Tribal/State Title IV-E Intergovernmental Agreements, Facilitating Tribal Access to Federal Resources

Although Title IV-E of the Social Security Act is an important funding stream for foster care and adoption services in American Indian communities, limited research has been conducted on the facilitation of tribal access to federal IV-E resources. Historically, direct IV-E funding has not been available to tribal communities, therefore, tribes have worked with their respective states to develop agreements that allow them to access these important funds. The purpose of this study was to provide a comprehensive overview of current IV-E intergovernmental provisions in order to assist tribes and states in strengthening both new and existing IV-E agreements. The research team conducted a nationwide content analysis of all existing current IV-E documents and conducted focus groups and telephone interviews with tribal and state representatives. Major findings include: 1) current IV-E tribal/ state agreements vary widely, thus, there is no “standard” for these agreements; 2) current IV-E tribal/state agreements focus mainly on foster care maintenance payments and services; and 3) although tribes have limited options in regard to accessing IV-E dollars (tribes must enter into an agreement with the state or they cannot access this funding source), they have established good working relationships with their respective states. Implications of these results for both tribes and states are discussed, and three recommendations are included to help facilitate tribal access to Title IV-E federal funding

High Crime Neighborhoods as a Driver for Toxic Stress Leading to Asthma

BACKGROUND: Social determinants of health and allostatic load theory suggest social environment can drive asthma diagnoses via the mechanism of toxic stress, the prolonged activation of stress response systems. While research has linked neighborhood crime to asthma, multivariate causal modeling has not been used to test toxic stress as the mechanism that links the two. The current study investigates neighborhood crime as a driver of pediatric asthma diagnoses via toxic stress. METHODS: A retrospective geospatial analysis of health and crime data was conducted. Health data was collected from the OU-Tulsa General Pediatric Clinic’s Electronic Medical Record while crime data was collected from the Tulsa Police Department. All variables were mapped geospatially using census tract as the unit of analysis. Structural equation modeling was used to test the causal model. Neighborhood crime indicators included homicide, rape, and narcotic-related offenses. Diagnoses of conduct, attention deficit, and other anxiety disorders were used in the analysis as toxic stress indicators. Asthma diagnoses were the outcome variable. To further test the model, data from 2016 was used as a calibration sample while data from 2017 was used as a validation sample. RESULTS: A full mediation model of high crime neighborhoods (n = 134) as a driver of toxic stress resulting in increased asthma diagnoses fit the 2016 data well (Χ2 = 15.6, p =.27; df = 13; RMSEA = .04 [90% CI: .00, .10]; CFI: .99; SRMR = .04). The results indicated the model accounted for 78% (R2 = .78) of the variance in asthma diagnoses. The model also provided a good fit to the 2017 data (X2= 23.6, p<.001; df= 13; RMSEA = .08 [90% CI: .02, .13]; CFI: .96; SRMR=.06). CONCLUSION: The results of the current study have important practice and research implications. While clinicians and researchers have become increasingly aware of the impact of social determinants of health, there has been little focus on improving clinical practices. Physicians interested in alleviated the burden of toxic stress and asthma should explore ways to reduce neighborhood crime at the policy level while also being aware of each of their patients’ unique circumstances in relation to where they live.N

Title IV-B Child and Family Services Plans: An evaluation of specific measures taken by States to comply with the Indian Child Welfare Act

This study responds to the lack of research on Indian Child Welfare Act of 1978 (ICWA) compliance by examining a nationwide sample of the ICWA section within state Title IV-B Child and Family Services Plans (CFSP) and Annual Progress and Services Reports (APSR). These plans and reports address the administration of state child welfare systems. The research team also conducted surveys and telephone interviews with 10 Administration for Children and Families (ACF) central and regional administrators and 9 state representatives. Among the findings are that ACF program instructions for both the CFSP and the APSR lacked detail and clarity as to what should be included in them. A majority of states reported consulting with tribes in the development of the CFSPs/APSRs, although no information was solicited regarding the context or the effectiveness of the consultation process. Over half of all state CFSPs and APSRs did not reference any of the three specific measures outlined in ACF\u27s guidelines: identification of Indian children, notification to the relevant tribe, and preference for Indian caregivers when determining placements for Indian children. WIth the exception of partnership agreements, a majority of state did not heed ACF\u27s suggested measures when creating their APSRs. A large majority of the states indicated they had in place or would develop specific policies, procedures, and protocol for ICWA compliance, but regarding the required specific measures, states either did not have or were not detailing these important components. Nearly all ACF regional administrators indicated that they had reviewed their respective states\u27 CFSP/APSR an had given them a satisfactory/good rating. Implications of these findings for tribal, state, and federal administrators are discussed, and recommendations are offered. Seven appendices present survey instruments, program instruction, and acronyms. (Contains 31 references) (TD