Another sign of progress at Chapin Hall

For a bastion of the child welfare establishment
such as Chapin Hall, this is a big change.

Their latest Issue Brief debunks the dominant, racist media myth about child abuse and COVID-19

 In September I wrote a post for this blog wondering if there’s been an epiphany at one of the most regressive forces in American child welfare  -- Chapin Hall at the University of Chicago. I wrote that

 For decades, Chapin Hall has been a bastion of 19^th Century-style “child saver” ideology and advocacy dressed up as “scholarship.”  You can read some examples of their track record here and here. But Chapin Hall has probably been at its worst concerning the whole issue of race. 

What gave me hope was a commentary in The Imprint by Chapin Hall’s executive director Bryan Samuels and also the fact that they’ve apparently withdrawn an “Issue Brief” from 2010 making the case that child welfare practitioners are so wonderful, so pristine in their lack of bias, that it is the one field in America that is immune from racism.

Now there is further reason for encouragement. It comes in the form of a new Issue Brief, published in September, this one about COVID-19 and Child Welfare. The paper lends the gravitas of Chapin Hall, long a “Godsource” for journalists covering child welfare, to debunking the widespread media-fueled myth that with fewer white middle-class “eyes” constantly watching overwhelmingly poor disproportionately nonwhite kids, their parents will unleash upon them a “pandemic of child abuse.”

 In doing so, they join the Associated Press, The Marshall Project and Bloomberg CityLab in pointing out the flaws in this racially biased mythology.

 

The Issue Brief does not say COVID-19 will do no harm at all.  The stress of increased poverty probably will lead to some increase in child abuse.  But to deal with that they suggest a novel approach – well, novel for Chapin Hall: Target the poverty, not the parents.

 In fact, they suggest carving out a large portion of cases, and apparently taking them out of the jurisdiction of child protective services agencies. I say apparently, because they’re a little vague about this. According to the Issue Brief:

 Child maltreatment categories should be refined to distinguish and address poverty-related neglect from child endangerment or abuse. … [H]otline reports of “neglect only” may be a phenomenon distinct from child endangerment. While lack of supervision, food, clothing, or shelter can surely jeopardize the safety of children, addressing these directly through concrete supports may be more efficient and effective than initiating a child welfare case that punishes families for living in poverty.

To which the proper scientific response is: Ya think????

Even more interesting is Chapin Hall’s analysis of that whole “pandemic of child abuse” myth, and the related claims that there will be a surge in child abuse discovered as more children return to school, and with that, a surge in the number of children placed in foster care. 

The Issue Brief points out that a sharp decline in reports from teachers and other school personnel is not unusual – it happens every summer.  It is not followed by a surge in actual child abuse in the fall.  If anything, these cycles suggest that, overwhelmingly, what’s really “missed” during the summer are false reports. 

And no wonder. When teachers are on the job reporting “child abuse” they’re almost always wrong.  Only 11 percent of their reports meet even the incredibly low standard for “substantiating” an allegation – it can be no more than a caseworker’s guess that it’s slightly more likely than not that the abuse or neglect occurred. 

But let Chapin Hall explain: 

Education personnel report the most cases of suspected maltreatment, but detect the smallest percentage of cases that reach the threshold for substantiation … Additionally, historical seasonal fluctuations in reporting that occur in response to school attendance largely affect the rate of unsubstantiated cases. Typical drop-offs in reports relate to concerns that do not reach the threshold of substantiated maltreatment; teacher reports in summer months that do result in substantiation remain steady. This suggests that in the current context, the number of reports that result in substantiated maltreatment is unlikely to fluctuate due to reduced teacher/school contact. 

Thus, it is unlikely that the dramatic reduction in hotline reports due to school closures will produce a rebound of substantiated maltreatment. Instead, those concerned with the well-being of children should shift their focus to the community drivers and economic stressors that elevate the risk for child maltreatment. Rather than focusing on how to increase mandatory reporting, efforts should be redirected to support and stabilize families to prevent child maltreatment. 

The danger of self-fulfilling prophecy 

Unfortunately, there is one factor this doesn’t take into account that may, in fact, make the return to school going on now different: self-fulfilling prophecy. 

As I explained in a previous post: 

If you tell teachers over and over again that while their students were out of school, they were abused in pandemic proportions, then the bruise that last year would have been seen for what it was, an accident, suddenly is child abuse.  The hungry child for whom they might have called a food bank now becomes a call to child protective services. 

So if there is a surge in foster care placements, it’s more likely to be the result of a generation of journalists who grew up on “health terrorism” – the deliberate distortion of the nature and extent of child abuse by advocacy groups supposedly seeking to “raise awareness” – buying into a fundamentally racist myth about child abuse and COVID-19. 

That Chapin Hall has made a modest contribution toward countering this myth is welcome.  But they could do a whole lot more.  As I noted in my previous post about Chapin Hall, in addition to once promoting the myth that there is no racial bias in child welfare, just two years ago they threw gasoline on the fires of foster-care panic in Illinois, contributing to skyrocketing needless removals of children in that state. 

They need to apologize, loudly and publicly, for both. 

And even now, the current Issue Brief shows an unfortunate, lingering fondness for the latest dangerous fad in child welfare, predictive analytics. 

But hey, I said epiphany – not miracle.

An epiphany at Chapin Hall? That depends on whether the noble words in a commentary by its director are backed-up by action

          At first the commentary in The Imprint by Bryan Samuels, executive director of Chapin Hall at the University of Chicago since 2013, might seem like just another in a long line of “well, what do you know? There is racism in child welfare!” commentaries from organizations that understand it’s the right p.r. move at the moment. 

             After all, it begins like pretty much all the others:             

Inequities have shaped our country since its founding. Centuries of discrimination have inflicted deep wounds, with disparate rates of COVID-19 infection and brutal policing being current symptoms of that troubled history. Outrage over these symptoms has sparked an examination of bias in our criminal justice, health care, education and financial systems. To that list I would add one other: the child welfare system.

             But here’s what makes this one intriguing.  Less than a decade ago, Chapin Hall did examine bias in the child welfare system – and found that there was none!  Now, not only do we have Samuels’ commentary, it also appears that the 2011 document denying the role of racial bias in child welfare has disappeared from Chapin Hall’s website.

             So is Bryan Samuels about to lead Chapin Hall in a new, better direction? The signals are mixed.

             For decades, Chapin Hall has been a bastion of 19^th Century-style “child saver” ideology and advocacy dressed up as “scholarship.”  You can read some examples of their track record here and here.

             But Chapin Hall has probably been at its worst concerning the whole issue of race.  They worked hand-in-glove with Elizabeth Bartholet, one of America’s most extreme advocates of a take-the-child-and-run approach to child welfare, to discredit the whole idea that there is racial bias in the child welfare system.  Two years before Samuels arrived there, Chapin Hall co-sponsored the stacked-deck conference discussed here.   Then one of their “scholars” co-authored an Issue Brief, issued in the name of Chapin Hall, whose thrust is 180 degrees from Samuels’ recent column.

             Let’s compare:

            In his recent commentary Samuels declares:

 [J]ust as we are overdue in revamping our criminal justice system, we are delinquent in addressing the institutionalized racism and bias that pervades our family and child well-being systems.

             But in the Issue Brief, Chapin Hall suggests there is no such bias. The Issue Brief ignores or misrepresents the abundant evidence of racial bias in the child welfare system. Here’s a summary of what Chapin Hall left out.

              In his recent commentary Samuels says:

             The systematic separation of children of color from their parents – without regard for the lasting trauma it entails –is a thread that runs through our nation’s history from slavery to Native American boarding schools to present day child welfare practice.

            This has been perpetuated by the misconception that we are nobly “rescuing” children from dangerous situations. On the contrary, research suggests that many children who spend time in foster care are more likely to experience negative outcomes than their counterparts who were not removed from their families.

             But in the Issue Brief, Chapin Hall suggests there hasn’t been enough of that “noble rescuing.”

             According to the Issue Brief, Black parents are “significantly” more likely to abuse and neglect their children – and, if anything, even more Black children should be taken away.  As the Issue Brief notes with approval:

 One speaker summarized: “African American children are at least as likely to be underserved as overserved” by current removal rates.

             In his current op-ed Samuels writes:            

Bold policy and legislation are needed to create and sustain a vastly different system that coordinates among multiple agencies to prevent trauma rather than create it, and to strengthen family and community capacity to ensure children are safe and thriving. This will require that we de-scale existing infrastructure and dismantle racist practices in favor of a new way to work.

             But the Issue Brief dismisses the notion of radical change and denies that there are “racist practices” to dismantle.

             So, will the real Chapin Hall please stand up?

             The good news is that when I went looking for the Issue Brief I couldn’t find it anywhere on the Chapin Hall website.  Perhaps my search was insufficient, or perhaps it was an accidental oversight the last time the site was updated.  But other documents from 2011 and earlier still are there.  (It’s readily available elsewhere for those who want to search for it; I prefer not to link to documents permeated with racial bias when it can be avoided.)

             The bad news is that the old Chapin Hall, blind to racial and class bias and blind to the harm of needless removal, was very much on display just two years ago.  Shortly after the high-profile death of a child “known to the system” Chapin Hall was commissioned to do a review.  A foster-care panic already had begun – and the slipshod quick-and-dirty review threw gasoline on the fire.

             Now, we’re seeing the results.  Between fiscal years 2018 and 2020 the number of children torn from their homes in Illinois has skyrocketed 30%.  The 17% increase in 2019 alone was the second highest increase in the country that year.  In fact, even as the number of children taken over the course of a year nationwide approaches a 21-year low, the number taken in Illinois has hit a 21-year high.

             Of course Chapin Hall wasn’t solely or even primarily responsible for that. But they had a chance to be a genuine scholarly voice of reason, and instead made everything worse. 

             All of the noble sentiments in Samuels' column are contradicted by what those who work for him have done in the past – and still are doing.

             So which is it going to be?

             If Samuels really means what he says, there are two things he could do right now:

             ● Formally and publicly apologize for co-sponsoring Betsy Bartholet’s whitewash – in every sense of the term – of racial bias in child welfare and formally withdraw the Issue Brief.

             ● Withdraw the poorly done, ill-though-out Illinois “review” and start over – this time with a review built around enacting the very reforms Samuels himself calls for.

Foster-care panic in Illinois: Chapin Hall throws gasoline on the fire

This is a follow-up to an earlier post about foster-care panic in Illinois which includes links and citations for all data and studies.

Back when he ran – and dramatically improved – the Illinois Department of Children and Family Services, Jess McDonald had a graph he called his “EKG chart” – because that’s what it looked like.

The chart showed the spikes in the number of children taken from their parents during any week in which a child abuse fatality was on the front page of the Chicago Tribune or the Chicago Sun- Times.

Right now, odds are the EKG would be off the charts.  Illinois almost certainly is experiencing its worst foster-care panic since 1993 – when the scapegoating of family preservation after the death of Joseph Wallace caused removals to skyrocket, plunged an already bad system into chaos, and was followed by an increase in child abuse deaths. 

UPDATE, SEPTMEBER 15, 2020: That is, in fact, what has happened.  Between fiscal years 2018 and 2020 the number of children torn from their homes in Illinois has skyrocketed 30%.  The 17% increase in 2019 alone was the second highest increase in the country that year.  In fact, even as the number of children taken over the course of a year nationwide approaches a 21-year low, the number taken in Illinois has hit a 21-year high.

The problem isn’t that the deaths are on the front page – that’s exactly where they belong. The problem is that politicians are rushing to learn the wrong lessons; and a bunch of people with a depressing record for dressing up their advocacy as “scholarship” are pouring gasoline on the fire.

The most recent horror stories, including the death of A.J. Freund, were caused by overloaded caseworkers, budget cuts and an ill-conceived privatization of services for families.  But you’re much more likely to score political points – and less likely to have to spend state money - if you rush to scapegoat family preservation.

And so, Gov. J.B. Pritzker does what politicians so often do in these situations: He embraces the Big Lie of American child welfare, and confuses child removal with child safety.  While he didn’t quite utter the common mantra “if in doubt, yank ‘em out” he came depressingly close, declaring: “We will make sure the message is clear: If the child is unsafe, we don’t want there to be any hesitation about removing a child.”

But it is far better for children when you remove the risk instead of the child – and, since most cases are nothing like the horror stories, in most cases, it is possible to do just that.

The problem with Pritzker’s approach is that it increases the danger to children – and I don’t just mean the enormous emotional trauma of needless removal. Pritzker’s approach also means increasing the already high risk of abuse in foster care itself, and increasing the overload for caseworkers, making it even less likely that they will find the next A.J. Freund.  These are all lessons that were learned after the Wallace tragedy – but now, apparently, have been forgotten.

Perhaps one should expect no better from politicians. But we should expect better from those who proclaim themselves to be scholars.  But Pritzker actually was responding to a quick-and-dirty “review” from advocates who have a long, ugly track record of presenting their anti-family advocacy as "scholarship" – Chapin Hall at the University of Chicago.

A not-so-systemic review

Chapin Hall was hired by the governor to do a “Systemic review of Critical Incidents” involving families that had received what Illinois calls “Intact Family Services.”  They spent all of six weeks on the task.

But there was nothing systemic about it. 

Instead, Chapin Hall simply reviewed existing reports on horror story cases conducted by the DCFS Inspector General’s office, reviewed a grand total of three fatality cases and some other documents and forms, and interviewed all of 14 “stakeholders.”

Since the sample was both tiny and non-random, it is impossible to draw sweeping conclusions – but Chapin Hall does so anyway.  You may be sure that had any family preservation advocate cited three carefully-chosen success stories to “prove” the fact that family preservation typically is better for children than foster care Chapin Hall would have thrown a fit.

But since we respect scholarship, we don’t do this. Instead, we cite massive peer-reviewed studies, including two specific to Illinois.

So, if you were going to judge the safety and appropriateness of various interventions, which research do you think is likely to be more valid? A handful of horror stories, selected precisely because they are horror stories, or a carefully matched experimental design involving more than 15,000 cases?

But then, Chapin Hall clearly had drawn its conclusions before even starting the “review.”  They rushed out a press release highlighting the low rate of child removal in Illinois – clearly signaling that was what they would conclude was a key problem.  And sure enough, that was the very first sentence in their review.

In fact, independent court-appointed monitors, who examine the system as part of a longstanding consent decree, have found again and again that as Illinois reduced its rate of removal child safety improved.  (Indeed, even the Chapin Hall review mentions, in a single sentence, a statistic that calls its entire thesis into question: Even now, with all the budget cuts and other recent mistakes, the rate of child abuse deaths in Illinois is below the national average.  That doesn’t prove that a low rate of removal reduces child abuse deaths, but it doesn’t exactly support a hypothesis that a low rate of removal puts children in danger.)

And, as we noted previously, the low rate-of-removal statistic is misleading. It’s skewed by Cook County. In the rest of the state, the rate of removal is much higher.

That’s not the only example of statistics abuse in the review.  In the recommendations section, the review implies that if there are enough reports alleging abuse that alone should be enough to take away the child.  Why? Because “research suggests that young children with previous allegations of physical abuse die at a rate 70% higher than children with allegations of neglect.”

A basic fact about child abuse fatalities

What this neglects to mention is a basic fact for which we all should be grateful: Though each child abuse death is among the worst imaginable tragedies, they are extremely rare tragedies. 

There are more than 73 million Americans under age 18.  Even if we double the official estimate, that would mean that 3,440 die each year of child abuse.  Even if we narrow this down and look only at the number of children who, in some way, become known to child protective services agencies, and fatalities among these children we’re still talking about a very few needles in a gigantic haystack – as Illustrated here nationally and for Illinois. 

That’s based on national figures.  Here’s the Illinois version:

So this “research” tells us only that the chances of any parent killing a child are infinitesimal – and the chances of a parent who was the subject of previous allegations killing a child are ever-so-slightly less infinitesimal.  Yet based on this, Chapin Hall seems to want a massive increase in the removal of children from their homes, solely based on previous allegations, regardless of whether those allegations had any validity.

This was, in fact, the same mentality behind DCFS’ failed experiment in using “predictive analytics – a dangerous fad in child welfare that amounts to what Prof. Virginia Eubanks, author of Automating Inequality calls “poverty profiling.” It appears they factored in things like: “people with multiple reports might be more likely to kill their children” without factoring in the fact that almost no parent ever kills her or his child.

The result, according to the Chicago Tribune:

caseworkers were alarmed and overwhelmed by alerts as thousands of children were rated as needing urgent protection. More than 4,100 Illinois children were assigned a 90 percent or greater probability of death or injury, according to internal DCFS child-tracking data released to the Tribune under state public records laws.  And 369 youngsters, all under age 9, got a 100 percent chance of death or serious injury in the next two years, the Tribune found.

At the same time, high-profile child deaths kept cropping up with little warning from the predictive analytics software, DCFS officials told the Tribune.

And yet, one of Chapin Hall’s recommendations is that DCFS “revisit the use of predictive models …”  Because in child welfare nothing succeeds like failure.

On top of everything else there is, at a minimum, an appearance of conflict of interest in turning to Chapin Hall.  The whole place is run by a former DCFS director, Bryan Samuels.

It’s not as if there is some shortage of genuinely objective scholars out there.  Some of them, from the University of Illinois School of Social Work Children and Family Resource Center, are already on the job: They’re the ones who monitor the consent decree – and who have found that when Illinois reduced its rate of removal child safety improved.

And there are plenty of groups outside Illinois.

But as long as Illinois politicians’ knee jerk response is to ask Chapin Hall for answers, the answer will always boil down to take the child and run.  And it will always be wrong.

Foster care in America: NCCPR issues Report Card on child welfare waiver proposals

Today, NCCPR releases a Report Card evaluating, and grading, all nine publicly-available proposals for waivers from federal child welfare funding rules. These are the grades:

Arkansas                  B+

Colorado                    B-

Illinois                        F

Massachusetts          B

Michigan                   C-

Pennsylvania             B-

Utah                            B+

Washington State    B+

Wisconsin                 F

The full report card is available on our website here. 

Foster care in America: Rutledge Q. Hutson is gloating - and that’s never good news for children

Regular readers of this blog might remember Rutledge Q. Hutson.  Her formal title is Director of Child Welfare Policy at the Center for Law and Social Policy.  A better title would be Leader of the “Yes, but…” Brigade that tried to stop Congress from enacting waivers from federal child welfare financing restrictions.  Those restrictions limit a huge pot of federal child welfare aid to funding foster care and nothing else.

Hutson is an expert practitioner of a standard tactic of America’s latter-day “child savers:” never say no to a good idea, just “yes, but…” it to death.

Despite her best efforts, Congress passed a law restoring the authority of the Department of Health and Human Services to issue up to ten child welfare waivers per year for the next three years.  But what Rutledge Q. Hutson and her allies couldn’t do in Congress, they managed to do through their man on the inside, Bryan Samuels, who runs the Administration on Children Youth and Families within HHS.  As is discussed in previous posts to this blog, Samuels has issued guidelines that effectively undercut the intent of waivers – to reduce needless foster care.  Instead, the guidelines seek to turn waivers into a program to make foster care “better” by providing more “services” to improve children’s “well-being.”

So it’s no wonder that last week, Rutledge Q. Hutson couldn’t resist gloating.  She took her victory lap during a meeting of representatives of various child welfare organizations.  For starters, she admitted the obvious: That she had, in fact, been against the waivers all along.  But not anymore.  Bryan Samuels had so radically altered their true purpose that Hutson was thrilled.  In particular, she’s ecstatic over the fact that waivers won’t be evaluated based on whether they keep children safely out of foster care and prevent reabuse. Instead, for a waiver to be successful it will have to show it also improved these children’s “well-being.”

This ignores two salient facts:

● The purpose of child protective services, the agency that can come into your home and take away your child, is not, in fact, to apply subjective judgments about that child’s “well-being.” Rather, its purpose is to prevent children from being abused.

● One of the best ways to improve any child’s “well-being” is to get him out of foster care if he’s already there and keep him out if he’s never been taken away.

Like almost all child savers, Hutson means well.  After all, the very first child saver, Charles Loring Brace, who, in the 19^th Century, engineered the confiscation of thousands of poor Catholic immigrant children and shipped them off to the south and Midwest to be raised by Protestant families, also meant well.  He sincerely believed Catholic immigrant parents were genetically inferior, and his scheme was essential for their children’s “well-being.”  Both Charles Loring Brace and Rutledge Q. Hutson have devoted much of their professional lives to a vision for helping vulnerable children.  The problem isn’t the good intentions, the problem is the lousy vision.

INVASION OF THE “WELL-BEING POLICE”

Turning child welfare agencies into Well-Being Police sets up both waivers, and parents, to fail.  It actually risks increasing entries into care in states with waivers.

That’s because it compounds one of the biggest problems in the system right now: the fact that once a parent loses a child to foster care that parent actually is held to a higher standard than a parent who never had child protective services in her life in the first place.

For example, no law says that a person who is unemployed can’t have a child.  But once a child is in foster care, getting a job – not just any job, but a job that satisfies the whims of a caseworker - often is a condition for getting the child back. Similarly, no law says that parent who lacks housing deemed suitable by a caseworker can’t have a child.  But once the child has been taken away, regardless of the reason, “suitable housing” often is a condition for getting a child back.  Witness these cases from Texas and South Carolina.

Now, under the Samuels waiver guidelines, the bar for getting a child back and being allowed to keep that child is raised still higher.  Waiver success, and therefore, parental success, is to be judged not only based on whether the parent does not abuse the child, but also on the basis of whether all sorts of “well-being” indicators improve.  So if a waiver keeps children safely at home but they still do poorly at school, that’s a failure.  If a waiver keeps children safely at home but they still have the same emotional problems (plus those that may have been caused by foster care) that, too, is considered a failure of the waiver and the parent.

Obviously, that ratchets up the pressure on parents.  And it creates a back door to bring the coercive power of child protective services far deeper into a family’s life.  In short, it gives child protective services even more grounds to tear apart families and hold children in foster care.

Gwendolyn Clegg, a parental defense attorney in Oklahoma, aptly summed up the problem with this approach in a recent article in the Tulsa World:

"Social workers want to fix all the issues in the whole family. I'm not saying that's a bad thing. …[but] The law only requires you be a D-plus parent, meaning it only requires them to correct the reasons their kids came to us.”

Of course that kind of statement gives a lot of my fellow liberals (especially Rutledge Q. Hutson-type liberals) apoplexy.  After all, shouldn’t every child have A-plus parents?

Well yes.  But not by government force or fiat.

There are all sorts of ways government can and should improve children’s well-being.  Government could ensure that every American has decent health care.  Government could pour funds into low-performing inner city schools (and, by the way, stop scapegoating the people who teach there.)  Government could guarantee access to high quality day care and preschool.  Government could ensure that no American is homeless or lacks decent housing.

Every step the government takes to reduce the scourge of poverty will improve all children’s well-being and help parents do an A-plus job.  And not one of those steps involves imposing on families the extremely dangerous, coercive power of the state.

When it comes to what government should be able to do by force of law to a family, it should indeed require no more than D-plus parenting.  There are a lot of good reasons for that, not least the fact that, foster care so often produces D-minus outcomes for children.

The idea of government as Well-Being Police also plays right into the hands of those on the far right who love to stereotype all liberal ideas, and undercut all efforts of government to offer a true helping hand, by exploiting the extremism reflected in the Hutson-Samuels approach.

WATCHING THE WAIVERS

Does this mean waivers are doomed to do more harm than good?  Not necessarily.  The actual federal law creating the waivers includes none of this nonsense perverting their intent.  What Samuels has issued are guidelines.  Waiver proposals that focus on their rightful purpose, safely reducing foster care, and on measuring success by seeing if foster care is, in fact, safely reduced (as determined by things like reabuse rates and rates at which children are returned to foster care) still can be approved, particularly if there turns out not to be a lot of competition for the ten available each year.

And the public will have some voice, at least in theory.

The first round of waiver proposals are due on July 9.  At some point thereafter, ACYF will post the proposals on its website and solicit public comment.  So check back then and see if your state has submitted a waiver proposal.  Then speak out – for it if it meets the true purpose of waivers, and against it if it’s the kind of waiver that would make Rutledge Q. Hutson and her latter-day child saver allies jump for joy.

Because the final decision rests with someone who understands what a waiver is supposed to do.

ACYF is part of the Administration for Children and Families, which is run by George Sheldon.  Back when he was running the child welfare system in Florida, which implemented a classic waiver with great success, he testified at that same hearing as Rutledge Q. Hutson.  During that hearing Sheldon talked about meeting with former foster children:

Child after child after child told me I would have rather stayed at home and dealt with the issues in that home than gone into a foster care system where I was moved from home to home and school to school.

So the best hope, maybe the only hope, for what should have been the biggest change for the better in American child welfare in decades is that George Sheldon will show Bryan Samuels who’s boss.

Foster care in America: The threat to waivers is even worse than I thought

As is discussed in the previous post to this Blog, when I read the guidance issued by the Administration on Children Youth and Families (ACYF) concerning the kinds of proposals they want to see for child welfare waivers, I was worried.

Now that I’ve heard ACYF Commissioner Bryan Samuels give a presentation about this guidance, I’m even more worried.

Samuels’ approach to child welfare in general, and waivers in particular, is one more classic example of good intentions gone wrong.  Samuels spent a large part of his own childhood in “the system.” I’m sure there is nothing he wants more than to transform the lives of other vulnerable children.  He’s devoted his life to it.  But Samuels’ personal experience was very different from most, and it’s blinded him to the fact that, for most children, the system is unfixable.  It’s blinded him to the fact that the first priority needs to be keeping children safely out of that system.

Last week, I listened by phone to one of several presentations Samuels has given around the country.  Here’s why it was so discouraging:

● Over and over and over again Samuels demeaned the notion that keeping children out of foster care is an end in itself; in effect, dismissing the mass of evidence that foster care is so inherently harmful that its safe reduction should be the top priority for waivers.   “That should not be the measure of success,” Samuels said.  “We want outcomes other than ‘we prevented foster care.’”

● Over and over and over he said that the two standard federal measures of progress – and of child safety -  reducing reabuse of children “known to the system” and foster care recidivism (the proportion of children returned home from foster care who are placed again) - are not valid measures of whether children are better off.  Rather, he prefers inherently more subjective measures of children’s “well-being.”

This ignores the fundamental fact that if you reduce reabuse and foster care recidivism you are improving children’s “well being.”  The whole point of the child protection system is to prevent child abuse.  If you reduce reabuse you have accomplished your primary goal.

That should, in fact, be the primary goal of a system aimed at children and families that includes the ultimate element of coercion.  Any system that can take away your children forever should not be involved in the highly-subjective assessment of whether children are happier or smarter.  Because if you allow that, then you allow coercive systems that have near absolute power and are permeated with racial and class bias to start judging whether impoverished Black children would have improved “well-being” if only they were confiscated from their families and assigned to live with middle-class white strangers.  The problems with that should be obvious.

That doesn’t mean “well-being” should be ignored.  But it should be addressed through a strong network of well-funded services made available to families on a voluntary basis.

SAMUELS BELITTLES HIS BOSS’ WORK

● Samuels belittled the achievements under current waivers – including the only  comprehensive statewide waiver – the one in Florida.  “Their crowning achievements are modest,” Samuels said.

The Florida waiver was implemented by two former secretaries of the state Department of Children and Families, Bob Butterworth and George Sheldon.  There is nothing modest about their achievements in using the waiver to dramatically reduce the number of children in foster care on any given day and entries into foster care over the course of a year, while improving child safety (as documented by independent evaluations).  It’s probably one of the reasons Sheldon was named to run the Administration for Children and Families – making him Bryan Samuels’ boss.  But Samuels apparently doesn’t think much of his boss’ work.

● Samuels derided one round of waiver proposals (I couldn’t make out over the phone if it was past proposals or those they may have received already for the current round), criticizing them because they “focus almost exclusively on deflecting children from entering care” – which is exactly what waivers should do.

Yes, Samuels couched all this in terms of providing more “help.”  He argued that children in foster care get more “services” than children in their own homes, and focusing on outcomes other that reducing reabuse and foster-care recidivism would push states to provide more “services” to children in their own homes.

But that is sophistry.  As I noted above, the whole point of having a child protective services system is to stop children from suffering from child abuse.  There are three ways to accomplish this:

--Stop taking children when they were not abused in the first place (when, for example, poverty is confused with neglect).  Instead, provide help to ease the worst of the poverty.

--If stress is building in a family that might lead that family to mistreat a child, provide the help that will ease the stress.

--Where there really has been maltreatment, provide families with the actual help they need so they don’t do whatever it was they did before. 

All of these already require more services.  Reducing reabuse is an excellent, relatively objective surrogate measure for whether the family is getting more help and whether the child’s “well-being” has improved.  Certainly it’s a better measure than some therapist’s subjective assessment – particularly if the therapist is being paid for every session of therapy she or he administers, or works in a group home or institution paid for every day it holds onto the child.

MUSIC TO THE EARS OF THE FOSTER CARE-INDUSTRIAL COMPLEX

● Samuels again made his distorted priorities obvious when he gave some examples of relatively low cost ways states could spend their waiver money, making clear these are things he’d like to see in proposals:

            --More “parent education.”

            --More effective “counseling” that might not be covered by Medicaid.

            --Helping young people in “independent living” develop relationship skills.

            --Training foster parents in understanding trauma.

In other words, use the money to make foster care “better” instead of to further reduce it. 

Notice also that these are the kinds of services likely to warm the hearts of the “foster care-industrial complex” – the network of counselors, parent educators, and operators of group homes and institutions who live off a steady supply of foster children.  They’re so-called “soft” services in which the family is “diagnosed” with an “illness” and cured through the beneficence of people who, in the 19^th Century, proudly called themselves “child savers.”  There was no mention of the kinds of concrete help like housing and child care and emergency cash that most families caught up in the system really need.

● Perhaps most appalling, Samuels even suggested that the waiver funds could be used for “redesigning how group homes work” and making residential treatment centers better.  Once again, Samuels ignored the mountain of research showing that institutions not only do not work, but also are inherently harmful.

IGNORING THE “EVIDENCE BASE”

That was the great paradox of Samuels’ presentation.  It was slathered in stultifying, au courant child welfare jargon.  Indeed, Bryan Samuels seems to believe there is no problem in child welfare that can’t be solved by throwing buzzwords at it.  One slide in the inevitable power-point presentation was headed: “Initiative to Improve Access to Needs-Driven Evidence-Based/Evidence-Informed Mental and Behavioral Health Services in Child Welfare.” 

The good news: A state that loads up its proposal with enough buzzwords probably will be able to do what it wants.

The bad news: Though Samuels constantly chants the mantra of “evidence based/evidence informed” he refuses to face up to the evidence about substitute care.

For example, in proposing that states waste waiver dollars on making residential treatment centers better, he cites one study of one institution that supposedly improved outcomes – but  the study did not follow up to see what happened to the residents after they were discharged.  In contrast, dozens of studies show the enormous inherent harm of residential treatment.  But Bryan Samuels pretends that evidence base doesn’t exist.

Only at the very end of his presentation, in response to a specific question, did Samuels make comments that appeared to be favorable toward some of the things one community, Los Angeles, tried to do to curb entries using its waiver.

What accounts for this?  Probably the tyranny of personal experience.

Samuels was institutionalized – living in the same institution for 11 years.  Unlike most, he was able to cope with it.  And in a system in which only one in five alumni does well, he became one of the one in five. 

But that, apparently, has left him incapable of facing up to what the system does to the other four in five; and, in particular incapable of getting beyond a notion that boils down to:  If we just make the foster homes and the group homes and the institutions “better” the other four in five will do just as well as I did.

The evidence base says otherwise.  And someone needs to make sure Bryan Samuels faces up to that, before a whole lot of money – and children’s lives – are wasted on waivers designed to “fix” foster care.  Because the evidence base is overwhelming: The only way to fix foster care is to have less of it.  And that is what waivers should be all about. 

Foster care in America: HHS guidelines undermine child welfare waivers

The best chance in decades to get serious about reducing the number of children torn from their families each year is being undermined by the agency that is supposed to make it work.

Last September, Congress restored the authority of the Department of Health and Human Services to issue “waivers” from rules that restrict a huge proportion of federal child welfare aid to funding foster care and only foster care.

Under current law, the foster care money is an open-ended entitlement.  For every “eligible” child placed in foster care – and that’s nearly half of all foster children – the federal government picks up a large share of the cost.  This creates a horrendous incentive: Though foster care costs more than better alternatives in total dollars, there are times when it might cost a state or county less to use foster care because the federal government picks up so much of the tab.

States that receive waivers get the chance to spend the money on better alternatives, as well as on foster care.  In exchange, they accept the money as a flat grant instead of the current open-ended entitlement.  The state gets the same amount of money, plus inflation, for every year of the waiver (typically five years), even if there are fewer children in care.  So as foster care is reduced, the state gets to keep the savings, as long as those savings are plowed back into child welfare.

The Congressional Research Service estimates that, had this deal been made available to every state back in 2005, and had every state accepted it, the states would have had $5 billion more to spend on child welfare by 2010 than they actually got under the current entitlement.

So the fact that Congress now is allowing ten states per year over the next three years to receive these waivers seemed like a real breakthrough.  But the devil is in the details – in this case, the guidelines issued by the Administration on Children, Youth and Families (ACYF).  The guidelines appear to have been written to undermine any effort to use waivers to prevent children from entering foster care or to speed reunification.  They will be discussed at a so-called “town hall meeting” at the ACYF offices in Washington this afternoon.

A BIGGER BAND-AID FOR A GAPING WOUND

For starters, the guidelines accept the false premise that all children in foster care have been abused or neglected.  The guidelines emphasize addressing the trauma caused by that abuse.  Nowhere do the guidelines recognize that many children in foster care have not, in fact, been abused or neglected (unless one considers poverty itself to be neglect) and it is foster care itself that often causes the trauma.

So it’s no wonder that instead of encouraging states to curb needless foster care – indeed, that’s not even listed as a goal - the guidelines give top priority to doing no more than providing a bigger Band-Aid to cover the gaping wounds opened by needless foster care placement.  The second priority is to create still more incentives to push adoption.

For page after page, the guidelines prattle on about improving “well-being outcomes.”  In other words: Try to undo some of the harm already done by bouncing children from home to home by providing more “counseling.” Or try to undo the harm done by moving foster children from school to school with mentoring programs and tutoring.

To the extent that helping families is mentioned at all, it is in a context that strongly implies providing more “counseling” for them – after their children already are in foster care.

Thus, for example, the guidelines state that

in order to achieve better outcomes for children who have experienced maltreatment it is essential to engage families, whether biological, foster or adoptive, in the process of healing and recovery. [Emphasis added.]

Note first the use of the pejorative, offensive term “biological parent,” instead of “birth parent,” which is value neutral.  The rest of the sentence makes clear the author’s view that all children in foster care have been abused and need help to heal from what the abusers did to them.

THE TROUBLE WITH BAND-AIDS

At least one study actually has tried to measure how much good this Band-Aid approach would do.  The answer?  Not much.

The study, done by Casey Family Programs in cooperation with Harvard Medical School, found that only about 20 percent of former foster children are “doing well” as young adults. (There is a complete analysis of the study and a link to the full study on our website here.)

The authors went on to design a complex mathematical formula to attempt to figure out how much they could improve these outcomes if  they could invent and use the perfect Band-Aid and every single problem besetting the foster care system magically were fixed. Their answer: 22.2 percentage points.  In other words, if tomorrow, foster care miraculously became perfect, it would churn out walking wounded only three times out of five, instead of four.  Yes, that’s worth doing – but not at the expense of better solutions.

To see why Band-Aids don’t work, one need look only at an example from the ACYF guidelines concerning an issue they propose to target: the misuse and overuse of psychiatric mediation on foster children.  This is a very serious, very real problem – but it is a problem inherent in foster care.  We know this because when children with exactly the same kinds of needs are placed in kinship foster care – that is with relatives – the percentage placed on meds is far lower.  It’s not hard to figure out why.  Grandparents are a lot more likely to love these children than total strangers – so grandparents are a lot more likely to put up with behavior that would prompt a stranger to demand a prescription to make the child more docile.

Thus, the solution to the misuse and overuse of psychiatric medication on foster children is to keep more children out of foster care and, where that’s absolutely unavoidable, do more to place them with relatives.  But the guidelines are seeking proposals not to curb foster care but only to provide that bigger Band-Aid, in this case “behavioral and psychosocial interventions [that] are considered first line or concurrent treatments for children for whom psychotropic medication is being considered or used.”

PERMANENCE SHOULD MEAN MORE THAN ADOPTION

The second priority is using waiver funds to further increase adoptions. 

Since 1997, the American child welfare system has been fanatical about equating permanence for children with adoption. The federal government even has offered states a bounty of up to $12,000 for every finalized adoption of a foster child over a baseline number – sometimes with awful results.  There is no similar incentive for reunifying families.

Instead of trying to balance the scales by asking for waiver proposals that emphasize quickly and safely reunifying families, the guidelines seek proposals that will further tilt those scales toward adoption.  Indeed, in a section discussing the need for programs to address permanence, every example deals with adoption.

Still another section deals with changing financial incentives for the foster care-industrial complex, the network of private foster care agencies, professional helpers and assorted hangers-on that lives off a steady supply of foster children.

The guidelines call for proposals that will implement “performance based payments.”  Often called performance-based contracting, this has enormous potential to reduce needless foster care.  A state with a waiver could use flexible funds to reward agencies for keeping children out of foster care or increasing the number of children reunified with their parents.  But the guidelines ignore those possibilities.  Instead, the one and only example offered is this:

A state could condition provider payments … on measurable improvements in child well-being outcomes or increased numbers of successful adoptions among the longest-waiting children in foster care.

REAL WAIVERS STILL ARE POSSIBLE – IF STATES FIGHT FOR THEM

On one level, this fundamental betrayal of the primary purpose of waivers shouldn’t be surprising.  These priorities are a perfect reflection of the priorities Bryan Samuels, the commissioner of ACYF, the agency which drafted the guidelines.  His unfortunate priorities have been noted on this Blog before.

Fortunately, Samuels’ boss knows better.  His boss is George Sheldon, commissioner of the Administration for Children and Families (ACYF is a division of ACF and both are within HHS).  As Secretary of Florida’s Department of Children and Families Sheldon and his predecessor, Bob Butterworth implemented the only statewide waiver granted the last time they were made available in 2006.  They used the waiver to cut significantly both the number of children in foster care on any given day and entries into care.  They did it by emphasizing permanence in all its forms – reducing the number of children who entered care, bolstering reunification and adoption.

Few people in child welfare seem to have a better understanding of the need to prevent needless foster care than Sheldon.  And Sheldon championed waivers both before and after taking the job at ACF.

That suggests that a state that really wants to use its waiver to actually reduce foster care through prevention and reunification probably still can do it – and should not be discouraged from trying by these guidelines.  The guidelines have lots of wiggle room.  And, frankly, it’s possible there won’t be much competition for the ten waivers available each year.

So a state with gutsy leadership and a strong commitment to prevention and family preservation still should be able to get a waiver.  But the state will have to emphasize what Bryan Samuels already should know:

● The best way to improve the “well-being” of children at risk of foster care is to make sure they are never placed in foster care.

● And the best way to improve the “well-being” of foster children is to get them the hell out of foster care.