Youth Services Insider: Caseys Pitch Title IV-E Reform

Youth Services Insider dropped in on a Capitol Hill briefing a week ago on a plan to restructure the federal IV-E foster care entitlement, which was proposed by Annie E. Casey Foundation (AECF) and Jim Casey Youth Opportunities Initiative.

We have written at length about that proposal here and here, but to reiterate in a nutshell: make foster care shorter, and make it better.

The foundations propose that the Department of Health and Human Services (HHS) support every child in foster care, but only for three years, and almost never in group care if they are under the age of 13. They also propose that the federal government invest in better, universally-licensed foster homes.

It is a package deal, AECF Family Services and Systems Policy Director Rob Geen noted at the briefing; the first part of the plan doesn’t work without the second, and vice-versa.

It was an interesting vibe at the meeting, held in the Capitol Visitor Center. Geen and AECF Child Welfare Strategy Group Director Tracey Feild led a point-by-point run-through of the proposal, stopping at each one to address questions and concerns they had already heard from the field.

YSI’s sense from numerous hallway conversations is that many advocates are in line with the goal of this proposal, but dubious about the impact of harsh limitations on group care and length of stay.

Click here for Geen’s overview of the various proposals with notes about concerns the foundations have heard. Following are a few of YSI‘s thoughts from the briefing.

Exceptions

Geen seemed surprised when it hadn’t been mentioned a half-hour into the session, so he brought up “the elephant in the room” himself: exceptions to the rule.

The most frequent question/criticism AECF had heard back, he said, was about exceptions to the lines drawn on length in foster care and restrictions on group care. There needs to be a way, some argued, that agencies could continue to draw on IV-E for a child to stay in care or to be in a group setting if that was in the best interest of the child.

The argument against that line of thinking is that exceptions sometimes eat rules. Let’s say to get an exception to the three-year rule, a caseworker needed to prove to a judge that the child has a diagnosed mental health disorder. There is now a state financial incentive in getting youths diagnosed, since it is the only way to get a federal partner to bear the cost of foster care.

Which is fine if the child actually has a mental disability. Not fine if the system is erroneously marking a child for life with a disorder, only to recoup more federal reimbursement.

Angry Grannies

The plan supports the notion of requiring licensing for kin caregivers, and for those kin to receive support commensurate with non-relative foster parents.

Of kin caring for children who have not been removed to state custody, Geen said, “We’re not suggesting those children be brought into the system.”

That is logical, of course, because such a system would be ripe for fraud. You couldn’t create a situation where all a family had to do to create a foster care payment was move a child to a relative’s home.

But it’s worth noting that there are thousands of relatives, many of limited means, who have taken responsibility for a child before state intervention was warranted. And at least some of them chafe at the notion that they get no support .

This is from an op-ed we ran by one such caregiver, Jan Wagner, in response to the Casey proposal:

Frequently children are voluntarily relinquished to a relative home by the parents prior to protective services removal to keep the child from unnecessarily entering the system.

Although it is the belief of both parties involved that this will be a temporary situation, it often becomes a long-term or permanent situation. The children, in fact, become abandoned. But these relative families cannot access the funding or services available to foster families other than a small Child Only Grant (TANF), Medicaid, and possibly a work-only child care stipend.

An AECF Waiver State

One attendee asked Geen if he thought it was conceivable that a trial run of this proposal could be run in one of the states that recently received a IV-E waiver from HHS.

“I mean, that would be great,” a bemused Geen replied quickly to that notion.

Doable? The most recent HHS update on the nine new waiver states shows that all nine have yet to begin implementation or have a start date. A state that signed onto this could almost certainly bank on some extra support from the foundations.

Those nine states, by the way: Arkansas, Colorado, Illinois (part two for them), Massachusetts, Michigan, Pennsylvania, Utah, Washington and Wisconsin.

The Ohio Training Model

A big part of the “make foster care better” portion of the plan involves steering systems toward competency-based training. Feild suggested that one state fits the bill to lead that.

“Ohio is the only state where training is truly competency-based,” she said.  They’ve defined it, have supervisors measure it, and have a QA [Quality Assessment] staff measure at random.”

“When It’s Everybody’s Job, It’s Nobody’s Job”

A nice turn of phrase used by Feild to argue the merits of enhancing IV-E reimbursements for foster parent recruitment and development, an aspect of the work she said often falls by the wayside when budgets get tight.

“It’s so sad to watch recruitment staff get detailed to handle backlogs and deal with shortfalls,” she said, citing research that about 50 percent of foster parents quit after their first child. “You not only lose foster parents, you don’t develop new foster parents.”

Youth Services Insider is mostly written by Chronicle Editor-in-Chief John Kelly

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