Tuesday, February 20, 2018

NCCPR in Youth Today on a plan for real reform of child welfare finance – from an unlikely source

The so-called Family First Prevention Services Act has been hailed as a radical change in how child welfare is paid for by the federal government. It’s not.The changes will barely make a dent in a system that lavishes billions of federal dollars on foster care, and far less on efforts to keep children safely in their own homes.

But the Trump administration’s proposed budget, a document that is, in most ways, as dreadful as one might expect, appears to revive a much more far-reaching, and much better, approach to changing the way the federal government reimburses states and localities for child welfare

Friday, February 9, 2018

Don’t believe the hype. The Family First Act is a step backwards for child welfare finance reform

Perhaps you’ve heard. Tacked onto the bill that averted another government shutdown is a child welfare finance “reform” measure called the Family First Prevention Services Act.

The bill was thought to be dead. It was killed last year by what one reformer who transformed his own institution years ago called the group home industry – the collection of private agencies typically paid for every day they hold foster children in the worst form of care, group homes and institutions -- and their public sector allies.

But it came back to life as part of the process of keeping the government open.  Now it’s law.

One might expect advocates of family preservation to celebrate, and some almost certainly will. The bill allows some federal money once restricted to funding foster care to be used for better alternatives.  And, in theory, it curbs federal funding for group homes and institutions.

Some very good child welfare reformers favor the bill. The best case for it was made by one of those reformers, Jeremy Kohomban. He transformed what was once one of the nation’s most regressive residential treatment centers, Children’s Village, in New York, into a leader in emphasizing trying to help children in their own homes or foster homes. Here’s his case for the bill.

Setting up prevention to fail

But I disagree.  In 2016, I wrote that the range of prevention services that could be funded under Family Frist was tiny, and there were absurd restrictions on which programs within that range could get federal aid. And instead of limiting group homes and institutions, I argued that the bill was so weak that it actually strengthened them, creating a whole category of institution that would be, in effect, sanctified in federal law.

So it’s no wonder that in 2016, the Congressional Budget Office estimated that only $130 million in additional federal funds would go to prevention each year – a drop in the bucket compared to the billions spent on foster care. CBO also estimated that the proportion of foster children in group homes and institutions would barely change – declining from 14 percent to 11 percent – over ten years.

So what the bill really does is set prevention up to fail.  When these minor changes don’t do much to curb needless foster care, those wedded to a take-the-child-and-run approach will say See? Changing financial incentives didn’t work, all those children must really need to be in foster care.  In fact, all those kids will still be in foster care because there was almost no real change in financial incentives.

A “presents for pimps” loophole

Nevertheless, the group home industry insisted that even the slightest restriction on their ability to warehouse children in the very worst form of “care” was more than they could handle.

Desperate to get something passed, supporters caved on issue after issue:

● They weakened a provision requiring institutions that supposedly engage in residential treatment to have actual clinical staff on site.

● They added a  “presents for pimps” loophole – creating a whole new category of institution exempt from restrictions on federal funding.

That was in 2016.

The new law

In one respect, the version that just became law may be a little better: although the types of prevention that can be funded are as limited as ever, the standards for specific programs don’t seem to be as onerous.

But in at least one key respect, possibly two, the version that just became law is even worse.

● There’s a provision (Section 2661) allowing funds from a much smaller existing “family support services” program to be diverted to “supporting and retaining foster families for children.” (I’m not sure if this is new, or if I’d simply overlooked it in previous versions.)

● States can delay the minor restrictions on funds for group homes and institutions for two years (though if they did that, they’d also have to forego the limited new prevention funding).  In fact, this is closer to a four-year delay.  The bill’s provisions concerning group homes don’t take effect until October 1, 2019 – states opting to delay would not be affected until October 1, 2021.

This gives the group home industry lots and lots of time to weaken the law still further.

The group home industry’s most reliable servant

Of course, in its story about the new law, the so-called Chronicle of Social Change, the Fox News of child welfare continues to carry water for the group home industry.  Thus the Chronicle story claims that

Ten years ago, such restrictions on congregate care would have occurred as foster care numbers were ticking down across the country. Today, states will have to find more foster home capacity while some accommodate rapidly rising numbers of kids.

The second sentence is untrue. There is another alternative: Stop taking so many kids needlessly. But, as I’ve noted before, the Fox News of Child Welfare always frames any effort to curb the use of congregate care in terms of group homes vs. foster homes; family preservation is left off the table.

And that story comes on top of another story devoted entirely to California groups whining about the law.

Goldilocks is wrong

And finally, as I wrote last year: Please, spare us all the Goldilocks defense; the one that goes, if some people think the law is too tough and other people think it’s not tough enough, it must be juuuuuuuuust right.

No. The fact that some in the group home industry have the gall to claim this law is too tough just shows how spoiled they’ve gotten after all those years getting to eat all the porridge.

Wednesday, February 7, 2018

Child welfare in Oregon: The audit and the elephant

A new audit of Oregon’s child welfare system is an exercise in willful ignorance. That makes it more part of the problem than part of the solution.

Earlier this week, Oregon Public Broadcasting’s Think Out Loud devoted a program to a new (and, as almost every headline noted, “scathing”) audit of the state child welfare system, conducted by the Oregon Secretary of State’s office. The producers invited me onto the program to respond to comments from the state’s two top child welfare officials and the lead auditor.

I was in a studio near Washington, D.C., so I couldn’t see the other guests. That’s why I’ll probably never know how they managed to fit all those guests and an elephant into one studio in Portland.

The elephant in the studio is, of course, Oregon’s obscenely high rates of tearing children from their families and trapping them in foster care. That elephant has been hanging around for decades – Oregon has been tearing apart families at rates far above the national average since at least the mid-1980s. Through all that time, the elephant has been ignored by the state Department of Human Services.  And the behavior of the auditors is, if anything, even worse.

The audit devotes exactly one sentence to the fact that Oregon is such an outlier when it comes to tearing apart families.  The lead auditor gave it a single sentence on Think Out Loud – and the sentence was shocking. She said she didn’t know if Oregon holding children in foster care at a rate she described as double the national average made the Oregon system “worse or better” than others.

In fact, it’s not quite that bad. Oregon actually holds children in foster care at a rate about 60 percent above thenational average, not double. But the fact that the auditor thinks the rate is double and still doesn’t know whether that makes Oregon better or worse is that much more appalling.

As I said during my segment on the program. which starts at 32 minutes in and can be heard here …

… it’s understandable that someone entirely new to child welfare issues would not know, at the very start of the audit,  if an insane rate of removal is “better or worse.” But how can you go through months and months examining an agency and still not know by the end of the process?  Did the audit team even ask why Oregon is such an outlier?  Apparently not.

Not that you asked, but …

Though the auditors didn’t ask, here’s why a high rate of removal makes a child welfare system worse:
● Most cases are nothing like the horror stories. Far more common are cases in which family poverty is confused with “neglect.” Other cases fall between the extremes. Massive studies of typical cases show that children left in their own homes fare better in later life even than comparably-maltreated children placed in foster care.  And a study of foster children in Oregon and Washington State showed that the foster care system churns out walking wounded four times out of five.
● All that harm occurs even when the foster home is a good one. The majority are. But study after study, including two from Oregon, found abuse in one-quarter to one-third of foster homes. The rate of abuse in group homes and institutions is even worse. 
Oregon, in particular, has seen scandal after scandal over abuse in foster care.  Indeed, on the very day those child welfare officials, the auditor and the elephant piled into that studio, it was revealed that DHS proposed deliberately allowing children to remain in homes where caseworkers admit they think the children are not safe – in order to settle a lawsuit seeking to bar the state from warehousing children in hotels. (It’s another example of how efforts to fix Oregon foster care have become  a pathetic game of whack-a-mole.)
● All the time money and effort wasted on false allegations, cases in which family poverty is confused with neglect and needless foster care, as in this Oregon case and this one, is, in effect, stolen from finding children in real danger who really do need to be taken from their homes.

So the implicit assumption behind the auditor’s ignorance – what she really was saying is: Maybe that high rate of removal makes children safer – is false. In all those months, the audit team never checked to find out.

That makes the entire audit an exercise in willful ignorance. And it invalidates many of its conclusions.

Much of the audit is built around the premise that there is a shortage of foster homes in Oregon.  But if you don’t know why Oregon is taking away so many children, you don’t know if Oregon has too few foster parents, or too many foster children.

So we get page after page about recruiting more foster parents.  Worse, the audit calls for  institutionalizing more children in so-called “residential treatment” – accepting as fact the claims of the residential treatment industry that this is the only option for children with serious behavioral problems.

Apparently in all those months of auditing the auditors never reviewed the mass of research showing that residential treatment is a failure and there is nothing residential treatment does that can’t be done better with Wraparound programs. Such programs bring all the help a child needs into her or his own home or a foster home.  To see how, perhaps the audit team will have a look at this video:

Similarly, the audit refers to DHS resorting to the very worst form of “care” opening up more parking place “shelters” as “potentially positive steps…” They express no concern at all that shelters are terrible for children. The qualifier “potentially” refers only to the fact that the shelter might not be enough to deal with the so-called “shortage” of foster parents.

A gratuitous swipe at kinship care 

The audit even takes a gratuitous swipe at the least harmful form of foster care – kinship foster care, placing children with relatives instead of strangers. Study after study after study has found that kinship foster care is more stable, more humane and, most important, safer than what should properly be called “stranger care.” Yet the audit declares that many foster children “have acute mental and physical health needs that career foster homes may be better equipped and specifically trained to handle.”

Why? Do the auditors think relatives are inherently too stupid to be properly “equipped” and “trained”?

And speaking of biases, just as only one sentence is devoted to Oregon’s high rate of tearing apart families, less than a sentence is devoted to the racial makeup of Oregon foster care. The audit notes that one-third of Oregon foster children are nonwhite. But that is mentioned only in the context of – as you’ve probably guessed by now -- the need to recruit more foster parents of color. The possibility that Oregon’s high rate of removal might be related to racial bias is not even considered.

Even when the auditors are right, they fail to ask the obvious questions. 

●The audit paints a picture of an agency so incompetent it can’t even produce an up-to-date organizational chart.  It also confirms something some of us have long known: Oregon is where good ideas in child welfare go to die.

But the audit doesn’t go back far enough – to the 1990s, when Oregon had a chance to reform its entire system along the lines pioneered by Alabama – and blew it. It’s not as if this information is hard to find – it’s all laid out in the epilogue to this Oregon Public Broadcasting / Salem Statesman Journal story.

●The audit discusses how badly DHS sometimes treats foster parents, and even how badly people in the agency sometimes treat each other. But it never asks the obvious question: DHS really needs foster parents, and it really needs its own employees. If this is how staff and foster parents are treated, how are they treating birth parents?

But since the list of “stakeholders” the auditors spoke to includes virtually everyone with any connection to the system except birth parents who lost their children to that system, it’s not likely the auditors would think to ask that question.  

Given all that, it’s not surprising that the recommendations amount to nothing but more of the same: Recruit lots more foster parents and hire lots more caseworkers.

But we already know exactly what that will produce: The same lousy system only bigger.

That won’t start to change until, at long last, someone in Oregon says “Hey: There’s an elephant in the room!”

Monday, February 5, 2018

Child welfare reform in Arizona: Teeing up the backlash when the frontlash has barely begun

In January, 2003, just four days after taking office, in the wake of the disclosure of a high-profile child abuse tragedy, the governor of Arizona, Janet Napolitano, gave a speech in which she told child protective services caseworkers to just take away the kids “and we’ll sort it out later.”

Fifteen years later, Arizona is only beginning to sort it out. And if a story in the Arizona Republic Sunday is any indication, the groundwork for a backlash already is being laid.

Napolitano’s remarks helped kick-start what would become the nation’s longest foster-care panic. The number of children taken from their parents skyrocketed, increasing year after year after year all the way through 2015. Even with a slight decline in 2016, Arizona took away children at a rate more than 50 percent above the national average.

For some of that time, the panic was encouraged by the state’s largest newspaper, the Republic. But last year that changed.

The Republic received a three-year grant to fund in-depth reporting on child welfare. Editors brought back to the Republic an outstanding investigative reporter, Bob Ortega.  He was tasked with, in effect, leading the Republic to take a bold, new look at child welfare, a look that would question everyone’s assumptions, including the newspaper’s own. That led to superb stories such as this oneAnd this one.

Though the project continues, there’s been a setback. Unfortunately for Arizona, Ortega left the Republic to join the investigative unit at CNN. 

The latest story

This latest story, about promises by the Arizona Department of Child Safety (DCS) to do more to keep families together, still has a lot to commend it. The story focuses on a mother struggling with drug abuse.  But instead of the usual horror story, this case is far closer to the norm – a mother who dearly loves her child and is winning her battle with addition.  In addition, a lot of space is devoted to trying to explain the emotional harm done to children by needless foster care. 

But, at the same time, one can almost feel some of the old Republic assumptions sneaking back into the coverage.

The story resurrects some myths that have plagued child welfare systems and child welfare news coverage for decades.

● The myth that child removal equals child safety. As noted above, the story acknowledges theemotional harm of needless removal – and doesn’t just brush it off in a paragraph.  But it still implies that if you take away the child at least the child will be physically safe.

Like so many stories before, this one implies, wrongly, that child safety and family preservation are opposites that need to be balanced. Leaving the child at home is constantly described in terms of risk – even if the story suggests the risk might be worth it.

But study after study shows high rates of abuse in foster care itself. Indeed, one of Ortega’s stories examined this very point.  He wrote:

In 2014, of 46 states that reported data to the federal Children's Bureau, all claimed that fewer than 2 percent of children in foster care had been harmed in the prior year. Arizona said that barely a tenth of 1 percent of children in care were verifiably harmed. But in surveys going back for decades, from 25 percent to as high as 40 percent of former foster children report having been abused or neglected in care.

For the overwhelming majority of children family preservation is the safer option.  It is foster care that is riskier – in every respect.

Consequences of needless foster care

And discussions of emotional harm that largely lack specifics about outcomes don’t tell the full story of that harm.

Since the mother at the center of the Republic story is recovering from drug addiction, it would seem particularly important to explain why helping her recover without placing her newborn in foster care is better for the child.

But there is no reference to research such as a the  landmak study of two groups of children born with cocaine in their systems,  One group was placed in foster care, another left with birth mothers able to care for them.  After six months, the babies were tested using all the usual measures of infant development: rolling over, sitting up, reaching out. Typically, the children left with their birth mothers did better.  For the foster children, the separation from their mothers was more toxic than the cocaine.

And, of course, there are those two massive studies of more than 15,000 typical cases, which show that children left in their own homes fared better in later life even than comparably maltreated children placed in foster care.

So from the point of view of child safety in all its forms, Arizona’s stated new approach – which emphasizes working harder to find ways to keep children safe without resorting to foster care --  makes sense.

● The myth of the ever-swinging pendulum.  What is it with journalists and pendulums, anyway?

Even when I was a reporter, I never understood the fondness of my fellow journalists for thinking of just about everything in terms of a swinging pendulum.  The Republic story is no exception. It keeps coming back to whether the pendulum is swinging and how to set that pendulum in just the right spot. Editors love those pendulums, too.  The metaphor makes it into a subhead and a pullquote.

The problem with the metaphor is illustrated by how it’s used in the story itself. The story notes a recent drop in the number of children in foster care in Arizona and promptly invokes the pendulum. But even with that decline, Arizona still holds children in foster care at a rate more than 30 percent above the national average. In child welfare, the pendulum generally swings only from taking away too many children to taking away far too many children. (I think I’ll make that one of my pullquotes.)

● Setting the reforms up for scapegoating. The story tells us that

since the new practice started late last summer, there have been child deaths and near-fatalities in which [the State Department of Child Safety] was involved. It's unclear, at this point, whether any of those cases involved a decision to leave a child at home, or under the supervision of a “safety monitor.” Investigations are ongoing.

In fact, even if it hasn’t happened yet there will be cases in which the new approach leads to leaving a child at home and something horrible happens to that child.

But the same thing happened under the old “take the child and run” approach, when caseworkers were so overwhelmed with children who didn’t belong in foster care that they had no time to investigate any case properly, and overlooked more children in real danger. And, of course, it happened every time a child was needlessly removed only to be abused in foster care.

But that won’t stop those wedded to the take-the-child-and-run approach from exploiting the tragedy, whenever it occurs and whatever the circumstances, to try to sabotage this first small effort to curb Arizona’s 14-year foster care panic. As I’ve noted before, opponents of safe, proven alternatives to foster care will never give up their horror stories – because it’s all they’ve got.

There is no approach to child welfare that eliminates every tragedy.  If you judge a system by its horror stories, all systems fail.  The question is which approach typically makes children safer – and on that the evidence is overwhelming: You can’t have child safety without family preservation.

For more about Arizona and its long, long foster-care panic, see our 2007 report on Arizona child welfare.