The Child Welfare Demonstration Program is authorized under section 1130 of the Social Security Act as amended by Public Law 105-89. These demonstration projects involve the waiver of certain requirements of titles IV-B and IV-E, the sections of the Act that govern foster care, adoption assistance, independent living, child welfare services, promoting safe and stable families, family preservation and support, and related expenses for program administration, training and automated systems. This authority provides States with an opportunity to develop creative approaches to dismantle the many barriers that may exist between children waiting in foster care and permanency. The States can design and demonstrate a wide range of approaches to improve and reform child welfare. These demonstrations will provide valuable knowledge that will lead to improvements in the delivery, effectiveness and efficiency of services. Thus far, 24 states are participating in the demonstration program.

In January 2000, the Department of Health and Human Services announced important child welfare regulations that will improve outcomes for abused and neglected children, children in foster care, and children awaiting adoption. The regulations will hold States accountable for services to at-risk children with a new, results-oriented approach in Federal monitoring of State child welfare programs. Under the regulation, States will be assessed for compliance with Federal requirements for child protective services, foster care, adoption and family preservation and support services under titles IV-B and IV-E of the Social Security Act.

The reviews will cover two areas: outcomes for children and families in terms of safety, permanency and child and family well-being; and the administration of State programs that directly affect the capacity to deliver services leading to improved outcomes. Federal staff will work with States in making improvements in programs before assessing penalties and withholding funds. If a State remains in noncompliance, a financial penalty will be assessed.

On October 31, 2001, The Research Forum hosted a conference at which researchers and policymakers discussed how research on child welfare may affect future policy. View the Child Welfare Conference Report. View the brief conference summary

Additional Resources on Child/Family Policy

Selected Summary Findings in Brief

Connecticut Child Welfare Waiver Project Findings:

• Children Referred: Of the total children evaluated for inclusion in the demonstration, 2/3 of the cases were deemed as having mental health needs too severe for them to be included in the demonstration.
• Services: The state found statistically significant differences in the percentage of children receiving the following 9 services (Crisis stabilization; Day treatment; Family therapy; Family preservation; Family support services; Behavioral aide; Respite care; Transportation services; and Flexible funds) as compared to the control group.

  The State also reported differences in the number of service units provided to families each month. The LSAs provided experimental group children with more frequent case management, family support, and transportation services than DCF provided to control group children. The LSAs provided children with less frequent medication/treatment monitoring, residential treatment, and inpatient hospitalization than DCF provided to children.

• Placement: The State reported that, on average, both groups of children (experimental and control) spent the predominant amount of their time in residential treatment centers.

  The lead service agencies (LSAs) were more successful at returning children home faster.

• Mental Health Outcomes: The State reported that both experimental and control group children improved significantly from program entry to 12 months using three measures of clinical mental health symptoms. The same rate of improvement between the two groups was evident on all three measures: reduction in clinical symptoms, decreases in level of functional impairment, and increases in strengths. Results at the 24-month interval showed continued improvements. Rates of improvement in clinical symptoms were above 50 percent for both experimental and control group children.
• Placement and Mental Health Outcomes: According to the State, the data suggests that there is a strong association between placements and mental health outcomes, and that many children experienced improvements in their mental health status, resulting in less restrictive placements. Specifically, children maintained in in-home settings showed the most improvement in behavior and functioning. The type of service program (i.e., DCF versus LSA) did not appear to have a significant affect on this relationship.

Delaware Child Welfare Waiver Project Findings:

• Children Referred: The total number of title IV-E eligible families enrolled in the demonstration was 36, and 18 families were pending approval. All of the children in the assisted guardianship program had special needs, particularly with respect to age and ethnicity.
• The average time for a guardianship to be awarded was 9 months but ranged from less than 3 months to more than year. Most of this time was spent waiting for a court date.
• Outcome findings were complicated due to a small sample and low response rates. While interview and survey responses indicated positive attitudes toward assisted guardianship, very few caseworkers and caretakers participated in interviews or returned surveys. The State's March 2002 Final Evaluation Report indicated that the individuals who completed surveys generally expressed satisfaction with assisted guardianship.

• Services: By February 2002, Delaware had served 530 families (53%). They cited early problems in referring individuals to substance abuse services. Counselors worked an average of nine months with cases (longer than the expected three months) and thus had larger caseloads and were unable to accept new referrals. One of the most significant challenges to implementation was the lack of external services.
• The average time spent in foster care was reduced by one third.
• The proportion of cases with children entering foster care was lower in the experimental group (33 percent) than in the control group (40 percent). However, no statistically significant differences were found regarding length of time to achieve permanency or the percentage of closures due to case plan completion.
• Cost neutrality had been achieved by February 2001.

Indiana Child Welfare Waiver Project Findings:

• One implementation barrier was identifying targeted numbers of title IV-E eligible children.
• Counties had increased, at a statistically significant level, delivery of the following services to cases in the experimental group: family preservation services, individual counseling, childcare and respite care, basic household assistance, and special education services.
• The number of children who received out of home care declined each month during the demonstration.
• The rate of children in placement settings outside Indiana declined during the demonstration from 45 per 1,000 in January 1998 to 25 per 1,000 in December 2002.
• For all children in care, the average distance placed from their home declined during the demonstration, from an average of 57 miles to 44 miles.
• Within demonstration counties, mean length of placement for all experimental group children who were removed from their homes was 290 days, compared to 316 days for matched control group children (p=.083)
  • Reunification. Children in the experimental group who were placed out-of-home were reunified with their parents significantly more often than children in the control group.
  • Termination of Parental Rights. The TPR process was significantly longer in experimental cases (a mean of 688 days) than in matched control cases (a mean of 620 days).
  • Adoption. For those in the experimental group who were not reunified, a lower percentage of them were placed with adoptive parents compared to the control group.
• A higher percentage of school-age children assigned to the experimental group were in school at case closure (91.1 percent), than was the case with control group children (83.6 percent).
• Utilization of the waiver during the demonstration varied considerably across the State, both in regard to how much it was used and how it was used.

Maine Child Welfare Waiver Project Findings:

• Of 222 people who completed regional workshops to train professionals and community members on special needs adoption, 80 percent completed pre- and post-tests, on which all demonstrated improvement.
• The majority (55 percent) of all caregivers reported that the types of services they most often requested were formal support services, including case management, professional therapy/counseling, school services, respite care, and support groups.
• Caretakers in the experimental group reported that the greatest barriers to receiving services related to the range of children’s needs, lack of services/supports in the community, lack of accurate information diagnosing children’s needs and suggesting assistance, and lack of time (due to caregiver’s full-time employment).
• An ongoing concern is the rate of attrition. As of December 2003, the total attrition rate was 53%.
• As of December 2003 there were few statistically significant differences reported between experimental and control groups on child-level variables, including well-being, behavior, and permanency. Some statistical differences have emerged in favor of the post-adoption services model on four family-level variables: (1) physical and emotional health of caregivers, (2) family members’ attachment to the adopted child, (3) trust between caregiver and adopted child, and (4) caregivers’ assessment of quality of family life after adoption.

North Carolina Child Welfare Waiver Project Findings:

• A key implementation finding was the need to include state and local fiscal staff in planning.
• States were initially reluctant to use flexible funding but as time progressed counties increased their use of funds over time.
• The probability of placement for children in experimental counties declined more than for children in the comparison counties, or other counties in the State, among children with a substantiated report of abuse or neglect from 1997 to 2001.
• Children entering placement during the years of the demonstration were more likely to exit placement than those who entered pre-waiver. This was true for all groups.
• The risk profile of children entering care in the experimental counties increased over the term of the demonstration.
• Experimental counties were able to reduce lengths of stay even though the seriousness of risks of children increased. More active experimental counties showed greater rates of decline in length of stay in foster care.
• In the early waiver years, decrease in re-entry was somewhat larger in the active counties. In the two most recent years where data is available, other waiver counties surpassed active experimental counties. Re-entry rates for children exiting placement was stable in the pre-waiver years and increased up to FY00.

• Initially the assisted guardianship payment was $250 per month, which was less than the standard foster care payment. During the first three years of the demonstration, none of the counties used the guardianship option. In 2000, the assisted guardianship payment was increased to equal the foster care maintenance program.
• Counties did not appear to use this option to achieve permanency in backlogged cases.
• The most frequently reported barrier to using the guardianship option was reported as the financial risk of continuing guardianship payments after the end of the demonstration.
• Several staff noted that their primary goal was to place children in adoptive homes.

Ohio Child Welfare Waiver Project Findings:

• Both experimental and control groups increased use of managed care strategies from year two to year four. In addition, experimental counties continued their use of overall managed care beyond year four while control counties significantly changed the way they used managed care strategies.
• Experimental counties differed from comparison counties in five areas: increased service array; more targeting of services; quality assurance and increased use of outcome data; increased overall use of managed care strategies; and increased interagency collaboration.
• Areas in which systematic differences between counties were not observed include: case management, financing, competition, utilization review and quality assurance, services array, interagency collaboration.
• Overall, no difference was found between experimental and control counties child welfare spending.
• Changes were noted as a result of the demonstration, they were not strong enough to reform the State's child welfare system fundamentally. In addition, observed changes were neither large nor targeted enough to create statistically significant differences in foster care expenditures or child and family outcomes.The waiver did not significantly affect permanency, placement stability, use of relatives for placements, proportion of children served in-home, and safety of children returned home.

Oregon Child Welfare Waiver Project Findings:

• Several issues limited the ability to measure the impacts and goals of the demonstration including the comparisons were made at the aggregate level,
• The availability of the guardianship subsidy appears to be an effective means of establishing legal permanency for children who already had long-term relationships with relative or non-relative caregivers.
• Patterns of child welfare expenditures (including foster care, TANF, Title XIX, State General Fund, and Title IV-E) changed significantly during the demonstration period. The effects of the Title IV-E waiver on these changes were minimal, however, as waiver-related expenditures represented less than one percent of total child welfare spending.
• Maintenance of children in their homes. Access to Title IV-E and/or SOC funding increased the likelihood that children remained in their homes within one year of the maltreatment incident.
• Return home. No association was found between increased flexibility of Title IV-E or SOC funding and the likelihood of children returning home one year after out-of-home placement.
• Relative placement. Access to Title IV-E funding was not related to the establishment of permanent placements with relatives within one year of the maltreatment incident.
• Placement stability. Access to SOC or Title IV-E funds was associated with an increased likelihood of children changing out-of home placements within one year. However, it is not possible to determine whether this finding reflected positive or negative outcomes since data regarding the reason for placement changes were not collected.
• Subsequent maltreatment. SOC and Title IV-E funds were not associated with re-abuse or neglect of children by their original caretakers within one year of the original incident.

• Most children (60%) in the OYFC population were placed in out-of-home care with neglect as the most serious type of maltreatment. About half of these were neglected through failure to provide; the other half, through failure to supervise. The most serious types of abuse for the rest were identified as follows:
  • 10%, physical abuse;
  • 8%, sexual abuse;
  • 14%, emotional, moral/legal, or educational abuse, or abandonment; and
  • 8% for reasons other than abuse or neglect (e.g., for mental health services or domestic violence).
  • Many OYFC children have experienced more than one type of abuse.
• Forty-four percent of OYFC children are in non-kin foster homes, and about one-quarter (24%) are in kinship foster homes.
• Caregivers were asked about children's health problems that "lasted or reoccurred." Over one-quarter of the OYFC children have some type of recurring physical or mental health problem.
• Current caregivers tend to be middle-aged or older; almost two-thirds (62%) are aged 40 or older. Caregivers in kin-care settings are more likely to be aged 60 or older than are caregivers in non-kin foster homes or group homes, and caregivers in group homes are much more likely to be under age 40 than caregivers in foster homes or kin-care settings.
• Caregivers are almost as likely to be single as married (45% vs. 53%).
• The education of the current caregivers typically is high school or less (56%).
• The average number of household members in kin-care and nonkin foster homes together is 5.2.
• On average OYFC children report feeling positive about their caregivers, reporting a high sense of relatedness, though children in group care report this relatedness to a lesser degree than those in kinship care.
• Children aged 6 and older were asked about their experiences in out-of-home care, including how they viewed their current living situation, their thoughts about where they would live in the future, and their views of their biological parents. In general, a positive picture of foster care arrangements emerged as most children like the people they are living with (90%) and say they feel like a part of the family (92%).
• The children in group home placements are generally less satisfied with their placement than the children in kinship or nonkinship foster care—more of these children do not like the people they live with and do not want their current arrangement as a permanent home.