By Teija Sudol

December 2009

Summary

For children in foster care, the number of placements, or places where they live, can impact daily functioning and adjustment as well as the child welfare agency’s ability to move the child to permanent placement in a timely manner. Because of the seriousness of long term consequences for children, placement stability within 12 months of entry into foster care was one of the three outcome measures established as the national standard of Permanency Outcome 1 for the first round of the Child and Family Services Reviews (CFSR). As one aspect of the CFSR, State performance was assessed in relation to the outcome measure definition, “of all children who have been in foster care for less than 12 months from the time of the latest removal from the home, 86.7% or more have had no more than 2 placement settings” (Children’s Bureau/ACF/DHHS, 2004). Only 14 States met the national standard for placement stability during the first round of CFSRs from 2001 to2004. 

Legislation for the past three decades has focused on effective permanency planning, increased placement stability and timely decision-making in child welfare. In response to this emphasis, the Children’s Bureau reports to congress on child welfare performance measures. State performance in 2005 on measures pertaining to Outcome 6: Increase placement stability indicated that “in most states, majority of children in foster care for less than 12 months in 2005 experienced no more than two placement settings” but that the longer children and youth stay in care the more placement disruptions they tend to experience (Children’s Bureau/ACF/DHHS, 2004; 2005). Since placement stability is critical to children’s well-being, “there is reason for concern when any child has three or more placement settings while in foster care.”

The results from the analysis of cases reviewed during the first round of CFSRs identified factors which can positively impact placement stability as well as factors which can contribute to increasing the number of placements (Children’s Bureau/ACF/DHHS, 2004). This information, along with other research, can point the way to better practice for child welfare agencies.

Facts & Statistics

Although moving children and youth from a placement to another is at times appropriate when the move supports achievement of case plan goals, generally foster care moves seem to do them more harm than good. Caused by an array of systemic and child/foster family factors, placement disruptions can contribute to behavioral and attachment problems, as well as other challenges for children , such as mental health issues, educational under-achievement, and unemployment and poverty in adulthood.

Data analysis and research document a number of findings related to placement stability:

Ø       AFCARS data for FY 2008 showed that 58% of youth exiting foster care have spent one year or more in care (Children’s Bureau/ACF/DHHS, 2009).

Ø       Placement stability declines substantially the longer a child is in foster care (Children’s Bureau/ACF/DHHS, 2005).

Ø       Placement stability may enhance the probability of children’s educational, physical, and mental health needs assessed and addressed appropriately (Children’s Bureau/ACF/DHHS, 2004).

Ø       According to one study, about 70% of placement changes were made to implement procedural, policy, and system mandates, e.g., moves to place a child with relatives or a sibling; almost 20% were linked to children’s behavior problems; and the remaining 10% to both foster and biological family related issues (James, 2004).

Ø       Based on research evidence, kinship or relative placements result in fewer moves, and can have 70% lower rate of disruption (Northern California Training Academy, 2008).

Ø       Entering enter foster care because of emotional abuse increases the risk of behaviorally related placement changes by 48% (James, 2004).

Legislation & Policies

Fostering Connections to Success and Increasing Adoptions Act of 2008 (PL 110-351) was designed to connect and support relative caregivers, improve outcomes for children in foster care, provide for tribal foster care and adoption access, and improve incentives for adoption. Amending parts B and E of Title IV of the Social Security Act, it provides new federal funding to states for subsidized guardianship payments for relatives, incentives for adoption, adoption assistance, kinship navigator programs, new family connection grants, and federal support for youth to age 21. Putting focus on kinship and relative caregivers, the new law has the potential to increase placement stability while children and youth are in the care of states, tribes and localities.

The changes to the Social Security Act from the Public Law 110-351 can be viewed at: http://www.acf.hhs.gov/programs/cb/laws_policies/cblaws/safe2008draft.htm

Earlier Federal Legislations that Impacted Placement Stability

Ø       Permanency planning became part of legislation when the Adoption Assistance and Child Welfare Act of 1980 (PL 96-272) was passed, specifying timeframes for child welfare case planning and case plan reviews for the first time.

Ø       Over a decade later, the Family Preservation and Family Support Services Program of 1993 (PL 103-66) and its amendment in 1997 put focus on family service and preventive services for children, youth and families at risk. Making prevention a national priority, it provided opportunities for states, tribes and localities to engage in child welfare reform.

Ø       Multi-Ethnic Placement Act (PL 103-382) of 1994 and its amendment, Inter-Ethnic Placement Act of 1996, prohibited the consideration of race in placement decisions and mandated that an increased effort be made to find and recruit potential foster families of color. It also required more timely placement of children into foster and adoptive homes.

Ø       Amending titles IV-B and IV-E, Adoption and Safe Families Act of 1997 (P.L. 105-89) was designed to shorten the length of time children and youth spend in foster care and speed up the process of terminating parental rights and freeing children for adoption.

Best Practices and Model Programs 

Child welfare legislation for the three past decades has reinforced the need for children and youth to be in stable and appropriate foster care placements in order to achieve better outcomes in terms of safety, permanency and well-being. Child welfare agencies can begin by focusing on factors that have been found by CFSR case level analysis to positively affect placement stability, such as: kinship placements, adequate services to families and caseworker contacts with parents (Children’s Bureau/ACF/DHHS, 2004).

The Program Improvement Plans that the states submitted as part of the first round of CFSR indicated strategies that they have used to address placement stability (Children’s Bureau/ACF/DHHS, 2004). Some of the strategies included:

Ø       Build on promising practice from more successful counties

Ø       Use of foster parent teams or support groups

Ø       Training on partnerships with foster parents, birth parents, agency staff, service providers

Ø       Expanded and targeted Foster Family recruitment

Ø       Data reports on stability distributed to county level

The results from the analysis of cases reviewed during the first round of CFSRs identified some factors that can positively affect placement stability, including: placement with relatives, adequate services to children, parents, and foster parents, involvement of children and parents in case planning, and caseworker contacts with parents. A child’s age seems to be another factor: most stable are ages 0-6 and 16-18, least stable 13-15. Significant associations were found between placement stability and meeting educational, physical health, and mental health needs (Children’s Bureau/ACF/DHHS, 2004).

Factors that negatively impact placement stability were also identified, such as: frequent use of shelters for initial placements and disruptions, few placement settings available for children with disabilities or behavior problems, inconsistent support services to foster parents, and mismatching placements to children’s needs (Children’s Bureau/ACF/DHHS, 2004).

Results-Oriented Management in Child Welfare at the University of Kansas School of Social Welfare provides a framework for exploring factors that contribute to the placement stability of children and youth in care, including child/family, service, organizational and community factors. The frame work also discusses the research evidence for each factor as well as the steps that an agency can take in addressing the issue. Formatted in a user friendly matrix the website is easily navigated to obtain concise information on research which provides the suggestions for addressing the multiple factors which impact placement stability. To learn more about this resource see: Results-Oriented Management in Child Welfare http://www.rom.ku.edu/ebp_stab.asp

Northern California Training Academy (2008) suggested some effective ways to decrease placement disruptions in a recent literacy review Placement Stability in Child Welfare Services (2008):

Ø       Support and training for foster parents

Ø       Concurrent planning (alternative permanency plan)

Ø       Placement-specific services (e.g., transportation, respite care, foster-family counseling)

Ø       Child-specific services (e.g., mental health services, after-school programs)

Ø       Increase caseworker retention through additional support (e.g., flexible working conditions, professional development opportunities)

 A multiyear Study of Placement Stability in Illinois (2004) examining the placement instability in foster care combined administrative data analyses of the placement histories of over 200,000 children in care with findings from a web-based survey of nearly 2,000 caseworkers. The findings of this comprehensive effort to examine placement instability suggested that the average number of placements children experience while in care could be effectively reduced by placing them with kinship and relative caregivers at entry to care. This would allow children to stay at relative homes without having to endure a subsequent placement change.

Online Resources

 National Resource Center for Permanency and Family Connections (NRCPFC) is a training, technical assistance, and information services organization dedicated to strengthening the capacity of State, local and Tribal child welfare agencies. NRCPFC offers resources on placement stability, including a one day curriculum developed in response to the clear indication that the caseworker visits to children in foster care are positively correlated to outcomes for children and families. http://www.hunter.cuny.edu/socwork/nrcfcpp/info_services/placement-stability.html

Child Welfare Information Gateway, also a Service of the Children’s Bureau (ACF/DHHS), provides resources and information on placement stability, and efforts to minimize the number of placements for children in out-of-home care. http://www.childwelfare.gov/outofhome/placement/stability.cfm

 

Children’s Bureau provides state and national data on adoption and foster care, child abuse and neglect, and child welfare that can help states, tribes and localities to examine and address the issue of placement stability. Compiled Results of the 2001-2008 Child and Family Services Reviews are available on the Child Welfare Monitoring pages. http://www.acf.hhs.gov/programs/cb/stats_research/index.htm

 

National Data Analysis System (NDAS) at CWLA and its National Working Group to Improve Child Welfare Data webpage includes several items related to placement stability, including results of a survey to clarify differences among states, common definitions, and Placement Change Definitions Implementation Guide. http://ndas.cwla.org/research_info/nwg/

Results-Oriented Management in Child Welfare at the University of Kansas School of Social Welfare discusses the child/family, service, organizational and community factors that contribute to the achievement of placement stability, as well as the research behind these findings. It also explores the possible steps to take for this outcome area. http://www.rom.ku.edu/ebp_stab.asp

Bibliography

Children and Family Research Center. (2004). Multiple Placements in Foster Care: Literature Review of Correlates and Predictors. Retrieved on November 15, 2009, from: http://www.cfrc.illinois.edu/LRpdfs/PlacementStability.LR.pdf

Children’s Bureau/ACF/DHHS. (2008). The AFCARS Report Preliminary FY 2006 Estimates as of January 2008. Retrieved on November 19, 2009, from: http://www.acf.hhs.gov/programs/cb/stats_research/afcars/tar/report14.htm

Children’s Bureau/ACF/DHHS. (2005). Child welfare outcomes 2002-2005: Report to Congress. Retrieved on November 19, 2009, from: http://www.acf.hhs.gov/programs/cb/pubs/cwo05/chapters/chapter4.htm

Children’s Bureau/ACF/DHHS. (2004). Findings from the initial Child and Family Service Reviews; 2001-2004. Retrieved on November 30, 2009, from: http://www.acf.hhs.gov/programs/cb/cwmonitoring/results/index.htm

Children’s Bureau/ACF/DHHS. (2004). 52 program improvement plans: Strategies for improving child welfare services and outcomes. Retrieved on July 17, 2009, from: http://www.acf.hhs.gov/programs/cb/cwmonitoring/index.htm

Children’s Bureau/ACF/DHHS. (2004). General findings from the federal child and family services review. Retrieved on July 17, 2009, from: http://www.acf.hhs.gov/programs/cb/cwmonitoring/results/genfindings04/index.htm

D’Andrade, A.C. (2005). Placement stability in foster care. In G. Mallon & P. Hess (Eds.) Child welfare for the twenty-first century: A handbook of practices, policies and programs, p. 608-622. New York: Columbia University Press.

James, S., Landsverk, J., & Slymen, D.J. (2004). Placement movement in out-of-home care: Patterns and predictors.  In Children and Youth Services Review, 26(2), 2004.

James, S. (2004). Why do foster care placements disrupt? An investigation of reasons for placement change in foster care. In The Social Service Review, December, 2004.

McMahon, J. (2005). Foster care placement disruption in North Carolina. In Fostering Perspectives, 10(1), 2005. Retrieved on November 15, 2009, from: http://www.fosteringperspectives.org/fp_v10n1/disruption.htm

Northern California Training Academy. (2008). A literature review of placement stability in child welfare services: Issues, concerns, outcomes and future directions. The Center for Human Services at UC Davis Extension. Retrieved on November 15, 2009, from: http://humanservices.ucdavis.edu/Academy/pdf/FINAL2LitReviewPlacementStability.pdf

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