Wednesday, November 17, 2010

Foster care in Los Angeles: The real lessons from the waiver evaluation


            On Monday I wrote about how Los Angeles Times reporter Garrett Therolf misrepresented an evaluation of Los Angeles County’s waiver from federal child welfare funding restrictions.

            Therolf falsely implied that the evaluation suggested the waiver had led to an increase in reabuse of children left in their own homes.  In fact, the evaluation makes no such claim  - and more recent data call into question whether there was such an increase.

          (There's more on Therolf's misreading of the evaluation, and some even more serious blunders in Therolf's reporting, in Daniel Heimpel's excellent column in The Huffington Post, and in this summary from the alternative LA Weekly.)

            But that doesn’t mean all is well with child welfare in Los Angeles – obviously, the system is in chaos, though the primary reason for that is the foster-care panic triggered by Therolf’s sloppy reporting.  But the evaluation also makes clear that the waiver isn’t working as well as it should. 

            What I take from the evaluation – and unlike Therolf, I want to make clear that these are my conclusions, not those of the evaluation’s authors – is that while the waiver has not compromised safety, it also hasn’t done nearly enough to curb the misuse and overuse of foster care in Los Angeles County.


            One theme runs through all of the waiver’s limits: The harm done by California’s powerful foster care-industrial complex, the network of private agencies that runs most of the group homes and institutions in California.  Since this kind of care is not only the worst for children but also the most expensive, these agencies scarf up an enormous amount of money.  But their power does not extend only to congregate care.  Many counties, including Los Angeles, subcontract a large part of the job of recruiting and overseeing foster parents to private Foster Family Agencies (FFAs).

            All of these private agencies have one thing in common: a profound incentive to encourage governments to take away more children and hold them in foster care for as long as possible.  That’s because they are paid for each day they hold a child in foster care.  If they don’t get enough referrals and don’t hold the children in care long enough, they’re out of business. 

            Their greed, apparently, is insatiable.  Even as virtually every other service in California was forced to endure severe budget cuts (including, of course, the kinds of help needed to keep children out of foster care in the first place) the group homes, institutions and FFAs sued to win themselves a rate increase

About a decade ago, when one California institution, now called EMQ Families First in San Jose, had a crisis of conscience, faced up to the fact that their program was failing and totally redesigned it to drastically reduce institutionalization, its biggest problem was not revolutionizing its approach to helping children.  Its biggest problem was what EMQ’s own CEO at the time called “the group home industry” which had the power to stop the state from funding this better approach.

            When Illinois changed these incentives for that sate’s private agencies, their foster care population dropped from over 50,000 in the late 1990s to under 16,000 today.  But California hasn’t made such a change.  So private agencies remain a powerful barrier to any reform effort.


            In Los Angeles, former Department of Children and Family Services director David Sanders had success in winning over almost every other constituency as he planned for and designed the waiver. But the evaluation reminds us, at one point in surprisingly blunt terms, that earlier initiatives had antagonized the group home industry and it remained hostile.  According to the evaluation:

The LACDCFS adoption of the [Annie E. Casey Foundation’s] Family-to-Family principles and its push to decrease the reliance on group homes by using them less frequently as a placement option and shortening the length of time a child spends in a group home threatens the core livelihood of many service providers. Understandably, the group homes, foster family agencies and their association were concerned.   The [waiver] is intended to further those goals and as a result, the provider community was wary of the plan being developed.  [Emphasis added.]

            The evaluation also reminds us that, from the beginning, the waiver plan was far too modest (again my conclusion, not that of the researchers).  DCFS never expected to free up more than a relatively small amount of money to transfer into additional services to keep families together.  So relatively few additional children would be kept out of foster care.  And that, in fact, is what happened.  In the time since the waiver began, on July 1, 2007, through April 1, 2010, the decline in the number of children in foster care in Los Angeles on any given day hasn’t been much greater than it was during the same number of months before the waiver.  And entries into care – the number of children taken from their parents over the course of a year, actually increased – thanks to the foster-care panic started by Therolf’s stories.

            This explains why Los Angeles County still takes away children at one of the highest rates of all large metropolitan areas.

            The evaluation report also reminds us that one of the reasons the amount available for better options was so low was that in 2006, after planning for the waiver was well underway, the private agencies persuaded the legislature to grant them a rate increase (the one they just went to court to get is in addition to this one).  So even as Los Angeles County sought to reduce the number of placements, each placement became more expensive.

            But the evaluation report also reveals there has been more than enough change to alarm the private agencies.

When children are placed in substitute care, placement with a relative – kinship care – almost always is the least detrimental alternative.  Study after study has found that kinship care placements are more stable, better for children’s well-being and, most important, safer than what should properly be called “stranger care.”*

            This is a success story for the waiver, or, as it’s called in the evaluation, the Capped Allocation Plan (CAP).  According to the evaluation:

One year into the CAP, the use of Foster Family Agencies was reduced to 40.6%, down from 54.1% at the start of the CAP. By the second year of the CAP, the use of Foster Family Agencies increased slightly again to make up 42.8% of all first placements. Relative homes made up 24.5% of all placements up from 14.4% at the start of the CAP.

            So at every step in the process, and at every turn, the FFAs, group homes and institutions have worked to undercut the waiver – and even the limited progress so far makes clear why.  As the evaluation itself points out, a reduction in out-of-home care “threatens the core livelihood of many service providers.”  
Given that kind of opposition from a powerful foster care-industrial complex, and given the agency’s poor leadership after Sanders left, it’s remarkable that DCFS made any progress at all.


            One of the things that makes private child welfare agencies so powerful is that, in a system more secret than the CIA, they have access to information – they have the case files, they know about the screw-ups and, if they so choose, they can leak them – selectively, of course.

In other cities over the years, it’s been pretty easy to see the fingerprints of private agencies paid for holding children in foster care on news accounts using horror stories to attack family preservation.

The agencies’ vested interest, combined with the free ride they’ve gotten, as a group, from Therolf, raises questions about whether some people at some private agencies might be doing the same thing now in Los Angeles.  I’m certainly not saying this is happening, I’m merely saying these circumstances raise questions about whether it’s happening.

But I’ll tell you what, Garrett: I’ll stop using that kind of phrasing to disguise speculation as reporting – if you will, too.

*-For a discussion of some of this research, and citations, see: Mark Testa, et. al., Family Ties: Supporting Permanence for Children in Safe and Stable Foster Care With Relatives and Other Caregivers, University of Illinois School of Social Work, Children and Family Research Center, October, 2004, and Generations United, Time for Reform: Support Relatives in Providing Foster Care and Permanent Homes for Children, March 2007,  See also, Marc A. Winokur, et. al, “Matched Comparison of Children in Kinship Care and Foster Care on Child Welfare Outcomes,” Familiesin Society, Volume 89, No. 3, 2008, and  David M. Rubin et. al., “Impact of Kinship Care on Behavioral Well-being for Children in Out-of-Home Care,Archives of Pediatric and Adolescent Medicine, 162(6):550-556.