Monday, August 15, 2011

Financing foster care: The pathetic alternative to real reform


In previous posts to this Blog, I discussed how, when the child welfare establishment wants to kill a good idea, they never say no, they just try to “yes, but…” it to death.

I discussed this in connection with legislation to restore the authority of the Department of Health and Human Services to issue “waivers” to rules that restrict the overwhelming majority of federal child welfare funding to foster care.  Such a waiver was a key factor in the big improvements in child welfare in Florida.

But even saying “yes, but…” isn’t enough.  If you’re going to kill a good idea, you have to pretend you’re not killing it.  So you propose an “alternative.”  That way, you can claim you’re not against reform, you’re just in favor of something even better – no matter how preposterous the alternative really is.

So, for example, opponents of truly providing health insurance to every American came up with a so-called alternative: Medical savings accounts and making it harder to sue doctors who do things like amputating the wrong limb.

It looks like the child welfare establishment now has its own pathetic “alternative” to real reform.  It’s something called the Promoting Accountability and Excellence in Child Welfare Act.  It should be called the Big Bureaucratic Hassle for Tiny Little Grants Act.  It would impose on states a whole lot more paperwork in exchange for the chance to compete for some very small grants to make foster care “better.”

The program would provide an average of $16 million per year for the next ten years, according to the Child Welfare League of America, which, of course, is all for it.  That’s less than four percent of what states now get through the existing federal prevention and family preservation programs, known as Title IV-B, and less than one half of one percent of the amount spent on foster care through Title IV-E. 

That this is meant to be an alternative to real reform can be seen in a memo released with the bill.  According to the memo:

The child welfare advocacy community has been primarily focused on overall child welfare financing reform (i.e. frontloading money) instead of working to identify and expand existing evidence-based practices currently operating at the state level. Comprehensive finance reform will cost billions of dollars and is not going to happen under the current economic climate.

For starters, this statement falsely characterizes and belittles real reform, suggesting it’s just a matter of “frontloading money” whereas this bill, in contrast,  must be better because it contains the golden buzzword “evidence-based.”  Then it says real reform “will cost billions of dollars…”  That’s not true either.

In fact, real reform is less about when the money is provided than what it can be used for.  Real reform allows billions of dollars that now can be spent only on foster care to be spent on better alternatives – alternatives which already have a far better “evidence base” behind them than foster care itself.  That doesn’t cost a dime more than the status-quo. 

All of this might not be so bad if the grants at least were aimed at prevention and family preservation.  A press release from the sponsor, Sen. Ron Wyden (D-Oregon) claims just that.   But a list of “performance measures” included with the bill itself suggests that the grants will be geared not toward avoiding foster care, but only toward making foster care itself “better.”  In other words, instead of real reform to reduce needless foster care, this is fake reform that will actually provide even more funding (albeit very little more) for foster care.

Other promotional material for the bill takes an Orwellian turn when it cites Illinois’ pioneering use of “subsidized guardianship” as an example of the kind of innovation that would be fostered through these token grants.

In fact, the Illinois subsidized guardianship program was made possible by a waiver – exactly the kind of real reform that the child welfare establishment wants to “yes, but…” to death, with bills like this one.

Perhaps the biggest giveaway concerning who really is behind this bill and what they really want is a provision calling for a study of something called “delinking” – the Holy Grail of child welfare finance for CWLA and their ilk.

I won’t go into all the complexities of delinking here, it’s all described in detail in our briefing paper on child welfare finance.  Suffice it to say that the “link” in question is the only brake on states’ otherwise unlimited entitlement to reimbursement for throwing children into foster care.  It is a stupid brake, a clumsy brake and a brake only Rube Goldberg could love – but it’s the only brake we’ve got. The only thing crazier than keeping it in place is getting rid of it without getting complete finance reform in return, and by that I mean not just waivers, but the total replacement of the foster-care entitlement with flexible flat grants.

I haven’t seen Sen. Wyden’s name connected with much in child welfare in the past.  My guess is he has no idea of the context for this bill and what some of its backers really have in mind.  He may not even realize that the criteria in his own bill steer the proposed grants toward “improving” foster care, not reducing it.

Sen. Wyden could make a far better contribution if he simply proposed to increase funding for the existing Title IV-B program by $16 million per year.