Systems Change in Child Welfare: Process Evaluation of a Cross-Systems Approach to Prevention, Family Reunification, and Well-Being

Low-income families face numerous barriers to well-being, among them the challenges of procuring stable, safe community housing and keeping children safe in those contexts. Research suggests that housing and child welfare are inextricably related; housing difficulties precipitate admission to foster care and delay family reunification (Cohen-Schlanger, Fitzpatrick, Hulchanski, & Raphael, 1995; Courtney, McMurtry, & Zinn, 2004). Families in the child welfare system frequently experience high service needs, corresponding to a range of mental health and psychosocial challenges.

Whereas the placement of children in foster care is the culmination of multidetermined problems, substandard housing is a key factor in the vast majority of maltreatment cases (Harburger & White, 2004; U.S. Department of Health and Human Services, 2010). Women with histories of homelessness are nearly seven times more likely to be child welfare-involved compared to low income, never homeless women (Culhane et al., 2003). Child welfare-involved mothers with substance abuse and comorbid mental health problems have lower rates of reunification (Marsh, Ryan, Choi, & Testa, 2006). Researchers advocate for better coordination of housing and psychosocial services across programs and agencies, which is particularly relevant for child welfare-involved children and families (McCoy-Roth, Mackintosh, & Murphey, 2012). In spite of increasing recognition of the interrelated nature of housing and child welfare concerns, there is evidence that general housing programs may be ineffective in addressing the multiple, complex, and relatively severe needs of families (Fowler, Taylor, & Rufa, 2011).

Recent practices promote integrating services across systems with the aim of preventing foster care placement, encouraging rapid family reunification, building community, and sustaining family stability. This presentation addresses the intertwined nature of housing and child welfare and describes a process evaluation intended to examine the effective elements of a statewide housing and child welfare initiative. Embedded in a federally funded randomized study of housing and child welfare, the process evaluation reflects the lessons of decade-long systems change initiatives undertaken by one northeastern state. The evolution of this statewide initiative reflects the application of ongoing program evaluation data and collaborative, cross-systems partnerships in the design, and expansion of a supportive housing program.  Emphasis is on: prevention components; processes (e.g., client engagement; cross-system data sharing) that appear determinative in ensuring coordinated solutions; dynamic barriers to implementation fidelity (i.e., capacity; balance between local adaptation, cultural sensitivity, and research priorities); challenges in the design and implementation of rigorous field research; and, coordination with stakeholders who might effect systems change.