COMMITTEE ON WAYS AND MEANS BILL THOMAS, California, Chairman
PHILIP M. CRANE, Illinois E. CLAY SHAW, Jr., Florida NANCY L. JOHNSON, Connecticut AMO HOUGHTON, New York WALLY HERGER, California JIM MCCRERY, Louisiana DAVE CAMP, Michigan JIM RAMSTAD, Minnesota JIM NUSSLE, Iowa SAM JOHNSON, Texas JENNIFER DUNN, Washington MAC COLLINS, Georgia ROB PORTMAN, Ohio PHIL ENGLISH, Pennsylvania WES WATKINS, Oklahoma J. D. HAYWORTH, Arizona JERRY WELLER, Illinois KENNY C. HULSHOF, Missouri SCOTT MCINNIS, Colorado RON LEWIS, Kentucky MARK FOLEY, Florida KEVIN BRADY, Texas PAUL RYAN, Wisconsin	CHARLES B. RANGEL, New York FORTNEY PETE STARK, California ROBERT T. MATSUI, California WILLIAM J. COYNE, Pennsylvania SANDER M. LEVIN, Michigan BENJAMIN L. CARDIN, Maryland JIM MCDERMOTT, Washington GERALD D. KLECZKA, Wisconsin JOHN LEWIS, Georgia RICHARD E. NEAL, Massachusetts MICHAEL R. MCNULTY, New York WILLIAM J. JEFFERSON, Louisiana JOHN S. TANNER, Tennessee XAVIER BECERRA, California KAREN L. THURMAN, Florida LLOYD DOGGETT, Texas EARL POMEROY, North Dakota
Allison Giles, Chief of Staff Janice Mays, Minority Chief Counsel  SUBCOMMITTEE ON HUMAN RESOURCES WALLY HERGER, California, Chairman
NANCY L. JOHNSON, Connecticut WES WATKINS, Oklahoma SCOTT MCINNIS, Colorado JIM MCCRERY, Louisiana DAVE CAMP, Michigan PHIL ENGLISH, Pennsylvania RON LEWIS, Kentucky	BENJAMIN L. CARDIN, Maryland FORTNEY PETE STARK, California SANDER M. LEVIN, Michigan JIM MCDERMOTT, Washington LLOYD DOGGETT, Texas
Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public hearing records of the Committee on Ways and Means are also published in electronic form. The printed hearing record remains the official version. Because electronic submissions are used to prepare both printed and electronic versions of the hearing record, the process of converting between various electronic formats may introduce unintentional errors or omissions. Such occurrences are inherent in the current publication process and should diminish as the process is further refined.

American Public Human Services Association, Betsey Rosenbaum

Casey Family Services, Raymond Torres

Florida Department of Children and Families, Hon. Kathleen A. Kearney

Maryland Department of Human Resources, Linda E. Mouzon

Merrill, Sonya, Connecticut Department of Mental Retardation and Direct Care

Michigan Family Independence Agency, James E. Beougher

Wulczyn, Fred H., Chapin Hall Center for Children, University of Chicago

American Bar Association, Center on Children and the Law, Eva J. Klain, and Martha W. Barnett, statement

Conference of State Court Administrators, Arlington, VA, David K. Byers, statement and attachment

National Family Preservation Network, Buhl, ID, Priscilla Martens, statement

Prevent Child Abuse America, Chicago, IL, statement

PROMOTING SAFE AND STABLE FAMILIES PROGRAM

House of Representatives,
Committee on Ways and Means,
Subcommittee on Human Resources,
Washington, DC.

The Subcommittee met, pursuant to notice, at 1:05 p.m., in room B-318 Rayburn House Office Building, Hon. Wally Herger (Chairman of the Subcommittee) presiding.

[The advisory announcing the hearing follows:]

Chairman HERGER. Good afternoon, and welcome to today's hearing on the Promoting Safe and Stable Families program.

The purpose of our hearing today is threefold. First, we will explore how States have used Safe and Stable Families funds, for example, to help children at risk of abuse or neglect. Second, we will examine what services make the biggest difference for families at risk or involved with the foster care system. And, third, we will consider what this all means as we head towards reauthorization later this year.

This Subcommittee played a key role in 1997 when, through the Adoption and Safe Families Act, we set the terms of the Safe and Stable Families program. That law sent a strong bipartisan message that children should not languish in foster care for so long that they have little hope of finding a permanent home. Since the Adoption and Safe Families Act was enacted, adoptions are up from 28,000 in 1996 to 48,000 in 1999, and child maltreatment is down nearly 7 percent. So it appears we are heading in the right direction. I would like to thank Mr. Camp especially for his continuing service on behalf of children in foster care.

We are pleased to have a number of extremely able witnesses with us today who know what happens when Federal dollars leave Washington and reach families in crisis. But in addition to our review of funding and services and the like, I hope we will also focus on what this all means for children.

Consider the story of an infant whom I will call Trina. Trina was the fifth of six children born to a mother addicted to crack cocaine. Trina's mother made her living on the streets. When Trina was born, her older brothers and sisters were already in foster care after being found in a filthy and unattended apartment with no food, a butcher's knife on the floor, and no toilet paper or diapers in the house. But their mother insisted she would be back on her feet soon, she just needed some time. So Trina's older siblings remained in foster care for more than 6 years.

Trina, however, has been adopted by a loving family. In contrast, two of her older siblings, after bouncing around the system, will age out of foster care without ever experiencing the safety and stability of a safe and permanent home.

It is hard to imagine all the ways Trina's life and prospects will be improved by living in a permanent, loving home. Now imagine the heartache and hurdles her older siblings, without that simple advantage, will have to overcome. We surely do not want to give up on any parent, but with the clock ticking on childhood, time is crucial and must not be wasted. So we will be very interested in whether children at risk are benefiting from recent changes and what more can be done to help them.

Without objection, each member will have the opportunity to submit a written statement and have it included in the record at this point.

Mr. Cardin, would you like to make an opening statement?

[The opening statement of Chairman Herger follows:]

Mr. CARDIN. Thank you, Mr. Chairman; and I, too, want to thank you for holding this hearing today as we look at the Promoting Safe and Stable Families program.

This Committee has a very proud record of trying to help our most vulnerable children. We were successful in the last Congress in working in a very bipartisan way to deal with children aging out of foster care. I think it is a result of the action of this Committee that we now have a stronger partnership with our States in dealing with this vulnerable group of children, and I would hope that we will have the same cooperation on this legislation. I am very encouraged by the President suggesting that we increase the funding by a billion dollars over the next 5  years.

Mr. Chairman, I want you to know, speaking for the Democrats, we want to work with you to pass legislation quickly for this increased funding so it can get out and help the people that need this assistance.

Currently this year, the program will be providing $305  million to our States to provide programs for family preservation services for children and families that are at risk or in crisis, community-based family support services to help prevent abuse or neglect, time-limited family reunification services and adoption promotion and support activities. So it is a pretty broad availability of programs that can be funded through this Federal program, and we look forward with you to bringing out legislation that will increase the authorizations so that we can make extra money available to these programs.

Mr. Chairman, I just want to mention one other area that I would hope that we would take a look at, and that is the link between substance abuse and child abuse. We have a crisis that we need to deal with, and we need to provide additional help to our States to deal with this issue. We know that somewhere between 50 to 80 percent of the parents of children who enter the child welfare system are substance abusers. We know there is a direct relationship between being a substance abuser and abuse of children. So I would hope that we would also figure out a way to provide additional help and resources in this direction.

So, Mr. Chairman, I look forward to working with you in a bipartisan way so that we can bring legislation to the floor as quickly as possible.

[The opening statement of Mr. Cardin follows:]

Chairman HERGER. Thank you, Mr. Cardin.

Before we move on to our testimony this afternoon I would like to remind witnesses to limit their oral statements to 5 minutes. However, without objection, all the written testimony will be made a part of the permanent record.

Will the witnesses please have a seat at the table. On today's panel we will hear from Betsey Rosenbaum, Director of Children and Family Services for the American Public Human Services Association.

Mr. CARDIN. If you can find your names. Fortunately, we are not videotaping this.

While there is a break I want to welcome Linda Mouzon, if I might, who is the Executive Director of the Social Services Administration for the Maryland Department of Resources. It is a pleasure to have you with us.

Mr. CAMP. If I might also, James Beougher, who is the Director of Child and Family Services Administration for the Michigan Family Independence Agency, I would like to welcome him as well and look forward to his testimony. Thank you.

Chairman HERGER. Thank you, Mr. Camp.

We do welcome you, Mr. Beougher; and we are very pleased to have the former chairman of this Subcommittee, Congressman Shaw. And Mr. Shaw -- Congressman Shaw, would you like to introduce one of your constituents?

Mr. SHAW. Yes, I certainly would. It is a constituent that we in Florida and certainly in my own city of Ft. Lauderdale are extremely proud of, and this is Judge Kathleen Kearney, who is no stranger to this Committee. She was very helpful to you in many areas of legislation having to do with adoption, having to do with foster care. She has a very distinguished record and now is the Secretary of the Florida Department of Children and Families, having been appointed in January of 1999 by Governor Jeb Bush.

I really got to know Judge Kearney very well during the period of very troubling time in Broward County, Florida, where we found that kids were lingering in foster care for extraordinarily lengths of time. I can tell you this is one lady you do not want to get on the wrong side of. And they got on wrong side of her, and she cleaned that mess up very, very quickly, both in her present position and also as a judge. She has been extraordinary. She has been just a tremendous resource and a spokesman for children.

This particular Committee does wonderful work, and I think it is not known for what we do, the wonderful things we do for families and children in this Committee. I commend you for having this hearing. I compliment you for inviting Ms. Kathleen Kearney back to testify before us.

Mr. CARDIN. Would the gentleman yield for just a minute? I would like to join you in welcoming Judge Kearney. I was going to give her an honorary position in our Committee, she has been here so often testifying.

Mr. SHAW. Well, I would accept that as your introduction. But I can tell you she was a great personal advisor to me when I chaired this Committee, and I am sure she is a wonderful resource for you to have with you here today.

Thank you. Appreciate you giving me the privilege of introducing her.

Chairman HERGER. Thank you very much, Mr. Shaw.

We appreciate having you with us, Judge Kearney. Also very pleased to have Linda Mouzon, Executive Director of the Social Services Administration for the Maryland Department of Human Resources; Dr. Fred Wulczyn of the Chapin Hall Center for Children, Chicago, Illinois.

And, Mrs. Johnson, would you like to introduce --

Mrs. JOHNSON. I would like to welcome Mr. Torres and Ms. Merrill to our hearing today.

First of all, it is a great pleasure to have you here from the Casey Family Services. You have done such a wonderful job of a creative response and a kind of allied relationship to some of our teenagers. It is so important to their growing up to be adults. It was really a pleasure to sit at the -- oh, shucks, what is the organization's name about adopted children that gives the dinner every year?

Mr. TORRES. North American Council on Adoptable?

Mrs. JOHNSON. No, I will get it in a minute. But I sat with one of the kids in Connecticut who had come through your program -- well, actually, he had been saved by your program. The problem is that he wasn't coming up through the foster care program. And really the opportunity that you give children and the support you give parents, adoptive parents and foster care parents and the independent living program, through those means to these children is really fantastic and has changed the course of life events for our young people in Connecticut.

And, Ms. Merrill, I just am -- it is a great pleasure to welcome you, but I really am in awe and admiration of your ability not only as a professional in the mental health area but also as a human being to be willing to not only provide foster care for older children, yourself adopt, devote yourself to foster care and adoption services to support families. They are very few out there who actually adopt older children from the foster care system. And you have done it with the not only great heart but from a professional -- with professional training that has been a tremendous asset to the young lives that you have touched.

Orphan Foundation, that is it. It is a name I hate. But it is true when you talk to these kids that is exactly what they are and what they have to contend with being.

So I really appreciate both of your being here, and I know the Committee will benefit from your input. And, Judge Kearney, it is indeed a pleasure to welcome you. You have been a great service to this Committee.

Chairman HERGER. Thank you very much. With that, we will begin our testimony.

Chairman HERGER. Ms. Rosenbaum first, please.

STATEMENT OF BETSEY ROSENBAUM, DIRECTOR, CHILDREN AND FAMILY SERVICES DEPARTMENT, AMERICAN PUBLIC HUMAN SERVICES ASSOCIATION

Ms. ROSENBAUM. Chairman Herger, Congressman Cardin and Subcommittee members, I am Betsey Rosenbaum, Director of the Children and Family Services Department at the American Public Human Services Association. APHSA has a long-standing interest in developing and promoting policies and practices that enable States to help our Nation's most vulnerable children and families.

I want to thank you for the opportunity to testify today. We want to commend the Subcommittee for recognizing the value of the Promoting Safe and Stable Families program and for holding this hearing. We are pleased that the House and Senate and President Bush have included in their budgets an increase of $1 billion over 5  years for this program.

Today's child welfare system serves some of America's most fragile and troubled children. In 1999, State CPS agencies received an estimated 2.9 million maltreatment reports, with an estimated 826,000 children found to be victims. As well, 568,000 children were in foster care, 118,000 were waiting adoption, and 48,000 were placed for adoption.

The Promoting Safe and Stable Families program is an important source of Federal funding for child welfare services. The 1993 enactment of the Family Preservation and Support Services program, later changed to Promoting Safe and Stable Families, offers States and communities a first-ever opportunity to begin fundamental reform of their child and family service systems. In the 7 years since, it has proven to be a vital source of support for vulnerable families. As you know, the four components of the program are family preservation, community-based family support, time-limited family reunification and adoption promotion and support services.

For example, Mr. Chairman, in Chico, Safe and Stable Families funds a mentoring program that exposes young parents to healthy life-styles and safe activities. In Gridley, funds provide education on parenting, health and safety issues. In fact, California is the largest recipient of these funds, with an allotment of $42 million, 15 percent of the total amount.

The Safe and Stable Families program is an important funding source for post-adoption services, including child care, respite care, crisis intervention and educational support. It provides for family support services such as family resource centers, home visiting and parenting classes for teens. The program also supports intensive family preservation services.

But, even with this program services to families remain underfunded. States have historically outspent the Federal Government and it is time for a more equitable State and Federal financial partnership.

When the child welfare financing structure was created over 20 years ago, the assumption was that Title IV-B service funding would grow significantly, but it hasn't. Currently, over 6.5 billion Federal dollars are spend on out-of-home care, while $992 million are spent on prevention and intervention services.

We believe that the following elements are essential for reauthorization:

First, increased funding for the program as included in the House, Senate and President's budget.

Second, additional funding is needed for other child welfare prevention sources, including CAPTA, which is also up for reauthorization, and the Social Services Block Grant.

Finally, the law requires States to spend a significant portion of funds on each of the four service areas which HHS has divided into 20 percent per area. We urge to you change this definition to allow at least 50 percent of the funding to remain flexible.

But, because there is no single comprehensive child welfare program at the Federal level but rather a collection of programs and requirements, the importance of the Safe and Stable Families program needs to be more broadly understood. Clearly, reauthorization of this program is critical, but other fundamental issues need to be addressed. These include the need for flexibility of Title IV-E funds for services other than foster care. We urge Congress to amend Title IV-E to give States the option to redirect Federal revenue for Title IV-E maintenance payments into their Title IV-B programs.

Other priorities include making the child welfare waivers more flexible and addressing the connection between substance abuse and child welfare. These issues are addressed in Crossroads: New Directions in Social Policy, our transition report to Congress and the President, and as well iscovered in my testimony.

In conclusion, the current structure of child welfare is disproportionately directed toward out-of-home care and doesn't promote services that encourage child safety and family reunification. The Safe and Stable Families program provides agencies with the opportunity to direct funds to the challenges faced by individual families and fulfill important service system gaps. In summary, we support reauthorization with the needed funding and program flexibility.

Thank you for the opportunity to testify.

[The prepared statement of Ms. Rosenbaum follows:]

Chairman HERGER. Thank you, Ms. Rosenbaum. Now we will hear from Mr. Beougher.

STATEMENT OF JAMES E. BEOUGHER, DIRECTOR, CHILD AND FAMILY SERVICES ADMINISTRATION, MICHIGAN FAMILY INDEPENDENCE AGENCY

Mr. BEOUGHER. Good afternoon Mr. Chairman and members of the Subcommittee. I am here representing the Michigan Family Independence Agency.

I want to thank you for the opportunity to share Michigan's experiences and perspective on the reauthorization of Promoting Safe and Stable Families. This legislation enables States to develop programs that focus on the issues that most affect vulnerable children and families, protection from abuse and neglect.

In Michigan, family preservation programs are key in providing an effective spectrum of intensive services to families with complex needs. These families can be birth families, foster families or adoptive parents.

Utilizing family preservation programs comes with the critical responsibility to evaluate their effectiveness. Michigan has identified key design components that must be present if programs are to successfully achieve their goals. They are: The child and family must be active members in the decision-making process and experience ownership in achieving the goals of safety and stability. Programs must be based on sound models working with the family and their community and building upon natural support systems. Uniform training of service providers is critical. Outcomes and expectations must be articulated and monitored. Quality assurance processes must be built into the program, and ongoing technical assistance and training must be mandated and provided.

We have reviewed national studies that claim family preservation models show no significant differences between families who receive these services and those that do not. Michigan's experience casts doubt on that assertion.

Our Families First of Michigan program began in 1988. Families First focuses on providing a broad variety of intensive home-based services for families to ensure child safety. Critical to its success, resources must be available to families 24 hours a day, 7 days a week; and we require comprehensive staff training and monitoring for strict adherence to the model.

Since 1992, Families First has undergone a series of formal evaluations that have concluded the program is effective in reducing out-of-home placement and is cost effective as compared to foster care. The most recent study included only cases where the court had first found probable cause for placement into foster care as well as a rigorous experimental control design including random assignment to the control group or the experimental group. Empirical data established that these intensive services resulted in 93 percent of Families First children living at home, compared to 43 percent of those in the foster care control group 1  year after Families First case closure. Additionally, less than 1  percent of Families First families experienced a subsequent occurrence of substantiated abuse, when compared to 6 percent in the foster care group.

A second program that we have is called our Family Reunification program. It also ensures integrity to the training and monitoring process. Again, an independent evaluation, in this instance funded by a foundation, found significant impact. At 12 months, 85 percent of the children completing the program had returned to and remained safely in their home, compared to 68 percent of the children who were placed in regular foster care. There was an additional savings of $5,000 per child due to reduced placement cost.

Michigan's commitment to providing a broad spectrum of family preservation services is also evident in our Family Group Decision Making program, which ensures safety and stability within kinship placements and builds upon the family commitment to their children by using a team approach between the children's protective services worker, the Family Group Decision Making provider and the extended family.

Michigan's Lenawee County has been nationally recognized for its success of using this model for Native American children. In 1999, out of 26 children in out-of-home care in this small county, 20 were of Native American decent, even though they were only 2 percent of the population. Currently, only two Indian children remain in foster care, and no new referrals of Indian children have occurred since the pilot began 18 months ago.

Our universal commitment to the principles of assuring children's safety, providing a stable home environment and opportunities for growth and permanency is evident in all of our preservation programs. Though time does not permit an in-depth accounting system, similar options can be found in Lenawee County where wraparound service has reduced the number of children housed in residential care from 24 to 2 and decreased the rate of placement into residential care from 18 per year to 1.

The common thread in the success of these programs is the intensive family-centered design of the service models, clearly defined outcomes and effective monitoring activities. I believe we have provided you some key evidence-based data to consider which presents the success of family preservation programs in achieving the goal of child protection stability.   Thank you.

[The prepared statement of Mr. Beougher follows:]

Chairman HERGER. Thank you very much. Now Judge Kearney to testify.

STATEMENT OF THE HON. KATHLEEN A. KEARNEY, SECRETARY, FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES

Ms. KEARNEY. Good afternoon. It is indeed a pleasure to be back in front of this Committee that has done so much for America's children.

My role today is basically to encourage you to reauthorize the funds within the Safe and Stable Families Act that is designed for court improvement initiatives. I was involved and still am in the dependency court improvement effort in Florida. I chaired the committee for 3 of its 6  years. Let me tell you what it was like in 1995.

The judiciary -- and at the time I was a circuit court judge hearing juvenile cases in Ft. Lauderdale -- was at war with social services. The guardian ad litem program was at war with the judiciary and social services. Law enforcement was not engaged actively in protecting America's children, and no one spoke to one another. At the time that the court improvement initiative came together, it brought all of the stakeholders, all of the players to the table to look in depth at what the real problem was in processing these cases through the courts.

In Florida, we gather data for over a year. One of the things we found that was so shocking is that for a shelter hearing, the time when the court makes the determination of when a child should be removed from their home, the average shelter hearing in Florida took 4 minutes. Imagine that decision, what information you can actually analyze if you are the judge in that 4-minute period of time.

We published all of the data from our 1-year in-depth analysis at a dependency summit where we pulled together 300 stakeholders, and we gave them an overview of what their system looked like. It wasn't pretty. But that more than anything galvanized stakeholders in the State to join together and to really look in developing at the system. That formed the actual nucleus of the Adoption and Safe Families Act reform which we are so grateful to Congressman Camp for. That formed the nucleus for our reform.

So, in 1997, when you passed APHSA, we had already looked at what we needed. We wove it in with APHSA, and we then changed Florida's statute for child protection.

We would think that that would be enough. But the reality was it was not. Because we had learned then, too, that we had to look in depth at the results of APHSA and whether we could implement them. So we have continued over the years, and the reason I am encouraging you to reauthorize this is I do not believe you can successfully implement APHSA without the engagement of the courts as well as social services in achieving the outcomes that you have set for us and for our children. Let me give you an example.

I asked Florida to be one of the first States to be audited by the Department of Health and Human Services; and they are coming this summer, in August. I did that because I know, frankly, we aren't doing very well; and I wanted the opportunity to look in depth with your help to see what needs to be done.

We have done a preaudit for the last year using the Federal methodology to see where we really are with APHSA. The results of the initial preaudit weren't very encouraging. In Miami for judicial reviews of children that are required every 6  months, they were only reviewing them 39 percent of the time. Permanency hearings that are required at the 12-month period were only being done 30 percent of the time.

Last year, at our fourth annual Dependency Court Improvement Summit, I published all of that data. People weren't very happy with me for making it very open and up front, but I really believe you can't solve problems unless you know what they really are.

We went back this year. We are now at 79 percent of cases being judicially reviewed.

Sometimes it helps to know that you are looking at the information. But when you think of the children whose cases are not being reviewed, that is the concern to me. I think it is important for this Committee to know that the court improvement effort is definitely used by the courts, and it is an opportunity for us to come together with social services. And, frankly, I think it would be impossible to do my current job without the full engagement of Florida's judiciary there helping to reform Florida's foster care system.

Thank you again for inviting me to come.

[The prepared statement of Ms. Kearney follows:]

Chairman HERGER. Thank you, Judge Kearney. Now Ms. Mouzon, please.

STATEMENT OF LINDA E. MOUZON, EXECUTIVE DIRECTOR, SOCIAL SERVICES ADMINISTRATION, MARYLAND DEPARTMENT OF HUMAN RESOURCES

Ms. MOUZON. Good afternoon, Mr. Chair, Congressman Cardin and members of the Committee. I am delighted to be here this afternoon.

I particularly wanted to hone in on some of the successes that we have had in Maryland as a result of receiving monies from the Safe and Stable Families program. And we strongly support its reauthorization. Under our family support programs we have taken our monies and given them to local communities so that they could design services that would meet the needs of the families and children that they see prior to them entering into our system. So, actually, these are prevention dollars.

Through these prevention efforts we have a number of programs which are highlighted in my testimony, but they range from healthy families, which means we are working with mothers who have just given birth, all the way through teen moms, to moms who are under 25, to parents who have been parents longer. We also include our adoptive parents and our foster parents.

One of the things that we have noticed is that the families who are served by these programs are able to stay away from our particular front doors, I would say, from the various systems. This includes not only the Department of Social Services but we also find out that these children are not entering the juvenile justice system, and we are very, very pleased with that.

In addition, we have our family preservation dollars which we have taken and utilized them in such a way that we can get referrals from our State Department of Education through the local school systems, through our Department of Juvenile Justice, through our mental health services as well as through local departments and self-referral. This means that we focus our efforts on family preservation once again prior to a family coming formally into our system.

Through utilizing these dollars this way, we have noticed there has been a decrease within the last year and particularly I would say a continuing decrease in the number of families that are entering into the formal system through our local Departments of Social Services; and you do have these charts in my testimony.

Another thing that we have done is we have utilized the funds to enhance our reunification efforts of children who are placed in foster care, and we use the family-to-family model that was promoted by the Casey Foundation in which we use community-based services. By utilizing some of these dollars for substance abuse, some to promote some community supports, we have been able to have an increase in the number of children who are reunited with their families. We have increased that from 39 percent to 42 percent, and we hope to continue that increase because we know this is a positive outcome for the children and for the families.

We have also utilized some of our dollars for our adoption services. We have a Statewide recruitment campaign that includes some of our faith-based congregations, and we also have utilized some private agencies so that we would have support groups for those who are interested in adoptions. And in Maryland we have been a leader in increasing the number of adoptions.

But I do want to address one area that is not covered, and that is the whole issue of substance abuse. Although as a required and mandated service through the ASFA legislation, no monies were sent to the State in order to support this particular service. As a result of that, we have had to do some innovative things in Maryland.

One thing is that we have what we call the Drug-Exposed Infants project in which we work with moms who deliver infants who are drug exposed at the time of birth. We collaborated with the Health Department, private hospitals, with our sister agency, the Alcohol and Drug Abuse Administration, as well as some of our social service agencies and treatment providers so that when a baby is born drug addicted we can provide services immediately.

One of the challenges is getting service upon demand, though, and that is an issue.

We also have some legislation that was passed in Maryland that indicates that we have to integrate our child welfare services along with our substance abuse services; and, therefore, we have established a protocol in which the courts are a partner and they order assessment and also some kind of comprehensive screening in order to ensure that mothers or fathers who come to our attention receive treatment services if indeed they are in need of those services.

We utilize substance abuse treatment providers also who will work in the local departments, and they make referrals to the appropriate setting so that the parents can receive their services. In addition, we receive the Federal waiver, a demonstration project in which we utilize collaborative teams that includes the parent and includes a caseworker. It includes those who are involved in the substance abuse community. It includes those who are former users of both systems, meaning the while welfare system and the substance abuse system, in a team format so that we can provide services to families who come to our attention and are in need of substance abuse services.

Indeed, I thank you for this opportunity to testify. You have my full testimony before you, and you can look at the results we have had in Maryland at the end.

[The prepared statement of Ms. Mouzon follows:]

Chairman HERGER. Thank you very much, Ms. Mouzon. We have been notified we are expecting to have three votes on the floor. I would like to -- if we could maybe begin with Dr. Wulczyn, and as soon as we finish your testimony we will recess and then return as soon as possible following the third vote. Dr. Wulczyn.

STATEMENT OF FRED H. WULCZYN, PH.D., RESEARCH FELLOW, CHAPIN HALL CENTER FOR CHILDREN, UNIVERSITY OF CHICAGO

Dr. WULCZYN. Thank you, Chairman Herger, members of the Subcommittee. Thanks for inviting me here. It is a pleasure not only to testify but to be joined here in the company of so many people who work day to day with children and families. It is a rare opportunity for an academic such as myself.

I work for the Chapin Hall Center for Children at the University of Chicago. We are an independent research and development center devoted to bringing sound information, rigorous analysis and an independent perspective to the public debate about the needs of children and the ways those can best be met.

I have three points that I would like to make this afternoon.

First, as others have already done, I want to acknowledge that the commitment of 200 million additional dollars in Federal support is certainly a welcome development. A year ago, the future of the Title IV-B, Subpart II, program was not as clear; and I think everybody understands how important these revenues are to the program.

Second, I think it is important that, as you contemplate reauthorization, that you understand a bit about context in relationship to broader social trends. As a Nation, we face something of a conundrum in that many of the positive social gains of the last decade have yet to be reflected in the size of our foster care population. For example, it has already been mentioned that child poverty levels have declined, and child maltreatment rates as measured using the NCANDS data are down. Yet the foster care population continues to rise. Since 1990, the number of foster children has grown from 400,000 to 568,000, an average of about 4 percent per year. In my written testimony, I compared the growth of the foster care population to the size of the population of children receiving TANF and AFDC. As you will see, there is a striking contrast in the direction of those two trends.

I don't want to make more of the relationship between cash assistance and foster utilization than is warranted. Clearly, many families on cash assistance are providing adequate care and supervision for theirs kids. Nevertheless, the connection between poverty and child maltreatment, foster care treatment is one to pay attention to, particularly as time limits begin to come to the States.

But it is clear that, despite welfare reform and the positive economic cycles that we have all enjoyed over the last decade, they have little impact one way or the other on the foster care population; and given the substantial investments in child welfare services since 1993 the snapshot of data tells much about how difficult it is to manage the child welfare system, particularly from Washington.

I would like to point out two questions that you might want to address as you are going forward. The first has to do with the question of flexibility, and the question there is that in many States the local picture is quite different than the national picture. That is, there are States and localities, New York City and Illinois among them, that have successfully begun to reduce their foster care population. As you contemplate Federal legislation you will want to be careful so as to avoid circumstances that might undermine those positive gains.

Secondly, the Federal funds received in the form of board and maintenance payments cannot as a rule be redirected. So it is very hard for States to reinvest money in those programs that might reduce the foster care population. That is alleviated somewhat by the 200 million extra dollars, but there is still a structural rigidity in how Title IV-E revenue from HHS reaches States.

The second question I want to call your attention to is the issue of targeting of dollars more wisely. There is a structure for targeting dollars in the current legislation. It is focused around types of services and outcomes. But I would ask that you contemplate whether or not this is a complete picture when it comes to the question you asked, Mr. Chairman, in your announcement: Are we meeting the needs of those children who are most in need? I think the answer to that question is a qualified no. It is qualified in that, every day, there are children in real danger who get the services they need. But it is not as clear that we do all that we can to target services effectively.

Consider, for example, that slightly more than 20 percent of all first admissions in the 12 archive States that we use to track trends involve children under the age of 1 -- 20 percent. Of those, nearly half enter before they are a month old. Other high-risk groups include 15-year-olds. The children most likely to be returned home are between the ages of 1 and 12. The children most likely to be adopted are children admitted as babies. Adolescents are very likely to run away. However, if they spend some portion of their 16th year in placement, half of those children go home. It is actually relatively rare that a child grows up in foster care.

We don't target services in a way that takes full advantage of all that we know about the utilization of care. In June -- on the 18th of June, next month, a group of scientists are going to be meeting here in Washington to discuss these issues, what we know about the utilization of foster care and what works; and I am hoping that members of your staff will be able to join us for that.

Also, on the issue of flexibility, I think it is important that the Congress consider creating a permanent structure for taking waiver demonstration projects to scale. I think the transferability proposals that were in the ASFA proposal last year are an ideal mechanism for creating what I indicated was a permanent structure for this notion of flexibility.

Finally, I want to add that going forward, targeting services efficiently and promoting flexibility will require the participation of the scientific community so that we learn more about what works and what doesn't work so that in 5 years these dollars can be accounted for with respect to outcomes for children and families.

Thanks very much for the time.

[The prepared statement of Dr. Wulczyn follows:]

Chairman HERGER. Thank you very much, Dr. Wulczyn. This Committee will recess until three votes have been completed. Then we will convene as soon as possible afterwards -- thank you very much -- and return to our remaining two witnesses and then for questioning.

This Committee stands in recess.

[Recess.]

Chairman HERGER. The Subcommittee will come to order, please. And we will resume testimony with Mr. Torres.

STATEMENT OF RAYMOND TORRES, EXECUTIVE DIRECTOR, CASEY FAMILY SERVICES, BRIDGEPORT, CONNECTICUT

Mr. TORRES. Thank you, Mr. Chairman and members of the Committee on Ways and Means, Subcommittee on Human Resources. My name is Raymond Torres. I am the executive director of Casey Family Services. Casey Family Services is a private, non-profit agency that has served numerable children and families for 25 years. We have worked primarily with older children and teens who are in foster care and in need of transitioning supports and with children who are adopted from foster care. It is based on that experience that I would like to speak today on the importance of post-adoption services.

Casey Family Services is the direct services arm of the Annie E. Casey Foundation, the largest foundation exclusively assisting disadvantaged children and families in the United States today. We are quite aware of the fact that the number of children in foster care has almost doubled in the last decade while the number of foster families has decreased by one-third. We have had a larger number of kids become eligible for adoption to the tune of 118,000 kids awaiting adoption.

Our experience in the field of foster care has taught us that that youngsters who are coming into care today are more traumatized than in the past. They are the victims of abuse, neglect, and sexual abuse. They are the youngsters who have the most difficulty while in the foster care system; and they are the youngsters who remain behind, because they are not prime candidates for adoption, and often these are the very same youngsters who stay in the system because they come from family situations that do not allow them to be reunified with their birth families.

As an agency, we are very committed to doing everything we can to help these youngsters transition out of foster care. But what we also have learned over the years that if you are able to provide a solid array of services and supports to adoptive families, even the most difficult youngster become a candidate for adoption.

This afternoon we will hear from one of our adoptive parents, Sonya Merrill, who took the giant step of adopting a group of siblings, three sister, who had been in foster care with some significant issues. Her story supports our experience as an agency: If you are interested in moving those 118,000 youngsters now awaiting adoption out of foster care, we all need to do more than simply promote awareness about the need for adoption.

We need to recognize that the needs of these youngsters are often complex, and that these needs do not change automatically by the mere fact of the child becoming adopted. Children who have been traumatized, who have grown up in the foster care system, have severe needs -- and they have the same needs the day after they become adopted. Unless we begin to take active steps to provide a safety net of services for these youngsters and their adoptive families, then it will be very difficult for these youngsters to first, become adopted and second, to stay adopted -- a simple premise, but, one that merits a great deal of attention and one that we are very pleased to be able to address.

The way that the foster care system has operated because, of the urgency of abuse and neglect, is that those youngsters waiting to be adopted have received the least attention, not because of any negative sentiment towards them, but because there has been a sense that they are safe. Well, because of that sense there has been a lack of attention given to their need for permanent homes with the kind of supports they need. If we do not take active steps to provide those supports for the families, then many families will remain hesitant to bring older children into their homes, knowing that the following day after they adopt that youngster, all the child's needs become their sole responsibility.

We take pride in the fact that there have been active steps in advancing adoptions of children in care. As it has been stated at this hearing today, more youngsters are being adopted. At the same time, there are 118,000 children still waiting to be adopted. Our interest is for us to do more to provide a safety net, provide services that will allow people considering adoption to be able to step forth and adopt these children, confident that they will receive the support that they deserve.

[The prepared statement of Mr. Torres follows:]

Chairman HERGER. Thank you very much, Mr. Torres. And now we will hear from Sonya Merrill, who is an adoptive parent and recipient of post-adoption services. Ms. Merrill.

STATEMENT OF SONYA MERRILL, MENTAL HEALTH PROFESSIONAL, CONNECTICUT DEPARTMENT OF MENTAL RETARDATION AND DIRECT CARE, AND ADOPTIVE PARENT AND RECIPIENT, POST-ADOPTION SERVICES, SOUTH NORWALK, CONNECTICUT

Ms. MERRILL. Thank you, Mr. Chairman and members of the Committee. I have been with Casey for over 10  years; but in 1995 that is when my journey really began with them, where I really experienced all the services that Casey does provide. I took in a sibling group originally of four, one of which, the male child, was treatment level, with severe behavioral problems. The girls all came with their own baggage. They were crack addicted.

This is Patricia; she was crack addicted. This is Semaj, who was crack addicted. This is Shakoya, who was sexually molested; and this is Joseph, who is treatment level with a lot of baggage. I personally have a 15-year-old daughter. These are all of us. So I went from one child to five instantly, overnight. And my outlook on it was that I didn't know if I could adequately take care of all of these children and provide for them what they needed. Even though I worked in mental health and I knew how to do some of the behavior modification and things like that, I was afraid that I could not facilitate their needs off of my income and just being one person. And Casey promised to me that they would not leave me, and they would help provide resources for me and that they did.

Mary Miller was my social worker at the time. The children were in my care for 4 years because the program that they originally came to me under was reunification and that is where the foster family works with the biological family, and we try and do parenting skills to help develop relationships with the biological parents to eventually get the children back to their parents. After 4 years it did not work. The mother was an addict.

So it became a revolving door, and the children were TPR'd and they came up for adoption. I knew I wanted the children, but at the same time again the question came up could I facilitate their needs, would I be doing them an injustice to bring them into my household knowing I was a single parent and I worked and I had other responsibilities and even though they were with me for four years they still had needs.

Semaj does not display any signs of crack in her system right now. Patricia is experiencing some problems with attention recall, and I knew that there had to be services that had to be provided; and I wasn't sure I had the means to meet them. Casey told me that through their post-adoptive services if I adopted them that they would provide these services. At present, Patricia is at Yale Children's Study Center undergoing a neurological psychological evaluation, which Casey is providing. I do know they were there for my other girls. My children are able to participate in Casey's after-school enrichment programs. They need tutorial sessions; Casey provides that.

There are just so many services that Casey has continued even since my adopting them that I know if it had not been for Casey that I could not have made this transition. Casey social workers, even though I have adopted the children, still keep in touch with us. I still get weekly calls; I still get visits; and they have become my children's extended family. When we have problems, they have problems. When we have fun, they have fun. Whatever the situation I am going through, Casey goes through.

I feel as a parent, a single parent, speaking for adoptive parents that -- not so much becoming an adoptive parent, is the exciting part; but the other part that makes you want to be a parent is when you know you have the resources of the post-adoptive programs to help, because you can't do it alone, because the children's needs don't disappear once you adopt them and give them a name. Even though they are stable, they still have problems.

In my case, I know there will still be more problems to arise because of conditions they came with. And I have also known when they arise I am going to need help. For me the post-adoption programs and services that have been provided have sustained my household. It also was a major factor in my decision whether or not I could be an adoptive parent and provide for the children. Love is good, but you also have to be real and meet the needs medically, psychologically, and emotionally for these children.

[The prepared statement of Ms. Merrill follows:]

Chairman HERGER. Thank you for your testimony, Ms. Merrill and I want to thank each of our panelists for testifying.

At this time, we will turn questioning over to the members; and I would like to remind the members that we do have 5  minutes for witness questioning. Ms. Merrill, I note in your testimony that you became a foster parent in 1995, and the adoptions were finalized in January of this year. Could you walk us through, please, the time line. When did you decide you wanted to adopt? How long did the adoption process take  -- was that an appropriate length of time? Is there anything that you would suggest for speeding up the process?

Ms. MERRILL. Okay. Initially, like I said, they were in reunification. It was after the fourth year of the mother revolving back and forth into rehabilitation and then disappearing, that the agency along with me realized that they were going to be reunified. For me that was a long process because emotionally my children were on a roller coaster. Shakoya, the oldest one, her nerves totally collapsed. She wound up losing her hair because she feared she had to go back into that environment with her mother.

The baby, Semaj, never bonded with the mother as a result of the mother not even coming into my home to learn to bond with her. She never knew her. And Patricia, she is an introvert. She did not want anything to do with it. So for me, 4 years was a long time seeing that the mother was not going to get better. As far as the adoption process, I believe my situation was a special one because it did not take long. They started the TPR, the Termination of Parental Rights, I believe that June. And we had thought it was going to take 18 months, but it did not. The paperwork went through, and that January we were notified that it was final. So that in itself was a very special situation because it did not take as long as they thought it was going to take for us.

Chairman HERGER. Well, thank you. Is this typical, the shorter time period with you -- would anyone like to comment -- or does it normally take longer? Does anyone have any comments on that? Any suggestions what we might do for speeding up the process, Dr. Beougher?

Mr. BEOUGHER. I will say a couple of things, if I could. First of all, Michigan has a fairly rapid adoption process once parental rights are terminated, and we have also had legal changes in Michigan that have sped up the process compatible with what the Adoption and Safe Families Act expects. But Michigan began in 1991 to reimburse private agencies based on results. So adoption agencies only get reimbursed when they actually accomplish an adoption, and the more promptly they accomplish an adoption, the greater the payment.

That has caused our adoptions to increase to the point where -- we now have more kids receiving adoption subsidy than we have in the foster care system. Adoption subsidies now total about 157 million a year for a little less than 20,000 children to put the impact of performance based contracting into perspective, in 1996, we had 2  percent of the kids in foster care; and we did nearly 10  percent of all the adoption of abuse and neglected kids in the country. We directly attribute that to contracting on the basis of outcomes and results. Finally, we have a public/private partnership; State adoption workers also do adoption services.

But it took us a while to figure out that if we set outcome performance expectations for them they would also increase. So adoptions in the public sector increased 22 percent last year over the previous year. Of the children who are adopted in Michigan, in fiscal year 2000 8,990 were adopted within a year after parental rights termination.

Chairman HERGER. Judge Kearney.

Ms. KEARNEY. Mr. Chair, I think that Ms. Merrill's story indicates a couple of issues, one that Mr. Cardin indicated earlier on, the need for substance abuse services for families early on, especially in the prevention aspect. But I also think it indicates clearly what the goals of APHSA were designed to do and that is, number one, make sure that children are safe and also to ensure their safety, their well-being and the permanence -- and it was designed certainly to prevent 4 years of children languishing in care.

I think what is so critically needed here and what Congress should look at is the assessment at the front end that when the children come in to look and see -- just listening to Ms. Merrill's story right now, as listening to it in my dual role sort of as judge and as the secretary of Department of Children and Families, there were risk indicators so high right at the very beginning. The fact that she had three children that were all cocaine dependent or exposed at birth -- where were we at child one? Why did we wait until child three for intervention. The fact that there was sexual abuse of a young male child. The risk indicators were all there for much earlier intervention and termination of parental rights, frankly, so these children could be cleared.

So I think you need to look at the needs for mental health services, the needs for substance abuse services, the integration of those services, and also a very strong risk assessment right at the front end so you don't have children and families languishing like this.

Chairman HERGER. So in other words, once the adoption began it seemed to move fairly rapidly.  But, there is a lot more that could be done efficiently and effectively upfront.

Ms. KEARNEY. Yes, Mr. Chair. And frankly that is what Congress did with APHSA, and so as you see when the children first came in in 1995, that law did not exist. So that is the beauty of it and what your work means for the country.

Chairman HERGER. Thank you very much. Mr. Cardin.

Mr. CARDIN. Thank you, Mr. Chairman. I really want to thank all the witnesses. This has been a very, very helpful presentation on the issues. And I couldn't help but think, Ms. Merrill, I am sorry you were not at our Committee markup yesterday when we took up the adoption credit and the special attention for special needs children. At least some of us want to get special attention. We have made a lot of progress on adopting children that have been in foster care, but there is still 118,000 that are eligible for adoption right now that are waiting. Most of those children are special needs children.

And, Ms. Merrill, you put a face on the problem for us, that this is not an easy task we have and those who step forward really are making a great -- doing a great service to our community and we thank you for that. And for the children, particularly, we thank you.

It is clear to me that there is general consensus that we should reauthorize the program, that there is still need for a Federal role in dealing with this issue, that we should support the President's request for an additional $200 million a year. That money is needed. And most of us have spoken to additional flexibility. You don't particularly like the regulation that mandates that you spend a certain amount in a particular category. So let me take the prerogative of a member of Congress and say we have now increased the program by $200 million, we have given you the additional flexibility. Where would you spend the money? You can spend the money anywhere you want. Where are you going to spend it?

Ms. MOUZON. First, I believe that we need more money in our child protective service program. So with flexibility we can now do some things at that end that we have not been able to do. We have never been given enough money to have either an adequate workforce for a population that is very challenging in the problems that are presented. I think it is there also that we can really start looking at some of the substance abuse issues that most of us have alluded to, because we want to catch them early on and we do need treatment on demand.

The other thing I think we would have to emphasize is a really good recruitment campaign. As Ms. Merrill and many of our adoptive families are, these are our foster parents. We are starting to eat up our foster resources, so we need a professional campaign in which we start introducing the system in a more holistic way to people to let them know that they need to be a part of whatever it is that we would plan to build upon.

The other thing, I think, is we need some good prevention dollars to increase our family supports. We only are able to have family support systems in 17 out of 24 jurisdictions in Maryland. As you know, we are a much smaller State than some of the other States. We need to have those supports available across the board. Everyone who comes to us with an issue should be able to receive a service. Right now that does not happen. If you come to us and you get there while the dollars are available, then you get one type of service; but those dollars do run out. And unfortunately then they are forced into services that are not as specialized. Those are some of the things we would do in Maryland.

But I know we would definitely pour a lot into substance abuse. And I should say, lastly, we will also look at mental health services. There are many children who are in need of mental health services because their parents' private insurance runs out. These children then become attached to the child welfare agency, and we have to take these children into care just so they can receive mental health services. There has to be a better response than us taking these children into care. We need to get the service to them that they need without having them fall under the APHSA requirements. And I think that is what we would do in Maryland, at least if I am still there.

Mr. CARDIN. Mr. Torres.

Mr. TORRES. As I stated before, I believe we are taking active steps to move more kids into adoptions. We need to do more to be able to support these families. We need to do more than pat them on the back; we need to have services available to them for when they need them. Adoptive families need counseling; they need respite. They need treatment. They often may need treatment-level care for short periods of time. And if the families knew in advance that the supports would be available for them whenever the need arises, then they would be more likely to step up and adopt these youngsters, because they would know there would be a safety net to support them for when issues come up with the youngsters. We support a continuum of care for these families, based on the needs of the youngsters.

Mr. CARDIN. Mrs. Rosenbaum.

Ms. ROSENBAUM. Yes. I think there are four categories of opportunity for spending right now, and I think that they provide for both remedial sorts of intervention, as well as for prevention. Maybe not primary prevention in the scope that everyone would like to see. I think the categories have worked well, and one of things that we are particularly interested in is allowing even more flexibility to provide the opportunity for Maryland to focus on family resource centers whereas Florida might want to look at something else. There are some administrative constraints right now. Each State seems to have fashioned very localized community approaches to serving families and recognizing that the money has limitations.

Mr. CARDIN. Let me, if I might, just talk on the substance abuse issue. You heard that I emphasized that on my opening comment, and I thought Judge Kearney's point about prevention in the early stages is right on target to save an awful lot of resources and we will have much better results the earlier we get into the issues. I know that Maryland is using some of the money for substance abuse, but I believe you also have a waiver so you have a little more flexibility in that regard. I guess my question is, is there broad enough authority within the current statute to use money for the purpose of substance abuse? Is it an issue of not enough resources, or is it the program is too restricted in the way that it is configured to be able to get the money out for early prevention issues such as substance abuse or other related problems? Do we need to amend the statute, or is it just a matter of resources?

Ms. MOUZON. Well, I would say a little of both. One of the issues is once a parent has their child removed from them, they are no longer eligible to receive any of the Medicaid services that would pay for substance abuse treatment. So it presents a challenge in how are you going to engage that family in treatment. And that is part of the reason we ask for the demonstration waiver. What we are able to do now is to transfer some of the placement dollars into treatment resources.

The other things that needs to be developed is a capacity, particularly for mothers, to go into treatment with their children. And presently that capacity is not there within the treatment-provider network. As a result of that, if we remove the children, we no longer have that bonding that needs to take place. And we have found through our drug-exposed infant projects, if we don't take advantage of that window of opportunity, then what happens is those moms will continue to be disconnected from those babies. The babies, as Ms. Merrill pointed out, are easy to get adopted; but unfortunately that mom will end up having another baby, and we end up taking these children cyclically through the child welfare system, and we certainly don't want to do that.

Chairman HERGER. Thank you, Mr. Cardin. Mr. Beougher, as Federal policy makers, what lessons should we draw from what you have learned from the Families First program in Michigan? And how about other States as well? And could they be expected to repeat your results?

Mr. BEOUGHER. I think I can't speak for what other States' experience is, but from ours only I think the only reason that we have any credibility and results is, one, because we feel we owe it to the taxpayers. I mean, we always have to take into account that we use the people's money wisely. If you are going to use the people's money wisely, you have got to set outcomes. You have got to hold people to outcomes. If you can't measure something, you do not know if it is successful.

And you also have to have uniform training, and you have to have accountability procedures in place so you can monitor whether the model you put in place is truly being used the way it was intended. And you have got to have uniform training. Those things seem to work time and time again in Michigan. If you have a hundred different models of something in a State, there is no way to measure whether it is being done in the way you have defined it. And there is no way to train uniformly, and there is no way to explain the story to the public in such a way that they can accept that a positive outcome has occurred.

Chairman HERGER. Thank you. Mr. Cardin.

Mr. CARDIN. Judge Kearney, I just wanted to follow up on the last question I raised and that is, are the statutes sufficiently broad to allow early intervention? I agree with accountability. I think we need to have accountability, but I think we should allow the flexibility necessary so you can get at a problem as efficiently as you can; and to me that means early intervention. And I guess my point is, is the statute broad enough to allow you to get at the issues at an early stage?

Ms. KEARNEY. I believe -- and I agree with my colleague from Maryland -- that it is a little bit of both. There are problems with the statute, I think, that can be amended and I also believe that it is a resources issue. Attached to my testimony is a chart that you will recall from before which is a child's journey through placement, where you literally will see next to the events in this young child's life all of the different Federal funding sources and streams that will go to fund this child's journey through child protection.

Right now -- we did not seek a waiver for our Title IV-B because, frankly, it was too difficult to obtain. We ended up withdrawing our IV-E waiver because after 3 years of not having heard anything, it became very difficult. So I really believe that Congress needs to act and address the flexibility issue because I do believe that you have seen great results in States where they demonstrate that they can be accountable, but at the same time take care of needs of the children within those States.

Chairman HERGER. Thank you very much.

Dr. WULCZYN. I wanted to comment, if I could, on the question of early intervention and how to best proceed and return to my remarks in my testimony. I think in order to succeed in developing early intervention programs, one has to take into account the contours of the population that are served in the child welfare system and understand that early intervention will mean different things, depending upon whether you are talking about intervening in the lives of families with 15-year-olds as opposed to families with infants, and it is that lack of focus in terms of how best to structure these programs to these target populations.

If 20 percent of the children coming into foster care are under the age of 1 month, it has a very specific meaning for the kinds of programs that will constitute an early intervention effort. And we do not have that kind of focus or that kind of direction emanating from Federal policy. And it would be useful if the Federal Government could incentivize States to take these much more focused perspectives on the programs they develop. In the context of outcomes and flexibility, I think you have a much better chance of seeing reductions in the national foster care population over time.

Chairman HERGER. Thank you very much, Dr. Wulczyn. And I want to thank each of our panelists for the very good testimony that each of you has presented to us today, and I would trust that the witnesses would respond in writing to any additional questions on these issues. It has been a very informative hearing. I appreciate the work that each of you has done and the time that you have given us today. And with that, the hearing stands adjourned.

[Whereupon, at 2:44 p.m., the hearing was adjourned.]
[Questions submitted from Chairman Herger to the panel, and their responses follow:]

American Public Human Services Association
Washington, DC 20002-4267
May 22, 2001

Representative Wally Herger
Chairman
Subcommittee on Human Resources
Committee on Ways and Means
B-317 Rayburn House Office Building
Washington, DC 20515

Dear Congressman Herger:

Thank you again for the opportunity to testify at your committee’s recent hearing on the reauthorization of the Promoting Safe and Stable Families Program. This is an important program that has proven to be a vital source of support for vulnerable families. Following are answers to your follow up questions regarding my testimony.

APHSA is satisfied with the four categories listed above and we believe these components provide families with vital services and support. They provide necessary coverage to two service areas that are relevant to child welfare -- early intervention and remedial services. The categories allow communities flexibility in creating responsive services that can be tailored to individual family needs, while at the same time supporting a broad continuum of services.

The HHS interpretation of "significant portion" as 20 percent of the funds being spent on each category creates an artificial situation in which services are selected to fit into a spending category rather than being reflective of the service needs and emphases of a particular state or community.

APHSA’s proposal calls for 50 percent of the funds to be used flexibly and for the remaining 50 percent to be allocated by 12.5 percent going to each of the four categories. Such a proposal assures minimum coverage of each program area while allowing a higher concentration of funds to be targeted to areas of greatest need. But we note, HHS currently permits states to spend less in a particular area, should a state present a compelling reason as to why this is necessary.

APHSA’s position is that substantial modifications to the Title IV-E waiver process should be made in order to allow more flexibility, a broader scope, and to foster system change. States believe that the current waiver process limits innovation and is not responsive to the sense of urgency to change the child welfare system.

The following changes to the waiver system should be made administratively:

• Expand the limited number of states that may conduct waivers on the same topic (such as guardianship);
• Eliminate the limited number of waivers that may be conducted by a single state;
• Enable states with the option to continue their waivers beyond five years;
• Eliminate approval criteria that require random assignment and control groups that limit statewide approaches;
• Loosen the rigid evaluation process; and
• HHS should approve alternative baselines, such as the use of historical baselines based on foster care use, to calculate cost-neutrality.

The following changes should be made through legislation:

• Eliminate the limited number of waivers HHS can approve -- thereby extending the waiver option to as many states as want to participate; and
• Reauthorize the Title IV-E Child Welfare Demonstration Waivers for an additional five years.

Additionally, the federal government should continue to evaluate the wavier projects to determine whether or not legislative changes are needed in terms of how Title IV-E dollars can be used. For example, perhaps the use of IV-E dollars for subsidized guardianship should be expanded to all states. Also, perhaps we have we learned enough from flexible financing waivers to warrant a federal financing change.

Substance abuse among families served by the child welfare system is a serious concern. As discussed in Crossroads: New Directions in Social Policy, APHSA’s transition report to Congress and the Administration, with parental substance abuse is one of the major reasons children come into the child welfare system, it is one of the most pervasive problems confronting today's child welfare system. The new permanency timeframes mandated by ASFA, along with welfare reform and changes to Medicaid and managed care that affected state and local governments have made it vitally important that child welfare and substance abuse treatment systems work together and reexamine their current service practices.

As you know, as a result of ASFA, judges are required to hold a permanency hearing within 12 months of a child being placed in out of home care, and a permanency goal must be set at this hearing. States must file petitions to terminate parental rights if a child has been in foster care for 15 of 22 months unless a compelling reason is documented. If parents don’t show progress toward correcting the condition that led to the removal of their child (very often, substance abuse) the agency or court may move to terminate parental rights. To prevent this from happening when it shouldn’t, substance abuse and child welfare systems need to collaborate and share information regarding treatment so that child welfare workers and the courts have the information they need to make decisions.

Unfortunately, there is limited funding set aside for agencies to collaborate and strategies to share information under the current law are too limited to effectively address the needs of the child welfare agency to carry out its responsibilities. Without appropriate information sharing regarding treatment progress, child welfare workers and the courts have inadequate or inaccurate information with which to make important placement decisions. While there are exceptions, most state and local child welfare and substance abuse treatment systems function independently of one another even when administrative responsibilities for both systems are located within the same department. Some jurisdictions have made efforts to coordinate services or collaborate on cases, but the two systems predominately focus on ‘their’ clients, either the abused and neglected child or the substance abusing parent. Recent studies have indicated a high failure rate (75 percent) for engaging and retaining women with children in the foster care system in treatment.

We recommend that the following be done to encourage collaboration between the substance abuse and child welfare systems:

• Provide new federal resources to address substance abuse within families in the child welfare system.
• Provide federal funding through a new child welfare/substance abuse partnership grant program to be administered jointly by state child welfare and substance abuse agencies. The focus of the grant would be on families with alcohol and drug programs who come to the attention of the child welfare system and would encourage joint activities designed to increase the capacity of both the child welfare and alcohol and drug systems to address comprehensively the needs of these families to improve child safety, family stability, and permanence and to promote recovery from alcohol and drug programs.
• Amend the federal substance abuse confidentiality statute and regulations to enable child welfare agencies and the courts to obtain the information from substance abuse treatment providers necessary to make permanency and safety decisions for children who are in the child welfare system. Confidentiality rules need to require sharing and redisclosure of information between the two systems, specifically to assess progress in treatment, assure safety, and make informed decisions regarding permanence.
• Remove barriers to Medicaid funding to ensure that a previously eligible Medicaid family retains eligibility while their child is in foster care so that caretakers can access services that help them overcome the problems that led to the child being removed from the home.

Substance abuse is a significant factor in over one-half the child abuse and neglect cases. Unless there are enough quality substance abuse services available to engage and retain parents in treatment, while helping them progress, so they can care for their children safely and to ensure that information is shared to help agencies and courts make informed decisions about safety and permanence, the goals of ASFA cannot be met.

We believe that S. 484, the Child Protection/Alcohol and Drug Partnership Act, is a positive approach to addressing many of our concerns.

Thank you again for your attention to this matter. Please feel contact me or Jennifer Grayson at 202/682-0100 if you have additional questions.

Sincerely,

Betsey Rosenbaum
Director, Children and Family Services

Currently, TANF is the funding source for Families First.  This change occurred as a result of modifications to Michigan’s state plan in April of 2000.  At that time, Michigan submitted a TANF State Plan amendment that included a number of programs that encourage the formation and maintenance of two-parent families.  These programs do not require a financial eligibility determination.  Families First was included in this group.

In Michigan, we spend $169.8 million dollars of TANF funds for Child Welfare programs. These dollars are allocated among staff wages and fringe benefits, Family Preservation Programs, the Teen Parent Program, Youth in Transition Program, Adoption Subsidy Programs and funds out-of-home care for non-Title IV-E eligible children or placements under our former Title IV-A Emergency Assistance Plan.

Our projected claim for Title XX for Child Welfare Services is $13.7 million dollars with additional cost allocation for staff bringing the total projected claim to $17.8 million for 2001.

2. I understand that research conducted for HHS on family preservation programs that followed the HomeBuilders model showed no significant positive results. Yet you have seen positive results under this model in your State.  Why do you think your program has been successful and others have not?

In Michigan, we believe our Families First Program, and other family preservation models, are successful in achieving their goals due to the State’s stringent adherence to those critical factors of model integrity, establishment of clear outcomes, monitoring performance, and on-going training.  Additionally, Michigan is committed to Family Preservation Program models that provide key decision making roles to the families they are intended to serve.  Michigan’s Family Preservation Programs view families as partners, as part of the solution rather than the problem.

Tangential to this philosophical intent is Michigan’s commitment to ensuring that the basic needs of families are met, specifically; shelter, food, clothing and medical care.  We have found that families experiencing crisis related to homelessness, hunger or medical treatment are not able to focus on improving and sustaining change in their family relationships.  In our Family Preservation programs, our goal is to assist families in meeting these critical basic needs in order to promote family stability and safety.

Our models are also based on inclusiveness of all community partners who have a stake in child protection.  For instance, local human service providers, faith-based organizations, and the educational system are but three of the integral community partners involved in providing a responsive continuum of service to families in need.

In brief, I would assert that the following critical components must be present in Family Preservation programs for them to be successful:

• Parent/child/family participation in individual service plan design and implementation
• Uniform training provided to all family preservation service providers
• Contractual service providers must be community based to ensure relevancy of services
• Defined outcomes and expectations for family preservation programs are clearly articulated and monitored
• Defined quality assurance processes are built into the family preservation program models and are monitored to ensure adherence to the model
• Technical assistance and training is on-going and provided through collaborative partnerships to assure relevance

3. If you received a block grant of child welfare funds with minimal Federal rules or could transfer funds across child welfare programs (from Title IV-E to Title IV-B) in a cost-neutral way, how would your child welfare programs change?  What impacts would this have on at-risk children in Michigan?

Michigan supports the concepts of transferability and de-linking in the award of federal funds utilized for child welfare services.  However, it is critical that funding levels of Title IV-B or Title IV-E not be decreased to accomplish the goal of block granting funds to promote flexibility. Should Michigan be permitted to transfer funds from Title IV-E to IV-B, we would invest a portion of the dollars into expansion of those programs where we have identified superior outcomes.

Another important aspect of this flexibility is that it would permit Michigan to offer Family Preservation Programs to families that are transitioning between more categorically funded services, specifically, returning home from an out-of-home placement.  Due to funding restrictions, we are often unable to provide the full continuum of services to families that we believe is necessary.  This often results in a disconnection in service continuity and a lack of cohesive service planning.  Flexibility in funding would enable states to enhance their family preservation strategies to focus on providing the most appropriate services versus providing services that are determined by available funding.

Relative to the impact upon at risk children, flexibility in funding would require the state to ensure adequate funding was available for all out-of-home placement’s that are necessary to protect the child from abuse or neglect.  Protection and safety must always be our first priority.  Determining the dollar reserve necessary to adequately cover out-of-home care costs would need to be made on historical data coupled with cost projections and it would require the state to develop and utilize a sophisticated cost methodology.

Another consideration relative to child safety is that an out-of-home placement is not always the safest option for children.  Abuses do occur in these settings, though not as frequently as in the family home.  Our commitment to Family Preservation programming places child safety as a priority and we would take steps to ensure this commitment continued should we be permitted to transfer funds between Title IV-B and Title IV-E.

Finally, one of the basic tenets of our Family Preservation program continuum is the focus on providing intensive, home-based services to the family.   For Family Preservation programs to be effective in the long term, families must learn how to develop natural support systems within their community.  These resources can be the schools, churches, local service clubs, neighbors and family members.   The key is teaching families that when a crisis occurs, there are resources available to them that can assist them in addressing their immediate needs while keeping the family intact and children safe.

In the long term, I believe that funding family preservation services at an enhanced rate will ultimately reduce the number of children at risk of abuse or neglect.  Family preservation programs are inherently teaching models.  They teach families and communities the value of ensuring child protection and safety through intensive intervention.  These services delivered “up front”, before the risk of abuse or neglect reaches a critical level, enables safety planning and community supports to be implemented.  This early intervention effectively teaches families and communities new strategies to employ in protecting their children.

In Michigan we believe this fundamental change would provide better protection for at risk children rather than decreasing these protections.

4. At several points in your testimony you describe how your programs have resulted in program savings, for example by reducing out-of-home (that is, foster care) placements.  Please tell us more about this – where is the money saved how much has been saved and how have those savings been reinvested?

The following data is specific to the Families First of Michigan Program.

While interventions provided by foster care and Families First are quite different, the ultimate goal of each is to ensure the safety of children.  In July 1998, the Office of the Michigan Auditor General completed a three-year performance audit of Families First.  The Auditor General found that Families First places “a high priority on the safety of children.”  The Auditor General also found that Families First can be a “cost effective alternative to out-of-home placement for certain eligible children.”

In this audit, the reported cost of a family receiving Families First program services averaged $4,367 in fiscal year 1996-1997 compared to the reported per child cost of foster care of $12,384 and institutional care of $56,206.

In the Families First Evaluation Summary Report,[1] the researcher looked at the costs associated with Post Treatment Services as a continuation of total costs associated with an out-of-home placement.  They found the following:

The cost of Foster Care services for children who re-entered foster care during the 12-month period following the date of their return home was $3,302 per child, averaged across the 225 children in the study.  By comparison, the cost of Families First children who entered foster care during the 12-month period post intervention was $2,123 per child, averaged across the 225 children in the study.  This results in savings of $1179 per child.

Michigan has experienced similar results through the use of the Family Reunification Program. The Skillman Evaluation[2] tracked the costs across three comparatives for 12 months prior to Family Reunification services and 12-months post services. The table below illustrates savings longitudinally over that 24-month period of time among groups of children and families who received the services and those that did not.

As this table illustrates, the savings over the length of the study were significant.  More importantly, however, is the human cost.  The largest category of children placed out-of-home are those who experience abuse and/or neglect.  The evaluation of the Family Reunification Program showed its greatest effectiveness with helping these families reunite and remain together.

In response to your question of reinvestment of savings, the savings from reducing the costs in out-of-home care paid for by Title IV-E were not reinvested into Family Preservation programs due to our inability to utilize Title IV-E dollars for costs other than placement.  However, should we be afforded the opportunity to reinvest Title IV-E dollars from savings achieved through the use of Family Preservation Programming, we would develop a comprehensive strategy focused on maximizing available funding to achieve the desired outcomes of protection, safety and stability for children.

I trust these responses adequately address your questions.  Thank you for the opportunity to provide you and the subcommittee with this additional information regarding Michigan’s programs.  If you have additional questions, please do not hesitate to contact me.

Sincerely,

James E. Beougher, Director
Child and Family Services Administration
Michigan Family Independence Agency

[1] Evaluation of Michigan’s Families First Program, Summary Report, March 1993, University Associates, Lansing, MI

[2] Evaluation of the Family Reunification Program, University Associates/The Skillman Foundation - 1999

Florida Department of Child & Families
Tallahassee, Florida 32399-0700
May 22, 2001

The Court Improvement Program (CIP) in Florida has several key indicators that attest to success in the implementation of meaningful enhancements to our child protection system. Florida's CIP has developed these initiatives:

A. The CIP obtained funding from the state legislature to develop model dependency pilot projects designed to supplement judicial resources that will result in more timely outcomes for children and their families. The Court Improvement Program’s assessment of Florida's dependency process provided hard data to support the need for these additional monies. CIP funds allow for the analysis of the model pilots to explore the value of statewide implementation.

B. The CIP analyzed the need and recommended certification of judgeships based in large part on the delays children and their families now experience in achieving permanency. The judicial branch was successful in obtaining more judges this recent legislative session and their assignment to dependency court divisions will be a priority. The CIP grant activities are strongly supported by the Florida Supreme Court and this has led to a statewide call for action within our local dependency court judiciary to implement necessary reforms for the child protection system.

C. The CIP instituted annual Dependency Court Improvement Summits, which bring together the judiciary and child protection system professionals to develop local court improvement plans under the leadership of the judges. These plans are reviewed and monitored by the state CIP staff. Annual reports are published that highlight innovative plans to improve local courts. These Summits have become so popular that the number of attendees has grown from 300 participants four years ago, at the first Summit, to 1200 participants last year.

D. The CIP, working in concert with the courts and our Department, helped to guide a complete rewrite of Florida statutes affecting children. These changes were directed toward bringing Florida law in closer alignment with federal law, and simplifying the work of professionals in the field and the courts who serve our children.

Florida is not the only state with a successful CIP initiative. The American Bar Association (ABA) Center on Children and the Law publishes annual reports compiling the innovations that have been accomplished across the country as a result of the federal funding. For example, Illinois has implemented a parent education program to inform parents about the dependency process; Massachusetts is designing a streamlined appeals process; Michigan has improved the search for fathers in dependency actions; Vermont has teamed "graduate" parents of the dependency system with new parents entering the system to serve as mentors; and, Philadelphia has established a special adoptions court to expedite this process to finalize placement for children. These are but a few of the examples that illustrate the investment outcomes for the CIP project.

Our Department works closely with the judiciary throughout the State of Florida. Our Department recently requested a couple of judges to not hear cases involving dependency because we believed that there was clear bias against the Department on the part of these judges and that their bias had a direct effect on the Department’s ability to protect abused, neglected, and abandoned children. This request was granted and the judges in question were reassigned.

At the same time and in the same area of the state that two judges were taken off the dependency bench, two other judges were working with the Department to concentrate on a permanency project which resulted in 78 children obtaining permanency who had been in the Department’s care greater than one year.

Another way the judiciary has partnered with our Department is by participating with our staff in training our child welfare attorneys. Judge Daniel P. Dawson and Judge Julianne Piggotte are currently working with our Child Welfare Attorneys and the Professional Development Center to create a training video for our staff on "advanced trial skills". In addition, throughout Florida, Department staff is having periodic meetings with the Judiciary and other stakeholders to discuss systemic barriers to obtaining permanency and protecting children in our care.

For example, in Orlando the dependency judges and Department staff agreed to an Administrative Order assigning cases to judges by Department service center. This change permits our Family Safety Counselors to appear before only one of the judges in Orlando. This change will make better use of the time of our attorneys and Family Safety counselors by limiting their court time.

I have maintained my relationships with my colleagues on the bench and we continue to look for more effective ways to protect children. Communication and education among the stakeholders in the dependency system is a key to working toward the same goals. Again, the CIP has been central to accomplishing these objectives. Some of the on-going activities to promote education and communication are:

A. The CIP convenes court improvement liaisons from every judicial circuit to monitor the statewide implementation of local initiatives and provide a forum for information sharing. The Department of Children and Families has similarly established court liaison contacts inside the Department for each judicial circuit, encouraging communication between the courts and the social service agency and facilitating early and creative resolution of problems which may arise.

B. The statewide CIP office publishes a bulletin quarterly for distribution to child protection communities around the state. This bulletin features court improvement innovations.

C. A web site and Web Conferencing System for various groups has been established to encourage information sharing and collaboration among child protection professionals.

D. The statewide CIP office provides ongoing technical assistance to Guardian ad Litem (GAL) programs with various projects such as the implementation of an automated case and volunteers management system, the revisions to the volunteer training manual, and the development of an accompanying instructor’s guide.

E. The CIP office also distributes bi-monthly packets for chief judges and dependency court judges to keep the courts apprized of current child protection issues. This office prepares and distributes training and reference materials, which provide the most recent references to changing statutes and rules.

There are several factors, to which we attribute the success of some of our major programs. Promoting Safe and Stable grant funds were used to provide wrap-around services for the children. Florida funded Protective Services, Family Builders, Intensive Crisis Counseling and Housekeep/Homemaker Programs as well as other services in the continuum of care with these funds.

Florida has increased the number of Protective Investigators and Protective Services staff in the field. Not only have we been able to provide them with better training but also with more access to support services for the families they serve.

Very truly yours,

Judge Kathleen A. Kearney
Secretary

Maryland Department of Human Resources
Baltimore Maryland 21201
May 24, 2001

The Honorable Wally Herger, Chairman
Subcommittee on Human Resources
House of Representatives
2268 Rayburn House Office Building
Washington DC 20515

Dear Congressman Herger:

Thank you for the opportunity to respond to your questions regarding my testimony on the Promoting Safe and Stable Families Program. Below are my responses to your inquiries.

Maryland’s Title IV-E Demonstration Project is designed to prevent unnecessary out-of-home placements and to reduce the length of stay of children in foster care by providing substance abuse treatment and support services to families through a team approach. The project is in its initial implementation phase. Various multidisciplinary treatment teams have assembled and are completing their cross-training. While concurrent identification of potential clients for random assignment is underway, to date child welfare clients have not been serviced by the Title IV-E Demonstration Project.

Although this project is just in its early stages, Maryland has had some positive experience with providing treatment services to families in the child welfare system through a State funded pilot project. This program, authorized by (Maryland) Senate Bill 512, provides substance abuse services to 300 families annually from seven jurisdictions. The program, initiated in October 1997, offers treatment and services to mothers of children who, at birth, have a toxicology screen that is positive for heroin or cocaine.

Some of our experience with this pilot program has encouraged us in the pursuit of the Waiver Demonstration Project.

Question A. Can you tell us what percentage of the families receiving substance abuse treatment are able to prevent their children from being placed in foster care?

Response: In the SB 512 pilot program, percentages have varied by jurisdiction, often dependent on the accessibility of treatment. In Baltimore City, of the women referred to the program who went into treatment, 44% retained custody of their children. In the suburban and rural areas, this percentage is higher, 60%.

The most significant barrier to success is availability, that is sufficiency of treatment "slots" or beds, and geographic accessibility. In addition, only a few residential facilities can accommodate a mother with her child(ren).

Question B: After a few years of treatment are the parents still clean and sober?

Response: Length of time in treatment varies. The most common is a 28-day inpatient stay followed by aftercare on an outpatient basis. Relapse is common in the recovery process. In addition, most of these women have multiple needs for a variety of services – educational, vocational, mental health counseling, and housing as well as substance abuse treatment, in order to maintain their sobriety. Few programs can provide the wrap-around services needed to enable a woman to continue her recovery.

Although data is not complete, some initial results are encouraging. Women (more than half) are choosing to enter treatment and of those most are successfully completing the 28-day programs. Many have expressed a strong desire to continue after their formal treatment has ended. If services can be provided when motivation is high, and continued as needed, lasting success should be possible.

Question C. How long do parents in this program have before termination of parental rights is considered?

Response: The Adoptions and Safe Families Act seeks to expedite permanency for children in the child welfare system. Parents are expected to comply with tasks designed to ameliorate the problems that brought the child into care and the agency is required to provide the services necessary to assist them. The goal of the Adoptions and Safe Families Act is to finalize a permanency plan for a child within 12 months. Because the preferred permanency option is safe reunification with the parents, it is a requirement of the act that states provide the services necessary to effect that outcome. If the state fails to do so, the case cannot proceed to TPR and the child cannot proceed to permanency.

Question A. This is being done without any explicit "charitable choice" language in the Safe and Stable Families program language, correct?

Response: That is correct. Maryland has voluntarily reached out to the faith community to garner their support in assisting the Department of Human Resources in its adoption recruitment efforts. We have learned that there are ties that bind us to the common cause of finding adoptive families for Maryland’s waiting children.

Question B. Have there been any of the concerns others claim when discussing this issue, for example, that church hiring practices are discriminatory or that churches might have to sacrifice some of their religious nature by accepting such funds?

Response: There has never been any concern that church hiring practices are discriminatory or that those churches might have to sacrifice some of their religious nature by accepting government funds. In fact, the churches that we have developed partnerships with strongly believe that it is significant when the two powers (church and state) join forces in order to get children adopted. It is a unique effort that yields many positive results for the Church, the State and all of society. This state and church partnership is extremely beneficial in creating "forever families" in Maryland and across the country.

Sincerely,

Linda E. Mouzon
Executive Director
Social Services Administration

Casey Family Services
Shelton, Connecticut 06484
May 24, 2001

The Honorable Wally Herger, Chairman
Subcommittee on Human Resources
Committee on Ways and Means
House of Representatives
Congress of the United States
1102 Longworth House Office Building
Washington, D.C. 20515-6348

Dear Congressman Herger:

I have received your letter of May 16, requesting additional information related to the testimony presented last week regarding the Safe and Stable Families Program. We are pleased to provide the following additional information and perspectives.

You will find that I have organized our input to correspond directly with your specific inquiries.

Many of the effective services and supports for adoptive families are inexpensive. Adoptive parent support groups are an excellent example of one low-cost way to continue to support adoptive families; educational workshops to help adoptive families deal with the specific challenges that children present or to anticipate problems that might arise as the child grows older is another such support. Other services, such as on-going counseling and respite for adoptive parents, or summer camps for children, cost somewhat more, but are still relatively inexpensive. More intensive services such as residential treatment are needed by far fewer children and for relatively short periods of time, but do cost more – more than most adoptive families can handle on their own. It is important to understand that there is no set formula for when these services will be needed, nor to what extent. Overall, your observation is exactly right: Most of these approaches are not expensive, and they are certainly less costly than returning children to the foster care system.

With regard to the waiver in the state of Maine, services are expected to be delivered in a manner that necessitates no new allocations of funding. Moreover, we believe that the program will provide cost-benefits and demonstrate that this kind of investment in preventive services ultimately results in cost savings. By allowing Title IV-E funds to be used flexibly in combination with Medicaid reimbursement for case management, it has been possible to provide a continuum of services that include prevention as well as treatment. In addition to individual and family counseling to address various behavioral and emotional problems, the program also provides support groups for parents and children, educational workshops that address adoption related issues and activities that promote better understanding about adoption in the community. The hope is that by providing these services before crises occur, future savings will be realized by a reduced number of days of hospitalization and other, expensive forms of care for these adopted youth, and possibly by a lower disruption rate for the families served. In collaboration, the Muskie Institute at the University of Southern Maine, Casey Family Services and the Maine Department of Human Services have developed a particularly strong research component that will provide the data needed to document benefits and associated costs within the next three to four years.

At the recent national post-adoption conference convened by Casey Family Services in Washington, D.C., state adoption directors from across the nation were uniform in the expression of their need and desire to find creative ways to finance post-adoption services. It is very likely that many states would be interested in considering waivers similar to the one in Maine that would allow greater flexibility in the use of Title IV-E dollars. It is critical, however, that we not restrict the availability of these funds for other needed services to vulnerable families and children.

We would urge that the Maine program designed jointly by the State Department of Human Resources, the Muskie Institute and Casey Family Services, be made readily available to all states. This program is proving successful both in responding to the needs of families and children following adoption and ensuring that state and federal funds are used responsibly.

We anticipate that the number of foster children needing adoption is going to continue to rise for the near future. The availability of quality post-adoption services is one essential key in encouraging families to step forward to offer a stable, nurturing family for these children who have experienced so much trauma in their young lives. At the same time, a number of private, non-profit agencies who are capable of offering excellent services to adoptive families continually struggle financially to find ways to fund and maintain such services.

Fees collected from the families often cannot cover the costs, since many of the families have only modest incomes. Insurance often does not pay for any of the cost or will pay for the child’s services, but not for the services the family may need. For example, in family counseling or therapy, the child’s therapy may be paid for, but the family’s participation would not be covered. Increased flexibility for states would present an outstanding opportunity for a cost-effective public-private partnership in every state depending on its needs. Flexibility would enhance the capability and stability of private, non-profit agencies committed to serving these families while at the same time greatly expand post-adoption resources for adoptive families and children.

Even at this early stage, we believe that the IV-E waiver program in Maine offers strong evidence of the potential benefit and value of this approach to flexibility in funding. We would welcome expansion of the demonstration program to allow other states to benefit sooner rather than later. Broadening the reach of the waiver program could be accomplished relatively easily by the U.S. Department of Health and Human Services through a regulatory change.

Casey Family Services would welcome any action that would enhance services and supports in order to strengthen fragile families. During President Bush’s tenure as Governor of Texas, his administration took a leadership role in looking at innovative ways to improve the plight of children in foster care who either needed to return home or to find new permanent, loving families through adoption. It is encouraging to us that he is now able to express his concern for children in these same circumstances who can be found in every state throughout the country. We certainly support the President’s recommendation for increasing the funds available to the Safe and Stable Families Program. However, it is very important that other human service programs, such as Title XX, not be cut in order to fund this increase since these other programs are also providing vital services to similarly vulnerable families and children.

Congress should avoid any action that might ultimately de-fund any of the four clusters of services outlined in the act. We may want to consider looking differently at the clusters and dividing them into two parts such as: adoption support/reunification and family support/family preservation as a way to offer more flexibility and still insure funding for all areas.

Families who adopt need to be able to count on the fact that help will be available when they need it. Even with the current percentages, the 20 percent for adoption is for "adoption promotion," not just for post-adoption services. It is our understanding that some states are using a considerable portion of the 20 percent for recruitment of families, which is also important, but reduces the earmarked dollars for post-adoption support. To do away with the percentages might well jeopardize future funding for adoption, already a small program.

It is important to maintain flexibility in funding streams. The Adoption Opportunities Grants program has a proven track record in helping states move ahead in post-adoption services despite a lack of resources. Combining this program with the flexibility of the IV-E waiver program would achieve sustainability for those services that have proven effective. At the same time, however, states still need to maintain accountability to ensure that the funds are used in the most efficient, appropriate manner. This may help to focus attention on the important issue of data collection related to the experience of the states in responding to adoptive families’ needs. In terms of the way systems operate, this is one of the areas that receive the least attention. Earmarks do help to ensure funding. We must fund all parts of the system in some balanced fashion if we are to prevent children from having to return to foster care.

According to the U.S. Department of Health and Human Services, 33 percent of all children adopted from foster care are adopted by single parents. Research indicates that most single adoptive parents are female and are most likely to adopt older children than infants. As a group, the single parent adopters of U.S. children tend to adopt "special needs" children who, in addition to being older, tend to be minority and/or handicapped children, and almost all have suffered abuse and neglect before being removed from their birth families. Single adults are, therefore, a critical resource for the children waiting in foster care.

The needs of single adoptive parents are similar to those of all adoptive parents in many respects. A strong support system is even more critical for the single parent. Often family, friends, or a church can provide many of the needed supports. When these resources are not readily available, community service agencies must be called upon to provide that network of care and support. The need for assurance of continued financial support and medical services may be even more vital for the single parent, since there is no spouse to rely on in times of economic instability.

A number of key factors contribute to this dramatic increase. Congress has been supportive of measures targeted to doubling the number of foster children adopted from approximately 27,000 per year in 1997, to 54,000 per year by the year 2002. The passage by Congress of the landmark Adoption and Safe Families Act of 1997 (AFSA) has been pivotal in raising the level of discussion by policymakers in Congress and in state legislatures, at the gubernatorial level in many states, and at the highest levels of public agencies across the country.

Typically, since the number of children in foster care and the number needing adoption is quite small relative to the number of welfare recipients or Medicaid recipients, for example, the issue of the need for these thousands of children to have permanent families has not been deemed a top priority. ASFA gave impetus to the U.S. Department of Health and Human Services and every state to look carefully at what was being doing to ensure the timely adoption of children in care who cannot return to their families of origin. It provided the impetus for setting specific targeted outcomes for states to achieve and rewarded states that were able to achieve these outcomes.

It is when Congress, the Administration, the philanthropic community, and every state work collectively with public and private agencies toward the goal of permanency for every child that effective action becomes a reality. Systems don’t change quickly or easily, so it is imperative that such a focus be maintained for a significant period of time in order to achieve the ultimate goals.

When the goal of doubling the number of adoptions is achieved in 2002, we will not have finished our job. There are 118,000 children in foster care today in need of, and eligible for, adoption. The number is expected to go even higher over the next year. It is essential that Congress, the Executive Branch at both the federal and states levels, and federal and state agencies across the country stay the course until the goal of permanency for every child who needs a family is achieved.

Casey Family Services provides post-adoption services in Connecticut through our Bridgeport and Hartford Divisions. Additionally, we have post-adoption programs in Vermont, New Hampshire, Rhode Island, and Maine. The programs generally consist of information and referral services; counseling for the children, parents, and the family as a whole; advocacy to help families obtain the services they need particularly from the education and mental health systems; educational workshops and training for adoptive parents and community professionals and community education about adoption and the needs of adoptive families. Staff give presentations at various community agencies such as libraries, schools, mental health facilities, and go to other community gathering places such as festivals, fairs and malls to set up information tables and educate the community about adoption.

We have experienced very positive feedback from the agencies and community groups with whom we have worked. In Vermont, for example, a result of our training with community mental health centers is that a question will be placed on the intake form that asks if the client is adopted. In the past, a counselor may not have known that a client was adopted and not made the connection between the problem being experienced and its relation to the adoption.

In the schools, teachers appreciate understanding more about the needs of adopted children and how some class assignments may be insensitive to their needs. For example, when teachers ask children to bring in baby pictures, they need to know that children adopted from the foster care system may not have any baby or birth family pictures. By exercising awareness and understanding, teachers can make the assignment less stressful and more sensitive to adopted children. Increased community awareness will result in more caring and supportive environments for adoptive parents and children.

Congressman Herger, Casey Family Services deeply appreciates your interest in this important area. We are grateful for this opportunity to share our experience and insights in greater detail. I hope that we have been able to provide useful information in response to your inquiries.

Thank you, again, for the privilege of presenting testimony at the May 10^th Hearing on the Safe and Stable Families Program. If other questions arise in the future, please consider Casey Family Services as a resource.

Sincerely,

Raymond L. Torres
Executive Director

[Submissions for the record follow:]

American Bar Association, Center on Children and the Law, Eva J. Klain, and Martha W. Barnett, statement

Conference of State Court Administrators, Arlington, VA, David K. Byers, statement and attachment

National Family Preservation Network, Buhl, ID, Priscilla Martens, statement

Prevent Child Abuse America, Chicago, IL, statement