Sunday, July 26, 2009

The waiver that saved Florida (and could have saved Michigan had they been smart enough to accept it)

There are people in child welfare who thought Florida would never change. They despaired of ever persuading officials at the state's Department of Children and Families that their fanatical embrace of a take-the-child-and-run approach in 1999 would lead only to disaster – which, of course, it did.

But now, Florida has changed. And now The New York Times has documented that change. The story shows how a state once synonymous with child welfare failure has begun a transformation, by emphasizing safe, proven programs to keep families together. And it shows how one change in particular made everything else possible – a change with profound implications for federal child welfare policy.

There are a lot of reasons Florida changed. NCCPR's four comprehensive reports, three rate-of-removal indexes comparing regions within the state and eight trips to Florida to meet with reporters (for the record, almost always in the summer) had more than a little to do with it. We wore away resistance to solutions that work, but that go against "gut instinct." By approaching media, not government, we helped break the monopoly in the marketplace of ideas held by the state's "child savers," to use the term their 19th Century counterparts proudly gave themselves.

The case for family preservation is so strong that it can win any free competition in that marketplace; the problem is getting those ideas heard. In contrast, the take-the-child-and-run approach is a bit like almost anything made by Microsoft; nobody really likes the product, but people keep buying it because everybody else is buying it or they don't know something else is readily available.

Our give 'em hell advocacy from the outside strengthened the hand of reformers on the inside. And when Charlie Crist became governor and his first DCF Secretary, Bob Butterworth, decided it was time to listen to new ideas, the reformers were ready.

Then Butterworth did something revolutionary: He ordered his agency to stop stonewalling. Under Butterworth and his successor, George Sheldon, DCF has become the most open, accountable child welfare agency in America. (O.K., that's a really low bar, but even by non-child welfare standards, DCF has been pretty impressive. It's done everything the law allows to be open, and interpreted every ambiguity in favor of openness.) Among other things, that bought DCF time to begin to show substantive improvement.

But credit for what may have been the most important single change – because it made all the others possible – actually goes to Crist's predecessor, Gov. Jeb Bush. Now, let me be clear: There is probably no political leader in America who did more to screw up a child welfare system than Jeb Bush. He and his appointees made one appalling decision after another. But the one and only thing Bush got right allowed Crist and his leaders at DCF to undo all the things Bush got wrong.

But, let the Times explain it:

While the focus on preserving families has taken hold in several states, here it has been backed by a federal waiver that allows the state to use foster care financing for prevention and mental health, an approach that advocates of the program hope will become standard nationwide.

Like an addict who finally realizes the destructiveness of his addiction and vows to quit, Florida agreed to give up its addiction to endless dollars for foster care. Florida relinquished the open-ended entitlement to federal aid for part of the cost of foster care for every eligible child. This is the system that, nationwide, has led to the federal government spending at least nine times more on foster care than on alternatives.

But Florida DCF agreed to accept this money as a flat grant. In exchange they were allowed to spend this money – more than $140 million per year - on safe, proven alternatives to foster care, instead of only on foster care itself.

It was a bold move. Had Florida been unable to control needless removal of children, it would have had to pay for all of those additional placements itself. (Indeed, the existence of the entitlement is one of the main reasons states don't control their addiction to foster care.) But when, as happened in Florida, these alternatives, which cost less in the first place, also led to reductions in foster care, the waiver let Florida keep the savings and plow that money into more help for families.

But the advantages don't end there. The waiver includes what is known in government jargon as a "maintenance of effort" provision. In other words, DCF can't just use the flexible federal funds to replace state funds. In fact, if Florida cuts state spending too much, it loses all the federal money. So even though Florida is among the states worst hit by the recession and even though there was enormous temptation to enact Michigan-style slash-and-burn child welfare budget cuts, the Legislature backed off, rather than lose all that federal aid.

Why mention Michigan in particular? Because, as I've mentioned so often before on this Blog, Michigan initially accepted the same waiver and then, at the last minute, someone in that state's child welfare agency turned it down. (Isn't it time someone in Michigan media tried to find out who made that idiotic decision and whether he or she still has any influence over child welfare in that state?)

So, the waiver saves children from the horrors of needless foster care, it improves child safety (as documented in an independent evaluation) and it saves money. Who could be against that?

Pretty much the entire American child welfare establishment, actually.

Of course, Marcia Lowry, supreme leader of the group that so arrogantly calls itself Children's Rights (CR) has problems with the Florida reform effort. For her it's a four-way threat:

It relies on preventing foster care instead of hopeless efforts to "fix" it while shoveling more children into it.

It's flexible instead of bureaucratic – the antithesis of the CR approach.

It was accomplished without decades of litigation caused by one of Marcia's micromanaging lawsuits. Indeed, Marcia tried to bring a class-action suit in Florida – joining one that originally had been brought by a very good Florida lawyer – and it got tossed out of court. (The fact that, in some jurisdictions, even Marcia's lawsuits can be better than nothing tells us only how bad some systems are.)

And it's got to be embarrassing that the waiver included that maintenance of effort provision, while Marcia's consent decree in Michigan doesn't have one, leaving that state free to slash funding for prevention and family preservation.

But none of that excuses getting figures, dates and context wrong, which she managed to do in the Times. She cited an increase in Florida child abuse deaths, as the Times put it, "in recent years."

She neglected to mention that:

As the Times story explains, much of the most recent increase was a result of a radical change in what the state's Child Fatality Review Committee considers neglect instead of an accident (something NCCPR pointed out on this Blog at the time). Indeed, the state's Fatality Review Committee itself attributed the "increase" in deaths to changes in reporting. It's on Page 1 of this report from the committee.

There is nothing recent about child abuse deaths increasing in Florida. All through the years that the take-the-child-and-run mentality dominated Florida child welfare, child abuse deaths, and in particular deaths of children "known to the system," increased.

In contrast, everything changed when reform started to take hold. The first year in nearly a decade in which entries into foster care in Florida significantly declined – 2007 – also was the first year in nearly a decade that such deaths actually decreased.

[UPDATE: JAN. 12, 2010: In 2008, the number of such deaths increased again, to about their 2006 level. So, in spite of the recession, and the ongoing pressure to broaden the definition of a child abuse fatality, deaths of children known-to-the-system were no worse than before the waiver - a remarkable accomplishment if one is inclined to measure safety based on fatalities.]

More important, since, as NCCPR has stressed repeatedly, fatalities are among the worst ways to measure overall safety, (and we'll gladly stop using that measure, just as soon as the media and people like Marcia agree to stop as well) that independent evaluation found that a far better measure of safety, reabuse of children, had been cut in half.

Marcia also objects to even setting goals for reducing the number of children in foster care. Yet Marcia's own lawsuit settlements don't just set numerical goals, they demand that child welfare systems meet specific target numbers for almost everything they do. She seems especially keen on adoption quotas. In other words, it's o.k. to set a goal for how many children you will sever from their families forever – and demand that a child welfare system meet it - but not o.k. to set a target for how many children you can return to their own parents.

But while Marcia objects to the whole reform effort, the waiver has many more enemies.

A few years ago the (George) Bush administration tried to change federal law to allow – not require, just allow – any state to fund child welfare the way Florida is funding it. The plan was strictly voluntary.

But, of course, if every state had the option to do this, then every state could reduce needless foster care the way Florida has done it. And that would be a huge problem for big, powerful private agencies that make their living warehousing children in foster care. It also would be a problem for public child welfare agency bureaucrats (like that one in Michigan) who'd have to explain why they had so little confidence in their own ability to avoid needless foster care that they were turning down the best chance in decades to fix their systems.

And who represents both groups? The Child Welfare League of America, of course.

So they were a major part of a successful campaign of fear and smear against flexible funding. "Block grant! Block grant!" they screamed (a term which, to liberals, is as scary as "death tax" is to conservatives, and, in this case every bit as misleading).

They were joined by groups like Every Child Matters and the Children's Defense Fund. At one point, CDF actually claimed that this voluntary plan would "dismantle foster care." (Did I mention that the plan was voluntary? What part of "voluntary" don't my fellow liberals understand?) CDF never even tried to back up the claim. But I am aware of no journalist ever demanding that CDF justify its patently-absurd claim, or calling them out for failing to do so.

Unfortunately, the opposition has the ear of the Obama Administration. My fellow liberals tend to be as deferential to the "foster care-industrial complex" as conservatives tend to be to the military-industrial complex.

The opponents have the politics. All Florida has is success. So it may be a long time before other states are offered the chance to do what Florida has done.