• Implemented 1/1/98.
• Counties given flexibility in planning and providing home and community-based services.
• Nearly 4,000 funding slots set aside for counties. Slots allocated to counties using formula based on child welfare and poverty data.
• $9,000 allocation per slot. Counties bore financial risk for costs exceeding $9,000 per slot.
• Demonstration continues under a short-term extension through June 2005.

Title IV-E eligible and non-IV-E eligible children: (1) in placement or at risk of placement; or (2) with substantiated reports of maltreatment; or (3) adjudicated delinquent; or (4) otherwise identified as at risk of abuse, neglect, or delinquency. .

Implemented statewide.

• Final evaluation report received 9/30/03.
• Comparison group design based on demographic, geographic, and case-related variables.
• 5,259 children in experimental group matched with same number in control group.
• 25 counties provided higher levels of family preservation services, counseling, child and respite care, basic household assistance, and special education services.
• Demonstration had modest impact most evident in counties that actively utilized waiver with fidelity to intensive services model.
• In contrast to the comparison group, children in active waiver counties in the experimental group: (1) a voided placement more often (46% to 38%); (2) were placed out of state less often (1.5% to 3.3%); (3) s pent less time in placement (mean of 290 days compared to 316 days); (4) exited to reunification more often (77% to 66%); and (5) were in school at case closure more often (91.1% to 83.6% for school-aged children).
• No differences between experimental and control group in foster care re-entry or maltreatment recurrence.

Original Waiver

• Implemented 7/1/97.
• Flexible funds used for county-based initiatives contingent upon State approval.
• Funding used for contracted and in-house initiatives to provide a variety of services and supports to families and children.

Five-Year Extension

• Approved June 2004
• Implemented 1/1/2005.
• Participating counties will continue to use title IV-E funds to develop and implement strategies for reducing the overall costs of placement in out-of-home care.
• Flexible use of IV-E funds on a discretionary basis to meet immediate needs of families and to expand use of Family Team Meetings.

Title IV-E-eligible and non-IV-E-eligible children at imminent risk of placement or already in placement.

Implemented in 19 counties throughout State.

Five-year extension Implemented in 21 new counties in addition to 17 original waiver counties, for a total of 38 counties.

• Final evaluation report received 11/02.
• Comparison group design.
• 19 experimental counties; 19 comparison counties selected based on size, demographics, number of title IV-E eligible children, and socio-economic status of families.
• Probability of entering placement among children with a substantiated maltreatment report declined significantly more in experimental counties than in comparison counties or in other counties not participating in the waiver demonstration.
• Consistently lower rate of foster care re-entry in experimental counties compared to baseline Fiscal Year 1993. Overall, no statistically significant differences between experimental and comparison counties in foster care re-entry rates.
• No significant differences between experimental and comparison counties in foster care exit rates or placement duration.
• Interim evaluation report expected in June 2007.
• Comparison group evaluation design.
• 34 comparison counties selected using three factors: 1) total title IV-E maintenance expenditures, 2) total administrative expenditures, and 3) number of children initially entering out-of-home placement during the past three State fiscal years.
• Propensity score matching (PSM) will be used to select a sample of children in comparison counties that matches the sample of experimental group cases.
• No outcome findings available to date.

Original Waiver

• Implemented 10/1/97.
• Counties paid a lump sum allocation based on historical and projected number of days in out-of-home care, costs of care, and percentage of IV-E eligible children.
• Focused on use of managed care strategies, including improved case management and coordination; utilization review; and quality assurance systems.

Five-Year Extension

• Approved implemented 10/1/04.
• Will focus on use of capped IV-E allocations to implement a more limited range of services.
• All counties will implement Family Team Meetings plus at least 1 and up to 4 additional services: (1) visitations between parents/caregivers and children in out-of-home placement; (2) services and supports to facilitate and maintain kinship and adoptive placements; (3) managed care strategies; and (4) enhanced mental health and substance abuse services.

Title IV-E-eligible and non-IV-E eligible children of all ages at risk of entering out-of-home placement.

• Final evaluation report received 6/19/03.
• Comparison group design. 14 experimental counties; 14 counties with characteristics similar to experimental counties served as comparison group.
• Both experimental and comparison counties increased overall use of managed care strategies.
• No significant differences between experimental and comparison counties in access to services or in overall use of managed care strategies.
• Experimental counties somewhat more likely to adopt joint funding and cost sharing mechanisms than comparison counties and to report positive collaborations between child welfare agencies and local social service organizations.
• Availability of flexible funds had no significant effect on reunification or adoption rates but did have a significant positive effect on exits to legal custody of relatives.
• No statistically significant differences between experimental and comparison counties in placement duration, placement stability, maltreatment recurrence, or foster care re-entry.
• Interim evaluation report expected August 2007.
• Comparison group evaluation design. Experimental and comparison group counties will be the same as in the original waiver demonstration.
• No outcome findings available to date.

Original Waiver

• Implemented 7/1/97.
• Financial flexibility given to counties to provide services to preserve families and improve permanency and safety outcomes.
• Flexible funds used for: (1) innovative services (e.g., enhanced visitation, facilitator services); (2) Family Decision Meetings; and (3) assisted guardianship.

Five-Year Extension

• Approved 3/04.
• Implemented 4/1/04.
• Will continue flexible funding and assisted guardianship components.
• State will also undertake a special study of Family Decision Meeting Service Coordination (FDM-SC).

Children who were in or at risk of out-of-home placement.

Implemented statewide.

• Final evaluation report received 3/03.
• Children divided into 4 comparison groups according to the availability of Waiver and/or state System of Care (SOC) funds in their county.
• Sample drawn from families active in child welfare services statewide between 1997 and 2001; resulted in a combined sample of 6,748 children across the 4 comparison groups.
• Challenges/barriers to implementation: (1) difficulties recruiting and retaining qualified service providers; (2) length of time to establish contracts; (3) cost neutrality requirements; (4) caseworker buy-in; (5) lack of Family Decision Meeting training for caseworkers.
• Statistically significant association found between access to Waiver and/or SOC funds and: (1) reduced likelihood of placement within one year of initial maltreatment incident; (2) increased likelihood of children changing out-of home placements within one year.
• No association between increased flexibility in use of title IV-E/SOC funds and: (1) reunification rates; (2) establishment of permanent relative placements; (3) risk of re-abuse or neglect by original caretakers within one year of original incident.
• Many innovative service programs curtailed or discontinued due to failure to maintain cost neutrality. Nearly all innovative service efforts that remained cost-neutral continued throughout the demonstration.
• Effects of waiver on costs were minimal as waiver-related expenditures were less than 1% of child welfare spending.