1. Ontario Looking After Children project: Overview of findings from research on implementation, outcomes, and costs Bob Flynn (rflynn@uottawa.ca) Centre for Research on Community Services University of Ottawa (Canada) ACWA Conference, Sydney, August 14, 2006

2. 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)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) 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) http://www.blackwell-synergy.com/toc/cfs/9/1

3. Outline Ontario Looking After Children (OnLAC) project (2000-present): Purpose Findings: Implementation Outcomes Costs Implications

4. OnLAC project: Purpose Evaluation of: Implementation of LAC in 53 local CASs Outcomes associated with LAC Costs of foster care

5. 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

6. 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

7. 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 (+)

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

9. 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”

10. 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

11. Predictors of perceived utility of AAR- C2 among foster parents (N = 93) Quality of LAC training received (+) Amount of LAC training received (+)

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

13. 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

14. Study 4: Placement satisfaction of young people living in foster or group homes* *Flynn, Robitaille, & Ghazal, 2006

15. “Would you say that your current living situation meets your needs?” (N = 397)

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

17. Mean (average) score on 9-item placement satisfaction scale (OnLAC, longitudinal sample, yr 1, N = 223) *Difference in means is statistically significant (p <.001),

18. 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

19. 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

20. 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

21. 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)

22. 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

23. 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

24. Parental rating of youth’s academic achievement, in reading, math & overall (Thirds based on Canadian [NLSCY] norms) Note. Top third experience better academic achievement

25. General self-esteem (thirds based on Canadian [NLSCY] norms) Note. Top third report higher levels of general self-esteem.

26. Peer relationships (thirds based on Canadian [NLSCY] norms) Note: Top third experiences higher levels of positive relationships.

27. Pro-social behaviour (thirds based on Canadian [NLSCY] norms) Note: Top third report higher levels of pro-social behaviour.

28. Anxiety/emotional distress (thirds based on Canadian [NLSCY] norms) Note: Top third report lower levels of anxiety/emotional distress

29. 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

30. 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?

31. “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)

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

33. 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)

34. 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

35. Implications of OnLAC project findings For practice For policy For research