Exploring the Use and Impact of Concrete Services in Child Welfare Practice

Introduction.  Concrete services are goods and services beyond traditional contractual services and include rent, utilities, healthcare, and other tangible items purchased directly for a family.  Concrete services provide flexibility and enhance normalcy, support child well-being, and achieve permanency goals by alleviating family stressors and reducing family need.  Given the expanded flexibility of the Title IV-E Waiver (Waiver), a Midwestern state’s child welfare agency (CWA) and the Waiver’s evaluators became interested in how the utilization of concrete services may have changed during the demonstration period, potentially better supporting safety, permanency, and well-being in new, creative ways. 

Methods.  This study utilized data from two Waiver Evaluation datasets, a quantitative analysis of administrative concrete service enhanced by qualitative analysis of CWA regional & executive manager interviews.  Concrete services request and disbursement data from a CWA-managed data system for FY 2010 through FY 2014.  Data were analyzed to determine similarities and differences in service requests by age, determine costs and increases/decreases in disbursements by category, compare requests with payments, and identify unique uses.  Evaluators collaborated with executive-level CWA staff to develop an interview designed to explore regional and executive managers’ perceptions of administrative, practice, service, and Waiver-related topics.  In 2014 and 2015, managers were asked specifically about the use and outcomes of concrete services for children and families.  Themes were identified using case study-inspired and basic thematic analysis.

Results.  Analysis of administrative concrete service data (N = 107, 422 disbursements) revealed that overall costs paid through the four categories (General Product; General Service; Material Assistance; Personal Allowance) of concrete services increased significantly from FY 2011 – 2012 to FY 2013 – 2014 (p <.05).  When available, data by child age were analyzed (N = 22, 566).  Most requests were for children ages 0-5 and overall General Products were requested most often (i.e., initial clothing; bedding).  Analysis of the qualitative data revealed differences between 2014 (N = 20) and 2015 (N = 18) interviews. In 2014, managers believed concrete services were effective in meeting safety, permanency, and well-being needs of children and families; however, lack of policy clarity and burdensome processes at times made it difficult to use concrete services.  Managers were able to provide unique examples of concrete service usage.  In 2015, managers described the routine use of concrete services to meet the needs of children and families and expressed a clear connection between the Waiver and the expanded use of concrete services.  However, managers were less likely to identify specific examples of unique concrete service usage.

Conclusion.  Concrete services can be used flexibly and creatively to prevent the removal of children, expedite permanency and enhance safety and well-being.  The flexibility of the Waiver supports the use of concrete services to achieve positive outcomes.  Quantitative and qualitative data collected during the Waiver demonstration period indicate greater use of concrete services and the perception that concrete services are necessary to meet the needs of children and families.  Next steps will involve exploring safety, permanency, and well-being outcome data for children and families who have received concrete services.