60P
The Business of Foster Care Child Placements
As a method for controlling costs and service outcomes in state child welfare systems, many states are choosing to use privatization and fiscal reforms that include managed care and performance-based contracting. According to the research, however, these managed care strategies negatively affect some service and child outcomes. Why this is occurring, however, is not exactly clear.
To provide insight into this area and increase knowledge about the impact of managed care funding strategies on the foster care population, this paper examines how licensed child welfare professionals who work in private child welfare agencies think about the managed care policies that influence a child's initial foster placement.
Method:
Nineteen semi-structured interviews were conducted with licensed child welfare professionals who work at one of two private child welfare organizations that contract with the Illinois Department of Children and Family Services and are involved in service and/or placement decisions. Although the majority of participants are "caseworkers" (47%), others filled different positions that include supervisor, licensing coordinator/supervisor, program director, and permanency worker. Of those, 26% worked five or fewer years at a child welfare agency, 21% worked between 6 and ten years, and 58% worked eleven or more years. In addition, 89% worked at multiple child welfare organizations and 47% worked in different positions during their child welfare career. Participants were recruited through information sessions and e-mail. Interviews elicited information about their experience in child welfare, the placement decision-making process at their agency, and relevant placement policies. Interviews were transcribed verbatim and coded using Atlas.ti qualitative software guided, partly, by inductive process and, partly, from other empirical work and theory.
Findings:
As this analysis reveals, a tension exists between the service goals for children and organizational goals of contracting child welfare agencies. Organizational and policy pressures to meet performance contracting goals and maintain program funding creates explicit and implicit pressures on child welfare staff to accept and place children with foster parents who appear unwilling and/or unable to provide "appropriate" care. Participants in this study further suggest that the context of decreasing number of children in state care, the state’s current fiscal crisis, and concerns about becoming unemployed and finding another job intensifies this pressure to promote the organization’s financial interests during this event.
Conclusion and Implications:
This analysis demonstrates how Illinois' policies for funding foster care services may have a negative and unintended impact on the placement of children in state care. Moreover, among contracting agencies and their staff, there is an added "value" for some children and that value shapes the services provided. In the Illinois’ child welfare system, children are inextricably linked with the money that funds their care. Thus, children are not just beings in need of care and support; they are also a funding source for POS agencies.