Case Management with Families Receiving Public Assistance: Results from an Empirical Evaluation

ABSTRACT

This article describes the results from a family-based case management demonstration program which served families in North Carolina during the period of 1990 to 1993. The model for the program was based on the family investment initiative strategy developed by the George Washington University Center for Policy Studies. Entitled the Family Investment Initiative, the goal of the program was to assist families receiving AFDC to reach economic self-sufficiency. Results indicate that this family-based case management approach has promise for helping AFDC-dependent families achieve economic self-sufficiency. Implications of the results for social work case management practice with families are discussed.     

Use of time and preferences for time allocation among urban,employed, married women

This study examines the relationship between employed wives' preferences for household production time, employment time, leisure, and their actual time use. A random sample of 235 employed, married women estimate their time use on an average weekday and weekend day in 13 activities and indicate their preferences for time in those activities. Hierarchical multiple regression procedures are used to examine the relationships between actual and preferred time use. Weekday employment time is not related to preferences for more or less time in household production but wives allocating more time to employment want to spend less time at that employment and more time in leisure. Weekend employment time is related to preferences for more time in leisure, child care, and other household work. Time spent performing household work is not related to preferences for more or less time in any activity except the desire for more leisure time on weekends.Ann Renigar Hiatt is Assistant Professor in the Department of Human Services, College of Education and Allied Professions at the University of North Carolina at Charlotte, Charlotte, NC 28223. Her research interests include employed women's time allocation, time pressures, and use of time management strategies. She received her Ph.D. from the University of North Carolina at Greensboro.Deborah D. Godwin is Associate Professor in the Department of Housing and Consumer Economics at the University of Georgia, Athens, GA 30602. Her research has focused on husbands' and wives' time allocation to household production, the effects of women's employment on family economic functioning, and family financial management. She received her Ph.D. from the University of North Carolina at Greensbore.     

Needs and preferences for employer supported child care: A feasibility study

Employees of a large suburban health care center were asked to identify their needs and preferences for child care, and existing fringe benefits that they would be willing to give up in order to obtain employer supported child care services. Results indicate that a majority of the 41 employees in the sample with children under 12 years of age experience problems relating to child care and that those problems affect their work performance. There is no clear preference for type of child care, however, and employees are unwilling to give up existing fringe benefits to obtain child care services. Results are discussed with implications for provision of employer supported child care that is sensitive to the individual needs of employees.Terese Dressel is a clinician/consultant with the DuPage County Health Department, 111 North County Farm Road, Wheaton, Illinois 61087. The research reported was conducted as part of her Masters thesis in the Department of Human and Family Resources, Northern Illinois University.Michael Martin is an Associate Professor in the Department of Human and Family Resources, Northern Illinois University, DeKalb, Illinois 60115. Research interests include child maltreatment and family violence.     

Welfare and adolescent sex: The effects of family history,benefit levels,and community context

To examine whether welfare serves as an incentive to early childbearing, this article explores the first steps in the process of becoming a teenage parent: risk of first voluntary sexual intercourse at an early age and, among teens having sex, contraceptive use at first intercourse. Alternative operationalizations of welfare include the AFDC benefit level in the state of residence, the ratio of the benefit level to family income, community-level welfare receipt, and family history of welfare receipt. Results do not support the hypothesis that higher welfare benefits provide an incentive that hastens sex or reduces contraceptive use. Analyses provide moderate support for a culture of poverty perspective among girls. Intergenerational welfare receipt has a borderline significant effect on the timing of first sex, and maternal welfare receipt predicts nonuse of contraception at first sex for girls. Strong support is found for a stressful life experiences perspective, in which both parental marital disruption and nonvoluntary sex predict earlier voluntary sex. Analyses were supported by a grant from the Office of Population Affairs, Department of Health and Human Services, under Grant # APR 00000959. Her research interests include teenage childbearing, family processes, public policy, and survey methodology. She received her Ph.D. from the University of Michigan. Donna Ruane Morrison is a Senior Research Associate, and her research interests include the effects of family structure and processes on the well-being of children. She received her Ph.D. in sociology from Johns Hopkins University. Dana A. Glei is a Research Analyst, and her research interests include employment, gender, and teen pregnancy and childbearing. She received her M.A. from the University of Virginia.     

The Durham Family Initiative: a preventive system of care

This article describes the Durham Family Initiative (DFI), an innovative effort to bring together child welfare and juvenile justice systems to reach DFI's goal of reducing the child abuse rate in Durham, North Carolina, by 50% within the next 10 years. DFI will follow principles of a preventive system of care (PSoC), which focuses on nurturing the healthy parent-child relationship. A community collaborative of government agency directors has signed a memorandum of agreement to implement the PSoC principles. The researchers will use multiple methods to evaluate DFI's efficacy.     

New Jersey Children's Behavioral Healthcare System: cross service delivery planning for transitional population of youth (ages 16 and 18+ years)

The continued need for improvement within a 'system of care' is essential as the need for mental health services by those 'youth' within the child welfare system continually grows. This article outlines the statewide reform of New Jersey's Children's Behavioral Healthcare System, which began in 2000, as well as including the recommendations of the University of South Florida as part of their 'Final Report: Independent Assessment of New Jersey's Child Behavioral Health Services' on continued changes within the system of care. Successful outcomes have resulted from this welfare reform initiative, which include most notably the significant caseload decrease of the Division of Youth and Family Services (DYFS) and the creation of a new cabinet entity, the Department of Children and Families (DCF). This article specifically outlines systemic recommendations to best serve the target population of 'transitional' youth between the ages of 16 to 18+ years utilizing interagency cooperation based upon 'theory of change' and Total Clinical Outcomes Management (TCOM) strategies.     

A review of the chance to grow project: A care project for pregnant and parenting adolescents

This paper reports on the process and outcome of an innovative program for pregnant and parenting adolescents, the Chance to Grow Project. One hundred sixty-one pregnant adolescents were exposed to intensive decision-making counseling and case management services. These young women were followed for 24 months, as were 87 pregnant teens who served as a comparison group. The results of the analysis suggest a number of important findings. These include a much higher placement for adoption of the babies of the program participants, higher levels of school retention, economic self-sufficiency, and more responsible sexual behavior on the part of the participants. This article describes the Chance to Grow Project in detail and suggests some important practice implications which can be drawn from this analysis.The Chance to Grow Project and its associated evaluation was funded by Office of Adolescent Pregnancy Programs, Office of Population Affairs, Department of Health and Human Services (Federal Grant Number APH 000128-05); Robert H. Brethen Foundation; Christ Child Society; Louise Kramer Foundation; Mathile Family Foundation; Charles McNamee Foundation; Gerald and Carole Miller Family Foundation; Montgomery County Community Human Services; United Way of Dayton; and the University of Dayton.     

Regulating behavior management practices in residential treatment facilities

Model licensing requirements were developed by the New Jersey Department of Human Services' Division of Youth and Family Services to assist child welfare/human services licensing agencies in regulating children's residential facilities that use mechanical/physical restraints, isolation and/or exclusion in order to manage the behavior of severely emotionally disturbed and acting out youths. These requirements also identified practices that should be prohibited, such as forced physical exercise, certain types of mechanical restraint and group punishment. This article highlights a number of studies that help support the rationale for the model licensing requirements. In addition, the article discusses staff ratios, policies/procedures, documentation requirements, informed consent, peer review committees and staff training.     

Improving access to health care for foster children: the Illinois model

Children in foster care have lower health status than do their peers and limited access to health care. The Illinois Department of Children and Family Services developed HealthWorks, a separate primary care preferred provider system for children in foster care. This study compared claims data for children in HealthWorks with children not enrolled in HealthWorks and with children in Aid to Families with Dependent Children (AFDC) who had never entered foster care. Children enrolled in HealthWorks were more likely than were other children to receive all of the services except general inpatient hospitalizations. They had greater odds of receiving general exams and physicians' services and were more likely to visit the emergency room than children who were not enrolled. They were more likely to receive all of the measured services when compared with children receiving Medicaid through AFDC.     

The retention of public child welfare workers: The roles of professional organizational culture and coping strategies

The purpose of the current study was to investigate how professional organizational culture and coping strategies (control coping and avoidance coping) related to workers' intentions to remain employed in child welfare. With a sample of 234 frontline workers employed in Department of Human Services-Division of Family and Children Services (DHS-DFCS) offices in a state in the Southeastern region of the U.S., the current study tested a model in which coping strategies mediate the relationship between professional organizational culture and workers' intentions to remain employed in child welfare. Structural equation modeling was used to test the proposed model. Results revealed that professional organizational culture and control coping were significantly and positively related to workers' intentions to remain employed in child welfare. In addition, control coping mediated the relationship between professional organizational culture and worker retention. On the other hand, a significant relationship between avoidance coping and workers' intentions to remain employed in child welfare was not found. Implications of the findings for practice and recommendations for future research are discussed.     

Re-entry among former foster youth in early adulthood: Findings from illinois

On January 1, 2010, the Foster Youth Successful Transition to Adulthood Act went into effect in the state of Illinois to legally permit former foster youth who are at least 18 years old and not yet 21 years old to voluntarily re-engage with child welfare agencies and juvenile court to receive Supporting Emancipated Youth Services. Not much is known about the number or characteristics of foster youth who have taken advantage of this new opportunity to receive support following a hardship. This study used administrative data from the Illinois Department of Children and Family Services (IDCFS) to describe foster youth who have legally re-entered out-of-home care after exiting through emancipation. Findings revealed that a low number of former foster youth re-entered out-of-home care. This article discusses possible explanations for why so few youth have re-entered out-of -home care when research suggests they may be at increased risk for making the transition to adulthood.     

Shared Family Care: Fostering the Whole Family to Promote Safety and Stability

ABSTRACT

Shared Family Care is an innovative child welfare service that temporarily places whole families in the homes of community mentors who, along with a team of professionals, help the families to obtain the skills and resources they need to move toward self-sufficiency and adequately care for their children. This article provides an overview of this model, identifies existing programs in the United States, discusses key elements of the model, summarizes outcomes and comparative cost information, identifies implementation challenges, and provides tips for starting a Shared Family Care program in any community.     

Protective supervision: An inquiry into the relationship between child welfare and the court system

Protective Supervision, in most states, is defined in statute as an option in which the child is allowed to remain in the home of high-risk parents under the authority of the court, with supervision provided by the child protection system. Protective Supervision provides states an option to fulfill the federal mandate, as expressed in its guidance on the Child and Family Services Review, to assure that children are safely maintained in their homes whenever possible and appropriate. Nevertheless, there is a paucity of published work on this option. Further, the relationship between child protection and the judicial system, implicit in Protective Supervision, is rarely examined. In response to this dearth of information, an exploratory study was undertaken in Minnesota, funded by the Minnesota Department of Human Services. Data were derived from focus groups in every region of the state, with both child protection and judicial system participants. This study offers insights into the complicated nature of the partnership between two complex systems — child welfare and the court system. Currently, there is wide variation in how Protective Supervision is understood and practiced. However, where there is mutual respect between child welfare and the courts, Protective Supervision offers a useful tool.     

Crossover youth post arrest: Placement status and recidivism

The association between child maltreatment and juvenile delinquency is well established. Maltreated youth experience significantly higher delinquency rates than their peers. Studies report that placement instability in substitute care and placement in congregate settings (e.g., group homes) contribute to higher rates of offending. To date, no studies have focused on the judicial response and the likelihood of continued offending. The current study investigates the association between post-arrest placement decisions and recidivism. We analyze administrative records from the Los Angeles County Department of Probation and the Department of Children and Family Services. The sample includes all first-time violent offenders with an open child welfare case. Forty-nine percent of youth experienced a subsequent arrest. Using Cox regression, we find that moving crossover youth from a family-like setting to a congregate care setting was associated with significantly higher rates of recidivism. We discuss the policy and practice implications of these findings.     

A grassroots prototype for trauma-informed child welfare system change

The development of trauma-informed child welfare systems (TICWSs) that advance individual agency practice to target transformation of the system as a whole has been conceptualized but not documented. A grassroots effort to build a TICWS with key participants (e.g., Department of Human Services, Community Mental Health, Family Court, schools) in nine Michigan communities provides a field tested model for implementation. This article described what emerged as the core elements for a TICWS, which includes (1) development and support of a project champion, (2) trauma identification, (3) comprehensive assessment of traumatic impact, (4) evidence based trauma treatment, (5) establishing a common trauma language, and (6) trauma-informed decision-making. Several new instruments for assessing aTICWS are identified. Lessons learned are highlighted for consideration of communities seeking to develop TICWSs.     

Reaching the hard to reach: innovative housing for homeless youth through strategic partnerships

This article features three housing programs designed to target the needs of youth aging out of child welfare. One program combines housing and treatment to move substance-dependent youth off the streets; one combines the resources of Urban Peak, the only licensed homeless and runaway youth shelter in Colorado, with the Denver Department of Human Services to prevent youth in child welfare from discharging to the streets; and one addresses the intense mental health needs of this population. It costs Colorado 53,655 dollars to place a young person in youth corrections for one year and 53,527 dollars for residential treatment. It costs Urban Peak 5378 dollars to move a young person off of the streets. This article describes how data have driven program development and discusses how policy implications and relationships with the public and private sector can leverage additional resources.     

Life satisfaction of young adults reared in low-income Appalachian families

This study examines issues related to the life satisfaction of young adults reared in white, low-income Appalachian families. Data from 38 female and 29 male subjects who participated in a longitudinal study are analyzed qualitatively. Level of global life satisfaction is found to be comparable to that of the general population with the salient domains being: personal, marriage and family, work, and financial concerns. Frames of reference are found to be important in subjective assessments of life satisfaction.This study (NCARS 11171) was supported by the Cooperative State Research Service, United States Department of Agriculture. Paper No. 10804 of the Journal Series of the North Carolina Agricultural Research Service, Raleigh, NC 27695-7601. The authors would like to acknowledge the assistance and support of Judith H. Fulbright, NCARS Social Science Research Assistant, University of North Carolina-Greensboro.Elizabeth B. Robertson is a postdoctoral fellow with the Consortium on Human Development, Frank Porter Graham Child Development Center, University of North Carolina, Chapel Hill, NC 27599. She received her Ph.D. from the University of North Carolina-Greensboro. Her research interests include parent-child relations and social development.Sarah M. Shoffner is Assistant Professor and Assistant to the Dean, External Relations, School of Human Environmental Sciences, University of North Carolina, Greensboro, NC 27412-5001. Her research interests include adolescent occupational socialization, especially the effects of employment, lower income rural youth life plans, qualitative methodology, and marital/family communication.     

Running away from child welfare placements: Justice system entry risk

A growing body of research indicates that running away from foster care increases the probability of subsequent involvement in the juvenile and/or adult justice system, especially for males. Using administrative data from the Michigan Department of Health and Human Services, this study examined the characteristics and behavior of a sample of 371 child welfare youth in Wayne County who ran away from foster care with a propensity scored matched sample of youth who did not run away. Youth were followed in administrative records of the MDHHS and justice system for eight years. The correlates of involvement in the juvenile and/or the adult justice systems included age at first child welfare placement, years in placement, number of placements, total length of time in residential care, running away from placement, as well as gender and legal status. Overall, 42% had at least one juvenile and/or adult conviction. Running away from foster care had the largest effect on subsequent justice system contact.     

Self-Employment as a Social and Economic Development Intervention for Recipients of AFDC

Summary

This paper reports findings from program evaluations of two demonstrations designed to (1) test self-employment as a social and economic development strategy for recipients of AFDC, and (2) identify policy barriers to improving the economic well-being of this population. The authors collected data through interviews with program participants and program operators and used secondary data contained in operators' management information systems and state Department of Human Services electronic files. Program results showed that self-employment is a viable social and economic development strategy for self-selected welfare recipients who receive business training and assistance in locating operating capital. The paper discusses implications for social work practice, education, and research.     

Individual vs. household determinants of the demand for medical care: A study of rural families

This article investigates, from a household perspective, the demand for medical care. Earlier (economic) studies have typically focused on individual utilization patterns; however, the data set employed here allows for an investigation of the role of other family members on individual demand. The theoretical results suggest that the labor force status (via the wage rate) of one family member may, in addition to influencing that person's rate of medical care use, effect the utilization of other household members. Separate physician visit demand equations are estimated for husbands, wives, and the household unit. The empirical results indicate that the wife's (full) cost of receiving medical care is a significant determinant of utilization by both the husband and other family members. Overall, the findings suggest that demand studies should take the presence of other household members and family structure into consideration when analyzing the determinants of individual medical care utilization.This study was supported in part by grant no. 1R03 HSO 2417-01 from the National Center for Health Services Research, HHS.Laurence Miners received his Ph.D. in economics from the University of North Carolina at Chapel Hill. He is currently an Associate Professor at Fairfield University and his research interests are focused mainly in the areas of health and labor economics. Correspondence concerning this article should be addressed to Laurence Miners, Department of Economics, Fairfield University, Fairfield, CT 06430.