Who Needs Group Care? Caseworker Perceptions of Youth Candidacy for Family Care and Needed Community-Based Services

Background and Purpose:

Concerns about group care utility (Barth, 2005), costs (Ringel & Sturm, 2001) and over-reliance (Lyons, Libman-Mintzer, Kisiel & Shallcross, 1998) have spawned efforts to improve level of care decisions and to understand whether and how community-based services can replace group care placements. It is likely that some youth in group care are good candidates for family care and that the availability of services within the community may facilitate a youth's successful transition from group care. Yet no research exists to help identify which youth are good candidates for family care and what array of community-based services youth to be successful outside of group care. This study explored factors associated with a child welfare worker's assessment of youth candidacy for family care and the services youth would need to be successfully maintained in a community setting.

Methods:

This study used survey data collected from child welfare workers (CWW) in two counties in a Mid-Atlantic state. As part of a larger evaluation, workers provided information about all youth in group care at a specific point-in-time (N=231). To identify factors significantly associated with positive appraisals of family care candidacy, exploratory bivariate analyses and logistic regression were conducted. Workers provided open-ended comments about what anticipated services a youth would need to be successful in a family setting. These comments were coded using thematic analysis. Two readers read these items and labeled recurring categories or ideas. Frequencies of each theme were computed to identify common issues.

Results:

The logistic regression model suggested that the strongest predictors of CWW's recommendation for youth transition to family care were youth desire for family placement (OR=17.2), availability of needed community services (OR=4.2), youth ability to connect with adults (OR=3.1), and school engagement (OR=2.3). Characteristics that decreased likelihood of being viewed as a good candidate for family care were having an IEP (OR=.26), having specialized placement needs (i.e., structure, high-level supervision) (OR=.39), and the CWW's perception that it was a bad time for a youth to move (OR=.21). CWWs identified specific services needed for a youth to leave group care, including specialized mental health (66%), education (22%) and general community resources like mentoring and recreational programs (25%). While some interventions like individual therapy are widely available, some services named are less accessible, like specialized programs for autism or trauma treatment. (Follow up data will indicate which children returned home within 6 months of these assessments and their current placement).

Conclusions and Implications:

Key predictors of family care readiness can be used to target youth for step-down efforts. Because youth preference played such a large role in a caseworker's assessment of family placement readiness, caseworkers should be trained to engage youth actively in permanency planning and explore youth concerns about family care. This study also found that youth transitioning from group care need diverse services beyond just mental health care. This array of needed community-based services may highlight niche areas for group providers to re-tool or expand their continuum of services by offering specialized programs within communities.