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Shame on U.S. – Our Federal Child Welfare System is a National Disgrace

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In the world of child welfare, there is a lot of good happening.  We have good people with good hearts working hard to keep children protected from abuse and neglect.  We have hard working individuals who put in hours and hours to make sure children who have been abused and neglect are able to live in safer environments and experience better outcomes than they would otherwise see.  We have policy advocates working diligently to inform evidence-based policy reforms.  And we have representatives in office pushing for laws that will continue to improve the child protective system.  All of this good has led to better outcomes for some children but, unfortunately, there are still tens of thousands of children across the country falling through the cracks the size of the Grand Canyon.

So, the question remains….why does our system fall so far short?  Why do so many of these children have outcomes including PTSD, unemployment, homelessness, sex trafficking victimization and imprisonment at rates far above any other group?  Why do we keep seeing headlines about a broken system, a system that repeatedly allows children to die due to abuse and neglect even after local child protective services have been alerted to their precarious state?  It’s a national disgrace.

The answer is not simple and has multiple layers.  Sure there are some bad actors out there.  Additionally, the child protective system is woefully underfunded (or at a minimum inappropriately funded).  But the answer can also be seen when you look at our federal child welfare structure.  Every state in the union accepts money (totaling billions of dollars) from our federal government in exchange for agreeing to follow federal requirements in administering the State’s child welfare system.  This places the federal government as the backbone of our child welfare system so it is worthwhile to take a look at the glaring holes that exist in our policy and the enforcement of that policy.

In a brand new study, Shame on U.S., the Children’s Advocacy Institute uses the federal government’s own internal documents as the basis to criticize all three branches of the federal government for being derelict in their duties to the most vulnerable children in our nation.  States are consistently failing to protect abused and neglected children but the Department of Health and Human Services (HHS) rarely exercises its oversight powers to ensure state compliance with federal mandates – essentially becoming the states’ complicit partner. HHS often takes on a passive monitor role, allowing states to self-certify compliance and set lower standards and performance expectations for themselves — all of which allow glaring inadequacies to go unabated.  In many instances, private citizens have been forced to turn to the courts to seek California’s compliance with federal child welfare laws but federal courts have been reluctant to find that federal laws allow aggrieved children and families a private right to sue.  And, unfortunately, Congress has shown little appetite to address these issues by plugging the holes where the executive and judicial branches are dropping the ball or failing to act.  This completes a trifecta of inertia and neglect and often leaves advocates, and more importantly the children they aim to protect, spinning in a circular trap.

Shame on U.S. connects all these dots for the first time, holding all three branches accountable, pointing out their inter-related failures and the critical need to cure these deficiencies.  There are concrete action steps that can be taken by each branch to mitigate the current harm.

HHS must:

  • Toughen its oversight and enforcement activities to ensure that each state operates its child welfare programs consistent with federal law, and HHS must impose serious consequences when states fall short;
  • Revise its evaluation program to end the process that allows failing states to meet a compromised set of lowered expectations;
  • Utilize its rulemaking authority in a more robust manner with regard to the interpretation of federal child welfare laws. Regulations are enforceable. Anything less is not.

Congress needs to:

  • Provide clear private remedies for children within all federal child welfare statutes, to enable private litigants to seek judicial recourse when violations occur;
  • Repeal or revise current law to ensure that all foster children are treated equally without regard to their economic status, that states comply with all aspects of all child welfare laws or suffer real consequences, and that HHS plays an active and vigilant role in ensuring state compliance via monitoring and enforcement activities;
  • Eliminate the “look back” provision that makes a child’s eligibility for federal foster care funds dependent on whether the child’s family would have qualified for AFDC in 1996. It is arcane, primitive, and hurts children and families;
  • Impose consequences on HHS for failing to follow through with its oversight and enforcement responsibilities;
  • Restore and reinforce funding for child welfare programs at levels that ensure an effective child welfare system, enact comprehensive child welfare finance reform to address a wide range of problems — such as a complex mix of mandatory and discretionary funding that results in haphazard payments to states, swaths of uncoordinated funding from disparate sources with inconsistent mandates; a host of unfunded mandates; and a dearth of accountability for the money spent by the states.

The federal judiciary should:

  • Acknowledge its role as a check and balance to lax executive branch enforcement of child welfare laws, and resolve any ambiguity in federal law as to whether children and families have a private right of action in their favor;
  • Ensure that states entering into consent decrees bring their child welfare systems into compliance with federal law in a more timely manner than is currently the case.

Support for these changes should cross political party borders.  The children these policies are designed to protect are, in a very real sense, our children.  Our representatives have crafted laws allowing for the removal of these children from their parents.  Our government then steps in and takes these children with the understanding that we, as a system, can protect and raise these children better than their parents can.  Leaving these gaping holes in our child protective system is a true national disgrace and each day that passes while we allow them to remain – Shame on U.S.

You can find the report at http://www.caichildlaw.org/Shame_on_US.htm

Author: Christina Riehl, Senior Staff Attorney at CAI 

Urgent Memo

URGENT MEMORANDUM
JUNE 11, 2014

TO:         CALIFORNIA’S SENATORS AND ASSEMBLY MEMBERS
FROM:   ONE OF YOUR 60,000 FOSTER CHILDREN
RE:         PLEASE!

Imagine if one of your legislative staffers was assigned to work on more than 300 bills … in one year. Imagine over 300 bill binders in your staffer’s office. Impossible, right?

My lawyer – the only adult in my life who is has the legal duty to make sure the laws you pass actually benefit me, the one adult in my life with a duty just to me – she has a case load of over 300 children like me, more than twice what the Judicial Council says is the maximum possible case load.

This is what such a case load looks like. My whole life and future is somewhere in these files.

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Senators, Assembly members, you by force of law have separated me from my parents. I am now being raised within a bureaucracy. I am being solicited by pimps; about half of sexually trafficked girls are right now in foster care with me. There is a good chance I will be homeless when I age out. I am far more likely to end up in prison than other youth. Odds are, I will not graduate from a four-year college.

Respectfully, last night you found money for many things but you decided to take away my voice, my champion. You took away my hope.

Please, I beg of you. Please reconsider. I am your child.

____________

If you would like to do something to help ensure California’s Foster Children have access to the effective representation they need, CONTACT GOVERNOR BROWN’s OFFICE and tell him that foster youth need adequate attorney representation. Dependency attorney caseloads must be reduced. 

Is the Constitution Merely A Protective Wall vis-à-vis the State? What About One Affirmative Duty to our Children As a Part of that Document?

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                  Little Johnny was 11 years old and his homeless mother had his five year old younger sister to worry about.  So she left him on a street corner in Ocean Beach, a neighborhood in San Diego, California.  Johnny looked for his Mom for four days before he was picked up by social workers.  During that time he scrounged odd jobs — including conning a restaurant manager into letting him wash dishes three hours a night.  He had earned just over $135.  When he was picked up she had every penny in his pockets, confining himself to one meal at the restaurant and provided by it, because “Mom needs it.”  Johnny is a bright-eyed boy with above average intelligence.  But he has a slight stoop due to a correctable bone malformation.  His teeth have painful cavities.  And he has not been in school for two years.  He is a microcosm of child poverty in the United States — a child with strong potential and admirable character but with health problems, an educational deficit, and likely relegation either to group home foster care or back to the streets.  Regrettably, Johnny S. is not unique.  Indeed, he lives in our wealthiest state and until gathered up, was sleeping under bushes by the beach, in the shadows of $5 million homes.

Over the past two decades, child poverty has been fluctuating between 10% to 20% of the population, with an overall upward trend.   The rate declined somewhat during the late 1990s, but are now trending back up.  And it is happening in the context of a now limited and reduced welfare-reform safety net; (b)  “severe poverty” (income under one-half of the federal poverty line) has increased but is not precisely measured — a problem Johnny S. represents; and (c) children in large numbers are living below or near the poverty line.  This last grouping now represents well over 37% of all American children, 42% of America’s infants and toddlers,  58% of her African-American children, and 62% of her Latino children.  ( See Reports of the National Center for Children in Poverty, Columbia University, www.nccp.org).

Child advocates are concerned about both ends of this spectrum – the severe poverty portending permanent damage, and the imminent creation of a large third-world underclass of  intractable poverty.  The latter concern is reflected in overall increasing income disparities, with the upper 1% of Americans now earning as much as the bottom 38% combined.  And the concern is underlined by barriers to upward mobility driven not only by childhood poverty, but by preclusive real estate (and rent) inflation; growing energy, gasoline and health care costs, and little increase in higher education capacity (including community college and technical training)  most will need for employment in the international economic labor niche of the United States.  This effective contraction is joined by many years of tuition increases well above inflation.  And impediments to mobility for these young include unprecedented economic solicitude for older adults.  While the federal budget deficit appears to be laudably in decline, it is still quite high by recent historical records.   Add to this sum more ominous Social Security and Medicare obligations — that expert economists now project over the next 70 years to reach well over $40 trillion,  $120,000 for each child and youth obligated to pay for it for the children now being born.  And that does not include the still formidable federal deficit, nor the surprisingly high public employee pension and medical coverage costs that have plagued Southern Europe and also threaten us.  Here is the problem:  Today’s liberals actually believe the pop song lyric “Money for Free and Chicks for Nothing.”   The world will manage later on.   Money will rain down the road.  That is not how it works.  Nor is the trend likely to improve given the power of the elderly politically, rather, the more likely future will be more subsidized operations and medicines to extend life by weeks or days, and higher social security benefits for more people.   Child advocates increasingly cite our unique cross-generational taking:   Instead of the longstanding American tradition of older adults investing in the young (particularly in opportunity for the impoverished), we are burdening them with our unprecedented debts and future costs.

Who are these children living near or below the poverty line?  What are the causes of their poverty?  What legal and societal remedies are available to give them realistic opportunity to advance?

Contrary to public perception, the parents of impoverished children are not consuming beer in front of soap operas — engaged in what some call “welfare as a way of life.”  The data reveal that 56% of these low-income families have at least one full time working parent; 28% work part time and only 16% are unemployed — many of whom would be willing to work if employment were available (id.).    However, the single most striking variable underlying child poverty is single-parenthood – both from divorce and unwed births — the latter have risen over the last thirty years from below 10% of all births to over 30%.  And contrary to the common view, these births are not to teenagers, the vast majority are to adult women.  Paternal support for these children is minimal, with average payments received amounting to less than $35 per month per child, and almost half of that goes not to families but to repay state and federal governments for welfare payments.  (See Chapter 2, California Children’s Budget 2004-05, Children’s Advocacy Institute at www.caichildlaw.org).   Most of the children in these unwed families live below the poverty line, and perhaps the most remarkable number from the U.S Census Population Survey reports is the difference between the median income of a female single head of household with two or more young children (about $11,000 in annual income), versus the median for those children in a family with a married couple (well over $50,000) (id.)   These numbers have grown even more stark over the past 8 years.

The conundrum for Johnny S. is the need for two incomes to support high rents and other rising costs of living.  His mother is caught between the rock of child care obligations for her children (which she either provides or finds $5,000 per child to finance) and the hard place of a single wage earner unlikely to net much more than her child care costs for two or more children.  Current federal policy makes the hard place harder because she is limited to 60 months of federal help (Temporary Aid to Needy Families) — and even if working part-time is given no credit for those months of income where she works less than 32 hours.  Remarkably, the Bush administration currently proposes a 40-hour minimum work week for such parents, with each month of full-time shortfall generating possible sanction — including the 60-month lifetime cut-off.

As discussed, child poverty involves both private decisions and public disinvestment.   Hence, the causes as cited by commentators tend to turn on their respective political leanings,  with conservatives citing reproductive irresponsibility, sexual license, lack of paternal commitment, as well as deficits and unfair burdens imposed on the young by the old and limiting their future aspirations.  Liberals cite reduction of the safety net, a minimum wage that is not adjusted to inflation and has declined to below the poverty level for parents of two or more children, and education disinvestment that jeopardizes future employability for an impoverished class.   Is it possible that both are correct?

According to many child advocates, the problem facing children is the truce silently in force between these traditional political antagonists.  Each appears to have surrendered its agenda favorable to impoverished children in return for the surrender of the other’s.   Hence, popular culture now purveys with impunity the notion that single parenthood is simply a different and somehow charming choice… with those dozens of sit-com and other adult-models (from Rachel on Friends to Roz on Frasier and many others) suffering no financial repercussions, child care dilemmas, or worries.  It is far beyond the old sitcom character of Murphy Brown.  Indeed, our fantasy parents in the media often do not seem to work for a living but the rent is magically paid.  No male appears to pay child support, nor does any child appear to need it.  Rather, our media flood us with sexual stimulation and commendation without apparent negative childbirth consequences, replete with cialis and viagra ads for hours of male hardening — while hypocritically eschewing condom ads.  Child advocates contend that for their part, liberal adults have surrendered (or been overborne) in the direction of momentous public disinvestment in children, especially impoverished children – with safety net support and education opportunity suffering the largest cuts.   And child advocates complain that both adult political groupings (although purportedly in “deep division”) have conspired to violate through deficits and huge obligations to the elderly the one pact always drawn in favor of children – that adults do not take from their children, but give to them.

So if these complaints have merit, what is the answer?   One prescription is to reverse the trade-off between private license and child disinvestment into the opposite proposition, one demanded from the body politic.   The Honorable Charles D. Gill has long advanced the public commitment part of it in a proposed constitutional amendment (Essay on the Status of the American Child — 2000 AD: Chattel or Constitutionally Protected Child-Citizen?, NACC Children’s Law Manual – 1998, at 337).  Our constitution is oriented  to inhibit the coercive power of the state vis-a-vis private, individual liberties.  But the constitutions of most developed nations also interpose some affirmative obligations on the state — obligations which need not impede checks on state coercion.  Similarly, the United Nations Convention on the Rights of the Child, now signed and ratified by every nation except the United States and Somalia, posit some minimal affirmative obligations to our children.  Such a compact may properly specify only those obligations that are clearly commended as a common floor: That our children will not be homeless, will receive adequate care and nutrition to develop healthy brains, will have minimal health coverage, and educational opportunity so they may provide for themselves and their children in turn.   What is the opposition to such a standard, spelled out with sufficient specificity to be enforceable?  Is it that we, unlike our less affluent contemporaries in Europe, cannot afford it?

We reserve for our constitution measures that may be politically unpopular but are a consensus “rule of the game” underlying our society.  Although denied “suspect class” status in equal protection cases, what group — in fact — is more politically impotent than impoverished children?  And what commitment do we have more basic than this one?

Would support for such a formalized pledge benefit from a cultural sea change that private decisions to have children warrant the preparation and respect that the miracle of childbirth implies?    That it include the simple and minimal obligation of parents simply to intend a child, and of a father to provide for his children?  Assume such a commitment were an acknowledged part of our culture, and became as “politically incorrect” to transgress as would an insult to a homosexual or a wheel-chair confined adult.  What would be the prospects for such a constitutional commitment, and to child investment in general, in such an altered environment?

One need not have a long conversation with Johnny S. to appreciate the merits of both a constitutional amendment and a cultural commitment to such children.

The author: Robert C. Fellmeth, is the Price Professor of Public Interest Law, University of San Diego School of Law

Congressional Priorities – Corporations Over Abused and Neglected Children?

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Where are our priorities?  If you look at what is happening in Congress, you will be reminded (again) that they are in the wrong spot!  Last week on Tuesday, April 29th, the House Ways and Means Committee convened and adopted seven different bills.  Six of the seven addressed the tax code and extended certain business-related tax deductions.  These six tax bills cost approximately $310 billion over ten years and were approved by the Committee without any requirement that the bills show an offset of cost savings.

Then, there was the seventh bill, the Preventing Sex Trafficking and Improving Opportunities for Youth in Foster Care Act (HR 4058). This is the bill that brought my attention to what was going on in our Capitol on a seemingly random Tuesday in April.  This bill was the only bill addressed that day that did not address the tax code AND it was the only bill that required at least some of its costs be offset.

To reiterate and make clear – our government could find billions of dollars to extend tax breaks to businesses, but, when trying to spend a few million dollars to try to help kids that are abused and neglected, those advocating for the change are going to have to find a way to pay for it.  What kind of priority is that?  What does that say about us?  If the saying, “put your money where your mouth is” holds, true, I’m hearing our Congress say we care way more about helping businesses than we do about helping the most vulnerable in our society.  Is that true?  I’m getting sick just writing it.

Certainly our current cast of characters in Congress would tell us that there is an offset of fiscal benefits to the economy such as more jobs and more taxes coming in from providing businesses with tax breaks.  There is likely some truth to that.  But $310 billion worth of benefits over 10 years?  I’m not buying it.  And, let’s compare that to what was argued over in HR 4058.  Before it could pass, a section of HR 4058 had to be removed because it was projected to cost approximately $12 million over the same 10-year time period. The section would have required state child welfare agencies provide a young person leaving foster care with a Social Security card, birth certificate, health information and in some cases a bank account. Wouldn’t providing youth the appropriate documentation and support upon leaving care lead to better education and housing outcomes for kids and ultimately more of these youth working and paying taxes too?

The way these seven bills played out highlights the winners and losers on Capitol Hill.  It is a reflection of who is in charge of the House and where their priorities stand.  I choose not to stand quietly and to instead put voice to my concern – our children are the most valuable asset to our country.  Let’s treat them that way!

Author: Christina Riehl is a Senior Staff Attorney at the Children’s Advocacy Institute.

Questioning U.S. Gun Policies – Who is Representing Us Anyway?

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This week appears to be a critical week in the efforts to move forward with common sense gun policies.  Unfortunately, President Obama’s calls for a ban on assault weapons and larger capacity ammunition magazines have completely stalled.  While not the focus of this week’s blog, I would be remiss to report this news without taking a moment to express my deep frustration and confusion.   In particular, how is a ban on large capacity ammunition magazines completely off the table?  What happened to our outrage after the shooter in Sandy Hook killed innocent children and school personnel by firing 154 bullets in less than five minutes through the use of his 30-round clips?  How many lives could have been spared if he had to reload more frequently?

Let’s talk about the measures that are currently on the table – efforts to strengthen current background check requirements – and the policies that are influencing the lobbying against these efforts.  Supporters would like a universal background check and would like to close a loophole in current law that requires no such check for sales at gun shows or through private sellers.  As reported by NPR, the NRA has previously expressed support for expanding background checks but since the Newtown shootings, the organization has been staunchly opposed to the idea.  Other gun rights advocates have tried to find a bit of a more balanced approach by expressing they might be open to expanding background checks to private sellers and sales at gun shows, but are against keeping records of those sales because that could lead to the creation of a national gun registry and they fear what the government will do with that information.

To put into context the NRA and other gun advocates’ lobbying on the current efforts to expand background checks, let’s look more closely at some of their recent lobbying efforts.  According to the Center for American Progress, since the 1970s, and increasingly over the past decade, the NRA and others in the gun lobby, have pushed Congress to incrementally chip away at the federal government’s ability to enforce gun laws and protect the public from gun crime.  The Bureau of Alcohol, Tobacco, Firearms and Explosives, or ATF, is the Federal licensing body for firearms dealers. Among other duties, the ATF is responsible for protecting our communities from violent criminals, the illegal use and trafficking of firearms, and ensuring that federally licensed firearms dealers comply with the laws and regulations that govern their businesses.  Since 1979, the ATF has been prohibited from creating a centralized database of gun sales records already in its possession.  One portion of these records includes the, on average, 1.3 million records ATF received each month from out-of-business dealers.  ATF is forced to keep these records in boxes in warehouses or on microfiche.  Because there is no centralized electronic database of gun records, when a gun is found at a crime scene, ATF agents must take days, or even weeks, sifting through hundreds of thousands of paper records, making numerous phone calls to the manufacturer or dealer that first sold the weapon, and relying on records kept by federally licensed firearms dealers in an attempt to identify the weapon’s owner.  Not surprisingly, this delay severely frustrates criminal investigations.  Why does the NRA and its allies want to thwart criminal investigations?  Further, considering there were more than 333,445 firearms traces in 2012, how much money could be saved by digitizing the records rather than paying for the man-hours required to complete the complicated and time-consuming paper search that would otherwise be completed with a few keystrokes and clicks of a mouse?

Thanks in no small part to the NRA’s lobbying efforts, since 2004, the FBI has been limited in their ability to maintain records that would help identify people who buy guns for another person who can’t legally purchase a gun, otherwise known as straw purchasers.  Currently, the FBI may only retain records of individuals who have successfully passed the National Instant Criminal Background Check System for 24 hours.  This limits law enforcement’s ability to recognize patterns that often suggest straw purchasing and gun trafficking.  The quick destruction of these records also removes ATF’s opportunity to proactively identify corrupt gun dealers who falsify their records to enable straw purchases.  Prior to 2004, the FBI retained these records for 90 days, allowing law enforcement the opportunity to look at the data for indications of criminal activity and to ensure the background check system is functioning properly and not being misused.  Why are the NRA and its allies thwarting the ability of federal agencies to be alerted to criminal activity before public safety has been jeopardized?

Perhaps most troubling is the NRA’s continued efforts to prevent any research into gun violence or into efforts to make guns and their use (and users) safer.  At the urging on the NRA, in 1996 Congress essentially silenced any federal public health research into firearms injuries by prohibiting the Center for Disease Control (CDC) from spending federal dollars on research that could be used to “advocate or promote gun control.”  CDC funding for firearms injury and prevention research has fallen from an average of $2.5 million annually between 1993 and 1996, to around $100,000 annually in 2012.  In 2002, in a rare move of funding for research, Congress appropriated $1.5 million to develop a National Violent Death Reporting System (NVDRS) designed to provide data on violent deaths in the United States in the hopes that the data will allow the development of strategies to reduce and prevent such deaths.  Unfortunately, the NVDRS is limited to 18 states and the NRA and their allies have pushed for restrictions limiting the data as it relates to gun deaths.  Again, why does the gun lobby want to limit publicly available information?  Why can’t we know what it takes to make guns safer?  This attitude is particularly troubling in light of a recent report by Bloomerberg indicating that gun deaths will likely exceed traffic fatalities by 2015.  The fall in traffic deaths has resulted from safer vehicles, restricted driving privileges for unsafe (young) drivers, seat-belt and other safety laws – all policies driven by our well researched information.  By contrast, the gun lobby’s successful push to limit up-to-date public health research into gun violence and gun-related injuries and deaths has resulted in  a dearth of information in this area and legislators and policymakers are left to guess how to best address these issues.

If you, too, think the time has passed for the NRA to be creating our national gun policy, I urge you to do something now.  The Children’s Defense Fund (CDF) is spearheading a sign-on letter in support of stronger laws to protect our children from gun violence.  Please consider signing on.  Or, go online, here, to send a letter to your representative – just fill in your name  and address and an email will be sent to your representatives expressing your desire for common sense gun safety laws.  You can also check out http://www.sandyhookpromise.org, a website created by members of the Newtown Connecticut community, together with parents of the victims at Sandy Hook to address gun violence.

Author: Christina Riehl, Senior Staff Attorney at CAI

The Affordable Care Act (ACA) and Former Foster Youth

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When the Affordable Care Act (the ACA) was signed into law, it provided a valuable benefit to young adults by allowing them to stay on their parents’ medical insurance until they reached the age of 26. The ACA’s provision allowing children to stay on their parents’ health insurance to age 26 is one of the law’s most popular provisions, for good reason. It takes most people some time to finish college and establish a career or to find a job that would allow them to obtain and maintain quality health care coverage. The ACA allows young adults to stay on their parents’ insurance and have vital health care coverage throughout college and it gives them time to establish themselves without having to worry about the catastrophic health care bills that would result from a health crisis.   A medical crisis that results in a large medical bill and the often extraordinary debt associated therewith is a difficult issue with which to be burdened at any age, but young adults are especially vulnerable. Young adults had the highest rate of uninsured of any age group and the lowest rate of employee provided coverage when the ACA was signed into law.  Incurring a burdensome medical debt at such a young age can hinder a young adult over the important years when he or she is embarking upon a career, obtaining an education, or otherwise attempting to establish a livelihood.

Given all of this information, Congress left one group of young adults waiting for this coverage. Foster youth have had to wait nearly four years longer than their peers who were not in foster care.  This, even given that the state is the parent of these youth, they are our children. These youth, our children, often have chronic health issues associated with the abuse or neglect which was the reason for their entry into foster care. Many have mental health or emotional health issues, and they do not have access to the familial and social safety net on which their peers can rely. That the ACA has made this group of former foster youth wait for the same coverage their peers enjoy is shameful.

After a nearly four-year wait, beginning in January of 2014, states will be required to provide Medicaid coverage to youth who are under 26 years of age and were in foster care and receiving Medicaid when they attained 18 or such higher age at which the state’s federal foster care assistance ends under title IV-E of the Act (when they reached 18 or aged out of foster care).  Despite the wait, this is excellent news for young adults who were in foster care. Particularly because anyone who meets these requirements is eligible for Medicaid, even if an individual is age 23 and has not had Medicaid coverage for years, if that individual meets the requirements, he or she can obtain Medicaid coverage.

Unfortunately, the Department of Health and Human Services (HHS), which is the agency that creates regulations for the implementation of federal laws, is proposing a regulation that would require states to provide Medicaid to young adults ONLY in the same state in which they were in foster care and not to a young adult who, for example, is attending college in one state but aged out of care in a different state. This is a glaring inequity. The same restriction does not apply to young adults who enjoy the benefit of their parents’ insurance, have the benefit of the familial safety net that parents’ provide, and did not age out of the foster care system.  Given that former foster youth are a very mobile population; this proposed regulation is of concern. Several foster care and children’s advocacy organizations have urged the department of Health and Human Services to issue regulations that would require states to provide foster youth with access to Medicaid coverage, regardless of the state in which they choose to reside.  The final regulations will be released later this year.

You can learn more about this issue from these sources:

Proposed Rule

CAI’s Comments

Children’s Defense Fund: Joint letter sent to HHS regarding the proposed rule

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Author: Christina Riehl, Senior Staff Attorney at CAI

Re-alignment or Retreat from Responsibility?

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Looking back on legislative developments having an impact on California’s children in 2012, it is hard not to notice two things that smashed into each other:

  • The State has effectively ended any funding for child welfare, instead “re-aligning” that funding responsibility to California’s 58 very different counties and assuring them additional programmatic flexibility.
  • Outside news reports and audits excoriated the child welfare system in Los Angeles County, the State’s largest.

As the Los Angeles Times wrote in February of 2013 about an internal L.A. County review done in 2012, a “stifling bureaucracy” was impeding effective child welfare:

“Investigations tend to rely on bureaucratic rules, not common sense and close observation, the report found. The department has issued more than 4,000 pages of policies detailing how social workers should do their jobs.

‘Creating social work road maps with this level of ‘how-to’ is like expecting a therapist to use a script that tells her what questions to ask and what responses to expect from her client in a therapy session,” the report said.

Lowell Goodman, a spokesman for the union representing the social workers, said, ‘Even the finest social workers in the country could not perform their best work in this system.’

‘Paperwork and the relentless attention to following [thousands of pages of] policies supersedes hands-on social work in importance,’ he said.”

An audit by the State Bureau of State Audits found similar problems and has noted that the County has not addressed them. [1]

County failures in administering child welfare are not new.  Sacramento County, for example,also hired an outside consultant to review its operations after a spate of grisly child deaths were reported in the Sacramento Bee.  The consultant in its final report in 2009 identified a large number of bureaucratic impediments to social worker effectiveness that imperiled the lives of children. For example, the Sacramento County report found:

“The County’s guidelines for its social workers contain 167 policies spanning more than 1,300 pages. Over 60 percent of these guidelines were last created or updated more than five years ago. CPS’s existing guidelines include a mix of outdated or conflicting guidance, caused, for example, when the division created a new guideline without revoking or amending a prior guideline document related to the same procedure.”

“The current CPS requirements and  operating structure hamper its ability to provide child welfare services effectively and efficiently.  Moreover, inconsistent procedures and failure to follow best practices have resulted in negative  outcomes for some children in the County’s child welfare system. Utilizing poor practices has also resulted in families and children not receiving the best services to meet their needs.  Consequently, the issues within these families that brought them into the child welfare system in  the first place may continue to be unaddressed, leaving children at risk. Improving CPS  operations and processes is imperative if the County is to address these issues and optimize its  service delivery to families and children in the future.” 

Likewise, in response to news stories in Los Angeles County about CPS performance, SEIU Local 721 in 2011 authored an exhaustive and detailed set of recommendations for improving and streamlining operations and enhancing social worker productivity. Most of the suggestions could be implemented within existing resources. Suggestions included how to eliminate duplicative paperwork, improve coordination between departments and employees, and shift staffing to ensure greater productivity and job satisfaction. But, these suggestions have been largely ignored.

And all of these county-level failings took place during the world prior to re-alignment, when the State had the power of the purse to influence policy.  Now, while the federal government continues to look to the State as the one throat to choke when it comes to ensuring its Title IV-E money is well spent, the State has less of a central role in guiding child welfare policy than perhaps ever before.

What is clear is this:  only until State and federal governments get serious about monitoring how federal tax dollars are spent will California’s abused and neglected children obtain the level of care and services they deserve.

 

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