insights: What are the top 3 objectives that child welfare federal finance reform should achieve?
#1 We need to be able to articulate a set of improved outcomes for children and families under which reform would be structured and be held accountable.
We are already using federal funds to promote safety, permanency and well-being. What do we want to do differently that requires better or different financing? Should we make the system smaller or serve more children? Who are the current set of initiatives working for and for whom are things not working? We need to ask what kinds of improvements in well-being are measurable.
#2 It must be cost neutral.
Finance reform has the potential to be transformative for child welfare, but the reality is a difficult one when it comes to any perceived increases in funding. Even a proposal in which spending stays the same is seen as an increase by the Federal Government because the trend line for the number of children in care is going down. Gaining a full understanding of all the associated spending across federal programs and identifying opportunities for cost savings, and outcome improvements, through the child welfare waiver demonstration projects and coming out cost neutral should be a goal of ours. Of course, it will also take significant advocacy and political will to make this funding stream do what it’s supposed to do – improve the lives of vulnerable children and families.
#3 Any finance reform strategy must speak to how to improve the performance of states.
Other factors to consider are the wide variations between state child welfare agencies. Not everyone performs the same over time. For example, Vermont’s caseload is down by 60%, but Texas’ has gone up by 25%.Illinois removes a very low percent of kids from their families, but on average the length of stay in foster care is 4 years, whereas Minnesota removes a lot of kids from their homes, but the average length of stay is less than one year.
Another example of where we could examine state performance is within subgroups. Since the adoption bill passed, there are half as many African American youth in foster care system today than there were 15 years ago. Ten states account for 80% of that reduction. They are doing something different, and it seems to be working. We need to identify what is working, what is not, and how the states differ in their practices.
insights: What characterizes child well-being and how is it measured?
Samuels: The greatest challenge to measuring well-being is that the data systems, as they are currently built, don’t capture/report the data needed. Of the indicators we do capture, we need to ask which are most relevant to child well-being and look for any opportunities where there are apples to apples comparisons with screening and assessment. Most states don’t have consistent screening tools throughout their system.
For example, we should ask how many kids are being put on psychotropic drugs before they are provided other social/emotional intervention(s) and how long are they on them. This may not be a great measure of well-being, but it can be measured and it may reflect or determine the outcome of other well-being indicators.
Chapin Hall will probably have a well-being indicators product ready to publish by end of 2014.
insights: What advice do you have for advocates of reform?
Samuels: As advocates for better child welfare practices, we have to be more precise in order to get something done in Congress. Throwing everything on the wall and seeing what sticks is not going to make change. If there is one bright spot, people on the Hill are more interested today in data and evidence than they were 10 years ago. They are open to being persuaded by data.
Past Title IV-E waiver programs did not produce enough evidence or positive impact to move anybody. The question remains as to whether states can do what they say they are going to do to get to those outcomes. At this point, it is too early to tell if their execution is precise enough to make change happen.
insights: What advice do you have for states that are trying to lead the reform effort?
Samuels: The best way to achieve reform is to approach Congress with better explanations of spending trends at the state level and how the use of the federal allocation leads to better outcomes.