Geographic Barriers to Achieving Timely Permanency: A Survival Analysis

Background and Purpose:

Federal Child and Family Service Review performance outcomes mandate that “children have permanency and stability in their living situations.” However, recent CFSR outcomes for one state show that children in fewer than two-thirds of foster care cases experienced concerted efforts toward permanency. Permanency in 12 months, placement stability, and exits to reunification were below national standards.

Reasons for differences in timely reunification are difficult to discern without considering factors like population density, removal rates, community indicators and/or social determinants of health, and availability of local services/supports. In response to these trends toward long-term instability for child and youth permanency, this study examined barriers to achieving timely permanency. Specifically, we examined the following research questions: (1) Are there differences in children and youth most at risk of not achieving timely reunification or adoption by geographic location? (2) What geographic factors impact timely permanency outcomes?

Methods:

To understand which children are most at risk of not achieving reunification, we conducted multivariate survival analyses of data from one midwestern state using an entry cohort approach. The entry cohort included children who entered care from 2012 through 2016 (N=19,416). We then examined median days to reunification or adoption by judicial district and by region, and collected and analyzed CFSR case read data and stakeholder interviews, stakeholder meeting documentation, data from an agency survey (N=261), four community events (N=69) across three of five regions, to assess agency and court/legal barriers and challenges to timely reunification.

Results:

We found four statistically significant risk factors for longer time to reunification: younger child age, child race is Black, removal reasons include parental substance abuse, and child has a disability. Risk factors for longer time to adoption included: older child age, and child race is Black. Geographic data revealed significant variation in median days to reunification and median days to adoption across judicial districts in the state, ranging from 353 days to 1,301 days for reunification, and from 1,020 days to 1,874 days for adoption. Data also revealed substantial differences in achieving permanency in 12 months for youth in care according to region. Factors identified as contributing to reunification outcomes that may vary by region include: inconsistent court and legal practices, lack of community resources/safety net, substance abuse, and mental health treatment, worker turnover and high caseloads.

Conclusions and Implications:

This study demonstrates significant variation in permanency outcomes across judicial districts and by region. These findings may suggest a need for cross-system collaboration, including statewide and regional partnerships, and strengthened partnerships between child welfare and court systems to align practices, share knowledge, and alleviate regional and jurisdictional challenges that threaten achievement of long-term permanency. Collaborative efforts should address service array and workforce challenges to mitigate geographic barriers to permanency and strengthen child welfare systems.