When Child Welfare Works A P R O P O S A L F O R FI N A N C I N G B E S T P R A C T I C E S

1. When Child Welfare Works APROPOSALFORFINANCINGBESTPRACTICES Presentation for National Organization of State Associations for Children March 27, 2014 THEANNIEE.CASEYFOUNDATION

2. Agenda • Why the urgency: The cost of doing nothing • Likelihood of congressional action • Overview of intent of proposal • Summary of recommendations • Feedback already received • Limitations to the proposal that require creative solutions

3. The Cost of Doing Nothing: Decline in Federal foster care participation rates

4. The Cost of Doing Nothing: Decline in Federal foster care funds

5. The Cost of Doing Nothing: Decline in Federal funds for child protective services and family support

6. The Cost of Doing Nothing: Decline in flexible Federal funds for child and family services including prevention P.L. 104-193 sets new ceiling of $2.38 billion Subject to sequestration President’s budget included $.5 billion cut P.L. 105-178 sets new ceiling of $1.7 billion H.R. 5652 repeals SSBG “The Committee…has determined that the SSBG program has critical program flaws that argue for its elimination…The following key flaws in the SSBG program reflect how it clearly does not serve taxpayers well: No focus… Duplicative…No state partnership…No accountability” H.Rept. 112-58 recommends repeal of SSBG

7. Likelihood of congressional action • Changes in Senate leadership • Significant bi-partisan staff-level interest in financing reform • End of waiver authority • Potential for budget reconciliation in next congress • Growing consensus on principles for reform

8. Intent of proposal • Target federal funds to support what works best for children and families with a focus on enhancing permanency and well-being • Protect the entitlement, ensures that all children in foster care are included in the entitlement • Make achieving timely permanency for children and maintaining them in families the fiscal responsibility of states AND make the federal investments necessary to allow states to achieve these key outcomes • Investto increase the quality and capacity of family foster care, support a qualified workforce, and ensure that adequate therapeutic and family support services are available to address children’s needs • Maintainthe current level of federal investment in child welfare

9. Children do best in families

10. Areas where financing can make a difference There are four key areas in which financing changes can make a difference: Therapeutic and supportive services Foster and kinship care Permanence and well-being Workforce

11. Improving permanence and well-being for children VISION Kids have families they can rely on to help them become successful adults.

12. Improving family foster care VISION Foster families have the training and support they need to help kids grow up in families. Relatives have resources to care for their own.

13. Building a more capable workforce VISION More experienced workers focus on directly helping kids.

14. Funding social and therapeutic services VISION Increased funding and flexibility for services to prevent placement, promote reunification and provide therapeutic intervention.

15. Feedback Received Recommendations receiving widespread agreement/support • Eliminating income test for IV-E eligibility • Reconfiguring SSBG • Foster parent and workforce investments • Medicaid Plan for meeting the needs of child welfare families Recommendations met with greatest concern • Limiting federal funds for long-term foster care • Limiting federal funds for non-therapeutic group and residential care • Lack on investment in prevention and post-permanency services, support for tribes

16. Limiting federal funds for long-term foster care Rationale • Incentivize, free-up necessary resources to invest in achieving timely permanency • Represents best practice even in challenging situations • TPR after 15 of the last 22 months + time to achieve alternative permanency arrangement < 3 years Potential Impact • Number of children in care for more than 3 years: 18% of children currently in care, 9.5% of entrants, 32.5% of children awaiting adoption • Permanency: “Children 12 years or older who continued to live in foster care after 3 years were nearly certain to age out of care before finding a permanent placement alternative.” [NSCAW] • Stability: Stability of care drops sharply after 3 years • Questions • Lifetime limit? • What about kids already in care? • What about youth in care after age 18? • Concerns • Reimbursement will drive placement decisions rather than best interests (compare to deinstitutionalization) • Slippery slope • Suggestions • Graduated decline in reimbursement rates • Reimbursement for children re-entering care • Exceptions to time limit

17. Limiting federal funds for non-therapeutic group and residential care Rationale • Recognition of the need for and benefits of family, and that children should not “grow up” in group homes • Many/most children are referred to group care because of a lack of alternative placement and not to meet their therapeutic needs • Research findings on poor outcomes, potentially adverse impact of group care for many children • Recognition of the developmental needs of younger children • Feedback from residential providers on time needed to address therapeutic needs, data showing diminishing returns from residential treatment after a period of time Potential Impact • Number of children experiencing group care • 15% of foster children are currently in group care • 25% of all children spend some time in group care • 20% of all children initially placed in group care • Number of teens experiencing group care • 33% of foster teens currently in group care • 57% of teens spend some time in group care • 40% of teens initially placed in group care • Enormous variation among and within states demonstrating significant differences in practice

18. Limiting federal funds for non-therapeutic group and residential care • Suggestions • Allow reimbursement for very short-term shelter care that meets therapeutic standards • Exceptions for both age and time limits, types of treatment facilities • Require comprehensive MH assessment prior to group care placement • Concerns • Where will children go for emergency placement? • Where to find foster parents for older children? • Residential providers often get children who have already been in several group settings • Existing family options unable to meet needs of children with MH • Possible unintended consequence may be short-sighted frequent replacement of children to multiple homes because the child isn’t getting the necessary level of care, increased state expenditures lead to decreased funds for other services and supports • Questions • How to define non-therapeutic? • Why age 13? • Why set 1 year as time limit?

19. Lack on investment in prevention and post-permanency services, support for tribes • AECF has a much larger agenda to support low-income families • Caseworker support for candidates (both in-home and post-permanency) • Medicaid access, ACA implementation could have dramatic impact • Protection of SSBG and IV-B key

20. Limitations to the proposal that require creative solutions • Exceptions to limitations on federal funding • Identify specific groups of children • Identify specific criteria for children • Allow a preset percentage of exceptions • Services • What specific services • Individual entitlement, funding entitlement, capped funding program • Time limited

21. Please contact us with additional feedback:Rgeen@AECF.org(410) 547-3679http://www.aecf.org/OurWork/ChildWelfarePermanence/WhenChildWelfareWorks.aspx