Advocates Weigh In On Nebraska's Foster Care Privatization Efforts

In case you missed out on the news, Nebraska is the process of “reforming” its foster care system by being the latest to hop on board the privatization bandwagon.

As the The Reader explains: “The reform process was designed to leave the government responsible only for providing case managers. Five contracted private agencies were to handle all other services, both in and out of the home, for an estimated 10,000 children statewide, according to December 2009 statistics from the Nebraska Department of Health and Human Services.”

It all started back in 2008, when Nebraska’s Department of Health and Humans Services announced an initiative called Out-Of-Home Care Reform. The State contracted with five lead agencies to provide safety and in-home services to children and their families. By November of 2009, service coordination began being passed from DHHS to the five private agencies, and the process was said to have been completed in April of 2010.

By October of 2010, legislators and advocates alike were raising concerns. The Omaha World-Herald reported that State Senetor Kathy Campbell of Lincoln raised her concerns after state officials announced that they had agreed with the Boys and Girls Home of Sioux City to end the agency’s contract.

“I think there’s just a number of questions that come to mind about the future,” she said.

“Nebraskans can clearly see the struggles of a child welfare system in trouble,” said Kathy Bigsby Moore, executive director of Voices for Children of Nebraska.

Moore said her group has “grave concerns” about the safety and well-being of the children and families affected by yet another transition in services.

On September 29, the Grand Island Independent called the effort “a failed experiment.” The editorial continues on to explain: “The evidence continues to mount that Nebraska’s move to privatize the foster care system has been an utter failure. Day after day brings more evidence that the system is broken.”

The editorial concluded that: “State HHS officials and Gov. Dave Heineman need to step up and admit that the privatization of the foster care system hasn’t worked and that children and foster parents are being hurt.”

On October 19, Nebraska Appleseed expressed similar concerns about the reform efforts, asking whether the State was heading in the right direction. As Appleseed explained: “We are concerned about the impact of these substantial changes on children and families in the system, particularly at a time when the system is already in flux.”

Appleseed concluded that: “This reform, not even one year old, has resulted in turmoil for hundreds of children and families, state and private agency employees, and community based agencies in our state as well as the loss of millions of dollars.”

Yesterday, Nebraska’s Foster Care Review Board weighed in on these very issues in a letter addressed to legislators.

“The implementation of the Reform was besought with problems from the start, as evidenced by CEDARS withdrawing from their contract on April 2, 2010, Visinet declaring bankruptcy and subsequently ceasing operations on April 16, 2010 and now Boys and Girls contract terminated effective October 15, 2010. As a result of the failure of these three Lead Agencies, the Reform has undergone constant change, has not been fully staffed resulting in multiple staff changes, payment delays to foster families and service providers, documentation issues, difficulties accessing services, visitation supervision issues and delayed permanancy,” the letter explains.

Based on 340 case reviews conducted by the Board in September of 2010, 34.7 percent lacked home study documentation; 30.6 percent lacked immunization records; 29.4 percent lacked placement reports; and 27.6 percent lacked visitation or other such reports.

Among other issues identified by the Board: “Foster parents report they are receiving less reimbursement than prior to the reform. They also report they no longer receive respite care or clothing reimbursement.”

Money is always at the heart of the issue, as the Board’s letter also explains that: “Therapists and other service providers report leaving the foster care system due to payment issues, or issues in which certain contractors will only utilize particular therapists with whom they presumably have an economic relationship.”

A recent report issued by Nebraska’s Platte Institute bears out the perverse financial incentives. The Institute found that: “The current system creates an incentive to shuffle a child into foster care, not because it is the best option for the child, but because in many cases funding is sure to follow. On the other hand, alternatives that actually cost less and are more effective are not taken into serious consideration.”

It is the children and their families that suffer the consequences, as the Foster Care Review Board notes also that: “Visitation sessions have been cancelled due to a lack of transportation driver.”

Children are being also being shuffled through multiple placements, a longstanding problem. The board notes that “Over 2,700 children have been directly affected by having their Lead Agency change at least once. Those changes result in having to work with new staff who lack case knowledge resulting in key documentation not being kept and services not being delivered.”

REAL REFORM

A Septemeber 10 editorial in the Journal Star strikes at the very heart of the problem – Nebraska’s high child removal rate. The editorial explains:

    New data from the U.S. Department of Health and Human Services show a widening gap between Nebraska and the rest of the nation in regard to the number of kids in foster care.

    This trend is disturbing and should be a cause for action.

    One of the key figures tracked by the federal Administration for Children and Families is the number of children placed into foster care.

    Nationwide, this figure declined 6.5 percent in 2009. But in Nebraska, entries into care rose nearly 7 percent to 3,563 children.

    This figure alone should force a re-evaluation of how Nebraska trains those on the front lines of child abuse and neglect reports to make decisions on whether to remove a child.

“Nebraskans can talk about being the heartland all they want, but when it comes to child welfare, it’s Nebraska that’s out of touch with America,” said Richard Wexler of the National Coalition for Child Protection Reform.

The editorial ultimately concludes: “Our status among the worst states in regard to best practices makes it imperative for state leaders to look at all possible avenues to make improvements and to do so with all deliberate speed. Our most vulnerable children are depending on it.”

As I note in my report on the privatization efforts in Kansas, clearly fast-track privatization is no panacea for our ailing patient.

Welcome to the grand social experiment called privatization – an experiment gone awry. It is a system that today rewards private service providers for the failures that have historically been relegated to the states.