Statement of Richard Wexler, Executive Director, National Coalition for Child Protection Reform, Alexandria, Virginia

Testimony Before the Subcommittee on Income Security and Family Support
of the House Committee on Ways and Means

May 23, 2006

Mr. Chairman, members of the Subcommittee, thank you for inviting me to testify today.  My name is Richard Wexler, and I am executive director of the National Coalition for Child Protection Reform, a nonpartisan, non-profit child advocacy organization dedicated to making the child welfare system better serve America’s most vulnerable children.

We are a very small organization, with no particular interest in becoming another big non-profit bureaucracy.  But what we lack in size, we make up for in track record.  To cite just one example: We were the only national child advocacy organization to predict the collapse of the Florida child welfare system – three years before it happened – because we knew that the child welfare agency there was embarking on the same course that had led other states and localities to disaster, a course they now are trying to change.

And we are proud to have been the only child advocacy organization, aside from the event sponsors, singled out for thanks by Rep. George Miller in his remarks opening the Child Welfare Summit he helped to organize in 2004.

There is more about NCCPR, our distinguished board of directors, our funders, and our track record on our website, www.nccpr.org

For now, though, I want to note only that I have gotten into the habit of referring to our organization as “the family-values left.” I am a lifelong-liberal-non-counter-cultural-McGovernick-lapsed-card-carrying-member-of-the-ACLU.  My board members include the former Director of Housing and Homelessness for the Child Welfare League of America and a former Legal Director of the Children’s Defense Fund.  Our Founding President is a former member of the National Board of the ACLU.  I mention this because children never should be caught in the crossfire of a left-right debate.  There are good ideas to be found at all points on the political spectrum, and when one emerges it should be embraced - - without regard to where it originated.

So the fact that one of the most important ways Congress can improve Child Protective Services happens to come from the Bush Administration is no reason for my fellow liberals to jerk their knees in opposition.  But too often, they have done just that.  Now that this fine idea has been embraced not only by Governor Jeb Bush of Florida and Governor Arnold Schwarzenegger of California, but also by Governor Jennifer Granholm of Michigan, I hope that my friends on the left will reconsider – and give the nation’s 47 other governors the same opportunity to help their vulnerable children, if they choose to seize it.

I refer to the Administration’s Child Welfare Program Option, the proposal to take billions of dollars now reserved for holding children in substitute care and allow states to use that money for safe, proven alternatives as well.  

The story of one child and his mother explains why this change has the potential to be so important.

This is what a single mother in the Bronx named Rose Mary Grant had to do every week for many, many months, just to see her 11-year-old son, Issa, as described in a keenly-observed story in the Westchester County, N.Y. Journal-News:

"Starting from her brick apartment tower, Rose walks a block to Gun Hill Road, takes the 28 bus to the subway station, catches the 5 train to Harlem, makes her way down 125th Street, boards the Metro-North train to Dobbs Ferry, and rides a shuttle …  At each step, she places two metal crutches ahead of her and swings forward on two prosthetic legs."[1]

 The journey would have been worth it, had there been something worthwhile at the end of the line.  But there wasn’t.  Issa was warehoused at a "residential treatment center." This is a form of care so utterly ineffective that even the head of the trade association for child welfare agencies, the Child Welfare League of America, had to admit that they lack “good research” showing its effectiveness and “we find it hard to demonstrate success…”[2] (He made these remarks in a pep talk to residential treatment providers, so it’s not surprising that he went on to blame the lack of success on the fact that children weren’t placed in RTCs soon enough). 

Issa is not paranoid, he's not schizophrenic, he's not delusional.  The only label pinned on him is Attention Deficit Hyperactivity Disorder.  Sometimes, at home, he was seriously out-of-control. But his handicapped, impoverished single mother couldn't do what middle-class and wealthy families do: find a good psychiatrist and hire home health aides. She couldn’t do that because the federal government does almost nothing to help pay for such alternatives.  But, in many cases, the federal government will gladly reimburse states between 50 and 83 cents for every one of the 86,000-or-more dollars it costs to keep children like Issa in his "RTC." 

Now consider another case, described in the cover story of the June, 2003 issue of the outstanding trade journal, Youth Today.  EMQ Children and Family Services used to be just like the place that warehoused Issa.  But 11 years ago, they admitted to themselves that what they were doing was not helping children.  So they shut down 100 of their 130 beds and came up with far better alternatives for the children.  They wound up helping more children at less cost and getting far better outcomes.[3]  Another institution, Youth Villages in Tennessee, won a national award for doing the same thing.[4]  Keep in mind that the children they helped in their own homes or foster homes are the very same children that the child welfare establishment – what I have come to call, “the foster care- industrial complex,” insists absolutely cannot be helped anyplace except in their institutions.

But both Youth Villages and EMQ encountered the same problem: For years, even though their alternatives were better and cheaper, they couldn’t get reimbursement from their states because of what Youth Today aptly characterized as opposition from “the group home industry.”  EMQ almost went out of business.

There are many cases that don’t involve institutions at all, but do involve needless use of foster care.  Here are a few:

• In Orange County, California, an impoverished single mother can’t find someone to watch her children while she works at night, tending a ride at a theme park.  So she leaves her eight-, six-, and four-year-old children alone in the motel room that is the only housing they can afford.  Someone calls child protective services.  Instead of helping her with babysitting or daycare, they take away the children on the spot.[5]
• In Akron, Ohio, a grandmother raises her 11-year-old granddaughter despite being confined to a wheelchair with a lung disease.  Budget cuts cause her to lose housekeeping help.  The house becomes filthy.  Instead of helping with the housekeeping, child protective services takes the granddaughter away and throws her in foster care for a month. The child still talks about how lonely and terrified she was – and about the time her foster parent took her picture and put it in a photo album under the heading: “filthy conditions.”[6]
• In Los Angeles, the pipes in a grandmother’s rented house burst, flooding the basement and making the home a health hazard.  Instead of helping the family find another place to live, child protective workers take away the granddaughter and place her in foster care.  She dies there, allegedly killed by her foster mother.  The child welfare agency that would spend nothing to move the family offers $5,000 for the funeral.[7]

Contrary to the common stereotype, most parents who lose their children to foster care are neither brutally abusive nor hopelessly addicted.  Far more common are cases like the ones above, cases in which a family’s poverty has been confused with child “neglect.” 

Why do states take children in these cases?  There are many reasons, but back in 1991, one of the most distinguished groups ever to examine the issue, the National Commission on Children, chaired by Sen. Rockefeller, found that children often are removed from their families "prematurely or unnecessarily" because federal aid formulas give states "a strong financial incentive" to do so rather than provide services to keep families together.[8]  That hasn’t changed.

Even the official journal of the Child Welfare League of America has reported that one-third of America’s foster children could be safe in their own homes right now, if their birth parents just had decent housing.[9] And that makes CWLA’s opposition to flexibility that much more disturbing.

Documentation for this, and other problems related to the widespread confusion of poverty with child “neglect” can be found in our Issue Papers at www.nccpr.org.

Other cases fall on a broad continuum between the extremes, the parents neither all victim nor all villain.  What these cases have in common is the fact that there are a wide variety of proven programs that can keep these children in their own homes, and do it with a far better track record for safety than foster care. Sometimes, these in-between cases involve substance abuse.  And that raises another question: Why even bother with parents – usually mothers -- in these cases?  But the reason to “bother” is not for the sake of the parents, but for their children.

University of Florida researchers studied two groups of infants born with cocaine in their systems.  One group was placed in foster care, the other with birth mothers able to care for them.  After six months, the babies were tested using all the usual measures of infant development: rolling over, sitting up, reaching out.  Consistently, the children placed with their birth mothers did better.[10]  For the foster children, being taken from their mothers was more toxic than the cocaine. 

It is extremely difficult to take a swing at “bad mothers” without the blow landing on their children.  If we really believe all the rhetoric about putting the needs of children first, then we need to put those needs ahead of everything – including how we may feel about their parents.  That doesn’t mean we can simply leave children with addicts – it does mean that drug treatment for the parent is almost always a better first choice than foster care for the child.

And every day we are seeing more evidence, most recently in research results from Washington State, that addiction to methamphetamine is just as treatable as any other addiction.[11]

That Florida study only hints at why avoiding foster care is so vitally important.  Last year, one of the groups opposing flexibility did a fine job of conjuring up all the old stereotypes: In a series of cookie-cutter reports released in different states with little beyond the name of the state, and the state chapter of the issuing organization, changed, they sought to have readers infer that children are taken only from sadistic brutes or hopeless addicts, and always are placed in, to use the phrase they repeated over and over “safe foster care.”[12]  Please beware of such “inference peddling.”

Most foster parents try to do the best they can for the children in their care, many are true heroes.  Nevertheless, often, foster care is not safe.  Sometimes it is not safe for the body; very, very often it is not safe for the soul.

One year ago, a prominent foster care provider, Casey Family Programs, and Harvard Medical School released one of the most ambitious studies ever conducted of foster care alumni.  Even as she spoke against flexibility, a representative from Casey Family Programs shared some of the alarming findings with you at a hearing last year.  But the case for flexibility is apparent in some of the findings she didn’t get to, that are even more shocking.  Fully a third of the former foster children said they’d been abused by a foster parent or another adult in a foster home.  (The study did not even ask about one of the most common forms of abuse in foster care, foster children abusing each other).  Overall, when looking at a series of measures of how these young people were functioning, only one in five could be said to be doing well.[13] 

I cannot fathom why some of my fellow liberals are so wedded to locking away billions of dollars and restricting those dollars to funding a system that churns out walking wounded four times out of five.

Some might reply that we can “fix” foster care – if only we spent even more money on it. Perhaps that’s why one leading opponent of flexibility was quoted in Youth Today as saying that “reducing foster care caseloads should never be an end in itself.”[14]  That comment was made by one of the finest child advocates I’ve ever known, one of the few people in Washington whose record over the years truly deserved the overused title, champion for children.  But on that statement, we could not disagree more.

Safely reducing foster care should be an end in itself, and it is a noble end, for it will spare thousands and thousands of children the emotional torment of separation from everyone they know and love.

And there is no “fix” for that torment.  That same alumni study used an elaborate mathematical formula to calculate how much better the rotten outcomes for foster children would be if everything about foster care were magically fixed.  The answer: 22.2 percent.  In other words, if you could wave a magic wand and make foster care perfect, it would churn out walking wounded three times out of five instead of four.

That’s worth doing.  But the real lesson of that study, and 150 years of experience with substitute care, is that the only way to fix foster care is to have less of it.  And to my friends on the right: If you’re thinking orphanages, a century of research says their outcomes are even worse.[15]

Financial incentives at the federal, state and sometimes local level – plus the power of the “foster care-industrial complex” marginalize drug treatment, and housing assistance, and day care, and all the other safe, proven alternatives to substitute care – all the ways to fix foster care by having less of it.   

The Administration proposes to change that.  I will not go into the details of the plan here – to the extent that we know them –  the Subcommittee already is familiar with them.  There are reasonable questions about this plan, involving arcane but important details you have heard about before.  They fall under headings like "maintenance of effort" and "eligibility lookback."  And there is one part of the plan with which we disagree.  For reasons discussed in more detail below, we oppose the use of TANF money for an emergency foster care fund, even though we believe such a fund would be used very rarely.

Last year, one member of this subcommittee complained about the fact that there is a plan but no legislative language.  That’s a fair complaint.  But that is also a reason to support the position originally taken by Sen. Clinton in a famous USA Today op ed column she co-authored with Rep. DeLay: that the plan deserves “careful consideration.”[16]  Such consideration is, of course, impossible if the plan is rejected before one even sees legislative language. But in much of the child welfare community, the response to this proposal boils down to: "Whatever it is, we're against it."

In some cases, that sounds like naked self-interest.  Of course CWLA is opposed - their member agencies hold children in foster care.  The Residential Treatment Center that held Issa so long and so needlessly is a prominent member – though I am pleased to report that in the years since I first raised this case in written testimony, that Center has hired a bold, visionary executive director who is trying to break with the agency’s past.

States and localities typically tell these agencies that their first job is to return these children safely to their own homes or, if that is not possible, find them adoptive homes.  But if they do that, those same states and localities will stop paying them.  The states say they want permanence, but they pay for limbo, reimbursing agencies for every day they hold children like Issa in foster homes or institutions.

Agencies piously proclaim that they would never, ever hold a child in foster care just because their parents are poor.  Similarly, it has been argued that the people in the system are simply too good and too decent to ever let money affect how they do their jobs.

Most of the people in the system are good and decent – certainly they are not jack-booted thugs who relish destroying families.  But we have seen over and over in all sorts of endeavors that lousy financial incentives can force good people to do bad things.

Most doctors and hospital administrators are as dedicated and caring as people in child welfare.  Yet it is now well-established that when hospitals are paid for every day they hold a patient they tend to hold patients too long.  And when doctors are paid on a pure fee-for-service basis, you are more likely to see unnecessary surgery.  Conversely, a pure HMO arrangement can deny patients hospitalization and surgery they really need.  There is an urgent need for balance - -but what is indisputable is: Financial incentives matter.

Why do some good, loving parents surrender their children to foster care when it’s the only way to get mental health care?  Not because they’re evil.  But because money leaves them no other choice.  Financial incentives matter.

Why did Sen. Rockefeller’s National Commission on Children, which examined these issues so thoroughly, find that children were removed from their homes “prematurely or unnecessarily”?  Because, they found, financial incentives matter.

Why did the Pew Commission on Foster Care zero in on how child welfare is financed as one of two key areas for reform? Because they realized financial incentives matter.

Congress provides millions of dollars in bounties every year, payable to states that increase the number of adoptions over the pervious year’s total.  So Congress knows: Financial incentives matter.

And to see how much they matter, one need look no further than Illinois, where changing financial incentives is the lynchpin of a reform effort that transformed that state’s child welfare system from a national disgrace into a national model.

In 1997, Illinois had 51,000 children in foster care – proportionately more than any other state.  Today, the foster care population in Illinois is under 18,000[17] – and, proportionately, below the national average.  At the same time, and this is most important, child safety has improved.

If you thought that was all due to adoption, it’s understandable. Since that’s the part of the story that is most popular politically, for many year it was the part that state officials liked to tell the most.  But the biggest changes in Illinois are that the state is taking far fewer children in the first place[18] – and it has changed financial incentives to get children back into their own homes faster.

Illinois no longer simply pays private agencies for each day they hold a child in foster care.  Instead, they’ve switched to a system they call “performance-based contracting.”  Agencies are rewarded for keeping children safely in their own homes or finding them adoptive homes.  They are penalized for letting children languish in foster care.  Once Illinois changed the payment system, lo and behold: The “intractable” became tractable, the “dysfunctional” became functional, the foster care population plummeted and, independent court-appointed monitors found that child safety improved.  Remember, these are the same children that those good, caring people said absolutely had to be in foster care, back when the financial incentives encouraged foster care.

No one is harder on agencies than the lawyers who bring class-action lawsuits to reform them.  In Illinois, the lawsuit that transformed child welfare was brought by Ben Wolf of the Illinois Branch of the ACLU.  Says Mr. Wolf:

“Performance contracting was the centerpiece of the reforms here.  In conjunction with the retraining and restructuring of the front-end investigations and initial removal decisions, it was the key reason that our system was able, consistent with safety, to become so much smaller.  Performance contracting was the principal reason that so many thousands of children were able to achieve permanency.”[19]

Some have argued that the very fact that Illinois managed to do this under the current system shows that there is no need to change federal financial incentives.  However:

• Illinois is an exception.  It required rare and extraordinary guts and imagination, combined with an unprecedented child welfare crisis – and the class-action lawsuit -- before the state could summon the strength to fight its “foster care-industrial complex” and accomplish real reform.
• Illinois was among the first states to take advantage of waivers and among the most creative in their use.  That option, of course, doesn’t even exist at the moment.

In order to accomplish its reforms, Illinois had to swim against the tide of federal policy as reflected by where the federal government puts its money.  If we really want to change child welfare and improve the prospects of America’s most vulnerable children, then the tide of federal policy needs to turn toward reform, so states that want to do better are swimming with the tide instead of against it.

This doesn’t mean that agency executives sit around a table clasping their hands and chortling with glee as they contemplate how to hold more children in foster care.  It’s much more subtle than that.  Rationalization is powerful – it’s easy to convince yourself that residential treatment really works when it doesn’t, or that those birth parents are so awful that this child really could use a few more months in foster care anyway.

A major study of child welfare in Milwaukee found that large numbers of children could be home if their parents just had decent housing.  But caseworkers were, to use that favorite child welfare term -- in denial -- about it.

According to the study: “workers may simply not be in a position to provide assistance with housing due to a lack of resources.  If this is true, they may tend to ignore housing as a problem rather than deal with the cognitive dissonance caused by the recognition that they cannot help their clients with this important need…”[20]

Similarly, because funding has been so skewed toward foster care for so very long, those very good frontline workers who do recognize that, for example, housing might save a child from foster care often believe they have no choice.  There’s no money for housing – there’s always money for foster care. As Dr.  Fred Wulczyn, Research Fellow at the Chapin Hall Center for Children told this subcommittee last year: “Once funding is tied up in the foster care system, redirecting foster care dollars when it is advantageous to do so is difficult.”[21]

Of course, financial incentives aren’t the only incentives pushing needless foster care.  There are the incentives caused by fear and loathing of birth parents – the false stereotypes that lead to assumptions that every child in foster care really needs to be there.  There are the incentives caused by highly-publicized deaths of children “known to the system” which can set off foster-care panics -- huge spikes in needless removals of children – which only divert scarce resources from finding children in real danger and actually lead to increases in child abuse deaths.  And there is the constant pressure of the foster-care industrial complex; agencies with their prominent boards of directors woven into a community’s business and civic elite.

For all of these reasons foster care is the path of least resistance.  And that’s the answer to another question raised by critics of flexible funding: Why don’t states just use the flexible funding options they have now like TANF and the Social Services Block Grant?  If some foster care is unnecessary, why are these dollars being used to fund it?  Because it’s easier, that’s why.  With all these incentives for needless foster care, it’s urgent to create a counter-incentive – something to make agency leaders think twice before encouraging a foster-care panic, for example.  The Child Welfare Program Option plan does that.  By making IV-E foster care maintenance funding flexible, it allows states to begin to build the infrastructure of prevention and family preservation that reduces needless use of foster care.  With the demand for foster care reduced – and the savings generated by prevention, which costs less than foster care -- states can begin to put their TANF and SSBG money back where it belongs, into safe, proven programs to support vulnerable children and families.  (As discussed below, when it comes to TANF, I suggest a stick as well as a carrot).

As I said, the misuse and overuse of foster care is rarely a conscious act.  But sometimes, it is.  Every once in awhile the mask slips.

The mask slipped when a social worker who deals extensively with New York’s private agencies stated in a sworn affidavit that “I have been advised by a foster-care agency caseworker that her facility has imposed a three-month moratorium on discharges, because it was not receiving sufficient referrals to fill its beds.”[22]

The mask slipped when an agency in Maine told foster parent Mary Callahan why she couldn’t adopt two foster children.  The worker told her: "Let's say we need 60 kids to make payroll and we only have 61.  We wouldn't be talking adoption or reunification with anybody until we got our numbers up."[23]

And the mask slipped last month in Michigan.

 Michigan is planning to make extensive use of the Family to Family program, which seeks to avoid foster care placement and, when such placement is necessary, keep children with their extended families, in their own neighborhoods.  That way, they are surrounded by friends, teachers, classmates and loved ones, visiting is easier, and foster parents can act as mentors to birth parents.  (Family to Family is an initiative of the Annie E. Casey Foundation which also helps to fund my organization, and should not, by the way, be confused with Casey Family Programs).

But the Associated Press reports that late last month, representatives of private foster care agencies trooped up to Lansing to oppose the program, telling a legislative committee that children should continue to be placed with total strangers far from home, because the strangers lived in better neighborhoods with better schools.[24]  Apparently, the fact that this is exactly what we’ve been doing for about 150 years, with horrible results, did not faze them.  The dreadful educational outcomes for foster children did not faze them.  And neither did the fact that, while every child should get to go to a good school, it is obscene to suggest that a child should have to trade in his family for the privilege.

So yes, most people in the system, especially on the frontlines, mean well.  But it also is worth bearing in mind the words of one of the most distinguished experts in the field of child welfare and mental health, Dr. Ronald Davidson. Dr. Davidson is director of the Mental Health Policy Program at the University of Illinois at Chicago Department of Psychiatry.  He’s been a consultant to the successful reforms in Illinois and was instrumental in getting the main campus of the state’s largest orphanage – once thought to be a model, but actually rife with abuse – effectively shut down.

Says Dr. Davidson: “Sadly, there is a certain element within the child welfare industry that tends to look upon kids in the way that, say, Colonel Sanders looks upon chickens …”

You have undoubtedly heard and read a great deal about the “addiction” problem in child welfare. But the biggest addiction problem in child welfare isn’t substance-abusing parents, though that problem is serious and real.  The biggest addiction problem in child welfare is politically powerful, old-line, well-established child welfare agencies with blue-chip boards of directors that are addicted to per-diem payments These agencies are putting their addiction ahead of the children.

And the biggest “enabler” of this addiction is the federal government, with its “open spigot” of money for substitute care, and far, far less for anything other than substitute care.

Breaking an addiction is extremely difficult.  One first has to get past the addict’s denial.  So it’s no wonder that so much of the foster care-industrial complex opposed the Child Welfare Program Option without even seeing it.

And some of the opposition to this proposal has consisted of a shameful collection of fear, smear, and scare stories.  At one point, one prominent opposition group even told its members that the plan would “dismantle” foster care.  That’s a great way to rally the base - - but it’s flat wrong.

• First of all, this is not a “block grant” in any meaningful sense of the term.  Under a block grant, several different funding streams are combined, states are allowed to use the money for any purpose covered by any of those funding streams – and, often, some money is cut from the total.

In contrast, this plan involves only one portion of one funding stream – Title IV-E foster care funds.  This money could be spent on prevention and adoption.  But the other funding streams remain separate.  Title IV-B funds for prevention, for example, cannot be used for foster care.  This “IV-B firewall” is a crucial feature of the plan.    Were IV-B and IV-E to be combined, the “foster care-industrial complex” would grab the prevention money to use for more foster care.  In fact, just such a shameful grab of funds intended to help families has occurred in the Temporary Assistance for Needy Families program, something I discuss below.

Flexibility cannot be absolute.  It must always be in the direction of helping the most vulnerable, not helping powerful special interests.  The Administration plan recognizes this.  In the absence of this firewall we would oppose the plan.  Indeed, the lack of such a firewall is the fatal flaw in the much more tepid recommendations from the Pew Commission.

• Second, this plan not only does not cut funding, in some cases, funding may go up.  Under this plan, states would receive the same, agreed-upon amount of money for each of the five years.  In contrast, states that stick with the status quo will find that the proportion of foster care costs covered by the federal government will decrease, as a result of the “eligibility lookback.”

Furthermore, while some have criticized the five-year commitment that would be required of states that choose to take part in the plan, that same five-year commitment means the funding level is guaranteed.  In contrast, the existing entitlement formula can be changed whenever Congress so chooses.  So it is ironic indeed that critics argue that the Administration plan is more vulnerable to cuts because it is a so-called “block grant.”  In fact, it is the status-quo that is more vulnerable to cuts.

• And perhaps most important, this plan is strictly voluntary.  Though states that opt in must stay in for five years, any state that feels it’s not getting a good deal can walk away from the table and stick with the status quo. If the fine print matches the broad outlines, governors and child welfare leaders who have the guts and imagination to try something with so much potential to do so much good, should have the right to do so, without being held back by their timorous colleagues and a foster care establishment with a huge vested interest in the status quo.

This year, three governors stepped forward.  As I noted at the outset, those governors are Jeb Bush of Florida, Arnold Schwarzenegger of California, and Jennifer Granholm of Michigan.  It would be hard to find three governors with more diverse perspectives.  It’s hard to imagine all of them agreeing on anything.  Yet all three have realized that it is a crime against children to force them to be separated from everyone they know and love, just because that’s the only way to get huge amounts of federal aid for their care.  All three have decided that the flexibility embodied in the Administration proposal is the best way to help their state’s vulnerable children. But all three had to go through a long, cumbersome waiver process to get this flexibility – a waiver process which, at the moment, no longer exists.

If another governor wants to step forward to help her or his state’s vulnerable children in the same way, why should she or he be denied that chance?  More important, why should that state’s children be denied the chance to escape the tragedy of needless foster care?

As I said at the outset, there are reasonable questions about this plan.  But because the plan is strictly voluntary, it doesn’t have to be perfect to be worth offering to the states.

Some of my friends on the left sometimes suggest that we should deny states this crucial flexibility in favor of this or that alternative bill.  These alternative bills often have some very good provisions.  Often, they would make fine additions to flexibility – but they are no substitute for it, because all of the proposals I’ve seen leave intact or even enhance the giant, open-ended, untouchable entitlement for substitute care.  That is a waste of money.  More important, it is a waste of children’s lives.  My friends on the left say “spend more.”  The Administration plan says: “spend smarter.”  We need to do both.

I have spent all of this time discussing an area where there is not enough flexibility.  Now I want to discuss an area where there has been too much: TANF.

It should be among the bigger scandals in child welfare - - though it’s perfectly legal.  But so far, I know of only one newspaper, The Hartford Courant, that has reported on it.[25]  Here’s how it works:

An impoverished single mother, desperate to keep her low-wage job leaves her children home alone because she can’t find day care she can afford.  She can’t get day care because federal aid that might provide such day care has been transferred elsewhere.  The children are taken away on a “lack of supervision” charge.  They are placed in foster care.  The foster parents and the bureaucracy supporting them, and the child abuse investigator, all are paid in part using the money diverted from low-income day care.

It happens because the federal government allows some states to use TANF surplus funds to finance foster care and even child abuse investigations.  The Courant reports that in Connecticut alone $129 million in TANF money has been diverted from basic, concrete help to keep families together into the foster care system that tears them apart. 

Peg Oliveira, a policy fellow and early child-care expert for Connecticut Voices for Children told the Courant: "Instead of using funds in a proactive way and helping families achieve self-sufficiency, they let things happen because they don't spend on child care and then try to fix it on the back end through [the child welfare agency].”

For various arcane reasons, not every state is allowed to use TANF money for foster care.  But nationwide, the Urban Institute estimates that $2.7 billion in TANF money was spent on child welfare services in the 2002 federal fiscal year.  Furthermore, of the total amount states spent on out of home care, 28 percent of the money came from TANF – again, a program created to help poor families become self-sufficient.[26]

That’s not always wrong.  Some states use this money to help grandparents and other relatives provide kinship care.

Ideally, that should not be necessary.  My friends on the left are correct in pushing to eliminate barriers to using IV-E to pay relatives at the same rate as strangers.  But until that happens, TANF is a legitimate source for such funding – because it supports families, and it supports an option that has consistently proven better for children and safer than what should properly be called “stranger care.”[27]

 But other states, like Connecticut, actually use TANF to subsidize foster care with strangers and child abuse investigations.  Congress should close the loophole that allows this.

Two final points:

• First, it is reasonable to work to link funding to outcomes.  But beware of any proposal that uses the Child and Family Services Reviews to measure those outcomes.  It is not true that a bad scorecard is better than no scorecard, and the CFSRs are dreadful.  The 50-case sample size means state performance can appear to be improving when it’s actually getting worse and vice versa.  Some CFSR outcome measures actually reward poor performance and punish success in keeping families together. And that’s only the beginning. There is more in our publication, The Trouble with CFSRs, also on our website, www.nccpr.org
• And finally, a word about one of the most important questions you’ve posed at this hearing: What services achieve improved child outcomes – or rather, make that four words: Intensive Family Preservation Services (IFPS).  The very term “family preservation” was invented to describe this kind of program.  The first IFPS program, Homebuilders®, was invented in Washington State in the mid-1970s.  The program is discussed in detail in NCCPR Issue Papers 1, 10 and 11, on our website.

But while Homebuilders is a trademark, “family preservation” is not.  Any child welfare agency can call anything it wants a “family preservation” program, even if it is nothing like the Homebuilders model.  The biggest problem probably is “dilution” of the model – agencies try to cut corners by taking the intensity out of Intensive Family Preservation Services.  Another problem is the failure of many programs to follow the Homebuilders emphasis on concrete help to ameliorate the worst effects of poverty.

And that has played into the hands of a child welfare establishment that is threatened by any alternative to foster care.   There are several studies showing the effectiveness of Homebuilders-type programs.  Some of them are summarized in our Issue Papers at www.nccpr.org  But proponents of a “take the child and run” approach to child welfare ignore them, while trumpeting any evaluation of an alleged “family preservation” program that finds the program doesn’t work -- without drawing a distinction between the Homebuilders model and others.

A new review of the literature draws that distinction.  It was conducted by the Washington State Institute for Public Policy and it’s available here: http://www.wsipp.wa.gov/rptfiles/06-02-3901.pdf

The authors conclude: "IFPS programs that adhere closely to the Homebuilders model significantly reduce out-of-home placements and subsequent abuse and neglect. We estimate that such programs produce $2.54 of benefits for each dollar of cost. Non-Homebuilders programs produce no significant effect on either outcome."

Of course, to fully realize those benefits, states need the flexibility to use money now restricted to foster care on safe, proven alternatives such a Homebuilders - -which brings us back to where we started.

Thank you Mr. Chairman and members of the Subcommittee.  I would be pleased to respond to any questions.

[1]Leah Rae and Shawn Cohen , “Issa’s story: a mother’s love isn’t enough,” The Journal News, Westchester County, New York, October 28, 2006.

[2] Shay Bilchik, “Residential Treatment: Finding the Appropriate Level of Care,” Residential Group Care Quarterly, Vol. 6 No. 1, Summer, 2005 (Washington: Child Welfare League of America).

[3] Martha Shirk, “The Gift of Wrapping,” Youth Today, June, 2003, available online at http://www.youthtoday.org/youthtoday/a%20june2003/story2.html

[4] Bill Alexander, “Radical Idea Serves Youth, Saves Money,” Youth Today, June, 2001.

[5]Laura Saari, “Checking Up on the Children,” Orange County Register, Jan. 17, 1999, p.E1.  

[6]Donna J. Robb, “Child Abuse Charge Unfair, Group Says” The Plain Dealer, March 11, 1998, p.1B.

[7]Nicholas Riccardi, “Grandmother Blames County in Latest Death of Foster Child” Los Angeles Times, June 15, 1999, p.B1.

[8]National Commission on Children, Beyond Rhetoric: A New American Agenda for Children and Families, (Washington, DC: May, 1991) p. 290.

[9]Deborah S, Harburger with Ruth Anne White, “Reunifying Families, Cutting Costs: Housing – Child Welfare Partnerships for Permanent Supportive Housing,” Child Welfare, Vol. LXXXIII, #5 Sept./Oct. 2004, p.501.

[10]Kathleen Wobie, Marylou Behnke et. al., To Have and To Hold: A Descriptive Study of Custody Status Following Prenatal Exposure to Cocaine, paper presented at joint annual meeting of the American Pediatric Society and the Society for Pediatric Research, May 3, 1998.

[11] Bill Luchansky, Ph. D, Treatment for Methamphetamine Dependency is as Effective as Treatment for Any Other Drug  (Olympia, WA: Looking Glass Analytics, December 2003) available online at http://www1.dshs.wa.gov/word/hrsa/dasa/ResearchFactSheets/LuchanskyMethFS1504.doc.  See also: Martha Shirk, The Meth Epidemic: Hype vs. Reality, Youth Today, October, 2005, available online at http://www.youthtoday.org/youthtoday/oct05/story2_10_05.html

[12] e.g., Abandoning Ohio’s Most Vulnerable Kids: Impact on Crime of Proposed Federal Withdrawal of Foster Care Funding Pledge: A report from Fight Crime: Invest in Kids Ohio, undated, 2005, Abandoning Oregon’s Most Vulnerable Kids: Impact on Crime of Proposed Federal Withdrawal of Foster Care Funding Pledge: A report from Fight Crime: Invest in Kids Oregon, undated, 2005, Abandoning Iowa’s Most Vulnerable Kids: Impact on Crime of Proposed Federal Withdrawal of Foster Care Funding Pledge: A report from Fight Crime: Invest in Kids, undated, 2005, and Keeping the Promise of a Safe Home for Northern California's Children: The Impact on Child Abuse and Future Crime of Capping Federal Foster Care Funds: A report from Fight Crime: Invest in Kids California. (By the time they got to Rep. Herger’s district, they changed the title, but it’s essentially the same report). 

[13]  Casey Family Programs / Harvard Medical School, Improving Family Foster Care: Findings from the Northwest Foster Care Alumni Study, (Seattle, WA: 2005).  Available online at http://www.casey.org/NR/rdonlyres/4E1E7C77-7624-4260-A253-892C5A6CB9E1/300/nw_alumni_study_full_apr2005.pdf

[14] “Foster Funding Overhaul on the Way?” Youth Today, September, 2004.

[15] Thirty-nine studies documenting these rotten outcomes are cited in Richard Wayman, Clinical Studies, Survey Review and Pediatric Research on Risks and Harm to Children and Youth Subjected to Large, Residential Institutions, a literature review available from NCCPR.

[16] Sen. Clinton and Rep. DeLay wrote:  “President Bush has offered one proposal that deserves careful consideration. He wants to give states an option to change the way foster care is financed so they can do more to prevent children from entering foster care, shorten the time spent in such care and provide more assistance to children and their families after they leave the system.” Hillary Rodham Clinton and Tom DeLay, “Easing foster care’s pain unites disparate politicians,” USA Today, February 26, 2003.

[17] See the Monthly Executive Statistical Summary published by the Illinois Department of Children and Family Services for the latest totals; previous editions document the total in 1997.

[18] Ibid.

[19] Personal communication.

[20]Mark E. Courtney, et. al., “Housing Problems Experienced by Recipients of Child Welfare Services,” Child Welfare, note 9, supra., p.417

[21] Testimony of Fred Wulczyn, Chapin Hall Center for Children, before the House of Representatives, Committee on Ways and Means, Subcommittee on Human Resources, Hearing on Federal Foster Care Financing, June 9, 2005, available online at http://waysandmeans.house.gov/hearings.asp?formmode=view&id=2765

[22]Affidavit of Barbara Winter, M.S.W., C.S.W., Hauser v. Grinker Index #16409/89, Supreme Court of the State of New York, County of New York, June 6, 1990, p.20.

[23] Personal Communication.  See also, Bonnie Washuk, “DHS must change, walkers insist,” Lewiston (Me.) Sun-Journal, December 9, 2003.

[24] David Eggert, “Private homes criticize state's approach to foster care,” Associated Press, April 26, 2006.

[25] Colin Poitras, “Child Care Funds Lacking,” Hartford Courant, March 25, 2006.

[26] Cynthia Andrews Scarcella, et. al., The Cost of Protecting Vulnerable Children IV (Washington,DC: The Urban Institute: 2004), available online at http://www.urban.org/UploadedPDF/411115_VulnerableChildrenIV.pdf

[27] University of Illinois Children and Family Research Center, Family Ties: Supporting Permanence for Children in Safe and Stable Foster Care with Relatives and Other Caregivers, available online at http://www.fosteringresults.org/results/reports/pewreports_10-13-04_alreadyhome.pdf