The Winter of Discontent
(Originally published December 2017)
This is a bleak time in child welfare, bleak in mood for many practitioners and advocates, bleak in the reality of under-resourced child welfare systems with acute shortages of foster homes struggling to cope with an opioid epidemic, and bleak in prospects for reform in states (e.g., Indiana) where, incredibly, Governors and legislators are cutting the budgets of child welfare agencies whose staff are “drowning” from overwhelming workloads. There has been widespread intense public dissatisfaction with child welfare systems for decades, frequently due to high profile child deaths which child welfare agencies were unable to prevent despite multiple opportunities. These child deaths and other perceived failures of child protection have often led to public outrage, to firing of caseworkers and supervisors and, occasionally, to replacement of whole management teams. In addition, in a few states and large cities child welfare staff have been prosecuted following child deaths for fraudulent recording or other alleged malfeasance.
High profile child maltreatment deaths on open or recently open CPS cases continue to occur with distressing regularity, and to generate much the same kind of public reaction, especially when children have been brutally beaten and tortured by caregivers prior to death. However, the mood that is pervasive among many practitioners, advocates and policymakers currently is disillusion and discouragement, rather than anger and outrage. Some of the bleakest assessments of child welfare systems I've heard in recent years have come from child welfare veterans who have spent most of their adult lives working in and managing public child welfare agencies and subsequently consulting with agencies' leadership teams. When professionals who have had intimate, up close and personal experience of child welfare systems for decades question whether vulnerable children in their state would be better off if the state's child welfare system was abolished and rebuilt from scratch, and when these views are stated without rancor or a desire to shock, it is time for sober reflection. Why would outstanding child welfare professionals believe that some state and county child welfare systems are doing more harm than good to vulnerable children and families? Why would some managers and consultants who have acquired significant influence seriously consider leaving child welfare employment in the midst of successful careers?
The roots of discouragement
It is not system flaws and deficiencies, or difficult challenges, that have caused discouragement and disillusion with child welfare, but rather the apparent inability in many states to find and implement practical solutions to unacceptable and intolerable conditions. There is nothing new about overwhelming workloads, foster home shortages, high rates of turnover of newly hired caseworkers and CPS investigators or bureaucratic mismanagement. These problems have been exacerbated in recent years by the nation's opioid epidemic (which has hit some states harder than others) and by increases in most states' foster care populations since 2012. Foster home shortages have led child welfare systems to engage in practices (e.g., placement of children in hotels, 24 hour placements, routine use of out- of-county placements) that are arguably themselves forms of system abuse. Furthermore, these practices cannot be rationalized as responses to emergency conditions in states such as Washington where they have been utilized for several years, and where policymakers have not taken steps to eliminate them despite media exposure.
There is nothing new about bureaucracy. Nevertheless, bureaucratic practices have, over time, made child welfare casework increasingly difficult through the gradual steady addition of policies and procedures, and by seeking to eliminate any and all discretion and initiative at the caseworker and unit level. Public child welfare agencies seem unable to stop adding on to policy frameworks though many child welfare managers understand the folly of doing so. However, there is little evidence of reflection within child welfare agencies and among child advocates regarding other bureaucratic practices that have undermined the growth of professionalism and convinced many practitioners that they need to leave child welfare sooner rather than later.
A workforce crisis reflected in 12-18 month turnover rates of 30%-50% of newly hired caseworkers in a number of states and large cities, and extreme shortages of foster homes in states experiencing an increase in entries into foster care have, in turn, had cascading effects that have further undermined public confidence in public child welfare
systems. Long standing antagonisms between foster parents and caseworkers have been intensified by lack of adequate support of foster parents, and by deep anger among some foster parents regarding alleged retaliation they have experienced following complaints made to supervisors and managers. Rapid turnover of caseworkers has added to units' workload problems, and has created extreme pressure on training programs to emphasize operations, e.g., completion of assessment tools, rather than conceptual understanding, and to produce “practice ready” caseworkers after a few weeks of training, an unreasonable demand that can never be satisfied.
Practical solutions, political power and self-efficacy
Many of the challenges that afflict child welfare agencies have straightforward solutions which, however, require the support of Governors and legislative action. One of the sources of discouragement among practitioners and advocates is the belief that policymakers will not adequately fund, or staff, child welfare systems even after multiple reports describing in detail the scope and effects of funding deficiencies. However, occasionally, a state legislature does something surprising such as (in Texas) giving caseworkers a one time immediate $12,000 salary increase. Legislatures can do surprising things, especially when faced with alternatives that would severely damage the state's reputation, for example, (again in Texas) removing the requirement that caseworkers have a college degree.
It is a mistake to assume that child welfare agencies' workload problems are due solely to staffing shortages. Adding to policy and procedural requirements contributes to workload problems; some of these additions are the result of legal mandates but most are voluntary. Implementing “best practices” without regard to resource requirements has had a disastrous effect on child welfare agencies, a hard to eradicate tendency due to relentless pressure from child advocates to adopt new policies. In addition, child welfare agencies need authorization to manage excessive workloads through prioritization practices. Greatly increased funding would do wonders for staff morale in child welfare agencies, but so would the authorization in law to take necessary steps to control workloads. Increased funding cannot substitute for an active coping style, a characteristic of resilient organizations as well as resilient individuals. Trustworthy managers do not passively stand by and allow their caseworker staff to “drown” from overwhelming workloads without strong protest. Every child welfare agency can engage in active efforts to use limited resources to best advantage.
The disarray and abusive practices (e.g., overuse and misuse of psychotropic medications) of foster care systems is due, in part, to inadequate funding, but is also the result of stubborn adherence to a failed business model for foster care. Recruiting and depending on volunteer foster parents to provide safe and therapeutic care to behaviorally troubled children and youth, and children with severe physical disabilities, has been a failure in child welfare in this country and others. No amount of high minded rhetoric and pleas from governors, mayors, advocates and private agencies is likely to change this reality. Nevertheless, there continues to be strong resistance to professionalizing 20-25% of foster care, or increasing compensation to adequately trained and well supported therapeutic foster parents.
Even in the midst of a foster care crisis characterized by the inability to recruit and retain sufficient foster parents for all age groups of children and youth, there is considerable resistance to making large new investments in foster care. Some influential foundations and advocates appear to believe that an increase in kinship care can replace both the need for residential care and non-kin foster care! This must be a compelling fantasy given that so many well informed people entertain it, but it's untenable for the same reason that a volunteer foster care model cannot work for about half of foster children and youth: kinship care providers, older and poorer than non-kin foster parents on average, are frequently unable to cope with behaviorally troubled youth or with severely physically disabled children. Kinship care can and should be increased, but it cannot (and will not) replace the need for non-kin foster care and residential care.
Design flaws in child welfare
For decades, there have been articulate critics who believe that public child welfare has inherent design flaws that cannot be overcome through programmatic initiatives, additional funding or reduced workloads. In 1995 and 2016, two prestigious national commissions released lengthy reports on child maltreatment related fatalities (see Within our Reach: A National Strategy to Eliminate Child Abuse and Neglect Fatalities, 2016 and A Nation's Shame: Fatal Child Abuse and Neglect in the United States, 1995) that recommended sweeping changes to the design of child welfare systems, design changes that would make child welfare interventions pro-active and preventative rather than reactive, crisis oriented and intrusive. In the view of these Commissions, intervening only after young children have been seriously harmed by caregivers, or endangered by parental substance abuse, mental health conditions and interpersonal violence, is often too late to prevent child fatalities. The most recent commission of highly esteemed experts split over the issue of whether the federal government should make an additional billion dollar investment in child welfare systems before implementation of recommended design changes.
Both of these reports received considerable media attention at the time of their release and then faded from public view. The recommendation of A Nation's Shame: Fatal child Abuse and Neglect in the United States to re-design public child welfare systems was ignored, and it is doubtful that this report had any effect whatsoever on numbers of child maltreatment fatalities in subsequent years. A similar fate probably awaits the recommendations for design changes and most of the many other recommendations in the 2016 report. Making recommendations for design changes that fall on deaf ears of advocates and policymakers is not the fault of the prestigious experts who served on these commissions. Legal mandates at the state and federal level that set the structure of child welfare have taken decades to develop; they have a powerful inertia that is difficult to overcome even when (rarely) governments are ready to make large new investments in human services.
Policymakers and advocates who believe that child welfare systems are fatally flawed
(i.e., wrongly designed) sometimes imagine developing child welfare anew from the ground up. The closest states have ever come to recreating child welfare systems during recent decades is through administrative restructure in which child welfare is joined with some (but not all) services to children and youth and placed in a stand alone agency. Washington State is currently engaged in a restructure of this type which many advocates believe will transform the organizational culture and public standing of the state's child welfare system in dramatic ways. However, the state's child protection and foster care systems are not being redesigned either in law or policy, and the child welfare system remains significantly underfunded and understaffed, pending implementation of the new agency. The question of how an expanded child welfare mission (focused on prevention and child well being) will be funded and supported in law in Washington State has not been answered.
Renewing confidence in child welfare
Discouragement among child welfare practitioners, advocates and policymakers can be overcome in three main ways:
1) Child welfare systems, including governors, legislators, advocates and practitioners must demonstrate the ability to develop solutions to critical problems such as foster home shortages, use of unsafe and inhumane practices with foster children and youth, high turnover of caseworkers (especially newly hired caseworkers and CPS investigators) and bureaucratic mismanagement that stifles critical thinking. These are big challenges that require new ideas and an experimental mindset. Even modest measurable progress in addressing these challenges will go a long way to restoring confidence in public child welfare systems.
2) A renewed sense of mission – periodically, child welfare agencies and their staff come together around a shared vision with practical, tangible meaning for children and families. Currently, child welfare systems have the potential to develop trauma-informed practice models that will affect every part of child welfare from investigation to foster care and court practices. The effect on staff morale of a renewed sense of mission is unmistakable: caseworkers, supervisors and managers are proud of their practice rather than apologetic or blaming of agency managers. Parents, foster parents and children are treated differently in an agency energized by a renewed sense of mission, and they notice the change immediately. Hopefully, the new child welfare department in Washington State will bring this kind of renewal.
3) Creativity and initiative are sources of confidence and motivate staff to “own” their practice and seek to improve their skills. Currently, most child welfare agencies are managed in ways that suppress initiative at the caseworker and unit level. Bureaucratic cultures focused on compliance need to give way to learning cultures that emphasize results. Child welfare managers must change the way they view themselves, i.e., as servant leaders with a light touch rather than heavy handed agents of command and control.