July 26, 2013 1
Children do best in families

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• 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

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• 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.

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• 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.

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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

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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

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Federal funding for child welfare
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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

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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

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• 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

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

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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

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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

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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

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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

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
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Savings and reinvestment ideas should result in level
funding, but must be implemented as a package

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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.

Panel Discussion
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