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Montana Title IV-E Waiver Demonstration Project

The Montana Title IV-E Waiver Demonstration Project will improve safety, permanency and well-being for children, youth and families involved in the Montana child welfare system by:

  • Providing customized child welfare services through Intensive Services Units;
  • Requiring formal and intensive family engagement in the case management process;
  • Utilization of effective and universal screenings and/or assessments;
  • Incorporating trauma-informed and evidenced based treatments.

Montana Title IV-E Child Welfare Demonstration Project Proposal
Congregate Care Title IV-E Waiver Meeting

Challenges facing Child and Family Services
  • Montana has experienced a steady and notable increase in out of home placements over the past several years—specifically in the ages of 0-5.
  • Montana foster care placement rates are higher than the National average.
  • An increasing number of children placed in kinship foster care without timely reunification or permanency. 
  • Use of high level care facilities for children for significant lengths of time.
  • Unaddressed or unidentified behavioral and mental health needs of children/youth.
  • Lack of universal trauma screening and assessment tool to identify trauma interventions to increase youth functioning.
 Keys to a Successful Title IV-E Waiver Demonstration Project
  • Safe Children
    • Strategies to keep children safe within their own families—preventing maltreatment & secondary trauma.
  • Strong Families
    • Community-based strategies to help at-risk families address causes of maltreatment and successfully raise happier and healthier children.
  • Supportive Communities
    • New & effective avenues to collaborate with public, private, faith-based, and other organizations to strengthen families & better prepare children to succeed in life.
  • Smart Investment
    • Flexibility to reinvest resources into more cost efficient approaches that achieve better outcomes.
  • Innovation
    • Redirect more resources to work within Montana communities to create & implement innovative solutions that better serve children & families.

Three innovations have been developed within the project to serve high risk populations and address challenges:

Innovation I will serve families with children ages zero to five who have been in foster care for less than sixty days or are at risk of entering foster care.  Families will receive evidenced based in-home services as part of their participation in the project. In addition, targeted and intensive concrete support and interventions for up to 6 months to allow the child(ren) & families to be safely served in the home.
Services will include but are not limited to:

  • Evidence based home visiting services in family environments;
  • Additional mental health or substance abuse treatment as needed for parents;
  • Concrete services to support safe family environments.
SafeCare Augmented

SafeCare Augmented is an evidence-based home visiting service model that will be provided to all families involved in Innovation I of the waiver.  SafeCare Augmented will:

  • Offer parents connections to necessary resources to address and resolve issues leading to incidents of child maltreatment;
  • Prevent and address factors associated with child abuse and neglect amongst the clients served;
  • Provide in-home instruction to parents to improve knowledge, skills and motivation to parent safely.

  Anticipated Outcomes of Innovation I

  • Decreased out of home placement rates for children ages 0-5 who are in care due to neglect.
  • Decrease in “short stayers” or number of children in foster care for less than 60 days.
  • Decreased repeat referral rate and decreased repeat intervention rate due to increases in linkages and referrals for families.
  • Improved developmental outcomes associated with child health and development.
  • Improved well-being outcomes as measured by the CANS assessment.
  • An increase in the family’s engagement in case planning.

Innovation II will serve families with children ages zero to twelve who are in the temporary legal custody of Child and Family Services and who are in a kinship placement.  Families will receive kinship support services and other evidenced based therapy.  An intensive family engagement model will allow these families to safely achieve reunification within 6 months or will move these children into permanency through the Kinship Guardianship Assistance Program (KinGAP)

Kinship Support and Family Re-Engagement Supports

  • Receive Evidence-based Trauma-Focused Cognitive Behavioral Therapy or Parent-Child Interactional Therapy as deemed necessary;
  • Engage in other interventions depending on needs of the children and family;
  • Access in-home kinship support services that provide increased understanding of kinship placements and trauma informed care;
  • Participate in team decision-making meetings to ensure active engagement in the case planning process.

Anticipated Outcomes of Innovation II

  • A decrease in lengths of stay in out of home care.
  • An increased rate of children and youth who achieve safe and timely permanency through reunification or kinship guardianship.
  • An increase in placement stability rates for children in kinship care placements (pre & post Guardianship).
  • Improved well-being outcomes as measured by the CANS assessment.
  • An increase in active engagement by the family in the case planning process.

Innovation III will serve children/youth ages zero to eighteen who are currently placed in a congregate care facility.  Safety, Permanency, and Well-Being Round Tables, Family Finding and Medicaid services will be utilized upon transition of the youth from congregate care into less restrictive placement.

Services Offered in Innovation III

  • The Family Finding model will be employed for youth in this target population who are unable to be reunified safely with a birth parent.  Youth engagement in this process will occur in accordance with the model.
  • Safety, Permanency, and Well-Being Round Tables (SPAW Roundtables) will be used to improve related outcomes and engage youth in their case planning process.
  • Community based Medicaid services will be provided upon transition of the youth from congregate care into a less restrictive placement.

Anticipated Outcomes

  • A decrease in “long stayers” (youth in care for 36 months or more) in out-of-home care.
  • A decrease in the placement rate and length of placement time for youth in congregate care.
  • An increase in placement stability rates for youth in congregate care.
  • An increase in youth achieving permanency from congregate care.
  • A decrease in repeat referrals regarding these youth in less restrictive placements.
  • A decrease in re-entry of these youth into congregate care.
  • Improved well-being outcomes as measured by the CANS assessment.
  • An increase in the engagement of youth in case planning.
 Child & Adolescent Needs & Strengths Assessment (CANS)

The Montana CANS is a trauma informed assessment which will be utilized to assess all youth entering the waiver program.  Utilization of the CANS assessment will:

  • Identify children and youth where trauma is negatively impacting their lives;
  • Provide appropriate referral for trauma-informed treatment;
  • Decrease over-reliance on psychotropic medications for children and youth in out-of-home care;
  • Improve child functioning to decrease the likelihood that children and youth requiring placement are placed in congregate care facilities.

For More Information Contact:

Erin Kintop
Title IV-E Waiver Program Manager
Child and Family Services Division
(406) 841-2421

Page last updated: 06/10/2014