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Title IV-E waivers emerged during a period of significant shifts in the U.S. child welfare system throughout the 1980s and 1990s in response to demands for policy reform. The waivers were designed to encourage innovation by granting state and tribal jurisdictions greater flexibility in the use of federal funds allocated for title IV-E foster care. Insights from waiver demonstrations conducted in the 1990s and 2000s influenced federal priorities reflected in the 2011 title IV-E waiver reauthorization. Twenty-seven demonstration projects were implemented between 2012 and 2019, featuring a broad array of programs, services, and initiatives (Graham, 2021).
Notably, the 2011 reauthorization emphasized the implementation of evidence-based programs while seeking to strengthen the rigor of child welfare evaluations through methodological requirements. While some waiver evaluations were able to achieve strong methodological rigor, others faced limitations in community settings that prevented the use of rigorous designs, resulting in inconclusive findings regarding program effectiveness. This study examined the causal effects of title IV-E waiver programs in reducing child maltreatment and foster care placements from 2012 to 2019 using difference-in-difference models and event study analysis.
Methods
Data and Sample. We examined the state level effects of title IV-E Waiver programs on child maltreatment reports, victims and foster care entries using state/year panel data from the National Child Abuse and Neglect Data System (NCANDS) and the Adoption and Foster Care Reporting System (AFCARS) from 2012-2019. We adjusted for a large number of state level covariates using data from the University of Kentucky Center for Poverty Research, the Current Population Survey, and the March Current Population Survey Annual Social and Economic Supplement.
Analytic Approach. To estimate the causal effects of Title IV-E Waiver programs systems on child maltreatment outcomes, we used difference-in-difference models, an approach that embeds policy changes as quasi-experiments in a regression model. Event study analyses were conducted to correct for the staggered implementation of programs across states. All analyses were performed in STATA 19.
Results. States that implemented title IV-E waiver programs during the study period experienced decreases in substantiated maltreatment (-236.21; p<.01) and decreases in foster care entries (-44.77, p<.01) when compared to states without programs. These results were robust after adjusting for covariates. Effects for the prevention of child maltreatment and foster care entry were strongest for states that implemented evidence-based programs of any type (-389.5, p<.001;-53.5, p<.01, respectively) and evidence-based parenting programs specifically (-286.7, p<.01; -66.1, p<.01, respectively).
Conclusions and Implications. The legislative intent of the title IV-E waiver program was to encourage the testing of innovations and prioritize the implementation of evidence-based programming. The Family First Prevention Services Act of 2018 made significant changes to the federal title IV-E program, including the authorization of matching funds to pay for selected evidence-based mental health, substance abuse, and in-home parenting. Findings suggest waivers were critical tools in the prevention of child maltreatment and foster care entry through the use of evidence-based programs, with parenting programs having the largest effects.