Reasonable efforts to preserve families? An examination of service utilization and child removal

Background: Recent federal policy has solidified the importance of preserving families, yet over 400,000 children enter foster care each year. Although a few studies have found that certain types of services, like intensive family preservation services, may reduce child removals, more research is needed.

Objective: This study examined the relationship between family preservation, family support, and basic need service utilization and child removal among families with substantiated cases of maltreatment.

Methods: We conducted a survival analysis using data from the National Child Abuse and Neglect Data System (NCANDS). We took a cohort of families with an investigation and substantiation of maltreatment in FY 2018 and followed them through FY 2019 to identify any that experienced a child removal during the study period. This included a total of n = 558,915 children.

Results: Approximately 15.33% of children experienced a removal during the study period. Case management was the most frequently reported service, followed by transportation services and family preservation services. In the multivariable analysis, family preservation services (HR = 0.95, p < .01), home-based services (HR = 0.98, p < .001), and housing services (HR = 0.87, p < .001) decreased the hazards of child removal. Family support services (HR = 1.36, p < .001), transportation services (HR = 2.30, p < .001), education (HR = 1.13, p < .01), case management (HR = 1.83, p < .001), or daycare (HR = 1.26, p < .001) increased the hazards of child removal.

Discussion: Findings from this study suggest that utilization of various services is associated with future child removals. While preservation and home-based services decreased the likelihood of removal, several basic needs services increased the hazards of child removal. This may reflect too little too late with services that may be better applied as primary or secondary preventive efforts. Implications for policy and future rollout of the Families First Prevention Services Act are explored.