Before describing the family characteristics, services provided, and outcomes of the study, we review the state policies and practices that guided the types of families referred for family preservation services.
In all three study states there were policies specifying the types of families eligible for family preservation services. These criteria emphasized the imminent risk of placing children in foster care if the services were not provided. All three states used the Homebuilders family preservation model and reported they followed the guidelines set forth by the Behavioral Sciences Institute (BSI), where Homebuilders began. (73) According to BSI, the family characteristics that are key to an appropriate referral are:
- Child is at imminent risk of placement. Placement has already been initiated or will be initiated at once without family preservation services;
- The family is in severe crisis;
- One parent is willing to meet with the family preservation worker at least once;
- There are some family strengths, resources, or social supports available that can be utilized to increase safety;
- There are no options for long-term placement with relatives;
- The family has been told that placement is imminent; and
- Other services have been tried and failed, or other less intense services would not be sufficient to resolve the problems that will cause placement.
Kentucky law defines FPS as "a short-term intensive, crisis-intervention resource intended to prevent the unnecessary placement of children at imminent risk of placement." Kentucky policy specifies that imminent risk includes children who are at risk of commitment as dependent, abused, or neglected; who are identified through the Regional Interagency Council as severely emotionally disturbed; or whose families are in conflict such that they are unable to exercise reasonable control of the child.
In New Jersey, family preservation is considered to be a "gatekeeper" to prevent out-of-home care for a child. According to state legislation, family preservation services are targeted at families with substantiated abuse or neglect, with the children at risk of harm from maltreatment. The state defines three levels of eligibility for targeting purposes. Only the first level applies to families with children at risk of foster care placement. It includes families with at least one child at imminent risk of placement, unless changes in family coping or behavior patterns are made, placement will occur. Cases in which there is one child in temporary placement less than thirty days are also eligible. The referring worker must base the assessment of imminent risk on a face-to-face interview with the family no more than five days prior to the referral. (74) Although the term "imminent risk" is used as the litmus test for referring families, definitions of this term are left to the counties and ultimately the individual caseworker and his or her supervisor.
In Tennessee, criteria outlined in policy are also based on the criteria established by the Behavioral Sciences Institute. CPS intake workers complete a risk assessment form to identify high, intermediate, low, or no risk situations. High-risk cases are identified as cases where "the child or children in the home are at imminent risk of serious harm if there is no intervention in the situation." A typical high-risk case might involve such factors as: 1) a vulnerable child; 2) a history of previous maltreatment; 3) a perpetrator who has continued access to the child; and 4) no available support or family strengths to offset the risks.
In Kentucky and New Jersey workers were being encouraged to focus family preservation referrals on younger children. Although not a written policy, managers were emphatic that families with younger children should be a priority for family preservation referral. Conversations with workers revealed that this was not necessarily being adhered to. In addition, when workers were queried about the types of families they actually referred to family preservation their responses varied.
Divergence of Practice from Policy. As expected, policy and practice were not always synchronized. In New Jersey, county practices on referral varied. Workers interviewed in the seven study counties presented several alternatives. In most counties the workers indicated they mainly referred ongoing cases, cases in which they had worked with families for an extended period of time. Workers had to demonstrate that they offered many alternative services and workers said that they used family preservation because it was the only service option left to offer a long-term case. Workers also indicated that they considered family preservation services most appropriate for family problem cases, rather than child abuse and neglect cases, especially those with adolescent issues.
In Kentucky, criteria outlined in policy mirror the criteria established by BSI. However, in practice workers said they referred cases that they felt really needed services, and were not necessarily facing imminent placement. Workers who referred cases from ongoing units as opposed to intake and investigation units said that ongoing referrals did not involve a specific incident of maltreatment. Instead, referrals of ongoing cases were more likely to involve chronic problems that were getting worse. When asked specifically about the types of cases referred for family preservation services, some workers identified:
- Low functioning parents with no parenting skills;
- Young mothers who are overwhelmed and need help getting supportive services;
- Dirty house cases, something very concrete that family preservation services could work on and see improvement in;
- Domestic violence cases; and
- Psychiatric cases where a parent might be schizophrenic and would not take medication.
When queried, supervisors stressed that referrals are made based on families in crisis who have an immediate need because of risk of placement.
Investigative workers in Tennessee reported that HomeTies was used as their first resort for families at imminent risk of removal because program staff could be in the home monitoring and assessing families. Ongoing workers reported that they used HomeTies as a last resort, after they had tried less intensive services because of the intensity of the intervention and the availability of concrete resources (flexible funding, transportation) that could be used. Department of Children's Services workers also said that the best candidates for HomeTies were families who needed assistance with communication skills and anger management.
Both Kentucky and New Jersey policies excluded families in which there was a substance abuse problem and a current plan for treatment was not being pursued. Kentucky excluded families in which there was sexual abuse and the perpetrator was still in the home.
We turn now to a description of the families in the evaluation. Descriptive information about the families was gathered from the initial interviews with caretakers. Those interviews included information on the family's involvement with social programs prior to referral to family preservation. Questions on family problems and social program participation were also asked in the post-treatment and follow-up interviews. Data from those interviews are presented in Volume Two of the report. In addition, administrative data were used to describe prior involvement of families with the child welfare system. Because families were randomly assigned, we would expect the families in the experimental and control groups to be similar at the time of random assignment, and for that reason, the sample is described as a whole. However, by chance it is expected that the groups would differ in statistically significant ways on a few variables. We identify below those characteristics on which the groups differed significantly.