Journal Issue: Children, Families, and Foster Care Volume 14 Number 1 Winter 2004
Reforming the Child Welfare System
There is no shortage of innovative child welfare programs and practices, yet in the past, innovations have been implemented as additions to the existing system rather than attempts to change child welfare at the systems level. As one child welfare expert notes, innovative and promising practices and programs are often “subverted and swallowed up by a pathological system.”83 To move child welfare from a crisis-driven system to true reform and renewal, systemic change is essential. Key elements in achieving systemic change include enhancing accountability mechanisms; improving the federal financing structure; providing avenues for greater services coordination and systems integration; and transforming how children and families experience foster care by rethinking the roles of courts and caseworkers.
Strengthening public oversight and encouraging organizational self-examination through enhanced accountability are critical elements for effectively transforming the child welfare system. Two key tools for improving accountability are external review boards and the CFSRs.
Under the 1993 amendments to the Child Abuse Prevention and Treatment Act (CAPTA), states are required to create external review boards to evaluate foster care policies. However, to date, no comprehensive evaluations of the role, function, or effectiveness of foster care review boards have been completed. One review of California's public citizen review boards questioned whether the oversight system met federal regulations.84Additional research on the function and effectiveness of review boards is needed to ensure they are fulfilling their public oversight function.
In addition, as mentioned earlier, the CFSRs are a groundbreaking step toward evaluating states' performance. The ability of the reviews to initiate true reform is linked to the quality and depth of states' performance- improvement plans and the investment states are willing to make to implement comprehensive reforms.
RECOMMENDATION: Enhanced Accountability
To enhance accountability, states should strengthen public oversight by effectively utilizing their external review boards, and ensure that adequate investments are made to fully implement their performanceimprovement plans.
Improving the Federal Financing Structure for Child Welfare
The federal financing framework for the child welfare system is quite complex, with funding coming from several different sources, each with its own requirements and limitations. The largest pot of dedicated funds for the child welfare system comes from Title IVE of the Social Security Act.85 In 2000, Title IV-E provided 48% of all federal spending on child welfare.86 Under Title IV-E, the federal government reimburses states for a portion of the costs associated with out-of-home care, but not for costs associated with prevention, counseling, and drug-abuse treatment.87
Income eligibility for Title IV-E is tied to the status of the birth parents, and the number of income-eligible children varies widely across states.88Currently, Title IV-E income ceilings are derived from the eligibility rules for the Aid to Families with Dependent Children (AFDC) program in 1996 (without adjustments for inflation), even though this program no longer exists. In 1999, approximately 55% of children in foster care were eligible for Title IV-E, but as the benchmark date for income eligibility moves farther into the past, more children are at risk of losing their eligibility. Additionally, American-Indian tribes that provide foster care services to tribal children are not directly eligible for Title IV-E reimbursement.89
Finally, critics argue that the constraints of Title IV-E funding favor placing children in out-of-home placement, and that this may result in too many children being placed in foster care. Although it is unlikely that the constraints placed on federal funding directly affect caseworker decision making, these constraints may squelch innovation and the incentive to invest resources in alternatives to foster care, and may thus reinforce the status quo of out-of-home placement.90
After the Social Services Block Grant, which accounts for about 17% of federal spending on child welfare, the next largest source of funds is Temporary Assistance for Needy Families (TANF). TANF currently accounts for about 15% of federal foster care dollars. In fiscal year 2000, states spent approximately $2.3 billion (14% of all TANF funds) on child welfare.91 Between 1996 and 2000, the amount of TANF funds used for child welfare purposes increased by approximately 317%.92This is due in part to declining public-assistance caseloads and in part to the flexibility of TANF funds. Within certain guidelines, TANF funds can be used for a number of services for which Title IV-E money cannot, such as in-home family services, parenting education, and family reunification services. TANF dollars are also an important resource for supporting kin caregivers. In some states, kin can receive TANF grants to cover the cost of caring for children in their custody, regardless of their own financial status. More than half of these “child-only” TANF grants are to relative caregivers.
At the same time, because TANF dollars are not dedicated to child welfare, their availability for child welfare services could diminish during hard economic times, when the need for public assistance increases. Indeed, in light of the recent economic downturn, states have begun to report declines in TANF funding for child welfare services in 2002 and 2003.93
The diminishing amount of TANF funds available for child welfare since 2000 underscores the need to address Title IV-E funding constraints. In fact, reforming the child welfare federal financing structure has been a topic of concern for several years. To test innovation and encourage reform, in 1994 the federal government approved waivers from Title IV-E funding regulations in 10 states.94In 1997, Congress expanded the number of waivers to 10 per year for 5 years. Waivers are a useful way of determining whether new uses for federal monies can improve outcomes for children and families. Currently, 25 waivers have been granted to 17 states to support such initiatives as subsidized guardianship, tribal access to Title IV-E money, substance-abuse treatment for caregivers, and enhanced training for child welfare workers.95Reauthorizing and expanding the number of waivers available can continue to build a research base to inform the restructuring of federal financing schemes.
Other financing reform efforts are also under way. In 2003, the Pew Foundation created a Commission on Children in Foster Care charged with examining how to improve existing federal financing mechanisms to reduce the time to permanency.96 In addition, this year, the Bush administration has proposed legislation that would give states the option of receiving child welfare funds as a block grant for a specified period of time. Block grants give states greater flexibility in how to spend federal dollars, but they cap the amount of funds a state can receive. Other proposed reforms that might increase the flexibility and reach of Title IV-E monies include giving states the option of delinking from AFDC eligibility requirements, and offering Indian tribes the option of being directly eligible for Title IVE money to ensure that federal dollars flow to all tribal children.
Addressing the challenges of the child welfare system requires greater resources from dedicated funding streams. As Allen and Bissel note, greater investment in children and families in child welfare is urgently needed. Thus, while the heightened interest in reforming federal financing is promising, altering federal funding mechanisms cannot belie the fact that the child welfare system is underfunded. That said, garnering additional resources in the current fiscal climate is an uphill struggle. Finding creative ways to use available funding streams is perhaps the most realistic way for states to increase the amount of federal dollars they can use to serve children in care.
RECOMMENDATION: Flexible Financing
The federal government should extend the flexibility and reach of federal foster care funds by reauthorizing and expanding the number of waivers available to the states and revising outdated eligibility requirements.
Coordinating Services and Integrating Systems
Navigating the complex web of agencies that make up the child welfare system can be frustrating for birth families, foster families, and social workers. Families involved in child welfare must interact with multiple service delivery systems, each with its own paperwork requirements, case plans, and eligibility requirements. Moreover, the lack of integration and coordination between multiple systems undermines efforts to provide continuity of care for children in foster care. The need for greater service coordination and systems integration has become more critical as the number of families in foster care contending with substance abuse or domestic violence has grown, adding further complexity to the overlapping relationship between public assistance and child welfare programs.
Public Assistance As discussed above, a substantial amount of TANF dollars flow to the child welfare system. However, the links between basic public assistance and child welfare are not purely financial. Families dealing with poverty, poor education, inadequate access to health care, and substance abuse are more likely to be involved in both public assistance and child welfare. More than half of the children who enter the child welfare system come from families eligible for welfare. In California, more than one out of every four new public welfare cases had some child welfare involvement in the previous five years.97 In Illinois, nearly 40% of children placed in foster care come from families who received welfare during the months their child was living in foster care.98 Through these “dual-system families,” the infrastructure of family social supports provided by public assistance and child welfare are informally but inextricably linked.99
Dual-system families often report feeling overwhelmed by the competing requirements from both systems. For example, work requirements may conflict with child welfare court appearances and visitation schedules. Coordination between the two systems could help parents meet the requirements of both agencies. Closer collaboration also makes sense because many of the problems dual-system families face affect both their ability to parent effectively and their ability to secure employment.100 Collaboration between public assistance and child welfare programs opens up possibilities for providing preventive services to families who are at high risk of entry into the child welfare system. Finally, both child welfare and public assistance programs have instituted shortened timelines for meeting certain requirements. Coordination of services would allow agencies to work together to assist families in meeting these timelines.
In addition to making the system more navigable for families, greater integration allows for greater information sharing across systems, which in turn would allow agencies to coordinate their efforts and to tailor services to meet unique family needs. Systems integration and information sharing with TANF, as well as other public agencies and service providers, can lead to comprehensive data systems that can track the service usage of children in care.101This information could then be used to document the service usage of individual foster children, improve continuity of care, and improve service planning.
Concerns about confidentiality, disclosure, and mandated reporting are perhaps the greatest barriers to collaboration. Such concerns should not be dismissed. The information collected about children and families involved with the child welfare system is extremely sensitive and, if widely shared, could be damaging. Additionally, the flow of information from TANF to child welfare agencies could result in more families being reported to the child welfare system. To protect children and families from overly intrusive practices, information sharing across systems should not be implemented without clear-cut written policies detailing what information will be shared, with whom, and under what conditions.
Nevertheless, many states are moving forward with creating an infrastructure that is conducive to collaboration. At least 20 TANF agencies have documented policies about how information will be shared across systems, and 13 states have their TANF and child welfare agencies co-located. As a result, greater integration, coordination, and information sharing across these agencies can facilitate more comprehensive and coordinated services to children and families. For example, Ohio has instituted regular meetings between public assistance, child protection, legal staff, and other agencies.102 And at least one state, Oregon, is moving toward consolidating child welfare and public assistance agencies.103
Substance Abuse and Domestic Violence
The links between substance abuse, family violence, and child maltreatment are startling. Because most child welfare agencies do not record this information, family problems with substance abuse and domestic violence often are not identified.104 Nevertheless, studies suggest that 40% to 80% of children in foster care come from families with substance-abuse problems, and child maltreatment co-occurs in approximately 30% to 60% of households where family violence has taken place.105
Failing to identify and offer treatment and services to families affected by substance abuse or domestic violence can lead to children staying longer in foster care. For example, one study found that courts identified a lack of appropriate services, specifically substance-abuse treatment, as a barrier to making prompt permanency decisions.106 Moreover, left unidentified and untreated, chronic family problems such as substance abuse and domestic violence are likely to reemerge after a child is reunified, leading to reentry into the foster care system.
Although there have been several attempts to pass federal legislation addressing the links between substance abuse, domestic violence, and child maltreatment, none have passed.107 However, several states have been granted waivers to test programs designed to address the co-occurrence of these problems. For example, Delaware's waiver allows federal foster care funds to be used to bring substance-abuse treatment specialists into the child welfare agency to assure that families are provided with appropriate substance-abuse treatment when a child first enters care in the hope of reducing the length of time children of substance abusing parents spend in foster care.108 The effectiveness of these initiatives is currently being evaluated; positive results could lead to more states providing integrated services to families.
RECOMMENDATION: Coordinating Services
State child welfare agencies should improve strategies to coordinate service delivery to children and families, including the appropriate sharing of information across programs and services.
Transforming How Children and Families Experience the System
The ultimate test of any effort to reform the child welfare system will be in how children and families experience the system. A prevailing theme throughout this journal issue is the tendency of the child welfare system to prescribe the same solutions for all children and families. Children of different ages receive the same mix of services, despite their differing developmental needs. Birth families are given the same case plans regardless of the specific challenges they may face. Kin caregivers are often treated in policy and practice like non-related foster parents, even though this group of caregivers is different from other foster families and may require specialized supports. The one-size-fits-all mentality of the child welfare system hinders efforts to provide services that are tailored to children's and families' unique needs.
Transforming the child welfare system from one that emphasizes compliance, process, and procedure to one that emphasizes flexibility and individualized treatment for children and families requires a re-imagining of goals. The goals of a transformed child welfare system would embrace a broader vision—a vision that recognizes the central role of protection, placement, and permanency, but that also strives to improve the life experiences of the children and families it touches. Making this transformation a reality starts with a significant rethinking of the roles played by the courts and caseworkers.
Rethinking the Role of the Courts
Courts play a central role in child welfare decision making, but most children and families regard them as foreboding and distant. Birth families often perceive the courts as adversarial and punitive.109 Foster families report feeling discounted, excluded, and unheard by the courts.110 In focus groups with former foster youth, many reported that they did not know what to expect when they went to court, that they felt left out of the court process, and that the court did not take their opinions seriously.111
Part of the reason the courts seem aloof and uncaring stems from the large number of child welfare cases and shortened decision-making timelines they face. Most courts simply lack the capacity to hear cases in a timely fashion, or to facilitate relationship building and continuity among judges, children, families, and caseworkers. Courts rely almost exclusively on state and local funds for operating costs and thus have significant constraints on their ability to increase capacity. Congress recognized the need to improve court performance in 1993, when it made funds available to local jurisdictions for court improvements. As Allen and Bissell recount, these funds have been used to improve how courts implement federal statutes and handle foster care and adoption cases in all 50 states and the District of Columbia.
More recently, the National Council of Juvenile and Family Court Judges has seeded 25 model courts throughout the U.S. to implement comprehensive court improvements. Reforms instituted by these model courts include ensuring clear and timely communication of court hearings, working with advisory groups to address systemic issues, creating “family drug courts” to assist birth families with substance-abuse problems and expedite reunification, and using alternative dispute resolution mechanisms, such as mediation.
The one-judge, one-family approach is an example of a model court initiative that holds promise for changing how judges, caseworkers, families, and children interact in the child welfare system.112 Under this initiative, the same judge follows a family's case from the first decision to remove the child to the permanency decision. It is hoped that the continuity established by following the case from start to finish will result in better decision making.
Rethinking the Role of Caseworkers
The success of foster care depends in many respects on the quality of the relationship between children, families, and caseworkers. Caseworkers are the face of foster care. They are involved at every level of decision making, they link families with needed services, and they can provide children with a sense of continuity that is often lacking in their foster care experience. Yet few caseworkers are able to play this supportive role. Most caseworkers carry large caseloads, labor under cumbersome paperwork demands, and, with minimal training and limited supervisory support, must make life-altering decisions on behalf of children. As a result, children in foster care often report that they rarely see their social workers, and foster caregivers lament the lack of contact and support they receive.
Child welfare workers manage caseloads varying in size from 10 to more than 100 cases per worker, depending upon the type of agency. By comparison, professional child welfare organizations recommend caseloads of between 12 and 18.113 Heavy caseloads limit the amount of time and attention caseworkers can give to children and families. To date, efforts to decrease caseloads have been largely unsuccessful due to persistent staff shortages in most child welfare agencies. In 27 of the 32 CFSRs completed to date, staff deficiencies were seen as contributing to agencies' inability to meet outcome measures.114
Child welfare casework is also a particularly stressful type of social work. In a recent GAO study, a number of caseworkers expressed concerns about the complexity of child welfare cases.115 Specifically, caseworkers reported that more families with drug and alcohol problems and a growing number of children with special needs were entering the child welfare system. Some workers even expressed concerns for their own safety. One study found that more than 70% of front-line caseworkers had been victims of violence or threatened with violence in the course of their work.116
The difficulties of assisting families with complex and diverse needs are exacerbated by large caseloads and cumbersome paperwork demands. The increased emphasis on shortening time to permanency, compiling accurate data on children in care, and meeting accountability requirements have substantially increased the paperwork and data-entry demands and reduced the amount of time workers can spend with children and families.
In addition, because child welfare is a particularly difficult field, a chronic shortage of caseworkers works against efforts to increase educational requirements. Fewer than 15% of child welfare agencies require caseworkers to hold either a bachelor's or master's degree in social work, despite evidence that caseworkers holding these degrees have higher job performance and lower turnover rates.117 Moreover, caseworker salaries are often low, and in some jurisdictions there is wide variation in salaries between public and private caseworkers.118 Thus, recruiting and retaining quality caseworkers is an ongoing challenge for most child welfare agencies.
Nevertheless, improving how children and families experience foster care depends on the ability of child welfare agencies to recruit, train, and retain talented and dedicated caseworkers. The best-planned reform efforts cannot be implemented without a well-trained and qualified staff. Further efforts to provide the right mix of recruitment incentives, quality training, supervisory support, and professional development opportunities are required to build a team of caseworkers capable of serving the complex needs of children and families in foster care.
Child welfare agencies have explored different avenues for increasing the number of qualified social workers on staff, such as forming partnerships with local universities to provide training for current staff and to prepare social work students for a career in child welfare,119 and providing opportunities for ongoing training and career development. However, the federal government could also assist states in recruiting and retaining qualified staff. For example, the government could consider creating a loan forgiveness program for social work students. Loan forgiveness programs are a useful means of attracting individuals to enter critical professions that lack qualified staff. Under such a program, students majoring in social work would be offered loans to support their academic work. Upon graduation, students who went on to employment in a child welfare agency for a specified period of time would have their loans forgiven. Several successful loan forgiveness programs are in operation. For example, to encourage health professionals to consider careers in such fields as clinical, pediatric, and health disparities research, the National Institute of Child Health and Human Development loan repayment program will repay loans associated with training costs, in exchange for a two-year commitment to work in the selected field of study.
The federal government could also make more funds available to private agencies for staff training. Through Title IV-E, the government provides matching funds for staff training and development of up to 75% for public workers but only up to 50% for private workers.120 As private workers make up a large portion of the child welfare workforce, the government should consider equalizing the reimbursement rate to private agencies for training and development to aid in the recruitment and retention of these vitally important workers.
In sum, judges and caseworkers are responsible for deciding the course of a child's journey through child welfare. However, large caseloads, shortened timelines, and other organizational challenges significantly limit these professionals' ability to build solid relationships with children and families that can improve decision making and improve how children and families experience foster care. Courts and child welfare agencies can do more to support judges and caseworkers and improve front-line practices.
RECOMMENDATION: Transforming Frontline Practice
The courts and child welfare agencies should restructure their organizations and adopt practices that support individualized planning and build continuity into the relationships between judges, caseworkers, children, and families in foster care.