Marked Improvement: Levels of Care for Foster Children

Foster kids who come to Quinte Children’s Homes have high needs, like mental health issues or behavioral problems. We’re committed to providing child-centred care, and that means making sure these kids have the treatment and support they need.

Our foster parents, what we call Parent Therapists, play a critical role in providing that care. We also have an evaluation system in place that ensures each child or teen has what they need, when they need it.

Customized foster care

“Our Ministry approved level system is in place to ensure every child has access to the level of service he or she requires without the disruption,” explained Melissa Hulshof, program coordinator at Quinte Children’s Homes (QCH).

“Other models move a youth around to achieve goals,” she said. “If they require more staffing support, they’re placed in a group home. Once that extra support is no longer needed, they’re moved into foster care. It’s very destabilizing.”

At QCH, children live with a Parent Therapist and the support around them changes according to their needs. They stay in the same home with the same family, which means more consistency and longer-term, stronger relationships.

“This model has a few different benefits,” Hulshof said. The most significant benefit is for the kids. Foster care systems in Ontario and around the world are moving towards family-based care because it has the best results.

However, there are more practical benefits, too. “We know we have the funding to meet a child’s needs without waiting on an approval process, as we would with the typical model,” Hulshof explained.

“We already have the resources on-hand, like individual and group counseling, psychiatry and specialized schooling. All we need to move forward with a plan for care is the legal guardian’s OK.”

Five levels of foster care

There are five levels of care, from minimal support to more intense supervision.
Level I: Transition to Independence. Generally assigned to young adults about to leave the foster care system, Level I includes minimal involvement from QCH. For any support that is still needed, we connect each individual to services within the community that can continue once they’re on their own.

Level II: Low Risk. At Level II, youth still receive some clinical support and supervision from QCH. However, for other needs like education, youth at this level are connected to other services that exist in the community.

Level III: Moderate Risk. For kids who still need regular support, this level includes some support for the Parent Therapist as well as eight hours of weekly contact between the individual, QCH staff and clinical services (like individual or group therapy). Kids can also access the specialized education available through Applewood Academy for Progressive Learning.

Level IV: High Risk. Building on the services available at Level III, kids at this level receive nearly 12 hours of ongoing weekly support through QCH. They are also able to access psychiatric services and classes at Applewood.

Level V: Very High Risk. For kids who need the most support, this level includes significant hours of direct support (double the number of hours allocated at Level III) as well as additional support for the Parent Therapist. It also provides access to psychiatric assistance and specialized education at Applewood.

When children and teens first enter care with QCH, they are automatically placed at Level IV to ensure that there are no gaps in care. That level of care is evaluated after the first 30 days.

Figuring out what support a child needs

To decide what level of support a child needs, QCH has an in-depth evaluation process that looks at three aspects: Their needs, strengths, and risks.

  • The Needs Assessment considers a child’s psychosocial history to identify any areas of difficulty. The evaluation looks at 103 different elements that impact his or her emotions, behaviour, thoughts, memory and learning capacity.
  • The Strength Assessment considers 40 different skills or capabilities that research has identified as helping youth smoothly transition into adulthood. By identifying each child’s strengths, we can make sure our approach to care plays into his or her particular interests and things they’re already good at.
  • The Risk Assessment considers a child’s overall health and safety, like behavioural problems, mental health issues like anxiety or depression, and any other medical or physical conditions that may need attention. It also looks at the ability of the child’s natural family to cope, considering things like the parent’s current stress levels, the strength of family relationships, and the child’s ability to learn basic life skills in the home.

The first assessment is done after a child has been in QCH’s care for 30 days, then again every six months with input from the Parent Therapist family, the child’s natural family as appropriate, the local Children’s Aid Society and QCH’s clinical team.

For a more detailed look at our evaluation process, review this complete description of our service model. If you have any questions, please contact us directly or add it to the comments section below.

Or check out some of our success stories from QCH Kids below:

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