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6. Service Needs and Receipt

Child welfare services are intended to address the safety and permanency needs of children by providing direct services and coordinating services needed to assist families and children. The determination of need occurs in a variety of ways, including observation, interviewing, and assessment by third-party evaluators. The precise configuration of services provided or orchestrated by CWS will vary according to the conditions that brought the child and family to the attention of child welfare services and to the services that they are already receiving. Although there is no precise legal standard for the time that addressing these needs will take, the expectation of the Adoption and Safe Families Act is that most families whose children are placed in foster care will have had ample chance to benefit from services that are provided before their 12-month permanency hearing. In keeping with these principles, we also expect that most children who have been in foster care for about one year will have received an assessment for their service needs and referral to needed services. This chapter addresses the child welfare and other human services needs and services for the children in foster care for one year and for their families (as reported by the child welfare worker).

6.1 Risk Factors and Initial Services

Child welfare services are initiated in response to specific risks to the safety of children. Although the exact parameters of such risk assessments vary considerably across settings and individuals, an expected result of all risk assessment systems is to generate a case plan that fairly and effectively addresses extant risks. Although assessing effectiveness of service plans is beyond the scope of this chapter, the evidence does have bearing on our understanding of fairness by addressing whether families with different levels of risk appear to get different kinds of services and whether children with differing needs receive differing levels of service.

What family risk factors were present at the time of placement?

Although information about the reasons children in this sample originally entered foster care is sparse, some data are available about the risk factors that brought children into care. Child welfare workers were asked to identify risk factors that the family might have experienced prior to the placement, including active domestic violence, low social support, caregiver as victim of abuse, monetary problems, no second supportive caregiver present, lack of cooperation with authorities, and prior reports of maltreatment. Not having a second supportive caregiver present was the most common risk factor present at the time of placement. (It should be noted that caseworkers were not asked to identify all of the risk factors for OYFC as they were for CPS, because during pilot testing child welfare workers indicated that they would not have knowledge of some categories, such as substance abuse and incarceration, for children and families at the time of placement. However, information about the broad use of substance abuse services suggests that the use of drugs and alcohol was a contributor to placement.)

Do these family risk factors vary by child’s race, type of abuse, age, or placement type?

We examined the presence of risk factors by race of the child and the results appear in Figure 6-1. The number of risk factors varies from 0 (7% had none on this list) to 7 (2% had all risk factors), with about 60% of the parents having between 3 and 5 risk factors. The likelihood of the presence of risk factors at the time of placement did not vary significantly by race of the child.

Figure 6-1. Risk Factors at Time of Placement, by Race of Child

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In addition, the likelihood of risk factors does not vary by the type of abuse of the child. Four types of abuse were included in this analysis—physical maltreatment, sexual maltreatment, failure to provide and failure to supervise. None of the risk factors was significantly related the type of abuse (Figure 6-2).

Figure 6-2. Risk Factors at Time of Placement, by Most Serious Type of Abuse

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Low social support (Chi-square=9.08, p<0.05), a history of abuse of the primary caregiver (Chi-square=8.70, p<0.05), and prior reports of maltreatment (Chi-square=12.32, p<0.01) are significantly related to child age. Families with children 1 to 2 years old appear more likely to have had low social support at the time the child was removed (Chi-square= 9.08, p <.05). Young children (1 to 5 years old) also appear more likely than older children to have come from families with caregivers with a history of abuse (Chi-square= 8.70, p <.05). Families with older children, however, had more often experienced previous reports of maltreatment (Chi-square= 12.32, p<.01) (Figure 6-3).

Figure 6-3. Risk Factors at Time of Placement, by Age of Child

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Risks were no different for children placed in kinship care, non-kinship foster care and group care (Figure 6-4). Apparently the removal reason and the placement resource that the child was in one year later are largely independent.

All of these findings about the risk factors at the time a child was placed should be interpreted as preliminary and with some caution because of the length of time that has elapsed since the placement and because the collection of risk data was not as comprehensive as it will be in the NSCAW CPS sample component data analyses.

Figure 6-4. Risk Factors at Time of Placement, by Placement Type

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6.2 Caregiver Services

What are child welfare workers’ assessments of general human services that are needed by and provided to parents?

Child welfare workers were asked what types of general services were needed by and provided to the caregivers (primarily, biological parents) from whom the children were removed. Overall, child welfare workers indicated that 78% of caregivers needed income assistance, 70% needed employment services, 77% needed substance abuse services, 78% needed mental health services, 73% needed legal services; 62% needed domestic violence services; and 90% needed Medicaid. Housing services were needed by 71% of caregivers and health care services were needed by 49% of the families (Table 6-1).

Table 6-1. Caregiver Need for General Human Services in the past 12 Months

Type of Service	Proportion Needing Service % (95% CI)
Housing	71 (66, 75)
Income Assistance	78 (74, 81)
Legal	73 (68, 77)
Medicaid	90 (87, 93)
Domestic Violence	62 (56, 67)
Employment	70 (66, 74)
Mental Health	78 (74, 81)
Health	49 (46, 53)
Alcohol or Drug	77 (75, 82)
Day Care	78 (73, 82)

 

To more fully address the questions about types of service needed by primary caregivers, a need classification was developed. For this, we identified all caregivers who had an unaddressed need for a service, as identified by the child welfare worker. This classification of need excluded (1) caregivers who were not identified as having a service need and were not referred to that service, (2) caregivers who were already receiving the service at the time of the interview, (3) caregivers who received the service after they had been referred, and (4) caregivers who were referred for assessment but determined not to need the service. Tables 6-2 through 6-11 show the distribution of need by the type of service.

Over two-thirds of caregivers had a need for housing services at the time of the interview (Table 6-2). Just over half of all caregivers did not receive housing services (38%) or did not receive services although they were referred to services (13%). Twelve percent of caregivers received housing services after they were referred.

Over three-quarters of caregivers needed income assistance at the time of the interview (Table 6-3). Although 13% of caregivers received income assistance once they were referred, 42% did not have their need addressed and another 8% did not receive income assistance even though they were referred by the child welfare worker.

Table 6-2. Caregiver Need for Housing Services

	%
Housing Services Not Received (57%)
Need unaddressed	38
Did not receive service though referred	13
Missing	7
Housing Services Received (14%)
Already receiving service	2
Received service after referral	12
Referral made and service determined not to be needed	0.2
TOTAL HOUSING SERVICE NEED	71

 

Table 6-3. Caregiver Need for Income Assistance

	%
Income Assistance Still Needed (57%)
Need unaddressed	42
Did not receive service though referred	8
Missing	7
Income Assistance Not Needed (20%)
Already receiving service	7
Received service after referral	13
Referral made and service determined not to be needed	0
TOTAL INCOME ASSISTANCE NEED	78

 

The majority of caregivers had a need for legal services (Table 6-4). Some caregivers received legal services once they were referred by a child welfare worker (17%), but many caregivers did not have their need addressed (36%).

Table 6-4. Caregiver Need for Legal Services

	%
Legal Services Still Needed (45%)
Need unaddressed	36
Did not receive service though referred	2
Missing	7
Legal Services Not Needed (27%)
Already receiving service	10
Received service after referral	17
Referral made and service determined not to be needed	0.2
TOTAL LEGAL SERVICE NEED	73

 

Many caregivers needed Medicaid services (Table 6-5). Though some caregivers did receive Medicaid after they were referred to the program by a child welfare worker (14%), many caregivers did not have their need met (58%).

Table 6-5. Caregiver Need for Medicaid

	%
Medicaid Still Needed (58%)
Need unaddressed	N/A
Did not receive service though referred	1
Missing	57
Medicaid Not Needed (32%)
Already receiving service	18
Received service after referral	14
Referral made and service determined not to be needed	0
TOTAL MEDICAID NEED	90

 

Many caregivers needed domestic violence services (Table 6-6). Just under half did not have their need for domestic violence services met even though a child welfare worker knew that a need existed. A small proportion of the caregivers did receive help once they were referred (13%).

Table 6-6. Caregiver Need for Domestic Violence Services

	%
Domestic Violence Services Still Needed (47%)
Need unaddressed	25
Did not receive service though referred	7
Missing	16
Domestic Violence Services Not Needed (15%)
Already receiving service	2
Received service after referral	13
Referral made and service determined not to be needed	0
TOTAL DOMESTIC VIOLENCE SERVICES NEED	62

 

Over two-thirds of all caregivers needed employment services at the time of the interview (Table 6-7). Although 10% of the caregivers did have their need met after they were referred to employment services, 58% did not have their need for services met.

Almost 80% of the caregivers needed mental health services (Table 6-8). Just over half (52%) did not have their need for mental health services met, though 11% of the caregivers did receive mental health services after they were referred by a child welfare worker.

Table 6-7. Caregiver Need for Employment Services

	%
Employment Services Still Needed (58%)
Need unaddressed	38
Did not receive service though referred	7
Missing	13
Employment Services Not Needed (14%)
Already receiving service	3
Received service after referral	10
Referral made and service determined not to be needed	1
TOTAL EMPLOYMENT SERVICES NEED	72

 

Table 6-8. Caregiver Need for Mental Health Services

	%
Mental Health Services Still Needed (52%)
Need unaddressed	36
Did not receive service though referred	11
Missing	5
Mental Health Services Not Needed (26%)
Already receiving service	2
Received service after referral	11
Referral made and service determined not to be needed	0
TOTAL MENTAL HEALTH SERVICES NEED	78

 

Just under one-half of the caregivers had a need for health services (Table 6-9). Most caregivers did not have their need for health services met (41%).

Table 6-8. Caregiver Need for Mental Health Services

	%
Health Services Still Needed (41%)
Need unaddressed	12
Did not receive service though referred	1
Missing	28
Health Services Not Needed (8%)
Already receiving service	4
Received service after referral	4
Referral made and service determined not to be needed	0.1
TOTAL HEALTH SERVICES NEED	49

 

Over three-quarters of all caregivers needed alcohol or drug services at the time of the interview (Table 6-10). Just over one-quarter (27%) of the caregivers had their need met, though most of the caregivers did not have their need met (49%).

Table 6-10. Caregiver Need for Alcohol or Drug Services

	%
Alcohol or Drug Services Still Needed (49%)
Need unaddressed for alcohol problem^	49
Need unaddressed for drug problem	85
Did not receive service though referred	28
Missing	0
Alcohol or Drug Services Not Needed (27%)
Already receiving service	42
Received service after referral	14
Referral made and service determined not to be needed	0
TOTAL ALCOHOL OR DRUG SERVICES NEED	77

^ Sums to more than 100% because some caregivers need both alcohol and drug services.

 

The majority of caregivers had a need for day care services (78%), although about one-fifth (22%) did have their need met after they were referred to services (Table 6-11).

Table 6-11. Caregiver Need for Day Care Services

	%
Day Care Services Still Needed (66%)
Need unaddressed	N/A
Did not receive service though referred	3
Missing	63
Day Care Services Not Needed (34%)
Already receiving service	12
Received service after referral	22
Referral made and service determined not to be needed	0.3
TOTAL DAY CARE SERVICES NEED	78

 

The description of the service needs of the biological parents at the time the child entered out-of-home care suggests that the most common needs (all 77% or higher) were for Medicaid, income assistance, day care services, mental health services, and alcohol and drug treatment services. In addition, alcohol and drug treatment were the two services most likely to continue to be needed following a referral for them.

Among those who did not receive services despite a referral, refusal to attend was cited as the reason the service was not received for 70% of those who needed and were referred to alcohol or drug services and 77% of those who needed and were referred to mental health services. Another 20% of people who needed and were referred to these services did not receive the service for some reason other than the above. Transportation and child care difficulties were attributed as reasons for not receiving mental health and drug treatment services in less than 20% of the cases. Three percent of the people who needed alcohol or drug services did not receive them because the service was not available in their area. No individual failed to receive either drug or alcohol services or mental health services due to ineligibility, lack of financing, scheduling problems, being wait-listed or because the service was inappropriate.

What proportion of primary caregivers needed and used alcohol or drug services?

Because of the high prevalence of substance abuse problems among child welfare clients, additional detail was gathered about the pathways to and use of substance abuse services. Child welfare workers were asked to report on the need for and use of alcohol and drug services by the primary caregivers of the selected children. The data are displayed in Table 6-12. According to the child welfare workers, about one-third of the primary caregivers needed services for an alcohol problem, and almost two-thirds needed services for a drug problem. The majority of those perceived to have a drug or alcohol problem did obtain a formal assessment. Among these, 83% were found to have a serious or moderate impairment, according to these data.

Table 6-12. Substance Abuse Service Needs, Assessment, and Assessment Findings in Past 12 Months, According to Child Welfare Workers

	A. Needed services (% of total cases)	B. Obtained a formal assessment (% of A)	C. Serious or moderate impairment found (% of B)
Alcohol	33	63	83
Drugs	58	73	83

 

In all, 91% needed services for a substance abuse (alchohol or drug) problem, 53% (of the total sample) were referred for services, and 29% actually received services. Many received more than one type of service. Of those who received substance abuse services,

• 61% received outpatient services,

• 53% were part of a 12-step program,

• 45% received inpatient services,

• 26% received intensive day-treatment services,

• 9% received detoxification services,

• 1% received methadone treatment, and

• 16% received a different type of substance abuse service.

6.3 Child Welfare Services

What types of child welfare services did families receive?

Child welfare workers reported on the services received by the families of origin of OYFC children. The analysis of these services begins with some general aggregation into three primary types of services that are often provided to families involved with the child welfare system and summarized in Figure 6-5. About 15% of families received intensive family preservation services; 16% received other home or community-based services; and 52% received non-intensive home-based services, which essentially consists of monitoring by the child welfare worker. Of those families receiving non-intensive home-based services, 88% received these services at least monthly, while the remainder of families typically received services less than once each month.

Figure 6-5. Proportion of Families That Received 3 Primary Types of Child Welfare Services

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Additional details in Tables 6-13 and 6-14 address the use of child welfare services provided by the child welfare worker indicating whether services were provided, for how long they were provided, and whether they were still being provided at the time of the interview.

Table 6-13. Receipt and Duration of Child Welfare Services

Service	Ever received? (%)	Still receiving service? (% of ever received)	Average duration of receipt (if service closed) (weeks)
Intensive Family Preservation	15	43	35
Intensive Home-Based Services	16	54	33
Non-Intensive Home-Based Services	52	61	44

 

Table 6-14. Receipt of Child Welfare Services

Service	Ever received? (%)	Average number of times received	Average number of weeks received
Home Management	18	35	22
Parent Training	40	19	17
Parent Aide	13	^	24
Respite Care	15	^	^
House Cleaning & Repairs	4	^	26
Individual Counseling at Home	48	10	31
Family Counseling		^	22
Foster Children Counseled	30	^	30
Child Care	31	^	19

^ Omitted because 6 or fewer responses.

 

Child welfare workers indicated that about half of respondents were still receiving one or more of these services, which is consistent with the long length of services provided in those cases where the services had closed. It is surprising that intensive family preservation services would have lasted so long (given the definition of a brief service provided during the interview). Table 6-14 breaks out the home-based services and provides more detail about what these services included. (These service durations are reported to be shorter than those in Table 6-13, in part because Table 6-14 includes cases that remain open.)

To what extent were reunification plans and efforts in place?

Child welfare workers were asked if there was currently or had ever been a plan to reunify the children who were then in an out-of-home placement. At the time of the interviews, 25% of children had already left care—child welfare workers were not asked about reunification plans for them. Although some of these children may have left care without a reunification plan (i.e., they ran away to home), it is a reasonable assumption that most of them were planfully reunified.

Among the 75% who had not been reunified, 10% never had a reunification plan. A current reunification plan existed for about one-quarter (25%) of OYFC children still in care, as shown in Table 6-15. For those children still in care with no current reunification plan, child welfare workers were asked if reunification efforts had ever been made with anyone in the child’s family. Such efforts had been made for 84% of the children for whom there is not a current reunification plan; 8% of all OYFC children never had a reunification plan. In all, about half of all the children have been reunified or have a reunification plan with the remaining half of all children being unlikely to be reunified (i.e., they have never had a reunification plan or no longer have one).

Table 6-15. Reunification Status and Activity

	% by Reunification Status	% by Reunification Activity	% of all children
Reunification Accomplished^	25
With Mother		80	20
With Father		10	2.5
With Other Person		10	2.5
Reunification Not Accomplished (child still in care)	75
Ever Had Reunification Plans		90
Currently Has Reunification Plan			25
Currently Has No Reunification Plan			42
Never Had Reunification Plan		10	8

^ Some of these children may not have been formally reunified (they may have run away to home), but their case data include an interview on record with their biological parent, so we are treating them as reunified.

 

Table 6-16 presents the breakdown of selected child and case characteristics for each category of reunification status. To identify characteristics associated with reunification status, bivariate tests of association were run for each child and case variable against the variable indicating reunification status. In these analyses, only race was significant, with white children being less likely than expected to be in the “returned home” category and black children being most likely to be returned home (p<.001).

With whom are the children to be reunified?

Child welfare workers identified with whom the children would be reunified. For 87% of those children still in care with a reunification plan, that plan targeted their mother; for 11% of these children the reunification plan targeted the father (Table 6-17). At this point in the case, few other reunification resources (e.g., the aunt, uncle, siblings) were involved.

Of the children who did not have a current reunification plan, had such efforts ever been made and, if so, with whom?

Child welfare workers were asked, with regard to children who were still in care but did not have a current reunification plan, to whom the previous reunification efforts, if any, had been directed; workers were permitted to identify as many family members as applied. For half (50%) of these children, reunification plans or efforts had been made with just one family member, and for 43% reunification efforts had been made with two family members. For 7% of these children, reunification efforts had been made with three or more family members.

Table 6-16. Reunification Status of OYFC Children by Select Child and Case Characteristics

	Reunification status Percent (95% CI)
			No current reunification plan
	Returned home	Current reunification plan	Previous reunification efforts	No previous reunification efforts
Age
1-2	15 (9, 24)	23 (17, 31)	29 (22, 37)	33 (17, 54)
3-5	24 (17, 34)	19 (8, 39)	13 (8, 19)	19 (7, 43)
6-10	32 (25, 40)	32 (20, 47)	31 (26, 37)	20 (10, 35)
11+	29 (21, 39)	26 (17, 38)	27 (22, 33)	28 (14, 48)
Gender
Male	47 (39, 55)	58 (49, 66)	46 (37, 56)	48 (29, 68)
Female	53 (45, 61)	42 (34, 51)	54 (44, 63)	52 (32, 71)
Race/Ethnicity^
Black	52 (40, 64)	39 (27, 52)	45 (35, 55)	43 (20, 69)
White	19 (12, 28)	37 (29, 45)	37 (28, 48)	24 (12, 42)
Hispanic	24 (18, 31)	13 (8, 22)	14 (9, 20)	29 (14, 52)
Other	6 (1, 22)	11 (5, 23)	4 (2, 9)	4 (1, 17)
Placement Type
Foster home		55 (38, 72)	59 (53, 65)	70 (46, 87)
Kin care	N/A	29 (16, 48)	34 (29, 39)	23 (10, 47)
Group home		15 (8, 28)	7 (5, 12)	6 (2, 17)
Most Serious Abuse Type
Physical	18 (10, 31)	7 (4, 13)	9 (6, 15)	3 (1, 9)
Sexual	7 (3, 14)	8 (4, 16)	9 (4, 22)	10 (2, 37)
Failure to Provide	23 (15, 34)	44 (32, 57)	39 (31, 47)	39 (25, 54)
Failure to Supervise	46 (38, 54)	37 (26, 49)	32 (26, 38)	29 (13, 53)
Other	6 (3, 11)	4 (2, 10)	11 (7, 17)	18 (4, 52)
Proportion of Clinical Scores
0	41 (25, 60)	28 (20, 39)	35 (28, 42)	24 (13, 41)
.17 to .25	32 (22, 43)	32 (18, 49)	29 (21, 37)	22 (11, 40)
.33 to .50	18 (13, 25)	21 (15, 28)	24 (17, 34)	32 (20, 48)
.60 to 1	9 (4, 21)	19 (11, 31)	12 (9, 16)	21 (10, 39)

^ Significant differences among reunification status categories at p<.001.

 

Table 6-17. Object of Current Reunification Plan

Family member	Percent (95%CI)
Mother	87 (78, 92)
Father	11 (6, 18)
Grandmother	0.4 (0, 3)
Aunt	0.3 (0, 2)
Other	2 (1, 7)

 

Table 6-18 describes the distribution of reunification efforts that had ended by the person’s relationship to the selected child. For 87% of the children for whom reunification efforts had been made, the mother was a part of these efforts, and in 40% the father was included in such efforts. Other reunification resources had been part of the effort to return the child from out-of-home care as well—the child’s aunt was the next most frequently included family member (12%), followed by a grandmother (8%), grandfather and uncle (4% each), and sister and brother (1% each).

Are child’s characteristics related to reunification?

Fifty-one percent of OYFC children had been reunified or had a current reunification plan. The remainder never had a reunification plan or did not currently have a reunification plan. Table 6-19 indicates the proportion of children, by selected child and case characteristics, who had a current reunification plan or for whom reunification had been completed.

A regression model was developed to try to understand which children had a current reunification plan (or had gone home) and to contrast them with those who had never had a reunification plan or no longer had a reunification plan. The model (R(2) = .06), which controlled for severity of abuse and proportion of clinical scores, in addition to age, race, and most serious type of abuse, indicates that differences by age are not significant, overall. Yet the youngest children tend to have fewer reunification plans than the children in the three older age groups, which would be consistent with the foster care caseload dynamics research, indicating that younger children are much more likely to have reunification plans changed to adoption (Barth, 1996). (Please note that questions about adoption plans were not asked in the baseline but will be asked in subsequent waves.) The only variable in the model that exhibited significant differences between categories with regard to current or completed reunification plans was most serious type of abuse (F=3.00, p<.05). Specifically, children with a most serious abuse type of failure to supervise are significantly more likely than children with a most serious abuse type of failure to provide to have a current reunification plan or completed reunification.

Table 6-18. Object of Ceased Reunification Efforts

Family member	Percent^ (95% CI)
Mother	87 (82, 91)
Father	40 (32, 50)
Grandmother	8 (4, 15)
Grandfather	4 (2, 8)
Aunt	12 (7, 17)
Uncle	4 (2, 8)
Brother	1 (0, 4)
Sister	1 (0, 4)
Other	4 (2, 7)

^ More than one response permitted.

 

Table 6-19. Current Reunification Plan (or Completed Reunification), by Selected Child Characteristics

Child characteristic	Percent yes	95% CI
Age
1-2 years	39	32, 45
3-5 years	62	40, 81
6-10 years	52	44, 61
11+ years	51	42, 59
Race/Hispanicity
Black/non-Hispanic	50	43, 58
White/non-Hispanic	44	34, 55
Hispanic	55	40, 68
Other	67	41, 85
Most serious type of abuse/neglect
Physical abuse	62	42, 78
Sexual abuse	44	29, 61
Failure to provide	46	35, 58
Failure to supervise	57	46, 68

 

The model was computed a second time, excluding the children with a completed reunification plan, in order to contrast those with a current reunification plan against those who never or no longer had a reunification plan. In this model (R2 = .06), out-of-home placement type was added to the list of independent variables. Results show that out-of-home placement type is significantly associated with whether a child still in care has a reunification plan or not (F=3.46, p<.05). Specifically, children in group homes are significantly more likely to have a current reunification plan than children in kin care settings. Children in non-kin foster homes and kin care settings are not significantly different with regard to their likelihood of having a current reunification plan. In addition, although race did not exhibit a significant effect overall (F=1.67, p=.18), comparisons within this characteristic indicate that children in the “other” group are significantly more likely than black children to have a current reunification plan (p<.05). Similarities in the presence of reunification plans for black, white, and Hispanic children are consistent with recent evidence that black children are beginning to have more equal access to reunification (Wulczyn, 2001). Presence of a reunification plan does not differ significantly based on any of the other variables in the model.

Were family risks at time of placement related to the likelihood of the child having a current reunification plan or completed reunification?

We examined the risks present in the child’s home at the time of placement to see if these appear to be related to whether the child currently had a reunification plan or had completed reunification. This analysis was limited, because risk assessment items completed at the baseline for the children in foster care were limited and excluded indicators of such key parental characteristics as substance abuse. The risk categories were not mutually exclusive; child welfare workers could select all risks that applied for each child. As can be seen in Table 6-20, the percentage of children with a current reunification plan or completed reunification does not appear to vary depending on the risks present, as the proportion of each risk group with a current reunification plan or completed reunification plan is similar to the proportion of all children in foster care for one year with a current or completed reunification plan. Possible exceptions are for those children whose caregivers did not cooperate with the authorities (Chi-square = 5.82, p <.05) and those children whose permanent caregiver was a victim of abuse (Chi-square= 4.58, p <.05).

Table 6-20. Current Reunification Plan or Completed Reunification by Risks Present at Time of Placement

Risks	Percent yes	95% CI
Prior reports of maltreatment	49	38, 60
Caregiver was victim of abuse	45	35, 55
Low social support	48	41, 54
Monetary problems	52	43, 60
Active domestic violence	43	30, 57
Did not cooperate with authorities	40	28, 53
No second supportive caregiver present	50	42, 58

 

What did foster parents of OYFC children think and feel about adopting them?

Foster parents were asked if they had legally adopted the child and, if not, if they have ever considered adopting the child if he/she could not return to his/her family. Although virtually no OYFC children (2%) had been legally adopted by their current foster parents, about two-thirds (68%) of the foster parents would consider adopting the child if that became an option in the future. Foster parents who had legally adopted the child or considered doing so in the future were asked what factors contributed to wanting to adopt the child. These responses are summarized in Table 6-21. About three-quarters (74%) of foster parents who had adopted or considered adopting the child in their care identify their feelings of love and affection for the child as one of the contributing factors. A similar proportion (72%) reported feeling that the child is part of their family as a contributing factor. Over half of these foster parents indicated that their desire for the child to grow up in a safe environment (62%) and their feeling that the child’s biological parents could not adequately care for the child (54%) were contributing factors. For over one-quarter (28%) of the foster parents, the fact that the child is related to them or someone in their family contributed to their desire to adopt. Six percent of the foster parents had already adopted one or more of the child’s siblings, which served as a factor contributing to their adopting or desire to do so.

Foster parents who had legally adopted the child or considered doing so in the future were also asked what factors discouraged them from wanting to adopt the child. These responses are summarized in Table 6-22. The most common factor discouraging foster parents from adopting is that the biological parents’ rights had not been relinquished or terminated (25%). For almost one-fifth of the foster parents (18%), there were no factors discouraging them from adopting the child. No foster parents indicated that the child’s race or ethnicity being different from their own or their family’s was a factor discouraging them from adopting.

Table 6-21. Factors Contributing to Foster Parent Wanting to Adopt Child

Factor	Percent^ (95% CI)
Feelings of love/affection for child	74 (65, 81)
Feeling that child is part of caregiver's family	72 (63, 80)
Desire for child to grow up in safe environment	62 (51, 72)
Feeling that child's biological parents cannot adequately care for child	54 (44, 64)
Concerned that child would otherwise be placed with another family	36 (27, 46)
Child is related to caregiver or caregiver's family	28 (21, 36)
Child's race/ethnicity is same as caregiver's family	15 (11, 21)
Not concerned that child's race/ethnicity differs from that of caregiver or caregiver's family	12 (8, 18)
Having already adopted child's sibling(s)	6 (4, 9)

^ Interviewers coded as many responses as the respondent indicated were applicable.

 

Table 6-22. Factors Discouraging Foster Parent from Wanting to Adopt Child

Factor	Percent ^ (95% CI)
Biological parent has not relinquished rights, or rights have not been terminated by court	25 (18, 34)
No discouraging factors	18 (13, 24)
Financial concerns	11 (8, 16)
Child has disabilities that caregiver may not be able to handle in a long-term situation	7 (4, 12)
Problems between child and other members of caregiver's family	5 (3, 8)
Child's race/ethnicity differs from that of caregiver's family	0

^ Interviewers coded as many responses as the respondent indicated were applicable.

 

Finally, foster parents were asked if they had talked with their child welfare worker about the possibility of adopting the child—85% of those foster parents who had considered adoption indicated that they had. Those foster parents who indicated they had spoken with their child welfare worker about this and those who had already adopted the child were asked how the child welfare worker responded to the caregiver’s willingness to adopt the child. Over half (52%) of the foster parents indicated that the child welfare worker was strongly encouraging. Another 37% indicated the child welfare worker was encouraging. Only 7% and 4% described their child welfare worker’s response as discouraging or strongly discouraging. (Note that questions about adoption plans were not asked of child welfare workers in the baseline but are asked in subsequent waves.)

6.4 Services for Children

When children are in out-of-home care, the child welfare agency can be expected to assess their well-being and endeavor to enhance it. Although many of those efforts to assist children in out-of-home care are provided directly by caregivers, specialized services may also be needed and provided. This section uses a variety of information sources to assess the underlying needs of children and to determine whether or not they are being addressed.

What specialty mental health services have OYFC children received and which children are receiving them?

To assess the mental health services that children in out-of-home care were receiving, we examined five questions that were asked of the child’s caregiver. Data were collected from the caregiver regarding whether the child had been to any of the following for emotional, behavioral, learning, attention, or substance abuse problems in the twelve months prior to the interview:

• a mental health or community health center,

• a therapeutic nursery,

• day treatment

• a psychiatric hospital or psychiatric unit in a medical hospital, or

• private professional help from a psychiatrist, psychologist, social worker, or psychiatric nurse since the investigation date.

The results are presented in Table 6-23. Overall, 23 percent of OYFC children currently in out-of-home care had received at least one specialty mental health service in the past twelve months. OYFC children most often received private professional help (13%) for emotional, behavioral, learning, attention, or substance abuse problems, while day treatment was the second most common (12%) service used to address those issues. OYFC children had been to mental health or community health centers, therapeutic nurseries, or psychiatric hospitals or units less frequently (4% each). Of the OYFC children who had received at least one specialty mental health service in the past twelve months, the proportion receiving private professional help was 58%, day treatment 30%, mental health or community health center 18%, psychiatric hospital or unit 15%, and therapeutic nursery 8%.

Table 6-23 also indicates the proportion of children receiving specialty mental health services by various child and case characteristics. Not surprisingly, age appears to be a significant factor with regard to whether a child had received private professional help or been to a psychiatric hospital or unit. Specifically, significantly fewer 1- to 2-year-olds (2%) had received private professional help than 3- to 5-year-olds (13%), 6- to 10-year-olds (17%), and children 11 years of age and older (20%) (p<.001). Similarly, no 1- to 2-year-olds were reported to have been to a psychiatric hospital or unit, which is significantly different than the 3% of 6- to 10-year-olds and 9% of children 11 years of age and older (p<.01). No 3- to 5-year-olds were reported to have been to a psychiatric hospital or unit, which is also significantly different than children 11 years of age and older (p<.01). One- to two-year-olds were also less likely (p<.01) to have received at least one specialty mental health service (8%) than were 6- to 10-year-olds (28%) and children 11 years of age and older (34%).

Table 6-23. Specialty Mental Health Services Received by OYFC Children Currently in Out-of-Home Care

	Specialty mental health service Percent (95% CI)
	MH or community health center	Private professional help	Therapeutic nursery	Day treatment	Psychiatric hospital or unit (inpatient)	Any Specialty MH Service
TOTAL	4 (3, 7)	13 (10, 18)	4 (2, 8)	12 (7, 20)	4 (2, 7)	23 (19, 27)
Age
1-2	3 (1, 14)	2 (1, 5)	3 (1, 8)	N/A	0	8 (3, 18)
3-5	2 (0, 7)	13 (8, 21)	6 (2, 21)	N/A	0 (0, 3)	20 (10, 36)
6-10	6 (2, 14)	17 (10, 26)	N/A	12 (6, 24)	3 (1, 8)	28 (20, 37)
11+	5 (2, 14)	20 (13, 29)	N/A	12 (6, 23)	9 (5, 17)	34 (25, 44)
Gender
Male	5 (3, 9)	15 (10, 23)	2 (1, 9)	9 (5, 16)	4 (2, 8)	23 (17, 31)
Female	3 (1, 8)	11 (7, 17)	6 (2, 15)	15 (7, 29)	4 (2, 10)	22 (17, 30)
Race/Ethnicity
Black	1 (0, 3)	7 (4, 14)	2 (1, 6)	14 (7, 26)	2 (1, 6)	15 (11, 20)
White	4 (2, 9)	22 (16, 31)	4 (1, 15)	12 (5, 24)	5 (2, 12)	29 (22, 38)
Hispanic	11 (5, 24)	10 (3, 26)	1 (0, 4)	0	0 (0, 1)	21 (12, 34)
Other	10 (2, 41)	12 (5, 28)	32 (14, 58)	34 (7, 78)	15 (4, 41)	47 (25, 70)
Placement Type
Foster home	4 (2, 8)	12 (9, 18)	6 (2, 14)	12 (7, 22)	3 (1, 7)	24 (20, 28)
Kin care	3 (1, 10)	8 (3, 22)	0 (0, 3)	4 (1, 18)	0 (0, 1)	12 (6, 21)
Group home	11 (4, 29)	38 (28, 49)	0	32 (13, 60)	21 (12, 34)	59 (42, 75)
Most Serious Abuse Type
Physical	2 (0, 15)	21 (11, 37)	0	4 (1, 14)	1 (0, 6)	26 (15, 41)
Sexual	14 (5, 35)	22 (8, 48)	0	17 (7, 37)	6 (2, 20)	46 (26, 68)
Failure to Provide	2 (1, 5)	10 (6, 18)	8 (3, 22)	2 (1, 5)	2 (1, 7)	17 (10, 28)
Failure to Supervise	1 (0, 4)	16 (9, 26)	1 (0, 6)	17 (8, 33)	2 (1, 7)	25 (15, 39)
Other	12 (3, 34)	2 (0, 11)	0	3 (0, 20)	3 (1, 11)	16 (6, 35)
CBCL Score
Non-clinical score	3 (1, 7)	11 (7, 16)	6 (2, 18)	6 (1, 27)	1 (0, 3)	18 (12, 26)
Borderline/Clin. score	8 (4, 14)	20 (14, 28)	2 (1, 8)	17 (11, 25)	8 (4, 14)	35 (28, 43)
Proportion of Clinical Scores
0	0 (0, 2)	8 (4, 17)	3 (1, 11)	0 (0, 3)	0 (0, 2)	10 (5, 18)
0 .17 to 0.25	3 (1, 6)	11 (5, 22)	1 (0, 5)	6 (1, 21)	5 (2, 12)	18 (10, 30)
0.33 to 0.50	8 (3, 19)	20 (12, 30)	18 (4, 55)	7 (2, 18)	4 (2, 8)	33 (24, 45)
0.60 to 1.0	10 (4, 25)	18 (9, 33)	3 (1, 10)	50 (34, 66)	10 (3, 26)	42 (33, 51)

 

With regard to race, significantly more white children (5%) than Hispanic children (0%) had been to a psychiatric hospital or unit (p<.05), and significantly more white children (22%) then black children (7%) had received private professional help (p<.05). Children in group homes (21%) were significantly more likely than those in both foster homes (3%) and kin care settings (0%) to have been to a psychiatric hospital or unit (p<.01). Similarly, children in group homes (59%) were significantly more likely than those in both foster homes (24%) and kin care settings (12%) to have received at least one specialty mental health service (p<.01).

The proportion of clinical scores (see Chapter 3) appears to be associated with whether OYFC children received several of the specialty mental health services. It was most significant for day treatment, as 50% of children with a “clinical” score on between 60% and 100% of the measures administered to them received this service—significantly different than those with 33% to 50% clinical scores (7%), 17% to 25% clinical scores (6%), or no clinical scores (0%) (p<.01). In addition, children with no clinical scores had been to a mental health or community health center in significantly lower proportions (0%) than those with between 33% and 50% clinical scores (8%) and 60% to 100% clinical scores (10%) (p<.05). Similarly, no children without a clinical score had been to a psychiatric hospital or unit, whereas 10% of children with 60% clinical scores or higher, had been hospitalized (p<.01). Finally, children with between 60% and 100% clinical scores (42%) were significantly more likely to have received at least one specialty mental health service than those with no clinical scores (10%) and those with between 17% and 25% clinical scores (18%) (p<.01). All of these relationships indicate that children with greater levels of social and cognitive problems on standardized measures are more likely to receive mental health services.

Our results indicate that between one-third and one-half of all the children who have very high proportions of clinical scores are receiving some kind of specialty mental health service. However, this could be because the proportion of “clinical scores” is a bit of a misnomer, since some of the scores were generated from measures of academic achievement rather than social or mental health problems. Among the children with a clinical CBCL score, 35% were receiving specialty mental health services—significantly different (at the p<.01 level) than the 18% of children with a non-clinical CBCL score who are receiving specialty mental health services.

We also examined the relationship between a child’s having a clinical CBCL score and receipt of specific specialty mental health services and found significant differences with regard to admission to a psychiatric hospital or unit and receipt of private professional help. Specifically, children with clinical CBCL scores were much more likely than children with non-clinical CBCL scores to have been admitted to a psychiatric hospital or unit (8% vs. 1%, p<.01) or to have received private professional help (20% vs. 11%, p<.05).

To further examine the relationship between various child and case characteristics on the OYFC child’s receipt of specialty mental health services, a logistic regression was performed that modeled receipt of any of the five specialty mental health services since the investigation date as reported by the current caregivers. The results are summarized in Table 6-24. Comparisons within the variables of placement type, most serious abuse type, child race/ethnicity, and the proportion of clinical scores were significant. Specifically, the model indicates children in both foster homes and kin care settings are significantly less likely than those in group homes to have received a specialty mental health service (p<.05). In addition, children with a most serious abuse type of other are less likely than those with a most serious abuse type of sexual maltreatment to have received a specialty mental health service (p<.05).

Table 6-24. Results of Logistic Regression Modeling on Receipt of Any Specialty MH Service by OYFC Children Currently in Out-of-Home Care

	Any specialty mental health service
	OR	95% CI
Age
2^	0.54	0.12, 2.46
3-5	0.67	0.22, 2.05
6-10	0.86	0.30, 2.45
11+	(reference group)
Gender
Male	1.07	0.54, 2.10
Female	(reference group)
Race/Ethnicity
Black	(reference group)
White	2.57**	1.35, 4.88
Hispanic	2.76	0.90, 8.41
Other	3.13	0.94, 10.37
Placement Type
Foster home	0.23*	0.06, 0.98
Kin care	0.13*	0.02, 0.76
Group home	(reference group)
Most Serious Abuse Type
Physical	0.68	0.19, 2.45
Sexual	(reference group)
Failure to Provide	0.54	0.21, 1.40
Failure to Supervise	1.00	0.33, 3.02
Other	0.23*	0.07, 0.81
CBCL Scores
Non-clinical score	(reference group)
Borderline or Clinical Score	1.07	0.33, 3.48
Proportion of Clinical Scores
0	0.17**	0.05, 0.57
.17 to .25	0.26*	0.08, 0.83
.33 to .50	0.48	0.19, 1.24
.60 to 1	(reference group)

^ One-year-olds are not included because they do not have a CBCL score. * p<.05; ** p<.01; Cox and Snell pseudo-R-square is .17.

 

Child race/ethnicity and the proportion of clinical scores were also significantly related to receipt of specialty mental health services. White children were significantly more likely than black children to have received a specialty mental health service (p<.01). In addition, children with between 60% and 100% clinical scores were significantly more likely to have received a specialty mental health service than those with no clinical scores (p<.01) and those with between 17% and 25% clinical scores (p<.05). This belies the arguments that mental health services are given to all children in foster care as a routine part of their service package or that they are provided based on availability rather than the needs of the child. At the same time, there appear to be many children with mental health problems who are not receiving specialty mental health care.

What supplementary or special education services did OYFC children need and receive?

In Chapter 3 of this report, and in previous research, children who have been in foster care have been shown to have poor educational attainment (Cook, 1997) and elevated receipt of special education services (Goerge et al., 1992). Our understanding of the types of educational services received by foster children is, however, quite limited and does not provide any basis for determining the relationship between a child’s needs and his/her receipt of educational services. Although a few estimates of the penetration rates of foster children into special education services exist, there is less information available about the receipt of other supplementary educational services to try to improve a foster child’s educational progress. We distinguish between special education and supplementary educational services for two reasons. First, the use of nonroutine, supplementary educational services (like tutoring) may be important to preventing students from needing special education services or otherwise falling behind. Their existence for foster children deserves documentation. Second, the survey did not always ask for the source of the services—i.e., whether or not they were provided by special education resources and under the auspices of an Individual Family Service Plan (IFSP) or Individual Education Plan (IEP) is not known. In these cases we treat them as “supplementary or special education” services. Children in this category could have been receiving either type or both types of services.

In this section, we look at several ways to estimate the need for and receipt of educational services. Child welfare workers were asked if the children under their supervision needed a variety of services and whether those services were provided to the child. Caregivers and teachers also indicated whether there was receipt of supplementary or special education services. In addition, we used information from the developmental assessments of the child, described in Chapter 3, to determine whether it was likely that the child would need special education services.

Child Welfare Workers’ Views on Children’s Educational Needs and Services Receipt

Child welfare workers indicated whether children needed any of the following services in the past 12 months: services to identify a learning problem or developmental disability; special education classes or services; tutoring; or services for any emotional, behavioral, or attention problem. About half of the OYFC children currently in out-of-home care (49%) were reported to need services for an emotional, behavioral, or attention problem, while almost two-fifths (39%) needed services to identify a learning problem or developmental disability. Just over one-quarter (26%) were identified as needing special education classes or services, and 17% needed tutoring (Table 6-25).

Table 6-25. Need of OYFC Children Currently in Out-of-Home Care for Supplementary or Special Education Services in the Past 12 Months: Child Welfare Workers' Report

Type of service	Proportion needing service % (95% CI)
Identify Learning Problem	39 (31, 47)
Special Education Classes/Services	26 (19, 34)
Tutoring	17 (14, 22)
Services for Emotional/Behavioral/Attention Problem	49 (44, 54)

 

If a need was identified, the child welfare worker was asked if agency staff had referred the child to the needed service. If no referral had been made, the child welfare worker was asked the reason. If a referral had been made, the child welfare worker was asked the result of the referral (i.e., service received or not received). If the child did not receive the service as a result of the referral, the child welfare worker was asked the reason. These data are summarized in Table 6-26. Overall, 15% of all children currently in out-of-home care were identified as needing—but not receiving—one or more supplementary or special education services.

Next, recognizing that child welfare workers may not have access to all the information about children’s services, we wanted to better understand the supplementary and special education services that children in out-of-home care actually receive. For these analyses, we examined questions that were asked of the child’s child welfare worker, current caregiver, and teacher. As just described, the child welfare worker was asked if the child was referred to or was already receiving any of the following: services to identify a learning problem or developmental disability; special education classes or services; tutoring; or counseling for an emotional, behavioral or attention problem. Child welfare workers were also asked if a formal assessment of the child had been made for an emotional, behavioral, or attention problem and if an IFSP was developed for the child. The caregiver was asked if the child had been tested for learning problems, if a professional had said the child had learning problems, if the child had been classified as needing special education services, or if the child was receiving or had received special education services. The teacher survey included items to indicate if the student had been given an IEP; if the student is educated in a special school, special class in a regular school, and/or a resource room; what percent of the day the student is served by special education; and what services other than special education instruction the student is receiving to address his/her special educational needs.

Table 6-26. Met and Unmet Need of OYFC Children Currently in Out-of-Home Care for Supplementary or Special Education Services: Child Welfare Worker's Report

	%
Service to Identify Learning Problem
Still needed	6
Received service after referral	25
Referral made and service determined not to be needed	1
Already receiving service	8
No need & no referral	60
Special Education Classes/Services
Still needed	5
Received service after referral	13
Referral made and service determined not to be needed	0
Already receiving service	8
No need & no referral	74
Tutoring
Still needed	4
Received service after referral	7
Referral made and service determined not to be needed	0
Already receiving service	7
No need & no referral	82
Services for Emotional/Behavioral/Attention Problem
Still needed	4
Received service after referral	39
Referral made and service determined not to be needed	1
Already receiving service	6
No need & no referral	50

 

To obtain a comprehensive view of the totality of supplementary and special educational services received, information from all three sources was considered. If any of the three respondents—the child welfare worker, caregiver, or teacher—indicated that the child was getting supplementary or special education services, the child was classified as having received a supplementary or special educational service. This approach was used because different respondents know about different elements of services—for example, only the foster parent might know if the child was receiving tutoring during an after-school program. In total, 86% of all OYFC children currently in out-of-home care are receiving supplementary and/or special education services.

Receipt of Special Education Services

A narrower approach was taken to obtain an estimate of students who were receiving formal special education services. In this analysis, only items specifically identifying receipt of special education services were included. Further, rather than accepting a “yes” response from any respondent with regard to the child’s receiving services, a hierarchy was implemented to identify the most accurate answer, when respondent answers were inconsistent. Out of the 727 OYFC cases, 100 (14%) had inconsistent responses across the three instruments. In order to resolve the inconsistent cases, teacher’s responses (if non-missing) were treated as definitive. A decision to weight the caregiver’s response over the child welfare worker’s response was made based on 91% agreement (total n=124) between the teacher and caregiver instruments, as opposed to only 78% agreement (total n=60) between the teacher and child welfare worker instruments. Utilizing this method (i.e., hierarchy of teacher, caregiver, child welfare worker), the data indicate that 26% of all OYFC children currently in out-of-home care receive special education services. (If precedence had been given to the child welfare worker over the caregiver this would have resulted in a weighted percentage of those receiving special education services of 41%.)

Next, we examined the relationship between children’s characteristics and their receipt of supplementary or special education services or special education services alone. As an approach to estimating the proportion of children in out-of-home care who had a need for supplementary or special education services and received them, children’s developmental scores were compared with their receipt of services. For this analysis, we looked at the population of OYFC children currently in out-of-home care with a clinical or borderline score on one or more of the measures as described in Section 3.4, with two differences: the Teacher Report Form was added as an additional source of information about mental health functioning. We then identified the proportion of this population that received some type of supplementary or special education testing, classification, or services as determined by the aforementioned questions. The results are presented in Table 6-27. Overall, 36% of OYFC children currently in out-of-home care with a clinical score on at least one of the indicated measures have been classified as receiving special education services, and 92% have been classified as receiving supplementary or special education services.

Table 6-27 also indicates the proportion of children receiving supplementary or special education services by various child and case characteristics. Significant differences emerged between age categories when looking at special education services alone, as well as supplementary and special education services. Specifically, significantly fewer children currently in out-of-home care between the ages of 3 and 5 with at least one clinical score (10%) have received special education services than 6- to 10-year-olds with at least one clinical score (43%) and children 11 years of age and older with at least one clinical score (47%) (p<.05). With regard to supplementary and/or special education services, significantly more children currently in out-of-home care 11 years of age and older with at least one clinical score (98%) have received supplementary or special education services than 3- to 5-year-olds with at least one clinical score (92%) (p<.05).

A significant difference emerged between categories of most serious abuse type when looking at special education services only. Specifically, significantly more children with a most serious abuse type of physical maltreatment (58%) have been classified as receiving special education services than children with a most serious abuse type of failure to provide (28%) (p<.05). Placement type was significant with regard to supplementary and special education services. Children in kinship care (80%) are significantly less likely to receive these services than children in non-kinship foster homes (96%; p<.01) and children in group care (96%; p<.05).

Table 6-27. Percent of OYFC Children Currently in Out-of-Home Care with at Least One Clinical Score^ Receiving Supplementary or Special Education Services

	Percent (95% CI)
	Special education services	Supplementary or special education services
TOTAL	36 (27, 47)	92 (87,95)
Age
1-2	24(12, 42)	84 (67,93)
3-5	10 (4, 24)	92 (80, 97)
6-10	43 (32, 54)	91 (80, 96)
11+	47 (36, 59)	98 (92, 99)
Gender
Male	40 (27, 55)	95 (89, 97)
Female	32 (24, 42)	88 (80, 94)
Race/Ethnicity
Black	36 (27, 46)	88 (76, 94)
White	40 (28, 53)	96 (89, 98)
Hispanic	32 (14, 57)	90 (70, 97)
Other	32 (15, 56)	99 (93, 100)
Placement Type
Foster home	39 (29, 50)	96 (92, 98)
Kin care	19 (8, 39)	80 (71, 87)
Group home	66 (52, 78)	96 (75, 99)
Most Serious Abuse Type
Physical	58 (41, 73)	99 (96, 100)
Sexual	44 (28, 61)	95 (67, 99)
Failure to Provide	28 (18, 40)	92 (84, 96)
Failure to Supervise	36 (21, 56)	92 (84, 96)
Other	51 (22, 79)	97 (84, 99)

^ BDI, BINS, CBCL, K-BIT, MBA, PLS-3, SSRS, TRF, VABS

 

To further examine the effects of the various child and case characteristics on the OYFC child’s receipt of supplementary or special education services, four logistic regression models were performed to model receipt of supplementary or special education services as reported by the child welfare worker, current caregiver, and teacher. Because of the differences in measures and services for younger children (1 to 5), they were modeled separately; results appear in Table 6-28.

Children aged 1 to 5 were identified as needing supplementary or special education services if they had one or more score in the clinical range on one of the measures that we judged to be most relevant to school achievement: the BDI, BINS, CBCL, K-BIT, PLS-3, SSRS, or Vineland Screener: Daily Living Skills. In the regression that modeled receipt of special education services, both child age and race/ethnicity are significant. Children aged 1 to 2 are significantly more likely than children age 3 to 5 to receive special education services (OR= 6.57, p < .01), and Hispanic children are significantly more likely than black children to receive such services (OR= 9.36, p < .01). The model that included receipt of supplementary education as well as special education services indicates only that children in kinship care are far less likely than children in non-kin foster care to receive supplementary or special education services (OR= 13.91, p < .001).

Table 6-28. Results of Regressions Modeling Receipt of Supplementary or Special Education Services for Children Currently in Out-of-Home Care With At Least One Clinical Score^ (1-5 years of age)

	Received Special Education Services		Received Supplementary or Special Education Services
	OR	95% CI	OR	95% CI
Age
1-2	6.57*	1.53, 28.27	0.50	0.09, 2.75
3-5	(reference group)
Gender
Male	2.62	0.47, 14.73	2.25	0.69, 7.30
Female	(reference group)
Race/Ethnicity^^
Black	(reference group)
White	1.29	0.21, 8.07	2.19	0.36, 13.32
Hispanic	9.36*	2.05, 42.77	2.08	0.32, 13.53
Placement Type
Foster home	5.42	0.84, 34.83	13.91**	3.34, 57.90
Kin Care	(reference group)

*p<.01, ** p<.001; Cox and Snell pseudo-R-squares are .29 (special education services) and .20 (supplementary or special education services). ^ BDI, BINS, CBCL, K-BIT, PLS-3, SSRS, VABS. ^^ “Other” race/ethnicity not included due to small sample size.

 

We completed similar analyses (looking at special education services alone, as well as combined supplementary and special education services) for children 6 and older, selected if they had one score or more in the clinical range on the CBCL, K-BIT, MBA, SSRS, TRF, or Vineland Screener: Daily Living Skills. These models are summarized in Table 6-29. In the regression that modeled receipt of special education services, the placement type is significant, with children in group care significantly more likely than children in foster homes (OR = .48, p < .05) and children in kin care (OR = .20, p < .05) to receive such services. In the regression that included receipt of supplementary education as well as special education services, only the gender of the child is significant, with boys having a higher likelihood of receiving supplementary or special education services (OR = 5.16, p < .05).

Table 6-29. Results of Regressions Modeling Receipt of Supplementary or Special Education Services for Children Currently in Out-of-Home Care with at Least One Clinical Score^ (6-15 years of age)

	Received Special Education Services		Received Supplementary or Special Education Services
	OR	95% CI	OR	95% CI
Age
6-10	0.87	0.42, 1.81	0.24	0.04, 1.34
11-15	(reference group)
Gender
Male	1.26	0.64, 2.49	5.16*	1.10, 24.21
Female	(reference group)
Race/Ethnicity
Black	(reference group)
White	0.63	0.26, 1.50	2.37	0.31, 17.94
Hispanic	0.38	0.10, 1.41	1.09	0.14, 8.67
Other	0.65	0.26, 1.61	3.77	0.32, 44.65
Placement Type
Foster home	0.48*	0.24, 1.00	1.49	0.11, 19.95
Kin Care	0.20*	0.06, 0.71	0.41	0.03, 5.51
Group Care	(reference group)

* p<.05; Cox and Snell pseudo-R-squares are .09 (special education services) and .08 (supplementary or special education services). ^ CBCL, K-BIT, MBA, SSRS, TRF, VABS.

6.5 Child Welfare Worker and System Characteristics

Nationally, there is limited information about the characteristics of child welfare workers involved with children at one year after placement into foster care. Their experience, race, education, training, morale, and compensation could all influence the way that they provide services. NSCAW provides a snapshot of who they are.

Although children are likely to have had more than one child welfare worker by the time they have been in foster care for one year, we ascertained the characteristics of their child welfare worker at the time of the baseline data collection. More than half were under 40 years old, 17% were between 40 and 49 years, and 18% were 50 and over. About 46% were white, 32% black, 11% Hispanic, and 12% identified themselves as other race or ethnicity.

To what extent does the race of the child match the race of the child welfare worker?

We also considered the distribution of children across child welfare workers. (Again, children in group care were excluded from these analyses.) Table 6-30 should be read as: 52% of all black/non-Hispanic children had black child welfare workers, 39% of black/non-Hispanic children had white child welfare workers, 4% of black/non-Hispanic children had Hispanic welfare workers, and 5% of black/non-Hispanic children have welfare workers of another race (“other”). Most black and white children had black and white welfare workers, respectively. However, most Hispanic children had white child welfare workers. About one-third of children of “other” races had welfare workers of “other” races and about one-third had white welfare workers.

Table 6-30. A Comparison of the Child Welfare Worker's Race to the Child's Race^

Child race (%)	Child welfareworker race (%)
	Black	White	Hispanic	Other
Black/non-Hispanic	52 (39, 66)	39 (27, 51)	(0.8, 13)	5 (3, 11)
White/non-Hispanic	17 (9, 29)	64 (47, 78)	9 (4, 21)	10 (4, 22)
Hispanic	16 (7, 32)	50 (26, 74)	19 (9, 35)	15 (4, 42)
Other	(3, 35)	30 (11, 59)	26 (7, 61)	33 (6, 80)

^ Percentages in bold indicate matches between child welfare worker and child race/ethnicity. Rows may not sum to 100% due to rounding.

 

Is there a relationship between race and age of these child welfare workers?

Although the relationship displayed in Table 6-31 between the race and the age of the child welfare workers is not significant, white child welfare workers had the highest percentage of workers in the 50-years-and-over age group. In addition, more Hispanic child welfare workers were under 30 than those of any other race group. The majority of child welfare workers in all race groups were aged 39 or younger.

Table 6-31. Race and Hispanicity of Child Welfare Worker, by Age of Child Welfare Worker

Age	Child welfare worker race
	Black (%)	White (%)	Hispanic (%)	Other (%)
<30 years	27 (18, 38)	31 (23, 41)	43 (24, 65)	27 (16, 41)
30-39 years	39 (27, 52)	28 (21, 38)	29 (12, 55)	51 (40, 62)
40-49 years	22 (16, 31)	16 (12, 21)	18 (10, 31)	9 (6, 15)
50 and over	12 (7, 19)	24 (18, 32)	10 (2, 32)	13 (8, 22)

 

What is the education level of child welfare workers?

The educational preparation of these child welfare workers varied widely, as indicated in Table 6-32. About 60% had a bachelor’s degree, and about 25% of those had their bachelor’s in social work. Twenty-one percent had a master’s in social work, and 16% had a master’s degree in another discipline. The child welfare workers who had a bachelor’s or master’s in social work training represented less than half (46%) of all those working with these children in foster care. Small proportions of the child welfare workers did not have any college degree or, at the other end of the spectrum, had a higher degree than a master’s.

Table 6-32. Child Welfare Worker Highest Educational Degree

Less than bachelor's degree	Bachelor’s in social work	Other bachelor’s degree	Master’s of social work	Other master’s degree	Ph.D. or other doctoral degree
2	25	36	21	16	0.10
(0.7, 4)	(21, 30)	(31, 42)	(15, 29)	(8, 28)	(.02, 0.48)

 

Is there a relationship between child welfare worker’s race and education level?

Figure 6-6 indicates that the child welfare worker’s race is significantly related to his or her degree (p<.05). Black, white, and Hispanic child welfare workers were most likely to have a bachelor’s degree in something other than social work than any other type of degree. Child welfare workers of “other” races were most likely to have a master’s degree in something other than social work than any other type of degree.

Figure 6-6. Child Welfare Worker Degree by Child Welfare Worker Race

[D]

6.6 Agency Characteristics and Service Delivery

Child welfare services are local in nature and those locations may be significantly related to service configurations. Using information collected in interviews with child welfare managers, we examined a few questions about the relationship between agency and Primary Sampling Unit characteristics and service delivery.

How do case characteristics vary by PSU characteristics?

We looked at several case variables from the perspective of four Primary Sampling Unit (PSU) characteristics to examine variance across PSU types. The case variables analyzed were out-of-home placement type, presence of reunification plans or previous efforts, special foster parent training, number of risks present in the household at time of placement, severity and duration of abuse (SxD score), proportion of clinical scores, overall z-score, and four child welfare worker characteristics: length of service, highest degree, race/Hispanicity, and age. The PSU characteristics compared were administration of the child welfare agency (state or county), PSU size (small/medium or large), urbanicity (rural or urban), and poverty level (poor or non-poor).

For the majority of the variables, no differences emerged across the four PSU characteristics. However, a few variables were notably different based on type of PSU. With regard to the number of risks present in the household at the time of placement, children in rural PSUs had significantly more risks than did those in urban PSUs (p<.05). In addition, children in non-poor PSUs had significantly more risks than did those in poor PSUs (p<.01).

The other two variables with notable differences were both child welfare worker characteristics—highest degree and race. It seems that county-administered agencies employ child welfare workers with more advanced degrees, as they have significantly more with social work and other master’s degrees and significantly fewer with social work and other bachelor’s degrees compared with state-administered agencies (p<.001). Although non-poor PSUs have significantly fewer child welfare workers with BSWs, they have significantly more with MSWs, as well as significantly more with other bachelor’s degrees. Poor counties have significantly more child welfare workers with other master’s degrees (p<.001). Small or medium, rural, and non-poor PSUs were all less diverse than their counterparts with regard to the race of their child welfare workers, as they had significantly fewer black and other race child welfare workers than large, urban, and poor PSUs (p<.05, p<.01, and p<.05, respectively). Small or medium and rural PSUs also have fewer Hispanic child welfare workers (p<.05 and p<.01, respectively).

 

 

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