Monday, September 25, 2017

The Real Benefit of Child Welfare Waivers: Eliminating Title IV-E Eligibility Determination

I’ve never been a huge fan of the Title IV-E waivers that 28 jurisdictions have obtained from the federal government to allow states to develop innovative programs to address federal child welfare goals. Maybe it’s because the one in my own jurisdiction, the District of Columbia, is currently being redesigned because the services it funded were underutilized at the same time as many system-involved families received little help.


Around the country, most states are funding the same set of programs, few if any of which can document impressive effects despite being billed as “evidence-based.” Moreover, in its most recent report on child welfare financing, Child Trends found that only nine percent of waiver funds were used for purposes not traditionally reimbursable under Title IV-E


But when reading an article about Florida I suddenly realized why the loss of the waivers could be disastrous for many child welfare systems and the children they serve. If Florida’s waiver expires, the Deputy Commissioner of Florida’s Department of Children and Families is worried about the state having to return to determining the Title IV-E eligibility of individual children.


For those who are not versed in the arcane details of child welfare finance, let me explain. States receive partial federal reimbursement for Title IV-E foster care expenditures only for children who would have been eligible for Aid to Families with Dependent Children (AFDC), a welfare program which ended in 1996.  To obtain their share of federal funding, states are forced to devote considerable resources to determine this eligibility for every child--a calculation which serves no other purpose..


Of course there has been inflation since 1996, so the proportion of children eligible for Title IV-E funding decreased from 67% in 2000 to under 50% in 2017. This means that every year states and counties are paying a higher proportion of foster care costs compared to the federal government.


Determining eligibility for foster care based on income makes no sense. A state or county pays for foster care even for youths who are not eligible for financial assistance based on poverty. If a child of Donald Trump or Bill Gates came into foster care, the state would pay. So federal reimbursement should not depend on the income of the parents.


I have not seen any estimate of how many people perform the soul-deadening task of determining Title IV-E eligibility, or how much governments spend on this useless exercise. That money would be much better spent on services to children in a desperately underfunded child welfare system.


Most states with waivers have been exempted from Title IV-E eligibility determination. To ensure that the projects are cost-neutral, the federal government established a cap on federal funding for each jurisdiction rather than reimbursing them on a per-child basis. These jurisdictions have been able to stop determining Title IV-E eligibility for kids entering foster care.


States should not need a waiver in order to avoid wasting human and financial resources to determine foster children’s eligibility for a defunct welfare program. Yet, advocates have been silent on this issue. There are several child welfare bills awaiting consideration by the 115th Congress in 2018. Unfortunately, none of them would eliminate the criteria for Title IV-E eligibility, not even the “Family First Act,” which has been billed as child welfare finance reform.


In his brilliant column, The Two Billion Dollar Question: Why Haven’t We De-Linked?, Sean Hughes tried to explain the reasons for this silence. He argues that “the focus seems to have shifted almost exclusively toward preventing entry into foster care, with little advocacy being devoted to actually improving the continuum of care for children in out-of-home care.” Shockingly, he reports that advocates have often told him that they would not want more funding for foster care even if they could get it.


It is hard to believe that people calling themselves child advocates could turn their backs on the heartbreaking needs of children in foster care by staying silent on the Title IV-E eligibility limits. Children in foster care need great foster parents who live near their homes and schools of origin, and who might be attracted by the offer of housing in supportive communities of foster parents. They need caseworkers who have the time to assemble and coordinate the multiple services they require. They need cutting-edge trauma-informed mental health services from top providers, not the low-end providers who often choose to participate in Medicaid. They need music lessons, art and dance classes, and driver’s education.


In light of the dwindling supply of good foster parents and the recent increase in the foster care rolls, large sibling groups and harder-to-place foster youths need high-quality boarding schools where sibling can be kept together, needed services can be provided in one place and where behavioral challenges can be addressed in a safe and non-traumatizing way.

Eliminating Title IV-E eligibility determination would be a good first step to providing all the enhanced services that foster kids need and deserve, and stopping the waste of desperately needed resources on eligibility determination.

7 comments:

  1. Eliminating IV-E eligibility work is the least of what we need to do. We know clearly from research that children exposed to trauma do best when they are surrounded by stable and caring adults. Yet we still spent most of our time and money taking such children away from the adults they know and love and temporarily paying strangers to care for them. We keep right on doing what we’ve always done, even when given the flexibily to do things that will keep children safer and keep them with their own families. It’s as if what we most want is to go on harming children and families, squandering tax dollars, and blaming social workers.

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  2. I think this article is brilliant. At one point in our state determined that we had approximately 200 FTEs in one form or fashion determining eligibility. The time, effort, resources and energy it takes to qualify a child for eligibility and is little to nothing to that child's care. it is about chasing the dollars and in doing so we lose sight of the primary responsibility.
    I disagree with Dan's response suggesting that there is a causal connection between eligibility determination and why children are removed- to the extent that that is an inference that can be drawn from his comments. To the extent that his comments suggest that we should focus more on keeping children home, he is absolutely correct. Perhaps a full turn so that title IV-E is solely for children who remain in home.

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    Replies
    1. Thank you! What state are you in? I'd love to hear from you directly via email at mariekcohen@gmail.com.

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