What’s Behind the Drop in New York City Foster Care Numbers? More than the Commissioner Chooses to Say

BluePrint

On December 12, 2017, the New York Daily News published an exclusive story of a dramatic drop in foster care numbers in New York City. Only 8,966 children were in foster care in Fiscal Year 2017, down from 2016’s total of 9,926. Moreover, New York City’s foster care rolls have been dropping over the past four years as the nationwide caseload increased.

Administration on Children’s Services (ACS) Commissioner David Hansell awarded his agency most of the credit for the decrease, telling the Daily News that “primarily it has to do with keeping families together whenever we can.” As he told the reporter, instead of immediately removing a child deemed to be at risk, ACS seeks to provide services to the family to ameliorate that risk without removing the child.

Hansell’s remarks to the Daily News can be questioned on two grounds. First, there is evidence that agency policy is not the only factor behind the caseload decline. Second, a simple decline in foster care caseloads is not evidence of progress unless we know the agency is not leaving children to languish in unsafe homes

A closer look at the numbers (contained in a Foster Care Strategic Blueprint Status Report issued by ACS on December 18), compared with population trends in New York City, reveals that more is going on than the Commissioner chose to discuss.

In New York City, according to Census data, the number of children in poverty fell from 553,499 in 2012 to 471,190 in 2016, a 15% decrease. During fiscal years 2012 to 2016 (a period that is off by 6 months from the annual data) New York’s foster care caseload fell from 13,820 to 9,926, a decrease of 28%. (See the table below for the numbers.)

It’s a well-known fact, and well-documented by research, that poor children are much more likely to be placed in foster care than their peers. There are many reasons why this might be the case, and some critics allege that some children are actually placed in foster care simply because they are poor.

Based on the decline in children in poverty, we could have expected roughly a 15% decline in the foster care rolls. The percentage drop in New York City’s foster care caseload was almost twice that, so agency policy probably did contribute to the foster care decline. But based on the percentages, demographic change may have been equally important.

Hansell did admit that there were “a lot of reasons” for New York City’s caseload to decline while the national caseload went up. But he did not choose to mention any of them.

We can’t be sure of the reasons for the decline in child poverty in New York. However, we do know of the influx of well-to-do people into many previously poor New York neighborhoods commonly described as “gentrification,” often driving poor people out of those neighborhoods.

A similar pattern may be observed in other cities experiencing rapid gentrification. For example, the number of children in poverty in San Francisco dropped from 16,000 in 2012 to 11,000 in 2016, according to Census data. And the number of children in foster care dropped from 1,073 in October 2012 to 811 in 2017 at the same time as the State’s caseload increased, according to the California Child Welfare Indicators Project.

Unfortunately, foster care caseload data is not easily available for most other cities, because the current Administration has instructed the federally funded center that houses large child welfare datasets to stop giving out this data to citizens after 20 years of doing so. However, it is highly plausible that other cities experiencing similar demographic changes also saw significant drops in foster care

There is another problem with Hansell’s remarks. A decline in foster care numbers is not in itself a reason for celebration. We must remember that the purpose of foster care is to protect children. As an important issue brief from a California child advocacy coalition argues, states which have been cutting their caseloads for years may reach a “bottom’ below which further caseload reduction is not feasible without compromising child safety. ”

New York’s foster care caseload has been dropping since 2007. To the extent that these drops are due to policy changes, the city may reach a point where it is not safe to continue in the same direction.

Hansell cheers about “fewer children removed, fewer families separated and much less trauma experienced by children.” But what about the children who are being traumatized when they are left with abusive or neglectful parents at home?

Hansell admitted that there are some cases where the risks of leaving a child in a home are too high, such as the case of Zymere Perkins, who died at the hands of his mother’s boyfriend after ACS missed numerous warning signs.

We must remember that the purpose of foster care and the child welfare system is not to reduce foster care caseloads. It is to protect children. Its success should be evaluated accordingly.

Children in Poverty and Children in Foster Care, New York City, 2012-2016

Year	2012	2013	2014	2015	2016
children in poverty	553,499	522,992	523,538	508,503	471,190
children in foster care	13,820	12,958	11,750	11,098	9,926

Source:

Children in Poverty: US Census Bureau, American Community Survey, http://factfinder.census.gov

Children in foster care: Administration on Children’s Services, Foster Care Strategic Blueprint Status Report, https://www1.nyc.gov/assets/acs/pdf/about/2017/BluePrint.pdf

Predictive analytics, machine learning, and child welfare risk assessment: questions remain about Broward study

analytics

On November 30, a major child welfare publication reported on a new study, published in the respected journal Children and Youth Services Review, that tested Broward County, Florida’s child welfare decision-making model against a model that was derived using the new techniques of data mining and supervised machine learning. The researchers concluded that 40% of cases that were referred to court for either foster care placement or intensive services could have been handled “with less intrusive options.” A close reading of this opaquely written paper, as well as conversations with two of the authors, Ira Schwartz and Peter York, reveal a pioneering effort at applying emerging data science techniques to develop a “prescriptive analytics” model that recommends the appropriate services for each child. This research is innovative and exciting but this first attempt at deriving such a prescriptive model for child welfare has serious flaws. These very preliminary results should initiate a conversation but should not be used to support policy recommendations.

The authors began with a large database of 78,394 children with their complete case histories between 2010 and 2015. They merged datasets from the Broward County Sheriff’s Office, ChildNet (the local agency contracted to provide foster care and in-home services) and the Children’s Services Council (CLC), which represents community based agencies serving lower-risk cases. The authors primarily used only one year of data on each child after they were discharged from the system. Children without a full year of data were not included. So the authors had a large selection of hotline, investigative, and service data for the children in their database as well as information on whether they experienced another referral within a year.

In a nutshell, the authors applied machine learning to build a model “based on the segmentation and classification of cases at each step of the reporting, investigation, substantiation, service and outcome process.” The result was the creation of groups or clusters that have a similar combination of characteristics based on hotline and investigative data. Each stage of the modeling process produces progressively more uniform groups. The goal was to ensure that if these groups received different treatments, the difference in outcomes would be due to the treatment and not some other aspect of the children or their situations. Within each group of similar children, the researchers compared those who receive different interventions, namely removal from the home or community-based prevention services. They used a technique called propensity score matching to control for differences between members of .each group that might affect their outcomes. The authors use one outcome–whether a child is re-referred to the system within a year of exit–to determine whether each intervention was successful.

Based on this analysis, the authors concluded that many families are receiving services that are too intensive for their needs. For example, they concluded that “at least 40% of the cases that were referred to the court and to Childnet (mainly for foster care) were inappropriate based on the outcome data for children in their cluster group. The authors then went on to claim that these “inappropriate referrals” are actually harming children. For example, “inappropriate referrals” to court were 30% more likely to return to the system after the court referral than they would have been if the referral had not been made. And “inappropriate referrals” to ChildNet were 175% more likely to return to the system than similar cases that did not receive such a referral.

Finally, the authors present a “prescriptive” model that addresses the question, “Which services are most likely to prevent a case from having another report of abuse an/or neglect [within a year]?” This concept of “prescriptive analytics” is a new one in child welfare if not human services in general. The authors devote only two paragraphs to this model but they note that it would result in a decline in “inappropriate referrals” to court and ChildNet.

Even if we accept the machine learning process presented by the authors as a reasonable basis for estimating risk, several issue remain about the authors’ findings. The first issue is the use of one-year re-referral rates to denote intervention success. Ongoing maltreatment may not be seen or reported for months or years. The authors report that 57% of their cases that received another referral did so within one year. However, that leaves 43% that were referred after a year had passed. These cases were not counted as “failures” by their model. In addition, because the databased covered only 2010 to 2015, the authors did not include any referrals that happened after 2015, including those that are yet to happen. If the authors classified some cases wrongly as not returning, this reduces the validity of their model.

The second problem stems from that famous social science bugaboo–unmeasured differences between groups. The authors relied entirely on hotline and investigative data on family history and characteristics. Yet, many family issues may not be reflected in the data. These could include unknown histories of criminal behavior, mental illness, violence, or drug abuse. If the authors observed that an intervention appeared to cause harm to certain children, the explanation may not be that the intervention was inappropriate. A more plausible explanation might be that that the matching algorithm failed to correctly assess risk as well as the social workers in the system. If the cases referred to the court were in fact those that social workers correctly identified as being at higher risk (even though this was not picked up by the algorithm) one might expect higher rates of return to the system of these cases relative to cases that were matched with them by the algorithm but not referred to the courts. This possibility seems a lot more likely than the possibility that court-ordered services made parents more abusive or neglectful.

A third problem relates to the use of the child rather than the family as the unit of analysis. The family or household is obviously the appropriate unit of analysis here. It was the parents or caregivers that perpetrated the abuse or neglect and they are the main recipients of services. Author Peter York agreed that using the family would be be more appropriate but explained that most of the data in the system were linked to the child and not the family. Using the child as the level of analysis means that the same parents will be counted as many times as they have children in the system. This will obviously weight larger families more heavily, with whatever biases this may introduce.

Finally, it is concerning that the authors reported about the proportions of children that were provided with too-intensive services such as foster care but not the proportion that were provided with services that are not intensive enough. We all know about the worst case scenarios when children die or are severely injured after the system failed to respond appropriately to a report, but there are many more cases in which allegations are not substantiated or interventions are not intensive enough, and the children return to the system later, often in worse shape. Reporting on one type of error but not its opposite invariably raises questions about bias.

The authors should not be blamed for making too much of their findings. In their article abstract, they do not mention the specific findings about over-reliance on foster care and more intensive child welfare interventions. Rather, they argue that their findings indicate that “predictive analytics and machine learning would significantly improve the accuracy and utility of the child welfare risk assessment instrument being used.” I fervently agree with that statement. But this new approach by Schwartz et al is qualitatively different from the predictive risk modeling algorithms currently being applied and studied by jurisdictions around the country. In particular, the authors used machine learning to identify groups with similar risks but which received different treatments. Their purpose was to assess the effectiveness of distinct treatments of different subgroups. How well this approach will accomplish that purpose remains to be seen. This fascinating study is just the the beginning of a conversation about the utility of this new approach, not an argument for reducing the reliance on foster care or community services.

No place for the children: A therapeutic group home closes while foster children sleep in hotels and offices

In my last post, I wrote about Washington State’s critical shortage of foster parents, which is r RuthDykemanCenter esulting in children staying in offices, hotels, and by-the-night foster homes. One of my suggestions was to reinvest in quality group care settings. Unfortunately, the state (along with most of the country) is moving in the opposite direction.

KUOW, Seattle’s public radio station, recently reported on the closure of a group home that provided therapeutic care to foster children with “severe behavioral problems and emotional needs.” At the Ruth Dykeman Children’s Center in Burien, Washington 15 children lived in lakeside cottages supervised by staff members, with nurses and psychologists on call.

Unfortunately, foster care ideology has changed and now any family setting seems to be considered better than any group setting, regardless of the needs of the child and the quality of the placement. The fact that group settings are more expensive than foster family homes might have something to do with this new bias.

Unfortunately, the type of children that were housed at Dykeman don’t do well in family foster care. Children with behavioral problems and emotional needs tend to bounce from one foster home to another, their behavioral problems worsening with each move.

Nevertheless, group homes have been shuttered around the country. In Washington state, according to Investigate West, “stagnant reimbursement rates have forced many facilities that contract with the state to reduce capacity or shutter altogether.”

The CEO of Navos, the mental health nonprofit running the Dykeman home, told KUOW that ending the contract for foster care was a source of great anguish to the leadership. But it was not financially sustainable. The nonprofit had been paying more than half the cost of running the home for years.

The Dykeman Center is not closing, but it is now off-limits for foster kids. It will now serve long-term inpatient psychiatric care, which is reimbursed at two to three times the rate, according to KUOW.

Now, the fragile children from the Dykeman Center will be competing with less troubled but still vulnerable foster youth for the dwindling supply of foster homes. Some may bounce from home to home, perhaps spending nights in hotels or pay-by-the-night foster homes where they have to be dropped off late in the evening and picked up early in the morning. Some have already been sent out of state, according to KUOW.

It is hard to conceive of a reality where this makes sense. But in the looking-glass world of foster care, ideology and money-saving work together to trump common sense and common humanity.

$600 for overnight foster care? Time to consider the alternatives

Washington State’s Children’s Administration (CA) is desperate. In order to avoid lodging abused and neglected children in hotel rooms or agency offices, it has increased to $600 per night the amount it is willing to pay foster parents to keep children in their homes for one night in emergency short-term situations, according to the independent news organization InvestigateWest.

Washington’s placement crisis is being driven by a large decrease in the number of available foster homes combined with an increase in the foster care population that coincides with a ballooning heroin and opioid addiction epidemic.

But even $600 overnight fees cannot generate an adequate supply of beds for Washington’s foster children. The state reported a total of 236 hotel stays in August 2017, at the remarkable cost of about $2,100 per night including the cost of paying two social workers and sometimes a security guard to supervise the children.

Washington may be unique in paying $600 per night, but the same combination of increasing foster care caseloads and decreasing or stagnant supply of foster parents can be found in most parts of the country. Governing Magazine reports that 35 states saw an increase in their foster care caseloads between 2012 and 2015.

Reports of children being housed in offices and hotels have come from California, Texas, Oregon, Kansas, and Georgia, Tennessee, and Washington DC. Children newly entering the system, and those with behavioral issues who are repeatedly kicked out of foster homes, seem to bear the ones most affected.

In addition to the incredible waste of government funds, the warehousing of already traumatized young people in temporary and non-therapeutic environments is the antithesis of the therapeutic care they need.

Another casualty of the desperate need for foster parents may be the reluctance to revoke the licenses of neglectful foster parents. In my five years as a social worker, I begged my agency not to renew the licenses of foster parents who refused to take their children to the doctor, never met their therapists and never visited their schools, even to pick them up when they were sick. I never got my way.

The recent congressional investigation of the for-profit MENTOR foster care agency illustrates the worst-case scenario of foster parents who killed the children who had been entrusted to their care. While severe maltreatment by foster parents is extremely rare, the continued licensing of unacceptable foster parents reflects in part the desperate need for their services.

We cannot rely on traditional foster care to solve a placement crisis of this magnitude. Alternatives must be considered, particularly for new entrants to the system and older and more challenging youths.

For children who have just been removed from their homes, the answer is clear. Temporary assessment centers need to be reinstated as the first step for children entering foster care. In the last few decades, many states closed their emergency shelters and assessment centers in the belief that institutional settings are bad for children.

The elimination of shelters and assessment centers resulted in the phenomenon of middle-of-the night placements that I described in a previous column. This system results in an almost random assignment of child to home based on who answers the phone at 3:00 AM. This is no way to match a child with the most appropriate placement.

For children older than elementary school age, particularly those with more challenging behaviors, we need to consider an array of alternatives to traditional foster care. Some of these options are on the border of family foster care and group care.

On the family side, these include programs in which professional parents receive a salary for caring for foster kids. To make professional foster care economically feasible, foster homes must be larger and serve anywhere between four and eight children. I have written about several such programs. These include Neighbor to Family, which provides professional foster care to sibling groups in the same home.

Some of these 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.

On the other side of the artificial foster home/group home divide are group homes that are structured like families, with live-in houseparents. These include Boys Town, homes following the Teaching Family model, the Florida Sheriffs Youth Ranches, and many others.

Residential schools, such as the Crossnore School in North Carolina or San Pasqual Academy in Escondido, CA, also have many advantages. Students live in cottages run by house parents and benefit from enriched educational opportunities, extracurricular activities, and medical and mental health services.

All of these programs have the added benefit of keeping larger sibling groups together, a major and often unrealized goal in child welfare. San Pasqual Academy, which provides only high school on campus, will even accept middle-school-age siblings to live in its residences and attend community schools until they are promoted to high school.

Child welfare leaders at all levels need to begin a conversation about alternatives to standard family foster care. Many of these models are more expensive than traditional foster care. But considering the short-term and long-term costs of temporarily housing foster children in offices and hotels for days or weeks at a time, the money would be well-spent.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Putting the Child Back in Child Welfare

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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