal interviews 5minimum o$ three6. Interviews are

conducted individually and as a $amily unit as a22ro2riate.

Physical ins2ection o$ the home to ensure com2liance with licensing regulations.

Each adult household member must submit three 2ersonal re$erences that address

hisBher ex2erience and ability to care $or children. 0dult cou2les in the household

must 2rovide at least one re$erence that s2eaks to the stability o$ the relationshi2

and each individualHs ability to co&2arent. 0ll re$erences are veri$ied.

ackground checks $or individuals over the age o$ 1A I $inger2rinting7

state and local 2olice checks7 Sexual 9$$ender (egistry check7 Child ProtectiveServices 5CPS6 background checks7 civil court 2roceedings $inancial statements7

:edical statements and educational statements as a22ro2riate.

0ny deviation in any o$ the background checks results in $urther ex2loration to

determine the 2otential im2act on licensure. I$ there are adult children who reside outside

o$ the home or other regular visitors to the $amily household they are incor2orated into

,5


26/41

the home study 2rocess and are re)uired to be interviewed and submit to the local and

state criminal CPS and Sex 9$$ender (egistry background checks. he 'icensing

S2ecialist reviews and incor2orates the $eedback $rom 2re&licensing training homeworkassignments content o$ the 2ersonal interviews re$erences and su22orting documents to

develo2 a detailed home study and make a $inal recommendation $or licensure.

o clari$y this model assumes that the $oster $amily has sa$e and stable housing. I$ a model2rogram 2rovides the $oster $amily with an agency&owned home it may be licensed as a

congregate care 2rogram.

9ngoing su22ort and training re)uirements were 2reviously cited. 'icenses are valid $ortwo years at which time the $amily submits their a22lication $or re&a22roval and a new

study is com2leted.

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27/41

I+( ,ducational Planning for 6omeless /out< DC* and -on.DC* involvedS2ecial educational 2lanning and $unding considerations are re)uired when ex2loring thedevelo2ment o$ housing and care $acilities $or !C and %on&!C youth. he :c@inney&Gento0ct 1+#* 2rovides grants to state educational agencies to ensure that children and youthex2eriencing homelessness have the same access to education 2rovided to all children. he

:c@inney&Gento 0ct de$ines Mhomeless children and youthH as individuals who lack a $ixedregular and ade)uate nighttime residence. his includes1,

Children and youth who are & sharing the housing o$ other 2ersons due to loss o$

housing economic hardshi2 or a similar reason sometimes re$erred to as dou*led#u!67

& living in motels hotels trailer 2arks or cam2ing grounds due to lack o$alternative ade)uate accommodations7

& living in emergency or transitional shelters7& abandoned in hos2itals7 or& awaiting $oster care 2lacement7

Q Children and youth who have a 2rimary nighttime residence that is a 2ublic or 2rivate

2lace not designed $or or ordinarily used as a regular slee2ing accommodation $orhuman beings7

Q Children and youth who are living in cars 2arks 2ublic s2aces abandoned buildingssubstandard housing bus or train stations or similar settings7 and

:igratory children who )uali$y as homeless because they are living in circumstances

described above.

In ,--1 under %o Child 'e$t ehind 'egislation the :c@inney&Gento 0ct was reauthori?edwith the $ollowing re)uirements see 022endix 8613

Q,-!ress !rohi*ition against segregating homeless studentsN he statute ex2ressly 2rohibitsa school or State $rom segregating a homeless child or youth in a se2arate school or in ase2arate 2rogram within a school based on the child or youthHs status as homeless.

Q&e'uirement for trans!ortation to and from school of originN he State and its localeducational agencies 'E0s6 must ado2t 2olicies and 2ractices to ensure thattrans2ortation is 2rovided at the re)uest o$ the 2arent or guardian or in the case o$ theunaccom2anied youth the liaison6 to and $rom the school o$ origin. here are s2eci$ic2rovisions regarding the res2onsibility and costs $or trans2ortation.

QImmediate school enrollment re'uirementN I$ a dis2ute arises over school selection or2lacement an 'E0 must admit a homeless child or youth to the school in whichenrollment is sought by the 2arent or guardian 2ending resolution o$ the dis2ute.

Q Changes in *est interest/ determination 0 'E0s must make school 2lacementdeterminations on the basis o$ the =best interest> o$ the child or youth. In determining

what is a child or youthHs best interest an 'E0 must to the extent $easible kee2 a

1,Education $or 8omeless Children and "outh Program7 Lnited States !e2artment o$ Education ,--/7 2. ,.

13Education $or 8omeless Children and "outh Program7 Lnited States !e2artment o$ Education ,--/7 2. 3.

,*


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homeless child or youth in the school o$ origin unless doing so is contrary to the wisheso$ the child or youthHs 2arent or guardian.

Q%ocal liaison in all school districtsN Every 'E0 whether or not it receives a :c@inney&Gento subgrant must designate a local liaison $or homeless children and youth.

"outh being served in non&!C runaway and homeless youth 2rograms are covered under the:c@inney&Gento 0ct. or youth 2laced in the custody o$ !C there is have limited coverage.In a :emorandum issued dated ebruary 15 ,--5 by the Commissioners o$ !C and State!e2artment o$ Education S!E6 an agreement was reached =that all children in !C custody2laced in emergency or transitional shelter 2lacements are entitled to and will be a$$orded the2rotections 2rovided by :c@inney&Gento.> his was also ex2anded to children and youth whoare in the transitioning 2hase into new $oster care setting u2 to 3- days.

Educational ;urisdiction

or youth that are in !C custody and a non&transitional or emergency setting !C is re)uired

to noti$y the 'E0 'ocal Educational 0gency6 via !C&A-3 see 022endix I6. his documentidenti$ies that the child is 2laced in a !C setting and identi$ies the youth as %exus or %o&%exus. his %exus status to identi$y as it assigns the legal and $inancial obligation $or the2ayment o$ educational services to the a22ro2riate school district. %exus is determined by thelegal and 2ermanent address o$ a 2arent or guardian even i$ the youth does not reside in theirhome. %o&%exus status may be assigned based on the $ollowing criteria whereabouts unknownno Connecticut residence 2arental rights have been terminated deceased identity unknown orcurrently incarcerated or treatment $acility and does not maintain a C residence.

In cases o$ regular education students there is ty2ically little im2act on the receiving schooldistrict $or %exus and %o&%exus youth. 8owever when a student is designated as s2ecialeducation eligible the %exus district is $inancially and legally obligated to $und and coordinatethe service delivery. %o&%exus youth become the $inancially and legal res2onsibility o$ the townin which the youth reside.

or consideration o$ congregate care settings ?oning o$ 2rograms have been denied by towns i$limitations on the number o$ %o&%exus youth were not negotiated. or exam2le ?oning $or a sixbed grou2 home may be re)uired to limit the number o$ %o&%exus youth. his a22ears to be2articularly true in towns with limited s2ecial educational 2rogramming.

or congregate 2rogramming the S!E a22roves all educational 2lans. he 'E0 is the districtthat a22roves out o$ district 2lacement or alternative educational 2rogramming $or individualyouth. Connecticut does not routinely authori?e youth in !C custody to be homeschooled.

Educational Surrogate Parents

or children and youth that are in the care o$ !C !C is res2onsible to ensure that aneducational surrogate 2arent is assigned who are eligible1/. 0n educational surrogate 2arent is an

1/CO"". 1,". S2A2. 345#67f through 45#67k8and 349a#:;l


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individual a22ointed by the State !e2artment o$ Education to service as the educational advocate$or the child in lieu o$ the youthHs 2arent. he surrogate 2arentHs attendance is re)uired $or allmatters related to s2ecial education services including re$errals evaluations and thedevelo2ment o$ Individual Education Plans. 0 youth is eligible i$

1. the child re)uires or may re)uire s2ecial education or early intervention services and

at least one o$ the $ollowing is a22licable

o he Commissioner o$ !C has been a22ointed as the childHs guardian or statutory

2arent

o the childHs 2arent or guardian

cannot be identi$ied

cannot be located

is unavailable to re2resent the child regarding s2ecial education or earlyintervention services and agrees or $ails to obect to the a22ointment o$ asurrogate 2arent.

or youth that are not in !C custody homeless youth are guided by the 8omeless 'iaisonassigned to each school district. he 'iaison is res2onsible to a22ly $or the a22ointment o$ asurrogate 2arent.

or victims o$ sex tra$$icking understanding the educational rights is critical as it has noted insome literature the existence o$ a correlation between school related 2roblems s2eci$icallylearning disabilities and sexual ex2loitation. 4ithout the knowledge o$ how advocate $or theeducational rights o$ homeless runaway and !C&involved youth there is little o22ortunity tominimi?e this s2eci$ic risk $actor.

Im2act on 8igher Education

Lnaccom2anied youth are considered inde2endent students or youth that have been in $oster careany time a$ter the age o$ 13 are automatically considered Minde2endent studentsH and cancom2lete the 0S0 without 2arental income or signature. hey may also be eligible $or $eewaivers $or the S0 exams.

,+


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+( 0reas for *urter ,xploration

A. Best (ractices for the Clinical 2reatment of =ictims of uman 2rafficking0lthough there has been little research on the best 2ractice standards o$ domestic minor sextra$$icking victims there is a growing body o$ research on the understanding o$ trauma itsim2act and recommendations $or treatment. rauma in$ormed care suggests that issues o$ sa$ety

and reintegration cannot be achieved until the res2onses to trauma are treated. Post&traumares2onses can result in the diagnosis o$ Post&raumatic Stress !isorder PS!6. PS! oncereserved $or war veterans and disaster victims a22lies to victims o$ other traumas. here$orereviewing the evidence based models recommended $or the treatment o$ PS! a22ears to be themost $itting.In researching a best 2ractice model $or the treatment o$ domestic minor tra$$icking victims thecritical com2onent $or services to be trauma&in$ormed. raditional models o$ talk thera2y areo$ten not e)ui22ed to meet the needs o$ this 2o2ulation.here are a number o$ recommended evidence&based thera2eutic models $or treatment o$ PS!and similar sym2toms and are generally based on cognitive behavioral or 2sychodynamictheories o$ treatment. !ue to the com2lexity o$ the trauma ex2erienced there is not one

2rescri2tive evidence&based model to re$erence. 8owever in com2arison with the treatment o$PS! success$ul o2tions include

,vidence.2ased Terapeutic Treatment 'ptions for PTSD

Cognitive Terapy0ims to challenge dys$unctional thoughts based on irrational or illogical assum2tions.

Cognitive.2eavioral Terapy&C N rauma ocused Cognitive ehavioral hera2y6Combines cognitive thera2y with behavioral interventions such as ex2osure thera2ythought sto22ing or breathing techni)ues.

,xposure Terapy0ims to reduce anxiety and $ear through con$rontation o$ thoughts imaginal ex2osure6 or

actual situations in vivo ex2osure6 related to the trauma.,ye Movement Desensiti=ation and 1eprocessing

Combines general clinical 2ractice with brie$ imaginal ex2osure and cognitiverestructuring ra2id eye movement is induced during the imaginal ex2osure and cognitiverestructuring 2hases6.

Stress Inoculation TrainingCombines 2sycho&education with anxiety management techni)ues such as relaxationtraining breathing retraining and thought sto22ing. (auch J Cahill ,--36

here are several models currently under develo2ment $or modi$ication and evaluation o$ im2acton adolescent $emales. 8owever one model Seeking Sa$ety 2resented with 2reliminary

2ositive outcomes. Seeking Sa$ety is a ,5&session manuali?ed intervention $or mental healthtrauma sym2toms and substance abuse15. 0lthough a relatively small sam2le si?e there wassigni$icantly better outcomes 2ost&treatment than treatment as usual grou2s including decreasedsubstance use trauma sym2toms and im2rovement in cognitive measures o$ PS! sym2toms.arriers to securing treatment services

15htt2BBwww.seekingsa$ety.orgB*&11&-3


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Con$identiality "outh in Connecticut can seek mental health treatment without the consento$ their guardian $or u2 to six sessions. he only exce2tion is i$ the 2rovider believes thatnoti$ication would be seriously detrimental to the minors well being. 1A8owever i$ the guardianis not in$ormed o$ the out2atient treatment services they are not liable $or the costs o$ treatment.here$ore securing treatment services $or 2rivately $unded services may become a barrier. In

addition many insurance carriers including 2rivate and :edicaid do not cover all home basedclinical services. 4hile there are $ew exce2tions7 these services are re)uire 2re&authori?ationand are ty2ically evidenced based models such as IIC0PS :! which do not meet the needso$ tra$$icking victims.'ack o$ Com2liance !ue to the o$ten transience o$ the 2o2ulation there is di$$iculty in$ul$illing weekly scheduled a22ointments. :any 2roviders will discharge a client a$ter three Mno&showH a22ointments as this is seen as non&com2liance with service delivery.'ack o$ skilled clinicians Fiven that this is a growing area o$ awareness it is likelythat !:S will $ind it di$$icult to locate clinicians that have the skill set necessary to begin thehealing 2rocess. his is evidenced by surveying 2ro$essionals in the $ield who they themselveswere challenged to identi$y a resource they would likely re$er to i$ needed. 4hile there are

clinicians trained in the models above not all are ex2erienced with the adolescent 2o2ulation norwith !:S.

B. )odels of Intensive Case )anagement4hile understanding e$$ective clinical methods 2erha2s the most crucial com2onent to thesuccess o$ treatment $or tra$$icking victims is based on the develo2ment o$ a meaning$ulconnection and relationshi21*. hrough examination o$ well&established 2rograms such asFE:S S0FE and CE0SE com2rehensive case management services are e$$ective yet the mostim2ortant as2ect is the )uality o$ the relationshi2 with the case manager1#. 4hile 2ro$essionalsagree that com2rehensive case management models 2rovide greater level o$ su22ort there arebarriers to the im2lementation that include di$$iculty in $unding sources di$$iculty in

establishing collaborative relationshi2s and lack o$ available resources.0n additional barrier that is 2resent in the current child wel$are system. 4hen a youth is 2lacedin a C level $oster home the youth is 2rovided with intensive case management and su22ort.I$ the 2lacement is not success$ul or the youth transitions to another setting the casemanagement services end. 4hile in some cases this may be a celebratory event $or victims o$tra$$icking there would a22ear to be bene$it to maintaining a consistent case manager that movesthroughout the system regardless o$ 2lacement even i$ youth is engaged high risk activity.

0 case exam2le is that o$ a 1A year old youth who s2iraled downwardemotionally7 she had a history o$ high risk sexual behaviors and had been sexually

1AConn. Fen Stat. R1+a&1/c

1*L.S. !e2artment o$ 8ealth and 8uman Services 8uman ra$$icking Into and 4ithin the Lnited States 0 reviewo$ the 'iterature

1#L.S. !e2artment o$ 8ealth and 8uman Services 8uman ra$$icking Into and 4ithin the Lnited States 0 reviewo$ the 'iterature7 2. 3,

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assaulted on more than one occasion. 8er aggression escalated when she wasdis2laced $rom her 2re&ado2tive $amily when another relative moved in. She hadlost contact with her biological $amily and now lost her ado2tive $amily. In themidst o$ all this she was engaging in risky sexual behavior i.e. texting nude2hotos. She was 2laced in a tem2orary shelter bed and became increasingly

aggressive. 0s she was no longer returning to the ado2tive $amily the C casemanager had to close out her case. 0$ter six months o$ residential treatment thesame youth was re$erred to C. he same agency assumed the case re)uestingto recruit a $amily s2eci$ically $or her. L2on their $irst meeting the youth askedthe case manager why she abandoned her when all M>those horrible thingsha22ened to me are you ashamed o$ me> 0lthough 2roviding intensive casemanagement may not have 2revented the traumatic ex2eriences7 she would havehad one less trauma to heal and relationshi2 to re2air. In addition the casemanager was able to start in a 2lace o$ strengths as she already had a relationshi2with the youth. his allowed their relationshi2 to solidi$y more )uickly andallowed the two o$ them to $ocus on the issues at hand such as kee2ing sa$e and

$inding a 2ermanent $amily.%ote urther ex2loration o$ intensive case management models stemming $rom thedisci2lines serving domestic violence victims and homeless youth is recommended. heclinical treatment model itsel$ does not a22ear to be the sole core com2onent o$ 2rovidingsuccess$ul interventions7 much thought and consideration should be given to the 2rogramdesign. !esigns that may include sense o$ sa$ety both 2hysically and emotionallyincreased ca2acity o$ housing 2rograms $or length o$ stay and ability to work with theclient at whatever stage she is at and the ability to assist in navigating the varied systemsthat become involved with tra$$icking cases.or the 2ur2oses o$ 2rogram management $urther ex2loration into the 8arm (eduction:odel7 commonly used in substance abuse treatment while working towards the goal o$sa$e behaviors this model seeks to look at behaviors and determine how to minimi?e therisk i$ acted u2on. he 8arm (eduction model utili?es motivational interviewingtechni)ues $rom the Stages o$ Change model and that choice is 2art o$ recovery7 anddi$$icult conce2t $or !:S survivors. Exam2le maybe while a youth is not given2ermission to 049' the likelihood a !:S youth consistently stated heBshe were goingto leave. eing able to discuss the event with the youth can allow the youth to sa$ety2lan think ahead o$ the 2otential conse)uences may minimi?e the risk events even i$ the049' occurs. his would be 2articularly use$ul in assisting 2rograms to develo22rogram 2olicies1+.

C. ,ngagement with intersecting service systems

!omestic Giolencehrough this 2rocess I $ound only 2eri2heral discussions among service 2roviders $romdomestic violence and human tra$$icking although victims share many o$ the samecharacteristics. 4hile there has been some integration o$ the material in 2ublished materialsthere was a lack o$ res2onse $rom the C domestic violence advocacy community. Lnknowing

1+htt2BBdocuments.csh.orgBdocumentsBmiBhousing$irstB8arm(educCom:odel.2d$

3,
http://documents.csh.org/documents/mi/housingfirst/HarmReducComModel.pdfhttp://documents.csh.org/documents/mi/housingfirst/HarmReducComModel.pdf


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the current status o$ collaborative e$$orts made by 'ove1/A I would recommend continuedattem2ts to engage with both CC0!G C Coalition 0gainst !omestic Giolence6 and with !ave:andel :andel 0ssociates.CC0!G may be able to 2rovide a national 2ers2ective on the intersection and collaborativee$$orts between the two 2o2ulations. htt2BBwww.ctcadv.orgB

!ave :andel :andel 0ssociates htt2BBwww.endingviolence.comB Phone #A-6 31+&-+AA!ave :andel has established a $ormali?ed 2resence within !C to 2rovide training andconsultation $or !C sta$$. 8e has ex2erience in working with both victims and batterersin domestic violence cases. Each local o$$ice is sta$$ed with a !G consultant who isavailable to 2rovide case consultation assist in assessment and sa$ety 2lanning. Fiventhe commonalities o$ the victims this may be an excellent resource to ta2 into 2roviding amore visible consultative role within the !C community and the community at large.

D. )edicaid &eim*ursement

0ll youth involved with !C are covered under :edicaid 8LS@"6 insurance. In 2rovidingany level o$ clinical care there is the ability to receive reimbursement. In addition any 2rivately$unded 2lacement may have health insurance which may reimburse $or a com2onent o$ theclinical services delivered. In consideration o$ any clinical service delivery it would bebene$icial to obtain additional consultation on the eligibility re)uirements. It should be notedthat when treatment is insurance driven there are o$ten restrictions on length o$ stay anda22roved service delivery. It is suggested that the any reimbursement received be secondary tothe $unding allocations.

33
http://www.ctcadv.org/http://www.endingviolence.com/http://www.ctcadv.org/http://www.endingviolence.com/


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+( 1ecommendationsIn synthesi?ing the in$ormation 2resented there were three emerging themes garnered $rom2ro$essional ex2erience interviews with community stakeholders and a review o$ 2romising2ractices $or clinical intervention and 2rogram designs.0( T10I-I-8 0-D C'-S>LT0TI'- S,1+IC,S

here was an overwhelming res2onse $rom all realms o$ service delivery that there continues tobe a need $or awareness raising training o22ortunities and case consultation services.In the surveys conducted des2ite being 2ractioners on the ground level many were only had avery basic knowledge o$ sex tra$$icking. :ore concerning is that as service 2roviders mostlacked the skill to identi$y signs o$ tra$$icking assess $or risk $actors and 2rovide a22ro2riateinterventions i$ re)uired. 4hile !C has continued to move $orward with the develo2ment o$curriculum there a22ears to be large ga2 in many service areas7 2articular in sectors that are notcongregate care&$ocused or non&!C involved.raining

1. Provide two&$our statewide training o22ortunities $or all thera2eutic level $oster care2rograms. here are 1# 2rivate 2rovider agencies that service the entire state. 0gencies

$rom Plainville 8art$ord !anbury and :il$ord have all ex2ressed interest incoordinating statewide or regional events. 'ove1/A could charge a $ee $or this training.arget audience would be both $oster 2arents and C sta$$.

,. Provide training $or Community ased 'i$e Skills C'S6 Program Educators. C'S isa !C $unded 2rogram $or youth ages 15&,1 in the custody o$ !C. Classroom andindividuali?ed curriculum 2re2are youth $or sel$&su$$iciency. hese are well $unded2rograms and can utili?e $unds $or training.

3. Ex2and to !C C9(E oster Care Systems. hey will not have a budget to $und orvery small6 but it is good P(. Consider collaboration with C00P www.ca$a2.org7 ;eanioiretti Exec. !irector7 #A-.,5#.3/--6 to $und 2ost&licensing training.

/. Provide ollow&u2 consultation to agencies that have had sta$$ trained. ;anus 8ousere2orted that the agency would like to have a yearly re$resher7 2erha2s discuss s2eci$iccases to better understand what areas o$ assessment needed im2rovement. unding is2robably not available.

5. Ex2lore training $or both youth and sta$$ through ;uvenile (eview oards "outhServices ureaus. CSS! is well $unded 2rogramming.

Curriculum1. Ex2lore models that have 2ublished data. 4hile :y 'i$e :y Choice is the 2re$erred

curriculum there have been no 2ublished results on the e$$ectiveness o$ the 2rogram.0dditionally while there is a ;(I 2rovides rain the rainer $or $acilitation there isno measurement on the model7 ie no observation o$ trainer ability.

3/
http://www.cafap.org/http://www.cafap.org/http://www.cafap.org/


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a. I$ this model continues to the be the 2re$erred curriculum recommendengaging in dialogue with ;(I regarding e$$icacy o$ curriculum

b. Consider creating new curriculum

,. here is no curriculum $or $oster 2arents on how to work with youth that have been

tra$$icked. his is a much needed curriculum.

3. Incor2orate i$ not already done so hel2$ul strategies in a home setting to minimi?erisk to youth and to $amily.

Consultation Services4hile !C has $ormed 80( in res2onse to identi$ied !:S my 2ro$essional ex2erience thatthere continues to be an internal disconnect between what occurs at Central 9$$ice 'evel and inthe local area. 80( is available to 2rovide consultation on cases7 however it is unclear i$ thatis $or only identi$ied or cases re$erred to the Careline. It a22ears that there is a need to have anaccessible resource in the local o$$ice to consult on cases 2artici2ate in clinical team meetingsand assist in the sa$ety 2lanning and assessment o$ 2otential cases.

1. Collaborate with !ave :andel :andel 0ssociates and ex2lore a 2artner relationshi2as he has existing sta$$ing model in !C.

,. 0ctively 2artici2ate in 80( meetings

3. !evelo2 white 2a2er on 2ro2osed service delivery as the 2re&cursor to an IntensiveCase :anagement Program

a. 4hen victim is identi$ied 'ove1/A Consultant is assigned to the case. heconsultant reviews the case record including the recent re$erral.

b. :ake contact with the !C worker to walk through the next ste2s7 ie 2ending

legal involvement advise on how to engage with youth 2ost&disclosure and2rovide any necessary su22orts.

c. I$ a22ro2riate visit with youth and com2lete assessment on clinical needs

d. consult with clinical team to develo2 case management 2lan.

e. meet with !C team bi&weekly7

Sta$$ing consultantB2er diem

Credentialed Service a22lication and $ee schedule1. Lnder category o$ ehavior :anagement K5,Bhr

2eavior Management service is intended to develo2 orsu22ort a thera2eutic behavior 2lan to be $ollowed by2arents caretakers teachers andBor other service 2roviders.Includes 2re2aration o$ a written thera2eutic behavior 2landesigned to assist in the management o$ the childTsbehavior.

35


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,. Duration /- hours or A- days whichever comes $irst3. his would be well&targeted at youth transitioning into C or !C C9(E

oster Care $rom 0ssessment beds.

(ecommendations o$ Community Stakeholders

1. Runaway & Homeless Youth CoalitionStacey Violante Cote, Esq., MSWDirector, een !e"al #$%ocacy ClinicCenter or Chil$ren's #$%ocacy() Eli*a+eth StreetHartor$, C (1)-(/ )0)230 4330s%iolant56i$scounsel.or"

7e4t meetin" is sche$ule$ or 893913: contact has +een initiate$

3. ;nte"ration with Court Suro"ram Mana"er#ntonio.$onis5ct."o%

Policy !evelo2ment and Program !esign

0s outlined in the 2rotocol $or becoming a licensed care $acility accreditation isnecessary. Currently Council on 0ccreditation is collaborating with !C to develo2 best2ractice 2olicy $or 2rograms. 8owever it is my im2ression that this e$$ort is stalled. I$'ove1/A considers moving $orward then this would be o22ortunity to begin workingwith 2rivate agencies to look at their 2olicies and begin to dra$t measures that 2rovide

3A
mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]


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sa$e secure and consistent messages to all the residents. It would entail taking a currenta22lication andBor 2rogram model and going through 2olicy by 2olicy. here are somebasics like cell 2hone use 049' 2olicy etc. :ore challenging would be grou22artici2ation and treatment 2rogress.

Community based Su22ort Services7 Community asedIn surveying the services there is a lack o$ identi$ied clinically trained thera2eutic su22ort sta$$to work with !:S. Similar to the structure o$ youth dro2 in centers allocated Msa$e ?onesHwithin central areas. Sta$$ 2rograms during evening and weekend hours. 0s the grou2 develo2sand it will o$$er trans2ortation $or youth to continue to 2artici2ate. his may be a o2en or closedgrou2 structured or unstructured grou2. he research clearly identi$ies that 2eer su22ort alongwith 2ositive relationshi2 with case manager is essential in the healing 2rocess. 0dditional2rogram considerations it to also house a mentoring 2rogram targeting the !:S 2o2ulation.or mentoring o$ !C involved youth there is a $ee $or service schedule and re)uirescredentialing. or the youth dro2 in center i$ designed as an a$terschool 2rogram there may be

$unding allocated through !C7 also on a $ee $or service basis.2( 6ousing Modelshe second emerging theme and 2erha2s the most signi$icant is the need $or sa$e stable yetskilled housing sites $or !:S. here are arguments on both ends o$ the s2ectrum with regardto congregate settings vs. $amily community based. he research overwhelmingly suggests thatsuccess$ul treatment is achieved at best 1,&1# months and when in settings with 2eers o$ similarbackgrounds. hat without the ability to address the trauma there cannot be movement intosuccess$ul integration into the community. 8owever until a youth $eels sa$e heBshe cannotbegin to address the trauma.4ithin the course o$ discussion o$ housing models the third theme will be discussed intensivecase management service delivery.

Proposed Continuum of Care Model for

Trafficking +ictims )it Integrated Case Management

0s we ex2lore this model there will be discussion o$ how com2onents o$ this model may beachieved in stages.

In brie$ Phase 9ne 0ssessment eds $or sa$ety and stabili?ation services. lend o$ the (8"Shelter and the S0( 2rogram7 may be designed as host home licensed $oster 2arent6 with oneyouth or grou2 setting with no more than 5 residents i$ grou2 care. '9S 1-&,1 days.Phase , ransitional 8ousing congregate setting 2re$erably in rural setting7 no more than 'C$or A7 only acce2t 2lacement o$ 5. Consideration $or allocation o$ community beds which are not$unded by !C. 4ith maximum 2lacement o$ 5 one bed to remain o2en $or either emergency2lacement or stabili?ation o$ youth 2laced in Phase 3 Community 8omes. Phase , is a moretraditional thera2eutic grou2 home model. 8owever the research would suggest that this model

3*


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is e$$ective $or early treatment o$ survivors. (e$er to 022endix ; $or a sam2le Sco2e o$ Services$or thera2eutic grou2 model.he last 2hase Phase 3 is Community 8omes. I highly recommend the ex2loration o$ the:ockingbird Society amily :odel. In theory this 2rovides the balance o$ structure yet $luiditywithin a sa$e community that !:S victims would thrive in. 0gain the model may contain all

licensed $oster homes or a mixture o$ grou2 care hub home6 and $oster care constellationhomes6. he S2eciali?ed Community 'iving :odel is 2rovided as an alternative sam2le thatincludes a sco2e o$ service and budget in$ormation. his model is similar to a host model withextensive clinical su22ort. re$er to older S2eciali?ed Community 'iving :odel6.Initial contact has been made with the organi?ation. Executive !irector ;im heo$elis ,-A6/-*&,131. It had been shared that there is an undisclosed agency in Seattle 40 ex2loring thismodel $or the same 2o2ulation.'astly although not re2resented in the $low chart that in addition to the intensive casemanagement services o$$ered throughout the course o$ 2lacement7 services may be o$$ered $oryouth that leave the 2rogram through a$tercare services 2lanned discharge6 or as a result o$ ayouth leaving the 2rogram. 9ne challenge as 2reviously mentioned is that there is no

o22ortunity to 2rovide continuity $or youth with regard to treatment and service delivery7es2ecially when discharge $rom one 2rogram to another.eing able to $und 2rogram that would 2rovide outreach at a minimum $or a youth that has le$tthe 2rogram would 2rovide additional o22ortunities $or intervention and I believe it would resultin a greater chance $or returning to the 2rogram.Im2lementation0s an overall 2rogram model this continuum o$ care can o$$er !:S consistency in valuestreatment modalities 2ractice models and sta$$ing. he Intensive Case :anager would beassigned at the time o$ entry into an assessment bed. he Case :anager would be able to $ollowthe throughout all 2hases o$ treatment and 2lacement. his is the recommended model7 howeverby 2artnering with existing 2rograms I believe there would be greater o22ortunity to move this2roect $orward in a more timely $ashion.

4ithin the existing structure there are two agencies that are 2roviding short&term assessmentbeds. wo beds are located in a sta$$&secured residential 2rogram run by %0I and two arehoused within the ridge amily Centers S0( home. hrough the course o$ this assessmentthere was extensive discussion with the S0( 2rogram manager :ike (olnik #A-&+*#&**+#regarding his ex2erience and identi$ied needs within the current structure. he ridge S0(48 is currently receiving training $rom 'ove1/A have ex2erienced care $or !:S victims andex2loring how to revise existing 2rogram structure to accommodate !:S 2lacements. heridge also has one community bed allocated so there is the 2otential to serve three $emales atone time. hroughout our discussion :ike indicated that the largest

Final Assessment Human Trafficking in CT

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