by Chris Switzer
Halfway through CA’s experiment with capped grants to fund child welfare services, little can be said about their effect on child welfare.
The US Congress is now considering whether to renew a program under which two California counties, Alameda and Los Angeles, have received capped federal grants to fund their child welfare agencies. The funding program represents an important change from the more traditional, open entitlements that tie grants of federal dollars to the number of children in foster care.
As a result of the change in funding structure, the two counties' child welfare departments don’t lose federal money when the foster care population goes down, nor do they receive more money when the population goes up. Instead, they receive the same set amount each year. A risk facing counties operating under capped federal grants is that they are responsible for covering the deficit if the number of children in foster care goes up.
Federal funding for Los Angeles and Alameda counties was based on what the counties spent between 2003 and 2005. As a result, the counties received more than they would have if they had not participated in the program: expenditures for both counties were lower in 2007 than they were in 2005 because the counties reduced the number of children in foster care.
Through the program, the counties have been able to take the revenue not used to pay foster families and use it for programs that help stabilize families, provide drug treatment to parents, and help high-risk youth find homes.
It’s impossible to determine, however, what improvements have resulted from California’s Title IV-E Child Welfare Waiver Demonstration Capped Allocation Project (CAP). Results have been mixed at best. In Los Angeles County, deaths caused by child abuse are on the rise1, several child welfare statistics are trending downwards2, and the county's child welfare department, the Department of Children and Family Services (DCFS), has cycled through three directors in six months. The county's Board of Supervisors recently voted to strip the county’s Chief Executive Officer of oversight of DCFS. More bad news came in news reports of the recent death of a 17-month-old former foster child who had been returned to her parents over the strong objections of the director of a foster family agency.
TITLE IV-E WAIVERS
California’s Title IV-E Waiver Capped Allocation Demonstration Project (CAP) is part of a federal program that gives certain states flexibility in how they fund child welfare services. California was the last state to be approved for the program, in 2006. Twenty-two other states participated in the program, but in 2006 the authority of the Department of Health and Human Services to approve waivers reached its sunset date. House Bill 1194, sponsored by Rep. James McDermott (D.-Wash.), would revive the program; the bill has passed the House of Representatives and will now be heard in the Senate Finance Committee.
States approved for the federal Title IV-E Child Welfare Waiver Program develop and implement innovative methods for funding foster care and child welfare departments. Some states, for example, have implemented programs to pay relatives to care for children removed from their homes. Encouraging results in those states helped spur Congress to establish the Guardianship Assistance Program as part of the Fostering Connections to Success and Increasing Adoptions Act of 2008. Waivers in other states have focused on providing treatment to caregivers with substance abuse problems.
Demonstration projects typically last five years, although extensions can be granted. The federal program's goal is to determine how different initiatives affect child safety, and to see how states can improve child welfare through changes in how services are funded. Each state’s demonstration project is independently evaluated.
Six states – Florida, Indiana, Ohio, Oregon, North Carolina, and California – have been approved for capped allocation demonstration projects, through which they receive a set amount of funding rather than an amount per child in foster care. By reducing their foster care populations, some states have realized surpluses, which can then be used, for example, to help high-risk youth find foster families, or to provide intensive in-home services to help some families stabilize and therefore avoid foster care altogether.
Proponents of the Title IV-E Welfare Waiver Program argue that under traditional funding structures, child welfare departments have an incentive to place children in foster care in order to draw down federal dollars through Title IV-E of the Social Security Act. In a hearing before the U.S. Senate Finance Committee on the renewal of the Title IV-E program, Senator Orrin Hatch (R-Utah) said that federal funding for child welfare is “directed at the least desirable outcome: removing a child or children from the home and placing that child in foster.”3 William Bell, president of the Casey Family Programs, said the biggest problem with how child welfare is funded is the “failure to align federal financing with desired outcomes.”4
The waivers have been cited as one reason that the number of foster children nationwide is falling5. Three of the states with capped allocations – California, Florida, and Ohio – led the nation in reducing foster care populations between 2002 and 2009.6 Los Angeles County has had particularly dramatic results in this area: a 24 percent drop in the number of foster children, and a 28 percent drop in the average time children spend in foster care.7 Last year around 800 fewer children were placed in Los Angeles County foster care than in 2007.8 Alameda County, which is also participating in the CAP waiver, has seen similar reductions in its foster care population.
WAIVER IN CALIFORNIA
Child welfare officials in Los Angeles were the first in California to push the state to participate in the waiver program, and since then Los Angeles County has implemented several innovative initiatives with CAP funding. They include intensive in-home services for children at risk of removal from their home, and cash assistance for older foster youth to help them make the transition to independent living.
The results, however, have been mixed. Child safety trends tracked by the Center for Social Services Research at UC Berkeley continue to “present a concern and area of focus for [Los Angeles DCFS],” according to an independent evaluation of the CAP published last year.9 For instance, the rate at which children in Los Angeles County reenter foster homes within a year of being reunited with their parents exceeds national targets, and has climbed from around 10.7 percent in 2007 to 12.4 percent in 2009. This suggests that some foster children are being returned too quickly to parents unprepared to care for them. While current re-entry rates are much higher in Alameda County, they have fallen slightly in recent years. Rates in California as a whole have remained steady at around 12 percent.
The CAP evaluation report, authored by San Jose State University researchers Charlie Ferguson and Laurel Duchowny, also found that in Los Angeles County more children who were abused but not removed from their homes experienced abuse again within 12 months – up from 9.6 percent of children just before the CAP began to 11.4 percent in 2008. By comparison, the rate dropped in Alameda County, according to UC Berkeley statistics.10
However, because of the way the evaluation was designed, these trends cannot be attributed to the counties’ participation in the CAP. The report looks only at child welfare trends in Los Angeles and Alameda counties, as well as at administrative changes at the state and county levels. It uses an interrupted time series design that tracks certain child welfare statistics, like the rate at which children experience abuse twice within 12 months while remaining at home, at specific points in time before and after the CAP was implemented. Because the report does not include comparison counties – counties not participating in the CAP but otherwise similar to the counties that are – the report cannot "attribute changes in outcome trend lines to a department's participation in the CAP." There may be any number of reasons for the changes, including the recent recession.
When Ferguson initially designed the evaluation, it included comparison counties. Comparing child welfare trends across counties would have yielded a better sense of the effect of the CAP on child safety. However, state officials requested that Ferguson remove the comparison counties from the evaluation design. The result has been a “far less rigorous analysis,” Ferguson said in an interview. Indeed, federal guidelines advise that evaluations of Title IV-E waivers should “assess whether proposed interventions support improved child welfare outcomes.”11
The US Department of Health and Human Services (DHHS) also requires that evaluations use one of three methodologies – random assignment, comparison sites, or matched samples – all of which can determine the effect of the waiver on child safety and welfare.12 California’s evaluation, which uses an interrupted time series design, was approved by DHHS during negotiations in 2006. Only one other state – Florida – uses an interrupted time series to evaluate its waiver. Since every county in Florida currently operates under that state’s waiver, no comparison counties are available.
According to state and county officials, California’s waiver evaluation does not require comparison counties. Officials didn't want to force counties not participating in the CAP to participate in the evaluation. And since the CAP changes a department’s entire funding structure, state officials wanted the evaluation to provide a broad overview of the CAP as it was implemented in Los Angeles and Alameda counties, rather than to examine individual initiatives and their effects on child welfare.
“It was never designed to look at individual policies,” said Michelle Love, Interim Assistant Agency Director of the Alameda County Department of Children and Family Services.
Alameda County DCFS has allocated some of its CAP funding – about half a million dollars in the current fiscal year – to evaluating its waiver initiatives.13 The department has added four staff members to collect data on those initiatives and on the outcomes of children who come under the department's care. This occurred in response to concerns that “some programs have continued without a useful understanding of how they improve outcomes.”14
ACDCFS is also working to increase the availability of statistics on child welfare trends. While the department’s move toward a stronger reliance on data predates the CAP, the county is particularly concerned that CAP-related decisions be made based on data and outcomes.
“Everything we have under the waiver should be evaluated,” said Love. “We’re looking at everything that has a dollar sign associated with it.”
Like Los Angeles, Alameda County has focused many of its efforts on safely reducing the foster care population. A program called Another Road to Safety, which was initiated before the waiver began but has continued with CAP funding, provides intensive in-home services to families with children who are in danger of being removed to foster care. Social workers make weekly visits to assess the home, provide life skills tutoring, and ensure that basic needs are being met.
Alameda County has also implemented programs to make foster care safer. Some programs focus on recruiting foster caregivers, an urgent priority given the 75 percent reduction in the number of licensed foster parents in the county over the last 15 years.
Such programs have been possible through the stable funding that the CAP has provided over the last few years. Not only have Los Angeles and Alameda counties been able to avoid severe budget cuts, they actually receive more money than they would if they were not participating in the CAP and were receiving grants proportional to the number of children in foster care.
If Congress chooses not to renew the federal Title IV-E Welfare Waiver Program, the counties will return to being funded through an entitlement in January 2013. With federal dollars again tied to the number of children in foster care, the counties may see a loss of revenue. Alameda County’s Michelle Love says that the department will soon plan the process of returning to entitlement funding.
While the counties have put in place dozens of initiatives under the CAP, little will be known in January 2013 about how they affect child welfare. This is due partly to the length of the demonstration project: officials and evaluators stress that they are not able to get a good sense of how effective initiatives are with only five years to plan, implement, and assess them. It is also difficult to compare the administrations and results of two counties with such vastly different foster child populations: even with recent reductions, Los Angeles has about 10 times as many foster children as Alameda.
It is unfortunate, then, that the official evaluation of the program ultimately can’t answer the question of whether Title IV-E Welfare Waivers help children. And that’s the one question Congress needs to consider this session as it debates renewal of the program.