Evaluation of Family Preservation and Reunification Programs: Final Report - Volume One. 7.5 Summary

12/01/2002

In all three states, most of the respondents to the first interview were women and birth mothers of the youngest child in the home. In Kentucky and New Jersey, a little over two-fifths of the respondents were African American, while in Tennessee, 83 percent were African American. In Kentucky, slightly more than half were Caucasian, compared to a little under half in New Jersey and only 15 percent in Tennessee. About half of the respondents in all three states had not graduated from high school. Half of the households in Tennessee were headed by a single birth mother, compared to 43 percent in Kentucky, and 34 percent in New Jersey. The average age of the respondents in Kentucky and Tennessee was about 32, while New Jersey respondents were older, an average of 39. Similar differences held for age of youngest child: an average of 4.0 in Tennessee, 4.6 in Kentucky, and 7.1 in New Jersey. The average number of children in the home was around 3 for all three states.

Approximately half of the respondents in Kentucky and New Jersey answered affirmatively to each of three questions about emotional difficulties: "feeling blue or depressed," "feeling nervous or tense," and "feeling overwhelmed with work or family responsibilities." In Tennessee, rates of reporting these difficulties were a little higher. Half or more of the respondents in all three states indicated that they did not have enough money for food, rent or clothing. Few respondents reported problems with drugs or alcohol. A third or two-fifths reported that they had been abused or neglected or both as a child.

About two-thirds of the respondents in New Jersey and Tennessee reported they participated in at least one of five income support programs: AFDC, food stamps, WIC, social security disability, and housing vouchers. In Kentucky, over 80 percent participated in one of these programs. In all three states, the rate of participation was less than 10 percent for each of the following programs: alcoholism treatment, drug treatment, marriage counseling, and job training. A third or two-fifths of the respondents indicated participation in Head Start or another pre-school program.

In Kentucky and New Jersey, about a fifth of the families had children who had previously been in a foster care placement. In Tennessee, only four families had children who had previously been placed.

The Target Group for Family Preservation Services. The families referred to family preservation services in Kentucky, New Jersey, and Tennessee had a variety of problems with a range of severity. Beyond that, they were a diverse group, varying in such things as family composition, ages of children, previous involvement in the child welfare system, and whether they were a foster care case at the time of referral to family preservation services. The question can be raised as to whether a single model can be expected to be appropriate across such a diverse caseload. Can one expect one approach to work as well with older as well as young children, with cases of abuse as well as chronic neglect and dependency, with cases new to the system as well as those with extensive prior involvement?

We may also inquire as to the extent to which the families served in these states are the families for which family preservation services are intended as outlined in the introduction to the chapter. There are two central elements usually found in specifications of the target group for family preservation: imminent risk of placement and the presence of crisis. The paradigmatic case is one in which an allegation of abuse or neglect has recently been made and the case is referred in the course of investigation of that harm. It is evident that many cases are not in this category, particularly in Kentucky and New Jersey. Some are dependency or parent-adolescent conflict cases. Many do not come from the investigative phase of a case but rather from "on-going" workers. Many do not appear to be in immediate crisis, as suggested by the fact that many cases were referred long after the latest reports of maltreatment and after the most recent case opening. Cases in Tennessee more often conformed to this model, although there were a number that did not.

It is true that family preservation services are often advocated in cases other than abuse and neglect (in fact, Homebuilders began in the context of adolescent mental health problems). Furthermore, the specifications of eligible cases, reviewed at the beginning of this chapter, suggest a fairly wide net, including cases referred from on-going workers. Behavioral Sciences Institute's own criteria for referral contain one item that seems to contradict the criterion of crisis: the requirement that other services have been tried and failed. Adhering to this requirement would tend to put off referral to family preservation beyond the time of immediate crisis.

Beyond ambiguities in the target group suggested by state policy and by Behavioral Sciences Institute, there are the observations of referring workers that they sometimes, even often, made referrals that did not meet the imminent risk criterion. Although a family might not have a child at risk of placement, they believed the family would benefit from the service, so found a way to refer it. The data presented in this chapter suggest that the imminent risk and crisis criteria were often not met. It appears that the target group for family preservation has been expanded beyond that originally intended, perhaps first by state policy and certainly by practice in the field. Such expansion of the target group is no doubt quite common for social programs. It is natural to attempt to provide a valued service, viewed as beneficial, to more and more cases.

But there is a reason for relatively narrow, carefully defined, target groups. Specification of the target group is closely intertwined with specification of the goals of a program (in family preservation programs, cases of imminent risk of placement are the target group for a service intended to prevent placement). Clarity of target group allows clarity of goals. Once the target group becomes broadened, there is the risk that goals will become muddied. Two problems may ensue: the service being provided may lose structure, definition, and focus; and it becomes more difficult to achieve demonstrable effects of the service.

So the group of families served by family preservation services in these states reveal a central tension: the urge to serve a wide range of families as against the desirability of maintaining program focus on well-defined groups. We have no ready solution to this conundrum, which may be inherent in large scale program implementation. We hasten to note that although we focus here on these three states, it is possible that most, if not all, states implementing family preservation programs face very similar issues.

Close of Volume One

As described earlier, this report is divided into three volumes. Volume One provided a description of the study implementation , description of each of the study sites, and a description of the families in the Homebuilders model sites. These chapters serve as the context for the analyses provided in Volume Two.

Volume Two provides an executive summary of the study, a study introduction/overview, an examination of services for the Homebuilders sites, outcome analysis for the Homebuilders sites, a description and analysis on the Philadelphia family preservation program, attrition analysis for the study, examination of family social support, investigating worker questionnaire analysis, staff questionnaire analysis, and study conclusions. All appendices referenced in both volumes can be found in Volume Three.

Endnotes

73. Behavioral Sciences Institute, "Key elements of an appropriate referral," Behavioral Sciences Institute, Federal Way, Washington, 1992.

74. As discussed in Chapter 4 the remaining two levels of eligibility focus on reunifying children with their families after they have already been in placement less than 90 days or are about to return home within the next two weeks.

75. "s.d." = standard deviation.

76. When married, divorced, and separated categories are collapsed and compared to never married, a larger percentage of respondents in the experimental group were never married, 40 percent vs. 28 percent, p = .04 (8 widowed respondents and 1 not ascertained respondent are not included in these collapsed analyses).

77. When the 2 unemployed categories are collapsed and compared to the employed category, a larger percentage of respondents in the control group were employed at the time of the first interview, 43 percent vs. 33 percent, p = .12.

78.Though not a statistically significant difference, the average age of the oldest child was greater for control group families than for experimental group families, 10.31 years vs. 9.42 years, p = .13.

79. More of the experimental group respondents indicated difficulty buying clothes for their children, 35 percent vs. 27 percent, p = .16.

80. Experimental group caretakers were more likely to answer that a child or children they care for went through alcohol or drug withdrawal when born.

81. The state of Kentucky reports five possible outcomes for reports of maltreatment; (1) substantiated, (2) found/substantiated, (3) some indication, (4) unsubstantiated and (5) unable to locate. Substantiated and found/substantiated were collapsed to form a "substantiated" category.

82. Our analyses did not include children in placement at the time of random assignment.

83. Placement spells are defined as any consecutive period of time in substitute care and may consist of several distinct placements (i.e., several different foster homes).

84.The question on the interview was worded in terms of "social security disability." We intended this to refer to Supplemental Security Income.

85. The average number of income support programs used was slightly higher for the experimental group than for the control group, 2.21 vs. 1.98, p = .13.

86. Fifteen percent of control group respondents and 17 percent of experimental group respondents reported an income less than $5,000; 32 percnet control and 22 percent experimental reported between $5,000 and $10,000; 15 percent control and 31 percent experimental reported between $10,000 and $20,000; 24 percent control and 18 percent experimental reported between $20,000 and $40,000, and 14 percent control and 12 percent experimental reported an income of $40,000 or more.

87. Control group respondents more often lived with a spouse or partner, 43 percent vs. 35 percent, p = .13.

88. In the New Jersey administrative data, there are seven possible outcomes of investigations of maltreatment: abuse/neglect/injury confirmed perpetrator, abuse/neglect/injury unconfirmed perpetrator, abuse/neglect/injury perpetrator unknown, unsubstantiated incident, unsubstantiated incident with concern, incident never occurred, and no outcome. The data above concern only persons who were children at the time of random assignment. The administrative data also record information on previous allegations involving persons who are now adults. Seventy-four adults (persons 18 or over at the time of random assignment) from 51 families had been the subjects of previous substantiated reports of maltreatment.

89. By a "spell" we mean a period of time in placement, which may consist of one or more distinct placements in different foster homes or in other settings.

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