Tag: foster care

No, family separations are not all the same

child protectionThere is an old political adage that you should “never let a crisis go to waste,” meaning that a crisis can awaken public interest and create an opportunity to advance policies that might otherwise be unachievable.

President Franklin D. Roosevelt, for instance, was able to pass much of his New Deal – including a dramatic expansion of the country’s social safety net via the Social Security Act – in the wake of the Great Depression with the American economy in shambles and the American public desperate for government support.

Unfortunately, in a cruel twist of irony, some child advocates are now using the devastation wrought by the Trump administration’s separation of children from their parents at the U.S.-Mexico border to advance arguments undermining a key part of the Social Security Act – support for children who cannot be cared for in their own homes.

Several weeks ago, Sherry Lachman, the executive director of Foster America, authored a Time essay suggesting “family separation is not just a problem at the border.” In this piece, Lachman bizarrely equates the separations at the border with removals of U.S. children from their homes by child protective services, suggesting even the latter are “inherently toxic.”

And last week, Vivek Sankaran associated the two systems, misleadingly citing statements in an opinion piece that were made about the border separations to attack child removals by child protective services – without disclosing that these statements actually referred to the latter rather than the former. Sankaran quotes Dr. Charles Nelson, professor of pediatrics at Harvard, as follows: “[T]here is so much research on [child removal] that if people paid attention at all to the science, they would never do this.”

Finding it hard to believe that a distinguished Harvard professor would suggest that children should never be removed into foster care, we contacted Dr. Nelson, who explained that his words were taken out of context, as he was referring to separations at the U.S.-Mexico border and not the removal of children from abusive or neglectful homes. Dr. Nelson agreed that any comparison of the two systems is misconceived, noting: “It is inappropriate to compare children experiencing forced separations from their parents in the context of migration to children removed from parental care due to maltreatment (abuse, neglect).”

The separation of children from their parents at the U.S.-Mexico border was an ill-conceived policy that arose from the desire to discourage migration. Rather than being aimed at protecting children, this policy was adopted despite the obvious fact that it would be extremely harmful to them.

The child welfare system, on the other hand, was created to protect children from harm inflicted by their own parents or guardians. It is a sad fact that some homes are dangerous to their own children. Forty-nine states reported 1,700 child fatalities due to abuse or neglect in 2016, and there is wide consensus that this is likely an under count. We don’t know how many more are severely injured but survive; it is doubtless much higher.

And deaths and severe injuries are only the tip of the iceberg. There is extensive literature on the lifelong consequences of child abuse and neglect. These include chronic health conditions, impaired brain development, poor mental and emotional health, social difficulties, juvenile delinquency and adult criminality, alcohol and drug abuse, and an increased likelihood of abusing one’s own children.

Moreover, foster care is a rarely-used intervention by CPS. Most systems try hard to keep children at home by providing services to the parents to help remedy the conditions that caused the maltreatment. In 2016, according to federal data, agencies placed slightly over 200,000 children involved in maltreatment investigations in foster care and provided other post-investigation services to about 1.1 million children and families.

Yes, removing children from their parents is often traumatic to the child. But it goes without saying that in some terrible home situations, the damage to a child of staying in the current home would be greater than the damage caused by removal.

As Dr. Nelson puts it:

Of course we would like to see the biological parents be successful in changing the family dynamics and preserving the parent-child relationship but if that is impossible, and the harms to the child continue, then the child should be removed from the home, either temporarily, if the home situation can be remedied, or permanently.

But, it is of utmost importance to act with alacrity – I think in many cases children are left for far too long in their biological homes and by the time they are placed into foster care or adoptive care, they may be irreparably harmed.

Setting aside the vastly different reasons for, and targets of, family separations at the border and child removals by child protective services, there are huge differences between the two sets of policies. Cathy Senderling-McDonald recently wrote an instructive and comprehensive summary of the distinctions, outlining the vast differences in living conditions, objectives, legal structure and oversight.

Using the suffering of parents and children at the border to denigrate foster care is not merely an illogical comparison, it is a harmful one that can result in suffering, lifelong damage, and even death to children. Moreover, it is offensive to those professionals who have devoted their lives to protecting children, and to the children who have suffered and died for lack of such protection.

Let us be clear: we want to prevent children from being removed from their parents whenever it is safe and appropriate to do so.

But let us be equally clear: until we eliminate serious child maltreatment and endangerment from every home, there will always be a need for foster care to keep kids safe. To pretend otherwise is naïve, dangerous and irresponsible.

This op-ed was published in the Chronicle of Social Change on September 6, 2018. I wrote it with Sean Hughes, the director of government relations for the consulting firm Social Change Partners. 

 

Child Welfare Myths: Black/White Disproportionality in Child Welfare is due to Racist Child Welfare System

Graph: http://www.childrends.org

According to federal data, black children were 13.8 percent of the total child population in the United States in 2014. Yet, they constituted 22.6 percent of those identified as victims of maltreatment, and 24.3 percent of the children in foster care. In Minnesota, the disparities appear to be even greater. Citing these disparities, two legislators have proposed the Minnesota African American Preservation Act.

The Act would create an “African American Child Well-being Department” within the Department of Human Services to receive notification of all cases involving African-American children and “directly  oversee, review, and consult on case plans and services” offered to these children. It would also create an African American Child Welfare Oversight Council.  Similar to the Indian Child Welfare Act, it would set a higher bar for removing African American children from their homes than white children and require greater efforts to reunify children once removed from their families.

The bill’s sponsors argue that racial disparities in child welfare are caused by differential treatment of minority families in terms of how allegations of maltreatment are investigated, resolved, and responded to. This is belief, which was supported by early research, has become accepted by the child welfare establishment.

The idea of racial bias in child welfare found support in the first two National Incidence Studies of Child Abuse and Neglect, which were published in the 1980s and 1990s. These studies, which attempt to count all episodes of abuse and neglect rather than just those that are reported and substantiated, suggested that there was no difference in black and white child maltreatment rates. The study authors suggested that black families received differential treatment by child welfare systems, resulting in their over-representation in these systems.

Starting about 2004, a coalition of foundations, nonprofits, and academics formed around the idea that this disproportional representation of black children in child welfare stemmed from a racist system. This coalition launched a well-funded campaign to reduce the representation of black children in child welfare and especially foster care. They issued reports, held conferences, and provided training and technical assistance to help states analyze their disproportionality problems.

As a result of this work, agencies around the country have adopted strategies like staff retraining, creating special administrative structures to advance racial equity, and special data collection efforts. As a social worker in the District of Columbia, I was subjected to multiple, often poor-quality trainings that tried to help me discover my hidden biases so that they would not affect my treatment of families. 

The fact that child welfare workers in many jurisdictions are disproportionately African American has not influenced the consensus in favor of such strategies, as pointed out in an excellent article by Naomi Schaefer Riley. When I pointed out in a training class that most District of Columbia child welfare social workers were African-American, I was told that did not matter, as Black social workers could be as racist as white ones.

But a cascade of new research has cast grave doubts on the accepted theory of disproportionality. The fourth (larger and more rigorous) National Incidence Study published in 2010 using data collected in 2005 and 2006 estimated that black child maltreatment rates were almost twice as high than those of whites. Further analysis showed that this difference was present in the earlier study, but due to small sample sizes, the differences were not statistically significant and hence not reported.

A conference, convened in 2011 by Harvard, Chapin Hall at the University of Chicago, the National Council of Juvenile and Family Court Judges and the National Court Appointed Special Advocates, brought together leading scholars on child welfare and race in front of an audience of child welfare leaders from around the country. A research brief summarizing the conference that was published by Chapin Hall concluded that “there is a significant black/white maltreatment gap, one that roughly parallels the gap in official maltreatment reports. This evidence contradicts the belief that black children are included at high rates in the child welfare system because of bias.”

The brief’s authors based their conclusions on the National Incidence Study as well as other empirical work reinforcing the conclusion that child maltreatment rates are significantly higher for black children. They suggested that the higher rate of maltreatment among African-Americans stems from the history of slavery and racism, which led to higher poverty and concentration in impoverished neighborhoods characterized by crime, substance abuse, unemployment, and limited community services.

In other words, disproportionality is rooted in racism. But It’s not a racist child welfare system that results in disproportional representation of black children in the child welfare system. Rather, it is the racist history of our country that has created the difference in child maltreatment which in turn resulted in disproportional representation.

The researchers concluded that trying to reduce racial bias in the system is not the way to address the inequity between blacks and whites in child welfare. Instead, we need to address the underlying social conditions. And until we can do that, we need to protect children, both by preventing maltreatment and by providing appropriate protective services.

Since the Harvard conference, the evidence continues to accumulate that black and white maltreatment rates differ. A recent study published in the journal Pediatrics concluded that the child abuse fatality rate for children aged four and under was 8.0 per thousand African-American children, compared with 2.7 per 100,000 white children.

Unfortunately, many child welfare agencies, advocates, and legislators, including the sponsors of the Minnesota legislation, are either unaware of, or do not want to recognize, the new consensus among researchers. As The Los Angeles Times put it:

“Many left the [Harvard/Chapin Hall] conference believing that any caseworker bias against black families accounted for only a small portion of the disparity in foster care rates … Yet, Los Angeles County officials pressed forward with programs that assumed that racial bias was a significant cause for the high rate of [foster care placement] of black children.”

As I have written in the past, Native American children have been victimized by a similar type of reasoning. The Indian Child Welfare Act has been responsible for separating Indian children from loving foster families and placing them with relatives they do not know. On some occasions, these relatives have hurt or killed them.

This focus on reducing alleged systemic bias may do more harm than simply wasting child welfare resources on bureaucracy and training. If black children are more likely to be maltreated, equalizing black and white representation in the child welfare system would leave many black children in danger of years of suffering or even death. As Naomi Schaefer Riley put it, “No it’s not racist to save minority children’s lives.”

Let’s recognize that foster care is a job–and pay accordingly

Being Beautiful Foundation
Image: Being Beautiful Foundation Facebook Page

 

May is Foster Care Month, and nobody deserves more honors than our nation’s great foster parents. But unfortunately, there are not enough of these true heroes to go around. Part of the problem is the myth that undergirds foster care in America: that fostering is not done for financial gain.

I have known several great foster parents. They include Mr. and Mrs. A, who must have attended every train-related attraction to feed their foster son’s fanaticism. There was Ms. B, who continued to host her two foster kids for weekends–and give them money–for years after they returned home to their mother. There are Mr. and Mrs. C, who never missed a parent conference or school event and who got their foster kids into a high-performing public charter school. For these great foster parents, foster care is a calling. Unfortunately, there are not enough of them.

For every Mr. A, Ms. B or Mrs. D, there is a Ms. X, who had never in an entire year been to her foster child’s school for a meeting, back to school night, or to see her in a performance. The child was never able to attend an evening activity at her school because the foster parent would not take her. Ms. X even refused to pick her up when she was throwing up; I had to go. Then there was Ms. Y, who refused to go to a meeting with her foster child’s teacher and therapist to improve the child’s school performance. She said, and I quote, “If I cared, I would go, but I don’t care.”

Ms. Y  worked the 3:00 to 11:00 shift, leaving for work about the same time her foster child arrived from school and not returning home until the teen was–or should have been–in bed. Most other foster parents worked full-time and were out of the house from early morning until after 6 pm. Most of them, unlike “real” parents, insisted that they could not take off work for any reason related to their foster child, be it a medical emergency, a school meeting, or a therapist’s visit.

It is time to stop pretending. A significant proportion of foster parents are fostering for the money. Some of them also like children, but they would not do it if not for the income. We pretend that fostering is an act of love, and therefore we pay foster parents only the amount we deem to be enough to support the child. That ensures that many children will not be supported adequately, since the foster parents are going to take their “salary” off the top before spending any money on the children.

The results of this fiction are visible everywhere. Of the 26,000 teens responding to a survey of New York youth in foster care in January 2018, nearly a quarter reported “lacking clean and appropriate clothes to wear, shoes that fit, and three meals per day.” This is not acceptable.

Our foster children need more than mediocre or bad foster parenting. Most of them have undergone trauma or serious neglect that has harmed their developing brains. And all have undergone the trauma of removal from their homes. They all need extra stimulation and therapeutic parenting, not benign indifference or worse.

Social workers are another casualty of bad and mediocre foster parents . I left my job as a foster care social worker after five years because I could no longer parent 10 troubled teenagers. After my fifth visit to the psychiatric emergency room with a child whose foster parent would not take them, I knew I could not do it any more.

Why aren’t these foster parents dismissed? As almost everyone knows thanks to daily news articles, there are not enough foster parents to provide homes for all the children in care. The nationwide foster parent shortage around the country is resulting in children sleeping in offices and hotels and bouncing from one inappropriate placement to another.

As a result of this crisis, agencies are unwilling to dismiss foster parents who are not doing their job, or even worse. Every year I had to fill out an evaluation of each foster parent. But when I said that Ms. X or Ms. Y should be dismissed, my superiors never listened. On May 18 Dahn Gregg, a social worker with the Oklahoma Department of Human Services (DHS)  reports that she wrote a letter to her supervisors claiming that the agency is placing children in unsafe foster homes. She told Channel 9 that these were families with serious mental health issues, homes where methamphetamine was used and sexual offenders were in and out of the home. Three days after writing the letter, Gregg was fired. (Oklahoma has been praised for doubling its number of licensed foster beds while other states are losing foster home capacity.)

What can be done? People talk about increasing kinship care and foster parent recruitment. Those are important strategies but unlikely to close the gap. Relatives are already bearing much of the caregiving burden and we cannot forget that many kin may may share the dysfunctional parenting styles of birth parents. We cannot accept unsuitable or even dangerous caregivers out of desperation.

We need to think about recruiting a new population–people who would not think of being foster parents unless they were paid a salary so that at least one adult per household could forego full-time work. This might bring in people who want to work with youth and might otherwise seek a job in human services. It might include mothers or fathers who want to stay home with their own children as well as their foster kids.

To make professional foster care economically feasible, foster homes could be larger, housing four to six children. Examples of such programs include Neighbor to Family, which provides professional foster care to sibling groups in the same home. Some  programs provide housing to foster parents in “foster care communities” which provide the added benefit of community support and programmatic resources on site. These include SOS Children’s Villages in Illinois and Florida, and  Pepper’s Ranch in Oklahoma. Some large foster homes, such as the Being Beautiful Foundation in Philadelphia, are licensed and funded as group homes.

One might worry that paying foster parents more would bring out of the woodwork even more people who are in it for the money. To prevent this, standards and training requirements for professional foster parents would have to be much higher than for traditional foster care.

Child welfare leaders at all levels need to begin a conversation about professionalizing foster care. Clearly, professional foster care is more expensive than traditional foster care. But considering the long-term costs (in welfare, criminal justice, and loss of economic activity) of not addressing the needs of the traumatized children in care, the money would be well spent.

 

 

Opioid Crisis: New federal report shows child welfare impact

opioid crisis
Image: Youth Today

After more than a decade of decreasing, the national foster care caseload rose by 10% between 2012 and 2016. Many public officials and commentators have blamed this increase on parental substance use, especially due to to the opioid crisis, but evidence has been lacking on the national level to support this conjecture. A new report from the Assistant Secretary for Planning and Evaluation (ASPE) of the U.S.  Department of Health and Human Services provides new evidence linking substance abuse with increasing foster care caseloads. It also highlights the daunting challenges facing those professionals at the interface of child welfare and substance abuse in hard-hit areas, and highlights the urgency of helping them meet these challenges..

The ASPE researchers obtained data on drug overdose deaths and hospitalizations and child welfare indicators for all of the counties in the US. They conducted quantitative analysis and statistical modeling to assess the relationship between substance abuse and child welfare. They also conducted interviews and focus groups with child welfare administrators and practitioners, substance use treatment administrators and practitioners, judges and other legal professionals, law enforcement officials, and other service providers who work with families affected by substance abuse in counties that are being hard-hit by the opioid crisis. Their key findings include:

  • Caseloads: There is a correlation between the severity of a county’s drug crisis and the burden on its child welfare system. The researchers found that when related factors are controlled, counties with higher rates of overdose deaths and drug hospitalizations had higher child welfare reports, substantiations, and foster care entries.
  • Nature of Cases: The researchers also found that higher rates of substance abuse overdoses corresponded to more “complex and severe child welfare cases,” as measured by a greater proportion of children with maltreatment reports that were removed from their homes. Substance abusing parents have multiple issues including domestic violence, mental illness and extensive history of trauma. Professionals in hard-hit areas described great difficulty in reunifying families due to the multigenerational nature of the epidemic (reducing the availability of kin caregivers) as well as the weakening and loss of community institutions including churches over time.
  • Treatment Challenges:  Several major challenges affect agencies’ ability to get treatment for substance-abusing parents. These include cursory and delayed assessments resulting in treatment delays; misconceptions about Medication Assisted Treatment (MAT), which has been found to be the most effective treatment for opioid use disorder; and lack of treatment options matching parents’ needs, including family-friendly treatment options.
  • Systemic Barriers: Agencies are struggling to meet families’ needs due to multiple systemic factors including inadequate staffing leading to unmanageable caseloads, shortages of foster homes, and difficulty coordinating between systems and states (in the many counties that border other states).

This study has many policy implications. Unfortunately, all of them involve the need for increased financial resources both within the child welfare system and beyond it. The nation’s supply of effective drug treatment needs a major boost. Child welfare systems need financial help to improve assessments, hire new staff and train all staff on substance abuse and treatment, and increase the availability of high quality placement options for the children affected by the substance abuse crisis.

  • Treatment. More treatment programs are needed to meet the needs of parents involved with child welfare. In particularly, the study documented shortages of MAT and family-friendly treatment options. Clearly the opioid crisis is much broader than its impact on child welfare and requires a much broader response. In a full-page editorial on April 22, the New York Times stated that Congress has taken only “baby steps” so far in addressing this crisis by appropriating only a few billion dollars over the past few years. The Times quotes Andrew Kolodny, co-director of opioid policy research at Brandeis University, that “at least $6 billion a year is needed for 10 years to set up a nationwide network of clinics and doctors to provide treatment with medicines like buprenorphine and methadone.” Supporters of the recently–passed Family First and Prevention Services Act, which allows Title IV-E foster care funds to be used for drug treatment and other services to keep families together, have exaggerated its potential to help parents obtain treatment. If the treatment slots do not exist, money to purchase treatment won’t help. Moreover, many or most parents involved with child welfare already have Medicaid or other insurance that could pay for treatment if it existed.
  • Assessment. It is crucial that parents involved with child welfare receive thorough assessments of their substance abuse and other needs. The lack of proper assessments is a also problem for parents and systems not affected by the opioid crisis. A change in the standards of child welfare practice requiring a thorough assessment, conducted by a licensed professional, for each parent with a child in foster care, is necessary. Of course this would require additional funding.
  • Training. Lack of knowledge among professionals about the efficacy of different treatment options can prevent parents from obtaining the most effective treatment. Child welfare and court staff need training in substance abuse and treatment options just as they need training in mental health, domestic violence, and other issues facing many of their clients.
  • Staffing. In areas that are overwhelmed by cases due to the substance abuse crises, staff shortages lead to burnout, which in turn leads to more departures and increased shortages. These staff shortages are dangerous to children and to staff themselves and should not be allowed to continue.
  • Foster placements. More placements are clearly needed in some hard-hit areas, but it is not likely that enough traditional foster homes can be found, especially in light of the widespread nature of the substance abuse epidemic in some of these areas. That’s why we may need to look at new placement options, including family-style group homes and professional foster homes for four to six children, including large sibling groups.

The new study from ASPE has received a shocking lack of attention. It adds new, more rigorously collected evidence to the avalanche of media reports that have documented the impact of the substance abuse crisis on children and families.  So far, the nation has not responded to this crisis with the urgency it demands. We will pay a high cost in the future–in broken families and damaged children–if we don’t provide the needed resources now.

 

 

 

 

Child Welfare Myths: Foster Care Is Worse than Remaining Home

removed kids
Image: Fox 26 Houston

As a field, child welfare seems to be particularly vulnerable to myths and misconceptions, which are often backed up by inaccurate interpretations of research. Unfortunately, these myths and misconceptions, when promoted by powerful and wealthy advocates, can be perpetuated and enshrined into policy.  This is the beginning of an occasional series in which I attempt to deconstruct some of the most common myths. We start with one of the most common and potentially destructive–the myth that children left with their families always do better than they would if placed in foster care.

This myth was recently exhibited in all its glory by the Arizona Star as part of a major series on child welfare in that state. Here is how reporter Emily Bregel describes a frequently quoted study.

Research indicates that children left with their own troubled families fare better than those brought into the foster care system. A 2007 study found children whose families were investigated for abuse and neglect but remained home were less likely to become teenage parents or juvenile delinquents than similarly abused children who were removed from home. Those left at home were also more likely to have jobs as young adults, compared with children of similar backgrounds who were put in foster care.

This oft-misquoted study was published by Massachusetts Institute of Technology’s Joseph Doyle in 2007. Doyle’s study has been used relentlessly–and often inappropriately–by advocates of reducing foster care placements. Doyle used a creative method to estimate the effects of foster care on Illinois children ages 5 to 15 who were receiving welfare and who were investigated for maltreatment for the first time between July 1, 1990 and June 31, 1991. He compared long-term outcomes (delinquency, teen motherhood, and employment)  for the children assigned to investigators with higher removal rates to outcomes for those assigned to investigators with lower removal rates.

By comparing the outcomes for the two groups, Doyle could estimate the effects of being placed in foster care for children who were on the margin of placement–those who might have been placed by one investigator and not by another. For those children, Doyle found large differences favoring those children who were not removed from their homes. Doyle’s results say nothing about the children whose cases were unambiguous and who would have been placed (or not placed) regardless of the investigator.1

Obviously, we cannot do a controlled experiment in which the same child is both placed and not placed in foster care to get at the true difference that it makes in children’s lives. Perhaps the best we can do is ask the children themselves. Researchers at the University of Chicago’s ChapinHall research center surveyed 727 sixteen and seventeen year olds who had in foster care in California for at least six months. When asked about their treatment by their parents or other caregivers before entering foster care, 36% reported that they were hit hard with a fist, kicked or slapped; 32.4% reported that a caregiver threw or pushed them; 28.4% reported missing school to do chores or care for a family member; 28.3% reported having to go without things they needed because the parent’s paycheck was spent on “adult interests,” 26.4% reported that their caregiver beat them up; and 24.9% reported that their caregiver failed to protect them from harm by someone else. A shocking 29.7% reported sexual molestation and 20.7% reported rape. Horribly, 18.6% reported that their caregiver tried to choke, smother or strangle them and 16.9% reported being locked in a closet or room for several hours or longer.

When asked about characteristics of the parent or caregiver they lived with before entering foster care, 48.8% reported inadequate parenting skills, 49.7% a criminal record, 48.3% drug abuse, 48.8 alcohol abuse, 33% reported that a caregiver was abused by or abused a spouse or partner and 25.6% said a caregiver had mental illness. In addition, a total of 56.9% reported that they either agreed, strongly agreed or very strongly agreed with the statement, “All in all I was lucky to be placed in the foster care system,” while only 17.6% disagreed.

The California survey suggests that more often than not, foster care is an improvement over families where children are unsafe, fearful, hungry, unsupervised, or unloved. However, I have learned from my own experience as a social worker that, while some children make the miraculous journey from hell to heaven when they are placed in the best foster homes, many foster homes are only slightly less chaotic and more nurturing than the homes from which the children have been plucked. The beatings, rapes, and hunger may be over but many children and youth continue to be neglected emotionally, educationally, and in other ways in foster care. When combined with the trauma caused by separation from family, it is not surprising that young people whose home lives were on the border between acceptable and unacceptable to an investigator may do worse in foster care than they would have done at home.

Neglect of children in foster care is inexcusable: these children need more than the usual nurturing in order to make up for the trauma and deprivation they may have already suffered in their birth homes. That’s why we need to increase the number of children placed with kin as well as other alternatives to traditional foster care, such as residential schools and hybrid arrangements that combine features of foster and group homes. But what we don’t need to do is abandon children in homes where they are not safe.

The misuse of Doyle’s article has supported the ideas that it is always better to reduce the number of children in foster care and that reduced care numbers are a prima facie indicator of improvement. It has led to many systems, like that of my home town of Washington DC, using reduction of foster care numbers as an outcome in itself–independent of trends in actual maltreatment. Using foster care reduction as an indicator of success fails to recognize that some placements are needed to keep children safe. It also means that jurisdiction, like New York City for example, may be claiming partial credit for the results of gentrification.

The misuse of research and data, especially when translated into policy, should disturb everyone regardless of their feelings about the particular issue. Doyle’s research suggests that when the case for removal is marginal, the default option might be to keep the child at home–with supervision and services by the state. It does not suggest that removal of a child from home is always the wrong decision or that programs should be rated solely on the ability to cut foster care rolls.

  1. Another problem with making inferences from Doyle’s study about foster care today is the age of his data, which are from 1990 and 1991. Child welfare culture and practices have changed greatly since that time and the relevance of research from 25 years ago is questionable. ↩

New book debunks prevailing child welfare myths

After the Cradle FallsA new book by two leading child welfare researchers aims to elucidate the complex world of child welfare for the general public and policymakers.  In After the Cradle Falls, Melissa Jonson-Reid and Brett Drake of Washington University provide a useful primer for the child welfare field. While they may be overly optimistic in assuming that a lay audience will pick up this book, it will certainly be useful for policymakers, journalists, students and advocates who want a general overview of child abuse and neglect, child welfare systems, and proposals for change.

Jonson-Reid and Drake make a particularly valuable contribution by highlighting myths and common misconceptions that are rife in the child welfare field. Among the common myths they debunk are the following:

  • “Neglect” is just another word for poverty, and parents become embroiled with Child Protective Services just because they are poor. Johnson-Reid and Blake explain that while poverty increases the risk of neglect, most parents who are poor do not neglect their children. Neglect is much more serious than a missed dental appointment or a messy house. Some neglect cases are extremely severe, even fatal. But even less severe cases can result in devastating lifetime consequences on brain development and the ability to form relationships.
  • Racial disproportionality in child welfare involvement is caused by racist decision-making by Child Protective Services (CPS). There is no dispute that African-American children are overrepresented in child welfare services and foster care compared to their share of the population. But Jonson-Reid and Drake conclude that “it is hard to find current empirical data that suggest that widespread bias within today’s CPS system is a significant driver of current disproportionality.” It would have helped if they had included the key research finding that actually debunked the myth about racism and disproportionality. As I have explained elsewhere, research has conclusively shown that higher Black representation in the child welfare system reflects higher rates of maltreatment in African-American families. This Black/White maltreatment gap may in turn reflect the relationship between race and poverty, as Jonson-Reid and Drake suggest.
  • State and local agencies have an incentive to take more kids into foster care. This trope was mentioned over and over again by supporters of the Family First and Prevention Services Act (FFPSA), which was signed into law on February 9, 2018. Jonson-Reid and Drake rightly give it short shrift. They explain that states are required to make “reasonable efforts” to keep children with their families and can be sanctioned by the federal government if they fail to document that they have made such efforts.  The authors could have cited some other key evidence against this myth.  For example, only about half of children in foster care are eligible for federal foster care support under Title IV-E of the Social Security Act and the federal government pays only part (50 to 83% depending on the state) of the cost. States and localities spent about $8 billion on foster care in FY 2014, 47% of their total child welfare spending, so it is hard to understand how they could have an incentive to place children in foster care. Moreover, states have access to other federal funds for services to intact families, such as TANF, Title IV-B, and the Social Services Block Grant.
  • Child welfare systems should prevent abuse and neglect. As the authors point out, child welfare systems (which they refer to as CPS, a term that I prefer to reserve for the investigation function only) have no truly preventative role. They are charged with responding to abuse and neglect after they have already occurred. This common misconception is particularly important in relation to the recent debate on FFPSA. Despite its name, the Act does not fund prevention; rather it funds treatment, or services to parents who have already maltreated their children. Obscuring the distinction between prevention and treatment prevents an honest and clear-headed debate about the appropriate allocation of resources between these purposes.
  • Child welfare is a broken system: Jonson-Reid and Drake argue that rather than being broken, the child welfare system has never been completed. They compare it to a fire department that will will send out a fire truck only 60% of the time, and often after the house has been consumed by flames. When a truck does respond, the firefighters may have minimal training in firefighting. A firefighter might show up without a truck and will have to wait until a truck with water is found. An injured person, instead of being taken into a hospital, may be placed in the home of someone who has no idea what treatment they need.
  • Child welfare can be fixed in a cost-neutral manner. Jonson-Reid and Drake point out that reform efforts (such as privatization or differential response) have often aimed to do more with less or the same amount of resources and have thus either done harm or failed to make a difference. They argue that any real improvement would raise costs but but could result in big long-run savings. They point out that we spend only $30 billion a year on child welfare when the long-term costs of child maltreatment have been estimated at $250 to $500 billion for each year’s cohort of victims.

The last myth is particularly poignant in view of the recent passage of FFPSA. It expands the use of federal Title IV-E funds to  services to parents at risk of losing their children  to foster care. But it  finances some of this new spending by taking money from other key functions of child welfare. like congregate care placements (necessary both for therapeutic reasons and to make up for the foster parent shortage), and foster care payments to kin, who will now not be allowed these payments if the parent is receiving federally-funded services.

Jonson-Reid and Drake end with an extensive list of suggestions for changing programming, policy and law. These include primary (or universal) prevention such as poverty reduction and educating parents about positive parenting, systemic improvements to child welfare (such as completing the system), and improving and expanding treatment for children and families. The list is somewhat overwhelming, but gives policymakers and advocates many options for where to start addressing this massive and complex problem.

After the Cradle Falls is a realistic and informed discussion of child welfare. It will be a useful resource to those who are open minded enough to accept the conclusions of science and common sense even when they conflict with the facile platitudes of ideologues, which have all too often had a disproportionate influence on policy and practice.

 

Family First: A “Reform” that Isn’t

Family FirstBy now most readers will know that Congress passed the Family First Prevention Services Act (FFPSA) as part of the continuing resolution to fund the government until March 23. The passage of this major legislation as part of a continuing resolution marks the final victory of an ideological agenda that has taken over the child welfare advocacy community.

FFPSA was drafted in secret without feedback from stakeholders such as state and county child welfare administrators, many of whom expressed opposition to the bill or at least concern about its consequences.  After several failed attempts to pass the bill over a two-year period, it was finally passed as part of a continuing resolution that was urgently needed to fund the entire government and avert a shutdown.

If we had a more pluralistic intellectual landscape in child welfare, FFPSA might have looked very different. Any bill calling itself “child welfare finance reform” should have started by addressing the most egregious flaw in child welfare financing–the linkage between Title IV-E eligibility and eligibility for the long-defunct AFDC program, which was terminated in 1996.

As a result of this linkage, fewer children are eligible for Title IV-E assistance every year, and states spend millions of dollars on the useless exercise of verifying eligibility for every child entering the system, as described by Sean Hughes in the Chronicle of Social Change. Yet, the advocacy community, in its single-minded quest to reduce the foster care rolls, gave up the fight to de-link foster care from AFDC.

Instead, the goal of “finance reform” became expanding the use of Title IV-E funds to included what the Act calls “prevention services.” These are not services to prevent abuse and neglect, but rather to prevent a child’s entry into foster care once that abuse or neglect has already occurred. FFPSA allows the use of these funds to fund parenting education, drug treatment and mental health services for parents.

Most of these “prevention” services logically belong to other systems, such as drug treatment and mental health, and are also funded by Medicaid. But prevailing ideology favors diverting foster care funds to other purposes, ostensibly to encourage prevention. In the most recent display of this ideology, the President and CEO of Casey Family Programs testified last week that “for every $7 the Federal government spends on foster care, only $1 is spent on prevention.”

No footnote was provided, but it appears that Bell was restating a common refrain that compares Title IV-E foster care expenditures with spending under Title IV-B, that is used mostly for in-home services. This comparison fails to take into account all the services provided by other programs, such as Temporary Assistance for Needy Families, Social Services Block Grant, the Child Abuse Prevention and Treatment Act, Medicaid, the Maternal Infant and Early Childhood Home Visiting Program and the Comprehensive Addiction and Recovery Act. Most of these programs are insufficiently funded, but it makes sense to increase their funding rather than divert funds that were designed to help good Samaritans meet the needs of the children they have volunteered to care for temporarily.

This view that a foster home is always better than a congregate (non-family) placement is another part of the prevailing ideology in child welfare. Congregate placements also happen to be more expensive, making restrictions on congregate care a perfect offset to FFPSA’s increased costs. It’s very convenient when ideological correctness coincides with saving money! Unfortunately, restrictions on congregate care may be harmful to children when there is a foster home shortage and so many of today’s foster homes are inadequate, as I described in my last column.

The lack of robust conversation and debate in the child welfare advocacy community has resulted in a “reform” that will create more problems than it solves. Our most vulnerable children deserved a better outcome.

 

 

 

 

 

 

The Family First Act: A Bad Bill that Won’t Go Away

continuing rsolution

Some bad ideas just won’t go away. The Family First Prevention Services Act (FFPSA) is rearing its ugly head yet again. The act, which failed to pass the Senate in 2016, has been incorporated into the continuing appropriations bill passed by the House of Representatives on February 6.

Chapter I of the Act, billed as “Investing in Prevention and Family Services,” would allow Title IV-E funds to be used to fund services meant to keep children out of foster care, including mental health and substance abuse treatment, parent training and counseling, and kinship navigator programs.

The general idea of allowing Title IV-E funds to be used for services to prevent foster care placement makes sense. (I prefer to call these family preservation services rather than “preventive services” because true preventive services would seek to prevent maltreatment before it occurred, rather than preventing removal from the home after maltreatment has already occurred.)  But the bill limits the list of services funded to mental health, substance abuse treatment, and parent education and training. It does not include services like domestic violence prevention, peer mentoring or support groups, crisis intervention, housing assistance, and many others that could be crucial to keeping families together.

Chapter II of FFPSA is billed as “Ensuring the Necessity of a Placement that is Not in a Foster Family Home.” This chapter would forbid federal reimbursement for a placement other than a foster family home (often called “congregate care”) beyond two weeks without an “age-appropriate, evidence-based, validated functional assessment” using a tool approved by the Secretary of Health and Human Services to determine that the child’s needs cannot be met “with family members or through placement in a foster family home.” Such placements must also be approved by a court within 60 days. The bill also establishes stringent requirements that must be met by agencies seeking to qualify for reimbursement, including on-site nurses, for example.

This approach is problematic for two reasons.

First, we don’t have enough foster homes. States around the country are reporting foster home shortages. Reports of children being housed in offices and hotels have come from California, Texas, Oregon, Kansas, and Georgia, Tennessee, and Washington DC. With group homes closed, this problem will only worsen.

The attempt to close congregate care facilities without providing an alternative is eerily reminiscent of the closure of institutions for the mentally ill in the 1960s. These hospitals were supposed to be replaced with community health services that were never funded. We are still reaping the consequences with the abundance of mentally ill people sleeping on the streets of America’s cities.

Nevertheless, the authors of the Family First Act made sure to specify that: “A shortage or lack of foster family homes shall not be an acceptable reason for determining that the needs of the child cannot be met in  a foster family home.” One wonders where these children should go but perhaps the sponsors don’t care. It is the states and counties that will find a place for the children, even if the federal government does not pay a share.

Second, we don’t have enough good-quality foster homes. Anyone who works with foster children and parents knows that a minority of foster parents do a spectacular job, treating their charges like their own children. But many of the other homes barely improve upon the abusive or neglectful homes the children were removed from.

I’m talking about foster parents that never visit the child’s school or transport them to activities, insist that the social worker to take them to the doctor and therapist, refuse to meet the child’s birth family, and siphon off part of the foster care payment for their own purposes. These children need extra love, support, and enrichment, not the bare bones of room and board and nothing else.

The widespread simplistic belief that a foster family home is always better than a non-family setting has been promoted widely with heavy support from ideologically driven funders and advocates including the Annie E. Casey Foundation and Casey Family Programs. These groups employ slogans like Every Kid Needs a Family, ignoring the fact that most children entering foster care do have a family that they want to return to, and would not necessarily prefer being placed in a family of strangers rather than an educational or group setting where they can receive the enrichment they need while awaiting reunification.

Research supports the idea that quality is more important than the type of setting, and that high-quality group care can have even better outcomes than high-quality foster home care. Moreover large sibling groups can often be kept together only by placement in a non-family setting.

It is hard to understand that anyone believe that a loveless, bare-bones foster home is better than an idyllic environment like the Crossnore School in North Carolina, where foster children  (including sibling groups) benefit from dedicated cottage parents, an onsite school, and multiple forms of mental health treatment, including equine-assisted therapy. But the bare-bones foster home has one advantage over Crossnore. It is much cheaper.

Clearly, legislators want the savings from eliminating non-family options to offset the increased costs imposed by the expansion of Title IV-E to include preventive services. The Congressional Budget Office estimated that the restriction on non-family placements would offset almost 70% of the costs of extending IV-E reimbursement to family preservation services, over a ten-year period.

It is not surprising that government officials in the three states with the largest foster care populations–California, New York, and Texas, have all expressed concern about or opposition to the Family First Act. Other states have expressed their opposition as well .

Aside from a pair of hearings that were orchestrated by the bill’s sponsors to support their vision for the legislation, there have been no hearings or floor debate on the Family First Act. Last year, it passed the House by voice vote, and its Senate sponsors tried to get it through without a vote before going on summer recess. They failed, thanks to courageous Senators who cared about children enough to resist pressure from the powerful coalition supporting the bill.

Lets hope that the same wise and courageous Senators make sure this dangerous legislation is not allowed to slip into law in the urgent effort to pass a continuing resolution. Lets not save money on our most vulnerable kids. Spending money on better placements now will surely reap savings down the road in crime, unemployment, and welfare receipt.

 

Grabbing the Wrong End of the Stick on Educational Stability for Foster Youth

vanFor decades, children in foster care have endured multiple school changes as they moved between foster homes and other placements. With each move there is another school placement, with some children and youth changing schools several times in the same year. This is not a satisfactory situation, especially because many children who are placed in foster care have already endured many school changes and long periods of absence from school, leaving them already behind academically.

But in order to bring about educational stability for foster youth, legislators  have grabbed the wrong edge of the stick. Rather than keeping foster youth near their original schools, Congress has passed legislation requiring education and child welfare agencies to transport children from new foster homes and placements to their former schools, no matter how long it takes and how much it costs.

The Every Student Succeeds Act  (ESSA) requires school systems to transport foster children to their original schools “whenever it is in their best interest.” There is nothing wrong with the legislation as written. Clearly, young people should be transported to their original schools if it is in their best interest. The question is, when is it actually in a child’s best interest to be transported to their original school?

Is it in their best interest to be in a van for up to four hours a day as the driver stops to pick up different children going to different schools? Is it in their best interest to be transported by a private services that gets them to school late daily? Is it in their best interest to be unable to participate in extracurricular activities because they have to be picked up right after school ends? Is it in their best interest to spend agency money that could be used for tutoring or therapy on transportation? These are all common problems that I observed as a foster care social worker in the District of Columbia when the children on my caseload were being transported to their original schools from their Maryland foster homes.

Some child welfare agencies, advocates,  and journalists seem to think that being transported to their original schools is always in the best interests of foster children.  But those who work directly with foster youth know better. As Margaret Henry, a Los Angeles Superior Court Judge, wrote in a powerful column, “Why spend money transporting children for hours to their home school, instead of working harder and more creatively to find them placements in their home school’s district?”

The contradictions of this backwards approach to educational stability are illustrated by a recent case that could have major implications for the education of foster youth nationwide, according to Dan Heimpel of the Chronicle of Social Change. “V. Doe” entered foster care in Rhode Island at the age of six in 2005 and had moved a dozen times by 2017. In May 2017, while she was living in a group home in North Smithfield, RI, the school district decided to move her to a special school for youths with disabilities and mental health issues after she had several altercations with other students at her high school.

Reportedly, V. Doe began to thrive at the new school and completed her junior year, hoping to graduate in 2018. But Rhode Island’s Department of Children, Youth and Families (DCYF) decided to move her into a foster home–a placement that soon disrupted. Rather than returning her to the original group home (perhaps it was full?), she was moved to a residential facility in another school district.

DCYF determined that it was in V. Doe’s best interest to stay in the North Smithfield School. The North Smithfield school district agreed but (reasonably) refused to pay now that V. Doe was no longer living in there (and had been there for less than a year). DCYF filed a petition with the State Department of Education arguing that the district’s action violated ESSA. The Education Commissioner agreed and required that she be re-enrolled immediately at the private school, with North Smithfield picking up the costs.

The advocates who are praising this solution seem to be missing some key points about what caused the problem and who is paying for the fix.

A DCYF youth who has bounced between foster homes and group placements a dozen times was finally thriving in a group home and a specialized school. Why did DCYF choose to move her out of the district just before her senior year in high school?  Could V. Doe be a victim of the fashionable assumption that “every child needs a family,” which not coincidentally happens to save money for the state as well? Unfortunately, V’s placement in the foster home did not last and now she was stuck in a new group home. The premature removal of young people from group care, to be placed in homes where they will be shortly kicked out, is also something that I observed as a social worker in foster care.

And then there is the issue of who pays the costs of DCYF’s mistake. V. Doe moved and out of multiple school districts in a demented game of musical chairs. The district that finally found a school that was right for her got stuck paying the costs until graduation. Wouldn’t it make more sense to have a centralized state fund (in either the education or child welfare department) for foster youth in this situation?

The backwards approach to educational stability embodied in ESSA is reminiscent of other false fixes for foster care, like legislation attempting to solve the shortage of foster homes by requiring more training for foster parents. It is not a coincidence that these approaches are often easier and cheaper (at least for the child welfare  agency) than policies that would get to the root of the problem. Instead, policies should aim at finding placements that are closer to students’ original schools . Readers wanting examples of better policies can see my recommendations and those outlined in Judge Henry’s column.