Bob Flynn (rflynn@uottawa) Centre for Research on Community Services

Ontario Looking After Children project: Overview of findings from research on implementation, outcomes, and costs

Bob Flynn ([email protected])Centre for Research on Community Services

University of Ottawa (Canada)ACWA Conference, Sydney, August 14, 2006

For more detailed information on the topic of this presentation, please see the following references:

Flynn, R. J., Dudding, P. M., & Barber, J. G. (Eds.) (2006). Promoting resilience in child welfare. Ottawa, ON: University of Ottawa Press. (http://www.utppublishing.com/pubstore/merchant.ihtml?pid=8652&step=4)

Flynn, R. J., & Byrne, B. (2005). Overview and findings to date of research in the Ontario Looking after Children project. OACAS Journal, vol. 49, no. 1 (April), pp. 12-21. (http://www.oacas.org/resources/OACASJournals/2005April/overview.pdf)

Flynn, R. J., Ghazal, H., Legault, L., Vandermeulen, G., & Petrick, S. (2004). Using general-population measures and norms to identify resilient outcomes among young people in care. Child and Family Social Work, 9, 65-79. (http://www.blackwell-synergy.com/toc/cfs/9/1)

Outline

Ontario Looking After Children (OnLAC) project (2000-present): Purpose Findings:

Implementation Outcomes Costs

Implications

OnLAC project: Purpose

Evaluation of: Implementation of LAC in 53 local

CASs Outcomes associated with LAC Costs of foster care

Milestones in implementing LAC in Ontario 2000-2006 & beyond

2000: OnLAC project begins; creation of AAR-C2 2001: LAC training & use of AAR-C2 begin 2002: First outcome reports & AAR-C2 revisions 2003: First review of provincial AAR-C2 data 2004: OACAS adopts LAC as official priority & establishes OnLAC

Council 2005: LAC becomes one of six priorities of Ontario CW

Transformation 2006: Definitive AAR-C2 version disseminated for use by all 53

CASs 2007: Plans of care (12,000 children) to be based on AAR-C2 2008: AAR-C2 to be part of new Single Information System 2009: Next revision of AAR-C2 planned

Study 1: How useful do child welfare staff find AAR-C2 in helping them in their work?* (% = “Very useful” or “Useful”; N = 126)

Understand child’s needs better: 77% Collaborate better with caregiver: 73% Prepare more useful plans of care: 70% Assist youth in planning future: 70% Perform service role more effectively: 66% Discuss more effectively with youth: 64%

Be more aware of youth’s progress: 64%

*Pantin & Flynn, 2006

Predictors of perceived utility of AAR-C2 among child welfare workers & supervisors (N = 125)

Frequency of discussion in supervision of information in AAR-C2 (+)

Quality of LAC training received (+) Amount of LAC training received (+) Amount of experience in using LAC (+)

Mean score (adjusted) on perceived utility of AAR-C2 scale, by frequency of discussion of information in AAR-C2 in supervision (N = 125)

17,47

13,86

11,52

7

9

11

13

15

17

19

21

Rarely or never From time to time Often or always

FREQUENCY OF DISCUSSION OF AAR-C2 IN SUPERVISION

PER

CEIV

ED

UTIL

ITY O

F AAR

-C2

Weakness in OnLAC implementation:information in AAR-C2 discussed too infrequently in supervision (N = 125)

Frequency of discussion of information contained in AAR-C2 in supervision: Among child welfare workers:

46% “Rarely or never” 46% “From time to time” 8% “Often or always”

Among supervisors: 7% “Rarely or never” 70% “From time to time” 23% “Often or always”

Study 2: How useful do foster parents find AAR-C2 in helping them in their work?* (% = “Very useful” or “Useful”; N = 93)

Make more useful suggestions to care plan: 84% Discuss more effectively with youth: 80% Understand child’s needs better: 79% Parent youth in care more effectively: 79% Collaborate better with child welfare staff: 79% Be more aware of youth’s progress: 79% Assist youth in planning future: 77% Clarify responsibility as foster parent: 73%

*Pantin & Flynn, unpublished manuscript

Predictors of perceived utility of AAR-C2 among foster parents (N = 93)

Quality of LAC training received (+) Amount of LAC training received (+)

Mean score on perceived utility of AAR-C2 scale, by foster parents’ perception of quality of LAC training (N = 93)

20,47

15,51

11,01

8

10

12

14

16

18

20

22

24

Poor Good Very good

PERCEIVED QUALITY OF LAC TRAINING

PER

CEIV

ED

UTIL

ITY O

F AAR

-C2

Study 3: Is greater success in achieving LAC goals with youth in care associated with more positive youth outcomes?* (N = 402)

Greater success in achieving goals of LAC was associated with: More positive relationship of youth with female

caregiver More positive relationship of youth with child welfare

worker Higher satisfaction of youth with current placement

*Pantin & Flynn, unpublished manuscript

Study 4: Placement satisfaction of young people living in foster or group homes*

*Flynn, Robitaille, & Ghazal, 2006

“Would you say that your current living situation meets your needs?”

(N = 397)

81%

15%

4%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

A great deal Some Very little

“Would you say that, overall, you are satisfied with your current living situation here?” (N = 405)

78%

16%

6%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

A great deal Some Very little

Mean (average) score on 9-item placement satisfaction scale (OnLAC, longitudinal sample, yr 1, N = 223)

25,2

21,4

15

18

21

24

27

Pla

cem

ent

sati

sfact

ion

score

Foster home Group home

*Difference in means is statistically significant (p < .001)

,

Study 5: Young people’s suggestions for improving their current placements*

Suggested improvements were related to: Self Birth family Foster family Placement

Change in type or location Physical features or surroundings Social features or climate

*Robitaille, Ghazal, & Flynn, unpublished manuscript

Study 6: Positive life experiences that promote resilience in young people in care*(N = 641 aged 10+)

Major themes that emerged: Foster home (18%) Relationships (23%) Personal development (12%) Education (16%) Activities & events (24%) Family activities (4%) Life transitions (6%)

*Legault & Moffat, 2006

Study 7: Hope in young people in care* (N = 374)

Hope: “pathways thinking” + “agency” thinking Hope in young people in care:

As high as in other groups Higher hope associated with:

Active (vs. avoidant) coping (+) Living in foster (vs. group) home (+) Male gender (+) Relationship with female caregiver (+) Physical aggression (-) Age (-)

*Dumoulin & Flynn, 2006

Study 8: Participation by youth in care in structured voluntary

activities* (N = 442) Participation in structured voluntary activities:

Most frequent in sports Least frequent in art, drama, music More frequent participation associated with

psychological benefits But: psychological benefits of participation

depended on youth’s level of substance use: Low substance use: high benefits High substance use: low benefits

* Flynn, Beaulac, & Vinograd (2006)

Study 9: Foster parenting practices & foster youth outcomes* (N = 367)

Greater foster youth pro-social behaviour: Associated with higher foster-parent nurturance

Greater foster youth emotional distress: Associated with higher parent-youth conflict

Greater foster youth conduct disorder: Associated with lower foster-parent nurturance Associated with higher parent-youth conflict

Greater foster youth indirect aggression: Associated with lower foster-parent nurturance Associated with higher parent-youth conflict

*Perkins-Mangulabnan & Flynn, 2006

Study 10: Identifying resilient outcomes among youths in care*

Comparisons made between: Non-random sample of Ontario youths in

care, aged 10-15 years (N = 340), & Random sample from general Canadian

youth population, aged 10-15 years (N = 5,539)

*Flynn, Ghazal, Legault, Vandermeulen, & Petrick, 2004

Parental rating of youth’s academic achievement, in reading, math & overall

(Thirds based on Canadian [NLSCY] norms)

80

37

15

32

5

31

01020304050607080

%

Bot third (notresilient)

Mid third(resilient)

Top third(highly

resilient)

Ontario CAS (N = 319) NLSCY (N = 5539)

Note. Top third experience better academic achievement

General self-esteem(thirds based on Canadian [NLSCY] norms)

28 27

38 3734

37

05

10152025303540

%



Top third(highly

resilient)


Note. Top third report higher levels of general self-esteem.

Peer relationships(thirds based on Canadian [NLSCY] norms)

49

33

19

2832

39

0

10

20

30

40

50

%



Top third(highly

resilient)


Note: Top third experiences higher levels of positive relationships.

Pro-social behaviour(thirds based on Canadian [NLSCY] norms)

3327

35 35 35 38

05

10152025303540

%



Top third(highly

resilient)


Note: Top third report higher levels of pro-social behaviour.

Anxiety/emotional distress (thirds based on Canadian [NLSCY] norms)

65

33

20

32

15

35

010

2030

4050

6070

%



Top third(highly

resilient)


Note: Top third report lower levels of anxiety/emotional distress

Study 11: Costs of foster care*(N = 119)

Data on 119 young people in foster care, aged 10 and over, from 3 Ontario CASs

111 youths in foster care, 8 in kinship care Sources of data:

Longitudinal data on needs & outcomes taken from AAR-C2 in 2001-2002 & 2002-2003

Costing data taken mainly from CAS accounting departments, supplemented by data on services from AAR-C2

*MacDonald, Flynn, Aubry, & Angus, unpublished manuscript

Three key questions

Q1: What is average cost of individual packages of care?

Q2: Do greater needs predict higher costs?

Q3: Are higher costs related to changes in child’s functioning over 12-month study period?

“Package of Care”

Complete set or “package” of services received by an individual child in care, from: CAS: board rates, clothing allowances, spending

allowances, reimbursed expenses for recreation, camp, dental services, therapy, etc.

Other government ministries: OHIP & Ministry of Health: doctor’s visits; hospital stays Education: classroom costs Court costs

Foster parents: Out-of pocket expenses not reimbursed by CAS

Volunteers (e.g., cost of services provided by volunteer driver)

Results for question 1: Annual average costs of total package of care (N = 119, including 3 “outliers”)

CAS Other agenciesCaregivers Volunteers

Total: $35,286.91 CAS: 65%

M = $22,892.73 Agencies: 28%

M = $9,854.47 Caregivers: 7%

M = $2,468.72 Volunteers: .02%

M = $70.86

Results for question 2:Needs & costs

Higher health needs predicted higher costs, suggesting equitable allocation of resources

Kinship care was less costly than foster care (but only 8 of the 119 youths were in kinship care)

Results for question 3:Costs & outcomes

Over 12-month study period, higher costs: Were not associated with changes on outcomes

of: Self-esteem Pro-social behaviour Emotional distress.

Were associated with increases on outcomes of: Conduct disorder Indirect aggression Ill-health

Implications of OnLAC project findings

For practice For policy For research

Documents

Bob Flynn (rflynn@uottawa) Centre for Research on Community Services