Library: Advocacy

Considering the Options: Evaluating Out-of-Home Placements

GUIDELINES
FIRST, focus on the child. If your information about his/her needs is inadequate, gathering the rest is futile. Once you know the child's needs, select the applicable questions below and start finding answers.

 Use what you have learned to check the "fit" of a placement for a specific child or to compare several placement options.

A. CAREGIVERS

1. What is their educational level and experience in this field?
2. What kind of supervision do they receive?
3. What is the rate of staff turnover?
4. What is the staff to child ratio?
5. What kind of interaction is observed between children and staff?
6. Who is responsible for keeping the family informed?
7. Who makes decisions regarding discharge?

B. PHYSICAL FACILITY

1. Is it safe?
2. Is it licensed/accredited and adhering to licensure standards?
3. Is it clean?
4. What is its general appearance?
5. Is there adequate space, privacy, supervision, security, access to outside services?
6. Is it in a rural or urban setting?
7. Is it handicapped accessible?

C. DEMOGRAPHIC FACTORS

1. How long does the admissions process take?
2. What is the capacity of the facility?
3. What does its current population look like: number, gender, age range, racial/cultural mix, children with special physical or emotional needs?
4. How long has it been in operation?
5. What is the average length of stay?
6. What are the usual sources of payment?
7. Where do the majority of children go when they leave?

D. THERAPY

1. What type(s) of therapy is available?
2. How does it work?
3. How frequently is it done?
4. Who provides it?
5. Are there additional costs?
6. Is family therapy available?
7. Is substance abuse treatment available?
8. Is treatment for juvenile sex offenders available?

E. HOUSE RULES/DISCIPLINE

1. How is behavior regulated?
2. Is corporal punishment used?
3. What are typical rewards and consequences?
4. What are the protocols for dealing with runaways, suicide attempts, violence, alcohol/drug possession, school problems?

F. FAMILY CONTACT

1. Are visitation facilities available?
2. Are off-campus visits permitted?
3. What are the rules regarding frequency, duration and privacy of visits?
4. Is any transportation assistance for families available?
5. Are visits used as reward/consequence for behavior?
6. May siblings visit?
7. May extended family visit?
8. How are letters, phone calls and their costs handled?
9. What provisions are made for children without families available to them?

G. EDUCATION

1. Do children go to school on or off campus?
2. How are special educational needs met by the school?
3. Is tutoring available?
4. How is homework handled?
5. May students participate in extra-curricular activities?
6. How are educational needs and results transmitted to the family?

H. HEALTH

1. Is there a separate sickroom or infirmary?
2. How are major and minor medical needs met?
3. How is medication kept and administered?
4. What kinds of emergency procedures are in place?
5. Has a child ever died while in this placement and, if so, under what circumstances?
6. What recreational facilities and equipment are available on and off campus?
7. What kinds of activities are required and what kinds are optional?
8. How frequently do the children have opportunities for physical activity, quiet time, activities of their own choosing?
9. What is the procedure for meals?
10. Are there any dietary restrictions?

I. SELF-DETERMINATION

1. Ask for policies or rules on teen issues such as dating, phone calls to and from friends, getting a drivers license and using agency vehicles and smoking.
2. What is the policy, if any, regarding worship attendance?
3. What rules govern personal belongings such as posters, video games, jamboxes and bikes?

J. PERSONAL CARE AND CLOTHING

1. Are there rules regarding bathing, hair, earrings and clothes?
2. Is there a minimum/maximum amount of clothing required at entry?
3. Who determines the need for clothing replacement?
4. How is new clothing chosen and purchased?

K. MONEY AND JOBS

1. Are children given an allowance?
2. Where does the money come from?
3. Are they allowed or encouraged to get jobs, either on or off campus?
4. How is their money secured?
5. How are they allowed to spend it?
6. Ask for examples of how concrete skills are taught such as cooking, budgeting, laundry, shopping, cleaning, finding an apartment, applying for a job.
7. Ask for similar examples of teaching the "soft" skills such as personal safety, sexuality, personal and employment relationships, building a support system and goal setting.

CASE EXAMPLE # 1

Robert, a black male, age 10, has serious emotional problems and an IQ of 125. Prior to agency involvement, Robert lived with his mother, stepfather and his two year old half-sister. He had been involved in a series of incidents including exposing himself to his little sister, fire-setting and running away. Preventive services were attempted but it was a case of too little, too late and after Robert was badly beaten by his stepfather as a punishment, the agency intervened and Robert was placed in Shelter Care. This facility will keep him for 30 days. 

1. Given this scenario, what type of out of home placement would you recommend and why?

2. Using the Guidelines, what are the five most critical questions you need to ask to best meet Robert's needs?

CASE EXAMPLE # 2

Justine, a white female, age 16, is borderline mentally retarded and diabetic. She is maintained on insulin which she is quite competent in administering. She acts younger than her real age. Her father, whom she never really knew, is deceased. Her mother is bedridden with heart problems and a history of her own poorly-managed diabetes. Justine is fairly well-motivated but has had such poor role models that her self esteem and ability to get along with others are both limited.

Two years in a relative placement where she was always "second best" didn't help. The relatives are now feeling they've "done their duty" and are asking for her removal by mid summer. Justine is working on her GED and would like to get a part-time job.

1. Given this scenario, what type of out of home placement would you recommend and why?

2. Using the Guidelines, what are the five most critical questions you need to ask to best meet Justine's needs?