The Foster Care Recruitment and Retention Crisis
(Originally published July 2016)
Many of this country's foster care systems are in crisis. The inability to recruit and retain adequate numbers of foster homes has led to widespread acute and chronic shortages of foster homes, shortages that have been compounded by the reduced use of residential care facilities in a number of states. The shortage of foster homes was not as apparent during the years, 2000-2012, when the number of children in out- of- home care nationally declined by almost 30%. However, for the past two and a half years, the country's foster care population has been increasing due in part to a post-recession drug epidemic. During the past year or two, public officials and child welfare managers around the country have been urging civic minded citizens to consider fostering children removed from substance abusing parents, seemingly without much effect.
Prior to the Braams Settlement agreement in Washington State (2000-2004) this state's child welfare system usually had about 6,000 licensed homes. More than a decade later after years of discussion of foster care improvements between child welfare managers and the Braam's panel, Washington State has less than 5,000 licensed foster homes. Increased demand for foster homes in many states, or a reduced supply of licensed homes (as in Washington), has led to a number of highly questionable practices discussed in the June 2016 Sounding Board (placing youth in hotels with two staff in an accompanying room, moving children daily from home to home and supervising these children during the work day in child welfare offices, placing children in homes located in distant communities, overcrowding homes through use of waivers to limits on capacity, splitting up sibling groups). These practices give anguish to child welfare managers doing their best to cope with systems operating in extreme conditions. Unfortunately, these are not desperate strategies that began recently in many states and which are likely to end in the near future. They have become long lasting strategies for responding to foster care shortages, in some states (including Washington and Oregon) almost another category of placement type.
Foster parent recruitment campaigns usually fall on deaf ears, in part because in many two parent families both adults are employed and already have more responsibilities than they can manage, and because most persons who might consider becoming foster parents lack the experience or training to care for emotionally troubled children and youth. However, possibly the main reason why ambitious media based recruitment campaigns generally fail to increase the number of families applying for foster home licenses is the negative “word of mouth” coming from current foster parents regarding working with public agencies. When experienced foster parents vigorously complain about the lack of support provided by child welfare caseworkers, inadequate reimbursement for the cost of care, and the lack of “voice” in case planning, why should their friends and acquaintances seek to repeat their experiences? I have participated in focus groups of foster parents with an alarming degree of anger expressed at caseworkers and agency managers. My guess is that a significant percentage of foster parents who feel they have been mistreated by child welfare staff and managers actively discourage others from becoming a licensed foster parent. Foster parent recruitment campaigns cannot succeed in these circumstances.
Creating Better Support for Foster Parents
In the June 2016 Sounding Board, “Is Foster Care Safe,” I discussed the experience of foster children for whom their caseworkers from public and private agencies were missing in action and inaccessible, and who changed so frequently that developing a relationship with them was impossible. Rules and regulations regarding health and safety visits cannot compensate for the lack of supportive relationships between caseworkers and foster children. Foster parents often have similar experiences of infrequent contact and grudging support from caseworkers too busy to have frequent contact with them, or even consistently return calls or responses to emails. I attended a foster parent banquet in Washington more than a decade ago in which the foster parents at the table engaged in humorous (but emotionally charged) speculations about how their children's caseworkers would cope with caring for the children in their home for even one day! These foster parents felt very much on their own in handling all manner of problems and issues with little or no help from caseworkers or anyone else in the child welfare system. Furthermore, when any group of persons in a human services organization does some of the organization's most difficult and challenging work, but are excluded from discussions of case plans or agency policies that affect them, they are likely to become embittered and occasionally engage in an unproductive venting of emotions.
The foster care recruitment and retention crisis is in part a “chickens come home to roost” effect (one of many) of operating large human services systems with inadequate staff and inadequate resources. Caseworkers with 25-30 children on their caseloads must find ways of doing a job that results in minimal personal contact with foster children and foster parents. When children and foster parents demand more caseworker contact and more agency resources than caseworkers can easily provide, the end result is often frustration and resentment on the part of agency staff.
Nevertheless, there are foster parents who survive and even thrive in their caregiving roles, and who gradually figure out how to meet their needs and the needs of children in their care. Some of these foster parents provide extraordinary care to large number of children, often for many years, learn how to work with and support birth parents, and exercise considerable influence on children's case plans through their relationships with caseworkers and CASA's. Some of these foster parents figure out early in their fostering careers that child welfare offices will never be a reliable source of emotional and concrete support. They find private agencies that offer dependable supports and accept reduced compensation for the care of behaviorally troubled children in exchange for these supports. Other foster parents gradually learn what they require to care for children with a multitude of behavior problems and patiently assemble these supportive resources over a period of years. This is not an easy or smooth path, but some exceptional foster parents have been able to develop special arrangements with child welfare offices, often after substantial conflict with case-workers and licensing staff.
Mockingbird's Family Model is a creative promising approach to supporting a network of 6-10 foster homes organized around a “hub” home that offers concrete support in working with child welfare offices, respite care and social activities for members of the network. The philosophy that underlies this model, i.e., “take care of the caregivers who take care of foster children,” is as important as the model itself. Every child welfare agency should adopt this philosophy without delay and then experiment with various strategies for putting this credo into practice. There is much else that needs to be done to reform the failed business model that public agencies are using to recruit and retain foster parents (see below), but creating a much improved system of supports for foster parents is urgent and necessary if foster care is to remain a key resource in child protection systems. The Washington State legislature has directed the Washington State Institute for Public Policy (WSIPP) to evaluate the Mockingbird Family Model. Cost benefit analysis will likely be an important element of this evaluation.
A New Model for Recruitment and Retention
A better model for foster care recruitment and retention will take account of the differences among persons considering becoming foster parents:
1) at least a third of foster parents become licensed to adopt a child, usually a baby or other young child,
2) another large percentage of foster parents become licensed to care for a specific child or sibling group often (but not always) related to them,
3) probably not more than 30-40% of foster parents become licensed to care for children of various ages with a variety of needs. Many of these foster parents are reluctant or unwilling to take some groups of children and youth, e.g., adolescents or children with severe behavior problems, into their homes. Given the acute chronic shortage of foster homes, it is common for licensing and home-finder units to give lip service acknowledgment to different motivations for seeking a foster care license and then persistently attempt to convince foster parents to take children with characteristics outside their comfort zone. It's not surprising therefore that many placements disrupt quickly, and that children with difficult to manage behaviors often move frequently from home to home. Foster parents who may have been reluctant to accept a child in the first place may be quick to throw in the towel when problems occur.
Foster care systems have several functions which are difficult to combine in practice and policy:
Providing shelter and a safe and a humane “port in the storm” for children unable to live with their parents or relatives for a variety of reasons, for example, a parent's incarceration, abuse or neglect, the collapse of another foster placement, a domestic violence incident that has incapacitated a parent;
Providing mental health services, therapeutic care and developmental repair to abused and neglected children, many of whom have no good reason to trust adult caregivers;
Developing and completing permanent plans for children and youth of all ages; in practice many of these permanent plans, especially reunification, fail. A large percentage (as much as a third in some states) of children in foster care at a point in time are in their second, third or even fourth placement episode, i.e., they have exited and then re-entered foster care.
Foster care systems have always had difficulty performing all three functions, but it is the mental health/developmental repair responsibilities that have presented the greatest challenges. The idea that uncompensated, inadequately trained and supported volunteer foster parents will be able to provide skilled and committed care to at least half of foster children and youth with mental health conditions has led to distressing rates of placement instability for behaviorally troubled school age children. In past decades, public agencies depended on residential care programs to take children and youth with severe behavior problems, frequently after a series of failed placements. There was a time 15-20 years ago in Washington State when youth in residential care averaged 10 or more placements. Child welfare systems in many states have made concerted efforts to reduce their use of residential care due both to high costs and to widespread abuse of youth by both staff and other youth in these facilities. However, there has not been much of an effort in most states to recruit and retain a professional cadre of foster parents to fill the gap in placement resources created by the loss of residential care facilities.
Do the Right Thing
States and large cities must cease using foster care systems as underfunded mental health systems that depend on unpaid, poorly compensated volunteer foster parents, a large percentage of whom have no background or interest in caring for behaviorally troubled children and youth. Why would thoughtful advocates, scholars and policymakers believe that this approach to caring for traumatized and severely neglected children could ever work? Perhaps wishful thinking combined with budget constraints has created a thick denial regarding system failure, at least until recently in most states.
It is time for child welfare systems to recruit, train, compensate and support a professional cadre of foster parents, possibly as much as one-fifth (1,000) of foster parents in Washington State. Simply delegating more of the responsibility for foster care recruitment to private agencies is not an adequate response. There needs to be a major change in how foster parents are recruited and trained and in their compensation and status. Washington State already has a large number of foster parents who have self identified as professionals. This is the group to start with in transforming how foster parents who take many of the most difficult children in foster care are compensated, supported and regarded. Negative word of mouth regarding foster parenting will not change until some large group of foster parents perceives the child welfare system in a positive light.
Child welfare agencies should also recruit foster parents willing to provide shelter for children and youth on short notice, and compensate these foster parents adequately for this service. Washington State used to have receiving homes in most counties (a model for shelter that is no longer used possibly due to budgetary reasons). Policymakers and managers should not tolerate for longer than a few more months the placement of children in hotels or in 24 hour placements. Something has gone seriously awry in the policy arena in any state where these practices have come to be tolerated.
I occasionally encounter the perspective that policymakers will not seriously entertain the idea of funding the creation of a large new cadre of professional foster parents paid a stipend (for example, $1000 per month) and compensated for foster care at an elevated rate; or fund receiving homes as per past policy and practice in Washington State. However, current practices have resulted in huge tort pay-outs for many years with no end in sight. Current practices in Washington and other states in which foster care systems are crumbling invite disaster and a flourishing industry of plaintiffs' attorneys.