Controlling the narrative: How the state of Washington is trying to censor the foster parent voice in court

by Christina Faucett

I am honored to publish this essay from Christina Faucett. Christina has been a licensed foster parent in the state of Washington for six years and has adopted one child from the foster care system. Prior to becoming a foster parent, she was a CASA for three years. She is currently a member of the DCYF Parental Advisory Group and is passionate about fixing what is broken in our child welfare system to keep Washington kids safe. She lives in the Seattle area with her husband and daughter. You can follow her on X at @DCYFWAtch.

In 2023, the Washington State Department of Children, Youth, and Families (DCYF) completely rewrote their Caregiver Report to Court form. This form is the only voice foster parents have in the dependency process, since they are not parties to the case, and thus are not entitled to receive legal counsel, file motions, read pleadings, or speak in court unless called on by the judge. Given this, one might expect that changes to the caregiver report form would by preceded by extensive communication and feedback from caregivers as part of the editing process. This did not happen.

I first became aware of these changes in the fall of 2023 when I was provided the new form to submit in my foster child’s dependency case. I then reached out to connections I had in DCYF to ask how these changes had come about, and who had participated in the process of editing the form. After being stonewalled by DCYF employees, I submitted a Freedom of Information Act (FOIA) request, the results of which I finally received a couple of weeks ago. 

My FOIA response revealed that the committee convened by DCYF to make the changes to the caregiver report to court included only one caregiver. However, it included three representatives of birth parents, including one former birth parent who had a child in foster care, a parent attorney and a social worker from the Office of Public Defense (which represents and provides assistance and advocacy for birth parents in dependency cases), along with other court and DCYF employees, and one CASA representative. At no point were caregivers informed of this committee’s existence, invited to participate on the committee, or asked to give feedback on the committee’s proposed changes.

The only foster parent representative on the committee works with Amara’s Family Connections Program, which encourages foster parents to maintain relationships with biological parents. Although this foster parent is a representative for what is called the “1624 Consultation Team” (named for the bill that created the group), which is a group of elected foster parent representatives who are supposed to raise the questions and concerns of foster parents in meetings with DCYF, no other 1624 representatives appear to have been informed of the pending changes. The Foster Parent Association of Washington also does not appear to have been informed of the pending changes. An August 2, 2023 post to their website states, “This seems to have been a sudden change and not everyone in the system is aware of it.”

Adding to the confusion, DCYF released two different Caregiver Report to Court forms, a long form and a short form. However, the forms have some completely different questions. For example, “Are you maintaining open and viable communication with the child’s biological parent?” is only included in the short form, not the long form. Even after an entire year of work on this by the committee, the reports still have numerous typos and errors. The new report was released with instructions that caregivers could submit it to the child’s CASA, not just their social worker, even though the CASA program in some counties did not want this responsibility and refused to submit the forms to the court on behalf of caregivers.

While not all of the changes to the caregiver report form are bad, a quick look makes it clear that DCYF is trying to limit input from foster parents to information that supports reunification, while simultaneously diminishing their opportunity to highlight their own relationship with the child (whom they may have raised for years, possibly from birth).

Some examples of changes:

  • A question soliciting caregivers’ thoughts on the Department’s case plan has been replaced with a question asking “Do you have any additional information that may help reunite the child or youth successfully with their biological family?”
  • A general question about how the child’s visits with parents are going has been replaced with, “What’s working well with family time? Explain.”
  • Other changes imply that caregivers have obligations they do not have. For example: “How have you included the parents of the child in the medical and dental appointments?” It is the social worker’s responsibility, not the caregiver’s, to inform parents of medical/dental appointments. The communication question mentioned above likewise implies that caregivers have an obligation to communicate directly with biological parents. Caregivers may have many legitimate reasons (including privacy and safety reasons) not to communicate directly with birth parents.
  • The old form had two questions about the child’s relationship with the caregiver and adjustment to living in the caregiver’s home. On the new long form these questions have been replaced with one question which is relegated to the bottom of the form under “additional information.” The short form doesn’t even ask caregivers about their relationship with the child living in their home; it only asks about the child’s behavior in the home. A question asking caregivers to “Describe child or youth’s interactions with positive adults (i.e., coaches, teachers, church, mentors, other relatives)” is given higher billing on the long form than the questions about their relationship with their primary caregiver.

DCYF has lost around 800 licensed foster homes since 2019, and since their six-month pause on issuing all new foster parent licenses from November 2022, to April 2023, the number of unfilled emergent placement needs has skyrocketed. If DCYF wants to achieve their goal of eliminating short-term stays for foster children and youth in offices and hotel rooms by December 2024, they need to start treating caregivers with the respect they deserve, not trying to further stifle their voices.

Child Welfare Update: February 2024

Greetings to my faithful readers! I’m trying out a different format for Child Welfare Monitor–a monthly newsletter format that highlights events and information that catch my eye. I’m not ruling out a single-issue piece now and then, particularly when there is a major new report or data source to discuss and analyze. Please let me know what you think of the new format. If you can think of a more exciting title than “Child Welfare Update,” let me know. And if you do find this to be a useful resource, please share it with your colleagues.

Adam Montgomery convicted of Harmony Montgomery’s death

In December 2021, Manchester, New Hampshire Police announced the disappearance of Harmony Montgomery, who would have been six years old if she were alive. We learned that Harmony’s noncustodial mother, Crystal Sorey, had called the police a month earlier to say that she had not seen or heard from her daughter since April 2019, two-and-a-half years earlier. The country was rapidly transfixed by the search for Harmony. We soon learned that the little girl, who was blind in one eye, had first been removed from Sorey at the age of two months by the Massachusetts Department of Children and Families (DCF) due to Sorey’s substance abuse. Harmony’s father, Adam Montgomery, was in jail at the time. Harmony was returned to her mother at seven months, and removed again at ten months. At almost three years old, and after two straight years in foster care with the same family that fostered her from the start and wanted to adopt her, Harmony was returned to her mother for the second time. At age three-and-a-half, Harmony was removed from her mother for the third time. Since Harmony was first removed, Adam Montgomery had been released from prison and begun visiting her. In February, 2018, a judge awarded Montgomery immediate custody of Harmony, without waiting for an assessment of his wife or a study of his living situation in New Hampshire.

A shattering report by the Massachusetts Child Advocate revealed the many missteps by all the professionals tasked with keeping Harmony safe. The OCA concluded that “Harmony’s individual needs, wellbeing, and safety were not prioritized or considered on an equal footing with the assertion of her parents’ rights to care for her in any aspect of the decision making by any state entity.” 

Two years after the search for Harmony began, Adam Montgomery has been convicted of her death, thanks to the testimony of his wife. She told prosecutors that after Harmony soiled her bed at night he beat her viciously on the head in the morning of December 9, 2019 and again that afternoon in the car when she soiled herself once more. He then injected opioids and ate fast food as Harmony died of her injuries in the back of the car. He concealed Harmony’s body for months until renting a U-Haul and dumping her remains somewhere outside Boston. Her body has never been found. Montgomery is already serving 32 1/2 years in prison for another case and I hope he will never see the light of day, but what about all the professionals who failed to prioritize Harmony’s needs? And what has Massachusetts done to ensure that there will be no more Harmonies? The adoptive parents of Harmony’s brother have been speaking out; I assume Harmony’s foster parents are too devastated to do so, but their hearts must be broken.

Race trumps child welfare I: Black children don’t get attached?

Harmony Montgomery’s case illustrates, among other things, what happens when the importance of attachment for young children is disregarded. Attachment theory, which is widely accepted and taught in classes on psychology, social work and human development, posits that a strong attachment is central to the development of infants and affects their brain development and their ability to form relationships throughout life. The critical role of attachment in human development, which has been confirmed in mammals as well as humans, is the reason that the Adoption and Safe Families Act (ASFA) set a timeline requiring states to file for termination of parental rights after a child had spent 15 of the last 22 months in foster care. That is the deadline that Harmony’s team disregarded when they returned her to her mother after two years in foster care and continued to work with both parents after her return to foster care at the age of three-and-a-half. The continued disruptions were so devastating for Harmony that her foster parents, according to the OCA, could no longer meet her needs when she was placed with them for the third time, and asked that she be transferred to a specialized therapeutic home.

But some lawyers that counsel parents in child protection cases are being told that attachment theory does not apply to Black children. In Race Trumps Child Welfare, Naomi Schaefer Riley calls attention to a paper called “The Weaponization of Whiteness in Child Welfare,” originally published by the National Association of Counsel for Children. The paper calls attachment theory a “tool to justify the separation of families” and a manifestation of “racism in psychology.” The authors take aim at professionals who utilize attachment theory to argue for the adoption of Black children by White foster families who have raised them from infancy rather than returning them to their parents or placing them with kin. They argue that a Black child who has lived with a White foster family for the entire two-and-a-half years of his life should be placed with a relative who has never even seen the child. Black families, they say, belong to a collective culture, which emphasizes the needs of the group as a whole over the needs of an individual. Thus, any suffering to an individual child, they imply, is justified by the gain to the group–though it is hard to understand how Black people as a whole gain from the traumatization of young Black children.

Race Trumps Child Welfare II: ABA “addressing bias in medical mandated reporting” in Michigan

The American Bar Association (ABA) has announced that its Center for Children and the Law is piloting a new initiative in Michigan “to address overreporting by medical professionals of Black, Indigenous and Latino/a children to the child welfare system.”  Without a footnote, the ABA reports that “injuries in Black children are 9 times more likely than those in White children to be reported as abuse despite evidence that child abuse and neglect occur at equal rates across races.” (Italics are mine.) Equal across races? I wonder what data they are using. While I am the first to acknowledge that maltreatment substantiation rates may not reflect actual incidence of abuse or neglect, evidence suggests that the two-to-one Blsck-White difference in child maltreatment substantiation rates is likely an understatement, not an overstatement. Moreover, Latino children nationwide are not reported to CPS disproportionately to their share of the population.

The pilots, funded by the Children’s Bureau, will use a “multisystem approach developed by the ABA’s Stop Overreporting Our People (STOP) project” to “address each decision made from the time a medical provider has a concern about maltreatment through child welfare hotline report and investigation to the decision of the judicial officer to remove the child from the home.” In Michigan, according to Child Maltreatment 2022, of the 174,000 referrals to the hotline in Federal Fiscal Year 2022, about 68,000 were screened in, about 139,000 children received an investigation or alternative response (down 12 percent from the previous year), and 23,500 were substantiated as victims of abuse or neglect–a whopping 37.7 percent drop over the previous year. Of those “victims,” a total of 2,760 or 11 percent were placed in foster care–along with an additional 956 children who were not substantiated as victims but may have been siblings who were deemed to be equally endangered. Despite the precipitous drops in investigations and substantiations and the very low proportion of children substantiated as victims that were placed in foster care, the ABA isn’t satisfied…or doesn’t bother to look at data. The Michigan pilots will also focus on how doctors are trained to report maltreatment, according to the ABA. Discouraging doctors from reporting the signs that they are uniquely trained to spot may not strike all readers as a good idea.

Where was CPS?

Utah: Abuse in plain sight: Ruby Franke, a parenting influencer who achieved fame by promoting her strict parenting style, was sentenced to up to thirty years after pleading guilty to aggravated child abuse of two of her children. Franke rose to prominence with a youtube channel called 8 Passengers (now taken down) that documented her life with her husband and six children and was criticized for promoting abusive discipline methods. She eventually formed a business partnership with another woman named Jodi Hildebrandt, who encouraged and participated in the abuse of Franke’s children. Both women were arrested in August 2023, after one of Franke’s children escaped the home and ran to a neighbor’s house asking for food and water. The neighbor noticed the child’s open wounds, duct tape around his ankles and wrists and emaciation and called the police. After the arrest, the oldest daughter posted on social media that: “We’ve been trying to tell the police and CPS for years about this, and so glad they finally decided to step up.” “Several of us tried to help,” one neighbor told the Salt Lake Tribune. “I know people left food on doorsteps knowing the kids might not be eating; I know people were making phone calls to DCFS, to the police — people really did try and care. No one was looking the other way.”

New Mexico: $5.5 million settlement reached in eight-year-old girl’s brutal death: The Santa Fe New Mexican reports that the New Mexico Children Youth and Families Department (CFYD) has agreed to pay $5.5 million to the brother and half-siblings of Samantha Rubino, acknowledging that it placed Samantha and her brother in the care of a man (Juan Lerma) with a history of child abuse and domestic violence, who had been investigated once before for abusing her and had not seen either Samantha or her brother for two years. Samantha died of blunt force trauma to the head, and Lerma placed her body in the trash. This is the latest in a series of big-money settlements by CYFD, funded by the taxpayers. New Mexico’s system is in crisis, with a backlog of 2,000 investigations of abuse and neglect. Is it too much to hope that the legislature will decide it is better to spend money up front to keep children safe than to pay massive settlements to their survivors?

The march continues to remove protections for homeschooled children

The powerful homeschool lobby continues its crusade to eliminate the few regulations that still exist to protect homeschooled children. In Nebraska, LB 1027 would eliminate two of the three minimal documents required for homeschool enrollments. It would bar school districts and Health and Human Services from investigating educational neglect in a homeschool setting. And it would give one parent the power to make homeschooling decisions without input from the other parent. The unicameral legislature’s Education Committee heard testimony from the Nebraska Christian Home Educators Association, the president of a Christian homeschoolers’ co-op, and another homeschooling parent. There was no testimony against the bill. The Education Committee has recommended the bill, and it is headed for a floor vote.

In West Virginia, legislators have tried to bar abusive parents from homeschooling ever since an eight-year-old girl named Raylee Browning died of sepsis, possibly caused by drinking toilet water, in 2018. Teachers had called CPS multiple times because Raylee was constantly hungry and covered in bruises. To avoid further problems, her guardians removed her from school for the ostensible purpose of homeschooling, thus enabling them to torture ber to death without interference. Every year since 2019, legislators have introduced Raylee’s Law, which would prohibit homeschooling if the parent or home educator had a pending investigation for child abuse or neglect or had been convicted of abuse, neglect or domestic violence. This very modest bill, which probably wouldn’t even have saved Raylee because her guardians did not have a pending investigation when they withdrew her from school, nor were they convicted of abuse, has never gotten through the legislature. This year it was voted down in the Education Committee by 15-5 after several legislators outlined their concerns–such as the fear that it would force children to enter public school before an investigation could be completed!

This year, the sponsors of Raylee’s Law managed to get a version of the legislation included in a bill that removes certain testing requirements for homeschooled children, and it passed by a voice vote. Unfortunately the amendment that passed was watered down further from the original bill, which itself was very weak The amendment that passed requires that a parent cannot withdraw a child for homeschooling if there is a pending child abuse or neglect investigation. But if the complaint is not substantiated within 14 days, the superintendent must authorize homeschooling. And the bill to which it was attached (HB 5180) reduces protection of homeschooled children by removing the requirement that parents submit academic assessments for homeschooled children in certain grades, as well as the requirement that the parent or home educator submit evidence that they have a high school or post-secondary degree.

Readers who care about the protection of homeschooled children and the drastic disproportion of power between homeschooling parents and advocates for their children should give to one of my favorite organizations, the Coalition for Responsible Home Education. They are doing their best on a shoestring budget, but they can’t afford to go to every state where protective legislation is threatened.

From the “Are you kidding me?” department

“Safe Haven laws” are a way for new parents who are not ready to raise a child to surrender their newborns safely without any questions or legal consequences. The laws exist in all 50 states. The Committee to Eliminate Child Abuse and Neglect Fatalities has endorsed these laws as a way to protect vulnerable infants and recommended that they be amended to extend the age of protected infants to age 1 and to expand the types of safe havens allowed. And it turns out that this option has existed in Europe since Pope Innocent III required churches to install “Foundling Wheels” in 1198!

In New Mexico, mothers are told they can anonymously surrender their infants through “safe haven baby boxes” located around the state. But recent media coverage from local stations KRQE and KOB4 has revealed the state’s Children Youth and Families Department (CYFD) has been investigating these surrenders–because they are required to do so by the state’s safe haven law. CYFD Secretary Teresa Casados told KRQE that “state law requires CYFD to investigate to ensure the mother was not forced to give up her baby, to make sure she is safe, and to inform the father of the child as well.” (She was apparently not asked what would happen if the father had raped or abused the mother.) She also explained that the Indian Child Welfare Act (ICWA) requires CYFD to look into each case and notify “all the tribes and pueblos” to ensure they are following the Act’s requirement that placement with a Native family be preferred. It is not clear that any other state has interpreted ICWA this way. New Mexico legislators rushed to draft legislation to retain the right of mothers to surrender their infants safely and anonymously, but the short session ended before a bill could be passed.

Never underestimate a persistent child advocate

John Hill, the Investigative Editor at Civil Beat, a nonprofit news outlet in Honolulu, Hawaii, has never given up on his quest to find out how a six-year-old girl named Ariel Sellers was placed with Lehua and Isaac Kalua, the adoptive parents who tortured her, culminating in her murder two-and-a-half years ago. The Kaluas have been charged with murder and abuse of both Ariel and her then 12-year-old sister, among other charges. The prosecution alleges that Ariel was kept in a dog cage and denied food, and that Lehua Kalua caused her death by duct-taping her mouth and nose. For more than two years, according to Hill, the Hawaii Department of Human Services has stonewalled in accounting for its actions in the adoption of Ariel, who was renamed “Isabella Kalua” by her adoptive parents. But Hawaii’s Public First Law Center, motivated by a series of columns written by Hill, has filed a motion to receive the foster and adoption records for Ariel and her siblings. Now Hill is asking uncomfortable questions about the January 2024 death of 10-year-old Geanna Bradley, who was also allegedly tortured and starved to death by her adoptive parents.

In a bizarre twist, the Honolulu Star Advertiser has reported that the Kaluas have retained custody over Isabella’s three sisters, who were removed from the home in September 2021. But apparently the state of Hawaii hasn’t moved to terminate the parental rights of the Kaluas. A special master appointed to oversee the interests of Ariel’s sisters is concerned that the failure to terminate the rights of the Kaluas will interfere with efforts to find permanent families and educational opportunities for the girls. (And already has, I would think!)

The guaranteed income craze continues

At its February oversight hearing, the Director of the District of Columbia Child and Family Services Agency announced a forthcoming grant from the Doris Duke Foundation to a guaranteed income for some low-income families. The announcement was greeted with congratulations from the Council Chair who referenced the great results from the recent Strong Families, Strong Futures pilot, which provided 132 new and expecting mothers with $10,800 in the course of a year. I don’t know where she got her information. An article in the Washington Post reported on interviews with three of the mothers participating in the pilot. One of the mothers took the money as a lump sum. Setting aside about $5,000 for essential expenses, she used the remaining money on a $6,000 trip to Miami preceded by the purchase of new clothes, shoes, gadgets and toys for all of her three children and a $180 hair and nails treatment for herself. Another mother decided to spend $525 on a birthday party for her one-year-old, who clearly couldn’t appreciate it. Program coordinators said that the mothers reported spending most of their funds on needs such as housing, food and transportation. But I’m not sure how I feel as a DC taxpayer to see my money spent in ways that I personally find wasteful, nor am I sure that allowing such spending provides appropriate training in how to budget scarce resources. Such no-strings-attached money giveaways might not be the best use of taxpayer money, even if foundations choose to support it.

And the prize for cynical use of data goes to….

Kentucky! The State’s Cabinet for Health and Family Services (CHFS) is crowing about Kentucky’s drop from the highest rate of child maltreatment “victimization” to number 13 among the 50 states and the District of Columbia. In a statement reported by Spectrum News1, CHFS said this improvement “demonstrates the efforts made by the Department for Community Based Services and its many partners to increase the provision of child welfare prevention services and reduce child abuse and neglect within the Commonwealth.” But child advocates and family court judges are not convinced, citing a longstanding problem with hotline workers screening out cases that should be investigated–exacerbated by the adoption of an actuarial screening tool at the hotline in April 2022. The report quotes two family court judges and a CASA program director who linked child deaths to the failure to investigate prior reports involving the same families. According to one judge, “The alarm has to be sounded because I’m not joking when I say children are perishing in the state of Kentucky because of this ‘Structured Decision Making’ tool….'” The judges are right. One has only to look at Kentucky’s commentary in the Children’s Bureau’s report, Child Maltreatment 2022.

An overall decrease for child victims was observed between FFY 2021 and FFY 2022.
Kentucky has worked diligently over the past several years to implement a safety model
which includes the implementation of SDM® Intake Assessment Tool and a thorough review and modification of the state’s acceptance criteria to ensure a focus upon children and families with true safety threats versus risk factors. This shift in the approach to the work may have contributed to the decrease in child victims this year.

Children’s Bureau, Child Maltreatment 2022, p. 13

In other words, they changed the screening criteria to screen out more cases and voilà! Fewer child victims! Amazing! The percentage of referrals that was screened in decreased from 45.5 percent in 2021 to 39.9 percent in 2022, and the maltreatment substantiation rate decreased from 14.9 to 12.3 per thousand children during the same period. But both of these rates have been decreasing since FFY 2018, so more factors than the new screening tool are likely responsible. It’s unlikely that a decrease in actual maltreatment is among them.

The placement and workforce crises continue

Every month brings another crop of articles on the intertwined placement and workforce shortages plaguing child welfare. February’s news on the placement crisis included a story from Texas Public Radio reporting on the release of hundreds of incident reports about “Children Without Placements” in the state from 2021 to 2023. They include stories of children squaring off to fight each other in the hallway of a Houston hotel that resulted in the hospitalization of one youth. These incidents, occurring at a rate of about two a day, often involved injured staff, injured youth, and calls to police.

In a state that requires some social workers to supervise youths in hotels and other unlicensed placements, its not surprising that about one in four caseworkers left the job in January, according to the head of the Department of Family and Protective Services (DFPS). And even workers who don’t have to supervise unruly youths are dealing with untenable caseloads and terrible working conditions. Some states are taking action to attract and retain workers. The Governor of Maine announced a series of three one-time lump-sum payments of $1,000 to recruit and retain child welfare workers. Let us hope it is enough to reduce the state’s high caseloads.

And now for some good news: efforts to keep siblings together

It’s always nice to read about people who see a need and create a program to meet it. February brought news of two new “foster care villages” to house larger sibling groups, an idea I have promoted in the past. In California, the actor Christian Bale achieved a dream he has nurtured for 16 years–breaking ground on Together California, a new foster home community in Palmdale, Los Angeles County. The project will include a dozen foster homes built to accommodate up to six siblings and staffed by full time, professional foster parents. A 7,000-square foot community center will offer academic, therapeutic, social, and recreational activities for young people in the foster homes and the surrounding community, which is very short on such resources.

In South Carolina, a new foster care “village” called Thornwell is transforming old houses built about 100 years ago to house foster families and large sibling groups. Two homes are in use, a third is under renovation and more homes await renovation provided the funds and parents can be found. Foster parents will pay one dollar of rent per month and receive free utilities. Children will be eligible for Thornwell’s early learning center, charter school, and recreational facilities. Here’s hoping for more programs like Together California and Thornwell!

Reform, not abolish, child welfare: A science-informed path

By Antonio R. Garcia, Jill Duerr Berrick, Melissa Jonson-Reid, Richard P. Barth, John R. Gyourko, Patricia Kohl, Johanna K.P. Greeson, Brett Drake, and Victoria Cook

A note from Child Welfare Monitor (CWM): CWM welcomes submissions from authors who represent points of view that are more evidence-based and child-centered than what is typically presented by leading media outlets and other child welfare publications. We are privileged to share this commentary from an illustrious group of child welfare scholars from schools of social work and social policy around the country. While this essay does not mirror the views of CWM in every detail, we share the authors’ basic premise regarding the need to reform, rather than abolish, the child welfare system.

Over the past couple of years, while teaching classes, presenting lectures, or offering invited talks and workshops, students and participants have inquired about the need to abolish the child welfare system. Some have questioned whether they should continue their pursuit of a career in this field. They are aware of the growing calls by abolition advocates, particularly UpEND and JMac for Families, to completely eradicate child welfare services, despite offering no evidence as to its likely impact on child safety or permanency.

Abolition advocates have successfully convinced a few scholars, an unknown number of students, and a surprising number of community members and decision-makers that child protective services must be eliminated. Acting on briefs supplied only by activist groups, the United Nations has even called for all major child welfare laws in the United States to be repealed or replaced. 

Why?  The narrative built by the abolitionists includes two major parts: First, classist and racist bias largely determines who has contact with the child welfare system, with poor children as well as Black and Native American children being routinely and unnecessarily harassed.  The resounding narrative–largely offered by lawyers, not child welfare scientists–is that the interventions and intentions of child welfare services and its staff are inherently racist (e.g., Roberts, 2022).  Some child maltreatment scholars (e.g., Briggs et al., 2023) have even gone so far as to reiterate Roberts’ claim that the modern child welfare system (CWS) was intentionally designed as a mechanism of racial oppression. This conclusion flies in the face of history as documented child welfare historians (e.g., Myers, 2004). Purveyors of this narrative ignore efforts like those of pioneering African American women pursuing the development of child welfare facilities for African American children who were routinely insufficiently served by family and community (Peebles-Wilkins, 1996); they fail to mention the work of the Children’s Defense Fund, and a diverse coalition of policymakers, who helped to shape the modern CWS through their work to expand family preservation and support services. Nor do they acknowledge that the Title IVE program was, in part, explicitly developed to extend equal protections to Black children (Hutchinson & Sudia, 2002).

Second, those who denigrate child welfare services argue that CWS interventions do more net harm than good, and for that reason should be abolished.  Child welfare services are said to sever familial connections (Roberts, 2022), and unjustifiably surveil children and families (Gruber, 2023). To that end, they argue that the best way to protect children and families is to abolish the current system and replace it with family and community-based responses (Kelly, 2021). This proposed alternative to CPS is remarkable for the degree to which it is vague and undefined.  Nothing approaching a concrete plan for such a system has ever been suggested to our knowledge.  Given the historical lessons of relegating unwanted or abused children to orphanages, orphan trains, indenture, or detention centers, it is difficult to point to an example of American communities fully embracing the care of children whose parents are unable to care for them.

The abolition movement sidelines any past record of successful reforms of child welfare or hope for future evidence-based or incremental change. Anxious, perhaps, that reforms have been uneven or too slow, the proponents of abolition do not suggest improving the complex and intricate web of local, state, and national child welfare policies that have been developed over the last 40 years.  Critically, their proposals have no evidence base. Instead, they rely on ideology that disregards the best available evidence (Barth et al., 2020).

The degree to which the abolition narrative is taken seriously is troubling.  Child safety is contingent upon training qualified professionals to respond to signs of abuse and neglect – and ensuring institutions have the resources to recruit and support them. Tuition is covered for many social work students if they agree to “repay” their time by working for the state’s child welfare system after graduation. The premise is to promote and retain a highly educated, culturally responsive child welfare workforce and prepare them to rely upon critical thinking skills and the best available evidence to promote child safety and permanency. With many states facing unheard-of staff shortages following the pandemic, the additional decrease in interest in the field is distressing. 

In our paper, The Stark Implications of Abolishing Child Welfare: An Alternative Path Toward Support and Safety, we offer an alternative path – a reformist position that focuses on four key elements of child welfare that must be maintained and improved to keep children safe:

1) receiving and responding to community signals about risk or harm to children;

(2) assessment of need coupled with a proportionate response;

(3) rights protections to ensure fairness and equity when placement outside the family is required; and

(4) procedures for accountability and quality improvement.

Without these key elements, we contend that children will be left in peril.  Many community members will not know how to respond to signs of risk and harm to children.  The progress we have made in the last few decades toward developing, implementing, and evaluating prevention and early intervention services to address trauma and promote healing will be disrupted. Supports for foster parents, kin, and child welfare staff will be disbanded. The elimination of court oversight will eliminate rights protections for parents, children, and extended family.  Racial inequities in economic hardship will make it more challenging for communities of colorto develop responses, which will likely yield an even larger gap in unmet needs for children of color.

Still, many in our field are challenged by having to choose between abolition and reform. At the core of this debate, we are contending with the interplay of science, practice, ideological beliefs, and conflicting values. What types of evidence are or should be used to guide our decision-making? How do we best balance the support of families with a child’s need for safety without defending the status quo? Said another way, we see no reasonable likelihood that abolishing child welfare services would result in a world where families are better supported to provide care that is not injurious to their children and children are better protected from the harsh realities of child abuse, including fatalities.

The debate offers an opportunity to examine current practice and whether it advances the needs of vulnerable children and families. We underscore in our paper that current services and funding are inadequate. To that end, we delineate alternative pathways to abolition providing some practical, evidence-informed recommendations, including but not limited to the following:

  • Create a robust family support and prevention infrastructure outside of Child Protective Services (CPS);
  • Reduce poverty and financial hardships through universal basic income supports and targeted economic supports for families in great need;
  • Resume the child welfare waivers program to expand and test innovations in case finding and response to family needs; and
  • Continue to improve alternative systems for reporting less serious concerns and connecting families to existing resources to reduce the number of families who are subject to unwarranted CPS investigations.

As discussed in our paper, we believe implementing these recommendations offers a holistic roadmap for (1) improving outcomes for all children and families and (2) mitigating racial inequities in exposure to economic hardship and access to services and programs.

Although many jurisdictions have a long way to go in fully aligning practices with our valued principles, the child welfare system, on the whole, has made much headway. We have made progress toward reducing foster care entries, enhancing permanency, supporting youth who must emancipate from care, and developing alternative response paths for less severe cases.  The number of children in foster care is now lower by more than 175,000 children than it was in 1991, despite population growth (US DHHS, 2022; US DHHS, 2000).

We have made advances in the development and implementation of evidence-based, and culturally appropriate parenting programs, and there are innovative approaches to screening and collaboration with other systems such as family drug courts and other models that are  being adopted around the country. Research indicates that families are better served by caring and competent child welfare staff. At a minimum, this means we need trained child welfare professionals to determine if abuse or neglect are occurring and how best to provide services to mitigate risk factors. If removal to foster care is required, trained social work and legal professionals need to be engaged in reunification services and the determination if it’s safe for children to go home.

Finally, it is critical that these efforts are continuously evaluated. Abolition would end the now-routine national reporting of the number of victims of child maltreatment, and their characteristics (i.e., NCANDS; Children’s Bureau, 2023). We would not know if new family- and community-based approaches were helpful or harmful, particularly for the families of color for whom both reformists and abolitionists are concerned. State-level systems that track the provision of services and outcomes would also end, meaning that trends in family needs and gaps in response systems would likely go undetected. We would also lack data to influence policy to end harmful practices and expand funding for effective prevention and intervention services.

As we note, “it is difficult to imagine how eradicating the only structures that exist to address this issue [child maltreatment] would result in any outcome other than jeopardizing the safety and well-being of children as well as reducing accountability to the families that CWS [the child welfare system] serves.”

This is a contentious moment in the journey to create opportunities and healing for all children and families. We hope our message conveys a sense of urgency to engage in critical, evidence-informed practice and policy – and to reflect upon how values, biases, and morals can impact decision-making.  The famous words of Nelson Mandela may be instructive: “There can be no keener revelation of a society’s soul than the way in which it treats its children.” In efforts to enhance practice and policy, we need child welfare professionals to gain the skills, cultural humility, self-efficacy, and motivation to ensure children live lives free of violence and abuse. Policymakers need to stay grounded in the pathway that has led to significant improvements in child welfare services and rely on research-based reforms. Our children deserve nothing less.

References

Barth, R. P., Jonson-Reid, M., Greeson, J. K. P., Drake, B., Berrick, J. D., Garcia, A. R., Shaw, T., & Gyourko, J. R. (2020). Outcomes following child welfare services: What are they and do they differ for Black children?. Journal of Public Child Welfare, 14(5), 477-499. https://doi.org/10.1080/15548732.2020.1814541

Briggs, E., Hanson, R., Klika, J. B., LeBlanc, S., Maddux, J., Merritt, D., … & Barboza, G. (2023). Addressing systemic racism in the American Professional Society on the Abuse of Children publications. Child maltreatment28(4), 550-555.

Children’s Bureau. (2023). National Child Abuse and Neglect Data System (NCANDS). U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families. https://www.acf.hhs.gov/cb/data-research/ncands

Gruber, T. (2023). Beyond mandated reporting: Debunking assumptions to support children and families. Abolitionist Perspectives in Social Work, 1(1). https://doi.org/10.52713/apsw.v1i1.12

Hutchinson, J.R. (2002).  Failed child welfare policy: Family preservation and the orphaning of child welfare. Washington DC: Child Welfare League of America.

Kelly, L. (2021). Abolition or reform: Confronting the symbiotic relationship between ‘child welfare’ and the carceral state. Stanford Journal of Civil Rights & Civil Liberties, 17(2), 255–320. https://heinonline.org/HOL/P?h=hein.journals/stjcrcl17&i=271

Myers, J. E. B. (2008). A short history of child protection in America. Family Law Quarterly, 42(3), 449–463. https://www.jstor.org/stable/25740668

Peebles-Wilkins, W. (1996). Janie Porter Barrett and the Virginia Industrial School for Colored Girls: Community response to the needs of African American children. In E Smith and L Merkel-Holguin (Eds.), A history of child welfare. Washington, DC: Child Welfare League of America.

Roberts, D. (2022). Torn apart: How the child welfare system destroys Black families, and how abolition can build a safer world. Basic Books.

U.S. DHHS. (2022). The AFCARS Report. Washington, D.C.: Administration for Children and Families.

U.S. DHHS. (2000). The AFCARS Report. Washington D.C.: Administration for Children and Families.

The child placement crisis: It’s time to lose the slogans and find real solutions

By Judith Schagrin

A note from Child Welfare Monitor: It is a privilege to publish this important essay by Judith Schagrin. Judith earned an undergraduate degree from the University of Pennsylvania and a master’s degree in social work (MSW) from the University of Maryland School of Social Work.  She unexpectedly found her passion in public child welfare, and more specifically, foster care after helping start an independent living preparation program for young people in care. After a decade as a foster care social worker specializing in adolescence in a large Maryland county department of social services, she supervised two different units before becoming the county’s director of foster care and adoptions, serving in this position for twenty years.  She also worked part-time for the Agency’s after-hours crisis response for a decade.  For almost 10 years, she served as a respite foster parent for a private foster care agency, and since 2008, has mentored a young person who aged out of care in California and came east for college.  In  2001, with a little help from her friends, Judith founded Camp Connect, a weeklong sleepaway camp to reunify brothers and sisters living apart in foster care and provide memorable experiences siblings can share for a lifetime.  For the past 23 years – one year virtual – she has spent the week at Camp Connect immersed in the care of Maryland’s foster children and youth.

The closing of children’s mental hospitals in the 1980s, the subsequent closure of detention centers leaving foster care to take up the slack, the movement to shutter all group homes and residential treatment programs and the prohibition of out-of-state placements have created a slow-motion train wreck whose results could have been predicted easily at every new chain in the sequence. Those results include children and youth staying in psychiatric hospitals long after being ready for discharge, “boarding” in emergency rooms and “placed” in hotels at a cost of $30,000 to $60,000 per child per month. From my 35-year vantage point as a caseworker, supervisor, and then running foster care and adoptions in a large Maryland county, I’ve had a front row seat to the evolution of this crisis and the failure to come up with real solutions. 

Deinstitutionalization

The first in a series of events that created this crisis occurred in the 1980s, when the deinstitutionalization that began for adults in the 1960’s with the civil rights movement expanded to include children.  Until then, youth remained in state hospital facilities for as long as a year or even more.  The closure of those state facilities led to the expansion of Medicaid-funded residential treatment centers (RTC’s), that stepped in to provide the longer term care once provided in the state hospitals.  In turn, group homes proliferated to meet the needs of youth discharged from RTC’s.  The advent of Medicaid was instrumental in expanding prIvate psychiatric treatment options, including hospitals.  But over time, Medicaid stopped funding even 30 days of treatment, limiting payment to only  a few days of crisis intervention. 

Today, many youth, especially older youth, are entering foster care not because of what we traditionally think of as maltreatment, but due to parental incapacity or unwillingness to care for them due to acutely problematic behavior, and behavioral health and/or developmental needs.  Services to meet these needs are often missing or inadequate, and parents of children with high-intensity needs cannot find residential treatment except through the child welfare system.  Medicaid doesn’t pay for treatment and care in a group home of any kind; access in Maryland requires the child welfare system’s physical or legal custody.

New approach to juvenile justice

In the early 2000’s, a series of Supreme Court decisions brought welcome changes to juvenile justice and shifted the country from the ‘get tough’ approach of the ‘80’s and 90’s to the ‘kids are different’ era.  Moving from punishment to rehabilitation and minimizing detention in favor of community services makes sense on both humanitarian and neuroscience grounds.  But it meant that youth who once fell under the purview of Juvenile Services now required child welfare intervention when parents or other caregivers were unwilling or unable to continue to provide care. The mother evicted from four apartments because of her son’s property damage; the grandmother who stepped in years ago and is no longer able to cope with her granddaughter after the third vehicular misuse charge and chronic episodes of running away; or a parent with younger children afraid that an older sibling known to have rages and episodes of violence will harm his siblings, are examples of desperate caregivers I have come across.

In Maryland, the first alarm that child welfare was ill-equipped to care for these youth was sounded in 2002 by local department directors in a memo to the head of the Department of Human Services.   Closing detention centers was a good thing, but alternatives weren’t developed for those youth unable to live at home, and no resources were provided to help child welfare accommodate its new clients. As the closure of state psychiatric facilities and detention beds was widely celebrated, the belief that every youth had a family eager and able to provide a home was more than a touch naive, as would soon become clear. 

Group home closures

Another domino fell in the early 2000’s, when group homes, many poorly administered with little oversight, became a scandal in Maryland.  A series of articles in the Baltimore Sun exposed the flaws of many group care programs, and some were forced to close.  With the scandals around bad group homes, the timing was perfect for state leadership, encouraged by a national advocacy group with deep pockets and the laudable dream of a family for every child, to lead a movement to shutter congregate care placements.  Funding constraints, too, forced some providers out of business.  Reimbursement rates did not keep up with costs, and some programs closed their doors due to inadequate reimbursement.   The state lost roughly 450  beds in five or six years, including entire residential treatment center programs.  Rate-setting ‘reform’, which began in October of 2021, will not be completed until July of 2026 if it stays on schedule.

At the same time group homes were being closed in Maryland, state agency leadership began to frown on out-of-state placements for youth with highly specialized needs when no placement in Maryland to meet those needs was available.  Public officials with little understanding of placement resources pronounced these out-of-state placements to be evil incarnate, and an overwhelming number of bureaucratic obstacles made them nearly impossible.  

With the loss of group homes as an option, we were urged to ‘re-imagine’ care for children, yet discouraged from developing individualized plans of care because insufficient flexible funding was allowed to make that happen.  We’re fond of slogans in child welfare, as if words will change outcomes, but too many initiatives are about clever slogans and not about substance.  If only we would review every child in group care, we were told, we would realize how many had other options.  With consultation from the national advocacy group, we spent hours seriously poring over the needs of our children in congregate care and attempting to find matches with kin or foster families.  Not at all surprising to our staff, “low hanging fruit” didn’t exist.   

We also initiated a rigorous “Family Finding” practice, in hopes of finding kin willing to become providers with services and supports.  What we learned is that youth in congregate care had  already exhausted family and “kin of the heart” resources.  Today it’s not clear that public officials and child welfare leaders grasp that children and youth wouldn’t be in hotels if there were any kin – fictive or otherwise – willing and able to provide care, or if parents could and would be a safe resource.

Youth with intensive, complex needs

As other doors closed, the child welfare system became increasingly tasked with providing residential behavioral health care for children and youth with high-intensity and complex needs for supervision and treatment.  The differences between those involved with the juvenile justice system (and may have gone to detention centers in the past) and those who are not are often hard to discern.  Both groups tend to engage in behaviors that pose a serious safety hazard  to themselves or others.  These  behaviors may include physical violence; property damage; compulsive self-harm such as cutting or swallowing objects; chronic truancy; frequent runaway episodes; sexual victimization of siblings; aberrant sexual behaviors such as public masturbation; molesting younger siblings; participating in petty crimes; harming family pets; and generally oppositional and dysregulated behavior.  

Contrary to the popular notion that the public child welfare system is tearing families apart, these are children whose families are typically frustrated, exhausted, and often eager to place their child.  Some even view foster care as a much-needed punishment, imagining that when the youth is ready to “behave,” they can return home.  Of course these young people have many strengths to be nurtured, but they need intensive supervision and therapeutic intervention by professionals trained to evaluate and address their special needs and work with families.

The gist of the matter is that we are serving two different out-of-home placement populations with very different needs.  One is a younger population in foster care primarily due to maltreatment stemming largely from parental substance abuse and/or untreated mental illness. The other is older youth with complicated behaviors, and behavioral health needs and/or developmental disabilities.  The parents and kin of the older group are asking for placement, not objecting to it, and are typically worn out and adamantly opposed to more in-home services.  In spite of the stark differences in these two populations, our policymakers and those upon whom they rely have failed to recognize their needs are not the same.

In Maryland and other states, treatment, or ‘therapeutic,’ foster care stepped in to accommodate this new population of older, harder to serve foster youth. To some extent this approach has been effective as an alternative to congregate care, but it’s not the panacea some would like to believe.  The desperate need for foster families willing to care for these youth means there’s a certain amount of pressure to lower expectations and even turn a blind eye to foster parents that do a less than stellar job.  Tales of locked refrigerators and youth left sitting on the stoop at the end of the school day until the caregiver came home soon proliferated.  However, we were told by representatives of a national advocacy group that, “Youth are better off moving from shabby foster home to shabby foster home than in the very best congregate care.”   In my own experience, instability begets instability and there’s little more soul-sucking than being rejected from family after family.

Setting aside the question of quality, foster care, whether treatment or not, has great challenges recruiting homes for youth with weapons charges, those with a history of drug dealing, or whose parents have refused to pick them up from the police after another runaway episode. “Cutters” and “swallowers” need 24/7 supervision to keep them safe and in general, kin have already tried to provide care long before the child’s entry into state custody.  With the closure of group homes and residential treatment centers in Maryland and the prohibition on out-of-state placements, finding placements willing to accept youth with high-intensity needs became literally impossible.  As a result, for years now children have been left in psychiatric hospitals (sometimes for months) after “ready” for discharge, and others are ‘boarding’ in emergency rooms for weeks or months.  

A failure to recognize reality

Instead of recognizing the lack of capacity to serve those youth with nowhere to go after being hospitalized, hospital representatives, public officials, and legislators blamed caseworkers for not ‘picking children up’, as though they were simply lazy and incompetent.   “Advocates” proposed legislation imposing more caseworker accountability as the solution, as though if caseworkers worked harder and filled out more forms, placements that didn’t exist would magically appear.  Fortunately, none of the legislation passed, but being a lonely voice trying to explain the source of the problem wasn’t lazy caseworkers or enough forms was painful.  Public officials, leaders and advocates also clamored for more “prevention” services, not recognizing the acute needs of older youth developed over many years and that new services authorized today are not going to keep them safely at home.

During my 20 years as the director for my county’s foster care and adoptions program, I can’t count the nail-biting times we came close to not finding a placement for a child – but we were always able to pull something together.  The state made funding available for a 1:1 staff person (or sometimes 2:1) we could offer existing providers, allowing us to use that as a bargaining chip. Of course, increasing reimbursement rates and staff salaries would have been far less expensive than millions for extra staff to support ill-equipped placements, but that change in fiscal allocation has yet to happen. 

Five years have now passed since I retired, and hotel placements have become not a rarity but a regular necessity.  At the rate of $30,000 to $60,000 per child each month (not including damages to hotels) to warehouse children in hotel rooms supervised by an untrained aide – one can only imagine what that kind of money could be doing productively for children.  Caseworkers are overseeing the most precarious and risky “placements,” and being ‘hotel reservation clerks’ isn’t the reason competent social workers choose to do the work.  We’ve all heard the tales of youth stealing their 1:1’s car; or youth locking themselves in their rooms doing what we don’t know; a youth who overdosed on his medication; parties taking place with the acquiescence of the 1:1; youth harassing guests; and the youth who leaped over the reservation desk to try to steal cash.

Over the years there have been many, many meetings among high ranking state officials and others; ironically, these meetings didn’t include the experienced and knowledgeable child welfare staff responsible for the children.  Lots of strategies, goals, and plans too – a personal favorite was the goal of instructing local department staff on hospital discharge planning, as if they weren’t already experts.  Despite all the meetings and all the hand-wringing, progress meeting the needs of the children in our care, or soon to be in our care when parents abandon them at the hospital or elsewhere, has been negligible. Years that could have been spent on developing and promoting new model programs have been wasted. In the meantime, Congress saw fit based on testimony from well-heeled advocacy groups to pass the Family First Prevention Services Act,  which limited congregate care even more by restricting funding to approvable options based on criteria seemingly pulled out of a hat.   

Today, the deepening and pervasive placement crisis is affecting nearly every state and attracting media attention around the country.  Given the financial resources dedicated to keeping children in hotels, finances clearly aren’t the issue.  And it certainly isn’t about quality of care, since hotel rooms, overstays in hospitals, and boarding in emergency rooms rank far below a quality congregate care program as a suitable home for a child.  

What is to be done?

In the short run, Maryland and other states need respite programs for young people awaiting placements in hospitals, emergency rooms, and hotels.  In the long run, we must acknowledge child welfare’s responsibility not only for maltreated children, but also those with high-intensity needs for supervision and treatment once served by other child-serving organizations.  We need to bring the finest minds together to reimagine how residential care is provided, and its role in the continuum of child welfare resources to meet the needs of older youth entering foster care because of needs related to behavioral health and/or developmental disabilities. That process should include some of the scholars who have been studying the use of congregate care in other countries where it is more highly valued as a treatment and a professional field.  Exploring the development of real alternatives to congregate care is also a worthy investment.  Finally,  the unintended consequences of the Family First Prevention Services Act that disincentivized needed placements without a credible replacement must be remedied.

How many more years until we wake up?  And how many children will have to be harmed?  A colleague had a quote in her office that stays with me always, “when we are doing something with somebody else’s child we wouldn’t do with our own, we need to stop and ask ourselves why.”  Who among us would consent to our own children boarding in emergency rooms, on overstay at hospitals, or ‘placed’ in hotel rooms?  If that’s not okay for our own children, it shouldn’t be okay for the children in our state’s custody either.


Diverse opinions not accepted: Censorship by a contractor of the U.S. Children’s Bureau

Instances of censorship and restrictions of free speech from both ends of the political spectrum have drawn increasing concern as the country’s polarization has increased. I have been very grateful that a digest of child welfare news and opinion articles funded by the federal government has for years been sharing my work–which often takes aim at the ideology prevailing in child welfare. But last July, the government contractor that prepares these digests declined to share one of my opinion pieces–while continuing to share other commentaries with a different perspective. My attempt to get an explanation has resulted in a series of bizarre communications that only heighten my fears that a government-funded organization is censoring the views that it shares.

Child Welfare in the News (CWN), a daily email sponsored by the US Children’s Bureau, has contributed significantly to Child Welfare Monitor‘s growth from its creation in 2016. CWN is an “email subscription service that provides a daily collection of news stories and opinion pieces from across the country and around the world.” It is an activity of the Child Welfare Information Gateway (CWIG), which is part of the Children’s Bureau and is managed by a consulting firm called ICF. For several years, I have been sharing links to Child Welfare Monitor commentaries with the ICF librarians who put together CWN and they have in turn provided links to these pieces, along with excerpts, in their daily mailings. At least until last July.

On July 24, 2023, I published The Misuse of Lived Experience in Child Welfare. The gist of the piece was that while all lived experiences are valid and valuable, their use can be problematic when experiences that support a particular perspective are highlighted and those that contradict it are not, or when evidence from data and research are ignored in favor of curated narratives. When I shared the blog post with the CWN staff as usual, I received a message saying “We’ll get back to you in a few days with a response on this article.” This was unexpected. When I checked for an update on July 31, an ICF librarian responded that “we are still working to review this article, and expect to have a response soon.” I emailed again on September 7 and heard that “We’ve not yet received a response or decision on this article.”

I replied asking to whom my commentary had been submitted and why, what the review criteria would be, and when I could expect a response. Receiving no answer, I wrote on September 14 to the Communications Director of the Administration on Children and Families, parent agency of the Children’s Bureau. I also submitted a Freedom of Information Act request asking for any emails that contain my name or that of Child Welfare Monitor.

On September 22, I received a response from Kai Guterman, the “Senior Manager of Knowledge Management” at ICF, which included the following:  “As you know from your past submissions, The Child Welfare Information Gateway is a service of the Children’s Bureau and as such, as part of our standard process our team reviews all requests submitted. Upon our review, this request was not selected for posting as it contains personal fundraising links.” I was totally baffled by this response. I was not aware of any “personal fundraising links” in my piece, but an alert reader informed me after I published this blog that the photo I used of the family of Vanessa Peoples (the mother whose bad experience with CPS was cited by Dorothy Roberts in her book), came from a GoFundMe page set up to help her and her family. Not realizing that at the time I replied, asking Mr. Guterman to describe these links so I could remove them and allow the post to be shared by CWN. Thirteen days later I received the following response:

Thank you for following up and agreeing to exclude the fundraising link. 

We have conducted a review of the Misuse of “Lived Experience” in Child Welfare blog submission request.  While we appreciate your submission, it has been determined that it will not be included in the Child Welfare in the News since this specific blog post has a strong emphasis on storytelling, calls out individuals [sic] names, makes personal opinion statements about individuals, and focuses on editorial and opinion-based content. 

As you consider future submissions, please review how much editorial or opinion-based content is included and ensure the content is not driven by or connected with fundraising purposes.   

Email from Kai Guterman, Senior Manager of Knowledge Management, ICF, October 5, 2023

This message from Mr. Guterman was even more confusing than the previous one. It is certainly true that my blog post names several individuals, including the writer Dorothy Roberts and several people who have shared their lived experience with the child welfare system in writing and/or in oral testimony, and I included links to all of their writings. But not many news or opinion articles shared by CWN fail to name individuals. And my post does not make any “personal opinion statements” about these individuals other than summarizing or quoting their views and saying that other types of experiences also exist. The “strong emphasis on storytelling,” leaves me totally baffled. Indeed, the major point of the essay was to question the use of individual stories to make policy. Is it possible that Mr. Guterman missed the point of my blog or did not read it at all? Moreover, removing articles that tell stories would probably exclude more than half the content that is currently included in CWN–pretty much every news story and many opinion pieces as well.

And finally, Mr. Guterman asserts that my piece “focuses on editorial and opinion-based content.” Yes, most of my blog posts are opinion pieces and are labeled as such in the CWN emails, along with opinion pieces by other authors. Since I published my lived experience blog, the newsletter has shared numerous opinion pieces. At least four of these commentaries were by a writer named Richard Wexler. From beginning to end, Wexler’s essays “focus on editorial and opinion-based content,” as Mr. Guterman put it. Here is one example from Child abuse: the surge that wasn’t, a commentary from August 17, 2023 that was shared by CWN.”The American family policing system, a more accurate term than “child welfare” system, is built on ‘health terrorism’ – misrepresenting the true nature and scope of a problem in the name of ‘raising awareness.'” Some of Wexler’s pieces “have a strong emphasis on storytelling.” For example, in Child Well-Being Doesn’t Require Family Policing, also shared by CWN, Wexler devotes seven paragraphs to the story of one family that he says was victimized by a false accusation of child abuse.

As far as “calling out individuals,” CWN shared a piece by Wexler entitled Attn: New Hampshire “Child Advocate – there are horrendous institutions in your state too.” In that commentary, Wexler “calls out” the New Hampshire Child Advocate by name, telling readers that she was “understandably proud of herself” for getting two New Hampshire teenagers out of an abusive institution. But she “took matters too far” when she said according to a local news station that she and her staffers could finally get a good night’s sleep after removing the two teenagers from the institution. But nobody should be getting a good night’s sleep as long as “children are institutionalized,” according to Wexler. “And [the Child Advocate], of all people, should know it” because last year her predecessor issued a report exposing abuse at a New Hampshire institution. He goes on to label as “disheartening” her proposal to form a commission to address the issue of residential care.

It is noteworthy that Wexler’s pieces tend to endorse the prevailing ideology about child welfare, albeit often in an extreme way, while mine tend to challenge it. But Wexler is not the only author of opinion pieces that tell stories and mention individuals and nevertheless are shared by CWN. In addition to commentaries by Wexler, the newsletter has shared opinion pieces with titles like “The Child Welfare System Is Failing Children, Separating Black and Brown Families,” and “What To Do When Children’s Services Comes to the Door,” which also endorse the prevailing view. But my essay has been rejected, ostensibly for the same characteristics that these pieces display. Could it be that the creators of CWN are discriminating based on viewpoint?

As Mr. Guterman mentioned, ICF produces CWN under contract for the Children’s Bureau, which has wholeheartedly endorsed the prevailing view of child welfare promoted by a group of well-heeled foundations and nonprofits, consulting firms and influential commentators. This narrative portrays a racist child welfare system that disproportionately investigates, intervenes with and separates Black children and families. It disregards the evidence that the need for protection is also much greater among Black children, suggesting that they are more likely underrepresented in relation to their need. The dominant viewpoint asserts that foster care is harmful and rarely necessary and that “prevention services” including financial aid can eliminate the need for most child removals. It holds that children should almost never be placed in non-family placements such as group homes or residential treatment centers. Proponents of this perspective hailed the Family First Act, which has failed to add significant preventive services while catastrophically reducing the availability of placements for the most troubled and traumatized young people, resulting in an explosion in the number of youths staying in offices, hotels and other inappropriate placements.

In my censored commentary, I provided examples of how the child welfare establishment and its preferred authors tend to share only the lived experiences that support their views, while ignoring experiences that support different viewpoints. And I gave examples of foster care alumni who have shared experiences of foster care and group homes that contradict the ones that have been repeatedly highlighted. Instead of choosing only the personal stories that support preferred views, I suggested that it is more useful to survey large samples of foster care youths or alumni. And I reported that such surveys result in much more positive views of foster care and group homes than those of the individuals who have been highlighted.

Over the years, Child Welfare Monitor has consistently expressed views that sharply question those of the child welfare establishment. But the CWN staff has never declined to share a piece because of its content. The website description of CWN states that the inclusion of a link “does not imply endorsement of any view expressed in a story and may not reflect the opinions of Child Welfare Information Gateway, the Children’s Bureau, or either organization’s staff.” So they clearly do not need to vet submissions for viewpoint.

The reason for the sudden change in practice (without notification or a change in the website language) remains a mystery, but one might speculate that it has something to do with a decreased tolerance for diverse views. But ICF or the Children’s Bureau would be violating the spirit and possibly the letter of the First Amendment if it were purposely excluding from a government publication content that does not fit the prevailing view. The Supreme Court has ruled that the government cannot discriminate against speech based on viewpoint, stating that: “When the government targets not subject matter but particular views taken by speakers on a subject, the violation of the First Amendment is all the more blatant. Viewpoint discrimination is thus an egregious form of content discrimination. The government must abstain from regulating speech when the specific motivating ideology or the opinion or perspective of the speaker is the rationale for the restriction.”

The possibility of viewpoint discrimination by the federal government or its contractor is deeply disturbing. But ICF’s dishonesty is also concerning. I was told for weeks that the article was still under review. When I persisted, I was told that my piece was censored because of “personal fundraising links” that I could not identify. When I asked to be shown the links so I could remove them, I was then given an entirely different explanation. And the new explanation was equally absurd, citing issues with my blog that either did not exist or were common to many other pieces shared in CWN. So there must be another reason they have not given me, and discrimination based on viewpoint is the only one that comes to mind.

It is unfortunate that my attempt to tell the truth about child welfare has finally come up against the increased intolerance for diverse views, even in a government-funded clearinghouse. Unless I find an organization that wants to take my case to court, it is unlikely that “The Misuse of Lived Experience” will be published in Child Welfare in the News. I’ll have to rely my readers to share my writing with their colleagues. Please share this blog and my censored post and urge people to follow Child Welfare Monitor. We cannot let the censors win.

The misuse of “lived experience” in child welfare

“Those closest to the problem have the answers to solving it. Every child welfare policy and project should prioritize incorporating the expertise, perspectives and experiences of the people whose lives have been directly impacted by the system. We call this ‘centering lived experience.'” There is a lot of truth in these words from an organization called Think of Us and a lot of good in the current focus in child welfare and other fields on considering the actual experience of people affected by systems when developing new policies and practices for these systems. But the emphasis on lived experience has potential pitfalls. When experiences that support a particular perspective are highlighted and those that contradict it are not, and when evidence from data and research are ignored in favor of narratives that may be outliers, there is a risk of adopting policies and practices that hurt, rather than help, children and families.

As described in a brilliant article by Naomi Schaefer Riley and Sarah Font, it is “individuals and groups with a platform” like foundations, government agencies, and journalists, that “select ​the people with lived experience to serve on advisory boards, testify to Congress, give media interviews, or otherwise disseminate their story.” The “lived experiences” that are selected tend to support the views of what I call the “child welfare establishment,” which includes federal, and many state and local child welfare agency leaders; foundations and nonprofits; consulting firms; and influential commentators and writers. They tend to believe that foster care is harmful and rarely necessary, and that on the rare occasions when children are youth must be placed in foster care, they should almost never be placed in “congregate care” placements such as group homes or residential treatment centers.

Let us start with the idea that foster care is rarely necessary, and the child protective services (or the “family policing system” as author Dorothy Roberts and others put it) removes children from loving parents who just need a little bit of help, thus harming rather than helping children. The story of Vanessa Peoples illustrated this thesis so well that it was shared by numerous media outlets before being picked up by Dorothy Roberts to begin her book, Torn Apart, about how the child welfare system “destroys Black families.” Peoples was a mother of three small children who was apparently doing everything right; she was married, going to nursing school, about to rent a townhouse and was even a cancer patient. But Peoples attracted the attention of both the police and child welfare and ended up hogtied and carted off to jail by police, placed on the child abuse registry, and subjected to months of monitoring by CPS after she lost sight of her toddler at a family picnic in June 17 when a cousin was supposed to be watching him.

From the information provided by Roberts and others, it sounds like Peoples’ was the victim of a hyperactive agency and police department, but it is also possible that critical details were omitted from the narrative. Moreover, Roberts did not include any narratives from people with a very different experience, like this one from Kiana Deane writing in The Imprint: “For me, meth became the pernicious thief that stole my home, my sense of belonging and, at times, my well-being. Being placed in a foster home saved me. Though foster parenting is not for everyone, I couldn’t imagine a world without the protection of the foster care system.” The Kiana Deanes are not asked to testify before Congress, highlighted in books by trending authors, or interviewed by the mainstream media for stories on foster care. (But kudos to The Imprint, which has published many narratives from youths who are grateful that they were placed in foster care.)

Then there’s the issue of group homes versus foster family homes. We all “know” that group homes and residential treatment centers are houses of horror because that is the only thing we ever hear. In the two hearings it held on the Family First Act, the Senate Finance Committee heard from only one person with “lived experience” in a group home, and that was Lexie Gruber, who told Senators about the locked food cabinets, punitive disciplinary system, over-medication, and the lack of emotional support that characterized her group home experience in Connecticut. But Senators did not hear from anyone like Imani Young, who wrote in The Imprint: “Eventually, OCFS (the Office of Children and Family Services) brought me to a wonderful placement called St. Christopher’s. …While in the NY child welfare system, I wanted to feel safe, comfortable, respected and not neglected, and St. Christopher’s made me feel all of THOSE above. They taught me independent living skills, helped me manage my money, got the counseling I needed, and taught me that there’s more to life.”  

Other than the selective presentation of lived experiences to be highlighted, another problem with using individual narratives to develop policy is that each person presents their own version of their story, which may leave out crucial details. It is rare for a journalist, author, or Congressional committee to check up on the accuracy of a story that supports the broader narrative they are seeking to portray. Vanessa Peoples’ wanted to portray herself as an innocent victim who did nothing to merit the intervention of CPS, and Roberts had no interest in finding inaccuracies in her story. Lexie Gruber, too, was intent on making the case against group care. She did not talk about the support that she must have gotten from the group home in order to get into college, or any other positive aspects of the care she received.

When the media, congressional committees or advocacy groups select only one set of lived experiences to highlight, real harm can result. Take the passage of the flawed Family First Prevention Services Act (FFPSA) in 2018 after only two hearings with a “curated” group of invited speakers who were clearly chosen to support passage of the bill. Lexie Gruber was the only former foster youth who spoke at the hearing on group homes and other congregate care placements, which was titled No Place to Grow Up: How to Safely Reduce Reliance on Foster Care Group Homes. When it was finally passed in 2018, FFPSA contained drastic restrictions on federal reimbursements for group homes and other residential placements. I wrote in a recent post about how those restrictions have contributed to a placement crisis around the country, with the most troubled foster youth spending weeks or months in offices, hotels, jails, hospitals and other inappropriate and harmful settings. I don’t claim that hearing from Lexie Gruber caused Congress to impose drastic restrictions on group homes, but it was certainly used to support that action.

Don’t get me wrong. Every individual’s story has value. Such stories allow us to visualize the reality behind dry data and statistics. But, to make policy, we need to know whether a story we hear is an outlier or representative of the average experience. It’s not that outliers don’t matter; we need to have protections to ensure that the worst possible outcomes (like the killing of 16-year-old Cornelius Fredericks in a residential treatment center run by Sequel Youth and Family Services) don’t occur. But making policy assuming the outliers represent the majority can lead to disastrous outcomes, like the congregate care provisions of FFPSA.

In contrast to individual narratives, surveying a representative sample of people with lived experience in a particular setting or system can provide information that is useful for policy purposes. Such information is not guaranteed to be accurate; survey response rates are often suboptimal and those who do respond may differ systematically from those who don’t. Nevertheless, such surveys are a much more accurate way of assessing lived experience than relying on individual anecdotes.

And it happens that in child welfare, surveys of older foster care youth and alumni present a much more positive picture than what has been presented by the child welfare establishment and the media. In four studies of former foster care youth reviewed by Barth et al, majorities said that they were lucky to have been placed in care. Most recently, the CalYOUTH study followed a cohort of 727 youth who were in foster care at age 17, with personal interviews every other year until they were 23 years old. At 23, 68.4 percent of the 621 respondents said that they were lucky to have been placed in foster care. And 57.4 percent were “generally satisfied” with their experience in foster care.

There are few studies of youth perspectives on residential care, but a recently published study in a leading child welfare journal reports on the experience of 450 youths placed in 127 licensed residential care programs in Florida between 2018 and 2019. The youths responded to a validated quality assessment that asked them to rate their facilities on elements of service quality in seven domains based on evidence and current best practice standards. Overall, youth provided high ratings of their residential programs on all seven domains. The mean ratings indicated that youths felt their facilities were “mostly to completely” meeting the standards across all domains.1

This does not mean that there are no children who could have stayed safely with their families and not been placed in foster care had the right help been provided. Nor does it mean that there are no terrible group homes. The current placement crisis (to which FFPSA has contributed) means that more youths will be placed in neglectful or even abusive homes or facilities than if this crisis did not exist. But when advocates of one point of view choose to share only those experiences that support their viewpoint, the use of lived experience to support particular policy proposals can lead to policy choices that are harmful to the people they are intended to help.

Note

  1. But not all surveys are based on large, scientifically-chosen samples. For example, the nonprofit,Think of Us, which has the aim of “centering lived experience,” published a report called Away from Home: Youth Experiences of Institutional Placements in Foster Care. That report is based on the responses of 78 young people residing in what it called “institutional placements, which included group homes, homes for pregnant and parenting teens, and therapeutic residential treatment facilities around the country. Among the conclusions of the report were that institutional placements were prisonlike (“carceral”), punitive and traumatic for their residents and failed to meet child welfare mandates to provide safety and wellbeing. The methodology section, relegated to an Appendix, reveals that the 78 participants were recruited through an “open call for participation through youth advisory boards and community partners.” Assuming that these are advisory boards and community partners of Think of Us, and knowing that the nonprofit and its CEO are associated with the dominant viewpoint on group care, one has to wonder whether the recruitment process produced an unbiased sample.

Residential care in child welfare: An international perspective

In my last post, Family First at five: Not much to celebrate, I discussed how the Family First Prevention Services Act (FFPSA) made it more difficult to provide residential care (often pejoratively called “congregate care” by the Act’s supporters) for the most troubled foster youth while doing little to ensure the development of alternatives. The result has not been surprising–an exacerbated placement crisis, with foster youth around the nation sleeping in hotels, offices, jails and other inappropriate settings. An important new book provides an international perspective on residential care. It shows that the U.S. ranks very low in the percentage of foster youth that are in residential care, casting doubt on the advisability of trying to further reduce residential placements. The obvious conclusion is that we would do better to increase the quality of residential care by raising standards for staff.

The new book, Revitalizing Residential Care for Children and Youth, is a compilation of research on residential care in 16 high and middle-income countries, edited by James K. Whittaker, Lisa Holmes, Jorge F. Del Valle, and Sigrid James, who are professors at universities in the US, England, Spain, and Germany, respectively.1 The editors define “residential care” as “any group setting where children spend the night,” encompassing settings that vary in size and function and that operate under the auspices of child welfare, juvenile corrections, or mental health. The 16 countries are viewed through a common template, making comparisons possible. However, there are problems with such comparisons. As explained in the second chapter, countries differ in the terms they use for different types of care and how they define these terms, among other things. The editors’ definition of “residential care” does not ensure that the same facilities are being counted across nations. A small group home with paid staff might be classed as “foster care” in some countries, and some facilities (like those for youth offenders) might be counted in the residential totals for some countries and not others.

Keeping in mind the impossibility of obtaining data that is totally comparable across countries, there appears to be a striking variation between nations in the utilization of residential care for youths who are in out-of-home placements. The editors defined the residential care utilization rate as the proportion of out-of-home care dedicated to residential care rather than family foster care or other types of out-of-home placements. This percentage ranged from seven percent in Ireland and Australia to 97 percent in Portugal, as shown in Figure 29.1, which is reproduced below. The United States had the third lowest residential care utilization rate, with ten percent of children in out-of-home placements being in residential settings. Moreover, the number of children in U.S. residential care fell by about 25 percent between 2015 and 2019. According to the editors, it appears that countries in the low-utilization category have made legislative changes (like FFPSA and California’s Continuum of Care Reform in the US) that have led to drastic reductions in residential care. But the countries with medium utilization rates (between 30 and 55 percent) seem to be focused on improving residential care by strengthening the elements believed to be associated with quality care rather than reducing the utilization of residential care.2

Source: James Whittaker et al, Revitalizing Residential Care for Children and Youth, page 430.

The authors also found great variability in the education and training requirements for residential care staff. These range from no minimum qualification in the United States, Canada and Australia, to high school level (Israel, Argentina and Portugal), to rigorous multiyear vocational training and/or university education in the other countries. A number of countries use both vocationally trained and university educated staff. For example, in Germany, about 70 percent of residential care staff hold a 3.5 to five-year vocational degree as educators (or in fewer cases two years as assistants) and 30 percent have Bachelors’ degrees in social work or “social pedagogy.”3

The editors found that it is countries with lower educational requirements for staff that have turned against residential care and have sought a drastic reduction of its use. Among those countries was, no surprise, the United States, along with Australia and England. In contrast, countries with a high qualification requirement have higher utilization of residential care. This correlation is not surprising. There is no doubt, say the volume’s editors, that “the quality of the services is directly related, in any field, to the qualifications, training and experience of the professionals who provide them.” In child welfare, they argue, “[I]t is difficult to carry out the work without a qualification based on the learning of very diverse theories related to child development, the clinical expressions of trauma, listening and helping techniques, the framework of family relationships, and ecological theories.” The editors suggest the existence of a vicious cycle, where low staff qualifications may led to poor quality and outcomes, which in turn lead to reduced funding, making it harder to recruit well-qualified staff.

Unfortunately, available data do not tell us what proportion of children and youth in residential care in each country are there for time-limited treatment for behavioral issues with a plan to “step down” to a family setting. Available data suggest that a majority or large minority of children and youth in residential care in the middle-utilization countries have a mental health diagnosis, which does necessarily mean that they are in a time-limited therapeutic setting. Most likely, the residential care population in the middle-utilization countries is a combination of youths with issues that require treatment in residential care and those who could be in family foster care if available As one of the editors notes in the introductory chapter, “residential care across the globe …does not seem to be limited to the narrow treatment-oriented and time-limited setting it is generally reduced to in several Anglo-American nations. In fact, in many countries,…., children and youth still spend years in residential care programs.”

The assumption that family foster care is always the better choice unless a child cannot function in such a setting may be unique to the English-speaking countries. Small, family style group homes, whether freestanding or part of a campus of such homes, may be difficult to distinguish from foster homes, especially if they use a house-parent model. In fact, the authors say, some countries classify “a small “family group” home, staffed by paid staff” as a foster home. I have argued in the past that high-quality family-like group homes may be better for children than mediocre or poor-quality foster homes and are especially appropriate for siblings. Indeed, as discussed in the book, France has 28 children’s villages, which are family-like units especially for siblings.

The evidence shared by Whittaker et al. has important implications for the United States. Given our low position on the scale of residential care utilization, one might logically conclude that further lowering the number of children in residential care would be unrealistic. In the two countries with lower residential utilization rates than the United States, Ireland and Australia, news accounts document an urgent need for more foster parents, with young people being separated from siblings, moving from one emergency placement to another for lack of a suitable home, and spending nights at hotels. Instead of trying to bring the residential share of foster care even lower, the U.S. might be better advised to follow the example of countries like Germany and Finland, which are focusing on improving residential care programs rather than eliminating them.

Cross-national comparisons are valuable in many policy areas, and the absence of such comparisons in child welfare debates is particularly unfortunate. Reading this book brings home the lack of international comparisons informing Congress when it passed the FFPSA. As far as I know, the supporters of FFPSA’s drastic restrictions on residential care never referred to other countries’ use of residential options; that’s not surprising as such comparisons may have led to uncomfortable questions about the premise that too many foster children and youth were in residential care.

Some members of Congress who supported the residential restrictions in FFPSA may have been more concerned about budgets than ideological objections to residential care. Improving residential care costs money, while cutting it may appear to help balance budgets. FFPSA was designed to be budget-neutral, so that restrictions for funding of residential care were required in order to offset the increase in spending for services to families. And it apparently did not matter to Congress if those costs were by necessity picked up by states that had no other options: the federal government would see the savings.

Perhaps the federal coffers have benefited from the restrictions on federal funding for residential care, especially because federal spending for the “prevention services” side of Family First has been negligible. But it is hard to believe that states have gained financially from the new law. Spending as much as $2,000 a night for a hotel room complete with staffing and security for foster youth, as Washington State is reportedly doing, cannot possibly be a better use of funds than improving and expanding residential care. And the effects on children and youth are disastrous. One can only hope that state leaders will be brave and smart enough to take the first steps in the direction of revitalizing residential care to be a nurturing and therapeutic environment for children and youth and a field that is a source of pride for its practitioners.

Revitalizing Residential Care for Children and Youth should be required reading for anyone involved in making policy or drafting legislation regarding foster care. But it is probably too much to hope that the anti-residential crusaders will choose to read this important book. They find it more comfortable to continue believing that cutting funds for these programs without providing an alternative will save money and help children at the same time.

Notes

  1. The countries studied include Argentina, Australia, Canada, Denmark, England, Finland, France, Germany, Ireland, Israel, Italy, the Netherlands, Portugal, Scotlad, Spain, and the United States.
  2. Portugal, with 97 percent of its out-of-home youth in residential care, is in violation of its own law establishing residential care as the last option for out-of-home care. It appears that the country has not developed the supply of foster parents needed to shift the system toward home-based care. Argentina, with 86 percent of children separated from their families living in residential care, is only in the early stages of developing family-based foster care. In Israel, a system of residential facilities or “youth villages” developed as a means of social integration of immigrant groups, starting with survivors of the Holocaust. This system of residential care operates under the MInistry of Education. A separate child welfare system developed later under the Ministry of Labor, Social Affairs and Social Services, to serve the needs of maltreated children, and 63 percent of the children in this system are also in youth villages.
  3. According to the editors, “[s]ocial pedagogy is grounded in a holistic understanding of the person and espouses participation, democratic processes, self-determination, and social and moral education within the context of everyday life as guiding values and principles for practice. Individualization (n contrast to standardization) and professional decision-making are further hallmarks of this approach.”

Family First at five: Not much to celebrate

Photo by Ivan Samkov on Pexels.com

When the Family First Prevention Services Act (FFPSA) passed as part of the Bipartisan Budget Act of 2018, it was hailed by many as a revolutionary step in the history of U.S. child welfare. Five years after the Act took effect, child welfare leaders have been weighing in with statements like this one from Rebecca Jones Gaston, Commissioner of the Administration on Children, Youth and Families: “Following its passage five years ago, the Family First Prevention Services Act has transformed our approach to child welfare and benefited families across the many states that have used it to provide concrete support and services.”1 But for those closer to ground-level and less invested in demonstrating the act’s success, there’s not much to celebrate.

FFPSA had two major goals: to keep children out of foster care altogether through services to families and to keep more of those who do have to enter care in family homes. In terms of the first goal, the law’s impacts on services to families have been almost negligible. And in its effort to keep foster children in families, FFPSA has exacerbated the critical shortage of appropriate placements for our most troubled youth, many of whom may need placements in larger settings. In this post, I examine these two goals and their outcomes in greater detail.

FFPSA’s Part I made it possible to allocate funds under Title IV-E of the Social Security Act, previously directed mainly to foster care, to services aimed at keeping children out of care. The law allowed spending on mental health, substance abuse prevention and treatment, and in-home parenting services, “when the need of the child, such a parent, or such a caregiver for the services or programs are directly related to the safety, permanency, or well-being of the child or to preventing the child from entering foster care.”

As I explained in my 2019 post, Family First Act: a False Narrative, a Lack of Review, a Bad Law, Part I was based largely on the false premise that current law, by allowing TItle IV-E funds to pay for foster care and not for services to prevent it, incentivized states to remove children rather than keep families together. While it is true that IV-E funds were not available to pay for services to children and families in their homes, that does not mean that no money was available to help keep families together or that states had an incentive to place children in foster care. In fact, states had long been using Medicaid and other funds for services to prevent placement of children in foster care. In Federal Fiscal Year 2017, according to federal data, out of the children who received services after a CPS investigation or alternative response, only 201,680 were placed in foster care, while 1,332,254 (or more than five times as many children) received in-home services such as case management, family support, and family preservation services.2

Disregarding the role that other funding already played in child welfare, the framers of FFPSA required that Title IV-E would be the “payer of last resort,” so that any services already paid for by Medicaid could not be paid for by Family First. By doing this, they ensured that states with a generous Medicaid programs would be hard-pressed to find any service already existing in the state on which to spend their TItle IV-E money. If not for this provision, such states might have chosen to supplement Medicaid funding for some of these services. Perhaps some states would have allowed Title IV-E funds to be used to pay high-quality providers who do not accept Medicaid funding due to the program’s low reimbursement rates and high paperwork burden. (During my time as a foster care social worker in the District of Columbia, we had contracts with high-quality providers who did not accept Medicaid in order to provide therapy for our most complex clients).

The choice to fund only parenting, mental health and drug treatment services by the framers was another design flaw of FFPSA. The absence of a domestic violence service among the funded services is striking. It is universally acknowledged that drug abuse, mental illness and domestic violence are the “big three” factors that result in foster care placement. But for some reason, the words “domestic violence” are nowhere to be found in FFPSA. Perhaps even more striking is the failure to include one of the most promising services to prevent foster care–high-quality child care. As I have written, not only does quality early care and education prevent foster care placement through multiple pathways, but it also provides an extra set of eyes on the child in case of continued abuse or neglect–greatly needed if FFPSA is to achieve its goal of keeping children both safe and out of foster care. Think of what a difference Congress could have made by providing matching funds to provide quality child care to all families with in-home cases!

Perhaps the most unfortunate feature of FFPSA’s Part I is the requirement that all funds must be spent on “promising, supported or well-supported practices,” with 50 percent of the total spent spent on “well-supported practices” — a percentage that increases after 2026. The law imposes strict requirements for designating a program as promising, supported or well-supported. It set up a clearinghouse to assess the data on existing programs and approve those that met the criteria. As Dee Wilson points out in one of his essential commentaries, the law gets it exactly backwards. We have very little evidence about what works to prevent foster care placement. What we need is to invest in innovative approaches to doing this safely. But FFPSA prevents the use of TItle IV-E funds for this purpose.

Thanks to the various restrictions imposed by FFPSA, the clearinghouse is woefully incomplete. For example, Cognitive Behavioral Therapy (CBT), the therapy of choice for depression and anxiety, which has not been approved nor is it on the list of programs to be examined by the clearinghouse. (“Trauma-Focused CBT,” a newer and much narrower and short-term model, has been approved.) No residential drug treatment program has been approved or is even slated to be considered. The requirement that the practice have a manual may be at fault for the failure to include CBT and residential drug treatment programs, but I’d like to hear from readers who may be better-informed. Buphenorphine therapy for opioid use disorder, which is often preferred to methadone therapy (which is approved by the clearinghouse)because it does not require daily clinic visits, has not been approved and is not slated for consideration, according to the Clearinghouse.. Of course, these popular programs are often funded by Medicaid anyway, so they would be ruled out by the last resort provision as well.

With all these restrictions on Title IV-E spending, it is not surprising that states have been hard-put to find useful ways to spend Title IV-E funds to keep families together. In an important article, Sean Hughes and Naomi Schaefer Riley cited the latest available federal data showing that just 6,200 children across the entire country received an FFPSA-funded service in FFY 2021, costing a grand total of $29 million. That is truly underwhelming given that about 600,000 children were found to be victims of maltreatment in FFY 2021.

The other major purpose of FFPSA was outlined in Part IV, entitled “Ensuring the Necessity of a Placement that is not in a Foster Family Home.” The purpose of this part was to keep more children out of “congregate care,” a term used to designate settings other than foster homes, such as group homes and residential treatment centers. FFPSA made it more difficult to place a child in a congregate placement by imposing conditions on Title IV-E reimbusement for such placements, and by limiting reimbursement after two weeks to facilities that qualify as “Quality Residential Treatment Programs (QRTP’s), a new category defined by the act. QRTP’s must meet strict criteria that many facilities that were caring for foster youth at the time of FFPSA’s passage could not meet without major changes. The act also (perhaps inadvertently) further restricted the number of congregate care beds available to foster youth by creating a conflict with a Medicaid provision called the “Institutions for Mental Diseases (IMD) exclusion” that prevents Medicaid paying the cost of care for children who are placed in facilities with more than 16 beds.

Like Part I, Part IV of FFPSA was in large part based on a false narrative. The myth this time was that every child does better in a family rather than in a more institutional setting. But as I described here, there are many foster youths who cannot function in an ordinary foster home, at least until after a stay in a high-quality residential treatment program or group home. These are the same young people who bounce from home to home and end up in hotels, offices, jails, and other inappropriate settings, but FFPSA made no provision for them.

Even if too many children had been placed in residential care without sufficient clinical justification (which is probably the case in at least some states), it would not be responsible to shut down congregate care placements before ensuring that appropriate foster homes were available for all the children being displaced. But just as the deinstitution movement of the 1960s closed mental hospitals before putting alternatives in place, FFPSA disregarded the question of where children would go when congregate settings disappeared.

As I described here, FFPSA exacerbated trends that were already underway. Group homes and residential treatment centers were already shutting down due to growing publicity about abusive incidents at some facilities, failure of reimbursement rates to keep up with costs, and resignation of staff due to poor pay and working conditions. Tragically, this reduction in residential capacity coincided with increased demand for care due to the youth mental health crisis and increasing levels of need in the foster care population due at least in part to delays in removing children from abusive and neglectful homes. The restrictions put in place by FFPSA added to the problem. As Hughes and Schaefer Riley put it, “If you want to understand why foster children across the country are being housed in a range of inappropriate temporary settings, including county and state offices, hospitals, hotels and shelters, FFPSA is a significant factor.” 

The trends just mentioned have contributed to a foster care placement crisis that has if anything worsened since I described it last October. In Illinois, the Department of Children and Family Services (DCFS) is being sued by the Cook County Public Guardian for allowing foster children to remain locked up in juvenile detention even after they’ve been ordered released. In Maryland, a disability rights group has just filed suit against the Department of Human Services and other agencies for keeping foster children in hospitals and restrictive institutions beyond medical necessity for weeks, months, or even as long as a year. In a must-read article, Dee Wilson documents a 370 percent increase in hotel/office stays in his state of Washington since 2018 despite a federal court order to stop the practice. At an average cost of up $2,000 per night (including the cost of paying two social workers and a security guard), overnight hotel placements cannot possibly be cheaper than group homes or residential treatment centers. Similar problems are reported around the country, differing only in which inappropriate settings each state is relying on.

As is often the case, California paved the way for FFPSA by passing its Continuum of Care Reform, designed to curb the use of congregate placements, in 2015. A new article in the Los Angeles Times recounts the results. The number of children living in congregate care has dropped from 3,655 to 1,727 since implementation of the law, but the state has failed to find the foster homes to replace the congregate care settings. As a result, Los Angeles County has placed more than 200 foster youths in hotels, sometimes for months. County officials report that two social workers have been assaulted by foster youths in separate incidents this year at hotels. Moreover, it appears that care at the existing congregate facilities has grown worse as larger numbers of troubled youths are placed together in fewer facilities. The results of California’s reform and of FFPSA were predictable and indeed predicted by some commentators (including this writer), but these predictions were ignored.

As Dee Wilson puts it, “The implementation of Family First legislation has accelerated the demise of residential care, which has decreased 25% nationally during the past five years. It has been the goal of the federal Children’s Bureau and influential foundations to reduce the use of residential care (which has a bad reputation among advocates and most scholars) and they have succeeded; but without developing — or sometimes even proposing – viable alternatives.”

Anyone who chooses to celebrate the “revolution” wrought by FFPSA is living in a dream world. It’s time for Congress to recognize and correct the many errors it made in passing the law. At a minimum, Congress should add funding for early care and education and domestic violence programs to the models that can receive funding under Title IV-E, loosen the standards for evidence-based practices, modify the last-resort provision to allow payment for services to providers who do not accept Medicaid, eliminate some of the restrictions on congregate care, and provide incentives for states to boost their capacity of quality residential programs. Until such changes are made, there will be nothing to celebrate.

.

  1. Alexia Suarez (asuarez@wearerally.com), [YOU’RE INVITED] Expert panel on the Family First Prevention Services Act. Email message, May 15, 2023.
  2. These are duplicated counts as children are counted again each time they are the subject of an investigation and receive post-response services.

What is the cause of racial disparity in child welfare?

There is no doubt that Black children and families are reported to child abuse hotlines, investigated, and removed from their homes more than White children. But many leading voices in child welfare today have made the dubious assumption that racial bias in reporting and child protective services is the underlying reason for these disparities. Unfortunately, based on this assumption, they propose policy solutions that risk destroying existing protections for Black children or even for all abused and neglected children. A star-studded group of researchers has collaborated on a paper that ought to put this presumption to bed for good. I hope that this brilliant paper is able to change the minds of some who have unquestionably adopted the fashionable theory that is being promoted by the child welfare establishment.

There is no dispute that Black children are reported to authorities, investigated for abuse or neglect, and placed in foster care at a higher rate than White children. The federal publication, Child Maltreatment 2021, reports that Black children are nearly twice as likely as White children to be the subject of a screened-in report and almost twice as likely to be substantiated as a victim of child abuse or neglect. In 2020, Black children were 14 percent of the child population but 20 percent of the children entering foster care. Kim et al estimated that 53 percent of Black children will experience a CPS investigation by the age of 18, compared with 28 percent for Whites. But are these disparities greater than what would be expected given the higher rates of poverty and other social problems among Black children? That’s the question that a group of 13 researchers addressed in a recent article on racial and ethnic differences in child protective services reporting, substantiation and placement, published in the leading child welfare journal, Child Maltreatment. The authors include most of the top researchers in the field, such as lead author Brett Drake and his co-authors Richard Barth, Sarah Font, Emily Putnam-Hornstein, Jill Duerr-Berrick, and Melissa Jonson-Reid–an accumulation of starpower rarely seen collaborating on a single article.

Previous studies cited in the paper have already concluded that when adjusting for income and family context, Black children were actually reported to CPS at similar or slightly lower rates than White children and that Black children who are the subject of investigations were no more likely to be substantiated or placed in foster care than White children. Despite these results, the belief that racial disparities are due to anti-Black bias in reporting and child protective services (CPS) decisionmaking has been asserted as established fact in publications by the federal government, numerous child welfare groups, the American Bar Association, the American Civil Liberties Union and Human Rights Watch, and many media outlets. A report by a leading legal advocacy group and the Columbia Law School Human Rights Institute urged the UN to investigate the American child welfare system for racial discrimination. After conducting its own review, a UN Committee recommended that the United States “take all appropriate measures to eliminate racial discrimination in the child welfare system, including by amending or repealing laws, policies and practices that have a disparate impact on families of racial and ethnic minorities.” Rather than advocating for reform of child welfare systems, some individuals and organizations, such as upEND, press for the extreme step of abolishing the entire child welfare system.

The new paper provides a needed antidote to the certainty that racial bias is the principal source of racial disproportionalities in reporting, substantiations, and foster care placements, and provide compelling evidence against it. The authors use universal national data to ask two questions:

  1. Are Black-White and Hispanic-White disparities in CPS reporting lower than, similar to, or higher than disparities in non-CPS measures of social risk and child harm?
  2. Once referred and accepted for investigation, do Black or Hispanic children experience substantiation and removal into foster care at rates lower, similar or higher than White children?

The authors focused on Black, White and Hispanic populations. Native American populations, which are also disproportionately involved in child welfare, are difficult to study because many are served by tribal child welfare systems and may not be reflected in the national data that the authors use. The authors used CPS data from the National Child Abuse and Neglect Data System (NCANDS), which gathers information from all 50 states, the District of Columbia, and Puerto Rico about reports of child abuse and neglect and their handling by child welfare agencies. Data from certain states and years had to be eliminated because of data quality problems and missing data. The elimination of all data from New York and Pennsylvania is unfortunate, but it is unlikely that these omissions changed the overall trends. Data for income and other indicators of risk and harm came from the Census Bureau, the Kids Count Data Center, National Vital Statistics records, and the Centers for Disease Control.

Question One: Reporting Disparities

The authors posit that the “expected rate” of Child Protective Services (CPS) involvement for a particular group of children should be “the rate at which children in that population experience child abuse, neglect, or imminent risk thereof.” But the authors explain that we cannot actually observe the incidents of abuse or neglect, as they are not always reported to authorities. And when reports are made, the system may not always make the correct decision when it decides whether or not to “substantiate” or confirm the allegations made by the reporter. To estimate the “expected rate” of being reported to CPS, Drake and colleagues used several categories of risk and harm that are known to be highly correlated with the risk of child abuse and neglect. Indicators of “social risk” included the numbers of children in poverty, children in single parent families, teen birth rate, and adults without a high school degree. To indicate harm to children, the authors used “very low birthweight,” “very preterm births,” infant mortality, homicide injury, and “unintentional death.”

Drake and his colleagues calculated “disparity ratios (DR’s),” by dividing the incidence of social risk or harm for Black or Hispanic children by the rates for White children by year. They found that the DR’s for all the measures of risk, and all of the measures of harm except accidental deaths, were greater than the DR’s for CPS reports. In other words, there was a greater disparity in risk and harm to Black children than there was in CPS reporting. Thus, given their likelihood of being abused or neglected, Black children appear to be reported to CPS less than are White children.

The tables below illustrate the incidence of risk, harm and CPS reports for Black children compared to White children. While Black children were reported to CPS at a rate close to twice the rate of White children throughout the period studied, their poverty rate was three times that of White children in 2019, the proportion of Black children in single-parent households was 2.5 times as as that of Whites, and the disparity in the rate of single-parent households and adults without a high school degree was almost as great. In terms of harm, Black children were four times as likely to be a homicide victim in 2019, nearly three times as likely to have a very low birth weight, and more than twice as likely to die of maltreatment, in 2019.

Disparities in Substantiation and Removal

To address disparities in substantiation and removal following investigation, Drake and coauthors compared the raw data and also ran regressions to adjust for demographic factors that might affect placement, such as poverty. They found that in both adjusted and unadusted estimates, Black children, once investigated, have been less likely to be substantiated and placed in foster care in more recent years. Before 2011, Black children were slightly more likely to be substantiated and placed in foster care than White children before the trend reversed. The unadjusted estimates are shown below.

When they compared Hispanic children to White children, the authors found a very different pattern. While Hispanic children face much more exposure to social risks like poverty than White children, they experience harm and CPS reporting at about the same rate as White children. This pattern is consistent with what is known as the “Hispanic paradox.” This term describes a well-documented phenomenon in the child welfare and medical literatures wherein Hispanic children and families have indicators of well-being similar to their White non-Hispanic counterparts, despite having much higher indicators on risk factors like poverty. For Hispanic children, there were slightly greater unadjusted rates of substantiation and placement than for White children, but these differences disappeared when statistical controls were added.

Conclusions and Implications

The authors draw two primary conclusions from their research. First, “Black-White CPS reporting disparities were consistently lower than Black-White disparities in external indicators of social risk and child harm.” Black children were exposed to more risk and experienced harm at greater rates than White children, and these disparities were consistently greater than the disparities in reporting. If either group is overreported in relationship to their risk it is White children. It is still possible, the authors point out, that all children are overreported to CPS in relation to external indicators of risk and harm. But “if there is systemic overreporting, it is not specific to Black children and thus, unlikely to be driven by racial animus.” They also found no evidence that once investigated, Black children were disproportionately substantiated or placed in foster care.

Second, the authors found continued evidence for the “Hispanic paradox” in CPS reporting compared to observed risk exposure. Although Hispanic children face substantially greater social risks than White children, they experience harm and CPS reporting at about the same rate as White children. This supports the well-documented pattern whereby more recently immigrated Hispanic families, despite having higher risk factors, tend to have indicators of well-being similar to Whites.

In the authors’ own words:

It is indisputable that despite progress in certain areas, the United States has not overcome the legacy of slavery, segregation and Jim Crow. This legacy lingers most clearly in the patterns of segregation that emerge in many of our metro areas…To assert that these patterns, and the poverty and chronic stress they perpetuate, would have no impact on behavioral and psychosocial functioning among the individuals and families in those neighorhoods is to reject decades of scientific consensus on human development. Indeed, this history and its unresolved legacy is essential to understanding why Hispanic families face similar individual socioeconomic disadvatage but appear to have sigificantly lower rates of CPS involvment than Black children.

If I have one quibble with the authors of this brilliant and essential article, it is their lack of attention to the possile psychological impacts of intergenerational trauma from the history of slavery, Jim Crow, and racial hatred and violence. As the child of Holocaust survivors, I can attest that the six years of trauma that my parents suffered after the Nazis invaded Poland has affected me and even my daughter. For families in which nearly every generation going back almost 400 years suffered the trauma imposed by living within slavery, Jim Crow, or a culture of virulent and violent racism that continues in some form today, it would be surprising if there was no current mental health impact on the generation that is parenting children today. Such a impact might include elevated levels of mental illness as well as self-medication through drugs and alcohol, both of which are associated with child maltreatment.

In the section on Implications, the authors assert the need to address the factors that underlie the differing rates of risk and harm to Black children, outside the CPS system itself–factors such as poverty and racial segregation. The belief that abolition of child protections would in and of itself help Black children, the authors point out, relies not only the assumption that CPS is racially discriminatory, which this paper has debunked. It also relies on the assumption that CPS provides no protection to children. Certainly there is room for improvement in our child protection systems, particularly in the quality of care they provide to children removed from their homes. Yet, foster youth testimonies such as “being placed in a foster home saved me,” or “Using my voice is the reason I am no longer in a household that is broken,” as well as the silent testimony of the more than two thousand children who die of abuse and neglect every year,1 are a testament to the untruth of this statement.

The authors suggest three courses of action for the future. First, we should acknowledge and address the true drivers of racial inequity among families, such as multigenerational poverty, underresourced schools, and lack of access to quality substance abuse and mental health treatment programs. Second, despite their results, we must acknowledge that racial bias may exist in certain localities and be prepared to address it. And third, “there is clearly room to consider restructuring child and family policy generally to include a focus on providing preventive services, including material assistance, to families. (See my discussion of universal yet targeted programs to prevent child maltreatment.)

The authors go on to state that “It is possible that a narrow focus on reducing Black children’s CPS involvement without addressing the pronounced inequities documented by the external indicators will result in systematic and disproportionate unresponsiveness to abuse and neglect experienced by Black children.” And indeed, there are already reports that professionals are already more reluctant to report Black children and CPS employees are more reluctant to substantiate or remove them.2 Or to put it more bluntly, the standards for parenting Black children will be lowered, and the level of maltreatment that Black children are expected to endure before getting help will be raised. Ironically, this calls to mind some manifestations of racism that have been cited by scholars and advocates, such as treating Black children as if they are older than their actual age, and thinking that Blacks have a higher pain threshhold than Whites. Of course if the child welfare abolitionists have their way, the entire system will be abolished, destroying protections for all children. That is unlikely to happen, but what is more likely is a weakening or repeal of critical laws like the Child Abuse Prevention and Treatment Act or the Adoption and Safe Families Act, which are both currently under attack, to eliminate or weaken provisions like mandatory reporting.

Sadly, few leaders on either side of our increasingly polarized political scene will be open-minded enough to read, understand and accept the conclusions of this important paper. While the progressive mainstream (and even many others in the child welfare establishment) has blindly accepted the notion that racial bias is the primary driver of child welfare disparities, conservatives remain obsessed with reducing the size of government and cutting taxes, refusing to recognize the need for massive spending, even a domestic Marshall Plan, to rectify the result of centuries of slavery and anti-Black racism in America.

Notes

  1. States reported 1,820 child maltreatment fatalities to NCANDS in 2021. But experts cied by the National Commission to Eliminate Child Abuse and Neglect Fatalities (p. 9) estimate that the actual number is at least twice as many as that reported to NCANDS.
  2. See, for example, Safe Passage for Children of Minnesota, Minnesota Child Fatalities from Maltreatment, 2014-2022. The report authors found evidence that raised the question of whether Minnesota child welfare agencies may have tended to leave Black children in more high-risk situations for longer periods of time than children of other races and ethnicities. See also Stacey Patton, The Neglect Of 4 Texas Brothers Proves That The Village It Takes To Raise A Black Child Is The Same Village That Stands By And Watches Them Die, Madamenoire, November 2, 2021. She states that “To reduce the number of Black children entering into foster care as a result of abuse, child welfare professionals are increasingly “screening out” calls for suspected child abuse.  There haven’t been any state or national level studies to show whether disproportionately higher numbers of calls of Black child abuse are being screened out to avoid claims of racial discrimination.  However, in my work as a child advocate, I keep hearing stories of non-Black child welfare professionals who don’t report abuse because they either don’t want to be accused of racism, or they just accept that beating kids is an intrinsic part of Back culture.”

Book Review: A Place Called Home: a needed antidote to the dominant narrative

It’s Christmas in Manhattan, and five-year-old David Ambroz (then called Hugh), six-year-old Alex and seven-year-old Jessica trudge through the freezing nighttime streets. “I’m only five,” writes Ambroz, “and all I know about Christmas is the stories I’ve heard at the churches where we go for free meals.” “Mom, we’re close to the Port Authority, can we go inside?” asks Hugh. “Walk straight. They’re after us” is the reply he receives. “There’s a calculation I make whenever I talk to Mom: Will she hit me, and is it worth it?” Ambroz explains.

So begins David Ambroz’s harrowing account of life with a mother, Mary Ambroz, whose mental state varies from manic to apathetic to floridly paranoid. A former nurse who was once married to a doctor,* Mary has been in the grips of her untreated mental illness for as long as Hugh can remember. The family bounces back and forth between New York City and Albany, eventually relocating to Western Massachusetts. The children are condemned to a life of sleeping at all-night Dunkin Donuts shops, dining on tiny cups of creamer mixed with sugar packets, and eating out of dumpsters, interspersed with short periods of relative normalcy when the family finds a temporary home. Those periods last until Mary decides the CIA or other pursuer is back on their trail. Some years the children don’t go to school at all, other years they change schools one or more times due to their frequent moves. The children don’t receive medical or dental checkups or vaccinations and visit the occasional clinic only for emergencies. When Hugh breaks his arm at the age of four, he is taken to the emergency room to have it set but never brought back to have the cast removed; when it starts to smell, Mary removes it with a kitchen knife.

Over the years the family has been investigated many times without getting any help, reports Ambroz. Mary Ambroz usually manages to convince authorities that she is a good mother, although she has lost custody more than once–one time when she threw a shoe at a judge in eviction court and was carted off to a psychiatric ward. The children went to a friend’s mother, but were returned to their mother as soon as she was released.

When she finds work as a live-in nurse for an older woman who allows the family to live with them, Mary instructs the children to call their benefactor “Aunt Flora.” Hugh is thrilled to live in an apartment where he can take a bath and to be enrolled in third grade only a month into the school year even though he missed most of second grade. In an apparent effort to ingratiate the family with “Aunt Flora,” Mary tells eight-year-old Hugh he is Jewish, renames him David, and immediately takes him to a doctor to be circumcised. But she does not bring him back for follow-up care and the wound becomes infected. Mary refuses to seek medical care despite “Aunt Flora”‘s pleas, rippimg off the protective mesh that had become stuck to the wound. Dismayed at Mary’s refusal to seek medical care for her son, “Aunt Flora” expels the family and they are living in Grand Central station again.

Even during relatively stable periods, when they are able to rent an apartment in Albany with the help of public assistance, life is far from normal for the children. Mary Ambroz doesn’t cook and when the food stamps start to run low the children have strategies for getting fed, like sneaking into Ponderosa Steakhouse by pretending to be part of a family that has already paid. A kitten they were allowed to adopt during a good period starves to death despite David’s attempt to steal enough food to keep him alive. “He ate his own shit and died,” his mother tells him. “Enough whining, David. You should have taken care of him,” she said, putting the body in a trash bag along with the cat toys and the litter box.

Mary Ambroz uses a gift of $500 to take a taxi to Boston, and the family ends up in a domestic violence shelter in Pittsfield, Massachusetts. Shelter staff try to help her get back on her feet and David tries to assist, accompanying her in selling vacuum cleaners door to door. The children are enrolled in school But that situation falls apart when Mary accuses a 65-year-old staffer groundlessly of sexually abusing David, after beating David up for allowing it to happen. “Nobody wants to tangle with my mother….And so, at this shelter for abused women, the response to our mother’s unhinged behavior is to move us to an apartment where they won’t have to witness the abuse.” And that is the same story, reports Ambroz, that repeats over and over again in their lives. Adults intervene with temporary kindnesses but don’t take steps to rescue the children from what is clearly a dangerous situation.

The children are thrilled with their new apartment, but Mary grows worse, alternating between almost catatonic apathy and violence. Twelve-year-old David realizes that foster care could be his salvation. He and his siblings been have been hiding their bruises for years at their mother’s demand but he finally understands that he must reveal his injuries in order to be saved. He shows his bruises to a DARE officer visiting his school. Two weeks later, two social workers knock on their door. “David, does your mother hurt you?” asks one of them, in front of his mother. As often happens when children are asked this question in the presence of the abusive caregiver, David retracts the allegation and the case is closed.

Mary Ambroz’s violence continues to escalate. She beats Alex severely with a curtain rod when he refuses to make a list of all the men with whom he has had sex. The children hatch a plan: 14-year-old Alex will ride a stolen bike 40 miles over the hills of Western Massachusetts at night to get help from a friend’s mother in Albany. The children gather $40 worth of food stamps, candy, and snacks and Alex is off. The family hears nothing for three weeks, and then the police call. Alex had made his way to Albany and disclosed the abuse to police and social services and is now in foster care. Once again, David is interviewed in front of his mother. Once again, denies the abuse. Once again, the social workers leave him and Jessica at home.

Just a few days later, Mary throws David down the stairs of their apartment building and then kicks his head, and everything goes dark. Covered with blood, David drags himself into the nearby courthouse and collapses into the arms of a bailiff. Finally David has had enough. From his hospital bed, he tells the investigating social worker what happened. His mother insists that he fell down the stairs, but the doctor opines that “it is not impossible, but these are pretty extensive injuries for a fall.” The CPS worker, unbelievably, tells David that while the investigation proceeds, “we think it’s best that you go home with your mom.” But a week later, the police knock on the door. A social worker tells David to pack his things. As he drives away from the apartment, David thinks, “This is it. I’m free.”

And now starts David’s life in foster care, which is only slightly less harrowing than his life with his mother. Jessica is placed in the foster home where Alex is living, but the home is not open to David and he knows why; the social workers can tell that he is gay. David spends his first night in foster care sleeping in the Department of Social Services (DSS) office, an experience of many children in foster care today. Then David is brought to a facility for juvenile delinquents, after being told by a social worker that it was not the right place for him but “we don’t have a place that can accept your kind.” At the facility he is called “fag” and “Ms. Ambroz” by a staffer, loses privileges for talking back, and is beaten up by other residents at the apparent instigation of the homophobic staffer. David’s illusion of safety is gone. “I am destroyed. It took everything I had to escape my mother. I thought nothing could be worse, but now, at twelve years old, I feel like this is it.”

David quickly cycles through several foster and group homes. He is finally placed with his siblings in the home of Buck and Mae, a couple who should never have been accepted as foster parents. After the children go to bed in their basement, they are not allowed upstairs for any reason, not even to go to the bathroom. They can’t use the shower without an escort, they can’t go into the kitchen except for mealtimes, and no snacking is allowed. Abetted by a succession of therapists, Buck and Mae try to suppress David’s homosexuality, forbidding him to close the door to the bathroom all the way and designing “manly” chores like clearing a swamp and digging out a backyard swimming pool. He is sent out to hang up wet laundry in the winter without gloves. They say he is too fat and put him on a starvation diet, and now he is hungry again and scrounging for food.

Thanks to a high school friend of David’s siblings, he is hired to work at a summer camp, and that summer changes David’s life. He bonds with the camp director, Holly, and her small daughter, a camper. Holly senses that something is wrong in David’s home. Knowing he needs support, she visits him weekly after camp ends but the visits eventually stop. Later David learns that Holly stopped visiting him after Mae became furious when she bought him new clothes. Holly called David’s social worker and asked to become his foster parent. She and her husband were working on receiving their foster care license until the social worker told them that Mae and Buck insisted it was better for him to be kept with his siblings.

Finally, Jessica and Alex run away. They disclose abuse at the foster home and refuse to go back. But there is no room in the new foster home for David, and DSS keeps David with Buck and Mae even while recognizing their abuse, requiring them to do additional training and not allowing them to take on new children. (Holly is never told that David is no longer with his siblings or invited to apply for her foster care license). Mae restricts David’s food even more while citing his obesity, even though he is dangerously underweight. Nobody at school appears to notice or care. Even when David faints in school, he does not explain that he is starving and no red flags are raised. Buck and Mae begin taking him out of school to work for an acquaintance, pocketing his pay and that too raises no concerns at school.

The torture escalates until one spring morning in 1995, Mae tells David he is staying home from school and David decides he is not going to take it anymore. He leaves the house and tracks down Holly, learning of her attempt to have him placed with her. Finally, David is placed with Holly, her husband Steve, and their two small children. He cannot believe that he is allowed to freely roam upstairs, or that he is allowed to eat whatever he wants, whenever he wants. Steve teaches David how to drive and laughs when he destroys their mailbox, saying he never liked it anyway. Holly ensures that he, Alex and Jessica get the braces that Mae refused to let them get since her kids could not have them.

David always loved school, but the dislocations imposed by his mother, and the hunger and absences posed by his foster parents, often affected his grades. One he is stable and fed, he gets straight A’s. As a high school junior, he joins the Foster Youth Advisory Council and begins attending annual meetings in Washington. But even with loving foster parents, David is tired of the system. He emancipates himself with the help of a fictitious custody arrangement with his siblings’ father and goes off to Spain for a miraculous year of healing and fun with a loving host mother. He applies and is accepted to his dream school, Vassar, with a generous financial aid package.

Even with his financial aid, David struggles to buy books and to survive during school breaks. (It is not clear why he does not ask Holly and Steve for these things or return to them for the holidays; it seems to be a matter of pride or reluctance to burden them.) He eventually gives up on fulfilling his mother’s dream that he become a doctor and switches his major to political science and his plan to law school, remembering his experience as a White House intern the summer before. At a meeting of the Foster Youth Advisory Council, he agrees to be a liaison to a collaboration working to help gay foster youth. That’s when he comes out as a gay man. The story ends with his graduation from Vassar in May 2002. He is on his way to UCLA to study law and public policy. Now, Ambroz works for Amazon as head of Community Engagement (West) and is the founder of Fostermore.org, an organization that encourages those in the entertainment industry, businesses, and nonprofits to raise money and heighten awareness about the needs of foster children.

A Place Called Home provides some important corrections to the prevailing narrative in child welfare. That narrative features struggling parents who are doing the best they can, and who are being persecuted by an evil “family policing system” that is dead set on removing their children. Clearly, that is not the story of David Ambroz and his siblings. At every stage of the child welfare process–reporting, investigation and reunification–the deck was stacked against the children’s interest in safety and stability and in favor of their mother’s keeping them. While it has been some years since David Ambroz was an abused child (he does not give his date of birth but we know that he graduated from Vassar in 2002 and we can assume he was born close to 1980) the problems he identified are very familiar to those with knowledge of the system and indeed some of them may even have worsened due to the current ideological climate in child welfare.

Failure to Report: The number of people who knew that David and his siblings were suffering but took no action to help them is truly staggering. As Ambroz puts it, “Priests, rabbis, teachers, shelter directors, church members, welfare employees and Aunt Flora have all been witnesses to our bruises and lice, our hunger, a ceaseless tide of neglect and abuse.” David acknowledges that reports were made and the children were even removed once or twice, but the vast majority of people who witnessed their abuse apparently did not report it. We often hear similar stories in the wake of a child’s maltreatment death. For example, eight-year-old Dametrious Wilson was killed by his aunt in June 2022. Though he missed 60 days of school in the year before he died, his Denver Colorado school never reported his absences as required by law, even when his aunt said she was keeping him home “for few weeks” as punishment for his behavior!

And yet, today there is a groundswell of opposition to mandatory reporting and serious proposals to eliminate it, mostly on the grounds that children of color are disproportionately reported. It is true that a staggering proportion of Black children are investigated by CPS; it has been estimated that over half of Black children experience a CPS investigation by the time they turn 18, compared to 28 percent for white children and 37 percent of all children. It is possible that reporting is overused in some communities and underused in others. But it seems more logical to address these problems directly (and also educate ordinary citizens about the need to report suspected maltreatment) rather than eliminating mandatory reporting itself.

Flawed investigations: Even when reports were made, the investigations were often flawed. Ambroz states that “Over the years we’ve been investigated many times without getting help. Mom always fights to keep us, and it’s a battle she’s mostly won.” So what went wrong? Ambroz gives us part of the answer when he explains that social workers and police interviewed him at least twice in front of his mother. Both times he recanted and denied the abuse he had alleged earlier, knowing that he risked severe punishment for telling the truth. It seems obvious that children should be interviewed away from their parents since either love or fear or both will lead them to lie. Yet, this clueless and dangerous practice of interviewing children in front of the alleged perpetrator contnues in many jurisdictions. In Minnesota, a young woman named Maya, who was forced to report her fathers’s sexual abuse while he was listening, worked with an advocacy group to draft Maya’s Law, which required that Minnesota children be interviewed privately regarding allegations of abuse. But like the previous attempts, Maya’s Law failed. Instead, the language was revised to read “When it is possible, and the report alleges substantial child endangerment or sexual abuse, the interview may take place outside the presence of the alleged offender…” Sadly, many “advocates” for Black and indigenous children argued against the requirement for private interviews, fearing that it would increase disproportional involvement of these groups in child welfare.

Unwarranted reunifications: Even when David and his siblings were removed from their mother briefly, they were returned at least twice with no indication they would be safe. When Mary returned from the psychiatric ward after throwing a shoe at a judge, “nobody cared that we are being put in the custody of a homeless woman who’d recently thrown a shoe at a judge in a court of law.” We know that many children are reunified with their parents despite a lack of evidence of any change in their behavior or capabilities. In Lethal Reunifications, I wrote about two such cases that ended in a child’s death, but clearly that is just the tip of the iceberg. We never know about the children left to suffer in silence, unless they decide to write about their experiences.

Necessity of foster care in some cases: The current narrative holds that foster care is almost never necessary. But David Ambroz’s story reveals the stark truth that some children must be removed in order to be saved. Of course every effort should be made to help parents conquer their problems while monitoring children for safety in the home. But in cases of chronic maltreatment, ingrained patterns may be impossible to change. As Dee Wilson put it in his briliiant commentary on chronic multitype maltreatment, “Chronic neglect is marked by the erosion or collapse of social norms around parenting resulting from chronically relapsing conditions.” There is no better example of such collapsed social norms than Mary Ambroz, who had completely lost any sense of responsibility to keep her children clothed, fed, and housed, not to mention to avoid abusing them. In such cases, it is wrong to sacrifice the well-being of the child or children for the general value of family preservation.

Ambroz’s story also provides a needed antidote to the current trope that what child welfare describes as neglect is actually just poverty. The confusion of poverty with neglect is a pernicious misconception being perpetrated today by those who wish to eviscerate the child welfare system. David’s story clearly shows the difference. He says of the mother of friends they make in Albany: “Aurora and her sons are poor like us, and yet she still manages to take care of them. She feeds and clothes them. She cares about where they are when they roam around at night. She gives them a home that is stable in all the ways I’ve never dreamed.” And there, in a nutshell ,is the distinction between poverty and neglect.

The dominant narrative portrays foster care as harmful for children and even abusive at times. That part of the narrative is accurate for the first part of David’s time in care, when the system proved incapable of keeping David and his siblings safe, let alone meeting their needs. Among the major reasons for this failure, Ambroz draws attention to the lack of qualified foster parents and overwhelmed social workers.

Lack of Qualified Foster Parents: David fell victim to one of the scourges of our system, insufficient numbers of good foster parents. For this reason, he was initially placed in a facility for juvenile delinquents where he was abused for being gay, and then in a totally unsuitable home. In Buck and Mae, David provides a classic example of a couple who become foster parents to make ends meet. The foster care payments they received helped Buck and Mae keep their house and clothe their children. It is not surprising that such foster parents exist: some foster care agencies leave recruiting brochures in food stamp offices and laundromats; one that I worked for advertised in in a publication called the PennySaver. And yet, even when David’s siblings ran away and their abuse allegations that were taken seriously enough that the agency decided to send no more children to this couple, they were allowed to keep David. One reason, as Ambroz points out, is that there are not enough foster parents, especially for large sibling groups, so the focus is on finding any “bed” for a child. As a foster care social worker in the District of Columbia, I knew many foster parents who were motivated mainly by money. My recommendations to fire such foster parents were never accepted because the agency needed the beds.

To address the shortage of good foster parents, Ambroz recommends recruiting more middle and upper-income foster parents with higher education degrees. In order to do this, he suggests providing benefits that might attract such parents, such as government pensions, participation in the federal employee health plan, and access to free or subsidized tuition and state colleges and universities. I’m not confident that any of these benefits will attract more educated foster parents, and financial incentives also pose the risk of attracting more educated versions of Buck and Mae. Perhaps the lesson of David’s story lies the willingness of Holly and Steve to be his foster parents and the unresponsiveness of the system to this request. There is now a big push to locate kin who can care for children who are removed–and this may be happening much more frequently than when David and his siblings entered care. Perhaps agencies can do more to find unrelated adults who may have bonded with children as their teachers, parents of their friends, mentors or employers, who might serve as foster caregivers. This is certainly done; I myself agreed when asked by CPS to provide a temporary home to a friend of my son’s. If most children who are removed could be placed with adults known to them, it would be easier to fire the Bucks and the Maes and reserve the great foster parents for the children for whom no known adults are available.

Overwhelmed social workers: One reason David’s social worker did not jump at the chance to move him to Holly’s home may be that she was overwhelmed. “I have a rotating cast of social workers, who don’t have the bandwidth to pay attention to anything but immediate and obvious problems,” Ambroz reports. Based on my experience as a social worker in foster care, I could not agree more. Foster care, especially for older and more troubled children, is plagued with constant crises. With caseloads in most jurisdictions far too high, social workers have no time to deal with anything besides the latest crisis. Contributing to the problem are frivolous paperwork and metrics that have nothing to do with child wellbeing. Between the foster parents who did not perform the most basic parental responsibilities, and the caseloads that were too high for me to pick up the slack, I could not spend the time I needed to ensure that each child received the care they needed to thrive, and I eventually left the job.

David Ambroz recommends attracting more and better social workers by decreasing their caseloads and increasing their pay and benefits by either a salary increase or alternative compensation such as student loan forgiveness and home loan assistance. These are excellent ideas. There are other ideas worth considering, such expanding and publicizing the current Title IV-E social work education program that provides tuition assistance for social worker students who want to go into child welfare. Also worth considering are recruiting among populations that do not traditionally seek these jobs, such as military retirees, and perhaps changing education requirements for social workers in child welfare to allow other backgrounds besides social work.

Flaws in the Analysis

While David Ambroz’s story is powerful and carries many important lessons, his acceptance of the current child welfare zeitgeist may have prevented his drawing the conclusions that logically flow from his story. First, he buys into the currently popular misconception that parents are being found neglectful when they are simply poor. Second, he misses the opportunity to advocate for strengthening child protection services, not weakening them.

Poverty vs. neglect: While I’ve already described how Ambroz’ story contradicts the currently popular assertion that “neglect” is synonymous with poverty, he unfortunately repeats that same trope. Describing the domestic violence shelter staff’s decision to place the family in an apartment after observing Mary Ambroz’s abuse of her children, Ambroz states that “[T]his is a pattern that is repeated across the country–children in poverty are given kernels of assistance but are rarely rescued from their circumstances.” But David and his siblings were abused children, not just children in poverty. As mentioned above, he acknowledges that other poor families were not like theirs. By confusing poverty with maltreatment, Ambroz loses a key opportunity to clarify the difference between these problems and to explain that eliminating maltreatment requires more than just economic assistance .

Child protection failures: In his list of policy prescriptions, included in an appendix to the book, Ambroz does not address any of the problems with CPS that were revealed in his memoir. He focuses mainly on foster care, as if his earlier experience as an abused child did not have policy implications. Ambroz could have thrown his weight behind mandatory reporting in light of the movement to end it and could have argued for education of all citizens on the need to report suspected abuse. He could have supported reforms requiring that children be interviewed away from her parents. But these such policies are opposed to the current climate in child welfare which favors hobbling or eliminating CPS and minimizing interference with families. Ambroz appears to be determined to stay within the mainstream, saying “the best way to reform foster care is to decriminalize poverty and help families remain intact whenever possible with wraparound support–be it jobs, mental health care, or whatever is needed.” If abused and neglected children can remain safe with wraparound support that is clearly the best option, but to receive this support, these children must be identified through reporting and investigation. It is unfortunate that Ambroz did not recognize the discrepancies between some of the lessons of his story and the dominant narrative in child welfare and missed the opportunity to spell them out.

Despite its flaws, Ambroz’s story takes its place with other haunting memoirs of abused children, like Stacey Patton’s That Mean Old Yesterday, Regina Calcaterra’s Etched In Sand, and most famously Educated by Tara Westover, which put the lie to the current narrative of good parents vs. the evil state. If only Ambroz had recognized the conflict between his narrative and the dominant one, his book would be even more useful. But the story speaks for itself; the commentary is secondary. David Ambroz’s story is a must-read for anybody who cares about the abused and neglected children among us, including those who are in foster care.

*The doctor was the father of Alex and Jessica, but Mary Ambroz never told David who his father was.