Children's Bureau Website - Oregon - Flexible Funding/Assisted Guardianship

Oregon

Demonstration Type:	Flexible Funding/Assisted Guardianship - Phase I¹
Approval Date:	October 31, 1996
Implementation Date:	July 1, 1997
Completion Date:	March 31, 2004²
Interim Evaluation Report Date:	July 2000
Final Evaluation Report Date:	March 2003

Target Population

Children ages 0 to 18 who are at risk of out-of-home placement or who are in out-of-home placement were eligible to participate in the demonstration. The target population for the assisted guardianship component was children between the ages of 4 and 17 who were in substitute care for more than 12 months and who lived continuously in a safe and stable home with a prospective guardian for at least 6 months. For the Family Decision Making (FDM) Service Coordination study in Phase II of the waiver demonstration, the target population was families newly entering the State's child welfare system, usually through child protective services.

Jurisdiction

Oregon implemented its project statewide across four regions: Metropolitan Portland (Metro), Western, Southern, and Eastern.

Intervention

Through its demonstration, Oregon provided financial flexibility to regions to help preserve families, provide permanency for children in care, and improve safety outcomes. The State designed its demonstration to encourage local collaborations among community stakeholders in order to promote the development of more effective, efficient, and innovative child welfare practices. During the initial implementation years, the demonstration was also part of the State's strategy to enhance its existing System of Care (SOC)³ initiative.

From the start of the demonstration and throughout the course of the project, each region was given the ability to utilize flexible funds for Innovative Services and/or Family Decision Meetings. In June 1999, the U.S. Department of Health and Human Services approved an assisted guardianship component of the demonstration, providing a third option (beginning in year three) for regions' use of title IV-E funds.

Innovative Services: Innovative service plans represented nearly half (44 percent) of the total number of waiver plans that were implemented during the demonstration. Most of these services were contracted out by agencies in the service regions to their local community service providers.

Enhanced visitation was the most prevalent innovative service provided during the demonstration. Other services in this category included facilitator services (e.g., drug and alcohol services or housing), in-home parenting services, and early assessment.
Assisted Guardianship: Oregon implemented its assisted guardianship program in year three of the demonstration. In order to be eligible for the assisted guardianship program, children must have been in substitute care for more than 12 months, lived continuously in a safe and stable home with a prospective guardian for at least 6 months, and must have been at least 12 years old if the prospective guardian was not a relative.

The State calculated the IV-E allocation each branch office could receive based on projected utilization of IV-E dollars for foster care. A portion of the branch foster care budget was redirected for flexible funding based on a locally prepared plan for alternative services. If the branch spent less of their flexible funds than budgeted, the difference was "banked" and available for future local waiver proposals. If additional foster care funds were needed, the State made up the difference with realized savings through the first quarter after the shortfall occurred. If the foster care growth rate did not fall below the control, the waiver activities were discontinued in that county.

Evaluation Design

Oregon's evaluation consisted of process, outcome, and cost-effectiveness components and used a quasi-experimental research design (no random assignment). Children were divided into non-equivalent comparison groups, according to the availability of waiver and/or flexible SOC funds during the child's one-year observation period. The four groups included the following:

Waiver/System of Care (SOC): children originating from branches that were waiver and SOC-active during the study period;
Waiver/non-SOC: children from branches that were waiver but not SOC-active;
Non-Waiver/SOC: children from branches that were SOC but not waiver-active; and
Non-Waiver/non-SOC: children from branches that were neither waiver nor SOC-active.

Oregon used the following outcome measures to test the overall effects of the demonstration: (1) maintenance of children in their homes, (2) return home, (3) relative placement, (4) placement stability, and (5) subsequent maltreatment.

For the assisted guardianship component, Oregon examined (1) assisted guardianship placements, (2) factors related to caretakers' decisions to pursue guardianship, and (3) access to community services. During the five-year waiver extension, the State measured outcomes in several other areas, including (1) permanency outcomes, (2) length of time in placement, (3) child demographics and relationship to caregivers, (4) maltreatment recidivism, (5) guardianship displacement, and 6) re-entry into care.

Evaluation Findings

Process Evaluation

A total of 7,700 children and 3,000 families were served under Oregon's demonstration. A total of 62 plans were implemented, 22 within the Metro region. Innovative services were provided to 1,614 children (some children received more than one service).

The State compared demographic data for children who received enhanced services under the demonstration with the universe of children served by the State's child welfare system during the period of July 1, 1997 through September 30, 2001. The population that received enhanced services was slightly younger, included a higher proportion of African American children, and a lower proportion of Hispanic children than the overall group. Gender divisions were equal for both groups.

Study Limitations

The following issues limited the State's ability to measure the impacts of its demonstration:

Comparisons were made at the aggregate level; for example, the waiver/SOC group included children who did not receive enhanced services along with those who did.
The demonstration occurred during a period of major human services reform by the State, which reduced the ability to isolate outcomes associated with the demonstration.
A dramatic downturn in the State economy, which forced deep cuts to human services programs, occurred during the course of the demonstration.
Services were implemented later than expected due to the time involved in developing the infrastructure and mechanisms to operate the demonstration statewide.
The State's broad systems change approach made in-depth examination of specific direct services impossible.

The following factors limited the State's ability to meet the goals of its demonstration:

Difficulties with recruitment and retention of qualified service providers;
Length of time necessary to establish contracts;
Inability of local contractors to work with families;
Cost neutrality requirements;
Problems generating caseworker buy-in; and
Lack of training for caseworkers on how and when to refer families for FDMs.

Innovative Services:

Analysis of interviews with state and local administrators showed that the cost neutrality requirement was one of the greatest challenges to implementation and continuation of innovative services. Because of their failure to maintain cost neutrality, many innovative services implemented early in the waiver demonstration were curtailed, discontinued completely, or shifted to other funding sources. However, the State notes in its final report that nearly all innovative service efforts that remained cost neutral continued throughout the demonstration.

The innovative services component of the project produced favorable results, including a reduction in caseworker workload by shifting the responsibilities for service provision to in-house or contracted staff. In addition, the State found that the implementation of innovative service plans improved overall service delivery within local child welfare agencies. The involvement of direct service providers was crucial to the development and implementation of successful innovative services projects.
Use of Assisted Guardianship:

The State suggests in its final report that the availability of the guardianship subsidy appeared to be an effective means of establishing legal permanency for children who already had long-term relationships with relative or non-relative caregivers.

The State opened 133 assisted guardianships between July 1, 1999 and December 31, 2001, more than doubling its goal of 60 guardianships. Approximately 70 percent of these guardianships were relatives of the children. More than half of local child welfare agencies statewide utilized this permanency option. In addition, nearly all placements remained stable one year after agreements were established. However, the State is concerned that many guardianship families lack the necessary information to access resources and services to meet the specific needs of their child.

Outcome Evaluation

The State maintains that its demonstration resulted in an increase in partnerships between local child welfare agencies and their community partners. Access to flexible title IV-E and State SOC funding contributed to increased numbers of children being maintained in their homes, reducing removal rates.⁴ In addition, the State reports that changes in funding during the demonstration had no negative impact on children or families.

As reported in the State's March 2003 Final Report, findings regarding Oregon's overall impact measures include the following:

Maintenance of children in their homes: Access to title IV-E and/or SOC funding increased the likelihood that children remained in their homes within one year of the maltreatment incident.
Return home: No association was found between increased flexibility of title IV-E or SOC funding and the likelihood of children returning home one year after out-of-home placement.
Relative placement: Access to title IV-E funding was not related to the establishment of permanent placements with relatives within one year of the maltreatment incident.
Placement stability: Access to SOC or title IV-E funds was associated with an increased likelihood of children changing out-of home placements within one year. However, it is not possible to determine whether this finding reflected positive or negative outcomes since data regarding the reason for placement changes were not collected.
Subsequent maltreatment: SOC and title IV-E funds were not associated with re-abuse or neglect of children by their original caretakers within one year of the original incident.

Cost Analysis

Overall, patterns of child welfare expenditures (including foster care, TANF, title XIX, State General Fund, and title IV-E) changed significantly during the demonstration period. The effects of the title IV-E waiver on these changes were minimal, however, as waiver-related expenditures represented less than one percent of total child welfare spending.

¹ Based on information submitted by the State as of March 2003. Back

² Oregon's demonstration project, originally scheduled to end in June 2002, received several bridge extensions before being approved for a five-year extension by the U. S. Department of Health and Human Services. Back

³ System of Care is a needs-based approach to working with children and families. It focuses on family strengths, and utilizes extended family and community to minimize the need for placing children outside their home in order to expedite children�s placement in permanent homes. Back

⁴ The State notes in its March 2003 Final Report that this finding should be interpreted with caution because the study did not measure impacts of specific services on child or family outcomes. Back

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