Vol. 4, No. 1 • Fall 1999

Respite Care Makes a
Tremendous Difference
for Some North Carolina
Foster Parents
by John McMahon

As any parent knows, getting a break from your kids,
even for a few hours, can be a lifesaver. When it comes to foster children, who may have medical or behavioral issues as a result of abuse, neglect, abandonment, or drug or alcohol exposure, the need for time apart can be even greater. In some cases, a break from the caregiving routine can mean the difference between a successful, stable foster home and foster parent burnout and placement disruption.

Formal Respite Care
Traditionally, foster parents have relied on the sources that most parents use for time off�grandparents, relatives, friends, especially other foster parents�people who know about looking after children. Whether informal (e.g., having the kids stay at Aunt Janet�s for the weekend) or formal (involving trained, paid care providers), these arrangements can all be considered forms of respite.

Agencies and programs that exist to give relief to families burdened by caring for a terminally ill relative or some other crisis have been around for some time in this country. Yet until recently, foster parents have been unable to use these publicly-funded respite resources or unable to pay private providers. In some cases, lack of adequate respite support made it difficult for states and counties to recruit and retain the foster families they desperately need.

Benefits
Respite for foster parents was started as a way for human service agencies to support and recognize the outstanding care given by foster parents. In some programs, respite is a regular part of the family support package offered to foster families caring for children with multiple needs. In fact, states such as Kansas and South Dakota require respite care for foster parents of certain children (OIG, p. 10). In other parts of the country, agencies offer respite to foster parents as an incentive to care for children who are medically fragile or as an incentive to accept emergency placements.

It is easy to see why agencies and foster parents like respite care. Agencies see it as a cost-effective way to help ensure the quality of care in foster homes, to reduce multiple placements of children, and to minimize the costs of recruiting, training, and licensing new foster homes. Foster parents embrace it for these reasons and because it helps them keep their commitment to kids while maintaining their own health and sanity.

But respite is not just for life and death situations. Foster parents Joyce and Doug Peterson first used respite care when they wanted to go on a family vacation. They have used respite since then, for shorter periods of time. �Respite gives your family a chance to have some time to talk through issues that may have come up� explains Joyce. �And our foster daughter enjoys it, too. It�s a very positive thing.�

Respite in North Carolina
Respite for foster parents is a mixed resource in North Carolina. Some counties started addressing this issue 10 years ago; others have just begun. Because the options available to foster parents differ widely across the state, it is impossible to talk in a general way about what to expect respite to be like in your area. For a list of the respite providers in North Carolina, see the National Respite Locator Service (800/773-5433). (Editor�s Note: many of the providers you will find at this link have specific target populations and may not be available to serve you unless you or your foster children fall into their service categories.)

Our state is home to the ARCH National Resource Center for Respite and Crisis Care. As the name suggests, this Chapel Hill-based organization exists to support respite providers and the families they serve. They are an excellent source of information (800/473-1727), but they do not provide respite services themselves.

One organization doing a lot to raise the profile (and the resources behind) respite care in our state is the NC Respite Coalition. Made up of respite service providers, representatives of state government agencies, and family consumers, the Coalition is working to:

� find out about the respite resources in NC,
� learn what must be done to access those resources, and
� assess respite needs, particularly for unserved or underserved populations.

The Coalition has divided the state into eastern, central, and western regions. Coalition members in each of the regions meet once a month or so, and representatives from all three regions meet twice a year. The next meeting of the large group will be held on January 26 in Alamance County.

The Coalition is also planning a statewide respite conference for November 2000 for families, caregivers, and providers. If you are interested in helping with the conference or in attending the January 26 meeting, contact Coalition President Phyllis Stephenson (336/449-7334).

Volunteer Families for Children
At present there is only one formal respite agency licensed by the state, Volunteer Families for Children (VFC). A private nonprofit agency, VFC recruits, trains, and monitors unpaid respite providers, called �host� families, to support families with children. Their primary mission is to provide support to at-risk families so that children never enter foster care in the first place, but they also serve many foster families to ensure that every foster child has a single, stable foster care placement.

Every VFC host family goes through a licensing process similar to the one for North Carolina�s foster parents. They are screened and their homes inspected, and they must undergo physical examinations and criminal background checks. Anyone may apply to be a host �family,� including single men or women. In addition, they must attend a 30-hour preservice curriculum (similar to MAPP/GPS) before they can provide respite, and they must attend 10 hours of training every year thereafter. Host families must have their homes inspected at least once a year as part of their annual license renewal.

VFC serves children aged birth through 18. The duration of the respite provided by VFC ranges from a single night to 30 days. The average period of respite provided to foster parents is over a weekend. The period of respite is not �fixed� in that parents may pick their children up at any time.

VFC is active in seven counties in four different areas of the state: Alamance, Burke, Cumberland, Durham, Hoke, Orange, and Wake, but they serve outlying counties if they can meet the need. VFC helps with transportation for many of the families using its services. To request respite from VFC, all families, including foster parents, must be referred by a professional, be it a DSS social worker, someone from the school system, or another helping professional, such as a minister.

Some counties have a contract with VFC to provide respite to their foster parents. When this is the case, DSS decides who qualifies to receive respite. In all other cases, applicants must fill out an application. Because the number of host families is smaller than the number of respite requests, VFC must often deny requests for respite.

Because they are a nonprofit organization, Volunteer Families for Children does inquire about your ability to pay when you request respite, but according to VFC�s Theresa Jeffers, they have never turned a child away for lack of funding. To inquire about becoming a host family or just find out more about VFC, visit their website or call their main number (919/852-5700).

Concerns about respite
As a foster parent you may have some initial concerns about using respite services. You may feel that you should not need respite, since you are the one who chose to take on the role of foster parent. You may fear that if you use respite, it will be viewed as an admission that you can�t handle the pressures and responsibilities of being a foster parent. Or you may be concerned that respite providers will not be able to care for your foster children adequately. For example, if you have foster children with behavioral issues, you may worry that if the children spend time in someone else�s care, your hard work stabilizing the child�s life will be undone.

If you have concerns, consider inviting respite program staff members and respite providers to discuss their services with your local foster parent group or county foster parent association. Also, do not hesitate to ask potential respite care providers for references, particularly from foster parents who have used their respite services.

Making the Most Out of Respite
As a consumer of respite care, pay particular attention to:

Matching. Look for a respite program that pays attention to the match between the respite provider, you, and your foster children. The matching process should include face-to-face meetings with all three. Although there may be frequent changes in the composition of your foster family, providers with an appropriate skill level should be matched consistently with the same foster parents when possible. Consistent matching is helpful both for the foster parents and the child(ren), who may be in respite care for successive visits and will value the comfort and consistency of care providers.

Communication. To make the respite period easier for everyone involved, review the general routine of the day and the child�s care needs with respite care providers. This will help them establish trust with the child they are looking after (see box on page 1 for more suggestions). When a respite provider is introduced to a foster family, an initial visit is desirable so the provider learns as accurately as possible the specific needs of the family. Clarify any questions you may have about what the respite provider can and cannot do.

Connecting with and advocating for respite
If you need respite, your first step should be to contact your social worker. He or she should know about the respite options available to foster parents in your community. Another place to turn for referrals is ARCH (800/473-1727). If you find that there are no respite resources in your area, consider advocating for some. Ways to start include:

Documenting the need. Make your respite needs known to local social workers. If word about the need for respite doesn�t get out, no new resources will be created.

Making the connections between respite and North Carolina�s goals for children. Most county DSS�s are doing everything they can to ensure that foster children have a single stable foster care placement. When advocating for respite, make it clear that the relief respite provides can be a vital tool for preventing foster care disruption.

Mobilizing other foster parents. Discuss the benefits and need for respite care with other foster parents in your county. Your group may want to consider joining the NC Respite Coalition (336/449-7334).

Conclusion
Most foster parents need temporary relief from the demands of caring for foster children, particularly those with disabilities or serious medical conditions. Without a break, any parent can be taxed to the point of losing the ability to provide high quality care. Periodic respite enhances the quality of care for the child, gives foster parents a needed break, and ensures healthy, stable placements for children.

Some material for this article comes from ARCH Factsheet No. 32, which was produced by the ARCH National Resource Center for Crisis Nurseries and Respite Care Services. We encourage you to visit their very helpful website.

Office of Inspector General (DHHS). (1994). Respite care services for foster parents. Washington, DC: Author.

John McMahon is editor of Fostering Perspectives.

Copyright � 2000 Jordan Institute for Families