Expedited Family

Reunification Project

Arizona Child Welfare Demonstration Project

Overview of Project

Description of Project Project Outcomes Program Components

Description of Project

Arizona’s project is designed to expedite reunification of children who are placed in out-of-home care through intensive in-home and aftercare services.

Description of Project

Target population are children who are: in out-of-home placement for no more than 9

months; in congregate care or licensed foster care

settings; for whom reunification is a case goal; and for whom the juvenile court concurs with a

case plan of expedited reunification

Description of Project

Located in Maricopa County Child Protective Services offices

Implementation in two phases

Phase 1 began in April 2006

Phase 2 began in January 2008

Project Outcomes

Reduce children’s length of stay in congregate and licensed foster care settings.

Decrease the likelihood of re-entry into out-of-home care.

Prevent the recurrence of child abuse and neglect.

Improve family-well being and functioning.

Program Components

Child and Family Teams Home Based Strategies and Interventions Flexible Funding Role of the child protection services worker and

waiver service provider

Child and Family Teams

Provides strength based framework for reunification

Team includes everyone involved in the case The team is responsible for all assessment, planning, intervention and aftercare phases of the reunification process

Home Based Strategies and Interventions

Array of services provided based on needs identified Minimum of 6 hours per week of face-to-face contact with clients Intensive visitation between parent (s) and children One provider for all services, monitoring and coordination

Flex Funding

Flex funds are used to address needs

such as: Specialized services Housing/Utilities assistance Transportation Job related expenses

Role of Workers

Provider staff (Expedited Reunification Team) Provider of all services to family Lead in facilitating CFTs Coordination of all services

Role of Workers

CPS WorkerRetains legal responsibilityProvide oversight of planning processNot make independent decisionsWork with the Expedited Reunification

Team

Evaluation Design

Existing Case CohortApril 2006 – June 2006

Waiver CasesAll eligible casesIn 6 CPS units

Comparison CasesAll eligible casesIn 3 CPS units

3 CPS Officeseach office with

2 units for waiver1 unit for comparison

New Case CohortJuly 2006 – December 2007

3 CPS OfficesAll new cases screened for

eligibility & exclusion

Random Assignment

Waiver CasesComparison Cases

Phase I: April 2006 – July 2007

Total Cases N = 174

(Ndeclined=13)

Matched N = 102

(Ndeclined=7) 4/17/06 – 6/30/06

Randomized N = 72

(Ndeclined=6) 7/01/06 – 7/31/07

Comparison n = 44

(ndeclined=1)

Waiver n = 58

(ndeclined=6)

Comparison n = 42

(ndeclined=1)

Waiver n = 30

(ndeclined=5)

AzPac: n=10 n=22 n=13 n=10 JFCS: n=34 n=36 n=29 n=20

Primary Caregiver Characteristics

94% mothers 85% Caucasian 24% Hispanic or Latina/o 9% African American 2% American Indian 33.8 years of age (avg) 16 to 69 years of age (range)

Target Child Characteristics

55% males 45% females 86% Caucasian 28% Hispanic or Latina/o 13% African American 2% American Indian 7.2 years of age (avg) 1 to 17 years of age (range)

Safety Related Outcomes

Is there a reduction in the recurrence of child abuse and neglect?

Summary of Substantiated Abuse and Neglect Reports Phase I – April 17, 2006 – July 31, 2007

Matched Cohort 4/17/06 – 6/30/06

Randomized Cohort 7/1/06 – 7/31/07

Waiver Comparison Waiver Comparison Total Cases in Demonstration Project 58 44 30 42 Number of cases with a report 8 9 4 5 Number of cases with substantiated report 1 0 0 0 Number of cases with unsubstantiated report 7 9 2 5 Number of cases with open report 0 0 2 0

Permanency Related Outcomes

Is the time in out-of-home placement reduced?

Summary of Reunified Cases Phase I – April 17, 2006 – July 31, 2007

Matched Cohort 4/17/06 – 6/30/06

Randomized Cohort 7/1/06 – 7/31/07

Waiver Comparison Waiver Comparison Total Cases in Demonstration Project 58 44 30 42 Number of cases reunified 14 13 13 7 % of Total cases reunified 24% 29% 43% 17% Number of children reunified 21 21 27 11 Length of time in out-of-home care from waiver begin date to reunification date Mean number of days Median number of days

183.6 147.0

235.9 243.0

171.1 161.0

158.5 171.0

Reentry Into Out-of-Home Placement

Is there a reduction in subsequent out-of-home placements?

Summary of Reunified Cases Returned to Out-of-Home Care Phase I – April 17, 2006 – July 31, 2007

Matched Cohort 4/17/06 – 6/30/06

Randomized Cohort 7/1/06 – 7/31/07

Waiver Comparison Waiver Comparison Total Cases in Demonstration Project 58 44 30 42 Number of cases reunified 14 13 13 7 Number of cases returned to out-of-home care

4 3 2 1

% reunified cases returned to out-of-home care

28% 23% 15% 14%

Number of children returned to out-of-home care

7 3 4 1

Length of time from reunification to out-of-home-placement Mean number of days Median number of days

98.4 53.5

79.7 109.0

108.2 108.5

100.0 100.0

Child and Family Well-Being Is there an increase in overall family well-

being and functioning?Summary of Child and Family Well Being

North Carolina Family Assessment Scale – Mean Ratings (std dev)1 Phase I – April 17, 2006 – July 31, 2007

Matched Cohort 4/17/06 – 6/30/06

Randomized Cohort 7/1/06 – 7/31/07

Waiver Comparison Waiver Comparison Cases with initial and closure ratings 27 0 4 1 A. Overall Family Environment Initial Closure

3.8 (1.5) 2.9 (1.5)

n/a

3.2 (1.7) 3.7 (2.6)

2.0 2.0

B. Overall Parental Capabilities Initial Closure

3.6 (1.1) 3.0 (1.5)*

n/a

3.0 (1.1) 2.2 (1.5)

5.0 3.0

C. Overall Family Interactions Initial Closure

3.0 (1.0) 2.5 (1.0)

n/a

2.5 (1.3) 2.5 (1.9)

4.0 4.0

D. Overall Family Safety Initial Closure

2.9 (1.1) 2.6 (1.3)*

n/a

2.7 (1.5) 2.7 (2.1)

4.0 2.0

E. Overall Child Well-Being Initial Closure

3.6 (1.1) 2.7 (1.3)*

n/a

2.0 (1.4) 1.7 (.9)

6.0 2.0

F. Overall Caregiver/ Initial Child Ambivalence Closure

2.4 (1.2) 2.3 (1.2)*

n/a

1.5 (.6) 2.5 (1.9)

5.0 2.0

G. Overall Readiness Initial for Reunification Closure

3.9 (1.1) 3.2 (2.0)

n/a

3.7 (1.5) 3.5 (2.9)

5.0 4.0

1 Items were initially rated using a six-point Likert scale ranging from Clear Strength (+2), Baseline/Adequate (0), to Serious Problem (-3). For analytical purposes the scale was transposed, where 6 presented serious problem, 3 represented baseline/adequate, and 1 represented clear strength. Higher mean ratings indicate problems, while lower mean ratings indicate strengths.

Summary and Accomplishments

Full implementation of project within nine months of waiver approval

Over 100 children from 88 eligible cases received waiver services

A higher percentage of waiver cases (43%) reunified than comparison cases (17%) for new cases July 1, 2006 and after

Improvements in selected child and family domains for existing waiver families

Lessons Learned

Develop strategies to better integrate waiver and substance abuse services

Explore strategies for continual training on waiver services and procedures

Develop increased management system support Develop quality measures on key waiver service

components Provide monthly reports to implementation team

on process, outcome, and cost indicators

For additional information:

Flora Sotomayor

IV-E Waiver Project DirectorDivision of Children, Youth & Families

Arizona Department of Economic Security

1789 W. Jefferson

Phoenix, AZ 85007

(602) 364-1346

fsotomayor@azdes.gov