At bottom, permanency planning is no more than a policy affirmation of the basic fact that children develop best in a secure nurturing environment--what we usually call a family home. The fact that the birth home, for any number of reasons, is not able to provide a child with this nurturing climate does not alter this fact nor obviate a child's right to a home, positive enduring relationships with adults, and an individual advocate who is solely committed to his or her best interests.
In child welfare, permanency planning has been the dominant perspective for many years. It is required in any program receiving assistance under Public Law 96-272, The Adoption Assistance and Child Welfare Act of 1980 which redirected "...current federal fiscal incentives away from out-of-home care and towards alternatives to placement, and...provide(d) protection for children to insure they enter care only when necessary, are placed appropriately, provided quality care, reviewed periodically, and provided permanent families in a timely fashion." Since most children with developmental disabilities have received services from a different funding stream, this concept has not had an impact in their lives until recently.
The last few years have seen numerous states reorder their priorities in services to children with developmental disabilities. Increasingly, the emphasis has shifted from services that focus exclusively on the disability to a more holistic perspective that sees the child first. The State of Michigan has been in the forefront of states that have used the permanency planning process as a vehicle for giving expression to this change in priorities.
In Michigan, permanency planning for children with developmental disabilities expands on the basic concept and recognizes the special demands which a child with a disability can place on a family. The state regulations describe the process as supporting both children and families. The first priority is to provide what is needed to maintain the child with the birth family. If this fails, the services system begins working towards reunifying the family. If reunification is not possible, and there is no active parental involvement, services focus on facilitating the adoption of the child. When these other goals cannot be achieved a plan is developed for a permanent foster family, with arrangements for on-going involvement with the birth family (if appropriate) and a guardian or advocate to keep an eye on the best interest of the child. Institutionalization is not considered for any child and, in practice, children are no longer placed in any group setting in Michigan.
Implementation of the permanency planning program requires not only changes in policy and procedure, but also changes in staff attitudes toward birth families. It requires a change in the purposes for which out-of-home placement is provided, i.e., utilizing placement as a temporary support to families, not a long-term answer for children whose families are experiencing stress and difficulty in parenting their developmentally disabled child. It also requires a goal-directed casework practice that assumes children ought to be with their families.
The Permanency Planning Project, which is now in its fourth year, has provided extensive training to mental health staff of those agencies involved in the project about such topics as the permanency planning philosophy and concept, the importance of the parent/child relationship, how to maintain and reunite children with their families, the impact of the pyscho-sociological processes of attachment and separation, and adoption proceses and procedures. Permanency planning casework activity has also been initiated for those children in care with the project agencies; 250 children in foster care with three agencies in metropolitan Detroit were screened and permanency objectives identified. As a result of efforts initiated through the project, 45 individuals have returned to their families from out-of-home placements and 18 children have been adopted.
Permanency Planning cannot work without having concrete services and resources to support children being with their families. As Gerry Provencal, Director of the Macomb-Oakland Regional Center, put it, "we don't believe in giving lip-service to the concept of family support, the important thing is to make good the concept. Our purpose is to help families re- establish contact with a member of the family with whom they may have lost contact, and to give them whatever support they may need to enable the member with disabilities to return home permanently as a full member of the family. So we ask families what they need to keep their son or daughter with disabilities at home or to help them to return home. The shopping list may include anything like help with getting on and off the bus, constructive use of leisure time, or assistance at mealtimes."
Concurrent with the development and implementation of the Permanency Planning Project, three other major initiatives were developed. The first of these is the family support program. This program provides funds to local community mental health boards to develop services to support families such as respite care, case management, and other services. The second program is the family support subsidy program. This program, which was signed into law in 1983, provides a subsidy of approximately $2,700 a year to families whose child is at home and is either severely mentally impaired, severely multiply impaired or autistic. The third program is the individual Medicaid Waiver program for 50 children.
All of these programs, however, are just the first steps in meeting
the goal of redirecting funds away from out-of-home placement and toward
support of families through a variety of services and resources like "as
needed" respite care, in-home aides, adaptive equipment, assistance with
physical plant modifications to the home, and training to deal with their
child. Certainly helping families to keep their developmentally disabled
child at home is, over all, a less costly alternative to out-of-home placement,
but more importantly, for the child, home is the best place to be.