The complementary research activities comprising this study yielded mixed findings regarding the service needs and well-being of children in TANF child-only cases with relative caregivers. The comprehensive literature review identified limited information specific to this population, although it did suggest that children in child-only cases with relative caregivers had often been exposed to traumatic experiences leading up to placement with a relative. Research on children in general relative care also suggests children placed in relative care have increased risk of medical, behavioral and educational problems. At the same time, literature specific to child-only cases with relative caregivers suggested that relative caregiver living arrangements often provided more stable financial situations than their standard TANF family counterparts.
Differing somewhat from the findings in the literature review, secondary analyses conducted as part of this study suggested that children in TANF child-only cases with relative caregivers compare favorably on many indicators of well-being to other children supported by TANF and other children in out-of-home care. However there were indicators of specific concern regarding mental health, trauma and educational problems.
Finally, case studies in five diverse states concur with the previous literature and the indicators identified in the secondary data analysis finding that many children in TANF child-only cases with relative caregivers have extensive material and service needs, to which TANF agencies are not equipped to respond. In particular, case studies revealed a lack of assessment and case management for children in TANF child-only cases with relative caregivers, and little collaboration between TANF and child welfare agencies.
Taken together, these findings suggest advantages of relative caregiver arrangements for children in TANF child-only cases, as well as cause for concern. Children who enter relative care do so as a result of serious disruption in their parents' ability to care for them. Under such circumstances, relative care is believed to be preferable to either parental care or foster care with nonrelatives. However, these children often experience substantial difficulties as a result of the previous experiences and separation from parents, and the TANF system lacks the necessary resources to respond to them. Key findings from this study stress these dual themes of protection and risk.
Many children enter informal kinship care as a result of circumstances that could justify child welfare involvement. Previous research shows that many children enter relative care as a result of maltreatment, substance abuse or mental illness of their parents, which may or may not have attracted attention from child welfare agencies. The substantial number of children in kinship care within NSCAW's sample of children investigated for abuse or neglect supports this contention. Service providers and relative caregivers in all five case study sites agree that children enter relative care due to serious disruptions in parenting, leading to serious risk or actual maltreatment.
Because children outside the child welfare system do not receive comprehensive assessments, it is impossible to estimate how many have experienced maltreatment that would have warranted child welfare involvement had it been recognized by authorities. Nor is it known how frequently the availability of kinship care averted abuse or neglect.
Relative care is considered preferable to other forms of out-of-home care, but often entails substantial sacrifice on the part of the caregiver. The Adoption and Safe Families Act requires child welfare agencies to give preference to relative placements when possible, based on extensive research indicating that children fare better with relative caregivers. NSCAW data suggest that children in TANF child-only cases with relative caregivers are more likely to receive preventive health care than children in foster care, and have favorable status with respect to developmental indicators and mental health. Relative caregivers in case study sites describe a fierce devotion to the children for whom they care, although many struggle to meet the physical, emotional and financial demands of child-rearing.
While acknowledging the benefits of relative care, state policies frequently assume that relatives will care for children with less financial support than is given to nonkin foster care providers. States vary widely on the extent to which relative caregivers become licensed foster parents, eligible for foster care stipends. Unlicensed relative foster parents, like relative caregivers outside of the child welfare system, must manage the care of a child with very limited financial assistance.
Many children in TANF child-only cases with relative caregivers have extensive unmet needs. Previous research has established that many children in TANF child-only cases with relative caregivers have physical, emotional, developmental, and educational needs at a rate far higher than children living with their parents. In addition to effects of separation from their parents, they experience long-term problems related to the experiences that precipitated relative care. Although secondary analysis of SIPP and NSCAW found that children in TANF child-only relative care were frequently in more favorable circumstances than those in other TANF households with respect to economic indicators and health care use, they demonstrated higher rates of mental health problems, trauma, and educational difficulties. Case study informants from both TANF and child welfare agencies, as well as relative caregivers participating in focus groups, echoed these findings, describing a high prevalence of complex needs among children in relative care. Many relative caregivers have neither the personal nor financial resources necessary to respond to these needs.
TANF agency representatives pointed out that children in TANF child-only cases with relative caregivers were likely better off in their current situation than they had been with their parents. While this may be true, NSCAW data and case study data suggests that they have needs comparable to those of children in foster care, and many of these needs will not be met.
Children in TANF child-only cases with relative caregivers fall between the mandates of the child welfare and TANF systems. The TANF child-only grant provides basic financial support to children cared for by relatives not legally responsible for them. However, TANF agencies, with their primary focus on self-sufficiency and employment readiness, typically offer neither assessments nor services appropriate to these children's needs. High caseloads and lack of expertise in children's issues limit the ability of TANF workers to respond to the complex needs of children in TANF child-only cases with relative caregivers.
The child welfare system, by contrast, is oriented to child well-being and service provision, but its resources may not be available to children in TANF child-only cases with relative caregivers. While relative care has removed these children from actual or imminent harm, it also effectively removes them from the child welfare system's mandate. Children who might have been entitled to the child welfare system's services had they been known to that agency are thus substantially underserved. In addition, fear of the child welfare system's authority makes many relative caregivers reluctant to seek out services for which children could qualify. These children, and their caregivers, forfeit access to a range of resources, including additional financial support, child-focused assessments and services, case management, and permanency planning.
Further research could guide effective services for this vulnerable population. Enhanced services to this readily accessible population could yield substantial impact. Their connection to the TANF system provides an opportunity - for the most part, unrealized - to identify vulnerable children, provide services in a manner that does not threaten family bonds, and prevent entry to the child welfare system. However, currently available data is not sufficient to assess the needs and well-being of children in TANF child-only cases with relative caregivers, nor to understand their interactions with service systems that might provide opportunities for service provision.
The variation in state policies and programs, particularly with respect to the interaction of TANF and child welfare systems, suggest that future research must be state-specific, although findings will be applicable across similar systems. Three types of information are needed:
Mapping the overlap between TANF and child welfare. While states report the number of foster care placements in relative care, and TANF agencies report the number of children in TANF child-only cases with relative caregivers, data on the overlap between these two populations is sparse. In particular, TANF agency informants in case study sites had difficulty estimating the proportion of TANF child-only relative caregiver cases involved with the child welfare system. Studies in states where administrative data systems allow matching of child welfare and TANF records would provide useful information about system involvement over time, financing, access to services and gaps in service delivery among children in TANF child-only cases with relative caregivers.
Assessing the needs of both children and relative caregivers. Data on children's physical, emotional, behavioral, mental health and educational needs could clarify relationships between case characteristics and risks to children's well-being. Data on relative caregiver resources and needs could help identify potential threats to children's safety and caregivers' ability to provide the long-term care that is frequently needed. This information could help identify children and caregivers at increased risk and prioritize services. Case records and required recertification contacts could offer opportunities for economical sampling and data collection.
Evaluating existing initiatives to serve children and relative caregivers. A variety of promising practices are developing, both within TANF agencies and as a result of collaborative efforts with child welfare agencies and aging services agencies. Strategies include case management, alternative service delivery approaches, enhanced financial support, and information and support for relative caregivers. However, data on the effects of these interventions is scarce. Rigorous evaluations addressing the impact of innovative programs on service access, utilization and costs; child and caregiver well-being; and diversion from child welfare and adult TANF involvement could guide future efforts to respond to this population.