The aim of this in-depth evaluation was to identify successes, challenges, and lessons learned in designing and implementing the FAM model of care. Based on these and other findings from this study, SF SOL has revised the FAM model and announced FAM 2.0, an exciting new iteration to be piloted between 2023-2025, and evaluated by HRC. To complete the initial study, HRC researchers collected four rounds of data between 2020 and 2022, including interviews with service providers, interviews and surveys with caregivers and youth; and youth referral case notes. The report highlights 5 key lessons, among others:
Youth impacted by CSE urgently need emergency housing options. Most of the youth referred to FAM did not have stable housing—they frequently changed placements, left placement altogether, or in some cases, were living with their exploiters. This made it challenging for providers to engage them in services. Youth in these circumstances may not be ready to transition directly into a family-based foster home setting. Because of this, it’s critical to develop a short-term, flexible, harm reduction-focused model of housing where CSE-affected youth in crisis can access services and stabilize before moving into a more structured home setting.
CSE-affected youth require creative, tailored solutions to engagement and family-based care. Youth referred to FAM faced a number of unique challenges, from pregnancy and parenting, to mental and physical health challenges, to involvement in the juvenile justice system. For FAM to adequately reach this population, it’s critical that services and support are responsive and adaptable to the unique needs of each youth, and that they account for the range of challenges that may arise during youth engagement.
The FAM model of care should be simplified and offered in partnership with foster family agencies already serving CSE-affected youth. FAM proved challenging to implement because of its complexity—the model involved coordinating numerous services across multiple organizations, there were barriers in recruiting caregivers, and challenges engaging youth away from their care placement. By focusing on the new components unique to FAM—specialized CSE training for caregivers, shared caregiving with a secondary caregiver, and flexible funding to meet youth needs—the FAM model could be simplified and more easily implemented by foster family agencies already serving CSE-impacted youth. This would expand the reach of FAM, reduce duplication of services, and improve the replicability and sustainability of the model.
Stigma towards CSE-affected youth and challenging housing requirements are major barriers to recruiting caregivers. Potential caregivers fear that youth impacted by CSE have difficult behavioral issues which they will be unable to manage. Community education and outreach campaigns through social media and other channels are critical for raising awareness of CSE and destigmatizing this community. Likewise, caregivers are often deterred by Resource Family Approval requirements related to housing, particularly that youth have their own room. Local government and service organizations should explore strategies to support caregivers who are struggling to meet housing requirements. For example, discretionary funds could be used for security deposits, application fees, furniture, moving costs, or temporary rental assistance. Long-term policy solutions are also critical. These could include making foster caregivers a priority population to attain affordable housing, or pursuing more flexible requirements for secondary caregivers. Such an arrangement could allow supportive friends and family to strengthen their commitment to youth at risk of CSE in their community, and allow them to benefit from FAM’s specialized training and resources.
Both permanency and community housing options should be made available to youth impacted by CSE. It is important to provide youth with the option to engage in permanency services to strengthen existing relationships and explore potential caregivers within their family or existing networks. Such services may be more likely to lead to strong commitments and long-term relationships that continue after FAM or their time in foster care ends. However, some youth do not have family members or other supportive adults who are willing or able to care for them, or who are capable of meeting foster caregiver approval requirements. These youth should be offered community-based placements with caregivers who they have not previously known. By ensuring both options are available, youth should be allowed to pursue the pathway to placement that best fits their unique needs.
The next iteration of this project, FAM 2.0, includes three innovative and critical support components for CSE-affected youth: secondary caregivers to create a shared model of caregiving, specialized training and peer support groups for caregivers, and fast and flexible funding to meet a variety of youth needs.
During the first year, the model will be piloted through Seneca Family of Agencies in San Francisco, later expanding to other foster family agencies and counties across the state. While the FAM model of care has undergone significant changes since the pilot’s inception, the goal has always been the same—to reimagine foster care for youth impacted by CSE so they are safe, empowered, and supported. This mission continues to guide FAM 2.0, the next iteration of FAM that will be piloted in 2023.