Evaluation of the Family Options Program Judith Woodland Julie Hind Evaluation of the Family Options Program Copyright © Department of Human Services 2000 All rights reserved. Except under the conditions described in the Copyright Act 1968 of Australia and subsequent amendments, no part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the copyright owner. Copies of this report are available from: DisAbility Services Division Department of Human Services 18 th Floor 555 Collins Street P.O. Box 4057 Melbourne 3001 Evolving Ways 02 6056 4106 03 9876 3132 Evaluation of the Family Options Program Acknowledgements The authors would like to thank the many people who have contributed to this evaluation. Particular thanks to the children and to the many people around them – their birth families, alternative families and Family Options workers and their managers. We greatly appreciate the time these people gave us and the willingness with which they shared their experiences. Their candidness has provided a rich source of information. We particularly thank birth families and alternative families for their generosity and for welcoming us into their homes over the three years of the evaluation. We thank Family Options workers for discussing with us both their triumphs and their dilemmas. This has, over the years, contributed valuably to ongoing program development. Our thanks also to the Department of Human Services staff both centrally and regionally. The contributions of those who formed the evaluation subcommittee in the first two phases of the evaluation are also acknowledged with appreciation. They provided needed advice, feedback and support to the researchers. Cas O’Neill and Nola Horne were part of the evaluation team for the first phase of the project. Cas O’Neill contributed significantly to the Literature Review throughout the entire project. Special thanks to Judith Gibbs, Latrobe University, for her reflective comments on our work. Names of children and other key people In providing an overview of the children and in relation to some of the people quoted, names are used to emphasise the real nature of the participants in the case studies. Names also serve as an aid to tracking quotes through the different chapters of the report. The names used are not the real names of the children or other participants. Names are not used at all where it is felt inclusion of a name would allow cross referencing to other identifiable material. Judith Woodland Julie Hind Evolving Ways October, 2000 Evolving Ways 02 6056 4106 03 9876 3132 Evaluation of the Family Options Program Acronyms BIST Behaviour Intervention Support Team CRU Community Residential Unit DHS Department of Human Services DSB Disability Services Branch (now DisAbility Services) H&CS Health and Community Services (predecessor of DHS) IDS Intellectual Disability Services Evolving Ways 02 6056 4106 03 9876 3132 Evaluation of the Family Options Program Contents Executive summary....................................................................................................i Recommendations...................................................................................................xii 1. Introduction.......................................................................................................1 1.1. What is Family Options?...............................................................................1 1.2. Background ...................................................................................................1 1.3. The evaluation...............................................................................................3 1.4. Summary of literature review........................................................................4 2. Methodology .....................................................................................................7 2.1. Action Research ............................................................................................7 2.2. The evaluation framework ............................................................................8 2.3. Techniques ....................................................................................................9 2.4 Ethical considerations .................................................................................14 2.5. Reliability and validity................................................................................15 2.6. Limitations ..................................................................................................16 3. Outcomes for children.....................................................................................17 3.1. What measures are used? ............................................................................17 3.2. Stable placement .........................................................................................20 3.3. Nurturing relationships................................................................................23 3.4. Quality of life ..............................................................................................25 3.5. What contributes to these outcomes?..........................................................34 3.6. Summary ......................................................................................................41 4. Alternative families.........................................................................................43 4.1. Who are they?..............................................................................................43 5.2. What motivates these alternative families?.................................................45 4.3. What changed over time?............................................................................47 4.4. What enables the caregiving?......................................................................48 5. Birth families...................................................................................................59 5.1. Ongoing contact ..........................................................................................59 5.2. Practices supporting the child’s birth family...............................................66 6. Practice guidelines...........................................................................................73 6.1. Interim guidelines........................................................................................73 6.2. Gaps in interim guidelines...........................................................................74 7. Conclusions.....................................................................................................77 7.1. Outcomes and contributing factors .............................................................77 7.2. Alternative families.....................................................................................78 7.3. Family Options as a broader program.........................................................79 7.4. Case practice ...............................................................................................80 7.5. Summary .....................................................................................................81 Evolving Ways 02 6056 4106 03 9876 3132 Evaluation of the Family Options Program Appendix 1 People and organisations participating in the evaluation........................................ 83 Appendix 2 Literature review..................................................................................................... 85 Appendix 3 References ............................................................................................................ 101 Evolving Ways 02 6056 4106 03 9876 3132 Executive summary Executive summary From the children’s birth families: Heaven! I was trying to think of the right word and it’s ‘heaven’ For us it’s good. We have gone from hell to paradise. It’s bloody beautiful! Relief…I feel relief now she is with a permanent family. She has a new family and 100% attention We’ve got peace of mind to know he is being looked after. We have peace of mind. You know they’ve got all the resources. We are more at ease Excellent. I couldn’t have wished for better. When it first happened I had a hard time handing him over to strangers. They must be kind-hearted people. 1. Introduction 1.1. What is Family Options? Family Options is a flexible care package that provides specialised family-based placement for people with disabilities. The service was established for children with disabilities who have high support needs. Subsequent guidelines indicate that placements for adults may also occur (Department of Human Services [DHS], 1997). The Family Options program has three components: a) ongoing case management; b) caregiver reimbursements; and c) a flexible financial package, consisting of placement establishment funding and recurrent discretionary funds. Family Options differs from other family-based placements for children with disabilities, particularly Shared Family Care, the Intellectual Disability Services (IDS) Permanent Care Initiative and Interchange, in that: − it provides ongoing placement of the child in an alternative family whilst retaining the capacity for guardianship to remain with the child’s family; − the profile of the children is characterised by high support needs; and − the level of resourcing to support placements is significantly higher