You get what you pay for: How Florida shifted funding priorities to foster care

Child welfare’s foremost data nerd has weighed in on the mess in central Florida child welfare caused by – well caused by a lot of things, including the dreadful performance of Eckerd Connects.  Eckerd is the “lead agency” in the region (though not for long) under Florida’s largely privatized system of family policing.  (Florida calls it a “Community-Based Care” (CBC) system of “child welfare,” but both those terms are euphemisms.) 

We wrote a detailed blog post about what went wrong last week.  Now there is a much more detailed post from Prof. Robert Latham, associate director of the University of Miami School of Law Children and Youth Law Clinic. He also has a degree in computer science and a talent for data visualization.  That makes him unafraid to go as deep into the weeds as necessary to determine whether a claim is true. 

In his most recent blog post, he documents, in chart after chart, why the claim by Eckerd that its failures are due to the agency not getting enough money is b.s.  As the headline for the post puts it “CBC Funding Doesn’t Make Children Live in Offices.” 

But there are some other significant observations.  Much as we did last week, Latham notes that 

None of the problems are new, and every player in the saga had some hand in creating the mess. The [Pinellas County] sheriff, who is now saying Eckerd could be criminally liable, is the child protective investigator in Pinellas county and has been removing children (at higher than statewide average rates) and handing them to Eckerd for years despite all the known problems. 

But he also explains how the Florida Legislature, the current administration of Gov. Ron DeSantis and the administration of former Governor Rick Scott skewed financial incentives for the “CBCs” toward holding more children in foster care and against trying to keep families together. 

In other words, in addition to all the other ways Florida government caved-in to the Miami Herald and reporter Carol Marbin Miller’s crusade to tear apart more families, the governors and the Legislature also rewarded agencies like Eckerd for holding children in foster care and penalized them for working to keep them safely at home. 

How the incentives work 

In 2010, back when Charlie Crist was still governor and the Florida Department of Children and Families had a visionary leader in George Sheldon, a small proportion of the complex formula for allocating funds to agencies such as Eckerd rewarded them if they reduced the number of children they trapped in foster care.  But by 2015, the year after Miller’s Innocents Lost series started a foster-care panic, that was gone.  Not only that, the proportion of the formula based on the number of children held in foster care doubled – from 30% of the formula to 60%.  It declined to 55% in 2018 – but it’s still, by far, the largest single driver of how much money Eckerd and its counterparts get. 

That isn’t even the worst of it.  The formula for how much these agencies get is based in part on what the other CBCs are doing – apparently, it’s a little like grading on a curve.  But in this case, the better you do the worse the grade. 

Writes Latham: 

[I]f an agency holds its numbers steady while every other CBC increases theirs, that agency will lose money in the formula. There is no incentive to be the first agency to lower the numbers … There is, however, an incentive to be the first to raise your numbers in a given category and capture a higher proportion before the other agencies catch up. This could be a good or bad thing depending on the category and the cost of care for that group. [Emphasis in original] 

In other words, if, say, a county sheriff is tearing apart families needlessly, a lead agency has no financial incentive to complain about it.  And they have no incentive to get children home as quickly and safely as possible.  In fact, if they do the right thing before anyone else, it’s great for the kids, but bad for the agency’s bottom line. 

Double standards and bad incentives 

Any discussion of financial incentives is plagued with the same sorts of double standards that afflict any discussion in child welfare: tearing apart families is automatically considered the good, “safe” option, while avoiding the horrific trauma needless removal inflicts on children, and avoiding the high risk of abuse in foster care itself, is somehow deemed risky. 

So you may be sure that were the legislature ever to restore even a slight incentive not to hold children needlessly in foster care, the Herald or the Tampa Bay Times would find the first available horror story and blame it on a supposedly dangerous incentive to return children home. 

Of course, neither newspaper has expressed any concern about the current incentive to
prolong foster care, with all of the well-documented emotional harm this inflicts on children (think Mexican Border because it’s the same kind of harm), the well-documented rotten outcomes this causes in later life,  the well-documented high rate of abuse in foster care – and, of course, the well-documented harm to children who fall into the clutches of outfits such as Eckerd. 

There are also huge incentives to prolong foster care beyond the financial: No caseworker wants to be on the front page of the Herald or the Tampa Bay Times, accused of “allowing” a child to die.  They need have no fear of being on the front page for tearing apart families needlessly.  The same dynamic applies to judges and agency administrators. 

The bad financial incentives compound all that. Changing them would be a very small step toward redressing the imbalance and allowing the system to handle each case on its merits. 

That this can be done in Florida is illustrated by what happened when Sheldon and before him Bob Butterworth ran DCF.  During their tenure a waiver from federal funding rules allowed more money to be used to keep families together.  Entries into foster care declined and independent monitors found no compromise of child safety. 

Then the Miami Herald came along and blew the whole thing up. 

Everything from the series of outstanding stories from the USA Today Florida Network, and the accounts of youth left to the tender mercies of Eckerd make clear the consequences.

Remembering George Sheldon …

... Including the legacy the Miami Herald wants you to forget

George Sheldon

When former Florida Gov. Charlie Crist, then a Republican, named one of the state’s most prominent Democrats, Bob Butterworth, to run the state Department of Children and Families, a joke made the rounds: “Nobody can fix DCF,” the joke went. “Now a Democrat will be blamed for the failures.”

Butterworth brought in another prominent Democrat, George Sheldon, to be his deputy. But if the joke was right about Crist’s secret plan, the joke was on him. Together, Butterworth and Sheldon engineered one of the largest transformations of any child welfare system in America. What was once the nation’s most prominent example of child welfare failure, became, relatively speaking, a remarkable success. 

When Butterworth left, there was speculation that Crist would never name Sheldon to the top job – after all, Crist had defeated Sheldon in two statewide election campaigns.  But he did.  And Sheldon expanded on the reforms begun under Butterworth.

During the Obama Administration, Sheldon became the nation’s highest-ranking official in child welfare, running the Administration for Children and Families at the Department of Health and Human Services. While there, he championed real child welfare finance reform.

The term “hero” is overused.  So is the term “champion for children.” But they both apply to George Sheldon, who died last week at the age of 71. 

Reading the tributes to Sheldon it is striking how many of them come from former foster children.  They knew that, finally, they had a real friend in a position of power.

Sheldon’s greatest accomplishment

Sheldon moved aggressively to curb the use of psychiatric medication on foster children, and he prohibited the use of foster children in drug trials.  He championed “normalcy,” working to clear away the bureaucratic barriers that made it hard for foster children to enjoy the smallest pleasures in life, such as a sleepover at a friend’s house.  And Sheldon and Butterworth took DCF out of the bunker, opening records and speaking candidly about the agency’s failures.

But their single greatest accomplishment was this: Sheldon and Butterworth dramatically reduced the number of children torn needlessly from their families – and independent monitors found they did it without compromising child safety.  The dramatic transformation was featured in The New York Times.  

Yet this appears nowhere in the Miami Herald’s obituary for Sheldon. 

The obit is filled with warm reminiscences and wonderful stories, like this one, from former journalist Martin Dyckman, about Sheldon’s time in the Florida Legislature:

In the 1970s, when the Legislature passed financial disclosure laws, Sheldon often ranked dead last among his colleagues in the House. One newspaper led a story about the financial worth of lawmakers by noting that then-Miami-Dade Rep. Elaine Bloom disclosed ownership of a pure-breed dog whose declared worth was greater than Sheldon’s, Dyckman recalls.

But the obituary profanes Sheldon’s memory by leaving out entirely his single greatest accomplishment in Florida. In 2,000 words, reporter Carol Marbin Miller found no room to even mention his work to safely and successfully keep more children out of the chaos of Florida foster care.  But, of course, Miller has led a crusade against those changes. Now, she wants to pretend they never happened.

But they did happen.  And the best way to honor George Sheldon would be for the people of Florida to turn their backs on the Miami Herald’s fearmongering and demand that DCF return to George Sheldon’s vision of child welfare reform.

Foster care in Florida: State’s reforms are NCCPR's latest “Way to do Child Welfare Right”

UPDATE, SEPTEMBER 28: Check out Sarasota Herald Tribune columnist Tom Lyons' take on Florida's improvement, and the waiver that did so much to make it possible.

Less than a decade ago, child welfare failure could be summed up in a single word: Florida.  The fact that a five-year-old foster child could disappear for more than a year before anyone at the Florida Department of Children and Families even noticed became a symbol of failure not just in Florida but nationwide.  The case was only the most visible example of how the take-the-child-and-run approach brought to DCF in 1999 had collapsed the entire system.

                Today in child welfare, Florida stands for something else: It stands for openness, innovation, and progress.  And it stands for the fact that you can’t have child protection without family preservation. That’s why today NCCPR adds the transformation of child welfare in Florida to our list of “Ways to do Child Welfare Right.”  

Two changes were crucial: First, in the tradition of a “team of rivals,” Gov. Charlie Crist, then a Republican, brought in one of the state’s most popular Democrats, former Attorney General Bob Butterworth, to lead DCF.  The joke at the time was that when Butterworth failed, Crist could blame the Democrats.  If that was the plan, the joke was on Crist.  For starters, Butterworth and his successor, George Sheldon (another Crist rival) started by dragging the agency out of its bunker, initiating a policy of telling the press and public as much as the law allowed, and interpreting all ambiguity in favor of openness. 

                Butterworth also started listening to current and former foster children – for real, not for show.  And that probably was the single most important factor leading him to reverse the agency’s course and embrace safe, proven approaches to keep children in their own homes.  Sheldon built on that as well.  Most recently, he launched an initiative to try to make foster children’s lives as normal as possible – that is, an effort to reduce barriers to living a normal family life that most of us don’t even think about – like the difficulties in getting a driver’s license or the requirement for background checks before a foster child can sleep at a friend’s house overnight. 

THE WAIVER MADE A BIG DIFFERENCE

                But the Crist administration doesn’t deserve all the credit.  Former Governor Jeb Bush, who did so much to plunge the agency into chaos, also made one crucial decision that made recovery from his own mistakes easier: He accepted a waiver from federal funding restrictions.  Money that, in other states, can be spent only on foster care, Florida can spend on better alternatives as well.   (It’s been argued that Bush’s decision had nothing to do with enlightened public policy and everything to do with him wanting to help his brother, the former President.  But who cares?  It worked).

                It’s all led to a 35 percent reduction in the number of children torn from their families between 2006 and 2009.  Independent evaluations, required by the waiver, have found that child safety improved.  If the Senate follows the House and approves legislation to restore the authority of the Department of Health and Human Services to issue such waivers, it will be easier for other states to achieve similar results.

                But there was one last barrier to adding Florida to our list.  No state could be considered a national leader in child welfare as long as it banned fit, loving parents from adopting just because of their sexual orientation.  The worst kept secret in Florida is the fact that the Crist Administration’s DCF leadership hated that law, but it was not struck down by a Florida appeals court until last week.

            Florida still has a long way to go.  It’s a big state and not every region has gotten the message.  So even with all the progress, the rate of child removal in Florida still was slightly above the national average in 2009, the most recent year for which data are available for every state.  And, as with all good systems, there still are huge mistakes in all directions.  Some children still are left in dangerous homes.  Other children still are needlessly taken from their families.  As we note in the publication we now call Thirteen Ways to do Child Welfare Right: All of the things that go wrong in the worst child welfare systems also go wrong in the best – but they go wrong less often.

                In addition, there is a powerful group of providers, advocates and others who still don’t get it – people who actually view the take-the-child-and-run era as the good old days.  And they never miss a chance to exploit the inevitable tragedies in a huge system to advance their agenda.

                But for now, Florida child welfare is heading in the right direction.  And while other reformed systems had to significantly change direction to start doing child welfare right, for Florida it was even harder.  In Florida it required a U-turn.