| Background. Families involved with the child welfare system often have severe and costly unmet health and social service needs. Contextual and organizational factors that could explain variation in service delivery are under-examined in the child welfare literature.;Conceptual Framework. The ecological perspective posits that child welfare agency behavior is influenced by both intra-organizational factors and the interaction of the child welfare agency with its external environment. In this dissertation project, the ecological perspective is applied to identify factors at three levels of the child welfare agency environment -- micro, meso, and macro -- that influence the services received by children and their families.;Research Objective. This project consists of three studies: The first examines the extent to which a micro-level factor, caseworkers' work climate, moderates the effect of a macro-level factor, performance-based contracting, upon services for caregivers. The second study examines how a factor at the meso-level, inter-agency collaboration between local child welfare and juvenile justice agencies, influences youth behavioral health service receipt. Finally, the third study examines how the accessibility of Medicaid, another macro-level factor, and the supplementation of Medicaid with child welfare funds affects children's mental health services.;Methods. Data were drawn from the National Survey of Child and Adolescent Well-Being (NSCAW) and the Caring for Children in Child Welfare (CCCW) project. Multivariate regression analyses incorporating the complex survey design of the data were used to examine associations between identified factors and families' receipt of necessary behavioral health and social services.;Findings. In the first study, caseworkers' work climate moderated payment structures intended to restructure service delivery. In the second study, designation of agency accountability and access to shared information systems positively influenced youth receipt of behavioral health services. In the third and final study, child welfare agencies' access to and supplementation of Medicaid funds was associated with the percentage of children receiving mental health services.;Implications. Child welfare policymakers, administrators, and researchers seeking to improve service access for children and families must consider the contexts in which these services are embedded, as well as how child welfare agencies' internal and external environments may interact to influence service use. |
