Negotiations began during the initial site visits. Discussions with staff focused on obtaining information on the state program and system while providing information to the state about the study. Site visitors needed to determine, as quickly as possible, if states were not interested in participating. Also, we had to establish site flexibility in working within the study guidelines and adhering to rigorous data collection methods early in the negotiation process. Negotiations always began at the state level to obtain permission from the child welfare commissioner or director. Although negotiations were tailored to individual sites, we followed general procedures which entailed numerous meetings with state and local personnel, written permission from the state director of child welfare services, and an agreed-upon detailed work plan delineating target populations, random assignment procedures, data collection plans, and targeting procedures. It was critical to go through a process with state and local agency personnel in which we explored their receptiveness to an experiment, including some alteration in referral procedures and a willingness to fill out our forms and partake in interviews. The most difficult process was working through workers’ concerns about withholding services from the control group. Extensive discussions were held about denying services to clients and having a computer make decisions about families’ lives. Although many caseworkers never felt totally comfortable with the idea of randomly assigning families to receive either family preservation services or other services, they eventually became resigned to the procedure. Many did come to accept that the experiment was set up to provide services to the same number of families served by family preservation prior to the study and understood that their present systems did not serve all families eligible for family preservation. It was more difficult for them to accept that particular families on their caseloads could not receive a service which they believed to be the best alternative for the families.
Targeting. A major problem that has plagued family preservation programs and their evaluations is targeting. To prevent placements effectively, these programs have been intended for cases in which there is an “imminent risk of placement.” Previous studies have indicated that family preservation services are often delivered to families in which placement is not likely. A goal of this evaluation was to address the targeting problem in at least some of the placement prevention programs to be studied so that the programs would have the best possible chance of success on the outcome measure of preventing foster care placement. We selected sites that realized that targeting was an issue and that were interested in developing strategies to improve targeting. We believed that targeting could be improved through removing from the referral pool some of the cases that would not experience placement in the absence of family preservation services or through diverting to the family preservation referral pool some cases that were placed. This might be called screening out the cases that are not at imminent risk of placement and screening in the cases that are going to be placed but can be safely maintained at home. To aid in this process the study team developed a screening tool for local agency personnel responsible for referring cases for family preservation services. The tool provides personnel the opportunity to review their decisions by using a risk index based on factual items such as previous substantiated complaints, more than one maltreated child, previous foster care placements, and the presence of substance abuse. The instrument yields a score, the midrange values of which were thought to suggest referral to funding preservation. A copy of the protocol is in Appendix B. A further discussion on the use of this screening protocol in Kentucky and New Jersey is included in each individual site report in Chapters 3 and 4.
Implementation plans for each site built upon already existing procedures. A written work plan was worked out with each site. A brief description of the plans for each site is presented below.
Kentucky has a statewide program using the Homebuilders model. A statewide coordinator is responsible for developing uniform selection criteria, training of and contracting with providers, and overseeing the program. The study was conducted in Louisville, where there is a single family preservation program provider, and child abuse and neglect cases are referred from intake or ongoing workers2. There was no age limitation on the children included in the experiment. Because family preservation does not serve drug abuse cases unless the caretaker is in treatment, or sexual abuse cases in which the perpetrator is in the home, these cases were excluded from the experiment. Referral to family preservation begins with worker and supervisor approval. A screener reviews all cases referred for family preservation to determine appropriateness of the referral. Based on this process, we asked the screener to use the screening protocol developed for the study. The protocol aided the screener in reviewing the risk level of each case. In addition, all cases for which a court petition was filed were reviewed to determine whether they meet family preservation criteria. If they did, they were referred to the screener who decided whether to refer the case for family preservation services. We conducted this review to identify cases that might be diverted from potential placement. A full-time site coordinator in the Louisville office assisted the screener and workers with survey tasks.
New Jersey has a statewide program using the Homebuilders model. As in Kentucky, a state office coordinator is responsible for uniform selection criteria, training of and contracting with providers, and overseeing the program. The study was conducted in seven counties: Bergen, Burlington, Camden, Essex, Monmouth, Ocean, and Passaic. The study population included Division of Youth and Family Service child abuse and neglect and family problem cases referred from intake or ongoing workers. The state had been trying to refocus delivery of family preservation services to families with younger children. Not all counties made this change, so all children under 18 were included in the experiment. Each of the counties has a screener who reviews referrals to make sure necessary information is provided. The screener continued in this role during the experiment. In addition, we asked workers and their supervisors to apply the study screening protocol to all cases being referred to family preservation to review their referral decisions. In some counties, the screening protocol was also used on cases being referred for foster care placement Two site coordinators were assigned to help screeners and workers across the seven counties.
Tennessee. During the study period, Tennessee had a statewide program using the Homebuilders model. As with the other study sites, a state coordinator was responsible for developing uniform selection criteria, training and contracting with providers, and overseeing the program. The study was conducted in Shelby County. There was only one HomeBuilders agency in the county. However, Shelby County is a service rich county in which there were a number of other service options similar to HomeBuilders available to families in the control group. The study population included Division of Children Services child abuse and neglect cases referred from intake workers. Only families in which at least one of the referred children was under 13 were accepted into the study.
Prior to the study, caseworkers referred families directly to the Homebuilders program. For the study, two hotline workers served as study screeners. Referral to family preservation began with worker and supervisor approval. The worker then called the designated screener to find out if there was an opening in family preservation. If an opening was available, the screener would contact Westat to obtain a random assignment. A full-time site coordinator in the Shelby office assisted the screener and workers with data collection.