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| Demonstration Type: | Flexible Funding - Phase II1 |
| Approved: | October 1, 2004 |
| Implemented: | October 1, 2004 |
| Expected Completion Date: | September 30, 2009 |
| Interim Evaluation Report Expected: | August 30, 2007 |
| Final Evaluation Report Expected: | March 30, 2010 |
The target population for Ohio’s Phase II waiver demonstration consists of children ages 0-17 who are at risk of or in out-of-home placement, and their parents or caregivers. Both title IV-E eligible and non-IV-E eligible children may participate in the demonstration.
Phase II of the demonstration is operating in 13 of the 14 counties that participated in Ohio’s initial five-year waiver demonstration: Ashtabula, Belmont, Clark, Crawford, Fairfield, Franklin, Greene, Lorain, Medina, Muskingum, Portage, Richland, and Stark. Hamilton County, which participated in the Phase I demonstration and began Phase II, discontinued its participation in October 2005. In October 2006, four additional counties joined the waiver demonstration: Coshocton, Hardin, Highland, and Vinton. At its discretion, the State may propose to include additional counties in the experimental group.
Participating counties continue to use title IV-E funds flexibly to prevent the unnecessary removal of children from their homes and to increase permanency rates for children in out-of-home placement. For Phase II, the State has selected five distinct “intervention strategies” that are the focus of waiver activities. As their core intervention strategy, all participating counties are implementing Family Team Meetings (FTM), which bring together immediate family members, social service professionals, and other important support resources (e.g., family, friends, extended family) to jointly plan for and make crucial decisions regarding a child in or at risk of placement. An independent, trained facilitator in each county arranges and supports the FTM process. In addition to FTMs, each participating county is implementing at least one of the following “core” service components:
Ohio’s evaluation includes process and outcome components, as well as a cost analysis. The State’s evaluation is testing the hypothesis that the flexible use of title IV-E funds to provide individualized services to children and families will decrease the frequency and duration of out-of-home placements, increase reunification rates for children in out-of-home care, decrease rates of re-entry into foster care, while keeping children at least as safe as they would have been without the Waiver.
As during the original waiver demonstration, the Phase II evaluation employs a comparison group design with counties serving as the unit of analysis. The same 14 counties that formed the comparison group during Phase I of the demonstration are being used in Phase II: Allen, Butler, Clermont, Columbiana, Hancock, Hocking, Mahoning, Miami, Montgomery, Scioto, Summit, Trumbull, Warren, and Wood Counties. In addition, several counties are being added to the comparison group to balance the four new counties in the demonstration group. In selecting counties to serve in the comparison group, the State considered several relevant demographic and child welfare variables to ensure comparability with experimental group counties, including population size and density, percent of county designated as rural, poverty rates, child abuse and neglect rates, out-of-home placements rates, and median number of placement days.
Process Evaluation
As part of the demonstration’s process evaluation, each participating county submitted to the State a logic model that describes linkages between its intervention strategies and expected outcomes. In addition, the process evaluation addresses the following factors regarding the overall implementation of the waiver in the demonstration counties:
As an additional component of the process evaluation, the State is conducting a descriptive sub-study that focuses on changes in child welfare agency leadership at the county level, local efforts to promote adoption, and the nature of child welfare agencies’ relationships with the courts. This sub-study primarily involves qualitative data collection methods, including site visits and telephone interviews with key child welfare and court staff.
Outcome Evaluation
The State’s outcome evaluation incorporates five sub-studies that address each of the demonstration’s core service components. These sub-studies include both descriptive data and a quantitative analysis of changes in observed outcomes. As appropriate, each sub-study compares experimental and comparison counties for significant differences in the following key child welfare outcome measures:
Cost Analysis
The State’s cost study compares the experimental and comparison counties for significant differences in foster care maintenance expenditures and non-placement-related expenditures, including the costs of some specific child welfare services and interventions.
The evaluation team is currently preparing the Interim Evaluation Report, which will include findings on all the evaluation studies. The draft report is due April 16, 2007.
Process Evaluation
The implementation status of each core service component is summarized below.
Family Team Meetings. All 17 experimental counties are implementing FTMs. In most of the participating counties, FTMs are available to all child welfare cases receiving ongoing services with a case plan goal of reunification or “maintain in home.” Because of limited capacity and resources, a few experimental counties (Clark, Franklin, Richland, and Stark Counties) are offering FTMs to selected samples of child welfare cases. All counties have agreed to several basic criteria for the conduct of FTMs: (1) all FTMs will be facilitated by independent trained facilitators; (2) an initial FTM will be held within 30 days of case opening, at least quarterly thereafter, and at all other critical points in the life of the case; and (3) FTM participants will include family members, foster caregivers, social service professionals, and other support persons important to the family.
Included in the Interim Evaluation Report are findings showing experimental counties’ fidelity to the FTM model, as well as some preliminary outcome results for the experimental versus the comparison counties.
Kinship Supports. Six counties, including Ashtabula, Greene, Lorain, Medina, Muskingum, and Portage, are implementing a Kinship Support component to identify, promote, and maintain kinship placements. The counties are providing supportive services such as financial assistance; help in obtaining housing, day care, and therapeutic services; and financial assistance to cover legal fees for the establishment of guardianship. Flexible waiver funds are also being used to hire staff dedicated to supporting kinship caregivers.
The Interim Evaluation Report summarizes process findings and suggests some new approaches to evaluating this service component.
Supervised Visitation. Ten counties, including Clark, Crawford, Fairfield, Medina, Muskingum, Portage, Richland, Stark, Vinton and Highland, are implementing a Supervised Visitation component to promote the reunification of children in out-of-home placement. The counties are providing supervised visitation to all children ages 12 and under who are placed in an agency foster home with a goal of reunification. All eight counties have agreed to several basic criteria for the conduct of visitations: (1) visits much occur on a weekly basis and last for a minimum of one hour, (2) each visit must be supervised by a child welfare agency worker, and (3) each visit must include a structured activity.
Included in the Interim Evaluation Report are findings showing experimental counties’ fidelity to the Supervised Visitation model, as well as some preliminary outcome results for the experimental counties.
Mental Health/Substance Abuse Services. Five counties, including Belmont, Lorain, Muskingum, Coshocton, and Hardin, are providing Enhanced Mental Health/Substance Abuse (MH/SA) services under the waiver demonstration. These counties’ demonstrations differ somewhat in terms of the populations targeted for MH/SA services. For example, Belmont, Lorain, and Muskingum Counties are targeting both children and adult caregivers. Pre- and post-service data have been gathered from case records in Lorain County.
The Interim Evaluation Report presents process and outcome results for Lorain County’s service enhancements. Analysis of the other counties’ initiatives will be completed in the coming years.
Managed Care. During Phase II, only one county–Franklin County–has implemented a Managed Care program as a major demonstration component. Franklin County’s Managed Care Program has been in operation since February 1999 and targets all children and families in need of ongoing child protective services. Managed care services continue to be provided through two contracted service providers: the Ohio Youth Advocate Program (OYAP) and the Permanent Family Solutions Network (PFSN). As of November 2006, OYAP was serving 506 cases, including approximately 435 new families for the year, while PFSN was serving 763 children in 391 families, including approximately 324 new families for the year.
Analysis of Franklin County’s managed care projects is underway, and some preliminary information is included in the Interim Evaluation Report.
Outcome Evaluation
The Participant Outcomes Analysis focuses on three topics: (1) child safety, through examination of case trajectories; (2) permanency outcomes for children who were in placement at the start of the Waiver; and (3) movement to less restrictive placement for children who were in placement at the start of the Waiver. For the Interim Evaluation Report, these analyses have used data from the first Ohio Waiver.
All evaluation reports associated with Ohio’s demonstration are available at the following Web page: http://jfs.ohio.gov/ocf/pohio.stm
1Based on information submitted by the State as of November 2006. Ohio completed its original flexible funding demonstration in December 2001 and received several short-term extensions through September 2004. Back
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