Early Experiences with

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Early Experiences with Iowas Subsidized
Guardianship Project
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Presenters

• Jeff Regula, Iowa Department of Human Services,
  Division of Child and Family Services Program
  Manager for IV-E Waivers
• Miriam Landsman, University of Iowa School of
  Social Work Lead Evaluator

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Purpose of Subsidized Guardianship

• Iowa has a significant number of children and
  older youth in foster care for whom neither
  reunification nor adoption is an appropriate
  permanency goal
• These children stay in foster care for long
  periods (5 years on average)

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Target Population

• Reunification and TPR are not in childs best
  interest
• In paid, licensed foster care for at least 6 of
  the past 12 months
• child is 12 or olderor part of sibling group
  with a child 12 or older and permanency goal is
  not adoption or reunification
• Child has resided with potential guardian (if not
  a relative) for past 6 months
• If older than 14, child consents to guardianship

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Policy How SG fits with other initiatives

• Child and Family Service Review
• Family Team Meetings
• PAL Preparation for Adult Living
• MIYA- Medicaid for Independent Young Adults
• ETV Education and Training Voucher
• Service Array Change

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Marketing Subsidized Guardianship

• Target audiences staff, courts, stakeholders,
  families, relatives, foster parents
• Brochures Making the Decision to Become a
  Childs Permanent Family
• Comm 267. Introducing the Iowa Subsidized
  Guardianship Program
• Links to existing communication channels
  (stakeholder panels, conferences, quarterly
  meetings with court)

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Cost Neutrality

• Cost neutrality constraints
• Relative Placements
• Time in Paid Foster Care

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Evaluation Plan

• Random Assignment to Experimental (SG option) and
  Control (no SG option) groups
• Process Evaluation
• Outcome Evaluation
• Cost Analysis

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Long-Term Outcomes
Short-Term Outcomes
Intermediate Outcomes
Core Activities
Outputs
Inputs
Develop waiver Implementation plan
Approved waiver plan
Improved permanency (experimental over control)
Understanding of SG Option by DHS staff,
courts, clients
Use of SG option Continues over the waiver period
Federal funds
Approved evaluation Plan and contract
Develop evaluation plan and contract
State funds
Decreased time to Permanency (exp over Control)
Randomization process Accurate identifies
eligible clients
Process evaluation data is Used to
refine/improve program
Training materials
Train DHS staff
Waiver work group
Improved safety for youth (exp over control)
IRB review
IRB approval (UIowa)
DHS staff
Established SGs Remain stable
SG option is offered to Eligible clients
Randomize into Exp and control groups
Court personnel
Data extraction review
Reduced foster care reentry (exp over Control)
Stakeholders (clients,/DHS courts) value the SG
option
Consumers
Monitor randomization
SGs are established
Improved youth well-being (exp over control)
Community stakeholders
Process evaluation
Surveys
SG program is cost-neutral
Interview/focus group guides
Cost savings/successful outcomes (exp
over Control)
Technical assistants
Telephone scripts
Outcome evaluation
Database
Client interview guides
Database of fed/state expenditures
Cost Study
Logic Model
Interim eval report
Dissemination
Final eval report
Data set and documentation
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Human Subjects Review

• Exemption from HHS Human Subjects Protection
  regulations under criterion 5
• Permitted the state to randomly assign youth to
  experimental (option of SG) and control (no
  option SG) conditions
• UI IRB still oversees evaluation
• procedures

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Random Assignment

• Eligible children randomly assigned to
  experimental and control groups in 21 proportion
• Random assignment is the strongest method for
  evaluating the causal impact of an intervention
  (SG) on outcomes (permanency, safety, wellbeing).

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Process Evaluation

• Evaluate implementation of the SG program
• Methods
• interviews DHS staff, clients
• focus groups DHS staff, court personnel
• surveys DHS staff
• data extraction SACWIS

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Key Questions--Implementation

• To what extent did implementation remain
  consisted with stated purpose and design
  (fidelity)?
• What program changes were made over time?
• What level of training and support was provided?
• What challenges were encountered?
• What benefits were most valued by guardians and
  children?
• How satisfied were various stakeholders?
• What lessons were learned/recommendations for
  improvement?

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Key Questions--Decisions Re SG Option

• What proportion of eligible cases chose the SG
  option?
• What proportion of eligible cases were offered
  the SG option?
• Under what circumstances did caseworkers not
  discuss SG option?
• How and when were clients approached about SG
  option?
• For what reasons did clients choose/not choose
  the SG option?

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Outcome Evaluation

• Compare experimental (SG option) with control (no
  SG option) on key measures of permanency,
  stability, safety, well-being
• Methods
• Interviews with guardians and youth
• Data extraction -SACWIS

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Key Questions Outcome Evaluation

• Does SG result in fewer children in LTFC?
• Does SG result in fewer children aging out of
  foster care?
• Des SG result in shorter time to permanency?
• Does SG result in decreased foster care re-entry?
• Does SG result in improved child safety?
• Does SG result in improved child well-being?

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Cost Evaluation

• Cost analysis compare costs of demonstration
  with traditional services (federal and state
  funds)
• Cost effectiveness evaluate costs with respect
  to attainment of desired outcomes

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Key Questions Cost Evaluation

• Are costs of key services from multiple funding
  sources comparable between experimental and
  control groups?
• Is the cost per successful outcome comparable
  between experimental and
• control groups?

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Start-up Issues

• Randomization (Why cant Johnny have a subsidy?
  Can someone take Johnnys place?)
• Are they still eligible for(school lunch,
  Medicaid)
• The list (What do I do with another list?)

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Data

• Randomization began 2/1/07
• 962 children met eligibility criteria
• 671 were randomly assigned to experimental (SG
  option) group
• 291 were randomly assigned to the control (no SG
  option) group

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Gender Experimental vs Control
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Age Experimental vs. Control
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Race Experimental vs. Control
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Ethnicity Experimental vs. Control
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Questions and Discussion
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