States Get a Chance to Experiment with Child Welfare Systems
November 30, 2011 | By Pamela Prah | Stateline
Devon, a 16-year old boy who lives in Clearwater, Florida, went into foster care when he was eight months old. He lived in a group home in his early teen-age years and was on track to stay there until he turned 18. But that didn't happen. Today, as a high school junior, he's busy playing guitar in local gigs, participating in ROTC, and volunteering in the community with Natalie Jernigan, the woman who adopted him just this past March.
"It's extremely unusual for a 16-year-old to be adopted," says Jernigan, an attorney with the state's child welfare system who was first Devon's mentor and a year later legally became his mother.
While other states have programs that offer the kind of intensive counseling that helped transition Devon from a group residence to Natalie's home, Florida's program is different in many respects, including the way it's paid for. Other states would not be able to use the federal dollars Florida used to fund the intensive in-home services that made Devon and Natalie a family.
Florida is one of six states that currently have permission from the federal government to tap certain federal money for foster-care alternatives. But other states are about to join the experiment. The Child and Family Services Improvement and Innovation Act, which President Obama signed this fall, will allow up to 10 states to use certain federal dollars for more community and home-based services. The overall goal of the demonstration projects must be to reduce the time children spend in foster care.
"We believe that about half of the 423,000 children in foster care today could go home to parents, relatives or to adoptive parents if these kind of intensive family preservation or reunification services are provided," says Connie White Mills, a spokeswoman for Youth Villages, the nonprofit that worked with Devon and Natalie.
Florida got a waiver to change its child welfare system in 2006. Since then it has reduced its foster care population by nearly 40 percent. It has been closely watched by the rest of the country.
A shift in approach
The federal government spends more than $12 billion a year to help states with child welfare, the Casey Family Programs estimated in a 2010 report. Most of those federal funds come through Title IV-E of the Social Security Act, the same law that sets out Social Security, Medicare and Medicaid policies.
But the child welfare section of the law is worded so that states can use those federal funds only to pay for keeping children in foster care or group residential services. The money can't be used to keep a family together or to provide in-home therapy, although another part of the Social Security Act does let states use federal money to prevent child abuse and neglect.
Mills says because Florida has the Title IV-E waiver, her organization was able to help Devon. His case, she says, is "an example of how intensive in-home services can help young people connect with family, either their own family or another through adoption."
The waiver program that Florida is using expired several years ago, but states that were already employing waivers, such as Florida, were allowed to continue using them. The law that President Obama signed in September brings back the Title IV-E waiver process and expands to 10 the number of states allowed to use it every year through 2014.
Any state that wants to take advantage of the law must make sure their projects remain "cost neutral," meaning that the amount the federal government provides cannot be more than the state would have gotten without the waiver. Florida and the other five states that had earlier waivers don't have to apply again. The others in that category are California, Indiana, North Carolina, Ohio and Oregon.
"This law will encourage more innovation and connect young people to the critical services they need," says William C. Bell, president of the Casey Family Programs, which has committed to investing at least $1 billion in the next decade to help reduce the number of children in foster care 50 percent by 2020.
More tracking and reporting added
Not even the federal government is sure how many of the programs being tried under the waivers are actually working. Evidence regarding the impact of the existing six waiver programs "remains inconclusive," according to a 2011 report from the U.S Department of Health and Human Services. The report says that states generally see the waiver demonstrations "to be critical facilitators, but not the drivers" of major child welfare reforms.
While states that get the waivers can spend the federal dollars in ways that they previously couldn't, there are still strings attached to the money. In fact, some wonder if the reporting requirements necessary to obtain a waiver under the new law may be enough of a headache to scare off some states from applying.
To get a waiver, states have to agree to adopt at least two of an array of "child welfare program improvement policies" that the federal government lists, among them extending the age limit for foster care benefits to 21 from 18 and doing more to place siblings in the same foster home. States will also have to track how well children allowed to remain outside foster homes do, compared to those who go through the foster home process.
These new reporting and tracking requirements are crucial, says Rutledge Q. Hutson, director of child welfare policy for the Center for Law and Social Policy, an advocacy group. "We need to know what happens to the child," she says.
For Devon's adoptive mother Natalie, what mattered most was not how the state got funding for the services that helped her and her son, but that the services were there. "We're a family now," she says.