Evaluation of Colorado’s IV-E Waiver Demonstration

Testing—and funding—new approaches 

The Colorado Department of Human Services initiated its Title IV-E Waiver on the heels of a statewide Child Welfare 2.0 plan that increased state-level funding and emphasis on in-home child welfare services. Through the IV-E Waiver, Colorado’s county child welfare departments implemented a variety of supportive interventions for families: facilitated family engagement meetings, Permanency Roundtables, kinship supports, and trauma-informed practices.  

We evaluated these interventions at the county level, conducting process, outcomes, and cost studies. We worked collaboratively with state and county staff and sought out the perspectives of families, youth, and kin caregivers—through site visits, key informant interviews, focus groups, and surveys. 

Local stakeholders are in the best position to interpret findings and provide key contextual insights. 

Keeping children safe in the least restrictive settings

A goal of the Colorado waiver was to decrease the use of restrictive congregate and group home placements and to keep children and youth at home or with kin when possible. Our study showed that under the waiver, there was an overall decrease in foster and congregate care use and an increase in kinship care use, particularly non-certified kinship care.  

Measuring intervention implementation

The evaluation incorporated an annual implementation index designed to gauge county-level implementation of the waiver interventions. The implementation index tool is an online survey that was administered annually to every county in Colorado. Drawing on Fixsen’s implementation science research, the implementation index catalogues implementation status across domains that are expected to improve the implementation and delivery of the interventions. The Index helps us understand the relationship between county-level implementation, case-level fidelity, and child and youth safety and permanency outcomes. 

While many factors that influence fidelity are outside of the control of child welfare agencies, understanding internal agency implementation drivers provides tangible and actionable ways for child welfare agencies—including child welfare administrators, managers, supervisors and caseworkers—to influence fidelity and thereby influence the safety and permanency outcomes of children and youth.

Cross-system collaboration and trauma-Informed practice 

Under Colorado’s waiver, counties implemented cross-system trauma interventions. These interventions reflect a growing body of knowledge related to the short- and long-term effects of adverse childhood experiences, as well as an understanding of the resiliency and healing that can come from trauma-related approaches and treatment. The trauma-informed interventions brought children and families access to trauma screening, assessment, and treatment tools. These cross-system interventions relied on collaboration between the Division of Child Welfare and the Office of Behavioral Health. To evaluate these interventions, we collected quantitative and qualitative data from both systems, and conducted collaboration mapping.  

The results

Across the Colorado counties participating in the waiver, HSRI found: 

• An overall decrease in foster and congregate care use, and an increase in kinship care use, particularly non-certified kinship care 
• An overall decrease in out-of-home expenditures
• Waiver intervention services were associated with increased safety and permanency of child welfare-involved children and youth
• Enhanced communication and relationships between the Colorado Department of Human Services, counties, courts, and child welfare community partners