Lack of Will to Keep Siblings Together in Foster Care, But there is a Way

As a social worker in the District of Columbia’s foster care system, I was often saddened to see siblings separated for a variety of reasons. We do not know how many siblings are separated nationwide, but studieshave found that “a substantial number” of children in foster care were not placed with all of their siblings who were also in care. This issue has not been studied at all since 2008.

Gordon Johnson, head of the Illinois Department of Children and Families in the 1980′s, was deeply perturbed by the separation of siblings already traumatized by removal from their families. When he became head of Hull House in Chicago, Johnson developed a new approach that enabled siblings to be placed in the same foster home. In 1998, Johnson brought the program to Florida as the non-profit Neighbor-to-Family (NTF), which now operates at multiple sites in four states.

NTF has several salient features:

• Most importantly, NTF places one sibling group per foster family. In exceptional cases, a very large sibling group might be split between two or more homes, but the foster families are responsible for making sure that the children see each other regularly.
• Foster caregivers are “an integral part of the therapeutic team … making decisions about the future of the children.” They are required to report regularly on the children’s progress, to mentor birth parents, and to help coordinate therapy and medical care. Foster parents need 70 hours of training to become licensed and 50 hours per year thereafter.
• Clinical services are integral to the program. Therapists work directly for the program, ensuring coordination with foster parents and social workers.
• Birth parents and extended family receive intensive services and outreach. Traditional foster care programs have the social worker serve both the parent and the children, which can result in worker burnout and service delays. NTF assigns a separate Family Advocate to each birth family.

Despite NTF’s many strengths, state policies limit the number of children who can benefit from this approach. All states have different foster care payment rates for children depending on their special needs. In some states, siblings with special needs cannot be placed in the same home as children without them, so they must be separated. Some states and localities have worked with NTF to find ways to keep siblings together in that scenario.

Originally, NTF foster caregivers received a salary and benefits. In exchange at least one foster parent per home was required to give up paid employment. That is no longer the case. Many states have prohibited foster parents from being employed by foster care agencies. This forced NTF to stop paying salaries and benefits to foster parents.

Instead, NTF adds a stipend to the regular state foster care payment. Because foster parents no longer receive benefits, NTF no longer requires that one foster parent give up paid employment. However, the program still requires that foster parents put the needs of the child first. They must be willing to take time off work for school meetings, doctor’s appointments, and the like.

Data suggest NTF is working. Children in NTF homes are reunited with their birth families faster than other children in foster care. The average length of stay in an NTF home was 8.57 months in 2014, as compared to the national average of 27.2 months. NTF is rated as a promising practice by the California Evidence Based Clearinghouse on Child Welfare. This rating was based on a study showing that NTF performed better than traditional foster care on indicators including placement stability, placement with siblings, moves to more restrictive settings, and reunification.

Unfortunately, NTF serves only about 500 children in total. Perhaps states and localities are unwilling to spend the additional money this program model requires. Federal support could help make the NTF model the default option for sibling groups. The model could be required for federal reimbursement; alternatively, an enhanced federal reimbursement rate could be provided for children served under this model.

Bureaucratic barriers that separate siblings should be eliminated. States should be encouraged to allow foster parents to be employees, thus allowing the original NTF model to be restored. As I argued in a previous column, professionalizing foster care would help ensure a sufficient supply of foster parents who are passionate about helping children.

This column appeared in the Chronicle of Social Change  on June 22, 2015.

Pay Foster Parents as Professionals

Just about everyone seems to agree that too many young people in foster care are spending too much time in congregate care, group homes and larger residential programs. The Obama administration has proposed requiring an initial justification that a congregate care placement is appropriate for a child, as well as renewed justification every six months that such a placement is still necessary.

Several members of the Senate Finance Committee, including Chair Orrin Hatch (R-Utah) and ranking member Ron Wyden (D-Ore.) have voiced support for limiting congregate care. Hatch proposed legislation last year to tighten restrictions on group homes, eliminating the federal match for group homes for very young children and (after a certain time period) for older youth.

As a former social worker, I too support some type of restriction on congregate placement so that young people are not placed there unnecessarily and do not stay too long. But such restrictions should not be adopted until something is done to increase the supply of high-quality foster homes.

In an earlier column, I wrote about my experience as a social worker in the District of Columbia, where many foster parents treat their foster children like boarders. They refuse to attend meetings, visit schools, or speak to therapists. Unfortunately, bad foster parents are rarely fired in the District unless they outright abuse or severely neglect their children. That’s because there is a shortage of foster parents in the city, as there is in jurisdictions all over the country.

At least one reason for the foster parent shortage is clear: It takes a special kind of person to be a great foster parent. Moreover, foster parents generally receive a stipend that is designed to cover only the cost of caring for a child. Usually this is not much more than $1,000 per month, even for a child with special needs. To get accepted as a foster parent, applicants (even family members) have to show that they do not need the stipend to make ends meet. Thus, most foster parents have to work, and not many working people have the time and energy to do a good job caring for someone else’s child. In my experience, many foster parents are away from the house from 6:00 am to 6:00 pm and are unable or unwilling to go to the child’s school, therapist or doctor.

We should pay for at least one foster parent per home to be a full-time parent. If we did that, we could tap a whole pool of people who want to work with children. There are several programs that do this already on a small scale. Jurisdictions like the District of Columbia, where housing costs are very high, might even want to consider buying houses suitable for two to four foster children and letting foster parents live there rent-free as part of their compensation.

Of course, paying foster parents a full-time salary means screening them more carefully to make sure to rule out those who might be in it just for the money. In addition, requiring intensive involvement by foster parents in the lives of their charges, imposing strict and relevant training requirements with feedback from trainers to program staff, evaluating foster parents strictly on their performance, and dismissing those who don’t measure up, should keep neglectful and greedy foster parents out of the system.

In its budget, the Administration has proposed  “specialized training and compensation for foster parents who provide a therapeutic environment for a child.” This proposal could be the vehicle for a demonstration project to begin moving toward professionalization of therapeutic foster care.

You might ask: How can the nation afford to pay foster parents as professionals? First, the savings from reducing group home placements in some jurisdictions could help pay for professional foster parents. Second, placing two or more children per home could make professional foster parenting financially viable. Clearly, children with therapeutic needs require more time, but a full-time foster parent has more time.

It is critical to deal with the foster parent supply problem before reducing congregate care placements. Let’s not restrict group homes and residential care before we have good, therapeutic homes for children who need them. Otherwise, many young people will end up in unsupportive, uncaring foster homes.

This column was published in the Chronicle of Social Change on June 15, 2015.

Protecting the Next Relisha

In her May 29 Metro column, “New funds for homeless may be legacy of Relisha Rudd,” Petula Dvorak blamed homelessness and a malfunctioning truancy system for the tragic story of Relisha Rudd, omitting the Child and Family Services Agency, whose job it is to protect children in the District.

Relisha’s family was known to the CFSA. The family had been the subject of several reports. There were numerous indications that the family was in trouble. Relisha’s brothers had frequent behavior problems at school, often a sign of trouble at home. School staff reported numerous warning signs, such as Relisha missing more than 30 days of school, Relisha often arriving for class dirty and Relisha and one of her brothers left waiting at school at the end of the day.

If the CFSA had an open case on the family, a social worker was expected to visit the family at least twice a month. It would have been a social worker’s job to make sure Relisha was okay.

The CFSA has been touting its success in taking fewer children into foster care. The acting director reported proudly this year that 62 percent of the children it serves are at home. That is good news indeed, as long as the children who are with their families are receiving the monitoring and services they need to be safe. Relisha certainly was not.

The D.C. Council needs to demand information about the handling of Relisha’s case so that other children will not suffer the same fate.

Marie Cohen, Washington

The writer was a social worker.

This column was published on the Local Opinion page of the Washington Post on June 5, 2015.

Don't Misunderstand Lexie Gruber's Foster Care Experience

At the Senate Finance Committee’s May 19 hearing on reducing the use of group homes in foster care, the testimony that drew the most attention was that of Lexie Gruber. Lexie, a bright and articulate young woman, was removed from her family at the age of 15 and remained in foster care until she aged out.

As a former foster care social worker in the District of Columbia, I was very affected by Lexie’s testimony. But I have concerns that it could be used to justify major new restrictions on group homes.

Lexie described a group home where she received no emotional support from the staff who were ill-equipped to handle her Post Traumatic Stress Disorder (PTSD) and depression. The atmosphere was nothing like a home; residents could not prepare their own food and cabinets were locked to prevent their “stealing” snacks.

Lexie’s testimony was part of a hearing held for the purpose of showing how bad group homes can be for kids in foster care. But not all group homes are the same. In Youth Today, I described the amazing care provided by Boys Town group homes in Washington, D.C. There was no ban on hugging and no locked cabinets at the home I visited. A wall full of photos documents the young men who had spent time there over the past 20 years, many of whom still come back to visit. The “Teaching “Parents” who live there have brought up their own children there along with those assigned to them by the foster care and criminal justice systems. We need to push for closing or improving bad group homes, not eliminating great ones like those operated by Boys Town.

Just as not all group homes are created equal, neither are all foster homes. The locked cabinets and lack of hugs can be seen in many foster homes. One of the saddest moments of my five years as a foster care social worker is when I had to find a new placement for a nine-year-old client who was kicked out of her foster home for disrespectful behavior. When we arrived at her new “therapeutic” home, a locksmith was busy putting a padlock on the foster parent’s bedroom door.

Perhaps the most compelling part of Lexie’s testimony was why she ended up in the care of strangers in the first place. She was initially placed with her uncle, but was removed from him after two months because he “did not have enough bedrooms to meet agency regulations.”

As a foster care social worker, I experienced the same barrier in trying to place clients with relatives. I was intent on placing a client with his sister who lived just over the border in Maryland. I rushed to complete the paperwork and walked it over to the Child and Family Services Agency. Within an hour, I got a call; the request was denied because Maryland required a separate bedroom for my client.

Lexie may have been correct in blaming a lazy social worker for not applying for a waiver in her case, but I know that no waiver was available for my client. Instead of his loving sister, my client went to a foster parent who provided no emotional support or supervision and barely met his physical needs.

At the hearing, Senator Ron Wyden (D-Ore.) asked Joo Yeun Chang of the Children’s Bureau several times what could be done about licensing requirements that prevent foster kids being placed with family. Each time, Ms. Chang responded that the Obama Administration intends to limit congregate care.

But this is a different issue. Of course the federal government could address the licensing issue by denying IV-E funding to states that impose this type of ridiculous requirement. What a shame that, by focusing exclusively on group homes, the administration missed an opportunity to advocate for another of its priorities: keeping children with their families.

This column was published by the Chronicle of Social Change on June 3, 2015.

Senate Finance Hearing: Too Down on Group, Too Rosy on Foster Homes

On May 19 the Senate Finance Committee held a hearing entitled “No Place to Grow Up: How to Safely Reduce Reliance on Foster Care Group Homes.” The hearing was designed to demonstrate that too many foster kids are being placed in group homes for too long.This appears to be an issue on which there is agreement from both sides of the aisle, uniting liberal sensitivities against “restrictive settings” with conservative desires to save money.

As a former foster care social worker in the District of Columbia, I found that the hearing failed to draw some crucial distinctions. First, residential care is not a placement but an intervention. Nobody believes that young people should be placed in institutions instead of in families. However, some young people need more intensive treatment before they can thrive in a family foster home. Without such treatment, these children often bounce from home to home until they end up pregnant or in the juvenile justice system.

One of my young clients – I’ll call him Quentin for the sake of anonymity – was in a truck which his mother repeatedly drove over her abusive husband, killing him. Quentin went through a series of foster homes, being kicked out of each one until he was finally arrested for car theft at the age of 14 and placed in a juvenile justice facility.

Upon release, he was placed in one of his previous foster homes, and that lasted just three months. Quentin had been skipping school, stealing his foster parent’s liquor and belongings, and smoking marijuana in the home. A psychological evaluation recommended a therapeutic group home to provide the structure and supervision Quentin needed.

But D.C.’s child welfare agency refused to provide a group home placement. We placed Quentin with the only foster parent available: a single parent who treated him as a boarder. He almost totally stopped attending school and was failing by the time I left my job last January.

The hearing also failed to distinguish between high-quality and lower-quality group homes. Credible research shows that smaller, well-run group homes can be more effective than therapeutic foster care in improving outcomes for foster youth with therapeutic needs. Boys Town Family Homes, for example, are run by married couples (“Teaching Parents”) who live full time in the home and care for six to eight boys.

I visited a Boys Town Home in D.C. that was sunlit and immaculate, with a wall covered with photos of former residents. The “Teaching Parents” had raised their own children in the home and their two-year-old was currently basking in the attention of all his “big brothers.”

My experience was in the District of Columbia, where less than nine percent of foster children are in group homes, as compared to 18 percent of foster children nationwide. If the federal government imposes further restrictions on group homes, other states will be in the same position as the District, where children are being placed in inappropriate family settings. We risk ending up like Australia, which eliminated over half of its residential placements, resulting in the migration of many children to the homeless and juvenile justice systems and a foster care crisis due to the loss of foster parents.

This month’s hearing also failed to differentiate between good and bad foster homes, with witnesses insisting that a family is always better than an institution. Senator Grassley said that children need to be in families so that someone will tuck them in at night. He never met “Ms. V,” a long-time foster parent who worked from 3 pm to 11 pm. She certainly was not available for tucking in “Renee,” a 14-year-old who was severely damaged by 10 years in foster care and repeated rejections by foster and potential adoptive parents.

Ms. V was supposedly a “therapeutic” foster parent and received extra training and compensation in exchange for caring for more troubled young people. But most of the “therapeutic” parents with whom I worked were no different from other foster parents. They provided nothing more than room and board, and had no contact with kids’ schools, therapists, or families. Ms. V refused to attend a meeting at school for Renee, who was failing, telling me, “I would if I cared but I don’t care.”

I am not advocating for group homes as a replacement for inadequate foster homes. But some young people need residential care as a short-term intervention. And for foster youth who can be placed with a family, we need to find loving, caring foster parents who can meet their therapeutic needs. This may require increasing compensation and training for foster parents dealing with older and more troubled youth. The Administrationhas indicated its support for this approach, and I plan to discuss possible program models in a future post.

This column first appeared in the Chronicle of Social Change on May 27, 2015.

Great Foster Parents I Have Known

In honor of Foster Care Month, I'd like to share the stories of some of the great foster parents I knew in my five years as a social worker in the District of Columbia foster care system.

Mr. and Mrs. C had grown children and grandchildren but lots of energy and love to spare. They took in three-month-old baby S when his mother abandoned him in a bout of rage. Mrs. C was retired and stayed home full-time with the baby, playing with him, talking to him, and loving him. Ms. C. brought S to every well-baby appointment even though some foster parents left this to social workers or other agency staff. When they brought S to visit his mother at the agency, Ms. C thanked her for letting them take care of S until she would be able to take him back. (Sadly, S's mother did not get him back, but he did end up going to his father.)

Ms. T was a single parent of a boy but wanted at least one girl in the household. She took in two sisters after the younger one was abused by her previous foster parent. Ms. T worked from home one day a week, allowing her to take the girls to medical appointments or see their teachers. Every weekend, she drove the children to visit their mother and picked them up at the end of the weekend. After the girls were reunified with their mother, Ms. T would often take them for the weekend at their request or their mother's. She continued to give them gifts and sometimes money when requested. Ms. T has now adopted a second set of girls whom she fostered.

Mr. and Mrs. F took in a ten-year-old girl and her four-year-old brother. Ms. F. worked part-time so that she could spend most of her time being a foster parent. She drove the children daily to their previous school so that they did not have to put up with a long van ride. When the older child was in fifth grade, the F's researched and visited charter schools in order to find a more challenging placement. They were able to get her into one of the most highly thought-of charter schools in the District .

Two siblings, K and M, were placed together in the home of a couple, but they soon expelled K due to her disrespectful behavior. Luckily, K ended up in the home of Ms. W, who saw the wounded child behind the defiance and let her know that there was nothing she could do to get herself kicked out. K's behavior improved in response. Ms. W was so anxious for K and M to see each other that she hosted sleepovers as often as M's foster parent would allow, picking M up and dropping him off. She also picked up their mother from her nursing home so that they could see her as well.

These great foster parents shared two important things—motivation and time. They all became foster parents because they wanted children in their lives and to make a difference in the lives of children. Secondly, they all had the time to devote to their foster children. Two of these foster families consisted of two-parent families in which one parent worked part-time or not at all. The two single mothers worked, but both had jobs with flexibility that allowed them to do things for their children on weekdays.

In five years of work in DC's foster care system, families like the C's, the F's, Ms. T. and Ms. W have been a minority of foster parents I've met, particularly among the foster parents caring for older, more troubled youth. I wrote in an earlier post and column for Youth Today about some foster parents who are providing nothing but room and board—if that. How can we attract more foster parents like the C's, the F's, Ms. T. and Ms. W? If we paid foster parents a salary, this would open up a new supply of potential foster parents—people who want to have a career helping our most vulnerable youth. This would of course increase costs greatly unless we asked foster parents to take more children. Until recently, one private agency in the District of Columbia contractepaid foster parents as employees to care for four children each. Such a model might merit a closer look. Or we might even want to redefine foster care to include agency-owned homes for 6-8 children such as those provided by Boys Town. These are considered group homes, but they actually have a greater resemblance to foster homes—operated by loving, dedicated married couples who have the time to provide the parenting their charges need.

Foster Parent Licensing for Relatives:An Unnecessary Barrier to Permanency

One of my happiest days as social worker in the District of Columbia's foster care system was the day I was able to place an 18-year-old client with her older brother under the District's emergency kinship licensing process, which allows a foster child to be placed with kin through an expedited “emergency licensing” process. My client's brother now had six months (which could be extended to nine) to obtain his permanent foster parent license. During that time, he had to complete extensive paperwork and take a 30-hour foster parent training class –meaning six hours per week for five weeks. And this turned out to be a big obstacle. The class he was offered was from 6:00 to 9:00 at night. My client's brother could not make it at that time because he was often needed to pick up his own two children from school and supervise them until their mother came home from work. As I frantically searched for a foster parent class, I began to wonder why he needed 30 hours of training in order to care for his 18-year-old sister.

This was not the first case where foster parent training requirements posed a barrier to placing clients with family. In another case, a ten-year-old who had been mostly brought up by grandparents in Tennessee was unable to be returned to them because they were unwilling to undergo 30 hours of training. Of course one might question their commitment to the children if they were unwilling to take the time to attend training, but the fact remains that they brought her up for most of her life and she wanted to be with them.

I had another client, aged 14, who had been in and out of the foster care system for ten years. He had been ejected from one foster home and was in another where he got no attention or emotional support. His older half-sister, with whom he was very close, was willing to take him. But her application was denied because she lived in Maryland, and Maryland required that their be a separate bedroom for my client. He was not allowed to sleep on a sofabed in the living room and I was told that the license would not be granted even if he slept in the bedroom and his sister slept on the sofabed. In this case, if the sister had lived in the District, the license could have been granted. She was willing to seek out a bigger apartment but was locked into her lease for 18 months. So my client remained in his grim, neglectful foster home.

Situations like those described above would not occur in all states. The District of Columbia and 19 states require relative caregivers to become licensed as foster parents, according to the Child Welfare Information Gateway. The other states do not require relative caregivers to be licensed, although they may have to meet similar standards, as in California.

The District and other states that require licensing for relative caregivers should consider eliminating licensing for relatives or establishing a more liberal set of requirements for relatives. There should be some standards, whether for a license or for a parallel process as in California. Relatives need to have their criminal and child abuse records checked and need to be assessed for their ability to care for a child. Their residences need to be assessed for safety. But additional requirements that are not necessary for health, safety and good care should be eliminated for relative caregivers.

All over the nation, there is a big push to keep children out of foster care with strangers and place them with relatives. This policy stems from the knowledge that it is best for children to be with family and also from the increasing shortage of qualified foster parents. Unnecessary requirements should not interfere with the interest of the state in placing children with their families.

This column was published at youthtoday.com on May 4, 2015.