ACWA 2010 The cost of support

1. ACWA 2010The cost of support University of Melbourne Dr Cas O’Neill, Professor Cathy Humphreys Monash University Dr Catherine Forbes Barnardos Australia: Find a Family Ms Elizabeth Cox, Dr Sue Tregeagle Funding: Ian Potter Foundation

2. Purpose of Study • Understand worker time required in a foster care program • Estimate costs of care based on worker time findings • Understand carer time above and beyond ‘ordinary’ parenting

3. The program- 25 years of Find a Family Specialised permanent care program for children 1/3 of children with complex needs or hard to place Carers involved in natural family contact 78% stability on first placement About one half of children are adopted Standardised case management system First NSW program to receive highest accreditation Subject to ten year longitudinal study NOTE: The observations of worker time did not show recruitment processes, however recruitment of carers is reflected in the NSW recognized casework costs applied to worker time.

4. Research context 34,000 children in out of home care, 2008-9 Foster carers leaving in significant numbers, low recruitment rates Placement disruptions are expensive (O’Neill) Low stability in care Outcomes are often poor (Cashmore and Paxman) Long term cost of inadequate support estimated at $738,741 per person (education, mental health, justice system etc (Raman, Inder & Forbes, 2005)

5. Themes in research literature on costing of programs The financial cost of current programs to the state Comparing the cost of one practice option with another option The cost (financial and psychological) of current programs and life situations to individuals The issue of underfunding and what a properly resourced program should provide Current funding for programs related to projected demand for future funding

6. Study methods • 27 children/placements • Over 9 month period • Diary records • Worker time and activity • Carer time and activity beyond ‘ordinary parenting’ • Analysis by groups: • First year (5) • Stable (5) • Unstable (5, possibility of costing a disruption) • Adolescents (5) • Adoption (5) • Extra – Placements threatening to disrupt (2)

7. What we found • Workers: average 3 hrs 32 mins per 5 day week supporting families in the study • Carers: average 6 hours 22 mins per 7 day week on activities above and beyond ‘ordinary’ parenting • Variations between groups, within groups and over time • Patterns often difficult to predict • Intensive work in first year may lead to later stability • Developing Costs – $125.60 per casework hour • DCS calculation for study year 2008-09 • Labour $100,350 + non-labour $63,130 = $163,480 (per annum)

8. Worker average hours per ‘study day’

9. Worker hours – 83% of worker time

10. Other worker time relationships Between average time per individual worker and Gender of the child Age of the child Number of health issues at the start of the placement Care category Care plan Total time child has been in care Time child in the Find a Family program If foster family has support for respite Worker experience Average costs determined

11. Findings that we expected First year placements receive very intensive support ($127) High time needs for Extra ($166) and Unstable ($114)groups Unstable and Adoptive groups had most time on legal activity NB Children had previously been through Children’s Court Average time for Extra group ($166) cost more than 2.5 times Stable ($58)or Adoptive ($58) groups per day Worker time for boys ($98)more time than for girls ($82) More difficult care categories require more time ($78 - $118) Variation in time spent with each family varied dramatically both within each category and across the 9 month period

12. Unexpected findings First Year ($127) grouptook more time than the Unstable ($114) group (in this program) Adolescent placements ($62) did not require much more support than the Stable groups ($58) orAdoptive ($58) High number of hours in first year of FaF program ($133) time decreased in years 2-4, then slowly rises again 3-5 year olds ($103) took most time on average 0-2 year olds ($68) took least time When placement unstable, more time spent directly children than with carers No disruptions during study, but two afterwards

13. Carer average hours per day

14. Carer time – 83% of carer time

15. Other carer time relationships Between average time per individual carer and Gender of the child Age of the child Number of health issues at the start of the placement Care category Care plan Total time child has been in care Time child in the Find a Family program If foster family has support for respite Worker experience

16. Carer findings Very similar to worker findings First year placements require very intensive support (1hr 42min) Boys (1hr 14min) take more time than girls (39min) Children aged 3-5 years take most time (1hr 26 min) Long term foster care with adoption (1hr 7 min) less time than without adoption (33 min) Carer hours larger where respite supported in placement Higher care category, more carer time needed Differences? Adolescent or Adoptive groups took more time than Unstable group More variable (1 – 30+ hrs pw), greater number of ‘extreme’ days

17. Limitations to methodology Small sample Though high rate of compliance Generalisability to other agencies/states Variability in consistency of recording Differing interpretations of what was to be recorded Were the chosen carers the most conscientious? Research effect

18. Improving outcomes for children Improving outcomes Instability is expensive Intensive support promotes stability This research New research methodology Program with established high stability rates Quantify worker time/costs and carer time Acknowledge the variability – a key feature of support Hopefully…helpful for funding negotiations, resource management and practice