    [House Hearing, 112 Congress]
    [From the U.S. Government Publishing Office]

                          IMPROVING PROGRAMS DESIGNED
                            TO PROTECT AT-RISK YOUTH

    =======================================================================

                                    HEARING

                                   before the

                        SUBCOMMITTEE ON HUMAN RESOURCES

                                     of the

                          COMMITTEE ON WAYS AND MEANS
                         U.S. HOUSE OF REPRESENTATIVES

                          ONE HUNDRED TWELFTH CONGRESS

                                 FIRST SESSION

                                   __________

                                 JUNE 16, 2011

                                   __________

                               Serial No. 112-HR4

                                   __________

             Printed for the use of the Committee on Ways and Means

                                    _____

                      U.S. GOVERNMENT PRINTING OFFICE
    70-886                    WASHINGTON : 2011
    -----------------------------------------------------------------------
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    20402-0001

                          COMMITTEE ON WAYS AND MEANS

                        SUBCOMMITTEE ON HUMAN RESOURCES

                             GEOFF DAVIS, Kentucky

    ADRIAN SMITH, Nebraska               LLOYD DOGGETT, Texas
    ERIK PAULSEN, Minnesota              JIM MCDERMOTT, Washington
    RICK BERG, North Dakota              JOHN LEWIS, Georgia
    TOM PRICE, Georgia                   JOSEPH CROWLEY, New York
    DIANE BLACK, Tennessee
    CHARLES W. BOUSTANY, JR., Louisiana

                           Jon Traub, Staff Director

                      Janice Mays, Minority Staff Director

                                C O N T E N T S

                                   __________
                                                                       Page

    Advisory of June 16, 2011, announcing the hearing................     2

                                   WITNESSES

    PANEL 1:

      The Honorable Dennis R. ``Denny'' Rehberg, a Representative
        from the State of Montana....................................     6
      The Honorable Karen R. Bass, a Representative from the State of
        California...................................................     8

                                     ______

    PANEL 2:

      The Honorable Bryan Samuels, Commissioner, Administration on
        Children, Youth and Families, Administration for Children and
        Families, U.S. Department of Health and Human Services.......    18

    PANEL 3:

      Patricia R. Wilson, Commissioner, Department for Community
        Based Services, Kentucky Cabinet for Health and Family
        Services.....................................................    61
      Lelia Baum Hopper, Director, Court Improvement Program, Supreme
        Court of Virginia............................................    69
      Tracy Wareing, Executive Director, American Public Human
        Services Association.........................................    79
      John Sciamanna, Director, Policy and Government Affairs, Child
        Welfare, American Humane Society.............................    88
      Steve Yager, Deputy Director, Children's Services
        Administration, Michigan Department of Human Services........   101

                           SUBMISSIONS FOR THE RECORD

    Adoptions Together...............................................   124
    Child Welfare League of America..................................   131
    Conference of Chief Justices, Conferences of State Court
      Administrators.................................................   140
    Cook Inlet Tribal Council........................................   148
    Dave Thomas Foundation for Adoption..............................   151
    Embrace Waiting Children, Inc....................................   157
    Evan B. Donaldson Adoption Institute.............................   158
    Family Design Resource, Inc......................................   163
    Zero to Three, National Center for Infants, Toddlers, and
      Families.......................................................   166
    Generations United...............................................   175
    National Association of Social Workers...........................   179
    National Committee of Grandparents for Children's Rights.........   184
    National Family Preservation Network.............................   194
    North American Council on Adoptable Children.....................   197
    Northwest Adoption Exchange and Oregon Post Adoption Resources
      Center.........................................................   201
    NYS Citizens' Coalition for Children.............................   205
    Research on Vulnerable Families..................................   207
    Sacred Authority.................................................   210
    Stephanie Trevitz................................................   212
    The Adoption Exchange............................................   216
    The National Mentoring Partnership...............................   220
    Voice for Adoption...............................................   223

                         IMPROVING PROGRAMS DESIGNED TO
                             PROTECT AT-RISK YOUTH

                                  ----------

                            THURSDAY, JUNE 16, 2011

                 U.S. House of Representatives,
                           Committee on Ways and Means,
                               Subcommittee on Human Resources,
                                                        Washington, DC.

        The subcommittee met, pursuant to notice, at 9:02 a.m. in
    Room B-318, Rayburn House Office Building, the Honorable Geoff
    Davis [Chairman of the Subcommittee] presiding.
        [The advisory of the hearing follows:]

    HEARING ADVISORY

    FROM THE
    COMMITTEE
     ON WAYS
    AND
    MEANS

      Chairman Davis Announces Hearing on Improving Programs Designed to
                             Protect At-Risk Youth

    Thursday, June 16, 2011

        Congressman Geoff Davis (R-KY), Chairman of the Subcommittee on
    Human Resources, Committee on Ways and Means, today announced that the
    Subcommittee will hold a hearing on improving programs designed to
    protect youth at risk of abuse and neglect. The hearing will take place
    on Thursday, June 16, 2011, in Room B-318 of the Rayburn House Office
    Building, beginning at 9:00 A.M.

        In view of the limited time available to hear from witnesses, oral
    testimony at this hearing will be from invited witnesses only.
    Witnesses will include a representative from the Administration for
    Children and Families, the Federal agency with oversight over child
    welfare services programs, along with other experts on these issues.
    However, any individual or organization not scheduled for an oral
    appearance may submit a written statement for consideration by the
    Committee and for inclusion in the printed record of the hearing.

    BACKGROUND:

        The authorizations for two of the child welfare programs under the
    Subcommittee's jurisdiction (the Stephanie Tubbs Jones Child Welfare
    Services program and the Promoting Safe and Stable Families program)
    expire at the end of fiscal year 2011. The last reauthorization of
    these programs, the Child and Family Services Improvement Act of 2006
    (P.L. 109-288), made significant changes such as requiring that foster
    children be visited at least once per month, ensuring that states
    consult with medical providers in assessing the health and wellbeing of
    children in care, and helping States better address caretaker substance
    abuse issues. This law also extended the authorization of the Mentoring
    Children of Prisoners program as well as the Court Improvement Program.
        The 2006 legislation also provided funds to support monthly
    caseworker visits and to improve outcomes for children affected by a
    parent's or caretaker's substance abuse. In addition to these changes,
    the law also increased accountability by requiring States to report
    expenditure data for the first time and by limiting the amount of child
    welfare services program funds States could spend on administration.
        In announcing the hearing, Chairman Davis stated, ``This hearing
    provides an important opportunity to review how key aspects of our
    nation's child welfare system are working. These two programs are
    designed to play a significant role in protecting children from abuse
    and neglect. We need to review recent changes to see if they are
    working to improve the lives of kids in foster care and those at risk
    of entering care. We also need to evaluate these programs to determine
    whether other changes are needed to ensure children are protected from
    abuse and neglect.''

    FOCUS OF THE HEARING:

        The purpose of this hearing is to review recent changes to the
    Stephanie Tubbs Jones Child Welfare Services program and the Promoting
    Safe and Stable Families program, as well as consider whether
    additional changes should be made in legislation to reauthorize these
    programs.

    DETAILS FOR SUBMISSION OF WRITTEN COMMENTS:

        Please Note: Any person(s) and/or organization(s) wishing to submit
    for the hearing record must follow the appropriate link on the hearing
    page of the Committee website and complete the informational forms.
    From the Committee homepage, http://waysandmeans.house.gov, select
    ``Hearings.'' Select the hearing for which you would like to submit,
    and click on the link entitled, ``Click here to provide a submission
    for the record.'' Once you have followed the online instructions,
    submit all requested information. Attach your submission as a Word
    document, in compliance with the formatting requirements listed below,
    by the close of business on Thursday, June 30, 2011. Finally, please
    note that due to the change in House mail policy, the U.S. Capitol
    Police will refuse sealed-package deliveries to all House Office
    Buildings. For questions, or if you encounter technical problems,
    please call (202) 225-1721 or (202) 225-3625.

    FORMATTING REQUIREMENTS:

        The Committee relies on electronic submissions for printing the
    official hearing record. As always, submissions will be included in the
    record according to the discretion of the Committee. The Committee will
    not alter the content of your submission, but we reserve the right to
    format it according to our guidelines. Any submission provided to the
    Committee by a witness, any supplementary materials submitted for the
    printed record, and any written comments in response to a request for
    written comments must conform to the guidelines listed below. Any
    submission or supplementary item not in compliance with these
    guidelines will not be printed, but will be maintained in the Committee
    files for review and use by the Committee.

        1. All submissions and supplementary materials must be provided in
    Word format and MUST NOT exceed a total of 10 pages, including
    attachments. Witnesses and submitters are advised that the Committee
    relies on electronic submissions for printing the official hearing
    record.

        2. Copies of whole documents submitted as exhibit material will not
    be accepted for printing. Instead, exhibit material should be
    referenced and quoted or paraphrased. All exhibit material not meeting
    these specifications will be maintained in the Committee files for
    review and use by the Committee.

        3. All submissions must include a list of all clients, persons and/
    or organizations on whose behalf the witness appears. A supplemental
    sheet must accompany each submission listing the name, company,
    address, telephone, and fax numbers of each witness.

        The Committee seeks to make its facilities accessible to persons
    with disabilities. If you are in need of special accommodations, please
    call 202-225-1721 or 202-226-3411 TTD/TTY in advance of the event (four
    business days notice is requested). Questions with regard to special
    accommodation needs in general (including availability of Committee
    materials in alternative formats) may be directed to the Committee as
    noted above.

        Note: All Committee advisories and news releases are available on
    the World Wide Web at http://waysandmeans.house.gov/.

        Chairman DAVIS. Good morning. Before we begin the opening
    statement, I would like to note that our line-up on the
    Republican side has changed a bit, due to Mr. Heller's move
    over to the United States Senate, and his departure from the
    People's House. Today I would like to welcome Tom Reed from New
    York, both to the subcommittee and to the committee, for his
    first hearing. Thanks for joining us; we look forward to your
    perspective. He replaces Mr. Smith of Nebraska, who now becomes
    a distinguished alumnus of our subcommittee.
        In today's hearing we are going to review several programs
    under our jurisdiction that are designed to help ensure the
    safety and well-being of children at risk of abuse and neglect.
    The majority of Federal child welfare spending is used to
    reimburse states for supporting and overseeing children while
    they are in foster care.
        However, the two programs we will focus on today, the Child
    Welfare Services program and the Promoting Safe and Stable
    Families program, are designed to prevent the need for foster
    care in the first place, as well as to help foster children
    return home safely or be placed with adoptive parents as soon
    as possible.
        These two programs were last authorized in 2006, and both
    expire at the end of the fiscal year. The 2006 reauthorization
    made significant changes, such as requiring that foster
    children be visited at least once per month, ensuring that
    states consult with medical providers in assessing the health
    of foster youth, and helping states better address caretaker
    substance abuse issues.
        The purpose of our hearing today is to review the effects
    of those changes, and to consider other changes that may be
    needed to promote the well-being of children at risk of abuse
    and neglect. While we will primarily focus on these two
    programs, we should also draw attention to the patchwork way in
    which child welfare programs currently operate.
        In our prior hearing on the program duplication, I noted
    that this subcommittee has jurisdiction over nine different
    child welfare programs, each with different purposes, spending
    requirements, and funding mechanisms. We need to ensure that
    these programs help and do not hinder states' efforts to serve
    families in need. We also must make sure we understand how this
    taxpayer money is used, and whether it is achieving its
    intended purpose.
        Amazingly, until 2006, there was no requirement that states
    report how they actually spend child welfare service program
    funds. In other words, for that program's first 70 years, the
    public had no way of knowing how this money was spent, and this
    is not a way to run a government.
        I look forward to hearing from our witnesses this morning
    on what we have learned from the recent changes to these
    programs, as well as what we can do to ensure more children
    remain safely in their own homes. Joining us today will be a
    mix of experts from Congress, the Administration, states, and
    outside groups. We look forward to all of their testimony.
        And I particularly want to single out one group that is not
    represented here today, possibly in the room, but one that my
    wife and I have long affiliation with, and that is CASA. I have
    done a lot of work through the years--really, over the last 25
    years--with families on the edge, and particularly our years of
    affiliation with CASA have been a great blessing. And I
    appreciate not only CASA's contribution, but all of the
    advocates, and especially the front-line volunteers and folks
    that are working directly with children, with the families,
    trying to bring stability and order.
        Without objection, each Member will have the opportunity to
    submit a written statement and have it included in the record
    at this point. And now I would like to recognize our
    distinguished Ranking Member from Texas, my friend, Mr.
    Doggett.
        Mr. DOGGETT. Well, thank you, Mr. Chairman. We share a
    similar interest in CASA. I have worked with several of the
    groups in the central Texas area, and they do outstanding work
    with able volunteers, as well as some of the other groups that
    are represented here this morning. And I am hopeful that we
    share not only that interest, but an interest in seeing that we
    put every taxpayer dollar to the most effective and efficient
    use possible to provide some of our most vulnerable children
    the services that they need.
        As you have noted, the funding for the Child Welfare
    Services program and the Promoting Safe and Stable Families
    program will expire--the authorization for it--at the end of
    September, unless we take action to renew them. These programs
    have been renewed, and have enjoyed bipartisan support in the
    past. And I hope that we can work together to extend and
    improve these services.
        The Child Welfare Services and the Promoting Safe and
    Stable Families initiatives provide about $700 million to the
    states this year for early intervention and family services
    designed to help our most at-risk families. These funds are a
    critical part of the efforts to ensure that children are raised
    safely in their homes. And when that is not possible, to find a
    permanent home with a relative or an adoptive family.
        In my home state of Texas, the Promoting Safe and Stable
    Families program has provided funds to help children in my home
    town in Travis County that are affected by substance abuse in
    the home. This program has enabled our county to develop a
    flexible, comprehensive continuum of services that is aimed at
    promoting recovery, and ensuring that children have a safe home
    free of drug addiction and abuse.
        We know that an investment in front-end services not only
    saves lives, but also can reduce the long-term cost of removing
    a child from a family home and placing them in foster care. We
    have seen in Texas how mindless budget cutting can hurt these
    same children. In Texas there was a proposal in the State
    Legislature that would have the effect of cutting services to
    prevent child abuse and neglect by almost half in the current
    legislature. And legislatures across the country, whether
    through the pressures of budgets or indifference, are faced
    with similar kind of cuts. That is why what we do here is
    especially important this year.
        I am troubled that the original Republican budget
    resolution considered earlier this year in the House would have
    cut the Social Services Block Grant program by $1.7 billion to
    the states, eliminating grants that would jeopardize protective
    services for almost 2 million at-risk children.
        Mr. Chairman, our committee does have a history of working
    together on these issues, and I look forward to cooperating and
    working with you and other Members of the Committee. I am
    pleased we have a couple of colleagues here to offer us
    insight, along with the experts from the field on this today.
    And I am sure it will be a productive hearing. Thank you.
        Chairman DAVIS. Thank you very much, Mr. Doggett. Before we
    move on to our testimony, I would like to remind our witnesses
    on both panels that oral statements are going to be limited to
    five minutes. However, without objection, all of the written
    testimony will be made part of the permanent record.
        On our first panel we will be hearing from two of our
    distinguished colleagues. First, the Honorable Denny Rehberg,
    my friend from Montana since I have been in the Congress, and
    the Honorable Karen Bass, who is joining us from California, a
    long-time advocate on these issues.
        Mr. Rehberg, please proceed with your testimony.

       STATEMENT OF THE HONORABLE DENNIS R. ``DENNY'' REHBERG, A
          REPRESENTATIVE IN CONGRESS FROM THE STATE OF MONTANA

        Mr. REHBERG. Thank you, Mr. Chairman. And I appear today
    not only on my own behalf, and as the representative of the
    State of Montana, as the chairman of the appropriations
    subcommittee, called labor, health and human services, and
    education.
        I have got a long history of interest in these issues, and
    have been in many of your states, both as a Shriner and as a
    national vice president of the Montana and national Muscular
    Dystrophy Association, as well as having co-founded and co-
    chaired the Baby Caucus with Rosa DeLauro, for the specific
    purposes of looking for areas of interest to keep families
    together, and the struggles that are placed in their way for
    doing that.
        I also want to thank you for the opportunity to talk about
    an issue that is of great importance to me in my home state of
    Montana, that of addressing the methamphetamine crisis, and the
    importance of family-based drug prevention treatment.
        Much of my activity in Montana meth is as a result of an
    individual by the name of Tom Sibel. He had owned Sibel
    Systems, eventually sold to Oracle, and he personally has put,
    at the last count that I was aware of, in the public-private
    partnership $60 million of his own money to create meth
    projects in states like Arizona, Colorado, Georgia, Hawaii,
    Idaho, Illinois, Montana, and Wyoming. And those of you who
    represent those states would recognize the Georgia meth,
    Montana meth, Arizona meth project.
        All rural areas of our nation have struggled with the
    devastation caused by rampant meth use, and Montana has been no
    exception. I have long supported the efforts of organizations
    that are in the forefront of drug prevention and treatment
    efforts in our states. In Montana, we do have the Montana meth
    project, an organization that does outstanding work conducting
    research and running statewide multi-media public awareness
    campaigns aimed at significantly reducing first-time meth use.
        The meth project's campaign of preventing kids from using
    meth, not even once, has led to a dramatic shift in the
    perception of meth use, and led to a 33 percent decrease in
    teen use of meth between 2007 and 2009. The meth project's
    campaigns have also led to more frequent parent-child
    communications about the dangers of meth, an important
    component of educating kids on the dangers of this addictive
    drug from a young age.
        While I think we have come a long way in improving efforts
    to combat drug use in the first place, I think we can still
    improve in the way we provide treatment for those who are
    struggling with substance abuse issues. I strongly advocated
    for family-based meth treatment, an approach which dramatically
    increases the effectiveness of long-term recovery, employment,
    and educational enrollment. This kind of treatment yields
    consistently positive outcomes in child well-being, family
    stability, and lower recidivism rates. Family-based treatment
    centers provide essential needs for the entire family,
    including children, rather than just the parent.
        I appreciate the fact that 2006 reauthorization of the
    child welfare programs under this committee's jurisdiction
    provided dedicated funds for states to work with parents and
    caregivers with meth and other substance abuse issues. And I am
    especially thankful that two of those grants went to Montana
    organizations.
        The bottom line? Families provide the best support systems,
    so making family the center of addiction treatment whenever
    possible just makes common sense.
        The purpose of today's hearing is to evaluate how key
    pieces of our nation's child welfare system are working. I hope
    that, as you develop and delve into the specific programs under
    your jurisdiction, like the Promoting Safe and Stable Families
    program, that are designed to address child safety and
    stability of families face substance abuse uses, you will focus
    on opportunities for family-based prevention and treatment
    whenever possible. My hope is that one day I will be able to
    report that meth addiction is no longer an issue in rural
    America.
        Until then, I thank the committee for the opportunity to
    share my perspective, and for--and its time on this incredibly
    important issue for families and communities elsewhere. Thank
    you, Mr. Chairman.
        Chairman DAVIS. Thank you, Mr. Rehberg, for your testimony
    on this critical issue, also a big issue in the Commonwealth of
    Kentucky right now.
        Ms. BASS. You could give your testimony.
        [The prepared statement of Mr. Rehberg follows:]

     STATEMENT OF THE HONORABLE KAREN R. BASS, A REPRESENTATIVE IN
                 CONGRESS FROM THE STATE OF CALIFORNIA

        Ms. BASS. Yes. Good morning, Chairman Davis and Ranking
    Member Doggett. Thank you for the opportunity to testify here
    before the committee today. I appreciated hearing your
    testimony about the meth problem.
        Actually, I became involved in the child welfare issue
    about 20 years ago. I started an organization in Los Angeles
    that was addressing the crack cocaine crisis which, if we look
    at both of those drug epidemics, it was certainly when we had a
    spike in child welfare cases. And, frankly, it is one of the
    key policy areas that I hope to work on while I am in Congress.
        In California, we have made enormous strides with reforming
    our child welfare system. In 1999, there were 140,000 children
    and youth that were removed from homes in California and placed
    in foster care. Today they are 57,000. In Los Angeles County
    there were 55,000 children removed from their homes, and today
    there are 15,000.
        But the fact remains that there is certainly still enormous
    work to do to improve our system to help at-risk children and
    families prevent entry into foster care. By providing help to
    families to prevent the spiral into abuse and neglect, we would
    avoid the substantial cost of foster care, avoiding the trauma
    of removal, and help families stay together.
        To the contrary, the current child welfare system, the
    primary focus is on families that have already been identified
    with child abuse or neglect issues. This ends up with families
    being separated, children in foster care, costly efforts at
    reunification, and a system that has more failures than
    successes. The fact that title IV-E funding cannot be used for
    prevention or post-reunification services has created a
    significant challenge to achieve better safety outcomes and
    finding permanent homes for children.
        However, in jurisdictions like Los Angeles County, some of
    these challenges have been mitigated because of the
    availability of Title IV-E flexibility. Funding waivers allows
    the county to implement prevention strategies outside of
    funding constraints and dollars chiefly tied to out-of-home
    removal.
        Given the limited number of IV-E waivers, the Promoting
    Safe and Stable Families, PSSF, funding is essentially the only
    resource currently available that can finance support services
    to families. These funds can be used to provide a continuum of
    services that support families that have entered the child
    welfare system and are working towards reunification, as well
    as expanding efforts to prevent families from entering the
    system, or diverting them when they have been identified. But
    we know that PSSF funding is not sufficient to provide the
    amount of services necessary to truly affect change in existing
    structure.
        I wanted to mention a couple of promising practices that
    the committee, I am sure, is aware of, but I think should be
    highlighted at this point in time. We know that there is many
    examples of programs that have been successful, and certainly
    my colleague mentioned a couple.
        One promising practice is the differential response
    framework, which offers a broad set of strategies for working
    with families at the first signs of trouble, based on their
    level of need or risk that is identified. Differential response
    is an evidence-based approach to prevent child abuse and
    neglect by ensuring child safety through expanding the ability
    of child welfare agencies to respond to reports of child
    maltreatment.
        Because of the effectiveness of the model, in California
    there is an effort to expand this response to families that are
    at risk of being involved in the system because of issues such
    as substance abuse, mental health, and domestic violence.
        Another one is up-front assessments. In 2004 Los Angeles
    County Department of Children and Family Services implemented a
    pilot program to address the high number of children in foster
    care. Point of engagement is a process that attempts to engage
    the family as soon as possible after the referral to the
    department in order to assess the family and provide services
    that allow the family to avoid child detainment all together.
        I want to give an example. There is a program in Los
    Angeles County called Shields for Families, and this is a
    program that was started at the height of the crack cocaine
    epidemic. I sat through one of the point of engagement
    responses that was done where the family members sat around and
    identified what the weaknesses, what the strengths were, and
    how to intervene in this situation. And I think it is an
    example of where they have been able to reduce the number of
    children that are in the system, all together.
        In conclusion, I would ask my colleagues to consider, of
    course, that prevention--an ounce of prevention, we all know,
    is certainly worth a pound of cure. As we work to reauthorize
    the Promoting Safe and Stable Families Act, these tried and
    proven community strategies are not only effective, but cost
    effective. And I encourage you to use prevention and early
    intervention models such as the ones adopted in LA County and
    Shields to inform your decision-making.
        Thank you for the opportunity to give testimony today.
        Chairman DAVIS. Thank you very much. I would like to thank
    both Mr. Rehberg and Ms. Bass for investing time to come in and
    share their insights. Does anyone have any questions from our
    colleagues?
        Mr. MCDERMOTT. Mr. Chairman, I want to commend you on
    getting the appropriator here, so that he can get an early buy-
    in on our authorization.
        [Laughter.]
        Chairman DAVIS. I appreciate the gentleman's perspective.
    It begs the fellowship----
        Mr. REHBERG. It----
        Chairman DAVIS [continuing]. Of the Appropriations and Ways
    and Means Committee, since the ratifying of the Constitution.
        Mr. REHBERG. Mr. Chairman, in response, I knew I was
    probably being set up by being here, so----
        [Laughter.]
        Mr. REHBERG [continuing]. Duly noted.
        Chairman DAVIS. Great. Thank you both very much. And that
    concludes our first panel.
        [Pause.]
        Chairman DAVIS. For our second panel, we will be hearing
    from the Honorable Bryan Samuels, commissioner of the
    administration on Children, Youth, and Families, Administration
    for Children and Families, from the United States Department of
    Health and Human Services.
        Mr. Samuels, please proceed with your testimony.
        [The prepared statement of Ms. Bass follows:]

      STATEMENT OF BRYAN SAMUELS, COMMISSIONER, ADMINISTRATION ON
     CHILDREN, YOUTH AND FAMILIES, ADMINISTRATION FOR CHILDREN AND
         FAMILIES, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

        Mr. SAMUELS. Great, thank you. Good morning, everyone.
    Chairman Davis, Ranking Member Doggett, Members of the
    Subcommittee, I appreciate the opportunity to speak to you
    today.
        Title IV-B is an essential program in the child welfare
    system. The work of Congress over the last 14 years has made a
    huge difference in the lives of children. Today there are 25
    percent fewer children in foster care, 14.5 percent less are
    entering care, and 7.5 percent more children are exiting care.
    And over the last 14 years we have seen an increase of 57
    percent in the number of adoptions achieved through foster
    care.
        I was the child welfare director in the State of Illinois
    from 2003 to 2007. The children of Illinois benefitted greatly
    from the reforms that Congress made. Today, Illinois has 65
    percent fewer children in out-of-home care than they did just
    14 years ago. However, my state struggled to meet the social
    and emotional needs of children, both in out-of-home care and
    in in-home care.
        In order for us to meet the needs of children in the foster
    care system, we need a strategy that is more trauma-informed
    and developmentally focused. In my experience, the four
    categories of Safe and Stable Families are the right ones.
    Children and families are served well by family preservation,
    family support, reunification, and adoption.
        I have seen the value of consistent case worker visitation,
    particularly the value it has for ensuring safety. In 2010
    nearly 75 percent of children were visited by their case worker
    each month. We expect these improvements to continue, and we
    will monitor them through the child and family services review.
        The Federal investment in meth also was a critical area of
    focus as the earlier panel discussed. We have seen declines in
    meth, overall, nationally. In Illinois we had a great fear that
    meth would be the crack cocaine epidemic for the 1990s. I am
    glad to report that, during my tenure, that did not occur, and
    that the number of children entering foster care because of
    meth declined. That said, not every community has benefitted
    from a reduction in meth use.
        More importantly, a recent study of children reared in
    homes where meth was used showed that they had substantially
    higher rates of post traumatic stress disorder (PTSD), and were
    exposed to multiple experiences of trauma and violence. Given
    the impact that trauma has on children and their development,
    we recommend, through the reauthorization of title IV-B, that
    you focus resources on improving the social and emotional well-
    being of children.
        In Illinois, 25 percent of children entering care had an
    elevated level of traumatic stress that warranted professional
    intervention. Child welfare research clearly shows that
    focusing on trauma could have a significant impact on the long-
    term well-being of children. Children who are exposed to trauma
    have learning and language difficulties, and they do poorer in
    school. Trauma creates disturbed attachment, aggressive
    behavior, loss of regulation in areas of sleep, food, and self-
    care, feelings of self-hate, and chronic ineffectiveness.
        The data for older children in foster care have a diagnosis
    of mental illness shows that 14 percent of them are diagnosed
    with PTSD, 20 percent with attention deficit hyperactivity
    disorder (ADHD), 27 percent with major depression, and 47
    percent with conduct disorder or oppositional defiance at some
    point in their life.
        Moreover, children who are diagnosed with a mental illness
    are prescribed psychotropic medications at substantially higher
    rates than the general public. Child welfare directors are
    gravely concerned about this issue. There is an emerging
    consensus that non-medical-based interventions, such as
    cognitive behavior therapy, behavioral management, and family
    skills training are needed, sometimes in addition to
    psychotropic medications.
        As a child welfare director, meeting the social and
    emotional needs of children in foster care was my biggest
    challenge. Today I believe that that is still the biggest
    challenge across the country in child welfare. I urge the
    committee to take into consideration the social and emotional
    needs of children as you make your decisions, going forward.
    Thank you.
        [The prepared statement of Mr. Samuels follows:]

        Chairman DAVIS. Thank you very much, Mr. Samuels. Now we
    will turn to questions. First, I would like to ask you a
    question related to streamlining administrative requirements.
        In April 2011, your agency announced it was reviewing the
    Child and Family Service Review process, which is how states
    are held accountable for the operation of their child welfare
    programs, including the two programs we are focusing on today.
    This announcement noted that you would consult with various
    stakeholders, consider changes to make sure that the reviews
    make sense, and really help states to make kids safe.
        Several states we have spoken with have told us--and I
    think our expert panel later this morning will address this--
    that the many different child welfare reviews, audits, and
    plans have become a very large bureaucratic burden on the
    states. Now, your own testimony on page 24 mentions your goal
    to ``reduce costly and unnecessary administrative
    requirements,'' and hopefully integrating and streamlining the
    process to get same critical data.
        What is your agency doing to make sure that Federal
    oversight is useful, and that it holds states accountable for
    things we care about, and that it doesn't divert state
    resources from helping children at risk of abuse and neglect?
        In addition, what else is the Agency doing to streamline
    the way child welfare programs are managed? And I was wondering
    if you can consolidate some of the many audits and other
    administrative requirements.
        Mr. SAMUELS. I will start with the child and family service
    review (CFSR). As you know, that is a regulatory process, by
    which we monitor the overall activities of child welfare
    systems across the country. We are in the middle of soliciting
    comment on that review process.
        Without violating the basic communications around the
    regulatory process, I can share that we are focused on three
    areas in looking at how to improve the child and family service
    review.
        The first is around the methodology. It is both cumbersome
    and at times inappropriately used. We are trying to make sure
    that the strategies of reviewing data, reviewing case files,
    and reviewing the performance of states, are methodologically
    sound.
        Second, we are concerned that the CFSR focuses on too many
    issues. As a result, state agencies are not clear about the
    most important issues. We would hope to reduce the focal points
    for the CFSR so that states are comfortable in being held
    accountable, and do the work required.
        And third, we think it is important to be accountable.
    Sanctions are one way of encouraging accountability. We think
    there are probably others, and we are actively reviewing all
    possible examples of oversight that move beyond just
    sanctioning states.
        We think by doing those three things, and doing those in
    the context of very active public involvement, we can create a
    system of review that is refined, targeted, and holds states
    appropriately accountable for their obligation under Federal
    law.
        Chairman DAVIS. I appreciate you sharing that. We will look
    forward to working with you more on that. One concern that I
    have, having seen both in health care and a number of other
    issues related to this, that every hour filling out paperwork
    or redundant reports by front-line personnel is one less hour
    they are actually spending doing their job, and it has a rather
    constricting effect on capacity for service delivery.
        Are there things that Congress can do to limit this
    fragmentation, and the administrative complexity, while making
    sure states achieve the performance goals that are laid out for
    them by the Agency?
        Mr. SAMUELS. I think there are a couple of things that
    could be done. First, I think there is great value in
    accountability. As you know, part of the President's proposal
    for 2012 was an increase of $250 million, specifically
    targeting improving the overall performance of states and,
    secondly, making investments in three specific areas. I am
    going to focus on the accountability issue.
        Under the proposal, we would elevate the expectation around
    performance, using a set of factors, outcome and quality
    measures, that states would be held accountable for on an
    annual basis.
        As you know, the child and family service review occurs on
    a three-year cycle, with about two years in between one round
    and the next. So, in terms of accountability, the child and
    family service review occurs in states once every five years.
    We think that should be elevated. The measures ought to be
    reviewed on a more regular basis. Our proposal would be to do a
    targeted review of states on an annual basis, and then use the
    CFSR to really drill down on the limited number of outcomes
    where states aren't performing well.
        We think continued quality improvement is absolutely
    essential, and we that it should be an annual, and not every
    five years.
        Chairman DAVIS. Okay, thank you. Mr. Doggett?
        Mr. DOGGETT. Thank you very much. Thank you for your
    testimony and your important work.
        There is something of a tension between our desire to give
    maximum flexibility for innovation and creativity and adapting
    these services, and our need to get accountability and ensure
    that these monies are being spent in the way that the Federal
    law intends. And I don't think--I know this is true in my
    state--we can always assume that, left without any
    accountability, that the state will get the job done correctly
    and in the most effective way, any more than we would assume we
    can do without accountability in other areas.
        Let me focus in on promoting safe and stable families, and
    the Administration's proposal to incorporate an incentive-based
    structure there to address the social, emotion, and health-care
    needs of children. Why is it necessary to create a separate
    model to address these issues?
        Mr. SAMUELS. When you look at the current use of title IV-
    B, both subpart I and subpart II, there is a limited amount of
    funding that actually goes into service interventions that
    specifically address the social and emotional needs of children
    in foster care.
        Again, I think it is important to recognize that
    maltreatment has a significant impact on a child's ability to
    function. In many instances, the impact of maltreatment doesn't
    rise to the level of a mental health diagnosis. Today, if you
    don't have a mental health diagnosis, states have a limited
    pool of funds to be able to address your needs.
        Trauma is a great example. Traumatic stress in a child has
    really significant impact. Child trauma is not, in and of
    itself, a diagnosis. Therefore, most children who would be
    served in a strategy to address their trauma would have to be
    served through funding other than Medicaid. It is our belief
    that there are insufficient funds to drive quality of service
    improvements needed to achieve good outcomes.
        I gave you the example of what we did in the state of
    Illinois, when I was a child welfare director. I was concerned
    about the developmental issues that children had in foster
    care, and their trauma. So we introduced an integrated
    assessment on the front end of every child within 45 days of
    entering care. It was a comprehensive review. We were able to
    know, from the very beginning, what they needed.
        In addition, we trained our case workers and our foster
    parents to recognize signs of trauma, and to address them. And
    we expanded three evidence-based strategies across all age
    groups, so that we could address those needs. I can tell you 6
    years ago that cost me more than $30 million.
        Mr. DOGGETT. You used somewhat clinical terms. But if I
    understand what you are saying, if you have a child who has
    been beat up, and beat up a number of times, but they are not
    to the point that a psychiatrist or other health care worker
    diagnoses their having a mental limitation or diagnosis, then
    there is some services you cannot provide to them that would
    prevent them from getting to that more critical level.
        Mr. SAMUELS. I think that is right. I think what we know
    from the literature and the science is that there are
    interventions that make a huge difference. We introduced three
    of them in the child welfare system while I was director in
    Illinois.
        I even had the opportunity to introduce two of them in the
    Chicago public schools, when I was the chief of staff there. We
    had a rash of student deaths. Over a two-year period of time we
    had over 500 children who were shot, and 85 that were killed,
    and there were lots of young people who were showing up to
    school every day, clearly demonstrating signs of traumatic
    distress.
        We were able to introduce two group-based trauma
    interventions that were evidence-based into schools throughout
    the city, because we knew that that was going to be the most
    effective way to reduce anxiety, to reduce stress, and to get
    better performance from children who were extremely vulnerable.
        Mr. DOGGETT. You mentioned a $250 million increase in your
    proposal. It is difficult here these days to avoid a $250
    million or more decrease. Why do you need the $250 million
    increase? What will you do with it? What would be done with
    that money?
        Mr. SAMUELS. The President's $250 million performance-
    incentive proposal has 2 components to it. The first one, which
    is critical, is that states would actually have to perform
    better than they perform today to receive any of the funds. So
    this would be a performance-based distribution. So states would
    have to, using historical data, improve on an annual basis
    against themselves.
        We are not comparing one state to another, we are comparing
    states to their historical performance. And what we would be
    saying is states that demonstrate better performance, receive
    additional funds so that they can continue to invest in their
    system. States that don't improve would not have access to
    those funds. So it would be a performance-based strategy.
        In addition to that, there are a range of services that
    states currently cannot provide. We identify three areas. I
    will name them very quickly.
        Chairman DAVIS. If you could do that in one sentence, that
    will be helpful.
        Mr. SAMUELS. One, social and emotional well-being; two,
    post-permanency services--children from adopted foster care
    face a struggle long after they leave out of home care and
    achieve permanency; and third, reducing the number of children
    who age out of the system. We think if you can move upstream,
    target those children earlier, we can reduce the sad and
    troubling effects of a child aging out.
        Mr. DOGGETT. Thank you so much.
        Chairman DAVIS. Thank you. Mr. Paulsen?
        Mr. PAULSEN. Thank you, Mr. Chairman, and thank you, Mr.
    Samuels. It is pleasant to hear your passion. Based on your
    experience, that sounds like some very troubling and difficult
    situations dealing with children that you are trying to protect
    and give a good chance in the future.
        I just have a question because, you know, the last
    reauthorization was several years ago. And, as we learned in
    the opening testimony, and as I am just learning as a new
    Member of this subcommittee, some of the provisions of the law
    required the visits of at least 90 percent of foster children
    each month. And we have seen the data, that almost all the
    states have certainly improved in this measure, and no doubt as
    a result of this requirement and the money specifically
    provided to help with these visits now.
        But if you look across these states, it sounds like there
    is a wide variation of how they are actually performing,
    ranging from, like, a low of 18 percent all the way up to 96
    percent of kids that are actually being visited each month.
        What is your agency actually doing to help all the states
    meet the goals for the targeted 90 percent standard? Is there a
    penalty? You talked about sanctions earlier. Is there a penalty
    if you don't hit the 90 percent standard? Are you recommending
    one, specifically?
        Mr. SAMUELS. Under the statute, there is a penalty. States
    that don't meet their goals are subject to a penalty. Goals are
    established on an annual basis.
        However, states can invest their own dollars back into the
    system in a way that allows them to forego the penalty. I know
    of only one state that actually had to pay their penalty.
        But let me make two quick points----
        Mr. PAULSEN. And what is the penalty?
        Mr. SAMUELS. The penalty is between one and five percent of
    their allocation within the Safe and Stable Families allotment.
        You see across the country dramatic changes. There are some
    states that were in the single digits, in terms of the number
    of children that they visited. And today, 4 years later, you
    see them in the 70 and 80 percent.
        My experience is that if you shine a light on an issue, and
    you tell people that you are actually going to track them and
    hold them accountable, most people step up. That is certainly
    the case in child welfare. We think the child and family
    service review is the appropriate place to monitor ongoing
    improvement. States know we are watching them, and they have
    demonstrated that they are going to put the resources in place.
        I would welcome the opportunity to come back to Congress on
    a regular basis and report to you the progress that is being
    made. I think there is little doubt that states have figured
    out how to do this, and as long as we hold their feet to the
    fire, I think they will continue to do that.
        Mr. PAULSEN. And let me ask you this, too, because you were
    just testifying just a little bit ago about the increased
    request for additional funds----
        Mr. SAMUELS. That is right.
        Mr. PAULSEN [continuing]. Of 200-some million dollars. And,
    you know, in a tough budget environment, obviously----
        Mr. SAMUELS. It is.
        Mr. PAULSEN [continuing]. You have got to justify that. But
    what about the thought of just with existing funds going to
    that performance-based, you know, with level funding, or
    changes in funding structure, going to the performance-based
    model just in itself?
        Mr. SAMUELS. I think part of that would require
    congressional action.
        The work that we have been doing around looking at
    incentives, and particularly the indicators that we would
    track, suggest that there are opportunities to introduce such a
    system within the child and family service review. The downside
    is simply that we do not have funding to support state
    reinvestments. It is my experience that, to get better, you
    have to invest in your infrastructure.
        Today, if you get better with your infrastructure, you
    produce greater rates of permanency. The results are that you
    have fewer children in care, and therefore, you get less
    support, federally. We need funding for states to invest in
    their infrastructure, so that the quality progress that they
    have already made, can be continued. And the services that they
    have in place that are producing good results can remain in
    place.
        Mr. PAULSEN. Well, Mr. Chairman, I know, as we look at this
    reauthorization, that is one of our challenges, obviously, is
    that reform always costs money. And I think we are going to
    have to look at ways of how we are going to bring forward
    reform, knowing we are in tough budget situations to have those
    resources available.
        Chairman DAVIS. I agree. So much of this is going to be
    addressing the process and the overhead that is driven by that.
        The chair now recognizes Mr. Reed from New York.
        Mr. REED. Thank you, Chairman. Appreciate it. Thank you,
    Mr. Samuels, for your testimony today.
        I want to follow up on your point that there would be a
    need for an act of Congress to implement this performance-based
    review. What act of Congress are you exactly looking for, or
    could that--be recommending to us to pursue, if we want to
    implement----
        Mr. SAMUELS. In the context of the $250 million we proposed
    in the Fiscal Year 2012 budget, funding would be available to
    address state performance. They could earn the money if they
    performed well. If they did not perform well, they earn no
    money, but we do not take money from them.
        Mr. REED. That is the additional $250 million?
        Mr. SAMUELS. That is correct. If the suggestion is that we
    ought to implement the performance-based standards by
    themselves, we could do that. But we could not take any further
    action against states than what Congress has already given us
    the authority to do.
        I think it would be difficult, in this context, to both say
    we are going to elevate these new performance standards to
    drive states, but without new authority and new money through
    which you are able to do that.
        I appreciate the need to hold them accountable. Congress
    has given us authority to do that.
        Chairman DAVIS. Would the gentleman suspend for a second?
        Could we either ask the folks in the hallway to be quiet,
    or close the door, one or the other?
        Mr. SAMUELS. So, let me answer the question a different
    way.
        Mr. REED. Yes, please.
        Mr. SAMUELS. As a former child welfare director, I felt
    absolutely confident that the Federal Government was using all
    of its authority to hold me accountable. And I think, today, we
    are.
        So, if you want to push states beyond where they are at
    today, you either need additional resources, or you need
    additional authority.
        Mr. REED. Well, I guess what I am trying to say, Mr.
    Samuels, is I associate myself with the comments from Mr.
    Paulsen, in that the performance-based mechanism that you are
    recommending with the additional $250 million of additional
    authorization makes sense to me. And as my colleague indicated,
    these are difficult fiscal times, and the likelihood of getting
    that type of----
        Mr. SAMUELS. Absolutely.
        Mr. REED [continuing]. increased funding is probably going
    to be slim to none, in my opinion. But taking the concept of
    what you are recommending as a good performance-based strategy
    to--the expenditure of these funds, I would encourage the
    Administration to continue to pursue that. And if there is
    anything you need from Congress in order to make sure you have
    the authority to do that with the existing funding levels that
    you have, please know that we would be very supportive or
    interested in those efforts.
        I would like also to ask--you had indicated there was a
    penalty, a financial penalty to states, when they didn't meet
    their 90 percent visitation levels for foster care. And then
    you--in your testimony you had indicated something--you are
    only aware of one state that actually paid the penalty, and
    states have been able to avoid that penalty by engaging in some
    sort of practice. Could you illustrate to me a little bit
    further as to what you are referring to for those states that
    avoid the penalty?
        Mr. SAMUELS. Sure.
        Mr. REED. What are they doing, and how are they doing it?
        Mr. SAMUELS. Currently, the way a state could avoid paying
    the penalty is simply by raising their level of match. Most
    states match at a rate much higher than required. States are
    spending more money than they are obligated to spend under
    Federal law. As a result, states just demonstrate that they are
    actually spending more money--and are able to avoid the
    penalty.
        So, it is simply a mechanism where states are putting out
    more money than they are claiming. Because of that, when they
    do run into trouble, they simply put up more money, and they
    are able to avoid the penalty.
        Mr. REED. Okay. So what they are essentially doing is
    allocating more money from their own coffers to avoid paying
    the Federal Government the penalty----
        Mr. SAMUELS. That is correct.
        Mr. REED [continuing]. That is being assessed by the
    Federal Government.
        Mr. SAMUELS. That is correct. So it is not that they are
    avoiding the penalty, per se, they are simply raising the rate
    at which they are demonstrating to the Federal Government that
    they are meeting the need.
        Mr. REED. Very good. I yield back. Thank you. Thank you,
    Mr. Chairman.
        Chairman DAVIS. Thank you, and the chair now recognizes Mr.
    McDermott from Washington.
        Mr. MCDERMOTT. Thank you, Mr. Chairman, for having this
    hearing. And, Mr. Samuels, I want to go to your experience
    before you got in the Federal Government, when you were in
    Illinois, and talk to you about the training of the workers,
    the front-line workers, how long it takes, how much you spend,
    what you try and teach them.
        And the second part of that is many of these kids are--it
    is suggested that they be put on pharmaceuticals for a variety
    of behavioral problems. Who makes the decision about whether
    the child is put on those pharmaceuticals? Is it the parent,
    the foster parent, or is the worker who authorizes--in other
    words, where is the----
        Mr. SAMUELS. Sure.
        Mr. MCDERMOTT [continuing]. Informed consent? If it is my
    child, and I take my child to a physician, the physician says
    the child needs pharmaceuticals, I authorize it and take the
    responsibility. Where does the responsibility lie for the
    putting of kids on pharmaceuticals?
        Mr. SAMUELS. Sure. Currently, states are basically
    responsible for determining who has the capacity and the
    authority to consent.
        Mr. MCDERMOTT. There is no national standard----
        Mr. SAMUELS. There is no national standard on who has the
    authority to sign off on psychotropics.
        In Illinois, the case worker can sign off on a
    psychotropic.
        Mr. MCDERMOTT. Can?
        Mr. SAMUELS. Yes. However, every prescription is reviewed
    by an independent contractor. So, a case worker could go into a
    doctor and a determination could be made that a child needs a
    psychotropic. They can sign off on that. But then they have to
    submit both the diagnosis, as well as the prescription, to a
    review process. Through that review process, if we determine
    that there is an inappropriate use of psychotropics, we can
    intervene, and we can intervene with a doctor who has the
    authority and the clinical expertise to do so.
        We are also, at least in Illinois, were able to monitor
    children as long as they are on a psychotropic. So we have the
    ability to know when they started and when they stopped. That
    is important, because it is sometimes the case that a child
    will go to one physician, and as a result, get a psychotropic
    and go to a different physician at a different time and receive
    a second prescription. Those may have interaction effects.
        In Illinois, we were able to track every psychotropic that
    the child is on to assure that there is no interaction effect.
    We could monitor issues around the unintended consequences of
    psychotropics. There are side effects to almost every drug. And
    so, being able to monitor and make sure that the prescription
    and the amount does not have a side effect that creates concern
    was also part of the system.
        And ultimately, what we had is a system where every child
    had a guardian in Illinois. And that guardian can intervene if
    they believe that psychotropics are inappropriate or
    ineffective for the child that they are representing.
        Mr. MCDERMOTT. Now, how long does it take to train a front-
    line worker? You take a young woman or man out of college, they
    have had maybe a social work--at best a social work degree, or
    maybe a history degree or something else, and they take a job
    at the Department of Health and Human Services of the state of
    Illinois. How long does it take you to bring them up to the
    point where they can operate independently?
        Mr. SAMUELS. In the state of Illinois, a worker would go
    through about a two-month set of training. After that two
    months they would then be paired with an experienced case
    worker. Through that case worker, their progress would be
    monitored over the next six months. And during that six months,
    there are intermittent circumstances where we bring them in for
    additional training.
        The experience in Illinois is that if you load up all the
    training up front in a classroom setting, and young people do
    not have the chance to practice and figure out where their
    strengths and weaknesses are, then you do not get the kinds of
    impact that you want, in terms of clinical competency and
    understanding of policies and programs.
        Mr. MCDERMOTT. So, the case load starts at two months----
        Mr. SAMUELS. That is right.
        Mr. MCDERMOTT [continuing]. After that first sort of
    educational block----
        Mr. SAMUELS. That is right.
        Mr. MCDERMOTT. Then you put them with actual patients?
        Mr. SAMUELS. That is right. It varies from state to state.
    So each state has their own training program for front-line
    workers. Now----
        Mr. MCDERMOTT. Now you have moved up to this Federal level.
    Do we need a national standard that emulates Illinois or
    something similar? Or----
        Mr. SAMUELS. So the position that I would take on that is
    that what we need is a national standard around the
    competencies that front line workers need to be effective in
    child welfare, more than we need a standard that says, ``Every
    state has to train every worker in the exact same way.'' But we
    ought to have a standard, and every state ought to meet that
    standard.
        Chairman DAVIS. Thank you very much. The gentleman's time
    has expired. Mr. Berg?
        Mr. BERG. Thank you, Mr. Chairman. Mr. Samuels, again, I
    want to thank you for your passion, and also your experience,
    really, from the ground up. I don't really care how big a
    school district is, 85 deaths a year just astounds me.
        But, you know, on the last reauthorization we required
    states to report how they are spending this money for the first
    time. And I am a big believer from learning from our past. What
    have we learned from that reporting on the states since the
    last reauthorization on how they spent their money? And what
    are the--again, I look at the states as the laboratory. What
    are the effective things that have come out of that?
        Mr. SAMUELS. To be honest, as a part of the last
    reauthorization, there was an increased effort to have states
    report. So, prior to the reauthorization, the standard was
    states had to submit a plan that said how they would spend the
    money. Today they also have to submit a plan about how they
    actually spent the money.
        That is the progress. We don't just have this kind of
    general understanding of what they said they would spend it on;
    they come back and actually have to report what they did spend
    the money on.
        Mr. BERG. Well, just so I am clear, so have any of those
    states given us that second part on how they spent the money?
        Mr. SAMUELS. They have.
        Mr. BERG. And then what have we done with that? I mean is
    there a matrix or measurement? Are we----
        Mr. SAMUELS. Primarily what happens with that information
    is that it is reviewed to make sure that states are using funds
    appropriately. We are looking at how they actually spend the
    money in accordance with the authority, to make sure that
    states aren't inappropriately moving money from one part of the
    budget to the other, one service to the other.
        Mr. BERG. So, really, it is a--is it appropriate, not
    whether it is an effective----
        Mr. SAMUELS. That is right, yes.
        Mr. BERG. So I guess I am assuming that people are honest
    with these expenditures, and I think we have to, obviously,
    have accountability, I mean, if we are going to get this turned
    around.
        So, maybe that is my other question. Do we have measures
    for each state? I mean I see some matrixes that you are using.
    Do we have measures, so we can evaluate a state?
        Mr. SAMUELS. We do have measures. Again, those measures and
    requirements are part of the child and family service review.
    And, as a result of that, we look at those measures every five
    years.
        Mr. BERG. Okay. What I would like to see is, if you would,
    bring a chart that would show each state.
        Mr. SAMUELS. Yes.
        Mr. BERG. And on those things that you are measuring----
        Mr. SAMUELS. Sure.
        Mr. BERG [continuing]. So we can look at each state and
    understand.
        The other question--I appreciate what you are saying, in
    terms of having accountability, asking states to improve from
    the prior year, and only would receive money if they do
    improve. You know, having said that, I think there is a certain
    level that we ought to expect. And if we have one state that is
    at the absolute bottom, making zero effort, and we have another
    state that is really doing outstanding service, you know, I
    would hate to see the state that is doing outstanding service
    receive nothing, not any incentive, and the state at the bottom
    just making a casual effort that gets them up one step and then
    another step and another step.
        And so, I just want to--you don't need to respond to that,
    I would just like to make that noted, that, again, as you are
    taking about that money, we cannot forget that people are out
    there doing a great job, and we need to support those.
        The final question I had really related to--we talked about
    the penalty, the one five percent--again, it is--states are
    smart. I am kind of disappointed that they are getting around
    this. So my question to you is, how are we going to fix this? I
    mean, truly, if we want them to do what we feel is going to
    help kids, what is our stick, or how are we going to improve
    that stick to hold them accountable?
        Mr. SAMUELS. I am hesitant to make a proposal today. I
    certainly would be willing to go back and consider that
    question and give you a more complete answer. What I can say
    today is simply that in a 4-year period of time, you have had
    about 40 percent of them meeting their visitation requirements
    to now close to 75 percent. Even though they are not actually
    paying a penalty, states are making substantial progress
    towards that 90 percent standard.
        I would be glad to come back with you to make a proposal.
    But the data clearly demonstrates that, even under the current
    system, progress is being made, and I think it is reasonable to
    assume that if we keep the light shining on this, states will
    get to that 90 percent, and they will get to it in the near
    term.
        Mr. BERG. Thank you. I will yield back.
        Chairman DAVIS. Thank you. The chair now recognizes Dr.
    Price from Georgia.
        Dr. PRICE. Thank you, Mr. Chairman. Thank you, Mr. Samuels,
    for your work.
        Serving four terms in the state legislature in Georgia, we
    have had some significant challenges in our state. And everyone
    hurts sincerely when kids fall through the cracks. And it seems
    that, often times, kids do. So I commend you for the work that
    you are doing.
        As a physician, my gut tells me that often times in these
    situations we are treating the symptoms and not the disease. So
    I want to address two specific areas of maybe not getting at
    the right area. One is the issue of waste within the system
    itself. Have you identified--with all the programs that are
    charged under your charge and elsewhere within the Federal
    Government, have you identified any redundancies in charge or
    in mission of specific programs that might be streamlined and
    better utilized, the limited resources that we have?
        Mr. SAMUELS. We are currently going through an internal
    review process for that exact purpose. As you know, the
    President put out a memo outlining the need to both look at
    reducing unnecessary activities, at the same time making sure
    that there are accountability standards. We are actually going
    through a review process now, and the general public has also
    been invited to identify areas where they think we could reduce
    administrative burden or increase accountability. I would love
    to be able to come back to you in a couple of months and share
    what we have learned through that review, and additional steps
    that we might take.
        Dr. PRICE. So your time line is a couple months on that
    report?
        Mr. SAMUELS. I think that is correct, yes.
        Dr. PRICE. And are you--you are pulling in the public. Are
    you pulling in state individuals who are--have identified----
        Mr. SAMUELS. That is correct. I mean the--a public notice
    has been--a Federal notice has been put out. So folks are
    actively engaged in reviewing those, and making
    recommendations. We have also reached out to all of the
    interest groups here, to make sure that they know that they can
    submit ideas that they have about reducing the burden of
    administrative cost.
        And so, we are beginning to see that information come in.
    But I haven't had an opportunity to review it, and would love
    to be able to come back to you and tell you more, once we have
    been able to analyze that information.
        Dr. PRICE. I look forward to seeing that. The other issue I
    want to touch on is--specifically, is the root cause of the
    challenge that we have in this country. As I say, often times
    we are treating the symptoms when we identify a kid at risk, a
    child that has been abused. We come in and try as best we can
    to help the child get through that situation.
        What is your agency--what are you doing to work with other
    areas of the Federal Government? Or are you working to identify
    the root cause of the challenges that kids have out there? And
    what are we doing to try to address that issue?
        Mr. SAMUELS. I cannot say that we are currently engaged in
    a process that is looking at root cause. What I can say that we
    are engaged in is a process of looking at the intersections
    between Federal policies across each department.
        So, we have been working closely with the Department of
    Education to see whether there are things that we can do
    different in order to get better educational outcomes for
    children in foster care. We have been working with SAMHSA and
    others to see if there is science on mental health services
    that we could learn from and integrate into the system.
        What we have tried to do is to work closely with our sister
    agencies to get smarter about the most effective strategies for
    intervening appropriately, both to prevent as well as to deal
    with maltreatment. But our focus is really on getting better
    outcomes for kids and families, as opposed to drilling down on
    root cause.
        Dr. PRICE. Is there any entity within the Federal
    Government that is looking at root cause, do you know?
        Mr. SAMUELS. I would have no way of knowing.
        Dr. PRICE. Wouldn't it be more wise for us, as a society,
    to, instead of just--instead of concentrating on treatment of
    the challenge when it arises, to try to prevent it from
    happening in the first place?
        Mr. SAMUELS. I think most would agree that prevention has a
    critical role--it reduces the long-term burden that occurs with
    the development of a mental illness, or a problem from a health
    perspective.
        While in theory, I can agree with you, I cannot, at this
    point, tell you that there is a way of getting at the root
    cause the way you describe it. I am not sure that there is a
    process currently in place, specifically, to do that.
        Dr. PRICE. Thank you. Thank you, Mr. Chairman.
        Chairman DAVIS. Thank you. The chair now recognizes Ms.
    Black from Tennessee.
        Mrs. BLACK. Thank you, Mr. Chairman, and thank you, Mr.
    Samuels, for being here today. This is an area that is
    certainly near and dear to my heart, serving in the Tennessee
    state legislature. We have dealt with issues about helping our
    at-risk children.
        And so, I want to follow up--and almost a thread--with the
    last three representatives asking questions about looking at
    prevention, root cause, evidence base. And those are probably
    words that those back in Tennessee were so sick of hearing me
    say that, that they were fed up with my asking those questions.
    But what I will say is that we finally, after 10 years, saw
    some real results. And I am very proud to say that we are, in
    your testimony, noted here about one of our programs.
        I want to say that there are good programs out there. And I
    would encourage the Department to look at those that do
    prevention. And I am going to lift one up, a nurse family
    partnership, where we know that if we take these children and
    put them--or take these young mothers and put them with people
    that can mentor them at the very beginning, that we see good
    parenting skills, healthy children, and a lot of great
    outcomes.
        So, I would encourage us to take a look in that area, and
    to start saying, ``What can we do on the prevention side, so
    that we don't have to treat these children for many, many, many
    years for things that are poor outcomes in their homes.'' So--
    --
        Mr. SAMUELS. Within the administration we can point out a
    number of areas where prevention and evidence base has been
    combined.
        Certainly the home visiting initiative that is in its first
    year--it is $100 million, next year it is almost $250 million--
    specifically targeting the prevention of the kinds of problems
    you have described. I think the home visiting is a good
    example.
        There is also considerable money invested in teen pregnancy
    prevention. In the child welfare system we have been working
    with agencies to introduce home visiting related to reducing
    abuse and neglect, which I think moves in the right direction.
    And we are currently spending some of our discretionary dollars
    to introduce evidence based trauma informed practice as a means
    of getting at some of those programs you described.
        Mrs. BLACK. Okay, so let me go to--I know I have limited
    time--let me go to my next piece on this, is that you do lift
    up in your testimony, in the PSSF program, where there are a
    number of states that you recognize for programs that they have
    initiated. And I know that one here in North Dakota
    specifically is an evidence-based program.
        Mr. SAMUELS. Yes.
        Mrs. BLACK. How are you using what is happening in
    incubators back in these states to be able to help other states
    to make sure that what we are using is evidence-based? Because
    what I have found in our state is that we spent a lot of money
    on programs that people said, ``Oh, they are nice and they are
    good,'' but there was not a measurement tool.
        And that may be where I think that we come in, from the
    Federal level, in whatever the states are doing, to lead them
    more toward evidence-based programs, as opposed to spending
    money on things that maybe, oh, they feel good, or somebody
    says they work, but we cannot measure them.
        So, number one, is what are you doing to use what comes to
    you from other states that is evidence-based and working to get
    that out, nationwide?
        And then, do you do anything to hold states accountable for
    the money that is spent in saying how is it evidence-based, are
    you measuring your programs--not directing them on what they
    necessarily have to do, because they are incubators, I
    understand that, but to at least say, ``Whatever you are doing,
    you are spending the money on, you have to show that there are
    results on the other side that are measurable.''
        Mr. SAMUELS. I would respond in two ways. One is that we
    certainly have integrated the evidence-based standard into much
    of the discretionary grants that we are currently making. There
    were evidence-based programs that were funded in the 2010
    cycle. We would anticipate funding additional ones in the 2011
    cycle.
        To date, child welfare agencies have not been held
    accountable for how they choose to spend money. They have been
    held accountable for whether that money produced outcomes that
    we care about in child welfare. So, I think it is hard to say
    that today we are holding them accountable for using evidence-
    based practices. What we are saying is you ought to be using
    whatever strategies are most effective at getting to the
    outcomes that you are being held accountable for.
        So, it is a slightly nuanced answer. We are not requiring
    evidence-based practices, but we are telling them that, ``We
    are going to hold you accountable,'' and we are trying to drive
    them in a direction of selecting and identifying evidence-based
    programs.
        We have also tried to elevate the presence of evidence-
    based strategies in a number of initiatives we are engaged in.
    Again, I point to trauma as one example, and the mental health
    services as another example where we have been demonstrating to
    states that evidence base can advance their cause.
        Chairman DAVIS. Thank you very much. The gentlewoman's time
    has expired. And last, but not least, the chair recognizes Ms.
    Bass from California.
        Ms. BASS. Thank you. Well, first of all, Mr. Chair, thank
    you for allowing me to ask questions, given that I am not in
    this committee.
        But I just wanted to ask you briefly about what is going on
    in states. Coming from California, a state that is in a
    terrible economic crisis like so many others, you talked about
    how states are meeting their targets, in terms of requirements,
    that the Federal Government places. Do you find--are you seeing
    anywhere, given the economic crisis in the individual states,
    that they are going backwards?
        And also, are states cutting back on their match?
        Mr. SAMUELS. I am unaware of any instance in which the
    states are cutting back on their match. We would be glad to go
    back and take a closer look at that if you would like, but I am
    not aware of any instances where that is occurring.
        I think certainly we can read about all of the reductions
    that are being made in state after state, and we have concerns
    around particularly case work ratios. We are concerned that
    with fewer workers doing those visits, meeting their
    obligations are harder to achieve. But at this point we don't
    have any evidence that we can specifically point at that says
    that, as a result of cuts, states are unable to meet their
    obligation.
        But again, our responsibility is to monitor that on a
    regular basis. We are trying to do that. And if we were to find
    that states, as a result of cuts, aren't meeting expectations,
    aren't meeting requirements, we would engage with those states
    and make clear to them what their Federal obligation is, and
    how we would hold them accountable if they fail to meet their
    obligation.
        Ms. BASS. Thank you.
        Chairman DAVIS. Thank you very much for investing the time,
    Mr. Samuels, coming here today to share with us. We are looking
    forward to working with you in continuing this dialogue to
    structure a reauthorization that addresses efficiency in
    process, but most of all works to help get to the root causes
    and protect kids out there on the front lines.
        If Members have additional questions, they will submit them
    to you in writing. And we would appreciate your responses back
    to the committee also, for the record.
        This concludes our second panel, and thank you very much,
    again.
        Mr. SAMUELS. Thank you.
        [Pause.]
        Chairman DAVIS. I appreciate everybody coming for the third
    panel, and also your patience, and also grateful to the powers
    that be that no votes have been called in the midst of this. I
    think we are going to be able to complete this without
    interruption on this critical subject.
        We are going to have five distinguished panelists. For me,
    in particular, it is very exciting to have our own long-serving
    front-line leader, Patricia Wilson, the commissioner of the
    Department of Community-Based Services from the Kentucky
    Cabinet of Family and Human Services. And most important to me
    in her extensive background is not the long list of accolades
    or administrative leadership positions that she had, it was her
    many, many years of front-line experience that brings a unique
    perspective to the work that she is doing now in helping
    children in the Commonwealth. I appreciate your being here very
    much.
        We also have: Lelia Baum Hopper, director of the Court
    Improvement Program for the Supreme Court of Virginia--thank
    you for being with us; Tracy Wareing, the executive director of
    the American Public Human Services Association; John Sciamanna,
    director of policy and government affairs, child welfare, at
    the American Humane Association; and Steve Yager, director of
    the Children's Services Administration from the Michigan
    Department of Human Services.
        Ms. Wilson, please proceed with your testimony.

     STATEMENT OF PATRICIA R. WILSON, COMMISSIONER, DEPARTMENT FOR
       COMMUNITY BASED SERVICES, KENTUCKY CABINET FOR HEALTH AND
                            FAMILY SERVICES

        Ms. WILSON. Thank you, Chairman Davis, Ranking Member,
    Members of the Subcommittee. Thank you so much for this
    opportunity to talk to you this morning about programs that are
    of supreme importance to our nation's children. I am honored to
    speak with you about these two programs that are so critically
    important to our nation's children: Child Welfare Services and
    Promoting Safe and Stable Families. In Kentucky alone,
    approximately 50,000 children are touched annually by these two
    programs.
        Most of my comments this morning are going to focus on the
    three key aspects that were in the last reauthorization: the
    monthly case worker visits, the regional partnership grants,
    and working with parents with substance abuse issues.
        First, the monthly case worker visits. As Chairman Davis
    noted, I am a former front-line worker and supervisor,
    something I am very, very proud of. I applaud Congress for
    setting the benchmark that every child in foster care should be
    seen every month. Nothing is more important to those children
    to have that contact with the individuals who know their case,
    who know their families, who know what is happening. It is also
    essential, as we move those children toward permanency.
        However, I would like to note that the method of
    calculating that performance is of concern to just not only my
    state, but to others. The current calculation is child-based,
    meaning that any missed visit to a child within a 12-month
    period negates all the visits that were made to that child. An
    alternative that could be considered would be looking at every
    visit counting as an event, in and of itself. And states would
    be given credit for all the visits that are made to children.
    States should be held accountable. Sanction is an acceptable
    means of correcting poor performance. But we also believe that
    states should be recognized for the performance that they do
    make
        Funding to support the case worker visits is much needed to
    help off-set the rising cost of transportation. Again, in a
    rural state such as ours, where children are sometimes placed a
    distance from their home in order to receive the treatment they
    need, the mileage that our staff incur traveling to and from
    those visits is costly for the state, and we appreciate the
    extra compensation to address that.
        The second aspect, improving outcomes for children with
    substance-abusing parents or caregivers. Last year in Kentucky,
    60 percent of the children in substantiated reports of child
    abuse or neglect were found to have families exhibiting
    substance abuse issues. It is a tremendous problem in our
    state.
        I do want to highlight, though, the positive impact of one
    of the regional partnership grants that Kentucky was fortunate
    to receive. Martin County, in rural Appalachia, has just over
    12,000 residents in the entire county. But it leads Kentucky in
    the percent of the child population in substantiated reports of
    child abuse and neglect. Approximately 6\1/2\ children out of
    every 100 children in that county were found to have
    substantiated reports. That compares to 1\1/2\ children per 100
    in the rest of the state. Half of those children were ages six
    or younger. Substance abuse by the parent was a driving force
    in the majority of those cases.
        Prior to the regional partnership grant, there was one
    substance abuse counselor in the entire county who provided one
    day of outpatient service per week. There was a four-month
    waiting period to even receive one hour of service per week.
    There were no support groups.
        With the grant, we were able to replicate a--our START
    program. This program pairs highly-trained parent mentors with
    specially-trained child protective service workers to provide
    intensive case work services to the families, partners with
    substance abuse treatment professionals to ensure quick access
    to treatment, and partners with the court to identify options
    for child safety and permanency.
        In the two-plus years of operation, the county has
    developed intensive outpatient services that are available four
    days and several nights per week. There are now 9 weekly 12-
    step meetings and a Families Anonymous meeting. There is a
    support group. And, very importantly, transportation is able to
    be provided to those individuals who need help in either
    accessing services, or--we have found through our evaluation
    accompanying the individual to the first four appointments with
    their substance abuse counselor is one of the most effective
    means of keeping them in treatment.
        To date, more than 40 percent of the parents served, most
    of whom are young marrieds are in their 20s, and have among
    them more than 100 children, have been able to become sober and
    maintain their children safely at home. Over time, we believe
    the success rate in Martin County will equal that of the 67
    percent success rate that we have in the other 3 counties where
    this program exists.
        Finally, the coordination of health care needs with
    children. We have entered into a cooperative agreement with our
    commission on children for special health care needs to address
    those needs of children in foster care by deploying registered
    nurses across the state. A larger issue, though, as
    Commissioner Samuels noted, is the use of psychotropic
    medicines.
        We have concerns that children who are taking multiple
    psychotropic meds may not have regular psychiatric
    consultation, that those medications may be prescribed by
    someone other than a child psychiatrist, and that there are
    children who are receiving benefit of that that could also
    benefit from alternative methods of behavior management.
        In closing, I would offer a general comment about the 20
    percent distribution, the interpretation across the 4 broad
    categories in Safe and Stable Families.
        Chairman DAVIS. If you could, sum up quickly, please----
        Ms. WILSON. Yes, sir.
        Chairman DAVIS [continuing]. Your time has expired.
        Ms. WILSON. With 15 years plus of experience, and data to
    support the assertion, states are finding there is a need to
    rebalance the funding within the service needs of families.
    Allowing states more latitude in determining the distribution
    of that allotment would provide increased opportunity to fully
    actualize the goals of Safe and Stable Families.
        Chairman Davis, Members of the Subcommittee, we appreciate
    your support, we appreciate your concern for children and
    families.
        We urge reauthorization, and I thank you for the
    opportunity to present the views.
        [The prepared statement of Ms. Wilson follows:]

        Chairman DAVIS. Thank you very much.
        Ms. Hopper.

      STATEMENT OF LELIA BAUM HOPPER, DIRECTOR, COURT IMPROVEMENT
                   PROGRAM, SUPREME COURT OF VIRGINIA

        Ms. HOPPER. Good morning, Chairman Davis, Members of the
    Committee. Thanks for the opportunity to discuss funding by the
    Virginia Court System of court improvement program funding. My
    name is Lelia Hopper, and I am director of the court
    improvement program in the administrative office of the courts,
    under the Supreme Court of Virginia. I have worked with the
    court improvement program since it was first authorized by
    Congress, and grants were made available in 1994.
        The challenge for court improvement programs is to sustain
    the considerable energy that it takes on the part of the
    judiciary and professionals who carry out the reforms daily
    that you all have instituted. Today, excellent court practice
    requires that we go beyond the basics. Since 2006, when the new
    CIP grants for training and data collection and analysis were
    made available, we have been able to substantially improve upon
    and energize early system reform efforts.
        Training grant funds since 2006, including those planned
    through the end of this grant year, have enabled Virginia's
    court improvement program to support 123 local and state
    training events, with more than 12,000 participants. We have
    also provided funding for juvenile court judges, attorneys,
    child dependency mediators, staff for CASA programs to attend
    13 national educational events that have enhanced their skills.
    The large majority of these individuals would not have
    benefitted from these educational opportunities without CIP
    funding support.
        In Virginia, many juvenile court judges provide leadership
    in their communities to provide--to improve child dependency
    court processes on a multi-disciplinary basis. Their
    involvement is supported by the best practice court program,
    instituted by my office in 2002, and substantially supported in
    the past 5 years with training grant funds.
        Today there are 37 active court teams, which account for 60
    percent of Virginia's foster care caseload. These teams have
    committed--have contributed to a 27 percent decrease in the
    number of children in foster care in Virginia over the past 3
    years. This reduction has been accomplished as a part of a
    transformation of Virginia's children's services system, of
    which the courts have been an integral part.
        The data grant. Our office produces 10 court performance
    measurement reports, utilizing case information that is entered
    by court staff into the juvenile case management system. In
    2010 we began development of these reports into web-based
    formats, making them more interactive and user friendly. We
    will complete this project this September.
        In 2008, we began making analyses of local juvenile court
    performance measures available to the courts. This analysis
    process is initiated by the presiding juvenile court judge,
    includes a written report, a meeting, and recommendations to
    improve court practice. To date, we have completed 15 of these
    court analyses.
        An interface between the courts and the state department of
    social services is something we have been working on for quite
    a while. Both of our agencies recognize that an interface would
    improve the ability of the courts and social services to
    process paperwork and make timely decisions for children in
    foster care. And we are scheduled to begin implementation of
    the first phase at the end of this year.
        Finally, we also have available online to our judges--and
    it is only to judges--something called the active foster care
    children report. It is updated daily and provides a snapshot of
    children in foster care identified by locality. It includes
    demographic information, foster care placement information,
    funding resources, and critical hearing dates. Prior to this
    electronic transmission, we could only provide this information
    twice a year in a hard copy to the courts.
        Mr. Chairman and Members of the Subcommittee, Virginia and
    the other court improvement programs across the country are
    effectively utilizing the court funds that you have provided to
    improve court practice. And we believe we are making a
    measurable difference for families and children who are under
    the jurisdiction of the court system.
        Thank you for your time.
        [The prepared statement of Ms. Hopper follows:]

        Chairman DAVIS. And thank you very much for your good work
    in Virginia.
        Ms. HOPPER. Thank you.
        Chairman DAVIS. Ms. Wareing.

    STATEMENT OF TRACY WAREING, EXECUTIVE DIRECTOR, AMERICAN PUBLIC
                       HUMAN SERVICES ASSOCIATION

        Ms. WAREING. Good morning, Chairman Davis and Members of
    the Subcommittee. I am Tracy Wareing, executive director of the
    American Public Human Services Association. And thank you so
    much for the opportunity to testify today regarding the
    promoting Safe and Stable Family and Child Welfare Service
    programs. And it is an honor to be sitting here with such a
    distinguished panel, as well.
        The American Public Human Services Association is a non-
    profit organization whose membership includes the Nation's top
    government human service executives from across each of the
    states, the District of Columbia, as well as hundreds of human
    service directors at the local--at the county level. We happen
    to also house nine affiliate organizations, including the
    National Association of Public Child Welfare Administrators,
    and I speak on their behalf today, as well. We are a bipartisan
    organization whose ideas and direction come from the open
    exchange and deliberation of the expertise of our members, two
    of which are on this panel, as well.
        This morning I would like to address the importance of
    prevention of child maltreatment, and the support of front-end
    services for children and families at risk, and then share two
    recommendations with you for revisions, as you consider
    reauthorization.
        As you know, Promoting Safe and Stable Families is one of
    the few Federal funding streams that supports services aimed at
    preventing children from coming into out-of-home care. In 2009,
    states reported PSSF funding as the single largest source of
    funding for preventative services, covering nearly 30 percent
    of children receiving preventative services, nationwide.
        Over the past five years, states have successfully reduced
    the number of children in foster care by more than 20 percent,
    as you heard from Mr. Samuels. In that same time period, the
    national repeat maltreatment rate also declined. By promoting
    community-based family support, family preservation,
    reunification services, and adoption support, PSSF has played a
    critical role in helping states alleviate situations that might
    otherwise lead to children being placed in foster care, due to
    abuse or neglect, or staying in care too long.
        We also appreciate the substance abuse and methamphetamine
    grants that were made available to states. These grants have
    been helping states to offer an array of services to address
    the specific needs of these families, and use a range of
    strategies too prevent and treat substance abuse. As you
    consider reauthorization of these programs, we want to
    acknowledge the importance of these to the states, and urge
    that you continue them.
        However, I think, as we have heard today, the bulk of
    Federal funding for child welfare is directed toward out-of-
    home care, and it comes from a patchwork of funding streams,
    and it is not directed to prevention. The overall allocation of
    title IV-E funds, compared with title IV-B funds, is about $10
    of out-of-home care funding for each dollar of in-home funding.
    We urge this committee to address comprehensive child welfare
    finance reform, and recommend increasing support for
    preventative and supportive services in directing Federal
    resources toward the front end, to improve the outcomes of
    children and families.
        While our members support the need for flexibility to
    deliver on an array of services that are responsive to the
    special needs of their community, they also understand the role
    of the Federal Government in ensuring Federal dollars are spent
    wisely and correctly, and that the outcomes we all desire are
    met. As our members continuously improve their internal
    processes, they have also worked to develop practical
    recommendations on streamlining Federal accountability measures
    under IV-B and IV-E, and have offered ideas to the
    Administration around that.
        But the methodologies for monitoring and measuring must be
    related to the outcomes we all desire to see. To that end, as
    you consider reauthorization of Promoting Safe and Stable
    Families, we recommend: one, relaxation of what is sometimes
    referred to as the 20 percent rule, which essentially requires
    equitable spending across the four categories of PSSF funding.
    That spending restriction is too rigid.
        Just to give you one example, California has shared with us
    that many of their smaller counties, some of which may perform
    no more than a few adoptions a month, struggle with utilizing
    the 20 percent spending requirement on the adoption promotion
    and support services. In those communities, the funds would be
    better directed to community-based family support and
    preservation.
        Additionally, a colleague on the panel here mentioned the
    methodology for calculating monthly case worker visits of a
    child. Our members are deeply committed to the best practice of
    timely, effective, and regular case worker visits, and the role
    they place in ensuring safety and facilitating reunification
    and permanency. But the fact is, the current methodology is
    flawed. A case worker could, in fact, see a child 20 times a
    year, but if 1 month was missed, that case and those visits are
    not counted.
        My written statement provides specific recommendations that
    our members believe will result in a much more accurate picture
    of the diligent efforts being made. And let me emphasize this
    is about methodology, not intent. Our members fully support the
    benchmarks set by the 2006 reauthorization.
        With that, I thank you so much for the opportunity to be
    here. We urge reauthorization of Promoting Safe and Stable
    families and Child Welfare Services programs, and would welcome
    questions. Thank you.
        [The prepared statement of Ms. Wareing follows:]

        Chairman DAVIS. Thank you.
        Mr. Sciamanna.

     STATEMENT OF JOHN SCIAMANNA, DIRECTOR, POLICY AND GOVERNMENT
          AFFAIRS, CHILD WELFARE, AMERICAN HUMANE ASSOCIATION

        Mr. SCIAMANNA. Thank you, Chairman Davis and Members of the
    Subcommittee.
        Since 1877, the American Humane Association has been a
    national leader in developing cutting edge initiatives to
    prevent and respond to child abuse and neglect. Our work in
    research, family group decision-making, differential response,
    and father engagement are a few examples of our efforts to
    strengthen families, children, and communities.
        Let me talk briefly about some of the important services
    under PSSF. Reunification services. Once a child has been
    reunified, access to after-care is limited, since Title E funds
    provides for support only when a child is in foster care.
        This week we co-hosted a briefing on Capitol Hill focusing
    on reunification. The compelling stories of the families who
    were there who were reunified with their children provided
    strong evidence that we could do so much more in this area. In
    2009, 276,000 children left foster care and 51 percent were
    reunified with their parents, we feel we can do much more in
    this area.
        One of our recommendations is that if we can't enact a
    comprehensive finance reform this year, then we should extend
    title IV-E entitlement funds to services for reunification,
    allowing dollars to address the only permanency option not
    currently funded under IV-E.
        We also recommend that the current 15-month restriction
    under Promoting Safe and Stable Families be removed, since we
    would like the dollars to follow the children home into the
    family.
        Adoption services. This subcommittee was key to enactment
    of the Fostering Connections to Success, and Increasing
    Adoptions Act. That started us towards a comprehensive reform
    of the finance system by eliminating the link to AFDC for
    adoption assistance.
        We are increasing the number of adoptions annually, and
    have made great success in the last decade. But for a small
    percentage of these families, there is a need for post-adoption
    services, as Commissioner Samuels mentioned today. Recently a
    coalition led by Voice for Adoption held a Capitol Hill
    briefing, with one of the recommendations being that there be
    specific funding to address these post-adoption services, so
    that states can establish an infrastructure.
        We recommend that the definition of adoption services under
    Promoting Safe and Stable Families be examined to see whether
    or not we could direct more dollars toward post-adoption
    services.
        We also suggest that when Congress created the de-link,
    that they directed states to reinvest dollars, maintenance of
    effort into Child Welfare Services. Congress may want to look
    at directing those dollars, as some adoption groups have
    advocated, toward post-adoption services as a way to provide a
    steady source of funding.
        Family support and family preservation are two very
    critical services. We certainly hope that they will continue to
    be categories in this area. There has been some consideration
    in the past about whether or not these categories should be
    collapsed. But we think that they, the four services, address
    four distinct families.
        The big challenge for all of this funding is that in recent
    years, when this committee has increased mandatory funding,
    appropriators have sometimes used it as a rational to decrease
    the discretionary piece of this program.
        The need for substance abuse services. We would echo a lot
    of the comments that have been heard here today. There is
    growing evidence about the importance and the effectiveness of
    comprehensive family treatment. We would suggest, however, that
    the specification toward methamphetamine be broadened, since
    there are a range of substance abuse issues and problems,
    depending on the locality and the part of the country, and
    grants should be based on the most effective strategies.
        Workforce development you have also heard a great deal
    about. Case load visits are important. But, as you have heard,
    there are some problems with the data collection. We need to
    work on that. What we don't want is a system where we are just
    checking off visits. Instead, we will need to encourage quality
    visits. We have done a number of workforce studies for states
    to help them with that, to establish quality visits.
        We think if the funding cannot be increased, we need to
    design a workforce strategy. Perhaps Congress should look at
    some sort of a race to the top that would allow some states to
    invest and--provide strategies that could develop a child
    welfare workforce development plan over several years.
        Court improvement. I won't go into great detail here,
    because you have heard about the effectiveness of that. So we
    certainly hope that Congress will keep--and, if at all
    possible--increase funding.
        We also want to emphasize that recently we released a
    report with several organizations about maltreated infants and
    toddlers. They are the biggest population coming into contacted
    with the child welfare system. We think there needs to be
    greater focus on this population, not to the exclusion of other
    populations, but perhaps we can, in the oversight or in the IV-
    B-1 plan, outline what states are doing to address this
    vulnerable population.
        Finally, in my closing comments, let me just say that if
    Congress cannot complete finance reform in this session, that
    they look at different ways to extend current funding in IV-E,
    whether it is to reunification services, or to doing some up-
    front services, such as differential response, an approach
    several of the states represented here today are implementing.
        In closing, we appreciate the efforts of this subcommittee
    and others to pursue these matters in what has always been a
    bipartisan and bicameral way. As some of the Members of this
    committee have pointed out in the past, children in foster care
    and child protective services are, in fact, our responsibility.
    And we need to make sure that we are their good parents until
    they find permanent families.
        [The prepared statement of Mr. Sciamanna follows:]

        Chairman DAVIS. Thank you very much.
        Mr. Yager.

    STATEMENT OF STEVE YAGER, DEPUTY DIRECTOR, CHILDREN'S SERVICES
         ADMINISTRATION, MICHIGAN DEPARTMENT OF HUMAN SERVICES

        Mr. YAGER. Good morning, Chairman Davis and Members of the
    Committee. Thank you for inviting me today to testify on child
    welfare reauthorization, specifically the Child Welfare
    Services program and the Promoting Safe and Stable Families.
        Today I want to hit three areas, as my colleagues have
    covered a couple of other areas. I want to touch on case worker
    visits, data infrastructure, and audits.
        Case worker visit funding is essential, and it has had
    positive impact on the children in Michigan. Michigan has seen
    a rate of case worker visits improved dramatically through the
    use of funding. Our base line in 2007 showed 14 percent of case
    workers actually achieving monthly visits with each child. In
    2010 that rate increased to more than 70 percent.
        We continue to aggressively pursue training for public and
    private case workers, courts, in foster and resource families,
    so not only will our rate of visitation improve to 90 percent
    by the end of fiscal year 2011, but also our quality will
    improve.
        Reauthorization and extension of the case worker visit
    funding will support our initiatives to continue improvement in
    the rate and the quality of home visits. I would concur with
    our colleagues regarding the method of determining compliance
    for that. It is a concern that I would share with them.
        As for substance abuse services, Michigan sees this as a
    continued need, as has already been stated, and we strongly
    support reauthorization of that funding.
        Data-driven decision-making. Michigan's data-driven
    decision-making initiative began out of necessity. Our goal has
    been to provide central administration and local office
    management and staff with the reports necessary to increase
    positive outcomes for the children and families served in
    children's protective services, foster care, adoption,
    licensing, and juvenile justice programs. Our philosophy is to
    provide the field with data reports so they have the knowledge
    needed to manage the workforce proactively, and focus on key
    areas of practice that have been shown to increase child safety
    permanence and well-being.
        In addition, the data reports provide central
    administration executives with the ability to review county
    performance, and the same areas of practice across the board.
        Now, for a minute I would like to speak a little bit about
    audited processes. Michigan recommends that all Federal
    processes be streamlined and linked, so the frequent intrusions
    and required corrective action plans resulting from the myriad
    reporting and review requirements are eliminated.
        For a state like ours that is also operating under Federal
    court consent decree, writing the reports, measuring data in
    subtle but different manners for each process and then
    participating in Federal reviews, program enhancement
    activities, leaves us with little time to work on implementing
    meaningful change.
        From 2008 to 2010, Michigan underwent a title IV-E review,
    child and family services review, statewide assessment and on-
    site review, the CFSR program improvement plan, the title IV-E
    departmental appeals board litigation, the children's rights
    lawsuit, and SACWIS on-site review, and other reviews of the
    public assistance side of the department. We do not object to
    oversight, but to the increasingly seemingly constant nature of
    that oversight.
        Michigan wants strong accountability in the operation of
    child welfare programs, but these divergent reviews and
    monitoring processes are too numerous to be value added,
    particularly to the staff responsible to providing services to
    families.
        Michigan recommends that current Federal review and
    planning processes for the child family services review and the
    child family services plan be blended into integrated and
    coordinated state planning processes. The proposal proffered by
    the American Public Human Services Association and the National
    Association of Public Child Welfare Administrators establishes
    both the manner in which this could occur, and the rationale
    for coordination. The proposal recommends a modified CFSR
    target of no more than three key practice areas. The state
    would be held accountable for its efforts to achieve
    sustainable improvement in those targeted areas.
        Assessment data and continuous quality improvement
    activities form the basis of these activities. The proposal
    would employ qualitative data from the state's case review
    system, giving the review a real-time value, instead of the
    historical data profiles employed in the current CFSR process.
        Under a coordinated plan, the states could more readily
    adapt to changes in funding, legislative focus, program
    operation, and external influences, essentially becoming more
    nimble in response to these changes. Currently, the two-year
    PIP period is counterintuitive to how child welfare really
    operates. Renegotiation is required for these modifications.
        With respect to the commonality of data, we agree that
    national data standards need to be established. However, the
    child family services review data profile and measurement
    processes confuse external stakeholders, case workers, other
    agency partners, and the consumer community, including the
    legislature and press. This confusion often unjustly
    contributes to public disdain for our work, and impacts staff
    morale.
        States should have more control over their individual
    processes. Michigan recommends using longitudinal data to
    assess our performance. This data modeling has a higher degree
    of reliability and we are able to move more quickly to assess
    the impact of changes in our policies and processes.
        Another key component is----
        Chairman DAVIS. If you could, sum up quickly, Mr. Yager.
        Mr. YAGER. We need an external review process, and we have
    that in Michigan. Blending the external with our internal
    processes will improve the review system.
        We believe the children's bureau, through technical
    assistance, can enable us to develop a more effective state-
    based system and would satisfy Federal review.
        Thank you for your time today. I appreciate this
    opportunity. I want to encourage you to reauthorize the Safe
    and Stable Families.
        [The prepared statement of Mr. Yager follows:]

        Chairman DAVIS. Thank you. Foster care is a shared system
    between the Federal Government and the states. I would like to
    start with Ms. Wareing. Given the 20 percent decline in the
    foster care caseload in the last 5 years, are states spending
    less, in terms of state dollars, on foster care and related
    programs?
        Ms. WAREING. Well, I actually don't--Mr. Chairman, I think
    that they are spending less on foster care. I think that they
    have tried to redirect some of their dollars to in-home
    services, because there is not the Federal support at that
    level. So, trying to work on things where you are promoting
    children being safe, but before they come into the child
    welfare system, and that requires a large amount of state
    funding in order to do that because there are limited--only,
    really, the title IV-B funds are available to support those
    types of programs.
        Chairman DAVIS. I noted a suggestion in your statement, as
    well as by others on the panel today, that there should be more
    flexibility in how Federal foster care and other funds are
    spent, including for services. Are states leading by example
    and devoting any state foster care dollars no longer needed
    specifically for foster care to services to prevent foster
    care, placements, and otherwise assist families?
        Ms. WAREING. From my experience--and I would certainly
    welcome colleagues who are closer to the ground--but yes, I
    think that is where states have tried to put their resources
    into programs that allow children to either not come into care
    or get home quickly. But that--you know, that has required a
    very concerted effort, and it does require resources around
    those prevention programs in order to make that happen.
        Chairman DAVIS. Ms. Wilson, would you like to comment, from
    a Kentucky perspective?
        Ms. WILSON. From a Kentucky perspective, we are actually
    spending as much or more money on foster care, the difference
    being that the total expenditure base may not be rising more,
    but the Federal support is declining. So we are spending more
    state dollars.
        We are taking, though, both Safe and Stable Families
    dollars and any other state-appropriated monies that we can
    redirect into preventative services. We wholeheartedly would
    like to see the number of children in foster care reduced by a
    greater proportion than what it is.
        Chairman DAVIS. Thank you. I would like to open a question
    up for the panel overall, just in my limited time. Earlier in
    the hearing we heard Mr. Samuels's ideas about streamlining. He
    talked about oversight streamlining, limiting measures of
    performance, the way the annual audits were approached. I would
    like to open it up for the panel on your thoughts on the
    proposal, on his ideas.
        Ms. WAREING. Mr. Chairman?
        Chairman DAVIS. And then we will go to Mr. Yager next.
        Ms. WAREING. Thank you. I would echo--first I would say
    that, on behalf of the American Public Human Services
    Association, we would acknowledge that Mr. Samuels and his
    staff have been very open to participation from the states.
    They have asked and reached out directly to state
    administrators and deeper to--for ideas about how to streamline
    the process.
        Our recommendations--and we have formal recommendations
    that we would be happy to share with this committee--would
    really bring together what are, in effect right now, planning,
    and then a review process, and then a monitoring process, and
    then a come back in and monitor again, into one seamless review
    process that would exist under the CFSR.
        Chairman DAVIS. Thank you. Mr. Yager?
        Mr. YAGER. I would support what Mr. Samuels had said. I
    think that's a great approach.
        I think there needs to be a fundamental shift away from
    multiple on-site reviews, often looking at the same cases at
    different points in time, to looking at the state's quality
    assurance system, encouraging a robust state quality assurance
    system that possibly could be certified by the Federal
    Government. They could then go into information out of the
    state's own system, as opposed to duplicating reviews across
    multiple counties.
        Chairman DAVIS. Mr. Sciamanna?
        Mr. SCIAMANNA. Yes, and we would agree that there is a need
    to do some reform for some oversight.
        One that especially is based more on outcomes for
    children--actually, this committee was, I think, instrumental
    in the Fostering Connections, in that you started to look at
    some of those outcomes in other areas, in terms of health
    planning, in terms of educational outcomes.
        And so, being able to kind of track that, and obviously
    also what is done at the front end, I think would be
    important--what we would like to see is a partnership more
    between the states and the Federal Government, so that that
    oversight and plan improvements can be jointly developed and
    implemented.
        Chairman DAVIS. I appreciate that. One of the things that
    we have started to work on in this subcommittee with an earlier
    piece of legislation--hope to see follow through every one of
    the entitlement reauthorizations--is data standardization and
    data integration that would allow us to bring the Federal
    Government into the 21st century, and move away from the old
    Cobalt-based programs of the 1960s and 1970s, make it more like
    the private sector, in terms of both data accuracy, but
    significantly reduce improper payments and, frankly, pushing
    redundant measurement programs out on you from the different
    agencies, so we can drill down and get that data, and hopefully
    have a more proactive partnership.
        With that, I would like to recognize the gentleman from
    Minnesota, Mr. Paulsen, for five minutes.
        Mr. PAULSEN. Thank you, Mr. Chairman. I will just ask a
    question of Ms. Wareing. You mentioned--at the end of your
    testimony you talked about one-fifth of the SSBG funding, about
    340 million of it, was devoted to prevention. I just noticed at
    the end of your testimony. Can you provide some additional
    background on that program, just for the record?
        I guess I am kind of interested in knowing what states
    spend that $340 million specifically on that you said is
    devoted to prevention. Like what type of prevention services,
    with at least some description of what those services do, or
    what they are.
        Ms. WAREING. Mr. Chairman and Congressman Paulsen, let me
    try to broad-brush, and if there are more specific information
    that we could detail you, provide for you with how states
    specifically spend that money, we are happy to do that
    research.
        But SSBG funding is the second-largest funding source for
    prevention activities, next to Promoting Safe and Stable
    Families for states. And they are able to leverage those
    dollars and really direct them to community-based services that
    are really designed much more on the prevention side of
    supporting families and--in the hopes that we are able to keep
    children safe and families well.
        And so, they could be things like some of the same kind of
    things that you might see in Promoting Safe and Stable
    Families. It could be community supports, it could be home
    visitation. It could be neighborhood parenting types of
    classes, and those types of things. You know, many of them, I
    think, are evidence-based--some of the questions that
    Congresswoman Black had talked about, in terms of ensuring that
    sort of--that the dollars are actually going to programs that
    work.
        But I would also say there are very few programs that have
    the kind of flexibility where you can leverage other dollars.
    And that is really what SSBG provides. It allows funds that may
    not be sufficient for a particular community to really be--to
    give you that extra push that you really need.
        Mr. PAULSEN. Is there a way to identify, like, how many
    families or people are actually served by this spending on
    prevention services, to get down to that type of data? Can you
    drive down to that?
        Ms. WAREING. Mr. Paulsen, I don't know, off the top of my
    head, but I would certainly be willing to look at that.
        Mr. PAULSEN. Or even what the average amount, for instance,
    per family or per person is, you know, allocated or is a part
    of that, just to--that would be helpful data, I think, as we
    are kind of looking at the--sort of the prioritization or the
    benefits of some of these programs, because you did note that
    in the testimony.
        Ms. WAREING. Yes, absolutely. And it is incredibly helpful
    funding. I would say it is designed to be flexible funding. And
    so I am not sure, off the top of my head, how precise they can
    go to the dollars spent per family, but we will certainly look
    at that for you.
        Mr. PAULSEN. Please, Mr.----
        Mr. SCIAMANNA. Just in regard to the social services block
    grant, there has been a series of surveys of states conducted
    by Child Trends most recently, and Urban Institute every two
    years, asking states what they spend on child welfare services.
    And SSBG has pretty consistently been around--I think it's 20
    percent of the Federal funding that states invest.
        It varies by the 50 states. It will be about 300 million in
    the child protective services, nationally, but may also
    supplement what states do in terms of foster care, adoption
    assistance and support, and for youth. So there is a range of
    services that it does provide. But it has been a very critical
    component of the child welfare funding system.
        Mr. PAULSEN. Thank you, Mr. Chairman. I yield back.
        Chairman DAVIS. Thank you. The chair recognizes Mr. Reed
    for five minutes.
        Mr. REED. Thank you, Mr. Chairman. I am hearing kind of a
    consistent theme here from the panel and from testimony that is
    coming across. Essentially, what I am hearing is that we need
    less auditing, more streamline reporting requirements to the
    Federal level.
        But I would note that when I read the testimony I see some
    successes. I see 27 percent less kids in foster care, I see 20
    percent over the last 5 years kids in foster care. So, does it
    not beg the question--I would be interested in the panel's
    response to--we have to be doing something right. And that
    has--we heard Mr. Samuels's testimony as to previously the
    requirement on the states was to give us a plan, and now it is
    give us a plan and then give us an accounting of how you spent
    the money.
        So, my gut tells me that that change in philosophy of
    accountability, it seems to be--being implemented in this area.
    It seems to be working. So, is there any disagreement with that
    philosophy from anyone on the panel?
        [No response.]
        Mr. REED. Okay. So when we recommend less auditing, less
    accountability, if you would, from the states to the Federal
    Government, how do we maintain the successes by removing that
    accountability provision? Mr. Sciamanna?
        Mr. SCIAMANNA. I guess it is not less accountability, but
    refining it. I think the child family service reviews were an
    important act by Congress in 1994. And I think even some of the
    states will say--they may have problems with what the current
    process is, but it did engage a number of stakeholders. So I
    think the question is more about a refinement of that process,
    and what is the most efficient way to oversee the states.
        So, I think that is more of the debate, because certainly a
    number of advocacy groups and states will have different ideas,
    but we do need to have that oversight, because we should be
    doing a lot more for a lot of these families.
        Mr. REED. Okay. Mr. Yager?
        Mr. YAGER. And certainly we would agree with that. The
    accountability is important. That is not something that we want
    to shy away from. What we would suggest is that--is how they
    hold states accountable is what makes a difference.
        If they come in and do multiple reviews, looking at same
    sets of cases, requiring a lot of our staff to focus a lot of
    time, and then write independent corrective action plans for
    each of those reviews, versus looking at the state's own data
    system and encouraging a robust data system that can be relied
    upon to prevent them from coming in at multiple points, they
    could rely on our data, supplement that with some coordinated
    efforts on site, and then produce their reports----
        Mr. REED. Well, that is good to hear. So no one is really
    objecting to the accountability.
        Mr. YAGER. No, sir.
        Mr. REED. It is just a matter of getting the information
    streamlined.
        Mr. YAGER. Yes, sir.
        Mr. REED. And I am interested--and there is a lot of
    testimony in here--about prevention, preventative action. And
    that, in my gut, makes sense.
        I note the court improvement program, Ms. Hopper. You
    indicated that the court improvement program contributed to the
    success in Virginia. Can you tell me exactly concrete examples
    of what programs, what preventative measures you took to
    accomplish that?
        Ms. HOPPER. Well, the courts, of course, don't deliver
    programs. But they monitor the cases as they come in. And I
    think one of the critical components in the work that has been
    done in Virginia is the collaboration across all of the child
    serving agencies.
        One of the mantras in Virginia is that it is not just
    social services that is responsible for these children; they
    are the community's children. And you need to bring together
    the schools, mental health agency, the health department with
    Medicaid. All of those agencies need to be at the table in
    supporting local departments of social services who hold
    custody of children in foster care, and are held--frankly, all
    of them need to be held accountable for delivering whatever the
    support is that the child and the family need to get them out
    of foster care, or get them to some other permanent placement.
        So, to some degree, prevention occurs when you are able to
    engage all of those agencies right at the beginning of the
    entry of the family into care. And one of the things that the
    courts in Virginia have done--and I think is also a hallmark of
    other court improvement programs across the country--is that
    the court is sort of a disinterested party, has the ability to
    provide the leadership to pull them all together and say,
    ``Yes, I may make the final decision, as the judge, but I need
    to know that you all are all at the table supporting the
    family, and ultimately the agency, if they have--if the court
    has to put the child in care in resolving these problems.''
        So, that kind of collaboration, which is supported by the
    child and family services review--but it has got to be more
    than a federally-directed effort. It has really got to be a
    locally-supported effort to be effective.
        Mr. REED. I know my time has expired. I appreciate the
    testimony, Ms. Wareing. And I did note in your testimony there
    was a study of the nurse initiative out of Elmira, New York,
    which is in my district. I will be reaching out to them to find
    out how that program is continuing to work. So I appreciate
    that.
        Thank you, Mr. Chairman, I yield back.
        Chairman DAVIS. Thank you. Mr. McDermott?
        Mr. MCDERMOTT. Thank you, Mr. Chairman. I received some
    information from a project in the State of Washington. So I
    want to put mine into the record. The Pierce County Alliance
    got a regional partnership grant from HHS to administer a
    promoting safe and family services programs like the one we are
    discussing this morning. It is called the Amphetamine Family
    Services Partnership. And it really is another example--and I
    think all of these, it would be nice if we could get them all--
    and I ask unanimous consent to put in the record a letter from
    Dr. Terry Schmidt-Wayland along with the evaluation of the
    program in the State of Washington.
        Chairman DAVIS. Without objection.
        [The information follows:]

        Chairman DAVIS. I think there are a number of very good
    practices that are out there, and the question is whether we
    have enough money to go further.
        I would say both to Mr. Reed and Ms. Black that the
    visiting nurse business was in the Accountable Care Act. Some
    of us put this in as a part of the whole of the revamp of the
    health care act.
        I would say also, Mr. Chairman, one thing that I wish we
    had up here--we have got these wonderful people who run these
    programs, but I think this audience is filled with people who
    have actually experienced it.
        I happen to know one of them sitting here was taken out of
    her home when she was 12 years old, when her mother was sent to
    prison, and her mother was sent to prison and 8 kids were taken
    into the system. They--when she came out of prison, she was
    deported, although she had a green card. She was deported,
    leaving eight kids here, in the United States. So this young
    woman went through six or seven homes, and then aged out, and
    managed to get herself through college at the University of--or
    Washington State University, and is an intern in my office.
        I would like to hear from you. those of you who are state
    directors, particularly. What are the problems of the
    interaction of the legal system of taking the parent away and
    locking them up, and leaving the kid in a set of foster homes?
        Because one of the issues that we had here on this sheet of
    paper which I sent around to everybody, which is how much money
    we are spending, you look down here, ``Mentoring children of
    prisoners.'' There is nothing.
        And I would like to hear from you what the problems are
    that you see in that particular genre of case, where you have
    taken the kid away and put the parent into prison. You said you
    had lots of it in Kentucky. Here is your opening.
        Ms. WILSON. Thank you. I think one of the greatest concerns
    we have is, particularly with young children, breaking that
    bond between a parent and a child, and how we facilitate trying
    to do visits between children with their parents, when parents
    are incarcerated. That is certainly something that we struggle
    with.
        The other issue, then too, is----
        Mr. MCDERMOTT. Is that because the distance to the state
    prison, or is it the reluctance of the foster parent to take
    the child, or----
        Ms. WILSON. It is a combination of factors. It is distance.
    It is just the sheer logistics of getting children their
    prescribed times for visits.
        One of the avenues that we have taken to try to work with
    this is we have an organization called Prevent Child Abuse
    Kentucky that actually goes into one or two of our Federal
    prisons and conducts classes with parents to prepare them for
    changes in their children. Because the other problem that we
    see is that when parents are released, their children are not
    the children they were when they left. And to help that parent
    be educated about effective parenting, but also about stages in
    development of children, so that when they are reunited they
    are better prepared to deal with the challenges before them
    that their children will bring.
        Mr. MCDERMOTT. What do you find in Virginia and Michigan?
        Ms. HOPPER. With regard to incarcerated parents and their
    children? I was just sitting here thinking one of--the only
    authority in Virginia in the district courts for bringing
    prisoner--we're talking district courts, where these cases are
    handled--for bringing prisoners to court, as opposed to circuit
    courts, is actually in the juvenile court with parents who are
    incarcerated, and are before the court in child dependency
    cases. And our legislature gave us that authority.
        And so, we actually encourage the courts to bring parents
    to court when they are having foster care review hearings or
    permanency planning hearings about their children.
        But the reality of it is, Congressman, that if you are
    going to take a child to a prison to visit their parents, the
    visitor situation is often not very good. It can be very
    stressful for a child. It can be tough to be in that kind of an
    environment. You need training for the people who take them, to
    help them make judgements about what happened to the child
    while they were there, and when they come back. And often these
    parents are there for a very long time.
        Chairman DAVIS. Thank you. The gentleman's time has
    expired. I would echo your sentiments, having been a prison
    volunteer for eight-and-a-half years in the Kentucky
    Corrections cabinet. That is a fairly traumatic experience for
    a child, especially if they have got some history that they are
    carrying in there.
        The chair recognizes Mr. Berg for 5 minutes.
        Mr. BERG. Thank you. One of the most difficult things, I
    think, in this whole process is the unintended consequences,
    where you sit around and you--it is probably no more evident
    than what you are dealing with, trying to figure out the best
    way to help these kids, and yet at the end of the day, the
    practicality of it, it sometimes has the opposite effect.
        And so, I just kind of wanted to expand on this. You know,
    I have--you know, the President has reduced the funding in half
    for this prison program. Is anyone familiar with--you know, I
    have heard it said that actually it is kind of detrimental to
    some of these children, because you are establishing a short-
    term relationship, and then you are kind of pulling that away.
    Is there anyone on the panel familiar with that, and could
    explain that position, if you will?
        Mr. SCIAMANNA. I think--yes, what I read on one of the
    mentoring programs--at least the HHS justification--was that
    their evidence seemed to be that a lot of these mentoringships
    were ending within six months, and I think a significant
    percentage within three months. And the concern is that, when
    that happens, then you reinforce the sense of abandonment.
        So, I think it is--at least in one of the programs they
    talked about better focusing some of the funding. So I--you
    know, I don't' know. You would have to ask the department
    exactly the details in this program. But I think that is one of
    the concerns that sometimes exists in some of these efforts.
        Mr. BERG. And from my perspective, I just really believe
    that unless you measure things you can't manage them. And too
    often we are putting money and putting new programs, and they
    just continue on without anyone really saying, ``Hey, wait a
    minute,'' you know, ``that king doesn't have any clothes on,''
    or, ``It's not working, and how can we''--which kind of bring
    up my other passion, and that is really people at the state
    level, you know, giving them the flexibility to know what works
    and what doesn't work, and allowing them to make those changes.
        And so, I guess, Ms. Wareing, we talked a little bit about,
    I guess what--I would like to ask you about the waivers, and
    you know, how you see that as a--I think you support that, but
    explain how you see that working. And we did pass a bill here
    at the end of May to encourage the waivers, and I was wondering
    if your organization was supportive of that, and maybe you can
    explain how that will help.
        Ms. WAREING. Sure. We are absolutely supportive of the
    expansion, essentially, of what had been the title IV-E
    waivers, as I think other folks have mentioned here, as my
    colleague at the end of the table, Mr. Yager, mentioned, the--
    you know, the ability to use the IV-E dollars in a way that is
    beyond the just bringing kids into foster care. It is really
    the idea of what child welfare finance reform, in a more
    comprehensive way, is driving at.
        It allows states to meet the goals we have said they need
    to meet, and be accountable to those goals, but fit it to what
    their community needs are, and communities are different, and
    states are different. And, you know, the ability to do that and
    take--in a very difficult fiscal time for all of us, be able to
    be flexible with those dollars and use them as smartly as
    possible, we fully support that.
        We also fully support examining child welfare finance as a
    whole. But a huge step would be to expand the ability of the
    waivers to reach many more states for an extended period of
    time.
        Mr. BERG. I will yield back. Thank you.
        Chairman DAVIS. I thank the gentleman. And now the chair
    recognizes Ms. Black from Tennessee.
        Mrs. BLACK. Thank you, Mr. Chair. And I want to follow up
    on the questioning that Congressman Berg just completed, and
    that is the sharing of the information, the good information,
    because you all have--those of you at the state level, you have
    very good stories about what has worked in your state. And
    certainly that is something that should be shared with others.
        At the same time, Ms. Wareing, I appreciate the fact that
    each community, each state, may be different in its own
    complexion, and why it is so important to give that flexibility
    and allow something to incubate at a state that may really be
    very successful.
        I would like to hear from each of you, whether you are at
    the state level or an organizational level, how that
    information that may be a good piece from some place else that
    is doing a good job--how do you get that information? How is
    that shared?
        And we will start with you, Ms. Wilson. I mean, I like a
    number of the things that are in your testimony, and I am going
    to be calling the people that I know back at our state, and
    talking to them a little bit about that. But how would you both
    share what you have done successfully, and then also hear what
    other people are doing?
        Ms. WILSON. Certainly. And I know some of the people in
    your state, and we would be happy to talk with them.
        We have two avenues, actually, of both receiving and giving
    information. One of those is, both through HHS, through ACF,
    and through organizations like APHSA, they are invaluable when
    we have the opportunity to share, either via conference calls,
    to share at conferences, make presentations about specific
    programs. And so, in return, we both provide that information
    and we get that information.
        I think all of us--a common theme that has been expressed
    this morning--I think if you were to look at each of the 50
    states individually, what you would find is that one of the
    things that the CFSRs did above all else was really push states
    to be succinct in their data collection, to target that data,
    and then to use that data. And I think that is the key, is
    using the data to inform the practices.
        So, we look to our national organizations to help us get
    the word out. We look to those organizations also to make
    states aware of practices, promising practices, as well as we
    do ACF, and to share that information among the states.
        Mrs. BLACK. Thank you. Ms. Hopper.
        Ms. HOPPER. The court improvement programs, of course, are
    significantly focused on court processes and relationships with
    communities.
        And the National Council of Juvenile and Family Court
    Judges, through their permanency planning for children
    department, is a terrific resource for us. And they cultivate
    judges across the country with particular expertise--many of
    them come from your states--that are available to us to use in
    our states to call on as resources.
        The National Center for State Courts is also a terrific
    resource.
        And then, the national resource centers that are funded
    through HHS, the Center on Legal and Judicial Issues and the
    Child Protection Center are two that we are currently using on
    training on child safety.
        So, the national resource technical assistance that is
    available probably--I look at it a little bit differently than
    the executive branch does, but they help to pull together best
    practices, and people who are really on the cutting edge of
    these issues. And we rely on them heavily to know what is going
    on across the country.
        Mrs. BLACK. Do you think other states are relying on them,
    as well?
        Ms. HOPPER. Oh, yes, ma'am. I do believe they are.
        Mrs. BLACK. Okay. Great, great. Ms. Wareing?
        Ms. WAREING. I would just add--and Pat so eloquently talked
    about the way that the associations really play a role. But,
    you know, there is a lot of people in this room, many people,
    who come to work every day thinking about the ways in which we
    can better serve, have better, healthier lives for our children
    and families.
        And part of what I think has happened in recent years that
    is remarkable in a way that has allowed really good things to
    happen--and if we didn't say this, I think other people on the
    panel would agree--Promoting Safe and Stable Families, and
    including some of the things that happened in the last
    reauthorization were very helpful. So, you know, that, I think,
    is an important thing to leave the panel with.
        But there is a real shared governance and leadership that
    exists across national organizations, at all levels of state
    and local government. And those are the--the more we can make
    that a dynamic relationship, as opposed to a linear
    relationship, that is the way that things get shared.
        Mrs. BLACK. Thank you.
        Mr. SCIAMANNA. Yes. Actually, I hope American Humane
    Association is part of the solution. We do have a research
    department, based in our Denver office, and we either partner
    with states or localities, as they implement these practices.
    Or we do research around specific programs or practices,
    differential response.
        Something that actually the state of Tennessee is
    implementing, it is the way you design your child protective
    services system. But there was extensive work, and it is
    ongoing work, in terms of the state of Minnesota and their
    progress, where they have had control groups findings on the
    results of differential response, how it has really helped
    families.
        So, in our case, what we have done is we have gone into
    states like Ohio and now New York, and we help them implement
    it on a county-by-county basis. But it is research-based, and
    it is similar to what we are also doing, in terms of the
    fatherhood outreach, through fathers with children in child
    welfare. There is a research component.
        Mr. YAGER. I would quickly add that the ACF hosts
    conferences, and those conferences are very available to us.
    They are often funded for us, and we are able to go and share
    information. But I would also add that there is child welfare
    list servs where we can get on in real time and talk with our
    colleagues across the country and share information back and
    forth about what works and what doesn't work.
        Mrs. BLACK. Thank you very much.
        Chairman DAVIS. I thank the gentlewoman, and I want to
    personally thank each of our witnesses who have come in today,
    taken the time to--some come from far away, knowing you have
    got a day job waiting for you that is accumulating demands
    while you are here with us.
        We look forward to working with you closely in the future.
    Any additional input that you would like to have, certainly we
    are very open to that and want to craft the most efficient and
    proactive reauthorization possible.
        And if Members have additional questions, they will submit
    them to you in writing. What we would ask is that you submit
    your answers also the committee, just so we can insert them in
    the official record, so everyone will have access.
        And thank you all again. And, with that, the committee
    stands adjourned.
        [Whereupon, at 11:12 a.m., the subcommittee was adjourned.]
        [Submissions for the Record follow:]