In 1993, the New York State Department of Social Services (DSS) and the New York City Child Welfare Administration (CWA) began testing a new approach to the financing of services to foster children and their birth families based on concepts from managed care. Before this initiative, private child welfare agencies providing foster care services were reimbursed by the state for each day a child was in foster care. Under the new approach, agencies were promised a flat amount for a 3-year period which was intended to cover the costs of providing services for an identified group of children. It was hypothesized that the change in the payment system would achieve earlier permanency for children through service continuity, intensified discharge planning, and aftercare services. The initiative involved six agencies. An experimental design was implemented involving comparison groups in five of the agencies, with random assignment in three. The new financing mechanism was to be used in the experimental groups while services to the comparison group would be paid for under the old system. Funds could be used for foster care costs and any other services the agencies believed would achieve earlier permanency.
The original intent in the initiative was to collect follow-up data from workers and perhaps families and to analyze administrative data on these families to compare the foster care experiences of children and costs in the experimental and comparison groups. However, resource limitations prevented the collection of follow-up data from workers and families and also limited the analyses of administrative data. The Evaluation of Family Preservation and Reunification Services has supplemented the evaluation efforts of New York.
The purpose of the evaluation was to document the implementation of the program and its effects on percentage of case closings, average days in foster care, family functioning, and child behavior. The evaluation included follow-up interviews with a sample of workers and client families, analysis of administrative data, and interviews with administrative, supervisory, and front line staff about the implementation of the demonstration. Administrative data on foster care careers of children were examined.
Six New York City child welfare agencies participated in the HomeRebuilders program: Harlem Dowling, Little Flower, Miracle Makers, New York Foundling, St. Christopher-Ottilie, and St. Christopher-Jennie Clarkson. The sample for the demonstration was initially selected by New York State from its records of foster care cases in the selected agencies. Criteria for selection were agency specific. The criteria were developed to fit the particular composition of each agency's foster care population.
The evaluation began about 2 years after the demonstration began and as it was facing a precipitous ending 6 months early. Involvement in the HomeRebuilders' experiment in midstream has resulted in some design limitations. While agency caseworkers had completed structured baseline assessments of the families at the beginning of the experiment, these were incomplete and were inconsistently available across agencies. For these reasons, it was decided not to use these assessments and rely solely on follow-up data. As a result it has been possible to assess differences between experimental and comparison group cases at Time 2, but change with respect to family functioning and child behavior between Time 1 and Time 2 could not be measured. Furthermore, entering the experiment at a time that a fair number of caseworkers had already left the agencies and the experiment faced termination inevitably resulted in gaps of information about the startup of the demonstration.