The Impact of Multiple Caseworker Changes on Child Permanency Outcomes: Illinois' Birth through Three IV-E Waiver

Background and Purpose: The child welfare field has prioritized the use of evidence-supported interventions to mitigate the adverse effects of child maltreatment on children in foster care. However, few evidence-based interventions have been implemented and rigorously tested using families involved in the child welfare system. The Illinois Birth through Three (IB3) Waiver aims to fill this gap by tailoring two evidence-based interventions to address the needs of children in foster care. The IB3 Waiver is a five-year federal demonstration project that compares families assigned to receive trauma-informed evidence-based interventions to similar families who are provided foster care services as usual. A caseworker is assigned to work closely with families to ensure treatment and permanency goals are met. Although research suggests that having a consistent and positive relationship with a caseworker is associated with positive child outcomes, many children assigned to the waiver experience multiple caseworker changes. Failing to account for the influence of multiple caseworkers on permanency outcomes can lead to biased intervention effects. This study examined the impact of number of caseworker changes on a child’s odds of exiting foster care via unification with a family member (i.e., birthparent, relative, fictive kin).

Methods: This study applies multiple membership modeling to Illinois administrative and intervention data from the Illinois’ Birth through Three IV-E Waiver.  Public and private agencies in Illinois were randomly assigned to an intervention or comparison group. Next, eligible children were rotationally assigned to the next available provider within each experimental group using the child welfare system’s existing rotational assignment procedure. Rotational assignment helps to ensure that each team and agency get a balanced representation of cases. Multiple membership modeling was applied to the data to account for the number of caseworker changes children experienced in the analytical sample (N=1662). Multiple membership weights were used to quantify the proportion of time a worker was assigned to a child’s case.

Results: At the time of analysis, only 19% of the sample had one caseworker assigned, whereas 81% of the sample had more than one worker assigned over the course of their foster care placement. On average, 20% of the children in the sample achieved family unification. Results from the multiple membership analysis showed that children in the intervention group were over 50% more likely than children in the comparison group to experience family unification. Also, the more workers assigned to a child's case, the lower the odds of unifying with family.  

Conclusions and Implications: Findings from a randomized control trial suggest children who are assigned to receive therapeutic, evidence-based interventions are more likely to achieve permanence than children who receive standard foster care services. The findings also suggest the number of caseworker assignments can impact child welfare outcomes. Children are more likely to achieve permanence if they are assigned few workers over the course of their stay in foster care.