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CHIX 404


A Recommendation to the Minister of Social Policy for Reward Payments for Foster Carers.




Henrietta Watson



6. 10. 2000




13 9.1996 talk to social workers.
Labour will Help Foster Parents:
Helen Clark, Labour Leader, speaking at the Association of Social Workers' annual conference in Wellington, said that Labour would stop the under funding of community based child and family support services. She said $11.5 million would be spent over three years on training and support for people who foster difficult children. She said that a Labour government would pay foster parents of particularly difficult children a part time wage in addition to board and expenses. Residential bed nights would also be funded on demand, and for youth offenders, appropriate secure facilities would be built.

Foster carers currently receive no reward payments for their work. This policy is based on the tenuous belief that fostering is not work but a vocation and that, as substitute parents, no special skills are required. This lack of recognition for the special needs of both foster children and their caregivers ignores the demands of the United Nations Convention for the Rights of the Child (UNCROC) but also contradicts all of the significant research relating to out-of-home care. Appropriate payment bands based on demonstrated skills, knowledge and qualifications are a cost-effective response to current retention, but especially, recruitment difficulties; they recognise the need to professionalise foster care in the best interests of children because payment effects the quality of care; they provide a more valued career path than is currently the case, and they accommodate all caregiver positions in the increasingly polarised debate over the status and payment of foster carers.

The current situation.
Child, Youth and Family (CYF) currently contracts and trains its foster carers (a 13-15 hour introductory course is compulsory) but also contracts other agencies to train and provide foster carers. There is currently no mandatory training or accreditation required to become a foster parent and no national standards that foster carers must meet, irrespective of their contracting agency. Unlike overseas, there is only one band of carer with board rates ranging from $78 to $129.80 depending on the age of the child. Extra expenses must then be negotiated from a profoundly compromised position.
"The whole business is run on fear, fear of losing the kids, or jobs."
"We are members of a team as long as we are doing exactly what we are told."
"Asking for special grants is taboo. I feel mean asking."
(UK Foster-Adopt@e-group.com, 2000)

Web-based discussion groups for foster carers reflect the same concerns irrespective of country suggesting that, in the absence of much significant research in New Zealand, issues relating to status and payment are global.
Deinstitutionalisation means that with less children coming into care, those that do are presenting earlier with significant psychological, emotional and behavioural problems (Kenny & Foster, 1997) that would formerly have been cared for by professional teams in residential units. Minnis (1999) in Scotland found that 60% have special needs that make discipline, care and relating to the child difficult (cited in Triseolitis et al, 2000) meaning that 'emotional' or 'competent' parenting is no longer adequate to meet complex, therapeutic needs (Daly & Dowd, 1992; Hampson, 1981). Research from the UK shows that 30% of placements break down in the first two years, 50% after three years and 8% of caregivers leave each year. Placements become increasingly vulnerable as children become older. The major causes of breakdown were the lack of recognition and feeling ill prepared for the level of problems. The former relates to perceived value while the latter relates to inadequate training, knowledge, coping strategies and support to deal with attachment issues, separation, abused pathology and biological parents. Without a job orientation it is difficult to impose mandatory training or demand extra time commitment and while only 15% of carers surveyed were opposed to salaries this was the same group that was disinterested in both training and support group contact (Triseliotis et al, 2000), an attitude affirmed by the substitute parent-private family myth. With each move a child's education, peer relationships, kinship contacts and psycho-social functioning are all negatively affected with the number of placements positively related to later adult emotional or behavioural problems (Marcus, 1992; Cashmore & Paxman, 1996).

Reward payments to foster carers affect the standard of care to children.
When retention and recruitment become difficult choice is limited and quality controls like screening families, performance criteria or matching children to carers all become hypothetical. If close monitoring, goal setting and skilled and supportive supervision are central to good outcomes (Shealy, 1995) then professional expectations from all parties become essential. The expectations that come from being part of a treatment team are different from those who see their role as substitute parents with equally autonomous rights. Fanshel (1966) recognised decades ago that of the two types of placement (privately motivated or socially/therapeutically oriented) the latter were more successful and had more appropriate discipline and interaction styles (cited in Hampson, 1981). A study of successful programmes in America found that those that paid parents for their professional services elicited a more professional attitude; they had consistently higher levels of goal attainment; they were more flexible and willing to accept any child; they were more likely to see themselves as a valued team member; and they were less likely to feel threatened by, or compete with, the social worker or biological parents (Hampson, 1981). Triseliotis et al's (2000) study in Scotland found that paid workers received greater support from social workers; they were more likely to facilitate relationships with kin; attend training and support groups; have better relationships with the agency and they were less likely to find children difficult. As further support, Smith's study of Early Childcare Centres leads her to conclude that the best predictor of quality childcare is the wage paid (1996).

Reward payments affect retention and recruitment.
Agencies that pay allowances have better retention and recruitment rates and this assumes higher morale and therefore less likelihood of abuse (Shealy, 1995).
Despite the increasing professional demands now placed on caregivers State policies are still based on the private/vocation model despite the contradictions with current social policy that places no value on unpaid or parenting work. A solo-parent foster-carer on a benefit for her own children must seek paid and proper work when the youngest child reaches six years irrespective of the ages of her foster children.
In the absence of professional recognition and with extra payments at the discretion of a financially pressured C.Y.F. service, Foster (2000) of the Otago Foster Parent Association noted that caregivers who are not financially self reliant, those who know their entitlements or whose incentive to foster is not based on religious calling are screened out by necessity despite the association of all three default criteria (autonomous, uninformed, unaccountable) with a lesser quality of care. (Personal Communication)

In the U.K., private agencies have created a shortage of foster carers willing to work for local bodies by paying three times the statutory rates and providing better support and working conditions. Shortages mean that 28% of children in Scotland are not placed, suggesting that 21,000 children in England (usually ethnic minorities, offenders, those with disabilities and sibling groups) remain unplaced (Triseolitis, 2000). Agencies save the expense of residential placements that cost between 1500- 3500 per week by charging local bodies 595 to 1575 per week depending on the package. In Kent, 1% of children is with private agencies but is costing 5% of the foster care budget with one agency making a pre-tax surplus of 1,224,712. Despite attacks of exploitation and profiteering the foster-care free-market benefits all but the taxpayer and local bodies forced to pay the escalating fees and in England, two million pounds on recruitment campaigns:
"We pay our staff well, we pay our carers well, and we still make a good living",
" It is the package around them and the child that keeps the most stressful placements stable and reduces breakdowns." (UK Foster-Adopt@ e-group.com, 2000)


Agencies have introduced a range of competing payment options and formulas from salary, fees, pensions, enhanced payments or combinations of all. Many statutory agencies are replacing enhancements with fees but they are a third of those paid in the private sector. Special grants and discretionary payments can differ from case to case and between regions causing resentment and frustration with two thirds of caregivers not informed of their entitlements.
Similar issues prevail in New Zealand but recruitment difficulties are managed by raising the threshold for intervention and while private agencies may charge up to five times the statutory bed night rate ($65 per night compared to $13) this has not resulted in increased payments to foster carers (Foster, 2000, Personal Communication). Without any coherent national policy that defines structure, standards and bands of foster care that can be related to competencies and payment scales, the arrival of well organised private agencies willing to pay more for caregivers is likely.

Meeting the State's obligations to UNCROC demands reward payments for career foster carers.
UNCROC defines the principles that the State agreed would inform all policy and practice related to any child deprived of their natural home. It must provide special care, (Preamble) assistance and protection from all abuse (20.1) and ensure the child's development (6.2); take all appropriate legislative and administrative, social and educational measures to protect children (19.1); ensure that services responsible for the care and protection of children shall conform with the standards established by competent authorities particularly in the areas of safety, health, in the number and suitability of their staff, as well as competent supervision (3.3); placements will be regularly evaluated (25); the State will take appropriate measures to provide material assistance and support programs to caregivers so that they can provide a standard of living adequate for the child's physical, mental, spiritual, moral and social development (27); and take all appropriate measures to promote physical and psychological recovery and social reintegration (39). All of these demands assume that the best interests of a child must be paramount (3.1) and what is best will be informed by the child (12).

The State is currently failing to ensure the special care, protection and developmental needs of its wards making it de facto abusive (Daly & Dowd, 1992). Any intervention compounds and produces a different more complex range of problems with evidence that 20% leave care with psycho-social problems they did not have on entry (Festinger, 1983). The State must therefore ensure safety by providing suitable numbers of quality staff, supportive supervision and regularly evaluated placements (3.3). Recruitment, retention of quality staff and monitoring become difficult when the contracting service is under funded, choice is limited and workers are valued differently. In the absence of national standards, with minimal screening or ongoing evaluation and with no input demanded from the child it is difficult to know how well children are being protected from abuse while in care or to assess the suitability of all workers. There are no systems in place for foster children to provide input into policy making or practices that concern them contravening the most foundational UNCROC principle.
Social workers are becoming increasingly alienated from the children and families they serve due to heavy workloads, placement drift and their own role ambiguities highlighted in an articulated 'reticence to intrude' (Smith et al, 1999) but the level of support from a competent supervisor is critical to outcomes especially if it increases the decision-making authority and professional status of caregivers (Daly & Dowd, 1992). One reason for the poor relationships with foster families found by Triseliotis et al. was not caseload pressure but a lack of fostering expertise and family and child work skills that social workers met through avoidance (2000). This further justifies the professionalisation of foster care that would establish another social work tier with specialist residential skills and acknowledges that foster parents are best placed to work with the child to prevent breakdown.

Appropriate
care is that which meets the developmental, wellbeing and best interest demands of UNCROC and is defined by competent authorities. Competent authorities are those informed by research and concerned with 'best practice.' Smith's study (1996) defines the components of foster care that are essential to a child's healthy development. Caregivers must be willing to allow emotional warmth and attachment, understand developmental needs, nurture peer relationships and those with the biological family and support the child's rights. Resources, reward and training are key elements in ensuring that the care giving is skilled, accountable and open to scrutiny.
Appropriate care from the child's perspective is safe, inclusive and facilitates contact with the natural family. A Dunedin study found that few children felt included in decisions or processes made about them (Smith et al, 1998) suggesting that paternalism still permeates all levels of social work culture despite the shift in attitude demanded by both the C.Y.P.F. Act (1989) and UNCROC's Article 12.
Triseliotis et al, (2000) found that contact with family can be crucial to wellbeing and placement outcomes but foster carers can become possessive, despite research by McAuley (1996 cited p125) that shows a child's thoughts and feelings are still strongly oriented to their birth families after two years. Those paid fees were more willing to facilitate contact than those who were not paid resulting in children who are less sad and angry.

It is important to note, at a time when accreditation seems likely, that generic, voluntary, academic training is not the panacea to protecting children. Hampson (1981) found that parenting styles are fixed and take at least two years of consistent support to change. Those with the lowest parenting skills gain least from any training. This means that training must be on going, practice-based and contextual and this demands a commitment, as noted before, that is not forthcoming from those without a job orientation (Triseliotis et al, 2000).

Currently the costs and burden of enacting the State's responsibilities rest inequitably with carers suggesting that the State is not taking all appropriate legislative and administrative measures to protect materially assist and support both carer and child. This lapse is made possible by the fact that CYF is both funder and provider and by the inevitable conflict of interest that arises when the Director General of Social Welfare is also a business manager under the Public Finance Act (O'Reilly, 1996). For instance,
CYF''s primary concern is to transfer the financial responsibility elsewhere as soon as possible often to WINZ via the Unsupported Child Allowance or to the foster parent as legal guardian. Both mean further decreases in family income, supervision and support but also side step taking responsibility for the special support needs of both to ensure recovery and social reintegration. Financial pressures and low income are characteristic of an increased risk of abuse (Daly & Dowd, 1992).

A coherent banding system is essential for a reward system.
Central to the establishment of reward payments is the need for a system that bands foster carers according to demonstrable skills rather than children according to arbitrary age groupings, as is currently the case. The Career Foster Parent Association in the USA acknowledges the career carer's role as primary change agent and they receive a higher daily rate on condition that the child is prepared to return to their family, they must provide recreation, be part of a multidisciplinary team and maintain journals and reports. They must have at least one-year experience or one year volunteer or professional experience or a Social Science degree. Ongoing training is mandatory. Glasgow is introducing a four-band system that differentiates between Carers (short and long term), Emergency Carers, and Community Parents who look after children with difficulties and Therapeutic Parents able to manage very challenging behaviours.
In Wales there has been a shift from banding based on courses attended to three bands based on demonstrable skills and proven competence. There is compulsory training for each level beginning with 72 hours with eight days recommended for the first band and a new publicly recognised qualification for residential social work is being introduced.
These measures have been a direct response to the changes brought by private agencies and aim to retain caregivers, minimise competition and shut down less reputable agencies by subjecting all providers to the same regulations, monitoring and licensing standards. In the U.K. every local authority is different but an entry level social work qualification is being introduced that will provide practice-based training, build confidence and provide an incentive for further academic training. (UK Foster-Adopt@ e-group.com, 2000)

The Otago Foster Care Association has integrated the best features of many of these programs and recommends 5-6 bands depending on the specialist skills required, i.e. Medical, Emergency, Respite, Behavioural, Career Individualised Carer and suggests unit points that are based on both experience and training. (Foster, 1998)

Recommendations
All professions equate income with skills and, as has been shown, financial reward is vital to attract and retain quality caregivers able to provide quality care. Payments to foster carers will be born from necessity rather than choice and they will avoid the need for carers to look for other, more valued work. Instituting a banding system that can be related to payment scales is essential and this demands a national body to approve training programs and examinations, relate credits to competencies, define standards of practice, and manage complaints, disciplinary procedures and deregistration. UNCROC principles must be the touchstone for all policy and practice and this demands that any organisation aiming to protect children must value and establish structurally their authentic participation. In the light of current sociology and research it is no longer plausible to treat foster children as the passive recipients of services conceived and delivered by adults, and their caregivers are ideally best placed to advocate for them. To ensure this caregiver contracts should require reports on their UNCROC compliance. A national body should also include caregivers and other child-related professions rather than ministerial appointments alienated from the community they represent. Until this infrastructure is in place an interim measure is to attach pensions and/or fees to board payments. Options needing to be considered by all stakeholders are: age based fees as in Scotland that range from 34 (0-8yrs), 52.40 (9-11years) and 107.85 (12-18yrs); a flat fee as in the UK of 112 reduced for the second child; flat fees related to training; or fees only for special schemes. Any payments must be uniform, be stated in policy with clearly stated entitlements to avoid the abuses of discretionary payments.
By introducing a five-band system that can be related to children's needs foster parents can define their own professional goals. Some will prefer to be more autonomous and uninvolved while others will seek ongoing training with increasing payments contingent on meeting goals. The minimum training standards for each band should be mandatory. Experienced foster carers can be credited with 'recognised prior learning' assessments from basic to therapeutic standards with the highest level being a 'Home-based Social Work' type accreditation that specialises in fostering issues. An interim measure would be provisional licenses that can be upgraded to different levels depending on skills and experience.

Implications.
The professionalisation that comes with payment scales can demand standards, it minimises recruitment costs, attracts and retains high quality parents, provides recognition and puts less pressure on social workers by preventing role tensions, breakdowns and burnout (Sellick & Thorburn, 1996, cited in Triselotis et al, 2000:170). A practice-based training may also augment an increasingly stretched Child Youth and Family service by introducing another tier of social worker. Without a surplus of carers the State's ability to deliver a service that can meet UNCROC principles is in doubt leading to inevitable later costs after discharge via mental health services, unemployment due to educational deficit, unwanted pregnancies and crime. Bands of foster care accommodate all reasons for fostering, they address the tensions permeating a fragmented community currently teetering between two models (Triseliotis et al, 2000) but most importantly they honour the Prime Minister's pre-election promise to stop the under funding of community support services and pay wages to foster carers who deliver therapeutic care (1996).

Supporting Literature
Bensley, A (1997) Paper presented. In N.J. Taylor & A. Smith (eds) Quality and safety for children living away from home, pp63-65. Dunedin: Children's Issues Centre.

Cashmore, J. & Paxman, M. (1996) Wards leaving care - a longitudinal study. Sydney: N.S.W: Social Policy Research Centre.

Daly, D. & Dowd, T.P. (1992) Characteristics of effective, harm free environments for children in out-of-home care. Child Welfare, 71, 487-496.        

Davis, I., Landsverk, J., Newton, R., & Ganger, W. (1996) Parental visiting and foster care reunification. Children & Youth Services Review, 18, nos 4/5, 363-382.

Festinger, T. (1983) No one ever asked us.... a postscript to foster care. U.S.A: Columbia University Press.

Foster, P. (1998) Registration and licensing procedures of accredited foster home operators. Draft discussion document. Dunedin.

Gil, E., & Bogart, K., (1982) Foster children speak out: A study of children's perceptions of foster care. Children Today, Jan-Feb.
        
Hampson, R.B. (1981) Special foster care for exceptional children: A review of programs and policies. Children & Youth Services Review. 10, 19-41

Horwitz, S., Simms, M. & Farrington, R. (1994) Impact of developmental problems on young children's exits from foster care. Developmental & Behavioural Paediatrics, vol 15, no 2.
        

Kenny, G. & Foster, P. (1997) Are foster carers professionals? A proposal for reform. In N.J. Taylor & A. Smith (eds) Quality and safety for children living away from home. (pp.31-40) Dunedin: Children's Issues Centre.
Lawder, E., Poulin, J., & Andrews, R. (1986) A Study of 185 Foster Children 5 Years After Placement. Child Welfare, Vol LXV, no 3.

Marcus, R., (1992) The attachments of children in foster care. Genetic, Social & General Psychology Monographs, 117 (4), 367-394.

O'Reilly, L. (1997) The rights of children living away from home, in N.J. Taylor & A. Smith (eds) Quality and safety for children living away from home. (Pp89-109) Dunedin: Children's Issues Centre.

Shealy, .N. (1995) From Boys Town to Oliver Twist. Separating fact from fiction in welfare reform and out-of-home placement of children and youth. American Psychologist, 50 (8), 565-568.

Smith, Anne (1996) Characteristics of safe, effective environments for children in out of home care: What does the literature say? In N.J. Taylor & A. Smith (eds) Quality and Safety for Children Living Away From Home. (Pp67-88). Dunedin: Children's Issues Centre.

Smith, A., Gollop, M., Taylor, N. (1998) Children's voices in foster and kinship care: knowledge, understanding and participation. Paper presented at the Twelfth International Congress on Child Abuse and Neglect, Auckland, 9 September 1998.

Triseliotis, J., Borland, M., & Hill, M. (2000) Delivering foster care. London: British Agencies for Adoption and Fostering.
United Nations Convention on the Rights of the Child (1989)


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