HHS Leader Rafael López: It’s Time to Flip the Script on Child Welfare

In late July of 2014, President Obama nominated Rafael López to serve as commissioner of the Administration on Children, Youth and Families, the division of the Department of Health and Human Services (HHS) that oversees most federal spending on state- and county-level child welfare services.

A year later, after the National Hispanic Leadership Agenda made his nomination “a top priority,” he was confirmed.

López built a lengthy resume in the youth services sector before joining the White House as senior advisor at the Office of Science and Technology Policy. He built the First Five office in Santa Cruz, Calif. – one outpost of a tobacco-tax fueled, statewide investment in early childhood – before joining former Los Angeles Mayor Antonio Villaraigosa’s cabinet as executive director of the city’s Commission for Children, Youth and Their Families.

He then headed east, taking a job as CEO of the Family League of Baltimore City, and then joined the Annie E. Casey Foundation as associate director for talent and leadership.

The Chronicle of Social Change Editor John Kelly sat down with López to discuss priorities, the rise in national foster care numbers, and child welfare finance reform.

Chronicle of Social Change: You have about a year left here as an administration.  

Rafael López: Being nominated by the president to a role that requires Senate confirmation was an educational experience. The time between being vetted, then nominated and actually being confirmed, was roughly two years. And the question that has to be asked of our country is, is that the best way to run a government? Whether for this role or many others.

My sense is we can do so much more and so much better at streamlining the way all presidential nominations are considered.

It is different coming in at the end of an administration, because you don’t have the years of runway.

CSC: So there’s only a certain number of things you can load up on. So tell me what they are and more specifically, tell me ideas on what you feel like you CAN do and what may need to be done after you’re gone.

López: A couple of clear priorities. One has to be regulations, because there are deadlines and dates that are out of our direct control. So there are four rules we’re prioritizing to be completed by the time we leave our office.

First is the Family Violence Prevention Services Act rule, related to how we serve survivors and victims of domestic violence. Our perspective is we’re going to make sure that everyone who is a victim of domestic violence gets the services they need and deserve when they need them. The rules will help make sure we can serve all people with the dignity they deserve.

Second is the Runaway and Homeless Youth Act … how we make sure we’re serving young people who have run away from their homes or are experiencing homeless, and updating the way in which we fund programs.

Third is around AFCARS, the Adoption and Foster Care Analysis and Reporting System. We haven’t updated those rules in quite some time and they require states to capture data on what is happening to young people and their families when they’ve been removed from their home. That’s the requirement that guides states on the data we collect.

And the fourth rule is related to CCWIS, Comprehensive Child Welfare Information System … the way in which tribes, county and state systems capture real-time information in their databases.

We haven’t updated those rules in about a quarter of a century. One can imagine if we’re requiring states and tribes to not only collect information but to store it and share it to better serve families, a lot has changed in technology in 25 years.

When a reporter wants to quote any number of data points related to children in care, you are essentially using data that’s a year-and-a-half old. It doesn’t have to be that way.

One of the things we’re trying to figure out is how to accelerate the sharing of data and be proactive in sharing data in an open data format. That’s not the way things have been run here for a long, long time.

CSC: Or really, in pretty much any child welfare system around the country.

López: The field has to catch up with technology and innovation. Tech and innovation are not the saviors of child welfare, but they are underutilized tools to more quickly deliver information to the people who should be using data – ourselves included – to make evidence-based policy decisions. These decisions can have life and death consequences.

CSC: How does the federal government figure into that?

López:  We are working with antiquated systems at HHS. So how we use tech here is a struggle and it shouldn’t be. And the tribes, counties and states where the work actually happens are struggling with this, too.

The question is how can we be a better partner to help support work on ground? Making sure we can be flexible, maybe using Title IV-E funding for administrative costs to fund tech systems.

At the end of the day, we actually do have the technology to be able to understand what’s happening, quicker, for children, youth and families. And part of the challenge is sharing information.

People often stand behind, or hide behind, privacy issues. But the larger question that should be asked is: ‘Yes, we want to respect the rights and the privacy of every single child in the system, but are we comfortable not sharing information that would make sure a child gets the services they need or deserve at a much more rapid pace?’

CSC: Predictive analytics is discussed a lot in child welfare these days, especially as a way to anticipate and get ahead of dangerous situations down the road.  

López: Predictive analytics is not going to solve the problem, but it is one tool.

When a child dies [from maltreatment], the stakes are raised, the news cameras are on, everyone is asking, ‘Why did this child die?’. And generally speaking, there are a series of commonalities that exist:

Lack of communication among staff who have responsibility for that child.

Lack of information sharing when multiple government entities have been involved with that child’s family.

And a lapse in being able to be responsive.

Those three issues are common to many cases. So how can we use big data to make better decisions to serve families when they need help?

Predictive analytics is absolutely worth exploring. If it can save more lives, why not give it a shot?

Are there clear privacy concerns? Of course, and my take is they aren’t insurmountable.

With full disclosure and transparency that rests firmly in respecting the rights of the child and family, we can do amazing things.

CSC: So outside the regulation arena, where would you like ACYF to make its mark before inauguration?

López: We are working on comprehensive guidance to the country on making sure that we do not discriminate against LGBTQ youth who are in care. Specifically, how we make sure same-sex couples who want to foster and adopt are welcomed and are able to do so. And third, that no federal funding is used for conversion therapy, at all. [Conversion therapy refers to attempts to convert lesbians and gay men to heterosexuality.]

CSC: I didn’t even realize conversion therapy was on the table for federal funding.

López: We need to be clear that the evidence is compelling and it doesn’t work. We want to make sure we are using the best science and data we have about how children should live with families.

Children aren’t raised by institutions, they’re raised by families who love them. We want to make sure that every child has a loving home and if a same-sex couple wants to adopt a child, we should welcome them as foster and adoptive parents.

We’re also laying the foundation to end youth and family homelessness by 2020. This work will not be completed by the inauguration, but critically important.

CSC: What do you think you can do in this time frame?

López: One of things we’re doing is making sure we’re coordinating our services. This sounds so basic but at the federal level, like so many governmental systems across the country, making sure we’re coordinating our work doesn’t always happen.

We’re also helping to inform and shape funding announcements. HUD [Department of Housing and Urban Development] received a significant allocation for funding 10 to 11 pilot sites deeply rooted in preventing youth homelessness.

We are partners with HUD on this issue. We’re taking years of experience on funding shelter programs to help inform what they’re doing.

We’re also partnering with the Department of Education on issuing joint guidance with regard to the Every Student Succeeds Act, trying to make sure that our educational and child welfare systems are working more closely together to achieve better results for our kids.

CSC: The number of children in foster care in the U.S. has gone up for two straight years after trending downward since 2002.

In September, you told the Associated Press that HHS is “concerned about any increases in the foster care numbers, and we are working hard with our state partners to better understand the reasons behind the increase.”

What have you learned?

López: One of things we’ve done with our team is to be far more proactive in reaching out to counties, states and tribes, both on the phone and in person, to hear what’s happening on the ground. And not just the stories, but how what they’re experiencing is showing up in our data.

We’ve taken a look at where the numbers are going down, or up, and why. What we’re finding is co-occurrence factors. Things like an increase in substance abuse, ranging from meth to opioids.

Second is access to mental health care. This is a common theme that we hear from our grantees and from states, counties and tribes.

And third is domestic violence.

These are the things we are finding as co-occurrence factors for removals of children. Counties states, and tribes are finding that substance abuse, in particular, is named as one of many causes for removal.

So what are we doing to work with them more closely? That’s what we’re constantly asking ourselves. How can we be more responsive?

CSC: Addressing substance abuse is probably one of the murkiest areas in terms of child welfare system response.  

López: Our regional partnership grants have had significant success in the past several years. This is a source of funding that pools together multiple constituencies and sectors on the local level to best support children, youth and families. It’s really important we make sure that substance abuse is woven into prevention.

This goes back to the need to really flip the script on child welfare in this country. By the time kids and families get to the programs we fund, there’s a crisis.

What if we actually flipped the script and put most of the money on the prevention side? Families getting the services they need before a crisis happened could prevent a pattern of needing both high-end and costly services that, quite frankly, haven’t always proven to work.

CSC: Thanks for that lead-in, because the Family First Act being worked on now in the Senate Finance Committee would enable states to use Title IV-E funds for prevention-side services. What is the administration’s view of that bill?

López: I would say the administration has not taken a formal position on the bill, partly because it’s still in draft form. So when the bill is dropped, we’ll take a hard look at it.

We would welcome legislation that, again, flipped the script on the narrative of child welfare in this country and places opportunities to invest in and scale prevention services to help children, youth and families across the country.

If, as the bill is currently proposed, we are able to use Title IV-E to fund prevention, that will be a game changer for the social sector in this country.

CSC: It would be a pretty drastic departure from the current federal role.

López: What we often see in the child welfare system is this pipeline. A struggling family early on: the cause is domestic violence, the cause is substance abuse, the cause is mental health. They don’t get help they need, so kids are removed and placed in foster care.

Then, those same kids struggle to get through school. They either don’t graduate from high school or don’t get a job. Then those same kids, who were in care or in group homes, become victims or targets of trafficking or become homeless.

So the data is pretty compelling in this country that, by and large, children who remain in the child welfare system do not have overwhelmingly positive results from being in the system. And it’s one of the most costly systems.

So why wouldn’t we try something different? Why don’t we have a greater sense of urgency to flip the script, not only on child welfare but many of these systems that just don’t seem to work well for children and families?

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John Kelly
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John Kelly is editor-in-chief of The Chronicle of Social Change.