3A. Duties of the Caregiver

So foster youth have rights, but whose job is it to make sure their rights are upheld? Both the caregiver and case worker have various duties to ensure healthy sexual and reproductive development and wellness. CDSS created a guide (Healthy Sexual Development & Pregnancy Prevention for Youth in Foster Care,For Children’s Residential Facilities and Resource Families) specifically for Resource Families and residential facilities which runs through the required and recommended duties, tips for talking to youth, runs through scenarios and answers, and provides additional online resources. You can access that guide HERE

What Are the Duties of the Caregiver?
# 1. Using the Reasonable and Prudent Parent (RPP) Standard which is “Careful and sensible parental decisions that maintain the child’s health, safety, and best interests while at the same time encouraging the emotional and developmental growth of the child.”
• Youth engage in age and developmentally appropriate social activities
• Respect and protect youth’s right

Recommended Questions when Applying RPP Standard
•Does the activity seem reasonable?
•Is this activity age or developmentally appropriate for the child?
•Is this activity appropriate given the child’s maturity?
•Is this activity consistent with the health, safety, and best interests of the child?
•Does this activity encourage the emotional, developmental, or cultural growth of the child?
•Does this actively assist in normalizing life in foster care?
•What are the inherent risks, hazards, or harms related to the activity?
• Is there anything based upon the child’s history to suggest that this activity would not be appropriate?

# 2. Caregiver should assist the youth in accessing sexual health services which include all of the services they can consent to as minors.
•Abortion
•Birth control including Long Acting Reversible Contraception (LARC)
•HIV and STD testing and treatment for youth age 12 and older

Scenario
The youth lets the caregiver know they have become sexually active with a partner.

What to do?
• The caregiver can review the Reproductive and Sexual Health Care Rights with the youth.
• The caregiver can offer reliable, non-biased information on safe sex and birth control to the youth.
• The caregiver can direct the youth to reliable websites with information about various types of birth control methods for pregnancy prevention.
• The caregiver can assist the youth in making an appointment with a health provider who can explain different birth control options.
• The caregiver shall provide transportation to the health care appointment.

# 3. Caregivers should be respecting the private storage and personal belongings of the youth in your care.
When it comes to prescribed medication, however, guidance directs caregivers to refer to Reasonable and Prudent Parent standards for self administration of medicine for minors. Youth may privately store condoms and spermicide purchased over the counter or acquired from a
medical provider, as personal items. For youth who are 18 or older, the Resource Family shall permit the youth to access medications necessary for self-administration.

# 4. It is the Resource Family’s duty to communicate with the caseworker if referrals must be made or they require assistance accessing resources and services.
It is important to maintain the confidentiality of the youth and only disclose information that the youth allows. When discussing with the caseworker, communicate:
• Topics discussed
• Resources and information provided
• Offers to remove any barriers
This disclosure describes the action taken to assist the youth rather than protect information about the youth.

#5. Maintain the Youths privacy & Confidentiality

Youth has a right to withhold consent to disclosure
Reminder- health providers can not share information with the youth’s parents, caregivers, group home, social worker, or probation officer without the youth’s consent. Youth have a right to withhold consent to disclosure and not have the provider tell the caregiver what care or information they shared with the youth. This is a right that applies to all minors and youth do not lose this right when they enter foster care.
If the youth does disclose information to the caregiver—because sexuality is a sensitive and highly personal subject—it is important that the caregiver maintain the youth’s privacy and confidentiality related to sexual and reproductive wellness. This includes but is not limited to:
• Sexual orientation
• Use of contraceptives
• Past services utilized

# 6. Caregivers should be directing youth to reliable sources of information that are medically-accurate, age-appropriate, non-biased and non-judgmental.
We are not expecting caregivers to be adolescent health experts but caregivers can still direct youth or help facilitate access to information they need or work together to find answers. JBAY’s website has a page of youth resources on sexual and reproductive health that is tailored to three developmental groups: early adolescents, middle adolescents, and transition age youth (link).

# 7. It is the duty of the caregiver to arrange for timely transportation to health-related services, as many reproductive health services are time-sensitive.

Examples:
•Transportation to the health care appointment when youth discloses they are sexually active
•Transportation to the health care appointment when youth discloses they are pregnant and would like an abortion
•Transportation to therapy, rape counseling or support groups when youth discloses they have forcibly had sex.

This is the caregiver’s duty regardless of belief or religion.

# 8. It is the duty of the caregiver to not impose personal biases or beliefs. Be respectful and professional.
Do not force, coerce or judge youth. Do not refuse to address any issue based on your own feelings or beliefs and be sensitive to trauma and cultural identity which can greatly affect how youth view their own sexuality.

Thought Exercise
To remain open and compassionate, we can ask ourselves:

How can I set my assumptions aside so I can get to know this person as this person is? It may help to make a commitment to set assumptions aside before meeting with/ having a discussion with the youth.

Perspective-taking
Involves taking another person’s viewpoint intentionally.

Try to imagine what it might feel like to be an LGBTQI youth who is meeting with you for the first time.
•What thoughts might come to mind?
•What might you worry about, or look forward to?