Research Question How should funds be allocated within the child welfare system among prevention and treatment programs to improve outcomes for the children it serves?
To provide objective analyses about how best to allocate funds among prevention and treatment programs to improve child welfare outcomes, RAND researchers built a quantitative model that simulated how children enter and flow through the nation's child welfare system. They then used the model to project how different policy options (prevention services, family preservation efforts, kinship care efforts, and a policy package that combined prevention services and kinship care) would affect a child's pathway through the system, costs, and outcomes in early adulthood. This study is the first attempt to integrate maltreatment risk, detection, pathways through the system, and consequences in a comprehensive quantitative model that can be used to simulate the impact of policy changes.
This research suggests that one need not choose between prevention and treatment: Combining options that intervene at different points in the system and striking a balance between prevention and treatment generate stronger effects than would any single option. The simulation model identifies ways to pursue both targeted prevention and treatment while achieving multiple objectives: reducing maltreatment and the number of children entering the system, improving a child's experience moving through the system, and improving outcomes in young adulthood. These objectives can all be met while also reducing total child welfare system costs. A policy package combining expanded prevention and kinship supports pays for itself: There is a net cost reduction of $12.3 billion, or 8 percent of total spending for a cohort of children born over a five-year period.
Key Findings Effects of Prevention Services Prevention has the broadest systemwide impact because it focuses on reaching children and caregivers before they enter the system and preventing maltreatment from occurring. Prevention reduces maltreatment episodes (–10 percent), referrals to the child welfare system (–3 percent), and the number of substantiated cases (–3 percent). Increasing prevention services requires a net increase of $1.8 billion, or 1 percent of total spending in the status quo. Effects of Family Preservation Efforts Family preservation efforts translate into better outcomes in young adulthood: reductions in the likelihood of substance abuse (–2 percent), criminal conviction (–3 percent), homelessness (–2 percent), and underemployment (–2 percent). Family preservation services lead to a 15-percent decrease in total spending. Effects of Kinship Care Efforts Increases in kinship care lead to small improvements in outcomes in young adulthood, primarily for criminal conviction (–1 percent) and underemployment (–1 percent). The kinship care option generates a 9-percent decrease in total costs relative to the baseline. Effects of Combined Policy Package When the quality and quantity of both prevention and kinship care increase, maltreatment episodes decrease by about 10 percent. As a result, referrals to the child welfare system also substantially decrease (–3 percent). There are also fewer out-of-home placements (–8 percent). The likelihood of negative long-term outcomes is reduced: homelessness (–7 percent), underemployment (–7 percent), criminal conviction (–7 percent), and substance abuse (–7 percent). There is a net cost reduction of $12.3 billion, or 8 percent of total baseline spending.
Recommendations Going forward, the model can be used to gauge the potential effects of a wide range of evidence-based options individually or in combination to help inform the development of national legislation to improve outcomes for children. In addition, model assumptions and data can be adapted to reflect the population and system structure in a particular state or local system and then used to assess the effects of different policy options in that jurisdiction.
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Content
Content
Policy Options for Improving Child Welfare
Table of Contents Chapter One
Introduction
Chapter Two
Conceptualizing a Complicated System
Chapter Three
Modeling How Children Enter and Flow Through the Child Welfare System
Chapter Four
Changes Projected for Different Policy Options
Chapter Five
Discussion
Research conducted by RAND Health RAND Labor and Population RAND Education RAND Justice, Infrastructure, and Environment
This research was funded by Pritzker Foster Care Initiative and conducted jointly under the auspices of four units at the RAND Corporation: RAND Health; RAND Labor and Population; RAND Education; and RAND Justice, Infrastructure, and Environment.
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