One Month of Spending, Years of Child Welfare Reform

The continuing resolution (CR) signed by President Donald Trump this morning funds the government until March 23. But it changed the landscape of federal child welfare funding for the foreseeable future.

Here is Youth Services Insider’s breakdown of the many long-term implications for youth and family services in the spending bill.

Family First Act Is Law of the Land

A few years back, Sens. Orrin Hatch (R-Utah) and Ron Wyden (D-Ore.) – the chair and ranking member on the Senate Finance Committee – merged their child welfare priorities into one bill. Hatch wanted to pressure states to cut down on the use of congregate care and group home placements; Wyden wanted to give child welfare systems more ability to fund services that prevented the use of foster care in more cases.

These were the seeds from which the Family First Prevention Services Act grew, a bill that now has significantly altered the child welfare financing landscape. The Title IV-E entitlement, currently reserved for foster care and adoption assistance expenses, can now be used for 12 months of services aimed at helping families without the use of foster care (well, sort of: many will surely require the assistance of relative caregivers).

The spending bill signed by President Trump includes funding through March 23, and provisions that permanently change the federal entitlement for foster care

As opioids and meth continue to wreak havoc on American families, the act will enable child welfare systems to tap into IV-E to get addiction treatment for parents that they determine, with the right amount of support, are not a danger to their children. So too for parents suffering from mental illness or basic parenting deficits.

On the other end of the spectrum, proponents of Family First hope that its restrictions on federal funds for congregate care settings is enough to pressure states into relying more on foster homes. There is no current limit to how long IV-E can be used for such placements. Under the new law, states will have only two weeks of federal support guaranteed.

“I cried for about 10 minutes this morning,” said Amy Harfeld, national policy director for the Children’s Advocacy Institute, speaking in celebration of the bill. “There are not a lot of things that shock the hell out of me, but seeing this long fight culminate in victory did. It’s revolutionary. This presents a really exciting challenge to folks in our field to think about the way we do finance child welfare and where we should be making investments.”

“Challenge” is an appropriate word. On the front end, the Family First’s prospects to keep more families together is contingent on states’ willingness to put in their own funds for substance abuse, mental health and parenting services. And success will further be contingent on greater knowledge and proliferation of evidence-based interventions that work to help these parents.

On the back end, use of congregate care has declined over the years as states have come to rely more on relatives and some have built their roster of foster homes. But as The Chronicle of Social Change reported this fall, in more than half of the states, foster home recruitment and retention has not kept pace with the rise in youth placed in foster care.

The Family First Act injects into that situation fiscal pressure to keep youth out of congregate care, where the feds won’t help pay for it, and into foster homes, where the feds will. The Family First Act does include a slate of exceptions to the congregate care limits, chief among them a pass for settings that can be deemed “qualified resident treatment placements.”

Ten years ago, such restrictions on congregate care would have occurred as foster care numbers were ticking down across the country. Today, states will have to find more foster home capacity while some accommodate rapidly rising numbers of kids.

John Sciamanna, vice president of public policy for the Child Welfare League of America (CWLA), summed up the challenges nicely in an e-mail to Youth Services Insider:

Like all child welfare legislation, this is a work in progress. There is great potential to add in new post-reunification and adoption services as well as up-front intervention services. The challenge will be to make sure as many states as possible take the option to draw down the new IV-E services fund.

In addition, we need to make sure that HHS [the Department of Health and Human Services] is flexible in the programs that can be funded. As part of this we also have to work to make sure that youth in particular are not pushed into another system (juvenile justice, for example) as oversight on institutional care is increased.

YSI will certainly dive deeper into the implications of and details in the Family First Act in the coming weeks.

Home Visiting’s Last-Minute Save

The Maternal, Infant and Early Childhood Home Visiting (MIECHV) program, which pairs professionals with new and expecting mothers to help prepare them for parenthood, faced a shortfall that likely would have prompted program eliminations and staff layoffs across the country.

On Tuesday, the House did not include reauthorization of MIECHV in its spending plans. That is sort of incredible when you consider that the House did include Family First, a new law with massive implications for a federal entitlement, and MIECHV has had bipartisan support for more than a decade.

By Wednesday, when the Senate introduced the CR that actually became law, MIECHV had received a five-year extension at its current rate of $400 million per year. Last year, advocates for the program might have been glum that the authorization wasn’t doubled or at least increased; today, they are surely relieved to just get out with a win.

“Today is a great day for children and families,” said Diedra Spires, CEO of the Dalton Daley Group, which helped coordinate the Home Visiting Coalition, in an e-mail to YSI.  “A five-year reauthorization of MIECHV is tremendous. We are also gladdened by the increased impact that the passage of multiple programs that serve and protect children and families will have over the next five years and beyond.”

The level extension of MIECHV sidesteps House Republicans’ desire to turn it into a match program, requiring equal fiscal participation by states by 2022. That plan had potential in theory to increase the overall investment in home visiting, but MIECHV proponents argued that the opposite would be the reality. Many states, they argued, would not be in a position to meet the federal allocations, leaving millions in MIECHV funds on the table.

Fatality Prevention Plans

Slipped into the original construct of the Family First Act is a provision from a separate law introduced in October by Hatch and Wyden following the Senate Finance Committee’s investigation of privatization in foster care.

Each state would be required under Title IV-B of the Social Security Act to conduct an annual review of child fatalities, collecting data on both the circumstances of the death and facts about the child’s history (siblings, presence of mental health or substance abuse issues, etc.).

The provision embeds the idea of a regular assessment of child fatalities envisioned in the recommendations last year by the Commission to Eliminate Child Abuse and Neglect Fatalities.

The language in the CR is a little looser than the October version, but requires two things from states on this issue: A description of the steps the state is taking to compile complete and accurate information on maltreatment-related deaths, and a description of steps that state is taking to implement a “plan to prevent the fatalities.”

$100 Million for Social Impact Projects

Pay for Success (PFS) projects, also known as social impact bonds, offer governments a sneak peak at the impact of evidence-based interventions and services before they (hopefully) commit to embedding them in policy. Private money is put up to fund the services with agreed-upon benchmarks for success; if the marks are met or exceeded, funders get their money back with potential bonuses. If the benchmarks are not met, the government doesn’t pay a dime.

The CR includes legislation providing $100 million to the Treasury Department to issue for PFS projects around the country. The department has a year to launch the competition for these funds, and another six months to select winners.

The legislation includes a laundry list of acceptable issues and populations for the projects to focus on. Among them:

  • Improving birth outcomes and early childhood health
  • Increasing the number of children living in two-parent households
  • Reducing the number of children living in foster care and returning to foster care
  • Increasing graduation rates
  • Increasing employment rates among youth and young adults
  • Reducing reliance among low-income families on the social safety net

The U.S. accounts for fewer than 20 percent of the 108 projects that have launched worldwide, but it accounts for about half of the total funding committed to PFS ventures, according to new numbers released by Social Finance.

Click here to read our recent interview with Tracy Palandjian, co-founder of Social Finance, on the state of the social impact financing

CHIP Extension Extended, Community Health Centers Get Boost

The Child Health Insurance Program (CHIP) was built as a protective wall to prevent health care costs from making families poor. It helps insure children whose parents make too much to qualify for Medicaid, but not enough money to afford the premiums for quality care for the whole family.

Like MIECHV, CHIP expired in September, and states were making noise about halting enrollment before last month’s CR extended the program for six years.

This deal added an additional four years, giving CHIP a full decade extension, which the Congressional Budget Office estimates will actually save the federal government $6 billion over the decade.

Community health centers serve about 27 million people a year in America, many of them low-income families. Federal funding expired in September, and is renewed in this bill with an increase from last year’s $3.6 billion. The centers will receive $3.8 billion this year, and $4 billion next year.

No DACA

Noticeably absent from the spending agreement is a fix for Deferred Action on Childhood Arrivals (DACA), the program through which people who arrived illegally in America as young children can move toward lawful residency. DACA was rolled out by executive order under President Obama after Congress failed to pass the DREAM Act, a legislative attempt to help this population.

President Trump has set the DACA program to expire in early March, weeks before the next funding deadline for the government. He wants DACA tied to a broader immigration reform.

If you are interested in federal juvenile justice and child welfare policy, read our special issue “Kids on the Hill.” Just hit this LINK

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John Kelly
About John Kelly 945 Articles
John Kelly is senior editor for The Chronicle of Social Change.

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