NCJ Number
246536
Journal
Child Abuse and Neglect Volume: 37 Issue: 10 Dated: October 2013 Pages: 871-882
Date Published
October 2013
Length
12 pages
Annotation
Out-of-home placement decision-making in child welfare is founded on the best interest of the child in the least restrictive setting.
Abstract
Out-of-home placement decision-making in child welfare is founded on the best interest of the child in the least restrictive setting. After a child is removed from home, however, little is known about the mechanism of placement decision-making. This study aims to systematically examine the patterns of out-of-home placement decisions made in a state's child welfare system by comparing two models of placement decision-making: a multidisciplinary team decision-making model and a clinically based decision support algorithm. Based on records of 7816 placement decisions representing 6096 children over a 4-year period, hierarchical log-linear modeling characterized concordance or agreement, and discordance or disagreement when comparing the two models and accounting for age-appropriate placement options. Children aged below 16 had an overall concordance rate of 55.7%, most apparent in the least restrictive 20.4% and the most restrictive placement 18.4%. Older youth showed greater discordant distributions 62.9%. Log-linear analysis confirmed the overall robustness of concordance odd ratios ORs range: 2.9-442.0, though discordance was most evident from small deviations from the decision support algorithm, such as one-level under-placement in group home OR = 5.3 and one-level over-placement in residential treatment center OR = 4.8. Concordance should be further explored using child-level clinical and placement stability outcomes. Discordance might be explained by dynamic factors such as availability of placements, caregiver preferences, or policy changes and could be justified by positive child-level outcomes. Empirical placement decision-making is critical to a child's journey in child welfare and should be continuously improved to effect positive child welfare outcomes.