Q&A: Jerry Foxhoven, Iowa’s New Child Welfare Boss

Jerry Foxhoven is no stranger to Iowa’s child welfare system. He spent the past few decades working to improve the legal protection of children and families in contact with the Iowa Department of Human Services (DHS).

Now, he will have a chance to run that agency. Longtime DHS Director Chuck Palmer retired in May, and in June, Iowa Gov. Kim Reynolds (R) tapped Foxhoven to fill the role. The 64-year-old attorney has led the Neal and Bea Smith Legal Clinic at Drake University since 2007. Before that, he spent six years heading up the Iowa Child Advocacy Board, which oversees the statewide Court Appointed Special Advocates and the Iowa Citizen Foster Care Review Board.

Foxhoven has his work cut out for him. He takes over while the state tries to respond appropriately to the recent deaths of two children – Natalie Finn and Sabrina Ray – who were adopted from foster care, and a year after overall budget cuts chopped $23 million from the DHS budget.

He sat down with Youth Services Insider to discuss what comes next in Iowa, and thoughts on some bigger picture issues in child welfare.

Youth Services Insider: How did you go about preparing for the job. What did you do in the weeks leading up and how did you spend your first few weeks on the job?

Jerry Foxhoven: I’d say I felt reasonably comfortable, particularly on the child welfare end. When I was preparing it was more on the Medicaid. [DHS manages IA Health Link, the state’s Medicaid program.]

We have a Medicaid director here [Mikki Stier] that’s outstanding, I have total confidence in the person right now that’s heading that division. She’s really terrific and has been doing it for quite awhile.

When you start out, you kind of have to evaluate people and if they’re good, listen to them and get out of the way.

YSI: Are you concerned about some of the current federal health care proposals on Medicaid – will they jeopardize child welfare contracts and services, in your mind?

JF: I hope not. There isn’t a lot of detail yet. Certainly there are some proposed cuts; on the other hand, everybody in Congress said they are going to add flexibility.

The question is, what flexibility is provided? My job is not to evaluate good and bad, but how to make it work.

YSI: Does Iowa’s child welfare system rely on Medicaid for contracted services, or is that paid for in other ways?

JF: I’d say it relies pretty strongly on Medicaid.

YSI: What do you think are the strongest parts of the Iowa child welfare system?

JF: I’d say in terms of child welfare, that we really don’t have a lot of turnover. We pay social workers well … they aren’t overpaid, don’t think I’m saying that.

So it’s a good career choice. They stay. In spite of tough times, amid financial issues and workload issues, they really believe in what they do. I’ve been in academia and the private sector, I would have to openly say these people work harder than any place I’ve ever been.

YSI: Deaths of two children by adoptive parents have brought the spotlight on the agency. Do you think those adoptions were finalized despite concerns about the parents, or that concerning things about the parents were simply missed?

JF: I can’t talk about those specific cases; both have criminal actions pending.

The majority of people who adopt are terrific adoptive parents. And then you’re going to have some that aren’t. So how do we leave them alone, but still get a handle on what do we do to protect those kids?

I was impressed that DHS made a few systemic changes immediately, before I got here, that help.

Jerry Foxhoven, the new director of the Iowa Department of Human Services

First: In the past, when they did abuse assessments, if another report came in on the same child – even if it was for a different reason – it was attached as an addendum on the first report. So if three reports came in within 10 days, it made sense because one worker would investigate. But the problem there is a year or two later, you only saw one child abuse report.

Second: We always treated all reports as equal. There was a change in training, right away, to emphasize to workers that if people with specialties made reports, those were to be prioritized.

We just did that with training, that when someone has specific knowledge of things, and that’s the issue, it is given more credibility. In these recent deaths, two kids starved to death. If we have a doctor saying, ‘This kid is malnourished,’ certainly we should give more weight to that than someone who just saw them in a Walmart parking lot.

We’re also developing rules that anyone with a subsidized adoption must take the children to a doctor once a year. We don’t know if we’ll need state legislation. It’s not a question of can we require it. The question is whether the feds will allow us to stop a subsidy for this.

YSI: This is an emerging issue in child welfare, how to better monitor adoptive households without intruding in the lives of families.

JF: We’re not asking a lot. All good parents take their kids to a doctor once a year. We just don’t want you flying totally under the radar. We’re not asking anything apart from what good parents should do.

YSI: The counter-argument there, though, would be, “make every parent document a doctor’s visit then,” right?

JF: We pick these parents. You can’t really compare them to birth parents. We expect more out of foster and adoptive parents than birth parents.

YSI: Both of these girls who starved to death were homeschooled, which has prompted some to call for some sort of regular check-in on homeschooled adopted kids.

JF: I do not see it as a homeschool issue. I saw it as a subsidized adoption issue. We don’t tell birth parents they can’t homeschool. So where do we draw the line with adoptive parents to say, you’re going to be different?

We believe in this state that people have a right to homeschool. But I’m not sure we believe that they have a right to not take their kids to doctor.

YSI: What do you think a system owes a youth who ages into adulthood from foster care without the permanency of reunification or adoption?

JF: They owe the youth the same a parent would: some connections and support when they reach 18. At the age of 18, you shouldn’t be shoved out the door with no insurance and no meaningful person in their life.

YSI: We are coming up on a decade of the passage of Fostering Connections to Success and Increasing Adoptions Act, which permitted states to expand IV-E foster care to 21. Would you like to see Iowa extend foster care to age 21?

JF: We have a program calls PAL, Preparation for Adult Living, that provides money for housing, training and school beyond 18 up to 21. It’s not technically within foster care; they can elect to get those benefits, and they can come back if they don’t choose to at first.

I’m not supportive of keeping it called foster care, because at 18 they get to make decisions of their own. So a kid who wants to walk away from it should be able to do that. It’s the best of both worlds, because they can continue to receive benefits.

YSI: At the Drake clinic, you guys have sought to increase the supply of legal help to kids in the system. Do you agree with the American Bar Association’s model standard suggesting that each child should have an attorney representing what they want, as opposed to only a guardian ad litem tasked with representing their best interests?

JF: Yes, I absolutely agree. Every kid should have an attorney. I’d be OK with kids really young, 3 and under, having a GAL with no lawyer.

YSI: How do you plan to incorporate the voices of youth in your system into the decision-making process?

JF: I always believe we should talk to youth about what they need. Most of the great bills I have had a part in promoting in Iowa came from foster kids.

YSI: You run the system now. Is there a group in Iowa that can directly connect you to youth?

JF: AMP, Achieving Maximum Potential. They are terrific, they promote a legislative agenda every year.

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