Chapter IV: Achieving Stable and Appropriate Placement Settings in Foster Care

The State child welfare agency has the responsibility to ensure that children are in stable placements while they are in foster care. Placement stability is addressed in national child welfare outcome 6: increase placement stability. For the Child Welfare Outcomes Reports, a child is considered to have achieved placement stability if the child experiences two or fewer placement settings during a single foster care episode.⁴⁹

State child welfare agencies also are responsible for ensuring that children in foster care are in placements that are appropriate to their age and service needs. This is addressed in national outcome 7: reduce placements of young children in group homes or institutions. For many young children (but not all), an age-appropriate placement means a family setting rather than a group home or institution. However, young children who need particular types of care to meet either their mental health or physical health needs should be placed in the most appropriate environments to meet those needs.

Table IV-1 presents the findings of State performance on measures of placement stability and placements of young children in group homes or institutions. With regard to placement stability, the data presented in the table reflect the various time frames relevant to the original Child Welfare Outcomes Report measure 6.1.⁵⁰

Table IV-1. Summary of State performance in 2005 on measures pertaining to outcome 6: Increase placement stability, and outcome 7: Reduce placements of young children in group homes or institutions

Outcome Measures	Performance Variables
	25th Percentile	Median	75th Percentile	Range
Measure 6.1a: Percentage of children in foster care for less than 12 months who experience two or fewer placement settings. (N=52)	80.8%	83.3%	86.7%	56.6 - 99.6%
Measure 6.1b: Percentage of children in foster care for at least 12 months but less than 24 months who experience two or fewer placement settings. (N=52)	51.4	59.4	65.3	32.3 - 99.7
Measure 6.1c: Percentage of children in foster care for 24 months or longer who experience two or fewer placement settings. (N=52)	26.9	32.3	38.3	11.6 - 99.3
Measure 7.1: Percentage of children entering foster care at age 12 or younger who are placed in group homes or institutions. (N=52)	4.9	7.2	11.9	0.9 - 24.6

As shown in table IV-1, in most States, the majority of children in foster care for less than 12 months in 2005 experienced no more than two placement settings (measure 6.1a, median = 83.3 percent). For example, there were only two States (North Carolina = 56.6 percent and Vermont = 66.5 percent) in which performance on this measure was below 70 percent. Despite the generally positive level of performance on this measure across States, it is important to remember that placement stability while in foster care is critical to children’s well-being. Therefore, there is reason for concern when any child has three or more placement settings while in foster care.

Although most States appear to be generally successful in achieving placement stability for children in foster care for less than 12 months, State performance changes dramatically when children are in foster care for longer periods of time. As shown in table IV-1, the median across States declines from 83.3 percent for children in foster care for less than 12 months to only 59.4 percent for children in foster care for 12 to 24 months, and then declines even further to 32.3 percent for children in foster care for 24 months or longer.

Surprisingly, State performance with regard to placement stability was not found to be associated with the ages of children entering foster care or with the ages of children in foster care on the last day of the fiscal year. Child welfare organizations and State agency administrators and staff frequently have suggested that, for some States, poor performance on the measures of placement stability is due to the large number of adolescents in their foster care systems. However, the findings of the data analysis conducted for the Child Welfare Outcomes Report do not support this interpretation. States with relatively high percentages of children age 13 or older either entering foster care in 2005 or in foster care on the last day of the year were neither more nor less likely to have low percentages of children experiencing placement stability, regardless of the length of time the children were in foster care. In fact, the correlations among these factors are close to zero.

The one variable that was found to be associated with placement stability was the median length of stay in foster care prior to adoption. The following correlations were found:

• Many States with a relatively high median length of stay prior to adoption also had a relatively high percentage of placement stability for children in foster care for 12 to 24 months (Pearson’s r = 0.40).
• Many States with a relatively high median length of stay prior to adoption also had a relatively high percentage of placement stability for children in foster care for 24 months or longer (Pearson’s r = 0.44). 

Although more information is needed to understand these relationships, one possible explanation is that, in some States, if children are perceived as being in stable placements (possibly preadoptive homes), States may be less likely to make concerted efforts to finalize the adoptions than they might be if the children were not in stable placements.

The data in table IV-1 also indicate that, in most States, young children entering foster care are not frequently placed in group homes or institutions. For 10 States, 5 percent or less of the children entering foster care at age 12 or younger were placed in a group home or institution. 

CHANGE IN STATE PERFORMANCE FROM 2002 TO 2005

The change in State performance over time was assessed by calculating a percent change in performance.⁵¹ Using a percent change calculation permits an assessment of the extent of change occurring over time by taking into account the size of the percentages being compared. For example, a change from 6 percent in 2002 to 7 percent in 2005 represents a change of only 1 percentage point; however, it reflects a +16.7 percent change. In contrast, a change from 75 percent to 80 percent represents a change of 5 percentage points, but only a +6.7 percent change.  Consistent with the Department's approach in prior Child Welfare Outcomes Reports, a percent change of 5.0 or greater was used as an indicator that meaningful change occurred. That is, for purposes of the analyses presented in this chapter, if the percent change in performance from 2002 to 2005 was not at least 5.0 in either direction (i.e., positive or negative), a determination was made that there was “no change” in performance.

Table IV-2 provides the number and percentage of States that improved performance, declined in performance, or exhibited no change in performance with regard to key measures for outcomes 6 and 7.⁵²

Table IV-2. Number of States exhibiting improvement, decline, or no change in performance from 2002 to 2005 with regard to measures pertaining to outcome 6 and outcome 7 (N=52)

Outcome Measures	Change in Performance: Number and Percentage of States
	Improved performance	Declined in performance	No change in performance
Measure 6.1a: Percentage of children in foster care for less than 12 months who experience two or fewer placement settings. (N=52)	10 (19%)	2 (4%)	40 (77%)
Measure 6.1b: Percentage of children in foster care for at least 12 months but less than 24 months who experience two or fewer placement settings. (N=52)	17 (33%)	13 (25%)	22 (42%)
Measure 6.1c: Percentage of children in foster care for at least 24 months who experience two or fewer placement settings. (N=52)	9 (17%)	31 (60%)	12 (23%)
Measure 7.1: Percentage of children entering foster care when they were age 12 or younger who were placed in a group home or institution. (N=52)	40 (77%)	8 (15%)	4 (8%)

As shown in table IV-2, most States did not exhibit a change in performance with regard to placement stability for children in foster care for less than 12 months. This is not surprising given the fairly high percentages for this measure in all years. Of the 12 States that did demonstrate performance change, 10 demonstrated improved performance. However, 60 percent of the States exhibited a decline in performance from 2002 to 2005 on the measure assessing placement stability for children in foster care for 24 months or longer (measure 6.1c). This raises questions about the ability of the States to maintain stability for children in foster care for long periods of time. 

There is a clear pattern over time of fewer placements of young children in group homes and institutions.

With regard to outcome measure 7.1, the data presented in table IV-2 indicate a clear pattern over time of fewer placements of young children in group homes and institutions. Performance on this measure was not found to be related to performance on any of the other outcome measures or to the number and characteristics of children in the State’s foster care population. 

SUMMARY OF FINDINGS

Placement stability declines substantially the longer a child is in foster care.

A consistent finding of the Child Welfare Outcomes Reports is that, although States are fairly successful in achieving placement stability for children in foster care for less than 12 months, the percentage of children who have placement stability declines considerably the longer the children are in foster care. This is an ongoing area in need of improvement, as indicated by the fact that 60 percent of States exhibited a decline in performance from 2002 to 2005 with regard to placement stability for children in foster care for 24 months or longer. Also, because the results of the analyses indicate that State performance on this measure is not related to the percentages of adolescents in the State’s foster care system, research in this area would be helpful in understanding the problem.

The national pattern of change in performance with regard to placements of young children in group homes or institutions suggests that most States are making concerted efforts to avoid placing young children in these settings unnecessarily.

---

⁴⁹ The count of placement settings does not include temporary stays in hospitals, camps, respite care, or institutional placements. Back

⁵⁰ For the second round of the CFSRs, three new measures were developed as part of composite 4: placement stability. These are not shown in this chapter because the measures are almost identical to the original measures of placement stability incorporated in measure 6.1. It was determined that it would be more useful to provide data for measure 6.1 in this chapter because these data are available for all 4 years. Back

⁵¹ Percent change is calculated by subtracting “old” data from “new” data, dividing by old data and multiplying by 100. For example, if maltreatment recurrence was 9.2 in 2002 and 7.6 in 2005, the percent change would be [(7.6-9.2)/9.2] x 100 = -17.4 percent change. Back

⁵² The data for the new measures of placement stability are not shown because they are essentially the same as the old measures, and because the data for the old measures permit a comparison from 2002 to 2005 rather than from 2004 to 2005. Back