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When Child Welfare Works

  1. July 26, 2013 1 Children do best in families
  2. 2 • The Annie E. Casey Foundation has been working to help improve child welfare systems for more than 20 years, which has given us the opportunity to see and support what works. • Based on this insight, we have developed a set of best practices that should guide reforms of child welfare systems. • No jurisdiction has mastered all of these practices, but there is an example of every best practice in multiple systems. • Together, they help ensure child welfare systems: – focus on keeping families together; – help children maintain connections to kin and siblings; – prevent or limit children being placed in non-family settings; – serve all families equitably; – properly support foster parents in their role; and – have a staff with the skills and tools to make good decisions Best practices in child welfare
  3. 3 • Children are removed from their families only when necessary. • Children are placed with relatives first, foster families second. • Foster care is used as a short-term intervention. • While in foster care, regular and ongoing contact with parents and siblings is maintained. Best practices in placement decisions • Children and youth are not placed in shelter care, assessment centers or non- therapeutic group homes. • Young children are not placed in residential treatment. • For older youth, residential treatment is only used on a short-term basis, with extensive family involvement in the treatment process.
  4. 4 • Agencies use strong practice models that focus on permanence and emphasize family and youth involvement in decision making. • Staff are well-trained with good supervision. • Staff have manageable caseloads. Best practices for child welfare system staff and services • Strong quality assurance mechanisms support continuous learning. • Systems provide a wide array of evidence-based in- home supportive services to prevent the need for placement and support reunification. • Reunification and post- permanency services limit time in care and ensure ongoing stability.
  5. 5 Kinship and foster parents are: • Well equipped to address special needs, behavioral issues and child trauma • Well supported by agency staff • Offered in-home services to help address children’s needs • Well integrated into the child’s care planning and treatment process Best practices in kinship and family foster care • Licensing rules ensure foster children live without restrictions that prevent them from enjoying normal extracurricular, recreational, activities and building friendships with their peers
  6. 6 Our federal financing system fails to prioritize these best practices. We can do better with the resources we have to provide incentives for change. Federal funds can be used more effectively
  7. 7 Federal funding for child welfare 7 Title IV-E of Social Security Act, 52% $7 billion Title IV-B of Social Security Act, 5% TANF, 22% Social Services Block Grant, 12% Medicaid, 7% Other, 3% $1.6 billion $1.0 billion $3.0 billion $.4 billion $.6 billion Total Federal Spending = $13.6 billion State/Local Spending = $15.8 billion SFY 2010 Data
  8. 8 Provide support, incentives or accountability for: • Good placement decisions • Timely permanence • Family engagement • Quality family kinship and foster care • Worker recruitment, retention, training • Therapeutic services Opportunities to improve federal child welfare financing
  9. 9 • Federal financing can encourage change. • Comprehensive reform is necessary. • Reforms can be accomplished with level federal funding. • Flexibility is necessary but not sufficient. • System reform trumps programs and services. • We can improve foster care while reducing the need for it. The time to act is now. Threats to key funding streams make the cost of doing nothing far greater than ever before. Building an approach to reform: Basic assumptions
  10. Areas where financing can make a difference There are four key areas in which financing changes can make a difference: Permanence Foster and kinship care Workforce Therapeutic and supportive services
  11. 11 Improving permanence and well-being for children Kids have families they can rely on to help them become successful adults. VISIONTIME IN FOSTER CARE SHELTER CARE, GROUP HOMES RESIDENTIAL TREATMENT INDIVIDUAL DEVELOPMENT ACCOUNTS NOW Reimbursement unlimited Reimbursement unlimited Reimbursement unlimited No IDA Accounts IDEAS Limit number of years of federal reimbursement Not reimbursable Not reimbursable for children under 13; Limit time in residential treatment for older youth IDA program for youth in care at age 16
  12. 12 Improving family foster care Foster families have the training and support they need to help kids grow up in families. Relatives have resources to care for their own. KINSHIP CARE FOSTER PARENTS STATE SUPPORT OF FOSTER PARENTS TAX INCENTIVES NOW Using unlicensed kin with TANF grants acceptable Only reimbursed when child is in home Reimbursed as administrative costs $1,000 tax credit for foster children in home for six months IDEAS All children required to be in licensed homes, with different standards for kin acceptable Allow for reimburse- ment even if child needs to be in residential treatment for a limited time Enhance reimbursement for recruitment, development and support of foster families Increase tax credit for teens, sibling groups and children with special needs VISION
  13. 13 Building a more capable workforce VISION More experienced workers focus on directly helping kids. CASEWORKER LOAN FORGIVENESS CASE WORKERS TRAINING OF CHILD PROTECTIVE SERVICES STAFF ADMINISTRATION ELIGIBILITY NOW Allowed after 10 years Non-clinical counseling to children and families not allowed Not reimbursable Overhead and direct service costs combined Tied to 1996 AFDC standards IDEAS Allowed after four years Allow reimburse -ment for all activities for primary case- worker Allow reimburse- ment for competency -based training Separate overhead from direct service (casework) Phased-in elimination of income eligibility requirement with reduced federal match
  14. 14 Funding social and therapeutic services VISION Increased funding and flexibility for services to prevent placement, promote reunification and provide therapeutic intervention. THERAPEUTIC SERVICES FAMILY SUPPORT SERVICES NOW Enormous variation in states’ use of Medicaid Title IV-B, SSBG and TANF at state discretion IDEAS Require state plan for using Medicaid to meet therapeutic needs of child welfare-involved families; Provide TA to implement recent HHS guidance Sustain and reconfigure existing funds for child welfare; Require greater accountability for TANF funds
  15. Savings Targeted reinvestments Time limit federal reimbursement for foster care Develop IDAs for youth in care at or older than age 16 Eliminate reimbursement for shelters, assessment centers, group homes License all kin caregivers Time limit reimbursement for residential treatment for 13+ Continue to pay stipend to foster parents when kids need short term residential treatment Eliminate reimbursement for residential treatment for children <13 Enhance reimbursement for foster parent development, recruitment, support Administrative clarity and simplicity Increase foster parent tax credits for teens, sibling groups, special needs Eliminate eligibility determination Forgive caseworker student loans after 4 years Distinguish overhead from direct services and related tasks Reimburse casework time provided by child’s worker of record Reimburse child protective investigation training 15 Savings and reinvestment ideas should result in level funding, but must be implemented as a package
  16. 16 Limitations and opportunities • Inherent limitations in using financing incentives to spur best practice • Additional areas in need of reform – Early intervention – Family courts – Tribal administrations – Adoption recruitment and post-adoption support • Uncertain political environment We will host additional meetings to explore these and other areas.
  17. Panel Discussion 17