Author: childwelfaremonitor

The Real Benefit of Child Welfare Waivers: Eliminating Title IV-E Eligibility Determination

I’ve never been a huge fan of the Title IV-E waivers that 28 jurisdictions have obtained from the federal government to allow states to develop innovative programs to address federal child welfare goals. Maybe it’s because the one in my own jurisdiction, the District of Columbia, is currently being redesigned because the services it funded were underutilized at the same time as many system-involved families received little help.

Around the country, most states are funding the same set of programs, few if any of which can document impressive effects despite being billed as “evidence-based.” Moreover, in its most recent report on child welfare financing, Child Trends found that only nine percent of waiver funds were used for purposes not traditionally reimbursable under Title IV-E.

But when reading an article about Florida I suddenly realized why the loss of the waivers could be disastrous for many child welfare systems and the children they serve. If Florida’s waiver expires, the Deputy Commissioner of Florida’s Department of Children and Families is worried about the state having to return to determining the Title IV-E eligibility of individual children.

For those who are not versed in the arcane details of child welfare finance, let me explain. States receive partial federal reimbursement for Title IV-E foster care expenditures only for children who would have been eligible for Aid to Families with Dependent Children (AFDC), a welfare program which ended in 1996.  To obtain their share of federal funding, states are forced to devote considerable resources to determine this eligibility for every child–a calculation which serves no other purpose.

Of course there has been inflation since 1996, so the proportion of children eligible for Title IV-E funding decreased from 67% in 2000 to under 50% in 2017. This means that every year states and counties are paying a higher proportion of foster care costs compared to the federal government.

Determining eligibility for foster care based on income makes no sense. A state or county pays for foster care even for youths who are not eligible for financial assistance based on poverty. If a child of Donald Trump or Bill Gates came into foster care, the state would pay. So federal reimbursement should not depend on the income of the parents.

I have not seen any estimate of how many people perform the soul-deadening task of determining Title IV-E eligibility, or how much governments spend on this useless exercise. That money would be much better spent on services to children in a desperately underfunded child welfare system.

Most states with waivers have been exempted from Title IV-E eligibility determination. To ensure that the projects are cost-neutral, the federal government established a cap on federal funding for each jurisdiction rather than reimbursing them on a per-child basis. These jurisdictions have been able to stop determining Title IV-E eligibility for kids entering foster care.

States should not need a waiver in order to avoid wasting human and financial resources to determine foster children’s eligibility for a defunct welfare program. Yet, advocates have been silent on this issue. There are several child welfare bills awaiting consideration by the 115th Congress in 2018. Unfortunately, none of them would eliminate the criteria for Title IV-E eligibility, not even the “Family First Act,” which has been billed as child welfare finance reform.

In his brilliant column, The Two Billion Dollar Question: Why Haven’t We De-Linked?, Sean Hughes tried to explain the reasons for this silence. He argues that “the focus seems to have shifted almost exclusively toward preventing entry into foster care, with little advocacy being devoted to actually improving the continuum of care for children in out-of-home care.” Shockingly, he reports that advocates have often told him that they would not want more funding for foster care even if they could get it.

It is hard to believe that people calling themselves child advocates could turn their backs on the heartbreaking needs of children in foster care by staying silent on the Title IV-E eligibility limits. Children in foster care need great foster parents who live near their homes and schools of origin, and who might be attracted by the offer of housing in supportive communities of foster parents. They need caseworkers who have the time to assemble and coordinate the multiple services they require. They need cutting-edge trauma-informed mental health services from top providers, not the low-end providers who often choose to participate in Medicaid. They need music lessons, art and dance classes, and driver’s education.

In light of the dwindling supply of good foster parents and the recent increase in the foster care rolls, large sibling groups and harder-to-place foster youths need high-quality boarding schools where sibling can be kept together, needed services can be provided in one place and where behavioral challenges can be addressed in a safe and non-traumatizing way.

Eliminating Title IV-E eligibility determination would be a good first step to providing all the enhanced services that foster kids need and deserve, and stopping the waste of desperately needed resources on eligibility determination.

Putting the Child Back in Child Welfare

It was the dead kids who inspired me to leave my comfortable, well-paid job as a researcher and become a child welfare social worker. Kids like Adrian Jones, Zymere Perkins and Yonatan Aguilar, who were killed by their parents after months or years of abuse.

The dead kids were out of their misery. But I couldn’t stop thinking about all the other kids living in fear of the next beating, watching child protective services (CPS) workers leave after accepting the mother’s or stepfather’s explanation of their bruises, and facing the now-angrier adult eager to punish them.

So I went back to school and added a Masters in Social Work to my Masters in Public Policy from Princeton and my B.A. in Sociology from Harvard. I was thrilled to be accepted as a CPS trainee at the District of Columbia’s Child and Family Services Agency (CFSA).

But my CFSA trainer told us we were not there to save children. I learned that the family, not the child, was at the center of child welfare policy. Our business was to find the strengths in each family.

We learned that “safety” meant simply the absence of “imminent danger.” A child could be “safe” but at high risk of abuse or neglect in the future. Such children should remain at home with monitoring and supervision by the agency, but since this is usually voluntary, the family can refuse to participate.

I later learned that even if the family agrees to participate, these in-home cases often closed quickly with little evidence of reduced risk to the child. I also learned of cases around the country, such as that of Yonatan Aguilar, in which these high-risk but “safe”kids died from abuse.

I never ended up being a CPS worker. I ended up instead in a private agency that provided foster care and case management to D.C. children.

Working in foster care, I learned even more about how the child is not the center of child welfare practice. Compliance with requirements, meeting benchmarks and saving money were much more important than helping children.

Assuring that a child had her physical exam on time, her two visits with the social worker within the month, her “Youth Transition Plan” every six months was paramount. But no problem if I did not have enough time to explore summer camp options, or talk to a teacher or therapist, because there was no benchmark for that.

These benchmarks could have perverse results, like the time I had to take a client for an extra physical because her placement had changed its designation from “respite,” so it was treated as a new placement. Working 60 hours a week to see my clients’ needs met, I could ill afford the time.

I learned that the field adheres to simple, feel-good policy reforms that just happen to save money and often have perverse effects on kids. Non-family residential placements are anathema in the current climate. But many excellent group homes and residential schools are far more nurturing than some of the uncaring foster homes I’ve seen.

Because of the virtual elimination of group homes in the District, social workers have to repeatedly find new placements for traumatized teens whose behavior results in repeated rejection by foster families in search of easy money with no behavior problems.

It is also accepted as gospel that children must achieve “permanency” rather than aging out of care. To increase the numbers of “permanent placements,” and reduce the number of kids aging out, workers often urge youth to accept adoption or guardianship with foster parents, relatives, or other available adults, even if they are uncaring or inappropriate. Never mind that some youth might do better staying in foster care until 21 and benefiting from continued case management and services, rather than being at the mercy of paid guardians who may divert their subsidies for their own purposes.

Once a child is off the foster care rolls, there is no mechanism to ensure that the “permanent” placement works out. And with subsidies being paid to adoptive parents and guardians, there is reason for concern. Of course, the results are not usually as catastrophic as the murder of two girls by the woman who adopted them from D.C. foster care, who collected subsidies while their bodies remained in her refrigerator.

In my experience in child welfare, I’ve learned that too many things take precedence over the welfare of children.To share what I’ve learned, I’ve blogged for two years as part of The Chronicle of Social Change blogger co-op. Those postings can be found here. With the end of the co-op, I am continuing my blog under the new title of Child Welfare Watch. I hope you will follow me as I continue to comment on child welfare developments from a child-centered perspective.

An earlier version of this column was published in the Chronicle of Social Change on September 21, 2017.