Child Welfare for Sale: Privatization and Outcomes for Children and Youth in Foster Care

Background: Over the past few decades there has been a shift in child welfare systems from state-run and administered foster care to privatization and reliance on both non-profit and for-profit organizations. Despite the majority of states now implementing some form of privatization of their child welfare systems, few studies have examined short and long-term outcomes after the implementation of these measures. The current study addressed this gap by assessing the impact of performance based contracting on outcomes for children in foster care over a 14-year span in a Southeastern state. Specifically, trends in the length of stay, proportion of exits to permanency, and placement stability for children in care were examined.  

Methods: Secondary data analysis was run using data from the Adoption and Foster Care Analysis System (AFCARS), an annually collected administrative database containing the population of children in care for each fiscal year. The analytic sample for this paper included the total population of children in foster care in a Southeastern state between 2000 and 2014, ranging annually from 12,781 to 15,459 children and youth. A segmented linear regression was run to compare rates of change over time in outcome measures for foster youth, while controlling for already-existing trends before the implementation of performance based contracting. All analyses were run using the Statistical Package for Social Sciences (SPSS), version 23.

Results: The results suggest that overall outcomes have been improving over the past 14 years, including a decrease in length of stay (µ = 809 days in 2000; µ = 457 days in 2014), and increase in placement stability and exits to permanency (µ = 25% in 2000; µ = 38.4% in 2014). Nonetheless, the rates of change have plateaued since the implementation of performance based contracting, with decreasing improvements over the past 7 years. The length of stay was decreasing by an average of 49.6 days per year prior to implementation of PBCs, and increased by an average of 35.2 days per year after its implementation. Therefore, after controlling for the already-existing trends prior to the implementation of performance based contracting, the rate of change has reversed, observing a smaller percent change since the shift of responsibility toward private agencies.  

Conclusion: Although preliminary analyses comparing average length of stays, exits to permanency, and placement stability suggest improvement over the past 15 years, the results from this analysis suggest that these trends were already in place before the implementation of PBC. Notably, rates of improvement have stagnated since the shift of responsibility for case management and placements to private organizations. Therefore, more research needs to be done and the impact of privatization needs to be examined before continuing to promote different forms of privatization of child welfare systems. Caution should be used before widely adopting PBC, in order to ensure that outcomes continue to improve for children and families involved in child welfare systems.