Executive Summary

Synthesis of Findings from the State Assisted Guardianship Title IV-E Waiver Demonstration Projects Executive Summary

Since 1996, seven States have implemented assisted guardianship waiver demonstrations: Delaware, Illinois, Maryland, Montana, New Mexico, North Carolina and Oregon. Montana and New Mexico's demonstrations offered a guardianship option for children in either Tribal or State custody. In two States - North Carolina and Oregon - assisted guardianship was one component of a larger, flexible funding waiver demonstration. The number of States implementing guardianship demonstrations reflects growing interest nationally in the use of guardianship as an alternative permanency option for some children in foster care, particularly children placed with relatives, who cannot be safely reunified with birth parents or who cannot or do not wish to be adopted. Families may choose not to pursue adoption for many reasons, including reluctance to terminate parental rights for fear of the detrimental effects on family relationships, rejection of adoption by the child, and cultural opposition to termination of parental rights.

Although all guardianship waiver demonstrations were similar in that they provided financial support for guardians of children who have previously been in foster care, the States' demonstrations varied in the amount of subsidy payments provided and in the eligibility criteria for guardianship. Eligibility criteria considered by the States included the caregiver's relationship to the child, the caregiver's status as a licensed or unlicensed foster care provider, the child's age, the child's IV-E eligibility status, and the child's length of time with the caregiver.

All States with assisted guardianship waiver demonstrations were required to conduct process and outcome evaluations, as well as a cost analysis. The States' evaluations used widely varying approaches in terms of research designs, sample sizes, and case assignment procedures. Four States - Illinois, Maryland, Montana, and New Mexico - implemented random assignment designs for their evaluations. North Carolina and Oregon conducted a descriptive analysis of their guardianship programs and examined differences in permanency and child safety outcomes at an aggregate, county-wide level. New Mexico used a comparison group design for the smaller Tribal component of its assisted guardianship program, while Delaware relied on a pre-post test model to examine differences in permanency and child and family perceptions of well-being before and after implementation of the waiver.

Major Process Findings

States varied greatly in terms of the scope and magnitude of their assisted guardianship programs. The number of guardianships awarded through the waiver demonstrations ranged from fewer than 30 in Delaware to over 6,800 in Illinois.
All seven States reported mixed reactions from caseworkers regarding the role and appropriateness of guardianship in case decision making. Issues raised by caseworkers included the effectiveness of guardianship in ensuring permanency, concerns that guardianship would decrease adoptions, and objections to the additional time, effort, and paperwork required to process guardianships.
Inadequate worker training and information dissemination on guardianship contributed to misconceptions and implementation problems in some demonstrations. States that expanded and strengthened their training programs - notably Illinois and North Carolina - observed a gradual increase in acceptance of guardianship as a legitimate permanency option among caseworkers and child welfare supervisors.
An important issue raised by some of the assisted guardianship demonstrations was whether caregivers were willing or able to accept lower subsidy payments in return for the advantages of having expanded decision-making authority and reduced government oversight when children exit foster to guardianship. Results from the Maryland and North Carolina evaluations suggested that guardianship was not an attractive option for many families when guardianship subsidies were set at rates significantly below those paid while the children were in foster care, since accepting guardianship meant a net loss in family income available to support the children.
The States reported several challenges in working successfully with the courts. Examples of these challenges included excessive petitions for additional permanency hearings, confusion regarding the legal definition of guardianship, and the pre-existing preferences and biases of judges and attorneys.
Concerns about assisted guardianship expressed by caregivers included lack of knowledge about the rules and procedures governing guardianship, the lengthiness of the guardianship process, and the potential loss of financial subsidies and support services once a youth turns eighteen. These findings suggest that prospective guardians may need more training regarding the definition, goals, advantages, and limitations of guardianship.

Major Outcome Findings

Placement Stability: Available data from the Illinois and Maryland evaluations indicate that experimental group children (i.e., those eligible for a guardianship subsidy) had comparable rates of placement stability - defined as the number of placements experienced over time - as children in other placement arrangements.
Placement Duration: Although most States did not track data on placement duration, available data from Maryland and New Mexico suggested that the availability of assisted guardianship as a permanency option may decrease the length of out-of-home placements.
Permanency Rates: Illinois found strong, statistically significant evidence that the availability of assisted guardianship increased net permanence, defined as exits from foster care placement to reunification, adoption, or guardianship. To date, no other State has found conclusive evidence that assisted guardianship improves permanency outcomes for children.
Maltreatment Recurrence: Findings from Illinois suggested that children placed with guardians were at least as safe from repeat maltreatment as children in other permanent settings. No other States have reported findings regarding the effects of assisted guardianship on maltreatment recurrence.
Foster Care Re-Entry: Two States - Illinois and Oregon - tracked specific data on the number of children who re-entered foster care following assignment to guardianship. Both States reported very small rates of foster care re-entry. In Illinois, of the 6,820 children statewide who entered subsidized guardianship between April 1997 and March 2002, only 117 (1.7 percent) required a return to child welfare public agency custody. In Oregon, only 4 of 133 children (3 percent) re-entered substitute care during the first year following award of guardianship.
Child Well-Being: Data from Maryland, Montana, and Illinois' evaluations suggested that children in guardianship fare as well as those in other permanency settings on several measures of well-being, including school performance, engagement in risky behaviors, and access to community resources.
Youth Perspectives on Guardianship: Evaluation findings from the Illinois, Delaware, and Montana's demonstrations indicated overall satisfaction on the part of children with their guardianship arrangements. Advantages of guardianship mentioned most frequently by youth included shedding the social stigma of foster care, an enhanced sense of stability, and more freedom to engage in normal childhood activities.
Caregiver Perspectives on Guardianship: Once guardianships are established or in process, foster caregivers in many States - including Delaware, Illinois, Montana, and Oregon - expressed satisfaction and support for this placement arrangement. In Montana and Oregon, caregivers cited their enhanced ability to make decisions regarding the child (e.g., around health care, family visits, and education) as a principal advantage of guardianship over foster care.
Caseworker Perspectives on Guardianship: In several States, including Illinois, Maryland, Montana, and North Carolina, caseworker support for guardianship increased over time. Most child welfare workers in these States came to view guardianship as an option that is as permanent as adoption, particularly for older children or for families and children that resisted termination of parental rights.

Lessons Learned from the Assisted Guardianship Waiver Demonstrations

Caseworker buy-in and support are essential to the successful implementation of assisted guardianship programs.
Child welfare staff need adequate training to understand policies and procedures regarding assisted guardianship. Thorough training on guardianship that is institutionalized as a standard part of caseworkers' professional preparation may increase utilization of this permanency option.
States will make guardianship a more attractive option if they offer financial subsidies at a level equal or comparable to those available through long-term foster care or adoption, along with additional post-permanency services and supports similar to those available to adopted children.
Close and early collaboration with the courts is essential to the development of streamlined procedures that promote the timely and efficient establishment of guardianships.
States and local governments should explore the implementation of specific placement review procedures to ensure that guardianship receives reasonable consideration as a permanency option. (For example, Delaware created a Permanency Committee to review each case in placement for more than nine months to ensure consideration of guardianship as a permanency option).
Evaluations of guardianship waiver demonstrations will be strengthened by more detailed tracking of offers and acceptance of guardianship. Because States may have expected more workers and families to pursue guardianship, they gave little initial consideration to collecting basic information regarding the number of children eligible for guardianship, the number of guardianships offered, the number of caregivers who accepted guardianship, the reasons for accepting or declining guardianship, and the number of guardianships eventually established. Future evaluations that track these statistics will help answer fundamental questions regarding the implementation of guardianship demonstrations, such as why more eligible children do not exit foster care to guardianship, and what barriers, such as caseworker or court opposition, impede the establishment of guardianships.

Next Steps

Final evaluation reports are still forthcoming from New Mexico and Montana in December 2005 and March 2007, respectively. Their studies will include more data on the implementation of assisted guardianships; worker, child, and caregiver attitudes toward guardianship; and child and caregiver functioning and well-being. Both North Carolina and Oregon have received five-year extensions of their waiver demonstrations into 2009 that will include assessments of the permanency and safety outcomes of children in guardianship arrangements. Illinois is currently implementing a second phase of its demonstration to test the efficacy of an enhanced guardianship option that offers post-permanency transition services to older wards who exit to guardianship or adoption after age 14.

In addition to the continuation of these existing demonstrations, two States - Minnesota and Wisconsin - have recently received approval to implement new waiver demonstrations involving assisted guardianship. Wisconsin's demonstration, scheduled to begin no later than February 2006, will provide licensed relative and non-relative foster care providers with a guardianship subsidy based on the foster care payment in effect for a child at the time he or she enters guardianship. Minnesota's demonstration, scheduled to begin in October 2005, will allow for expanded eligibility and services within the State's title IV-E foster care program to support an increased subsidy level and a continuous set of benefits for foster families who adopt or accept permanent legal custody of children in their care.