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ied GerontologyFruhauf et al.

JAG34210.1177/0733464812463983J

Original Article

The Needs and Use of Programs by Service Providers Working With Grandparents Raising Grandchildren

Journal of Applied Gerontology 2015, V   ol. 34(2) 138­–157 © The Author(s) 2012 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0733464812463983 jag.sagepub.com

Christine A. Fruhauf1, Brooke Pevney1, and Kimberly Bundy-Fazioli1

Abstract Grandparents who raise grandchildren often need support services. Yet, little is known about what service providers' need in order to better serve grandparents. As a result, qualitative methods were used to understand service providers’ views about programs and services they use when assisting grandparents raising grandchildren. We conducted telephone interviews with professional service providers (N = 16) from agencies serving grandparents. Data were transcribed verbatim and transcripts were analyzed using an inductive, constant comparison approach. Findings revealed two themes reflecting the types of services and support mechanisms providers’ use with grandparent caregivers and providers’ needs and recommendations to better serve grandparent caregivers. Participants fully supported continual funding for the Kinship Care System Navigator position and discussed the importance of community providers sharing a common voice and working together. It is important that professionals who serve grandparent caregivers are knowledgeable and willing to collaborate with other providers to meet grandparents’ needs. Keywords grandfamilies, service utilization, qualitative methods, Kinship Navigator Manuscript received: March 29, 2012; final revision received: September 7, 2012; accepted: September 14, 2012. 1

Colorado State University, Fort Collins, CO, USA

Corresponding Author: Christine A. Fruhauf, Colorado State University, Campus 1570, Fort Collins, CO 80523, USA. Email: [email protected] Downloaded from jag.sagepub.com at WEST VIRGINA UNIV on May 4, 2015

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Grandparent caregivers (i.e., grandparents who take on the sole responsibility of raising grandchildren) often report needing assistance from service providers (Hayslip & Kaminski, 2005). In particular, grandparents need help with understanding government benefits and entitlements (e.g., Temporary Assistance for Needy Families [TANF], Social Security, and Supplemental Nutrition Assistance Program); navigating community services and resources; and connecting with legal, medical, and school systems (Cox, 2009; Gordon, McKinley, Satterfield, & Curtis, 2003). Although the needs of grandparents who raise grandchildren are well known, there is a dearth of information about the perceptions of service providers (e.g., professionals working in aging services, family and child protective services, mental health, and spiritual health) whom care for and help grandparent caregivers. This is particularly important given there has been a rapid growth in the number of grandparent caregivers over the past 30 years (Lugaila & Overturf, 2004; Robinson-Dooley & Kropf, 2006). Grandparents often find their caregiving arrangement begins as a family crisis with little or no time to prepare for their new role (Cox, 2007; Landry-Meyer & Newman, 2004). Along with this, there is a concern that grandparents who voluntarily choose to care for grandchildren will most likely receive fewer services and have a harder time navigating the system than other caregivers who are a part of the child welfare system (Bundy-Fazioli & Law, 2005; Gordon et al., 2003). Possible reasons grandparents do not receive services include (a) not being aware of available services, (b) not willing to receive help, and (c) being fearful of working with the child welfare system (Bundy-Fazioli & Law, 2005; Gladstone, Brown, & Fitzgerald, 2009; Smith & Beltran, 2003). Yet, research reveals that grandparent caregivers may be in greater need for support and service assistance than other families (Gordon et al., 2003) as grandparents are at risk for negative health outcomes, decreased social support and increased isolation, and challenges with their grandchildren (Fuller-Thomson & Minkler, 2000; Hayslip, Emick, Henderson, & Elias, 2002). Therefore, the purpose of this article is to describe findings from a research project focusing on service providers’ needs and their use of supportive programs when working with grandparents who parent grandchildren.

Theoretical Perspective Transactions within the person-in-environment perspective are a foundation of applied social service practice (Germain & Gitterman, 1980) and a useful approach for working with older adults. This perspective is important for research on grandparents who are full-time parents to grandchildren as it approaches the “needs of both the individual and the systems and the environments with which

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they interact . . .” (Cox, 2007, p. 563). Furthermore, another useful perspective is that of the ecological systems theory (Bronfenbrenner, 1979). The ecological approach brings in the family to social services and assumes that the individual, family, and environment are connected and must be considered jointly (Bronfenbrenner, 1989) when working with families. That is, when one system is not working it impacts the other system. Depending on the impact, it could have a negative result on grandparent caregivers and their grandchildren as they try to find and use services. This theoretical approach has been supported as particularly relevant to grandparent caregivers (Cox, 2003). Taken together these two theoretical perspectives provide the foundation for this study and are useful for understanding service providers’ perceptions of grandparents raising grandchildren as it allows for understanding how they can better assist this type of family.

Barriers to Service Utilization Despite the fact that grandparents experience multiple needs when raising grandchildren, grandparents also experience barriers and obstacles in receiving assistance from service providers. Grandparent caregivers report multiple reasons for not receiving services. Grandparents of a certain age may not qualify for support services aimed to meet the needs of older adults. For example, the National Family Caregiver Support Program (NFCSP) of the Older American’s Act provides benefits to grandparents and other relatives age 55 and older who are raising children under age 18 (Smith & Beltran, 2003). Yet, it is known that grandparents’ average age is in their 50s (Chalfie, 1994; Landry-Meyer, 1999); those less than age 55 do not qualify for assistance from the NFCSP. In addition, grandparents often do not qualify for financial support through the child welfare system because they have not become a certified kinship provider or a foster parent to their grandchildren (Bundy-Fazioli & Law, 2005). Grandparents report they have difficulty accessing resources and navigating the service network (Smith & Beltran, 2003) and are uninformed about available resources (BundyFazioli & Law, 2005). Thus, grandparents may benefit from working with a Kinship Care System Navigator (KCSN; Cox, 2009). A KCSN is a designated person who works with grandparents and other kin caregivers responsible for parenting children. The Navigator links and connects grandparent caregivers to services they may need (Cox, 2009) and also provides social support when needed as s/he listens to grandparents’concerns. Even with community efforts to support a Navigator position, some grandparents may feel a stigma associated with needing and applying for services (Cox, 2009) and, as a result, are embarrassed to ask for help. For example, Glass and

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Huneycutt (2002) report, “for many grandparents it is embarrassing and difficult to seek this assistance. It can be a humiliating experience, especially if the individuals at these agencies are not sensitive to the unique circumstances of grandparents at this time” (p. 242). This may unfortunately lead grandparents to mistrust caseworkers or feel judged by them (Gladstone et al., 2009). Finally, grandparents report being afraid that service providers may take their grandchildren away from them (Gladstone et al., 2009; Gordon et al., 2003). Most important, however, is the lack of perceived sensitivity and knowledge of service providers by grandparent caregivers. Grandparents’ thoughts are not surprising given that as Raphel (2008) suggests, “many service providers are unaware of grandparent or relative caregivers and have no system for identifying them or helping them access appropriate services” (p. 118). Furthermore, grandparent caregivers are known to “have less interaction from caseworkers than foster caregivers” (Raphel, 2008, p. 119), and Smith and Dannison (2003) report 96% of educators in their study had little formal knowledge about the dynamics among grandparents parenting their grandchildren. Cox (2007) states that practitioners “must be sensitive to the fact that many problems are not due to an inherent incapacity or pathology but rather are the result of a lack of understanding of available resources or how to access them” (p. 563). For these reasons, it is important to understand service providers’ needs and use of supportive programs when working with grandparent caregivers as this line of inquiry has the potential to improve service delivery and, therefore, the lives of grandparents and grandchildren (Landry-Meyer, 1999). Thus, the guiding research questions for this article are the following: 1. What services do providers use with grandparent caregivers? 2. What do providers need to better serve grandparent caregivers?

Methodology This qualitative research methodology is grounded in both interpretive and participatory inquiry paradigms (Lynham, 2002). The interpretive paradigm is situated in the belief that knowledge is derived from the “constructed meanings of stakeholders” (Lynham, 2002, p. 226). Grandparent caregivers have varying needs and, in order to properly respond to these needs, it is important to understand from stakeholders providing services their understanding of the problem. Furthermore, participatory inquiry aligns with the interpretive paradigm philosophy as they are both collaborative research forms (Heron & Reason, 1997). The belief in participatory inquiry is that knowledge is socially constructed through the worldview of participants (Heron & Reason, 1997; Lincoln, Lynham, & Guba, 2011).

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These two paradigms part ways in how methods are conducted; thus, for clarity, it is important to highlight that this research is the second phase of a two-part study. The first phase of this project used Community-Based Participatory Research through engagement with key stakeholders from inception of the research problem to interpretation of the findings (Israel, Eng, Schulz, & Parker, 2005). The second phase of this study, and the focus of this article, utilized interpretive methods. Interpretive methods guided our exploration of service providers’ views; thus, assisting us with the explicit understanding that our knowledge as researchers is co-constructed based on “our past and present involvements and interactions with people, perspectives, and research practices” (Charmaz, 2010, p. 10).

Procedures After we received approval from our Institutional Review Board, a trained graduate research assistant contacted potential participants either through e-mail or telephone and screened them for eligibility. Potential service providers for this study were identified during focus group sessions (phase one of a two-part study) with grandparent caregivers who represented kinship careers within and outside of the child welfare system. When grandparents spoke of specific service providers in the community, we asked them if we had their permission to directly contact the provider and invite him/her to be interviewed for this study. At the time of data collection we assured grandparents that we would not reveal their identity when recruiting service providers. If given permission, we contacted potential providers directly to see if they would be willing to participate in the research study. Inclusion criteria included participants who were providing services (either directly or indirectly—as a supervisor) at the time of the interview and willing to participate in one telephone interview. Service providers were asked when they would like to participate in the telephone interview and told that the interview would last between 25 and 60 min (depending on the length of their responses). A convenience and purposeful sample, therefore, was used for this study. Telephone data collection were appropriate for this population because of time constraints of the interviewees and because of the structure of the interview protocol. The research assistant conducted telephone interviews that were recorded and transcribed verbatim. The research assistant read the human subjects assurances and procedures to each participant at the beginning of the interview; all participants gave their verbal consent to participate in the research study. Interviews ranged in length from 15 to 75 min.

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Fruhauf et al. Table 1. Participant Demographics. Name Daniel Emily Kristinea Stephanie Davida Joycea Mikea Susie Lilly Pata Billa Georgea Kyma Donna Virginia James

Agency Health and Human Services Health and Human Services Mental Health Services Mental Health Services Mental Health Services Homelessness Services Spiritual Health Services Aging Services Aging Services Volunteer Advocate Program Mental Health Services Child Services Public Health Services Aging Services Health and Human Services Health and Human Services

Gender Male Female Female Female Male Female Male Female Female Female Male Male Female Female Female Male

Age

Years working in current position

— 56 61 40 44 61 75 50 54 60 36 54 55 60 60 57

8 years 5 years 31 years 16 years 8 years 1 year 14 years 11 years 4 years 12 years 7 months 2 years 10 years 6 years 9 years 20 months

Note. aParticipants reported direct face-to-face contact with grandparent caregivers. All other participants reported either supervising case managers (who have direct contact with grandparent caregivers) or served in other managerial/leadership roles at their agency.

Participants A total of 16 service providers participated in the research project. Participants included 10 women and six men representing various divisions of the Department of Human Services (DHS; n = 4), area agency on aging (n = 3), mental health services (n = 4), childcare services (n = 1), public health (n = 1), a church (n = 1), and a homeless shelter (n = 1) in Northern Colorado. Service providers ranged in age from 36 to 75 years old (M = 55). Furthermore, the number of years working in their current position included as little as less than 1 year to 31 years (M = 9 years) and half of the participants reported having direct face-to-face contact with grandparent caregivers. We included participants who were willing to participate and who did not have direct contact with grandparent caregivers, as they were involved with policy and funding allocation for services benefiting grandparents and grandchildren. All participants names used in this article are pseudonyms and identifying information was omitted (see Table 1).

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Interview Protocol A semistructured interview guide was used to collect data from service providers. The interview guide began with questions addressing basic demographic information. Participants answered questions, such as (a) When you come in contact with grandparent caregivers what services do you provide? (b) What do you need to better serve grandparent caregivers? Probes were used to explore if they had seen an increase in this type of family form since they began working in social services.

Data Analysis Guided by our theoretical perspective, previous literature reviewed, and our research questions (Ryan & Bernard, 2003) the constant comparison approach (Charmaz, 2010) was used to derive themes from data gathered from interviews with service providers. Transcripts were read in their entirety by all three authors. All authors made notations about patterns in reference to what the data were describing. A pattern can be characterized by similarity and difference, frequency of mentioning the topic, and correspondence of how and when things happened (Saldaη˜a, 2009). Patterns were then broken down into codes. A code is “a word or short phrase that symbolically assigns a summative, salient, essence-capturing, and/or evocative attribute for a portion of . . . data” (Saldaη˜a, 2009, p. 3). We then engaged in a constant comparison method of sorting through our notations into “like minded codes” or codes that were similar by linking an idea or pattern together (Saldaη˜a, 2009). A line-by-line analysis of the data was then conducted (Charmaz, 2010) to refine the codes (Saldaη˜a, 2009) resulting in the current themes for this study. Themes describe codes that “look alike” and “feel alike” when grouped together (Lincoln & Guba, 1985, p. 347) and “contain clusters of coded data” (Saldaῆa, 2009, p. 11). After themes were developed and a final coding scheme was created, we used a computer software program (i.e., ATLAS.ti) to assist in organizing and retrieving coded data. To ensure trustworthiness we engaged in prolonged engagement, peer debriefing, and member checking. The concept of prolonged engagement is an activity used to build credibility in the data analysis process. Lincoln and Guba (1985) assert that prolonged engagement helps researchers to understand the context of the phenomenon under study, helps to minimize researcher distortions of the problem, and helps to build trust within the community. The first and third authors have collaborated for over 4 years working on grandparents raising grandchildren issues and are active members in a community alliance serving this population.

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As a result, we were consciously aware of our research bias, as well as the reality that our findings were a co-constructed process between participants and researchers (Guba, 1990). Peer debriefing was also used to ensure trustworthiness as we consulted with three other researchers familiar with grandparent caregivers about our findings. These steps assisted in enhancing credibility of the findings and resulted in further data analysis. A colleague suggested further examination of the data to see if themes were associated with the type of agency and/or if participants had direct contact with grandparent caregivers. No new themes developed from further analysis and no differences were found. The last activity we engaged in to ensure trustworthiness was member checking. The first author presented the findings of this study at a monthly meeting to which six stakeholders were present. In this session, stakeholders provided feedback and validation of themes.

Findings In the findings section, we discuss the themes from our data. The first theme, existing services and support comprises the following codes: in-system navigation, KCSN, community support, and national support used by participants to better assist grandparent caregivers. The second theme is service providers’ needs, including three codes: educating service providers, program flexibility, and sustainable funding for programs.

Existing Services and Support All participants discussed existing programs and services that they access and use with grandparent caregivers. For example, respondents stated they use various services available through their agency and by the KCSN in their county. Service providers also mentioned other community groups and the NFCSP that supports their efforts toward meeting the need of grandparents who parent grandchildren. In-system navigation. Service providers discussed assisting grandparent caregivers with many challenges within the community infrastructure of services. For example, in-system services includes information and referral, assisting grandparents with filling out documents (e.g., preparing for legal arrangements, Medicaid documents, food stamps, etc.), reviewing eligibility requirements to be certified for foster care reimbursement payments, case management, education around parenting skills, and emotional support. This is consistent with Kristine, when she stated,

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I am blessed with the ability to provide a nice wide array of services. I can offer [grandparents] individual therapy for the adult or for the child or family therapy. I also am able to offer parenting groups that are designed to build the relationship between the parent and the child, the grandparent and the child . . . I think we can do some animal assisted work . . . case management, resource and referral, childcare. I don’t offer the child care, but I can certainly get [grandparents] pointed in the right direction. Kinship Care System Navigator. Participants discussed the importance of the KCSN in the community they work. For example, the KCSN assists grandparent caregivers (and other kin caregivers) typically outside of the Department of Health and Human Services system in accessing resources and services. The Navigator provides case management and emotional support, leads educational programs, coordinates grandparent support groups, and provides information and referrals for community resources. This includes assisting grandparents in understanding programs and services as well as navigating their way through the system to get to the resources they need. The KCSN role is best described by Bill as he described his current position as the Navigator, I provide free consultations which is a lot of navigating. It’s like case management . . . take a look at what supports are out there and giving people the options . . . Just kind of knowing what they would be eligible for. So, then I work with a caseworker or case manager to make sure that those options are then presented to the grandparents. As well as, I work with the schools . . . anywhere that there’s a system I help navigate . . . I say, “hey, put it on me. I’ll fight for ya.” The KCSN position is housed at a center focusing on programs for traumatized children and families and receives funding from local foundations, DHS, and an Area Agency on Aging. Other participants also discussed using the KCSN as a resource. Many respondents stated when they run out of services and programs for the grandparents they serve, they send them to the KCSN. For example, Mike stated “I let people know about the grandparents raising grandchildren support group out at the Center.” Another participant, James, instrumental for working with other community partners to secure funding for the KCSN position in his county stated, “a system navigator can help these grandfamilies [grandparents and other kin]. Understand the system. Navigate through the system. Get to the resources that they need. And, we have done that by providing the position of the system navigator [in the community].”

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Community support. Although service providers and the KCSN provide direct services and programs to grandparent caregivers, other countywide initiatives help support their efforts. For example, participants mentioned two groups in Northern Colorado that assist them (albeit often indirectly) with their programs. These groups are the Larimer County Alliance for Grandfamilies (LCAG; Fruhauf, Bundy-Fazioli, & Miller, 2012) and the Weld County Grandparent Task Force (WCGTF). The LCAG and the WCGTF are collaborations comprised of grandparent caregivers and partners representing various community agencies. Both groups provide information and referral, support to service providers, and collaboration toward raising community awareness for better understanding of grandparents who raise grandchildren. Bill shared his beliefs on the collaborative support from the LCAG when he stated, You’d be a lone wolf [without their help], but the fact that I have the support from our collaborators makes it much more higher probability of my success. I haven’t receive this level of support in a social work position like I have here by the Larimer County Alliance for Grandfamilies . . . When you can call the top dog and get an answer, a piece of information or a some tips on how to navigate [services for grandparents]. Another respondent shared her belief about the importance of shared leadership in the community. She stated, “the exciting thing was then the Extension office kind of took a leadership role and got [the LCAG] together. A lot of people were interested in this topic . . . to do a strategic planning session on how to address the need.” National support. In addition to local countywide initiatives, federal programs support service providers and the grandparent caregivers they serve. For example, the NFCSP provides support services to grandparents and other relative caregivers aged 55 and older who are raising children 18 years of age and younger. Participants spoke of the benefit this program has brought to older grandparents in Northern Colorado. For example, Lilly stated that through the NFCSP in her county the funds helped pay for, “a support booklet that you know provided some financial and legal guidance for grandparents.” Another participant stated, although the NFCSP funds “took awhile for the money to trickle down to [the county] level . . .” it helped support her (i.e., Susie) work with the LCAG.

Service Providers’ Needs Although existing mechanisms for support provide valuable services for providers, participants identified areas in which they need additional help to better

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serve grandparent caregivers. Three codes were identified as follows: (a) educating service providers, (b) program flexibility, and (c) sustainable funding. Therefore, educating service providers about grandparents’ needs and “best” practices for better serving grandparents is the first code. The second code addresses the usefulness of employing flexibility when assisting grandparents. Then sustainable funding for the existing programs and advocating for such funding are of upmost importance. Educating service providers. Due to the different family structure associated with grandparents raising grandchildren, participants identified that there is importance and a value in service providers gaining a thorough understanding of this population. Grandparents’ reality creates the need for education, training, and/or awareness building for service providers. Mike responded by stating, “preschool teachers and paraprofessionals need to [understand grandchildren’s problems better] in guiding behavior in holding children . . . holding their attention longer.” Furthermore, it was noted by George that “a lot of my people are not trained to [guide the grandparents we serve]. So, it’s been a process of training here and then we give [grandparents] their options.” There are many reasons why educating service providers is important. Yet, one important part for education is raising awareness and resource development. More specifically advocating for more funding to assist grandparents who raise their grandchildren. This sentiment was well put by a participant who describes her desire for universal, collaborative support for grandparent caregivers and other adults providing care. Lilly shared that, “The bottom line is if we all come together with a common voice around certain caregiving issues and resource needs . . . Then there’s more chance of getting our voice heard and getting those needs met.” Grandparents are time and again unaware of the services and resources that are available in the community. This lack of resource knowledge suggests that it is the responsibility of the service providers to know what resources and services are in the community to refer grandparents. David, however, explains that he can connect people when he stated, “well I do lots of things that I do because I can direct people to resources. I know that there is a support group or there’s an association in Northern Colorado of grandparents raising grandchildren.” Another participant, James, similarly acknowledges : The themes that I’ve gathered particular over the last 20 months would be one of the need for understanding available resources, that’s a major theme. Another major theme is . . . of course having someone available to help particularly new grandparents. Understand resources and services that are available.

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It was identified that the initial integration within services system, available within the county, is the most difficult for grandparents. Systems are often unclear and have “unwritten rules” that make it hard to navigate and get the needed assistance. Service providers need to be educated on community resources so that they can help grandparents both within and outside the child welfare system navigate other community systems and benefit from the services that are available. Yet, participants did not give specific suggestions for the type of training they needed and the format that would be best utilized, as well as no mention was given about what they would like to learn about during a training. Program flexibility. Not only are service providers calling for more education and awareness, but they also recognize the need for flexibility with implementing programs and how services are offered to grandparent caregivers. For example, many providers discussed the need to be able to provide educational programs to grandparent caregivers at different times during the day and well into the evening. Providers recognized some grandparents’ needs are not met because of time conflicts between work, school, and home responsibilities. As well as, participants stated they need to do a better job meeting the needs of grandparent caregivers from diverse backgrounds. For example, support groups for “Spanish-speaking grandparents” is a must. Furthermore, flexibility was also discussed in relation to how programs are administered. A participant stated, “[I believe] more flexibility [is needed] with the ways that we actually enforce or administer the orders [about working with grandparent caregivers]. Additional services for [grandparents] . . . ” are also important. Service providers also reflected that they need trust and support from their supervisors and from the agency in which they work. This is not always the case as James indicated, “The policies and the administration we have here at the DHS gives a great deal of trust in division managers and some flexibility. Whereas you may not get that in some of the more conservative counties.” Trust and flexibility were important among providers, as well as sustainable funding for programs and services. Sustainable funding. Grandparent experts have identified the KCSN position as being a valuable resource to grandparent caregivers and their ability to navigate and find their way through a complicated system. To illustrate the significance of this position in helping grandparent caregivers, Susie stated, I think that the Kinship Care System Navigator Position is essential to maintain . . . If I were to list that my biggest thing I think that needs to be done. I think . . . that goes a long way, because that position can, you know, provide a lot of emotional and case management, emotional support case management, information and referral and you know on and on.

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Raising awareness, providing education, and resource development are all essential resources that are provided by the KCSN. Identifying funding sources and obtaining grants to sustain a position of this nature takes a tremendous amount of time. The current KCSN, Bill, stated, “But, you know, to develop new resources to sustain my funding so I can keep going and keep getting people linked up and being involved, kind of being the voice for this group.”

Discussion One of the most challenging hardships of grandparents who assume full-time parenting responsibilities for grandchildren is navigating and finding services within complex systems (Cox, 2009; Glass & Huneycutt, 2002). Despite the fact that there is an increase in the number of grandparent caregivers, research is limited on the impact the growth has on service providers. In this study, we utilized the person-in-environment perspective and the ecological systems theory to expand the literature on service providers who work with and on behalf of grandparents raising grandchildren. Sixteen service providers from a diverse range of agencies discussed current services and programs they implement to better serve grandparents and their perceptions for better meeting grandparent caregivers needs. Service providers discussed available supports and services they use to serve and assist grandparent caregivers. For example, they provided information and referral, counseling services, educational focus around benefits and legal issues, and assisted grandparents with filling out paperwork. Several service providers made specific mention of the importance of the KCSN in helping grandparents. The KCSN is essential as the position often serves as the voice for grandparents when they believe they are not being heard (Cox, 2009). The literature on supportive services for grandparents raising grandchildren identifies positions such as the KCSN as being useful to assist in gaining referrals to resources and direct services to grandparents and relative caregivers raising children (Smith & Beltran, 2003). Nationally, these services are aimed to link grandparent caregivers to resources and funding programs such as TANF grants, Medicaid, and other public benefits including legal assistance and food stamps (Beltran, 2011). Although participants in this study discussed this position as a beneficial resource that they use, Navigator positions currently only “exist on a state-wide basis in New Jersey, Ohio, and Washington State, and have recently begun implementation in five other states: Connecticut, Kentucky, Indiana, Minnesota, and New York” (Beltran, 2011, para. 2). Colorado is not included in the states implementing such positions, yet a few counties and programs in Colorado have created positions within child welfare, aging services, and/or

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mental health programs to utilize the help of a KCSN. These positions within Colorado are based on national KCSN models. With only three states having existing systems navigator programs and five other states that have begun implementation, the results of our research provides support for expanding statewide and even national implementation of the KCSN. Further research, however, is necessary to better understand the benefits of the KCSN along with implementation of state policies benefitting grandparent caregivers (Smith & Beltran, 2003). Despite the fact that service providers assist grandparent caregivers with many issues (Cox, 2009; Hayslip & Kaminski, 2005; Mayer, 2002), respondents for this research perceived needs in two key areas in order to better serve grandparents raising grandchildren. Consistent with previous research, participants suggested needing more education about grandparents, their needs and struggles, and how to better serve grandparent caregivers (Hayslip & Kaminski, 2005). This was particularly important among participants who reported having direct contact with grandparents. Second, participants indicated that continued funding is essential to maintaining the services they already implement. Without such funding, providers are unable to offer services and, as a result, grandparents and grandchildren will likely suffer. Although funding was discussed among all participants, those who did not have direct contact with grandparent caregivers and who were more likely to serve as supervisors and/or program managers/ directors reported funding being of great concern and of dire need for providers to better do their job. Improving funding and seeking resources can be facilitated with community help. For example, many participants mentioned the Larimer County Alliance for Grandfamilies as providing assistance. The Alliance is a collaboration whose mission is to work collaboratively to support the health and well-being of grandfamilies (e.g., grandparents and other kin assisting children) through community education, development of support systems, and advocacy for change (Fruhauf, Bundy-Fazioli, & Miller, 2012) and was based on a community mobilization model (Miller et al., 2010). An interesting finding revealed that service providers were aware of the LCAG, but did not serve as active members of the Alliance. These findings lead us to believe that providers, regardless if they are involved in the Alliance, are impacted by the work completed by this community group. Communities should consider mobilizing their community by building grandparent coalitions (Miller et al., 2010; Fruhauf, Bundy-Fazioli, & Miller, 2012)

Limitations and Future Research Recommendations Regardless of the fact that important insights were gained from participants in this research study, findings cannot be generalized to the larger service provider

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population, as this research was conducted in Northern Colorado. Furthermore, although the sample for this study was diverse based on sex, number of years working in direct service provision, and agency representation, age of service providers was similar and ethnicity of participants is unknown. Therefore, future research would benefit from obtaining a more diverse sample of service providers who work with and on behalf of grandparents and grandchildren. Furthermore, caution has to be given as potential sampling bias might have occurred given grandparent caregivers who participated in the focus group sessions assisted in selection of potential participants. Finally, a potential limitation to this study is that service providers were not asked about the perceptions of the barriers grandparents face in getting access to services. From analyzing the information gained from this study, the following recommendations for future research are important to expand research on service providers assisting grandparents. Further investigation on the benefits of the KCSN is necessary. For example, this area of research would benefit from a systematic national survey examining Kinship Navigator positions regardless if they are state implemented or a local initiative. In this survey, grandparents should be asked for their input on the value they place in the KCSN, how the KCSN has assisted them in their caregiving roles, and what other services providers were utilized as a result of working with the KCSN. Service providers should also be sampled. They should be asked about the level of their interactions with the KCSN, their value they associate with the KCSN, and the number of grandparents they refer to the KCSN and the number of grandparents they receive in their program as a result of the KCSN. In addition to the KCSN, providers in this study discussed the importance of community-based alliances and coalitions in meeting their needs. As a result, it is important to further research the benefits of community support programs and resources by sampling key leaders in communities similar to the groups mentioned by participants in this study. Community-based initiatives might be increasingly important given the likelihood such organizations might have on decreasing the financial burden placed on one agency.

Implications on Professional Practice and Policy The findings from this study have implications for direct practice and policy. To ensure quality services and greater sensitivity toward grandparents throughout the transition in caring for grandchildren, it is imperative that all service providers be up to date on their knowledge of the population and its needs. Unfortunately, agencies providing services tend to operate in silos and although this practice is changing within communities (Cox, 2007; Gladstone et al.,

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2009), it still exists. In grandparent households, the needs of the family can cross multiple systems such as housing and food assistance, mental health, aging, school systems, substance abuse, and therapy for experiences with trauma. In order to respond to the needs of grandparents, it is imperative that service providers use a systems perspective to understand the role of service providers working with the family (Cox, 2007, 2009). For service providers, based on our research, the best way to work with grandparents is by partnering and coordinating their efforts. Grandparent caregivers have a wealth of life experience, and it is recommended that service providers gain a better understanding of grandparent caregivers so that they can approach grandparents with care and sensitivity if they work with them directly, or have a better understanding if they do not work hands on with grandparents (Fruhauf & BundyFazioli, 2013). Often, grandparents will have a sense of what they need for their family. It is the role of the service provider to listen and be responsive. It behooves the service provider to stay current on available resources within their community and know of available opportunities for grandparent education and training (Thomas, 1990). For example, continued educational programming (such as video conferences) would benefit professionals working with grandparents (Targ & Brintnall-Peterson, 2001). Offering education classes for service providers around the challenges grandparent caregivers face and how to approach working with them within a level of sensitivity is necessary (Dolbin-MacNab & Targ, 2003). National and state organizations may also be sources of potential funding for supporting service providers. For example, administrators with Area Agencies on Aging and DHS should consider providing calls for proposals to community agencies for funding to serve grandparents who parent grandchildren. As a result, service providers representing diverse service sectors could apply and, if successful, receive funding to support their efforts toward meeting the needs of grandparent caregivers. From the person–environment fit and the ecological systems theory, funding mechanisms using this approach will likely build reciprocity between service providers, the community, and national programs. If funds do not exist, service providers should work toward advocacy within their community to best argue that this is important and should be funded. That is, providers should have talking points and data representing the population they serve to best capture potential donors and funders. Finally, engaging with city council representatives, state senators, and congresspersons can lead to increased awareness, funding, and support for grandparents (Fruhauf, BundyFazioli, & Miller, 2012; Roe, 2000).

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Conclusion The increase in the number of grandparents as parents is not surprising, given the increased attention toward unifying children with family members through kinship care (Fuller-Thomson & Minkler, 2000, 2003). This advance is creating a larger population of grandparent caregivers with increased struggles and needs. Despite research indicating that grandparent caregivers may be in greater need of supportive services than other families, there is a concern that grandparents who are voluntarily choosing to raise their grandchildren will most likely receive fewer services and have a harder time navigating the system then kinship foster families who are a part of the child welfare system (Bundy-Fazioli & Law, 2005; Gordon et al., 2003). Based on findings from this research study, service providers utilized a variety of support programs and other services when assisting grandparents. Service providers should continue to become aware of and have an understanding for resources in their community. Doing so, they can advocate for grandparents and learn how to contribute in sustaining the resources that are currently available. Service providers increased knowledge of grandparent caregivers and support through advocacy of service providers’ work with grandparents are imperative steps toward further empowerment of grandparents and assisting them in obtaining the services and supports they need.

Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding The author(s) received partial support from the College of Applied Human Sciences at Colorado State University for this research project.

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Author Biographies Christine A. Fruhauf, PhD, is an Associate Professor and Director of Undergraduate Programs in the Department of Human Development and Family Studies at Colorado State University (CSU). She also coordinates the Gerontology Interdisciplinary Minor at CSU and serves as Chair of the University Engagement Work Team of the Larimer County Alliance for Grandfamilies. Her research focuses on grandparentgrandchild relationships, including grandchildren caregiving for grandparents, GLBT grandparenting, and grandparents raising grandchildren Brooke Pevney, MSW, is a graduate of the Masters in Social Work program from the School of Social Work at Colorado State University. During her graduate work, she served as a research assistant on multiple projects impacting the Larimer County Alliance for Grandfamilies in Northern Colorado. Currently, she works as a social worker at a long-term care facility in Colorado. Kimberly Bundy-Fazioli, PhD, LCSW, is an associate professor in the School of Social Work at Colorado State University. She is a research affiliate with the Social Work Research Center, Applied Research in Child Welfare and Chair of the Larimer County Alliance for Grandfamilies. Her research interests include addressing the needs of grandparents raising grandchildren, child welfare issues, and social work education and practice.

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The needs and use of programs by service providers working with grandparents raising grandchildren.

Grandparents who raise grandchildren often need support services. Yet, little is known about what service providers' need in order to better serve gra...
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