SPEAKERS CONTENTS INSERTS Tables
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40–823 CC
1997
ENCOURAGING ADOPTION
HEARING
before the
SUBCOMMITTEE ON HUMAN RESOURCES
of the
COMMITTEE ON WAYS AND MEANS
HOUSE OF REPRESENTATIVES
ONE HUNDRED FIFTH CONGRESS
FIRST SESSION
FEBRUARY 27, 1997
Serial 105–3
Printed for the use of the Committee on Ways and Means
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COMMITTEE ON WAYS AND MEANS
BILL ARCHER, Texas, Chairman
PHILIP M. CRANE, Illinois
BILL THOMAS, California
E. CLAY SHAW, Jr., Florida
NANCY L. JOHNSON, Connecticut
JIM BUNNING, Kentucky
AMO HOUGHTON, New York
WALLY HERGER, California
JIM McCRERY, Louisiana
DAVE CAMP, Michigan
JIM RAMSTAD, Minnesota
JIM NUSSLE, Iowa
SAM JOHNSON, Texas
JENNIFER DUNN, Washington
MAC COLLINS, Georgia
ROB PORTMAN, Ohio
PHILIP S. ENGLISH, Pennsylvania
JOHN ENSIGN, Nevada
JON CHRISTENSEN, Nebraska
WES WATKINS, Oklahoma
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J.D. HAYWORTH, Arizona
JERRY WELLER, Illinois
KENNY HULSHOF, Missouri
CHARLES B. RANGEL, New York
FORTNEY PETE STARK, California
ROBERT T. MATSUI, California
BARBARA B. KENNELLY, Connecticut
WILLIAM J. COYNE, Pennsylvania
SANDER M. LEVIN, Michigan
BENJAMIN L. CARDIN, Maryland
JIM McDERMOTT, Washington
GERALD D. KLECZKA, Wisconsin
JOHN LEWIS, Georgia
RICHARD E. NEAL, Massachusetts
MICHAEL R. McNULTY, New York
WILLIAM J. JEFFERSON, Louisiana
JOHN S. TANNER, Tennessee
XAVIER BECERRA, California
KAREN L. THURMAN, Florida
A.L. Singleton, Chief of Staff
Janice Mays, Minority Chief Counsel
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Subcommittee on Human Resources
E. CLAY SHAW, Jr., Florida, Chairman
DAVE CAMP, Michigan
JIM McCRERY, Louisiana
MAC COLLINS, Georgia
PHILIP S. ENGLISH, Pennsylvania
JOHN ENSIGN, Nevada
J.D. HAYWORTH, Arizona
WES WATKINS, Oklahoma
SANDER M. LEVIN, Michigan
FORTNEY PETE STARK, California
ROBERT T. MATSUI, California
WILLIAM J. COYNE, Pennsylvania
JIM McDERMOTT, Washington
Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public hearing records of the Committee on Ways and Means are published in electronic form. The printed hearing record remains the official version. Because electronic submissions are used to prepare both printed and electronic versions of the hearing record, the process of converting between various electronic formats may introduce unintentional errors or omissions. Such occurrences are inherent in the current publication process and should diminish as the process is further refined. The electronic version of the hearing record does not include materials which were not submitted in an electronic format. These materials are kept on file in the official Committee records.
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C O N T E N T S
Advisories announcing the hearing
WITNESSES
U.S. General Accounting Office, Mark V. Nadel, Associate Director, Income Security Issues, Health, Education, and Human Services Division
Adopt a Special Kid/America, Maureen K. Hogan
American Bar Association, Kathi L. Grasso
Child Welfare League of America, David S. Liederman
Kansas, State of, Hon. Bill Graves, as presented by Teresa Markowitz
Michigan Family Independence Agency, Richard E. Hoekstra
National Indian Child Welfare Association, Terry L. Cross
W.K. Kellogg Foundation, Valora Washington
Wulczyn, Fred H., University of Chicago
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SUBMISSIONS FOR THE RECORD
American Humane Association, Englewood, CO, Robert F.X. Hart, statement
Florida Department of Children and Families, Tallahassee, FL, Edward A. Feaver, letter and attachments
Harris County Children's Protective Services, Houston, TX, George Ford, letter and attachment
ENCOURAGING ADOPTION
THURSDAY, FEBRUARY 27, 1997
House of Representatives,
Committee on Ways and Means,
Subcommittee on Human Resources,
Washington, DC.
The Subcommittee met, pursuant to notice, at 11:05 a.m., in room B–318, Rayburn House Office Building, Hon. E. Clay Shaw, Jr. (Chairman of the Subcommittee), presiding.
[The advisories announcing the hearing follow:]
ADVISORY
FROM THE COMMITTEE ON WAYS AND MEANS
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SUBCOMMITTEE ON HUMAN RESOURCES
CONTACT: (202) 225–1025
FOR IMMEDIATE RELEASE
February 20, 1997
No. HR–3
Shaw Announces Hearing on
Encouraging Adoption
Congressman E. Clay Shaw, Jr., (R–FL), Chairman, Subcommittee on Human Resources of the Committee on Ways and Means, today announced that the Subcommittee will hold a hearing on making adoption more frequent. The hearing will take place on Thursday, February 27, 1997, in room B–318 Rayburn House Office Building, beginning at 10:00 a.m.
Oral testimony at this hearing will be heard from invited witnesses only. Witnesses will include a representative from the U.S. General Accounting Office, state child welfare administrators, foundation officials, legal scholars, and child advocates. However, any individual or organization not scheduled for an oral appearance may submit a written statement for consideration by the Subcommittee and for inclusion in the printed record of the hearing.
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BACKGROUND:
Last November, Chairman Shaw asked Rep. Dave Camp (R–MI) and Rep. Barbara Kennelly (D–CT) to work on a bipartisan basis to develop a legislative proposal to promote adoption. After developing a preliminary list of proposals, Reps. Camp and Kennelly met with a wide range of advocates, interest groups, and child welfare administrators to get their reactions to the existing proposals as well as entertaining additional ideas. Reps. Camp and Kennelly, along with several colleagues, will soon introduce adoption legislation based on this effort. The President has also shown his support for encouraging adoption by incorporating an adoption proposal in his Fiscal Year 1998 Budget.
In announcing the hearing Chairman Shaw observed: ''There is now widespread agreement that adoption is too rare and that Federal legislation can help States do a better job of protecting maltreated children while moving toward adoption in a more timely fashion. Given the remarkable level of agreement that we should enact legislation this year, I want the Subcommittee and then the full Committee to build toward a consensus bill in an orderly and deliberate manner. Dave Camp and Barbara Kennelly have gotten us off to a good start. We will initiate the public phase of our work with this first hearing.''
''For too many children, foster care has become a way of life, putting children in foster care limbo. There is bipartisan concern about the fate of these children and an emerging consensus that cooperative action between Federal, State, and local governments can greatly increase the number of these children being adopted,'' Camp said. ''I have no doubt that our hearings will begin to show the public that there are several actions we can take at the Federal level that will actually lead to more adoptions.''
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Kennelly added that the current child welfare system neither provides adequate protection for children nor moves them quickly to permanent living arrangements. Rep. Kennelly declared: ''We look forward to working with the President to protect children and promote adoption. No child should have to wait endlessly for a permanent, loving home.'' Both Reps. Camp and Kennelly stated that, beginning with the Subcommittee public hearing next week, they are looking forward to building a broad consensus for legislation that will increase the number of adoptions.
FOCUS OF THE HEARING:
The Subcommittee will receive testimony discussing innovative State practices in promoting adoption and the emerging issues in the promotion of adoption.
DETAILS FOR SUBMISSION OF WRITTEN COMMENTS:
Any person or organization wishing to submit a written statement for the printed record of the hearing should submit at least six (6) copies of their statement and a 3.5-inch diskette in WordPerfect or ASCII format, with their address and date of hearing noted, by the close of business, March 13, 1997, to A.L. Singleton, Chief of Staff, Committee on Ways and Means, U.S. House of Representatives, 1102 Longworth House Office Building, Washington, D.C. 20515. If those filing written statements wish to have their statements distributed to the press and interested public at the hearing, they may deliver 200 additional copies for this purpose to the Subcommittee on Human Resources office, room B–317 Rayburn House Office Building, at least one hour before the hearing begins.
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FORMATTING REQUIREMENTS:
Each statement presented for printing to the Committee by a witness, any written statement or exhibit submitted for the printed record or any written comments in response to a request for written comments must conform to the guidelines listed below. Any statement or exhibit 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 statements and any accompanying exhibits for printing must be typed in single space on legal-size paper and may not exceed a total of 10 pages including attachments. At the same time written statements are submitted to the Committee, witnesses are now requested to submit their statements on a 3.5-inch diskette in WordPerfect or ASCII format.
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. A witness appearing at a public hearing, or submitting a statement for the record of a public hearing, or submitting written comments in response to a published request for comments by the Committee, must include on his statement or submission a list of all clients, persons, or organizations on whose behalf the witness appears.
4. A supplemental sheet must accompany each statement listing the name, full address, a telephone number where the witness or the designated representative may be reached and a topical outline or summary of the comments and recommendations in the full statement. This supplemental sheet will not be included in the printed record.
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The above restrictions and limitations apply only to material being submitted for printing. Statements and exhibits or supplementary material submitted solely for distribution to the Members, the press and the public during the course of a public hearing may be submitted in other forms.
Note: All Committee advisories and news releases are available on the World Wide Web at 'HTTP://WWW.HOUSE.GOV/WAYS_MEANS/'.
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 202–225–1904 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.
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NOTICE—CHANGE IN TIME
ADVISORY
FROM THE COMMITTEE ON WAYS AND MEANS
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SUBCOMMITTEE ON HUMAN RESOURCES
CONTACT: (202) 225–1025
FOR IMMEDIATE RELEASE
February 25, 1997
No. HR–3—Revised
Time Change for Subcommittee Hearing on
Thursday, February 27, 1997,
on Encouraging Adoption
Congressman E. Clay Shaw, Jr., (R–FL), Chairman of the Subcommittee on Human Resources, Committee on Ways and Means, today announced that the Subcommittee hearing on Encouraging Adoption previously scheduled for Thursday, February 27, 1997, at 10:00 a.m., in B–318 Rayburn House Office Building, will begin instead at 11:00 a.m.
All other details for the hearing remain the same. (See Subcommittee press release No. HR–3, dated February 20, 1997.)
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Chairman SHAW. Good morning. We are glad to have all of you, and also I am delighted to welcome back an old friend of this Subcommittee, Barbara Kennelly, who has been very much involved in the area on which we are going to have this hearing today.
Few issues considered by the Human Resources Subcommittee are more important than adoption. Nothing we do is more important than ensuring children's safety, often by finding permanent homes for them. Consequently, this is an important day for the Nation's abused, neglected, and I might add forgotten children.
This morning, Dave Camp and Barbara Kennelly introduced legislation that seems certain to increase the frequency of adoption in this country. Equally important, Camp and Kennelly have captured a range of ideas in their bill that will provide a starting point for this Subcommittee to develop legislation promoting adoption. I have every confidence that this Subcommittee and the Full Committee will pass this adoption legislation and that we will bring the bill to the House floor and we will pass it with an overwhelming bipartisan vote. This issue is so important and our opportunity to pass a good bill so real that I think it might get through the Senate without extensive debate. That would be a first.
Our hearing this morning and the excellent group of witnesses we have invited will provide a further stimulus to the legislative process. Many of the witnesses have clear and forceful ideas about how Congress can promote permanent placement for abused and neglected children, including sound ideas on how we can promote adoption. I welcome all our witnesses and give them my sincere thanks for appearing before our Subcommittee. We will listen carefully to your advice.
Let me add that I encourage all the Members of the Subcommittee to carefully study the Camp-Kennelly bill, to examine the testimony of today's witnesses, and to reflect on the background material presented to the Subcommittee during our breakfast meeting this morning. Within the next several weeks, I will work with Dave Camp and Barbara Kennelly, as well as other Members of the Subcommittee and with groups and individuals outside Congress, to write a Chairman's markup bill based upon the Camp-Kennelly bill. We will then conduct a hearing on the markup bill and move swiftly to markup.
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In short, this Subcommittee will write and pass bipartisan legislation to promote adoption and will push the bill through the House. During this process, all of us should keep our eye on the real opportunity we have to help those most unfortunate American children.
Ms. Kennelly.
Ms. KENNELLY. Thank you, Chairman Shaw. I would just like to thank you for having this hearing today. As many in the audience do know, it is just the beginning of a process when a bill is introduced. The process then continues by going before a Subcommittee, then Full Committee, then to the floor of the House, and the same thing happens on the Senate side. So I thank you, Mr. Shaw, for doing this in February, giving us time to address the situation.
Mr. Camp and I have worked for a number of months on the bill we are introducing today. However, you always improve things and we are looking to the experts, the people who work out in the field with the individuals involved in this legislation, to bring to us any information they think we should have to improve the bill.
I thank you very much for beginning this session as early as you are on this question and I appreciate it, as Mr. Camp does.
Chairman SHAW. Well, we certainly appreciate the hard work and effort that you and Mr. Camp have done over many months of very tireless effort.
This morning, we will be expecting a vote on the floor somewhere around 11:45, we have been told. At that time, we will recess just long enough for the Members to get over and vote and get back. I will tell the witnesses this morning that I will strictly enforce the 5-minute rule and the reason for that is because we are going to be losing our Members as the House closes down. They will be leaving on airplanes to go back to their home districts and I want to be sure all of the witnesses have an opportunity to be heard with as many of the Members as we can have before you.
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This morning, I would like to welcome the first panel—Mark Nadel, who is a Ph.D., Associate Director, Income Security Issues, U.S. General Accounting Office, here in Washington; Valora Washington, also a Ph.D., program director, Families for Kids, W.K. Kellogg Foundation, in Battle Creek, Michigan; Kathi Grasso, assistant staff director of the Center on Children and Law, American Bar Association, here in Washington, DC; and David Liederman, executive director of the Child Welfare League of America, here in Washington, DC.
Welcome to all of you and, Mr. Nadel, if you would start out this morning. By the way, we have all of your written statements that, without objection, will be made a part of the record and you can feel free to summarize as you see fit.
STATEMENT OF MARK V. NADEL, ASSOCIATE DIRECTOR, INCOME SECURITY ISSUES, HEALTH, EDUCATION, AND HUMAN SERVICES DIVISION, U.S. GENERAL ACCOUNTING OFFICE
Mr. NADEL. Mr. Chairman and Members of the Subcommittee, I am pleased to be here today to discuss State efforts to reduce the time children spend in foster care and, where appropriate, to facilitate adoption. At your request, we are completing a report on the progress States are making to expedite the permanent placement of children. While my written statement covers the full range of issues in that report, this morning I want to focus on how the States are reducing timeframes for permanency hearings and on initiatives designed to expedite the permanent placement, particularly adoptions, for children.
First, I will address State statutory and policy changes that require permanency hearings sooner. The prolonged stays of children in foster care have prompted 26 States to enact laws or policies to shorten the time between entering foster care and the first permanency hearing to less than the federally allowed 18 months. A majority of these States provide for a maximum of 12 months. In two of these States, Colorado and Washington, the shorter timeframe applies only to younger children.
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Now, it should be noted that nearly all State laws, like Federal law, do not require that a final decision actually be made at the first hearing, only that a hearing be held. In our review, we found three types of initiatives that the States have implemented to speed up the process that may end in adoption.
First, some States have streamlined termination procedures; for example, a Kentucky project focused on reducing the time required to terminate parental rights once a permanency decision had been made to do so. This effort included retraining caseworkers, lawyers, and judges on the consequences of long stays in foster care and streamlining the process caseworkers must follow for the termination of parental rights.
Between 1989 and 1991, the State thereby decreased the average time to terminate parental rights by slightly more than 1 year and reduced the average time these kids spend in foster care from about 3 to 2 years. However, as the number of children available for adoption rose, the State was forced to focus its efforts on identifying potential adoptive parents and better informing the public about the availability of adoptive children.
Second, some States are experimenting with concurrent planning. Under this approach, child welfare officials can reduce time by working toward reuniting a family, while at the same time developing an alternative plan for permanently removing the child if reunification efforts fail. Caseworkers can then emphasize to parents that if they do not adhere to the requirements in the case plan, their parental rights can be terminated.
Colorado has started using this approach for children under the age of 6 in conjunction with its law requiring that a permanency hearing be held at 6 months for children of that age. An ongoing evaluation in one county found this process results in a somewhat higher rate of permanent placement—87 percent, compared to 70 percent in a control group.
Finally, we saw some streamlined procedures to improve the functioning of courts. For example, Hamilton County, Ohio, juvenile court officials focused attention on the court's involvement in achieving permanency more quickly by developing new procedures to expedite case processing. The county uses specially trained magistrates to hear cases and achieves continuity by assigning one magistrate for the entire life of the case.
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According to court officials, the county saved thousands of dollars by doing this because they could operate three magistrate courts for what it would cost to operate one judge's court. And also the percentage of children leaving temporary and long-term foster care in 2 years or less increased from 37 to 75 percent.
While these changes hold promise, I would like to conclude by making a couple of observations on what we found. Like any change, these initiatives are not self-implementing and often require a culture change. For example, in the case of Kentucky's expedited process of terminating parental rights, the State faced the challenge of changing the way decisionmakers view termination of parental rights.
Many caseworkers saw termination as a failure on their part because they were not able to reunify the family. As a result, they seldom pursued termination and instead kept the children in foster care for long periods. In addition, judges and lawyers were often not sufficiently informed of the negative effects on children who do not have permanent homes. Thus, as part of this project, newsletters and training were provided about the effects on children of delaying termination of parental rights.
Second, it must be cautioned that these initiatives can also create unintended consequences. Identifying appropriate cases for expeditious termination and processing them faster, thereby making more children available for possible adoption, can create difficulties if efforts to develop more adoptive homes have not received equal emphasis.
Finally, our efforts to assess the overall impact of these initiatives were hampered by the absence of evaluation data. While I have noted that some projects improved timeframes and lowered costs, we found the States generally did not conduct evaluations of their programs and outcome information was often limited to State reports and the observations of State officials. Although many of these reports showed improvements, there was usually no valid basis of comparison. So it was difficult to reach definitive conclusions about the actual effectiveness of these projects.
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The lack of program and evaluation data will continue to hinder the ability of program officials and policymakers to fully understand the overall impact of initiatives and ultimately, of course, to improve them. Incidentally, this problem illustrates why it is so important to have the longitudinal study of child welfare that was mandated in last year's welfare reform legislation. While the scale of that is somewhat different than the projects we are talking about here, it will provide a valuable baseline of information from which to proceed.
Mr. Chairman, this concludes my formal remarks. I will be happy to answer any questions at the conclusion of the panel.
[The prepared statement follows:]
Statement of Mark V. Nadel, Associate Director, Income Security Issues, Health, Education, and Human Services Division, U.S. General Accounting Office
Mr. Chairman and Members of the Subcommittee:
I am pleased to be here today to discuss states' efforts to reduce the time children spend in foster care and, where appropriate, to facilitate adoption. The Federal cost for foster care was almost $3.1 billion in fiscal year 1995 and is estimated to increase to almost $4.8 billion in 2001. Available data suggest that more than 40 percent of foster children stay in care for 2 years or more. In addition, almost 30 percent of children were placed in at least three different settings while in foster care. This situation is not in the best interest of children who, without benefit of permanent homes and stable care givers, may be more likely to develop emotional, intellectual, or physical problems.
At your request, we are completing a report on progress states are making to expedite the permanent placement of children. My testimony today will discuss (1) state efforts to reduce the timeframes within which hearings must be held to determine permanent placements for foster children, (2) state initiatives designed to expedite permanent placements for foster children and the effectiveness of these initiatives, and (3) key factors that facilitate changes in this part of the child welfare system. My comments are based on an analysis of statutory and policy changes in all states and the District of Columbia regarding the timeframes for the first hearing at which a permanent placement for a foster child is to be determined and discussions or visits with child welfare officials in seven states about the programs they have implemented to address the length of time children spend in foster care.(see footnote 1)
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In summary, signaling the importance of permanent placement to the well-being of children, 26 states have established more stringent requirements on the timing of the first permanency hearing than has Federal law, which requires a hearing within 18 months. In addition, the states we reviewed undertook operational and procedural initiatives to expedite the permanent placement process as well as make well-informed permanent placement decisions. Although most of these states did not systematically evaluate their initiatives, they reported that many of the initiatives have contributed to reducing the time spent in foster care or decreasing the total number of foster placements made for a child. State officials reported that the key factors in successfully implementing these initiatives were the long-term involvement of key officials, an extended commitment of resources, and the need for a change in perspective of caseworkers and judges in order to recognize that, in some cases, termination of parental rights is the best solution for the child's future.
BACKGROUND
State child welfare systems consist of a complicated network of policies and programs designed to protect children. With growing caseloads over the past decade, the systems' ability to keep pace with the needs of troubled children and their families has been greatly taxed. From fiscal year 1984 through 1995, the foster care population grew from an estimated 276,000 children to 494,000.(see footnote 2) In 1995, about 261,000 of these children were supported by Federal funds through title IV–E of the Social Security Act.(see footnote 3)
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The Federal Government plays an important role in financing foster care and establishes minimum procedural requirements for the placement process. As required by the Adoption Assistance and Child Welfare Act of 1980 (P.L. 96–272), states must make reasonable efforts to prevent or eliminate the need for removing children from their homes. Once a child is removed from the home, the state must also provide services to the family and the child with the goal of reuniting them. If reunification is not possible, the state is to find permanent placement for the child outside the family home.
To guide the permanency planning process by which a state is to find permanent placements for foster children, the act also requires that the state develop a case plan for each child. Each case plan must be reviewed at least every 6 months and, within 18 months, a permanency hearing must be held to determine the future status of the child. If a final decision is not made at this hearing, Federal law provides that additional hearings be held at least every 12 months. Options for the child's future status can include, but are not limited to, reuniting the child with his or her family, placing the child for adoption, continuing temporary foster care, or continuing foster care permanently or long term because of the child's special needs or circumstances. Increasingly, children are being placed with their own relatives, who then may sometimes receive foster care subsidies.
SEVERAL STATE STATUTORY AND POLICY CHANGES REQUIRE PERMANENCY HEARINGS SOONER
The prolonged stays of children in foster care have prompted 26 states to enact laws or policies to shorten to less than the federally allowed 18 months the time between entering foster care and the first permanency hearing. Twenty-three of these states have enacted such laws, while three others have done so by administrative policy. A majority of these states require the hearing within 12 months. In two states, the shorter timeframe applies only to younger children. Colorado requires that the permanency hearing be held within 6 months for children under age 6, and Washington requires the hearing to be held within 12 months for children aged 10 or younger. The remaining 24 states and the District of Columbia have statutes consistent with the Federal requirement of 18 months. (For a description of the 26 state statutes, policies, and time requirements, see app. I.)
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The state laws, like Federal law, do not require that a final decision be made at the first hearing. Ohio and Minnesota, however, do require that a permanency decision be determined after a limited extension period. Ohio, for example, requires a permanency hearing to be held within 12 months, with a maximum of two 6-month extensions. At the end of that time, a permanent placement decision must be made. According to officials in Ohio's Office of Child Care and Family Services, the requirement for earlier permanency hearings was made to expedite the permanent placement process and reduce the time children spend in foster care. State officials also believed, however, that this requirement may have unintentionally resulted in increasing the number of children placed in long-term foster care because other placement options could not be developed. State data, in part, confirmed this observation. While long-term foster care placements for children supported with state funds dropped from 1,301 in 1990 to 779 in 1995, long-term placements for children from low-income families who are supported in part with Federal funds rose from 1,657 to 2,057 in the same period.
STATES MAKE CHANGES IN PERMANENCY PROCESS WITH SOME PROMISING RESULTS FOR FOSTER CHILDREN
Although the states we reviewed did not systematically evaluate the impacts of their initiatives, they have implemented a variety of operational and procedural changes to expedite and improve the permanency process. These states reported that these actions have improved the lives of some children by (1) reuniting them with their families more quickly; (2) expediting the termination of parental rights when reunification is not feasible, making it possible for child welfare agencies to begin looking for an adoptive home sooner; or (3) reducing the number of different foster care placements in which children live.
New Service Strategies Help Reunification Process
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Some states implemented low-cost, creative methods for financing and providing services that address specific barriers to reuniting families. Arizona's Housing Assistance Program focused on families in which the major barrier to reunification was inadequate housing for the family. According to reports and data from the Arizona Department of Economic Security, between 1991 and 1995, as the result of the program, 939 children were reunited with their families, representing almost 12 percent of the children reunified during this period. State officials estimated that this program saved the state over $1 million in foster care-related costs between 1991 and 1995.
States Streamline Termination Procedures
Arizona and Kentucky placed special emphasis on expediting the process by which parental rights could be terminated. Arizona's Severance Project focused on cases in which termination of parental rights was likely or reunification services were not warranted and for which a backlog of cases had developed. In April 1986, the state enacted a law providing funds for hiring severance specialists and legal staff to work on termination cases. The following year, in 1987, the state implemented the Arizona State Adoption Project, which focused on identifying additional adoptive homes, including recruiting adoptive parents for specific children and contracting for adoptive home recruitment services. State officials reported that the Adoption Project resulted in a 54-percent increase in the number of new homes added to the state registry in late 1987 and 1988. In addition, they noted that the Severance Project contributed to a more than 32-percent reduction in the average length of stay between entering care and the filing of the termination petition for fiscal years 1991 through 1995.
To reduce a backlog of pending cases, Kentucky's Termination of Parental Rights Project focused on reducing the time required to terminate parental rights once a decision has been made to do so. This effort included retraining caseworkers, lawyers, and judges on the consequences of long stays in foster care and streamlining and improving the steps caseworkers must follow when collecting and documenting the information required for termination procedures. A report on this effort indicated that between 1989 and 1991, the state decreased the average time to terminate parental rights by slightly more than 1 year. In addition, between 1988 and 1990, the average length of stay for children in foster care decreased from 2.8 years to 2.0 years and the average number of different foster care placements decreased from four to three.(see footnote 4) However, as the number of children available for adoption rose, the state was forced to focus its efforts on identifying potential adoptive homes and shifted its emphasis to strategies to better inform the public about the availability of adoptive children.
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Concurrent Planning Can Lead to Greater Efficiency
Some states are experimenting with concurrent planning. Under this approach, child welfare officials work toward reuniting a family while developing an alternate plan for permanently removing the child if reunification efforts fail. By working on the two plans simultaneously, caseworkers reduce the time needed to prepare the paperwork for terminating parental rights if reunification efforts fail. Under a concurrent planning approach, caseworkers emphasize to the parents that if they do not adhere to the requirements set forth in their case plan, parental rights can be terminated. Some state officials attributed obtaining quicker permanent placements in part to parents making more concerted efforts to make the changes needed to have their children returned home.
Colorado began using concurrent planning formally in 1994 for children under age 6 in conjunction with the implementation of the law requiring that for children under age 6, the permanency hearing be held within 6 months of the child's entering care. The program has been implemented in five counties. Preliminary data from an ongoing evaluation in Jefferson County shows that 65 out of 78 children, or 87 percent, achieved permanent placement within 1 year of initial placement as compared with 50 of 71 children, or 70 percent, in a control group. State Department of Human Services officials told us that concurrent planning was a key factor that contributed to the success of children's being placed more quickly in permanent homes.
Streamlined Procedures Improve Court Functioning
All decisions regarding both the temporary and final placement of foster children come through states' court systems. Therefore, Hamilton County, Ohio, juvenile court officials focused attention on the court's involvement in achieving permanency more quickly by developing new procedures to expedite case processing. To do so, in 1985, they revised court procedures by (1) designating lawyers specially trained in foster care issues as magistrates to hear cases; (2) assigning one magistrate to each case for the life of that case to achieve continuity; and (3) agreeing at the end of every hearing—with all participants present—to the date for the next hearing.
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According to court officials, the county saved thousands of dollars because it could operate three magistrates' courtrooms for about the cost of one judge's courtroom. Also, a report on court activities indicated that because of these changes, between 1986 and 1990, the number of children (1) placed in four or more different foster care placements decreased by 11 percent and (2) the percentage of children leaving temporary and long-term foster care in 2 years or less increased from 37 to 75 percent.
States Have Not Assessed the Impact of Initiatives
Our efforts to assess the overall impact of these initiatives were hampered by the absence of evaluation data. We found that the states generally did not conduct systematic evaluations of their programs, and outcome information was often limited to state reports and the observations of state officials. Although many of these efforts reported improvements, for example, in speeding the termination of parental rights once this goal was established, the lack of comparison groups or quality data from the period before the initiative made it difficult to reach definitive conclusions about the initiatives' effectiveness.
KEY FACTORS ESSENTIAL FOR MEETING GOALS OF INITIATIVES
States increased their chances of successfully developing and implementing initiatives when certain key factors were a part of the process. When contemplating changes, state officials had to take into consideration the intricacies of the foster care process, the inherent difficulty that caseworkers and court officials face when deciding whether a child should be returned home, and the need, in some cases, for caseworkers and judges to recognize that termination of parental rights should be pursued.
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When Kentucky officials, for example, initiated a project to shorten the process for terminating parental rights, they faced the challenge of changing the way caseworkers and members of the legal system had viewed termination of parental rights. Many caseworkers saw the termination of parental rights as a failure on their part because they were not able to reunify the family. As a result, they seldom pursued termination and instead kept the children in foster care. In addition, judges and lawyers were often not sufficiently informed of the negative effects on children who do not have permanent homes. Thus, as part of this project, newsletters and training were provided about the effects on children of delaying termination of parental rights.
Officials in the states we reviewed recognized that improving the permanency planning process requires concerted time and effort, coordination, and resources. These officials identified several critical, often interrelated factors required to meet these challenges. These included (1) long-term involvement of officials in leadership positions; (2) involvement of key stakeholders in developing consensus and obtaining buy-in about the problem and its solution; and (3) the availability of resources to plan, implement, and sustain the project.
OBSERVATIONS
With the expected rise in foster care caseloads through the start of the next century further straining state and Federal child welfare budgets, increasing pressure will be placed on states to develop initiatives to move children into permanent homes more quickly. Many of these initiatives will need to address the difficult issues of deciding under what circumstances to pursue reunification and what time period is appropriate before seeking the termination of parental rights.
We found promising initiatives for changing parts of the permanency process so that children can be moved from foster care into permanent placements more quickly. Developing and successfully implementing these innovative approaches takes time and often challenges longstanding beliefs. To succeed, these initiatives must look to local leadership involvement, consensus building, and sustained resources.
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As these initiatives become a part of the complex child welfare system, however, they can also create unintended consequences. Identifying appropriate cases for the expeditious termination of parental rights and processing them faster—thereby making more children available for possible adoption—can create difficulties if efforts to develop more adoptive homes have not received equal emphasis.
We also observed that a critical feature of these initiatives was often absent: Many of them lacked evaluations designed to assess the impact of the effort. The availability of evaluation information from these initiatives would not only point to the relative success or failure of an effort but also help identify unintended outcomes. The lack of program and evaluation data will continue to hinder the ability of program officials and policymakers to fully understand the overall impact of these initiatives.
Mr. Chairman, this concludes my formal remarks. I will be happy to answer any questions you or other Members of the Subcommittee may have.
For more information on this testimony, please call Gale C. Harris, Assistant Director, at (202) 512–7235. Other major contributors are David D. Bellis, Social Science Analyst; Shellee S. Soliday and Octavia V. Parks, Senior Evaluators; Julian Klazkin, Senior Attorney; and Rathi Bose, Evaluator.
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RELATED GAO PRODUCTS
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Child Welfare: Complex Needs Strain Capacity to Provide Services (GAO/HEHS–95–208, Sept. 26, 1995).
Child Welfare: Opportunities to Further Enhance Family Preservation and Support (GAO/HEHS–95–112, June 15, 1995).
Foster Care: Health Needs of Many Young Children Unknown and Unmet (GAO/HEHS–95–114, May 26, 1995).
Foster Care: Parental Drug Abuse Has Alarming Impact on Young Children (GAO/HEHS–94–89, Apr. 4, 1994).
Residential Care: Some High-Risk Youth Benefit, But More Study Needed (GAO/HEHS–94–56, Jan. 28, 1994).
Foster Care: Services to Prevent Out-of-Home Placements Are Limited by Funding Barriers (GAO/HRD–93–76, June 29, 1993).
Foster Care: State Agencies Other Than Child Welfare Can Access Title IV–E Funds (GAO/HRD–93–6, Feb. 9, 1993).
Foster Care: Children's Experiences Linked to Various Factors; Better Data Need (GAO/HRD–91–64, Sept. 11, 1991).
Child Welfare: Monitoring Out-of-State Placements (GAO/HRD–91–107BR, Sept. 3, 1991).
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Chairman SHAW. Thank you.
Ms. Washington.
STATEMENT OF VALORA WASHINGTON, PH.D., PROGRAM DIRECTOR, FAMILIES FOR KIDS INITIATIVE, W.K. KELLOGG FOUNDATION, BATTLE CREEK, MICHIGAN
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Ms. WASHINGTON. I am Valora Washington from the Kellogg Foundation. I would really like to share with you briefly what we have done in terms of having a comprehensive community-based change in the adoption systems. In order to have change, we really have to have people thinking differently as a community about what is happening to these children.
Improvements in the courts happening alone, improvements in practice of social workers alone, or anything else will not really be as effective as all of these elements working together. So the Kellogg Foundation has put together in 11 communities, which are listed in the written testimony, a comprehensive plan to change the way people think about these issues and to make concrete outcomes for children achievable, because one of the things we found is that the whole system is characterized by a lack of accountability and a lack of specific outcomes toward which people are trying to achieve.
So we funded 11 States to put together comprehensive plans and to work on various parts of the system simultaneously, and at the same time we supported special grants that are targeted toward court improvement, public policy work, bringing more voices of children of color and people in the communities to the process, strengthening the opportunity for employees to support the adoption of children, and strengthening the voices of families themselves.
We have in the written testimony significant detail about what the communities are doing to achieve this, but I want to emphasize that we are really stressing a community-based approach. We have involved over 14,000 people in these communities telling us what a new vision of the community and the system might be. People told us the same things that you already know.
It takes too long for these kids to get adopted. It costs too much. Children are languishing without being identified. Children of color are overrepresented in the system. The families don't really have their voices heard and the whole system is quite fragmented. And these children are largely invisible to the public and we have got to shed more light on these children.
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We have tried to have a community vision for change and operate around some central values that we feel people have to take a look at if we are really going to change the system. The central value that we look at is seeing what we are doing to children through the eyes of the children themselves, so that even the timeframes that have been established so far are very long in the eyes of a child. A child who is 5 years old and has to wait 18 months for a hearing—that is a really long time, and a hearing that is probably going to be continued several times at that.
What we have tried to do is have our communities and our States focus on outcomes for children, achieving specific outcomes, not processes, not conferences, not a lot of talking, but achieving real outcomes for children, and these outcomes are five that guide everything we are doing.
First, we say that every family should receive support to stay together because too many families are being disrupted unnecessarily. Then we say, when children do have to move from their biological families to another placement, the children should have one caseworker or one casework team, and we also say one judge. They should have one assessment process, not multiple processes. They should have one stable foster home and not be shifted from place to place. That is the way we treat children today. And they should have 1 year to a permanency decision being made, not 1 year to a hearing, but 1 year to a decision, because we are looking at this through the eyes of the child and what children are experiencing.
So there are two things that we have asked every State to do. We have asked every State to, number one, clear the backlog; that there are thousands of children in our system. People don't know who they are and where they are. Let's go to the backlogs and clear those backlogs. Number two, we ask people to fundamentally change the system so that new generations of children don't simply take the seats that the backlogged children experienced.
We have had a number of significant achievements and accomplishments in this comprehensive approach in the 11 States that are provided in detail in the written testimony, but let me briefly summarize what we have achieved.
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First of all, in our Families for Kids sites, we have increased and expanded the number of people who are involved in addressing this issue at a community and State level. This is very important because we know if we are going to have significant change, the whole community has to become more aware of and more involved in the solution.
We have also developed and applied a lot of new service delivery models. We also help to focus more accountability in the system, and I would really like to spend more time with you talking about how we must put more accountability to children into the system.
We have spent a lot of time and effort developing reliable database tracking systems for children, and we focus a lot of attention on children of color, particularly Native American, Hispanic, Latino, and African American children, who are the majority of children caught up in the system.
Some of the examples of how we have achieved these six things are that we have really given resources to make the voices of children and families heard, particularly bringing more of the Native American tribes into the processes. We have institutionalized in many cases 1 year to permanency through reducing timeframes, changing some of the legal requirements, reducing the number of changes in court venues, and so forth.
We have institutionalized the one-assessment outcome using a lot of the family conferencing model that you have heard the former gentleman talk about. We have institutionalized one caseworker and one judge. We have had some tremendous success in trying to reduce the number of people and changes that the child is experiencing and bring more clarity to the system.
We have institutionalized one stable foster care placement doing dual case planning, concurrent planning, giving more attention to kinship care, and so forth. But most importantly, we have tried to focus on accountability. For the first time in most of these States, we know who the children are and we know where they are through the data tracking that we have developed.
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I want to say that through this process, about 8,000 children have already been adopted. Many of our States have already doubled the number of adoptions, but we feel there is still very much to be done because just simply doubling the number of adoptions in itself is only part of the solution.
I will be glad to answer more questions.
[The prepared statement follows:]
Statement of Valora Washington, Ph.D., Program Director, Families for Kids Initiative, W.K. Kellogg Foundation, Battle Creek, Michigan
I am Valora Washington, program director for the Families for Kids Initiative of the W.K. Kellogg Foundation of Battle Creek, Michigan. I appreciate this opportunity to share the experiences of our community partners working to place children in permanent homes in eleven states.
The W.K. Kellogg Foundation was established in 1930 ''to help people help themselves through the practical application of knowledge and resources to improve their quality of life and that of future generations.'' Its programming activities center around the common visions of a world in which each person has a sense of worth; accepts responsibility for self, family, community, and societal well-being; and has the capacity to be productive, and to help create nurturing families, responsive institutions, and healthy communities.
FAMILIES FOR KIDS IN BRIEF
Families for Kids (FFK), initiated by the Kellogg Foundation in 1991, has as its goal to achieve permanency for children who are waiting in foster care. Recognizing that the problems facing these children are deep and systemic, in 1993 the Foundation made a number of grants to locations throughout the United States to engage in a visioning process which would involve the broad community in addressing the barriers to finding families for children. In 19 sites, over 14,000 people were convened to discuss the problems and design solutions to them. Of these 19 sites, 11 were selected in 1995 to implement their plans for increasing the opportunities of children in the child welfare system to find permanent families. Grants averaging $3 million dollars over 3 years were awarded to: Pima County, Arizona; Mississippi; Massachusetts; Kent County, Michigan; Montana; Kansas; New York City, New York; North Carolina; Washington; North East Region of Ohio; South Carolina
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In addition to the site/geographic grants, a number of other awards were awarded to catalyze key systemic reforms. These include grants to:
• improve state courts
• inform policy
• strengthen the voices of communities of color
• encourage employer-paid adoption benefits, and
• strengthen the voices of families and communities
Finally, the Foundation is supporting comprehensive efforts to evaluate and offer public information about waiting children.
In this testimony today, I will share with you an overview of the FFK community-based approach to systemic reform; what communities across the nation have told us are the challenges that must be addressed; the FFK vision for change; and our initial achievements and lessons learned.
FAMILIES FOR KIDS: AN INCLUSIVE, COMMUNITY-BASED APPROACH
Our story began in 1990 as the Foundation developed a programming plan for the decade. In this process, we realized that most childhood programming generally assumed children were raised in their biological families and communities of origin. Generally overlooked in this assumption is the nearly 500,000 children who reside in foster care on any day. Most foster children need temporary placement while their parents improve their parenting abilities or bring stability to their own lives. However about 100,000 children will be unable to return to their biological homes.
Could the Foundation, we wondered, help create a better future for these waiting children who will not be returning home? After extensive consultation with adoption experts—including families—we realized right away that another set of demonstration projects would not be most useful. Throughout our Nation there already exists dozens of effective strategies and innovative specialty agencies. We realized the time had come to build upon the successes of what we already know through decades of research and practice. How could communities bring to scale and institutionalize changes that would make a lasting difference for ALL children, not just the lucky few in a special program?
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Urged by its advisors to support comprehensive change, the Foundation issued a request-for-proposals titled Families for Kids: a Grant Program to Change Adoption Systems (1992). More than 200 proposals were submitted. Rather than fund a number of isolated proposals, however, the Foundation decided to establish a strategic initiative that could unify and strengthen the efforts outlined in the best of the proposals. Designed expressly to help communities define their own solutions to the tragic problem of waiting children, community visioning became the central planning strategy.
We discovered through experience that the community visioning process could draw together representatives from all sectors of the community to plan collaboratively toward a common goal: a permanent ''forever'' family for every waiting child. We also discovered that visioning could help planners transcend the mental limits imposed by constantly experiencing the system as it is, freeing them to reimagine the system as it could and should be. These acts of imagination in the service of change also helped communities create, from diverse perspectives, a common ground of values and strategies. Finally, the community visioning process generated passion and inspired hope, that most fragile and necessary ingredient of systems change.
WHAT COMMUNITIES TOLD US: THE CHALLENGE
As FFK has unfolded, both the Foundation and its community partners learned a number of invaluable lessons and identified some common perceptions of the challenge. What communities told us is briefly summarized below:
• IT TAKES TOO LONG. Children reside in foster care for long periods of time before achieving permanency. We know that waiting children lucky enough to be adopted will first spend an average of 3.5 and 5.5 years in a limbo of temporary placements. Less fortunate are the thousands of children in care who ''age out'' of the system or are emancipated without ever experiencing a stable, loving, permanent home.
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• IT COSTS TOO MUCH. Between 1989 and 1991, a $200,000 project of the American Bar Association—reduced the time children spent in foster care by as much as 18 months, resulting in a savings of $2 million.
• CHILDREN LANGUISH WITHOUT BEING IDENTIFIED. While practitioners are keenly aware that many children are waiting for a family, actually identifying the specific children can be a daunting task. Automated information systems may not have up-to-date and accurate information. For a host of reasons, identifying and maintaining accurate information on children in need of permanence is a major undertaking.
• CHILDREN OF COLOR ARE OVERREPRESENTED IN THE FOSTER CARE SYSTEM. Children of color make up over half of the children in substitute care in the 31 states from which data is available—nearly twice their representation in the national average.
• SERVICES ARE FRAGMENTED AND THE SYSTEM IS UNCOORDINATED. Foster care and adoptions are separate units in most jurisdictions in the United States. Fragmentation also is the result of many workers—both private and public—attending to one case. Through the life of his/her case, a child will have many social workers. Further, a child's case may easily appear before three to six different judges.
• FAMILIES ARE NOT FULL PARTICIPANTS. Although they may be the primary focus of change, traditionally parents and other family members have had little role in the decisions affecting them. The end result in many cases is that the process of terminating parental rights becomes highly adversarial, with parents becoming disaffected from their child, from family members who could be assisting their child, and from the entire child welfare system. The role of foster parents and adoptive parents also may be complicated. Foster parents who have traditionally been seen as temporary care givers now include the child's kin, long-term foster parents, and potential adoptive parents. Thus their roles are highly charged with multiple options and decisions, which may not be fully understood.
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• CHILDREN IN FOSTER CARE ARE LARGELY INVISIBLE TO THE PUBLIC. Public awareness of adoption issues largely has not gone beyond sympathy for ''Baby Jessicas''—a relatively few healthy, white infants and toddlers who have been fought over in the courts by well-fixed nuclear families embroiled in custody disputes. Unfortunately the tens of thousands of bereft waiting kids with special needs—FFK's target population—remain invisible.
Communities have experienced deep frustration and a bit of cynicism as they begin to address these complex challenges. As I will testify later, FFK sites are experimenting with creative remedies to address these issues.
A NEW VISION FOR CHANGE
Every child can have a permanent home. Both the substance and process of achieving this broad goal for FFK is monitored through the lens of a clear set of deeply held values; five specific measurable outcomes; and two key strategies. These values, outcomes and strategies are outlined below:
VALUES
Six values were developed from the community visioning process.
• Looking at Reform Through the Eyes of a Child. Our child welfare system was established with the best intentions, yet it was designed primarily to meet the needs of adults and institutions. FFK communities use a new lens through which to view the current system and make change: the needs and perspectives of waiting children.
• Doing as Well as We Know. Many small specialty adoption agencies have already designed effective systems for helping waiting children find families. FFK grantees are making these and other model programs available to all waiting children in their target populations.
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• Putting Families and Communities in the Driver Seat. History teaches us that reforms designed and imposed from the top fail or have limited success. In FFK communities, families and communities play leading roles in developing reform plans, informing system decisionmaking, and advocating for change.
• Diversity. Every FFK team includes people from major community and ethnic groups, together with professionals from across the child welfare and court systems.
• Collaboration. FFK communities have forged strong public/private partnerships among child-serving agencies and involve consumers in system processes.
• Comprehensiveness. Rather than address isolated problems with isolated programs, FFK communities are engaged in reforming many sectors of the system simultaneously.
THE FIVE OUTCOMES
The Foundation also distilled five measurable outcomes from the best of the early proposals. These five outcomes have become the benchmarks against which FFK progress is measured and will be the pillars of a reformed placement system:
• Comprehensive support to keep families together
• Only one caseworker or casework team to handle each case
• Only one assessment process to determine need
• Only one stable foster family before permanent placement
• Only 1 year to permanent placement
These outcomes interact synergistically and must all work together to achieve real system reform. Evidence of activity to support one outcome necessarily relates to other outcomes as well.
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KEY STRATEGIES
To achieve these outcomes, two clear strategies have been articulated. As a first step, each site undertook to identify the existing backlog of children waiting in the foster care system in their jurisdictions and to propose strategies for meeting these needs of these children to achieve these outcomes. Second, for the long term, sites aim to fundamentally reform child welfare systems so that future backlogs will not occur.
INITIAL ACHIEVEMENTS AND LESSONS LEARNED
Initial results from the FFK Initiative indicate evidence to support six accomplishments:
• FFK has expanded the circle of participants involved in the change process.
• K has applied new service delivery models. These include not only systemic changes in the traditional child welfare services but also streamlined court procedures and new programs for legal education.
• FFK has helped to focus accountability on the mandate of the child welfare system in terms of policy and practice.
• FFK is developing reliable data-based child tracking systems that are now driving reform. These models are making systemic, measurable impacts on the backlogs of waiting children.
• FFK has drawn needed attention to the issues of children of color.
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EXPANDING THE CIRCLE
To increase the voices of families and children and other community members in the development of the adoption change system, one of the major activities of FFK sites relates to expanding the circle of participants in creating a new future for children. From the start FFK has seen itself as a community-based reform—one that sought to include previously excluded players such as children and families; it also has seen itself as a movement aimed at comprehensive, fundamental reform that could be successful only if it created extensive collaboration between child-serving agencies. Thus, establishing and maintaining new working partnerships has been a continuing preoccupation.
There are three major types of FFK partnerships:
• Community Partnerships in Reform Planning were used in all 11 sites as part of the visioning process.
• Public/Private Partnerships. In eight of the 11 sites, private agencies are either the grantee or cograntee, or have a formal partnership arrangement with the public agency.
• Partners in New Service Models: FFK sites are using a variety of community-based organizations and agencies, together with support from the corporate sector, to provide core permanency services. And, children and families are being involved in decisionmaking about their futures as never before. For example, Mississippi provided more than 30 counties, including the Mississippi Band of Choctaws, financial assistance to develop County Family Advocacy Committees. Youth in Mississippi (the Sun Team) and New York (Foster Care Youth United) have been powerful voices for change. In Montana, the consensus is that current state-tribal relations represent a historic breakthrough. And a regional collaboration in Ohio FFK unites nine counties in the northeastern region of the state as they meet their particular needs while learning how to operate collectively in program and policy areas that affect all nine.
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APPLYING NEW SERVICE DELIVERY MODELS
FFK projects collectively have already resulted in new models of service that are both institutionalizing the five outcomes and beginning to reduce the backlogs of waiting children. No one project has all the answers, but together they have the potential to point the way to a system that can work for children. Compared to their predecessors, all these models are more:
• clearly designed with the principle of timely permanence as an organizing concept
• culturally relevant to consumers
• supportive of the participation of families and relatives in system decisionmaking
• flexible in the range of services available to consumers
• open to ideas and expertise from a variety of sources both inside and outside service organizations, and
• informed in their decisionmaking processes
Highlights from some of the most promising of these models follow and are related to the FFK five outcomes below.
(1) Models to Institutionalize ''One Year to Permanency'' Outcome.
• With the technical assistance of the University of Michigan Child Advocacy Law Clinic and the leadership efforts of several highly influential judges, many of the sites have made statutory changes to streamline case processing in the courts. These changes speed the placement of waiting children by:
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—reducing timeframes for abuse and neglect hearings and related investigations (WA, SC, OH)
—improving compliance with the 12-month standard of P.L. 96–272 judicial reviews—or even exceed these requirements (SC, AZ)
—changing the legal requirements for termination of parental rights (MT, NYC)
—reducing the number of changes in court venues (MS, MA)
—making courts more uniform in operations (WA, MA, MS)
—embracing the ''one-case-one-judge'' principle by lengthening judicial assignments, improving court calendaring, and exploring the development of family courts (WA, MA, AZ, OH, and NC)
• The University of Michigan Child Advocacy Law Clinic also offers:
—technical assistance to startup child advocacy law clinics (Begun in SC, WA, AZ; under discussion in MS, MT and others)
—development of a network of child welfare law offices (A guidebook for opening such offices has been completed; offices from all sites are identified and connected on the World Wide Web.)
—a legal resource hotline for child welfare judges and lawyers (Dissemination of this model to other states has begun.)
—special fellowships for law students and senior judicial personnel in grantee communities (41 law students trained and placed in FFK sites; 4 senior fellows graduated to date.)
• Kansas has developed a special computer program which presents pictures and information on waiting kids and often travels with a special FFK van to state fairs and other local events where families can use portable computers to locate children available for adoption. Kansas has also had extraordinary success in winning the recruitment support of major corporations.
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• Mississippi offers an example of a broad-based recruitment effort which includes a consortium of adoption agencies, statewide contract recruitment specialists, a network of churches, and county advocacy Committees. Each of the adoption agencies in the Family Builders Consortium has committed to placing a specific number of children in the backlog.
• Many sites (notably WA, SC, NYC, and MA) are actively engaged in establishing far-reaching changes in practice, including
—revising administrative codes in accord with the Indian Child Welfare Act of 1978, State Tribal Agreements, and judicial rulings
—developing standards of practice on adoption preservation
—implementing standardized risk assessment systems
—standardizing methods for documenting the condition of children requiring placement services
—documenting the types and levels of services provided by contracting agencies
—training workers on a variety of issues such as reasonable effort, joint public/private adoption, and cultural sensitivity, and
—conducting workload studies as a basis for requesting additional positions
(2) Models to Institutionalize the ''One-Assessment Outcome.''
Most sites are now implementing service models that institutionalize the single, coordinated assessment outcome. While the models differ from site to site, they share these common characteristics: they give families and children a real voice in decisions affecting their lives, they greatly widen the circle of community and system players who are working to achieve permanency for children, and they transfer some of the power courts now have to families. Adapting a ''family conferencing'' model pioneered in New Zealand, several sites are drawing not only parents but also extended family members, neighbors, children, and even the perpetrators of maltreatment into the placement decisionmaking process. Additionally children in the backlog are often the beneficiaries of new assessment and planning team efforts like those discussed in the following:
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• In Kent County, Michigan the Family and Community Compact program is aimed at diverting children from entering the traditional child welfare system. The Compact is activated when removal of a child is imminent because of abuse or neglect. All pertinent family members, select friends and professionals agree to attend a family conference, and to develop and implement a permanency plan for the child. The court is only involved if the family does not agree to accept services; the case is closed after 90 days if the service plan has not been completed.
• In Kansas, the family conferencing model—being implemented now in Shawnee County (Topeka)—places children under guardianship of the public child welfare system with relatives who then can become eligible to receive public assistance for the child.
• In Massachusetts, Family Consultation Teams, composed of family members, foster parents, pre-adoptive parents, guardianship parents and providers—are providing support to staff from the Department of Social Services on a variety of key permanency decisions.
• Assessment and planning teams represent coordinated efforts to systematically review cases on a regular basis. The Administration for Children, Youth and Families in Pima County, Arizona has created four cross-functional assessment teams staffed by the Permanency Planning Specialist, Case Manager, CPS Specialist, Adoption Specialist, and a worker with intake experience.
• In North Carolina's eight pilot counties, teams composed of local professionals, foster and adoptive parents, and other interested community members are meeting monthly to review difficult cases and make recommendations to speed permanency.
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(3) Models to Institutionalize the ''One Caseworker'' Outcome.
Clearly, the team conferencing models described in the previous section do, for some children, provide consistent casework through the advocacy of teams with stable memberships and an unwavering focus on permanence. Additionally counties in North Carolina are adopting what they call a ''single caseworker'' or ''single casework team model.''
(4) Models to Institutionalize the ''One Stable Foster Care Placement'' Outcome.
Many of the service models mentioned in foregoing sections will eliminate or reduce ''foster care drift:'' multiple placements together with unconscionably long—three to 5 years—stays in substitute care.
• Another innovation called ''dual case planning'' (or ''concurrent planning'') simultaneously plans for a waiting child's reunification with birth parents and for the termination of parental rights and adoption. This eliminates a second waiting period should reunification fail. This ''foster-adopt'' family model pioneered in Washington, is now being piloted in Sedgwick County, Kansas, and appears to be attracting interest elsewhere, as well. The efforts of FFK state initiatives in testing this model will be important for future child welfare service reforms.
• Washington State has redefined guardianship to include children younger than the previous eligibility age of 12.
• Since Federal reimbursement is not available to support guardianships, the full cost of subsidized guardianships rests with the states. Although most states do not subsidize guardianships, Massachusetts and Washington are providing full subsidies. And, under a Federal waiver from current policy, North Carolina has received permission to apply Federal funds to experiment with assisted guardianships.
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• New policy changes are giving kinship care legitimacy as a permanency option in Kent County and North Carolina; additionally, most sites are exploring the many policy ramifications of kinship care as a permanency option.
• Several sites, notably Massachusetts and Mississippi, are using ''Resource Families'' to offer supportive services to biological, foster, and adoptive parents. Resource families provide a flexible variety of functions: respite care and parent skill modeling to care givers, as well as on-going TLC and mentoring for children.
• Another important service innovation has been the application of discretionary funds and discretionary services to minimize obstacles to permanency without establishing new programs. Several sites, including Arizona, Massachusetts, and North Carolina, are using such funds to assist families in completing the adoption process. Funds might be used for such purposes as legal consultation and recruitment consultation to improve public agency decisionmaking.
(5) Models to Institutionalize the ''Comprehensive Family Support'' Outcome.
Ensuring permanency requires providing services to families of all kinds, first to prevent child removal, and, if that is not possible, to increase the chances of reunification. If reunification is not possible, the child's new caretakers may require supportive services. Three model programs are providing such support:
• Massachusetts is making special efforts to encourage cooperation between the several adults who have or have had primary responsibility for a child's care: biological families, other relatives, foster families and adoptive families. So far, 21 community grants have been awarded providing for family advocacy, family support (including educational and support groups), as well as communication to raise local awareness of the plight of waiting children.
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• Child welfare agencies often provide a limited range of supportive services and offer no way for families to get services elsewhere. Thus families may get services that they don't really need and go without services crucial to permanency for their children. Massachusetts is using a service voucher system that has recently been expanded statewide. Families may use vouchers to purchase much needed beds, transportation services, respite care, day care, or any other reasonable service that meet a critical permanency need.,
• While most biological parents can depend on a variety of tangible child-care benefits offered by their employers, most prospective or actual adoptive parents cannot. The Adoption and the Workplace project, funded by an FFK grant to the National Adoption Center, is beginning to change all that. Through the Center's work, 30 employers have made new or enhanced adoption benefits available to 500,000 employees.
FFK HAS HELPED TO FOCUS ACCOUNTABILITY ON THE MANDATE OF THE CHILD WELFARE SYSTEM
The foundation of systems change is the recognition of the mandate of the permanency objective of child welfare. This foundation consists of both policy, either statutory or regulatory, and practice, the implementation of policy throughout the system. Model services which exist outside the main policy framework have only limited ability to influence the system, since an integrated approach with coherent policy and consistent practice is needed for systemic change. To date, the FFK initiative has focused on three main areas of policy and practice
• expanding permanency options through kinship care, guardianship and subsidies
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• reducing the length of time a child will wait for adoption and
• improving social work practice.
A few examples:
• Several communities have passed legislation to reduce the timeframes related to abuse and neglect hearings.
—Newly revised legislation in Washington changes the definition of abandonment to 3 months where there has been no contact with the child or agency by the birth parent or financial contribution to the child's care.
—In South Carolina, the Children's Code Act of 1996 provides for shortened timeframes for investigations and hearings on child abuse and neglect. Expedited judicial review for probable cause for removal must occur within 72 hours compared to the current 10 days.
—South Carolina and Arizona have passed new statutes to ensure timely judicial reviews of cases although full implementation is yet to be realized.
• Changing the legal requirements for termination of parental rights has received significant attention by many sites.
—In Montana, a Task Force to review statutes affecting adoption and make recommendations for changes in the statutes was mandated during the 1995 legislative session and its work is nearly complete.
—Mississippi and Massachusetts have passed legislation that places the responsibility for termination of parental rights under the jurisdiction of the Juvenile or Youth Court, which is the Court with jurisdiction for abuse and neglect petitions, thus reducing changes of court venue.
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—In South Carolina, disallowing a petition to terminate parental rights can no longer be based solely on the grounds that there have been insufficient efforts to offer rehabilitative services to families.
—In Ohio, when foster parents or relatives adopt, the 6 month wait to finalize adoption is maintained, but the time spent with foster parents or relatives before adoption is credited to the wait time.
• Changing the administrative/management structure is also being pursued.
—Massachusetts implemented performance based contracting for adoption services in 1995. This contracting system and payment methodology is based on the completion of specific adoption milestones. The payment methodology provides incentives for timely placement with adoptive families.
—Kansas has recently embarked on a sweeping plan to implement privatization of all child welfare services in the state except child protective services.
FFK IS DEVELOPING RELIABLE DATA-BASED TRACKING SYSTEMS
One of the most consistent themes to emerge from the evaluation of the initiative is the need to create or improve information regarding children in the system, particularly those waiting for adoption. Fortuitously, the recognition of this need for better information occurred at the time when state child welfare information systems are receiving increased national attention and enhanced funding from the Federal Government. Currently, all sites either are in the process of planning or are implementing modifications or updates to their automated child welfare information systems.
There also is evidence that sites have made significant advances in accessing information from the existing state child welfare information systems and in generating additional information. Combined, these efforts have resulted in increased information about children and their cases. Although the work is far from complete, the expanded base of relevant child and service information, and the more sophisticated use of data by sites are extremely important developments likely to be long-lasting outcomes of FFK. It is important to note that sites are not only using data to describe children and system processes; they are also using data to drive change, as the following examples will show.
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• In Pima County, Arizona, data developed by the FFK initiative is used by the cross-functional assessment teams in case planning and by supervisors in monitoring case movement and providing supervisory consultation.
• In South Carolina, an adoption tracking system has been used to produce studies of county foster care activity, time in care, stability of care, and sibling placement. Interestingly, these ''new'' data are now used by the State in its official evaluations of county directors. This reflects a level of performance accountability that historically has not been present in the child welfare field.
• In Washington, there has been an emphasis on using data in setting regional performance expectations and in aiding management and practice decisions.
• In Ohio, systematic analysis of state data was instrumental in helping the state discover the sometimes inappropriate use of a long-term foster care status for children in some counties. The state is now reevaluating the use of this status.
Many sites have already doubled the number of adoptions (SC, Kansas) Cluster evaluators estimate that the number of annual adoptions across all sites is approximately 8,000. These early successes must be tempered by the following qualifying information:
• the number of kids adopted remains small in comparison to the numbers of kids in care.
• the number of kids in care more than 1 year has decreased only in Kansas. It has stayed the same or increased slightly in other sites.
• kids of color continue to be grossly over represented in foster care, and
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• in a majority of sites children of color continue to be under represented among those children who are adoptees
These trends will need careful monitoring. At the present time, they are understood as the baseline against which future accomplishments will be measured.
FFK HAS DRAWN ATTENTION TO THE ISSUES OF CHILDREN OF COLOR
Given its focus on identifying and supporting specific children waiting for permanency, FFK sites have addressed the challenge of disproportionality by race among children in foster care. Since 1992, FFK sites have engaged a number of focus groups specifically targeted to develop solutions for the African-American, Hispanic-Latino and Native American children residing in FFK communities. Examples of effort related to children of color include the following:
• In recognition of the need to increase the number of children of color placed for adoption, a number of implementation sites (Washington, South Carolina, Arizona, Massachusetts) are targeting communications toward African-American, Native American or Hispanic-Latino audiences, including bilingual materials and efforts directed toward churches, minority businesses and neighborhood associations.
• The inclusion of adoption-related services that have a cultural focus based on an understanding of the issues facing adoptions today is one of the significant achievements demonstrated by the FFK sites. For example:
—In Kent County, Michigan, efforts are underway to support a community-based kinship care program that is informed by and geared to the specific needs of African-American children and families.
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—In partnership with the Bureau of Indian Affairs, Montana FFK supports permanency specialists on each of the seven reservations who can implement new directions of permanency among the tribes.
—In Washington, an African-American Initiative is funded through a grant to the Seattle chapter of the National Black Child Development Institute.
• In South Carolina the African-American Adoption Center has been established in partnership with One Church One Child of South Carolina and Reid House. Together these organizations have access to more than 2000 predominantly Black churches.
• As part of FFK, the National Latino Child Welfare Advocacy group formed and conducted a multi-methodological study to shed light on the most fundamental question of the needs of Latino children and families. The study focused primarily on six states representing the diversity among the nation's Latino population: California, Florida, Illinois, Michigan, New York, and Texas.
While it is clear that African-American and Hispanic children are overrepresented in foster care, the data on their adoption rates in FFK sites is mixed. We are carefully monitoring these trends in the context of baseline data which we have now collected that can be compared against future accomplishments.
SUMMARY AND CONCLUSIONS
The FFK vision takes its shape from a number of mutually reinforcing elements. First, the initiative's motto, ''A permanent family for every waiting child'' and its tag line, seeing reform ''through the eyes of a child'' have had tremendous intuitive appeal across the political and professional spectrums. Keeping the focus on the real needs of children—through the constant repetition of these themes—has helped system factions overcome turf disputes and form practical and effective working partnerships in pursuit of the common vision. Second, the five outcomes have given a clear structure and direction to these efforts, as have the two strategies of backlog reduction and system reform.
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Together, these efforts have produced four useful lessons:
1. The ''One Year to Permanence'' outcome has emerged as the driver of reform, reinforcing FFK motto and uniting once warring agencies in pursuit of the common vision.
2. Allowing children and families to have a powerful and continuing voice in reform—to tell their own stories—has been indispensable in getting policy makers and professionals to see with new eyes and keep the faith.
3. Many different audiences must be reached if ''permanency'' is to grow as a movement. More precise targeting of new audiences—particularly nonprofessional audiences—is key. Further, more culturally sensitive communications is necessary; this will require more knowledge and understanding and probably new methods.
4. Intense focus and accountability around reducing the backlog of waiting children as a short-term goal has given communities a chance to garner early wins and celebrate concrete successes while still pursuing the more challenging goal of systems reform.
We recommend that any reform effort address six essential elements:
(1) Increase Attention to the Status and Outcomes for Children of Color. Efforts to date have not yet yielded satisfactory improvements for children of color, although they remain the majority group in systems of care.
(2) Support and Consolide the Successes of Best Practices and Models. In the near-term, communities will need to redefine measurable objectives and timeframes in which to achieve them. Work remains to be done to identify successful communities nationwide, their most successful and transportable models, and assist in the process of introducing these models to the field. Areas for replication consideration include:
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• common definitions of permanency outcomes and criteria for assigning outcome goals for children
• timeframes for processing of termination and adoption proceedings
• selection of methods to include parents and relatives in system decisionmaking
• best models and methods for achieving backlog reduction
• best models and methods for institutionalizing the five outcomes
• reconsideration of the relationship of kinship care to permanency
(3) Increase Engagement in Court Reform. Achieving permanency for waiting children is inseparable from court reform. The Foundation conducted an intensive National Networking meeting in January 1997 to share information about existing, successful court models (e.g. South Carolina, Arizona, and Mississippi) and to further emphasize and facilitate community involvement in the Court Improvements Projects.
(4) Enhance Effective Family Advocacy Groups. Communities believe that effective family advocacy groups are necessary to ensure the sustainability of permanency efforts.
(5) Build More Community Capacity to use Data to Drive Reform. The development and use of better information and data has been critical to FFK successes in reducing backlogs and changing service models and policies. As communities share their successes with new audiences, they will need help translating data into messages accessible to the general public.
(6) New Attention to Front End of System. FFK staff in some states report that the front end of their systems are ''going crazy'' with new entrants. This could compromise hard-won achievements by diverting attention and resources away from permanency activities.
Thank you for the opportunity to share these experiences of the FFK communities. For further information, we have available, at no cost, a library of the following resource materials:
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Families for Kids/Adoption Change Brochure/1992
''Families for Kids Who Wait: Promising State and Local Directions in Community-based Adoption Reform''
''Families for Kids of Color: A Special Report on Challenges and Opportunities''
''Families for Kids: Building the Dream''
''Latinos and Child Welfare/Latinos y el Bienestar del Nino Voces de la Comunidad''
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Chairman SHAW. Thank you, Dr. Washington.
Ms. Grasso.
STATEMENT OF KATHI L. GRASSO, ASSISTANT STAFF DIRECTOR, CENTER ON CHILDREN AND THE LAW, AMERICAN BAR ASSOCIATION, WASHINGTON, DC
Ms. GRASSO. Mr. Chairman and Members of the Subcommittee, I appear today on behalf of ABA, the American Bar Association, as the designee of its president, N. Lee Cooper, who has placed a high priority on adoption and the legal profession's involvement in helping children achieve the legal security of a loving and permanent home. As evidence of this commitment, he recently issued a challenge to State and local bar associations to improve legal representation in cases involving abuse, neglect, and adoption.
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I am currently project director of the Michigan Juvenile Court Improvement Program, and prior to my employment with the American Bar Association, I represented hundreds of children in abuse, neglect, and termination of parental rights cases in Maryland, including Baltimore City.
I am speaking today on the vital role of courts in achieving permanency for children in foster care, especially the expeditious adoption of children who cannot return home. My testimony addresses the progress being made as a result of the Federal court improvement grants appropriated by Congress under the 1993 Omnibus Budget Reconciliation Act to the highest courts in each State and the opportunities they provide for systemic improvements.
Under these grants, 48 States and the District of Columbia have been thoroughly assessing the quality of their juvenile court dependency processes. All have applied for continued Federal funding so that they can move to implement the recommendations that are coming about as a result of the assessments.
Preliminary data on the functioning of courts nationwide is emerging as States submit their final assessment reports to the U.S. Department of Health and Human Services. Most reports to date are very thorough, frank, and critical. Many States are identifying promising, innovative approaches to expediting the permanency planning process for children.
I would refer the Subcommittee to figure 1 attached to the testimony for a listing of the numerous issues addressed in the court improvement reports. As identified in the State court assessments and the ABA's work in the field, many courts need to address problems that are contributing to significant delays in achieving permanency for children in foster care and are a primary obstacle to the placement of children with adopted families.
These problems include, number one, insufficient judicial and other court staff to handle overcrowded dockets; number two, serious delays in the courts hearing and deciding cases; number three, unprepared or overburdened attorneys for children, parents, and child protective services agencies; and number four, judges lacking experience or interest in child welfare concerns.
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So far, court improvement projects have recommended reforms that are both realistic and systematic. For example, in Georgia, the Georgia advisory Committee recommended the development and distribution of standards of practice for judges and attorneys working on juvenile cases. Responding to a lack of sufficient judicial staff to carry the overwhelming caseload, Oregon is requesting that its State legislature create additional judicial slots designated solely for juvenile cases.
Self-assessments have also identified a number of jurisdictions with court systems that work relatively effectively and can be models for the Nation. In Michigan, the project team concluded that despite a number of identified problem areas, several courts with a committed and expert judiciary have implemented systems of case scheduling, assignment, and monitoring that are enhancing the courts' ability to make timely permanency planning decisions.
Figure 2 of our testimony lists some specific recommendations from State assessment reports submitted to date. It is important to note that many States, in formulating recommendations for change, are looking to standards on model practice and procedure, known as the Resource Guidelines, that have been endorsed by the National Conference of Chief Judges, the National Council of Juvenile and Family Court Judges, and the American Bar Association.
I would like to close by sharing an experience I had when I practiced in Baltimore City and represented children there in abuse and neglect cases that demonstrates the importance of improved court practices in child abuse and neglect cases. Unfortunately, the case I am about to tell you about was not unique to my practice.
I was appointed to represent a little boy who had been living in the same foster home for the first 3 years of his life. At the time of my appointment to represent him, his foster mother could no longer care for him because of her age. His biological parents had only had minimal contact with him over the course of the 3 years.
At a foster care review hearing, I argued to the court that the local Department of Social Services should immediately find an adoptive home for him and file a court petition to terminate parental rights. The court agreed and framed its order so that the agency quickly moved to implement a permanency plan of adoption. He was adopted soon after and when he met his adoptive parents for the first time—keep in mind he was only about 3—do you know what he asked them? He asked them, ''Where have you been all this time?''
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While it was finally the court that enabled the boy to receive a secure and permanent home, a better court process could have drastically shortened his wait. The very reforms advocated by many of the federally supported State court improvement projects would have speeded his adoption. If there had been earlier and stricter judicial permanency planning hearings, if judges had lower caseloads and were better trained in child abuse cases, if cases were not being transferred among judges, and if attorneys for children and agencies had more time for each case, this child probably would have been adopted much sooner.
I ask you to support the States as they move to reform their juvenile and family court systems so that all children who are the victims of abuse and neglect can come to know the support and love of family and will never have to ask the question of my former client, ''Where have you been all this time?''
Thank you.
[The prepared statement follows:]
Statement of Kathi L. Grasso, Assistant Staff Director, Center on Children and the Law, American Bar Association, Washington, DC
Mr. Chairman and Members of the Subcommittee, the American Bar Association (ABA) appreciates the opportunity to present testimony concerning the need for systemic improvements in our Nation's juvenile court systems so that all children who have been the victims of abuse and neglect can come to know the support and love of family.
My name is Kathi Grasso, and I am an attorney with the ABA Center on Children and the Law. I appear today on behalf of the American Bar Association as the designee of its President N. Lee Cooper. I am currently project director of Michigan's juvenile court improvement program and am working closely with Michigan's State Court Administrative Office in Lansing, as well as with an advisory board comprised of experts on that state's child welfare system. Prior to my employment with the ABA, for over a decade, I represented hundreds of children in abuse and neglect and termination of parental rights proceedings in Maryland, including Baltimore City. In Baltimore City, I was Chief Attorney of the Legal Aid Bureau's Child Advocacy Unit, the office providing legal representation to almost all children in Baltimore's foster care system. My ABA colleagues, Eva Klain and Mark Hardin, also helped to prepare this testimony.
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The ABA has for many years devoted considerable attention to improving court processes affecting children in foster care. In 1980, the ABA House of Delegates adopted a resolution in support of passage of the Federal Adoption Assistance and Child Welfare Act of 1980, P.L. 96–272, 42 U.S.C. 620–629, 670–679. In 1988, the ABA House of Delegates further called for substantial amendments to that Act to strengthen the role of the legal system and ensure more consistent services for children, including creation of Federal fiscal incentives to courts to reduce or limit delays in foster care litigation and improve court rules governing foster care cases. Earlier this month, the ABA House approved a recommendation supporting Federal legislation to remove barriers to adoption.
The ABA Center on Children and the Law has been actively involved with improving the handling of child abuse and neglect proceedings for many years, including previously testifying before Congress on several occasions, developing model statutes and court rules, providing technical assistance to states, and developing legal manuals for attorneys and judges.(see footnote 5) ABA President N. Lee Cooper places a high priority on adoption and the legal profession's involvement in helping children ''achieve the legal security of a loving, permanent home.''(see footnote 6)
I am speaking today on the vital role of courts in achieving permanency for children in foster care and other out-of-home placements, and especially the expeditious adoption of children who cannot return home. My testimony addresses the progress being made as a result of the Federal court improvement grants, appropriated by Congress under the 1993 Omnibus Budget Reconciliation Act to the highest courts in each state, and the opportunities they provide for systemic improvements.
By funding the Court Improvement Program at the United States Department of Health and Human Services, Congress clearly recognized that improved state court processes in the handling of foster care and adoption proceedings are essential if we are to promote and protect the well-being of children and families. The grants enable each state to develop and implement a plan for systemic court improvement. Forty-eight states and the District of Columbia were awarded court improvement grants. Currently, most of these states are in the final stages of producing the findings of their assessments and developing recommendations for reform. Many states are identifying promising, innovative approaches to expediting the permanency planning process.
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The Importance of the Federal Court Improvement Program
It has been sixteen years since the Federal Adoption Assistance and Child Welfare Act was enacted by Congress to combat the harm children experience when left ''adrift'' in the child welfare system. The Act clarified and expanded the role of courts and child welfare agencies in achieving stable, permanent placements for children committed to state care. It requires courts to conduct foster care review hearings and to ensure that children are not unnecessarily separated from their families when appropriate services can keep them together. Since its enactment in 1980, the number of child abuse cases brought to the attention of state courts has increased dramatically, as has the complexity of those cases.
On any given day in our Nation's juvenile dependency courts, judges are called upon to decide issues of vital importance to thousands of children and their families. Court decisions in abuse and neglect cases are often of a ''life and death'' nature as courts must determine whether children will be safe in specific placements. Courts must also at the same time think of the long-term and make ''hard'' decisions about whether children's ties with parents, siblings, and other relatives will be forever severed. Moreover, they must evaluate the provision of services, including medical, psychological, and educational services, to children in foster care to ensure that permanency plans can be implemented quickly.
Unfortunately, in many cases, these decisions of ''vital'' importance are based on the presentation of minimal evidence to the court. In numerous courts throughout this country, judicial and attorney caseloads are such that too often emergency removal hearings, foster care review hearings, and other pertinent court reviews last no longer than five or 10 minutes. Many courts spend more far more time on the handling of a routine small claims case than on a case of a child whose life is at stake. Overcrowded dockets, inefficient case scheduling systems (causing social workers and others to waste precious time waiting for cases to be heard), unprepared or overburdened attorneys, and frequent rotation of judges who may or may not have expertise or interest in child welfare law, all contribute to significant delays in achieving permanency for children in foster care and are a primary obstacle to the placement of children with adoptive families.
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Without well-functioning court systems, the preparation of case plans or the provision of social services alone cannot achieve the timely adoption of abused and neglected children who are unable to return home. Real improvement in the court system requires a better organized approach to child abuse and neglect proceedings, including improved caseflow management, a highly disciplined process of reviewing cases in a timely and comprehensive manner, the appointment or election of judges who are educated on child welfare law and related concerns, the appointment of skilled attorneys for children, and sufficient numbers of judges to give cases the attention they warrant. The Court Improvement Program funded by Congress is designed to accomplish these important goals.
State Courts' Self-Assessments
As required by the Federal court improvement grants, states are completing detailed self-assessments to evaluate the quality of their court process and identify obstacles to achieving timely permanency plans for children. To collect data, states have applied sound research methodology. They have relied on written surveys, site visits, detailed interviews with court participants, court observation, case file review, focus groups and a variety of other information gathering methods.
All grant recipients have established advisory Committees to provide guidance to the projects. The Advisory Committees are composed of a wide spectrum of individuals involved in local court processes, including judges, judicial administrators, attorneys representing children and parents, foster parents, former foster children, Court Appointed Special Advocates (CASAs), members of citizen foster care review boards, and the staff of government social service agencies. Participation often requires a commitment of volunteer time and effort, as well as a commitment of resources from the state. The inclusiveness of the advisory Committees provides additional strength to these projects by ensuring broad-based community involvement and the identification of unique, effective local court practices.
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It is important to note that many states in analyzing their self-assessment findings and in formulating recommendations for change are looking to standards on model court practice and procedure endorsed by the National Conference of Chief Justices, National Council of Juvenile and Family Court Judges, and the American Bar Association. Known as the Resource Guidelines: Improving Court Practice in Child Abuse and Neglect Cases (hereinafter Resource Guidelines),(see footnote 7) they ''are recommended for use by judges, court personnel, social service workers, attorneys and related professionals [to] ensure that as many children as possible have stable, caring, and supportive families, not only during their early years, but for a lifetime.''(see footnote 8) The overriding principle underlying the Guidelines is that child abuse and neglect cases must be a court priority if timely and thoughtful case decisionmaking is to occur in the cases of our most vulnerable children. Approaching the standard of quality mandated by the Guidelines presents a major challenge to all of us involved with juvenile court improvement.
Preliminary Results of the State Court Assessment Reports
Preliminary data on the functioning of courts nationwide is emerging as states submit their final assessment reports to the Department of Health and Human Services. Based on the 17 final reports publicly released so far and work the ABA has conducted in the field, the preliminary results appear very promising. Given the modest dollar amount of the grants, most reports to date are very thorough, frank and critical. These initial reports demonstrate that ''real'' court improvement is possible and in fact, a small proportion of courts are already in near compliance with the Resource Guidelines discussed above.
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Improving the quality of court hearings is a priority issue for many states. For example, in Michigan, the Lieutenant Governor's Children's Commission specifically directed the court improvement program to examine how quarterly review hearings could be conducted to make them more effective.(see footnote 9) The Michigan assessment report addresses the issue and like other state reports explores how factors, such as reasonable caseloads for judges and attorneys, adequacy of attorney representation, and court calendaring of cases, influence the ability of courts to make timely decisions relevant to permanency planning.
Other issues addressed in the reports include: additional detail on the content of hearings; CASA programs; training and education of judges and other court participants; judicial management of abuse and neglect dockets, including compliance with statutorily mandated timeframes for hearing completion; timeliness of appeals; treatment of parties and witnesses; timely delivery of needed services to parents and children; the courts' compliance with requirements of the Indian Child Welfare Act; adequacy of court facilities; and use of computer technology. Figure 1 provides a more complete listing of the issues addressed in the assessment reports.
As an example of preliminary findings, the quality of legal representation of children in many jurisdictions is problematic. One state determined that in 99 percent of cases, a guardian ad litem is appointed for the child in abuse and neglect proceedings. However, in that state, only 63 percent of children have guardians ad litem appointed at the time of their removal from their homes. One-third of the children removed were not represented by a guardian ad litem at their first court hearing, and three percent were not appointed a guardian ad litem until the adjudication stage, when the merits of child abuse and neglect petitions are judged. In another state, more than 30 percent of youth reported that they had never met their attorney or saw their attorney less than once a year.
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The Resource Guidelines view access to competent legal representation for all parties to juvenile court proceedings (e.g., social services agency, children and parents) to be essential to the effective functioning of juvenile and family courts.(see footnote 10) Highly skilled and diligent attorneys are instrumental in ensuring that judges have the evidence, documentary and testimonial, that they need to make well-considered judgments about the lives of children and their families.(see footnote 11)
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Figure 1. Subjects of Court Assessment
Quality of hearings: completeness and depth
Quality of legal representation
Appointment and engagement of attorneys
Attorney performance expectations and compensation
CASA programs
Specialization of the court
Training and education of judges
Length of judicial assignment and rotation
Special qualifications and experience of judges
Actual timing of hearings
Judicial time standards for stages in the court process
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Active judicial management of the calendar
Regular data collection on timing of hearings
Interruption of contested hearings
Timeliness of appeals
Treatment of parties and witnesses
Coordination with other agencies and organizations
Timely delivery of needed services to parents and children
Information on service availability provided to court
Informative reports and pleadings
Presence of knowledgeable workers in court
Judicial personnel staffing and financing
Use of computer technology
Indian Child Welfare Act considerations
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Self-assessments have also identified a number of jurisdictions with court systems that work relatively effectively and can be models for other jurisdictions. In Michigan, the project team concluded that, despite a number of identified problem areas, several courts are in near compliance with many of the standards of the Resource Guidelines governing the handling of child abuse and neglect cases. For the most part, they have implemented systems of case calendaring and assignment, case flow management techniques, and early attorney appointment that are enhancing the courts' abilities to make timely permanency planning decisions. Even more importantly, the majority of Michigan's courts handling abuse and neglect cases are comprised of specialist judges and referees who are relatively well-educated on child welfare concerns, had previous experience in the field prior to coming to the bench, and have exhibited leadership and commitment to improving the lives of children and families.
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Building on their assessments, the states have and are formulating recommendations for court improvement. The following are several examples:
• Demonstration projects to create one or two ''high functioning'' courts. If these projects are successful, the state may implement these model systems throughout the state.
• Development of regular long-term training curricula for new judges, attorneys, caseworkers, and CASA volunteers to educate them about child welfare law and basics principles of child development. Training should be regular, continual (i.e., not one time only) and mandatory.
• Creation of legal manuals for judges, attorneys, and child advocates.
• Development of materials to explain the court process to parents, older children and foster parents, including booklets and videotapes.
• On-site technical assistance on improving court calendaring practices, caseflow management and consistent information systems.
Figure 2 lists specific recommendations excerpted from state assessment reports submitted to date.
So far, court improvement projects have recommended reforms that are both realistic and systematic. Georgia's advisory Committee recommended the development and distribution of standards of practice for judges, attorneys and court personnel working on juvenile cases.(see footnote 12) Responding to a lack of sufficient judicial staff to carry the overwhelming caseload, Oregon is requesting its legislature to create additional judicial slots designated solely for juvenile cases. New Mexico has developed a model contract addressing the appointment and compensation of guardians ad litem. Some states are pursuing additional funding through state legislative appropriations. All these reforms allow children to move through the court process more quickly, enabling courts to achieve permanency in the placement of foster children and adoption for those children who cannot return home.
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Once a State has completed its self-assessment and recommendations for reform, it must develop and implement its plan for improvement. This is the second phase of the Court Improvement Program. All participating 48 states and the District of Columbia have applied for continued funding during the second phase of the program.
Successes and Future Potential of Court Improvement Efforts
One of the most valuable outcomes of the Court Improvement Program is the ability for states to share information and replicate the successful reforms and innovative strategies implemented in other states. This process generates energy among those who work in the court system and who often face difficult cases on a daily basis. It has revitalized the often overwhelmed system itself.
The Court Improvement grants have allowed states the ''luxury'' of a detailed look into their own practices and how they compare with the best practices available for responding to child abuse and neglect cases. Many states have compared their findings to the recommendations set forth in the Resource Guidelines. As I stated before, approaching the standard of quality represented by the Resource Guidelines represents a major challenge for state courts.
The process of assessing court practices has resulted in additional benefits as well. The ability to focus so closely on this often neglected area of court functioning raises the visibility of dependency courts and children's issues at the highest levels of the state court systems, including the highest appellate courts and administrative offices. The assessments provide statewide information that administrative offices can use to standardize proceedings and promote a consistent review of cases and provision of services.
It also allows the administrative offices of the courts to establish protocols and procedures to better gather information of their own performance in the future. With improved computer technology and information management systems, courts will be able to track children through the system, determine whether they are being placed in permanent homes, match adoptive families with foster children, and identify where delays continue to exist in the court process. The involvement of social service agencies on the project advisory Committees and as subjects of surveys, site visits and interviews is making those agencies rethink their own policies and procedures related to the court process.
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An additional benefit of improved court proceedings relates directly to the children and families the courts are intended to serve. The treatment of individuals under their jurisdiction should be an important consideration of court administration. Families are not being served well if they must wait half or even a whole day for a 5 minute hearing or have their case continued because a social worker or attorney is not present. The court's increased ability to communicate effectively with children, families, social workers and others during timely, more in-depth hearings conveys the message that abuse and neglect cases are to be taken seriously, that the court's orders are to be obeyed, and that children and families are to be treated with dignity.
The Need for Continued Federal Support of State Court Improvement Efforts
Juvenile courts are charged with the responsibility to ensure the safety and well-being of children. Without a close look at how these courts are discharging this responsibility and a well thought-out plan for improvement, our courts will continue to fail many of the children coming before them.
It is clear that the Federal State Court Improvement Program is beginning to produce sound results across the country. These modest grants are allowing States to focus on child abuse and neglect proceedings in a way that was previously impossible. The ability to examine the process by which states place children with loving and nurturing adoptive families, reunify children with their families, and achieve permanency for children who have often been shuttled from one foster home to another is indeed a necessity.
While court improvement is cost-effective as it ultimately will reduce children's length of stay in foster care, it requires additional resources, such as additional judicial staff, training and education, and enhanced judicial competence through better recruitment, training and judicial assignment practices. Implementation of the state-based court improvement recommendations can go a long way to achieving those goals.
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I would like to close by sharing an experience not unique to my own practice that demonstrates the importance of improved court practices in child abuse and neglect cases. I was appointed to represent a little boy who had been living in the same foster home for the first 3 years of his life. His foster mother could no longer care for him because of her age. His biological parents had only had minimal contact with him. At a foster care review hearing, I argued to the court that the local social services agencies should immediately find an adoptive home for him and file a court petition to terminate parental rights. The court agreed and framed its order so that the agency quickly moved to implement a permanency plan of adoption. He was adopted soon thereafter. And when he met his adoptive mother and father for the first time, he asked: ''Where have you been all this time?''
While it was, finally, the court that enabled the boy to receive a secure and permanent home, a better court process could have drastically shortened his wait. The very reforms proposed by the Resource Guidelines and advocated by the federally supported state court improvement projects would have speeded his adoption. If there had been earlier and stricter judicial permanency planning hearings; if judges had lower caseloads and were better trained in child abuse cases; if cases were not being transferred among judges; and if attorneys for children and agencies had more time for each case this child probably would have been adopted much sooner. We need to provide the impetus to continue court reform efforts that make such successes possible. I ask you to support the states as they move to reform their court systems so that all children who are victims of abuse and neglect will become members of loving families.
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Figure 2. Examples of State Court Assessment Report Recommendations
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Georgia
Recommendations:
• the development and implementation of improved, uniform methods of recordkeeping and court management of juvenile court caseloads.
• increased education and training, including the provision of cross-training and training manuals, for all persons working with juvenile court cases.
• the development and distribution of standards of practice for judges with juvenile court jurisdiction, attorneys practicing in juvenile court, and court personnel working on juvenile cases.
• representation of all parties, including children who are the subject of the proceedings, at all stages of decisionmaking by the courts.
• state funding for a juvenile court judge to hear juvenile court cases in every county or circuit, and state funding for full-time judges whenever the workload is sufficient for a full-time judge.
Final Report of the Georgia Supreme Court Child Placement Proceedings Project (August 1996).
Iowa
Recommendations:
• To improve judicial oversight of the permanency process, including termination and post-termination proceedings to improve quality of hearings and subsequent decisions.
• To improve communication concerning the permanency process and termination requirements and procedures between Courts, DHS, and County Attorneys.
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• To improve communication of rights and responsibilities to family members involved in the court process.
• To improve service of notice procedures and early identification of noncustodial and missing parents and foster parents.
Iowa Supreme Court Improvement Project for Child in Need of Assistance Cases: A Study of Iowa's Court Performance in Child Abuse and Neglect Cases and Plan for Improvement (September 1996).
New Mexico
Recommendations:
• Improving the efficiency and effect of the extensive oversight and multiple reviews and staffings required for children in the care and custody of the state by streamlining and restructuring these processes.
• Accelerating permanency through the introduction of Permanency Planning Hearings and shorter timelines for adjudications and judicial review.
• Improving the quality of representation for both respondents (parents) and children by having all judicial districts contract with attorneys for this work.
• Improving outcomes for Indian children under the Indian Child Welfare Act (ICWA) by conducting further study, promoting tribal-state agreements, and providing training.
Improving Outcomes for Abused and Neglected Children through State Court Improvement: Strategic Plan for Implementation (May 1996)
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Oklahoma
Recommendations for Statutory Changes:
• Requiring that the court conduct a permanency planning hearing instead of the currently required re-disposition hearing and to require that a permanency plan for the child be developed and approved at this hearing.
• Possibly establishing time limits on the use of temporary foster care and to limit the use of long-term foster care as a permanent plan option.
• Establishing timeframes for the completion of termination proceedings (no longer than 180 days with very limited provisions for extensions).
Recommendations to Improve Court Practice in the Handling of Deprived/TPR Cases:
• To encourage courts that are experiencing delays in the completion of TPR proceedings to consider establishing procedures for the early screening of termination petitions.
• To conduct a continued permanency planning hearing at 2 month intervals as long as temporary placement continues with the goal of family reunification as the permanent plan.
CASA Recommendations:
• Examine the feasibility of providing additional statewide funding and logistical support for local CASA organizations including at least partial state funding for local program startup and on-going operations.
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• Develop mandatory training requirements for CASA volunteers and establish a state-sponsored training and orientation program that all volunteers are required to attend.
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Chairman SHAW. Thank you.
Mr. Liederman.
STATEMENT OF DAVID S. LIEDERMAN, EXECUTIVE DIRECTOR, CHILD WELFARE LEAGUE OF AMERICA, WASHINGTON, DC
Mr. LIEDERMAN. Thank you, Mr. Chairman. I am David Liederman from the Child Welfare League of America. Let me first thank you for your efforts to improve the child welfare system, and particularly Congressman Camp and Congresswoman Kennelly. We appreciate your efforts to move ahead. Thank you.
I first want to provide some context to the discussion. The League is made up of nearly 900 public and nonprofit agencies that work with 2.5 million abused and neglected children. I think our system is really under stress, enormous stress, and that is not likely to change really fast; the combination of the impact of welfare reform, the uncertainties related to welfare reform, the impact of continued high poverty rates, the impact of kids living in just basically lousy neighborhoods for kids to grow up, with too much crime, too many drugs, too much substandard housing, too many things that none of us like, and then add to that the impact of some new experiments that are generally called managed care experiments, that vary from State to State and county to county, but are certainly creating an enormous amount of uncertainty and added pressure on both the public and nonprofit agencies charged with the responsibility of protecting children in this country.
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There is a lot of stress out there, but it doesn't mean that we bury our heads in the sand and say let's hope it all goes away, because I think there are some things that we can do now. The first order of business is to ensure child safety, and I think you try to address that. Child safety is paramount and children's safety should be our first order of business.
We all know that some kids can be maintained safely in their own home and some kids cannot. Consequently, it behooves all of us to make every reasonable effort to keep kids in their own home when we can safely do that. But reasonable efforts does not mean unreasonable efforts. It means reasonable effort, and I think it requires that we have the full array of services available, including substance abuse treatment services. These are critical services to so many of the kids and families entering into the child welfare system who have drug and alcohol problems.
Second, I think we should continue the outstanding bipartisan effort that you are developing. I think it is terrific, long overdue, and it will help improve the system. And we want to work with you so we can really expedite the adoption process for nearly 100,000 special-needs kids who are waiting for adoption, who are waiting for loving homes to go to. There are some wonderful experiments and examples of how we can improve the system going on around the country, and I think you have included some of those ideas in the proposed legislation.
Clearly, one of the important issues is financial incentives. Financial incentives to the States to expedite adoption will get their attention.
Let me just mention that all of the current experiments going on to reform child welfare are being carried out under current law. From Kansas, which you are going to hear about in the next panel from Teresa Markowitz where they are trying to redesign their whole child welfare system, redesign the way they finance and administer child welfare services, as well as the way they provide child welfare services, including adoption services, to hundreds of other less ambitious experiments around the country.
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The important thing we need to remember is that in every instance these experiments must be carried out carefully. I always try to remind people that when we are experimenting with the most vulnerable kids in the United States of America, we need to do it carefully. We need to have a sign on the wall that says ''handle with care'' because these are vulnerable kids and whatever we do, we need to make sure we do it so that we don't hurt children more than they are currently being hurt.
If reform is about saving money, Mr. Chairman, we are all going to fall flat on our face. If that is what some States and counties are trying to do, just save money, it is not going to work. It will cause more problems in the long run. What we know is that saving money in many instances means that kids and families are not going to get some of the services that they need, and none of us want that to be the case.
And, finally, let me conclude by encouraging this Subcommittee to look at the possibility of requiring that every State develop measurable standards. Valora mentioned accountability and I want to spend 1 minute on that subject.
We would be thrilled if this Subcommittee said today, tomorrow, next week, that every State and every county in the United States of America serving abused and neglected kids is required to have an accredited child welfare program, a program accredited by one of the two major accrediting bodies in the United States, the Council on Accreditation of Services for Children and Families or the Joint Commission on Health Care Organizations, that accredit child welfare programs.
If we are serious about dramatically improving the system, then accreditation and the implementation of standards is what it is all about. It will guarantee qualified and well-trained staff effective information systems and quality assurance programs to be in place. It guarantees better outcomes than we are currently receiving.
Today, as we speak, the State of Illinois is becoming the largest State in the country to go through the process of accrediting their child welfare program. They are currently engaged in that process because of the leadership of Governor Edgar and Jess McDonald, who runs the child welfare program.
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Counties like Franklin County, which is Columbus; Fulton County, which is Atlanta; Harris County, which is Houston, Texas, have accredited child welfare programs. There is no reason why every public and nonprofit agency serving abused and neglected kids in this country should not be accredited. There is not a person in this room that would go to a hospital that wasn't accredited. There isn't one person in this room that would want any of their kids to attend a university that wasn't accredited. Why can't we do the same thing for the most vulnerable kids in the United States of America, abused and neglected children? I think we would go a long way toward reforming the system if we required the States and counties to move in that direction.
I want to end on that note. We look forward to working with you. We thank you for your leadership, and thank you very much.
[The prepared statement follows:]
Statement of David S. Liederman, Executive Director, Child Welfare League of America, Washington, DC
Mr. Chairman and Members of the Subcommittee, I am David Liederman, Executive Director of the Child Welfare League of America (CWLA). Our nearly 900-member agencies across the United States work to improve conditions for children and families in crisis and at risk. Thank you Chairman Shaw and Members of the Subcommittee for holding this hearing and inviting me to speak on the critical issues of adoption and permanency for children in the child welfare system. I applaud this Subcommittee for its deliberate and thoughtful efforts on these matters and look forward to working with you in improving timely decisionmaking and better outcomes for abused or neglected children. We, too, are encouraged by the administration's initiative to strengthen the Federal commitment to help more children achieve permanency.
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The Mission: Improving Child Safety and Permanence
As you know, child protection and permanency are not simple issues. The decisions involve multiple systems at multiple levels that must work in a synchronized fashion. They far too often entail life or death decisions and fundamentally concern the healthy growth and development of our children. The best way to ensure child safety and permanence is to assist families to successfully care for their children. We all know that if you don't get childhood right, there's so much that can go wrong. Overwhelming evidence tells us that most perpetrators have been victims. The recent Time magazine report on how a child's early experiences can shape a lifetime reaffirms what we know that prevention and early intervention are the best bet for children and society, and that we've got to do better.
Once children have come to the attention of the child welfare system, there are certain basic principles that underlie good decisionmaking and enhance success:
• The first responsibility is to attend to a child's safety and protection. For some children and families, family preservation services and family reunification services are not indicated and should not, in fact, be pursued. Other families, perhaps as many as 80 percent of those who come to the attention of the child protection system, can be helped to gain the skills they need to live together safely or to come to another resolution that benefits the child, including placement with another family or in another setting.
• Whenever it can be done safely, it is important to strengthen family ties, keeping children connected to their family of origin. It is vital for all people, but especially for children, to be part of a family. Roots are important to children. ''Where do I come from?'' ''Where do I belong?'' are questions that all children and youth ask. As a matter of fact, many troubled adults are still struggling with this question.
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• Children need permanent living arrangements. They do not do well when they are moved from place to place with no sense of the past or the future. Children need legal protection as part of their own birth families, or through adoption.
To make these principles to ensure safety and permanence operational, agencies must have the capacity to work intensively with children and their families, to conduct accurate assessments, to work effectively with law enforcement and the courts, and to develop and mobilize needed resources. Perhaps most important, agencies need to implement sound child protection and permanency planning practices.
Despite improvements and progress, the nation's collective response to abused, neglected and abandoned children is failing to provide both protection and permanence for many children. There are many reasons for this, not the least of which is the tripling in the number of children reported abused and neglected since 1980, the failure of state, Federal and local targeted resources to keep pace with this rise.
Eliminating Barriers and Improving Outcomes Require Multilevel, Multifaceted Approaches
There are agency and wider-system, legal and financial barriers to adoption and other permanency arrangements for children in need of homes. The Administration's initiative on adoption describes well many key barriers, including
• delays because of practices in a child welfare agency, among the multiple agencies that must be involved in decisionmaking, and in agencies across state lines;
• delays in court/judicial practices;
• delays related to staff beliefs and attitudes;
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• limited pool of permanent families for children with special needs.
An array of quality services and the resources to support them are key to enabling agencies, courts and families themselves make good timely decisions. Far too often, courts are compelled to delay permanency decisions because the child nor the family has received assistance recommended much earlier. Some communities providing intensive prevention and early intervention, by contrast, have shown success in improving and speeding up permanency decisions and timeliness.
These barriers do not exist in the child welfare agency alone. Other agencies, including health and education agencies, as well as the courts are key partners in planning for and achieving successful outcomes for children. At a recent meeting of local CWLA agencies that provide adoption services, participants cited court-related issues among their chief concerns. All service providers, the courts, and the legal community must work together to ensure that children and their families are receiving appropriate services and to enable timely and sound decisionmaking in their behalf. Court assessment and improvement is not only vital, but unlikely to occur in any widespread manner, without Federal funding and encouragement. (Reasonable Efforts Advisory Panel, 1995) In addition, continued national leadership and adequate financial resources are essential if we are to ensure that these barriers are removed and that children who cannot return to their families can be moved to adoption or other permanent homes in a timely way.
Staff Training and Supervision Essential to Good Outcomes
Staff have a very tough job on the frontline, everyday, dealing with the hardest issues imaginable. They are responsible for
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• conducting accurate assessments regarding child safety, family capacity and motivation, and family strengths and resources;
• intervening effectively when safety is a concern; developing an appropriate service plan that meets the needs of the child and family; engaging the family in making the needed changes;
• obtaining or developing needed resources;
• documenting progress and problems; and
• working effectively with legal counsel, the courts, and with other service agencies to move the case to an optimal resolution for the child.
We know that the inexperienced and poorly supervised workers with high caseloads are not equipped to make good decisions to prevent or intervene in a crisis situation.
Reform Initiatives Increase
Common Themes
Widespread dissatisfaction with the current child welfare system has led to calls for reform and reform activities at local, state, and national levels. Recommendations for rectifying the crisis vary greatly, and reform initiatives are so far isolated efforts. However, several themes and directions have emerged.
• Engaging in concurrent planning. This approach considers the options of family reunification and adoption simultaneously in order to facilitate more timely decisionmaking. It combines at the same time efforts to rehabilitate the family with development of an adoption plan.
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Colorado and Washington have successfully employed this strategy to improve appropriate and timely decisionmaking and permanency.
• Developing differential response capacities. These efforts focus on developing capacity to provide customized interventions to individual children and families using a array of alternative responses. Highly trained staff with a range of skills and decisionmaking tools, as well as strong linkages among professionals and services, are necessary to provide an individualized response rather than a one-size-fits-all approach.
In Massachusetts, the CPS agency includes domestic violence specialists who provide training and assistance to staff as well as direct casework for the many families who experience spousal abuse as well as child maltreatment.
St. Louis, Missouri's Sigel Education Center, a community-governed school-based center, is developing a number of innovative approaches for meeting specific needs of the community. Plans include a heightened protective response targeted to high-risk sections of the neighborhood and a school-based CPS worker who will focus on diverting educational neglect and truancy cases from becoming CPS reports.
In New Jersey, Certified Alcohol and Drug Counselors have been placed in six urban offices to work with CPS staff to assess families. In addition, intensive training is provided to CPS workers on child protection issues and substance abuse. (Griffin, 1996)
• Responding authoritatively to serious abuse and neglect. These efforts involve building capacity to identify potentially high risk cases, emergency response systems for crisis intervention, new ways of working with law enforcement, and strong connections with the court.
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Montgomery County, MD, plans to pilot a team approach to assessment in which a child protective services intake worker, a local law enforcement officer, and a representative from a community-based organization co-screen all child abuse reports. Planners expect that this type of team assessment will result in improved screening and decisions and a more timely response to serious cases. (Child Welfare League of America, 1996)
At Louisville, Kentucky's Neighborhood Place Ujima, the Department of Social Services is developing safety strategies specifically for investigating and service children under 5 years old who are the subject of reports involving serious injuries or neglect. (Center for the Study of Social Policy, 1996)
• Diverting low-risk cases. Some jurisdictions are developing dual-track CPS systems that triage services. Low-risk or unsubstantiated cases are referred to early intervention, community resources, while CPS focuses on more serious cases where abuse and neglect is confirmed. By restricting the responsibilities of the public agency, it is hoped that limited resources can be targeted more effectively.
Recent legislation in both Florida and Missouri allows CPS to develop a dual track system. In Florida, all child abuse hot-line calls are screened to initially determine their seriousness. Cases of children obviously at risk are immediately investigated, while a family service response is provided for lower risk cases. Revisions in Florida's law now provide for assessment of all reports.
Missouri legislation focuses on five sites, where investigations are limited to cases requiring police involvement, and family assessments are conducted for all other situations. (American Humane Association, 1996; Center for the Study of Social Policy, 1996)
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• Developing an array of collaborative, community-based, early intervention and prevention resources. To prevent maltreatment and to safely divert low-risk cases from CPS, a strong network of both informal and formal community resources must be in place that can provide support and services for vulnerable children and families. All members of the community must join together to protect children and strengthen families. In this way, child protection and child welfare becomes more a concern of everyone in the community.
In Louisville, Kentucky, a partnership of 20 public and private agencies has developed a network of Neighborhood Place, community centers that house staff from income support, child protection, health, employment, and other services for local families.
• Combining the strengths of existing programs and resources to respond well to child safety and permanency needs. A serious shortcoming of current child protection and child welfare systems has been the specialization and fragmentation of programs and services. Not only have children and families suffered as a result of service systems that are not well connected, but the practitioners themselves often have missed important opportunities to learn from and assist one another in their work with children and families.
Responding to a lack of treatment services for persons with chemical dependency, the Sacramento County, CA, Department of Health and Human Services initiated a project to build capacity with the Department to provide primary Alcohol and Other Drug treatment services. An important element of the project has been the training of child welfare staff to provide direct group treatment services to substance abusing clients.
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• Strengthening families to achieve the goal of child safety. Child safety and well-being is the goal of child welfare overall, and strong families are one of the primary means of achieving that goal. Some families cannot safely care for their children, and efforts must be made to identify those families and take appropriate timely action. However, many vulnerable families, with some form of support, are capable of providing a nurturing home.
New Orleans' Project FAST (Family Action Support Team) was developed by Kingsley House, a private nonprofit community agency. Using a ''strengths model,'' staff respond to low-risk cases by emphasizing the inherent capacities of families rather than their weaknesses. Evidence indicates that the project has helped families maximize their strengths, as well as reduce risks to child safety; has enormously reduced recidivism; and has contributed to a decrease in abuse and neglect reports. (American Humane Association, 1996)
• Engaging parents in shared decisionmaking. A number of approaches engage parents in identifying potential harm to their children as well as finding resources to prevent harm, planning steps to provide protection and well-being, and taking responsibility for their part in achieving safety goals. Practice focuses on engaging the family in mutual problem-solving and joining with them as partners to protect their children.
Family Unity and Family Group Conference Models have their roots in New Zealand where CPS agencies bring together families and their natural support networks (extended family, friends, and community) at a group meeting to jointly determine how to ensure child safety and provide family support. Since 1990, the Oregon Children's Services Division has encouraged staff to use one of several family decisionmaking processes as a method of increasing family cooperation in child protection, accessing informal supports and assistance, and planning for permanency. (American Humane Association, 1996)
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• Redesigning the role of the courts. Because child welfare and the courts have strong policy, legal, and decisionmaking connections, new directions require re-thinking the role of the courts.
A number of jurisdictions are developing mechanisms for using community-based services and supports for families without instituting a full and formal court proceeding. The National Council of Juvenile and Family Court Judges (NCJFCJ) is working with four sites Louisville, KY; Honolulu, HI; San Jose, CA; and Cincinnati, OH to develop and implement diversion procedures that comply with state and local laws and agency policies. This process involves all parties who are responsible for the safety of children in the decision to use community-based services. Since the court approves the plan, the process ensures shared accountability by the court, child welfare agency, and service providers. (Center for the Study of Social Policy, 1996)
Managed Care and Child Welfare
Perhaps the newest and most sweeping change in approach has been the increasing adoption of managed care principles for child welfare services. The term managed care refers to a variety of approaches intended to control the utilization or cost of services. In another definition, managed care is a negotiated quality of care for an identified population for a negotiated price. Managed care attempts to balance the provision of care to each individual against the resources available to serve the entire pool. Managed care plans in the health and behavioral health arena where they initially emerged, vary widely in quality and scope. Although there is yet little evidence about managed care in child welfare, it is likely that there will be many varieties tried.
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Managed care can affect child welfare in two ways. In the first scenario, under many Medicaid waiver proposals, managed care organizations will get funding to deliver primary and behavioral health services to the children and families child welfare agencies serve. In the second scenario, child welfare agencies will adopt managed care models for managing and delivering various child welfare services. Managed care plans and privatization efforts are being promoted in various states to control costs and achieve more acceptable results for the dollars spent, not only in the health and behavioral health (mental health and substance abuse) but also for nonmedical systems such as child welfare.
A survey conducted by CWLA last year found that most states were planning or considering some application of managed care principles. However, while the majority of states are considering applying managed care principles and technologies to the financing and delivery of child welfare services, the evidence of wide diversity among state plans is significant. There is no single, universally acceptable managed care or privatization model for child welfare services. In each state, plans are being shaped by unique political, geographic, demographic, and systemic characteristics and resources.
Numerous challenges those required of all quality managed care systems and those unique to child welfare will have to be addressed to make a smooth transition from the current way of financing and delivering child welfare services to a workable new system. Child welfare administrators must significantly alter behavioral health managed care approaches to fit the unique needs of the population and the legal mandates of the system while, at the same time, preserving the essential features that all effective managed care systems share.
It is too early to determine the impact of managed care on permanency planning and outcomes. We don't know what the system will look like in 18 months. Although managed care and child welfare look similar on the principles of the most appropriate, least restrictive, and time-sensitive options, there are concerns about the application of managed care's utilization management with an involuntary population in state custody. Notably, will access or quality be sacrificed for cost containment? Will the complex relationships among children, families, and communities of care necessary to child protection and permanency be lost in the singular managed care focus on the individual?
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Kinship Arrangements Increase and Require Attention in Permanency Planning
When children cannot be reunited with their parents, efforts should be made whenever possible to keep children in kinship care with their kin care givers. Kinship care arrangements should be preserved when they are safe, nurturing, and stable.
Legal guardianship, a method of achieving stability, is often more acceptable to kinship care givers than adoption because it does not involve terminating the rights of the child's parents, who in many instances are the kin's children. Guardianship gives kinship care givers the authority to determine where the child lives, authorize emergency surgery or other extraordinary medical care, and the duty to protect, educate, and discipline the child and to provide food, clothing, shelter, and ordinary health care for the child. Guardianship requires court authorization and is subject to possible termination when parents seek to regain full parental authority. The court must determine that such a reversal is in the child's best interests, however.
We support the administration's efforts to explore the permanence needs of children even when adoption does not seem to be the chosen alternative, as is often the case for many children in kinship care. We encourage states to investigate the possibilities of guardianship for children in care for whom adoption is not appropriate. Guardianship can keep children rooted, empower families, and ease the burden on the foster care system.
Proposed financial incentives to states for increases in all forms of legal permanence could provide great impetus to move children in care toward legal permanence more expeditiously.
Innovations Under Child Welfare Waivers
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HHS has approved waiver request from five states Ohio, Oregon, North Carolina, Illinois, and Delaware. The waivers will allow the states to test approaches to guardianship; comprehensive services models; prevention and treatment of substance abuse; and managed care. These approaches need to be carefully evaluated.
Quality Assurance and Accountability
Adherence to Standards for Quality Care
Standards of quality care and benchmarks for performance are essential to making good initial assessments, monitoring progress and judging outcomes. States vary widely in their performance and capacities. States should adopt standards for their public and private service agencies and assist them to improve practice and outcomes. CWLA for many years has been the principal national organization responsible for developing child welfare standards. Our 11 volumes of standards are recognized by child welfare professionals throughout the world as constituting ''best practice'' standards. The Council on Accreditation for Family and Children Services and the Joint Commission on the Accreditation of Health Care Organizations are two nationally recognized bodies that provide operational standards in the field. Unfortunately, there remains a wide gap between the bar set in these standards and what actually occurs in practice. It is our belief that every agency serving abused, neglected, or otherwise vulnerable children should be required to meet acceptable standards of practice by a nationally recognized accrediting body of their choice. Eighteen public agencies and over 500 private agencies can now make that claim. Our goal should be every agency. Our children deserve that much.
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Federal Leadership and Monitoring Continues To Be Essential
Federally conducted program audits are an important means of ensuring that states are working conscientiously to both keep children safe, to keep them connected to their families, and to achieve permanence for children. Federal oversight and ability to provide technical assistance remain critical functions to improve safety and quality care. Legal actions have found that more than 20 states have failed in many ways to properly care for children, including making reasonable efforts when appropriate.
In conclusion, we have learned a lot on which to build and we are learning about new approaches that hold promise. We must not be timid, but we must be cautious in our experimentation to deliver what we all desire a permanent home, no further harm, and high quality services. It is equally important that benchmarks of performance be set in each state so that all parties have clear and appropriate expectations and responsibilities and make the necessary investments to keep children safe. That will enhance the appropriate and timely adoption of children in need of homes as well as help children who can remain or be reunified safely with their families.
With current and increasing demands, we need a system with all the options and we need them to work well. I look forward to working with the Subcommittee and the administration to make sure that happens.
INSERT OFFSET FOLIO 2 HERE
[The official Committee record contains additional material here.]
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Chairman SHAW. Thank you. Ms. Grasso, I think you said it all when you quoted the child as saying, ''Where have you been?'' Maybe that is what they are going to say to the Congress when we finally get this bill passed, but we will be there.
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Mr. Camp.
Mr. CAMP. Thank you, Mr. Chairman. Ms. Grasso, I know you mentioned the court improvement project and I understand that started in 1995. It has been in existence for 3 years now, which is exactly the amount of time the young child you mentioned was in foster care, and 33 States have not yet completed their projects after this 3-year period and I know this is due to end in 1998.
How likely is it, do you think, that the States will complete their projects and have the necessary changes in place in their court systems by that time?
Ms. GRASSO. To date, 17 States have submitted their final reports and many others—I can't give you the exact figure, but many, many others are just in the process of producing their final assessments. They are in the draft phases. A number of advisory committees around the States are currently reviewing those reports, and with those reports come plans for recommendations as well as implementation.
I can't predict the plans will be put into place in all States by 1998, but I believe there is momentum and that it could very well happen. And my understanding is that at least 48 States and the District of Columbia have applied for additional funding so they can continue the process. So there is a lot of energy out there. As a matter of fact, a list serve has come into being in which States or participants in the juvenile court processes throughout the country are conferring on a daily basis about innovative programs, so I believe it is possible.
Mr. CAMP. All right, thank you very much. Dr. Washington, thank you for your testimony. I want to thank all of you for your testimony and thank you all for coming. I wondered if there was any elaboration you could give us on barriers to adoptions that communities might have identified through the 11-State program that you testified to.
Ms. WASHINGTON. Yes, and what I would like to also say about the barriers is we have produced several publications which describe in detail what the communities told us, and we will be glad to provide those to any of you free of cost.
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One of the main things the communities told us is that it costs too much and they believe there are financial incentives for agencies to keep children in foster care longer than they need to be kept there. This is what communities believe, that because people and agencies, public or private, can continue to be reimbursed for foster care payments and there is no accountability for results, but the money comes according to how long the child is kept there, communities fear they are using that as a way to keep children in care too long. There is a lot of that kind of discussion occurring in the 11 States in which we are working.
Mr. CAMP. OK, thank you, and I know there is not much known about kinship care. Is there anything you can tell the Subcommittee about kinship care that you may have learned? And I know you may not have focused on that area.
Ms. WASHINGTON. Yes. We have 5 examples in the testimony of people who are using kinship care effectively. Let me give you one example. In Kent County, Michigan, people are using kinship care and family conferencing as a means to divert children from entering the system in the first place, and this has been so effective to date that there has been significant redeployment of the child welfare professional work force as a result of that effort.
Mr. CAMP. Thank you. Thank you very much. Thank you, Mr. Chairman.
Mr. LIEDERMAN. Could I add something on the kinship care?
Mr. CAMP. Sure.
Mr. LIEDERMAN. There are about 100,000 kids in kinship care in the country. Most of them are with their maternal grandmothers. Clearly, there is an issue here and it relates to permanence. I think what we need to realize is that for a lot of these kids adoption is not going to be in the cards, but legal guardianship or subsidized legal guardianship could be in the cards and it would accomplish the same purpose. It is going to be very hard for grandmothers to move to terminate parental rights against their own children who are the parents of their grandchildren, so I think we need to consider that.
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Mr. CAMP. Yes. Well, they wouldn't be doing that moving. It is the petition by the Department of Social Services or whatever State agency.
Mr. LIEDERMAN. Of course, but they would have to comply and be in agreement with it.
Mr. CAMP. Are the 100,000 children—that is separate and apart from those children that are in foster care?
Mr. LIEDERMAN. No. If you consider the entire foster care system in the country is about 500,000 kids, about 100,000 of those are in what we call relative foster care, as opposed to nonrelative foster care.
Mr. CAMP. OK, thank you.
Thank you, Mr. Chairman.
Chairman SHAW. Ms. Kennelly.
Ms. KENNELLY. Yes, thank you. Ms. Grasso, it is something of a feeling of deja vu going into this effort. I have worked for years in child support enforcement and trying to make that better in this country. And everybody agrees we should have child support enforcement, but it is never a big deal back in the individual States, whether it be the chief executive officer or the judiciary.
Now, we are doing foster care and you are telling us about what you are doing. How do we get the States to get more involved? How do we get the States to improve their court systems? Right now, in Connecticut, in the budget that recently came out, our court systems are being cut back. Are we going to go down another road where everybody thinks it is wonderful that we do foster care reform and have children be more ready for adoption and yet just see nothing happen at the State level?
Ms. Grasso. We have to keep in mind that the Federal court improvement grants went to the highest courts of every State and many of the advisory Committees and people participating on these advisory Committees are leaders within their States and have testified before State legislatures, and are relatively influential people within their jurisdictions, and I believe that is making a difference.
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For example, I am working in Michigan with the State court administrative office of the Supreme Court of Michigan, and so we have the attention of people who can make a difference within the court system. The issue does arise, as you have stated, Where is the money going to come from?, and State officials, advocates within the States, are going to have to advocate to their State legislature about the importance of these hearings or else there will not be change. It is difficult.
Ms. KENNELLY. A challenge.
Ms. GRASSO. It is a challenge, right.
Ms. KENNELLY. Thank you. Mr. Liederman, Mr. Camp and I had a number of meetings in trying to illustrate what we meant by reasonable efforts, and we outlined it and we illustrated some examples. This morning, Mr. Shaw had a meeting here at 8 a.m. to try to get us ready to begin this process and we had GAO there and some others, and they said that social workers look upon the fact that they can't get the child back to the parent as a failure. Therefore, they sometimes get too caught up in reasonable efforts to reunite families.
Are we on the right path?
Mr. LIEDERMAN. I think you are but I think it is very difficult to legislate reasonable efforts. I think it would probably be more sensible to ask HHS to develop guidelines through a consensus-building process, which would take some time, but it would be important to develop guidelines with input from the States and counties, as well as the voluntary agencies because to legislate reasonable efforts, I think, would be very hard.
I think most of us believe, I think probably everyone in this room believes, that all things being equal, the best place for kids is in their own family and if we can accomplish that, we would all be thrilled. But we all recognize that sometimes you can't accomplish that because you can't do it safely. Sometimes there isn't really family there that can provide proper care for the children.
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I think we need to continue to make reasonable efforts, but again reasonable is not unreasonable, and I think we should ask HHS for guidelines—and I don't know why HHS hasn't done this up until now. The law was passed in 1980. It is now 1997. It would seem to me, in 17 years, we ought to have been able to figure out how to give some instructions to the States and to the counties about what reasonable efforts means as provided in the 96–272 law.
Ms. KENNELLY. Well, I hope you will work with us, as you have in the past.
Mr. LIEDERMAN. We would love to. We would be happy to do so.
Ms. KENNELLY. Thank you.
Chairman SHAW. I would like to add here, though, that HHS has had 16 years, passing over many administrations, to come out with some guidelines and we have yet to see them.
Mr. Levin.
Mr. LEVIN. Thank you, Mr. Chairman. I will be very brief. It is very good to have this hearing. I am glad you have called it. Just two quick questions so my colleagues can take over.
Are we seeing results in Michigan?
Ms. GRASSO. Yes, we are, very promising results. I spent time in Wayne County, Roscommon County, and Jackson County, and we issued a survey throughout the State to judges and referees. In Michigan, many of the jurisdictions can be models, as I said in testimony, related to you have a very expert and specialty bench that appears to be very committed to the handling of these cases.
Mr. LEVIN. So we are seeing results in the number of kids who are moving out of foster care.
Ms. GRASSO. That is true. We did some individual case file review applying social science methodology, which indicated that progress was being made in that arena. Michigan, you should be mindful, also has very strict statutory requirements for the conducting of hearings. They are much more—permanency planning hearings, foster care reviews, are conducted much more frequently than in many other States around the country and that has made a difference.
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And when you ask people in Detroit, in Roscommon County, in Jackson County, if they are overburdened by all these frequent reviews, their response is, No, this is making a difference and this is getting kids out of the system more quickly.
Mr. LEVIN. Thank you. Maybe you can send us a note on this, picking up Ms. Kennelly's comment. There is a feeling we have been through this before. I remember hearings a few years ago, quite a few years ago. Maybe you could drop us a note on why we have so much trouble in this area, why we keep spinning on this issue.
Thank you for your courtesy, Mr. Chairman.
Chairman SHAW. Thank you, Sandy. The Subcommittee will recess long enough to go vote and get right back. I would ask this panel if you could stay. A number of us have some more questions we would like to ask and then we will get to the next panel as quickly as possible.
We will recess for approximately 15 minutes.
[Recess.]
Chairman SHAW. If we could reassemble, Mr. Collins, you may inquire.
Mr. COLLINS. Thank you, Mr. Chairman. I only have one question because I really have enjoyed the input from our panelists here. It has been very enlightening and has given me some ideas to go back home and ask some questions about in the 10 counties that I represent in Georgia.
But my question is for Mr. Nadel, and I find with interest that you say States have not assessed the impact of the initiatives, that your efforts were hampered by the absence of evaluation data. Why is this? I mean, how do States know what the heck they are doing if they don't evaluate what they are doing?
It bothers me that we say we have got to give them some incentives to look after children. I think they don't need cash. They need a kick in the rump. Why are they not collecting this data?
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Mr. NADEL. I am not sure. I think in some cases it may be a funding issue. Good evaluation does cost some money. There are always issues about, well, constructing a control group. We are not saying it is easy, and often States or officials may mistake getting what looks like initial good results with a program actually working. I think the question is what would have happened in the absence of the program. Are the kids you are taking through your project representative of the kids in the whole system, or was there cream-skimming? There are all sorts of questions that you don't really know the answer to.
As to why the States don't do it, it may be funding, as I said. It may be just a lack of knowledge of what to do and it may be these are really busy people who are in many cases trying to do their best, but like long-range planning, evaluation often falls by the wayside when you are in a state of perpetual crisis, or perceive yourself to be.
Mr. COLLINS. I find all of those excuses, but none of them a reason. I don't know how you can gauge in any type of operation, whether it be public or private, the success of your programs or your gains or losses if you don't evaluate what you are doing.
Mr. NADEL. Well, we certainly agree.
Mr. COLLINS. I find that very alarming that you are coming back with that report, and I appreciate each one of you being here. Thank you.
Mr. LIEDERMAN. Congressman, if I could just add, I want to go back to the notion of accreditation and the notion of meeting acceptable standards. As long as we don't require the States to meet uniform standards that require outcome measures, quality assurance, evaluation, and all of those pieces as part of that process, then what you are going to have is a patchwork system, which is what we currently have, with every State and county deciding how they want to run their child welfare program.
Some flexibility is obviously important and recommended, but there needs to be a baseline measurement that we can, as a humane, caring society, satisfy ourselves that abused and neglected kids are properly being cared for. And that is why I think we feel so strongly at the Child Welfare League of America that the issue of standards and accreditation needs to be put up front and is something we ought to really seriously consider.
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Mr. COLLINS. Well, I wouldn't want to sign off on that today, but I don't mind taking a look at that. I get kind of puzzled, too, and concerned when we start requiring States to do certain things that may lead to what you are talking about. But I do think the States themselves and the people within the State who are concerned about these children ought to evaluate what they are doing, what they are accomplishing or what they are not accomplishing, how they are spending the funds, and if the funds are being expended in the proper way that is helping the child. You know, to spend money is one thing, but that is not the point of the whole program. The point of the program is to help children in need.
You have given me some ideas that I am going to explore back in the district that I have the pleasure of representing and I appreciate it.
Ms. WASHINGTON. Mr. Collins.
Mr. COLLINS. Yes, ma'am.
Ms. WASHINGTON. I would like to encourage you and the comments that you are making because I think the question before us is so basic. I think the average jurisdiction that you go into, people do not know who the children are or where the children are. This is basic. How can you run any kind of system without knowing who your clients are, where they are, not to mention what their needs are?
So there is very basic data, even more basic than questions of evaluation and accreditation, that are really troubling because one of the reasons we are in this crisis framework is because these children are invisible. They are invisible to the public and they are invisible to all of us, and it has to start with knowing who these children are and where they are.
Mr. COLLINS. Well, I find it interesting, the comments, and I appreciate that. And knowing the programs in Georgia and the care that our Governor has for children in all areas, it would be surprising to me to find that there is no data back there to back up what they are doing, but I am going back and ask. I am very interested in this.
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Thank you.
Chairman SHAW. Mr. McCrery.
Mr. MCCRERY. Just one question. Dr. Washington, would you please elaborate on your statement that there is a problem with some of the agencies keeping children in foster care because if they place them permanently, they lose their funding? What funding are you talking about? How is that funding administered and what can we do to turn that around?
Ms. WASHINGTON. OK, I would be glad to elaborate on that. The question I was asked is what are communities telling us are some of the barriers, and what people are saying is that the foster care payments keep coming as long as the child is in care. And I think you are going to hear one of your panelists on the second panel give you some detail about that later on today, but people are afraid that agencies keep the money or benefit financially the longer children are in care because they keep getting the subsidies.
And, in fact, there is some question as to whether the subsidy that is intended for the child—if all or half of that subsidy actually goes to the care givers of the child—that oftentimes the agencies are keeping a large portion of the subsidy. So people are afraid that is a powerful disincentive toward keeping children languishing in care.
Mr. MCCRERY. Who administers the subsidy?
Ms. WASHINGTON. Well, the States; there are State and Federal subsidies.
Mr. MCCRERY. And the States get the money from the Federal Government?
Ms. WASHINGTON. And in some cases, the States also add their own resources to it as well.
Mr. LIEDERMAN. I would just like to take issue with that statement. In all the years I have worked in this field, I have not found that to be true. There could be some agencies out there that purposefully keep kids in foster care, but I don't know who they are. I think it is everyone's intent to move kids into a permanent situation as quickly as they can. That is the intent, and the amount of the adoption subsidy the States provide, in many instances, is roughly comparable to the foster care payment, so there is not a financial incentive to keep kids in foster care.
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I think sometimes kids languish in foster care because out of sight, out of mind, but not because someone is trying to intentionally keep them in foster care to keep the money rolling in.
Ms. WASHINGTON. And I would say I am merely reporting what people in the States have told us. I am not saying it is a fact. I think that it is a question that could be investigated. I am merely reporting in answer to the question that people often say this is a barrier.
Mr. MCCRERY. OK, thank you.
Chairman SHAW. Mr. Hayworth.
Mr. HAYWORTH. Thank you, Mr. Chairman. I thank you for holding this hearing today. I thank all the panelists for their attendance and their testimony.
Dr. Nadel, as I am reading your prepared testimony, I note that my home State of Arizona is lauded for some initiatives, and I would like you to elaborate a little bit on what Arizona is doing well that perhaps serves as a model for the other 49 States and where sufficient work remains, both within Arizona and the rest of the Union, to solve some problems. What is Arizona doing well?
Mr. NADEL. Well, one thing is sort of going back to before the parental termination issue in terms of reunification. Arizona has a very interesting initiative to try to keep the family together for those families that can and should be held together and it is called the Arizona Housing Assistance Initiative, which I think is mentioned in my formal statement. And in that initiative, they look at those situations where it is really a housing problem, where just a little bit of housing subsidy would enable a family to have stable, safe housing, and thereby stay together, where that is identified as a source of stress.
Other States will also try to zero in on particular barriers to family reunification, zero in on those as well. For example, Tennessee has something called a wraparound project which will also aid with fairly small amounts of money that might be just what is needed to keep a family together for things that aren't normally considered within the purview of child welfare agencies—transportation for the parents; again, housing, that kind of thing.
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On the other end of it where termination is the way to go, unfortunately, Arizona also has a project like Kentucky that was focused on termination, and what they did was to get a special appropriation from the State legislature. I think it was about $175,000, and they hired caseworkers to focus just on those cases dealing with termination. A while ago, we had the discussion of why kids are in foster care so long and the various incentives, and one of the issues there is an incentive having to do with the dynamics of the system and the workload, and that is when a kid is in foster care, at a minimum, you know that he or she is safe from further abuse.
And in a stressed system, the attention of the caseworkers will often be, understandably, to put out the next fire; you know, go to the next case where a kid is in real danger. I think the basis of the Arizona project is the understanding that caseworkers are going to put out the next fire, and they have caseworkers dedicated only to those situations where termination of parental rights appears to be the way to go, and that appears to be successful. In general, also, we found that Arizona was one of the States that pretty much redesigned their system and tried to consolidate and rationalize it as well.
Mr. HAYWORTH. Dr. Washington, I appreciated your remarks and the study done by the Kellogg Foundation. I was interested really in outlining the parameters of your desires and the goals, to have some consistency, to have some simplicity, if you will, for children. It almost sounds to me like a program that could be called the power of one—one judge, one stable foster home, 1 year to resolution.
Ms. WASHINGTON. One assessment.
Mr. HAYWORTH. One assessment. How appealing do you think this is? As always, there is the translation from what is desired to what is real. In terms of what you have seen in the areas you have examined and the areas where they are making changes according to the studies and the concerns you have, how close are we to that ideal in the real world based on what you have seen?
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Ms. WASHINGTON. One of the things that I think is an advantage of the 11 States with which we are working is that, in addition to having a strong conceptual framework where we have sought the advice of over 14,000 people, we also have the practical experience of actually doing this and trying to accomplish it bringing all these strings together in these 11 States. So we are not just talking about an idea. We are reporting on what we have actually done and accomplished in these 11 States.
And we are finding, as the written testimony details, tremendous accomplishments in pulling all of these threads together—the legal work with social work practice and a lot of these threads, and the community voice, bringing all of those things together.
You asked what is working well in Arizona. We just had a judicial conference, bringing our 11 States together, talking about how to have judicial and legal reform. In Arizona, there is some very strong judicial leadership around these five outcomes, people who have been very strong and working with us over the past 5 years in trying to accomplish the outcomes that have been set for children, very strong leadership we are seeing out of Arizona.
Mr. HAYWORTH. Thank you.
Chairman SHAW. A quick question, Mr. Liederman. You mentioned certification. What certification process is out there? Is that something that has to be created?
Mr. LIEDERMAN. No, no. There are two nationally accepted accreditation programs and they are both independent accrediting bodies. One is the Council on Accreditation for Services to Children and Families, which accredits 18 public agencies and over 600 private agencies. The other is the Joint Commission on Health Care Organizations, which basically accredits residential treatment programs and treatment/foster care. Programs that have a treatment or a medical focus—it is a medical model.
The Council on Accreditation is a 4-year cycle in that you have to be reaccredited. The Joint Commission is a 3-year cycle. They are both extremely well-respected programs using measurable standards, addressing a lot of the issues that we talked about today, including adoption. The Child Welfare League has been writing adoption standards for 75 years.
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Chairman SHAW. How many States require accreditation of their work?
Mr. LIEDERMAN. The State of Illinois, which is going through its own accreditation process, will require that all of the agencies that they contract with who serve abused and neglected kids be accredited.
Chairman SHAW. Now, the agencies they contract with, is this the managed care model that you are talking about?
Mr. LIEDERMAN. No. These are agencies that provide adoption services, provide foster care services, provide family preservation services, all of the agencies that serve the kids who come into the child welfare system in the State of Illinois.
Chairman SHAW. How does this managed care work in this situation that you refer to in your testimony?
Mr. LIEDERMAN. Well, managed care is much more complicated. Managed care is a kind of a generic term that is used to describe a lot of efforts that States and counties are embarking upon to redesign the way they administer, finance, and provide services to kids in the child welfare system.
I think when you hear the Kansas model, it is the most dramatic model in the country. Basically, they have shifted the administration of their entire child welfare system away from themselves to nonprofit agencies in Kansas who will be running the adoption programs, the foster care programs, and the family preservation programs in that State. It is a very ambitious and dramatic experiment. In Hamilton County, Ohio, which is Cincinnati, public and nonprofit agencies are working together to change the way they serve the kids that need residential treatment.
Massachusetts is doing the same in a program where the State is contracting with a series of nonprofit providers. One of the things that distinguishes the Massachusetts program is they are using what they call a capitated rate system. So instead of having different rates for different kids, depending on the seriousness of the problem, they have one rate. They say, ''We will pay you x amount of dollars to provide services to this child and you can provide foster care services, or family preservation services, or residential treatment, or you can move the child to an adoptive family. You can do whatever is required; we will pay you one fixed rate. And the goal is permanence. At the end of the day, we want the kids permanently placed in loving families or in some other permanent situation, either permanent foster care, kinship care, legal guardianship, some kind of permanence.
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So what you have here, Mr. Chairman, is a lot of experiments going on around the country and some of them are more advanced than others. But some States don't want to use the term ''managed care'' because managed care sometimes connotes something they don't want to be associated with. But there are managed care principles which speak to outcome measures, the use of strong case management principles, quality assurance, and so forth, that are being put in place.
Mr. MCCRERY. Mr. Chairman, just a quick followup on that.
Chairman SHAW. Yes, sir.
Mr. MCCRERY. The capitated system you mention, is that legal——
Mr. LIEDERMAN. Sure, absolutely.
Mr. MCCRERY [continuing]. Under the Federal guidelines for using the money?
Mr. LIEDERMAN. Absolutely. It is still an open-ended entitlement to the child to receive foster care. All they are doing is capitating the rate. They are not limiting the service.
Mr. MCCRERY. But isn't some of the Federal money tied to foster care, for example?
Mr. LIEDERMAN. Sure, it is. There is Federal money tied to the rate.
Mr. MCCRERY. But if they don't put the child in foster care, they don't get the money. How can they say you get the money regardless of which avenue you take?
Mr. LIEDERMAN. Because if you look at every State child welfare budget, what you find is that about 25 percent of the money, on average, is Federal money and the rest of it is State money. So they can mix and match their moneys to provide whatever kinds of services they need, and that is why I indicated they are doing it under current law. You don't need to change the current law to do some of these experiments.
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Mr. MCCRERY. While I appreciate your conclusion, I question if that is so. I think we ought to investigate that. I am not saying that is a bad program. It has a lot of merit, I think, but I am not sure that they are not in violation of some Federal law or guideline.
Mr. LIEDERMAN. No. I think some of the experiments are being done under waivers from HHS.
Mr. MCCRERY. OK.
Mr. LIEDERMAN. So in those cases, HHS has basically given the State a waiver to mix and match their Federal money.
Mr. MCCRERY. That may be something——
Mr. LIEDERMAN. One of the advantages of the capitated rate is the flexibility——
Mr. MCCRERY. Sure.
Mr. LIEDERMAN [continuing]. That it gives the agency to provide the appropriate service for the child and not be restricted to one kind of service over another kind of service.
Mr. MCCRERY. Sure. We are big on flexibility in this Subcommittee so that has some appeal.
Mr. LIEDERMAN. Right, right.
Mr. MCCRERY. But we need to check, Mr. Chairman, I think, to see what restrictions we place on States and maybe put in place some greater flexibility so they can do things like this without worrying about breaking the law.
Chairman SHAW. Thank you, and thank all of you. You have been a wonderful panel and I think we have all learned quite a bit this morning.
Thank you.
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Mr. LIEDERMAN. Thank you very much.
Chairman SHAW. By the way, before this panel leaves, I have got a number of questions that Mr. Coyne, who is unable to be with us today, has asked that I submit to you in writing. So we will make those available to you and if you could take those and answer them, we will make those answers a part of the record, without objection.
[Mr. Coyne's questions to panel 1 and their answers follow. A response from Ms. Washington was not available at the time of printing.]
INSERT OFFSET FOLIOS 19 TO 20 HERE
[The official Committee record contains additional material here.]
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Responses From the U.S. General Accounting Office
Question 1. I wonder if one of you could provide a definition of ''permanency'' for the Subcommittee. I think it is very important that we all understand what we mean when we talk about permanency. Does it mean permanent adoption and family reunification alone, or are there other solutions that fit into the definition of permanency, such as guardianship or long-term foster care?
Answer: Permanency is not defined by federal law or regulation. As noted in our recently issued report titled Foster Care: State Efforts to Improve the Permanency Planning Process Show Some Promise (GAO/HEHS–97–73, May 7, 1997), federal law requires that a permanency hearing be held to determine the future status of the child. The choices that can be made regarding the future status include reunifying the child with his or her family, continuing the child in foster care for a specified period, placing the child for adoption, or continuing the child in foster care on a permanent or long-term basis because of the child's special needs or circumstances. According to some experts in the field, permanency means that the child is placed in a setting from which the child no longer has a fear of being removed—the child knows that he or she is home to stay and will not be uprooted again.
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Question 2. Would one of you please comment on the research about the effects of long-term foster care, and specifically of multiple placements, on children.
Answer: Our work did not include a systematic review of the research on the effects of long-term foster care.
Question 3. Would one of you please provide some demographic data on the children currently in the foster care system?
Answer:
Questions for and Responses from Mark Nadel—GAO
Question 1. As you point out in your testimony, the federal government spends a great deal of money on foster care each year and these costs are only expected to rise. As you also point out, we have very little idea of how states are doing in their efforts to reduce the number of children in foster care. What, in your estimation, can be done in a timely fashion to enhance the data collection efforts of states so that we can better keep track of children and their families?
Answer: In Foster Care: State Efforts to Improve the Permanency Planning Process Show Some Promise (GAO/HEHS–97–73, May 7, 1997), we noted that several national efforts are under way that may improve the information available on foster children. Most states are currently designing or implementing the Statewide Automated Child Welfare Information Systems (SACWIS) as required under the title IV–E foster care program. These systems are to include case-specific data on all children in foster care and all adopted children placed or provided adoption assistance by the state or its contractors. In addition, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 104–193) appropriated funds for a national longitudinal study based on random samples of children at risk of abuse or neglect or determined by a state to have been abused or neglected. This study is to include state-level data for selected states.
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Once these systems and the longitudinal study are fully in place, we should have a much more adequate source of information. Additionally, these data collection efforts may facilitate the implementation of more systematic evaluations of state initiatives and help program officials and policymakers better understand the overall impact of program changes.
Question 2. As most of the witnesses have testified, one of the most popular methods for reducing the number of kids in foster care is to expedite the permanency hearing process. As you mention on page three of your testimony, some state officials believe that expediting this process may have some unintended consequences that result in more children being placed in long-term foster care. Do you think this is a problem that will become more common as more states change their permanency hearing requirements?
Answer: As noted in our testimony and in Foster Care: State Efforts to Improve the Permanency Planning Process Show Some Promise (GAO/HEHS–97–73, May 7, 1997), 26 states already require the first permanency hearing to be held sooner than the federally-required 18 months after a child enters foster care. The state laws, like federal law, generally do not require that a final decision be made at the first hearing. However, Ohio and Minnesota do require that a permanency decision be determined after a limited extension period, and state officials in Ohio believed that this requirement may have had the unintended result of increasing the number of children placed in long-term foster care because other placement options could not be developed. State data, in part, confirmed this observation. From 1990 to 1995, long-term placements for children supported with federal funds rose from 1,657 to 2,057.
In the report cited above, we concluded that as states implement new initiatives, unintended consequences may occur. For example, if states require more stringent time frames for holding permanency hearings, they must adjust to this shorter time period to avoid placements based on expedience rather than careful deliberation about what is best for the child. We also noted that because of the complex nature of the child welfare system, states and localities must consider the entire system when attempting to make reforms.
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Question 3. From the research you have conducted, have you gotten a sense of the variation in state procedures to terminate parental rights? Do these procedures vary a great deal from state to state and do you see this as problem?
Answer: We did not obtain details on the termination of parental rights procedures or the grounds for termination from each state. In The Child Advocate's Legal Guide: Effective Collaborative Work to Speed Permanence for Children in Foster Care (North American Council on Adoptable Children, March 1995), an overview of states' termination of parental rights statutes indicates that while the grounds for termination vary by state, no state mandates that the court terminate parental rights under any specific circumstance.
Question 4. It seems as though concurrent planning, in which family reunification efforts are conducted simultaneously with adoption plans, has worked where it has been tried. I wonder if you found any adverse consequences from this method of permanency planning? What do you see as the future concurrent planning?
Answer: In the three states (Colorado, Washington, and Tennessee) where we discussed their use of concurrent planning, none of the officials stated that there were any adverse consequences resulting from its use. Many child welfare agencies across the nation are interested in pursuing concurrent planning. Based on this interest and the awareness of the need to make more timely decisions about children in foster care, we have plans to study this approach to permanency planning in more detail in the near future.
Question 5. Why do you predict that the foster care caseload will increase in the future?
Answer: The most recent estimates (March 1997) from the Congressional Budget Office (CBO) project that the federally-assisted (title IV–E) foster care caseload will increase by 21 percent from 1997 to 2002. CBO based this projected increase on historical trends in caseload growth. While many believe that welfare reform will have an impact on foster care caseloads, the CBO projection does not include such an estimated impact because insufficient information was available to judge the magnitude or direction of such changes. The recent projection does, however, assume some dampening effect in growth due to the welfare reform legislation related to technical adjustments in administrative costs and the ways that foster care eligibility are to be determined.
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[The GAO report, Foster Care: State Effort To Improve the Permanency Planning Process Show Some Promise, is being retained in Committee files.]
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American Bar AssociationCenter on Children and the LawMay 29, 1997Human Resources Subcommittee
House Committee on Ways and Means
B–317 Rayburn House Office Building
Washington, DC 20515
RE: Question by Representative Coyne on Testimony of Kathi Grasso
Dear Sir or Madam:
On February 27, Kathi Grasso of the ABA Center on Children and the Law testified at a hearing of the Human Resources Subcommittee of the House Committee on Ways and Means. After the hearings, Representative Coyne sent out questions to several witnesses including Kathi. His question to Kathi is as follows:
''As you point out, the role of the court system is exceedingly important in permanency planning. As efforts are made to bring greater efficiency and responsiveness to the adjudication process, and as caseloads increase, do you foresee any shortage of what you call 'highly qualified and diligent' attorneys to participate in the process.''
I am answering the question on her behalf, with her permission:
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Yes, we do foresee shortages of skilled attorneys. Right now, in many parts of the United States, attorney caseloads are much too high in child protection cases, compensation is low, and many attorneys are not well trained. This is a byproduct, in part, of the chronic under funding of courts handling child abuse and neglect cases throughout the United States, including funding for legal representation. It is also the result of unclear or low expectations of attorneys by many courts. We expect that the federally funded grants to state court systems ( to improve the courts' handling of child abuse, foster care and adoption cases) will encourage the courts to enhance the quality and availability of attorneys. Most of the court improvement projects view the quality of legal representation as one of their top priority issues.
We also believe that other court improvements will alleviate rather than exacerbate attorney shortages. Better caseloads, fair compensation, and strong training programs will attract sufficient numbers of qualified attorneys. Improved court proceedings will enhance the quality of practice and also will help attract and retain better attorneys. Improvements in scheduling and caseflow management will move cases through the courts, easing the burdens on attorneys. Better calendaring and docketing will reduce court waiting time for attorneys, thus making up for the fact that the hearings themselves will last longer.
Realistically, however, we expect that some states will improve legal representation more effectively than others. Further, as with other court improvement issues, real progress will take time.
Sincerely,
Mark Hardin,
Director, Child Welfare
cc: Kathi Grasso
Bruce Nicholson
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[Ms. Grasso's responses to Mr. Coyne's questions for the panel at large were not available at the time of printing.]
INSERT OFFSET FOLIOS 21 TO 25 HERE
[The official Committee record contains additional material here.]
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Chairman SHAW. The next panel we have is Dr. Fred Wulczyn, Chapin Hall Center for Children at the University of Chicago; Teresa A. Markowitz, commissioner of children and family services from Topeka—we have already talked around here quite a bit; Richard Hoekstra, who is the director of the division of adoption services, Family Independence Agency, in Lansing, Michigan; Terry Cross, executive director of the National Indian Child Welfare Association, from Portland, Oregon; and Maureen Hogan, who is the executive director of Adopt a Special Kid/America, Washington, DC. What a great name that is.
Dr. Wulczyn.
STATEMENT OF FRED H. WULCZYN, PH.D, RESEARCH FELLOW, CHAPIN HALL CENTER FOR CHILDREN, UNIVERSITY OF CHICAGO, CHICAGO, ILLINOIS
Mr. WULCZYN. Chairman Shaw, Members of the Subcommittee, thank you very much for inviting me to speak with you today. My name is Fred Wulczyn. I am a research fellow at the Chapin Hall Center for Children at the University of Chicago, an independent research and development center devoted to bringing sound information, rigorous analysis, and independent perspective to the public debate about the needs of children and the ways in which those needs can be met.
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For much of the past 17 years, I have been studying State child welfare systems, first in Illinois, later in New York where I was a policy analyst and director of the Child Welfare Managed Care Initiative. Most recently, as codirector of the multistate foster care data archive, with my colleagues Robert Goerge and Allen Harden, I have been studying the foster care experiences of some 500,000 children in 6 States, including California, Illinois, Michigan, Missouri, New York, and Texas. Among other topics, our research has focused on the risk of placement into foster care, the length of time children spend typically in foster care, and the likelihood that, once discharged, the children will return to foster care.
Before I begin my remarks, I would ask you to hear in what I have to say the echoes of comments that have been made already today, particularly as they pertain to funding, research and evaluation and accountability, the availability of information, evaluation, and baseline data.
My primary focus this afternoon will be on my experiences of first developing and then implementing the HomeRebuilder Demonstration Project in New York City from July 1991 through December 1995, a time when I was working for the New York State Department of Social Services.
To begin, I want to point out three facts that will help you to understand the prevailing programmatic and policy context. First, by 1990, the well-documented increase in the number of New York City children in foster care had already started to slow even though the population of children would continue to grow for another 2 years. This change was due to the fact that admissions began to fall in 1990, eventually reaching levels roughly equivalent to what they were in 1986, the year immediately prior to the crack crisis and foster care crisis in New York City.
In short, by the midnineties, the size of New York City's foster care population was sustained not by record numbers of children entering the placement system, as had been true, but by changes in the population of foster children that were highly correlated with length of stay.
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Second, roughly half of all foster care children are in the care and custody of voluntary agencies that have entered into a contractual relationship with the city of New York. There are approximately 65 of these agencies, ranging in size from those that care for a few hundred to those that care for more than 2,000 children. The remaining children are in the direct care of the administration for Children's Services.
Finally—and this relates to points that were raised earlier—these agencies are reimbursed on a per diem basis; that is, for each day of care provided, the agency receives a payment made up of Federal, State, and local dollars, depending on the eligibility of the child. So long as the child is in its care, the agency receives reimbursement on behalf of the child, provided the applicable rules and regulations are followed as proscribed.
I raise these issues because they capture a fundamental dilemma in the delivery of child welfare services. The dilemma is related to the fact that under the current system of reimbursement, a very large proportion of the revenue that is available to States, counties, or private agencies for the delivery of child welfare services is contingent on whether or not a child is in foster care.
For example, in New York State, approximately 75 percent of the total child welfare budget, not including title XX, is driven by per diem payments for foster care. Among other things, what this means is that the jurisdictions that make a concerted effort to lower foster care utilization either by reducing admissions and/or by reducing the time children spend in care will see total revenue flowing through the system go down, not because the needs of the children and their families have been resolved, but because professionals have opted to meet those needs in settings other than foster care.
In New York, we attempted to address these problems by developing what we called the HomeRebuilder Demonstration Project. In effect, the HomeRebuilder Project was designed to test whether capitated payments to voluntary providers of foster care could be used to deliver and manage foster care programs in such a way that the needs of children and families could be addressed more effectively and more efficiently.
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As such, we had two core objectives: To demonstrate the effectiveness of service continuity, intensified discharge planning, and after-care services as a means to achieve earlier permanency, and to test an alternative to the per diem method of agency reimbursement. The rest of my testimony has more detail about the design of the specific program. Let me just speak briefly about what we found and then conclude with some recommendations.
In my testimony, there is a chart that describes the discharge rates through the first year of the program, and let me also add that a more detailed evaluation is being conducted by Westat as part of the National Family Preservation Evaluation. At the end of the first year, the data show that 79 percent of our HomeRebuilder children had been discharged from foster care, compared to 85 percent. We would go on to achieve a 24-percent reduction in the length of time in care for those children that participated in the demonstration project over and above what we had anticipated they would use, an expectation that was based on our historical analysis of available data.
What was learned from the HomeRebuilder Project? First and foremost, these results from the HomeRebuilder Project focus attention again on the critical role fiscal reform must play within the broader context of child welfare reform. In particular, the opportunity to reinvest funds that would have otherwise been used to pay for foster care is a crucial first step in creating fiscal strategies that are aligned with policy and programmatic objectives.
In this regard, it is important to recall that one intent behind the fiscal reforms introduced as part of the Adoption Assistance and Child Welfare Reform Act of 1980 was to create a bridge between IV–B and IV–E Federal funding. While the actual mechanisms created to accomplish this goal proved unsuccessful, the rationale behind the policy, removing Federal fiscal incentives to place children in foster care, was and continues to be a problem that stands in the way of real system reform.
Second, the HomeRebuilder program demonstrates that through careful understanding of how foster care services are utilized, it is possible to target service dollars more wisely, especially when this understanding is used in combination with a fiscal strategy that creates the opportunity to build wraparound services.
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Moreover, the project clearly shows that providers of child welfare services—and this need not be limited to private contract providers—can manage and deliver services within a context of expectations that pertain to the timely discharge of children from foster care. Indeed, it is only in this context of measurable performance standards that the child welfare system will improve over time. My experience with HomeRebuilders tells me that the basic tools to proceed down this path are within our collective grasp.
Finally, if I were asked to make recommendations, I would suggest the following. First, the title IV–E waiver program passed by Congress and the administration nearly 3 years ago should be expanded because it represents one framework for extending to States the opportunity to respond to local circumstances with greater programmatic and fiscal flexibility.
Second, since the waiver program is time-limited, work should begin on a more permanent mechanism for solving the funding dilemma that I outlined at the outset. While I can offer no concrete proposal, I can say that any such legislative initiative will have to consider a more sophisticated approach to what is universally described as risk-sharing, whether those risks are defined in financial terms, in terms of service quality, or in terms of social risks that confront children and families.
In particular, the question of who will bear responsibility for higher costs and the terms and conditions which outline that responsibility is particularly important. Understandably, providers in the HomeRebuilder program were concerned about rising costs that were beyond their control, and there are many of these. Similarly, States will be justifiably concerned when faced with fiscal strategies that do not recognize the risks they face today and those they will face in the future.
Nevertheless, I believe it is possible to reach a point of agreement that achieves a more compelling distribution of risk within the child welfare system, a system that now distributes a large share of the risk on those participants least able to bear it, the children and families who should benefit from child welfare services, but all too often do not. In reaching this point of agreement, we would move simultaneously to the middle ground of what is now a polarizing debate over how to best finance child welfare services.
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Chairman Shaw, Members of the Subcommittee, let me thank you again for the opportunity to speak with you. It has been my privilege. May I also say that my colleagues and I at the Chapin Hall Center are prepared to work with you in any way that we can.
Thank you very much.
[The prepared statement follows:]
Statement of Fred H. Wulczyn, Ph.D., Research Fellow, Chapin Hall Center for Children, University of Chicago, Chicago, Illinois
Chairman Shaw, Members of the Subcommittee, thank you very much for inviting me to speak with you today. My name is Fred Wulczyn. I am a Research Fellow at the Chapin Hall Center for Children at the University of Chicago, an independent research and development center devoted to bringing sound information, rigorous analysis, and an independent perspective to the public debate about the needs of children and the ways in which those needs can be met. For much of the past 17 years, I have been studying state child welfare systems, first in Illinois and later in New York State where I was a policy analyst and Director of the Child Welfare Managed Care Initiative. Most recently, as Co-director of the Multistate Foster Care Data Archive with my colleagues Robert Goerge and Allen Harden, I have been studying the foster care experiences of some 500 thousand foster children in 6 states, including California, Illinois, Michigan, Missouri, New York and Texas. Among other topics, our research has focused on the risk of placement into foster care, the length of time children typically spend in foster care, and the likelihood that once discharged from placement a child will return to foster care.
The HomeRebuilder Project
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My primary focus this afternoon will be on my experiences first developing and then implementing the HomeRebuilder Demonstration Project in New York City during the period of time from July 1991 through December 1995, a time when I was working for the New York State Department of Social Services. To begin, I want to point out three facts that will help you to understand the prevailing programmatic and policy context. First, by 1990 the well-documented increase in the number of New York City children living in foster care had already started to slow, even though the population of children in foster care would continue to increase for another 2 years. This change was due to the fact that admissions began to fall in 1990, eventually reaching levels roughly equivalent to what they were in 1986, the year immediately prior to the foster care crisis. In short, by the midnineties, the size of New York City's foster care population was sustained not by record numbers of children entering the placement system as had been true, but by changes in the population of foster children that were highly correlated with length of stay.
Second, roughly half of all foster children are in the care and custody of voluntary agencies, not-for-profit entities that have entered into a contractual relationship with the city of New York for the purposes of providing substitute care for children. There are approximately 65 of these agencies in New York City, ranging in size from those that care for a few hundred children to those that care for more than two thousand. The remaining children are in the direct care of the administration for Children's Services.
Finally, these agencies are reimbursed on a per diem basis. That is, for each day of care provided, the agency receives a payment made up of Federal, state and local dollars, depending on the eligibility of the child. So long as the child is in its care, the agency receives reimbursement on behalf of the child, provided the applicable rules and regulations are followed as proscribed.
I raise these issues because they capture a fundamental dilemma in the delivery of child welfare services. The dilemma is related to the fact that under the current system of reimbursement, a very large proportion of the revenue available to states, counties, or private agencies (depending on how services are organized in a particular state) for the delivery of child welfare services is contingent on whether the child is in foster care. For example, in New York State, approximately 75 percent of the total child welfare budget (excluding Title XX) is driven by per diem payments for foster care. Among other things, what this means is that jurisdictions that make a concerted effort to lower foster care utilization either by reducing admissions to foster care and/or by reducing the time children spend in care will see total revenue flowing through the child welfare system decline, not because the needs of children and their families have been resolved, but because professionals have opted to meet those needs in settings other than foster care.
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The HomeRebuilder Program was one attempt to resolve two important issues facing New York during the early nineties. The first problem had to do with the fact by 1991–92, the primary dynamic sustaining the very large number of children in New York's foster care system was length of stay and not admissions, while the second problem had to do with the funding dilemma I just described. Taken together, concerted efforts on our part to place children with families permanently in less time than had been historically true (i.e., to reduce length of stay) would have lowered our capacity to support those children and families outside the foster care system.
What then was the HomeRebuilder Demonstration Program?(see footnote 13) In effect, the HomeRebuilder Program was designed to test whether capitated payments to voluntary providers of foster care could be used to deliver and manage foster care programs in such a way that the needs of children and families could be addressed more effectively and more efficiently. As such, the Program had two core objectives:
(1) To demonstrate the effectiveness of service continuity, intensified discharge planning, and aftercare services as a means to achieve earlier permanency for children, and
(2) To test an alternative to the per diem method of agency reimbursement.
The basic design of the HomeRebuilder Program was quite simple. For a selected group of children in foster care, participating agencies received a fixed payment intended to cover the expected cost of foster care for a 3-year period. The level of funding was established prospectively, thus agency revenue was not directly dependent on the level of foster care utilization as it is when per diem rates are used to finance placement costs. In turn, agencies were free to select the combination of foster care, discharge planning, and aftercare activities that best met the needs of the family. The usual categorical restrictions on how foster care program costs are claimed through the standards of payment were waived for the most part so that agencies could select activities without worrying specifically about reimbursement. By funding discharge planning and aftercare activities with funds that would otherwise be used exclusively for board and maintenance payments, HomeRebuilder created a capacity to provide what are frequently called ''wraparound'' services.
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Both the fiscal and programmatic objectives of HomeRebuilder were based on the assumption that these wraparound services would reduce the overall need for foster care among the children selected for the program. While the statutes and regulations that structure child welfare services recognize the value of placement prevention and reunification, funding patterns have rarely stressed discharge planning and aftercare services as a separate and clinically unique period in the life of a foster child. As a result, most child welfare providers will acknowledge that the services used to support families prior to and just after reunification are probably the weakest link in the continuum of child welfare services. In other words, at a time when the number of children who must he discharged from placement is high, the services that prepare families for discharge and help stabilize families after reunification or adoption are not well formed or well organized.
The HomeRebuilder demonstration sought to stimulate more careful discharge planning and aftercare services by making funds available to meet service needs prior to and after reunification. The goal of these services was to help families overcome barriers that impede progress toward reunification. The assumption underlying the program was that discharge planning and aftercare services would reduce the amount of time children spend in foster care and lower the rate of foster care reentry in the same way that preventive services help families avoid unnecessary placements.
The reduced length of stay and lower rate of reentry were crucial to the fiscal rationale developed for the HomeRebuilder program because budget constraints have limited the ability of states to appropriate funds for new services. To the extent that placement duration and reentry are reduced, costs associated with maintenance payments and administration are avoided. As part of the demonstration project, the maintenance and administrative payments that are avoided become available for the purchase of those services that lead to a reduction in length of stay. Further, the program has been designed so that over the life of the demonstration project, the aggregate level of unexpended maintenance payments would be equal to or less than the aggregate level of expenditures for discharge planning and aftercare related services. Thus, the HomeRebuilder demonstration was designed to be cost neutral.
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The costs of services provided as part of the demonstration were financed with a capitated payment made to the agency for each eligible program participant. Capitated payments were based on the typical (historical) length-of-stay patterns for members of the target group. The expected level of maintenance payment expenditures over the life of the demonstration was calculated using then-current per diem rates adjusted to reflect any increases. Rather than receive a per diem payment for each child in the demonstration, the provider received a payment sufficient to cover the cost of a reasonable period of foster care. The capitation-based expenditures were discretionary and could be used for a mix of placement and community-based services, depending on the child's needs and the prospects for reunification. By design, the funds made available through the capitation payment could have been used to pay for a variety of services including service integration and program development.
Preliminary Findings
Although it is too soon to draw firm conclusions about the long-term impact of HomeRebuilder on foster care utilization, it is possible to examine the data from the first year and determine whether programs operated within the goals established for the first year. To do this, the baseline length of stay, assuming no intervention, has to be compared with the actual length of stay and an anticipated length of stay based on lower-level foster care utilization prompted by the agencies discharge planning and aftercare services. The comparison between the baseline length of stay and the actual or observed length of stay reveals the extent to which children in the HomeRebuilder program experienced shorter placements, while a comparison between the observed length of stay and the anticipated length of stay speaks to whether agencies have managed their HomeRebuilder program within the financial assumptions developed at the beginning of the project.
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Figure 1 compares, for each agency together, the placement experience of the HomeRebuilder children with the children who belong to the comparison group. The figure shows the percentage of children still in care on September 30, December 31, March 31, and June 30, 1994. The data show that about 79% of the HomeRebuilder children remained in care at the end of the first year compared with 85% of the children in the comparison group. Thus, at the end of the first year, HomeRebuilder' programs successfully accelerated the discharge of children from foster care. Further analysis of the data will examine the background characteristics of the children discharged to determine how the children differed, if at all, from one another in terms of their family background, placement history, and the well-being of family members.
Conclusion
What was learned as a result of the HomeRebuilder experience? First and foremost, the these results from HomeRebuilder Project focus attention again on the critical role fiscal reform must play within the broader context of child welfare reform. In particular, the opportunity to reinvest funds that would have been used otherwise to pay for foster care is a crucial first step in creating fiscal strategies that are aligned with policy and programmatic objectives. In this regard, it is important to recall that one intent behind the fiscal reforms introduced as part of the Adoption Assistance and Child Welfare Reform Act of 1980 was to create a bridge between Title IV–E and Title IV–B funding streams. While the actual mechanisms created to accomplish this goal proved to be unsuccessful, the rationale behind the policy (removing Federal fiscal incentives to place children in foster care) was and continues to be a problem that stands in the way of system reform.
"The Official Committee record contains additional material here."
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STRIP OFFSET FOLIO 3 HERE
Second, the HomeRebuilder Program demonstrates that through careful understanding of how foster care services are utilized it is possible to target service dollars more wisely, especially when this understanding is used in combination with a fiscal strategy that creates a ''wraparound service capacity'' through reinvestment. Moreover, the Project clearly shows that providers of child welfare services (and this need not be limited to private or contract providers) can manage and deliver services within a context of expectations that pertain to the timely discharge of children from foster care. Indeed, it is only within a context of measurable performance standards that the child welfare system will improve over time. My experience with HomeRebuilder tells me that the basic tools to proceed down this path are within our collective grasp.
Finally, if I were asked to make recommendations, I would suggest the following. First, the Title IV–E waiver program passed by Congress and signed by the administration nearly 3 years ago should be expanded because it represents one framework for extending to states the opportunity to respond to ''local'' circumstances with greater programmatic and fiscal flexibility. Notwithstanding the effort that is needed to implement waivers, the 10 state limit seems restrictive at a time when the Federal Government is trying to encourage greater discretion at the state and local level. Second, since the Waiver Program is time limited, work should begin on a more permanent mechanism for solving the funding dilemma I described at the outset. While I can offer no concrete proposal at this time, I can say that any such legislative initiative will have to consider a more sophisticated approach to what is universally described as ''risk-sharing,'' whether those risks are defined in financial terms, in terms of service quality, or in terms of the social risks that confront children and families. In particular, the question of who will bear responsibility for higher costs and the terms and conditions which outline that responsibility are especially important. Understandably, providers in the HomeRebuilder Program were concerned about rising costs that were beyond their control, of which there were many. Similarly, states will be justifiably concerned when faced with fiscal strategies that do not recognize the risks they face today and those that they will face in the future. Nevertheless, I believe that it is possible to reach a point of agreement that achieves a more compelling distribution of risk within the child welfare system, a system that now distributes a large share of the ''risk'' on those participants least able to bear it—the children and families who should benefit from child welfare services, but all too often do not. In reaching this point of agreement, we would move simultaneously to the middle ground in what is now a polarizing debate over how to best finance child welfare services.
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Chairman Clay, Members of the Subcommittee, let me again thank you for the opportunity to speak with you today. It has been my privilege. May I also say that my colleagues at the Chapin Hall Center for Children and I are prepared to help the Committee and the administration address these issues in any we can.
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Chairman SHAW. Thank you.
Ms. Markowitz.
STATEMENT OF HON. BILL GRAVES, GOVERNOR OF KANSAS; AS PRESENTED BY TERESA MARKOWITZ, COMMISSIONER OF CHILDREN & FAMILY SERVICES, DEPARTMENT OF SOCIAL AND REHABILITATION SERVICES, TOPEKA, KANSAS
Ms. MARKOWITZ. Mr. Chairman, hello. My name is Teresa Markowitz. I am the commissioner for children and family services within the Department of Social and Rehabilitation Services in Kansas. I am here on behalf of the Governor, Bill Graves, and the Secretary, Rochelle Chronister.
What I would like to share is what our vision is for Kansas kids. It certainly is a very exciting time for us as we move toward permanency for children. I think in the State of Kansas we all grew up with the belief that there is no place like home, and that is certainly a belief that we are committed to today.
This is just a cheat sheet for all of you as we go through this.
Basically, we have developed several initiatives, but I think the ones you will want to know about today are the three privatization initiatives—family preservation; it was implemented July 1, 1996. Adoption is the second of those and it was implemented October 1, and then foster care and group care is just a couple days away. March 1 is when it begins its transition, so we are close to that one happening.
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What I would like to do is just kind of walk you through the attachments very, very briefly and kind of give you a glimpse of what we are doing in Kansas and hopefully spur some questions that you might have.
Why make the changes in Kansas? I think that has been one of the biggest questions. I think there are three major reasons why we looked at changes. First and foremost was permanency. Our average length of stay for children in a single stay in foster care is 13.2 months, which we still saw as excessive and needed to look at that.
Equitable services across the State for all Kansas kids was not something that we were achieving. We wanted to look at making sure that every Kansas kid had the same baseline of services available to them. And certainly we wanted to make this an outcome-driven delivery system. We wanted to not know necessarily the processes, but are we achieving what we want to for these particular children?
Describing the privatization initiative in Kansas, I think what we were trying to do was make sure that providers in the State of Kansas were able to continue to provide the service, and the question was would they have the capacity if we made this too large. So what we did was we divided the State up into five geographic regions in the family preservation and the foster care, and we also divided up the delivery into the three that we have talked about—family preservation, adoption, and foster care. So, that allowed providers in the State that we have had hundreds of years of history with to still be able to bid on these initiatives.
I think you have heard testimony around is it managed care, is it not managed care, and I think we prefer to see it as not being a managed care system because it really isn't, because we have divided it up like we have. I think there are some common themes to what you would find in a medical managed care delivery system. Things like a case rate, pooled funding as much as we possible can, and certainly an outcome-driven system are some of the commonalities.
Child welfare initiatives. I won't spend a lot of time on it, but just some of the goals and some of the objectives and the assumptions around the initiative. In particular, I think the strongest was trying to create a partnership so that the left hand and the right hand knew what they were doing with private contractors and public agencies. I think we all wanted to do what was best for kids, but I am not sure in the Old World, as I refer to it, that we necessarily knew what each other was doing. This forces us into that more than ever before.
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Some of the benefits. I won't go into those necessarily. Indirect consequences; I think this list will grow as we mature with these initiatives, but these are some of them that we have identified immediately that we are working on today. I think some of the things that were questioned as far as barriers and dollars and how do you access those dollars in a New World are certainly barriers that I would love to talk about.
I have included a lovely map of Kansas. We have the five regions and that is how they are colored there. You can obviously see the western part of the State is rather large as a region, but it is also the least populated area in the State.
I have also included facts and statistics about Kansas, everything you wanted to know, except I don't think I mentioned that Kansas University is number one in basketball. But if I didn't, let me do that now. What you will see on this, in particular, are some things I think will be of interest to you. This initiative was not generated by the legislators to decrease costs in the State. There has not been additional funding put into this initiative. We also have been—we have eliminated 200 public agency positions, not people, because we held open vacancies so that they could find other jobs within the organization, but it did eliminate the positions as we went to this privatized world.
Also in my statement I discuss family preservation. It is the specific outcomes that we are using in these contracts. On the right-hand columns you will see outcomes thus far that we have achieved. Again, we are still new, so some of them we can't measure yet.
Next, I discuss adoption. There again we are too early. It is October 1 that we started, so I don't have a lot of outcomes yet. I can tell you some of the process things that are in the box at the bottom that show some successes. We are hopeful. It looks good, but it is too early to tell. And then the foster care is too early because, again, we don't start it until March 1.
The final page, which is probably one of the critical ones for us, is the accountability and the monitoring. This certainly is a new way of doing business for us. I mean, there is no way around that. We are excited about it. We think we have been successful so far, but these are levels of monitoring that we are going through to assure daily, hourly, weekly, monthly—that if changes need to be done, that we make those changes quickly; that we don't sit around a table and talk about it for 1 year and then maybe the next year do something about it. We need to be ready to make the changes as we need it.
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Mr. Chairman, that concludes my testimony.
Thank you.
[The prepared statement follows:]
Statement of Hon. Bill Graves, Governor of Kansas; as Presented by Teresa Markowitz, Commissioner of Children & Family Services, Department of Social and Rehabilitation Services, Topeka, Kansas
Mr. Chairman, my name is Teresa Markowitz. I am Commissioner of Children and Family Services within the Department of Social and Rehabilitation Services (SRS) in Kansas. I am here today on behalf of Bill Graves, Governor of Kansas, and Rochelle Chronister, Secretary of SRS in Kansas.
I would like to share with you our vision for children in Kansas. This is a very exciting time for Kansas children as we move toward permanency for children. We are committed to the belief: ''There's no place like home.''
We have developed several initiatives to ensure that children are safe and living in permanent families. These initiatives in particular are:
1. Improved child protective services, increased confirmations and increased convictions.
2. Privatization of the majority of the rest of the SRS delivery system, including;
A. Family Preservation—Implemented July 1, 1996; 17 bids; Child Placing Agencies, Mental Health Centers, Drug & Alcohol Treatment Facilities.
B. Adoption—Implemented October 1, 1996; 1 bid; Child Placing Agency.
C. Foster Care (Reintegration)—Implemented beginning March 1, 1997; 17 bids; Managed Care Organizations, Child Placing Agencies, Mental Health Centers.
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What I would like to do now is walk you through the attachments and, hopefully, give you a glimpse of what we are doing in Kansas.
Child Welfare Initiatives in Kansas
I. Why make any changes?
1. Focus on permanency.
2. Provide services equitably across the state.
3. Allow public agency workers time to focus on child protective services.
4. Outcome driven system, with defined levels of accountability.
5. Reduce number of public agency workers associated with single family (integrated model).
6. Create atmosphere of partnership with others involved with children.
7. In ''old world'', the incentive was for provider to keep beds filled—Now it is permanence.
II. Description of Privatization in Kansas.
1. Ability to utilize current providers in Kansas.
2. No current Kansas provider large enough to do all of the delivery:
A. Divided state geographically into five areas.
B. Divided delivery system into three: Family preservation, adoption, foster care.
3. Not ''managed care'' but some common themes:
A. Outcome based service delivery system.
B. Pooled funding; to allow contractors decisions based on clinical need, not funding stream(s).
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C. Case Rate; set dollar amount per child/family tied to achieving outcomes (not based on process).
4. Public Agency (SRS) will continue to maintain responsibility for child protective services, investigation.
Overview
I. GOAL: IMPROVE OUTCOMES FOR KANSAS CHILDREN AND FAMILIES
II. OBJECTIVE: Public agency/private contractors have equal ownership and responsibility to a set of shared outcomes which include:
1. More children will remain safe from further abuse.
2. Fewer children will enter foster care.
3. Children in placement will experience fewer moves.
4. Length of time in a nonpermanent placement will be reduced.
5. More children who return home from foster care will remain at home.
6. The length of time from termination of parental rights to adoption will decrease.
7. Siblings will be together.
8. Clients will be satisfied with services received.
III. ASSUMPTIONS:
1. An outcome driven service delivery system results in focused services to achieve goals.
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2. The single case rate to achieve goals and maintain responsibility for 12–18 months creates a focus on high quality, cost effective services.
3. The need to remain fiscally sound prevents ''drift'' at any stage in case planning to achieve permanency.
4. Placing fiscal and clinical services with the contractor breaks the cycle of fitting children/families into pre-designed services and moves toward flexible services specific to the family's needs.
5. The design assures equal services statewide, with community based efforts.
IV. BENEFITS:
ORGANIZATIONAL
1. Public/private shared goals, outcomes
2. Public/private equal responsibility for services
3. Clearly defined roles, responsibilities
4. Creates partnership
5. Partnerships utilized to address judicial/legislative
CLIENT SPECIFIC
1. Single integrated public worker
2. Single private contractor responsible for service delivery
3. Child does not get passed along an endless chain of providers
4. Service ''drift'' is prevented
5. Service delivery is holistic, consistent, seamless
V. INDIRECT CONSEQUENCES:
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1. With the success of outcomes comes the reduction in the number of specialized service providers.
2. Established a new relationship between government and private sector as partners.
3. Massive amounts of training is necessary.
4. High level of competition develops among providers in new current delivery systems.
VI. BARRIERS:
1. Lack of a comprehensive data system.
2. Potential loss of IV–E funds (majority of IV–E dollars are dedicated to ''foster care'', when outcomes are achieved foster care utilization decreases).
3. Attitudes of mistrust.
4. Attitudes of devaluation of previous efforts.
5. Magnitude of paperwork required for eligibility and utilization to access multiple funding streams: title XIX, XX, IV–B and IV–E.
6. Timeliness of Judicial System in responding to motions to terminate parental rights.
INSERT OFFSET FOLIOS 4 TO 5 HERE
[The official Committee record contains additional material here.]
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ADOPTION MEASURE
Outcome #1: Children shall be placed for adoption in a timely manner.
1. 70% of children shall be placed with adoptive families within 180 days of the receipt of the referral for adoption.
Outcome #2: Children shall have permanent homes through the adoption process.
1. 90% of adoptive placements shall be finalized within 12 months of the placement date.
2. 90% of adoptive placements shall continue to be intact 18 months following finalization.
Outcome #3: Adoptive family members shall be satisfied with adoptive services.
1. 90% of families (parents and youth age 14 and over living in the home) shall report satisfaction with the adoption process at the time the adoption is finalized.
Outcome #4: Siblings should be kept together.
1. 65% of children will be placed with at least one sibling.
Outcome #5: Children shall remain in the same foster care placement pending adoption.
1. 90% of all children placed for adoption shall experience no more than two moves from the point in time parental rights are terminated until the adoption is finalized.
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* Outcomes pertaining to adoption are long-term and, depending upon the outcome, data on many of the client outcomes will not be available for 12 months.
Results after 4 months:
• Contractor is averaging 42 finalizations per month. SRS averaged 31.
• 58% of the children adopted were over the age of six.
• 37% of the children adopted were nonwhite.
• An additional 48 children have been placed in an adoptive placement.
REINTEGRATION (FOSTER/GROUP CARE) MEASURE
Outcome #1: Children are safe from maltreatment.
1. 95% of children in the care and supervision of the contractor will not experience confirmed abuse/neglect while in placement.
2. 80% of children will not experience confirmed abuse/neglect within 12 months after reintegration.
Outcome #2: Children experience a minimal number of placements.
1. 90% of children referred to the contractor will have no more than three placement moves subsequent to referral.
2. 65% of all children will be placed with at least one sibling.
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Outcome #3: Children maintain family, community and cultural ties.
1. 70% of children referred after the implementation date are placed within their contract Regional Boundaries.
2. 75% of youth, 16 and over, released from custody have either completed high school, obtained a GED or are participating in an educational or job training program.
Outcome #4: Children are reunited with their families in a timely manner.
1. 60% of children placed in out-of-home care are returned to the family within 6 months of referral to contractor.
2. 90% of children are integrated with their family do not re-enter out-of-home custody within 1 year of return home.
Outcome #5: Clients will be satisfied with services.
1. 80% of parents and youth (ages 14 and over) report satisfaction with services as measured by the Client Satisfaction Survey upon case closure.
* Implementation begins March 1, 1997.
Accountability and Monitoring
Monitoring of the system will occur at a number of different levels:
System External Review
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The Department will contract for a systems evaluation to cover service areas provided directly by SRS staff and services provided directly by contractors. The external evaluation will be designed to provide information on the overall effectiveness of changes in the service delivery system and SRS infrastructure, as well as to provide effectiveness data relative to each region as well as statewide, and relative to national statistics. The systems evaluation will cover the following service areas:
1. Intake/Assessment/Investigative Responsibilities (SRS)
2. Case Management (SRS)
3. Family Preservation (Private Contractor and Subcontractors)
4. Adoption (Private Contractor and Subcontractors)
5. Foster/Group Care (Private Contractor and Subcontractors)
System Internal Review
This monitoring will be done by the Children and Family Services Commission. Extensive protocol development will occur with input from providers, advocacy groups and the legal community. Such reviews will focus on substantiation of contractor case records; monitoring of training and contractor employee qualifications; review of administrative and supervisory procedures of the provider; review of critical incident files; and client satisfaction surveys. Periodic financial audits will also be conducted by the SRS audit unit (Contract Manager, Grants/Contracts Management Unit).
ACLU Settlement
Monitoring will be conducted to determine compliance with each element of the Settlement Agreement (Internal Quality Assurance Monitoring Unit [IQAMU], Legislative Post Audit [LPA]).
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Program Specific Review
Each contract is outcomes-based, with specific measures identified to assess contractor compliance. Contractors are required to submit monthly reports (Area Contract Specialist, Contract Manager, Grants/Contracts Management Unit).
Case Specific Review
Contractors are required to submit child and family case plans. (Contractor, SRS Social Worker, Area Contract Specialist).
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Chairman SHAW. Thank you very much.
Mr. Hoekstra.
STATEMENT OF RICHARD E. HOEKSTRA, DIRECTOR, DIVISION OF ADOPTION SERVICES, MICHIGAN FAMILY INDEPENDENCE AGENCY, LANSING, MICHIGAN
Mr. HOEKSTRA. Yes. My name is Richard Hoekstra. I am the director of the Division of Adoption Services for the Michigan Family Independence Agency. I want to thank you for this opportunity to talk about our adoption program in Michigan.
I want to share just a little information about myself and my career in adoption because there are some important things I have learned about adoption. I started in 1962, 10 years in a private agency, and then in 1972 I started with the Department of Social Services. In 1976, for a period of about 6 years, I had the opportunity to talk to well over 1,000 adult adoptees who have come back to the department to ask for information from their adoption records, and I think I learned more from those adult adoptees than any other experience I had in the field of adoption.
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I learned, for example, that I think adoption basically does work. Most of these children, now adults, experienced a successful parenting experience and were successful adults. Nevertheless, they did find that adoption was something they revisited throughout their life. It was a lifelong process to try to understand what adoption meant to them, and one of the things they did often was to find out information from their records.
When they did so, I was always impressed by how much they wanted to know about their families of origin and what the State had done in terms of trying to help their families of origin. I think they always felt better about their adoptions when they learned that efforts had been made to try to help their families and they learned that their adoption was something that was absolutely necessary. There was no other alternative for them.
So, that was something that I learned from adult adoptees, and I want to stress that because I think adoption should be viewed as something that is a necessary program. I also think I learned from them that it is the best alternative that we have for permanent wards of the State. It is the best form in terms of all the benefits it provides for a child. I don't think there is any other form of permanency that is quite as effective or successful as adoption.
I think, finally, what I learned is that there is terrific urgency for us to provide for every permanent ward of every State an opportunity to be adopted. They will not all achieve adoption, but they must be provided with that opportunity. That need is very, very urgent, and I think what you are doing in the legislature on a national level is very important to that effort.
I want to talk a little bit about Michigan's way of doing adoptions, which has included purchase from the private sector since 1976. In 1976, we had more wards than we were able to place with the staff that we had available in what was then known as the Department of Social Services. I was not the one that made the decision. Somebody who was there before me—I came in 1976—but the decisions, I think, were reached in 1974. They decided to turn to the private sector and develop a contract with private agencies.
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In 1976 we entered into contracts with about 45 licensed agencies in Michigan. Any licensed agency was free to join and participate in the contract. We gathered cost data. We set one rate for all of the agencies. I think it was about $2,500 at that time. The agency received payment under this contract only when they placed the child in adoption. There was no front-end money for recruitment or home studies or anything that led to an adoption. You had to achieve the adoption to get paid.
That system remained relatively unchanged until 1992. It was successful, though, because I think the public sector and the private sector as partners energized each other. There was kind of a competitiveness that was set up between the public sector and the private sector, particularly from the public sector. They didn't want to go out of business and the private sector wanted to grab it. And I think, between them, we really energized each other and I think that accounted for a lot of success in placing kids.
But in 1992 we made some fundamental changes and we tried to develop—instead of 1 rate, we developed 3 rates—and the rates were designed to produce certain outcomes that were desirable; namely, timely placements and particularly placements of children who had waited for a long time. Thus, for example, right now if an agency who has a child in their foster care—a State ward in foster care with a private agency—if they are going to place a child within 5 months of permanent wardship, they get $8,600. If they do so within 5 to 7 months, they get $6,000, and after 7 months they get $3,535.
At 6 months, a child who does not have a family selected must be put on our Michigan Adoption Research Exchange. That is a photo listing that is statewide. Any agency can place that child off the exchange for $8,600, the highest rate that we offer, except the agency that is responsible for the foster care. They cannot get the $8,600. So it is designed to promote early placement and designed to also try to facilitate placement of kids who end up waiting to be adopted. It has worked quite well.
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That chart shows you what has happened since 1992. I can give you a few figures. From 1986 to 1991, our permanent ward population—that is not on there—but our permanent ward population went up 57 percent, but our placements increased only by 41 percent. But since we have gone into this 3-tiered approach, our permanent wards increased from 1992 through 1996 by 41 percent, but our placements increased 66 percent.
So in the last 5 years, for the first time that I have been in charge of this program, we have been able to outpace—the placements outpace the new children that are becoming available, and that is a very important achievement and I am very, very pleased with that achievement.
So I want to commend you on what you are doing here. I feel there has to be a sense of urgency throughout the Nation for kids to achieve adoption. That has to come from a lot of different ways. The support has to come from the political world. It has to come from administrators, it has to come from advocacy groups. Everybody involved in adoption has to know that our goal is that every permanent ward has to have the opportunity to be adopted.
Thank you very much.
[The prepared statement follows:]
Statement of Richard E. Hoekstra, Director, Division of Adoption Services, Michigan Family Independence Agency, Lansing, Michigan
Michigan has long been a leader in the placement of permanent state wards in adoption. The Family Independence Agency, and its predecessor agencies, the Department of Social Services, The Michigan Children's Institute, and the State Public School started placing neglected and dependent children entrusted to the State before the turn of the Century. However, only a small number of state wards were placed in adoption until C.F. Ramsey, the first Superintendent of the Michigan Children's Institute, pioneered the first family based placement program for state wards in the thirties. Mr. Ramsey designed a program that expanded the use of foster homes as the placement of choice for newly committed wards rather than institutional settings. Using foster homes to care for most of the wards laid the groundwork for a strong adoption program.
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The Michigan Children's Institute and, later, the Department of Social Services' foster care/adoption staff placed state wards in adoption from the thirties to the sixties. Starting about 1970, the Department began to place a small number of children for adoption with a few private adoption agencies, primarily Spaulding for Children, on a case by case basis. However, by 1974, it became apparent that the number of wards needing adoption was beginning to exceed the Department's adoptive placement resources. At the same time, many private adoption agencies were facing a declining population of infants available for adoption. The Department decided to pursue purchase of service from the private sector on a statewide basis, a decision that benefited both sectors.
The initial effort to purchase services from the private sector began in 1976 and involved contracts with some 50 private agencies. The contract for all agencies was identical. The major features included:
1. Mandatory referral of wards by local Department offices to the private agencies under contract except those children who were to be adopted by foster parents or relatives.
2. Time limited opportunity for the agency that accepted the child for adoptive placement to achieve placement or return the child to the Department for statewide adoptive family recruitment.
3. Performance based reimbursement for service, paid at the point of adoptive placement and confirmation.
4. A reimbursement rate that was based on the average cost per adoption of all agencies under contract or, in other words, an averaging of the average cost of each agency under contract.
Approximately 5 years into the contract, the Department offered private agencies the opportunity to develop a cost per unit of service (hourly rate) and bill the Department for the number of units that were provided leading to an adoptive placement. A number of larger private agencies converted to the unit rate reimbursement system while most of the smaller private agencies remained on the average cost system. In 1991, a state audit was critical of the unit of service reimbursement method stating that it delayed placement by encouraging agencies to accumulate billable hours leading to a placement.
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Based on the 1991 audit and several other concerns, the Department made substantial changes in the contract with private agencies in 1992 that:
1. Eliminated the unit of service reimbursement method.
2. Provided a performance based reimbursement method that applied to all agencies under contract.
3. Replaced mandatory referral of state wards to private agencies by making the Department local office or private agency responsible for providing foster care services responsible for initial adoptive placement services. By this time, more than half of Department wards were in purchased foster care.
4. Required mandatory registration of a child on the Michigan Adoption Resource Exchange (MARE) 6 months after commitment to the state.
5. Provided rates of reimbursement that reward an agency for timely placement and retained performance based reimbursement for service at the point of adoptive placement and confirmation.
There have been no substantial changes since 1992, but modifications have been made to fine tune reimbursement to achieve specific outcomes related to timely placement.
The purchase of service system for Fiscal Year 1997 can be described as follows:
Introduction
The Adoption System is based on a commitment to full utilization of public and private resources to achieve timely placement for state wards.
1. The Family Independence Agency (FIA) local office, or private foster care agency under contract with the FIA, has primary responsibility for adoptive placement within 6 months from the date of permanent wardship for a child in its care whose plan is adoption.
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2. If a child is not placed within 6 months of permanent wardship, the child shall be registered on the Michigan Adoption Resource Exchange. Failure to register the child, as required, shall result in a 20% reduction in the foster care agency's administrative rate until the child is registered.
3. Once a child is registered on MARE, the child is available on a statewide basis for placement by any private adoption agency under contract with the Agency or any FIA local office.
Purchase of Adoption Service
All foster care agencies under contract with the Agency, licensed to provide adoption services, and all nonprofit licensed adoption agencies without foster care program will be offered adoption contracts.
Reimbursement
Reimbursement for adoption is based on a flat rate system:
1. A premium rate ($8,600.00) will be paid to a noncustodial agency that places a child registered on MARE with a recruited family. A foster or relative family is not considered to be a recruited family. The premium rate will be paid to a custodial agency that achieves an adoptive placement within five months of the child's permanent wardship date.
2. An enhanced rate ($6,000.00) will be paid to the foster care agency that places a child in its care within 7 months of permanent wardship. An agency will also receive the enhanced rate for placing a child within nine months of permanent wardship if the child was referred to the agency for adoptive placement within 4 months of permanent wardship.
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3. A standard rate ($3,535.00) will be paid to an agency that places a child in its care seven months after the date of permanent wardship.
4. An enhanced preplacement fee ($2,600.00) will be paid to the foster care agency when a child in its care is referred to another agency or FIA local office within 4 months of the child's permanent wardship date and an adoptive placement is achieved within 9 months of the child's permanent wardship.
5. A standard preplacement fee ($1,300.00) will be paid to the foster care agency when a child in its care is placed by another agency or FIA local office and the criteria for an enhanced preplacement fee does not apply. Attachment 'A' shows the number of adoptive placements of Department wards by Family Independence Agency staff and private agencies.
The private agencies began to outpace FIA starting in 1989. To some extent, this reflects an increasing use of purchase of foster care services from private agencies. Currently 66% of FIA family foster care is purchased. However, the increases in placements by private agencies since 1991 appear to reflect the modifications in the contract as well. Placements by the private agencies increased 73% from 1986 to 1991 and increased by 84% from 1991 to 1996.
The changes made in 1992 seemed to spur on FIA staff as well. Placements increased by 14% from 1986 to 1991 and by 43% from 1991 to 1996. It is the opinion of FIA that the competition between the public and private sectors has contributed to the increases in adoptive placements since the 1992 modifications in the contract.
Attachment 'B' indicates the placement performance by individual FIA local offices and private agencies under contract in 1996 and the combined total of adoptions for 1996: 2,189 placements.
Michigan has done an outstanding job of achieving adoptive placements for state wards particularly since turning to purchase of service in 1976. To illustrate, in 1995, approximately 27,000 children were adopted out-of-foster care nationwide and Michigan made 1,860 of those placements. Given that the total population of children in foster care in Michigan in 1995, including temporary and permanent wards was 14,662, this is a remarkable performance. This performance reflects the strong support for adoption in the State of Michigan from parent advocacy groups, such as Michigan Foster/Adoptive Parent Association, FIA Administration, the Association of Accredited Child and Family Agencies, and the Michigan Federation of Private Child and Family Agencies. Finally, much credit must be given to Governor John Engler and to Lt. Governor Connie Binsfeld for their continuing commitment and active participation in achieving permanency for the children entrusted to the care of the State.
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While it is critical to provide adoption opportunities to all permanent state wards, it is important to keep a balanced perspective on adoption. Adoption is clearly the placement of choice for a child who is a permanent state ward. No other form of permanency offers as much security to a child without parents. However, it is essential that one views adoption as a necessary service for children and not as desirable in and of itself. Strong family preservation programs in the continuum of child welfare services are essential in order to prevent unnecessary removals of children from their families of origin. Effective re-unification programs are essential to return children to those families of origin who can be helped to change the behaviors that caused their children to be removed. When strong family preservation and re-unification services are provided, adoptive placement is pursued only when it is necessary. We have learned from adult adoptees that they are more comfortable about having been adopted when they learn that efforts were made to help their families of origin to prevent the adoption in the first place. They provide the best argument for maintaining strong family preservation services.
The success that Michigan has achieved in placing children from foster care into adoption reflects the broad support and emphasis that has been placed on adoption for a number of years. Placement of children from foster care into adoption has been and continues to be a state priority. In Fiscal Year 1996, placements numbered 2,189, an 18% increase, while the number of children whose plan was adoption increased by 10% during Fiscal Year 1996. There is no doubt that the effort being made here today can lead to a nationwide priority on placing children in the foster care system in permanent homes through adoption. a nationwide emphasis on adoption as a priority is needed and will bring results.
INSERT OFFSET FOLIOS 6 TO 7 HERE
[The official Committee record contains additional material here.]
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Chairman SHAW. Thank you, sir.
Mr. Cross.
STATEMENT OF TERRY L. CROSS, EXECUTIVE DIRECTOR, NATIONAL INDIAN CHILD WELFARE ASSOCIATION, PORTLAND, OREGON
Mr. CROSS. I am Terry Cross, the executive director of the National Indian Child Welfare Association, and I want to talk with you today about this mission, what I see as your vision for children, really the need to grow up with a sense of belonging and have a family to call their own and to protect that sense of belonging and permanency.
You have heard about governmental entities of States and counties doing these child welfare services, but I am here because there is another governmental entity that does this kind of service, too, and that is Indian tribes across the country. And Indian tribes are represented here today to ask to be a full partner in your vision. We want to be a full partner in having our children grow up with that sense of belonging, and right now we are not a partner.
This year is 20 years since my first trip to Washington, DC, to do advocacy for Indian children, and in that 20 years I have seen a tremendous change in our communities and in the way we do business. And part of that is when I came here 20 years ago, there were only maybe a dozen tribal juvenile and child courts in the country. There were probably only 15 tribal child-placing agencies in the country, with only a handful of children in care under the custody of tribes.
At the time of the passage of the IV–E provisions of the permanency planning, I don't think any of us envisioned a world where now 550 tribes do some form of child welfare services. Over 300 have their own tribal courts and juvenile codes, and we estimate that there are about 6,500 Indian children in foster care under the jurisdiction of tribal courts.
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One of the things that that means is that in seeking this vision of protecting a child's sense of belonging, Indian tribes are one of your best partners, and I am here to say that it is time for this body and other bodies that deal with Indian people to stop treating us like a problem to be solved and treat us like a resource and a partner in solving those problems.
We can't do that, however, when we are excluded from the process, and in an oversight and because of the circumstance of the time, we were not included in the IV–E provisions. Our children don't enjoy the same protections of permanency that all other children experience. We are not eligible—our tribes are not eligible—because of the way the legislation was written, to receive Federal reimbursement for foster care. As a result, we have the only children in the country whose placements are not subject to the same kind of review process.
The only way tribes can get IV–E payments is to have those passed through States, and those passthroughs have to come through agreements, but those agreements are cumbersome and they do not work well. As an example, there are only 50 tribes out of 550 in the Nation that have IV–E agreements. Only 15 of those 50 provide for any administrative and program dollars to go toward serving Indian children, and only 2 of those pass through any training dollars and those are both in Mr. Camp's State.
There are a lot of barriers to forming those agreements. Tribal relations with States, often involving other issues, prevent there being negotiation in children's issues. Well, there are other sources that try to fill this gap. One of those other sources is BIA child welfare services, but that is a finance of last resort. It is also money that gets in competition with other social service needs, and so tribes have to decide whether they are going to bury indigent people or whether they are going to pay for foster care.
And in that small amount of resource, 90 percent of those funds go to tribes in only six States, and there are tribes in two States that receive no funding from the Bureau of Indian Affairs. And there are no permanency rules attached to any of that funding, so that when the Bureau of Indian Affairs pays for foster care, there are no permanency, no review processes required.
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Then there is another big area that tries to fill this gap. We estimate that 20 percent of all of the children placed by tribes are in unsubsidized homes, people who are opening their homes to Indian children without any payment whatsoever. I think that that is intolerable. There is a note in our written testimony that only 40 children on a Navajo reservation are in unsubsidized homes. They have now corrected that for us and it is closer to 300, and I will provide that information.
Well, the tribal capacity is much greater than what it used to be in providing these services, and I want to say that in 1988 there was a study that showed that when Indian tribes do their own services, fewer children go into care in the first place. They tend to go home sooner and they have better permanency outcomes. So despite the controls, our tribes are doing a better job. We just need to be empowered to do that.
So what we are asking—even though tribes do a tremendous job on a little bit of money, without direct access to IV–E, it is a second-class service system, and that is not appropriate. Indian children face greater obstacles to permanency in many situations and have less protection than all other children, and I would say that failure to fix the oversight that happened in 1980 is going to mean that any changes that you do here in this process will complete miss Indian children because it will simply perpetuate the problem.
Finally, those costs to correct these problems are minimal. We are not talking about a big chunk of children, but we are talking about a group of children who really deserve to have this corrected and this historical oversight fixed.
[The prepared statement follows:]
Statement of Terry L. Cross, Executive Director, National Indian Child Welfare Association, Portland, Oregon
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Mr. Chairman and Members of the Subcommittee, this testimony is submitted on behalf of the National Indian Child Welfare Association based in Portland, Oregon (see attachment). Our testimony will focus on Indian children and their limited opportunities to benefit from the Title IV–E Foster Care and Adoption Assistance program (herein referred to as Title IV–E) and what we believe to be an effective solution to this inequity. Our testimony will show that otherwise-eligible Indian and Alaska Native children have not enjoyed the same guarantees for foster or adoptive care services that other children have in this country. Native children are the only class of children without entitlement to foster care and adoptive services in this country. In our view, this issue, as much as any other issue, has impacted the ability of Indian children to secure a sense of permanency after being removed from their homes.
The Title IV–E Foster Care and Adoption Assistance Programs—Services Not Guaranteed to Indian Children
As you know, the IV–E program was enacted in 1980 as a part of major legislative changes to the child welfare system in this country. Enactment of Title IV–E and changes to the Title IV–B Child Welfare Services program under the Social Security Act established new Federal protections for children who were removed from their homes and resources to help them gain permanency in their lives. Title IV–E provides states with a permanently authorized entitlement program that provides matching funds to support placements of AFDC-eligible children in foster care homes, private nonprofit child care facilities, or public child care institutions. These foster care maintenance payments are intended to support the costs of food, shelter, clothing, daily supervision, school supplies, general incidentals, liability insurance for the child, and reasonable travel to the child's home for visits. Matching funds are also available for administrative activities that support the child's placement and training for professionals and parents involved in these placements. The foster care program had been mandatory for all states that participated in the former Aid to Families with Dependent Children (AFDC) program, and under the new welfare reform law it is mandatory for states that operate a Temporary Assistance for Needy Families (TANF) block grant.
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Title IV–E also provides entitlement funds to support adoption assistance activities, and like the foster care program, is mandatory for all states that operated the former AFDC Program or the new TANF block grant. Activities which qualify for matching funds include: maintenance payments for eligible children who are adopted, administrative payments for expenses associated with placing children in adoption, and training of professional staff and parents involved in adoption. To be eligible for these matching funds states must develop agreements with parents who adopt eligible children with special needs. Special-needs children must be AFDC- or SSI-eligible. However, states may also claim nonreoccurring adoption expenses for children with special needs who are not AFDC- or SSI-eligible. While Title IV–E broadly defines special-needs children as those who have characteristics that make them difficult to place, Title IV–E gives states discretion as to the specific categories of special-needs children that they will recognize (e.g. older children, minority children, and children with physical, emotional, or behavioral problems).
Another area of support under Title IV–E is the Independent Living Program. Title IV–E was amended in 1986 to include a program that would assist youth who would eventually be emancipated from the foster care system. The funding under this program was intended to support services for AFDC-eligible youth who were age 16 or over make a successful transition from the foster care system to independent living when they become ineligible for foster care maintenance payments at age 18. The program was expanded in 1988 to include all youth in foster care, regardless of AFDC-eligibility. Two years later amendments to Title IV–E gave states the option of providing services to youth up to the age of 21. Some examples of services provided under this program include: Basic skills training, educational services (e.g. GED preparation), and employment preparedness.
We have given the above overview of the services provided under the Title IV–E entitlement program to emphasize that these are services not guaranteed to otherwise eligible Indian children.
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Indian Children and Title IV–E
While Congress intended for the Title IV–E program to serve all eligible children in the United States, Indian children who are under the jurisdiction of their tribal court do not have an entitlement to this important program afforded other children. The statute provides services only for income-eligible children placed by states and public agencies with whom states have agreements.
We believe it is a drafting oversight that the Foster Care and Adoption Assistance Act of 1980 made no provision for funding for children placed by tribal courts nor for tribal governments to administer Title IV–E funds and seek reimbursement for foster care and adoption services provided Indian children under their jurisdiction. We see nothing in the legislative history to suggest otherwise, and conversations with the office of Representative George Miller, the primary author of the 1980 Act, suggests it was not intentional. During last year's consideration of welfare reform legislation a number of Members including Representative Don Young, Senator John McCain, and Representatives Bill Richardson and George Miller wrote this Subcommittee asking that the bill be amended to provide direct funding to tribes under the Title IV–E statute. Mr. Richardson introduced legislation, H.R. 261, on January 7, 1997 to provide direct funding to tribes under Title IV–E. Unfortunately, the Title IV–E statute is not the only social services related program which has given little thought to services for people living on Indian reservations.1 We urge Congress to always keep in mind that tribal governments are not subsets of state governments. They are legally distinct and separate from state governments. Federal statutes authorizing services need to make specific provision for tribal delivery systems.
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Title IV–E Tribal-State Agreements/Office of Inspector General
Only 50 of the 550 federally recognized tribes have been able to enter into agreements with states to provide access to at least some IV–E funds.2 These agreements primarily provide foster care maintenance moneys only—not administrative, training, and data system funding. In only 15 of the 50 agreements do states provide tribes with IV–E administration funds and to our knowledge only 2 of the agreements provide any IV–E training funds to tribes. None of the agreements provide funding for information systems development for tribes which are available to states under IV–E. Even when agreements are reached, tribes and states realize that a more efficient system would be to fund tribes directly.
A picture of the situation for tribal access to Title IV–E and other Federal social service and child welfare funds was provided in a report by the HHS Office of Inspector General (OIG), ''Opportunities for Administration for Children and Families to Improve Child Welfare Services and Protections for Native American Children'', August 1994. The report documented that tribes receive little benefit or funding from Federal Social Security Act programs, specifically Title IV–E Foster Care and Adoption Assistance, the Title XX Social Services Block Grant, and the Title IV–B Child Welfare Services and Family Preservation and Support Services moneys.3 While tribes receive a small amount of direct funding under both of the IV–B programs (about $7.4 million combined in FY1997), there is no direct funding available to tribes under the much larger Title IV–E and Title XX programs.4
In order for tribes to receive funding under these programs they have had to rely on states to share a portion of their allocation. This option has been available in only a handful of states and in amounts that are extremely small. Not surprisingly, the above-mentioned Office of Inspector General study—in listing options for improving service to tribes—stated that the surest way to guarantee that Indian people receive benefits from these Social Security Act programs is to amend the authorizing statutes to provide direct allocations to tribes.
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With regard to funding passed through from the state to tribes, the OIG report states:
• In 15 of the 24 States with the largest Native American populations, eligible Tribes received neither Title IV–E nor Title XX funds from 1989 to 1993. In 1993 alone, these 15 states received $1.7 billion in Title IV–E funds and $1.3 billion in Title XX funds.
• Nine of the 24 States reported that some Tribes in their States received Title IV–E and/or Title XX funds in 1993.
• Eight States reported that 46 Tribes received $1.9 million—.2 percent—of the States' $82 million Title IV–E funds, while 4 States reported that 32 Tribes received $2.8 million—.3 percent—of the States' $98 million Title XX funds.
The OIG report discusses the barriers to tribal-state agreements regarding Title IV–E (and Title XX):
No Explicit Authority
The Congress provided no authority for ACF to award Title IV–E and Title XX funds directly to Tribes; and the law neither requires nor encourages States to share funds with Tribes;
State Responsibility for Tribal Compliance With Requirements of P.L. 96–272 for Title IV–E Funds Is Problematic for States
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Some states are reluctant to enter into Title IV–E agreements with tribes because, under the law, the state would be held accountable for tribal compliance with Title IV–E. States could, if tribal records were out of compliance, lose their Title IV–E and section 427 incentive funds. We know that this is an issue with a number of states, including Alaska, Arizona, and New Mexico.
Disputes Between Tribes and States About Issues Unrelated to Child Welfare
Both state and tribal officials reported that points of contention between state and tribal governments unrelated to child welfare have made agreements impossible to reach. Issues concerning land rights and jurisdiction have thwarted these agreements. At least one state made receipt of foster care money contingent upon the tribe adopting the complete set of state child welfare policies and procedures.
Matching Share Issue
Most tribes will have difficulty providing the match required for Title IV–E funds, and most states do not want to provide it. In some cases where there are tribal-state IV–E agreements, the state has provided the match for foster care maintenance funds.
Tribal Lands That Extends Into Multiple States
In cases where tribal lands extend across state borders (e.g., Navajo is in Arizona, New Mexico and Utah) the prospects of concluding multiple IV–E agreements have proved infeasible. Eight federally recognized tribes have lands that extend into multiple states.
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The OIG report also notes that state officials with whom they talked favored direct IV–E funding to tribes:
With respect to IV–E funding, most State officials with whom we talked favored ACF (Administration on Children and Families) dealing directly with Tribes. This direct approach for Title IV–E would eliminate the need for Tribal-State agreements, and because Title IV–E is an uncapped Federal entitlement, would not affect the moneys available to the States. (p. 13).
Tribal Efforts To Provide Foster Care/Adoption Services for Their Children Absent Title IV–E Agreements
While tribes cannot receive Title IV–E funds directly from the Department of Health and Human Services, and have had little success in obtaining IV–E funds through their states, a limited number have been able to put together some stop gap measures to partially fund these services. These attempts to provide foster care and adoption services are not a substitute—or should not be—for the reliable funding for services provided to states and children outside of Indian country under the Title IV–E statute. Indeed, because of the limited nature of these alternate resources, tribes may have no choice but to place IV–E eligible children in unsubsidized homes.
We begin with an estimate of need. There are approximately 405,000 Indian children who live on-or-near their tribal lands.5 While not all of these children will need foster care or adoption services, the most recent data suggests that approximately 6,500 of these children will be placed in substitute care during the fiscal year.6 Based on the characteristics of Indian children in care as identified through case reviews by Bureau of Indian Affairs staff and tribal child welfare administrators, it is estimated that between 3,900 to 4,600 of these children meet the eligibility criteria of Title IV–E.7 Using the estimates of Title IV–E eligible Indian children and data obtained from the 1996 Green Book for the twenty-four states with the largest tribal populations, we were able to estimate the Federal shares of Title IV–E funds that could flow to eligible Indian children for foster care services (maintenance, training, information systems) at between $21.4 and $25.3 million a year.8 This estimate does not take into consideration variable rates for therapeutic foster care and institutional care for which we have insufficient data. Individual estimates for Adoption Assistance and Independent Living services expenditures for Indian children were not made because of a lack of data, but could be expected to increase expenditures by approximately 10%.9
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Child Welfare Assistance Funds Provided by the Bureau of Indian Affairs (BIA)
The BIA has provided a limited amount of discretionary funds—about $21 million annually—to a relatively small number of tribes for use as a ''resource of last resort''. The program provides only foster care maintenance payments and institutionalized care but has no administration, training or information systems funds connected to them. These funds are also in competition with other programs under the BIA Tribal Priority Allocation category. This means that if there is an urgent need to increase funding for other programs such as road repairs, employment and training services, or emergency burial assistance services, Child Welfare Assistance funds may be subject to reduction. The BIA has no funds specified for use in promoting permanency planning as are available in the Title IV–E Adoption Assistance program.
The BIA funds clearly fall short of need. The total number of substitute care placements subsidized under this program for FY 1996 was 3,400 with approximately 60% to 70% of those children estimated to be Title IV–E eligible.10 Distribution patterns of these funds reveals that approximately 90% of the funds go to Navajo Nation and tribes in just six other states (Arizona, New Mexico, Utah, Nevada, North Dakota and South Dakota).(see footnote 14) Tribes in California which number 100 (and who do not have IV–E agreements with their state) have not been able to access these limited BIA funds.
Even though the Navajo Nation receives a major portion of the BIA Child Welfare Assistance funds, they still report placing at least 40 children a year (who should be eligible for IV–E funding) in unsubsidized homes.12 This illustrates the inadequacy of the BIA funds.
Unsubsidized Homes
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Not wanting to leave children in harmful situations, tribes have had to resort to alternative vehicles for protecting children who must be removed from their homes. A common method is the placement of Indian children in unsubsidized homes. This often requires the good will of a family in the community who will commit their personal resources, time and home to a foster care, legal guardianship, or pre- adoptive placement for a needy child. Even though the commitment is made with love, the vast majority of these families find this event to be stressful and sometimes unworkable after a period of time, especially when considering the numbers of Indian families on tribal lands who live in or close to poverty.13
Most tribes will still license the unsubsidized family foster home and provide assistance on foster parenting, even though it often involves shifting scarce child protection funds from one account to another in order to meet emergency and other pressing needs. However, additional services that support the child and foster family which are reimbursable under Title IV–E state programs are not always available, causing additional stress on the foster or pre-adoptive family and putting the placement at risk for disruption.
The lack of Title IV–E funding is also felt at the front end of developing permanency for Indian children. Tribal child welfare programs which are responsible for recruiting potential foster care and adoptive families have difficulties recruiting and maintaining families because they cannot guarantee basic maintenance payments and few support services for the placement. While strong community values and individual generosity often prevail in helping provide temporary homes for needy Indian children, the numbers of homes actually needed often does not meet the need because of limitations on support that can be offered to these families.
Elements of a Tribal Title IV–E Amendment
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We recommend an amendment to Title IV–E of the Social Security Act which contains the following elements:
• extend the Title IV–E entitlement to tribal placements in foster and adoptive homes which meet eligibility requirements
• authorize tribal governments to receive direct funding from HHS for administration of the IV–E program
• recognize tribal standards for foster home licensing.
• allow the Secretary flexibility to modify the requirements of the IV–E law for tribes if those requirements are not in the best interests of Indian children
• allow the Secretary to modify IV–E matching requirements in recognition that tribes, unlike states, have not previously received funding to build the type of service delivery systems available to the states, and permit other Federal and state funds to be used for any required tribal match
• continue to allow tribal-state IV–E agreements
• develop HHS regulations in partnership with tribes and others with expertise in the child welfare field.
Tribal Administration of Foster Care/Adoption Assistance Program Would Be Consistent With Welfare Reform Law and Proposed Adoption Legislation
Our recommendation that the Foster Care and Adoption Assistance Act be amended to provide direct funding to eligible children on Indian reservations and to tribal governments for the administration of the program serves the purposes of the newly enacted welfare reform law and Congressional and Administration interest in adoption legislation.
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Under the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, a state cannot receive Temporary Assistance for Needy Families (TANF) funding unless it operates a foster care/adoption assistance and child support enforcement programs under Titles IV–E and D of the Social Security Act. Congress explicitly recognized the interrelationship between the effort to end dependence on public assistance with the need for a strong child support enforcement program and an effective system for helping our most vulnerable children—those living in poverty who require temporary or permanent placements outside their homes. Sadly, the Federal entitlement statutes concerning foster care and adoption and child support enforcement have been of very little benefit to Indian children living on reservations.
While tribes are eligible to apply to administer TANF under the new welfare reform law, it does not require them to operate foster care/adoption assistance and child support enforcement programs. It would have been disingenuous to have made these requirements, since tribal governments—unlike state governments—have never received annual Federal funding from the IV–D and IV–E programs. The welfare reform law includes a new provision which we hope will assist tribes in establishing Title IV–D programs, but we know that development of child support enforcement programs will take time.
Providing direct Title IV–E services to children in Indian country also serves the interest as we understand it of this Subcommittee and the Clinton administration in promoting quicker permanent placement of children. While a few tribes have access to IV–E foster care maintenance payments, even fewer have access to funding to any IV–E infrastructure (training, information systems, recruitment of families) needed to operate the complete range of services for intervention and making permanent placements of children. The HHS Adoption 2002 report states that slightly over half of the children in foster care awaiting adoption who are designated as having ''special needs'' are minority children. These children are considered harder to adopt. If tribal communities were provided their rightful institutional role under the Title IV–E law, they could be of tremendous assistance in placing Indian and Alaska Native children.
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Tribal governments and tribal communities are in the best position to place their children in permanent homes, but they have been thwarted by a Federal statute which ignores them. When Indian children have been under the care of tribal programs, as compared to public, private or Bureau of Indian Affairs programs, these children have a shorter length of time in substitute care and are more likely to secure family based permanency.14 This last consideration may be the most important in terms of why we should keep Indian children under the care of their tribal communities.
We should now use the opportunity of what apparently will be Federal adoption legislation to provide Title IV–E services for Indian children and tribal governments comparable to that provided to other eligible children and to state governments.
Thank you very much for the opportunity to testify before this Subcommittee. I will be happy to respond to any requests for additional information or clarification.
INSERT OFFSET FOLIOS 8 AND 9 HERE
[The official Committee record contains additional material here.]
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Chairman SHAW. Ms. Hogan.
STATEMENT OF MAUREEN K. HOGAN, EXECUTIVE DIRECTOR, ADOPT A SPECIAL KID/AMERICA, WASHINGTON, DC
Ms. HOGAN. Thank you. My name is Maureen Hogan. I am the executive director of AASK, Adopt a Special Kid/America. AASK is a national umbrella organization which represents a network of affiliated special-needs adoption agencies and volunteers all over the United States. We make possible the movement of hundreds of children from foster care to adoptive homes every year. Though for many years we were based in San Francisco, 6 months ago our founders asked me to move our headquarters to Washington to establish an advocacy organization exclusively on behalf of children in foster care with special needs.
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When our program was started, most of the children that we placed had birth defects and medical disabilities. Over the 25 years we have been in existence, however, special needs has come increasingly to refer to children who are abused or neglected. Now, the label ''special need'' may mean that a child is older, is a minority, has siblings, is medically fragile, HIV-positive, was born drug- or alcohol-exposed, or has been sexually or physically abused or abandoned, increasingly by substance-abusing parents, unfortunately.
Many people would consider these children unadoptable. Yet, we have demonstrated thousands of times that, in fact, there is a loving parent for every child, whatever their special need may be. For 25 years, our program has not only found homes for these kids, we have, as we speak, waiting lists of parents all over the country anxious to adopt them, no matter what their circumstances.
For us, the discussion of adoption reform is not a theoretical exercise. We and the children confront the reality of this issue every day. The children don't need more demonstration grants for research to accelerate placements. The children don't need 5 more years of research to identify the barriers to adoption. After finding homes for thousands of living, breathing children, we know exactly what the barriers are and how to eliminate them.
We know that by offering our adoption services free of charge and removing artificial financial requirements, we can place children in families, families who especially in minority communities might never have thought they could afford to adopt. In fact, since our program and others like it charge little or nothing for our placements, the recently enacted tax credits actually have done little to encourage special-needs adoption for us. Many of our families don't earn enough income to file a tax return. Yet, they manage to run loving and orderly homes.
Most Americans could never imagine adopting eight drug-exposed siblings ranging in age from 2 to 10 at one time. However, last year in Dallas, Texas, we did exactly that. The family that adopted these children had always wanted a larger family, but they could never have afforded to adopt these children if they had had to pay for the placements.
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We know that by eliminating age discrimination against both children and adults, so-called unadoptable teenagers can find patient parents in the homes of retirees. Hundreds of older parents who have the time to focus on rebuilding the lives of these kids are turned away by public agencies. Often, children with difficult medical conditions or behavior problems thrive with the attention that can only be provided by a full-time care provider.
Last year, also, in Dallas, we placed four siblings with fetal alcohol syndrome ranging in age from 11 to 4 in the home of a couple in their late fifties. Though, by many standards, any of those children individually would be considered a difficult placement, they are together as a family because we do not limit eligibility for prospective parents to those under the age of 40.
We know that using the Internet and a national database of waiting children and parents, we can eliminate the geographic barriers that separate prospective parents from the children who most need them. Using our adoption exchange, which was recently featured in an article in Policy Review, we have created a virtual adoption agency which matches children with parents wherever they are.
In fact, last week we were able to identify prospective parents in Michigan for a sibling group of 10 children in Arizona who have languished in the system for 3 years, a task most experts would have considered impossible. When confronted with the task of finding a home for an infant born in Texas with a serious brain deformity, we were able to find parents for her in Ohio within days after our search began.
While over the years we have learned how to find adoptive homes for these children, we have also discovered that the most difficult barriers to providing stable, loving environments for them are often the very programs designed to help them. Unfortunately, it has been our overwhelming experience in virtually every State in the country that it is the exploitation of Federal and State subsidies which encourage most public agencies and some private foster care providers to retain children in care long after they should leave.
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It has also been our experience that in some States, even when prospective adoptive parents have been identified and licensed the adoption voluntarily endorsed by the biological parent, the public agency will still refuse to expedite the placement. In many parts of the country, our social workers feel much more like hostage rescue teams than adoption specialists.
Though California, for instance, has the third largest population of children in foster care, it ranks 48th in placement rates, we believe, as the result of habitual abuse of entitlement programs. The Federal and State funds for these programs rarely trickle down to the children and families for whom they were intended, and as a result the children are effectively penalized twice, first when they are deprived of the subsidies intended to provide for their often highly specialized medical and education needs and, second, when they are deliberately deprived of the opportunity to grow up in a loving, stable home.
The current foster care maintenance program is an example of a cost-plus system which encourages public agencies to retain children in foster care. Once the children are released to adoptive homes, the Federal contribution to local agencies disappears. The same public agencies are commonly the third-party payers for SSI payments for children with special needs. In many cases, those SSI payments never reach the children. Instead, the funds are diverted to the county or parish general fund.
As an aside to Mr. McCrery's observations, we can tell you that we have ample documentation of these abuses, and in some parts of the country we believe that the distribution of funds is roughly 85 percent of the money retained by public agencies, who will argue that they need the money to supervise the placements, but we can show you hundreds, perhaps thousands of instances where those agencies can't locate the children in their programs, much less supervise their care.
In counties all over the country, children are held hostage to a complex web of subsidy payments which represent a significant source of income for municipal governments operating completely without oversight. It is our unavoidable conclusion that the biggest single barrier to adoption is the fact that children have become profit centers for agencies reluctant to lose cash flow.
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It should also be noted, ironically, that many public sector employees have become extremely defensive about reforming the system because they are concerned about losing their jobs. Perhaps the ultimate irony is that the funds that are captured in these schemes are not returned to the child welfare agency budgets in most cases. Most often, they are cycled back into the county's general operating accounts, where they may buy police cars instead of hiring more social workers. And while the sheriff's department may get raises, the social workers rarely do, and so while social workers juggle impossible caseloads of 50 and 60 children, they may not realize they are as abused by these practices as are the kids.
And I would say as a comment on Mr. Liederman's observation about accreditation in Harris County, Texas, we have a big program in Texas and Harris County has one of the worst placement rates in the State of Texas. And in spite of accreditation, with 3,000 children in care last year, they placed 59 of them in adoptive homes. We have 10 adoptive parents waiting for every child that comes out of the system in Texas, so accreditation is really only a part of the answer. While we would argue that accreditation is a good thing, it is not the only answer.
Mr. CAMP [presiding]. Ms. Hogan, I note the red light is on, and you might just conclude your remarks in a paragraph or two.
Ms. HOGAN. Sure. I have a number of recommendations here, including tying funding to performance, not effort; placing a 12-month limit on family reunification; providing legal standing for foster parents in court hearings. We need desperately to clarify fiduciary obligations and strictly enforce them. We need to eliminate interstate barriers to adoption, and we need to very carefully limit caseloads for social workers.
It is ironic that the very thing that many people perceive as helpful to these children often represents the biggest barrier of all to their placement, and we find it almost unbearable to think that nearly 15,000 Americans a year go overseas to adopt, often at great expense, and often for children with special needs. And it is just a scandal that they find it easier to cut redtape in Third World countries than they do in their own communities.
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We applaud your efforts, but we would just caution you that these children don't need rhetoric, they don't need bureaucracy, and they sure don't need more money. They don't get the money that is there now. What they need are parents, and we would hope that by shifting the Federal reimbursement for pay to success and not effort that we can resolve this terrible problem.
[The prepared statement follows:]
Statement of Maureen K. Hogan, Executive Director, Adopt A Special Kid/America, Washington, DC
My name is Maureen Hogan. I am the Executive Director of Adopt A Special Kid/America (AASK). AASK is a national umbrella organization which represents a network of affiliated special needs adoption agencies and volunteers all over the United States. AASK makes possible the movement of hundreds of children from foster care to adoptive homes each year. In the life of our program we have been responsible for facilitating thousands of adoptions of so called ''special needs'' children. AASK is supported by private contributions, fees for services provided to public agencies, and demonstration grants.
Our program was founded twenty five years ago in San Francisco by Bob and Dorothy Debolt, who were the subjects of an Academy Award winning documentary called ''Who Are The DeBolts and Where Did They Get All These Kids'' about their own adoption of sixteen special needs children. Though based for many years in San Francisco, six months ago the DeBolts asked me to move the head quarters to Washington to establish an office to specifically advocate on the behalf of children in foster care with special needs.
When our program was started most of the children AASK placed had birth defects and medical disabilities. Over the twenty five years our program has been in existence ''special needs'' has come increasingly to refer to children who are abused or neglected. Now the label ''special need'' may mean that a child is older, a minority, has siblings, is medically fragile, HIV positive, was born drug or alcohol exposed or has been sexually or physically abused or abandoned.
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Many people would consider these children unadoptable. Yet we have demonstrated thousands of times that, in fact, there is a loving parent for every child whatever their special need may be. For twenty five years our program has not only found homes for these kids, we have waiting lists of parents all over the country anxious to adopt them no matter what their circumstances.
For us the discussion of adoption reform is not a theoretical exercise. We and the children confront the reality of this issue every day. The children don't need more demonstration grants for research to accelerate placement rates. The children don't need five more years of research to identify the barriers to adoption. After finding homes for thousands of living, breathing children we know exactly what the barriers are and how to eliminate them.
We know that by offering our adoption services free of charge and removing artificial financial requirements we can place children in families. Families who, especially in minority communities, might never have thought they could afford to adopt. In fact, since our program and others like it charge little or nothing for placements, the recently enacted tax credits do little to encourage special needs adoption. Many of our families don't even earn enough income to file a tax return yet they manage to run loving, orderly homes.
Many Americans could never imagine adopting eight drug exposed siblings ranging in age from two to ten. Nevertheless by offering adoptive placements free of charge, by providing training and support for the family, AASK found those kids a family which already had three biological children. Last year all eight children went home with a Dallas family who wanted a larger family. The adoptive family could never have afforded to adopt eight children at one time without AASK's free services and the Adoption Assistance Program.
We know that by eliminating age discrimination against both children and adults, so called unadoptable teenagers can find patient parents in the homes of retirees. Hundreds of older parents, who have the time to focus on rebuilding the teenagers lives, are turned away by public agencies. Often children with difficult medical conditions or behavior problems thrive with the attention that can only be provided by a full time care provider. Last year also in Dallas we placed four siblings with fetal alcohol syndrome ranging in age from eleven to four in the home of a couple in their late fifties. Though by many standards any one of those children would be considered a difficult placement they are together as a family because we do not limit eligibility for prospective parents to those under the age of forty.
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We know that using the Internet and a national database of waiting children and parents, we can eliminate the geographic barriers that separate prospective parents from the children who most need them. Using our adoption exchange, which was recently featured in an article in Policy Review, we have created a Virtual Adoption Agency which matches children with parents wherever they are. Last week we were able to identify prospective parents in Michigan for a sibling group of ten children in Arizona who have languished in the system for three years, a task most ''experts'' would consider impossible. When confronted with the task of finding a home for an infant born in Texas with a serious brain deformity we were able to find parents for her in Ohio within days after our search began.
While over the years we have learned how to find adoptive homes for these children we have also discovered that the most difficult barriers to providing stable loving environments for children are often the very programs designed to help them. Unfortunately, it has been our overwhelming experience in virtually every state in this country that it is the exploitation of federal and state subsidies which encourage mostly public agencies and some private foster care providers to retain children in the foster care system long after they should leave it.
It has also been our experience that in some states, even when prospective adoptive parents have been identified and licensed and the adoption voluntarily endorsed by the biological parent, public agencies will still refuse to expedite the placement. In many parts of the country our social workers feel more like hostage rescue teams than adoption specialists.
Though California has the third largest population of children in foster care, it ranks forty eighth in placement rates as a result of habitual abuse of entitlement programs. The federal and state funds for those programs rarely trickle down to the children and families for whom they were intended. As a result, the children are effectively penalized twice: first, when they are deprived of subsidies intended to provide for their often highly specialized medical and educational needs; second, when they are deliberately deprived of the opportunity to grow up in stable, loving homes.
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The current Foster Care Maintenance program is an example of a cost plus system which encourages public agencies to retain children in foster care. Once the children are released to adoptive homes the federal contribution to local costs disappears. The same public agencies are commonly the third party payees for SSI payments for special needs children. In many cases those SSI payments never reach the children. Instead the funds are diverted to the county or parish general fund.
In counties all over the country, children are held hostage to a complex web of subsidy payments which represent a significant source of income for municipal governments without effective oversight. It is our unavoidable conclusion that the biggest single barrier to adoption is the fact that the children have become profit centers for agencies reluctant to lose cash flow.
It should also be noted that many public sector employees have expressed the fear that reforming the system will cost them jobs. Perhaps the ultimate irony is that the funds that are captured in these schemes are not returned to child welfare agency budgets. Most often they are cycled back into county operating accounts where they buy police cars instead of hiring more social workers. While the sheriff's department may get raises, social workers rarely do. While social workers juggle impossible case loads of fifty and sixty children, they may not realize that they are as abused by these practices as the children. Many possible approaches to reforming this system have already been discussed. From our point of view, to ensure meaningful reform any discussion of changing the system must include:
• Funding Tied to Performance Not Effort. The federal contribution should be contingent on progress toward reunification or adoption rather than poorly defined, non- specific goals.
• A Twelve Month Limit on Family Reunification. Clinical experience proves that if family reunification is not successful in the first twelve months, it almost certainly will not be successful. No expenditures incurred more than twelve months after first contact with the system should be reimbursed. In fact, the process of attempting to reunify hopelessly dysfunctional families, provides another source of funds for expanding patronage and bureaucracy. Reunification efforts after the first twelve months delays the inevitable and often places children at additional risk. Tinkering with ''reasonable efforts'' language will not solve or noticeably reduce the problem.
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• Standing for Foster Parents. Guardian Ad Litems rarely see the children outside of the courthouse. Caseworkers are frequently so overburdened they can go months without seeing the children. Only foster parents spend every day with the children at risk. Nevertheless foster parents are frequently threatened with loss of the children and loss of licensure, when they ask to be heard in court.
• Clarification of Fiduciary Obligations. Third party payees must be put on notice that they have fiduciary obligations and will be punished for violations of those duties.
• Eliminate Barriers to Interstate Adoption. Licensing requirements should be standardized across the United States. Medicaid benefits for special needs children should be portable in all fifty states.
• Case Loads for Social Workers in Should Be Limited. Caseworkers can effectively handle about fifteen children at one time. Nationally caseworkers average forty to fifty children. Their case load is exacerbated by unnecessary court delays and regulatory paperwork. In addition caseworkers are ''supervised'' by several layers of their own department management, the guardian ad litems, HHS and the courts. Each supervisor adds burdens to the caseworker but avoids responsibility by spreading the blame.
There are about 600,000 children residing in the American foster care system at any given time. Between 50,000 and 100,000 of these kids are already legally free to be adopted. Ironically, while these American children wait nearly 15,000 American families a year travel abroad and adopt children at great expense overseas, many of whom have special needs. It is a scandal that these parents find it easier to cut red tape in third world countries than it is to build their families in their own communities.
The very thing that many people perceive as helpful to these children may represent the biggest barrier of all to placement in loving homes. While adults manipulate the system, using foster care subsidies like block grants, the lives of their ''clients'' grow increasingly destabilized. For many of these children the abuse they experience in the foster care is more damaging to them than the abuse or neglect that led them into the system.
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These children don't need rhetoric. They don't need more money. What they need is parents. By shifting the federal reimbursement to pay for success not effort, we feel you will take the first step to resolving a national disgrace.
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Mr. CAMP. Thank you very much, and thank you all for your testimony.
Mr. McCrery.
Mr. MCCRERY. Well, Ms. Hogan, that was quite some testimony. I would be interested in seeing your documentation of the agencies using the money for their general funds, or diverting the money from these programs into the county or State general fund. That would be interesting to see and, in fact, if it is being done, I would say that it is illegal.
Ms. HOGAN. It is definitely illegal. I can tell you that——
Mr. MCCRERY. We ought to——
Ms. HOGAN [continuing]. I come to this issue with a background in the investigative business and, in fact, I was hired by AASK as a result of investigations that my husband and I, who have an investigative business here in Washington, conducted around abuses of the foster care system. And I think that it is really important to point out especially to organizations like the Child Welfare League and other groups whose membership is combined of both public and private agencies, it is virtually impossible for private agencies like ours to have a dialog with public agencies about these abuses because they will oftentimes literally penalize the private program.
You know, the program that Mr. Hoekstra was describing in Michigan, which is very much how we operate in a fee-for-service situation, kind of exemplifies the inherent conflict here. Our agencies, who are well aware all over the country of these abuses, are in a very difficult position with the local public agency because they will literally threaten to not place kids with us anymore, and so the kids then are penalized again.
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So it is really important that the discussion of these abuses take place with the protection that Congress can give it. Many of these cases that I am talking about involve litigation right now and so obviously some of the people would require subpoenas to testify. We would be happy to show you a great deal of evidence.
Mr. MCCRERY. Yes. I would appreciate it if you would provide us with some of that.
Ms. HOGAN. Sure.
Mr. MCCRERY. And also, if you have any documentation for your assertion that SSI payments for special-needs children are being diverted.
Ms. HOGAN. Yes. In fact, we believe that that is where the greatest abuses lie, particularly in the State of California. We have, again, seen ample instances where SSI money was being collected for children that the county involved couldn't find. So we have terrible, terrible concerns about that.
[The following was subsequently received:]
INSERT OFFSET FOLIOS 26 AND 27 HERE
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Mr. MCCRERY. OK, and just to give the other panelists an opportunity maybe to respond to anything that Ms. Hogan has said, because she said some things that are different. Anybody have any response? Anything you want to say? I know some of you represent some of these agencies that——
Mr. HOEKSTRA. I am unaware of any diversion of money like that in Michigan. If it is happening, I am totally unaware of it. The SSI payments for a child, for example, who is adopted, the State can collect that until the adoption is confirmed. Once the adoption is confirmed, then we are not permitted to be the payee anymore, and I think that is consistently followed.
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Ms. HOGAN. I would just like to clarify Michigan's role. I was the keynote speaker 2 weeks ago at the Michigan State Foster and Adoptive Parents Association annual meeting and I had a chance to talk to literally hundreds of parents in Michigan. We think that Michigan's program is really extraordinary. They have really done a wonderful job confronting and admitting some of the weaknesses in the program.
Mr. MCCRERY. OK, OK, Michigan is clear. [Laughter.]
Ms. HOGAN. But the point is there are about five or six States where this is not a problem. The rest of the States involved——
Mr. MCCRERY. Five or six States where it is not a problem——
Ms. HOGAN [continuing]. As much.
Mr. MCCRERY [continuing]. And 44 States, or so, that have a problem, OK. Does Kansas want to absolve itself of any——
Ms. MARKOWITZ. Certainly, in Kansas, I am not aware of that either. As far as adoptions, in particular, we are one of the Kellogg Foundation States, as well, and I think we have done some exceptional things with our adoption program in the last several years that don't accuse us of——
Mr. MCCRERY. OK. Well, Mr. Chairman, maybe we ought to identify a few States that we have allegations of abuse in and bring them in and let them defend themselves at the appropriate time.
Ms. HOGAN. I would be glad to suggest to you that New York, California, and Illinois would be three States—and perhaps Florida—three States that desperately need to be examined.
Mr. MCCRERY. Thank you.
Mr. CAMP. Thank you, Mr. Hoekstra. Well, thank you all for your testimony, and I appreciate your comments on the Michigan adoption law. I wondered, is it—do families take longer? I notice that they don't get the incentive grant if the child is placed with a family or relative, and in your statistics I can't really see any breakout. Is it more difficult to get an adoption, because we are interested in this whole kinship issue which is the term——
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Mr. HOEKSTRA. No. When a child is on the Michigan Adoption Resource Exchange, we don't permit payment to an agency of $8,600 if they place with a relative or a foster parent.
Mr. CAMP. Yes.
Mr. HOEKSTRA. That is the only time that that applies. Of the 2,189 children that were placed in 1996, 78 percent of them were placed with foster parents and relatives. So on a breakdown between those, 30 percent of them were with—30 percent were with relatives and 48 percent were with foster parents. So in that initial 5-month placement, for example, if you make a placement within 5 months, you get the $8,600, the custodial agency, the agency that has the child in their foster care. They can pick a foster parent, they can pick a relative, or they can pick a recruited family.
Now, obviously, what happens is most of the agencies are able to get that $8,600 in that 5-month period because they are picking a foster parent and a relative. It actually promotes that kind of adoption.
Mr. CAMP. I see. Well, there has been some talk about giving States a bonus for the increase in the number of adoptions and I wondered what you thought about that proposal, and then also do you think that that bonus should pass through to private agencies?
Mr. HOEKSTRA. Well, I have a reaction to the word ''bonus'' because that discussion has been held in Michigan and we always use the word ''incentive.'' So I don't like the word ''bonus,'' but otherwise I am comfortable with the concept of an incentive. I am somewhat concerned. For example, in the State of Michigan, we are gradually cleaning out a backlog of kids and it won't be too long when we will be placing the kids as they come into care and we won't have any way to expand or increase our number of adoptions. So if there are incentive payments to States, it could hurt us if we are already at our maximum, but the concept of incentives I am comfortable with.
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Should I go through the—what is the part about the private agency? Could you——
Mr. CAMP. If there is an incentive to a State, should that flow through to a private agency, a Federal incentive to the State?
Mr. HOEKSTRA. I don't see why not.
Mr. CAMP. OK. The other question I had was has there been any evidence—and, Ms. Markowitz, perhaps in Kansas, too, I guess it maybe doesn't apply to you—but has there been any evidence of any cutting corners to get the enhanced rate, or is there any concern with that?
Mr. HOEKSTRA. No. That is kind of—I want to stress that we are only recruiting for 22 percent of our children. The rest of them are being placed with families that have provided care for the child before the child became legally available. Now, some relatives were not the caretaking relative, but most of the relative placements are with relatives who have been providing the care.
All of the foster parent adoptions are with foster parents who have been providing care to the child before they became legally available, which means that it is reasonable to assume that an agency can place a child within 7 or 5 months when you are talking about a child that is already living with a family that has been selected, probably been earmarked before termination of parental rights to be the family of choice. We think that we are not worried about cutting corners.
Also, every time a child is placed in adoption in Michigan, there are several steps that it has to go through. For example, all of the State wards have a guardian in Lansing and that guardian reads every family study before granting consent to the adoption. It also has to go through a court process, so the court has to review all of the documentation. So I don't feel fearful that they are cutting corners to get that.
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Mr. CAMP. So to understand that statistic, 22 percent of the adoptions are unknown, or it is a new family in Michigan, at least?
Mr. HOEKSTRA. Yes.
Mr. CAMP. All right.
Mr. WULCZYN. Mr. Camp, if I could just add something quickly to that?
Mr. CAMP. Yes.
Mr. WULCZYN. I think that for the Congress to consider incentives, it is important to look at incentives for reunification, as well as adoption; that children leaving to all types of permanent homes takes a long time, longer than perhaps it should. And to create incentives only on the adoption side might create incentives to move children into adoption who, given proper incentives, might be returned to their biological families. So I think it is important to look at all permanency outcomes and consider the way in which we finance child welfare services either supports or undermines the likelihood that they will find permanent homes in as little time as possible.
Mr. CAMP. All right. I just wondered if you had any comment.
Ms. MARKOWITZ. As far as the case rate is concerned and cutting the corners, I think there is that concern that you have to pay attention to. And in our design, what we have are outcomes that make the contractor or the provider responsible not only during the time they are servicing them, but past that time. They have 12 to 18 months of responsibility for that child once the child is adopted or once the child is back at home, so that it is risky for them to cut corners because they don't get any additional dollars to continue to take care of that child for that amount of time. So, that is why we try to balance that.
Mr. CAMP. OK. Just before we conclude, Mr. Cross, I wondered if you had any further comments about what we have been discussing.
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Mr. CROSS. I just want to make one point about the idea of kinship care being included in this. That is very important to tribal communities and one of the things—I wanted to share with you a comment from a grandmother that I met in North Dakota a couple of years ago doing some focus groups in an evaluation of a private agency. And this grandma was taking care of her grandchild—actually, two grandchildren, one of whom had fetal alcohol syndrome, and in asking her about kinship care and should kinship care be subsidized, she made the comment to me that ''this private program allows me to do the traditional job that grandmas are supposed to do that I could not do with my fetal alcohol grandchild if it weren't for that support.''
And I think that is so true of the kinds of kids coming into care, of the multiple problems that they have, and when we try to place them with relatives without giving those relatives any support. So I would really encourage inclusion of the kinship care ideas in your legislation.
Mr. CAMP. OK, thank you. And, Dr. Wulczyn, one final question. I know there has been discussion about a Federal incentive for placing children in foster care and if that were to be removed and a block grant approach were taken, what is your comment on that?
Mr. WULCZYN. Well, I think that is—it is obviously a very controversial issue. I think that, as I indicated in my testimony, there is a middle ground between entitlements and block grants. I think we rarely look at the concept of how risks, costs and other types of risks that exist in the system, how they are currently distributed. I think entitlement systems have certain costs associated with them, primarily the one where we pay through per diem rates for children in foster care, and have a difficult time refinancing other services through accomplishments measured in terms of reduced length of stay or reduced placement rates.
There has to be, I think, in the Federal funding mechanism a way to recapture IV–E dollars for other types of services. The waiver program is an excellent start, and I think we will learn a great deal about how that is accomplished.
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Mr. CAMP. OK. Ms. Markowitz, I think Kansas has a per-capitated payment system already. How is that working?
Ms. MARKOWITZ. Well, it goes back to what he just talked about, in that the IV–E is of great concern to us in the long run because if we are successful with our outcomes and kids are not in out-of-home placements, we are going to lose a lot of Federal dollars. So we are going to get penalized for doing a good job, and so block grants—I don't know what you call it, but some way to free us up to be able to use those dollars in more creative ways is certainly something of great interest to Kansas.
Mr. CAMP. OK, thank you.
Mr. Hayworth.
Mr. HAYWORTH. I thank my friend from Michigan for the time here. Thanks to all the panelists for being with us.
Mr. Cross, as you are well aware, the Sixth District of Arizona has more Native Americans than any other district in the contiguous United States, so obviously there is a special concern for Indian children and for adoption programs there. I understand in your written testimony you state that the title IV–E programs that support adoption assistance activities are not guaranteed to Indian children. But at the same time, there is a program called the Indian Child Welfare Act.
Would you kind of back up and give us a notion and explain how that functions and how these two interact?
Mr. CROSS. Well, the interaction is disjointed because the portion of the Indian Child Welfare Act that we are concerned with here is title II, and title II gave Indian tribes some capacity to develop services and affirmed the right of tribes to take jurisdiction over their own children and gave them the opportunity to develop their own tribal courts and their tribal codes, which dramatically increased the number of tribes—as I mentioned in my oral testimony—the number of tribes providing services to children and the number of tribes that are placing children in foster care as a result of that, and with good outcomes.
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The problem is that you can have the right to do child welfare services. You can have the tribal code and the tribal court and a limited program, but if you can't get reimbursement for foster care, you depend on volunteer families or you depend on the State around you or kids stay in placements that they shouldn't. Right now, it is a pretty intolerable situation.
Mr. HAYWORTH. One of the concerns I have had representing Indian country in my time in the Congress is something that perhaps touches on the controversial, as we have talked about block granting and a variety of different ways to provide needed revenues. I have been a proponent of direct funding to sovereign tribal governments because so often there seems to be a trap, unintentional, but you get into the situation with tribes and with States where you are dealing with set-asides and all these formulas that oftentimes seem to be an afterthought.
I understand under the Richardson proposal, title IV–E funding would be provided directly to the tribes. Now, we have just talked about some of the challenges of having the will and maybe having the codification of sovereign tribal governments to do things, but not having the money. I am just wondering, has there been any estimation done of the cost of the proposal of direct funding, or has CBO scored any of these numbers for you yet?
Mr. CROSS. There was an early estimate of the Richardson proposal that was about $20 million. We have done some calculations that are in my written testimony. We estimate that the Federal share of the reimbursement would be somewhere between $21 and $25 million. In a bigger picture, and you include the training dollars and the adoption assistance and some of the other things that are attached to IV–E and the non-Federal share, the price tag gets up around $36 million.
Mr. HAYWORTH [presiding]. So $36 million is what we may be looking at here?
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Mr. CROSS. Right.
Mr. HAYWORTH. Our intertribal council in Arizona has approximated that should direct funding to tribes be enacted, 300 Indian children in our State would be eligible for similar title IV–E funding. I guess to break it down on the State level in real, live terms, how much would the funding for this group of children cost? I mean, can we peel it off there exponentially, reversing from what your numbers are, and is there a specific design out there for how we could apply this?
Mr. CROSS. Do you mean how many—those 300 children, what would the costs there be?
Mr. HAYWORTH. Yes.
Mr. CROSS. I can get back to you with a pretty close figure because we have the formulas and the current costs, but I did an estimate on the 40 children that were Navajo. It would be about $250,000, and so you can do the math.
Mr. HAYWORTH. Extrapolate.
Mr. CROSS. Yes.
Mr. HAYWORTH. Well, to borrow a phrase from the dear Ranking Member from Michigan, my good friend, if you can drop me a line, drop me a note on that.
Mr. CROSS. OK, I sure will.
Mr. HAYWORTH. And we will compare computations.
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Mr. HAYWORTH. I just wanted to pause at this juncture and thank you for your attendance and the rest of the panelists and those who have remained with us from the first panel, all that have joined us this afternoon. My friend from Michigan had to go catch a plane, as I will be doing and going back to Arizona shortly. And let me heartily commend you visit the Sixth District of Arizona some time, ladies and gentlemen, when you get a chance, especially this time of year with spring training.
But thanks to all of you. This is a serious problem we confront and I think there is sentiment on both sides that we can move toward reasonable, rational solutions embodied in some of the good work done by everyone who has joined us today. So, with that, thank you very much for your attendance.
[Mr. Coyne's questions to panel 2 and their answers follow:]
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Adopt a Special Kid/AmericaJune 2, 1997Honorable William J. Coyne
Subcommittee on Human Resources
Committee on Ways and Means
U. S. House of Representatives
Washington, D.C. 20515
Dear Congressman Coyne,
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In response to your questions at the February 27, 1997 hearing by the Human Resources Subcommittee on promoting adoption I am happy to provide you with our perspective.
Since our organization was founded twenty seven years ago we have learned that a critical element of successfully promoting special needs adoption has been the careful preparation of prospective parents. To that end, we recruit parents using a network of grassroots volunteers and an intensive orientation process. The orientation is then followed by an eight week training program and a comprehensive home study.
Only after that process are adoptive parents considered in the context of which child or children are right for them. After placement is made we also provide families with respite care during the potentially difficult adjustment period after the adoption takes place.
Before and after placements are made we also try to match parents with mentors in the community who have successfully adopted children with special needs similar to those being considered by the prospective adoptive family. This network of grassroots volunteers, which is all over the country, are an invaluable element in achieving remarkably low disruption rates among our families.
We provide all these services to adoptive families at little or not cost. We do not have minimum income requirements for our families but are only interested in how effectively families manage the resources they have. But perhaps the most important element in the recruitment process is the availability of Adoption Assistance Payments (AAP), Medicaid and other subsidies available to help adoptive families with the financial responsibility special needs adoption can sometimes create.
With respect to encouraging adoption through bonuses and tax credits, we would caution the committee that perceived solutions may not have the intended effect. Many of the families who adopt our children do so free of charge. Also, many families who adopt children with special needs have incomes so low they are not compelled to file tax returns. Since there is no expenditure of funds, either for the placement or in tax payments, there is nothing to refund.
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For our families, a tax credit will not be a factor in their decision to adopt. In fact, we believe that an unintended consequence of the tax credit may have been to encourage a significant increase in costly international adoptions. This may have actually reduced the pool of available parents for American children.
Last year while more than 50,000 American children were legally free to be adopted virtually free of charge only 21,000 were actually placed. At the same time 15,000 American families went abroad to adopt, often children with special needs, mostly at great expense. Some of these families report to us that the tax credit was, at least in part, an incentive. Unfortunately, all of this serves to underscore the unspoken message the tax credit sends that adoption is expensive.
Also, some representatives of private agencies have suggested passing through proposed bonuses to private agencies. While our organization would benefit from such a plan we would oppose this idea. It is our belief that an unintended consequence of this proposal would be to encourage churning and creaming of children. Creaming is the practice of finding homes for the easiest to place children, breaking up sibling groups in the process. Churning is the practice of placing the same child more than once in a short period of time due to disruption, collecting more than one bonus per child.
While bonuses to states may seem like a helpful tactic, in reality the states have a far greater incentive to promote long term foster care which generates a base rate of $20,000 to $30,000 per year per child. Since there are few effective enforcement mechanisms in the system to institute accountability when states abuse these subsidies there is little incentive for the states to trade off a lucrative entitlement for a much smaller ''bonus.'' A one time bonus paid directly to families adopting a child or children with special needs might prove helpful.
We greatly appreciate your attention in this matter. As a native of Pittsburgh I am especially pleased to see your involvement in this critical issue. If you have any other questions please feel free to contact our office or visit our web page at www.aask.org.
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Sincerely,
Maureen K. Hogan
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Chairman SHAW. Thank you, and this Subcommittee stands adjourned.
[Whereupon, at 1:26 p.m., the hearing was adjourned.]
[Submissions for the record follow:]
Statement of American Humane Association, Children's Division, in Support of Providing Title IV–E Foster Care and Adoption Assistance Benefits for Indian Children Directly to Indian Tribes, As Submitted by Robert F.X. Hart, Executive Director, American Humane Association
Mr. Chairman and Members of the Subcommittee, this written statement is submitted on behalf of the Children's Division of the American Humane Association in support of the request currently before you to amend the Title IV–E Foster Care and Adoption Assistance program to allow Indian tribes to directly receive Title IV–E benefits for all foster care and adoption assistance services.
A brief introduction is in order, since some of you may not be familiar with the Children's Division of the American Humane Association (AHA), its work, and our concern about this issue. We are a nonprofit national membership organization composed of individuals and agencies concerned about the well being of this country's vulnerable children and families. Currently, we are headquartered in Colorado, but our members are from throughout the nation. As the nation's oldest agency dedicated to the protection of children from abuse and neglect, we have provided leadership in the development of programs, policies, and services to at-risk children and their families since 1878.
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AHA's main objectives are to: (1) increase the abilities, knowledge and effectiveness of child welfare professionals and child welfare agencies; (2) enhance the community's capacity to respond effectively to the needs of vulnerable children and families; (3) improve the information and capacities available to public and voluntary child welfare agencies that help them to respond effectively to child abuse and neglect; and (4) facilitate a concerted national response to the problem of child maltreatment.
In our view, an effective national response to child abuse and neglect should include building the capacity of local communities both to prevent abuse and neglect and to ameliorate its effects on children. To build that capacity within distinctive cultural communities such as Native American tribes, adequate resources should be provided to allow for the development of culturally sensitive services, and for capacity building activities such as training and the implementation of infrastructure such as information systems that support service provision.
As the operating agency for the National Resource Center on Child Abuse and Neglect of the National Center on Child Abuse and Neglect, AHA recently completed a ''Tribal/State Child Welfare Project Report'' which concluded in part that tribes currently must rely on ''developing partnering relationships, mixing and matching resources, and collaborating with other programs to make the most out of the limited resources [available to them to provide child welfare services].'' (Tribal State Child Welfare Project Report, p. 13). Yet, the same report concluded that current child welfare best practice and current Federal policy both point to the conclusion that the best way to promote the stability and security of Indian families is by keeping Indian children who must be placed outside of their own homes within their own culture, whenever possible. To help ensure that this occurs and to promote training and infrastructure supports for tribal child welfare services, it is only equitable that Indian tribes, and the children and families who are their members, be given the same access as other Americans to the Title IV–E funds that support foster care and adoption assistance services.
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With the today's national policy emphasis, as reflected in the Adoption 2002 initiative, on providing safe, permanent homes for all American children, it is time to rectify the inadvertent oversight in Title IV–E that denies Indian tribes direct access to foster care and adoption assistance funds. We at AHA urge you to include within whatever Federal adoption legislation is forthcoming provisions to:
• extend Title IV–E funding entitlement to tribal court and tribal and private child welfare agency placements in tribal foster and adoptive homes that otherwise meet eligibility requirements;
• allow the governments of federally recognized tribes to receive Title IV–E funds directly from the U. S. Department of Health and Human Services (HHS);
• allow the Secretary of HHS to modify the requirements of Title IV–E for tribes if those requirements do not allow for services that meet the best interests of Indian children; and to develop in their stead, in partnership with tribes, regulations that reflect current expertise in the best child welfare practices to benefit Indian children;
• allow the Secretary of HHS to modify Title IV–E matching requirements for tribes, as appropriate; and
• continue to allow tribal-state Title IV–E agreements.
Thank you for the opportunity to present this statement to the Subcommittee.
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(Footnote 1 return)
These States are Arizona, Colorado, Georgia, Kansas, Kentucky, Ohio, and Tennessee.
(Footnote 2 return)
The American Public Welfare Association estimated these numbers on the basis of data voluntarily reported by the States; it designated the 1995 number as preliminary.
(Footnote 3 return)
Under title IV–E of the Social Security Act, Federal funds are provided to States to cover a portion of the food, housing, and incidental expenses of children in foster care. To be eligible for Federal support, children must be from families who met the 1995 eligibility criteria of the now terminated Aid to Families With Dependent Children (AFDC) Program. The States incur all foster care costs for children not eligible for Federal support.
(Footnote 4 return)
Report on Improving Practice: Termination of Parental Rights (Frankfort, Ky: Kentucky Department of Social Services, September 1991.)
(Footnote 5 return)
As provided by the House Rules requiring disclosure of relevant grants, the ABA Center on Children and the Law received funds from the State Justice Institute to develop assessment materials for State courts to use in conducting their court improvement self-assessments (Evaluating the Administration of Justice in Foster Care Cases; $39,618). In addition, the Center addresses court improvement, among other issues, through the National Legal Resource Center on Children and Court Issues (U.S. Department of Health and Human Services; $1,310,794). It also has subcontracts along with the National Center for State Courts with the Michigan Supreme Court, State Court Administrative Office (Michigan State Probate Court Assessment: Handling Foster Care and Adoption Cases/U.S. Department of Health and Human Services; $107,170) and the California Judicial Council (National Center for State Courts/U.S. Department of Health and Human Services; $26,800). These subcontracts fund ABA staff who are conducting portions of the court assessments for Michigan and California.
(Footnote 6 return)
ABA, ''Promoting the Adoption of Children: Activities by Lawyers and Bar Groups,'' A Report From the American Bar Association Office of the President (February 1997).
(Footnote 7 return)
National Council of Juvenile and Family Court Judges, Publication Development Committee, Victims of Child Abuse Project, Hon. David E. Grossman, Chairman, Resource Guidelines: Improving Court Practice in Child Abuse and Neglect Cases (Reno, Nevada: National Council of Juvenile and Family Court Judges 1995).
(Footnote 8 return)
Ibid, 8.
(Footnote 9 return)
Binsfeld Children's Commission, In Our Hands at 44 (Lansing, Michigan: July 1996).
(Footnote 10 return)
National Council of Juvenile and Family Court Judges, Resource Guidelines, 22.
(Footnote 11 return)
Ibid.
(Footnote 12 return)
Final Report of the Georgia Supreme Court Child Placement Proceeding at 28–31 (August 1996).
(Footnote 13 return)
This description of the HomeRebuilder Program is taken from Wulczyn et al., ''HomeRebuilders: A Family Reunification Demonstration Project,'' in Duerr-Berrick, Jill, Richard Barth, and Neil Gilbert (eds.), The Child Welfare Review, Volume 2, (New York: Columiba University Press, 1997).