Evaluation of Family Preservation and Reunification Programs: Final Report - Volume Two. 2.5 Caseworkers' Reports of Services

09/01/2002

In the second interview, caseworkers were asked whether they had made referrals to any of 25 services, such as childcare, homemaker services, income programs, treatment programs of various sorts, and health care. Results from these 25 items are shown in Table 2-5.

Table 2-4
Caretakers' Reports on Relationship with Caseworker, Post-Treatment Interview
  Kentucky New Jersey Tennessee
C E p C E p C E p
% % % % % %
Worker listened to your concerns most of the time 71 87 0.001 56 78 0.001 71 91 0.02
Worker understood your situation very well 75 90 0.002 62 79 0.001 64 81 0.09
You and worker agreed on goals most of the time 66 76 0.06 40 72 0.001 38 58 0.09
Did worker sometimes talk with you about issues that were not easy to talk about? 27 34   29 44 0.01 22 51 0.003
Caseworker helped you to see your good qualities 67 79 0.03 47 70 0.001 53 82 0.001
Caseworker helped you to see your problems 66 76 0.1 52 72 0.001 50 82 0.001
Did you see your caseworker     0.09     0.003      
More often than you wanted 9 18   12 14   19 27  
As often as you wanted 70 62   43 59   44 48  
Not often enough 21 20   45 27   36 25  
Note: C = Control Group, E = Experimental Group
Table 2-5
Caseworkers' Report of Services Provided to Family, Post-treatment Interview
  Kentucky New Jersey Tennessee
C E p C E p C E p
% % % % % %
Childcare or baby sitting 8.7 8.5   9.3 7.7   2.1 8.9  
AFDC or other public income (except SSI) 4.3 4.8   4.3 4   4.2 5.6  
SSI for adult or child 1.9 0.6   1.2 0.7   2.1 0  
Food stamps 2.5 6.1   4.3 3.3   4.2 6.7  
Drug treatment 3.8 4.2   11 5.5 0.05 0 10 0.03
Alcoholism treatment 3.8 2.4   8 5.5   0 6.7 0.09
Legal aid 3.7 7.9   1.8 4.8 0.08 0 5.6  
Help with education 13 22 0.03 14 26 0.001 4.2 15.6 0.05
Respite care 5 6.1   5.5 5.5   4.2 4.4  
Parent training 29 67 0.001 28 67 0.0001 31 68 0.001
Health care 12 22 0.02 15 18   8.3 22 0.04
Inpatient mental health 4.3 2.4   2.5 5.1 0.14 2.1 0  
Outpatient mental health/counseling 39 36   25 37 0.01 17 20  
Health assessment 13 24 0.01 17 21   13 13  
Housing financial assistance 3.7 12 0.005 5.5 4.8   0 5.6  
Other housing services 1.2 10 0.01 1.9 3.7   0 5.6  
W.I.C. 1.9 2.4   3.1 2.6   2.1 3.3  
Emergency financial assistance other than housing 5.6 33 0.001 18 22   6.3 23 0.01
Job training 0.6 1.8   1.2 2.2   0 5.6  
Emergency shelter 3.7 1.8   6.2 1.5 0.02 2.1 2.2  
Recreational services 7.5 24 0.001 11 23 0.001 4.2 21 0.008
Family planning 9.9 15   11 20 0.009 8.3 10  
Self help groups 10 3.6 0.02 4.3 8.8 0.056 2.1 8.9  
Household management 10 32 0.01 12 28 0.0001 17 29  
Homemaker services 3.7 13 0.003 6.8 1.5 0.01 8.3 3.3  
Other 9.3 16 0.08 15 16   17 14  
N 161 165   162 272   48 90  
Note: C = Control Group, E = Experimental Group

Kentucky. Caseworkers for the experimental group reported that their clients were provided with an average of 3.7 of these services, while caseworkers from the control group reported their clients were provided with an average of 2.1 of these services (p = .0001). (16) In the primary analyses, 10 specific services were provided significantly more often to the experimental group than to the control group (significance levels were all at p = .05 or less). These services include help with education, parent training, recreation services, health care, health assessment, housing financial assistance, other housing assistance, emergency financial assistance, household management, and homemaker services. A greater proportion of caseworkers from the experimental group selected the unspecified category of "other" services provided (p = .08). One service, self help groups, was provided significantly more often to the control group than the experimental group (p = .02). (17)

New Jersey. Experimental group caseworkers reported that on average their clients were provided 3.5 of these services, while control group families were provided 2.4, a difference significant at .0001. (18) When individual services are examined, there were six services that were provided significantly more often to the experimental group (education services, parent training, outpatient mental health, recreational services, family planning, and household management). Three services were provided significantly more often to the control group: drug treatment, emergency shelter, and homemakers. (19)

Tennessee. Experimental group caseworkers reported providing an average of 3.2 services, compared with 1.6 for the control group, significantly different at .0002. (20) Six individual services were significantly more often provided to experimental group families (drug treatment, help with education, parent training, health care, emergency financial assistance, and recreational services). (21) No services were significantly more often provided to the control group.

Workers serving clients in both the experimental and control groups were asked to complete a one-page contact report following each in-person contact with a family member (see Appendix K, Volume 3). The report was a simple check-off form, asking about who was present in the visit and about the content of the conversation. Although these forms were quite simple and easy to fill out, it proved difficult to get workers to complete them. We implored workers who did not fill out these forms to do so, and we have at least one on a fair proportion of the cases. However, it is likely that for at least some cases on which we have forms that we do not have them for all of the contacts. We are unable to determine how many contacts occurred for which we have no forms. Furthermore, the quality of information may be affected by the fact that some of the forms were submitted after many calls from our office and after long delay. The following analyses were limited to those families with contact reports. Only "primary" analyses are reported for contact reports.

Some data on contact forms are presented in Table 2-6. Forms were received on between 71 percent and 91 percent of the experimental groups and between 51 percent and 71 percent of the control groups. It should be noted that the lower rate for control group cases is partially due to the fact that there was no contact in the four weeks after the date of random assignment, the period of time for which we requested contact forms for the control group (a period comparable to the 4 week period of services for the experimental group). On average, more contact forms were submitted for the experimental group than for the control group. In addition to the overall number of reports submitted, in all three states the experimental group received significantly more home visits, visits with caretakers, visits with the other parent, and visits with children. The experimental group workers were more likely to involve other adults in the family, non-family members, and other workers. As experimental group families received significantly more contacts than the control group families, they also received significantly more individual activities. For both experimental and control families, in all three states the most common concrete service was the provision of transportation. Purchasing food, child care, and providing clothing, furnishings, and supplies were also common forms of concrete services.

Table 2-6
Contact Forms
  Kentucky New Jersey Tennessee
C
%
E
%
p C
%
E
%
p C
%
E
%
p
Number of cases with at least one form submitted 111
(63%)
124
(71%)
  119
(71%)
250
(91%)
  25
(51%)
73
(74%)
 
Average number of forms per case 3.1 13.8 .001 4.4 12.4 .001 2.5 9.5 .001
Average number of home visits 1.9 10.3 .001 3.6 10.8 .001 2.0 8.0 .001
Average number of visits with caretakers 2.4 12.8 .001 3.8 10.3 .001 2.2 8.2 .001
Average number of visits with the other parent 0.4 2.2 .001 0.6 1.9 .001 0.2 1.7 .01
Average number of visits with children 2.1 10.3 .001 3.6 9.4 .001 1.9 7.2 .001
Concrete Services
Transportation 0.5 3.5 .001 0.9 2.3 .001 0.2 1.9 .001
Buying food 0.1 1.0 .001 0.4 0.8 .003 0.0 0.5 .01
Child care 0.3 0.4   0.2 1.0 .001 .04 .21 .03
Clothing, furnishings, and supplies 0.2 0.9 .001 0.2 0.6 .01 0.0 0.3 .01
Topics of Discussion
Discipline of children 1.5 7.1 .001 2.2 6.0 .001 1.4 4.7 .001
Goals 1.8 6.0 .001 2.1 6.6 .001 1.8 4.2 .001
Caretaker's interaction with children 1.5 6.0 .001 2.2 5.7 .001 1.7 4.8 .001
Child's anger management 1.1 3.9 .001 1.6 4.8 .001 0.8 1.5 .06
Supervision of children 1.1 4.0 .001 1.4 2.9 .001 1.6 2.9 .001
Note: C = Control Group, E = Experimental Group

The contact forms contained additional concrete services and topics of discussion (see Appendix K, Volume 3). Only those that were most often reported are shown here. Entries are average numbers of times per family that an item was reported, for those families with at least one form submitted.

Contact forms also captured general information about the topic of discussion, counseling, or instruction. In all three states, for both experimental and control families, the most common topics of discussion were the discipline of children, goals, and the caretaker's interaction with the children. Other common topics were the child's anger management and supervision of children.

Experimental Group Contacts. We examined further the contact forms for the experimental group to explore some issues in the adherence of programs to the Homebuilders model of service, subscribed to in all three states (see Table 2-7). In addition to other critical elements of family preservation, the Homebuilders model specifies that workers should provide an in-home contact within 72 hours of referral, and family preservation workers should be available seven days per week. Substantial contact should take place within the first week; Kinney, Haapala, and Booth suggest that the typical case receive 11 hours of service in that time. (22) Concrete services are also an important component of service, particularly early in the case.

In Kentucky, of the 124 experimental families with submitted contact forms, 55 (44%) received an in-home contact within 72 hours, 97 (78%) had contact in the first week. Those 97 families had an average of 5.1 hours of face-to-face contact in the first week. Regarding availability of worker, 18 (1%) of contacts occurred on either Saturday or Sunday. Finally, 34 (27%) of the experimental families received some type of concrete service within the first seven days.

Table 2-7
Experimental Group Contacts
  Kentucky New Jersey Tennessee
N % N % N %
Number of families with contact data 124   250   73  
Total number of contact forms submitted 1713   308   690  
Contacts in week 1 280 16 753 24 169 25
Contacts in week 2 353 21 667 22 142 21
Contacts in week 3 322 19 601 19 133 19
Contacts in week 4 322 19 515 17 111 16
In-home contact within 72 hours 55 44 183 73 42 57
In-home contact with 7 days 97 78 219 88 53 73
Concrete service within 7 days 34 27 95 38 21 29

In New Jersey, of the 250 experimental families with submitted contact forms, 73 percent received an in-home contact within 72 hours, 219 (88%) in the first week, and those families had an average of 6.5 hours of face-to-face contact in the first week. Regarding availability of the worker, only 196 (6%) of submitted contacts occurred on Saturday or Sunday. Finally, 38 percent of the experimental families received some type of concrete service within the first seven days.

In Tennessee, of the 73 experimental families with submitted contact forms, 42 (57%) received an in-home contact within 72 hours, 53 (73%) had contact in the first week. We are able to calculate hours of contact for 45 of these 53 cases and these cases had an average of 8.3 hours of face-to-face contact in the first week. Regarding the availability of the worker, 60 (9%) contacts occurred on either Saturday or Sunday. Finally, 21 (29%) of the experimental families received some type of concrete service within the first seven days.

These data seem to indicate that some "structural" aspects of the Homebuilders model (contact within 72 hours of referral, amount of contact in the first week, services provided at all hours, including weekends, and concrete services early in the case) are not always upheld in these states. However, it is not possible to draw firm conclusions about this, because of issues in the quality of the contact form data discussed earlier.

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