Outcomes of Kinship Care Placement

Outcomes of Kinship Care Placement Donna Harrington, Ph.D. University of Maryland School of Social Work 23rd Annual UC Davis Western Regional Child Abuse and Neglect Conference Sacramento, CA, September 13-15, 2004

Workshop Goals • Define kinship care placements • Discuss rates of kinship care placements • Review research on outcomes • Discuss limitations of research • Describe a few recent studies in detail • Discuss subsidized guardianship initiatives • Availability • Outcomes Outcomes of Kinship Care

Participants • What types of settings do participants work in? • Child welfare • Medical • Other • What type of work do participants do? • Clinical • Research • Administration • Experience with kinship care? Outcomes of Kinship Care

What is Kinship Care? • Living with a relative because parents are unable to take care of the child • Formal – placement arranged by a child welfare agency • Informal – arranged within the family without involvement of a child welfare agency • “Relative” may include fictive kin, who are close to the child, but not related by blood Outcomes of Kinship Care

Informal Kinship Care • Much more common than formal • Only a few studies have examined, therefore little is known (Cuddeback, 2004) • Ehrle and Geen (2002) – children in formal and informal kinship care were similar • Both experiencing greater hardships than children in non-kinship foster care Outcomes of Kinship Care

Why Kinship Care is Needed • Children may be unable to live with their parents because of • Death • Incarceration • Maltreatment • Mental illness • Substance abuse • Illness, including HIV/AIDS • Other Outcomes of Kinship Care

Numbers • 2000 US Census – 5.6 million children reside with grandparents or other relatives • 26% of children in out-of-home care lived with relatives (Harden, et al., 2004, based on Adoption and Foster Care Analysis and Reporting System [AFCARS] data) • Kinship care is fastest growing type of out-of-home placement • In a number of states more children are entering kinship care than foster care Outcomes of Kinship Care

Numbers from National Survey of America’s Families • 1999 – 2.3 million children did not live with their parents (Billing, et al., 2002) • 90% of those children lived with a relative • Most arrangements are made privately within the family • March 2002 – almost 2.2 million children living with a relative (Fields & Casper, 2001, in Carpenter & Clyman, 2004) • 10 times the number in traditional foster care • 3% of children live in kinship care Outcomes of Kinship Care

Changes in NSAF Numbers • 1997 – 1.8 million children living with relatives • Increase primarily due to informal (i.e. outside the child welfare system) placements • 1.3 million in 1997 • 1.8 million in 1999 • Formal placements stable around 400,000 (Billing, et al., 2002) Outcomes of Kinship Care

Increased Use of Kinship Care in the Public Child Welfare System • Changing reimbursement policies that permit relatives to receive foster care payments • Increasing foster care caseloads • Decreasing numbers of foster parents • Increasing emphasis on maintaining family ties (Iglehart, 2004) Outcomes of Kinship Care

Placement Rates • In Baltimore, up to 75% of children in out-of-home care are placed with relatives • In New York City, approximately 50% of children in out-of-home care are placed with relatives (Kolomer, 2000) Outcomes of Kinship Care

Placement with Relatives • Separation from parents can be traumatic • Trauma may be minimized by placement with relatives • Often experience significant economic hardship or poverty • Unknown whether risk of living in poverty on development moderated by benefits of living with relative (Billing, et al., 2002) Outcomes of Kinship Care

Theoretical Advantages ofKinship Care • Continuity of family identify and knowledge • Access to relatives other than kinship caregiver • Continuity of ethnic, religious, and racial • Caregiver’s familiarity of child based on pre-existing relationships (Cuddeback, 2004, based on Hegar, 1999) Outcomes of Kinship Care

Pros and Cons • “Some of these findings raise concern… it is important to examine whether the theoretical advantages of placing a child in kinship family foster care outweigh some of the disadvantages characteristic of kinship placement (i.e. lower socioeconomic status, fewer resources, less training and support)” (Cuddeback, 2004, p. 625) Outcomes of Kinship Care

Perceptions of Kinship Care • Child welfare professionals have reported • Generally children are better off being fostered by kin • Kinship care children have a stronger sense of belonging • Have more continuity in their lives • Level of care and parenting in kinship homes is generally good (Cuddeback, 2004) Outcomes of Kinship Care

Perceptions of Kinship Care continued • Child welfare professionals also report • Kinship foster care families are more difficult to supervise • Require more time to assess • Make case plans harder to enforce • Are more likely to delay reunification • Less likely to be able to meet health and educational needs (Cuddeback, 2004) Outcomes of Kinship Care

Disproportionate Placement of African American Children in KC • “Kinship care is consistent with values and family patterns that are firmly etched in African-American history … and … child welfare workers use kinship placements to fill the need for culturally relevant placements” (Iglehart, 2004, p. 613) Outcomes of Kinship Care

From Exclusion to Overinclusion • 1995 – African American children approximately 15% of US child population • Almost 30% founded allegations of abuse and neglect • 41% of child welfare population • 49% of out-of-home placements (Smith & Devore, 2004) Outcomes of Kinship Care

From Exclusion to Overinclusion continued • Historically African American children excluded from child welfare system • Orphaned children “absorbed into the … community by other adult[s] … who took over the parenting role in keeping with kinship care patterns familiar in their African cultures” (Smith & Devore, 2004, p. 429) • Mid 1800s and early 1900s white run charity organizations, mutual aid societies, and settlement houses ignored, segregated, or served African Americans during special hours Outcomes of Kinship Care

From Exclusion to Overinclusion continued • Exclusion continued through the Progressive Era reform movement • Slight change occurred post World War II as the “Black presence became more evident in the urban centers of the North. Greater strides toward inclusion were accomplished as a response to the racial unrest in many cities” (Smith & Devore, 2004) Outcomes of Kinship Care

From Exclusion to Overinclusion continued • By 1950s, civil rights activity expanding, number of children of color in child welfare system increased • Increase due to three factors: (Billingsley & Giovannoni, 1972, cited in Smith & Devore, 2004) • Large numbers black families migrate to north • Civil rights movement; integration focus • Decreasing poverty among white children; formal system increasingly caring for poor minority children Outcomes of Kinship Care

From Exclusion to Overinclusion continued • African American children greater risk for mandated abuse and neglect reporting • Currently two tiered system • Formally licensed and trained relatives receiving foster care payment rates • Unlicensed relatives receiving TANF payments • Often also receive fewer agency support services • Some may not receive any financial support Outcomes of Kinship Care

From Exclusion to Overinclusion continued • Financial concerns in child welfare system • Kinship care is usually less costly • On average TANF payments are 50% lower than foster care rates (Smith & Devore, 2004) • Throughout welfare reform of late 1990s preference for kinship care placements continued • ASFA (1997) affirmed place of relatives in providing child welfare services Outcomes of Kinship Care

From Exclusion to Overinclusion continued • ASFA required shortened time frame to achieve permanence • Termination of Parental Rights (TPR) for all children in foster care for 15 out of last 22 months • TPR petition not required if child placed with a relative Outcomes of Kinship Care

From Exclusion to Overinclusion Policy Implications (Smith & Devore, 2004) • Policy “to address ‘minimum standards of care’ which are grounded in cultural values about parenting and child rearing” (p. 442) • Realistic standards • Not based on Euro-American middle class values Outcomes of Kinship Care

From Exclusion to Overinclusion Policy Implications (Smith & Devore, 2004) continued • Policies “valuing … the cultural tradition of a reliance on extended family (blood and fictive kin) need to be developed to reduce the unnecessary placement of African American and other children of color” (p. 442) Outcomes of Kinship Care

From Exclusion to Overinclusion Policy Implications (Smith & Devore, 2004) continued • Acknowledge “that poor children tend to have poor relatives” (p. 442) • Provide more equitable financial and service support • “Require evaluation of culturally competent practice” (p. 442) Outcomes of Kinship Care

Federal Licensing Guidelines • January 2000 – USDHHS issued guidelines instructing states to use the same requirements for relative foster homes as they do for non-relative foster homes to obtain Title IV-E reimbursement for care of children placed with kin (Barbell & Freundlich, 2001) Outcomes of Kinship Care

Kinship Caregivers • “Some research suggests that kinship caregivers might foster less effectively…, and that kinship caregivers receive less support, services, and training and have fewer resources than non-kinship caregivers” (Cuddeback, 2004, pp. 623-624) • May contribute to differences in outcomes Outcomes of Kinship Care

Caregiver Demographics • Compared with non kinship caregivers, kinship caregivers are more likely to be: • African American • Older • Single • Less educated • Unemployed • Lower socioeconomic status Outcomes of Kinship Care

Grandparents raising Grandchildren • Compared with grandparents not caring for their grandchildren: • Report more limitations of daily activities • Increased depression • Lower levels of marital satisfaction • Poorer health • Some evidence that benefit from support groups (Cuddeback, 2004) Outcomes of Kinship Care

Harden, et al. (2004) • Comparison of kinship (n = 50) and foster (n = 51) care parents • African American – 96% kinship, 80% foster • Mean age of caregivers – 56.2 (+ 10.2) years kinship, 44.9 (+ 9.4) years foster • Caring for 2.7 (+ 1.7) children • Recruited in Washington and Baltimore from child welfare agencies Outcomes of Kinship Care

Harden, et al. (2004) Results • Kinship caregivers reported • Less warmth/respect • More strictness/overprotectiveness • More parent-child conflict/anger • Fewer social resources • Fewer married and more widowed • Fewer with other adult present (32% v. 63%) • More with income < 20,000 (62% v. 18%) Outcomes of Kinship Care

Harden, et al. (2004) Results continued • Kinship caregivers reported • Fewer own home (50% v. 82%) • Fewer employed (32% v. 66%) • Fewer high school graduate (64% v. 87%) • More with chronic illness (50% v. 20%) • More medical treatment (50% v. 14%) • More hospitalized > 1 time (80% v. 51%) • More prescribed medication (60% v. 27%) Outcomes of Kinship Care

Harden, et al. (2004) Discussion • “Kinship care providers reported parenting attitudes that have been associated with deleterious child outcomes in other studies of parenting… However, the parenting findings were clearly related to the background characteristics of this sample, in particular the older age and single parent status of the kinship care providers” (p. 666). Outcomes of Kinship Care

Harden, et al. (2004) Discussion continued • “In general, results of this study corroborated other evidence that kinship parents have fewer social and economic resources, and poorer health, than traditional foster parents” (p. 666) • “Children… reared in… high-risk contexts have a higher probability of poor outcomes, such as academic underachievment, deficits in social competence, and mental health difficulties” (p. 667) Outcomes of Kinship Care

Kinship Homes • Compared with non kinship homes • More crowded • Worse general structural condition • Not as clean, safe, or pleasant • More likely to have acknowledged past violence in the home • Expressed concerns about other adults in home using drugs or alcohol • Neighborhoods rated less well (Cuddeback, 2004) Outcomes of Kinship Care

Placement Stability • Compared with non kinship care, children in kinship care • Have more stable placements • Have fewer prior placements • Limited evidence remain in care longer • Limited evidence less likely to reenter care • Better contact with birth parents Outcomes of Kinship Care

Permanency Outcomes • Some evidence that kinship families less likely to adopt or accept legal custody • Unclear if less likely to adopt because child welfare professionals less likely to discuss this option or other reasons Outcomes of Kinship Care

Reluctance to Adopt • Relatives may decline adoption because of blood ties and cultural reasons (Burnette, 1997) • Relatives may not be reluctant to adopt if • Provided with accurate information • Assured of receiving ongoing subsidy payments and continued role of birth parents • Option to keep children’s birth names after adoption (Geen & Berrick, 2002; Testa & Shook, 2002) Outcomes of Kinship Care

Comparison with Children in General Population • Children in kinship care function less well: • More behavior problems • More problems with homework • Below average scores in reading, math, cognitive functioning, problem solving, reasoning, and listening comprehension, but above average in oral expression • Similar to children in non-kinship care and maltreated children not in care (Cuddeback, 2004) Outcomes of Kinship Care

Behavioral and EmotionalWell-Being • 13% of 6-17 year olds living with relatives exhibit high levels of problems • Higher than the 7% of those living with parents • Within poverty groups (<200% Federal Poverty Level), no difference in rates • 14% children in relative care • 11% in parent care (Billing, et al., 2002) Outcomes of Kinship Care

Carpenter and Clyman (2004) • Adult physical and emotional wellbeing • Nationally representative sample of women with a history of living in kinship care • 1995 National Survey of Family Growth • Subsample of 18 to 44 year olds Outcomes of Kinship Care

Carpenter and Clyman (2004) continued • Sample • Kinship care group – women who lived with any relative, without either biological parent, for at least one month (n = 471) • Comparison group – lived with at least one biological parent throughout childhood (n = 8289) • Excluded women who had been in foster care or group homes at any time in childhood Outcomes of Kinship Care

Carpenter and Clyman (2004) Results • Kinship group • More likely African American (29.2% v. 13.2%) • Less likely complete high school (79.2% v. 88.8%) • More likely obese (25.1% v. 18.4%) • More likely current smokers (40.5% v. 28.1%) • More likely poor (124% FPL v. 191% FPL) Outcomes of Kinship Care

Carpenter and Clyman (2004) Results • Kinship group • More likely unwanted first sexual experience (13.1% v. 8.4%) • “Women in the kinship group exhibited higher rates of worse physical and emotional wellbeing than in the comparison group, across all of the outcomes of interest” (p. 680) Outcomes of Kinship Care

Carpenter and Clyman (2004) Results – Multivariate Analyses • After controlling for other predictor variables (e.g. age, smoking, obesity, etc.) kinship care was not a significant predictor of poor health status or limited life activities • Kinship group remained more likely to have experienced extended period of anxiety even after control variables Outcomes of Kinship Care

Carpenter and Clyman (2004) Results – Multivariate Analyses • Kinship care group women more than twice as likely to report general unhappiness with life, even after adjusting for periods of anxiety and poor health Outcomes of Kinship Care

School Performance • Compared with the general population, children in kinship care • Fewer attendance problems • Fewer suspensions and expulsions • Less likely to be working at or above grade level (Cuddeback, 2004, based on Dubowitz study) • Other studies find no differences in educational performance for kinship and non-kinship care children Outcomes of Kinship Care

School Suspensions or Expulsions • 26% of 12-17 year olds living with relative suspended or expelled during survey year • Twice as high as the 13% of those living with parents • Within poverty group, 31% of those living with relatives v. 21% of those living with parents (Billing, et al., 2002, based on National Study of America’s Families [NSAF]) Outcomes of Kinship Care

Outcomes of Kinship Care Placement