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

Oregon

Demonstration Type:	Flexible Funding/Assisted Guardianship - Phase II¹
Approval Date:	March 24, 2004
Implementation Date:	April 1, 2004
Expected Completion Date:	March 31, 2009
Interim Evaluation Report Date:	October 31, 2006
Final Evaluation Report Expected:	September 30, 2009

Background

During its five-year waiver extension (Phase II), Oregon is continuing its demonstration of the flexible use of title IV-E funds and continues to make assisted guardianship available as a permanency option. Changes to the demonstration since its approval include the termination of the special study of Family Decision Meeting Service Coordination (FDM-SC), an expansion in the scope and intensity of its current evaluation of assisted guardianship, and the initiation of an evaluation component to study enhanced visitation services (EVS) in more detail.

Target Population

Children ages 0–18 who are at risk of or currently in out-of-home placement are eligible to participate in the flexible funding component of the demonstration. The target population for the assisted guardianship component includes children between the ages of 4 and 17, who have been in placement for more than 12 months, and who have lived continuously with a prospective guardian for at least six months. The EVS component targets cases in which at least one child in the family has been in substitute care for more than 30 days.

Jurisdiction

Flexible Use of Funds: During Phase II of the demonstration, almost all counties in the State (referred to in Oregon as child welfare "branches"), along with Native American Tribes that have a formalized title IV-E agreement with the State, may receive flexible title IV-E funds for innovative child welfare services. The exceptions are the child welfare branches in Jackson and Clackamas Counties, which are serving as a comparison group for evaluation purposes.
Family Decision Meeting Service Coordination (FDM-SC): The child welfare branches in Multnomah, Josephine, and Yamhill Counties served as experimental sites for the special study of FDM-SC, while the child welfare branches in Clackamas and Lane Counties served as comparisons sites.
Assisted Guardianship: Assisted guardianship is available to all eligible families statewide during the Phase II waiver extension.
Enhanced Visitation Services: Child welfare branches in four counties—Linn, Josephine, Clatsop, and Tillamook—are currently using title IV-E funds to provide enhanced visitation services.

Intervention

Flexible Use of Funds: During Phase II, experimental group branches and participating Tribes may use title IV-E funds for a variety of child welfare services, including post-permanency, maltreatment prevention, crisis intervention, and reunification services. Services provided through flexible title IV-E funds are specifically tailored to the unique needs of children and families in participating child welfare branches.
Family Decision Meeting Service Coordination (FDM-SC): During the Phase II waiver extension, the State initiated a special study of FDMs. Interest in an expanded FDM project arose after the evaluation of the State's original demonstration concluded that FDMs accounted for nearly half of all expenditures of flexible IV-E funds. This enhanced study of FDM-SC sought to define the role and functions of FDM facilitators, formalize the structure and tools for developing and monitoring family service plans, and develop measures for ensuring fidelity to the FDM model. Due to serious challenges related to implementation, sample recruitment, and contamination of the comparison sample, the State terminated FDM-SC as a separate waiver component in 2006.
Assisted Guardianship: Oregon continues to offer assisted guardianship to all eligible children in foster care under its Phase II waiver extension. Assisted guardianship is offered to caregivers only when reunification and adoption have been ruled out as permanency options. Through the program, guardians receive a monthly subsidy equal to the State's basic monthly foster care payment and have access to the same post-permanency support services as adoptive parents.
Enhanced Visitation Services: In December 2006, the State submitted a proposal to evaluate EVS during the remainder of its long-term extension. Compared to traditional visitation programs, EVS typically incorporate the following features: (1) visits occur more frequently and last longer; (2) visits take place in a more "natural" setting outside of the DHS office; (3) visitation staff provide parent coaching or skill building during the visits; (4) expanded visitation hours provide greater flexibility for scheduling visits, with evening and weekend options; and (5) visitation staff perform more extensive documentation of visits.

Evaluation Design

The evaluation of the Phase II demonstration includes process and outcome components, as well as a cost analysis. Each demonstration component is being evaluated separately.

Flexible Use of Funds: The process evaluation for the flexible funding demonstration component involves semi-structured telephone interviews with key State and local child welfare administrators and a review of planning, policy, and other relevant documents. Descriptive and qualitative data are synthesized to explore the types and duration of services provided under the demonstration, the extent of community engagement in the provision of services, the methods employed by the State for monitoring and resolving problems with the use of flexible funds, and the strategies used by child welfare branches to maintain cost neutrality.

The outcome evaluation for this waiver component involves monitoring the progress of branches on pre-selected Child and Family Services Review (CFSR) outcomes, including foster care re-entries, maltreatment recurrence, length of time to achieve reunification and adoption, and stability of foster care placements. Progress is measured by comparing a child welfare branch's baseline score on each CFSR outcome with its score at the mid-point of the demonstration and again at the end of the demonstration. When multiple branches are implementing similar types of services and/or tracking the same CFSR outcomes, cross-site analyses and syntheses are being conducted to the extent possible.
Assisted Guardianship: The process evaluation for the assisted guardianship demonstration component examines the age, race, and other demographic characteristics of children who exit to guardianship, reunification, or adoption, as well as the relationship of guardians to children who exit to guardianship (e.g., a grandparent, other relative, unrelated foster parent). In addition, the State seeks to examine the factors that affect caseworkers' decisions whether to offer assisted guardianship and identify the reasons caregivers give for accepting or declining the subsidized guardianship offer. The State is also identifying reasons for dissolutions and seeking to understand the use of assisted guardianship by Native Americans. The State is obtaining this information through administrative data, case file reviews, and interviews with caseworkers and caregivers.

For the outcome component of the enhanced guardianship evaluation, the State is measuring changes over time in several child welfare indicators, including the number and proportion of children exiting to guardianship, reunification, or adoption; length of time in out-of-home placement; the number and proportion of children with a subsequent substantiated report of abuse or neglect; and the number and proportion of guardianships that are dissolved.
Enhanced Visitation Services: The process evaluation for EVS examines differences in the implementation of enhanced visitation programs among the child welfare branches that provide this service, while the outcome study examines differences in safety and permanency outcomes between children who have or have not received EVS. Using a matched-case comparison research design, children who participate in EVS are matched with a group of children residing in a comparison child welfare branch based on selected demographic and case characteristics. The State estimates a total study sample of 160 to 200 children, resulting in between 80 and 100 children in both the experimental and comparison groups.

Evaluation Findings

The following section summarizes findings and the status of evaluation activities as of April 2008 for the three active waiver demonstration components:

Flexible Use of Funds: Cumulatively through December 31, 2007, 9 of 22 active waiver plans (41 percent) showed improvement in at least one CFSR outcome measure, with 7 of 26 CFSR outcomes (27 percent) measured across all plans showing improvement.² These numbers reflect a marked decline in performance over the prior reporting period ending June 30, 2007, when 21 of 33 active plans (63.6 percent) improved on at least one CFSR outcome and 19 of 34 CFSR outcomes (56 percent) measured across all plans showed improvement. The State's overall performance on five key CFSR outcomes (time to reunification, placement stability, maltreatment recurrence, foster care re-entry, and length of time to adoption) remained flat or declined slightly. The State continued to perform poorly on the CFSR outcome of reunification within 12 months of placement; as of December 2007 it had fallen to 59.5 percent, or 4.8 percent below its baseline performance of 64.3 percent.
Assisted Guardianship: The State is in the process of generating a sample of caseworkers for its supplemental study of assisted guardianship process measures (i.e., the "offered, accepted, refused" study). The next steps for this study component involve sending sampled workers a chart to report on the offer, acceptance, refusal, and establishment of assisted guardianship for their eligible cases. As part of both the process and outcome evaluations, the State evaluation team will also review case files from dissolved guardianship placements in an effort to understand both the factors that led to the dissolution as well as the impact the dissolution had on youth and families. The State is also developing and approving a protocol to interview between 50 and 75 caregivers beginning in May 2008 regarding their experiences with assisted guardianship. Moreover, the evaluation team will conduct site visits to Oregon tribes, and perform an in-depth analysis of Department of Human Services (DHS) administrative data to investigate the utilization of assisted guardianship by Native Americans. Preliminary findings suggest that Native Americans utilize assisted guardianship at higher rates than other racial/ethnic groups.

The State recently completed a series of interviews with 25 DHS caseworkers to explore barriers to establishing and maintaining guardianships, as well as the advantages and disadvantages of guardianship compared with other permanency options. Key challenges identified by caseworkers to the establishment of assisted guardianships included:
- Inadequate training, combined with a general lack of knowledge and expertise at the local level regarding the process for establishing guardianships;
- Bias toward adoption over guardianship by caseworkers and supervisors, combined with general resistance to changing current casework practices;
- Paperwork and the bureaucratic complexity of the guardianship process; and
- Heavy caseloads that limit caseworkers' time to pursue guardianship.
Perceived benefits of assisted guardianship included:
- The potential to achieve permanency more quickly than through adoption;
- Great acceptability to certain ethnic/cultural groups, particularly Native Americans;
- Avoidance of the adversarial process of terminating parental rights (TPR); and
- Ending involvement of the child welfare system in families' lives.
Limitations or disadvantages of guardianship identified by caseworkers included:
- A perception that it is not as legally and psychologically permanent as adoption;
- Loss of child welfare agency and financial support, particularly the adjustable personal care rates available through foster care and adoption assistance; and
- Concerns about child safety following case closure.
Since the start of Oregon's Phase I waiver in July 1997, 1,199 children have exited to assisted guardianship statewide; of these, 858 children (72 percent) have active guardianships, 148 children (12 percent) have aged out, while the guardianships of the remaining 193 children (16 percent) have closed for a variety of reasons that will be explored as part of the State's review of case files and DHS administrative data.
Enhanced Visitation Services: Recruitment of children for this evaluation component occurred between May and October 2007. The sample includes 254 children, of which 128 have been assigned to the control group and 126 to the experimental group.

As of December 2007, approximately 37 children (29 percent) in the experimental group were documented as having received EVS. Initial case record reviews were completed in November 2007, and will continue every six months to monitor maltreatment recurrence, child welfare service case re-openings, and re-entry into foster care. An ongoing challenge to accurately tracking the effects of EVS is the prevalence of undocumented visits to children, particularly by relative caregivers or biological parents visiting their children under the supervision of a foster caregiver. As of June 2007, the State estimated that approximately 14 percent of children in the experimental group and 21 percent of children in the control group had received undocumented visits.

Beginning in April 2008, the State began focus groups with child welfare caseworkers and contracted service providers regarding the implementation of EVS, the criteria and process for selecting participants, relationships between child welfare agencies and contacted providers, and the perceived impacts of EVS on targeted children.

Additional findings will become available as implementation continues.

¹ Based on information submitted by the State as of April 2008. Back

² Each of the 22 active waiver plans may include one or more CFSR outcome measures. Therefore, the cumulative number of outcome measures across all waiver plans presented above reflects some degree of duplication (i.e., the same CFSR outcome measure may be counted more than once). Back

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