[House Hearing, 109 Congress]
[From the U.S. Government Publishing Office]
FEDERAL FOSTER CARE FINANCING
=======================================================================
HEARING
before the
SUBCOMMITTEE ON HUMAN RESOURCES
of the
COMMITTEE ON WAYS AND MEANS
U.S. HOUSE OF REPRESENTATIVES
ONE HUNDRED NINTH CONGRESS
FIRST SESSION
__________
JUNE 9, 2005
__________
Serial No. 109-14
__________
Printed for the use of the Committee on Ways and Means
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36-661 PDF WASHINGTON DC: 2007
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COMMITTEE ON WAYS AND MEANS
BILL THOMAS, California, Chairman
E. CLAY SHAW, JR., Florida CHARLES B. RANGEL, New York
NANCY L. JOHNSON, Connecticut FORTNEY PETE STARK, California
WALLY HERGER, California SANDER M. LEVIN, Michigan
JIM MCCRERY, Louisiana BENJAMIN L. CARDIN, Maryland
DAVE CAMP, Michigan JIM MCDERMOTT, Washington
JIM RAMSTAD, Minnesota JOHN LEWIS, Georgia
JIM NUSSLE, Iowa RICHARD E. NEAL, Massachusetts
SAM JOHNSON, Texas MICHAEL R. MCNULTY, New York
PHIL ENGLISH, Pennsylvania WILLIAM J. JEFFERSON, Louisiana
J.D. HAYWORTH, Arizona JOHN S. TANNER, Tennessee
JERRY WELLER, Illinois XAVIER BECERRA, California
KENNY C. HULSHOF, Missouri LLOYD DOGGETT, Texas
RON LEWIS, Kentucky EARL POMEROY, North Dakota
MARK FOLEY, Florida STEPHANIE TUBBS JONES, Ohio
KEVIN BRADY, Texas MIKE THOMPSON, California
THOMAS M. REYNOLDS, New York JOHN B. LARSON, Connecticut
PAUL RYAN, Wisconsin RAHM EMANUEL, Illinois
ERIC CANTOR, Virginia
JOHN LINDER, Georgia
BOB BEAUPREZ, Colorado
MELISSA A. HART, Pennsylvania
CHRIS CHOCOLA, Indiana
DEVIN NUNES, California
Allison H. Giles, Chief of Staff
Janice Mays, Minority Chief Counsel
______
SUBCOMMITTEE ON HUMAN RESOURCES
WALLY HERGER, California, Chairman
NANCY L. JOHNSON, Connecticut JIM MCDERMOTT, Washington
BOB BEAUPREZ, Colorado BENJAMIN L. CARDIN, Maryland
MELISSA A. HART, Pennsylvania FORTNEY PETE STARK, California
JIM MCCRERY, Louisiana XAVIER BECERRA, California
DAVE CAMP, Michigan RAHM EMANUEL, Illinois
PHIL ENGLISH, Pennsylvania
DEVIN NUNES, California
Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public
hearing records of the Committee on Ways and Means are also published
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current publication process and should diminish as the process is
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C O N T E N T S
__________
Page
Advisory of June 2, 2005, announcing the hearing................. 2
WITNESSES
U.S. Department of Health and Human Services, Hon. Wade F. Horn,
Ph.D., Assistant Secretary for Children and Families........... 7
______
Casey Family Programs, Adrienne Hahn............................. 50
Chapin Hall Center for Children, Fred Wulczyn.................... 56
Florida Department of Children and Families, Don Winstead........ 44
SUBMISSIONS FOR THE RECORD
Bryan, Barbara, Davidson, NC, statement.......................... 75
Child Welfare League of America, Alexandra Yoffie, statement..... 78
Children's Law Center of Los Angeles, Monterey Park, CA, Miriam
Aroni Krinsky, statement....................................... 83
County Welfare Directors Association of California, Sacramento,
CA, Frank J. Mecca, statement.................................. 86
Fight Crime: Invest in Kids, David Kass, statement............... 89
Generations United, Pamela Pressley, statement................... 92
Gladwell, Lisa, River Edge, NJ, statement........................ 94
Mullenix, Glenna Bible, Jefferson City, TN, statement............ 96
National Council For Adoption, Alexandria, VA, Thomas Atwood,
statement...................................................... 101
National Indian Child Welfare Association, Portland, OR, Terry L.
Cross, statement............................................... 103
Podesta Mattoon, Seth Nichols, statement......................... 105
Reese, Cheryl Renee, Round Rock, TX, statement................... 105
Richards, Frank, Hillsborough, CA, statement..................... 106
Roberts, Daniel Allen, Dunnellon, FL, statement.................. 107
South Carolina Children's Foster Care Review Boards, Columbia,
SC, Denise Turbeville Barker, statement........................ 108
The Sociology Center, North Little Rock, AR, James Roger Brown,
statement...................................................... 109
Transitions Incorporated, Boca Raton, FL, Eric Roy Budwizer,
statement...................................................... 114
Zero to Three: National Center for Infants, Toddlers, and
Families, Matthew E. Melmed, statement......................... 116
FEDERAL FOSTER CARE FINANCING
----------
THURSDAY, JUNE 9, 2005
U.S. House of Representatives,
Committee on Ways and Means,
Subcommittee on Human Resources,
Washington, DC.
The Subcommittee met, pursuant to notice, at 10:05 a.m., in
room B-318, Rayburn House Office Building, Hon. Wally Herger
(Chairman of the Subcommittee) presiding.
[The advisory announcing the hearing follows:]
ADVISORY
FROM THE
COMMITTEE
ON WAYS
AND
MEANS
SUBCOMMITTEE ON HUMAN RESOURCES
CONTACT: (202) 225-1025
FOR IMMEDIATE RELEASE
June 09, 2005
No. HR-3
Herger Announces Hearing on
Federal Foster Care Financing
Congressman Wally Herger (R-CA), Chairman, Subcommittee on Human
Resources of the Committee on Ways and Means, today announced that the
Subcommittee will hold a hearing on Federal foster care financing. The
hearing will take place on Thursday, June 9, 2005, in room B-318
Rayburn House Office Building, beginning at 10:00 a.m.
In view of the limited time available to hear witnesses, oral
testimony at this hearing will be from invited witnesses only.
Witnesses will include Administration and State officials, and other
individuals familiar with Federal foster care financing issues.
However, any individual or organization not scheduled for an oral
appearance may submit a written statement for consideration by the
Subcommittee for inclusion in the printed record of the hearing.
BACKGROUND:
In fiscal year 2004, the Federal Government provided more than $7
billion in dedicated funds for child protection. The bulk of these
funds--almost $5 billion--supported children who had been removed from
their homes and placed in temporary foster care. Federal foster care
funds are available to assist States with maintenance payments,
administrative costs, and training to provide services for certain low-
income children. These funds are provided on an open-ended basis, which
means that States are reimbursed by the Federal Government for a
portion of any allowable cost. At the hearing, the U.S. Department of
Health and Human Services is expected to release new data on Federal
foster care funds received by States under this open-ended system. This
hearing will review how the current foster care financing system works
and examine how children have fared under this system.
In announcing the hearing, Chairman Herger stated, ``We have
repeatedly heard over the past few years how children have been left at
risk in the current child protection system. Everyone should expect
better outcomes, starting with our primary focus and utmost priority,
ensuring these vulnerable children are well cared for and safe. I look
forward to learning more at this hearing about how current funds are
being spent, and how funding is related to outcomes experienced by
children.''
FOCUS OF THE HEARING:
The focus of the hearing is on Federal foster care financing
issues.
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Chairman HERGER. Good morning, and welcome to today's
hearing. Today's hearing provides new insights on efforts to
protect children who have been abused and neglected by their
own parents. Specifically, we will learn from a U.S. Department
of Health and Human Services (HHS) report released today what
the programs designed to protect children cost and what that
spending buys in terms of protection for children. Most of what
the Federal Government spends each year on child welfare
programs, about $5 billion in all, supports low-income children
in foster care. These funds support the cost of maintaining
children in out-of-home placements, the cost of administering
this program, and some training costs.
What we will learn today is that Federal funding per child
in foster care ranges from about $5,000 to more than $40,000
per year, depending on the State. Those are huge differences
between the States. What is even more surprising is that the
evidence shows that more spending does not necessarily mean
better outcomes for the children. This information will add
important details to our knowledge about the current child
protection system.
Unfortunately, much of what we have learned during recent
hearings has highlighted ways the current system fails to
adequately protect children. For example, previous hearings
have shown that States lack important data needed to protect
and even keep track of children in foster care. Every State
failed to pass Federal reviews of their child protection
programs. When it came to the sensitive issue of whether
children in foster care can be placed in clinical trials and
under what circumstances, we had to engage HHS to survey States
about their policies. We look forward to getting this
information. We learned about the real-world effects when
systems don't perform, such as a brutal starvation case in New
Jersey, and the beating death of two infants in Baltimore
released to their mother, a foster care runaway.
Last year, I introduced legislation that would have
reformed how foster care and adoption programs are financed.
That legislation would have locked in growing levels of funding
for payments to families for administration and for services.
It offered an additional $2 billion in funding, much for
services designed to better protect children and keep them out
of foster care in the first place.
Clearly, it is hard to look at the current funding system,
with average Federal spending per child per State ranging from
$5,000 to more than $40,000 per child, and say that system is
responsibly spending taxpayer dollars. That doesn't include
what States spend on foster care from the Temporary Assistance
for Needy Families (TANF), Social Services Block Grant (SSBG),
or Medicaid programs, or even their State funds. All of that
spending, as the report suggests, is not related to better
outcomes for children. That is disturbing. There has to be a
better way.
With us today are a number of experts, as well as
Administration and State officials, to discuss the HHS report
and its implications. I would like to thank all our witnesses
for joining us today to explore this important issue. Without
objection, each Member will have the opportunity to submit a
written statement and have it included in the record at this
point. Mr. McDermott, would you care to make a statement?
[The opening statement of Chairman Herger follows:]
Opening Statement of The Honorable Wally Herger, Chairman, and a
Representative in Congress from the State of California
Today's hearing provides new insights on our Nation's efforts to
protect children who have been abused and neglected by their own
parents.
Specifically, we will learn from an HHS report released today what
the programs designed to protect children cost, and what that spending
buys in terms of protection for children.
Most of what the federal government spends each year on child
welfare programs--about $5 billion in all--supports low-income children
in foster care. These funds support the costs of maintaining children
in out-of-home placements, the costs of administering this program, and
some training costs.
What we will learn today is that federal funding per child in
foster care ranges from about $5,000 to more than $40,000 per year
depending on the state. Those are huge differences between states. But,
what's even more surprising is that the evidence shows that more
spending does not necessarily mean better outcomes for children.
This information will add important details to our knowledge about
the current child protection system. Unfortunately, much of what we
have learned during recent hearings has highlighted ways the current
system fails to adequately protect children.
For example, previous hearings have shown that states lack
important data needed to protect and even keep track of children in
foster care.
Every state failed to pass federal reviews of their child
protection programs.
When it came to the sensitive issue of whether children in foster
care can be placed in clinical trials and under what circumstances, we
had to engage HHS to survey states about their policies. We look
forward to getting that information.
And we learned about the real-world effects when systems don't
perform--such as a brutal starvation case in New Jersey and the beating
deaths of two infants in Baltimore released to their mother, a foster
care runaway.
Last year I introduced legislation that would have reformed how
foster care and adoption programs are financed. That legislation would
have locked in growing levels of funding for payments to families, for
administration, and for services. It offered an additional $2 billion
in funding, much for services designed to better protect children and
keep them out of foster care in the first place.
Clearly it is hard to look at the current funding system, with
average federal spending per child per state ranging from $5,000 to
more than $40,000 per child, and say that system is responsibly
spending taxpayer dollars. And that doesn't include what states spend
on foster care from the TANF, Social Services Block Grant, or Medicaid
programs, or even their state funds. And all that spending, as the
report suggests, is not related to better outcomes for children. That's
disturbing.
There has to be a better way.
With us today are a number of experts as well as Administration and
State officials to discuss the HHS report and its implications. I'd
like to thank all of our witnesses for joining us today to explore this
important issue.
Mr. MCDERMOTT. Thank you, Mr. Chairman. At times, we are
separated by a political divide, but you and I share something
much more powerful than political party affiliation. We are
both dads. Perhaps I can speak for both of us when I say
parenting is one of the toughest jobs you would never want to
give up, true?
Chairman HERGER. True.
Mr. MCDERMOTT. As we move ahead in Committee, let's
remember that something powerful unites us; no doubt you and I
lived a good part of our lives following the same philosophy,
we wanted our children to be safe, healthy, happy, and have a
chance to do better than we have done. It is every parent's
dream. It is our responsibility as we look at the kids in
foster care who need us as much as our sons and daughters did.
Now, I agree with you that the child welfare system is in
need of reform. The stakes couldn't be higher, and there is an
urgent need for action; there has been talk about it for years.
We have all heard the tragic stories about children being
abused, tortured, even murdered when they are under the
supervision of the child welfare system. Every State has an
example every year and State legislatures gather around and
ring their hands, and we go on. All of us, not just the foster
care system, must take responsibility for protecting our most
vulnerable children. If not us, who is going to do it? If not
now, when?
Now, there is a lot we can do together. For instance, we
can advocate for prevention and focus attention on support
services that can help stop abuse and neglect before it occurs;
I think the Chairman and I might agree on that. However, I
strongly disagree with anyone who suggests that the only way to
emphasize prevention is to cap, cut, or block foster care.
Robbing Peter to pay Paul will not improve outcomes for
children, and that is our responsibility. If anything, denying
or shifting the financial burden will only lead to more
tragedies, in my view.
It has been suggested that the open-ended nature of Federal
foster care payments is part of the problem because the
payments might be an incentive for States to keep children in
out-of-home placements. That theory holds if only these same
Federal dollars were sent to the States as flexible capped
grants, everything would be fine. Well, two words describe
that, ``Get serious.'' That theory ignores the truth about
funding.
Worse yet, it is brazenly callous to the untold number of
unsung heroes in every State who dedicate themselves to making
the world better for kids who got a bad break in life. Whoever
thought this one up still believes the world is flat. Well, the
world is round, so let's get together on the facts.
Every State already has financial incentives to move kids
out of foster care. No State doesn't have that. Caseworkers are
overwhelmingly making decisions based on what they believe is
best for the child, not the State treasurer. According to the
Urban Institute, half of all Federal spending comes from
nondedicated sources outside the Federal foster care, such as
TANF, the SSBG, or Medicaid. In other words, States already
spend flexible funds on foster care when they could spend the
money on something else.
The States don't deserve a black eye in this discussion. We
do. If we say prevention and family support services are
important, then we need to put our money where our mouth is.
The Congress has not been shy about spending money on just
about everything else--we will put out shortly here a $400
billion defense budget, half the discretionary spending in this
country, and we say we don't have any more for foster care. We
cannot forget that 40 percent of the cases in which child abuse
or neglect has been substantiated, proved, they do not
concurrently receive any follow-up services--40 percent of the
cases in which there is child abuse.
Now, even the Bush Administration advocated last year for
$100 million annual increase for promoting the Safe and Stable
Families (P.L. 107-133) program, which focuses on prevention.
These are tough times, and we have got a war to fight in Iraq,
so the President walked away from his commitment in his most
recent budget proposal. We just can't do that. My hope today is
that we are marking a beginning with a real hope for real
solutions, and I welcome the opportunity to learn more from our
witnesses. The stakes are too high to make this anything other
than a bipartisan issue. I look forward to considering serious
solutions from Republicans and Democrats.
Also, Mr. Chairman, I hope you and I will work together to
hold hearings to consider solutions from both sides of the
aisle. We have within our power the ability to work together to
find a solution. Children who cannot defend themselves look to
us to make a difference in their lives--safe, happy, healthy,
with a chance. That is all they want, and I think that is what
we have to do as their surrogate parents. Thank you, Mr.
Chairman.
Chairman HERGER. Thank you, Mr. McDermott. Before we move
on to our testimony, I want to remind our witnesses to limit
their oral statements to 5 minutes; however, without objection,
all the written testimony will be made a part of the permanent
record. To start our hearing this morning, I would like to
welcome Dr. Wade Horn, Assistant Secretary for Children and
Families at HHS. Dr. Horn, please proceed with your testimony.
STATEMENT OF THE HONORABLE WADE F. HORN, PH.D., ASSISTANT
SECRETARY FOR CHILDREN AND FAMILIES, U.S. DEPARTMENT OF HEALTH
AND HUMAN SERVICES
Dr. HORN. Thank you. Mr. Chairman, and Members of the
Subcommittee, I am very pleased to appear before you today to
discuss the current state of child welfare financing and the
continuing need for reform.
Currently, the Federal Government spends approximately $5
billion per year to reimburse States for a portion of their
annual foster care expenditures. Given the weaknesses in the
current child welfare financing structure, we are convinced
that the reform envisioned by the President's Child Welfare
Program Option is critical to achieving better results for
vulnerable children and families. There are six key weaknesses
that we have identified with the current child welfare
financing structure.
First, the program has evolved to include complex
documentation requirements. There are four categories of
expenditures for which States may claim Federal funds, each
matched at a different rate. In addition, there are several
statutory eligibility rules that also must be met in order to
justify claims made on a child's behalf; some apply at the time
a child enters foster care, while others must be documented on
an ongoing basis. These eligibility rules are based in part on
the Aid to Families with Dependent Children (AFDC) program,
which no longer exists. The time and costs involved in
documenting and justifying claims is significant. In addition,
the process also frequently results in contentious
disallowances, appeals, and litigation.
Second, there are widely different claiming practices among
States. For example, based upon 3 year average claims from
fiscal year 2001 through fiscal year 2003, the average annual
amount of total foster care funds received by States ranges
from $4,155 to $41,456 per title IV-E eligible child.
Third, the current funding structure has not resulted in
high-quality services. Strengths and weaknesses of States'
child welfare programs, identified through the child and family
services reviews indicated significant weaknesses in programs
across the Nation.
Fourth, there seems to be no relationship between State
expenditure claims and service quality or outcomes. There are
States with both high and low levels of Federal title IV-E
claims of each level of performance in the children and family
services reviews. In addition, there is no relationship between
the amount States claim and the proportion of children for whom
timely permanency is achieved.
Fifth, the current program structure is inflexible and
emphasizes foster care over other solutions. Specifically,
foster care funding represents 65 percent of the Federal funds
dedicated to child welfare services, and adoption makes up
another 22 percent. In contrast, funding sources that may be
used for prevention and reunification services represent only
11 percent of Federal child welfare program funds.
Finally, the current program has not kept pace with best
practices in the changing child welfare field. The result is a
funding stream seriously mismatched to current program needs.
Over the last few years, we have made great strides toward
reorienting child welfare programs to be outcomes focused;
however, until the funding is structured to support these
outcomes, further improvements will be constrained.
Given the serious weaknesses of the current structure, the
need for child welfare financing reform has never been more
evident. In order to assist States in assuring positive
outcomes for children and families, the President's fiscal year
2006 budget once again proposed to create a Child Welfare
Program Option that would permit States to choose to administer
their foster care programs more flexibly, with a fixed
allocation of funds over a 5-year period. States that choose
the program option would be able to use these funds for foster
care payments, prevention activities, permanency efforts,
training for child welfare staff, and other such service-
related child welfare activities.
States that choose not to receive funding provided by this
option would continue operating under the current title IV-E
entitlement program. While States that choose this option would
have much greater flexibility in how they use title IV-E funds,
they will continue to be required to maintain the child safety
protections under current law.
The proposal also includes a maintenance of effort
provision to ensure that States selecting the new option
maintain their existing level of investment in the program. The
Administration believes that this proposal would offer a
powerful new means for States to structure their child welfare
services programs in a way that supports the goals of safety,
timely permanency, and enhanced well-being for vulnerable
children and families.
In closing, I would like to thank the Subcommittee,
especially you, Congressman Herger, for your ongoing commitment
to improve our Nation's child welfare system and for allowing
me to highlight the President's bold vision for strengthening
the system through the Child Welfare Program Option. We look
forward to working closely with you and the rest of the
Committee on this proposal. I am convinced that the result will
be a stronger and more responsive child welfare system that
achieves better results for vulnerable children and families.
Thank you, and I would be pleased to answer any questions you
might have.
[The prepared statement of Dr. Horn follows:]
Statement of The Honorable Wade F. Horn, Ph.D., Assistant Secretary for
Children and Families, U.S. Department of Health and Human Services
Mr. Chairman and Members of the Subcommittee, I am pleased to
appear before you today to discuss the current state of child welfare
financing and the need for reform. With what we know about weaknesses
in the current child welfare financing structure, we are convinced that
the reform envisioned by the President's child welfare program option
is critical to achieving better results for vulnerable children and
families.
Currently, the Federal Government spends approximately $5 billion
per year to reimburse States for a portion of their annual foster care
expenditures. Foster care services are intended to provide temporary,
safe alternative homes for children who have been abused or neglected
until they can safely return home or be placed in other permanent
homes. Federal foster care funds, authorized by the Social Security
Act, are paid to States on an uncapped, ``entitlement'' basis. This
means that any qualifying expenditure by a State will be partially
reimbursed, or ``matched'' without limit. Over the years, layers upon
layers of regulations and policy interpretation have been developed to
define which expenses qualify for reimbursement. Although each may have
made sense individually, cumulatively this represents a level of
complexity and burden that fails to support the program's basic goals
of safety, permanency and child well-being.
I will use my time today to provide a brief overview of the funding
structure for the title IV-E Federal foster care program, and share
what the Administration believes are key inherent weaknesses of the
program and how the President's proposal to establish a Child Welfare
Program Option would address these weaknesses. Additional detail on
each of these issues is available in an analysis of Federal foster care
financing being released by HHS today.
Background of Title IV-E Foster Care
The Federal Government has, since 1961, shared the cost of foster
care services with States. Prior to this time foster care was entirely
a State responsibility. From 1961 until 1980, foster care funding was
part of the Federal welfare program, Aid to Families with Dependent
Children (AFDC), originally known as Aid to Dependent Children (ADC).
However, since 1980, foster care funds have been authorized separately,
under title IV-E of the Social Security Act.
From 1980 to 1996, States could claim reimbursement for a portion
of foster care expenditures on behalf of children removed from homes
that were eligible for the pre-welfare reform AFDC program as long as
their placements in foster care met several procedural safeguards.
While the underlying AFDC program was abolished in 1996 and replaced by
the Temporary Assistance for Needy Families Program (TANF), income
eligibility criteria for title IV-E foster care continues to follow the
old AFDC criteria as it existed prior to the enactment of the TANF
program.
The major appeal of the current program has always been that, as an
entitlement, funding levels were supposed to adjust automatically to
respond to changes in ``need.'' However, we do not believe that under
current conditions--with the link to old AFDC eligibility criteria,
these adjustment features respond appropriately and equitably to
reflect true changes in need.
Key Weaknesses of Current Structure
There are six key weaknesses that we have identified with the
current child welfare financing structure:
1. The program has evolved to include complex documentation
requirements;
2. There are widely different claiming practices among States;
3. The current funding structure has not resulted in high quality
services;
4. There seems to be no relationship between State claims and
service quality or outcomes;
5. The current program structure is inflexible and emphasizes
foster care over other solutions; and
6. The current program has not kept pace with best practices in
the changing child welfare field.
I would now like to address each of these weaknesses in more
detail. First, documenting eligibility and claiming foster care funds
is burdensome for States. There are four categories of expenditures for
which States may claim Federal funds, each matched at a different rate.
In addition, there are several statutory eligibility rules that also
must be met in order to justify claims made on a child's behalf. Some
apply at the time a child enters foster care, while others must be
documented on an ongoing basis. The time and costs involved in
documenting and justifying claims is significant. In addition, the
process also frequently results in contentious disallowances, appeals,
and litigation.
Second, differing claiming practices result in wide variations in
funding among States. Based upon three year average claims from FY 2001
through FY 2003, the average annual amount of total Federal foster care
funds received by States ranges from $4,155 to $41,456 per title IV-E
eligible child, with a median of $15, 914. The range in the maintenance
claims was $2,829 to $22,418 per title IV-E eligible child with a
median of $6,546. Claims for child placement services and
administration ranged from $1,190 to $23,724 per title IV-E eligible
child with a median value of $6,909. These figures represent only the
Federal share of title IV-E costs; if one were to include the State
share in these calculations, the expenditure figures would be
substantially higher.
It is unlikely that disparities this large are the result of actual
differences in the costs of operating foster care programs or reflect
differential needs among foster children. Some States are quite
conservative in their claims, counting only children in clearly
eligible placements and defining administrative costs narrowly. Other
States have more aggressively pursued administrative processes
necessary to justify more extensive claims. Variation in States'
claiming practices may be seen most clearly in the relationship between
claims for title IV-E maintenance and title IV-E administrative costs.
Six States claim less than 50 cents in title IV-E administrative costs
for every dollar they claim in title IV-E maintenance, while nine
others claim more than two dollars in title IV-E administrative costs
per every title IV-E maintenance dollar.
Third, the current structure has not resulted in high quality
services. Strengths and weaknesses of States' child welfare programs
are identified through the Child and Family Services Reviews (CFSR).
States reviewed have ranged from meeting standards in one to nine of
the 14 outcomes and systemic factors examined. Significant weaknesses
are evident in programs across the nation.
Fourth, we have been able to document through the CFSR that State
title IV-E claims bear little relationship to service quality or
outcomes. There are States with both high and low levels of Federal
title IV-E claims at each level of performance on these reviews. In
addition, there is no relationship between the amounts States claim and
the proportion of children for whom timely permanency is achieved. Wide
disparities in Federal claims might be viewed in a favorable light if
States were achieving better outcomes with higher spending; however,
this argument does not hold up to scrutiny in the face of the CFSR
results. Average per-child claims did not differ appreciably between
the highest and lowest performing states. In fact, the CFSR findings
were disappointing even for States with relatively high costs.
Fifth, the current structure is highly inflexible, and places an
emphasis on foster care over other solutions and services that would
either prevent the child's removal from the home or speed up permanency
efforts. Specifically, foster care funding represents 65 percent of
Federal funds dedicated to child welfare purposes, and adoption
assistance makes up another 22 percent. In contrast, funding sources
that may be used for preventive and reunification services represent
only 11 percent of Federal child welfare program funds.
Lastly, the current financing structure has not kept pace with
changes in the child welfare field, including the growing role of
kinship foster care, the significant extent to which parental substance
abuse often underlies the abuse and neglect of children, and the
field's increased emphasis on permanency planning for children in
foster care. The result is a funding stream seriously mismatched to
current program needs. From complex eligibility criteria based in part
on a program (i.e., AFDC) that no longer exists, to intricate claiming
rules, it is clear that the current system of title IV-E funding is
driven by process rather than outcomes.
Over the last few years, we have made great strides towards re-
orienting child welfare programs to be outcomes focused. However, until
the funding is structured to support these outcomes, further
improvements will be constrained.
Child Welfare Program Option
Given the serious weaknesses of the current structure, the need for
child welfare financing reform has never been more evident. In order to
assist States in ensuring positive outcomes for children and families,
the President's Fiscal Year 2006 budget once again proposes to create a
Child Welfare Program Option that would permit States to choose to
administer their foster care programs more flexibly, with a fixed
allocation of funds over a five-year period, should this approach
better support their unique child welfare needs. This concept was first
proposed in FY 2004 and we continue to believe this option offers a
number of distinct advantages over both current law and traditional
block grants that have been considered in the past.
The Program Option provides States with greater flexibility so they
can design more effective ways to strengthen services to vulnerable
children and families. States that choose the Program Option would be
able to use funds for foster care payments, prevention activities,
permanency efforts, training for child welfare staff, and other such
service-related child welfare activities. States that choose not to
receive funding provided by this option would continue operating under
the current title IV-E entitlement program.
While States that choose this option would have much greater
flexibility in how they use title IV-E funds, they would continue to be
required to maintain the child safety protections under current law,
including requirements for conducting criminal background checks and
licensing foster care providers, obtaining judicial oversight over
decisions related to a child's removal and permanency, meeting
permanency timelines, developing case plans for all children in foster
care, and prohibiting race-based discrimination in foster and adoptive
placements. The proposal also includes a maintenance-of-effort
requirement to ensure that States selecting the new option maintain
their existing level of investment in the program.
In addition to providing a new option for States, the President's
proposal includes a $30 million set-aside for Indian Tribes or
consortia that can demonstrate the capacity to operate a title IV-E
program. Currently Tribes are not eligible to receive title IV-E
funding, although some Tribes are able to access funds through
agreements with States.
The Administration believes that this proposal would offer a
powerful new means for States and Tribes to structure their child
welfare services program in a way that supports the goals of safety,
timely permanency and enhanced well-being for vulnerable children and
families.
Conclusion
In closing, I would like to thank the Subcommittee, especially you
Congressman Herger, for your ongoing commitment to improving our
Nation's child welfare system and for allowing me to highlight the
President's bold vision for strengthening the system through the Child
Welfare Program Option. We look forward to working closely with you on
this proposal. I am convinced that the result will be a stronger and
more responsive child welfare system that achieves better results for
vulnerable children and families.
I would be pleased to answer questions at this time.
______
ASPE ISSUE BRIEF
Office of the Assistant Secretary for Planning and Evaluation
Office of Human Services Policy--
U.S. Department of Health and Human Services
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ABOUT THIS ISSUE BRIEF
This ASPE Issue Brief on ``How and Why the Current Funding Structure Fails to Meet the Needs of the Child
Welfare Field'' was written by Laura Radel with assistance from staff in the Administration for Children and
Families.
The Issue Brief provides an overview of the financing of the Federal foster care program, documenting and
explaining several key weaknesses in the current funding structure. It also discusses the Administration's
alternative financing proposal, the creation of a Child Welfare Program Option, which would allow States to
choose between financing options.
Office of the Assistant Secretary for Planning and Evaluation
Office of Human Services Policy
U.S. Department of Health and Human Services
Washington, DC 20201
Michael J. O'Grady, Ph.D.
Assistant Secretary
Barbara B. Broman
Acting Deputy Assistant Secretary for Human Services Policy
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FEDERAL FOSTER CARE FINANCING
How and Why the Current Funding Structure Fails to Meet the Needs of
the Child Welfare Field
This Issue Brief provides an overview of the Title IV-E Federal foster
care program's funding structure and documents several key weaknesses.
Executive Summary
The Federal foster care program pays a portion of States' costs to
provide care for children removed from welfare-eligible homes because
of maltreatment. Authorized under Title IV-E of the Social Security
Act, the program's funding (approximately $5 billion per year) is
structured as an uncapped entitlement, so any qualifying State
expenditure will be partially reimbursed, or ``matched,'' without
limit. This paper provides an overview of the program's funding
structure and documents several key weaknesses. It concludes with a
discussion of the Administration's legislative proposal to establish a
more flexible financing system.
The program's documentation requirements are burdensome. There are
four categories of expenditures for which States may claim Federal
funds, each matched at a different rate. In addition, there are several
statutory eligibility rules that must be met in order to justify the
Title IV-E claims made on a child's behalf. Some of these apply at the
time a child enters foster care, while others must be documented on an
ongoing basis. The time and costs involved in documenting and
justifying claims is significant.
Differing claiming practices result in wide variations in funding
among States. The average annual amount of Federal foster care funds
received by States ranges from $4,155 to $41,456 per eligible child,
based on three year average claims from FY2001 through FY2003. It is
unlikely these disparities are the result of actual differences in the
cost of operating foster care programs or reflect differential needs
among foster children.
The current funding structure has not resulted in high quality
services. Strengths and weaknesses of States' child welfare programs
are identified through Federal monitoring visits called Child and
Family Services Reviews. States reviewed have ranged from meeting
standards in 1 to 9 of the 14 outcomes and systemic factors examined
(the median was 6). Significant weaknesses are evident in programs
across the nation, but many of the improvements needed cannot be funded
through Title IV-E.
States' Title IV-E claiming bears little relationship to service
quality or outcomes. There are States with both high and low levels of
Federal Title IV-E claims at each level of performance on Child and
Family Services Reviews. In addition, there is no relationship between
the amounts States claim in Title IV-E funds and the proportion of
children for whom timely permanency is achieved.
The current funding structure is inflexible, emphasizing foster
care. Title IV-E funds foster care on an unlimited basis without
providing for services that would either prevent the child's removal
from the home or speed permanency. Foster care funding represents 65%
of Federal funds dedicated to child welfare purposes, and adoption
assistance makes up another 22%. Funding sources that may be used for
preventive and reunification services represent only 11% of Federal
child welfare program funds.
The financing structure has not kept pace with a changing child
welfare field. The structure of the Title IV-E program has continued
without major revision since it was created in 1961, despite major
changes in child welfare practice. The result is a funding stream
seriously mismatched to current program needs. It is driven towards
process rather than outcomes and constrains agencies' efforts to
achieve improved results for children.
The proposed Child Welfare Program Option offers substantial
benefits. The Child Welfare Program Option, first proposed in HHS's
Fiscal Year 2004 budget request and currently included in the
President's Fiscal Year 2006 budget request, would allow States a
choice between the current Title IV-E program and a five-year capped,
flexible allocation of funds equivalent to anticipated Title IV-E
program levels. It would allow innovative State and local child welfare
agencies to eliminate eligibility determination and claiming functions
and redirect funds toward services and activities that more directly
achieve safety, permanency and well-being for children and families.
The combination of detailed eligibility requirements and complex
but narrow definitions of allowable costs within the Federal Title IV-E
foster care program force a focus on procedure rather than outcomes for
children and families. The Administration's proposed Child Welfare
Program Option is intended to introduce flexibility while maintaining a
focus on outcomes, retaining existing child protections, and providing
a financial safety net for States in the form of access to the TANF
Contingency Fund during unanticipated and unavoidable crises. The
result will be a stronger and more responsive child welfare system that
achieves better results for vulnerable children and families.
Introduction
The Federal Government currently spends approximately $5 billion
per year to reimburse States for a portion of their annual foster care
expenditures. Foster care services are intended to provide temporary,
safe alternative homes for children who have been abused or neglected
until such time as they are able to return to their parents' care
safely or can be placed in other permanent homes. Federal foster care
funds, authorized under Title IV-E of the Social Security Act, are paid
to States on an uncapped, ``entitlement'' basis, meaning any qualifying
expenditure by a State will be partially reimbursed, or ``matched,''
without limit. Definitions of which expenses qualify for reimbursement
are laid out in regulations and policy interpretations that have
developed, layer upon layer, over the course of many years. Each may
have made sense individually, but cumulatively they represent a level
of complexity and burden that fails to support the program's basic
goals of safety, permanency, and child well-being.
This paper provides an overview of the current funding structure,
and documents several key weaknesses. In essence, the paper shows that:
(1) The current financing structure is connected to the old Aid to
Families with Dependent Children program (AFDC) for historical, rather
than programmatic reasons; (2) The administrative paperwork for
claiming Federal funds under Title IV-E is burdensome; (3) Current
funding is highly variable across States; (4) Child welfare systems
claiming higher amounts of Federal funds per child do not perform
substantially better or achieve better outcomes for children than those
claiming less funding; (5) The current funding structure is inflexible
and emphasizes foster care payments over preventive services; and (6)
The financing structure has not kept pace with a changing child welfare
field. The paper concludes with a discussion of the Administration's
proposal to establish a Child Welfare Program Option, allowing States
to receive their foster care funds in a fixed, flexible allocation as
an alternative to the current mode of financing.
Background and History of Title IV-E Foster Care
The Federal Government has, since 1961, shared the cost of foster
care services with States. Prior to this time foster care was entirely
a State responsibility. Since its very first days foster care funding
was intimately linked to Federal welfare benefits, then known as the
Aid to Dependent Children Program, or ADC. In fact, the Federal foster
care program was created to settle a dispute with the States over
welfare payments to single-parent households. At the time, some States
routinely denied welfare payments to families with children born
outside of marriage. These States had declared such homes to be morally
``unsuitable'' to receive welfare benefits. Following a particularly
extreme incident in which 23,000 Louisiana children were expelled from
ADC, the Federal Department of Health, Education, and Welfare (HEW), in
what came to be known as the Flemming Rule after then-secretary Arthur
Flemming, directed States to cease enforcement of the discriminatory
suitable homes criteria unless households were actually unsafe for
children. If homes were unsafe, States were required to pay families
ADC while making efforts to improve home conditions, or place children
in foster care. When States protested the added costs of protecting
children in unsafe homes, Congress reacted by creating Federal foster
care funding. In this way, the Federal Government ensured States would
not be disadvantaged financially by protecting children (Frame 1999;
Committee on Ways and Means 1992).
From 1961 until 1980, Federal foster care funding was part of the
Federal welfare program, Aid to Families with Dependent Children
(AFDC). Since 1980, however, foster care funds have been authorized
separately, under Title IV-E of the Social Security Act. From 1980
through 1996, States could claim reimbursement for a portion of foster
care expenditures on behalf of children removed from homes that were
eligible for the pre-welfare reform AFDC program, so long as their
placements in foster care met several procedural safeguards. While the
underlying AFDC program was abolished in 1996 in favor of the Temporary
Assistance for Needy Families Program (TANF), income eligibility
criteria for Title IV-E foster care continues to follow the old AFDC
criteria as they existed just before welfare reform was enacted. States
are reimbursed on an unlimited basis for the Federal share of all
eligible expenses.
It should be noted that while Title IV-E eligibility is often
discussed as if it represents an entitlement of a particular child to
particular benefits or services, it does not. Instead, a child's Title
IV-E eligibility entitles a State to Federal reimbursement for a
portion of the costs expended for that child's care.
Title IV-E remained little changed from its inception in 1980 until
the passage of the Adoption and Safe Families Act in 1997 (ASFA). With
ASFA, Congress responded to concerns that children were too often left
in unsafe situations while excessive and inappropriate rehabilitative
efforts were made with the family. It also addressed what was at least
a perceived reluctance on the part of child welfare agencies and judges
to seek terminations of parental rights and adoption in a timely
fashion when reunification efforts were unsuccessful. ASFA clarified
the central importance of safety to child welfare decision making and
emphasized to States the need for prompt and continuous efforts to find
permanent homes for children. These permanent homes might be with their
birth families if that could be accomplished safely, or with adoptive
families or permanent legal guardians if it could not. ASFA, together
with related activity to improve adoption processes in many States, is
widely credited with the rapid increases in adoptions from foster care
in the years since the law was passed.
ASFA's emphasis on permanency planning has contributed to
increasing exits from foster care in recent years, both to adoptive
placements and to other destinations including reunifications with
parents and guardianships with relatives. Combined with relatively flat
numbers of foster care entries, the number of children in foster care
has begun to decline, the first sustained decrease since the program
was established.
State claims under the Title IV-E foster care program have always
grown more quickly than the population of children served. But the
recent declines in the number of children in foster care have
substantially curbed the tremendous growth the program experienced
during the 1980s and 1990s. The number of children in foster care began
declining slowly in 1999 after more than doubling in the preceding
decade. Federal foster care program expenditures grew an average of 17
percent per year in the 16 years between the program's establishment
and the passage of the Adoption and Safe Families Act (ASFA) in 1997.
During that period, in only 3 years did growth dip below 10 percent.
However, in the five years since ASFA was enacted, program growth has
averaged only 4 percent per year. While some of the growth through 1997
paralleled an increasing population of children in foster care,
spending growth far outpaced growth in the number of children served.
Improvements in States' ability to claim reimbursement and expanded
definitions of administrative expenses in the program also contributed
to funding growth. Figure 1 displays the growth in foster care
expenditures and the number of children in foster care funded by Title
IV-E.
Figure 1. Federal Claims and Caseload History for Title IV-E Foster
Care
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
The major appeal of the Title IV-E program has always been that, as
an entitlement, funding levels were supposed to adjust automatically to
respond to changes in ``need,'' as represented by State claims. Annual
discretionary appropriations were unnecessary to accommodate changing
circumstances such as a larger population of children in foster care.
The automatic adjustment features of the entitlement structure remain a
strength, however, only so long as they respond appropriately and
equitably to factors that reflect true changes in need and that promote
the well-being of the children and families served. There is little
reason to assume this is true at present. Figure 1 shows that funding
levels and caseloads have not closely tracked one another for over a
decade, and indeed since 1998 have been moving in opposite directions.
Documenting Eligibility and Claiming Foster Care Funds is Burdensome
In order to receive Federal foster care funds, States are required
to determine a child's eligibility, and must document expenditures made
on behalf of eligible children. This documentation becomes the basis
for expenditure reports that are filed quarterly with the Federal
Government. The Federal share of eligible expenditures may then be
``drawn down'' (i.e. withdrawn from Federal accounts) by States. While
good estimates of the time and costs involved in documenting and
justifying claims are not available, such costs can be significant.
As laid out in law and regulations, there are four categories of
expenditures for which States may claim Federal funds. Each of these is
matched at a particular rate that varies from category to category. In
addition, the match rate for foster care maintenance payments varies
from State to State and may be adjusted from year to year. These
categories are:
foster care maintenance payments for eligible children
(matched at the Medicaid rate which varies by State and by year, but
currently ranges from 50 to 80%)
short- and long-term training for State and local agency
staff who administer the Title IV-E program, including those preparing
for employment by the State agency, as well as for foster parents and
staff of licensed child care institutions in which Title IV-E eligible
children reside (75% Federal match)
administrative expenditures necessary for the proper and
efficient administration of the program (50% Federal match)
costs of required data collection systems (50% Federal
match)
With so many different categories of expenses, each matched at a
different rate, States must accurately track spending in each of these
categories and attribute how much of their efforts in each category are
being made on behalf of eligible children. States report that doing so
is cumbersome, prone to dispute, and does not accomplish program goals.
Adding an additional layer of complexity, costs must be allocated to
those programs which benefit from the expenditures, a standard practice
in Federal programs. A State's cost allocation plan is approved by the
Federal Government and distributes expenses that relate to multiple
programs and functions.
The categories of administrative and training expenses are
typically the most difficult to document and the most often disputed.
Federal regulations (45 CFR 1356.60) provide the following examples of
allowable administrative expenses:
eligibility determination and re-determination, plus
related fair hearings and appeals
referral to services
preparation for and participation in judicial
determinations
placement of the child
development of the case plan
case reviews
case management and supervision
recruitment and licensing of foster homes and
institutions
rate setting
a proportionate share of agency overhead
costs of data collection systems
There is an ambiguous dividing line between an administrative
expense such as case management and ineligible service costs, such as
counseling. Such activities may be performed by the same staff and
sometimes in the same session with a client. This makes accurate
claiming difficult and gives rise to frequent disputes about allowable
expenditures. For this reason, administrative costs are much more
frequently the subject of disallowances than are other funding
categories.
The ability of States to claim Title IV-E funds spent on training
activities is confounded by statutory and regulatory provisions that
are mismatched with how State agencies currently operate their
programs. For instance, while many States now contract with private
service providers for administrative functions such as those listed
above, they receive lower rates of Federal reimbursement of their costs
for training these workers to perform these functions. Only costs
incurred by the State in the training of State and local agency workers
and those preparing for employment with the state agency can be
reimbursed under Title IV-E at the enhanced, 75 percent match rate
(rather than the 50 percent match rate for administrative expenses).
Furthermore, only public funds or expenditures can be used to match
Title IV-E training funds. It is common practice to consider the staff
time and other resources of a state university as match for Federal
funds when training child welfare agency employees. However, this
practice disadvantages States that utilize private colleges and
universities for training and limits the training resources available,
particularly in rural States where the number of State universities and
colleges are limited and at great distances from those people requiring
the training.
Just as claiming rules are complex, requirements for children's
Title IV-E eligibility are also cumbersome. Several eligibility
requirements must be met in order to justify the Title IV-E claims made
on a child's behalf. These are described in the text box below. Some of
these apply at the time a child enters foster care, while others must
be documented on an ongoing basis. Most of these are procedural
requirements intended to protect children from potential harm caused by
inattentive agencies and systems. It is unclear, however, that they
function reliably as eligibility criteria. For example, the fact that
judicial determinations routinely include ``reasonable efforts'' and
``contrary to the welfare'' determinations may represent a judge's
careful consideration of these issues, or may simply appear because
prescribed language has been automatically inserted into removal
orders. These process requirements were essential when Federal
oversight was limited to assuring the accuracy of eligibility
determinations. However, now that the Child and Family Review process
(discussed in some detail in a later section) provides comprehensive
assessments of States' child welfare programs, some of what are
currently individual eligibility criteria could be addressed more
effectively as part of the systemic assessment process.
The eligibility criterion that is most routinely criticized by
States and child welfare advocates is the financial need criteria as
was in effect under the now-defunct AFDC program. As noted above, this
requirement relates to the historical origins of the foster care
program as part of the welfare system. However, there is no policy
reason that the Federal Government should ``care'' (in monetary terms)
more about children in imminent danger of maltreatment by parents who
are poor than it does about children whose parents have higher incomes.
The requirement is particularly peculiar because the AFDC program was
eliminated in favor of Temporary Assistance for Needy Families in 1996.
Therefore the means test used for Title IV-E no longer parallels the
income and asset limits for existing welfare programs. And since this
so-called ``look back'' provision did not index the 1996 income and
asset limits for inflation, over time their value will be further
eroded. Fewer children will be eligible for Title IV-E in the future as
income limits for the program remain static while inflation raises both
incomes and the poverty line.
That each child's eligibility depends on so many factors, some of
which may change from time to time, makes Title IV-E a potentially
error-prone program to which there is recurrent pressure for accuracy,
close procedural scrutiny, and the taking of disallowances. On the
other hand, the potentially large sums involved mean that disallowances
are met with procedural disputes, appeals, and protests from agency
directors, legislators, and governors. Yet it is not at all clear that
the time and effort spent tracking eligibility criteria results in
better outcomes for children. For all the complexity of the eligibility
process, the number of States out of compliance is actually quite low.
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Eligibility Requirements for Title IV-E Foster Care
Contrary to the welfare determination. A child's removal from the home must be the result of a judicial
determination to the effect that continuation in the home would be contrary to the child's welfare, or that
placement in foster care would be in the best interest of the child. Children in foster care as a result of a
voluntary placement agreement are not subject to this requirement.
Reasonable efforts determination. The State agency must obtain a judicial determination within 60 days of a
child's removal from the home that it has made reasonable efforts to maintain the family unit and prevent the
unnecessary removal of a child from home, as long as the child's safety is ensured. In addition, there must be
ongoing documentation that the State is making reasonable efforts to establish and finalize a permanency plan in
a timely manner (every 12 months).
State agency placement and care responsibility. The State child welfare agency must have responsibility for
placement and care of the child. Usually this means the child is in the State's custody. A tribal agency or
other public agency may have responsibility for the child's placement and care if there is a written agreement
to that effect with the child welfare agency.
Pre-welfare reform AFDC eligibility. The State must document that the child was financially needy and deprived
of parental support at the time of the child's removal from home, using criteria in effect in its July 16, 1996
State plan for the Aid to Families with Dependent Children program. Income eligibility and deprivation must be
re-determined annually.
Licensed Foster Family Home or Child Care Institution. The child must be placed in a home or facility that
meets the standards for full licensure or approval that are established by the State.
Criminal background checks or safety checks. The State must provide documentation that criminal records checks
have been conducted with respect to prospective foster and adoptive parents and safety checks have been made
regarding staff of child care institutions.
Special Requirements in the Case of Voluntary Placements. If a child is placed in foster care under a
voluntary placement agreement, Title IV-E eligibility rules apply slightly differently. Determinations that
remaining in the home is contrary to the child's welfare and that reasonable efforts have been made to prevent
placement are not required in these cases. However, if the child is to remain in care beyond 180 days, a
judicial determination is required by that time indicating that continued voluntary placement is in the child's
best interests.
----------------------------------------------------------------------------------------------------------------
Compliance with eligibility rules is monitored through Title IV-E
Eligibility Reviews that have been conducted since 2000. Fifteen of the
forty-four States reviewed by the end of 2003, plus the District of
Columbia and Puerto Rico, were found not to be in substantial
compliance with IV-E eligibility rules. The remainder had minimal
errors in their eligibility processes and were generally operating
within program eligibility rules. Even among the States required to
implement corrective action plans, several are not far from compliance
levels.
Of those States not in substantial compliance, the pattern of
errors varied. The most widespread problems relate to reasonable
efforts to make and finalize permanency plans. Ten states had large
numbers of errors in this category and 44% of all errors involved
reasonable efforts violations. In most cases these are cases with late
or absent permanency hearings; that is, States were not operating
within the time frames laid out by the Adoption and Safe Families Act.
Four States had frequent licensing problems, usually that children were
placed in unlicensed foster homes (23% of all errors). Three States had
significant errors related to the application of pre-welfare reform
AFDC eligibility criteria (11% of all errors). Two States had quite a
few missing criminal background checks on foster parents (8% of all
errors). There were very few errors with respect to ``contrary to the
welfare'' determinations, placement and care responsibility, or
extended voluntary placements. A full listing of errors documented in
eligibility reviews through Fiscal Year 2003 appears in Table 1.
Differing Claiming Practices Result in Wide Variations in Funding Among
States
States vary widely in their approaches to claiming Federal funds
under Title IV-E. Some are quite conservative in their claims, counting
only children in clearly eligible placements and defining
administrative costs narrowly. Other States have become more skilled in
the administrative processes necessary to justify more extensive Title
IV-E claims. Further, not all States have the financial means or
budgetary inclination to invest in the full array of foster care
related services for which Federal financial participation might be
available. The result of these different approaches is a complex
pattern of Title IV-E claims covering a great range of funding levels.
However, the disparities in Title IV-E claiming are so wide and so
lacking in pattern as to undermine the rationale for the complex
claiming rules.
Figure 2 shows the average amount of funds each State claimed from
the Federal Government for Title IV-E foster care during FY2001 through
FY2003, shown as dollars per Title IV-E eligible child so as to make
the figures comparable across States. That is, for each State the three
year average annual Federal share in each spending category is divided
by the three year average monthly number of Title IV-E eligible
children in foster care, to give an average, annualized cost per child.
Three year averages are used to smooth out claiming anomalies that may
occur in a single year because of extraordinary claims or
disallowances.
There is a wide range in the amounts claimed as well as in the
division of claims between maintenance payments and the category that
includes both child placement services and administration. These are
the two principal claiming categories. The remaining categories,
training and demonstrations, were relatively small in most States.
Spending on State Automated Child Welfare Information Systems (SACWIS)
has been excluded since these system development costs can vary
substantially from year to year in ways unrelated (at least in the
short term) to services for children.
Total Federal claims per Title IV-E child (averaged across three
years), excluding funds for the development of State Automated Child
Welfare Information Systems (SACWIS), ranged from $4,155 to $41,456.
The median value was $15,914. The range in maintenance claims was
$2,829 to $22,418 per Title IV-E child, with a median of $6,546. Claims
for child placement services and administration ranged from $1,190 to
$23,724 per Title IV-E child, with a median value of $6,909. These per-
child amounts reflect only the Federal share of Title IV-E costs, which
vary according to the match rates used for different categories of
expenses. If one were to include the State share in such calculations,
the expenditure figures would be substantially higher. This discussion
has been framed in terms of the variation in Federal share so as to
best illustrate and isolate issues related to the Federal funding
rules.
--------------------------------------------------------------------------------------------------------------------------------------------------------
Table 1. Distribution of Errors Among States Found Not in Substantial Compliance with Title IV-E Eligibility Rules
---------------------------------------------------------------------------------------------------------------------------------------------------------
Lacking Missing Child Welfare Extended
Number Criminal Reason- Contrary to Agency Lacks Voluntary 1996 AFDC
Cases Found Licensing Back- able the Welfare Placement and Placement w/ Criteria Disallow-
Ineligible Problems ground Efforts Determina- Care Re- out Court Not Met ance Amount
Checks Violations tions sponsibility Approval
--------------------------------------------------------------------------------------------------------------------------------------------------------
New Jersey 2000 Initial 44 33 0 14 0 4 3 3 $269,903
Primary (IP)
--------------------------------------------------------------------------------------------------------------------------------------------------------
Kansas 2000 IP 16 6 0 6 7 0 0 10 $74,265
--------------------------------------------------------------------------------------------------------------------------------------------------------
Maine 2001 IP 24 22 0 3 0 2 0 3 $182,737
--------------------------------------------------------------------------------------------------------------------------------------------------------
Hawaii 2001 IP 25 0 18 1 0 2 1 3 $238,432
--------------------------------------------------------------------------------------------------------------------------------------------------------
Iowa 2001 IP 22 0 3 6 6 0 0 15 $156,915
--------------------------------------------------------------------------------------------------------------------------------------------------------
Vermont 2002 IP 26 2 0 4 7 4 0 14 $312,918
--------------------------------------------------------------------------------------------------------------------------------------------------------
Maryland 2002 IP 37 3 1 36 1 0 0 1 $601,820
--------------------------------------------------------------------------------------------------------------------------------------------------------
Wisconsin 2002 IP 23 3 0 13 4 2 2 1 $206,833
--------------------------------------------------------------------------------------------------------------------------------------------------------
New York 2003 IP 31 0 0 26 7 4 2 5 $806,811
--------------------------------------------------------------------------------------------------------------------------------------------------------
New Jersey 2003 Secondary 56 27 4 36 5 6 7 1 $6,220,853
--------------------------------------------------------------------------------------------------------------------------------------------------------
District of Columbia 2003 IP 54 39 24 19 4 7 1 2 $1,416,169
--------------------------------------------------------------------------------------------------------------------------------------------------------
Puerto Rico 2003 IP 70 17 7 98 7 0 0 26 $271,056
--------------------------------------------------------------------------------------------------------------------------------------------------------
Montana 2003 Primary (P) 22 1 0 28 2 1 1 0 $317,752
--------------------------------------------------------------------------------------------------------------------------------------------------------
West Virginia 2003 P 25 4 0 20 0 0 1 0 $451,305
--------------------------------------------------------------------------------------------------------------------------------------------------------
Alabama 2003 P 23 2 2 19 1 0 1 1 $174,856
--------------------------------------------------------------------------------------------------------------------------------------------------------
Mississippi 2003 IP 10 9 0 3 1 0 0 0 $8,133
--------------------------------------------------------------------------------------------------------------------------------------------------------
Arkansas 2003 IP 10 6 3 0 0 0 0 1 $67,067
--------------------------------------------------------------------------------------------------------------------------------------------------------
Total Cases with Errors 518 $11,777,825
--------------------------------------------------------------------------------------------------------------------------------------------------------
TOTAL ERRORS 757 174 62 332 52 32 19 86
--------------------------------------------------------------------------------------------------------------------------------------------
Percent of all errors 23% 8% 44% 7% 4% 3% 11%
--------------------------------------------------------------------------------------------------------------------------------------------------------
During 2000 to 2003, 50 states plus the District of Columbia & Puerto Rico were reviewed; of these 35 were found to be in substantial compliance and 17
not in substantial compliance.
Six states (PA, MA, FL, TN, MN, & MI) have not been reviewed.
Six states (KS, NJ, WV, AL, TX, & MT) have had an initial primary plus a primary or secondary review.
Substantial compliance is defined as less than 8 errors for an initial primary review or 4 errors in a primary review. In secondary reviews substantial
compliance is calculated as a percentage of cases and/or dollars.
Ineligible cases may have more than one error reason.
Licensing errors were usually children placed in unlicensed homes. In Maine, most errors were foster homes that lacked a fire inspection. Most
reasonable efforts violations were late/absent permanency hearings.
Figure 2. States' Foster Care Claims--Federal Funds (excluding SACWIS)
per IV-E Child (average of fiscal years 2001 to 2003)
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
As shown in figure 3, the balance between maintenance and
administrative claims also varies considerably among the States. Claims
for child placement and administration vary from 10 cents per dollar
claimed of maintenance to $4.34. Six States claim less than 50 cents in
administration for every maintenance dollar claimed, while nine States
claim more than $2 in administration for every dollar of maintenance.
These differences reflect the extent to which States use a wide or
narrow definition of child placement and administrative costs. In
addition, some States claim administrative expenses for non-IV-E
children as ``Title IV-E candidates'' over extended periods of time,
even if those children or the placement settings they reside in never
qualify under eligibility rules. In such States this drives up
administrative costs as a proportion of total Title IV-E payments. A
Notice of Proposed Rulemaking published by HHS January 31, 2005
proposes to prohibit this practice except under limited circumstances.
Figure 3. Administrative Dollars Claimed per Dollar of Foster Care
Maintenance Varies Widely (calculated on the basis of average claims
FY2001 through FY2003)
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Below, factors such as the quality of child welfare services are
examined in relation to the funding differences across States. Here it
is simply observed that the spread of claims is far wider than one
would expect to see based on any funding formula one might rationally
construct. It is unlikely that differences this large are the result of
actual differences either in the cost of operating a foster care
program or reflect actual differential needs among foster children
across States.
The Current Funding Structure Has Not Resulted in High Quality Services
If State and local child welfare systems were generally functioning
well, most of those concerned might take the view that the
approximately $5 billion in Federal funds, and even more in State and
local funds, was mostly well spent. In fact, however, knowledgeable
observers are hard-pressed to name systems that are functioning well
overall. Typically one aspect of an agency's efforts may be lauded,
while serious weaknesses are acknowledged in other areas. Even so, good
evidence of system performance has, until recently, been hard to come
by.
After several years of development and pilot testing, the
Children's Bureau in 2000 began conducting Child and Family Services
Reviews (CFSRs) in each State. These reviews, which include a data-
driven Statewide Assessment and an onsite review visit by Federal and
State staff, are intended to identify systematically the strengths and
weaknesses in State child welfare system performance. Once areas of
weakness are identified, States are required to develop and implement
Program Improvement Plans (PIPs) designed to address shortcomings.
During onsite reviews, teams examine a sample of case files of children
with open child welfare cases and interview families, caseworkers and
others involved with these cases to determine whether Federal standards
have been met. System stakeholders such as child advocates and judges
are also interviewed. In addition to examining practice in specific
cases, the reviews also examine systemic factors such as whether the
States' case review system, training, and service array are adequate to
meet families' needs. Overall, 47 specific factors are rated and then
aggregated to assess whether or not ``substantial conformity'' with
Federal requirements is achieved in seven child outcomes and seven
systemic factors (shown in the text box below).
----------------------------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------
Outcomes and Systemic Factors Examined in Child and Family Services Reviews
Outcomes
Children are, first and foremost, protected from abuse and neglect.
Children are safely maintained in their homes whenever possible and appropriate.
Children have permanency and stability in their living situations.
The continuity of family relationships and connections is preserved for children.
Families have enhanced capacity to provide for their children's needs.
Children receive appropriate services to meet their educational needs.
Children receive adequate services to meet their physical and mental health needs.
Systemic Factors
Statewide Information System
Case Review System
Quality Assurance System
Training
Service Array
Agency Responsiveness to the Community
Foster and Adoptive Parenting Licensing, Recruitment, and Retention
----------------------------------------------------------------------------------------------------------------
As described above, there are 14 areas in which a State might be
determined in or out of substantial compliance during its Child and
Family Services Review. Figure 4 shows the distribution of State
performance on initial reviews among all 50 States and the District of
Columbia. Median State performance was to be in substantial compliance
in 6 of 14 areas. States reviewed to date have ranged from meeting
standards in 1 area to 9 areas. While simply counting the areas of
compliance presents a very general, simplified, and broad-brush
approach to evaluating child welfare system quality, the purpose here
is not to analyze system performance in any detailed fashion. It is
simply to recognize that most States achieved substantial compliance in
fewer than half of areas examined, and that all systems reviewed have
been in need of significant improvement. Indeed, in the area of
permanency and stability in their living situations, an area of crucial
importance to children in foster care, no State has yet met Federal
standards although a few approach them. Clearly the current Federal
funding structure has not, to date, resulted in a child welfare system
that achieves outcomes with which we may be satisfied.
Figure 4. Summary of Results for Child and Family Services Reviews (for
50 States plus DC)
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
States' Title IV-E Claiming Bears Little Relationship to Service
Quality or Outcomes
Even if not achieving high quality overall, one might expect and
hope that spending variations among States might relate to the overall
quality of child welfare systems as revealed in results of the Child
and Family Services Reviews. Analyses presented below relate the
variations in claiming patterns among States described above to child
welfare system performance.
Figure 5 shows per child claims plotted against the number of areas
measured in the CFSR in which the State was found to be in substantial
compliance. The three states with the highest claims per child were in
compliance with 6, 3 and 5 areas respectively of the 14 possible areas
of compliance in their first Child and Family Services Review (CFSR).
Average per-child claims did not differ appreciably between the highest
and lowest performing states. The eight states that were in compliance
in the fewest areas (1, 2 or 3 of 14) averaged $19,293 in Federal funds
per Title IV-E child, while the 12 highest performing states (in
compliance with 8 or 9 of the 14 areas) averaged claims of $19,824 per
child. There are States with relatively high- and low-Federal claims at
each level of CFSR performance.
Claiming levels similarly bear little relationship to States'
performance in achieving permanency for children in foster care. Figure
6 plots each State's Federal claims for the Title IV-E foster care
program per Title IV-E eligible child against the percentage of
children in foster care for whom permanency is achieved. Permanency
data, from the States' Child and Family Services Reviews, shows that
States' success in either reunifying children with parents within one
year or finalizing an adoption within two years of foster care entry
varies widely. Six States achieve permanency within these time frames
for under one-third of children in foster care, while five either
approach or exceed the national standard of 90 percent. Most perform
somewhere in between. The wide disparities among States' performance on
what is a key child welfare function seem unconnected to the amount of
Federal funds claimed from the major source of Federal child welfare
funding, the Title IV-E foster care program.
Figure 5. Child and Family Services Review Compliance Is Only Weakly
Related to Levels of Title IV-E Foster Care Funds Claimed Per Eligible
Child (data shown for 50 States plus DC)
[GRAPHIC(S) NOT AVAILABLE IN TIFF FOMRAT]
If claims levels are not strongly related to child welfare system
quality or outcomes, what other factors might be involved in
determining spending? Variation among States in the actual foster care
rates paid to families caring for children bears only a weak
relationship to per-child foster care claims levels (figure 7). As an
example, four of six States with basic maintenance payments in 2000 of
less than $300 per month for a young child had higher than median
levels of claims per child. These four States also had higher Federal
claims per child than did four of seven States which in 2000 paid basic
maintenance rates of higher than $500 per month for young children.
Patterns of residential care use among States are similarly unrelated
to claiming disparities.
Wide disparities in Federal claims might be viewed as positive if
States were achieving better outcomes with higher spending. This
argument does not hold up to scrutiny, however, in the face of Child
and Family Services Review results. The findings of these reviews are
disappointing even in States with relatively high costs. Of course,
because Title IV-E is the focus here, this analysis only includes
foster care costs. States' spending on other child welfare services may
contribute to performance. The wide variety of these other potential
funding sources and their variability among the States, however, makes
it quite difficult to examine them in a consistent fashion.
Figure 6. Permanency Outcomes are Unrelated to Levels of State Title
IV-E Foster Care Claims (data shown for 50 States plus DC)
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
The Current Funding Structure is Inflexible, Emphasizing Foster Care
Title IV-E has long been criticized because it funds foster care on
an unlimited basis without providing for services that would either
prevent the child's removal from the home or speed permanency (see, for
example, The Pew Commission on Children in Foster Care, 2004 and
McDonald, Salyers and Shaver 2004). Funding sources for preventive and
reunification services, primarily the Child Welfare Services Program
and the Promoting Safe and Stable Families Program funded under title
IV-B of the Social Security Act, are quite small in comparison with
those dedicated to foster care and adoption. As shown in figure 8,
foster care funding under Title IV-E made up nearly two-thirds (65%) of
Federal funding dedicated to child welfare purposes in Fiscal Year
2004. Adoption Assistance funding (also authorized under Title IV-E)
represents another 22%. Funding sources that may be used for preventive
services (but which also fund some foster care and adoption related
services), including funds from the Title IV-B programs and the
discretionary programs funded from authorizations in the Child Abuse
Prevention and Treatment Act, represent 11% of Federal child welfare
program funds.
Other Federal social services programs such as the Social Services
Block Grant (SSBG) and Temporary Assistance for Needy Families (TANF)
also fund some services for families experiencing or at risk of child
welfare involvement, as can Medicaid. These funding streams are not
intended primarily for these purposes, however, and, with the exception
of SSBG, available program data does not break out spending on child
welfare related purposes. (The Fiscal Year 2002 annual expenditure
report for the SSBG program (HHS, 2004) shows that states spent a total
of $634 million in SSBG funds for child welfare services that year.)
Surveys and analysis conducted by private research organizations
indicate these funding sources provide considerable funding for child
welfare services, though much of that is still concentrated on out-of-
home care. Studies conducted by the Urban Institute found that in State
Fiscal Year 2002 these ``non-traditional'' Federal child welfare
funding sources (primarily SSBG, TANF, and Medicaid) paid for just over
$5 billion in child welfare services. Of this total, $2.1 billion was
spent on out-of-home placements, $1.3 billion paid for other services
including prevention and treatment, $419 million went to administrative
activities, and $98 million funded adoption services. States were
unable to categorize purposes on which the remainder of funds were
spent, nearly $700 million (Scarcella, Bess, Zielewski, Warner and
Geen, 2004).
Figure 7. Foster Care Maintenance Rates Are Weakly Related to Foster
Care Claims
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Some have argued that because foster care is an entitlement for
eligible children while service funds are limited, Title IV-E
encourages foster care placement. However, it seems unlikely that
caseworkers make placement decisions on the basis of children's Title
IV-E eligibility, nor is it likely that judges use Title IV-E status as
a significant factor in their placement rulings. Indeed, caseworkers
and judges are often unaware of children's eligibility status. A lack
of available family services, however, could plausibly tip caseworkers'
decisions toward placement or delay a child's discharge. Quantifying
such effects is difficult, however.
Many in the child welfare field believe that with more flexibility
in funding States would devote additional resources to preventive and
reunification services, and that better outcomes for children and
families could be achieved. Since 1996, Child Welfare Demonstration
Projects in 17 States have generated evidence about the effects of
allowing State and local agencies to use Federal foster care funds more
flexibly, either for children not normally eligible for Title IV-E or
for services Title IV-E would could not otherwise cover. While most of
the States tested a single, specific alternative use for foster care
funds, such as guardianship subsidies or improved interventions for
parents with substance abuse problems or children with serious mental
health conditions, four States are testing broader systems of flexible
funding that resemble the Administration's proposal for a Child Welfare
Program Option. These demonstrations are operating in Indiana, North
Carolina, Ohio, and Oregon. In each case, the State provides counties a
fixed allotment of Title IV-E funds which then may be used to pay for
services to prevent foster care placement, facilitate reunification, or
otherwise ensure safe, permanent outcomes for children.
Figure 8. Federal Child Welfare Funding, FY2004
[GRAPHIC(S) NOT AVAIILABLE IN TIFF FORMAT]
This chart includes only programs dedicated to child welfare
functions. It does not include funding for programs with broader or
other purposes of which portions may be used on child welfare
functions. For most of these broader programs (such as TANF, Medicaid,
and the Social Services Block Grant) federal data cannot reliably
identify the portion spent on child welfare. Percentages are calculated
from 2004 spending figures shown in the President's FY2006 budget
request.
Evaluation results to date are encouraging. While the
demonstrations did not always achieve their goals, in no case did
outcomes for children deteriorate as a result of increased flexibility.
North Carolina found flexible funding contributed to declines in the
probability of out-of-home placement following a substantiated child
abuse or neglect report. Demonstration counties in Ohio expressed
increased support for prevention activities and were more likely than
traditionally funded counties to create new or expanded prevention
services. And in Oregon, the combination of demonstration funds and the
State's System of Care Initiative dramatically improved the likelihood
that at-risk children could remain safely in their homes rather than
being placed in foster care. It should be noted that demonstration
projects did not provide any more Title IV-E funds than the State would
have received in the absence of a demonstration. The projects were
cost-neutral. States were granted only the flexibility to spend funds
in broader ways than is normally allowed.
Flexible spending alone will not address the weaknesses in child
welfare systems around the country. But such flexibility can allow
strong local leaders to implement practice improvements more easily and
thereby generate improved outcomes. Among the types of practice changes
implemented in flexible funding demonstrations are strengthened family
assessments; enhanced visitation; intensive family reunification
services; family decision meetings; and improved access to substance
abuse and mental health treatment. That nearly half of States have
implemented waiver demonstrations indicates widespread interest in more
flexible funding for State child welfare programs. Interest in flexible
funding has grown now that many States have successfully implemented
new service models while enhancing, or at least not compromising,
safety, permanency, and child well-being.
In recognition that flexibility can produce best results when
accompanied by enhanced funding, the Bush Administration has
consistently supported funding increases for child welfare. In
particular, HHS budgets from FY2002 through FY2005 each included
substantial proposed increases for the Promoting Safe and Stable
Families Program, in the amount of $1 billion over five years. However,
Congress each year appropriated substantially less than the requested
amount. For FY2005, the Administration also proposed substantial
increases for several key child abuse prevention efforts authorized
under the Child Abuse Prevention and Treatment Act, which again were
not funded by Congress.
The Financing Structure Has Not Kept Pace with a Changing Child Welfare
Field
A great deal has changed in the world of child welfare since the
Federal foster care program was established. The program initially
created in 1961, however, has continued without major revision to its
financing structure. The result is a funding stream seriously
mismatched to current program needs. The goals of the child welfare
system are to improve the safety, permanency, and well-being of
children and families served. By requiring that the great majority of
Federal funding for child welfare services be spent only on foster
care, the financing system undermines the accomplishment of these
goals.
Title IV-E funding was designed with the intention that the program
funding would adjust automatically to changes in social need. However,
it is difficult to conclude from claims levels that social need has
been the driving force behind spending patterns that vary wildly from
State to State. Service practices seem to have adjusted to the funding,
rather than vice versa. Throughout the program's history, growth far
outpaced changes in the population of children being served. And while
current growth has slowed considerably, declines in the number of
children in foster care have not yet translated into lower program
claims. The recent stabilization of the program's funding, however,
makes this a good time to re-examine the structure of Title IV-E and
whether that funding structure continues to meet the needs of the child
welfare field. Since the number of children in foster care is expected
to be flat or declining for the foreseeable future, there is less
short-term risk in potential financing system changes than is the case
when needs are rapidly escalating.
Improved preventive and family support services for children and
families at risk of foster care placement, therapeutic care and
remediation of problems for families with children in foster care, and
post-discharge services for families after children leave out of home
care, are each essential to the achievement of the child welfare
system's goals. Yet these are precisely the services that Title IV-E is
least able to support. The result has been child welfare systems unable
to achieve positive outcomes for children. This weak performance has
been documented by Child and Family Services Reviews conducted across
the nation. But as States develop and implement Program Improvement
Plans, Title IV-E funds are largely unavailable to address the
challenges.
From complex eligibility criteria based in part on a program that
no longer exists, to intricate claiming rules that demand caseworkers'
every action be documented and characterized, Title IV-E is a funding
stream driven toward process rather than outcomes. With the advent of
the Child and Family Services Reviews, and systemic improvements
initiated in response to the Adoption and Safe Families Act, Congress
and the Department of Health and Human Services have made significant
strides toward re-orienting child welfare programs to be outcomes
focused. Until the funding is structured to support these outcomes,
however, improvements may be constrained.
Proposed Child Welfare Program Option Described
The President's FY2006 budget once again proposes to create a Child
Welfare Program Option (CWPO) which would allow States a choice between
the current Title IV-E program and a five-year capped, flexible
allocation of funds equivalent to anticipated Title IV-E program
levels. This concept was first proposed by the President for FY 2004.
While the last Congress did not complete work on child welfare
financing, the Administration continues to call for consideration of
financing reform. The President's proposal has a number of distinct
advantages over both current law as well as in contrast to more
traditional block grants that have been considered in the past.
The Child Welfare Program Option would allow States to use Title
IV-E funds for foster care payments, prevention activities, training,
and other service-related child welfare activities--a far broader range
of uses than allowed under current law. Increased flexibility will
empower States to develop child welfare systems that support a
continuum of services for families in crisis and children at risk while
being relieved of the administrative burden created by current Federal
requirements, including the need to determine the child's eligibility
for AFDC.
Child safety protections under current law would continue under the
President's proposal. These include requirements for conducting
criminal background checks and licensing foster care providers,
obtaining judicial oversight of decisions related to a child's removal
and permanency, meeting permanency time lines, developing case plans
for all children in foster care, and prohibiting race-based
discrimination in foster and adoptive placements.
In contrast to some previous flexible funding proposals, the
President's Child Welfare Program Option would be an optional
alternative to the current financing system. States desiring the
flexibility it would afford could opt in during the initial program
year for a five-year period. State allocations would be based on
historic expenditure levels and would be calculated to be cost-neutral
to the Federal Government over a five-year period. A State could choose
to receive accelerated, up-front funding in the early years of the
program in order to make investments in services that are likely to
result in cost savings in later years. The proposal includes a
maintenance of effort requirement to ensure that those States selecting
the new option maintain their existing level of investment in the
program. But those States unwilling to accept the risk and the promise
of flexibility could choose to continue operating under current program
rules.
To address fears that some future social crisis might create
unexpected and unforeseeable child welfare needs, the President has
also proposed to allow participating States access to the TANF
Contingency Fund if unanticipated emergencies result in funding
shortfalls. Specific criteria would govern the circumstances under
which States could withdraw funds from this source. This feature, too,
responds to concerns expressed in past child welfare financing
discussions.
The proposal includes two set asides within the Child Welfare
Program Option. The first would provide some Tribes direct access to
Title IV-E funds. Under current law Tribes may only receive Title IV-E
funds through agreements with States. Through a proposed $30 million
set aside in the CWPO, however, tribes demonstrating the capacity to
operate foster care programs could receive direct funding to do so and
would be subject to similar program requirements as States.
A second set aside would dedicate a relatively small amount of
funds to facilitate program monitoring, technical assistance to support
the efforts of State and tribal child welfare programs, and to conduct
important child welfare research. These funds will ensure that
sufficient resources are available to understand how the new option
affects child welfare services and outcomes for children and families,
and to support States in their efforts to reconfigure programs to
achieve better results.
Benefits of the Proposed Child Welfare Program Option
The Child Welfare Program Option would allow innovative State and
local child welfare agencies to eliminate eligibility determination and
drastically reduce the time now spent to document Federal claims. This
effort could then be redirected toward services and activities that
more directly achieve safety, permanency and well-being for children
and families. Investments in preventive services and improved case
planning could also reduce foster care needs. States taking child
welfare funds through the Option would be held accountable for their
programs through Child and Family Services Reviews and standard audit
requirements. But these States would no longer be required to document
expenditures in the level of detail now required to justify Federal
matching funds. The flexibility afforded by the Option would allow
agencies to direct funds to those activities most closely addressing
families' needs. HHS could then focus more fully on partnerships with
States to achieve positive outcomes for children and families.
The proposed Child Welfare Program Option:
Creates Structural Incentives for Better Outcomes. The
CWPO provides incentives for child welfare system improvement because
it is through better outcomes that a State would ``win'' under the
program. With a fixed funding level, States would be better off
financially if children either stay at home safely, return home
quickly, or are placed in adoptive homes (since Adoption Assistance
would remain an entitlement). Since these are also the preferred
outcomes for children, the program creates structural incentives that
are in line with program goals.
Facilitates Quality Improvement. The CWPO would encourage
States to fund service improvements, particularly those called for in
their Program Improvement Plans (PIPs) by allowing Federal funds to be
used for the full range of activities contemplated under the PIPs. In
contrast with current law, States operating under the CWPO that are
successful in reducing the need for foster care will be able to
reinvest their Title IV-E funds in other child welfare services rather
than losing them to diminished foster care claims.
Reduces Burden. Under the CWPO, the level of
documentation required of States in order to receive Federal child
welfare funds would be reduced dramatically. While States would still
be required to spend funds on child welfare services, they would no
longer need to justify to the Federal Government for funding purposes
precisely which services were delivered to which children. State and
local funding decisions could in turn be made more in line with the
needs of children and families without respect to whether the specific
activity were reimbursable under Title IV-E.
Increases Flexibility. The restrictions in current law
regarding which child welfare services may be provided with Federal
funds constrain State and local decision making regarding service
offerings. The increased flexibility afforded by the CWPO will provide
officials closest to child welfare cases with additional funding
options, potentially leading to a more comprehensive service array for
children and families.
Promotes Ongoing Programmatic Adaptation and Innovation.
The current system for claiming Federal funds encourages status quo
programming through its documentation requirements and close scrutiny
of categories in which funding levels change significantly from year to
year. States risk disallowances if they change how they claim or the
services for which they claim Federal funds. Alternatively, under
current law innovation may be implemented without Federal financial
participation, a relatively costly option. The CWPO, on the other hand,
would enable states to innovate using their Federal foster care funds.
Funds could be shifted among child welfare functions without concern
for artificial expenditure categories or differential matching rates.
The result is likely to be increased attention to outcomes for children
and an improved ability to focus funding on strategies most likely to
result in improved performance.
This paper has described the funding structure of the Title IV-E
foster care program and documented a number of its key weaknesses. In
particular, the combination of detailed eligibility requirements and
complex but narrow definitions of allowable costs force a focus on
procedure rather than outcomes for children and families. Rules which
have built up over the years cumulatively fail to support the program's
goals of safety, permanency and child well-being. In addition, the
restrictiveness of the Federal foster care program prevents States from
using these funds, by far the largest source of Federal funding
dedicated to child welfare activities, to implement many important
elements in their Program Improvement Plans. These plans have been
required of all States to address weaknesses in their programs detected
during Child and Family Services Reviews. The Administration's proposed
Child Welfare Program Option is intended to introduce flexibility while
maintaining a focus on outcomes, retaining existing child protections,
and providing a financial safety net for states in the form of access
to the TANF Contingency Fund during unanticipated and unavoidable
crises. The result will be a stronger and more responsive child welfare
system that achieves better results for vulnerable children and
families.
References
Scarcella, Cynthia Andrews, Bess, Roseana, Zielewski, Erica Hecht,
Warner, Lindsay, and Geen, Rob (2004). The Cost of Protecting
Vulnerable Children IV. Washington, DC: The Urban Institute. Available
online at: http://www.urban.org/
Template.cfm?Section=ByAuthor&NavMenuID=63&template=/TaggedContent/
ViewPublication.cfm&PublicationID=9128.
Committee on Ways and Means, U.S. House of Representatives (1992).
1992 Green Book. Washington, DC: U.S. Government Printing Office.
Committee on Ways and Means, U.S. House of Representatives (2004).
2004 Green Book. Washington, DC: U.S. Government Printing Office.
Available online at: http://waysandmeans.house.gov/
Documents.asp?section=813.
Frame, Laura (1999). Suitable homes revisited: An historical look
at child protection and welfare reform. In Children and Youth Services
Review, Vol 21, Nos. 9/10, pp. 719-754.
McDonald, Jess, Salyers, Nancy, and Shaver, Michael (2004). The
Foster Care Straightjacket: Innovation, Federal Financing and
Accountability in State Foster Care Reform. Urbana-Champaign: Child and
Family Research Center, School of Social Work, University of Illinois.
Available online at http://www.fosteringresults.org/
The Pew Commission on Children in Foster Care (2004). Fostering the
Future: Safety, Permanence and Well-Being for Children in Foster Care.
Washington, CC: The Pew Commission on Children in Foster Care.
U.S. Department of Health and Human Services (2005). Budget in
Brief FY2006. Washington, DC: U.S. Government Printing Office.
Available online at: http://www.hhs.gov/budget/docbudget.htm.
U.S. Department of Health and Human Services (2004). SSBG 2002:
Helping States Serve the Needs of America's Families, Adults and
Children. Washington, DC: Administration for Children and Families.
Available online at: http://www.acf.hhs.gov/programs/ocs/ssbg/index.htm
Note on Data Sources:
Data presented in this report are derived primarily from HHS
information sources. Most are publicly available as follows:
Data on Title IV-E funding and caseload history (figure
1) are from the ``2004 Green Book'' published by the U.S. House of
Representatives Committee on Ways and Means (tables 11-2 and 11-3).
Years not included in the 2004 Green Book may be found in the
equivalent table from previous editions. The 2004 Green Book is online
at: http://waysandmeans.house.gov/Documents.asp?
section=813.
Data for 2002 Federal foster care claims is available in
2004 Green Book, table 11-8. Other years used in this report are
unpublished HHS data. These data are used in figures 2, 3, 5, 6 and 7.
Final Reports for Child and Family Services Reviews
(which contain data used in figures 4, 5 and 6) and Title IV-E
Eligibility Reviews (containing data used in table 1) are available
online from the Children's Bureau within HHS's Administration for
Children and Families at: http://www.acf.dhhs.gov/programs/cb/cwrp/
index.htm.
State foster care maintenance rates shown in figure 7 are
those reported by the Child Welfare League of America. They are
included in the 2004 Green Book, table 11-9.
Data on child welfare funding in figure 8 are derived
from 2004 actual figures shown in HHS's FY2006 Budget. Available online
at http://www.hhs.gov/budget/docbudget.htm.
Chairman HERGER. Thank you, Dr. Horn. I think your closing
sentence really sums it up. All of us, even though we might
have different opinions on how to reach the results, are united
that this is a system that we need to work together to fix. I
am convinced there isn't anyone in any of these States that is
involved in any of these programs who does not have the right
intentions of making it work. The fact is, it is not working;
and working together with Mr. McDermott and yourself and the
Administration and all of us is the only way we can do that.
My concern is, we have gone on for too many years talking
about this and yet not taking the steps to actually make sure
we have the results with these young children, that they
deserve and, certainly, the American taxpayers demand. The
gentlelady from Connecticut, to inquire.
Mrs. JOHNSON. Thank you, and welcome, Dr. Horn. How much do
we know about these numbers? If they range from over $4,000 to
a little over $41,000, do we know how much goes to the foster
care family, how much goes to supporting services, how much
goes to administrative costs?
Dr. HORN. Yes. In the report itself there is a chart that
breaks down those figures by how much goes into foster care
maintenance payments, and those are the payments that reimburse
States for----
Mrs. JOHNSON. Is this gross or by State?
Dr. HORN. It is by State. We also break it down into how
much goes into administrative costs and how much goes into
training, and our costs reimbursements for the States.
Mrs. JOHNSON. Does it break it down into support services?
Do we know what portion of the money is spent on services to
support families? Maintenance, administration, and training are
the ways that we pay for it, but do we know what the money is
being spent on? Some of the administration, I would assume, was
actually paying local community-based services to support the
family.
Dr. HORN. I can tell you that the amount of the almost $5
billion that is being spent on services is zero.
Mr. MCDERMOTT. Zero?
Dr. HORN. Zero, if by ``services'' you mean providing
interventions to help children and families, that is, to
provide, for example, access to mental health services,
parenting education services. You can't use these funding
streams to provide services to these families. If you are
talking about prevention----
Mrs. JOHNSON. What about providing services to families, to
a child in foster care placement? Can't some of this money be
used for those kinds of services once the child is placed?
Dr. HORN. It depends on what your definition of
``services'' is. If you are talking about preparing, for
example, a social worker preparing to go to court, to the 12-
month----
Mrs. JOHNSON. If the child has significant emotional
difficulties and needs to be able to also see a counselor, I
thought that kind of service could be paid for.
Dr. HORN. No.
Mrs. JOHNSON. That is all just State funding?
Dr. HORN. They can use other Federal funding sources. For
example, title IV-B funds or Safe and Stable Families program
funds. That is the problem with the title IV-E funding stream;
it doesn't allow you to pay for the services that kids require
to be able to prevent----
Mrs. JOHNSON. I am keenly aware of that. When you say these
dimensions of numbers, Connecticut is high on this. They can't
possibly be spending all that money, even including all the
State employee salary and everything, administration, so I just
wondered if you knew anything more about what is behind the
numbers?
Dr. HORN. We can give you a breakdown----
Mrs. JOHNSON. For instance, in health care and everything
we do a wage adjustment, so Connecticut's wages are much higher
and the cost of living is much higher, so you do get a real
disparity, a significant disparity in cost areas. That doesn't
appear to me to account for the great disparity that you are
seeing in this chart.
Dr. HORN. For example, in the title IV-E program, you can
pay for referrals to services, but you cannot pay for the
services themselves. You can pay for the development of a case
plan, but if the case plan has elements in it that say certain
kinds of services should be provided to the child, you cannot
use title IV-E funds to pay for these services. That is why
this program is broken. You know that better than anyone.
Mrs. JOHNSON. Well, I do know that. On the other hand, I
know that the proposal that I made, which if it actually would
have been adopted when I made it, States would have a lot more
money than they do now. We are having trouble getting that
adopted; we are having trouble because States are just plain
scared about a flat budget, about a set amount. If they are
unwilling to do that, what can we do about the category of
grants and the flexibility? What are our other options here?
This is much too serious to be stuck where we are stuck. We
have been stuck there 5 years in the short term, 10 years in
the long term, maybe 15 years in the long term.
Dr. HORN. I think it is important to emphasize a
distinction between earlier proposals, like you and I were both
involved in, and the President's proposal, that the current
proposal from the President is one that provides an option to
the State. A State can simply stay in the same system if they
think the current----
Mrs. JOHNSON. It is a one-time choice, isn't it?
Dr. HORN. It is a choice for 5 years, and at the end of 5
years they can opt back into the current financial system.
Mrs. JOHNSON. If they opt back in, what is their base?
Dr. HORN. Well, they would go back to a system where the
State would be reimbursed for claims that they send in to the
Federal Government.
Mrs. JOHNSON. They wouldn't be harmed by being out for 5
years if they wanted to?
Dr. HORN. That is right.
Mrs. JOHNSON. Is that the major change between this
proposal and preceding proposals?
Dr. HORN. Well, this has been the President's proposal for
the last 3 years, and it is also the proposal, as I understand
it, that is reflected in the Chairman's proposal, proposed
legislation. If we go back a few years to the early 1990s,
there were different proposals on the table. You are quite
right, if we had enacted those proposals, States would have
more money than they have now.
Mrs. JOHNSON. Well, between this report and the earlier
report--about a year or so, was it--how catastrophically
children are doing in foster care, and the lack of services, we
do need to move forward. I am disappointed that money is not
there, but we will may be able to find other money. I hope you
will work with us on that.
Chairman HERGER. I thank the gentlelady. The gentleman from
Washington, Mr. McDermott, to inquire.
Mr. MCDERMOTT. Thank you, Dr. Horn, for your testimony.
Last year when you were here, you said the President is firm in
his commitments to continue to seek and secure full funding,
$505 million per year, for this important program. Why has he
backed off this year?
Dr. HORN. Each year we put a budget together, and this year
the budgetary constraints were such that we weren't able to
again----
Mr. MCDERMOTT. Is that less children?
Dr. HORN. Each year you put a budget together.
Mr. MCDERMOTT. You don't pay attention to what the caseload
is; you just set a number. Is that what I am to get out of
that?
Dr. HORN. First, I think it is important to keep in mind
that the President did get, in fact, $500 million over 5 years
in additional funding under the Safe and Stable Families
program, which he proposed and the Congress appropriated.
Congress chose not to appropriate the other half of that----
Mr. MCDERMOTT. He backed down to the Congress. That is good
to hear. I am glad to hear the President pays attention to the
Congress----
Dr. HORN. The second thing I would point out is, in last
year's budget he also asked for increases in the Child Abuse
Prevention and Treatment Act (P.L. 93-247) programs.
Mr. MCDERMOTT. Tell me something, which puzzles me. I have
been doing this for a while, and I never understand why after 3
years you have no legislative language to bring up here and lay
on the table. You say, we have a proposal, and proposals are
proposals, proposals are proposals, but when are you going to
bring legislative language so we can actually work on it?
Dr. HORN. We have been working with the Chairman on his
bill. If you would like me to come up and work with you on
legislative language, I will make that appointment with you
tomorrow.
Mr. MCDERMOTT. The Chairman is the problem; it is not the
White House?
Dr. HORN. No. The Chairman has actually proposed
legislation.
Mr. MCDERMOTT. Why don't you lay your proposal on the
table?
Dr. HORN. We have laid our proposal on the table.
Mr. MCDERMOTT. I notice that your--one of the things about
your chart that I would just point out--it is misleading, and
Mrs. Johnson was really asking you about it--is, you are using
only foster care money. You are not talking about any TANF
money, you are not talking about any Medicaid money, you are
not talking about any SSBG money.
The presentation is misleading. It is practically useless
because you can't figure out what is going on in any particular
State when you see that Tennessee is down here at $4,000, and
Ohio--for heaven's sake, Ohio--at $44,000, Connecticut is
$32,000. What is going on? There is nothing--we don't learn
anything from this because you didn't put all the dollars, and
I think that is really the point.
What troubles me--and I guess, besides your proposal, which
you don't put in writing--you also have a proposal that would
restrict the States' ability to claim administrative funds for
foster care children living with relatives whose homes have not
been licensed, so you are going to cut out some money there.
You also have a proposal to eliminate the ability of States to
claim Medicaid matching payments for case management services
provided to foster care children with health care needs.
Finally, there is a legislative proposal to reduce foster
care eligibility for certain children by overturning a court
decision by the Ninth Circuit Court. Now, it seems to me not
only has the President backed off, but you are also cutting
money by taking away things that now States are using to
supplement whatever this chart is really supposed to mean. How
do you justify cutting money and then saying, if we just give
it to them in a big bag, it will be okay? Is that the idea?
Dr. HORN. Again, I want to remind the Committee that this
is an option. If the State doesn't think this is a good deal
for them, they don't have to say yes, they don't have to take
the option. I don't understand why you feel you should make
that decision for the States. States have the option to
continue their current funding structure if that is what they
feel they should do. Why shouldn't a State, if they feel they
could use the money more flexibly for the betterment of the
children in their State, why shouldn't they have the option to
do that?
Mr. MCDERMOTT. Well, maybe you can help me with that.
Besides the President's brother who, I would expect, would
probably go along with his brother, how many State Governors
have come forward supporting the President's plan and proposal?
Dr. HORN. Well, the issue is, if you make an option
available, States will go into decisionmaking as to whether or
not they want to do it.
Mr. MCDERMOTT. How many have said, ``please give us that
option''?
Dr. HORN. Well, we have a number of States who have
requested through the child welfare waiver demonstration
process to, in fact, do precisely this.
Mr. MCDERMOTT. Which ones are they?
Dr. HORN. Oregon, Indiana, North Carolina, and Ohio.
Mr. MCDERMOTT. Are they agreeing to a cap or a block grant?
Dr. HORN. Under existing waiver authority, what States get
is a cost-neutral waiver that they can then use title IV-E
funding flexibly as reflected in the President's proposal for a
variety of different kinds of services. What do we find? We
find that of the three States that concentrated on preventing
removal of children from their homes, all three of those States
showed significantly reduced placements in foster care without
any detriment to child well-being. We also found in Indiana
that there is a significantly reduced time to reunification for
children who were in foster care to return to their family of
origin because States were able to provide their families with
intensive services while the child was in foster care.
Mr. MCDERMOTT. If it is a good idea, why aren't the other
47 States coming forward and asking for it? You named three
States that have asked for it.
Dr. HORN. Four.
Mr. MCDERMOTT. Four, excuse me. Where are the other 46? If
it is such a good idea, why are these other Governors asleep?
Dr. HORN. It would be up to them. If they have an option--
even if only one State takes it----
Mr. MCDERMOTT. We don't need the President's proposal, we
already have a proposal. If they come forward and ask for a
waiver, they are all taken care of.
Dr. HORN. The only difficulty is they cannot do that waiver
statewide. They can do it in certain jurisdictions within the
State, but not statewide. We have had States come to us--Ohio
has, for example--asking us to allow them to do the waiver
statewide, but that is not possible under the Child Welfare
Waiver Demonstration authority. Even if there is only one State
that wants to do it, what is the problem with them doing it and
demonstrating whether this makes a difference for kids in their
State?
Mr. MCDERMOTT. Because you are cutting the money. Thank
you. Thank you, Mr. Chairman.
Dr. HORN. May I just clear up one thing, Mr. Chairman? The
proposed regulation that you referenced, Congressman, has to do
with the fact that some States are claiming administrative
costs for children who are not part of the title IV-E program.
The administrative cost portion of the title IV-E program is
meant to help States with the administrative costs of
administering the title IV-E program. Why should States be able
to claim administrative costs for kids who are not part of the
program? We are simply saying that is what the statute says. We
are simply enforcing the statute.
Chairman HERGER. The gentleman's time has expired. The
gentleman from Colorado, Mr. Beauprez.
Mr. BEAUPREZ. Thank you, Mr. Chairman. The gentleman from
Washington says he is troubled; I am troubled, too. I am
troubled by some of the results I see in here. Especially when
it says in here that there is absolutely no correlation to
spending more money and permanence for foster kids, that
troubles me greatly.
Now the old adage, ``If it ain't broke, don't fix it''
probably applies, but it is broke and we ought to fix it. In
advance of this hearing, Mr. Horn, I checked with my Governor's
office in Colorado; he is very interested in pursuing this. You
can probably add Colorado to your list of States, too, of who
wants to talk to you if this moves forward. As I looked at
figure 2, this chart--and this is just the Federal dollars--
tell me, first of all, what is the relationship between Federal
and State matching money?
Dr. HORN. It depends upon which of the four Federal funding
streams in the title IV-E foster care program you are referring
to. Some expenses are matched at the Medicaid match rate, some
are matched at 50 percent, some at 75 percent enhanced match.
Mr. BEAUPREZ. I think we are 50/50. There is a lot of money
being spent. I am stunned--one of the places, again, I am
troubled is by the amount of administrative dollars that are
being spent. You have already talked about that to a degree.
Do you have any indication--time is money, and it looks
like we are spending a whole lot of money on time here--is all
of this money being spent on administration? Are we forcing the
States to push paper unnecessarily, perhaps, or have the States
sometimes developed an empire because they can't?
Dr. HORN. The current funding structure forces the States
to do things that are highly burdensome and that take away
valuable resources that could be used to provide services to
children.
Mr. BEAUPREZ. Every program I have talked to back in my
State, whether it is at the county level where the rubber
really meets the road, county officials that are trying to
administer TANF or a WIC or Head Start or this program tell me,
``Boy, when you go to Washington, if you could get us more
flexibility, please, please, please.''
When you are talking about not forcing, but as I
understand, again, your proposal is a voluntary program for
more flexibility, that is what very much intrigued local
officials when I talked to them about that. I, for one, at
least applaud you for that. Tell me, it just seems
incomprehensible with the disparity in the money spent from the
various States, $4,000 to over $40,000--did I hear you right,
there is really no correlation between the amount of money
spent and permanence for the kids? Which I assume is the
objective here, right?
Dr. HORN. The analysis is very clear that when you
correlate the amount of money that is being drawn down from the
title IV-E program with permanency outcomes, that is, the
number of kids who are either reunified within a year with
their family of origin or placed for adoption after removal
within 2 years, when you do that correlation, 99.8 percent of
all the variance is accounted for by something other than the
amount of money States are drawing down. The amount of variance
and permanency outcomes that is accounted for with the amount
of money that States are drawing down is minuscule.
I hasten to add, I am not blaming the States. The States
are simply operating under the system as it is currently
structured. It is not as though the States are saying, We
really like jumping through all these hoops, doing all this
paperwork, doing these cost allocation plans; we really like
spending all this money on everything except services for kids
in our foster care program. States don't say that but that is
what we make them do. It seems to us that we ought to at least
give them the option of structuring things differently.
Mr. BEAUPREZ. Whether it is Medicaid--I heard from one of
my doctor-administrators that 30 percent of her overhead is
administrative overhead, and if we could only save some of that
paper-pushing money. Tell me in the little bit of time we have
got left, Dr. Horn. We are talking kind of in theory and
intangibles here. If we provide them that flexibility, what
sort of things might a State do to promote this permanence
outcome?
Dr. HORN. First of all, I think they would provide more
prevention services for families so that those children are not
abused and neglected in the first place. An interesting model
for prevention, one that has received a lot of empirical
support, is home-based nurse practitioner visiting, where high-
risk families are visited in the first 2 years of their lives
by a nurse practitioner who helps those families with some
general child development knowledge and also provides social
support. Those studies have shown that if you do that for the
first 2 years of a child's life, by the time the child is 16
years of age, we have reduced by 75 percent substantiated cases
of child abuse and neglect.
A compassionate society, is not one that says, let's have a
really wonderful foster care system for kids to go into after
they are abused and neglected, as important as that is, but
rather one that says, let's try to prevent those tragedies from
happening in the first place. Why not allow States to put more
investments into prevention?
Also, States could use flexible funding for intensive
reunification services once the child is placed in foster care.
In Indiana that is what they did, and they showed they were
able to reunify families faster. There are a lot of ways that
this money could be used as a State option in order to provide
services for kids that would enhance permanency.
Mr. BEAUPREZ. I thank the Chairman.
Chairman HERGER. I thank the gentleman. Thank you for your
last comments. I think this is exactly what this Committee--in
a bipartisan manner, in all of us working together--needs to be
working to do. What do we do to help these young kids? I think
your point of the fact--I am convinced, as you have mentioned,
there aren't any of these States that are on purpose setting up
these programs to fail. It is that we at the Federal level have
set up the hoops that they have to jump through that is
preventing these young people from getting the services they
need to help them in their lives. I thank you for that. The
gentleman from California, Mr. Becerra, to inquire.
Mr. BECERRA. Thank you, Mr. Chairman. Mr. Secretary, thanks
for being here. Let me ask a question, because I know we are
interested in trying to follow up on the Administration's
proposals, especially with this optional proposal for--I guess
it is called the Child Welfare Program Option. Can you provide
us with the legislative language that the Administration has
come up with to have us go forward with any particular optional
program that you have devised?
Dr. HORN. I would be very happy to come and meet with you
and work out legislative language that would reflect the
President's proposal.
Mr. BECERRA. No. I am asking for the legislative language
that you all have for this option that you are proposing that
Congress pass.
Dr. HORN. We understand that the legislative process is an
interactive one between the Administration and the Congress,
and we would be very happy tomorrow to come up to your office
and start working on legislative language.
Mr. BECERRA. You don't have the legislative language?
Dr. HORN. We have a proposal that is very detailed, and we
believe it wouldn't take very much for us to translate it with
you, in partnership, into legislative language.
Mr. BECERRA. That proposal that is detailed, is that before
us already? Have you provided that?
Dr. HORN. Yes.
Mr. BECERRA. We do have that? Do you have that with you
right now?
Dr. HORN. Not in my back pocket, but I can get it to you.
Mr. BECERRA. If we have already gotten it, forgive me, but
I don't happen to have it with me, so if you could be sure that
whatever detail you have on the proposal you make available to
us, because my understanding is, you don't have legislative
language, but you do have, as you have described, details on
this proposal for an opt-out program.
Dr. HORN. I would be very happy to share that with you.
[The information was not received at time of printing.]
Mr. BECERRA. I appreciate that.
The other question relates to this idea of block granting.
To me, the difficulty I have with block granting is that when
you talk in terms of funding based on aggregate members, the
macro numbers, to me that begins to treat those that you are
trying to service, trying to help, the children in this case,
foster care children, as commodities because you are not basing
a determination based on the needs of that particular,
individual child, but some aggregate, macro number that a State
is providing to you. Each year your funding that we would
provide, under your plan, to a State for its foster care
children wouldn't be based on a child's particular needs and
the collective children's needs in that State, but based on a
number on paper that says that from year to year funding may
increase or decrease based on a macro formula.
To me, the more we treat children as widgets, especially in
the foster care program, the more you actually make them
believe that that is what they are, widgets. We are, in
essence, warehousing them somewhere, rather than treating them
as individuals who need to have the attention and need to have
the sense of caring that now we have at the highest levels, a
block grant that defaces, in essence, the foster care
recipients here, the children.
I don't know how we would go about making these children
feel that they should have esteem and believe that someone
cares about them if you are now going to be telling the State
that your funding is based not on the actual need of the
children in your State, but based on last year's funding level.
I don't know if there is a question here, but I would certainly
give you an opportunity to respond.
Dr. HORN. Well, again, it is important to keep in mind that
this is not a block grant proposal, it is an option; if a State
doesn't want to opt into this, they can continue on----
Mr. BECERRA. They are locked into what they would receive
once they go into this option, right?
Dr. HORN. For 5 years.
Mr. BECERRA. If one year my State of California has, what
is our number, somewhere in the area of about 60,000--is it
60,000 children in foster care? I am looking at your chart
here; I am not sure if that is the correct number, but say it
is 60,000. What happens if all of a sudden we continue to see
some hard times in California, let's say some drought
difficulties hurt our farmland communities and we have even
more poverty among our agricultural communities where we
already see 15 to 20 percent unemployment rates. Your formula,
if a State should opt in to your opt-out program, our optional
program, wouldn't take care of it if the needs increase
dramatically for foster care.
Dr. HORN. Under the President's proposal, States that find
themselves in that situation, who do opt in, with circumstances
beyond their control, seeing an increase in foster care, would
be able to draw down funds from the $2 billion TANF contingency
fund----
Mr. BECERRA. That is a contingency fund. This isn't a
contingency. If you have got kids who are now in foster care,
we are not sure if they are going to leave foster care in a
year or if they are going to be there for some quite time. That
is not a contingency for most States; that becomes a hard
expenditure to try to help that child.
Dr. HORN. Perhaps I misunderstood your question. I assume
what you are asking is, let's say you have 60,000 kids in
foster care in California. You have a fixed amount of money. If
the caseload drops to 40,000, everybody's happy. That is what I
think would happen if you are able to use these funds more for
prevention and reunification services, for example. What
happens if the caseload goes from 60,000 to 70,000? That is
where the contingency fund comes in. The State would draw down
additional money from the contingency fund.
Mr. BECERRA. You roll the dice?
Dr. HORN. It is not a roll of the dice.
Mr. BECERRA. Are you guaranteeing us that the rolls will
drop, that there will be fewer foster care----
Dr. HORN. If they don't, the point is that you get to draw
down additional funds over and above the fixed allotment.
Mr. BECERRA. Right. The rainy day fund is used for what
would otherwise be a natural increase in the size of your
foster care population. The Chairman has been gracious for the
time. We can explore this more. I look forward to receiving the
details of your plan, but I must tell you it really concerns me
when we start talking about kids as widgets and commodities
versus what they really are, productive and potential future
leaders of this country.
Dr. HORN. I agree with you that we should never treat
children as widgets. The problem is that right now, if the
widget needs services, you can't pay for them through the title
IV-E program; that is the problem. If you have a broken widget,
you can't use this money to fix it?
Mr. BECERRA. Cutting $4 billion over the next 5 years under
your particular program doesn't help any more than what we
have.
Dr. HORN. Where did we cut $4 billion under our program?
Mr. BECERRA. When you give me the details of your plan, I
will go through the $4 billion that you are cutting.
Dr. HORN. I know we are not cutting $4 billion.
Chairman HERGER. The gentleman's time has expired. The
gentlelady from Pennsylvania, Ms. Hart, to inquire.
Ms. HART. Yes. I thank you, Mr. Chairman. If I am not
mistaken, we have already established that it is not the money
that makes a success in foster care, so we can argue over the
money, but I think the point that you made earlier is that we
want to provide flexibility for the folks who are actually on
the frontline. Is that your goal?
Dr. HORN. That is exactly right.
Ms. HART. Like a lot of Members of Congress, we have had
our own experiences, snapshot experiences, with the foster care
system. As a private practice lawyer I had a pretty bad
experience with a family who wanted to try to adopt a child,
and the foster care system pretty much insisted on keeping this
child in the foster care system. My concern when you talk about
permanence for the child, can you give me a little bit of the
theory behind what you think this flexibility will allow as far
as permanence that is best for the child, which may not be
reunification with the family?
Dr. HORN. See, I do not believe--and I agree with
Congressman McDermott on this, and we actually point it out in
the report. The current funding structure provides an incentive
for children to be pulled out of their homes and placed in
foster care. There is no evidence that that is the case, and
even in theory, it would work only if the Federal Government
picked up 100 percent of the cost.
The State has to put some money in, so it is a real cost to
the State to put a child in foster care. The difficulty is that
you can't use any of that money to prevent a placement in
foster care, and once the child is in foster care, you can't
use any of that money for services that will allow you to
reunify that child with their family in an expeditious manner.
What you can use the money for is continued placement in foster
care and to reimburse States for some of their costs,
administrative costs for running the program, but not for
services for that child.
Ms. HART. On the front end, when we are talking about a
child who has been removed from a family and there is progress,
and so there is an expectation that this child will be able to
be reunified, is there an amount of time that they are
expecting? Is there, a couple years, 3 years, whatever it is,
that this program would expect this child to be able to be in
foster care reasonably before that child is returned to the
family or another permanent placement is decided? Is that
something that is conceived of in this plan?
Dr. HORN. Some of those issues were addressed in previous
bipartisan legislation originating in this Committee. For
example, his Committee reduced the length of time between when
a child is put in foster care and their dispositional hearing--
basically a hearing that says, what is the plan here, what are
we going to do, what is the goal--from 18 months to 12 months,
and that was a very good thing. There is also a requirement
under a current statute that every 6 months there be an
administrative review to make sure that the plan still makes
sense.
Ms. HART. That is a Federal requirement?
Dr. HORN. Yes. All of that stays; even under the option,
all of that stays. It is important to get a plan in place
quickly, it is important to have some review of that plan in a
systematic and timely fashion. The biggest problem is that you
can spend money on developing the plan, but if the plan says
these are the three services that this family needs in order to
help reunify this child, you can't use title IV-E foster care
funds to pay for these services.
Ms. HART. Under this proposal we would be able to do that?
Dr. HORN. That is exactly right.
Ms. HART. That is helpful then. The next step, though--
because I still see a green light--how many times and how many
reviews are expected, or anticipated, before there really is a
permanency plan? When you say there is a review every 6 months,
can there be a review every 6 months for 6 years?
Dr. HORN. Sure, in theory one can, although again there are
time limits in the statute that require if a child is in foster
care for 15 of the most recent 22 months there is a presumption
that the State agency should start to move toward termination
of parental rights and subsequent adoption.
Ms. HART. The States are doing that a little bit
differently.
Dr. HORN. Yes. In fact, we are seeing a dramatic increase
in the number of adoptions out of foster care because of the
work of this Committee. We have gone from about 28,000
adoptions a year back in the mid-1990s, to about 50,000
adoptions a year out of foster care today and that is a direct
result of the work of this Committee.
Ms. HART. Okay, good. Just finally, because I am running
out of time, is there anything in the Federal regulation
currently that would be against the actual adoptive parents in
that case being the foster care? Is there any prejudicial
regulatory----
Dr. HORN. Not that I am aware of.
Ms. HART. Good. I just want to make sure. Okay, thank you.
I appreciate your cooperation. Thank you, Mr. Chairman.
Chairman HERGER. Thank you. Dr. Horn, on my time, the
gentlelady from Connecticut has a brief correction that she
would like to make.
Mrs. JOHNSON. I just wanted to clarify that in my
frustration about this report, and also the report we had on
State compliance with the overall law for permanent placement
of children. The picture is terrible, but I am a strong
advocate of flexibility. We had a waiver in my State. It was
the first time the pipes of services began really talking to
each other and thinking through, how can we use this money best
for children? It was extraordinarily powerful and it was
extraordinarily successful, and we are minimizing the power of
that through this kind of discussion. On the other hand, the
problems are extraordinary, and we have got to figure out some
way to get through this and get change to happen. Thank you.
Thank you, Mr. Chairman, and I appreciate that.
Chairman HERGER. Dr. Horn, there have been some questions
on whether or not the Administration has a plan, and I just
want to make it clear, the legislation that I have proposed has
been the Chairman's legislation, legislation we have been
working on hand and hand with you and the Administration to
work through. I just want to make that point clear.
Probably one of the biggest criticisms of changing the
current funding system is this concern of some unforeseen
circumstances that could cause foster care caseloads to
increase significantly. For example, I have heard repeatedly
from individuals about how this policy would hurt kids if drugs
such as methamphetamines would cause foster care caseloads to
grow substantially. Dr. Horn, could you tell us how the
President's option would assist States in these circumstances.
Dr. HORN. There are two ways. First of all, as I previously
discussed, the President's plan would allow a State that saw an
increased need for foster care placements to draw down
additional funds from the $2 billion TANF contingency fund,
which has already been appropriated. The money is there, but
very little of that money has ever been drawn down under the
TANF program. We would like the flexibility for States who
choose this option to be able to draw down additional funds if
they see an increase in foster care placements in their State.
More to the point, if States are able to build community-
based prevention programs, then you will see less kids made
vulnerable to these kinds of changing circumstances. The
current system, at least from the Federal funding level, is
weighted toward foster care. It is not that they are running
around pulling kids out of their homes and placing them in
foster care willy nilly, but they are basically sitting around
waiting for a kid to show up already abused and neglected. What
we need to do is provide States the ability to build
comprehensive, community-based systems of care that prevent
these kinds of tragedies from happening in the first place.
States can't do that with this funding source.
Now the President understands there are other funding
sources. It is the reason why he proposed and the Congress
appropriated $100 million of additional funds per year under
the Safe and Stable Families program; some of that can be used
for prevention. It is also why last year he proposed increases
in the Child Abuse, Prevention and Treatment Act but Congress
didn't appropriate as much as he wanted.
The President understands the funding streams. This is the
largest funding stream. Why in the world do we say the largest
funding stream the Federal Government has, where there is no
evidence, none, that it is related to better outcomes for kids,
we are going to leave that alone? We are not going to touch it
and allow States the option of using that money more flexibly,
because we here in Washington know better than Governors'
offices about the best way to use those funds in their own
States?
It seems to me that we ought to provide the States the
option of building comprehensive, community-based systems of
care so that those children are not made vulnerable to these
kinds of changing circumstances that otherwise would lead to
increases in abuse and neglect.
Chairman HERGER. Thank you. Following up that question, is
there any reason to believe that the current funding structure
adequately protects States against those spikes in foster care
caseloads?
Dr. HORN. None, because they can't. Those funding streams
don't become available to the State until a child has been
abused, neglected and placed in foster care. It is not possible
to use those funds to protect kids from abuse and neglect. That
is the problem.
Chairman HERGER. What is being--this concern is not really
being adequately taken care of, even now under the current
program?
Dr. HORN. Absolutely not. Look, if the title IV-E funding
streams could be demonstrated to be correlated with
improvements in outcomes for kids, if you could demonstrate
that these funding streams were--in fact, were allowing States
to have really good outcomes in their child welfare system--
then we wouldn't be having this conversation.
In the same way that it was hard to demonstrate that AFDC,
back in 1996, was this wonderful program that helped millions
of people escape welfare dependency and poverty, given the
absence of evidence that it was working so well, this Committee
and the Congress decided, in concert with President Clinton, to
change the system. It seems it is time for us to ask the same
question about child welfare.
Chairman HERGER. Well, thank you, again, Dr. Horn, for your
testimony. I thank you. Your testimony indicates why this
system is so severely broken. It isn't that anyone is
intentionally wanting it to be broken or to do all this harm to
these innocent children, but the fact is, it is broken, and the
sooner we can work together to repair it, the better off our
Nation will be--and certainly these young children that are
involved. I thank you.
Mr. MCDERMOTT. May I have just one question?
Chairman HERGER. Very quickly.
Mr. MCDERMOTT. If I am not incorrect, the last 3 years the
number of children in poverty in this country has been up all 3
years, right?
Dr. HORN. It has gone up, as you would expect, during a
recession.
Mr. MCDERMOTT. That definition that you gave of getting rid
of the AFDC was going to make it all better for kids has not
worked?
Dr. HORN. You don't think TANF has improved things for kids
and families in this country?
Mr. MCDERMOTT. If more kids are living in poverty, isn't
that--is that a measure you don't want to use?
Dr. HORN. It is substantially down since the 1990s.
Mr. MCDERMOTT. If the plan you put in, TANF, is supposed to
work and bring kids out of poverty, and now you have more kids
in poverty, you call that a success?
Dr. HORN. You have less kids in poverty since 1996.
Mr. MCDERMOTT. Not the last 3 years.
Dr. HORN. Yes, the last 3 years.
Mr. MCDERMOTT. The way the system is structured, the last 3
years it didn't work, right?
Dr. HORN. I don't believe that is true.
Chairman HERGER. Are there a million fewer children in
poverty today than there were when we started this?
Dr. HORN. Yes.
Chairman HERGER. This has dramatically worked even though
we had a recent change.
Mr. BECERRA. Mr. Chairman, is our measure--are we looking
at where children are today or are we looking at where children
were in 1996? Today, a child who lives in poverty is concerned
about what is going on for that child today, not what happened
in 1996.
Chairman HERGER. Well, that is obviously a fact, but I
think we need to look at the direction we are going. I believe
virtually everyone would have to admit this TANF program has
been overwhelmingly successful. With that, I would like to
thank you, Dr. Horn, and ask our next witnesses to be seated at
the table.
On this panel we will be hearing from Don Winstead, Deputy
Assistant Secretary of the Florida Department of Children and
Families; Adrienne Hahn, Vice President for Public Policy at
Casey Family Programs; and Fred Wulczyn, Research Fellow at the
Chaplain Hall Center for Children.
Mr. MCDERMOTT, I understand you have someone you would like
to introduce.
Mr. MCDERMOTT. Thank you, Mr. Chairman.
It is a pleasure today to have Adrienne Hahn here from the
Casey Family Foundation. She comes with a heap of experience.
She is an attorney, who worked for a number of years as the
Director of government Relations for the Independent Sector,
which is a coalition of 700 nonprofit organizations ranging
from March of Dimes to Boys Home in Nebraska to the Children's
Defense Fund. She comes with a broad experience before coming
to the Casey Family Foundation, where she really is in charge
of focusing on child welfare reform. It is a great pleasure to
you have here today.
Ms. HAHN. Thank you for inviting me.
Chairman HERGER. Mr. Winstead to testify.
STATEMENT OF DON WINSTEAD, DEPUTY SECRETARY, FLORIDA DEPARTMENT
OF CHILDREN AND FAMILIES, TALLAHASSEE, FLORIDA
Mr. WINSTEAD. Thank you, Mr. Chairman. Mr. Chairman, Mr.
McDermott, Members of the Committee, I am pleased to appear
before you to discuss Child Welfare financing. I am Don
Winstead; I am Deputy Director of the Florida Department of
Children and Families.
I returned to Florida in March of this year after more than
3 years of service at HHS, and although I was familiar with
this issue in my time with the Federal Government, I would like
to be very clear today that my comments are from the State's
perspective. In my written statement, I summarized the
development of community-based care in Florida, described
improvements being made in program outcomes, and provided an
Internet link for our online performance dashboard. If you
would like to see how our performance is in every area of
Florida, all it takes is a couple of clicks of your mouse.
Since my return to the State, I have been shocked by the
amount of time and attention that is consumed by administrative
issues related to financing. Simply stated, child welfare
financing is a nightmare. Complex and inconsistent eligibility
requirements frustrate frontline professionals and those who
administer child welfare programs, depriving children of time
and resources.
The Chief Financial Officer (CFO) from our community-based
care provider in Broward County, Fort Lauderdale, put it this
way, quote, ``Speaking as a CFO who has come from the private
sector, I am still amazed at how much of my time is taken up
wrestling with the State and Federal complexities and defending
our actions to the oversight people. I am guessing that a whole
50 percent of my time is taken up with these issues. I can also
say with absolute certainty that we spend close to a million
dollars a year to manage Federal eligibilities,'' end quote.
Title IV-E eligibility relies on eligibility rules that
derive from the now-defunct AFDC program, as it existed in
1996. TANF funding, another source we use, relies on at least
two sets of eligibility rules; regular TANF has one set of
requirements, and costs that are eligible because they are
allowable under a prior AFDC State plan require a different
process. Even the SSBG, which is very flexible, has one set of
rules for regular SSBG's and a different set of eligibility
requirements for SSBG's transferred from TANF. The sum of that
leads to a very complex and burdensome system.
Central to your focus today is child welfare financing
under title IV-E. The eligibility requirements, as Dr. Horn has
detailed, are complex and burdensome. It emphasizes out-of-home
care and does not provide for prevention services and
reunification services that can be so important. The
President's 2006 budget outlines the Child Welfare Program
Option. The President's proposal is similar to concepts from
were part of the Child Safe Act of 2004--your legislation, Mr.
Chairman. We believe the framework of the Child Welfare Program
Option would offer substantial improvements over the existing
program and merits serious consideration by the Congress.
A couple of key features: First of all, it provides an
option for States to select an allotted amount of Federal funds
to use flexibly for prevention and in-home services, as well as
out-of-home care. We believe the allotment should be the
equivalent to the State's anticipated future title IV-E funding
and should consider funding trends, demographics and provide
for contingencies. This would permit States to choose the
option to eliminate complex eligibility requirements and have
greater flexibility in meeting the needs of children. We
believe this flexible funding option should include foster
care, but we would support keeping adoption subsidies as an
uncapped entitlement.
This approach would align funding incentives with good
casework practice. In addition, we would support more
flexibility in use of title IV-E funds in our ways of operating
and administering child welfare programs. Some of the current
constraints are tied to the obsolete provisions of the now
defunct AFDC program. Eliminating complex and obsolete
eligibility requirements would permit States to better align
procedures among programs particularly in areas where we
administer and operate the programs through community-based
providers.
Florida is transforming our child welfare program. We have
established community-based care organizations to provide a
system of care within each community in our State. We are
committing more State resources and encouraging local
communities to add their resources and their commitment to this
partnership. We believe that providing States with the
opportunity to use Federal funds with greater flexibility would
greatly assist us in meeting our goals, and we encourage your
serious consideration of legislation that would provide this
option. Thank you, Mr. Chairman.
[The prepared statement of Mr. Winstead follows:]
Statement of Don Winstead, Deputy Secretary, Florida Department of
Children and Families, Tallahassee, Florida
Mr. Chairman, Mr. McDermott, and Members of the Committee, I am
pleased to appear before you to discuss child welfare financing. I am
Don Winstead, Deputy Secretary of the Florida Department of Children
and Families. The Department of Children and Families is the state
agency in Florida responsible for child welfare.
I returned to the State of Florida in March of this year after more
than three years of service in the U.S. Department of Health and Human
Services (HHS). Although I was familiar with the issue of child welfare
financing during my time in Washington, I would like to be very clear
that my comments today are from the State's perspective.
Community-Based-Care
Florida's child welfare system has undergone substantial reform and
redesign. In the past, like most states, Florida performed protective
investigations and provided services to children and families through
caseworkers who were employees of the state agency.
Under Governor Bush's leadership, Florida has transformed our child
welfare system by implementing a community-based care model. The key
feature of community-based care is that the provision of services is
fully integrated into the infrastructure of communities. In Florida, a
lead agency is charged with coordinating and providing all foster care
and related services in a geographic area no smaller than a county.
With 22 competitively selected lead agencies serving Florida's 67
counties, the statewide transition to community-based care was
completed in May 2005.
Lead agencies are governed by volunteer boards of directors
representing key stakeholders in their respective communities. These
include business leaders, community providers, court representatives
such as guardians ad litem, law enforcement officials, community
funding agencies like the United Way and county government.
To further enhance local community service integration, Community
Alliances were created by Florida statute in 2000. The role of the
Community Alliance is to serve as a catalyst for community resource
development and to provide a focal point for community participation
including joint planning for resource utilization, needs assessment,
and goal setting.
In addition to the implementation of a community-based care
structure, Florida is also contracting with Sheriffs in five counties
to perform protective investigations and a sixth Sheriff's office is
beginning start-up activities this year.
In April 2005, Florida Tax Watch, a private, non-profit, non-
partisan research institute that is widely recognized as a watchdog of
citizens' hard-earned tax dollars, issued a briefing reporti
calling for an integrated, streamlined monitoring system for child
welfare service contracts. Along with a number of thoughtful
recommendations, the Florida TaxWatch report found that community-based
care is showing results. The report noted that information from the
Department of Children and Families and Community-Based Care lead
agencies showed that improvement is being made in these areas:
---------------------------------------------------------------------------
\i\ http://www.floridataxwatch.org/
more children being visited each month;
fewer children in care;
fewer children in out-of-home care;
fewer children re-entering foster care;
more children adopted;
more available foster families; and
less foster home crowding.
For those who may be interested in tracking performance on these
and other outcome measures in Florida, we have developed a performance
``dashboard.'' This dashboard is available on the internet so that
performance data is accessible to our stakeholders, community partners
and the public. The performance data can be accessed at http://
dcfdashboard.dcf.state.fl.us
We believe that the best results for children and families will
come through community-based solutions. Our community-based care
organizations are building systems of care that will promote better
outcomes through more effective use of scarce federal and state
resources. This is good news for Florida's children and families.
However, there is still much work to do.
Child Welfare Funding is Complex and Burdensome
Since my return to the state, I have been shocked by the amount of
time and attention that is consumed by administrative issues related to
financing. Simply stated, child welfare financing is a nightmare.
Complex and inconsistent eligibility requirements frustrate front line
professionals and those who administer child welfare programs--
depriving children of time and resources.
The Chief Financial Officer from our community-based care provider
in Broward County put it this way,
Speaking as a CFO who has come from the private sector, I am
still amazed at how much of my time is taken up wrestling with the
State and federal complexities, and defending our actions to the
oversight people. I am guessing that a full 50% of my time is taken up
with these issues. I can also say with absolute certainty that we spend
close to a million dollars a year to manage federal eligibilities, . .
Peter Greenhough, Chief Financial Office
ChildNet, Inc.
While the focus of today's hearing is title IV-E funding, it is
important to place the issue in the context of the variety of federal
and state funds that are used in child welfare.
Our child welfare programs rely on a variety of funding sources
including title IV-E, Temporary Assistance for Needy Families (TANF),
Social Services Block Grant (SSBG), and other state and federal funding
sources. As the chart below shows, over 90% of our federal funds used
in child welfare come from TANF, title IV-E and SSBG, with TANF being
the largest single source of funds.
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Title IV-E eligibility relies on eligibility rules that derive from
the now-defunct Aid to Families with Dependent Children (AFDC) program
as it existed on July 16, 1996. TANF funded services rely on at least
two sets of eligibility rules. Regular TANF has one set of requirements
while activities that are TANF-eligible because they were allowable
under a prior AFDC state plan require a different eligibility process.
SSBG has flexibility, but SSBG funds transferred from TANF have a
financial eligibility requirement that does not apply to SSBG funds not
transferred from TANF.
One reason for the relatively high proportion of TANF funds in
child welfare in Florida is related to the Relative Caregiver program.
In 1998, Florida established a Relative Caregiver program that is
funded primarily through TANF. Over half of the children in out-of-home
care in our state are in relative placements, many in TANF-funded
relative settings.
In our public assistance programs, Florida has embarked on an
exciting redesign of the entire eligibility process to use modern
technology to make programs more efficient and more accessible. We are
reducing our reliance on bricks and mortar and asking community
partners to allow applicants to access services through computer
portals located in their service sites. To date, we have identified
over 2,000 sites where community partners will provide better access to
our common customers.
I mention this to contrast the situation with child welfare
financing. In public assistance, we have used statutory flexibility to
simplify access to TANF, food stamp programs and Medicaid eligibility.
In child welfare, however, we remain mired in the procedural
requirements of AFDC. In many ways, child welfare eligibility is more
convoluted and difficult than eligibility in public assistance.
The Need for Reform of Child Welfare Financing
Central to your focus at today's hearing on child welfare financing
is title IV-E funding. The eligibility requirements for title IV-E are
complex and burdensome. There are different categories of expenditures
with differing federal matching rates and the documentation and
reporting requirements are complicated, subject to interpretation, and
prone to dispute. These would be easier to justify if there was a clear
relationship between the requirements, goals, and outcomes of the
program. This, however, is not the case.
IV-E funding emphasizes out-of-home care and does not provide for
services that prevent removal of children from the home and support
reunification, when this can be accomplished safely. Prevention
services, family support services for children who are at risk of
placement in out-of-home care, therapeutic care and services to
remediate issues that prevent reunification are important to achieving
child welfare goals. In addition, services for families after children
leave foster care are critical. However, these services are not
allowable costs under title IV-E, the primary federal funding source
for child welfare.
Recommendations for Change
The President's FY 2006 budget outlines a Child Welfare Program
Option. The President's proposal is similar to concepts that were part
of the ChildSAFE Act of 2004 (HR 4856). We believe the framework of the
Child Welfare Program Option would offer substantial improvements over
the existing program and merits serious consideration by the Congress.
Key features that should be considered include:
Provide states an option to select an allotted amount of
federal funds to use flexibly for prevention and in-home services as
well as for out-of-home care.
The allotment should be equivalent to the state's anticipated
future IV-E funding and should consider funding trends, demographics,
and provide for contingencies. This would permit states that choose the
option to eliminate complex eligibility requirements and to have
greater flexibility in meeting the needs of children. We believe this
flexible funding option should include foster care, but we would
support keeping adoption subsidies as an uncapped entitlement.
This approach would align funding incentives with good casework
practice. The capacity of a protective investigator to safely leave a
child at home, or move quickly to return a child home, with appropriate
supports in place to address continued risk, is the first permanency
option that child welfare can place in action for children. This
approach would encourage states to prevent removal where possible and
to accomplish reunification when this can be done safely. Children who
cannot safely remain in the home or safely be reunified should be
expeditiously moved toward adoption or other appropriate permanency
option.
Provide greater flexibility in administration and
operation of the program.
In addition to providing more flexibility in the use of title IV-E
funds, states should have greater flexibility to administer and operate
child welfare programs. Some of the current constraints are tied to
obsolete provisions of the now defunct AFDC program. Eliminating
complex and obsolete eligibility requirements would permit states to
better align procedures among programs, particularly in areas where we
administer and operate the programs through community-based providers.
Greater flexibility in administration and operation of the program
should be provided regardless of whether a state chooses the Child
Welfare Program Option. Consideration should also be given to reforming
the cumbersome and arcane cost allocation requirements under which
costs are attributed to the various federal and state funding sources.
These procedures could and should be simplified.
States should be able to administer and operate child welfare
programs consistent with how we administer other major programs. It
would greatly improve the seamlessness of title IV-E funds with major
funding sources such as TANF and permit service providers to focus more
attention on service and help increase our focus on the service needs
of children and families rather than the bureaucratic requirements of
eligibility and documentation.
Florida is transforming our child welfare program. We have
established community-based care organizations to provide a system of
care within each community in our state. We are committing more state
resources and encouraging local communities to add their resources and
their commitment to this partnership. We believe that providing states
with the opportunity to use federal funds with greater flexibility
would greatly assist us in meeting our goals and we encourage your
serious consideration of legislation that would provide this option.
Chairman HERGER. Thank you. Ms. Hahn, please proceed.
STATEMENT OF ADRIENNE HAHN, VICE PRESIDENT, PUBLIC POLICY,
CASEY FAMILY PROGRAMS
Ms. HAHN. Mr. Chairman, Members of the Committee, I am
pleased to have this opportunity to share experiences and
recommendations of Casey Family Programs as you consider
Federal foster care financing options. Casey Family Programs is
the Nation's largest national foundation whose sole mission is
to provide and improve and ultimately prevent the need for
foster care. We draw from 40 years of experience in expert
research and analysis to improve the lives of children and
youth in foster care in two important ways: by providing direct
services and support to foster families and promoting
improvements in child welfare practice and policy.
Casey Family Programs was started by Jim Casey, founder of
what is now the world's largest delivery company, United Parcel
Service. We are here today to provide our input regarding a
very important and significant topic, foster care financing.
Casey Family Programs highly recommends the Committee bear in
mind these three things when it examines the issue of foster
care financing. First, it is imperative that Congress maintain
the open-ended entitlement including administrative funds for
title IV-E that are tied to performance-based measures. Having
the ability to measure results will help us better understand
the successes of the program and where we can make adjustments.
History is not a good guide for States to accept cap
funding for foster care or even a flexible block grant with
guaranteed funding level. As many of you know, the Social
Service block grant was severely cut from its authorized level
of $2.9 billion to $1.7 billion where it has remained frozen
since 1998. The title IV-B, Subpart I, Child Welfare Services
Fund has consistently been appropriated at far less than the
authorized $325 million. We must recognize that many of these
funds are used for prevention and family support in an effort
to avoid entry into foster care, which is precisely the deal
that the Administration is offering States with title IV-E.
However, the purchasing power has been eroded and the real
dollar value of the existing block grants have been reduced.
Consequently, States are facing a balancing act between the
real needs of other groups served by the block grants and the
consistently shrinking buying power.
We at Casey Family Programs are very concerned that child
welfare financing changes should not reduce the Federal fiscal
resources now available, or make administration of programs
more complex for States. Casey recommends that the entitlement
be continued and that more flexibility be added particularly to
assist relative care givers and to provide preventive services
to families. In keeping with the idea of the greater
flexibility to the States, Casey Family Programs conducted an
extensive analysis of the child welfare financing waivers last
December. A copy of that executive summary or report is
attached for the record. In addition, the full report entitled
``The Effects of Federal Child Welfare Financing Waivers'' is
available on www.casey.org.
Second, based on the findings from those white papers, it
is critical that States are permitted to be reimbursed through
title IV-E for subsidized guardianship. Through our work we
found that positive results, and even cost savings, occurred in
the area of assisted guardianship and kinship care. There was
much enthusiasm in States for assisted guardianship and kinship
care. The waiver activity demonstrated success, and even proven
savings in Illinois.
Recognizing non-licensed kinship care homes for
reimbursement under title IV-E would allow all States to reap
the benefits of these programs. Our analysis also demonstrates
the need to adequately fund existing funding programs such as
TANF and SSBG. By providing adequate funding for these
programs, States may use some funds for child well-being
activities currently provided under child welfare waivers.
Third, we urge the Committee to focus on providing
statutory language to encourage States to provide mental and
behavioral health and rehabilitative services to the child
welfare population under their existing Medicaid and State
Children's' Health Insurance Programs (SCHIP). Fifteen of the
25 child welfare waivers utilize title IV-E funding for
behavioral health services, including substance abuse, despite
authorization of such services under Medicaid and SCHIP.
Although children whose foster care is federally reimbursed are
automatically eligible for Medicaid behavioral mental health
services, often States are purchasing them through capped funds
such as through title IV-B, TANF, or SSBG, or with title IV-E
waiver funds.
This recommendation is underscored by a recently released
study from an extensive research project that Casey did in
corroboration with Harvard Medical School that examined the
long-term effects of foster care on more than 650 young adults
who were formerly in care. One of the most significant findings
were the fact that these youths experienced post-traumatic
stress disorder at rates twice as high as U.S. war veterans,
including soldiers returning from Iraq and Afghanistan. These
findings, along with many others highlighted in this report,
reflect how difficult it is for these children's circumstances
and how important it is to provide access to effective mental
health treatment.
In closing, I would like to thank the Committee for
affording Casey this opportunity to present our views, and we
would welcome the opportunity in the future to work with the
Committee on proposals to improve the delivery of child welfare
services.
[The prepared statement of Ms. Hahn follows:]
Statement of Adrienne Hahn, Vice President, Public Policy, Casey Family
Programs
Mr. Chairman, Members of the Committee, I am pleased for the
opportunity to share the experiences and recommendations of Casey
Family Programs as you consider federal foster care financing options.
My name is Adrienne Hahn, Vice President of Public Policy for Casey
Family Programs.
Casey Family Programs is an operating foundation based in Seattle,
Washington. It has 40 years of experience of caring for abused and
neglected children. Casey Family Programs was started by Jim Casey,
founder of what is now the world's largest package delivery company--
United Parcel Service. In 1907, the enterprising 19 year-old, Jim,
borrowed $100 from a friend to begin this Seattle-based business which
is now worth billions of dollars.
It was with this same enterprising and visionary spirit that Mr.
Casey founded Casey Family Programs. His hope was to create stability,
security and a sense of permanence for children in need of stable
family homes. All that we have done over the past four decades prepares
us to step up in a bigger way than ever before. This explains why we
are genuinely appreciative the opportunity to speak you today on this
important issue of foster care financing.
Much concern has been expressed in recent years regarding child
welfare financing and state program flexibility--especially whether
more flexibility can be granted only if it is coupled with reduced
federal funding. I would urge you at the outset not to make that the
case. There is no evidence to demonstrate that states can improve child
well-being outcomes with capped funding, even if given more flexible
use of various funding streams.
History is not a good guide for states to accept capped funding for
foster care, or even a flexible block grant with a guaranteed funding
level. The Social Services Block Grant (SSBG) was severely cut, from
its authorized level of $2.9 billion to $1.7 billion, where it has
remained frozen since 1998. And the Title IV-B, Subpart I Child Welfare
Services fund has consistently been appropriated at far less than the
authorized $325. Even as states have repeatedly advised the Congress
that these funds are used for prevention and family support to avoid
entry into foster care--precisely the ``deal'' that the administration
is offering states with IV-E--the purchasing power has been eroded and
the real dollar value of the existing block grants have been reduced.
So In paying for some child welfare services through SSBG or TANF,
states face a balancing act between the real needs of other groups
served by those block grants and the constantly shrinking buying power.
Casey's analysis of the child welfare demonstration waiver projects
further indicates that limited, fixed funding poses problems for child
welfare programs, in that the budget neutrality provision has been a
barrier to success of the demonstrations.
Chairman Herger, Casey appreciates you bringing greater attention
to the need for more performance based results, given the many concerns
about outcomes for children. We know we can and must do better for the
children who require protection, family services directed to
prevention, or foster care.
I believe that we all want similar things from the nation's foster
care system. Among these are: more flexibility in use of various
funding streams; better accountability in assuring that goals are met;
and effective pre-placement services for families, which can reduce the
incidence of out of home placement. We also agree, I am sure, that we
need to find ways to reduce the inequitable response to and treatment
of children and families of color in the child protection and foster
care system.
Most of all, we want to make sure that no child is taken from his
or her family whenever possible, and that family voices are heard in
defining what they need. We want to assure that when foster care is
unavoidable, the child goes to a home that respects his tradition and
culture. To achieve this, it is essential that we provide a sufficient
workforce that is well trained, and adequate resources to recruit,
train and support foster families.
We know that some of the data are discouraging and that
improvements must be made. Any changes in the federal financing of
foster care need to facilitate and enhance the ability of the states
and counties to make the improvements needed. Capping or reducing funds
now available to the states for foster care and child welfare services
would likely slow states' progress in improving outcomes.
We at the Casey Family Programs are very concerned that child
welfare financing changes should not reduce the federal fiscal
resources now available, or make administration of programs more
complex for states. Casey recommends that the entitlement be continued
and that more flexibility be added, particularly to assist relative
caregivers and to provide preventive services to families.
Specifically, our recommendations include the following:
Title IV-E entitlement funding structure should be
preserved. A capped block grant to states poses the potential for
funding cuts for critical child welfare services. States' entitlement
to administration funds should also be maintained, with no reduction in
the rate of reimbursement.
Title IV-E funds should be made available to children
requiring services in their homes, to help prevent out-of-home
placement.
Title IV-E funds should be made available to all children
removed from their homes, including those placed with relative
caregivers and in subsidized guardianships. States should be held
financially harmless. The federal eligibility link tied to AFDC
eligibility as of 1996 is outdated, burdensome to administer, and
illogical, because children may need protection regardless of the
financial circumstances of their biological family.
State child welfare systems should continue to be
accountable for meeting federal standards ensuring child safety and
well-being.
State child welfare systems should be provided adequate
resources to meet those standards.
Another area of concern that we would like to see addressed is that
of eliminating disproportionality and disparities in results for
children of color in the child welfare system. Children of color are
over-represented in the child welfare system and too often have poorer
experiences when they are in the system and when they leave it--even
when they come from similar situations and circumstances.
Casey recommends that a GAO study be done to examine the entire
continuum of care with respect to children of color, with a focus on
how states can reduce their disproportionate representation in the
system and improve outcomes. The study should look at how responses
differ to reports of abuse, removal from home into foster care,
prevention and treatment offered the family, length of time in care,
and adoption rates, compared with the general child welfare caseload.
Hopefully the report's recommendations will include possible solutions
that states can use.
Meanwhile, states need to look at how they can better address the
disparities, such as by targeted recruitment of staff and foster
families of color, and providing training that is culturally
appropriate, could help to reduce the disparities.
Casey Analysis of Child Welfare Waiver Evaluations
Mr. Chairman, I believe one way Casey can bring some light to the
discussion on child welfare financing is to share the results of our
analysis of child welfare financing waivers, completed last December.
We attach for the record a copy of the executive summary, titled The
Effects of Federal Child Welfare Financing Waivers. The full report is
available online, at www.casey.org. Casey analyzed child welfare
demonstration projects designed to expand state program flexibility
while maintaining, but capping, the current level of program funding.
Our analysis of the waiver evaluations available to date lead one
to the inescapable conclusion that it would be premature to move to a
level block grant or capped allocation of Title IV-E funding. State
demonstrations conducted with child welfare waivers generally do not
demonstrate the kind of statistical significance necessary to conclude
that children benefit in measurable ways from waiver activities, but
they do indicate that limited funding is a significant barrier to their
successful implementation.
The core findings of our analysis that relate to child welfare
financing and state program flexibility, is that there is only limited
success among waiver demonstration programs that maintain budget
neutrality, a federal requirement.
Waiver activities have a cost associated with them that must be
offset by other child welfare activities in order to remain budget
neutral. Therefore, it is vital to know that positive outcomes outweigh
the potential negative outcomes from the shift in spending, before
expanding allowable activities that can be reimbursed through Title IV-
E in a capped or budget neutral environment.
Our analysis found positive results--even cost savings--in the area
of assisted guardianship and kinship care, but did not find
statistically significant outcomes in other waiver areas under
federally-required budget neutrality. In many cases, waiver activities
were more expensive than anticipated and therefore had to be pulled
back during implementation, which negatively impacted potential
positive outcomes. In general, waiver evaluations required by law did
not have statistically significant findings, primarily due to low
participation. As a result, it is difficult to determine whether waiver
activities benefit the children they serve.
In addition to recommendations based on the analysis, the Casey
report looks at other federal funding resources that can be used for
child welfare services. We note in the analysis that most child welfare
waiver activities attempted by states in a budget neutral context could
have been conducted alternatively under other federal programs such as
Medicaid, State Children's Health Insurance Program (SCHIP), Temporary
Assistance for Needy Families (TANF), and the Social Services Block
Grant (SSBG). Each of these programs provides existing authority to
states for many of the activities performed through the child welfare
waivers.
Though evaluations of waiver activities do not support sweeping
reforms of the child welfare system, they do raise targeted policy
options that could benefit State child welfare programs:
Allow subsidized guardianship to be reimbursed through
Title IV-E: There was much enthusiasm in states for assisted
guardianship and kinship care. This is the only waiver activity that
demonstrated success within the context of budget neutrality, and even
with proven savings in Illinois. Recognizing non-licensed kinship homes
for reimbursement under Title IV-E would allow all states to reap the
benefit of these programs.
Adequately fund existing programs: Federal programs such
as TANF and SSBG already provide the authorities for states to conduct
many waiver activities. More adequate funding for these programs may
allow states to use some funds for child well-being activities
currently provided under child welfare waivers. Some states do provide
child welfare-related services under one or both programs. However,
TANF funding has been fixed since 1996 and no increase is anticipated,
while the SSBG authorization was significantly reduced in 1998, making
it an unlikely source to expand child welfare services.
Explicitly authorize mental health and rehabilitative
services for the child welfare population under Medicaid and SCHIP:
Fifteen of the twenty-five child welfare waivers utilized Title IV-E
funding for behavioral health services, including substance abuse,
despite authorization of such services under Medicaid and/or SCHIP.
Although children whose foster care is federally reimbursed are
automatically eligible to Medicaid, behavioral and mental health
services for foster children are often purchased by states under other
capped federal programs, such as Title IV-B, TANF or SSBG, or with
Title IV-E waiver funds.
We urge the Committee to focus on providing statutory language to
encourage states to provide mental and behavioral health and
rehabilitative services to the child welfare population under their
existing Medicaid and SCHIP programs.
To reinforce our recommendation on access to mental health services
for foster children, I want to discuss another Casey study released
this year. Our findings from Improving Family Foster Care: Findings
from the Northwest Foster Care Alumni Study strongly emphasize the
long-lasting effects on young adults of not having access to proper
mental health care during their years in foster care. Conducted jointly
with Dr. Robert Kessler of Harvard University, the report shows that
compared to the general population, a disproportionate number of alumni
(at ages up to 24) had certain kinds of mental health problems,
especially post-traumatic stress disorder, major depression, social
phobia, panic syndrome, and generalized anxiety.
Over 54 percent of the alumni had at least one current mental
health problem, compared with 22 percent for the general population.
Particularly striking--and sad--is the fact that one in four (25%) had
experienced symptoms of Post-Traumatic Stress Disorder (PTSD) within
the past 12 months. These PTSD rates are nearly double that of most
U.S. war veterans. For comparison, 6% of Afghanistan veterans, 12-13%
of Iraq veterans, and 15% of Vietnam veterans currently suffer from
PTSD.
Members of the Committee, I submit that among all of our concerns
about improving the care of children entrusted to the child welfare and
foster care system, this shocking evidence of the lack of proper mental
health care stands out as one of those that--collectively--we can and
must do something about.
Thank you for the opportunity to present the views of the Casey
Family Programs. Our public policy office here in Washington is
available to work with the committee on proposals to improve the
delivery of child welfare and foster care services. Not only does Casey
conduct our own research, but we partner with a variety of non-
government organizations and foundations investing resources on these
issues.
______
Attachments:
Executive Summary, The Effects of Federal Child Welfare Financing
Waivers
December, 2004, Casey Family Programs. (2 pages)
Graph: Mental Health Diagnoses Among Foster Care Alumni and the General
Population. Improving Family Foster Care: Findings from the Northwest
Foster Care Alumni Study, Casey Family Programs, 2005.
The Effects of Federal Child Welfare Financing Waivers December 2004
Executive Summary
Much concern has been expressed in recent years regarding child
welfare financing and state program flexibility. In an effort to
educate policy-makers, Casey Family Programs has undertaken an analysis
of child welfare demonstration projects designed to expand state
program flexibility while maintaining, but capping, the current level
of program funding. In looking at evaluations to date, we found only
limited success for demonstration projects that maintain budget
neutrality. In addition, our analysis found that alternative federal
programs provide existing authority to states for many of the
activities performed through child welfare waivers.
It is important to note that waiver activities have a cost
associated with them that must be offset by other child welfare
activities in order to remain budget neutral, a federal waiver
requirement. Therefore, it is vital that, before expanding allowable
activities that can be reimbursed through Title IV-E, statistically
significant evidence indicates that the activity has positive outcomes
that outweigh the potential negative outcomes from the shift in
spending. Our analysis of the waiver evaluations available to date lead
one to the inescapable conclusion that it would be premature to move to
a level block grant or capped allocation of Title IV-E funding. State
demonstrations conducted with child welfare waivers generally do not
demonstrate the kind of statistical significance necessary to conclude
that children benefit in measurable ways from waiver activities, and
indicate that limited funding is a significant barrier to their
successful implementation.
Our analysis found positive results in the area of assisted
guardianship and kinship care (and even cost savings), but did not find
statistically significant outcomes in other waiver areas under
federally-required budget neutrality. In many cases, waiver activities
were more expensive than anticipated and therefore had to be pulled
back during implementation, which negatively impacted potential
positive outcomes. We note in our analysis that most child welfare
waiver activities attempted by states in a budget neutral context could
have been conducted alternatively under other federal programs such as
Medicaid, State Children's Health Insurance Programs (SCHIP), Temporary
Assistance for Needy Families (TANF), and the Social Services Block
Grant (SSBG). In general, waiver evaluations required by law did not
have statistically significant findings, primarily due to low
participation. As a result, it is difficult to determine whether waiver
activities benefit the children they serve.
Recommended Targeted Reforms That Could Make a Difference
Though evaluations of waiver activities do not support sweeping
reforms of the child welfare system, they do raise targeted policy
options that could benefit State child welfare programs:
Allow subsidized guardianship to be reimbursed through
Title IV-E: There was much enthusiasm in states for assisted
guardianship and kinship care. This is the only waiver activity that
demonstrated success within the context of budget neutrality, and even
with proven savings in Illinois. Recognizing non-licensed kinship homes
for reimbursement under Title IV-E would allow all states to reap the
benefit of these programs.
Adequately fund existing programs: As noted above,
federal programs such as TANF and SSBG already provide the authorities
for states to conduct many waiver activities. Unfortunately, funding
for TANF has been level since 1996, and funding for SSBG has actually
decreased in recent years. Adequate funding may allow states to use
these programs for child well-being activities currently provided under
child welfare waivers.
Explicitly authorize mental health and rehabilitative
services for the child welfare population under Medicaid and SCHIP:
Foster care placement instability has been associatedwith increased
mental health costs during the first year infoster care, particularly
among children with increasing generalhealth care costs.\1\ Fifteen of
the twenty-five child welfare waivers utilized Title IV-E funding for
behavioral health services, including substance abuse, despite
authorization of such services under Medicaid and/or SCHIP. Children
whose foster care is federally reimbursed have been automatically
eligible for Medicaid since 1980.\2\ Nevertheless, behavioral and
mental health services for foster children are often purchased by state
child welfare agencies under other capped federal programs, such as
Title IV-B, TANF or SSBG, or with Title IV-E waiver funds. Policy-
makers should focus on why states are not already providing these
services under Medicaid and/or SCHIP, and consider inserting more
explicit statutory language to encourage states to provide mental and
behavioral health and rehabilitative services to the child welfare
population under their existing Medicaid and SCHIP programs.
---------------------------------------------------------------------------
\1\ PEDIATRICS Vol. 113 No. 5 May 2004, pp. 1336-1341
\2\ MaryLee Allen and Mary Bissell, Safety and Stability for Foster
Children: The Policy Context, Vol. 14 The Future of Children No. 1, at
59 (December, 2003).
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
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Chairman HERGER. Thank you Ms. Hahn. Again, you mention
that these children--the study showed that they have twice the
rate of stress of soldiers, if there is any indication of how a
system is broken, I think that is certainly it. Thank you. Dr.
Wulczyn to testify.
STATEMENT OF FRED WULCZYN, PH.D., RESEARCH FELLOW, CHAPIN HALL
CENTER FOR CHILDREN, CHICAGO, ILLINOIS
Dr. WULCZYN. Chairman Herger, Members of the Subcommittee,
thank you very much for inviting me to speak with you today. My
name is Fred Wulczyn. I am a research fellow at the Chapin Hall
Center for Children at the University of Chicago, an
independent research and development center devoted to bringing
sound information, rigorous analysis, and an independent
perspective to the public debate about the needs of kids.
I want to thank you for the opportunity to speak with you
today about outcomes for children served by our Nation's child
welfare system and whether expenditures on their behalf align
with those outcomes. My remarks today are based on my research
with States and localities, including places like New Jersey,
Connecticut, New York, Illinois, helping public child welfare
agencies better understand their outcomes and linking outcomes
to funding. In the interest of time, I will keep my remarks
brief and to the point.
As you have heard, one of the central challenges facing
child welfare administrators today has to do with managing how
the child welfare system is financed, while working hard to
achieve positive outcomes for children and families. The task
is complicated because even though Federal policy favors
prevention over foster care, Federal funding in the United
States leans more heavily toward foster care over other types
of services. In response to this fiscal incentive, States and
localities have over the years come to rely on foster care as a
large part of the system that serves maltreated children. Today
as States work to meet the needs of children and families
without removing them from their homes and communities, the
nature of Federal funding does indeed limit the opportunity,
because once funding is tied up in the foster care system,
redirecting foster care dollars when it is advantageous to do
so is difficult.
As you know, various proposals designed to address how
Federal revenue flows to the States have been offered over the
years. Some critics of the current system recommend expanding
the level of funding, the types of services eligible for
Federal reimbursement, and the list of who is eligible to
receive federally funded services. Proposals that fit this
category increase flexibility by expanding the scope of
services.
Other critics of the current system prefer block grants as
a solution. Block grants increase flexibility by pulling back
on the rules that regulate how Federal revenue may be spent. As
I am sure you know, the various proposals that fit these
categories have strengths and weaknesses. I will not delve into
the arguments except to make a single point, which is this: any
proposal that purports to increase flexibility over the use of
Federal funds earmarked for foster care, that does not contain
an explicit and unambiguous link between outcomes and funding,
is inherently inferior to a proposal that does contain such a
link. The reasons why this is true are quite simple. Within the
child welfare system, flexibility refers to the ability to
spend funds earmarked for one type of service, in this case
foster care, or some other type of service that achieves the
same outcome. The aim of the foster care program is to provide
services, provide for the safety of the children, funds that
are spent on services other than foster care must meet the
safety needs at a level commensurate with or better than what
would have been true had those dollars been spent on foster
care. If the services provided do not lower the need for foster
care, then funds originally earmarked for foster care must be
spent on foster care. That is the way to provide safety.
In other words, real flexibility depends on changing foster
care outcomes. Without better outcomes, fiscal flexibility
exists in name only, regardless of how revenue is conveyed to
the States from the Federal Government. Proposals that connect
outcomes with finance have several other advantages over
proposals that do not. First, the focus on outcomes keeps the
needs of children front and center. Historically, changes to
fiscal policy have been seen as a way to drive the system
toward better outcomes. The assumption has been that sound
fiscal policy begets better outcomes. A focus on outcomes flips
this thinking on its head by placing fiscal decisions in a
context defined by outcomes. In this context the dynamic shifts
such that better outcomes begets better fiscal policy.
Second, the direct and unambiguous link between outcomes
and finance focuses greater attention on agency management, the
linchpin of success in any and all serious reform efforts,
regardless of how the system is funded. To achieve real
flexibility as I have defined the term, each State needs to
devise a service strategy that matches increased purchases of
preventive services with real changes in the utilization of
foster care. For this to happen, each State has to understand
their baseline utilization of foster care, the pattern of
outcomes and the service alternatives that offer the best and
clearest alternative to reducing the need for foster care.
Without clear baselines, no State locality or provider can hope
to know whether investments in alternative services are having
their intended effect.
Third, a clear link between outcomes and funding also
provides a more seamless approach for connecting State
performance with what is happening at the local level. One of
the critical tasks facing States is how to convey their power
to allocate Federal revenue flexibly to the local level. In
county operated systems, local child welfare administrators may
want to offer greater flexibility to their network of
providers. There is no loss of accountability for outcomes as
funding passes from one level of government to another because
outcomes are tied to funding.
In closing, let me offer the following conclusion. We have
had for the past 25 years, if not longer, a child welfare
system in which funding and outcomes are only loosely
connected. I am not surprised that per capita spending for
foster care bears little relationship to outcomes. However, we
have to remember that the rationale for how the current system
is funded draws on a different set of principles. The current
system was not designed with an explicit link between outcomes
and funding in mind. If we want a child welfare system that
connects outcomes with funding, then we have to construct a
policy context that makes that link explicit. Simple
entitlements do not accomplish that aim anymore than simple
block grants do. Thank you very much for your time.
[The prepared statement of Mr. Wulczyn follows:]
Statement of Fred Wulczyn, Ph.D., Research Fellow, Chapin Hall Center
for Children, Chicago, Illinois
Chairman Herger, Members of the Subcommittee, thank you very much
for inviting me to speak with you today. My name is Fred Wulczyn. I am
a Research Fellow at the Chapin Hall Center for Children at the
University of Chicago, an independent research and development center
devoted to bringing sound information, rigorous analysis, and an
independent perspective to the public debate about the needs of
children and the ways in which those needs can be met. I want to thank
you for the opportunity to speak with you today about outcomes for
children served by our nation's child welfare system and whether public
expenditures on their behalf align with those outcomes. My remarks
today are based on my research with states and localities, helping
public child welfare agencies better understand their outcomes, and
linking outcomes to funding. In the interest of time, I will keep my
remarks brief and to the point. If I may be of further assistance to
the Committee, I hope you will feel free to ask. I would be happy to
help in anyway that I can.
One of the central challenges facing child welfare administrators
today has to do with managing how the foster care system is financed
while working hard to achieve positive outcomes for children and
families. The task is complicated because even though federal policy
favors prevention over foster care, federal funding in the United
States leans more heavily toward foster care over other types of child
welfare services. In response to this fiscal incentive, states and
localities have over the years come to rely on foster care as a large
part of the system that serves maltreated children. Today, as states
work to meet the needs of children and families without removing them
from their homes and communities, the nature of federal funding for
foster care limits the opportunity, because once funding is tied up in
the foster care system, redirecting foster care dollars when it is
advantageous to do so is difficult.
Various proposals designed to address how federal revenue flows to
states have been offered over the years. Some critics of the current
system recommend expanding the level of federal funding, the types of
services eligible for federal reimbursement, and the list of who is
eligible to receive federally funded child welfare services. Proposals
that fit this category increase flexibility by expanding the scope of
services. Other critics of the current system prefer block grants as a
solution. Block grants increase flexibility by pulling back on some of
the rules that regulate how federal revenue may be spent.
As I am sure you know, the various proposals that fit these
categories have their strengths and weaknesses. I will not delve into
the arguments for or against, except to make a single point, which is
this: Any proposal that purports to increase flexibility over the use
of federal funds earmarked for foster care that does not contain an
explicit, unambiguous link between outcomes and funding is inherently
inferior to a proposal that does contain such a link. The reason why
this is true is quite simple.
Within the child welfare system, flexibility refers to the ability
to spend funds earmarked for one type of service (i.e., foster care) on
some other type of service that achieves the same outcome. Because the
aim of the foster care program is to provide for the safety of
children, funds that are spent on services other than foster care must
meet the safety needs at a level commensurate with or better than what
would have been true if those dollars were used to provide foster care.
If the services provided do not lower the need for foster care (e.g.,
by reducing the likelihood that a child will enter placement, reducing
the time a child is in foster care, or reducing the likelihood of
returning to foster care following discharge), then funds originally
earmarked for foster care must be spent on foster care. In other words,
real flexibility depends on changing foster care outcomes. Without
better outcomes, fiscal flexibility exists in name only, regardless of
how revenue is conveyed to the states from the federal government.
Proposals that connect outcomes with finance have several other
advantages over proposals that do not. First, the focus on outcomes
keeps the needs of children front and center. Historically, changes to
fiscal policy have been seen as a way to drive the system toward better
outcomes. The assumption has been that sound fiscal policy begets
better outcomes. A focus on outcomes flips this thinking on its head by
placing fiscal decisions in a context defined by outcomes. In this
context, the dynamic shifts such that better outcomes beget better
fiscal policy.
Second, a direct and unambiguous link between outcomes and finance
focuses greater attention on agency management, the lynchpin of success
in any and all serious reform efforts, regardless of how the system is
funded. To achieve real flexibility as I defined the term above, each
state agency has to devise a service strategy that matches increased
purchases of preventive services with changes in the utilization of
foster care. For this to happen, each state has to understand their
baseline utilization of foster care, their pattern of outcomes, and the
service alternatives that offer the best hope of reducing the need for
foster care. Without clear baselines, no state, locality, or provider
can hope to know whether investments in alternative services are having
their intended effect. The link between outcome and funding also
requires active monitoring in real time. If the link to outcomes is not
explicit from the outset, it will not be possible for states to
understand how they are doing relative to assumptions that have been
made regarding the potential benefits of any given program strategy. In
other words, self-correction is only possible after the fact, when it
is too late.
Third, a clear link between outcomes and funding also provides a
more seamless approach for connecting state performance with what is
happening at the local level, provided the baselines are established on
a state-by-state basis, which is how this should be done. One of the
critical tasks facing states is the need to pass their power to
allocate federal revenue flexibly onto the local level. In county
operated systems, local child welfare administrators may want to offer
greater flexibility to their network of providers. Because outcomes are
tied to funding, there is no loss of accountability for outcomes as
funding passes from one level of government to the next. This feature
is absolutely critical to promoting a rational, outcome driven system.
Fourth, connecting outcomes with funding within a flexible funding
strategy provides an opportunity for devising more sensible risk-
sharing arrangements between the federal and state governments. Risk
sharing refers to what happens when the observed demand for foster care
exceeds the expected demand and costs increase. For the most part,
everyone agrees that increased foster care costs driven by real changes
in demand (e.g., greater risks to children) should be addressed with a
plan that equitably shares costs between the various levels of
government. However, distinguishing between a real increase in demand
and increases caused by other factors is impossible if the parties to
the discussion do not have the clear baselines needed to pinpoint how
and why demand increased (e.g., more admissions, longer lengths of
stay, greater reentry). The baselines needed to deliver real
flexibility provide the input needed for those discussions.
In closing, let me offer this conclusion. We have had for the past
twenty-five years, if not longer, a child welfare system in which
funding and outcomes are only loosely connected. I am not surprised
that per capita spending for foster care bears little relationship to
outcomes. However, we have to remember that the rationale for how the
current system is funded draws on a different set of principles. The
current system was not designed with an explicit link between outcomes
and funding in mind. If we want a child welfare system that connects
outcomes with funding, then we have to construct a policy context that
makes that link explicit. Simple entitlements do not accomplish that
aim anymore than simple block grants do.
Chairman HERGER. Thank you very much. Now, the gentlewoman
from Connecticut to inquire.
Mrs. JOHNSON. Ms. Hahn, I have tremendous respect for the
Casey Foundation and the work you have done for children and
the difference you have made in their lives. I am, however,
disappointed in your analysis. I appreciate that the history of
block grants isn't all good but it is also true that these
block grants would be tied by law to the same increases in
baseline that the current program is tied to. Now foster care
spending goes up according to baseline projections, and where
there is an expected increase there is an expected rise in the
baseline, and that is what the State gets. Unfortunately, both
good and bad, there are States that are leveling out or
declining, sometimes because they can't find foster parents,
not because the children don't have needs.
You know--and in the proposal as it has been detailed,
legislative language or not, you can choose to have 20 percent
a year. You can choose to allocate your 5 years of baseline
increase any way you want. It costs a lot more money to give
States an option, because only those States that have a clear
upward trend in their baseline are going to take it.
I think by making analogy to other programs, the Community
Service Block Grant is a particular case because of the
vagueness of exactly what it does, and the accountability
issues. I am a big advocate of it. I am a chief advocate. It is
a completely different--you are comparing apples and oranges.
You are saying we need to fund guardianship, which I agree--I
don't know why you are not harder on States about not using
Medicaid to pay for mental health services when Medicaid covers
mental health services, and that could save foster care
dollars. We are all saying the administrative nightmare that is
this program is worse than any other program I have ever seen
because all four parts are different.
Then there is TANF and there is this and there is that. You
can't duck on this one. I appreciate your concerns about the
block grant. Are there any ways we can build it in, and why not
an option? At least those block grant funds could be used for
funding guardianship and substance abuse treatment and the
other kinds of services that families need to keep kids out of
foster care.
We have all kinds of models. I hear it every day. We kept
the family together. We didn't have to take the kid out because
we went to the parents' alcohol abuse problem and we began
talking about it, treating it, and the whole family was
involved. The idea of just not doing anything because the
history of every block grant isn't good, the history of TANF is
very good. In spite of the fact that caseload has dropped 50
percent, we have stayed absolutely true to our pledge to keep
funding at the same level. There is a lot of service money in
TANF that never used to be there.
You have got to help us on this administrative issue. If
you don't want to take on the option of flexibility because of
your fears, then make recommendations about how we very
radically simplify the program so much less money goes into
administration. I don't think I have ever seen a program in
which so much money went into administration. If you look back
at that evaluation of the States' performance under the Safe
Families Act, not one State--after how many years--was in
compliance. It was an absolutely appalling review and then this
review.
There isn't any good news out there. This program is doing
badly and it is for the children who need it most. We have got
to do better than say the old way has to stay and we have got
to add money for this, that, and the other thing, because in
today's world that just isn't going to happen. Whether I like
it or not is not the issue. I really expect more of the Casey
Foundation. I know how important guardianship is. We have had
some excellent testimony on things we have to do. We have to
have the States--we have to give them the latitude. You must be
aware of all the wonderful things that they are doing.
Ms. HAHN. I guess let me start, because you raised a number
of issues.
Mrs. JOHNSON. I am just appalled at the negativeness of
your testimony and its failure to address the obvious problems
that, day in and day out, that caseworkers at DCF in
Connecticut, who are dedicated, wonderful people, are
struggling with.
Ms. HAHN. First I want to apologize. I didn't mean to cut
you off, Congresswoman Johnson. I apologize. First thing I want
to say is Casey doesn't defend the status quo. We recognize
that there are problems with the current situation in child
welfare and actually lay out three recommendations that we feel
would help improve the current child welfare system.
Recommendation one was--dealt with the issue of kinship
care and ensuring that they were able to be reimbursed. The
second issue dealt with SSBG and TANF. Now, the reason why we
think that is extremely important is because right now, based
on the Urban Institute study that was released in December of
2004, it showed that 43 percent of child welfare services are
paid for through SSBG, TANF, and Medicaid. It is very critical
that those programs be adequately funded because States are
using those dollars to pay for the exact preventive services
that you, the Committee, and Dr. Horn has been advocating for.
Third, I wholeheartedly agree with you and Mr. Chairman
about the issue around the post-traumatic stress syndrome for
kids in foster care. It is appalling. I like to say that it is
like children walking around who are walking wounded. Would we
consider it acceptable to allow our soldiers to return back to
the States with these levels of post-traumatic stress syndrome?
I think not. That is why we feel it is very critical.
I know that the Medicaid program is not in the jurisdiction
of the Committee on Ways and Means. It is in the jurisdiction
of Energy and Commerce. However, we know that you--there is
much interplay between child welfare and Medicaid and it is
very critical, I think, to take this opportunity to speak on
this issue because clearly Medicaid is not paying for these
services, and that is why.
Mrs. JOHNSON. My time has expired but I do hear what you
are saying. Just to say more money in these categories, when
under the current circumstances, when in TANF we really have
had a remarkably persistent and honorable commitment, I think
is not realistic. There is so much money we can save within the
current program through administrative reform and using the
money more effectively, and we need your help on that as well.
Chairman HERGER. The gentle lady's time has expired. The
gentleman from Washington, Mr. McDermott, to inquire.
Mr. MCDERMOTT. Thank you, Mr. Chairman. Mr. Winstead and
Ms. Hahn, would you support Congress removing a cap on title
IV-B?
Ms. HAHN. I guess I will speak up for--yes, absolutely. The
purpose of title IV-B is for preventive services to a large
extent, and in fact that was the way it was sold to the child
welfare community. Unfortunately, it has never been adequately
funded up to its authorized levels. If we removed that cap, it
would allow States to have the flexibility that Dr. Horn has
spoken to and what we are hearing from the States in order to
be able to do more on the front end as opposed to the tail end.
Mr. WINSTEAD. Congressman, if you would like me to take
more money with me back to Florida, I would be glad to have the
extra luggage with me. However much the funding is, I think the
critical issue is can we make it work better, can we be more
efficient, and can we be more effective in our funding? We need
to focus more on prevention. I think the proposal that is made
by the Administration in the Chairman's bill will help us to do
that but certainly we need to focus more on prevention.
Mr. MCDERMOTT. You don't have any problem with taking more
money? What I hear you saying is that if you could move the
money around, you wouldn't need more money. Is that what I am
hearing you say?
Mr. WINSTEAD. No. What I am saying, Mr. McDermott, is that
if we could take the resources we have and use them more
efficiently and effectively, it would be better than the
complex and burdensome rules that we have now where we have to
look back to 1996 eligibilities in title IV-E. The AFDC program
was repealed by this Subcommittee and this Committee, yet it
still is alive and well embedded in the lookback provisions of
title IV-E. That is why that kind of complexity and that kind
of administrative burden is what we would like to do away with,
so that our frontline professionals can focus more on the job
of several children and not on the accounting tasks related to
eligibility.
Mr. MCDERMOTT. Let me ask a question further from Ms. Hahn
about the question of the whole methamphetamine question. Tell
me about that and what is going on out in the various States
around the country.
Ms. HAHN. Well, why don't we start with Washington State
first? In 1996 we looked at the number of individuals going
into that State around substance abuse treatment specifically
for the meth issue, and it was at 1.5 percent. It is now in
2003 at 20 percent. Washington State is not unique. Colorado
has very similar numbers as well. We are also seeing it in
northern California and it is growing across the country.
Recently. Casey had a convening of child welfare State
directors in the seven States that were in operation and we
heard across the board, Arizona, Texas, California, Idaho,
Washington State, that they are seeing the issue growing and
that is leading to higher numbers of caseloads. That, again,
reemphasizes, where is the ability for States to be able to
respond to a crisis like that?
We experienced much the same with the crack cocaine issue.
We hadn't anticipated or saw anything in previous years to
prepare us for that. I know that Dr. Horn has made mention of
the fact that there is the contingency fund in TANF. He didn't
mention the fact that they also provide $200 million in the
Congressional Budget Office (CBO) baseline as well.
However, let me just give you an example of just one State
alone. Texas just passed $250 million to provide for additional
caseworkers. Now, that is 250 million. We are providing
Congress $200 million for all 50 States. I think that speaks
volumes about the fact of how much resources would really be
readily available when States experience what we are seeing
already, as it looks like the tip of an iceberg in terms of a
surge around this issue.
Mr. MCDERMOTT. If you have got yourself locked in for 5
years and you have a spike, where do you go? You get it all out
of that $2 billion.
Ms. HAHN. You would look at that, the contingency fund. You
would look at this also, the CBO baseline. Right now as we just
said, Texas alone, that $200 million, they have expended
already $250 million, which exceeds that. If you have all 50
States drawing down on those TANF contingency funds--and
remember, TANF is also to be paying for these same low-income
families on another issue as well--so to think that that would
be adequate resources I think is very optimistic.
Mr. MCDERMOTT. The money that--or if we added the word
prevention to title IV-E, would that help?
Ms. HAHN. I think that there is an enormous need for
allowing States more flexibility, but I think flexibility tied
to a capped funding. There is no way that we can show that
there is going to be proven results in terms of better outcomes
for kids. If we did speak to prevention, I think this would be
wonderful, because as we know, we can save so much more on the
front end as opposed to the tail.
Mr. MCDERMOTT. Dr. Horn made a big point of saying no money
can be used for services. If we allowed prevention in that
placement services and administrative costs and prevention, if
we added that word, simple word, we would at least open it up,
although it is capped, that still makes a problem.
Ms. HAHN. Yes. I think this would be of benefit.
Mr. MCDERMOTT. Thank you, Mr. Chairman.
Chairman HERGER. Thank you. The gentleman from Colorado,
Mr. Beauprez, to inquire.
Mr. BEAUPREZ. Thank you, Mr. Chairman. Ms. Hahn, I expect
we were all blanched considerably at your testimony about Post
Traumatic Stress Disorder (PTSD). Those are absolutely
staggering results from your study. Do you have any information
that would indicate whether the PTSD is a result of what
happened before or during foster care?
Ms. HAHN. Actually we were so troubled by those numbers at
Casey that we are now working with Harvard University to find
out where exactly--is it a result of what they experienced
prior to coming into care; is it a result of what they
experienced during their care; is it a result of the fact that
once we emancipated them they weren't provided any health
insurance coverage because their State didn't provide health
insurance up to the age of 21 under Medicaid? We are really
trying to find where along the continuum are these kids
actually receiving the most harm. I think it might be a
combination of the factors, truthfully.
Mr. BEAUPREZ. Were there geographic variations? Did your
results vary widely depending where these children came from?
Ms. HAHN. Actually, no. What we did see, and I know the
post-traumatic stress syndrome is also a very troubling issue.
Included in our testimony, our written testimony, we also
looked at some other issues around mental health outcomes and
we saw that kids in the foster care system also had higher
rates of depression, substance abuse, sociophobia; and we
actually tied that, interestingly enough, to some educational
outcomes that explained why we had higher rates of kids going
into obtaining a General Equivalency Degree (GED). Many of them
expressed the fact that they couldn't stand to be in a closed
setting of a school classroom, and therefore they found that a
GED allowed them to deal with some of their mental health
issues as opposed to trying to do the more traditional route.
We are following up on these studies to see if there is some
more information that we can garner in terms of where exactly
along that entire continuum is leading to not only the post-
traumatic stress syndrome but these other troubling outcomes as
well.
Mr. BEAUPREZ. Some of your dialog just moments ago--
actually, I probably already demonstrated in my first Q and A
that I am a fan of flexibility. I hear it from my State
officials over and over again. Your testimony in regard to the
meth increases that I am very much aware of in my State--and
while some areas are going to deal with those kind of problems,
some aren't; some are going to deal with other problems, some
aren't. That to me argues for local officials having more and
more ability to deal with their own peculiar circumstances or
unique circumstances.
Doctor, you are the one who said if you are going to go
down this path of providing flexibility, I think, I don't want
to put words in your mouth, but it seemed like you acknowledged
that our outcomes, at least today under the system as it
exists, are not as good as we would like them to be. Is that a
fair characterization?
Dr. WULCZYN. I think it is a fair characterization. I also
think that it is fair to say that it is very hard to draw a
single conclusion about a system that is as diverse and as
complicated as this one is. Even in States that have not
performed particularly well on the child and family service
review, there are places in those various States where there
are models of good child practice. I think it is very difficult
to draw sort of one-size-fits-all conclusions.
Mr. BEAUPREZ. Perhaps we then should learn from those where
the outcomes have been good. You are the one who suggested
rather strongly that if we are going to go down the flexibility
path, then we ought to tie it to outcomes. What outcome
specifically ought we be incentivizing, I guess, if we can put
it in that context?
Dr. WULCZYN. Well, that is exactly the question. I think
there is already, in terms of how the field has developed over
the last 10 years, considerable consensus on what are the
outcomes. How long do children stay in care? What is the
likelihood that they will be reunified with their parents? What
is the likelihood that they will be adopted? I think it is
useful to point out in this context that the child and family
service reviews do not measure those outcomes. They get close
but they do not measure. The idea of correlating public
expenditures, Federal expenditures with the State level
outcomes as derived from the child and family service review, I
think you get--you are on target, but you are not hitting the
center of the target, the bulls-eye. It is very important. That
is why I made a point of saying we have to be very explicit
when we talk about linking outcomes with revenue and we need to
start with the outcomes and then looking at the implications
vis-a-vis funding.
Mr. BEAUPREZ. Lastly, if I might in a few seconds. If we
are providing taxpayer dollars and we are insisting on certain
outcomes and those outcome targets are not met, then what do we
do?
Dr. WULCZYN. Well, you have several options at your
disposal. There are penalties embedded in the current Federal
legislation in terms of what happens when States don't meet
Federal standards. I think that those are the sticks. I think
the carrots are providing technical assistance using the model
child welfare programs, to the extent they exist around the
country, to better educate folks on program miles. I think it
would be useful to fund better and more comprehensive research
in the area. The funding for child welfare research was zeroed
out of the budget in 1996. We are running a multibillion dollar
program and there is a very small research and development
program from the Federal Government. That has hurt the field
tremendously.
Mr. BEAUPREZ. I thank the panel and thank you, Chairman.
Chairman HERGER. The gentleman from California, Mr.
Becerra, to inquire.
Mr. BECERRA. Thank you, Mr. Chairman. Thank you for your
testimony. I think it helps further enlighten the issue. Ms.
Hahn, I want to get back to some of the issues that were raised
with regard to the whole issue of flexibility and block grants.
You begin your testimony, your written testimony at least, with
some details about why we should have some concerns about cap
funding or flexible block grants with a guaranteed funding
level. You point out how the SSBG, which others have pointed
out along with you is an important component in trying to help
us service foster care children, that it was severely cut from
what it was authorized at $2.9 billion to now $1.7 billion and
there is where it has remained since 1998. Obviously we have a
lot more to do since 1998, but we still have the same amount of
money as in 1998, and that is one of the pitfalls of trying to
just cap the moneys or block grant it because States are unable
to have even the flexibility, if they desired to do what they
need, because they don't have the resources.
You also touched on the issue of the whole problem with
kids who have to deal with methamphetamine addiction and the
whole issue that occurs with them. My understanding is that
mental health services today are not reimbursable by the
Federal Government for any State that provides those mental
health services to that child or to that foster family for that
child. Is that correct?
Ms. HAHN. Well, the money is under the Medicaid program for
targeted case management. Unfortunately the Administration has
decided to cut that program as a part of the President's
budget, which is extremely alarming in relation to the studies
that we have done that speaks to the high rates of post-
traumatic stress syndrome and the other issues that plague kids
in the foster care system, higher rates of substance abuse,
depression, and so forth.
Mr. BECERRA. Let me tell you that I think that we should
publish further testimony rather than try to hide it, because I
think you rely on history and numbers to tell us what could
happen. While I think all of us would like to see flexibility,
we have to be realistic. You can't continue to expect
caseworkers, who are underpaid and overworked, to want to do
this job as we continue to see the caseloads become more
complicated; maybe not even so much increasing, but becoming
much more complicated. Methamphetamines were not part of our
mix for foster kids 20 years ago. Today they are becoming a
greater part, and, as you said, perhaps the tip of the iceberg.
Rather than strap a State by limiting its funding or actually
causing the State to have to have it compete, agencies compete,
whether you give more money for administrative costs to help
train a caseworker versus provide actual services to that
foster child, to me it seems like what we need to do is target
the moneys so that we address where the real gaps are for a
State and where the real deficiencies are.
I don't think that we can expect--and we are going to be
meeting here over and over and over again to talk to all of you
as experts and to the Secretary, Secretary Horn in the future,
if we don't do something to address the fact that people who
are trying to provide services and do yeoman work, as I believe
the Chairman may have said, are underpaid. Any comment on that?
Any comment from anyone on the panel on that?
Ms. HAHN. Well, I think just one of the big issues is that
Casey strongly supports the need for greater flexibility but
flexibility alone is not going to solve the issue. I think
Texas really speaks to that very eloquently. Right now Texas
uses 40 percent, funds 40 percent of its child welfare services
through TANF dollars. Yet at the same time, they are
experiencing a--true, probably a lot to do with the meth issue.
Nonetheless, they are experiencing a real dramatic increase in
caseload. It has gone up from 16,000 to basically 22,000. Even
despite the fact that 40 percent of their moneys are flexible
to a large extent, they still are not being able to reach the
outcomes that they would hope to achieve.
Mr. BECERRA. It reminds me of the whole situation we see
our soldiers facing in Iraq, where we have got these
sophisticated weapons that cost millions if not billions of
dollars, yet we find that so many of our soldiers are having to
put up metal sheets to help protect their vehicles from the
propelled grenades that are sent at them.
If we could just target our money a little bit wiser, we
could do a lot more and certainly not shortchange those areas
where we know we could have a great result if we were to just
provide the resources. I think what all of your testimony
points out is that we do have to provide more flexibility, but
we have to do it in smart ways. You can't say that simply
providing flexibility means that you can start cutting the
funding. Some of these States are doing yeoman work. Again, I
applaud the folks that do some of these--some of the work in
foster care because it is so debilitating emotionally for the
foster care caseworker as well.
I hope that what we find is a way to not only give you the
flexibility but truly help you target the resources where they
need to go so that we don't see you in another 5 years coming
back and saying, well, you gave us the flexibility but we still
found that we are losing caseworkers after twoyears on the job,
and we have more kids coming in under circumstances we did not
expect. After the methamphetamine blip, now we are seeing
something else. I urge you all to continue, and I hope you
always will be candid in your testimony, because we need that
as we try to make the best assessments. Thank you.
Mr. WINSTEAD. If I can quickly just comment, Mr. Becerra,
that I think one of the critical things is to build effective
community-based systems of care to bring together the resources
and the expertise and communities to focus on these issues. We
are experiencing methamphetamine issues disproportionately in
rural areas of Florida and the Panhandle in central Florida,
and those community-based solutions I believe are going to be
the most effective.
Mr. BECERRA. That is right on target. I just hope we don't
do what we did with mental health when we talked about doing
community-based services where we took folks out of
institutions but then didn't provide the community-based care
but you are right.
Chairman HERGER. Gentleman's time has expired. The
gentlelady from Pennsylvania, Ms. Hart, to inquire.
Ms. HART. Thank you, Mr. Chairman. Mr. Deputy Secretary, I
appreciate your testimony. I was a State Senator for 10 years,
and that is really where a lot of my experience comes in with
trying to make sure the system on the frontlines is working. I
gathered that the proposal would actually help you in what your
goal is, and that is to basically make sure the services are
provided. Right now it seems from your testimony that there is
a lot of time spent on process and compliance, yet you really
don't have that power that you need to focus on outcomes. Is
that correct?
Mr. WINSTEAD. Yes, Congresswoman. The issue I think for us
is that in order to make the system work, we need to bring
together a variety of Federal, State, and local resources. The
more effectively that we can help local communities knit that
together, the more effectively that they can provide services
to the children and families that need them and produce those
outcomes.
I would certainly concur wholeheartedly with the need to
have clearly defined outcomes and to tie incentives to those
outcomes. That certainly would be something that our State
legislature would also support in the direction that they are
very interested in. The more effectively we can bring those
resources together, then the more effectively we can serve
children and families. The complexities that we have in title
IV-E eligibility particularly, along with some of the other
funding sources, are part of the problem, not part of the
solution.
Ms. HART. From your testimony, the CFO of Childnet had
stated that he spends close to a million dollars a year to
manage Federal eligibility. Obviously, given more flexibility
and more opportunity to make the decisions on the State level,
on the local level, would you see that almost as an increase,
even if we keep funding levels the same?
Mr. WINSTEAD. Sure, if they are resources that are going
today to maintain eligibility and administrative and accounting
processes, and it is not only a lot of the time, 50 percent of
the time of the CFO is certainly there, but a lot of resources
that he talks about are frontline caseworkers that are having
to spend their time documenting eligibility, documenting
administrative processes to justify various Federal funding.
That is time that we can free up, and if we can use that more
effectively that is a more efficient use of resources that will
let us do our jobs better.
Ms. HART. I think it also would make the caseworkers a lot
happier.
Mr. WINSTEAD. I would say virtually all of our caseworkers
got into the business not because they wanted to be
accountants.
Ms. HART. Right. Actually it is a common complaint. Our
goal certainly is to make sure that those who are actually
providing the direct services and, every case being different,
are going to have the opportunity to utilize the resources that
we give them obviously to the best advantage of the child and
the family.
Mr. WINSTEAD. Yes.
Ms. HART. What would--aside from the opportunity to use the
money more effectively, do you see a problem with funding under
this plan? It has been stated and restated over and over again
that there is some phantom loss of money here.
Mr. WINSTEAD. I understand that, and the same struggle; I
was with the State also in 1995 when we were looking at what
would the future be like for TANF, and we heard many of the
same concerns. It was an extraordinary benefit to children and
families in Florida that we got that flexibility and the fixed
funding has not turned out to be an issue there. As you can see
from my testimony, we spend a lot of TANF money in child
welfare. A lot of that is part of a program we call the
relative care giver program. The first goal of TANF is that
children in needy families grow up in their homes or the homes
of relatives. We thought it was very consistent with TANF
purposes to take that portion of our children and create a
special program, which we did. We use a lot of TANF money for
that. That is an example, I think, of making good use of
flexibility.
I understand the fear that people would have about funding,
but I think it has been pointed out, we are not talking about
fixed funding. We are talking about an anticipated level of
funding consistent with what you would expect to earn under
title IV-E. If we can get the same amount of dollars but use
them more efficiently and effectively, then we are ahead.
Ms. HART. Well, I think you have answered my question.
Thank you and I yield back.
Chairman HERGER. I thank the gentlewoman. Dr. Wulczyn, if I
could ask a follow-up question to what was asked before. In
your experience of working with States and their outcomes
linked to the level of funding, are there examples of cities or
States that have systems in place to track outcomes in real
time that might help us with our work? For example, what does
New York City do in this regard?
Dr. WULCZYN. Well, that is an excellent example of the kind
of progress that is being made in relationship to connecting
funding with the outcomes that the Administration For Childrens
Services is seeking. It is perhaps a bit too much inside
baseball to go into the details. I think that the
Administration for Children's Services has made tremendous
progress on establishing the kind of explicit link between
outcomes and services that I talked about and in a way that I
think highlights some of the tensions that have been brought to
the Committee's attention regarding what is basically a risk-
sharing problem that happens. That is the case.
What happens when our expectations for the future don't
match what actually happens? How do we reconcile the two
differences? There are various proposals that have been put
forth for sharing that risk. I think that the experience in New
York City is an example of how to understand the risk, and how
to develop proposals for dealing with it in a fair and
equitable manner that eliminates the notion of a cap but
connects the money to the outcomes.
Chairman HERGER. Thank you. Mr. Winstead, what would
adopting the President's option, if available, mean for the way
you operate child protection programs in Florida? What would
you change, and what would most benefit?
Mr. WINSTEAD. I think the primary benefit, it would be to
simplify the way that we use funds. It would help free up the
time of frontline caseworkers and those who administer those
programs so that our community-based systems of care could
operate more effectively.
First of all, let me say, Mr. Chairman, I don't think, in
fact I know, that we do not remove children from their homes
based on their funding or return children from foster care
based on what funding is tied to them. However, the time it
takes us to manage those administrative processes is time taken
away from the needs of children and their families. If we can
say to our community-based partners, here is the money that you
are going to have, you can use those funds to help prevent
entry into foster care, when that can be safely done for
children who have been removed from their homes but who can be
safely returned home through a provision of services, that you
can use resources for that purpose, for children who are
returning after a stint in foster care, that you can use those
resources, as well as provide out-of-home care when children
cannot be safely returned, then I think that flexibility is
what we need.
Chairman HERGER. Mr. Winstead, I want to thank you for your
comparison. I know there is a great deal of concern, the idea
of block granting is a scary thing to many. Yet the example of
what we saw, what we are seeing happening with TANF, where we
block granted and we actually saw those on welfare roles
reduced by some 60 percent, and yet the money remained there,
that that was an incentive there, and perhaps the incentive to
try to adopt earlier, try to get these children out into homes
and allow this incentive of the dollars to remain there, I
think is one that we certainly should explore and I----
Mr. WINSTEAD. Mr. Chairman, it is incontrovertible that the
lives of tens of thousands, perhaps hundreds of thousands of
children in Florida are better because of the legislation you
passed in 1996.
Chairman HERGER. I thank you for that. Mr. McDermott, did
you have a follow-up question?
Mr. MCDERMOTT. Yes, thank you, Mr. Chairman. It sounds as
though you have a better understanding of what the President's
proposal is than I do because you sound pretty positive. One of
the things about that program would be the baseline that would
be locked in for 5 years. Is that correct?
Mr. WINSTEAD. As I understand it, it would be an amount of
money that would--that States would have the option to take a
disproportional amount of that early in the process and rather
than just taking an equal amount over 5 years is my
understanding.
Mr. MCDERMOTT. I was just sitting up here pondering how it
is going to work, having done this for a long time. Sometimes
we make decisions and haven't got any clue what Murphy's Law is
going to turn out to be when it gets out on the ground. Now, I
look at this chart we were given which shows us, Ohio, at
$40,000 and Tennessee at $4,000, and I see you are somewhere
around $15,000. If they locked you in at that level for 5
years, you would be glad to stay with that?
Mr. WINSTEAD. Mr. McDermott, we would want to examine those
figures very carefully of course. I think----
Mr. MCDERMOTT. I thought maybe you were ready to commit
here today so we could move on.
Mr. WINSTEAD. I think in concept, I think, assuming that--
--
Mr. MCDERMOTT. I know in concept but how are you going to
have this negotiation go on when you have got Florida down here
in the middle and you have got Ohio up here? Now, what kind of
negotiation--do you think that is going to go over on in the
HHS Secretary's office, Mr. Leavitt's?
Mr. WINSTEAD. Congressman McDermott, when you see a ranking
of Federal funds to States, a list that puts us in the middle
makes us proud most days. Sometimes, we are a little bit on the
low end of that.
Mr. MCDERMOTT. You don't want to be locked in for 5 years
at that level.
Mr. WINSTEAD. If it is fairly reflective--and we would have
to see the details of the proposal--but if it is fairly
reflective of what we would expect to receive in title IV-E
funds in the next 5 years and if you look back over the past 5
years, our title IV-E funds from our figures have been
relatively stable, and I think that there may be variation in
other States, but if we have been stable in the past 5 years
and we can project out and we see numbers that look like they
treat the State of Florida fairly, that would be reflective of
what we would likely receive in the next 5 years, and we have
access to contingency funds, so that if there is an unexpected
shift, that we would have some place to go with that, then I
think we would be very interested in that. That would be good
for our State.
Mr. MCDERMOTT. If I can summarize what you said, you really
said what you would like to see is the legislative language.
You could see exactly how it is going to work for the State of
Florida. Is that correct?
Mr. WINSTEAD. I don't know whether it is the legislative
language. I would like to see the spreadsheets. I think, in
concept, what I have seen sounds like it would be something we
would be very interested in and certainly very supportive of
having that option.
Mr. MCDERMOTT. That reminds me of the story about how
Kruschev and Eisenhower were talking about this, and they said
they could solve the international problems of nuclear weapons
except for the details. It was the details that got them every
time, and I think that is maybe what we are talking about here.
Mr. WINSTEAD. Well, we would look forward to having the
ability to work on those details with the Federal Government
because where we are right now is, we know the details today
are burdensome and complex.
Mr. MCDERMOTT. Thank you, Mr. Chairman.
Chairman HERGER. You are welcome. It is these details that
we want to work on. Just the fact that we have States that are
receiving $4,000 and another State receiving $40,000, and yet
there is no noticeable difference in the results of these
foster care children tells us that we have a problem of the
greatest magnitude. As was pointed out by Ms. Hahn, this is
only part of the money they are receiving. They are receiving
far more money than $4,000 and $40,000. We have a major
problem. The gentlelady from Connecticut to inquire.
Mrs. JOHNSON. I thank the Chairman. A couple of things.
First of all, I am glad the Administration doesn't have
legislative language on the table. Don't you understand the
power that gives us, the opportunity that gives us? They have
given us a detailed proposal. One of the things that you say
over and over again is you want a State-by-State decision about
base. I think that is wise. We have had a lot of trouble in the
past with blanket cut-off years and so on, so what I would be
interested in, Mr. Winstead, in what considerations--in other
words, we couldn't just say pick the highest cost, the highest
spending year and decide we will go with it. What should be the
parameters? What are some of the guidelines you would suggest
that we should put around those negotiations between the
States? You can think about this and get back to us, because I
think that is important to recognize that the base is going to
be important.
Mr. WINSTEAD. Yes, and I would be happy to give you more
detail. I think three concepts that I tried to mention in my
testimony: one is, I think it would make sense to look at the
trend State by State and see what is happening in the trend in
terms of dollars and in terms of children. I think it would be
important to look at the demographics and in terms of how that
is going. We are a growth State, and that is certainly
something that is also important to us. I think the other thing
is the contingencies, having access, so that if there is an
unanticipated event, that there is an appropriate contingency
fund available for that. I think those would be three areas of
particular concern, and we would be very happy to get into the
fine details on those.
Mrs. JOHNSON. Good. Thank you. Ms. Hahn, I hope in your
study with Harvard, that you will include in your study the
Independent Living Program because the post-traumatic stress
issue is very different for those kids who have had, in a
sense, a pre-adult experience together and then moved from that
16, 17-year-old group that are able to stay in that with
support and go to college. Whether they go to college or not,
they are able to stay in a program beyond 18; that is
important.
Ms. HAHN. We totally concur with you, Congresswoman
Johnson. We think it is utterly critical that we look at that.
Mrs. JOHNSON. Just briefly, Mr. Wulczyn, would you either
in writing, because you are not going to have much time left
here, but we need to know more about the New York experience.
How did you share the risk? What were the terms, because it is
striking what New York was able to accomplish? I thought your
whole testimony was going to be dedicated to that. It was
dedicated to what was really pretty arcane about linking, but I
appreciate how important that is. Let me give you a couple of
minutes, whatever time I have left, on the Chicago experience.
Then if you will get back to us in writing, how you think we
could deal with this risk issue because that is really what
everybody is concerned about. What is the contingency? How are
we going to define that, and what is going to happen if you hit
that?
Dr. WULCZYN. Sure. Let me say that, on the question of base
lines, the one thing that I would have to add, particularly
given the testimony regarding the relationship between outcomes
and funding, is that if our baseline only looks at funding,
where are the outcomes in that situation? We need to have a
baseline understanding of, how long do children stay in foster
care? What is the likelihood that they will enter? What is the
likelihood that they will move around while they are in foster
care? What is the likelihood they will be adopted? That has to
be in that baseline assessment, and then we need to look at
that in relationship to the money. Not the other way around.
We have already heard that there is no relationship, so
let's start with the outcomes and then see how the funding
relates to that. I think that that is absolutely critical.
Otherwise, you are going to be left 10 years from now with a
system that has a block grant or whatever you want to call the
nature of the appropriation, but without that explicit design
on day one connecting it to outcomes, you run the risk of
failing to establish that connection because a block grant by
itself is not a link to outcomes. It is a promise of a link to
outcomes. It is not a guarantee.
On the question of linking risk for costs for providing
safety services for children, I think there are a number of
proposals that would be suited to resolving the differences
between the open-ended entitlement and the block grant, the
hard company cap. I think one way to accomplish an analysis of
that would be to look at the Pew Commission findings on their
resolution of this basic tension, which is something that I
know they worked very hard on. I think that there is a model
there. Whether there is something in there that appeals to the
various constituencies in this Committee, I think is something
that requires some analysis of the details. As we have heard,
that is where the action is.
Let's take a look at those details and see how they differ
one from the other. I think that there would be a variety of
ways to modify the Pew Commission proposal that makes it look
less like the old entitlement system but that requires
analysis. I think the middle ground here is findable if people
take the time to do that.
Chairman HERGER. The gentlelady's time has expired.
Gentleman from Colorado, Mr. Beauprez to inquire.
Mr. BEAUPREZ. Thank you, Mr. Chairman. Really, a comment
and not even a question. We hear the word ``details'' a lot
here lately, and I think we are exactly right. It feels like
the details are wagging the dog a little too much. I look at
this chart again. I can't take my eyes off figure two in the
report. When we have got States that are spending, many States
spending $10,000, some States spending over $20,000 per case
just on administration, frankly, it is obscene. I think about
another partner, who I guess we are supposed to represent in
all this, and that is the American taxpayer. We have got an
obligation, I think, to at least spend the money wisely if we
can.
I remember one of the--another study that was dropped on my
desk a couple of years ago that indicated, thanks to the
efforts of those of us back here in Washington, that in, of all
places, emergency rooms, we burden doctors and nurses with 1
hour of paper work for every hour of patient care.
Mr. Winstead, you talked about your caseworkers. At least
we ought to be focused on letting caseworkers be caseworkers
not pencil pushers. It seems to me that, in the name of good
care and good outcomes, we ought to at least focus there on how
we can be a whole lot more efficient. We talked about the
arcane rules that are still driving much of what we burden you
folks with and your staffs. That just seems to me to be
bordering on insanity. Maybe they ought to do a study on that
mental disorder, too.
Mr. BEAUPREZ. Mr. Chairman, this has been a far more
interesting hearing than, frankly, I was prepared for. I found
it very fascinating and very productive. I applaud you for
bringing it to us, and I applaud the members of the panel for
their testimony. Thank you very much
Chairman HERGER. Well, I thank you. Interesting, but yet
very, very tragic what we are dealing with. The gentlelady from
Pennsylvania, Ms. Hart, to inquire.
Ms. HART. Thank you, Mr. Chairman. I have--he is hard to
follow. One of the things that was sort of touched on in a
roundabout way is, everybody's interested in outcomes, but I
think the difficulty that we have had is actually linking, the
government's behavior, whether it is funding or particular
programs, with outcomes. I know different States have had
positive experiences.
I guess I want to ask Dr. Wuczyn--is that the way you say
it? In the studies that you have done, is there something that
is really obvious that is working well as far as connection of
both funding and outcome, but also certain changes that some of
the States have made or some of these programs have made with
really good outcomes?
Dr. WULCZYN. Well, I don't know that it----
Ms. HART. Sticks in your mind as a positive.
Dr. WULCZYN. I don't know that it qualifies as obvious
because I want to be clear there is no silver bullet here that
is going to solve all the problems.
Ms. HART. That is what I was asking you for, though.
Dr. WULCZYN. It is not an inoculation. I think there are,
in a place like New York City, where the caseload has gone from
nearly 50,000 to under 20,000 in a span of 8 years time, I
think we can draw some lessons from that situation. There are
other places like Illinois that have seen similar declines in
the caseload. I think there is reason for hope. The Committee
tends to be drawn to the issue when there is tragedy, but I
think it is important to remember that there are situations
where a lot of progress has been made.
It is a question of investment, investment in
infrastructure, training, computers, filing cabinets,
caseworker salaries, all those things are vitally important to
running a modern child welfare system that cares about outcomes
for kids. I think they do a lot of that in New York City.
Commissioner Scoppetta, if he were here, Commissioner Bell,
Commissioner Mattingly would say unequivocally that those
things are very important. If you want better outcomes for
kids, you need to invest in them directly and indirectly, and
that speaks to the issue of administrative costs. Those are
administrative costs. You want better services. You have to
have investments in those things. Whether or not the
disparities that we have seen justify that, that I can't say, I
am not a commissioner, but those are the sorts of things.
I think we run into somewhat more difficult territory when
we talk about evidence-based practices that really work; that
is to say, they have a known benefit so that, if you provide X,
Y or Z service, you will diminish the demand for foster care. I
think that Dr. Horn talked about nurse-to-family partnerships.
There are other selective approaches to dealing with children
and families where there is a risk of placement, but they are
not widely used. The bench strength here, if you will, the
number of programs that we don't invest nearly enough in those
things, given the size of this program and the very important
problems that families have.
Ms. HART. Well, I guess if you claimed there was a silver
bullet, everybody in this room would probably question that
anyway.
Mr. Winstead, Mr. Secretary, as far as your experience in
the things that you have been able to improve in the time you
have been--what would you say you have done to really make the
most difference as far as this? Would you be able to even
improve even more as far as your processes that flexibility
that we are talking about?
Mr. WINSTEAD. I think the key improvement--and we just have
completed in recent months the transition to community-based
care in Florida, which has been a multiyear transition.
Certainly the process is far from over; it is a continuous
process. We now have complete in every area of Florida
community-based care and developing systems of care.
Florida Tax Watch, which is a taxpayer watchdog
organization in Florida, recently wrote a report that I
referred to in my written testimony with a link to that report
some of the outcomes that they noted as more children being
visited each month, fewer children reentering foster care, more
children being adopted, less foster home crowding. Another part
of our strategy and something we think is very important is
increasing transparency of those outcomes. That is why we put
our outcomes not only for child welfare, but for all the
programs we administer on the Internet by outcome, by area of
the State, so that people can hold us accountable for
continuing to show results.
Ms. HART. Thanks, I appreciate that. I thank all three of
you panelists for coming in with your expertise and for your
commitment to this issue. Thank you, Mr. Chairman.
Chairman HERGER. Thank you, Ms. Hart. I want to thank each
of our witnesses that has appeared before us. This has been a
very informative hearing. This is an incredibly serious issue,
obviously, that we are dealing with. When we see the fact that
we have children that are passing through the foster care
system that are being rated with post-traumatic stress at twice
the level of our soldiers returning from Iraq, that tells us
something. When we see that the funding varies from less than
$5,000 to $40,000-plus going into these children, but yet no
noticeable change in the outcome, that indicates we have an
issue that it behooves all of us to work together to change for
the better just as soon as we possibly can. I thank you. With
that, this hearing stands adjourned.
[Whereupon, at 12:13 p.m., the hearing was adjourned.]
[Submissions for the record follow:]
Statement of Barbara Bryan, Davidson, North Carolina
Taxpayers--federal, state and local--as well as contributors to
tax-exempt non-profit groups are being defrauded under color of law as
children are injured and innocent families are dis-membered in and
because of America's foster care system.
Without the usually unquestioned spending of billions of dollars
appropriated by Congress, changes would have to be made.
States routinely cannot find hundreds of children either taken or
entrusted to their agents. Children suffering real abuse and neglect,
and always emotional trauma, in instant pre-adoptive homes (as former
foster homes have too often become), are ignored because of financial
and adverse publicity consequences to agencies that removed and
reallocated them.
The Third World ``Rule of Suspect,'' one decried by more in
Congress today for imprisoned foreign enemy combatants, is alive and
has been hell for parents and caretakers ``suspected'' of often clearly
non-existent abuse and neglect of children. Anonymous reporting, ruled
out in the old USSR in 1984 because it is so unreliable, is the sine
qua non of America's child protection reporting that consigns a child
to foster care.
Paper Orphans are a tax-subsidized phenomenon of the monopoly (no
other agency permitted to investigate or handle child abuse/neglect
reports: see the shameful DeShaney decision of the USSC) designated
child protection agencies who recommend ``termination'' of parental
rights.
That is achieved with an immunizing stroke of a judge's pen and
both the agency and adopting strangers are eligible for adoption
bonuses (per 1997 Adoption and Safe Families Act). Most states sweeten
the pot with post-adoption subsidies, now a part of nearly every out-
of-agency adoption for some.
Sibling Date; Marry?
Very few children in America are genuine orphans. Most have
relatives, family friends, neighbors or godparents who could, and are
willing to, keep them if they must be moved temporarily or permanently
from parental homes.
Taxpayers are defrauded and children are at risk for what already
has happened--brothers and sisters, not knowing they were redistributed
by foster care, dating each other or marrying--because too many agency
directors encourage taking an expensive, heart-breaking route to
purported child protection rather than allowing the child to remain
somewhere in the natural family or minimally in frequent contact.
If ``most of the prison population once was in the foster care
system'' is a true statement, the success and efficiency of the program
is obvious.
The public pays for backpacks, teddy bears, memory books and more
to make moving around among strangers or getting accustomed to never
seeing one's grandparents, siblings and other friends and relatives
more palatable.
Foster care in America is a disaster: financially, legally,
emotionally, physically and by nearly any other perspective or measure
possible to consider it.
That so many influential people in Congress, media, entertainment,
sports as well as other elected, appointed and employed positions of
respect have themselves adopted children and may prefer not to reveal
the entire story of the system has slowed exposure of long known
problems.
Supremes Avoid Precedent Setting
Equally, it is clear that the U.S. Supreme Court prefers not to
deal with human and civil rights issues relating the foster care and
how a child is sent to it or fares in it as an ``institution.'' If the
whole truth were told, if Constitutional law were applied to federal
and state permissions to suspect, accuse, remove children, forever cut
them off from natural family and to be financially rewarded for
reallocating them, it would and will rival the eras of slavery,
sterilizations, treatment of native Americans and more.
Currently, although known for years, two health issues that have
been accepted by courts in America and still are--despite notice--are
being upended in United Kingdom's courts and professional review
boards.
Specifically they are the imaginative but mythical ``Munchausen
Syndrome by Proxy'' (MSP) for which there never has been scientific
support and the concept of ``Shaken Baby Syndrome'' (SBS) for which
there is considerable science proving that without severe accompanying
neck injury shaking cannot be the cause of the ``signs'' of SBS when
they are described.
Because foster homes have become pre-adoptive homes, and because
belief about MSP allows existing and subsequent children to be removed
from a presumptively homicidal lying mother, newborns are whisked from
delivery rooms and into the arms of delighted people who are doubtless
pleased that mute media ignores the reality of both syndromes'
discrediting.
Rare and brave federal auditors have tried for years to show the
shambles of the foster care misspending and occasionally the damage to
children and families. The Commonwealth of Virginia in the early 1990s,
through the office of its then-Attorney General's assistant, tried to
beat a federal audit of its foster care system by covering its failure
to visit homes every year. It had regulations changed to say every
other year was all right. That has improved since.
The best cover up, and example of why Congress is looking
(repeatedly) at the same errors that only have been refined as well as
the spin given auditors who genuinely try to learn, was that HHS/OIG
noticed 40 court papers had failed to check the now ASFA-trumped
``reasonable efforts'' block about keeping the family together.
Nunc pro tunc, Nice Try
Cleverly, but in vain, the State tried to substitute 40 nunc pro
tuncs that, of course, did have the blocks checked after all.
Most people gave up arguing ``reasonable efforts'' because there
simply were none made. When an agency decides to take a child--and most
often they are instantly put into foster care without alternatives,
especially when they are attractive and marketable, the biggest
influence is the attitude (preservation or termination) of the agency
director. (see Ray Sirry, PhD dissertation at VCU).
Nearly always the ticket to regaining children from foster care
was/is a mental health evaluation, but only if it is done by person or
group either informally or by contract connected with the accusing
agency. The anti-Fifth Amendment breach, agreed to in desperation by
parents believing their children can be liberated faster if they
``cooperate,'' turns out to be ``evidence'' gathering and the child/ren
too seldom ever leaves foster care to return to natural family.
In 1995 I walked the halls of Congress to leave with each office
four pieces of paper and the plea to NOT continue sending boatloads of
money to states to be used as they had been and, in the intervening
decade, become worse.
Using the analogy of gas, rags and matches, I explained that
CONGRESS and its large appropriations is, in the end, the proximate
cause of the problem that cannot be avoided in its tragic expression in
foster (or hostage, albeit official and legal) care.
Unmonitored money, actions
Congress provides the gas. Without huge amounts of money to spend
and gain, individuals who use and get it might well not warehouse
children they cannot do better for than the real abuse that some of
them suffered (but still did not need to become a Paper Orphan).
States provide the rags. State agencies accept the giant
appropriations and often do a pass-through, creating ``revenue
enhancement'' by upping the value of the dollars in creative ways that
consultants figure how to gain. That includes how children are
``labeled'' as special needs, at risk and the like, sometimes just
because they have not yet been adopted at various descending age
limits.
Agencies strike the matches. It is at the local level that the
usually unmonitored expenditures occur. Federal auditors, and judges
also, read the ``documentation'' in the agency record or court case
file of an accused. I would have removed my own children if what was
once written about me in 1983-84 had been true.
Foster care is an unsupervised, largely completely unneeded and
expensive money sink and family-fracturing cottage industry that never
should be used at all unless there truly are orphans in America without
relatives and friends who can take them in. Grandparents and others
should, in appropriate situations, not be deprived of the benefits and
services (when they are both or either) available to children but only
to be given to cooperative strangers.
Every admiration a reasonable citizen has for his/her own home--
mixed up and messy as is every one sometimes and in some too often--has
been turned on its head by the ease with which parents may be
``suspected'' and children taken and put into foster care.
Legal Extortion?
Oh, and the legal extortion of instant child support orders: that
has a lasting impact on IRS collections and HHS outflow. Parents
mortgaging their homes to liberate children from foster care, people
unable (and unwilling) to pay ``child support'' for children who could
stay with relatives without cost and not dun the taxpayer, find liens
against their earnings IF they can keep a job after their employers are
called and businesses visited by investigators on the report.
Countless Americans, former taxpayers, even if the agency has its
own attorneys overturn its actions against innocent parents, cannot get
or keep employment. That is because their pre-employment credit checks
show there is a problem so they are not hired. If they do work, their
usually low wages are garnished, all to pay a debt they had no control
in creating and should never have been made: one to foster care that
injured the child and family.
A benefit of these hearings could and should be a federal law
requiring states whose errors are proved, early or late, to make whole
the injured citizen, especially one under the eternal mark of a child
support lien that was needless ab initio.
States should be required to expunge and remove (after ensuring the
injured parties have true and correct copies) all ``documentation''
used to break up the family that remains in courthouses. Currently
there is no mechanism to make that paper vanish even if the agencies
have purged their records.
Because I personally know and/or have closely communicated with
countless hundreds of families whose children were taken into foster
care, I know things that I also know have been communicated to every
possibly interested person for decades. Too frequently the most often
suggested and tried ``solution'' is to bring law suits to ``reform
foster care.''
Wrong answer.
Purse & Sword of State
We can re-form Frankenstein but we still have a monster. Children
do not deserve to be punished for suspicions--even correct ones--
against their parents or caretakers. I deal with false mistaken,
mischievous or malicious allegations, too many arising from
professionals hoping to distract an anticipated adverse professional
report or malpractice action, hence ``Shawna's Bill'' (ask for it).
Parents cannot overcome the power of the purse and sword that
Congress ensures states have to defend against extraconstitutional but
``legal'' actions of their empowered but unmonitored agents. Top law
enforcers in each state--the Office of Attorney General--also is the
lawyer for the offending agencies. Guess whose interests are first and
best served?
Taxpayers should not be subsidizing all: everything that happens
before, during and consequences of foster care as well as local and
larger payoffs for suits that finally succeed against those needless
and injurious actions that led to foster care and what happens when a
child's natural protectors are prevented from being there for him/her.
Only by tell the whole truth, now and not another decade or two
later when the worst offenders, originators and continuing proponents
are retired or deceased, will Congress have the heart and stomach to
stop funding family-fracturing, child-traumatizing foster care (ever
more obvious pre-adoptive pipeline, as it became after ASFA and
continuing Congressional appropriations made money more available).
If the right, reasonable, compassionate and Constitutional route is
chosen, the current foster care system that fuels America's holocaust
of the home will go into the history books and stop dis-membering
American families.
Statement of Alexandra Yoffie, Child Welfare League of America
The Child Welfare League of America (CWLA) and our nearly 900
public and private nonprofit child-serving member agencies nationwide
applauds the House Ways and Means Human Resources Subcommittee for
addressing the issue of federal funding for child welfare at this
hearing. We believe that as a country we must confirm our commitment to
prevent child abuse and neglect and support those children whose lives
have been affected by abuse and neglect. We support strengthened
partnerships between federal, state, and local governments and
providers in the nonprofit and charitable communities in order to do a
better job of protecting our nation's most vulnerable children.
A Comprehensive System of Care
We urge this Subcommittee to examine the entire child welfare
system in its review of federal financing. In addition to foster care,
the child welfare system also includes child abuse and neglect
prevention, treatment, out-of-home care, adoption, and services
provided to children and families when a child returns from foster care
or becomes part of a family through adoption. It is critical that any
evaluation and reform of the child welfare system not be narrowly
focused on just one funding stream, such as Title IV-E funding that is
used to subsidize the foster care system.
Nearly three million children are reported as abused and/or
neglected annually and nearly 900,000 children are substantiated as
victims of abuse and neglect. We do not know if these reports actually
capture all of the children whose lives may be affected by abuse and
neglect. We do know that of the children reported as neglected or
abused, many will receive some form of preventive services. However, we
also know that 40% of children substantiated as victims of abuse or
neglect never receive any services. Approximately 20% of children
reported as abused and neglected are placed in foster care as a result
of an investigation or assessment.
Federal Funding Sources that Support Child Welfare
CWLA urges the Subcommittee to expand its review of federal funding
for child welfare to encompass the entire system of federal supports.
The funding made available through Title IV-E Foster Care and Adoption
Assistance is absolutely critical and should be maintained as an
uncapped, open-ended entitlement program. However, an exclusive focus
on Title IV-E Foster Care and Adoption Assistance funding, which
provides 49% of all federal funding for child welfare services, is too
narrow and captures only a portion of the patchwork of federal supports
that states and communities use for child welfare.
Title IV-E Foster Care and Adoption Assistance
A new report issued by the U.S. Department of Health and Human
Services Office of the Assistant Secretary for Planning and Evaluation
(ASPE) on June 9, Federal Foster Care Financing, points out a number of
key weaknesses with the current Title IV-E funding structure and
concludes that allowing states to receive a capped amount of funding,
or block grant of Title IV-E funding will lead to ``a stronger and more
responsive child welfare system that achieves better results for
vulnerable children and families.''
CWLA has long called for comprehensive reform of the federal/state
partnership that supports abused and neglected children and their
families. The status quo is not working. CWLA has highlighted the
weaknesses in the current Title IV-E federal funding structure numerous
times in testimony presented to this Subcommittee. We agree with the
observations contained in the HHS report about these weaknesses,
however, we disagree with the recommendation that the best way to
ensure better outcomes for children is to cap federal funding for Title
IV-E.
In testimony previously presented to this Subcommittee, CWLA has
pointed out many of the same observations contained in the HHS report
about the limitations of Title IV-E funding. Observations contained in
our previous testimony have included:
The current Title IV-E financial eligibility criteria
connected to the old AFDC program has resulted in a diminishing of
children eligible over time. This link needs to be eliminated or
adjusted.
The administrative paperwork for claiming under Title IV-
E is complex, burdensome, and costly to states.
The current system is inadequately linked to both need
and outcomes.
Current Title IV-E funding is highly variable across
states.
Funding is limited to payments for out-of-home care and
cannot be used for child abuse prevention, treatment, and aftercare.
The current Title IV-E funding structure is inflexible.
The ASPE report proposes that an analysis of Title IV-E will
explain to policymakers all they need to know about child welfare
financing. However, an examination of only Title IV-E foster care
funding cannot tell members of this Subcommittee very much at all about
a state's child welfare system.
The ASPE report uses two facts to emphasize the problems with the
Title IV-E funding structure. The report finds that a broad range of
per child spending currently exists. However, this report does not
accurately portray the federal child welfare investment being made or
the children who receive them. The report looks at only Title IV-E
foster care funding and children receiving Title IV-E payments. The
report calculates that Title IV-E maintenance claims, ``averaged across
three years . . . [state spending] ranged from $4,155 to $41,456.'' The
report also indicates that, ``the range in maintenance claims was
$2,829 to $22,418 per Title IV-E child, with a median of $6,546.''
These findings are not an accurate portrayal of state's spending on
child welfare. For instance, the HHS report cites Ohio's per child
Title IV-E spending to be at the high end of $41,456 and Tennessee's
spending to be a the low end of $4,155 per child. While this Title IV-E
per child spending may be accurate, it fails to take into consideration
that 88% of Ohio's federal child welfare funding comes from Title IV-E
(including adoption assistance) while Title IV-E accounts for only 20%
of Tennessee's spending on child welfare.
The report also does not acknowledge that over one-half of all
federal child welfare funding comes from funding streams other than
Title IV-E. The report also fails to acknowledge that Title IV-E
administrative and training funds provide supports to children in
adoptive families, as well as foster families.
The report also finds that there is not a link between higher
spending and improved performance on the gross measures used by the
Child and Family Service Reviews. We agree with HHS's acknowledgement
in the report that, ``simply counting the areas of compliance present a
very general, simplified, and broad brush approach to evaluating child
welfare system quality.'' A link between the level of Title IV-E foster
care funds and the results of a state's Child and Family Service
Reviews do not tell a complete or accurate story. An additional caution
is that an analysis of outcomes and Title IV-E expenditures cannot be
tied solely to maintenance payments. Reimbursement for a child's food,
clothing, shelter, school supplies, and watchful supervision never
purports to be about outcomes, only about meeting the child's physical
needs. Although providing the funds for two or three meals a day and a
new pair of tennis shoes is important, it will not move children toward
permanency.
Again, we emphasize the point that examining Title IV-E in
isolation, or merely restructuring it, is an inadequate response to the
comprehensive reform needed. True reform of this nation's federal
financial support of children in the child welfare system must not be
limited to maintenance payments to support children in foster care or
other residential facilities. Reform must include a continued and
expanded commitment for Title IV-E administrative and training funding,
which provides funding towards a strong and well-trained workforce.
Comprehensive reform must also include a review of the other major
funding streams that support children and families in the child welfare
system. These supports include Title IV-B prevention funds, CAPTA,
Medicaid, TANF, and the Social Services Block Grant.
Foster Care Caseloads are Affected by a Number of Factors
A review of federal financing must also include a review of all of
the factors that impact foster care caseloads, including those factors
outside the control of the child welfare system. While there were
523,000 children in foster care at the end of fiscal year 2003, each
year over 800,000 children will spend some time in foster care. In
2003, 278,000 children left foster care while 296,000 children entered
foster care.
Factors within the child welfare system that affect foster care
caseloads include the lack of preventive and supportive services for
families and children and an inadequately staffed, and in some
instances poorly trained, child welfare workforce. Many factors outside
the control of the child welfare system impact the number of children
placed into foster care. These include poverty, the economy, and
epidemics--such as the explosion of HIV-AIDS in the 1980s (a topic
recently examined by this Subcommittee) and the crack-cocaine epidemic
in our urban centers in the late 1980s.
The current use and manufacture of methamphetamines in many rural
areas is the most compelling factor to suggest that foster care
caseloads may increase. According to a June 2003 report from the U.S.
Department of Justice, there were 2,023 reported cases of children
residing in seized meth labs in the United States in 2002. This
represents an increase from 216 cases reported in 2000. National data
also suggests that in at least 70% of all methamphetamine arrests,
there is a child living in the home.
Other factors that influence foster care caseloads include the
impact of state and local policy, political leadership, how well courts
coordinate with child welfare systems, and court oversight through
consent decrees and other oversight efforts.
Reducing Foster Care Caseloads
CWLA agrees with the goals of the Adoption and Safe Families Act
(ASFA)--to ensure that children are placed into, or remain in foster
care only if absolutely necessary for their safety. New investments in
prevention are needed to reach this goal. CWLA fully supports a
comprehensive child welfare system that is able to take measures to
ensure that child abuse and neglect is prevented and that families have
the supports they need to care for their children so fewer children
need foster care.
No evidence exists that demonstrates that capping federal support
for foster care will result in fewer children needing foster care. A
Title IV-E entitlement does not lead to more children being removed
from their homes and placed into foster care simply because open-ended
federal funding is provided for foster care.
In fact, evidence contradicts suggestions that Title IV-E foster
care funding drives state systems to remove children in order to draw-
down federal funds. CWLA examined state foster care caseloads from 1999
through 2002, and found that 28 states showed patterns that counter
these suggestions. These 28 states followed one of two patterns: either
they experienced a decline in their foster care caseloads and their
Title IV-E claims decreased faster than their non-Title IV-E funded
placements; or their overall caseloads increased and their Title IV-E
claims increased slower than their non-Title IV-E funded placements. Of
the remaining 23 states, one state showed inconclusive evidence and the
remaining 22 states results were mixed.
If Title IV-E drove states to remove children and place them in
foster care, then the patterns in these 28 states would have been
different. When a state's foster care caseload increased, Title IV-E
funded placements would have increased faster than the non-Title IV-E
funded placements. Additionally, when a state's foster care caseload
decreased, Title IV-E funded placements would have decreased slower
than the non-Title IV-E funded placements.
Foster care placements have declined from 1999 through 2002, from
565,253 in 1999 to 532,739 in 2002. Caseloads have varied widely, with
24 states experiencing some increases and another 27 experiencing some
decreases. Overall, while placements declined between 1999 and 2002,
the non-Title IV-E subsidized placements have actually increased. The
number of children placed in foster care without federal assistance has
increased. Between 1999 and 2002 Title IV-E placements declined from
302,422 to 254,004, while non-Title IV-E funded placements increased
from 262,831 in 1999 to 278,735 in 2002. The number of children placed
in foster care who were eligible for federal funding actually
decreased.
Furthermore, if Title IV-E drove states to remove children and
place them in foster care, states would not be using other flexible
funds, such as state or local dollars and other federal funds like the
Social Services Block Grant (SSBG) and Temporary Assistance for Needy
Families (TANF), for foster care placements except when absolutely
necessary. For example, Texas experienced a substantial increase of
30.7% in overall foster care caseloads in the last five years and a
recent Urban Institute survey of state child welfare financing found
that Texas uses more TANF funds than any other state as a percentage of
its overall child welfare financing. Forty-seven percent of federal
funding for out-of-home care in Texas comes from the TANF block grant--
not Title IV-E. Title IV-E provided 39% of the state's out-of-home
placement funding.
CWLA's Call for Reform
CWLA believes that the way to ensure the goals articulated in ASFA
is to ensure that states and communities have the resources necessary
to prevent foster care placements from ever occurring. CWLA urges this
Subcommittee to reject the Administration's proposed Child Welfare
Program Option and instead take action on what is truly needed to build
a comprehensive system of care so that children are protected.
If Congress feels constrained this year, then incremental steps can
be implemented to improve the lives of children.
Fully fund Title IV-B (Subparts 1 and 2) and make funding
mandatory. Furthermore, an increase should be considered so that
services can be provided to the 40% of children who are now reported as
not receiving services, even though abuse or neglect has been
substantiated. As part of an effort to improve accountability, an
annual report on Title IV-B spending should be required. This detailed
information will provide data on how many children and adults are
assisted with these funds. Increased funding for Title IV-B (Subparts 1
and 2) must be part of any comprehensive plan to ensure that federal
funds are available to prevent child abuse and neglect.
Eliminate the financial eligibility criteria for Title
IV-E Foster Care and Adoption assistance. Current outdated income
eligibility criteria represent a carryover from when federal foster
care funding was part of Aid to Families with Dependent Children
(AFDC).
CWLA appreciates, however, that incremental change may be necessary
in addressing this concern; therefore, CWLA recommends, as an interim
step, that the Title IV-E Foster Care eligibility link with AFDC be
replaced with a link to another federal program, such as Medicaid.
Maintain the federal commitment to provide guaranteed
support for training child welfare workers through the Title IV-E
training program. Access to these federal training funds should be
expanded to support the training of private agency staff, related
child-serving agency workers, and court staff working with any children
in the child welfare system. The decisions made everyday by workers
affect the lives and well being of children in the child welfare
system. A well trained and adequate workforce will ensure better
outcomes for these children.
Maintain Title IV-E administrative funding as a separate
source of funding.
While many envision ``administrative'' funds as paying for the cost
of office space and utilities, it is in fact much more than that. Title
IV-E administrative funds are used to pay for the hours of court time
spent by caseworkers preparing for and attending court hearings related
to children in foster care. It includes the time workers spend meeting
with the families and children to discuss what needs to be done in
order to achieve permanency for the children or time spent helping
foster parents cope with the needs of the children. Administrative
costs pay for workers time spent accessing services for children that
are not provided by the child welfare system such as education and
mental health. Administrative costs are used to pay for the travel
expenses workers may incur as a result of working with a specific
child. Recruiting foster and adoptive families for specific children
are also paid for with administrative funds.
States reported to the U.S. Department of Health and Human Services
that nearly half of Title IV-E Administrative funds were spent for case
management and nearly 20% was used for pre-placement services. Less
than 5% of the funds were reported as being used for eligibility
determinations.
To better understand and improve accountability, annual reporting
requirements should be strengthened to ensure that states' use of these
funds are more clearly reported to better describe expenditures that
are administrative expenses and those that are case planning and
management, pre-placement services, and other important activities.
Extend Title IV-E funding to kinship/guardianship
placements for children in state custody. Grants should also be
provided to states to facilitate the development of kinship navigator
programs. States should be allowed to have separate training standards
for kinship placements while safety and background requirements are
met.
Make Medicaid targeted case management (TCM) and
rehabilitative services available for children in the child welfare
system. The federal matching rate for TCM and rehabilitative services
should not be reduced.State child welfare systems should have a lead
role in how Medicaid services are provided to children in the child
welfare system to ensure that therapeutic and rehabilitative services
are available to these children.
Provide new federal targeted funds to states and private
child welfare agencies to seed or start initiatives that expand and
strengthen the child welfare workforce. Federal loan forgiveness should
also be made available to students who become child welfare workers.
Provide Native American tribes with direct access to
Title IV-E Foster Care and Adoption Assistance and greater access to
Title IV-B funding. The Senate version of a TANF reauthorization
includes a provision that would expand Title IV-E access in this way.
We urge Congress to include this provision in the final TANF bill.
Restore funding to the Social Services Block Grant (SSBG,
Title XX of the Social Security Act). In 2002, SSBG represented 12% of
all federal funding for child welfare services.
CWLA Concerns About the Proposed Child Welfare Program Option or Block
Grant
The ASPE report on federal foster care funding concludes with a
recommendation in support of the President's proposed Child Welfare
Program Option or block grant. CWLA presented this Subcommittee with
our concerns about this proposal in testimony submitted on 6/11/03.
(Available online at http://www.cwla.org/advocacy/
financingtestimony030611.htm) We believe that that the Administration's
proposal does not offer the depth of reform or the guarantee of
sufficient federal financing necessary nationwide to improve the child
welfare system and ensure that all children are protected. The proposal
appears to freeze federal resources at a time when there is a great
need for significant new investments and reform in our national child
welfare system.
CWLA's Concerns about the Administration's Proposal:
The proposal breaks the link between federal entitlement
funding based on the number of eligible children and transforms it into
a fixed amount of funds no longer driven by need.
The proposal does not address the complex array of
federal funding sources for child welfare. Title IV-E Foster Care, the
subject of the Administration's proposal, comprises only 38% of all
federal child welfare spending.
The Administration's foster care proposal is cost
neutral, setting a five-year cap on spending. The proposal does not
recognize the need for any new resources to build a system of care to
better protect children and address pressing issues, including supports
for the child welfare workforce and substance abuse treatment for
families that come to the attention of the child welfare system.
A state choosing the Administration's foster care option
would receive a fixed allocation/block grant based on the current Title
IV-E eligibility criteria that link eligibility to 1996 AFDC standards.
This means that the allocation/block grant would be based on a
declining number of children becoming eligible over the next five
years.
The proposal would not ensure that funds would be used
for prevention services. Current Title IV-E funding does not cover all
children in out-of-home care and few, if any states, adequately fund
their child welfare systems so as to provide the safety and permanence
contemplated by current law. States may have to use the fixed
allocation/block grant funds to cover non-Title IV-E eligible children.
There is no guarantee that any funds would be used for prevention
services. Federal Title IV-E funding currently supports less than 50%
of the children in out-of-home care.
The proposed state maintenance-of-effort is based only on
state funds currently used to draw Title IV-E federal funds. Since the
financing of child welfare services (adoption, foster care, child
protection, and other services) involves a variety of federal, state,
and local funds, it appears that states would be able to reduce state
spending by billions of dollars and still meet the federal spending
requirement necessary to draw down the fixed allocation/block grant.
Questions remain about the formula being developed to
determine each individual state's share of the fixed amount of funding.
Will all states that take the fixed allocation/block grant option and
project they will have increased costs over the next five years be
eligible to receive increased funds? Will the formula be based on
historical claim or actual reimbursements? Since the overall total
federal allotment is fixed, would some states get less if other states
negotiated an increase since certain formulas that benefit one state
could result in less funding for another state?
In order to access needed additional funds if states
experience a dramatic increase in child welfare caseloads (or an
increasingly complex caseload with greater needs), the proposal
suggests that states could access the TANF emergency fund. The trigger
that would allow a state to draw these TANF funds would be based on
national and the individual state increases in foster care. These
criteria would not necessarily reflect what is happening in a county or
city where the bulk of the foster care population might be found.
Furthermore, these emergency relief funds would divert funds from TANF.
If the same event (a recession for example) caused both cash assistance
and foster care caseloads increase, a state may have to choose whether
they wanted to fund increases in TANF or foster care.
The proposal would combine Title IV-E training funds into
the fixed allocation. States would have to choose what, if any, portion
of the allocation could be dedicated to training and staff development.
While an optional block grant will allow for a reduction
in some administrative burden and cost, this benefit should not be
over-estimated. Caseworkers will still be required to establish that
reasonable efforts were made in keeping a family together. States will
still be subject to financial audits. Caseworkers will still be
required to track and input data, especially in light of any new or
additional outcome measures that will have to be driven by data
collection, input, and time. We should not ignore the reality that
casework is labor intensive and complex. According to the ASPE report,
the areas where states were found to be in substantial non-compliance
with Title IV-E regulations include problems related to reasonable
efforts to make and finalize permanency plans; problems with the
licensing of foster homes; problems with background checks; and
problems related to eligibility rules tied to the 1996 AFDC standards.
Of these areas of non-compliance, only AFDC eligibility would no longer
be a problem if the block grant option were taken.
Conclusion
CWLA believes that important and necessary reforms must be enacted
to ensure a consistent level of safety and care for all of America's
children. We look forward to working with this Subcommittee to develop
and move forward with proposals that meets all the needs of America's
most vulnerable children and families and ensures that every child is
protected.
Statement of Miriam Aroni Krinsky, Children's Law Center of Los
Angeles, Monterey Park, California
The Honorable Bill Gray, former Majority Whip and Vice Chairman of
the Pew Commission on Children in Foster Care, aptly observed,
``Children need the grounding of a permanent home. You don't get that
in foster care. You get it in a family.'' As a nation, however, we fail
to put our money behind such sound policies.
Because Title IV-E, the largest source of federal child abuse
prevention and treatment funds, can only be accessed once a child is
removed from his or her biological family and brought into the foster
care system, the child welfare system is left with little or no
resources to provide in-home or other preventive services that could
keep more families intact. Nor is there fiscal encouragement for
practices that enable children to be reunified with their birth
families or live permanently with other relatives.
Family maintenance and family reunification efforts are overlooked
in the crafting of our budgetary priorities. The current risk-averse
position of removing children from their homes provides a short-term
solution, but may well engender long-term problems for the very
children we are trying to protect and better. Moreover, we laud the
valuable family resource represented by relatives who, although they
may be reluctant to usurp the parental role, nonetheless are willing to
assume legal guardianship and give children safe and lasting homes.
However, we fall short of providing financial or other critical support
for relative caregivers.
Regulations, driven by fiscal policy, confront social workers with
an impossible dilemma. They are forced to either wait until a situation
becomes serious enough to warrant removal, then place children in
foster care at great expense both to the child and the community, or do
nothing and risk a resulting tragedy.
Once a child is removed from his or her family, life in foster care
can be a turbulent experience, characterized by movement from placement
to placement, disruption of schooling, and the severing of ties with
all that is familiar to the child, often including siblings and
extended family. Children in foster care possess a resilience and
indomitable spirit that serve them well, despite the worst that life
has thrown their way, but they also pay a heavy emotional toll, often
feeling that they are not good enough for their own family or any other
family to want them. Their self-image declines, and prospects for
building supportive relationships in the future pale.
It thus is not surprising that foster youth, too often living in
chaotic circumstances, find it difficult to keep up--75% of children in
foster care are working below grade level in school, almost half do not
complete high school, and as few as 15% attend college.
Nor is it surprising that these troubled youth become troubled
adults. Within two to four years after young people emancipate from
foster care, 51% are unemployed, 40% are on public assistance, 25%
become homeless, and one in five are incarcerated. Moreover,
approximately one in three return to live with their biological
families after ``aging out'' of foster care, even though too often none
of the family's underlying problems has been addressed.
With each abandonment and each severed relationship, the child
finds it more difficult to trust again, to move beyond his or her
victimization, and to develop healthy relationships in the future--
whether it be with a caregiver, family member, or his or her own child
someday. One former foster youth observed, ``Coming out of foster care,
I didn't know how to have relationships with people. I always found a
way to burn those bridges.''
Another youth wrote the following in response to the 2005 Los
Angeles Foster Care Awareness Campaign theme, Where Have I Come From .
. . Where Am I Going? ``As I look back, my life has been rough for the
past 17 years. My mom left me and my sister crying in a bucket of
tears. It was hard for me, but my sister told me to stay strong. One of
these days we are going to find our own home. I told her when that day
comes everything will be all right. But for right now, I am going to
finish going to school during the day and write my poems during the
night.''
Searching for solutions and new approaches in no easy task. The
Children's Law Center of Los Angeles (``CLC'') is the largest
representative of foster youth in California, if not the nation. CLC is
committed to help devise and promote new practices in foster care on a
local, state, and national level.
There are a variety of areas where we believe that new approaches
to our nation's longstanding and less than successful way of doing
business could enhance our ability to address the needs of abused and
neglected youth in foster care. And in light of every state's failure
to achieve the standards set forth in the recent federal child welfare
system reviews, to date, the time is ripe for change.
First, consideration should be given to reform of the ``front
door'' of the system and the need for more flexible funding mechanisms.
Current restrictions on federal funding streams favor entry of children
into foster care rather than the development of supportive prevention
and diversion programs. In particular, Title IV-E--the largest share of
our federal child welfare financing system--fails to devote adequate
resources to programs and services aimed at maintaining children at
risk, when appropriate, in the home.
Indeed, there is a disincentive to serve children within their home
under existing federal funding eligibility requirements that tie
monetary allocations to the placement of children in out of home care
and the length of time a child spends in care. A social worker has
relatively few programs or child welfare services, either long term or
on an emergency basis, to provide immediate stabilization and
maintenance of a child at risk within his or her family of origin. In
many instances it would be in the child's best interest to keep the
family intact, with supportive services directed toward that end.
Under the current funding structure, however, the lack of resources
available to children who would be best served within their existing
family results in early warning signs being effectively ignored. At the
time of a family's initial contact with child welfare, the risk may not
be serious enough to warrant the drastic step of removing the child
from his or her family home. The lack of funding for cost-effective in-
home services or ongoing visitations by the social worker, coupled with
long wait lists at community based agencies, ultimately places the
child and family at greater risk for future abuse.
Unless they apply for a waiver of these regulations, states are
barred from spending federal money to provide a full range of services
that might stabilize fragile families at risk, protect children in
their own homes, and divert them from the foster care system.
Tellingly, states that have received waivers and thereby are released
from federal-funding constraints point to positive results. Innovative
programs that provide a continuum of services from prevention to
treatment, to support for children once they leave the foster care
system have been shown to have significant success.
Second, current federal financing laws effectively close off
guardianships for many relatives by making federal financial assistance
available only to relatives who either remain within the foster care
system or choose to adopt. In addition, relative foster parents lose
financial assistance if they become legal guardians. This makes it
impossible for families who cannot afford to carry the financial burden
of care on their own to pursue legal guardianship.
The number of children in long-term care declined by one third in
states where Title IV-E waivers opened the door to use of federal
dollars to support permanent legal guardianship by relatives, according
to a national study, Family Ties: Supporting Permanence for Children in
Safe and Stable Foster Care with Relatives and Other Caregivers. Mark
Testa, Fostering Results Co-Director and author of the brief,observed:
``Our research shows that foster children are safer and more secure
when placed with relatives than in foster homes unknown to them.''
California's experience points to the promise of this model. The
state established the Kinship Guardianship Assistance Payment program,
Kin-GAP, an option that allows relatives to receive a financial subsidy
for the children in their care. The program has contributed to the
reductions in the number of children in long-term kinship foster care
in the state by 42.8 percent during its first two years.
This program enables families to receive needed support, without
having unnecessary government intrusion including social worker visits
and court appearances required by law when a child is in foster care.
As a result, children placed with relatives have the advantage of
maintaining cultural and familial connections and establishing a more
normal family life.
``Kin-GAP has been good for our family,'' a California grandfather
of four said. She explained that, prior to her exit from foster care
through the Kin-GAP program, ``I used to take a day off work several
times a year, so I could go to court with my grandchildren. A social
worker came out to our house every month. The children were
embarrassed, maybe a little ashamed, to be in foster care, and I was
frightened that a judge who didn't know us was making decisions about
them.''
As a result of Kin-GAP, California's child welfare and court
systems have benefited from decreased supervised caseloads and
administrative cost savings. However, the program is funded through the
state's Temporary Assistance for Needy Families program, thereby
potentially limiting its future stability and coverage. Moreover, even
with Kin-GAP, relatives continue to struggle based on woefully
inadequate support and assistance.
In sum, federal child welfare funding can and should be
restructured in a manner that would enable local jurisdictions to fully
fund child welfare services, whenever and wherever those services are
needed. As recommended in the report of the Pew Commission on Children
in Foster Care, FOSTERING THE FUTURE: Safety, Permanence and Well-Being
for Children in Foster Care, new approaches should be developed to
release the current federal funding straitjacket and allow for use of
the largest source of federal child welfare funds in a manner that
better attends to the needs of children and families, without
jeopardizing child safety.
A more flexible federal funding stream would allow for the creation
of effective and comprehensive methods of diverting families from the
foster care system, while also stimulating greater innovation aimed at
supporting families. By allowing child welfare agencies to implement
services aimed at serving families before tragedy strikes, the Federal
Government will ultimately realize the ability to serve more families
with greater success.
Increased flexibility in the use of resources would allow counties
and states to develop and access a wide variety of community resources
to respond to the safety and permanency needs of all children and
families in the most timely, effective, efficient and least intrusive
manner. Such a restructuring of financing for child welfare services
would enable states to develop a more effective and fact-driven
differential response at the front end of the foster care system, based
on a rational assessment of both risk to the child and family
strengths. This approach would also enable the more intensive court
supervised interventions to be focused on children and families with
the greatest need.
The Pew Commission recommended not simply greater leeway in the use
of federal dollars, but also that states be allowed to ``reinvest''
federal dollars that would have been expended on foster care into other
child welfare services, if those approaches safely reduce the use of
foster care. States should be allowed to use federal funds proactively
for services to keep children out of foster care or to leave foster
care safely.
The Commission also recommended that the Federal Government expand
and streamline the child welfare waiver program, devote resources to
training, evaluation, and sharing of best practices, and provide
bonuses to states that make workforce improvements and increase
permanence for children in foster care. All of these approaches warrant
the Committee's serious consideration.
As Pew Commissioners wrote, ``[W]e believe that dissatisfaction
with the failure of the current financing structure to produce better
outcomes for children is sufficiently strong that leaders on both sides
of the aisle are ready and willing to consider new financing
proposals.'' We hope this positive prognostication is accurate.
Talking about better programs for abused and neglected children is
not sufficient. Our nation must start acting and developing a federal
budget that reflects a tangible commitment to a better future for
abused and neglected youth. These are the children of our community and
our future. They deserve our very best efforts.
Thank you for affording me the opportunity on behalf of the
Children's LawCenter and the thousands of young clients we represent to
offer my perspectives in regard to ways our nation can better serve our
neediest and most vulnerable children.
Statement of Frank J. Mecca, County Welfare Directors Association of
California, Sacramento, California
The County Welfare Directors Association of California (CWDA)
appreciates the opportunity to submit testimony for the record
regarding federal foster care financing. CWDA has long advocated for
changes to the federal child welfare financing structure in order to
better serve abused and neglected children and their families. We
support federal changes that will help states and counties achieve
better results for these children and move them more quickly into safe,
permanent homes. Each of California's 58 counties operates a child
welfare program, with oversight from the state and Federal Governments.
Counties are partnering with the state and with their communities in
numerous ways to enhance children and family services, but federal
reform is necessary to achieve the desired results.
According to the California Department of Social Services:
More than 700,000 children come into contact with
California's child welfare system annually.
On any given day, more than 175,000 children are in
contact with the child welfare system.
More than 86,000 children were in foster care in 2004.
That compares to 108,000 children who were in foster care in 2000.
Of the children in foster care, about 19,000 will reunify
with their parents and 8,000 will be adopted during the course of a
year.
Most children entering foster care (76 percent) were
removed from their homes for neglect-related reasons.
Of children who enter foster care, more than 50 percent
are age five or under.
Every year, California county child welfare agencies
receive more than one-half million reports of suspected child abuse and
neglect. Of these referrals, the vast majority of the cases receive no
services, despite assessments that indicate many of these families
would benefit from services and support to prevent child abuse and
neglect.\1\
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\1\ California Department of Social Services (August 26, 2004).
Child Welfare in California: Facts at a Glance. http://
www.dss.cahwnet.gov/cdssweb/res/pdf/Factatglance.pdf
Based on our counties' experiences in administering California's
child welfare system, CWDA has six legislative principles it wishes to
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share for the record:
CWDA supports maintaining Title IV-E funding as an open-
ended entitlement, including funding for administrative activities,
training, services and automation;
CWDA supports increased flexibility in the use of IV-E
funding for a broader array of services, especially to achieve the
Child and Family Services Reviews outcomes;
CWDA supports increased Title IV-B funding, which is a
more flexible funding source for services to children and families;
CWDA supports de-linking the Title IV-E eligibility rules
from the old AFDC program;
CWDA supports federal funding for guardianships to
enhance permanency options for children; and,
CWDA supports the flexibility afforded under the Rosales
decision to extend IV-E eligibility to relatives caring for children
previously eligible only for Temporary Assistance to Needy Families
benefits.
Our detailed comments follow.
Maintain IV-E Entitlement Funding
CWDA strongly urges that the IV-E entitlement be maintained. Foster
care maintenance, administration, training, and automation funds should
be kept as uncapped funding streams. Maintaining the federal commitment
to a stable, dependable funding source is critical for states as they
invest in the very programs that the Child and Family Services Reviews
(CFSR) encourage them to create and expand. Those investments are
needed to prevent abuse and neglect, intervene appropriately in
families where abuse and neglect are occurring, and achieve timely,
permanent solutions for children.
Last year, California built on the model started with the CFSR by
initiating a statewide system improvement effort recognizing that local
communities are in the best position to assess their strengths and
needs and jointly develop strategiesto improve and achieve child
safety, permanence and well-being. Known as the Child Welfare System
Improvement and Accountability Act (AB 636), the law established a
comprehensive approach to oversight and accountability which measures
and monitors the performance of every county's child welfare services
system.
We support the continuation of separate entitlement funding for the
Statewide Automated Child Welfare Information System (SACWIS). The
ability of states and counties to accurately and effectively measure
their improved outcomes over time is an important element in improving
the child welfare system.
Title IV-E administrative funds support social workers who form the
system's foundation. These vital staff provide the day-to-day contact
with children and families, foster families, the court system,
community agencies, and other partners. They work to ensure the best
result for children and families in their caseload. Key to the system's
success is regular, quality contact between them. Court orders
requiring enhanced services and the increasing workloads are already
straining the system in many parts of the country, including
California. Additionally, CFSR outcome measures depend in large part on
social workers' ability to meet with and assess the needs of children
and families. Funds for placement services and administrative
activities are therefore fundamentally intertwined.
California, like other states, faces a shortage of trained social
workers, inadequate funding to hire enough workers, and increasing
demand for a wider array of services and supports for families. A
comprehensive study of child welfare workloads in California counties
released in 2000 found that our child welfare workers carry caseloads
twice the recommended levels, making it difficult, if not impossible,
for them to provide services beyond the basic protections to children
and families--let alone the enhanced services that are needed in order
to substantially improve counties' performance.\2\ Since that time, the
state's fiscal situation has not improved, and the number of
requirements placed on child welfare staff have only increased. Those
demands have also increased due to increasing methamphetamine abuse in
a number of our counties. Predictable and stable federal funding which
continues the federal, state and county partnership is a critical
underpinning to the IV-E system.
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\2\ California Department of Social Services (April 2000). SB 2030
Child Welfare Services Workload Study: Final Report. Sacramento,
California.
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Provide Flexibility to Use Title IV-E for Broader Services
Title IV-E continues to focus on out-of-home foster care placement
rather than providing prevention and reunification services. Further,
Title IV-E dollars are limited primarily to income-eligible children.
Ironically, use of federal Title IV-E funds is not allowable for most
of the services and supports that the CFSR seeks to increase.
Consequently, states and counties must use their limited Title IV-B
funds and patch together funding from other inadequate sources. This
fragmented system means that thousands of families are unable to
receive the services they need, and children remain in foster care far
longer than they should.
Enabling states and counties to use Title IV-E funds in a more
flexible manner would lead to system improvements. Allowing counties to
use Title IV-E to pay for substance abuse and mental health treatment,
for example, could ensure faster access to these services. Parental
substance abuse is estimated to be a factor in two-thirds of foster
care cases.\3\ Similarly, up to 85 percent of children in foster care
exhibit significant mental health problems.\4\
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\3\ U.S. Department of Health and Human Services (April 1999).
Blending perspectives and building common ground: A report to Congress
on substance abuse and child protection. Washington, DC. Retrieved from
http://aspe.hhs.gov/hsp/subabuse99/subabuse.htm
\4\ Marsenich, L. (2002). Evidence-based practices in mental health
services for foster youth. Sacramento, CA: California Institute for
Mental Health.
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Increase Funding and Access to Title IV-B Funds
Counties use a patchwork of numerous programs, including funding
from the substance abuse, mental health, education, and medical care
systems to serve children and families in the child welfare system.
Counties also use Title IV-B funding, an allocation that is much
smaller but more flexible than Title IV-E. Title IV-B funding can be
used for a wide range of activities to protect and reunify families,
but it is an insufficient allocation that most California counties
exhaust in the first three months of each fiscal year.
Increasing the amount of funding provided through Title IV-B would
assist counties and states in providing the types of services allowable
under the existing rules for this funding source, including expanding
investments in providing prevention, reunification and family support
services. In California, a Title IV-B expansion would support ongoing
child welfare system reform initiatives and facilitate implementation
of the State's Program Improvement Plan (PIP).
De-link Title IV-E from AFDC
CWDA supports eliminating the AFDC look-back requirement, which
wastes precious resources on the processing of unnecessary paperwork,
so that limited funding and social worker's time can be focused on
direct services to children and families. The cost of care and services
for children whose parents don't meet the outdated AFDC criteria are
the sole responsibility of the states and, in California, the state and
counties. Federal funding should be available to children in need of
protection regardless of their parents' income.
County staff must evaluate every child who enters foster care to
determine those who are Title IV-E eligible, using AFDC rules that are
nearly a decade old. Federal financial participation is available only
for children who are removed from income-eligible homes based on the
old rules. Yet, states and counties are federally required to provide
the same services to non-IV-E eligible children and meet the same
outcomes, without any federal assistance. Because the income
eligibility rules have not been updated, the number of eligible
California children has dropped. Between 1999 and 2002, the number of
foster children receiving Title IV-E funds in California dropped by
24.9 percent, and the proportion of the foster care caseload that was
IV-E eligible was reduced by 7.85 percent.\5\ This decline is expected
to continue if nothing is changed, with the state and counties paying
the entire cost for ineligible children.
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\5\ U.S. House of Representatives, Committee on Ways and Means,
2004 Green Book.
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Provide Federal Funding for Guardianships
About 40 percent of all children first entering foster care in
California live primarily in a relative care placement. These children
are more likely to be placed with their siblings, less likely to have
multiple foster care placements and more likely to maintain their
living situation and family relationships when they turn 18 than
children who are placed with non-relatives.\6\
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\6\ Needell, B., Webster, D., Cuccaro-Alamin, S., Armijo, M., Lee,
S., Lery, B., Shaw, T., Dawson, W., Piccus, W., Magruder, J., & Kim, H.
(2004). Child Welfare Services Reports for California.
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CWDA strongly supports federal financing of guardianships. Due to
the success of California's ground-breaking Kin-GAP program created in
1998, thousands of California children are in permanent homes. However,
the future of Kin-GAP may be in jeopardy, since it is financed with
increasingly scarce TANF funds. Kin-GAP has encouraged relatives to
enter into permanent guardianships for children as an alternative to
adoption. Participants receive monthly subsidies equal to the amount
they would have received as foster parents, with a sliding scale based
on regional costs and the age of the child. Kin-GAP, however, cannot
assist non-relatives who assume guardianship of children, because of
TANF funding rules.
CWDA supports federal legislation to include guardianships as an
allowable activity in the Title IV-E maintenance funding stream, and
enable children placed into guardianships to retain IV-E eligibility,
with the maintenance subsidy payable to the guardian. Continued receipt
of IV-E funding would be consistent with the federal Adoption and Safe
Families Act of 1997 (ASFA), which contains provisions aimed at
promoting adoption and permanent placement for children removed from
their homes due to abuse or neglect.
Maintain Rosales v. Thompson
CWDA strongly opposes any efforts to legislatively overturn Rosales
v. Thompson. Thousands of vulnerable children living with needy
caretaker relatives have benefited from the decision of the Ninth
Circuit Federal Court of Appeals to uphold a California state court
decision to extend Title IV-E eligibility to these families. If Rosales
wereoverturned, caregivers of these children would be eligible only for
lower, TANF-funded assistance, which would make needy relatives less
financially capable of caring for children and increase the likelihood
that those children will not have a stable placement. Overturning the
decision would run counter to a nationwide focus on recruiting and
supporting relative caregivers.
Conclusion
The County Welfare Directors Association of California appreciates
the opportunity to provide written comments on federal financing of
foster care. Thoughtful and well-structured reforms are vital to
children and families. States and counties need an enhanced and more
flexible federal partnership to improve the safety, permanence, and
well-being of children and families. CWDA stands ready to work with
members of the Human Resources Subcommittee to achieve those goals.
Statement of David Kass, Fight Crime: Invest in Kids
Thank you for the opportunity to submit this written testimony. My
name is David Kass, and I am the Executive Director of Fight Crime:
Invest in Kids, an anti-crime group of more than 2,500 police chiefs,
sheriffs, prosecutors, and victims of violence from across the country
who have come together to take a hard-nosed look at what the research
says works to keep kids from becoming criminals. Law enforcement
leaders know from their firsthand experience that child abuse and
neglect is often only the first chapter in a tragic story of violence.
Abuse and neglect increase the likelihood that a child will engage in
later violence. Leaving children in dangerous homes where they may be
subject to continuing abuse or neglect makes them even more likely to
grow up to become criminals, endangering the safety of our communities.
We commend the House Ways and Means Subcommittee on Human Resources
for drawing attention to the need to increase prevention services and
address the inadequacies of the child welfare system. As you consider
reform of child welfare financing, we encourage you to adopt the
following recommendations:
Maintain Title IV-E foster care maintenance ``room and
board'' funding as an uncapped entitlement;
Allow states to reinvest funding saved by reducing foster
care expenditures into prevention and services, without capping foster
care funding;
Increase funding for the Promoting Safe and Stable
Families program and in-home parent coaching programs, and reject
proposals that combine designated prevention funding with other funding
thereby decreasing expenditures that help prevent children from being
abused or neglected in the first place; and
Consider child welfare reform through a deliberative
process that allows for full debate of this complex, critical issue
with the goal of changing federal policies to best protect children--
not through the budget reconciliation process, which has the sole goal
of reducing expenditures.
Child Abuse and Neglect
Each year, 900,000 cases of child abuse and neglect are
investigated and verified by state child protection systems. The Third
National Incidence Study of Child Abuse and Neglect, a Congressionally
mandated study, concluded that the actual number of children abused or
neglected each year is three times the officially recognized number,
meaning that an estimated 2.7 million children in America are abused or
neglected every year. It is estimated that more than 2,000 children die
from abuse or neglect each year, including 1,400 deaths that are
officially reported.
Research confirms what law enforcement leaders know--that being
abused or neglected sharply increases the risk that children will grow
up to be arrested for a violent crime. Severe abuse and neglect,
particularly when they occur during the earliest months and years of
life, can permanently injure children in ways that make them much more
susceptible to engaging in violence. The best available research
indicates that, based on confirmed cases of abuse and neglect in just
one year, an additional 35,000 violent criminals and more than 250
murderers will emerge as adults who would never have become violent
criminals if not for the abuse or neglect they endured as kids.
Child Abuse and Neglect Prevention
We strongly agree that prevention must be the focus of child
welfare reform. By the time law enforcement gets involved, it is too
late to undo the damage that results from child abuse and neglect.
After all, over half of the children who die from abuse or neglect were
previously unknown to Child Protective Services, and children who
survive abuse or neglect are dramatically more likely to engage in
later crime and violence.
Fortunately, there are effective prevention programs that are
proven to reduce child abuse and neglect and later delinquency, helping
to reduce the need for foster care placements. For example, the Nurse
Family Partnership in-home parent coaching program provides home visits
by trained nurses to low-income, first-time mothers from pregnancy
until the child is two years old. The nurses provide coaching in
parenting skills; help reduce cigarette, alcohol, and drug use during
pregnancy; and provide other support. Rigorous research, published in
the Journal of the American Medical Association, shows that when the
Nurse Family Partnership randomly assigned at-risk mothers to
participate in this program, children whose mothers were left out of
the program had five times as many confirmed reports of abuse or
neglect as the children whose mothers received this in-home parent
coaching program. Fifteen years after services ended, the mothers who
participated had only one-third as many arrests, and their children had
only half as many arrests compared to those who received no services.
The RAND Corporation concluded that the Nurse Family Partnership saved
$4 for each $1 spent, and paid for itself by the time the kids were
three years old.
Unfortunately, too many families do not have access to such
prevention programs. In fact, the Nurse Family Partnership serves only
12,000 of the 500,000 eligible women nationwide. This inadequacy has
led to numerous preventable foster care placements, and an
unnecessarily large number of kids growing up to become violent
criminals.
However, proposals that would remove the long-time federal
guarantee of foster care ``room and board'' funds for the protection of
abused or neglected children would jeopardize the safety of these
children, while providing no guarantee or likelihood that any
substantial part of the funding would go to prevention.
Maintain Uncapped Foster Care ``Room and Board'' Funding
For kids who have been abused or neglected, every attempt should be
made to keep children safely at home. However, when that is not
possible, we must ensure the availability of a safe foster home so that
kids are not subject to continuing abuse or neglect. Researchers
compared outcomes of abused and neglected children who were initially
placed in foster care with outcomes of abused and neglected children
who were initially left at home and then later placed in foster care
because of continuing abuse or neglect. They found that abused and
neglected children who were wards of the court and initially remained
at home, but were later placed in foster care because of continuing
abuse or neglect, were 27% more likely to become violent criminals than
abused or neglected children who were initially placed in a safe foster
home. In fact, four out of ten wards of the court who were abused or
neglected and left in their homes but later needed to be placed in
foster care grew up to become violent criminals.
To ensure that children are not left in dangerous homes where they
are subject to continuing abuse or neglect, it is critical that
Congress maintain Title IV-E foster care maintenance ``room and board''
funding as an open-ended entitlement. Between 1999 and 2003, over \3/4\
of the states had increases in the number of children needing a safe
foster home during at least one year. Over \1/4\ of the sates had
increases of more than ten percent in at least one year but did not
reach the increased level needed to access the contingency fund in the
foster care cap legislation proposed by Subcommittee Chairman Herger
last year. In 2003, ten percent of the states had foster care caseloads
that were at least 35% higher than their 1999 caseloads.
There are many reasons why a state's foster care caseload may grow,
some of which are beyond the control of a child welfare agency. For
example, the growing epidemic of methamphetamine is already beginning
to lead to a substantial increase in children needing a safe foster
home in some states. In 2003, the Drug Enforcement Administration
counted more than 17,000 methamphetamine lab seizures by law
enforcement across the country. These seizures alone resulted in
thousands of children needing foster care placements. In addition,
judges and child protection workers in Colorado have labeled
methamphetamine the ``walk away'' drug because many parents who are
addicted to methamphetamine abandon their children, resulting in the
need for more safe foster homes.
Foster care caseloads may also rise as states improve their ability
to fully and more accurately investigate reported cases of abuse or
neglect. As stated above, the actual number of children abused or
neglected nationally is estimated to be three times the officially
recognized number. Increased abuse and neglect education and awareness
outreach efforts to doctors, nurses, law enforcement officers,
teachers, child care providers, and the general public may also result
in the identification of more children who have been abused or
neglected and need foster homes.
We are extremely concerned that, in the event of capped foster
care ``room and board'' funding, a cash-strapped state with a rising
foster care caseload and set funding would have to make a difficult
decision: risk leaving children in dangerous homes where they may be
subject to continued abuse or cut other services for kids, such as
prevention, to pay for foster care. Either option would result in more
child abuse and neglect and more crime. Therefore, we agree with the
Pew Commission on Foster Care's recommendation to maintain the foster
care ``room and board'' payments as an uncapped entitlement.
At the July 13th, 2004 hearing before your subcommittee, Pew
Commission Chair Bill Frenzel stated the Pew Commission's opposition to
capping foster care ``room and board'' assistance, even with a
contingency fund. As Mr. Frenzel stated:
We recommend maintaining that entitlement without a cap. The
members of the Pew Commission feel strongly that protecting children
who cannot stay safely in their own homes is a shared Federal-State
responsibility--and that the Federal Government should maintain its
responsibility, especially if the need for foster care increases
dramatically for reasons beyond the control of State policymakers, as
was the case in the early 1990s. Mr. Chairman, we recognize that you
designate the TANF Contingency Fund as a safety net for States that
experience severe increases in foster care. In a capped system, a
contingency fund is essential. But in our deliberations, we concluded
that an uncapped system was a better approach, in part because the
Contingency Fund is hard for States to access in a timely manner and
may not contain sufficient funds to respond to a nationwide surge in
the need for foster care.
We agree that it would be very difficult for states to access the
contingency fund proposed in the legislation that Chairman Herger
introduced in July 2004. The average number of children in foster care
in a state would have to increase by 15% (provided the national
caseload also increased by 10%), or 20%, in order for a state to access
the contingency fund for additional resources. The amount that could be
claimed from the contingency fund would be limited nationally and on a
state by state basis (to 20% of the state's federal foster care
allotment). In the past 25 years, there have only been two years when
foster care caseloads increased more than 10% nationally in one year.
Those two years were during the peak of the crack cocaine epidemic--
1987-1988 and 1988-1989. In addition, the contingency fund would only
help the state for the year in which it experienced the dramatic
increase in caseloads. The following year, even if the caseloads remain
at the same elevated level, the state would revert to its previously
set foster care ``room and board'' capped funding for that year.
The law enforcement leaders who constitute Fight Crime: Invest in
Kids have seen children sexually abused, abandoned, or beaten so
severely that there is no question that they need safe foster homes.
Foster care funding is not ``free money'' encouraging states to take
kids away from decent parents. To receive federal foster care funding,
states must contribute a funding match. In addition, to receive federal
foster care funding, a judicial determination must be made for each
child that there were reasonable efforts to prevent foster care
placement. As Assistant Secretary for Children and Families Wade Horn
stated during the June 9th hearing, there is no evidence that uncapped
foster care funding is an incentive to unnecessarily place kids in
foster care. The June 2005 Office of the Assistant Secretary for
Planning and Evaluation Issue Brief on Federal Foster Care Financing
states, ``Some have argued that because foster care is an entitlement
for eligible children while service funds are limited, Title IV-E
encourages foster care placement. However, it seems unlikely that
caseworkers make placement decisions on the basis of children's Title
IV-E eligibility, nor is it likely that judges use Title IV-E status as
a significant factor in their placement rulings. Indeed, caseworkers
and judges are often unaware of children's eligibility status.''
Allow States to Reinvest Saved Foster Care Funding
Capping foster care ``room and board'' funding is not the only way
to allow states to shift funding from foster care to prevention and
services if they reduce their foster care expenditures. We support the
Pew Commission's recommendation to amend Title IV-E to allow states to
reinvest foster care savings, while maintaining Title IV-E foster care
``room and board'' payments as an uncapped entitlement. Under such a
proposal, if a state reduced its foster care ``room and board''
expenditures below the state's projected foster care expenditures by
reducing the number of children in foster care or the length of stay in
foster care, the state could reinvest the federal savings in prevention
and child protection. This proposal would promote flexibility and would
help ensure that states that can safely reduce their foster care
expenditures have funding to pay for prevention and services to keep
kids at home.
Increase Funding Designated for Child Abuse and Neglect Prevention
We are also concerned that the proposed new flexible state grant,
Safe Children, Strong Families, in the foster care bill that Chairman
Herger introduced last year, would not accomplish the goal of increased
funding for prevention services. Historically, states have used multi-
purpose funding for prevention services only after they have met needs
related to kids who have already been abused or neglected, except when
funding is specifically designated for prevention, such as in the Title
IV-B Promoting Safe and Stable Families (PSSF) program. A September
2003 Government Accountability Office report demonstrated that over 70%
of funding from the flexible Title IV-B Child Welfare Services program
is spent on child welfare system uses to help kids who have already
been abused or neglected and only 10% is spent on family support/
prevention and family preservation, while over 60% of funds from PSSF
supports prevention and family preservation services and only 8% is
spent on child welfare system uses. The Safe Children, Strong Families
grant would combine funding from PSSF with other child welfare funding
streams in a flexible grant. Without funding specifically designated
for upfront prevention services, states would likely decrease--rather
than increase--their investments in prevention.
Instead of combining the Promoting Safe and Stable Families program
in a flexible grant, we recommend that Congress increase funding for
this program by at least $1 billion over five years and make all of the
funding mandatory to ensure that the program receives its full
authorized amount. Increasing funding for PSSF would enable states to
implement programs proven to prevent child abuse and neglect and
thereby reduce foster care placements. The discretionary component of
PSSF is authorized at $200 million per year. Despite the fact that the
President had requested this amount, PSSF has never received more than
$101 million per year in discretionary funding. Making all of the PSSF
funding mandatory would ensure that the full amount is available to
help prevent child abuse and neglect, which would reduce foster care
placements and later crime. In addition, we recommend that Congress
provide funding specifically for evidence-based in-home parent coaching
programs for at-risk families, such as the Nurse Family Partnership
described above. To reduce foster care caseloads and keep children
safely at home, Congress should increase investments specifically
designated for proven prevention programs like in-home parent coaching.
Use a Deliberative Process to Consider Child Welfare Reform
Since child welfare financing is extremely complex, we urge the
Committee to use a deliberative process that allows for full
consideration of the best ways to prevent child abuse and neglect and
ensure that children have safe, permanent homes through legislation
with the goal of changing federal policies to best protect children. We
urge you to not include child welfare financing reform in budget
reconciliation legislation, which has the sole goal of reducing
expenditures and would limit the opportunity for debate and adequate
attention to this critical issue.
By maintaining Title IV-E foster care ``room and board'' payments
as an uncapped entitlement, allowing states to reinvest saved foster
care expenditures on prevention and services, and increasing funding
for the Promoting Safe and Stable Families program and in-home parent
coaching programs, Congress would protect the safety of kids who have
already been abused and neglected while preventing more kids from
suffering abuse or neglect. These strategies will help to break the
cycle of violence caused by child abuse and neglect that victimizes
many thousands of additional innocent people each year.
Thank you for this opportunity to present our views on how your
subcommittee can help to reduce child abuse and neglect and later
crime.
Statement of Pamela Pressley, Generations United
As an organization dedicated to improving the lives of children,
youth, and older people through intergenerational strategies,
Generations United is pleased to have this opportunity to submit
testimony about federal foster care financing issues to the
Subcommittee on Human Resources of the Committee on Ways and Means.
Generations United recommends that foster care and child protection
programs be maintained in a way that ensures continued access to the
programs while sustaining and improving the level and quality of
services and protections in order to enhance outcomes for children and
families. Efforts to provide flexibility to the states should be tied
to improved outcomes for those intended to benefit from the programs
and resources.
Among the children served by the foster care system are those being
raised by grandparents or other relatives. According to the U.S Census
2000, more than six million children across the country are living in
households headed by grandparents or other relatives. More than 130,000
of those children are part of the formal foster care system.
Children are being raised in relative headed families due to a
variety of factors such as parental substance abuse, incarceration,
HIV/AIDS, death, poverty, mental health issues and military deployment.
Subsidized guardianship programs have demonstrated success supporting
families and obtaining permanency goals.
Recommendation: Allow states to use Title IV-E federal funds for
subsidized guardianship
Many relatives choose to become licensed foster parents in order to
receive foster care payments which provide them the necessary resources
to raise children in their care.
As with all children, the goal is permanency, however in certain
family situations, guardianship or permanent custody might be the best
permanence option available when children cannot return home. A
federally funded Subsidized Guardianship Program would allow states the
flexibility to use Title IV-E funds to support subsidized guardianships
that move grandparent-headed families from temporary to permanent
placements. State waiver programs have demonstrated the cost
effectiveness of the use of such funds and the positive impact this has
on families.
Benefits of Subsidized Guardianship
Subsidized guardianship arrangements are particularly important for
children raised by grandparents or other relatives because they:
Enable families to maintain bonds with the birth
parent(s) who may have a physical or mental disability that makes them
unable to care safely for the children in their own home;
Honor the wishes of many older children who may not wish
to be adopted and/or to break ties with their birth parents;
Allow birth parents who may one day be able to resume
caregiving activities to regain custody of the child with the oversight
and approval of the courts and/or child welfare agency;
Respect the norms existent in many cultures where
terminating parental rights defies important societal norms of extended
family and mutual interdependence;
Provide the courts with flexibility to limit or expand
the legal guardians' and parents' authority as necessary to best serve
the changing needs of individual children, their caregivers, and birth
parents; and
Limit state oversight and intervention in the lives of
children who are being raised by grandparents or other relatives, for
whom adoption and reunification have been ruled out, and who want to
minimize the states ongoing role in their lives.
Supportive Research
An evaluation of the Illinois Title IV-E waiver program found that
over five years, subsidized guardianship provided permanence for more
than 6,800 children who had been in foster care, that discussing all
permanency options actually helped to significantly increase the number
of adoptions, and that the children involved perceived guardianship as
providing as much security as adoption. GU strongly encourages states
to use Title IV-E federal funds for subsidized guardianship
Generations United is the only national membership organization
focused solely on promoting intergenerational strategies, programs, and
public policies. We represent more than 100 national, state, and local
organizations representing more than 70 million Americans. GU is the
only national organization advocating for the mutual well being of
children, youth, and older adults. We serve as a resource for educating
policymakers and the public about the economic, social, and personal
imperatives of intergenerational cooperation.
Thank you to the members of to the Subcommittee on Human Resources
of the Committee on Ways and Means for the opportunity to submit
testimony about federal foster care financing issues.
Statement of Lisa Gladwell, River Edge, New Jersey
It is with mixed feelings that I make this, my third statement for
the record regarding my family's plight to reunite: to reverse the
unjust and illegal termination of a vulnerable and loving family and
the responsibility of the Federal Government to ensure state adherence
to federal standards. Without a requirement of accountability the
Federal Government is party to the annihilation of families and the
deprioritization of innocent children's well being through the creation
of income streams for states.
Understanding the spirit and good intent of the Adoption Assistance
and Child Welfare Act of 1980 and the Adoption and Safe Families Act of
1997, it is none the less irresponsible to distribute hundreds of
millions of taxpayer dollars to immoral state administrations hungry
for handouts which will maintain the bureaucratic status quo absent of
any compliance to federal standards.
My children's last day at home was the same day I asked for help
with my alcoholism. My children were never abused or neglected, but by
virtue of my disease I was classified as negligent. My husband, not an
alcoholic, was torn from his sons' lives because he took the advice of
addiction experts, encouraged the recovery of his children's mother,
educated himself and believed what the professionals said: that
addiction is a family disease and recovery is attainable. The State of
New Jersey told him he must rid himself of the problem--me--if he was
ever going to have his children returned. He moved out of our home
thereafter. But, that was insufficient to those bent on destroying our
family. He was declared in court as ``non-autonomous'' for
participating in recovery support activities and programs designed to
educate and encourage an addiction free life. Ultimately his belief in
and following the advice of experts has proven correct (I have been in
recovery for over three and a half years at this time), but ``doing the
right thing'' has left him estranged from his sober wife and completely
severed from his two young sons. Is this the application of the
legislation the Federal Government had in mind?
Since my testimony and appearance before your committee (November
9, 2003 statement published as part of the Human Resources' November
19, 2003 Hearing on Improved Monitoring of Vulnerable Children, orally
testimony at the January 28, 2004 Human Resources Hearing to Review
Federal and State Oversight of Child Welfare), my experience and
knowledge has expanded greatly in regard to the immoral Child Welfare
Machine and the state practice of child trafficking. What I have
learned is frightening. The depth of in-grained corruption, attitude of
entitlement, unchecked power and unethical conduct necessary to feed
the Child Welfare Machine is astonishing as is the complicit acceptance
of this practice by public servants charged to protect and defend the
vulnerable from being pulverized and sorted into income producing
commodities and discarded scraps of human waste.
When pressed for specifics in my family's case, James Davy, the New
Jersey Commissioner of Human Services has made contradictory and
blatantly false statements in writing as to the basis of the state's
action. The New Jersey Child Advocate, requested to provide an
independent assessment of those statements, chose not to answer on the
record, despite having the information, responsibility and moral
obligation to do so. New Jersey Legislators, state attorneys,
commissioners' staff, members of the judiciary, ``advocates'' and
public servants all have given witness to and provided validation to
the existence of what is nothing less than domestic child trafficking,
but yet all are powerless against the fiscally driven Child Welfare
Machine, fueled on the carcasses of vulnerable families and discharging
the best interest of children as an emission.
This practice of bullying of weak individuals by the Child Welfare
Machine in the bureaucratic school yard, egged on by associates, in
plain view of those lacking the courage and/or power to speak up and
with an eye on the next, unsuspecting target is reprehensible. Lest we
forget:
First they came for the Communists,
And I didn't speak up,
Because I wasn't a Communist.
Then they came for the Jews,
And I didn't speak up,
Because I wasn't a Jew.
Then they came for the Catholics,
And I didn't speak up,
Because I was a Protestant.
Then they came for me,
And by that time there was no one
Left to speak up for me.
--Reverend Martin Niemoller, 1945
Ignorance abounds--and the survival of the Child Welfare Machine
depends on that. Federal Legislators have confidently stated there are
no federal incentives involved in adoption. The public, by enlarge, is
unaware of their tax dollars being spent to finance the immoral
decimation of families. But, those in significant decision-making
positions within the state judiciary as well as other key roles are
acutely aware of this significant source of revenue which funds their
paychecks. The Director of New Jersey's Division of Youth and Family
Services' staff personally told me, after speaking with her superiors
and upon conceding that my family's case involved unethical actions,
that they are not interested in introspection or willing to examine any
of their ethical lapses. It is the job of the [understandably
overtaxed] Child Advocate to ``catch them.''
No longer blissfully ignorant, I now have personal knowledge
beginning with the unfortunate victimization of my innocent loved ones.
It is no wonder that I have been warned to be cautious for my speaking
out on this issue financially threatens many powerful people. I have
met many others who also hold the permanent scars from the
reprehensible Child Welfare Machine and even more who are being
processed now as fiscal fuel for this bully. These travesties of
justice are not just happening in New Jersey--there are countless inter
and intra state victims of this immoral practice. Often it is in the
interstate conflicts that the perverse role of federal funding most
prominently reveals itself. No one else should have to hear during
their last visit with their children the caseworker nonchalantly
volunteer, ``Don't worry, this is not goodbye. As soon as they turn
eighteen they will come home.''
My reluctant journey is to eliminate this federally financed
holocaust: to provide a voice for those who have been robbed of theirs
by personal devastation, dehumanization and suppression by the machine
feeding upon them. I do not take this journey lightly. It is mine, but
it was not my choice (or that of my loved ones). It is not my strength,
courage or limited abilities that carry me on this path. It is belief
in the spirit and principles of this great nation, its respect and
concern for its entire people and, finally, divine intervention that
drives me forward. Again, I will be part of the solution: my family and
others deserve nothing less.
In recovery over three and a half years, since well before the
termination of my family, I am active in recovery support. From my
individual recovery to active leadership roles in regional as well as
state organizations, my life is a testament to the reality (and
miracles) of recovery. To attain the ultimate financial target of
severing my parental rights, the state's [admitted] non-experts'' in
addiction erroneously doomed me to a hopeless life of addiction,
lacking the psychological capability to maintain a meaningful recovery.
With that mistaken and self-serving prognosis, the Child Welfare
Machine sentenced my family to execution.
There are many of ``us'' in all stages of ``life sentences'' due to
the abuse of federal funding. The Child Welfare Machines, thumbing
their noses at federal standards, are thriving on federal dollars. The
Jackson ``family'' of Collingswood, NJ momentarily brought the Child
Welfare Machine to the national spotlight. Initially, to squelch the
public outrage, NJ DYFS workers were blamed, removed and/or fired.
Through public scrutiny, the NJ Child Welfare Machine was forced to
prostrate itself to falsely assuring the public the issues have been
rectified and to dim the national spotlight. Quietly, however, New
Jersey Child Welfare Machine returned to the status quo. The workers
were quietly returned, the administration continued intact and the
financial incentive that created this devastating situation continues
unabated today. What of the Dollars of Hollywood, Florida and the
Davisons of Beachwood, New Jersey?
Today the corrupt Child Welfare Machine and domestic child
trafficking are healthy and continue to churn out victims. These
travesties of federal funding continue and will do so until states are
held accountable to federal standards: genuine requirements to consider
family preservation, provide reasonable efforts for family
reunification. Financial incentives to traffic children must be
eliminated in favor of the seeming ``expense'' to preserve and reunify.
It is irresponsible and morally reprehensible in light of reality to
continue to financially fuel the corrupt Child Welfare Machine without
oversight and accountability. The Federal Government has an obligation
to its citizens/stakeholders to ensure their dollars are being spent
wisely and ethically.
I have made many contacts through this tragedy and received much
moral support. But in my search for assistance from those interested in
and responsible for affecting change, I have been unsuccessful to date.
Amongst notable others, the Children's Bureau responded with a form
letter completely unrelated to this practice. In fact, there seemed to
be no acknowledgement that they were concerned or making a note of
these issues. Again, ignorance is bliss. Personally I am aware of a
website under development with frightening accurate details of the
Gladwell tragedy, which may include (readily available for your
examination and investigation) documents, tapes, transcripts, etc.
Also, there are documentaries underway calling attention to these
atrocities. But, I ask of you, the federal committee culpable for
monitoring and controlling this funding of corruption, where is MY
family to go for justice? What can I do to help you make this
immorality and devastation stop for all those victimized? Please help
the vulnerable and innocent from being destroyed: stop the states from
putting their fiscal priorities before the best interest of children
and the preservation of family.
May God continue to bless your good works. I look forward to
hearing your thoughtful words.
Statement of Glenna Bible Mullenix, Jefferson City, Tennessee
I appreciate the work you are doing and the fact that you have
allowed me to submit my information. This is only the tip of the
iceberg, as far as I, and a lot of other people are concerned. I am
feeling so much guilt, as I made most of the referrals to CPS, because
I thought they could help me. I don't think I am as naive as I once
was, the last 8 months' research has helped me grow in truth and
knowledge. To whom does DCS answer? DCS is like the Vatican; ruled by
them, contained by them, a great many resources for money, they
``govern'' us, we have no way to be heard (of course the church does
have confession booths, but where do we go? Don't say to court, that's
a joke!) The 2 judges I have dealt with are so ``DCS'' oriented, I
wonder if DCS pays them or entertains them, or owns them? I bet if some
of the money was cut back, DCS wouldn't be so quick to hold children
for 2 or 3 or 5 years! And what was W thinking when he enacted this
adoption deal, giving DCS the ``incentive'' to steal kids, put them up
for adoption and get the money? That is like the proverbial carrot in
front of the rabbit!
SOME OF MY FINDINGS DO GO BACK SEVERAL YEARS, BUT IT STILL OBVIOUS
THAT A LOT OF WHICH MS. MILLER WAS CONFRONTED WITH, AT HER TIME OF
BEING APPOINTED BY GOV. BREDESEN, HAVEN'T EVEN BEEN ADDRESSED, LET
ALONE CORRECTED. THE ONLY POSITIVE I WAS ABLE TO SEE IS THAT HER FIRST
DUTY WAS TO PROTECT TENNESSEE FROM A LAWSUIT FILED AGAINST HER
DEPARTMENT, BEFORE SHE TOOK OFFICE. I AM SURE SHE GOT KUDOS FOR THIS,
BUT WHAT NOW? BASICALLY SHE HAS UNTIL 2006 TO COMPLY! BUT IF I CAN SEE
SOME OF THEIR FAULTS, U AM NOT SURE THEY ARE GOING TO MAKE IT.
MY 3 GRANDCHILDREN, THE WOLFE CHILDREN, IN FOSTER CARE THROUGH THE
MORRISTOWN OFFICE, CERTAINLY APPEAR TO BE A POSITIVE FISCAL RESOURCE,
FOR DCS, IS THIS WHY THEY ARE STILL IN CUSTODY?
ALSO, OMNIVISIONS IS STILL CONTROLLING DENNIS' CARE AND EXAGERATING
HIS NEED FOR THEM TO STILL BE CO-ORDINTING HIS CASE. ANOTHER, MORE
DISTURBING FACT, IS THE REQUEST HAS BEEN MADE, NUMEROUS TIMES, TO
REMOVE DENNIS FROM HIS FOSTER MOM, AS SHE IS BEING ALLOWED, BY OMNI,AS
FAR AS I AM CONCERNED, AND ELMER STAPLETON, IN PARTICULAR, TO KEEP HIM,
HOPING SHE WILL HAVE HIM FOR 2 YEARS. SHE WANTS TO ADOPT HIM AND HAS
NOT HIDDEN THIS FACT AS EARLY AS JANUARY OF 2005!!!!!!!! THIS CASE
EXEEDS THE LIMIT NECESSARY FOR FOSTER CARE OF ALL 3 OF THESE CHILDREN!!
THEY HAVE ME AND THE BOYS' DAD, BOTH APPROVED TO HOME THEM, AND YET DCS
AND OMNI STILL ARE DRAGGING THEIR FEET. THIS CANNOT BE IN THE BEST
INTEREST OF THESE CHILDREN, I DON'T CARE WHAT ANY CASEWORKER, CO-
ORDINATOR, OR DIRECTOR SAYS!!! I DO BELIEVE I HAVE MADE MYSELF CLEARLY
UNDERSTOOD.
GLENNA BIBLE MULLENIX
THE CONTINUING CRISIS
In October of 2004, the regional newspaper The Tennessean reported
that: ``A recent series of alarming cases--ranging from severe physical
abuse to prolonged sexual abuse to the beating death of a toddler--has
prompted renewed scrutiny of the state Department of Children's
Services' ability to protect children.''
One state legislator suggested that the problems in DCS are so
entrenched that the agency may have to be abolished and rebuilt from
the ground up.
``One of the things we have to decide is, do we abolish DCS and
start over?'' said state Senator Thelma Harper (D, Nashville).
``There are days when every one of us has that thought,'' said
Department head Viola Miller. ``We may not be perfect, but we're better
than nothing.''
Senator Harper, a member of the Select Committee on Children and
Youth, said Miller came into a ``sinkhole'' when she took over the
agency in January, inheriting 20,000 cases that hadn't been acted upon
in two years.
Some child advocates said that some DCS workers simply don't
respond to reports of abuse, even when the abuse has been confirmed. If
families question the judgment or authority of a caseworker, the
workers ``take it personally'' and sometimes become vindictive, said
Helen Shelton, a victims' advocate with the Tennessee Victims
Coalition. She also said workers sometimes fail to deal with confirmed
cases of abuse.
``I have found in my 15 years of experience that when the authority
of DCS is questioned, the best interest of the child is set aside and
they take it personally,'' she said. ``I'm so sick of this department
abusing their authority and failing to protect the best interests of
the child.''
Linda O'Neal, executive director of the Tennessee Commission on
Children and Youth, conceded that some caseworkers aren't receptive to
criticism or suggestions from the families they work with but said
there is a new training program designed to alleviate that problem. The
Commission she directs is an independent state agency formed to
evaluate services for children in state care and act as an advocate for
legislative and policy improvements.
DCS head Viola Miller also conceded that some case workers have not
been as open and compassionate as they should have been in dealing with
some situations, while describing her new training program.
``A big focus of this training is about building trusting
relationships with families and treating people with empathy,
compassion and dignity,'' she said.
THE NEW YEAR BEGINS
The year 2005 began with a report of the parents of a six-month-old
boy presenting a $600,000 claim to the Tennessee Claims Commission
after their son drowned in the bathtub in a foster home.
The foster mother, Sherika Hamilton, was scheduled to make her
first court appearance on charges of aggravated child neglect in mid-
January.
DCS became involved with the family after the boy was born, and
after his mother was hospitalized for post-partum depression.
Another veil was lifted on the operations of the juvenile courts
when it came to light that Wilson County Judge Barry Tatum had been
ordering foreign-born women to learn English for the good of their
children. In a January case, he insisted that an 18-year-old Mexican
woman take language classes and consider using birth control.
``A parent has the right to raise a child the way they see fit, but
government gets involved at some point,'' Tatum said. ``I'm concerned
about the civil rights of the child and what will happen to her.''
The immigrant woman and her American-born toddler both entered the
state's custody in 2003 after a complaint was made to DCS accusing the
mother of neglect by not following up on immunizations said a DCS
spokesperson.
Local civil rights attorney Jerry Gonzalez said the case sounded
similar to another recent order issued by Tatum, a decision that
Gonzalez is appealing. In that case, Gonzalez said, Tatum had ordered a
Mexican woman in a neglect case to learn basic English within six
months. If she didn't comply, a hearing was to be held to consider
terminating the mother's parental rights to her 11-year-old daughter.
``Ordering a woman to learn English or lose her child, that's
blatantly unconstitutional,'' Gonzalez said. ``The First Amendment
allows all of us to speak whatever language we choose to speak. There's
nothing compelling us to speak English, to learn English or be able to
write English.''
Judge Tatum said he could not immediately remember the case
Gonzalez referred to because of the volume of cases that move through
his courtroom.
``This is clearly not acceptable, and we're worried that the judge
has gone over the line,'' said Hedy Weinberg, executive director of the
American Civil Liberties Union of Tennessee. ``A judge should not
require a parent to learn English to have access to their child, and
the government should not be telling parents how to communicate with
their children.''
``The need for fundamental reform of the child welfare system was
readily apparent from the mid-1980s on,'' writes Lisbeth Schorr, who
explains that: ``Current services and approaches, while much
criticized, have a constituency often resistant to change, including
tens of thousands of caseworkers trained in traditional approaches.''
Many of them suffer from what Schorr describes as a ``bureaucratic
malaise,'' one that ``routinely sabotages and undermines the agency's
capacity to change.''
Sociologist John Hagedorn recounts his efforts at reforming the
Milwaukee child welfare system as having been thwarted by a deeply
entrenched ``good old boy network'' composed of lifetime bureaucrats
and services providers. He cautions his reader to beware of ``symbolic
reforms.'' Among the lessons he learned was that efforts at reforms
``historically have been coopted by bureaucracies and used to feed
their self-interests.''
Beyond the interests of the caseworkers and the upper level
management bureaucrats is an army of self-styled professionals who earn
enviable livings serving as field consultants and expert witnesses
while masquerading as benevolent ``reformers'' to legislators and other
outsiders with their eyes on a child welfare agency caught in the
spotlight.
An army of counselors, psychologists, parent educators, group home
providers, foster parents, home visitors, attorneys, as well as other
industry vendors and adjuncts add only further to the burden of
bringing about reform.
Another army of educators provides the industry with training
seminars, and with an ever-growing body of largely useless and
derivative articles in industry journals, even as they rake in
uncounted millions in federal grants. A recent examination of one such
writer's resume indicates a federal grant allotment of $80,000 for just
one article in print. Simply stated, the child welfare system has far
too many ``stakeholders'' with far too much at stake to allow for
meaningful reforms.
Through a variety of industry-only trade associations, a discreet
spider's web exists behind the helping facade. Attendance at
invitation-only industry events, such as the annual CPS Risk Assessment
Roundtable, help to ensure both the cross-contamination of ideas and
the building of cordial affiliations between various players in the
industry.
The National Center for Youth Law currently maintains a
``Litigation Docket,'' which holds an ever-growing list of legal
actions taken against states and their child welfare institutions for
gross violations against children.
Yet is this the best answer to be devised? ``This system has been
sued and sued and orders have been issued and people have just
continued on their merry way,'' observed George Miller as he presided
over the federal hearings leading to the passage of the Adoption
Assistance and Child Welfare Act during the 1970s.
Service provision to parents in need is a rarity in the field of
child protection, and in this respect, Tennessee mirrors well the
majority of other states:
Stakeholders were in general agreement that services to parents,
particularly in foster care cases, are not adequate to support
reunification and that the agency in general tends to be child-focused
rather than family-focused in its service approach. Stakeholders noted
that the agency will specify for parents the services in which they are
expected to participate, but will not facilitate access to, or
engagement in, those services. In addition, parents often are expected
to pay for the services themselves if their insurance does not cover
them.
Retaliation against foster parents who advocate on behalf of the
children in their care is a theme that is familiar to many child and
family advocates, and Tennessee provides no exception to the rule, as
the report explains:
A key problem noted by stakeholders in two sites included in the
onsite review is that foster parents sometimes are threatened with the
removal of children in their care if they ask about subsidies or other
forms of financial supports. Several stakeholders also expressed the
opinion that DCS rarely provides foster parents with services to
preserve placements when foster parents indicate that they are
experiencing problems with a child in their care or with their ability
to continue as foster parents.
By the time the federal reviews were completed, it was reported
that: ``No state fully complies with standards established by the
Federal Government to assess performance in protecting children and
finding safe, permanent homes for those who have suffered abuse or
neglect.''
Tennessee scored among the ranks of the worst. ``Federal officials
said 16 states did not meet any of the seven standards. These states
were Alaska, California, Georgia, Illinois, Indiana, Michigan,
Minnesota, Nebraska, North Carolina, Ohio, Oklahoma, South Dakota,
Tennessee, Washington, West Virginia and Wyoming,'' the New York Times
reported.
In June of 2003, DCS conducted some housecleaning, firing its top
Memphis official, Regional Administrator Juanita White, amid an
investigation into the deaths of several children under state care. The
Shelby County office under her direction had come under scrutiny
earlier during the year when The Associated Press reported on a state
audit that found the administrator tried to conceal questionable
purchases, including $5,750 paid for the use of a yacht club.
For the seventh consecutive year, Children's Services
inappropriately requested and received reimbursement from TennCare for
children not eligible for TennCare services. Inappropriate
reimbursements were for incarcerated youth, children not in state
custody, children on runaway status, and hospitalized children. Total
overpayments were $1,742,440.
In November of 2003, the Children's Rights lawsuit now settled,
Sheila Agniel, the federal court monitor in the settlement, found that
DSC was complying with only 18% of the corrective provisions it was
required to meet by February 2005.
The service delivery system for foster children and their families
needs improvement
IS DCS AN ADOPTION AGENCY? JUST FOR THE MONEY? THEY ARE SELLING OUR
BABIES!
Special Section: November Is National Adoption Month
HHS Awards Adoption Bonuses to States
On October 14, 2004, U.S. Department of Health and Human Services
(HHS) Secretary Tommy G. Thompson announced the awarding of $17,896,000
in adoption bonuses to 31 States and Puerto Rico. The funding comes
from the Adoption Incentives Program and is given to States that were
successful in increasing the number of adoptions from the public child
welfare system over the number of adoptions in 2002.
This is the first time that bonuses have been given to States and
territories since the program was revised and strengthened in December
2003. The bonuses go to State child welfare agencies for a variety of
child welfare and other related services including adoption and
adoption-related services.
``Adoption is a wonderful option for families and must be promoted
by all levels of government,'' said Secretary Thompson. ``The Federal
bonuses we are announcing reward States that have worked hard to help
children--particularly older children--in the child welfare system find
loving, adoptive homes.''
The Adoption Incentive Program, which was revised and strengthened
last December by the Bush Administration, for the first time adds a
focus on the growing proportion of children aged 9 years old and above
who are in dire need of adoption before they ``age out'' of foster
care. Two key changes that strengthen States' adoption and child
welfare services are:
An additional bonus of $4,000 to States for each child
aged 9 and above adopted from the public child welfare system. This
bonus is on top of the current $4,000 provided for each child and on
top of the $2,000 bonus for each special needs child adopted.
The threshold to receive incentives has been reset based
on the number of adoptions in FY 2002, making States that reached their
highest number of adoptions in the earlier years of the program more
likely to qualify for a bonus.
``President Bush has worked hard to increase the number of
adoptions so more children can grow up in safe, stable, and loving
homes,'' said Dr. Wade F. Horn, HHS Assistant Secretary for Children
and Families. ``Today's grants continue this Administration's efforts
to promote adoption from the foster care system so no child will be
left behind.''
Currently, there are 129,000 children in the public child welfare
system waiting to be adopted. Of this number, approximately 50,000
children each year are placed into adoptive families. Approximately
19,000 children ``age out'' of the foster care system without ever
having the opportunity to be adopted. The adoption bonus is in addition
to a website previously launched by ACF--www.adoptuskids.org--aimed at
the recruitment and retention of adoptive families for children in the
foster care system.
For a complete list of HHS adoption bonuses, go to www.acf.hhs.gov/
adop_inc_2003.htm.
Related Item
For more information about the Adoption Incentive Program, read
``President Signs Adoption Promotion Act of 2003'' in the December
2003/January 2004 issue of Children's Bureau Express (http://
cbexpress.acf.hhs.gov).
I SENT THE NEXT LETTER TO TENNCARE, THINKING THEY WERE PAYING THE
BILL:
TO WHOM IT MAY CONCERN,
I AM UNDER THE IMPRESSION THAT DCS, MORRISTOWN, AND OMNIVISIONS,
KNOXVILLE, MAY BE HOLDING ALL 3 OF MY GRANDCHILDREN WITHOUT VALID
REASONS. THE OLDEST, A BOY, ERIC DANE WOLF, HAS ADHD, WHICH IS WELL-
CONTROLLED BY MEDS AND IN THE RIGHT ENVIRONMENT. HIS MOM IS THE ONLY
ONE WHO HAD A PROBLEM WITH HIM DUE TO HER ABUSIVE BOYFRIEND. MY
DAUGHTER IS NOW IN TREATMENT FOR CO-DEPENDENCY.
THE SECOND OLDEST CHILD, ALSO A BOY, HAD BEEN DIAGNOSED AS ADHD,
BUT WHILE IN DCS AND OMNI CUSTODY IT WAS DETERMINED HE IS NOT ADHD.
HOWEVER, DCS AND OMNI ``CLAIM'' HE STILL NEEDS A ``THERAPUETIC'' FOSTER
HOME AND THEY STILL NEED TO SEE HIM? I CLAIM THIS IS FRAUDULANT! HE IS
A VERY SWEET, DOCILE CHILD AND NEEDS TO AT LEAST BE IN THE SAME HOME
WITH HIS BROTHER AND SISTER. HE HAS BEEN SEPARATED FROM THEM SINCE 2
WEEKS INTO CUSTODY. THIS IS SO WRONG! THE YOUNGEST, A GIRL, IS FINE,
JUST NEEDS OUT OF FOSTER CARE ASAP, AS DO THEY ALL.
AS A FORMER NURSE, WHO ONCE DID QA/UR, I CAN KINDA ``SMELL''
ATTEMPTS TO INCREASE A LENGTH OF STAY WITHOUT ADEQUATE CRITERIA! THANK
YOU.
GLENNA BIBLE MULLENIX
TO WHOM IT MAY CONCERN:
I have just returned from a non-productive meeting at DCS with
Amanda Dunn, Leslie England, Teresa Dockery and Omni workers Amanda
(don't know last name) and Elmer Stapleton. It started out like they
wanted to address concerns I have expressed via e-mail and phone
messages. It turned out to be to tell me how I had violated the
program.
Even though I expressed my concerns, valid concerns like, why is
Dennis' foster mom so obsessive and thinks she is going to adopt him
and why did she tell me ``Dennis has no family''? DCS agreed, verbally
that it had been inappropriate, but Omni, Elmer, took up for her as if
what I had said was a lie, it isn't a lie! I also asked Elmer why he
attended Dane's ball games, since he is not Dane's Omni worker due to a
conflict of interest since his mom is Dane's foster mom. He told me it
was a public place. I told him that's what I said about going and DCS
now forbids me to go watch my grandson play ball as it is considered a
non-supervised visit. I have no contact with him, I watch, cheer him
on, and leave. I am sickened unto death at the things DCS AND OMNI get
by with and I see some of it as fraud. In particular that Omni is
seeing Dennis, although it has been determined that he is not ADHD and
his behavior is excellent, yet I heard his date of release is NOVEMBER,
2006!!!!!!!FRAUD!!!!!!! He is separated from his brother and sister and
there has been no attempt to reunite them so they can bond once again.
STALL TACTIC LEADING TO FRAUD! WHICH MAY EVENTUALLY LEAD TO TERMINATING
PARENTAL RIGHTS AND THUS ADOPTION AND MORE MONEY? DID SIMON LEGREE HAVE
ANYTHING TO DO WITH FOUNDING DCS? Dane has been allowed visits with his
Dad and begs not to be taken back to his foster home and cries. NOT
ACTING IN THE BEST INTEREST OF THE CHILD! He doesn't need to be in
foster care either! What is his release date, November, 2010? Ariel has
never had issues and could have been placed with me, as Tennessee will
grant custody to someone who has been an integral part of the
children's lives and her mother and I are the only ones in her life!
Based on this, I should have been considered long ago and considered
now for immediate custody.
My daughter, their mom, is in a treatment program, finally, and
appears to be very involved so she can get her children back and be the
mother they need. It may take her 9 to 12 months, but that's fine.
The paternal grandfather and his wife, the children's step-
grandmother, are allowed visits with the children in their home, phone
calls, go to ball games, etc., but I am not. Want to know why? Because
they go along, like cattle, as does the boys' dad, and accept anything
DCS and Omni tells them. I on the other hand stand up for the
injustices I see, the children's readiness to leave foster care, and
the need to do it ASAP due to being alienated from their family and
because several have already expressed an interest in adopting them.
GROSS MISCONDUCT BY FOSTER MOMS
These paternal grandparents refused to take custody of them on Oct.
8th and that's why they put them in foster care. When they were close
to being placed a time before this (this is their first time in foster
care) I called these grandparents and asked them to help me keep them
out of foster care and was told, ``let them go to foster care,'' they
could not have cared less! My daughter didn't have them call and ask if
I would take them, because she had lied to them about me and DCS
thought I was not a very good candidate, due to the lies. She was angry
at me for the referrals to DCS I made and wanted to get back at me and
knew she could hurt me by keeping the children from me. Since Jan has
been in treatment, she has notified DCS that she told the lies and is
trying to rectify her error.
I now have to consider if I want supervised visits, the only person
involved to need to be supervised, or not. I am considering my options.
I truly enjoy watching my grandsons play ball, like I did last year.
Giving my support in what they are doing is so important to them and
most anything they do I just think they are the best!
Bottom line, I must be the only person to ever question the reasons
for continued stay in foster care, confronted them and Omni regarding
this, how unreasonable the plans to keep them is, and the continued
care by Omni constitutes fraud. I am not popular, but one thing Ms.
Dunn said is that I am a good child advocate. I knew I was and I will
continue to be until DCS and Omni do the right thing for these
children. I was told I needed to ``work with'' them. I told them I did,
I made most of the referrals for almost 4 years and since then have
seen their inconsistencies, been lied to, had several people tell me 3
or 4 answers to the question I ask, and use the court system as a
scapegoat when they are unable to come up with a valid reason for my
concerns about the actions they have taken.
I have written everybody but God and I talk to Him, but nobody
seems able or willing to do something to correct all of my allegations,
concerns, and requests. The judge even told me I had no legal claim to
get custody of these children when I knew a person with an integral
role, had the right. I am that person. I am so tired of swimming
upstream by myself. I can't afford a lawyer and tried to get one pro
bono, but when they learn DCS is involved, they drop it like a hot
potato.
Remember, Morristown DCS also handles Claiborne County, where baby
Haley lived and DCS never acted on her referrals, stating there wasn't
a valid need, well, not until she was rushed to the hospital, near
death, due to child abuse!
PLEASE HELP MY GRANDCHILDREN GET OUT OF ``THE SYSTEM'' BEFORE THEY
ARE SWALLOWED UP. THEIR FAMILY NEEDS THEM AND THEY NEED US.
Statement of Thomas Atwood, National Council For Adoption, Alexandria,
Virginia
Dear Chairman Herger and Members of the Subcommittee:
The National Council For Adoption thanks you for the
opportunity to submit this written statement for your June 9,
2005 hearing's record, on the subject of federal foster care
financing. The National Council For Adoption (NCFA) applauds
the Human Resources Subcommittee's perseverance in studying and
reforming federal foster care financing. The Chairman's and
Subcommittee's leadership in addressing this issue has helped
to create an excellent opportunity to take an important next
step in foster care reform. In both political parties, and
across the philosophical spectrum, there is a rare moment of
consensus regarding many key principles and policies that can
be adopted to better serve children in foster care, through
financing reform.
There are important differences, which must be debated and
resolved in the legislative process. But in reviewing the major
federal foster care financing reform proposals--such as the
Child SAFE Act of 2004, the report of the Pew Commission on
Children in Foster Care, and the President's Child Welfare
Program Option--it is clear that there are large areas of
agreement, both in principle and policy. Whatever one's ideas
regarding the ``perfect'' reform agenda, many of the ideas that
have been presented would be improvements upon the existing
policy. We should not let the perfect be the enemy of the good.
NCFA urges all leaders and stakeholders to take advantage of
this rare moment of consensus and achieve the achievable, for
the sake of America's deserving foster children.
At the level of principle, there is widespread agreement
that federal foster care financing must be made more flexible,
so that states are not so narrowly restricted to spending their
federal dollars on foster care maintenance. NCFA agrees with
the many advocates and policy makers who have cited the need to
enable states to direct some of these funds to prevention and
reunification efforts. NCFA would add parent recruitment and
preparation to this short list of priorities for which states
need more flexibility in their federal foster care funding.
There are enough prospective parents resources in America
to care for the children in foster care, but they need
leadership in order to recognize their callings to adopt or
foster parent. There are more than 425 married couples for each
child waiting to be adopted out of foster care, and millions of
qualified singles who could adopt as well. There are three
places of worship for each child waiting to be adopted, and all
of America's faiths exhort their believers to care for orphans.
There are private adoption agencies that, with training, could
join in serving children in foster care, through adoption and
foster placements, pre- and post-placement counseling, and
other services. Increased flexibility in federal foster care
funding would loose the ``laboratories of democracy'' on this
strategic agenda of parent recruitment and preparation.
States need to be able to spend their foster care dollars
on effective efforts to prevent children from entering the
system in the first place and to rehabilitate families so they
can be reunified. But please consider one cautionary note:
While moving in this direction, let us not forget one of the
main reasons Congress enacted the Adoption and Safe Families
Act in 1997. At that time, many children were languishing in
foster care because the child welfare system's efforts to
preserve the family sometimes went beyond any reasonable
expectation that it was in the child's interest to do so. We
should be careful to avoid recurrences of that problem.
At the policy level, there is widespread consensus on:
allowing states to reinvest unspent foster care funds in other
child welfare services; expanding and improving child welfare
waiver options for states; de-linking federal foster care and
adoption assistance payments from AFDC income standards, to
cover all children; extending foster care and adoption
assistance payments to tribes and territories; and guaranteeing
increasing foster care funding. If all that Congress
accomplished was to enact these policies, Congress will have
achieved a great deal.
The issue of whether foster care maintenance payments
should be capped is important. But considering that both sides
support, at a minimum, guaranteed rising foster care spending
and access to contingency funds, it is difficult to see how the
outcome of that debate, whatever it is, should cause a reformer
to oppose the final legislative product. NCFA will have more to
say about these and other related issues in a later
publication.
Mr. Chairman and Members of the Subcommittee, if ever there
was a good use of federal taxpayer dollars, it is to provide
for right and timely placements of children in foster care.
America's foster children are in public care for their
protection, through no fault of their own. The National Council
For Adoption applauds your efforts to ensure that federal
foster care funding is adequate, and appropriately directed, in
order to ensure the safety, permanence, and well-being of
America's deserving foster children. NCFA stands ready to
assist you in this worthy cause, in any way possible.
Statement of Terry L. Cross, National Indian Child Welfare Association,
Portland, Oregon
The National Indian Child Welfare Association (NICWA) submits this
statement on the Administration's proposal to change the financing
structure of the Title IV-E foster care program.
The June 9 testimony of Wade Horn, Department of Health and Human
Services Assistant Secretary for Children and Families, relies on an
issue brief from the Office of Human Services Policy as a justification
for the Department's recommendations. The Department's study concerns
state administration of the Title IV-E foster care program. We expect
that significant improvements could and should be made to the IV-E
program as administered by the states. We also recognize that the study
is a snapshot of the program not taking into account, for instance,
local and state funds that are available for foster care services and
up-front investments that states have made in their child welfare
systems.
Our organization, on the other hand, is focused on tribal
government delivery of child welfare services to the children under
their jurisdiction. Foster care is an important component of any tribal
service delivery system, but tribes have not been allowed to directly
access the Title IV-E program, and, therefore, we find that
generalizations about state service delivery have limited application
to American Indian and Alaskan Native (AI/AN) children under tribal
care. Our experience, accumulated over 20 years of working with tribal
and state governments on child welfare issues, reveals important
principles that guide successful program and policy decisions. We
actively use these to guide our work in improving access and the
quality of child welfare services to this population. First, tribal
governments have a sovereign right and governmental responsibility to
protect their children. They also have unique knowledge and resources
that are critical to successfully addressing child abuse and neglect
issues with their tribal members. Therefore, service delivery and
financing schemes must support them as the primary service provider and
decision-making entity. Second, AI/AN children have better outcomes
when their connection to their cultures, families, and tribes are
supported and actively incorporated in child welfare interventions.
Third, the ability to exercise tribal authority and responsibility is
based in large part on the resources available. Adequate resources are
necessary for tribal governments to successfully carry out their
authority for children under their jurisdiction.
The Administration's proposal, entitled ``The Child Welfare Program
Option,'' would provide to tribes and tribal consortia $30 million
annually in capped entitlement funds to operate Title IV-E foster care
programs. Only those tribes that can ``demonstrate the capacity'' to
operate a Title IV-E program would be able to access these funds. When
the Administration first made this proposal in its budget three years
ago we were very encouraged by its recognition that something should be
done about the fact that the Title IV-E statute does not include tribal
governments and the children under their jurisdiction. We also
recognized that the proposal did not address several issues and hoped
to be able to work with the Administration to move forward on workable
legislation to allow tribes to directly administer the IV-E program.
However, the Administration has shown little interest in other Tribal
IV-E proposals and has provided few details regarding their own
proposal. This environment has made it difficult to meaningfully
discuss the fundamental issue of AI/AN children being left out of a
federal entitlement program and effective solutions to this inequity.
We do agree with the Administration's position that the continued
linking of IV-E eligibility to the former AFDC eligibility is outdated
and should be changed. There either needs to be new income eligibility
criteria, or IV-E services should not be income-based.
We also agree that adding more service flexibility in the use of
IV-E Foster Care funding, including increased support for kinship care,
would be beneficial.
We have major concerns with the Administration's proposal in the
following areas:
Tribes Have Only One Option. The proposal does not allow tribes the
same options as states. It would allow tribes (and a limited number at
that) only one option, and that is to administer the new capped
program. States, on the other hand, could either administer the current
open-ended entitlement program or opt to administer the more flexible
capped program.
Not All Tribes Would Be Eligible to Administer the Program. The
proposal would allow only some tribes to administer the program--those
that the Department deems to have the capacity. Little information is
given about what criteria would be utilized, but Department
representatives have previously indicated that it might be based upon
the eligibility of certain federal programs (i.e., Title IV-E and IV-B,
Subpart 2--approximately 70 tribes) that are not available to all
tribes. Nonetheless, it is clear that not all tribes will be allowed to
provide the services and protections of this important program to their
children.
This sends a confusing message regarding how Indian children who
are abused and neglected will be provided foster care services in an
equitable and comprehensive fashion.
As we understand the proposal, tribes would have only two years to
decide to administer the IV-E program. That in and of itself would
severely limit tribal participation. IV-E is a complicated program and
many tribes may require more lead time. As tribes have watched states
operate the IV-E program and seen first hand the issues they face in
trying to manage this program effectively, many tribal governments may
not want to jump into a program without first assessing their readiness
and having time to make adjustments needed to successfully operate the
program. Unfortunately, the Administration's proposal would likely
severely limit tribal participation and ask tribes to hurry decisions
that should be made more carefully.
The Funding Baseline Is Too Low. We feel the Department's $30
million cap for tribal IV-E programs is too low. We do not know how the
Department arrived at that figure. The most recent CBO score on tribal
IV-E legislation (S. 667, which is included in the Senate Finance
Committee-approved welfare reform bill) estimates $66 million after the
program has been available to tribes for a number of years. Tribal
governments have not been afforded the opportunity to operate the Title
IV-E program and therefore have not been able to establish historical
data on their needs or trends in relation to foster care. The best
option is to allow tribes to administer the program on an open ended
entitlement basis; after 10 years, we would see what a reasonable
baseline would be. We expect that tribes will come gradually into the
IV-E program, just as they have into the TANF program.
Tribes Left Out of Adoption Assistance. The Administration's
proposal does not include tribal eligibility for the Adoption
Assistance Program. We find this puzzling given the high priority the
Department places on adoption. There is no reason why tribes should not
be eligible to administer this portion of the IV-E program.
Capping the Program Could Harm Tribal-State Agreements. We are very
concerned that capping the funding for the IV-E program will be a
disincentive for states to enter into future IV-E agreements with
tribes, and some states may not want to renew existing agreements.
There are and will be cases where a tribe finds that a tribal-state IV-
E agreement is the better route for them than direct administration of
the program.
Conclusion
Our best recommendation is for the Administration to re-evaluate
their communication and decision-making strategy with regards to the
tribal portions of their proposal. By more effectively utilizing their
tribal governmental consultation policies, we think a meaningful
dialogue can be established that can lead to better services for all
AI/AN children. We continue to be in communication with Subcommittee
staff about various Title IV-E Foster Care and Adoption Assistance Act
proposals and look forward to continuing this dialogue. We are hopeful
that there will finally be the political will in Congress to end the
discriminatory treatment of vulnerable Indian children and look forward
to assisting you in this endeavor.
Statement of Seth Nichols, Podesta Mattoon
Under current law, private non-profit and for-profit child care
institutions of any size are eligible for foster care maintenance
payments regardless of accreditation. However, public child care
institutions with more than 25 children are not eligible, even if they
are accredited. This poses a problem for public institutions that house
more than 25 children but, no more than 12 children per building on one
campus. The requirement of separate budgets and separate on-sight
management of each building is not a viable option for these
institutions due to cost and personnel constraints.
While it is understood that the Federal Government does not want a
return to the public orphanage system of days past, please explain why
this requirement of separate budgets and separate on-sight management
exists?
Statement of Cheryl Renee Reese, Round Rock, Texas
In fiscal year 2004, the Federal Government provided more than $7
billion in dedicated funds for child protection. The bulk of these
funds--almost $5 billion--supported children who had been removed from
their homes and placed in temporary foster care.
It is amazing that throughout the some odd 50 years no one has
thought about the children at all. This 5 billion dollars would have
better served the state if family members would be considered for
payment instead of strangers. When you have family members that want to
help but, budget shortfalls will not allow them to without some
assistance from the state. The state will chose a non-family member,
possibly a crowded home with violations and or drugs for the child to
go on in this home. Not once thinking if it is necessary for this child
to be on drugs in the system maybe some assistance to the parents could
have prevented this child from being removed in the first place. I am
not suggesting that the state put children on drugs as a method of
helping them. I am just saying how best can the state help the family
before removing children.
I myself have assisted three foster children who are my nieces and
nephew, by giving them a place to live and grow up. There was no
assistance provided or even mentioned. There have been other family
members taking in family children in order to get them out of the
system and with family. Initially we asked for daycare assistance
because it was not in our budget. We were denied because we made too
much money. There was no consideration that our money may have been
allocated in other directions and we needed a little assistance until
we could adjust or budget to include daycare. Not to mention clothing
and food and extra gas. After 13 years of no assistance we don't even
try to get it anymore. While trying to get the children out of the
system they were cared for worse than the mother was providing for
them. Their clothing didn't match nor was their hair taken care of, it
was uncombed and matted, we had to cut and treat for months.
My nephew was medicated by the system because they said he was
hyper. His mother abandoned him because she said he needed to be fixed.
He did not need to be medicated and he asked at 10 years old if he had
to continue to take the slow down medicine. He said it made everything
go in slow motion. He was prescribed redalen for his hyperness.
In March of this year there was a report done by 60 minuets about
grandparents having to take in their grandchildren. While this is not
new, it has been ignored for many years. These grandparents are on
fixed income but, still want to try to keep the family together. This
is just another example of the unavailability of assistance. These
people need your help to keep these children from going into a
different system when they are older.
Below are just a few of the things I saw that need to be addressed
by the committee. Please take a look at them.
Goals of Child Protective Services:
Remove the children as a last resort, not first then investigate.
Determine what imminent dangered really means for CPS.
What service can CPS provide to assist the parents 1st before
removing the child.
Qualify immediate family members to assist with children before
putting in nonfamily member home.
Give assistance by way of clothing, food and daycare stipends.
Plan for returning children be an attainable plan.
If children are removed, their care should be better than what the
parents were doing.
Hair care is not considered cosmetic, this should fall under
regular care of child.
Keep the children drug free while in the system, If they were not
on drug while at home why are we medicating in the system?
Statement of Frank Richards, Hillsborough, California
Thank you for providing an opportunity for input on this important
issue. Although I am sending this as a private citizen, it is my
experience with Foster Care from the vantage point of a former
administrator of a Child Support program that makes me aware of this
issue. I held the position of Deputy Associate Commissioner of Child
Support Enforcement Services in New York City from 1998 to 2004. I
should note that this input reflects my personal view only.
If the Committee is looking at funding for the Foster Care effort,
and is seeking consistency across the States, I would urge the members
to look at the issue of child support collections made on behalf of
children in Foster Care. Having worked for child support agencies in
New Hampshire and New York, my experience can hardly be claimed to be
national, but I do believe that the problems inherent (in collecting
support from parents whose children are in Foster Care) are common;
collection rates are low and the rates of reimbursement (to the Foster
Care programs) are relatively low nationally.
My recommendations fall into two basic areas: the first being ways
to improve the collection rates, which would lower the cost to the
states and to the Federal Government for administering the program; the
second a means of sharing the collections with the children,
particularly older children, while they are in placement, or in the all
too common instances when older children are emancipated into adulthood
directly from Foster Care. Collections could be used as ``allowance''
(to help maintain ties between children and parents, and to improve
life in Foster Care), and to provide individuals with a nest egg that
may assist them in their all too often failed efforts to become fully
functional, independent members of society in the event they remain in
Foster Care until adulthood.
In the first instance, child support regulations regarding Child
Support and Foster Care need to be both simplified and fortified.
Existing federal requirements do allow for coordination between Foster
Care and Child support programs, but I believe the relationship is
tenuous. Child support program requirements technically insist that
support be sought from both ``absent'' parents (which is sometimes
appropriate), even when child welfare workers are working to reunite
children with their families (often a single parent). There are
certainly times when taking court actions against parents in the early,
often delicate stages of intervention are inappropriate (at least in my
view). I believe, honestly, that if child support workers and foster
care workers were better able to share the same basic mission (of
serving the true needs of the children), that Congress would make it
easier for caseworkers to place child support activities against one or
both parents ``on hold''. (This can be done but the process is
cumbersome).
If done correctly, child support matters could be considered in the
initial hearings, or instructions regarding support could be included
in the order separating children from the parents. This would clarify
the intent of the court and provide a clear direction for both agencies
to work from.
In return for this heightened sensitivity, I would at the same time
seek increased and improved cooperation. If the funds (or potential
funds) from collections are truly seen by Foster Care workers as
something that will benefit the child directly--then I believe the two
programs can and would work in better concert, and that overall
collections would increase. This would be aided by better information
sharing between the two programs, and perhaps improved automated
interfaces. If the efforts on the part of both agencies/programs could
be focused on the cases where the court has ordered support from the
onset (which should happen in any/all ``voluntary'' placements) or on
taking only taking a parent or parents back to court for child support
when it is truly appropriate (thus spending less time documenting why
nothing was done) then I truly believe revenue would increase. While
not all Foster Care cases are IV-D, clarifying program requirements and
laws regarding support and Foster care would go a long way.
Better define when child support actions should be taken and
against whom.
Short-term ``protective actions'' should be avoided.
Parents who will be reunited (or where the plan calls for
it) within a year perhaps, should be avoided.
Parents who are able to pay and have place children into
Foster Care ``voluntarily'' should have child support actions included
in the initial court actions.
Whenever Foster Care workers identify child support as an
important asset to the child and/or family, child support against any
truly absent parent should be initiated in early court proceedings,
with child support agencies and foster care agencies working in
concert. Paying support may be an excellent way for a parent who
desperately wants a child ``back'', or who might want to gain custody
to ``prove'' responsibility.
The main issue here is, for support enforcement and Foster Care, to
better define a common mission for Foster Care cases, to avoid multiple
case hearings and fruitless documentation--the result will be increased
assets made available to the program. I my view this should be used in
two ways: to reduce Foster Care expenditures, but also to make better
investment in the children themselves.
This brings me to my second main point. Currently, mostly to
promote cooperation from TANF case heads, child support regulations
allow a ``pass-through'' of child support benefits directly to the
families. This does serve to provide motivation for cooperation in
court, and helps provide agencies with information, but it also
increases the financial resources of very low-income households, and it
may document the presence of other resources for the children--an
absent parent who pays support.
Foster Care has no provisions for pass-through. While it makes no
sense for a parent to in essence be paying pass-through to themselves,
provisions for allowance to the children in placement certainly makes
sense. Particularly for older children this could be important. In my
view regulators should look carefully at the all too large population
of children that leave Foster care at age 18 or 21; many either never
``leave the system,'' or end up back on it, or worse in prison. If
during the course of their placement in Foster Care, some or possibly
all of the child support received on their behalf was held in escrow,
decisions could be made over the course of their case histories as to
how this asset should be applied.
The support collected on behalf of young children whether
or not they return to a parent or parents should certainly be used to
offset government expense (in many if not most cases);
Children in care with a parent paying support should be
granted some sort of allowance;
Children whose parents have paid support should NOT be
allowed to be dropped from the system at ``adulthood'' without
providing them with something of a ``nest-egg''--for schooling, getting
settled, whatever. This could reduce long-term expenses in many
programs.
I honestly believe that if the right decisions are made both
objectives could be met. Children could better served with less overall
government expense if these programs were better coordinated.
If there are any questions I would be pleased to respond.
Statement of Daniel Allen Roberts, Dunnellon, Florida
This is in response to the issue of the Funds that are distributed
to the States. These funds primarily come from the The MONDALE Child
Abuse Prevention and Treatment Act of 1974 (CAPTA--Public Law 93-247).
While this law title sounds as if it is a valid area of concern and
proper law, it has been the incentive of improperly incarcerating
Children into foster care, and adopted out and away from non offending
parents each and every year. As it is, the money also provided to
Foster Care and to the Offices responsible for placing them, not only
railroads children from innocent parents who are low income and cannot
afford legal help, but due to the sheer volume of children, places the
children in danger as just about anybody is sought out to house these
children. In the efforts to also find children to fill these
statistics, CPS (Child Protective Services) Agents have been known to
violate the 4th Amendment, 5th Amendment, 6th Amendment and 14th
Amendment of our U.S. Constitution on a regualr basis. The police also
wrongly think the CPS Agencies are not subject to these Amendments, and
enforce illegal investigations, impossible to do case plans all for the
sake of getting the children removed from the home for the monetary
incentives. They also target children who are disabled to secure Title
IV-E funds from Social Security. To also prove this money that is paid
out clogs the Foster Care System to the point of children being abused
and killed in Foster Care far more than if they were left at home is
here: Number of Cases per 100,000 children in the United States. These
numbers come from The National Center on Child Abuse in Washington.
CPS--Physical Abuse (160) Sexual Abuse (112) Neglect (410) Medical
Neglect (14) Fatalities (6.4) Parents--Physical Abuse (59) Sexual Abuse
(13) Neglect (241) Medical Neglect (12) Fatalities (1.5) As you can
see, children are abused far more in care than at home. The calculated
average is for every 1 abused child removed from an abusive home, there
are 17 unabused children removed from loving non-offending homes
nationwide. Please remove the Motive for the States to process Children
in huge quantities from non offending parents by ending totally this
funding. It's imperative we take the profit out of destroying good
families away from the states and CPS. Sincerely, Mr Daniel A. Roberts
& Family care, and adopted.
Statement of Denise Turbeville Barker, South Carolina Children's Foster
Care Review Boards, Columbia, South Carolina
As the Subcommittee on Human Resources evaluates the financing for
public foster care administered through Title IV-E, I would like to re-
emphasize the role of state citizen foster care review board programs
in ensuring the safety, permanence and well-being of children placed in
the foster care system. South Carolina is one of several states with
citizen foster care review board programs who contract with their state
child welfare agencies for Title IV-E funding to fulfill the mandate
for independent, third party review required by Title IV-E. We seek
continued support for this funding from your subcommittee in order to
ensure that state citizen foster care review programs are recognized
for their ongoing efforts to provide programmatic data and targeted
recommendations for improvement to their state child welfare agencies
about their foster care programs. If there are expanded evaluative
services we could provide that would be helpful to you in your review
of the foster care program, we would be happy to participate in
discussions around that possibility.
In 1974, South Carolina was the first state to implement a citizen
foster care review program. Thirty years later, our program remains
strong and citizen review influences program and policy in 23 other
states patterned after South Carolina's original model. Our small
coalition has been a leading voice in foster care review issues around
the country. We have previously sought funding from your committee to
support this national network (NAFCR) in order to unify and expand
efforts started by state grassroots organizations who invest so much to
secure permanent homes for children in foster care.
The SC Foster Care Review Board program was an active participant
in the Child and Family Service Review conducted in South Carolina.
Points targeted in South Carolina's Program Improvement Plan(PIP) have
now been incorporated into the data tracked by local foster care review
boards and we will provide a check and balance on time lines and
outcomes required by South Carolina's PIP. Recommendations made in the
2003-2004 South Carolina Foster Care Review Board Annual Report are
based on Review Board data related to violations of Public Law 96-272,
violations of Title IV-E requirements, South Carolina law, and other
specifications of the South Carolina PIP. A full copy of this report is
available on our website: www.govoepp.state.sc.us/children/foster.htm.
Looking back, I can say with confidence that without the influence
of citizen review programs, these positive changes in the child welfare
system would not have occurred:
The passage of Public Law 96-272 in 1980--This landmark
legislation, with its requirement for periodic review of children in
foster care, would not have happened without the invaluable information
provided by the determined citizen foster care review organizations in
existence at that time;
Development and passage of model termination of parental
rights statues across the country that have enabled the adoption of
thousands of children in foster care;
A continued focus on the need for permanence for all
children in the foster care system--Child welfare agencies continue to
be overburdened and without the vigilant oversight provided by boards
of citizen advocates, the system might easily revert to an ``emergency
management'' mode that traps children in the foster care system
indefinitely with no hope of a positive future with a permanent
family--in SC we would not have seen a decrease in the length of time
children spend in foster care;
Citizen volunteers serving on local foster care review boards have
penetrated the veil of confidentiality that prior to 1974, shielded the
foster care system from public scrutiny and accountability--This well-
trained, informed and growing population of volunteers in each local
community have done more to advance the importance of child abuse
prevention, adoption and community responsibility for system change,
than any other volunteer movement in this country--we have just done it
quietly and at the local level.
These are just a few examples of how trained and dedicated
volunteers can move and improve the system. I have worked with the
citizen review program in South Carolina for the past twenty-five years
and I know citizen foster care review board programs can be invaluable
to you as you seek to improve quality assurance assessments for states
receiving Title IV-E funding. Funding for third party, external citizen
review through Title IV-E is critical if we are to continue and improve
the progress made thus far.
Statement of James Roger Brown, The Sociology Center, North Little
Rock, Arkansas
Five-year-old Florida foster child Rilya Wilson was kidnapped from
State custody in February 2001. Florida officials did not detect the
kidnapping for fifteen months. The kidnapping went undetected for two
reasons, Rilya Wilson was kidnapped by persons knowledgeable of the
inner workings of the child protection system, and Florida Department
of Children and Families case file record forms were falsified for
fifteen months. Case workers falsely reported Rilya Wilson was in
Florida State custody and in good health.
The Rilya Wilson case is not an isolated incident. Falsification of
child protection system records is part of a national pattern of
organized crime. For one example, Employees of the Florida Department
of Children and Families were also implicated in the kidnapping of an
Arkansas child that involved falsification of records. In a June 6,
2002, opinion, the Arkansas Supreme Court ruled that an infant Arkansas
citizen had been illegally transferred to Florida State custody in what
was essentially an interstate criminal conspiracy to seize and
transport children in complete disregard of State and Federal law. (See
Arkansas Department of Human Services v. Cox, Supreme Court of Arkansas
No. 01-1021, 349ark, issue 3, sc 9, 6 June 2002 http://
courts.state.ar.us/opinions/2002a/20020606/01-1021.wpd)
The Rilya Wilson case is merely the tip of a criminal iceberg.
Beginning about 1973, criminal elements in the mental health and social
work professions began cooperating to construct a nationwide organized
criminal bureaucracy to exploit children and implement a shared
political agenda behind the legislated secrecy of the child protection,
juvenile justice, and mental health systems. (For details see EVIDENCE
BOOK SUBMITTED TO CONGRESS link on page 9.) The current result is a
nationwide organized criminal operation integrated across the child
protection, mental health and social work systems that uses everything
from sophisticated science fraud-based ``evaluation'' instruments
structured to produce false positives (see EVIDENCE BOOK) to third-
party State service contracts written to sustain a system of structural
corruption in which State employees and contract service providers must
falsify records and testimony or they will not continue to be employed
or paid.
To maintain their existence, organized criminal operations such as
these are no different from other bureaucracies that must construct
policies, methods, and procedures necessary to sustain daily
operations. The only special adaptation required to run criminal
operations in government and quasi-government agencies is that
organized crime bureaucracy policies, methods, and procedures must be
integrated into the policies, methods and procedures of the umbrella
agency or program and not be detected as criminal processes.
The existence of organized crime in the child protection system in
any given State is not that difficult to detect. Prominent among the
indicators (see EVIDENCE BOOK) are:
1. Systematic, consistent falsification of child protection agency
records and testimony, contract mental health evaluations and
testimony, and social work intervention records and testimony;
2. The annual number of ``founded'' child abuse allegations can be
predicted from the number of conditional federal grant and
reimbursement salary fund dollars needed to balance the State child
protection agency payroll (the number of children taken into State
custody each year will be the number sufficient to generate the federal
fund claims necessary to balance the agency payroll); and
3. Third-party contracts to file State child protection agency
federal fund claims will contain provisions that only compensate the
contractor for increases in federal funds paid to the State over and
above the amount paid in the previous contract for such claim filing
services.
Inserting a contract provision that links a federal fund claims
contractor's compensation to increasing annual federal fund dollars
generated over the previous contract period is a classic example of
structural corruption. If the contractor fails to increase paid federal
fund claims for a specified time period (usually quarterly), their
contract can be cancelled. The end result is a system in which everyone
stays employed only if the annual number of founded child abuse cases
always increases and never decreases, or annual paid federal fund
claims increases and never decreases. An important byproduct of this
criminal process for exploiting children, independent of the true child
abuse rate, is the blind political support for the criminal operations
generated by the constant flow of conditional federal funds into the
respective State's economy. In the Rilya Wilson case, even the Foster
Mother continued to receive and accept payments for the care of Rilya
over a year after the child disappeared. Caseworkers reportedly told
her to take the money.
An ironic twist is that this corrupt modern child slave trade
system is another example of history repeating itself. A criminal
bureaucracy previously developed and operated in the Swiss social
welfare system from about 1850 to 1950 under the same pretext of
protecting children from alleged inadequacies of their parents. The
Swiss Verdingkinder system is described in Peter Neumann's documentary
film ``Verdingkinder '' and Marco Leuenberger's Thesis,
``Verdingkinder. Geschichte der armenrechtlichen Kinderfursorge im
Kanton Bern 1847-1945, 211 S., 1991.'' (An internet search using the
term ``Verdingkinder '' will produce links to some English language
articles.)
The Swiss ``Verdingkinder'' and United States child slave trade
systems have the following social processes in common:
1. Poor families are required to register with the Government.
(U.S. Public Assistance, Welfare, Medicaid, Medicare and numerous other
special programs.)
2. Once registered with the Government, Parents are subjected to
ongoing monitoring to determine if ``the best interest of the child''
is served by removing the child from the home and placing the child in
State ``protective'' custody.
3. Children who age out of the system are not intellectually and
emotionally prepared for adult life, especially marital relationships.
4. Decisions about the ``best interest of the child'' are made by
Government employees using vague subjective criteria and State or
personal economic interest.
5. Children are auctioned off or distributed under government
sanction. (U.S. Child Protection Agencies post pictures of children
held for adoption on the internet, and foster parents are enticed with
additional household income generated by foster child ``support''
payments.)
6. Children are physically abused, starved, and malnourished by
State and foster custodians.
7. Children are sexually abused by State and foster custodians.
8. Children are murdered by State and foster custodians.
9. Children are economically exploited. (In the Swiss system by
the middlemen, farmers and businesses using the child slave labor; In
the U.S. system by State employees who wrongfully seize children for
federal funds to meet the agency payroll; by psychiatrists,
psychologists and social workers filing fraudulent insurance claims; by
crime victim therapy service providers filing claims for nonexistent or
fictitious child abuse crime victims; and by attorneys, prosecutors,
child abuse investigators, juvenile court judges, and civil court
judges who exploit false child abuse allegations to sustain their
income, power or prestige.)
10. Criminal activity is concealed through falsified records,
incomplete records and failure to keep records.
11. Government agencies pay fees and subsidies to State and foster
custodians who physically abuse, murder, sexually abuse and
economically exploit children.
12. Law enforcement agencies ignore or cover up criminal acts
against children by State and foster custodians.
13. When prosecutions do occur for crimes against Verdingkinder or
foster children, the punishment is minor compared to the crime.
14. The operation intended to benefit poor families and children
becomes an organized criminal enterprise that economically, physically,
and sexually exploits children.
15. Government officials and media not directly involved in the
criminal activity refuse to believe that a child slave trade could
develop in a civilized nation like Switzerland or the United States.
16. The economic exploitation of children in the Swiss
Verdingkinder system coincidently did not end until machinery was
developed that provided a cheaper means of farm and factory production
than child slave labor. The United States child exploitation system
will not end without intervention unless States find easier methods of
obtaining federal fund revenues equal to the amount currently generated
by taking children into State ``protective'' custody.
17. Both the Swiss and United States child slave trade systems
expanded and operated outside of Government control. (The private
purchasing and sale of children in the U.S. are conducted by private
child brokers and child adoption attorneys.)
Relevant insights can also be extracted from parallels in the
embarrassment of the Bush Administration over numerous ignored warnings
that Osama bin Laden planned to hijack planes and fly them into
buildings, and the embarrassment of Florida Officials having to explain
fifteen months of falsified child protection records, sworn court
testimony that Rilya Wilson was in Florida State custody and doing
fine, and falsified federal fund claims for services delivered to a
child who may have been dead the entire time. After the collapse of the
World Trade Center, both the American Public and terrorists worldwide
now know the United States is vulnerable to attack, due in large part
to corruption, incompetence and mismanagement in intelligence and law
enforcement agencies.
As a consequence of the Rilya Wilson case in Florida, the Public
and every child molester, pornographer and other criminals who need
children for their misdeeds know that the corruption, incompetence and
mismanagement in the child protection system can be exploited as cover
to acquire children for their own illicit purposes. What happened to
Rilya Wilson in Florida can, does, and will happen in any State where
the current organized criminal exploitation of children is allowed to
continue. Sooner or later other criminals are going to become
sufficiently aware of the mechanisms the current child protection
system organized criminals use to manage their criminal bureaucracy,
that child molesters, pornographers, pimps, and drug smugglers will
also be able to exploit the system, as were the people who reportedly
kidnapped Rilya Wilson and returned a week later to collect her
clothes. This was the behavior of persons who believed they had no
reason to fear being held accountable for kidnapping or any other
criminal offense.
Among the obvious criminal opportunities is obtaining information
about the illicit activity (falsifying federal claims, official
reports, insurance claims, etc.) of individual State employees or
licensed professionals, such as psychiatrists and psychologists, and
blackmailing or otherwise compelling them to allow access to children
for criminal exploitation or perversion.
Of major importance to prosecutors is that the systematic
falsification of records by child protection system crime participants
in psychiatry, psychology, social work and child abuse investigation
units, results in the systematic falsification of evidence used in
child-related criminal and civil judicial proceedings. (See EVIDENCE
BOOK.) It may be tempting for police and prosecutors not to look too
closely at experts and evidence which make convictions easier, but
relying on criminals who protect themselves by providing tainted
essential services and corrupted evidence to the people who should be
arresting and prosecuting them is a house of cards that will collapse
locally or nationally at some point. We have contemporary examples of
chaos created by the falsification of evidence in the Los Angeles
Police Department, and the newly-documented error rate in death row
convictions. Several decades of both Los Angeles and death row cases
have to be reviewed and readjudicated.
When the disastrous consequences of entering the fourth decade of
organized criminal administration of the child protection system are
finally disclosed, State Governments and the Federal Government face
having to remedy the chaos and carnage caused by malicious
prosecutions, false child abuse allegations and convictions, falsified
adoptions, bankrupted families, damaged children and adult lives, and
the children stolen by State employees and diverted into prostitution
and other criminal activities.
In addition to the Swiss Verdingkinder scandal, at least one other
historical precedent exists with several parallels to the manner in
which the United States child protection system currently engages in
the now-documented systematic abuse and atrocities with the tacit
approval of State Officials and Federal Agencies and Officials.
From 1976 to 1983, the government of Argentina under the control
of a military junta conducted a ``Dirty War'' against anyone perceived
as ``leftist.'' Just as with child protection agencies, the Argentine
Military Junta went after anyone who criticized either the way it
operated or its policies. Most of the same types of people targeted by
the Military Junta are likewise targeted by child protection agency
organized crime managers: the poor, critics of the system, social
activists, people who resist personal intimidation and the abuse of
fellow citizens, and people who ask too many questions.
In Argentina, thousands of individuals and entire families were
rounded up and executed by being beaten to death, shot in the back of
the head, or sedated and thrown alive from an airplane over the open
ocean. Concurrently, the Argentine Military maintained a list of
soldiers wanting children. Pregnant women taken into custody were kept
alive until their babies were born, then executed. Infant children of
the pregnant women and murdered families were distributed among the
soldiers who killed them. [Criminal investigations and prosecutions of
Argentine soldiers involved in the atrocities are still going on.] (See
http://www.yendor.com/vanished/junta/caraballo.html and http://
seattletimes.nwsource.com/html/nationworld/
2001960898_argentina21.html.)
On October 7, 1976, United States Secretary of State Henry
Kissinger met with Argentina's Foreign Minister Admiral Cesar Augusto
Guzzetti. At the time of this meeting, Congress was preparing to
approve sanctions against the Argentine Junta because of widespread
reports of human rights abuses. Henry Kissinger communicated to
Guzzetti United States Government approval of the Junta's use of mass
arrests, torture, and mass executions to deal with suspected leftists.
According to a declassified transcript of the meeting, Kissinger
stated:
``Look, our basic attitude is that we would like you to succeed. I
have an old-fashioned view that friends ought to be supported. What is
not understood in the United States is that you have a civil war. We
read about human rights problems but not the context. The quicker you
succeed the better. The human rights problem is a growing one. Your
Ambassador can apprise you. We want a stable situation. We won't cause
you unnecessary difficulties. If you can finish before Congress gets
back, the better. Whatever freedoms you could restore would help.''
National Intelligence Archives: http://www.gwu.edu/ nsarchiv/NSAEBB/
NSAEBB104/.
Those working to obtain justice for the victims of abuse and
atrocities committed by perpetrators embedded in the United States
child protection system should keep Kissinger's words in mind as
another parallel. Even with the possibility of Congressional action on
the horizon, reform efforts can be undermined by friendship or economic
ties between Federal Officials and State-level cronies directly
participating in the child protection system organized crime.
Some of the more brutal foster care abuse and death scandals were
cases in which children taken into State custody were placed in the
homes of case workers in violation of regulations prohibiting it. In
some cases the abuse and deaths occurred in the homes of the very case
workers who had seized the children. (See EVIDENCE BOOK.)
One disturbing parallel is that for Argentina's Military Junta and
for the United States child protection system, proof of guilt is not a
requirement to be placed under government control; allegation or
suspicion of guilt alone is sufficient. In both systems, whether you
die or survive the process, the life you had before is completely
destroyed and you are tainted for the rest of your life by the mere
fact of an allegation or suspicion.
Unless something is done to shut down the organized criminal
activity in every State in which it currently exists, Rilya Wilson is
not going to be the last horror story to capture national attention.
Similar incidents in the future will continue to ruin careers as the
Rilya Wilson kidnapping did in Florida. People will end up in prison
for crimes far more severe than falsifying a few reports to obtain
federal funds for their State, or filing fraudulent insurance claims.
Prosecutors, Legislators, and other State officials who thought they
were benefitting their State by ignoring criminal acts in the child
protection system which bring federal fund dollars into the State's
economy may end up having to face situations far uglier than they ever
thought.
Former Arkansas State Senator Nick Wilson was sentenced to federal
prison for his sponsorship of and participation in one such legislated
criminal enterprise to exploit children. Several Arkansas attorneys
involved in this scam lost their licenses to practice law.
During the 2001 Arkansas Legislative Session, Senate Bill 860,
drafted by Arkansas Department of Human Services employees, was
discovered to contain provisions that would have required employees to
lie about records and facts, even if subpoenaed. The bill was withdrawn
once the Legislator duped into being the primary sponsor was made aware
of its contents.
An Austin, Texas, DHS Supervisor committed suicide after being
arrested for operating a foster child prostitution ring from his office
computer. Also, the Texas Comptroller has issued a report on the
exploitation and abuse of children in State custody, including some who
were forced to live outdoors in tents year-round. (See CHILD SLAVE
TRADE PAGE link below.)
Congress is now in the preliminary phase of possibly holding
hearings on corruption in the child protection system. Public hearings
on the abuse of children and parents involved in the child protection
system have been held in at least two States. Reforming the child
protection system is currently part of the platform of candidates who
are running for public office in at least three States.
For information regarding the status of a possible Congressional
Investigation of the child protection system, contact local United
States Representatives and Senators.
The handwriting may or may not be on the wall now, but child
protection system criminals will continue to push the envelope on
everything they can get away with until they are stopped and
prosecuted. The important issue is how much more obvious,
sophisticated, brutal and embarrassing organized crime in the child
protection system will be allowed to become before it is addressed--and
stopped.
While the current state of knowledge about interlinked organized
crime in the child protection, mental health, and social work systems
paints a dismal picture, it also reveals practical solutions to the
problem of how to arrest and prosecute participants in this organized
crime bureaucracy. Information publicly available now makes it possible
to catalogue the criminal acts used to sustain the child protection
system organized crime bureaucracy. These criminal acts include but are
not limited to:
1. Murder;
2. Manslaughter;
3. Kidnapping;
4. Conspiracy;
5. Blackmail;
6. Terroristic threatening;
7. Witness tampering;
8. Evidence tampering;
9. Perjury;
10. Fraud;
a. Medicaid
b. Medicare
c. Federal grant and reimbursement programs
d. Insurance claims
e. Crime victim reparation claims
f. Psychological testing results
g. Psychological diagnoses
11. Tampering with government records;
12. Falsifying government records;
13. Deceptive and unconscionable trade practices by psychiatric,
psychological and social work practitioners operating as public
businesses;
14. Emotional, mental and physical child abuse;
15. Racketeering;
16. Human trafficking;
17. Production and possession of child pornography;
18. Child prostitution; and
19. Organized crime generated child abuse statistics collected
from States and reported to Congress and the public violate the Federal
Data Quality Act.
One simple achievable remedy would be the establishment of a
special organized crime task force in each State specifically targeting
interlinked organized crime in the child protection, mental health, and
social work systems. Associated with this crime control effort would be
the enactment of legislation prohibiting science fraud-based insurance
claims and the establishment of science fraud detection protocols
within State insurance fraud divisions. Currently, no State or Federal
Code exists prohibiting the use of science fraud for illicit purposes.
Governors facing State budget deficit crises could find this approach a
useful tool for shutting down corrupt agencies and programs with
minimum political backlash. What special interest group could publicly
protest an effort to shut down organized crime in the child protection,
mental health, and social work systems without raising questions about
their own motives and credibility?
Creating an organized crime task force to go after criminals in the
child protection, mental health, and social work systems, and
establishing science fraud detection protocols to control fraudulent
psychiatric, psychological, and social work service provider insurance
claims are attainable goals for those individuals and groups seeking to
end the current atrocities committed in the name of child protection.
Objections that sovereign immunity applies to state employees and
expert witness immunity applies to the testimony of mental health and
social work practitioners are not valid in many States when gross
negligence, gross incompetence, or acting with malice are present.
To provide additional and future updated information on the
criminal exploitation of children in the child protection, mental
health, and social work systems, a page on THE SOCIOLOGY CENTER web
site has been dedicated to monitoring the child slave trade in the
United States. The Child Slave Trade Page currently contains
information on how to contact the FBI Human Trafficking Task Force;
downloadable PDF format copies of some evidence books submitted to
Congress (including mine); child protection system criminal
intelligence; links to support organizations and other information. In
the hope this National Advisory will alert the public to the organized
criminal threat to families concealed behind the veil of child
protection system secrecy and help prevent any repeats of the Rilya
Wilson horror story, I draw the following material to your attention:
1. The Child Slave Trade Page at http://
www.thesociologycenter.com/slavetrade.html.
2. EVIDENCE BOOK SUBMITTED TO CONGRESS: The Compendium of
Documentation of Organized Crime Methods and Procedures Integrated into
State and Federal Agencies for the Purpose of Political and Economic
Exploitation of Children and Families Through State and Federal Child
Protection, Mental Health, and Social Work Systems. (356 pages
summarizing more than ten years research on organized crime methods and
procedures in the child protection, mental health and social work
systems. File size: 3.6 MB.) at http://www.thesociologycenter.com/
EvidenceBooks/COMPENDIUM.pdf
3. ``Forgotten Children: A Special Report on the Texas Foster Care
System'' Texas Comptroller, April 2004 http://www.window.state.tx.us/
forgottenchildren/
4. ``UK firm tried HIV drug on [New York] orphans: GlaxoSmithKline
embroiled in scandal in which babies and children were allegedly used
as `laboratory animals.' '' Antony Barnett in New York, Sunday April 4,
2004, The Observer. http://www.guardian.co.uk/medicine/story/
0,11381,1185360,00.html
AN OBJECTIVE PROTOCOL FOR ANALYZING EVIDENCE IN CHILD ABUSE
ALLEGATION CASES HAS BEEN DEVELOPED BASED UPON DECLASSIFIED CENTRAL
INTELLIGENCE ANALYSIS METHODOLOGY. SEE MANUAL AT http://
thesociologycenter.com/HypothesesTestingManual/HypothTest
ManualFinal.pdf
ALSO: Two national organizations have been working to obtain
Congressional and State level hearings on fraud, corruption, and abuse
of power in the child protection, mental health, and social work
systems. Contact these organizations for information on their current
activities and reports:
Statement of Eric Roy Budwizer, Transitions Incorporated, Boca Raton,
Florida
Assistant Secretary for Children and Families Wade Horn
testified that there are Weaknesses in the current child
welfare financing structure, including complex and inflexible
requirements and lack of connection between money spent and
Quality of service provided.
Well I agree to that statement. I have been trying to start
a pilot model program to complement the services available to
emancipated foster youth. The statistics are staggering. This
population deserves the attention that other populations of our
society receive. It is now 2 years since I organized my public
non profit to provide services to the children that age out of
the foster care system, and I am still having difficulties
receiving funding. The following is a description of my
organization. I would appreciate any kind of assistance that
could be offered to me. Thank you all for your most generous
time, sincerely Eric Roy Budwizer.
Transitions Incorporated
Who we are:
Transitions is a nonprofit organization founded in 2002 to
complement the services available to youths who are making the
challenging transition from foster care to independent living.
Our Mission:
It is the mission of Transitions to enhance the long-term-
self-sufficiency among emancipated foster youth by providing
them with the skills, resources, and support to make a
successful transition to adulthood.
Our Services:
Transitions pursues its goals through various programs that
offer resources, skills training, and support.
Supportive Independent Living Program (SILP)
The objective of the SILP is to provide emancipated foster
youth with access to safe, stable, affordable housing, where
they have the opportunity to develop and use life skills to
achieve long-term-self-sufficiency with support.
Homelessness is the number one problem youths face after
discharge from foster care.\1\ To address this serious issue,
Transitions developed the Supportive Independent Living Program
(SILP). The SILP's participants are provided with the necessary
resources to help them become self-sufficient-adults living in
the community.
The goals of the SILP are accomplished by making available
to the participants a micro loan up to $1,500 dollars. This
loan is used for the first month's rent and security deposit on
an independent rental unit co-signed by Transitions. The
participants also receive a stipend of $200 dollars to get them
started with crucial living necessities such as a bed, bedding,
kitchen supplies, and bathroom items.
The participants of the SILP are also assisted with a
monthly rental subsidy. Here the goal of transitions is to give
the participants support in achieving long-term-housing-
solutions--not temporary housing. Having the participants pay
30% of their income towards their rent helps to achieve this
goal. Overtime, the portion paid by Transitions gradually
decreases, and the portion paid by the participants increase.
Once the subsidy has terminated, tenancy of the apartment
officially transfers over to the participants, and they may
remain living in the unit as they wish. Community integration
is achieved by having the rental units scattered throughout the
community. This ``scattered Site'' model is affective because
it integrates the participants into the community, provides an
opportunity to develop independent living skills, and removes
the stigma of foster care.
Transitions also provides the participants with an
opportunity to acquire various skills needed to live
successfully as an adult in the community. Transitions provides
the participants with a comprehensive curriculum that covers
such topics as personal money management, social skills,
personal health and hygiene issues, community resources
educational goals, and work related issues. This is achieved
through Transition's supportive services.
Transitions participants receive a comprehensive network of
supportive services to ensure their first experience in
independent living is successful. These services average five
to seven hours of individual services each week per
participant. Discussed at those meetings are steps that the
participants are taking to meet their individual goals in the
areas of employment, health, education, personal financial
management, and personal relationships. This part of the
structured services is geared towards the personalized
individual and then put into practice through group
interactions.
Transitions participants also attend a weekly peer meeting
facilitated by a Transitions Life Coach. The purpose of these
meetings is to help the participants utilize positive peer
support with the skills being acquired through the individual
support services. This weekly peer meeting also integrates
life-skills training to address the challenges they face in
independent living, educational, work, and personal/
interpersonal issues.
As a positive reinforcement, participants that attend the
weekly peer meeting and pay their rent on time will receive a
$50 dollar food stipend to help them out with their grocery
expenses.
Transitions participants also participate in a community-
building event. The participants do this each and every month
to ensure consistency. These events are selected and planned by
the participants, and helps the participants develop a
community of peers and other adults. This gives the
participants an opportunity to acquire and utilize leadership
and organizational skills. It also incorporates a sense of
community spirit and belonging. During the event, participants
are given an opportunity to interact with people who are in
similar circumstances and discuss the day-to-day challenges
they face.
The successful participant will be able to sustain self-
sufficiency within the community, thus enabling the individual
to live in and support the community and be a positive force in
the economic, spiritual, and civic pride of that community.
Transitions founder and CEO Eric Roy Budwizer is from
Natick Massachusetts. He now resides in Boca Raton Florida. He
attended college at Framingham State College and graduated with
a Bachelor of Arts Degree in Psychology in 1998. He then
continued his studies and earned his Master of Arts Degree in
Counseling Psychology in 2001. Eric Roy Budwizer has ten years
experience in the field of mental health services. His
expertise lies with working with youths in state foster care.
He is very dedicated and passionate about his endeavors in
providing assistance to this population.\1\
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\1\ Department of Health and Human Services, Statistics from the
U.S. and Florida, 1999.
Statement of Matthew E. Melmed, Zero to Three: National Center for
Infants, Toddlers, and Families
I am pleased to submit the following testimony on federal foster
care financing on behalf of ZERO TO THREE. My name is Matthew Melmed.
For the last 10 years I have been the Executive Director of ZERO TO
THREE. ZERO TO THREE is a national non-profit organization that has
worked to advance the healthy development of America's babies and
toddlers for over twenty-five years. Mr. Chairman, I would like to
start by thanking you for your ongoing commitment to strengthen our
nation's child welfare system. I commend you and the Subcommittee for
holding hearings to address the current structure and financing of the
foster care system.
The implications of spending time in foster care are particularly
important for very young children. We know from the science of early
childhood development that infancy and toddlerhood are times of intense
intellectual engagement.i A child's first years set the
stage for all that follows. During this time--a remarkable 36 months--
the brain undergoes its most dramatic development, and children acquire
the ability to think, speak, learn, and reason. In fact, by age three,
roughly 85 percent of the brain's core structure is
formed.ii Future development in key domains--social,
emotional, and cognitive--is based on the experiences and relationships
formed during these critical years.
---------------------------------------------------------------------------
\i\ Shonkoff, J., & Phillips, D. (Eds.). (2000). From neurons to
neighborhoods: The science of early childhood development. Washington,
DC: NationalAcademy Press.
\ii\ Bruner, C., Goldberg, J. and Kot, V. (1999). The ABC's of
early childhood: Trends, information and evidence for use in developing
an early childhood system of care and education. A joint publication of
Iowa Kids Count and the Iowa Forum for Children and Families.
---------------------------------------------------------------------------
Portrait of Very Young Children in Foster Care
Infants are the fastest growing category of children entering
foster care in the United States.iii They comprise the
largest cohort of young children in care--accounting for 1 in 5
admissions.iv Twenty-one percent of all children in foster
care were admitted prior to their first birthday and 45 percent of all
infant placements occurred within 30 days of the child's
birth.v
---------------------------------------------------------------------------
\iii\ Dicker, S., Gordon, E., Knitzer, J. (2001) Improving the
odds for the healthy development of young children in foster care. New
York: National Center for Children in Poverty.
\iv\ Ibid
\v\ Wulczyn, F., Hislop, K., & Harden, B (2002). The placement of
infants in foster care. Infant Mental Health Journal, 23(5), 454-475;
Oser, C. & Cohen, J. (2002). America's babies: The ZERO TO THREE
PolicyCenter data book. Washington, DC: ZERO TO THREE Press.
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Once they have been removed from their homes and placed in foster
care, infants and toddlers are more likely than older children to be
abused and neglected and to stay in foster care longer.vi
Half of all babies who enter foster care before they are three months
old spend 31 months or longer in placementvii and they are
less likely to be reunified with their parents. Thirty-six percent of
infants who enter care between birth and three months of age are
reunified with their parents compared to 56 percent of infants who
enter care at 10-12 months of age.viii
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\vi\ Wulczyn, F. & Hislop, K. (2002). Babies in foster care: The
numbers call for attention. ZERO TO THREE Journal, (22) 4, 14-15.
\viii\ Ibid
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Developmental Impact of Child Abuse and Neglect on Very Young Children
The developmental impact of child abuse and neglect is greatest
among the very young. Infants and toddlers are extremely vulnerable to
the effects of maltreatment. Its impact on their emotional,
developmental and physical health can have life-long implications if
not properly addressed. Research shows that young children who have
experienced physical abuse have lower social competence, show less
empathy, have difficulty recognizing others' emotions, are more likely
to be insecurely attached to their parents, and have deficits in IQ
scores, language ability, and school performance.ix Without
intervention, by the time these children reach school age, they will
also likely be at risk for social problems and learning deficits.
Compounding the problem, one third of the individuals who were abused
and neglected as children can be expected to abuse their own
children.x
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\ix\ Shonkoff, J., & Phillips, D. (Eds.). (2000). From neurons to
neighborhoods: The science of early childhood development. Washington,
DC: NationalAcademy Press.
\x\ National Research Council. (1993). Understanding child abuse
and neglect. p. 223.
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According to one longitudinal study, being abused or neglected as a
child increased the likelihood of arrest as a juvenile by 59 percent,
as an adult by 28 percent, and for a violent crime by 30
percent.xi Abused and neglected children are also more
likely to have mental health concerns (suicide attempts and
posttraumatic stress disorder); educational problems (extremely low IQ
scores and reading ability); occupational difficulties (high rates of
unemployment and employment in low-level service jobs); and public
health and safety issues (prostitution in males and females and alcohol
problems in females).xii However, research confirms that the
early years present an unparalleled window of opportunity to
effectively intervene with at-risk children. And intervening in the
early years can lead to significant cost savings over time through
reductions in child abuse and neglect, criminal behavior, welfare
dependence, and substance abuse. It is critical that child well-being
be the first priority in all child welfare cases.
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\xi\ Widom, C., & Maxfield, M. (2001). An update on the ``Cycle of
Violence'', Research in Brief, Washington, DC: U.S. Department of
Justice, Office of Justice Programs, National Institute of Justice.
\xii\ Ibid
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ZERO TO THREE Recommendations
We at ZERO TO THREE are very concerned about the financing of the
federal foster care system. Any changes made to strengthen the system
must not include a reduction in the federal fiscal resources that are
currently available. It is critical that we preserve Title IV-E as an
open-ended entitlement and ensure that any flexibility provided to
states enables them to invest in the full continuum of services--from
preventive services to post permanency services. If states do not have
the assurance of the open-ended entitlement, they will not have the
option to turn their attention and resources to preventive services.
Instead, they may be forced to choose between providing foster care
maintenance payments and providing prevention and post permanency
services that are key if we hope to reduce the number of children going
into foster care. Our recommendations on financing include the
following:
Maintaining Title IV-E Foster Care Maintenance Payments
and Adoption Assistance as open-ended entitlements. An open-ended
entitlement program, Title IV-E is the largest source of federal
funding for child welfare, providing 48 percent of all federal funding
for child welfare in 2000.xiii Other programs that support
child welfare services for the most part are not entitlements and in
recent years, funding for these programs has been reduced or held
constant. Title IV-E has increased each year because of the growing
number of children in need. Title IV-E's open-ended funding ensures
that caseworkers always have the option of removing eligible children
from dangerous situations in their homes when other approaches have not
worked. This open-ended entitlement is also an assurance for states and
allows them to turn their attention and resources to preventive
services. Without the assurance of federal funds for foster care
maintenance payments, states will not be able to invest in front-end
services which enable them to reduce the number of children going into
foster care. It is critical that Congress maintain Title IV-E Foster
Care Maintenance payments and Adoption Assistance as open-ended
entitlements to ensure an ongoing and stable federal commitment to
supporting the needs of abused and neglected infants and toddlers.
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\xiii\ Child Welfare League of America. 2004 Children's Legislative
Agenda. Financing Child Welfare Services. Retrieved November 28, 2004
from www.cwla.org/advocacy/2004legagenda01.htm
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Allowing states to reinvest federal dollars that would
have been expended on foster care to prevention and training efforts if
states safely reduce the use of foster care maintenance. Under current
law, when states reduce their foster care expenditures, they lose the
federal share of savings associated with the reduction. However,
keeping a child out of foster care can involve significant investments
for states in early intervention, treatment, and support once a child
leaves foster care. States should be allowed to reinvest the federal
dollars that would have been expended on foster care to prevention and
training efforts if states are able to safely reduce the use of foster
care maintenance payments. The additional funds would provide an added
incentive to states to move away from relying on foster care by
allowing them to transfer the federal savings into a broad range of
prevention and training efforts to further reduce the need for foster
care.xiv States should then be required to match the federal
dollars that they transfer to prevention and training efforts.
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\xiv\ The Pew Commission on Children in Foster Care, Fostering the
Future: Safety, Permanence and Well-Being for Children in Foster Care,
2004.
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Expanding and designating substantial funding to build
early, preventive services and post permanency services to preserve and
support families. The structure of child welfare funding must ensure a
continuum of services, beginning with those that can help prevent abuse
and neglect and keep families together. Currently such ``front-end''
services must compete for funding with more crisis-oriented services.
Services to preserve and support families are particularly important
for families with infants and toddlers who may need extra support in
parenting. We know that 40 percent of young children in foster care
were born prematurely or with low birthweight, suggesting challenging
behaviors for which parents may lack the skills to cope. Reunification
or adoption may bring additional challenges for parents. We know that
foster children who have returned home to their biological families or
have been adopted often exhibit difficult behaviors as well as
emotional issues and medical conditions that may impact their
development--often due to a history of maltreatment and extended stays
in foster care. While the Promoting Safe and Stable Families Program
currently requires states to spend ``significant portions'' of funds
for Family Preservation and Family Support programs, this vague
standard and the level of funding for the program do not meet the need
for supporting families. Greater investment and more direction to
states are needed to create a system that begins with preventive and
supportive services. Such services may include home visiting services
and family support services for families struggling with substance
abuse and maternal/paternal depression while the child is in out-of-
home care and once the child returns home.
Concerns Beyond Financing
Our concerns about the foster care system extend far beyond how the
system is financed. Congress must also focus its attention on the
social, emotional and cognitive needs of infants and toddlers in foster
care and those who are at-risk of entering care. We must ensure that
there is greater awareness among federal and state policymakers,
judges, social workers, and parents of the unique needs of very young
children in the system and assure that babies and toddlers in out-of-
home care have access to the services they need to support their
healthy development. Our recommendations include:
Require the Department of Health and Human Services to Promote Greater
Awareness of the Unique Needs of Infants and Toddlers and
Improve Their Care While in the Child Welfare System:
Provide guidelines for states for the care of infants and
toddlers in the child welfare system in the Child and Family Service
Reviews (CFSRs) including:
Visitation standards and developmentally appropriate
visitation practices for infants and toddlers in out-of-home care. One
of the major challenges faced by young children in foster care is
maintaining attachment relationships with their parents. Current
visitation practices usually consist of brief encounters that occur
anywhere from once a month to once or twice a week. For very young
children, infrequent visits are not enough to establish and maintain a
healthy parent-child relationship. Infants and toddlers build strong
attachments to their biological parents through frequent and extended
contact. One month in the life of a baby is an eternity. Parental
visitation can and should be looked at strategically. Visits can play
an important role in concurrent planning and can be used to assess the
parent-child relationship and how the family is progressing. The
frequency and success of visits between children and parents can
provide a caseworker with evidence for either movement to an
alternative plan for the child (i.e. adoption or guardianship) or
movement for early reunification. Visits should occur frequently, in a
safe setting that is comfortable for both parent and child, and should
last long enough for a positive relationship to develop and strengthen.
Guidelines should be developed for states on visitation standards and
developmentally appropriate visitation practices for infants and
toddlers in out of home care. In addition, supports for visitation--
training for child welfare workers and foster parents--should be
developed since the challenges of seeing and losing a parent during a
visit can be so painful for all involved.
Minimizing multiple placements while in out-of-home
care. In the first year of life, babies need to have the opportunity to
develop a close, trusting relationship or attachment with one special
person. The ability to attach to a significant caretaker is one of the
most important emotional milestones a baby needs to achieve in order to
become a child who is trusting, confident, and able to regulate his or
her own stress and distress. For babies in foster care, forming this
secure attachment is difficult. Multiple foster care placements present
a host of traumas for very young children. When a baby faces a change
in placement, fragile new relationships with foster parents are severed
reinforcing feelings of abandonment and distrust. Babies grieve when
their relationships are disrupted and this sadness adversely effects
their development. All placement decisions should focus on promoting
security and continuity for infants and toddlers in out-of-home care.
Guidelines should be developed for states on how to minimize multiple
placements for infants and toddlers in out of home care. For example, a
state may decide to develop specialized foster care homes for infants
who come into the child welfare system or decide to develop a system
for tracking the number of moves an infant makes while in foster care.
When a change in placement is necessary, child welfare workers and
foster parents should receive training and information on how to handle
transitions with infants and toddlers.
Provide incentives and adequate funding for states to:
Promote timely permanent placements for infants and
toddlers in foster care by creating a new permanence incentive that
includes reunification with the child's biological family, adoption or
guardianship. States should be provided with a Permanence Incentive to
promote timely permanent placements for infants and toddlers in foster
care. As previously discussed, when a baby faces a change in placement,
fragile new relationships with foster parents are severed reinforcing
feelings of abandonment and distrust. Creating a Permanence Incentive
would help to ensure babies are placed in a stable foster care
arrangement and moved to a permanent placement as quickly as possible
whether that move is through reunification with the biological family,
adoption or guardianship. Post permanency services should also be made
available for families to facilitate the child's successful transition
back home.
Provide training for child welfare workers and staff of
related agencies who work with infants in foster care around the unique
needs of infants and toddlers. There is a wealth of scientific
knowledge available about very early child development which can be
used to make informed decisions about babies in the child welfare
system. However, child welfare workers are overburdened and do not have
the time or means to seek the training that would provide them with
this scientific knowledge base. Congress should provide grants to
states to enable them to develop and provide training for child welfare
workers and other staff who work with infants in foster care around the
unique needs of infants and toddlers. Staff of related agencies who
work with infants in foster care may include mental health specialists,
child care providers, Early Head Start teachers and early intervention
specialists. Funds are needed not only to support the development of
the training but also to provide reprieve for the caseworkers and other
agency staff so they can have time off for ongoing training.
Improve the courts' ability to address the needs of
infants and toddlers through training for juvenile and family court
judges and cross-systems approaches to building community capacity to
address these cases. Juvenile and Family Court Judges are uniquely
positioned to improve the well-being of infants and toddlers in the
child welfare system and to ensure that they are receiving the
resources and supports they need to address their special needs. In
fact, judges have an opportunity, perhaps the last one for these most
vulnerable infants and toddlers, to focus on healing in the process of
adjudicating the case.xv A groundbreaking effort has been
developed in the Miami-Dade Juvenile Court to address the well-being of
infants, toddlers and their families. Three years of data in the Miami-
Dade Juvenile Court show substantial gains in improving parental
sensitivity, child and parent interaction, and behavioral and emotional
parental and child responsiveness. Congress should provide incentives
and adequate funding for states to improve the courts' ability to
address the needs of infants and toddlers through training for Juvenile
and Family Court Judges and cross-system approaches to building
community capacity to address these cases.
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\xv\ Lederman, C., Osofsky, J., & Katz, L. (2001). When the bough
breaks the cradle will fall: Promoting the health and well being of
infants and toddlers in juvenile court. Juvenile and Family Court
Journal, (52)4, 33-37.
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Implement the CAPTA and new IDEA mandate requiring states
to develop provisions and procedures for referral of a child under Age
3 involved in a substantiated case of child abuse and neglect to Part C
of IDEA. As states work to implement the CAPTA and IDEA mandate, they
face new challenges in trying to ensure that the Part C system is able
to respond to these new referrals. Impacts will vary substantially from
state to state because of significant differences among states' Part C
systems. In some states, very large increases in workload for providers
of Part C evaluation, assessment and intervention services are likely
as a result of this legislation. In all states, a need to enhance the
capacity of the Part C system to respond to social-emotional and
behavioral problems (early childhood mental health) is likely. And in
most or all states, the cost of responding to this federal mandate will
be a problem, given very tight state budgets, unless the Federal
Government significantly increases funding for Part C. Congress should
provide incentives and adequate funding for states to implement the
CAPTA and IDEA mandate.
Increase access to early intervention screening and Part
C services for infants and toddlers in foster care. Because of the
rapid rate of development in the first three years, developmental
screening in early childhood needs to be repeated on a regular basis
with infants and toddlers in the child welfare system. These babies
have ongoing risk factors that predispose them to developmental delays.
We know that different domains of development have key milestones
emerging at different times in early childhood. For example, a six-
month-old may receive age appropriate scores in motor and speech-
language development; however, when that child is 18-months-old and the
demands of communication are more sophisticated, that six-month-old may
now be a toddler with a significant language delay. And this delay may
not be picked up without guidance to foster parents and child welfare
workers on the need for early intervention. Congress should provide
incentives and adequate funding for states to increase access to early
intervention screening and Part C services for infants and toddlers in
foster care. They should receive developmental evaluations every 6
months before one year of age and then annually until 3 years of age.
Increase access to preventive and treatment services for
families in the child welfare system for whom substance abuse is an
issue. Millions of children and families are impacted by the growing
epidemic of substance abuse. In fact, an estimated 11 percent of all
children live in families where one or more parents abuse alcohol or
other drugs.xvi This issue is even more pressing for
families in the child welfare system--up to 80 percent of children in
the child welfare system are affected by substance
abuse.xvii Families need access to a community-based,
coordinated system of comprehensive family drug and alcohol treatment.
Congress should increase access to prevention and treatment services
for families in the child welfare system for whom substance abuse is an
issue. Prevention and treatment services should include: prevention and
early intervention services for parents at-risk of substance abuse; a
range of comprehensive treatment options including home-based,
outpatient, and family-oriented residential treatment options;
aftercare support for families in recovery; and preventive and early
intervention services for children that address their mental,
emotional, and developmental needs.
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\xvi\ Child Welfare League of America. 2004 Children's Legislative
Agenda. Substance Abuse, Families and Recovery. Retrieved December 14,
2004 from www.cwla.org/advocacy/2004legagenda14.htm
\xvii\ Child Welfare League of America. 2004 Children's Legislative
Agenda. Substance Abuse, Families and Recovery. Retrieved December 14,
2004 from www.cwla.org/advocacy/2004legagenda14.htm
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Require state child welfare agencies to:
Include in their state plans a description of their
approach to addressing the specific needs of infants and toddlers
including the items addressed by the department of Health and Human
Services Guidelines Regarding Care of Infants and Toddlers in the Child
Welfare System. Infants and toddlers in foster care have needs that are
very different than older children. They also move through the child
welfare system in ways that are very different than older children--
they stay in care longer, they are less likely to be reunified with
their parents and they are more likely to be abused and neglected while
in foster care. State Child Welfare Agencies should address the unique
needs of infants and toddlers in their state plans, with a detailed
description of their approach to dealing with issues for babies in
foster care such as reducing multiple foster care placements, assuring
regular visitation with biological parents, assuring that all infants
and toddlers have access to early childhood and family mental health
services, addressing the effects of trauma and separation on infants
and toddlers, and promoting interventions that can help foster their
healthy development across all domains.
Establish cross-system commissions on young children in
foster care to ensure that they receive comprehensive, developmentally
appropriate health care, mental health assessment and access to mental
health services, and access to quality early care and learning
experiences.
Children in foster care often have needs that extend beyond the
scope of the child welfare agency and receive services from a variety
of other agencies such as mental health agencies, health agencies, and
early learning programs. If these various agencies that provide
services and supports to at-risk children and their families were in
close contact, we would be better able to ensure that the children's
physical, social, emotional and cognitive needs were met. Congress
should require that states establish multi-disciplinary commissions on
young children in foster care to ensure that they receive
comprehensive, developmentally appropriate health care, mental health
assessment and access to mental health services, and access to quality
early care and learning experiences. These commissions should also
provide interdisciplinary cross-system training for case workers, home
visitors, foster parents, advocates, child care providers, and early
intervention specialists and others who work with children in the child
welfare system so that all public programs available for babies,
toddlers and their caregivers (i.e. WIC, Early Head Start, Child Care,
TANF, Medicaid, Part C, home visitors, Title V Maternal and Child
Health, and State Children's Health Insurance) can come together to
support early development.
Conclusion
We must ensure that babies and toddlers in the child welfare system
are healthy and safe. During the first years of life, children rapidly
develop foundational capabilities--cognitive, social, and emotional--on
which subsequent development builds. The amazing growth that takes
place in the first three years of life creates vulnerability and
promise for all children. These years are even more important for
maltreated infants and toddlers. We know from the science of early
childhood development what infants and toddlers need for healthy
social, emotional, and cognitive development. We also know that infants
and toddlers in the child welfare system are at great risk for poor
outcomes. We must continue to seek support for services and programs
that ensure that our nation's youngest and most vulnerable children are
healthy and safe.
An effective child welfare financing approach must ensure that
states can focus on what is best for individual children rather than
pushing them toward one option or another. It is simply unacceptable to
wait until the safety of very young children is put at-risk before
proper investments are made to address their needs. However, it is
unrealistic to think that placement in out of home care will not be the
proper course of action for some children. We must therefore provide
states with adequate funds to both ensure the safety, permanence and
well-being of children in foster care and provide preventive services
for those at risk of needing care.
I urge the Subcommittee to at a minimum, maintain the federal
fiscal resources that are currently available for children in foster
care. We must preserve Title IV-E as an open-ended entitlement and
ensure that any flexibility provided to states enables them to invest
in the full continuum of services--from preventive services to post
permanency services. I also urge the Subcommittee to acknowledge and
address the unique needs of our youngest citizens who are in out-of-
home care and ensure that they have access to the services and supports
they need for healthy social, emotional, and cognitive development.
Thank you for your time and for your commitment to our nation's at-
risk infants and toddlers.