Evaluation of Family Preservation and Reunification Programs: Final Report: Volume 1: Philadelphia

6. Philadelphia

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Contents

• 6.1 Introduction
• 6.2 Characteristics of Philadelphia's Children and Families
• 6.3 Child Welfare Services
  • 6.3.1 Child Abuse and Neglect Intake
  • 6.3.2 In-home Services
• 6.4 Services
• 6.5 Training
• 6.6 Public-Private Collaboration
• 6.7 Funding
• 6.8 Implementation of the Evaluation
  • 6.8.1 Random Assignment
  • 6.8.2 Challenges to Implementation

Endnotes

6.1 Introduction

This section begins with an overview of the characteristics of children and families in Pennsylvania and Philadelphia County. The chapter continues with information on child welfare services in Philadelphia County, a detailed description of Services for Children in their Own Homes (SCOH) and FPS, and a description of the implementation of the evaluation. ⁽⁶⁰⁾

Information on population characteristics and child welfare structure and process is presented to provide an understanding of the context in which services were provided, and to identify any changes that occurred during the implementation of the evaluation.

6.2 Characteristics of Philadelphia's Children and Families

There are approximately 2,900,000 children under age 18 in the State of Pennsylvania. The majority of children are Caucasian (78 percent) and more than three-quarters are fourteen years old or less (Table 6-1).

Indicators of child health, education, and social and economic welfare in Pennsylvania, compared to the nation, are presented in Table 6-2. Data have been abstracted from the Kids Count Data Book, published by Annie E. Casey Foundation. With respect to most indicators, Pennsylvania's families and children are similar to the national average. Notable exceptions include a lower percent of children without health insurance (15% in the nation compared to 8% in Pennsylvania), and a lower teen birth rate (30% in the nation compared to 22% in Pennsylvania). The Casey Foundation developed a family risk index based on the following indicators: 1) number of children who are not living with two parents, 2) households in which the head of household did not have a high school diploma, 3) family income is below the poverty line, 4) parents did not have steady employment, 5) the family was receiving welfare, and 6) no health insurance for the children. Using the Casey risk calculation, in Pennsylvania 12 percent of the children are considered at risk compared to 14 percent of children nationwide. ⁽⁶¹⁾

Philadelphia has approximately 385,000 children under the age of 18. Similar to the state statistic, 26 percent of children are under 5 years old. Fifty-two percent of the children under age 18 in Philadelphia County are African American, while 32 percent are Caucasian.

Comparing indicators of child and family well-being in Pennsylvania and Philadelphia County (Table 6-3), it appears that children in Philadelphia County are not faring as well as those statewide. Philadelphia County has relatively high rates of low birth weight, births to unmarried women, and adults with less than a high school diploma. Philadelphia has a poverty rate over twice the state rate, has twice the proportion of children below the poverty level, and has a median household income nearly $10,000 less than households statewide.

Poverty is an important problem in the Philadelphia area. Nearly 22 percent of persons in the county, and almost one-third of children in the county, live below the poverty level. Substance abuse is also widely recognized as an established problem in Philadelphia and among child welfare cases, and is a central focus of family preservation efforts in Philadelphia. Of the 25 largest Metropolitan Statistical Areas (MSA) in the U.S., Philadelphia ranked 6th in rates of alcohol use, 13th in illicit drug use, and 17th in cocaine use in the years 1991 to 1993. ⁽⁶²⁾ These estimates indicate that from 1991 to 1993, an average of 59.1 percent of those age 12 and older in the Philadelphia MSA had used alcohol in the past month, compared with 49.9 percent for the U.S. as a whole. In terms of illicit drug use, Philadelphia MSA residents were more typical of the U.S. population in general with 5.7 percent having used illicit drugs and 0.6 percent cocaine. Data on drug dependence and treatment for the Philadelphia MSA were also similar to figures for the U.S. as a whole. One percent of the Philadelphia residents over 12 were dependent on illicit drugs over a one-year period; 2.8 percent were dependent on alcohol; 0.8 percent received treatment for drug use, and 0.6 percent received treatment for alcohol use. ⁽⁶³⁾

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6.3 Child Welfare Services

Public child welfare services are administered at the county level in Pennsylvania. The State's Department of Public Welfare inspects and licenses county child welfare agencies, and retains some regulatory authority.

To provide background for the findings from the evaluation, an overview of the number of children in out-of-home placement in Philadelphia County for three years prior to the study and the first year of the study, and the number of child abuse and neglect reports in 1990 and 1994 are presented in Table 6-4.

The number of children in out-of-home care in the county remained fairly stable from 1994 to 1997, at approximately 7,800 children. About 2 percent of children in the County were in out-of-home placements in 1994. Philadelphia County had about 11,700 reports of abuse and neglect in 1990. There was an increase in the number of abuse and neglect reports, by about 1,000, between 1990 and 1994. The reports of abuse and neglect involved an estimated 3 percent of all children in the county in 1994. ⁽⁶⁴⁾

6.3.1 Child Abuse and Neglect Intake

Child abuse and neglect (CAN) cases in Pennsylvania generally enter the child welfare system through statewide or county hotlines. There are two types of CAN cases -- child protective service (CPS) cases and general protective service (GPS) cases. CPS cases are those with alleged harm, or with threat or risk of harm to the child. These cases include allegations of physical abuse that result in severe pain or dysfunction, sexual abuse, medical neglect, or lack of supervision resulting in a specific physical condition or impairment, psychological abuse attested to by a physician, or repeated injuries with no explanation. ⁽⁶⁵⁾ GPS cases include most instances of child neglect, including environmental conditions such as inadequate housing, inadequate clothing, and medical neglect not leading to a specific physical condition (e.g., failure to keep appointments or get prescriptions). ⁽⁶⁶⁾ Both CPS and GPS cases are relayed to the appropriate county DHS office via central intake for that county.

Philadelphia has a central intake for all CPS and GPS cases. The Children and Youth Division (CYD) of the Department of Human Services (DHS) is responsible for child welfare investigations and services. CPS/GPS investigations on new cases are handled by CYD Intake Units. ⁽⁶⁷⁾ The "unit of the day" receives intake cases. CPS cases are given priority and GPS cases fill out the unit's remaining intake allocation for the day. Other cases, known as voluntary requests for services, include other court referrals, hospital referrals, referrals from other resources, requests for emergency placement, walk-ins, and runaways ⁽⁶⁸⁾ are referred through a "general intake," separate from CPS and GPS intake.

Figure 6-1.
CPS/GPS Abuse and Neglect Case Intake

Central intake has a 24-hour-a-day response capability. Investigation of CPS cases must begin within 24 hours after a report; investigation of GPS cases must begin within 5 days after a report. During these investigations, intake workers make a determination of the level of risk of harm to children and service needs of the family based on a standardized risk assessment. In general, children in low risk cases are provided with necessary services and their case is closed; intermediate risk cases are opened and families are referred to private agencies for services; and children in high risk cases may be referred to FPS or other services, or placed in foster care or another type of substitute care (judicial involvement is always required in high-risk cases). Intake investigators decide whether to open or close cases (changing from a "pending open" status assigned at the original call). CPS cases can be either: founded (by conviction of abuse in criminal court); indicated (based on evidence from a medical report, admission of the perpetrator, or CPS investigation); or unfounded. GPS cases are either substantiated or unfounded. GPS cases may also become CPS cases during investigation.

Services can be provided to children and families by an intake worker during investigation, although cases with more risk are more likely to be provided services at intake. For high-risk cases, services are usually required immediately to ensure the safety of the child. Counties must report results of CPS investigations to the state within 30 days after the original hotline call. If there is no report within 60 days, the record is automatically expunged from both the state and county systems.

After an intake worker has determined the level of risk for a child, the case is opened for services and sent to a DHS CYD Family Service Region (FSR) unit for case planning and further referral for services. There are four FSR units in Philadelphia County.

In 1996-97, a Centralized Referral Unit (CRU) was created to handle case referrals to residential treatment and SCOH service programs. The CRU is supervised by the Special Services Administrator, and serves as a conduit between and support to staff in Intake and the FSRs. The intent was to have one unit keep track of current openings in the private SCOH and residential treatment programs. However, this goal has not been realized and some SCOH referrals continue to come directly from intake staff who have established relationships with private agency staff. Intake workers should have a service (e.g., family preservation or SCOH) in place or refer the case to the CRU before the case is transferred to a FSR.

Philadelphia has always had a strong privatized system of service delivery. Large charity organizations in the city provided services to children and families beginning in the early 1900s. Private agencies did their own intake and services to children, and were paid through request for payment to the county up to the mid-1970s. In 1975, the Philadelphia County began CPS services. The late 1970s and 1980s saw exponential growth in service delivery and placement of children. As a result, DHS provided direct intake and protective SCOH services during the 1980s. As the need for services expanded, the number of private, publicly monitored, contracts expanded as well.

A DHS reorganization took place in the late 1980s to separate intake (evaluation, investigation and emergency services) from backend services such as foster care and adoption. At this time, FSRs were developed. Since the 1980s, almost all in-home services in Philadelphia have been purchased from private agencies.

DHS in Philadelphia County went through attempts at system reorganization in the 1990s. In the late 1990s, as part of a permanency planning initiative, DHS experimented with a FSR unit set aside specifically for permanency planning, to more closely coordinate permanency planning for children. However, with the implementation of ASFA, expediting permanency became the job of all FSR workers in the system. In 1997, DHS devised mechanisms for geographic-based assignment of workers and delivery of services to promote a more community-based service delivery system. Plans called for intake to remain centralized while families were assigned to workers based on geographic location. Implementation is moving forward, although not as quickly as was hoped.

In addition, the State of Pennsylvania and County of Philadelphia were parties in a class action suit brought by the ACLU concerning the quality of care provided to children who have been removed from their homes. With the implementation of ASFA, many charges contained in the lawsuit were addressed through new state and county policy. The state was released from the lawsuit, and Philadelphia and the ACLU entered into a consent decree to resolve remaining grievances, whereby the ACLU would participate in a number of case readings every 6 months, over an 18 month period.

6.3.2 In-home Services

6.3.2.1 Services to Children in Their Own Homes (SCOH)

In 1978, state legislation mandated SCOH in all counties. These services were (and still are) intended to support intact families and protect victims of child abuse and neglect who remain at home. One of the early SCOH programs in Philadelphia was staffed by paraprofessional workers with caseloads of three families per worker. Workers served as advocates for families. Over time, teams of social workers and paraprofessionals were developed. Caseloads grew to about eight families per worker by 1990.

SCOH are provided by about 20 private agencies in Philadelphia. DHS contracts with a private agency to deliver a specific level of SCOH for each case. Initially there were three intensity levels of SCOH: Level I consisted of 1 hour of in-home service a week; Level II consisted of 2 hours of in-home service per week; and Level III consisted of 3 hours of in-home service per week. However, Level I is no longer in use as it was thought to be insufficient for a case. Level II and Level III continue to be provided.

SCOH are usually initiated by a joint meeting of family members, the FSR caseworker, and the private agency SCOH worker in the family's home. Because it is often difficult to arrange such meetings around FSR caseworkers' schedules (their protective service investigations and court appearances take precedence over SCOH meetings), delays in the start of SCOH are common. Some private SCOH agencies have bypassed the joint meeting and begun services without an initial meeting with the FSR caseworker.

Once in SCOH, cases move through the program quickly. DHS has tightened time frames in the program. After nine months of services, cases are automatically terminated from SCOH unless there is a new risk assessment and DHS agrees to a six-month extension. SCOH caseloads vary across agencies from approximately 8 to 14 cases per worker.

6.3.2.2 Family Preservation Services (FPS)

In response to the crack-cocaine epidemic, which hit Philadelphia in the mid-1980s, the state legislature allocated funds for a "Pennsylvania Free" (Penn Free) program to service crack cocaine-addicted women and their families. Funding for this program was channeled through county mental health departments and services were often provided through contracts with private agencies. Three of these programs were launched in Philadelphia. Although they were called family preservation services (FPS), the Penn Free programs were not nearly as intensive as current FPS and included a mix of in-home and office-based contact with clients.

From 1986 to 1989, a private service provider in Philadelphia, Youth Service, Inc., operated an in-home, family-based program funded by the Edna McConnell Clark Foundation. Initial referrals included some very difficult cases, the program was not able to achieve quick and substantial reductions in the risks to children, and placement rates were high in this early cohort. Referrals shifted to families with chronic problems in which children were not at risk of placement. By the end of the Clark-funded project, cases in the program were similar to those serviced in SCOH.

In the late 1980s, Pennsylvania state child welfare administrators were very impressed by presentations on family preservation services at national meetings of state governors. A strong commitment to family preservation developed at the state level and in some counties. The Pennsylvania Family Preservation Act of 1989 encouraged counties to establish family preservation programs, "enabling children who would otherwise be subject to out-of-home placement to remain at home" (P.L. 218, No. 35). The impetus for this law came from experience with local programs that were similar to family preservation services and the influence of the national family preservation movement. Because public programs in Pennsylvania are administered at the county level, the state had no way to force FPS on counties, and some were resistant. Therefore, the state sought county-level "buy-in" to the family preservation ideal by setting up grants to counties for FPS.

During an initial phase-in period, grants were provided to counties on a competitive basis, based on a review of proposals submitted by county children and youth agencies, with no county matching fund requirements. State law does provide some guidelines within which county-run programs operate, however counties were generally left to decide whether and how to provide FP services. There has been considerable variation across counties in the implementation of FP programs. Advocates hoped that FPS would eventually be available statewide, but that has never happened.

6.3.2.2.1 Philadelphia FPS

Philadelphia began providing FPS in 1991. Philadelphia did not apply for a state FPS grant the first year they were available (1989), but applied and received a grant to begin in 1990, and started services in 1991. Services began with one DHS FP unit. Tabor Children's Services coordinated with DHS on the grant, jointly planned the first FPS program, and was the first private agency to deliver FPS in the county. After the first year, administrators made note of families who did not benefit from the FPS provided. Based on that information, specialized FPS models were developed to meet the needs of various communities and clients. As a result, specialization became an important part of FPS in Philadelphia, and continues to be a hallmark of Philadelphia County FPS. Each private agency who received DHS FP grants served a specific target population such as teen parents or parents with drug and alcohol abuse problems. In the first few years, the FPS programs in Philadelphia were not at capacity. Referrals to the program were few and some referrals were inappropriate for the program. Efforts made to "market" FPS to intake workers were successful and the number of families entering the program grew.

As a result of FP expansion, in 1994 DHS began the Specialized Family Preservation/ Reunification Section, a centralized, specialized section made up of five units. This model made sense for practice and practical reasons, to maintain necessary support, training, and reinforcement, while at the same time encouraging cohesion in practice, and enforcing accountability.

In 1994-95 the Philadelphia FP programs served 341 families with 888 children. In 1995-96 FPS were provided to 462 families with 1,452 children. In 1996-97, the figures were 616 families with 1,642 children. By 1999, there were approximately 16 FPS programs provided by 12 private agencies across the county. Plans to expand the program continue. In 2000, the county had the capacity to serve 1,000 families per year in family preservation and reunification programs.

FPS in Philadelphia County has focused on serving families with substance abuse problems, a focus that has its roots in the Penn Free programs. Substance abuse is the primary emphasis of the FPS program operated by the Abraxas Foundation, and to a lesser extent, by Tabor Children's Services, two agencies serving both experimental and control group families in our study. As mentioned earlier, specialization of services is a hallmark of Philadelphia FPS. Other private agencies provide FPS to specific populations in need.

The Abraxas Foundation focuses on substance abuse among young parents. Many of these clients need in-patient treatment. Some are status offenders or are classified as "pre-delinquent." Abraxas operates treatment and rehabilitation programs for delinquent and dependent youth with substance abuse problems, drug sellers, sex offenders, and youth with emotional and behavioral disorders. Other than FPS, most of Abraxas's programs serve youth referred through the juvenile justice system.

The FP programs at Tabor Children's Services focus on substance abuse, child maltreatment, family conflict, life skills, parenting needs, and parent education. Most of the families in these programs have children under 12, although families with older children are sometimes referred. Tabor Children's Services is a multi-service child welfare agency with adoption, foster care, and supervised independent living programs. Its parent agency, Tabor Services, also has mental health and day care divisions.

The FP programs at Youth Service, Inc., focus on family conflict, most often in three-generational households with young parents. Conflict resolution and parenting skills training are emphasized, and crisis nursery and day care services are available. Carson Valley School specializes in serving status offenders, teenage victims of abuse, cases of parent-teen conflict, and some teenagers with mental health and mental retardation problems; group treatment is provided for teens and parents. Congreso de Latinos Unidos is a bi-lingual, bi-cultural, multi-service program for families in North Philadelphia; its FP program services include life skills training, parenting training, family conflict resolution, and substance abuse intervention.

Target Population. Philadelphia County defines the target population and goals of family preservation in somewhat more expansive terms than the traditional FPS Homebuilders-type model. The FPS program is focused more broadly by serving children who are at intermediate risk of removal from the home, as opposed to serving only children at imminent risk, and provides 12 weeks of services. The caseload size of five families per caseworker, set by the 1989 Act, has generally been adhered to.

When the FP program began in Philadelphia, most of the referrals involved drug and alcohol abuse in families with young children. As the program progressed, families with older children were also referred, as were parents with mental health problems and other needs. Little systematic information is available about the characteristics of families served by Philadelphia's family preservation and SCOH programs. However, data available from one FPS program indicate that of the first 40 cases served by the one FP program, 70 percent were receiving AFDC, 78 percent had at least one family member with a serious drug or alcohol addiction, and 8 percent involved children who were born addicted to drugs. Three-quarters of the families were African American, 23 percent were Caucasian, and 3 percent were Hispanic. More than half (55%) of the mothers served by the program were never married, 28 percent were divorced, and 3 percent were widowed. ⁽⁶⁹⁾

Referral. Referrals to the FP program usually come from central intake. In Philadelphia, the public agency's specialized FPS section develops selection criteria, approves families to receive FPS, and works closely with the private providers. The decision to refer a case is made by intake or a family service region worker. The referral is assigned to a DHS FP worker, by the DHS FPS receiving supervisor, for assessment. Ideally, the referring DHS worker and FP worker would go out together to meet and assess the family for FPS. However, sometimes the DHS worker cannot attend the meeting and the DHS FP worker and a private FP supervisor and/or worker will go out to help assess the family. Criteria used to make a determination on a referral include: 1) can the family identify at least one achievable goal?, and 2) is the family willing to accept intensive services from an agency? ⁽⁷⁰⁾ A family service plan is drawn up by the DHS FP worker at the time of assessment. If a case appears feasible for FPS, the DHS FP supervisor will assign the case to a private provider FP worker, if one has not been assigned at that point, to begin the ongoing work with the family.

The DHS FP worker generally performs all the public-sector mandated functions and activities such as the family service plan, any court petitions or appearances, CPS interventions, mental health and/or placement planning if necessary, and attends all mid-point and ending meetings with the family. The DHS FP worker may also assist the FP provider worker in identifying resources or responding to emergencies.

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6.4 Services

Family Preservation is a 12-week program that focuses on the strengths of families. Workers provide about 10 hours per week of direct contact with the family in their home. There is a formal, 6-week case review meeting, attended by DHS staff, private agency staff, and family members. This meeting is seen as an opportunity to review case progress and receive feedback from the family. An additional formal meeting is held at the end of FPS services, attended by the DHS worker, private agency worker, and family members. If aftercare services are required, a DHS FPS "transitional unit" worker and private agency SCOH worker also attend the meeting. About 50 percent of FPS cases close within 12 weeks (i.e., close at DHS). Approximately 15 percent of families have chronic problems that need more attention and in these cases, children may enter placement. About 30 percent of families receive 3-6 months of follow-up services.

6.5 Training

DHS and private agency FPS workers are required to attend 40 hours of in-service training per year (compared to 20 hours per year for other child welfare workers). In the first few years after the passage of the state Family Preservation Act, annual statewide conferences were held to orient and train FPS workers. This practice ended under the administration of Governor Ridge. For several years, FPS workers were expected to fulfill the 40-hour training requirement by attending in-service trainings provided within their own agencies, general sessions provided by the state regional training center, and professional meetings and conferences. DHS contracted with Philadelphia Child Guidance to provide 25 days of clinical training per year for FPS staff at DHS and the private agencies. Training is provided in three groups, each of which is comprised of staff from several provider agencies. Each year there are 8 days of training for each group and one general session. Training focuses on interviewing skills, clinical observation, crisis intervention, and issues specific to family preservation work within a multi-systems perspective.

6.6 Public-Private Collaboration

Working relationships between private and public agency FPS staff are quite positive. Private agency and DHS staff participate in initial, midterm, and final meetings with FPS clients and caseworkers in the family's home. Communication and case coordination between public and private workers are frequent and fairly thorough. Private agency workers find the DHS FPS staff accessible and responsive. Overall, the public-private partnership includes family-centered practice, constructive public-private partnerships, and clear division of responsibility for case management and direct service provision.

6.7 Funding

Initially, Pennsylvania Department of Public Welfare (DPW) grants to CYD set reimbursement for Family Preservation at the a rate of $4,000 per family per year. In 1994, DPW adjusted the rate up to a maximum of $4,500 per family. Philadelphia County has continued to fund family preservation based on a flat rate per family (some other counties pay a per diem rate). Grant amounts remained stable and the capacity of individual programs in Philadelphia decreased in 1994. For example, programs that once contracted to serve 100 families a year for $400,000 now aim to serve about 88 families a year for the same amount. Overall expenditures and service capacity have increased with the addition of new programs. In 1996-97, DHS funding for FPS programs in Philadelphia County was slightly under $2 million, up from approximately $1.7 million in the previous year.

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6.8 Implementation of the Evaluation

A review of programs in Pennsylvania and Philadelphia for participation in the study began in 1994. Our interest in Philadelphia County was sparked by the fact that it had one of the few intensive family reunification programs in the country. However, at that time, the Philadelphia reunification programs were relatively new and were not serving enough cases to support an experiment. Discussions with a Social Work Administrator in charge of FPS in Philadelphia County, a strong supporter of rigorous evaluation of FPS, shifted our focus to consider the placement diversion programs that serve cases with serious substance abuse problems. Further discussions with the administrator and her staff took place in June 1995. Philadelphia was an interesting site for the study for three main reasons: 1) the FPS program was not a Homebuilders model like the other study sites, but instead focused on broader use of FPS including servicing intermediate risk cases and providing extended services to families; 2) Philadelphia's SCOH provided the opportunity to study differences in service intensity between the FPS and SCOH cases; and 3) the FPS program also provided a targeted look at families with drug and alcohol problems.

Support for the study was obtained in a series of meetings with DHS administrators in 1995 and 1996. The study was approved by the Philadelphia DHS Commissioner and the Pennsylvania DPW in the Spring of 1996. Many questions about implementation of the study arose in discussions with DHS middle managers. Central issues included eligibility criteria, random assignment, and case flow. These issues were resolved in meetings that occurred in the fall of 1996 and early 1997, under the leadership of the DHS FPS administrator and a FPS unit supervisor. Initial plans to obtain referrals for the study from the CRU were abandoned; instead it was determined that referrals would come directly from Intake.

The selection of programs included in the evaluation in Philadelphia was purposive. Programs that served families who were not referred through the CPS/GPS system were eliminated from consideration. The focus was on programs that specialized in cases with substance abuse problems. The study included two private agencies in Philadelphia that provided FP services, Abraxas and Tabor Children's Services, both of which also offered SCOH. A third SCOH agency, Youth Service, Inc., was included to insure that there were enough SCOH for cases that were randomly assigned to the control group. Thus, there were two FPS programs and three SCOH programs in the study. All five programs served the entire county.

Cases were enrolled in the study as follows. A DHS FPS unit supervisor reviewed all cases before they were referred for services to determine whether the case was eligible for the study. If eligible, the FP supervisor then determined whether there were openings in at least one of the FPS programs, and in one of the SCOH programs participating in the study. If openings were available, the FPS supervisor called Westat, where the case was randomly assigned by computer to either family preservation or SCOH. The case assignment was relayed immediately to the FPS supervisor over the phone. If one or both of the participating study agencies could not provide services at the time, the case was referred for SCOH in one of the agencies that was not participating in the experiment.

6.8.1 Random Assignment

Random assignment of Philadelphia cases to study groups began in March 1997. When the study began, the hope was to enroll 500 cases into the study within a one-year period. Referrals were slow during the summer of 1997, but picked up in the wake of renewed attempts to remind intake workers that FPS was an option in many cases. However, despite repeated efforts to increase the referral rates for the study, overall, rates were considerably slower than expected. The enrollment period was left open for 26 months.

A total of 362 cases were randomly assigned. Of these, 9 were determined to be inappropriate referrals and were removed from the study. ⁽⁷¹⁾ Table 6-5 shows the distribution of cases by experimental group.

The basic analysis of differences between experimental and control groups concerned those cases labeled "net study cases." Cases that were deemed to require family preservation should have been designated as exceptions. However, in a few cases the group assignment was violated, that is, the group to which a family was assigned was switched. We identified six violations throughout the study. All six cases were switched from the control group to the experimental group. No violation cases switched from the experimental to the control group.

Some cases in the experimental group were provided minimal services because of refusal by the family to participate, failure of the family to comply with initial expectations of the program, or because the provider agency turned the case back. Turnbacks occurred when family preservation services workers were unable to contact the family or the family did not meet the criteria for service (in a few such cases, children were not considered to be at risk). These cases received varying amounts of service, ranging from none to some. There were 71 of these minimal service cases in Philadelphia, 4 in the control group and 67 in the experimental group. Of the 67 experimental group cases, 10 (15%) received at least one family preservation contact. Only 2 of these 10 families received more than five contacts. The breakdown of violations and "minimal service" cases is shown in Table 6-6.

6.8.2 Challenges to Implementation

Data Collection. As in other study sites, the burden of data collection fell largely on private agency FP staff, however, even more so in Philadelphia where private workers provided services to both the experimental and control group cases. Because the study protocols were introduced to the private agencies early on in the process (in the middle of 1995), the agencies were able to incorporate some of the data collection instruments for the study into their normal data collection routines. In particular, the evaluation's contact sheet, a form which workers filled out upon each contact with a family, was adopted for use by several private agencies in Philadelphia.

Private Agencies. A site coordinator assisted in Philadelphia with data collection efforts. The site coordinator frequented the DHS and private agencies to gather information on cases. Reorganizations by two of the private agencies provided challenges to collecting information for the study. During the study period, one agency was purchased by a for-profit company and as a result key administrators and staff who were study contacts and had provided information for the study left the agency. This situation posed a significant challenge, but the site coordinator and study staff were able to maintain communication with the private agency staff and assemble information on cases as needed. Also, for a time in one agency, the same workers were reportedly serving both SCOH and FPS cases in the study.

Caseworker Assignment. By tracking cases as they moved through DHS and the private agency providers, the study documented substantial delays in the assignment of DHS caseworkers to SCOH cases and in the assignment of DHS FPS workers. This resulted in families not receiving services due to the requirement that both DHS and private worker meet with the family on the first visit. Table 6-7 illustrates the time between random assignment and assignment of a caseworker for cases over a one-year period of the study. Families to receive FPS at one agency waited an average of 6.7 weeks to receive a caseworker, and those families to receive SCOH services waited an average of 9 weeks. ⁽⁷²⁾ Since FPS was supposed to be a 12-week program, delays of 7 weeks were substantial. Prolonged time between random assignment and assignment of a caseworker resulted in challenges in data collection. Initial caretaker interviews that were intended to capture a family's situation at the start of services were delayed. Further discussion about the time between random assignment and interviews in Philadelphia is presented in Volume 2, Chapter 4 of this report.

The information presented on characteristics of children and families in Pennsylvania and Philadelphia County, on child welfare services in Philadelphia County, and on implementation of the evaluation provides a context for understanding the study data and analyses on family characteristics, services to families, and outcome comparisons presented in Volume Two.

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Endnotes

60. Information in this chapter is based on reports and documents provided by the Department of Human Services of Philadelphia County, interviews conducted with personnel at both the public and private agencies, and data resources such as the 2000 U.S. Census and the Kids Count Data Book by Annie E. Casey Foundation, 2000.

61. Kids Count Data Book, Published by Annie E. Casey Foundation, 1999.

62. Substance Abuse and Mental Health Services Administration. Substance Abuse in States and Metropolitan Areas: Model-Based Estimates from the 1991-1993 National Household Surveys on Drug Abuse. Summary Report. Washington, DC: U.S. Dept. of Health and Human Services, Public Health Service, September 1996.

63. Substance Abuse and Mental Health Services Administration. Substance Abuse in States and Metropolitan Areas: Model-Based Estimates from the 1991-1993 National Household Surveys on Drug Abuse. Summary Report. Washington, DC: U.S. Dept. of Health and Human Services, Public Health Service, September 1996.

64. Curtis, et al., 1995.

65. Prior to 1995, CPS reports were limited to physical abuse resulting in pain or dysfunction, sexual abuse, medical or physical neglect leading to "a condition," emotional or psychological abuse reported by a physician or certified school psychologist, and "established patterns of injuries."

66. Formerly, GPS cases were not legally defined; however in 1999 the state promulgated regulations on GPS cases to promote more uniform investigation of these cases.

67. CPS/GPS investigations on open cases are conducted by Family Service Region (FSR) caseworkers.

68. Delinquency cases are handled by the probation office of family court and the probation office provides service planning and supervision for these children.

69. Abraxis Foundation, 1995.

70. Sex abuse cases are rarely served through FPS because they require long-term treatment.

71. The nine inappropriate referrals include reunification cases, cases in which the children identified as at risk were out of the home, one case that was already receiving services, and cases from units that were not participating in the study.

72. Caseworker assignment to cases was only tracked through 15 weeks from random assignment.

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