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Arizona

Demonstration Type:	Expedited Reunification Services
Approved:	June 30, 2005
Implemented:	Expected April 2006
Expected Completion:	March 30, 2011
Interim Evaluation Report Expected:	December 2008
Final Evaluation Report Expected:	October 2011

Target Population

The target population for Arizona's demonstration includes title IV-E-eligible and non-IV-E-eligible children. These are children (1) who are in out-of-home placement for no more than nine months in a congregate or licensed foster care setting (e.g., shelter facilities, group homes, residential placements, and licensed foster homes); (2) for whom reunification is the case plan goal; (3) whose caregivers agree to participate in the waiver demonstration; and (4) for whom a juvenile court concurs with a plan of expedited reunification. Children who meet these eligibility criteria at the start of project implementation, or who enter placement in a congregate or licensed foster care setting during the effective dates of the waiver, may participate in the demonstration.

Jurisdiction

Arizona's demonstration will take place in up to two project phases. Phase I will be implemented for a 15-month period in randomly selected Child Protective Services (CPS) units in the Mesa, Thunderbird, and Tempe Child Welfare Offices in Maricopa County. Depending in part on initial evaluation findings from Phase I, the State may expand the demonstration to other CPS offices in Maricopa and Pima Counties and to one or more rural Arizona counties.

Intervention

Arizona's demonstration will test innovative child welfare services that focus on expediting family reunification for children in congregate and licensed foster care settings. Participants in the waiver demonstration will have access to a variety of services, including the following:

• Home-Based Strategies and Interventions will include counseling (individual, family, and marital therapy), family assessments, case planning, and intensive case management in accordance with the child's safety plan and family assessment. Services will also include counseling and skill development related to conflict resolution, anger management, communication and negotiation, parenting education and child behavior management, problem solving, stress management, home management, job readiness, and linkages to community-based resources.



• Child and Family Teams (CFTs) will provide a framework for facilitating the reunification of children in out-of-home placements with their caregivers. CFT participants will include the Family Reunification Specialist, extended family, family friends, the child welfare case manager, and other significant people. These teams will work together to support the family in the assessment, planning, intervention, and aftercare phases of the intervention.



• CFT members will work with the family's child welfare case manager to (1) complete a Strengths and Risk Assessment and (2) develop a safety and family plan. The CFT will identify the core strengths and needs of the family and work with it to create an action plan for obtaining needed resources and overcoming barriers to the child's reunification with the family. The CFT will meet as frequently as needed and will monitor the family's progress towards maintaining a stable and safe living environment after a child's reunification and during an aftercare phase lasting up to six months.



• Flexible Funds will be available for use when the CFT and/or Family Reunification Specialist identify basic or immediate family needs that cannot be met through existing resources. The use of flexible funds will be specific to the individual needs and circumstances of each family. Examples of the use of flexible funds include provision for basic physical needs (e.g., food, clothing, shelter, or furniture); home repairs; financial support for a parent mentor; or counseling, therapeutic, or similar services that would otherwise be unavailable to the family.

Evaluation Design

Arizona's evaluation will test the hypothesis that intensive home-based reunification services, child and family teams (CFTs), and flexible funding will: (1) reduce children's length of stay in congregate and licensed foster care settings; (2) decrease the likelihood of re-entry into out-of-home care; (3) prevent the recurrence of child abuse and neglect; and (4) improve family well-being and functioning.

The State's evaluation approach involves a modified comparison site design in which CPS units in three Maricopa County CPS offices - Mesa, Thunderbird, and Tempe - have been randomly selected to serve as experimental and control groups. In Arizona, each CPS office contains three investigation units and three case management units. For this evaluation, the State has chosen two units to comprise the experimental group and one unit to serve as the control group within each of the three participating CPS offices.

Once the demonstration is implemented, existing cases from CPS units in the experimental group that meet the demonstration's eligibility criteria will be offered enhanced demonstration services. New child protection cases will then be randomly assigned to CPS units in either the experimental or control group; cases assigned to the experimental group will receive enhanced services, whereas cases assigned to the control group will receive a standard set of traditional child welfare services. To the extent possible, the State will assign children to the experimental or control group at the time of the first court hearing, which usually occurs within five to seven working days of out-of-home placement.

Study Size

Arizona estimates that approximately 375 ongoing cases may be initially eligible for assignment to the demonstration once implementation begins, of which 250 will be assigned to the experimental group and 125 cases in the control group. In addition, the State estimates that 36 new cases will be eligible for the demonstration each month across all three participating CPS offices, or approximately 12 cases per CPS office. Of these 36 cases, 18 will be assigned to the experimental group and 18 to the control group, for a total of 270 new cases in each group. In total, Arizona estimates that 520 cases will be assigned to the experimental group and 395 cases will enter the control group during Phase I.

Process Evaluation

Arizona's evaluation will include interim and final process evaluations that will describe how the demonstration was implemented for the experimental cases and identify how enhanced services differed from traditional services received by subjects in the control group. Questions to be addressed in the process evaluation include:

• What was the logic model for the demonstration project and did it change over time?



• What were the processes for planning, organizing, implementing, and monitoring the project?



• What were the characteristics of staff involved with the project, and what was their level of involvement?



• How were services delivered to families? What types of services were received and what was the duration of services?



• What was the role of the juvenile courts in the project? What was the nature and intensity of the collaboration between the courts and State and local child welfare agencies?



• What contextual factors may have affected the implementation and outcomes of the project?



• What were the demographic and other important characteristics of participating families?



• What barriers were encountered during the implementation of the project, and what steps were taken to address these barriers?

As part of its process evaluation, Arizona's evaluation contractors will conduct formal interviews with social workers and supervisors in participating CPS offices, as well as with staff from contracted service providers involved in the delivery of intensive reunification services. To measure caregiver satisfaction with demonstration services, the State's selected service contractor(s) will administer satisfaction surveys to all enrolled caregivers, which will then be submitted to the State's evaluation contractor for analysis.

Outcome Evaluation

Arizona's outcome evaluation will compare the experimental and control groups for significant differences in the following outcome measures:

• The proportion of children reunified with their parents/caregivers;



• Length of stay in congregate care placements or in other out-of-home placement settings;



• The proportion of children with a subsequent maltreatment report, both alleged and substantiated;



• The proportion of children who re-enter out-of-home care; and



• The proportion of children and parents/caregivers who experience improvement in well-being and functioning as measured by the North Carolina Family Assessment Scale.

In analyzing outcome data, Arizona's evaluation contractor will examine differences in outcomes by various subgroups (e.g., child age and presenting problems).

Cost Analysis

Arizona's cost analysis will examine the costs of key elements of the services received by children in the experimental group and compare these costs with those of the usual services received by children in the control group. The cost analysis will include an examination of the use of key funding sources, including all relevant Federal sources such as titles IV-A, IV-B, IV-E, and XIX of the Social Security Act, as well as State and local funds. In addition, the State is conducting a cost-effectiveness analysis where feasible to identify costs per successful outcome for the experimental and control groups. This analysis may be conducted using one or more key outcome measures in which statistically significant differences between the experimental and control groups are identified.

Evaluation Findings

Evaluation findings are pending implementation of Arizona's demonstration.

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