HD34 - AIDS/HIV Education Information for Foster Care Youth and Guidelines for Implementation by Local Social Services Departments
The 1993 General Assembly requests through House Joint Resolution 680 that the Department of Social Services "develop AIDS/HIV education guidelines for use by local social services departments for foster families with children under the age of 16 in their care." It also directs the department to determine whether, upon development of these guidelines and, if necessary, approval by the Board of Social Services, local social services departments should be required to implement the guidelines. In addition, HJR 680 further directs the department to recommend the means of establishing this mandate if mandatory implementation is determined to be appropriate.
In response to the legislative directive, a work group was formed that consisted of representatives from the state departments of Social Services, Health and Education, local departments of social services foster care staff, foster parent trainers and foster parents representing the Virginia Foster Care Association. This report summarizes the processes the work group used to develop an information packet and arrive at recommendations for distribution. Included with this report is the HIV/AIDS Education Information packet that was developed.
HIV, human immunodeficiency virus, is the virus which breaks down the body's immune system and causes AIDS, acquired immunodeficiency syndrome. HIV can be found in the blood, semen, vaginal secretions or breast milk of an infected person. The immune system fights off infections and certain other diseases. When the immune system fails, common illnesses such as colds may become life-threatening.
Currently, for AIDS "there is no cure, there is no vaccine, there is only education" (AIDS Quarterly, PBS, February 1, 1990).
According to the Virginia Department of Health, from May 1982 through August 11, 1993, 4,665 cases of AIDS have been reported in Virginia, of which 1,170 were reported this year. The number of cases projected for all of 1993 is 1,800. The total reported in 1992 was 748. The appreciable increase noted this year is because the Centers for Disease Control and Prevention (CDC) expanded the case definition for AIDS effective January 1993.
Among the 5,131 cases of HIV infection reported from July 1989 through August 11, 1993, 2,060 (40 percent) belong to the 30-39 year age group; the number in the 20-29 year age group is a close second at 1,892 or 37 percent.
As of Spring 1993, more than 850 people aged 20-29 have been diagnosed with AIDS in Virginia. Because a person can be infected with HIV for 10 or more years before symptoms appear, a significant number of these young people would have been infected as teenagers. Experts agree that teens are at higher than average risk of contracting HIV because of their unpredictable and often risky behavior.
Well-documented research shows that young people are under-informed about the risk of contracting AIDS. In an appearance (August 1993) before the General Assembly Subcommittee studying AIDS, Dr. Grayson B. Miller, Director, Office of Epidemiology, Virginia Health Department, and others said many teenagers remain unconvinced they can get AIDS by having sex and injecting drugs. "...Young people often consider themselves immortal." Dr. Grayson said, "We must convince them otherwise." (DAILY PRESS, August 27, 1993). The only effective weapon in the fight against the spread of HIV infection is prevention.
AIDS education is a subject that is covered in the Family Life and Health Education curriculum in most Virginia schools. Recognizing, however, that some youth in Foster Care tend to change locations frequently and may not receive the information when it is presented in school, the General Assembly Subcommittee studying AIDS determined that a plan needs to be developed to assure AIDS education for youth in foster care.
The Department of Social Services through the Independent Living Program under Foster Care services provides AIDS education and prevention information to youth aged 16 to 21. However, the General Assembly Subcommittee studying AIDS said that "AIDS awareness and prevention is essential to the health and safety of every child in this Commonwealth." Consequently, the committee directs the department to provide AIDS education information to every youth in foster care, not just those aged 16-21 years old.
The work group developed an HIV/AIDS Education Information packet for foster families and the youth in their care by using materials recommended and made available by staff from state agencies for health and education. To determine the method most feasible for assuring that the information was given to foster families, a survey of local agency workers and administrative staff, foster care trainers and foster parents was conducted.
The packet is designed to give foster parents sufficient basic information to prepare them to begin a discussion with youth about HIV/AIDS and its prevention. The packet design allows foster parents discretion and flexibility in determining when to share information with youth based on a youth's age and current knowledge. Following are the materials directed to foster parents, with optional use for youth in their care, as well as to the birth children of the foster parents:
1. Letter to Foster Parents (explains the need to provide the HIV/AIDS information to youth);
2. Talking with Young People About HIV (a guide for starting a conversation);
3. Common Questions, Accurate Answers (factual questions and answers about HIV/AIDS);
4. Proper Way to Use a Condom; and
5. Sexual Abuse Information...Every Child's Basic Safety Knowledge.
The education information packet is completed with the enclosure of three brochures containing age-appropriate information directed specifically to youth in the following age groups:
6. AIDS Prevention Information for Children Aged 4-8;
7. AIDS Prevention Information for Youth Aged 9-12; and
8. AIDS Prevention Information for Youth Aged 13-19.
The brochures are easy to read and do not necessarily require assistance from an adult to read or understand.
Each local agency will be asked to voluntarily develop a plan for disseminating the HIV/AIDS Education Information packet to families who provide foster care for youth in the custody of the agency. The agency's plan is to include a statement that encourages foster parents to utilize the information packet and other information available about HIV/AIDS to talk to the youth in their care about HIV/AIDS and its prevention. The agency is to identify how it will disseminate the education information packet and identify training that may be provided on HIV/AIDS by selecting one of the four options that follow or a combination of the four options:
OPTION 1. At a minimum, the local agency plan may consist of distributing the information packet to all foster parents providing care for youth in the custody of the agency. The packet encourages foster parents to talk to youth in their care.
This plan should include a tracking system that will enable the agency to document that the information was shared with foster youth. The plan should also state how the agency will disseminate the HIV/AIDS information.
OPTION 2. Add to Option 1 Optional Training. Offer training to foster parents about how to talk with youth about HIV/AIDS and its prevention. Training may be part of the agency's pre-service (training that occurs before a child/youth is placed in the foster family home) or the in-service training (training that occurs after the child/youth is placed).
Agencies that do not have established pre-service or in-service training for foster parents may choose to develop a training program for HIV/AIDS prevention.
OPTION 3. Add to Option 1 Mandatory Training. The agency can choose to mandate HIV/AIDS education training for all families providing foster care for youth in the custody of or placed by the agency or Family Assessment and Planning Teams (Comprehensive Services Act for At-Risk Youth and Families).
OPTION 4. Other. The local agency may determine another plan not described by the department.
Since other education issues and prevention information for foster parents are not mandated, it would appear that mandating this one issue, HIV/AIDS education, would be an unnecessary regulation.
Developing guidelines for local agencies to use and then encouraging local agencies to develop a voluntary plan for implementation of the HIV/AIDS education information keeps with the focus of the Comprehensive Services Act for At-Risk Youth and Families (CSA). Under the Comprehensive Services Act localities are allowed choice in implementation of services to youth and families within a broad framework for the provision of services. Since the HIV/AIDS education information is packaged and ready for distribution minimum preparation and planning is demanded of the local agency. In addition, a voluntary plan would lessen the concern of local agencies of additional work without additional funds.
RECOMMENDATION 1. The department should print copies of the HIV/AIDS Education Information packet and make them available for local agencies to distribute to foster parents.
RECOMMENDATION 2. Local agencies should be strongly encouraged to develop a plan to disseminate the HIVIAIDS Education Information packet to foster families with children and youth in their care and to offer training for foster parents about HIV/AIDS through local agency pre-service and in-service training programs or other training set-up by the agency to meet this need.
RECOMMENDATION 3. The department should provide HIV/AIDS education training for foster parents and agency workers in the five department regions to support local training programs expanded or set-up to meet this need.
RECOMMENDATION 4. To fund recommendation #3, the department should allocate $30,000 using Title IV-E funds ($22,500 federal dollars and request $7,500 for the state match).