Private Organization Accreditation

White's Residential & Family Services is Indiana's largest social services agency offering accredited and comprehensive residential, foster care, independent living, adoption, and home-based services.


Family Services of the North Shore

Kathleen Whyte, Manager of Human Resources / Accreditation Coordinator

Family Services of the North Shore is about to enter our third accreditation cycle with COA. Accreditation has provided us with a framework that enables us to demonstrate accountability to our clients, our funders and our donors. There is no question that the accreditation process and COA have benefited our agency.
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Child and Family Services promote child and family well-being, protect children’s safety, stablilize and strengthen families, and ensure permanency.

PA-CFS 19: Supports and Services for Expectant and Parenting Youth in Out-of-Home Care

The agency promotes the safety, permanency, and well-being of youth in out-of-home care who are pregnant or expectant, and youth who are parenting, by providing resources and supports that empower youth to make informed decisions about pregnancy, experience healthy births, and develop the skills needed for personal functioning and parenthood.

Interpretation: The needs of expectant and parenting youth can be met through a comprehensive continuum of care that ranges from counseling and referral for youth receiving in-home services to “whole family” placements in specialized family foster care, residential treatment, or supported living arrangements, and includes effective coordination with schools, courts, healthcare providers, mental health and substance use programs, and other child and family serving systems. Although the standards in this section reflect best practice for any expectant or parenting youth, in recognition of the nature and model of in-home service delivery they will only be evaluated in relation to youth in out-of-home care. 

Note: The terms “expectant youth” and “parenting youth” refer to both expectant mothers and fathers, and are intended to promote engagement and supports for youth in the child welfare system that are fathers. The term “pregnant youth” refers exclusively to birth mothers.

Research Note: Research shows that youth in out-of-home care are significantly more likely to become pregnant and give birth before age 21 than youth in the general population. Parenting youth who have been in foster care are also more likely to experience rapid repeat pregnancies, and to be investigated and charged with abuse or neglect, than other young parents.

Rating Indicators
Full Implementation, Outstanding Performance
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.  
  • All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions; exceptions do not impact service quality or agency performance. 
Substantial Implementation, Good Performance
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement. 
  • The majority of the standards requirements have been met and the basic framework required by the standard has been implemented.  
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.  
Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.  
  • The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.   
  • Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner. 
  • Service quality or agency functioning may be compromised.   
  • Capacity is at a basic level.
Unsatisfactory Implementation or Performance
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.  
  • The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.  
Please see Rating Guidance for additional rating examples. 

Table of Evidence

Self-Study Evidence On-Site Evidence On-Site Activities
    • A description of services and support for expectant and parenting youth
    • Procedures for: 
      1. Case management and service coordination
      2. Referring for and accessing core services
      3. Developing parenting plans
      4. Working with youth who are fathers
    • Local community resource and referral list(s)
    • Policy on the rights of expectant and parenting youth prohibiting separation of youths' children without substantiated abuse or neglect allegations
    • Informational materials provided to youth
    • Parenting skills assessment
    • Educational curricula
    • Contracts or service agreements with community providers for the provision of services to expectant and parenting youth
    • Interview:
      1. Agency leadership
      2. Relevant personnel
      3. Youth served, and their children if appropriate
      4. Resource parents
      5. Residential treatment providers
    • Review case records

  • PA-CFS 19.01

    Pregnant youth receive timely, ongoing, relevant, and accessible services appropriate to their needs that address:

    1. value-neutral pregnancy and birth options counseling;
    2. prenatal health care;
    3. diagnosis and treatment of health problems, including sexually transmitted diseases;
    4. genetic risk identification;
    5. food and nutrition;
    6. mental health care;
    7. substance use conditions;
    8. smoking cessation; and
    9. labor and delivery.

    Interpretation: Regarding element (f), expectant mothers should be screened for depression, informed about postpartum depression, and connected to available support and treatment services.

    Research Note: Youth who do not wish to continue their pregnancies often face challenges obtaining accurate information about the steps legally required for termination. For example, if state law requires minors to obtain parental notification or consent in order to terminate a pregnancy, youth may need assistance to identify and contact the appropriate individual(s), or to obtain a judicial bypass when appropriate.
    Research Note: Studies indicate that youth in foster care who become pregnant are less likely to receive prenatal care within the first pregnancy trimester. Agencies may experience challenges in achieving timely delivery of prenatal care due to concealment, running away, or other circumstances that may delay notification.
    Research Note: Parenting youth tend to experience higher rates of mental health issues, such as prenatal and postpartum depression, substance use, and post-traumatic stress disorder, as a result of the difficulties of balancing the stressors and developmental tasks of adolescence with the challenges of parenthood. Among youth in out-of-home care this risk is often further compounded by a history of traumatic experiences.

    Research Note: Home visiting programs, such as nurse-family partnerships, have been identified as an effective model for delivering pregnancy and parenting education and counseling for at-risk maternal and infant populations.

  • PA-CFS 19.02

    Youth who give birth receive postnatal care and support related to:

    1. postpartum health care;
    2. postpartum depression;
    3. breastfeeding education and assistance;
    4. pediatric care, including well-baby visits and immunizations; and
    5. family planning.

    Interpretation: Postnatal care should include: timely, relevant information to help new mothers promote their own, and their infants’, health and well-being; information on how to recognize and respond to signs and symptoms of problems in both themselves and in their infants; and screening for and addressing changes in the new mother’s mood, emotional state, behavior, and coping strategies.

    Note: See PA-CFS 18 regarding all expectations on physical and mental healthcare for children in out-of-home care.

  • PA-CFS 19.03

    Agency policy prohibits the separation of children from youth parents for reasons other than abuse or neglect, and expectant and parenting youth are informed of their legal rights regarding the custody of their children. 

    Interpretation: Agency policy should clearly assert that children of youth should only be brought into agency custody in response to health and safety concerns, and never solely due to the youth parent’s involvement with the agency, young age, or as a means of obtaining services or financial support for the child.

  • PA-CFS 19.04

    Expectant and parenting youth are helped to develop skills and knowledge related to:

    1. basic caregiving routines;
    2. child growth and development;
    3. meeting children’s social, emotional, and physical health needs;
    4. environmental safety and injury prevention;
    5. parent-child interactions and bonding;
    6. age appropriate behavioral expectations and appropriate discipline; 
    7. family planning; and 
    8. establishing a functioning support network of family members or caring adults.

    Interpretation: Agencies should tailor how topics are addressed based on service recipients’ needs. For example, when serving expectant parents or parents of young children, education on environmental safety and injury prevention should address topics such as safe practices for sleeping and bathing.  

  • PA-CFS 19.05

    Workers collaborate with expectant and parenting youth and their caregivers, co-parents, and other family members when appropriate, to develop individualized parenting plans that define:

    1. the rights and responsibilities of the youth parents; and
    2. each individual’s role and expectations for supporting the youth parents to care for their children.

  • PA-CFS 19.06

    To ensure that expectant and parenting youth receive appropriate services, workers monitor:

    1. prenatal and postpartum care;
    2. the development of parenting and independent living skills;
    3. signs of postpartum depression; and
    4. progress with education, career development, or vocational training.

    Interpretation: To promote the achievement of educational goals, the agency may coordinate with an education or school advocate to ensure that youth who are pregnant or parenting are treated equitably and fairly in school environments that accommodate and support their circumstances.

    Research Note: Research has linked postpartum depression, delays in returning to school exceeding six months, and inconsistent use of contraception to an increased likelihood of repeat pregnancies among parenting youth in foster care.

  • PA-CFS 19.07

    Workers assist expectant and parenting youth to obtain or enroll in assistance that will support youth to care for their children and work towards financial independence, including:  

    1. public benefits such as Medicaid, WIC, SNAP, and TANF;
    2. transportation;
    3. maternal and child health programs;
    4. legal assistance;
    5. affordable and quality child care;
    6. community resources, such as free clinics; and
    7. services for special needs, mental health, or substance use, when appropriate.

  • PA-CFS 19.08

    The agency promotes responsible fatherhood and paternal engagement by:

    1. indicating in the case record when youth in out-of-home care become fathers;
    2. ascertaining the relationship between expectant youth parents;
    3. linking young fathers to services that help them to understand their legal rights and responsibilities, establish legal paternity, and adjust to the role of responsible fatherhood;
    4. determining the youth father’s role in service planning, as appropriate; and
    5. assisting pregnant youth to notify birth fathers, when appropriate.

    Interpretation: Element (e) may not be applicable when the expectant mother is not in the agency’s care.

    Research Note: National data on the preponderance of youth fathers in out-of-home care is lacking due to inconsistencies in both reporting and documentation of when youth become fathers. However, one regional study of youth exiting care in the Midwest found that nearly half of young men exiting foster care reported having impregnated a partner, a rate significantly higher than the nationwide rate of their peers (20 percent).

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