ISSUE BRIEFS | APRIL 2021 In-Home Services to Strengthen Children and Families Most children involved with the child welfare WHAT'S INSIDE system are not separated from their families but instead receive services while living at What are in-home services? home. These child welfare "in-home services" are designed to strengthen and stabilize families that come to the attention of child In-home services delivery protective services (CPS). This issue brief explores effective in-home In-home services funding services that are being used to promote safety and help keep children and families together, as well as practical considerations for their In-home services practice elements implementation. It then presents promising practices used by States and jurisdictions that Evidence-based programs are working to improve their delivery of in- home services. Promising practices Conclusion References Children’s Bureau/ACYF/ACF/HHS | 800.394.3366 | Email: [email protected] | https://www.childwelfare.gov 1 WHAT ARE IN-HOME SERVICES? routines, and manage stressful everyday situations. The location where services are Child welfare in-home services are a delivered will depend on the protocols of the continuum of prevention-related supports local service providers and the availability of and programs designed to enhance the services. protective capacity of caregivers and improve the conditions that may contribute to safety In defining in-home services, there and risk concerns for children (e.g., mental is a common misconception between health concerns, substance use, parenting those described above and home visiting practices). They can be primary prevention programs, which match at-risk families services geared toward the general population; with professionals or paraprofessionals secondary prevention services for families who provide support, education, training, with one or more risk factors for child and resources during visits to the home. maltreatment; or tertiary prevention services Home visiting programs are often used aimed at preventing out-of-home placement as a preventive approach with high-risk for families in which maltreatment has already populations, such as teen parents and occurred, provided children can remain in families with infants and young children. their homes safely. Tertiary in-home services However, some home visiting programs allow children to stay connected with their address the needs of families receiving in- siblings, extended family, friends, school home services and can be used or adapted connections, and other support systems and for a child welfare population, often through provide resources that can help parents their inclusion as part of an in-home services focus on addressing the issues that led to case or treatment plan (see Child Welfare abuse or neglect or that could lead to Information Gateway's Home Visiting web future maltreatment. section for more information.) In-home services may be voluntary or HOW ARE IN-HOME SERVICES INITIATED? court ordered and can encompass an array When a report of child maltreatment is filed of supports, interventions, and programs, with CPS, intake workers screen the report to ranging from transportation and housing assess the allegations and determine whether assistance to intensive family preservation there are any immediate or impending safety services. The term "in-home" refers to the concerns. If safety concerns are identified location where the child and family are and thresholds are met, CPS will recommend residing and not necessarily to the place that the family receive either an investigation where services are delivered. The services or a family assessment, the latter of which may be provided in the community or other is typically an option in jurisdictions using places, such as at a counseling center or child differential response systems. In either case, welfare agency. However, services offered child welfare caseworkers will conduct a in the home have several added benefits. safety and risk assessment to determine They give providers opportunities to identify how safe children are in their homes and the family strengths, offer support around family level of risk for future harm. These safety Children’s Bureau/ACYF/ACF/HHS | 800.394.3366 | Email: [email protected] | https://www.childwelfare.gov 2 and risk assessments, accompanied by a more WHAT TYPES OF SERVICES ARE INCLUDED? comprehensive family assessment, are used to There is no standard set of required in-home inform the feasibility of maintaining the child services; the goal is to find the right combination safely in the home through the use of safety of services and supports tomeet the specific plans. Safety plans are written agreements needs of each family. In-home services are designed to help parents focus on addressing the geared toward meeting the following goals: issues that led to unsafe conditions or threats to child safety, strengthen parental protective Ensuring children's safety capacity, and enhance community connections Strengthening parental protective capacity so families can safely and sustainably care for children without further agency intervention. Improving overall adult, child, and Safety stabilization creates conditions for family functioning working collaboratively with families to cocreate Building caregiving and coping skills case plans with individualized in-home services. Supporting healthy and nurturing relationships Fostering physical, emotional, behavioral, and WHO RECEIVES IN-HOME SERVICES? educational well-being and mental health In-home services are typically provided to Enhancing the potential for permanency families who have open cases with a child welfare agency and whose children remain at Services to address family challenges could home or have returned home from foster care. In include general prevention-related or some cases, the allegations of child maltreatment knowledge-building information or referrals for have been substantiated, but the child is not in tangible and intangible support, such as—but not immediate or impending danger. In other cases, limited to—the following: allegations have not been substantiated, but a Age-specific parenting support, including comprehensive assessment of family functioning teen or adult parent training, coaching, or prompts the provision of targeted services to skill building to help with complex parent- help strengthen parental protective capacities child interactions and address any general concerns. In-home Individual and/or family therapy services can also be provided to families whose children have returned home after a stay in Referral for substance use treatment and skill foster care; in these cases, the child welfare building to enhance coping and encourage agency strives to ensure that parents have the behaviors that replace substance use necessary strengths, protective capacities, and Referral for mental or behavioral health community and relational supports to safely care treatment followed by support in applying for their children and prevent their reentry into what was learned in treatment to improve care. During fiscal year 2018, approximately 2 family management and child safety million children nationwide received prevention Information and referrals for resume-building services and about 1.3 million received services as well as interview and job training to postresponse services from a child welfare help with economic and financial stability and agency (Children's Bureau, 2020b). self-sufficiency Children’s Bureau/ACYF/ACF/HHS | 800.394.3366 | Email: [email protected] | https://www.childwelfare.gov 3 Assistance with child care and IN-HOME SERVICES DELIVERY transportation Child welfare agencies must deliver effective Concrete assistance, such as food, in-home services that can stabilize and clothing, furniture, or housing to strengthen families and prevent the need for contribute to positive health and out-of-home care whenever possible. In some well-being outcomes instances, caseworkers can provide in-home services directly to families, and in other VOLUNTARY VS. COURT-ORDERED IN- HOME SERVICES instances they may facilitate contact between families and community-based service In-home services can be delivered either providers, such as family resource centers on a voluntary basis (meaning that family (FRCs). Having the capacity to provide an members have agreed to participate of their array of evidence-based or evidence-informed own accord) or as the result of a court order family support, family preservation, and (meaning a judge has mandated a family's postreunification services enables agencies participation). Policies regarding whether to provide individualized treatment so that these services can be delivered on a voluntary children can remain safely in their homes. or court-ordered basis vary by State. A diverse service array includes programs Caseworkers may encounter difficulties when that can address the physical, emotional, attempting to engage families in voluntary social, mental, developmental, and services because some potential participants educational needs of children and families, may view the services as either intrusive or while also considering key systemic unlikely to provide useful benefits. (Daro factors, such as individual, family, and et al., 2005). In addition, parents may fear community circumstances that may impact that more frequent contact with the child service delivery. welfare system and its service providers could put them at risk for having their