Friday, June 23, 2017

Adoption Subsidies Deserve a Closer Look

outh Services Insider has predicted that Adoption Subsidies Could Become a Hot Topic in Child Welfare. There is good reason to take another look at these subsidies.
Most adopted parents are loving and generous people who spend much more on their children than they receive in subsidies. But some adoptive parents and their advocates seem to see the subsidies as an entitlement that they can enjoy regardless of whether they are still caring for their children, or worse, maltreating them.
An earlier YSI article,  New York State Could Be the First State to Take a Closer Look at Adoption Subsidies, described new legislation that would empower the state to verify that adoptive parents are still supporting their children before continuing to pay adoption subsidies. The bill arises out of a concern about adoptive parents that have stopped supporting their adopted children but continue to receive subsidies.
The mechanisms required by the bill are very moderate. As YSI puts it, it does not order county agencies to “patrol adoptive homes for compliance with [their subsidy agreements], a move that would almost certainly be seen as an overreach.”
The bill does nothing more than to require each family receiving a subsidy to certify annually that it is living up to its obligations. If a family refuses to certify or ignores the request, a state can investigate. The bill also allows the state to investigate if it receives a report that a family is no longer supporting an adoptive child.
These are very modest measures. I would prefer an annual visit with the child to make sure that all is well. Nevertheless, a state alliance of foster and adoptive parents has “concerns” about the bill.
I don’t know what surprised me more: that foster and adoptive parents would have concerns about such a seemingly innocuous bill, or that a move to monitor adoptive homes would “almost certainly be seen as overreach.”
But after studying the issue, I realized that the federal position on adoption subsidies has created a sense of entitlement to these benefits among adoptive parents, regardless of if and how they are caring for the children..
As the American Bar Association (ABA) explains in an informative article about adoption subsidies and fraud, federal law requires a state to terminate an adoption subsidy when it learns that the adoptive parent is no longer supporting the child. But it provides no means for a state to make this determination.
And the federal government has deprived the states of the best opportunity for states to cut off fraudulent payments, which is an annual eligibility determination. The federal Child Welfare Policy Manual does not prohibit states from redetermining eligibility for adoption subsidies. But in response to a question from New York State, HHS made clear that states cannot cut off adoption subsidies if parents refuse to reply to a request for information, according to the ABA article.
As the ABA points out, “other federal benefit programs do not rely solely on the recipients to advise the government when they are no longer eligible for benefits.”
It’s no wonder that the “overwhelming consensus” of the 41 agencies cited by YSI as responding to a question from the Administration on Children and Families was that states should have the authority to rescind adoption subsidies.
The executive director of an organization representing foster and adoptive parents in New York told YSI that it is concerned about adoptive families that are struggling to reunify with their adopted children who have run away. But the legislation does not mandate that the subsidy be discontinued in such a case; just that the situation be investigated.
The U.S. will have its first national data on disrupted adoptions next year, but evidence from New York already suggests it is a significant issue. Potential savings from  recouping undeserved subsidies could be significant. In the current fiscal year, it is estimated that the federal outlay for adoption subsidies will be almost $2.7 billion.
A much smaller but more distressing problem than adoption disruption involves adoptive parents that abuse or neglect the children for whom they are receiving subsidies, sometimes even resulting in death. In my next column, I will propose a way to address this problem.
The overwhelming majority of adoptive parents have opened their hearts and their homes with no motive other than their love of children. I highly doubt that these parents would object to an annual check-in for the renewal of the funds that they are receiving through taxpayer support.
This column was published in the Chronicle of Social Change  on June 23, 2017. 

Monday, June 19, 2017

Risk, Not Substantiation, Should Drive Services to Families

A new report from L.A.’s Office of Child Protection (OCP), as recently reported by Daniel Heimpel in The Chronicle, recommends revising current policy to enable the Department of Child and Family Services (DCFS) to offer services to families of children at high risk, even if they do not have a substantiated allegation of maltreatment. But even more importantly, the report points to new thinking about using risk rather than substantiation as the trigger for child welfare services.
The OCP report was established in response to the horrific death of Yonatan Aguilar after four investigations failed to find abuse or neglect in his home. The County Supervisors wanted to know if the County’s Structured Decision Making (SDM) risk assessment tool was at fault in Yonatan’s death.
But as I wrote back in November 2016 (SDM Not the Root of System Failure in Yonatan’s Death), OCP found that the problem was not a misuse of the SDM risk-assessment tool. That tool correctly identified the child as being at high risk for future maltreatment. The problem was the action, or lack thereof, by DCFS.
Specifically, the problem was DCFS practice when an SDM risk level is high, or very high, but a referral allegation is not substantiated. While OCP found agency policy to be unclear, guidance issued to staff indicates that a case should not be opened when the allegation has not been substantiated. As Heimpel pointed out, this conflicts with the recommendation of California’s SDM Manual, which recommends that a case be opened most all high-risk or very high-risk families, and that an explanation be provided when a case is not opened .
OCP recommended that DCFS’ policy for cases where the SDM risk level is high or very high, but referral allegations are unfounded or inconclusive, should be revised so efforts are made to connect the family with voluntary services and supports. Such a policy is in effect in other jurisdictions, including the District of Columbia.
Such a change would be an improvement but might not save many children. That is because, as Heimpel points out, efforts to involve families with maltreatment allegations in voluntary services through differential response have had mixed results.
Part of the solution may lie in an idea that was buried in the middle of the OCP report. OCP analyzed 1,225 referrals investigated by DCFS between 2012 and 2016 where the child was later seriously injured or killed. They found that as in the case of Yonatan Aguilar, more than half of the fatalities and near-fatalities occurred when the allegation was not substantiated.
These findings are consistent with research studies over the years that have found little or no difference in future reports of maltreatment of children who were the subject of substantiated or unsubstantiated reports. For example, studying all infants born in 2006 who were reported to CPS and remained at home, Emily Putnam-Hornstein and colleagues found that the proportion reported again hardly varied between those who were screened out, unsubstantiated, and substantiated; more than half of babies in all of these groups were reported again within five years.
According to OCP, its data “support the growing conversation in the field that allegation substantiation may be inadequate to identify those children who are most at risk for future safety concerns and negative outcomes.” The authors go on to report that they spoke with “child welfare experts who expressed interest in placing more importance on levels of risk (instead of on allegation dispositions) when making case decisions, and in offering services and supports to families that may help to reduce this risk.”
The OCP closes the report by saying it will “partner with DCFS and other key stakeholders to further explore the larger question of the role that assessing risk should play in child welfare,” as well as “the effectiveness of allegation substantiation.”
Moving away from allegation dispositions (and toward level of risk) as a trigger for case decisions makes a lot of sense. While imminent danger should remain the trigger for removal of a child, high risk of future harm should be a trigger for the agency to open a case for monitoring or services.
But what happens if the parent does not agree to participate? In these cases, the agency could bring the family to court to require participation. This is already allowed in Los Angeles and other jurisdictions, although not used as often as needed. In Los Angeles County, the agency can order a “non-detention petition” when it determines that the safety and protection of a child require judicial intervention but it has not removed the child from the home.
Breaking the link between substantiation and services offers one avenue for preventing more at-risk children from falling through the cracks. But unless the agency is able to require parents to participate in services and accept agency supervision, children like Yonatan Aguilar will continue to die.
This column was published in the Chronicle of Social Change on May 30, 2017.

A Better Way to Ensure Educational Stability for Foster Kids

In a recent article, L.A. Moves to Fill Educational Stability Gap for Foster Youth Like Alex and Shirley, Daniel Heimpel reported that the Los Angeles County Board of Supervisors approved a pilot program to ensure that foster youth have transportation to their school of origin.
After describing the new legislation and discussing its importance, Heimpel told the story of “Alex,” a foster youth who found a placement with the family of a school friend after initially being placed in a group home 50 miles from his school.
While educational stability is an important goal, it seems somewhat incongruous to use Alex’s story to illustrate how the new legislation would help achieve it. The new law would not require that students like Alex be placed near their existing schools. Rather, it would require Los Angeles to transport Alex 50 miles each way from the group home to his school.
Margaret Henry, a Los Angeles Superior Court Judge, noticed the same problem. In her column, When Finding Educational Stability for Foster Youth, Maybe It Does Take a Village, she asks: “Why spend money transporting children for hours to their home school, instead of working harder and more creatively to find them placements in their home school’s district?”
Keeping a child in their home school district, as was done for Alex, creates a win-win situation. The county saves money, and most importantly, the child is spared from spending hours a day in transportation – hours that would cut into time for homework, social life and extracurricular activities.
Judge Henry suggests that parents at schools with a high rate of foster care placement should be recruited, trained and approved as resource families in advance, so that they will already be in place when a child needs a home.
She is on the right track. But I’m not sure that her plan of recruiting foster parents in advance will work.
Years ago, I received a call asking whether I would be willing to provide temporary care for a friend of my son’s, who could no longer remain safely at home. Of course I said yes, and he stayed with us until the crisis was resolved. Although he stayed with us only about a month, I would have been happy to keep him as long as necessary.
But if I were asked by my son’s school to become licensed as a foster parent in the event that one of his classmates were placed in foster care, I would probably not have responded.
As Judge Henry herself points out, most parents are not interested in becoming licensed to take care of a theoretical child. Many more parents would agree to take care of a friend of their own child.
Moreover, Judge Henry’s proposal would apply only in schools with a high percentage of students who are placed in foster care. I don’t know how that would be defined in practice, but what about all the young people in other schools?
There are other ways to place kids near their schools. Before placing a child far away from his/her school, social workers should be required to take specific steps to find a local placement. This would include asking both the child and the school to suggest potential foster parents, which might include parents, teachers and coaches.
Of course, finding a placement near the current school will be easier in cases where the agency knows in advance that a foster child will need a new placement. But when a child needs a placement immediately, Los Angeles County can use its four emergency foster care shelters to keep the child for up to 72 hours while transporting them to their home school.
The timeline is tight, but once a willing family is found, the licensing process should not require more than 24 hours if treated with the urgency it deserves. Like many other jurisdictions, California allows both kin and adults with a prior relationship with a child to obtain an emergency foster care license based on a safety inspection of their home and a criminal background check. The results of the background check can be obtained on the same day, according to DCFS Public Affairs Director Armand Montiel.
Of course, the new foster parents must then go through the more stringent procedures to obtain a permanent license. But in the meantime, children remain at their home school.
Through immediate and energetic recruitment and licensing of foster parents who live near a child’s school, Los Angeles County and other jurisdictions can avoid either unnecessary school changes or long and expensive commutes for children in foster care.
The county may have to hire specialized recruitment staff for this purpose only, but clearly the savings in transportation costs would be far greater.
This column was published in the Chronicle of Social Change on May 22, 2017.

Racial Disparities in Child Welfare: Time for Some Critical Thinking

On April 17, 2017, the San Diego Union-Tribune reported that the Clinton Foundation is launching an initiative to study the foster care and juvenile justice programs in San Diego County. A particular focus will be to identify the factors that lead to racial disparities in both systems.
County Supervisor Greg Cox told the paper that he hoped “that one of the deliverables we would find is a decrease in out-of-home placement of African Americans.”
I can’t speak with experience on the juvenile justice system. But I am disappointed that the Clinton Foundation does not appear to have kept up with the research about racial disparities in child welfare. 
Nobody disagrees that African Americans are more likely to be involved with child welfare and placed in foster care. In 2014, according to federal data, black children were 13.8 percent of the total child population in the United States. Yet, they constituted 22.6 percent of those identified as victims of maltreatment, and 24.3 percent of the children in foster care.
Many parent advocates and others have long argued that these disparities do not stem from higher maltreatment rates for black children, but rather from racism embedded in the child welfare system. Their theory was that black children are more likely to be reported, judged to be abused or maltreated, and removed from their families because of racism among child maltreatment reporters; and, in the end, by the child welfare system itself.
The idea of racial bias in child welfare found support in the first three National Incidence Studies of Child Abuse and Neglect, which were published in the 1980s and 1990s. These studies, which attempt to get at all incidences of abuse and neglect rather than just those that are reported and substantiated, suggested that there was no difference in black and white rates of abuse and neglect. The study authors suggested that black families received differential treatment by child welfare systems, resulting in their over-representation in these systems.
Starting about 2004, a coalition of foundations, nonprofits, and academics formed around the idea that this disproportional representation of black children in child welfare stemmed from a racist system. This coalition launched a well-funded campaign to reduce the representation of black children in child welfare and especially foster care. They issued reports, held conferences, and provided training and technical assistance to help states analyze their disproportionality problems.
As a result of this work, agencies around the country have adopted strategies like staff training, creating special administrative structures to advance racial equity, and special data collection efforts. As a social worker in the District of Columbia, I was subjected to multiple low-quality, heavy-handed trainings that tried to help me discover my hidden biases. Many diversity trainers have done really well out of the presumption that disproportionality stems from racial prejudice.
But a larger and more rigorous National Incidence Study published in 2010 estimated that black maltreatment rates are almost twice as high than those of whites. Further analysis showed that this difference was present in the earlier study, but due to small sample sizes, the differences were not statistically significant and hence not reported.
The evidence continues to accumulate that black and white maltreatment rates differ. A new study just published in the journal Pediatrics concluded that the child abuse fatality rate for children aged four and under was 8.0 per thousand African-American children, compared with 2.7 per 100,000 white children.
conference, convened in 2011 by Harvard, Chapin Hall, the National Council of Juvenile and Family Court Judges and the National Court Appointed Special Advocates, brought together leading scholars on child welfare and race in front of an audience of child welfare leaders from around the country.
research brief summarizing the conference concluded that “there is a significant black/white maltreatment gap, one that roughly parallels the gap in official maltreatment reports. This evidence contradicts the belief that black children are included at high rates in the child welfare system because of bias.”
The brief’s authors based their conclusions on the National Incidence Studies as well as other empirical work reinforcing the conclusion that child maltreatment rates are significantly higher for black children.
The authors suggest that the higher rate of maltreatment among African-Americans stems from the history of slavery and racism, which led to higher poverty and concentration in impoverished neighborhoods characterized by crime, substance abuse, unemployment, and limited community services.
The researchers concluded that trying to reduce racial bias in the system is not the way to address the inequity between blacks and whites in child welfare. Instead, we need to address the underlying social conditions. And until we can do that, we need to protect children, both by preventing maltreatment and by providing appropriate protective services.
Unfortunately, many child welfare agencies around the country are either not aware of, or do not want to recognize, the new consensus among researchers. As The Los Angeles Times put it:
“Many left the conference believing that any caseworker bias against black families accounted for only a small portion of the disparity in foster care rates … Yet, Los Angeles County officials pressed forward with programs that assumed that racial bias was a significant cause for the high rate of [foster care placement] of black children.”
This focus on reducing alleged systemic bias may do more harm than simply wasting child welfare resources. If black children are more likely to be maltreated, equalizing black and white representation in the child welfare system would leave many black children in danger of years of suffering or even death.
This column was published in the Chronicle of Social Change on May 8, 2017.