Coming Together to Create the Child Welfare System We All Want

Susan Dreyfus, CEO of the Alliance for Strong Families and Communities

Our nation’s future vitality depends upon all children having the opportunity to grow into healthy, successful, socially and civically engaged adults. Essential to that process is ensuring that children have access to stable, nurturing relationships and the resources needed to support their development.

The Family First Prevention Services Act, which was signed into law as part of the Bipartisan Budget Act on February 9, 2018, is an important step toward realizing this goal. For child welfare leaders, it represents both opportunity and challenge as we look to radically re-imagine the current child welfare system into one that emphasizes prevention, early intervention and evidence-based practices for children and families.

The challenge ahead will require that everyone – from the public to the private sector – come together to create and implement a thoughtful and carefully planned blueprint for change. It will truly take all of us.

As someone who leads a national network of community-based health and human services organizations, and a former leader of two state child welfare systems, I am incredibly optimistic about the future health of child welfare thanks, in part, to this groundbreaking legislation. The Family First Act builds on the findings and recommendations of the federal Commission to Eliminate Child Abuse and Neglect Fatalities, on which I was honored to serve. It is a starting point and an opportunity to move toward a public health approach to ensuring the safety, health and well-being of children.

The historic passage of Family First represents a federal funding shift by changing the way Title IV-E funds can be spent by states and enabling broader use of those funds for prevention of entry into foster care. Public child protection agencies can now draw on these federal funds for promising and evidence-based in-home services and supports, including mental health services, substance abuse treatment and counseling to help keep families intact.

But we can do more to build stronger families. Achieving a vision of a 21st century model for child welfare will require a realignment of the practice, policy, regulatory and fiscal mechanisms to our desired goals and values at the local, state and federal levels, beyond what is required by Family First.

What does such an alignment entail? It requires a shift in system emphasis from one of child protection, where action is taken after the harm to a child has occurred, to a greater focus on primary prevention and early intervention, with child and family well-being systems guided by a set of shared values, principles and evidence-based best practices. Adverse experiences, like abuse and neglect, can disrupt cognitive, physical and emotional development, which can undermine health and well-being later in life. Preventing abuse and neglect and intervening early are two important ways we can maintain and stabilize a child’s developmental process and avoid more costly interventions down the road.

These shifts will also require the integration of a broader set of systems beyond a single county or state public sector agency, as is too often our focus today. A public health systems approach understands that the welfare of our children is a shared responsibility across child protection agencies, community-based organizations like those in the Alliance, early childhood and K-12 education, healthcare, law enforcement, and the courts, to name just a few. Partners in this new system will need to adapt and change to achieve a level of integration that ensures that no child falls through the cracks.

Jerry Milner, head of the Children’s Bureau at the Department of Health and Human Services, discusses the Family First Act with Dreyfus and other Alliance leaders. Photo courtesy of the Alliance for Strong Families and Communities.

Building new capacities and competencies across the broader system will take both time and patience. To be successful, current public child protection systems will need to radically change to integrate prevention and early intervention services across the education, health care, law enforcement and judicial sectors. One promising example of this can be found at the Child Advocacy Center (CAC) in Memphis, Tennessee. One of 750 CACs across the country, it has made great strides in the fight to reduce child abuse and neglect through a coordinated community response. At the Memphis CAC they are working under one roof to identify those at risk and prevent tragedy before it occurs.

We must also invest more in research, of which very little now exists in child welfare, to identify best practices and replicate them nationwide. This will also require incentivizing those of us in the system to innovate and develop the next evidence-based models for the future. This is a critical role community-based child welfare organizations like those in the Alliance network can and do play, but these organizations must be reimbursed for the full cost of the outcomes we desire and treated as full partners in that effort, not simply vendors and providers of services.

Another important change we must address and adapt to is that, for those children and youth who ultimately must be removed from their homes and families, they often need a higher level of behavioral health intervention. We must understand that for many of these children, adverse childhood experiences can disrupt their cognitive and physical development, which can lead to significant behavioral health challenges.

For these children and youth, quality, family-centered, trauma-informed, therapeutic residential interventions should be the treatment of choice for stabilization and healing and not the last placement as it often is today. We must create continuums of care that allow children to receive the right care at the right time so they can successfully move toward permanency and get their lives back on track.

Family First puts us on a path to success, but in order to achieve that success, we must act with a careful sense of urgency and work together across sectors with the goal of always putting the well-being of children at the center of what we do. Collectively, we have opportunity to move beyond a compliance-driven deep end approach in the wake of this new law.

We should fully embrace this 21st century vision for a preventative child welfare system that serves the unique needs of children and families and provides the right amount of services and supports to achieve the best results possible. To achieve these goals, we must also ensure that community-based child welfare organizations have a seat at the table and a voice in navigating these policy changes and how they are implemented to fully support children and families.

Susan Dreyfus CEO of the Alliance for Strong Families and Communities and a former child welfare director in Washington and Wisconsin.

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