Three Axioms of Child Welfare Reform

(Originally published June 2011)

The pace of child welfare reform seems to steadily increase as public child welfare agencies respond to public outrage following high profile child deaths or other perceived failures of child protection, or as a result of class action lawsuits and settlement agreements, Child and Family Service Reviews (CFSRs) or their internally generated initiatives. Until recently, the cycle of reform involving extensive planning by internal and external committees, training of staff, implementation and (rarely) evaluation occurred every few years in many states or large cities with periods of time to consolidate innovations before the next reform cycle was launched by unpredictable events and resulting political pressures.

 

However, in recent years child welfare systems in many states or large counties have layered one reform initiative on top of others still being planned or in the early phase of implementation, so it is not always possible to identify a distinct cycle of reform. Multiple reform initiatives with different goals may be concurrently in various stages of planning and implementation. For example, in recent years Washington State’s Children’s Administration (CA) has embraced family team meetings and other Family to Family practices, adopted new risk and safety tools and practices, changed its computer system, implemented a new solution based practice model, and is currently engaged in a sweeping legislatively mandated privatization initiative (2106) that has the potential to fundamentally restructure how child welfare services are delivered around the state. This list omits other major changes in CA such as administrative consolidation of six regions into three regions, and changes in state statutes that guide child protection and other facets of child welfare.

 

Child welfare directors are under relentless pressure from legislators, the executive branch and child advocates to improve their agencies, and they understand that they may only have 2-3 years to implement reforms before a political crisis or change in Governors leads to their exit from the agency. In addition, reform initiatives serve as promissory notes to policy makers and advocates pressing for changes, and, in doing so, muffle public criticism of child welfare leadership while reforms are being planned and implemented. They signal key decision makers that new leaders are serious about grappling with agency deficiencies.

 

Nevertheless, promissory notes come due, and disappointed expectations may lead key policy makers and advocates to give up on the possibility of genuine reform. For example, CA managers promised legislators and advocates that FamLink, the agency’s new computer system, would greatly improve CA’s capacity to assess and serve families. When FamLink turned out to be an expensive ill advised disaster that made it difficult to close cases and compromised data integrity, the view of key policy makers and advocates that CA in its present administrative structure could not be reformed was confirmed. Failed reform initiatives breed internal cynicism and external disdain. They are also expensive and time consuming, not to mention having a profound effect on agency staff’s confidence in the judgment of top managers. Major reform initiatives are “all in” bets that raise public expectations and commit a huge percentage of limited agency resources to courses of action difficult to undo. For this reason, new child welfare leaders rarely disavow the reform initiatives of their predecessors. Instead, they signal their views of recently adopted policies and practices to agency staff through inattention and neglect of implementation efforts while developing their own ambitious initiatives.

 

Fortunately, some reform initiatives succeed in significantly improving child welfare agencies, usually because leaders took the time to fully engage agency staff in planning and implementation, and because political leaders supported substantial increases in resources needed to reduce workloads and improve services for children and families. What has happened in the past 10-15 years in Illinois, New York City and Los Angeles County, and the continued ability of Minnesota’s child welfare system to lead by example, is evidence that genuine reform is possible even in the most difficult circumstances.

 

In planning ambitious child welfare reform initiatives, child welfare leaders and policy makers should consider the following three axioms:

 

Axiom 1 – Child welfare systems in which the number of children in foster care is increasing can not be reformed.

 

Imagine the following scenario: a state’s child welfare system has increased its foster care population by 10-15% in the two years following a highly publicized child death. As the number of children in foster care has increased, the legislature has given the agency new caseworkers and supervisors to keep caseloads at a reasonable level, funded new attorneys to represent the child welfare agency and judges or commissioners to hear new dependency cases, increased substance abuse, mental health and domestic violence services for parents, raised reimbursement rates to foster parents and private agencies for children in out- of- home care, and expanded prevention and early intervention services to reduce the number of CPS reports. Would increases in a state’s or county’s foster care population have a devastating effect on the quality of child welfare services in these circumstances?

 

Now imagine the more likely scenario: as the foster care population increases, there are no increases in caseworkers, supervisors, attorneys, judges and commissioners, family support services or foster parents and financial and other support of foster parents or in prevention / early intervention services. Instead, the agency adopts new assessment tools and guidelines and raises expectations for caseworker contacts with children on open cases. Agency managers make public statements about the importance of accountability, and promise that caseworkers and supervisors will be held to more exacting standards. To make this point, a caseworker or two and supervisor (or manager) are fired. Are children likely to be safer or better served following this common scenario?

 

Reductions of the number of children in foster care creates opportunities for reinvestment in a range of family support services, permanency services and services for foster children and adopted children. Service delivery systems can achieve a better balance between in- home services and out- of- home care.  The size of caseloads usually declines, and the gap between expectations described in policy manuals and the level of services provided by line units decreases. Practitioners and managers begin talking about improving the quality of services, not because they are accountable and want to avoid blame, but because they care about outcomes and about the children and families on their caseloads.

 

Axiom 2 – Child welfare agencies that fail to invest in workforce improvements will not be able to sustain reforms no matter how promising the initial changes in practice.

 

Possibly the most common mistake made by legislators and managers engaged in planning reform initiatives is to assume that changes, usually additions, to policies and procedures will lead to practice improvements. This is rarely the case as child welfare agencies invariably already have overwhelming regulatory frameworks, and adding to these frameworks usually does more harm than good. Adding or changing assessment tools usually has little if any effect on practice unless caseworkers use these tools as designed, a rare occurrence in my experience. Furthermore, standardized assessment tools of all types can be used as a substitute for professional skills and knowledge, in which case their use harms the workforce by undermining professionalism.  

 

Frequently, in major reform initiatives additions to regulatory frameworks are coupled with resource enhancements, and the negative effects of these changes are masked by the improvements in staffing levels and services. Child welfare agencies can be substantially improved by increased resources intelligently deployed. Jess McDonald, former director of Illinois’ child welfare system, has estimated that Illinois’ IV –E waiver led to over a billion dollars of savings between 1997 and 2009 that was reinvested in child welfare improvements. There is no question that children currently in Illinois’s child welfare system are safer and better served than was the case in the mid- 1990s.    

 

 Flexible IV–E waivers and some class action lawsuits, for example in New Jersey, have resulted in huge reinvestment opportunities in some child welfare jurisdictions; and these new resources have been used to great advantage in Los Angeles and Alameda counties in California and in Florida and some Ohio counties. However, reform initiatives that invest in more and better services delivered by an overworked and underpaid work force are unlikely to sustain positive changes in practice. Child welfare systems must also reduce and maintain caseloads at reasonable levels, pay professional salaries, invest in the professional development of their staff, and create organizational cultures in which practitioners’ voices are heard and valued. Absent workforce investments, when resources are significantly reduced during a budget crisis and staffing levels and services are cut, reform agendas will begin to crumble as experienced caseworkers, supervisors and managers leave a sinking ship.

 

For this reason, privatization initiatives that transfer responsibility for service delivery to caseworkers who make significantly lower salaries than their public agency counterparts will not in my view have long term benefits in child welfare. It is even more objectionable when the CEOs of these private agencies are paid salaries 2-3 times greater than their public agency counterparts while private agency staff who deliver direct services are paid $30- 40,000 per year.    

 

The best single investment public and private child welfare agencies can make in their future is to pay new and experienced professional staff for certifications in substance abuse, mental health, domestic violence, child development (including adolescent development), cultural competence, developmental disabilities, adoption services, etc. A more skilled and knowledgeable work force will deliver better services in a wide range of practice models; and they will be able to utilize assessment tools in a way that enhances rather than dumbs down practice. Paying for the cost of certification programs and increasing salaries of certified staff by as little as 5 per cent could lead to major workforce improvements.

 

How has Minnesota’s child welfare system led the way in child protection reform for the past 15 years? Arguably, it is the experience and quality of the workforce at all levels of county agencies and in the state office that has provided the foundation for innovation and testing of new practice models. Minnesota pays its staff decent salaries, and a critical mass of child welfare mangers support innovations supported by both the state office and originating in local offices. New practice models can be (and have been) tested with highly experienced and skilled staff and with full management support in a number of Minnesota counties. However, it is far from certain that these same practice models will lead to positive changes in practice in counties and states that have inexperienced,  poorly paid and poorly managed workforces.  

 

Axiom 3 – The true measure of child welfare reform is what children, parents and stakeholders say about changes in practice, not quantitative measures.

 

Quantitative measures based on administrative data are important sources of information, but they are often poor indicators of effective practice. CFSR measures are conceptually flawed (both the safety and permanency measures), and are likely to be “gamed” by agencies willing “to look good at the expense of being good” (Shay, 2002). The extent of foster care reductions is an inherently ambiguous measure, as it may be unclear whether reductions in entries and/ or increases in exits are due to sound practices, or are the result of administrative pressure to reduce numbers of children in care regardless of consequences.

 

Even if quantitative measures were far better than they actually are, they would not be a substitute for qualitative measures which are needed to add a cogent narrative to help understand the practice meanings of changes in quantitative measures. It is already apparent from education reform how much damage can be done by a naïve belief in standardized test scores as a measure of student learning. It is not just that test scores are a poor reflection of learning; an emphasis on testing as the end all and be all of education has undermined and corrupted the educational process. Less egregious (but nevertheless) damaging effects in child welfare have resulted from a foolish emphasis on inadequate CFSR measures. In particular, relatively new supervisors and managers have developed their professional expertise in an era of data driven practice which has given little or no weight to the lived experience of children and families. Poorly considered quantitative measures and an unreasonable dependence on them can and will harm child welfare practice and practitioners.

 

These three axioms can be restated in positive terms:

 

  • Bring resources and demands into balance by stabilizing or reducing  the state’s or county’s foster care population. Reinvest any savings generated by foster care reductions into developing a better balanced service delivery system and reducing caseloads.

  • Make major investments in the child welfare work force, including (in most states) increasing salaries of caseworkers and supervisors, paying higher salaries to staff with important certifications, reducing caseloads, giving caseworkers periodic sabbaticals from case assignment, and giving a bigger voice to practitioners in guiding child welfare reform.

  • Utilize qualitative input from children, birth parents, foster parents and service providers as the key measure of child welfare reform initiatives and to provide a narrative that explains the concrete effects of practice changes.

 

References

 

Shay, Jonathan, Odysseus in America: Combat Trauma and The Trials of Homecoming, Scribner, 2002.  Shay’s discussion of positive leadership is the best thing I have read on leadership in recent years.

  

deewilson13@aol.com

    

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