Abstract: In May of this year, hearings were held into foster care group home facilities operated by MENTOR Holdings, the nation’s largest foster care group home provider. The US Senate Finance Committee assumed jurisdiction over questions surrounding the company, which involved the deaths of at least six children. Senators thereafter sent letters to 50 State Governors, demanding answers to questions concerning how their respective child welfare systems are administered. Legislation has been proposed that offers promising changes in foster care. Another hearing is set for August.
During a Senate Finance Committee hearing entitled No Place to Grow Up: How to Safely Reduce Reliance on Foster Care Group Homes, held on May 19, Senator Chuck Grassley (D-Iowa) began the proceedings by explaining that foster care group homes, whether they are cast as “congregate care” or go by some other name, are unique in that the evidence shows that they can easily cost up to ten times as much placement in more family-like settings.
These facilities, Grassley explained, are highly correlated with a variety of poor outcomes, leading too many children down the wrong paths, including those of homelessness, substance abuse, incarceration, and poverty.
“What makes no sense,” Grassley continued, “is that in some instances, if the proper services had been available, these young people could have have remained safely at home and not needed to go into foster care in the first place.”
Committee Chairman Orrin Hatch (R-Utah) explained in a prepared statement that he was working with fellow members of the Committee to introduce legislation that would limit the federal matching funds to group homes for very young children and, after a period of time, for older youth as well.
Orrin Hatch has a remarkable way with words, managing to boil difficult issues down to their very essence in words that everyone can readily understand. The May 19 hearing provided no exception to this rule. As Hatch explained it:
I know that some might have concerns about limiting federal funds for any type of placement. Here’s how I look at it: No one would support allowing states to use federal taxpayer dollars to buy cigarettes for foster youth. In my view, continuing to use these scarce tax payer dollars to fund long terms placements in group homes is ultimately just as destructive.
Hatch explained that in order in inform the committee’s work, he and ranking member Ranking Member Ron Wyden wrote a letter to all 50 Governors “requesting responses to a series of questions related to the oversight of private child welfare service providers.”
He concluded by adding, “I look forward to receiving answers to our inquiry and moving forward on this matter.”
Finance Committee Ranking Member Ron Wyden (D-Ore) in turn delivered testimony proposing ways to safely reduce reliance on foster care group homes.
Senator Wyden began with the logical premise that “the best way to reduce reliance on congregate care is to prevent children from entering foster care at all.”
He explained that the terms “congregate care,” “group homes” and “residential treatment” are often used interchangeably; but the structure and quality of these settings varies widely. More to the point, Wyden explained,
For decades lawmakers, practitioners and advocates have talked about the need to provide support and prevention services for children and families in crisis. These investments can help keep children safe in their homes or with other family members while reducing the need for costly and traumatic transfers to the foster care system.
For this reason, I’ve drafted legislation to reform the foster care finance structure to give states and tribes the ability to use federal dollars that are now reserved only for foster care placements to finance new tools to keep families together.1
In seeking to demonstrate that this was truly a bipartisan effort, Sen. Wyden reached out to his colleagues on both sides of the political aisle, saying: “It’s no understatement to say children are counting on us to get this right. I look forward to working with you, Chairman Hatch, my colleagues, and others to make sure we accomplish this goal.”
Senator Charles Schumer (D-NY) spoke of tremendous accomplishments in New York City that saw the foster care population decline from 45.000 in 1993, to only 11,000 in 2014. Moreover, the City reduced the number of children in congregate care from 5,000 to 1,000 over the course of the last 15 years. This was through a combination of a greater reliance on kinship care, providing individualized services to children and families, and other initiatives that seek to find children safe and permanent placements.
Senator Schumer emphasized that each child has a unique and individual set of circumstances, and that services to prevent removal, or to reunify children with their families, must be individually tailored. Only through a federal waiver were such improvements possible. Schumer emphasized that the flexibility that comes from waivers and possible future reforms to Title IV-E funding are the crucial elements of such reforms.2
Some of the most poignant testimony was provided by Ms. Lexie Grüber, who had herself spent time confined to a group home against her will.
“When I walked through those doors on the first day, I felt like a wrongly accused prisoner walking into a jail to serve time for a crime they did not commit,” she told the Committee.
She described at some length the array of psychotropic medications that she was forced to take for a variety of mental diagnoses that were left behind her after she finally left the group home.3
In closing, she continued on to explain that, “If someone were to ask me what group homes are like, I would tell him or her that group homes are modern-day orphanages. These institutions cannot provide the moral, ethical, or social learning that is essential to healthy childhood development. Every child deserves a family. When we remove children from unhealthy families, we make a promise to provide them with a healthier family that can nurture and support them. This is a promise that we must uphold. There is a series of data that shows that young people are being placed in these settings without good reason and are left for far too long. Additionally, a wide body of national literature demonstrates that youth in group homes face poor outcomes once they age out of foster care.”
THE APPROPRIATE VENUE
In early June of this year, Senators Orrin Hatch and Ron Wyden sent a six-page letter to National Mentor Holdings, the nation’s largest for-profit foster care company. The letter requests detailed information regarding the company’s business practices, as well as the treatment of thousands of children in its care.
The Senators cited a number of disturbing stories concerning the company in media reports, not the least of which included accounts of the deaths of six children in the company’s care. The letter states that as the Finance Committee has direct jurisdiction over the Title IV-E program, from which foster care funds are typically drawn, the Committee is exercising its legal jurisdiction over these issues.
The U.S. Senate Finance Committee would be be the most appropriate venue for enacting meaningful change in the child welfare and foster care systems, as it pulls the proverbial pursestrings on federal funding to the States, primarily, though not exclusively, through Title IV-E of the Social Security Act – the source for the lion’s share of foster care funding – as well as Title IV-D, through which some meager funds flow intended to assist families in need of some assistance to prevent the otherwise unnecessary removal of their children from their homes.
The issue of reform has appeal to both sides of the political aisle. Even if one were to leave aside the humanitarian costs of congregate, residential, or group home care, there is no denying the excessive fiscal costs associated with most forms of institutional care.4
A San Joaquin County Grand Jury report issued in 2013 found that group home “placements are funded by AFDC-FC with rates ranging from $6,649 to $9,419 per child per month.” When you run the math, the cost of housing just one child in a group home for one year, the actual cost to the taxpayer runs anywhere from $79,788 to $113,028. For a family with three children in group home care in San Joaquin County, the cost would run from $239,364 to $339,084 for three children.
This is the part that, as Senator Grassley explained, does not make sense. While the money that was at one time intended to assist families, and to prevent placement in foster care, is now entirely unavailable to help families, the federal government continues to fund the programs to pay for institutional care at many, many times the cost of prevention.
Not even the most generous combination of Temporary Assistance for Needy Families, Food Stamps, WIC, and Medicaid combined – which are all that is left of what we consider as “welfare programs” – would amount to between $239,364 to $339,084 per year for a typical family with three children. In reality, their needs are far more modest. Some may need help with a down-payment on an affordable apartment, some others may need help with a utility bill, or a small subsidy to help cover childcare costs for a working mother. As a taxpayer, would you rather help a family out of a difficult situation with a few hundred dollars to help them keep the lights turned on, or would you rather spend tens of thousands of dollars to pay for the group home owner’s next Mercedes Benz?
Beyond the immediate costs are the longer term costs of childhoods stolen, and opportunities lost. Study after study has demonstrated the inextricable links between foster care placement and – as Senator Grassley pointed out – multiple poor outcomes, including homelessness, substance abuse, incarceration, and poverty.
Some children grow into adults and manage to overcome the odds, as did Lexie Grüber, who now holds a professional position. She did not, however, deserve to spend a term of her life in conditions that she describes as tantamount to being in a prison. Tragically, not all children have the resilience, the determination, and in some cases the good fortune to dig themselves up and out once they are emancipated from foster care to the streets without any means of support.
One of the foster care outcomes that is gaining greater attention lately is that of young teens turning to prostitution as a means of survival upon their emancipation from foster care.
The Los Angeles Times reported by way of a headline story in November of 2012 that: “Most L.A. County youths held for prostitution come from foster care.”
What do you suppose the The L.A. County Board of Supervisors did about that particular revelation? CBS-affiliated KNX radio reported that the Board wants to start a task force to investigate the problem, citing County Supervisor Michael Antonovich as saying: “These children often come from broken homes with a history of neglect and abuse, and foster children often overlap with runaway and homeless youth with a lack of resources, that makes them more vulnerable.”5
These points are not entirely lost on Capitol Hill. Removing children from their homes because their parents can barely afford to keep a roof over their heads during difficult economic times does not make for sound economic policy. Indeed, it has proven to be far more expensive than helping families ever was. Maintaining the bureaucracy that has become the child removal apparatus is a very expensive proposition, indeed. And, it is time that we all recognized that.
Regardless of how one feels about “other people’s children,” one would do well to consider the longer term consequences of turning our collective backs on them. If you spend any time traveling in any major city, you’ll encounter them among the homeless population. And, if you ever experience the misfortune of spending a night or more in a prison cell for a minor offense – guilty or not – you’ll find yourself rubbing elbows with quite a number of them. Few would tell you that they had willingly chosen the course their lives had taken that ultimately lead them there.
THE NEXT HEARING
On July 28, 2015, Orrin Hatch released an announcement that he will “convene a hearing on Tuesday, August 4, to explore alternatives to help families and children reduce reliance on foster care group homes. The hearing, titled “A Way Back Home: Preserving Families and Reducing the Need for Foster Care,” will take place at 10:00 a.m. in Room 215 of the Dirksen Senate Office Building.
“The over-use of foster care group homes has led to many problems for our most vulnerable children,” Hatch said. “With this hearing, members of the Committee will have the opportunity to explore a variety of policy options and current services that are available to help families and protect children from these destructive homes. Finding ways to keep children safely in their own homes or in the care of a loving and stable relative is a much better alternative than relying solely on foster care.”
Senator Ron Wyden plans to reintroduce his discussion draft of proposed federal legislation during the August hearing.
“This proposal is meant to address the lopsided structure of federal child welfare financing in which the vast majority of dollars are reserved for payments only when children are removed from their home,” Wyden said at the time of the document’s original release.
Some of the most influential leaders on Capitol Hill have it within their power and jurisdiction to shape history by getting this right. I remain cautiously optimistic that something good will come out of all this.
“It will all be worth it if it saves just one child,” the child savers like to say. Let’s hope this effort accomplishes far more than just that.
1. By no means is this an exaggeration. Among the more ambitious reform efforts was that of the Select Committee on Children, Youth and Families, Chaired by George Miller, which took over ten years to carve out P.L 96-272, more commonly known as the reasonable efforts requirement. Of more recent vintage was the Pew Commission on Foster Care, an ad hoc committee composed of luminaries in the field whose proposals received a considerable amount of press coverage, eventually leading to the Fostering Connections to Success and Increasing Adoptions Act, which was passed unanimously by Congress in 2008 and signed into law by President Bush. The Pew Commission concluded its initiative in 2009. The system was the subject of reports by the Urban Institute, notably Running to Keep in Place: The Continuing Evolution of Our Nation’s Child Welfare System, which essentially found that efforts at imposing oversight and accountability resulted in a greater emphasis on documentation and clerical work, impeding decision making authority, leaving workers less time to spend with children and families. Other major studies were rolled out by Casey Family Programs, The Edna McConnell Clark Foundation’s Program for Children, which was phased out after 30 years of effort, and the National Commission on Children, whose voluminous efforts are located at the National Archives. The system has been scrutinized by various Grand Juries, and has been the subject of a large number of federal studies and audits. The first truly comprehensive national study of the child welfare system was conducted by the Children’s Defense Fund during the 1970s. Its report, Children Without Homes, released in 1978, weighed in at over 300 pages, and it provided a stunning indictment of the child welfare system. Its findings are as timely today as the day it was written.
2. The gains noted by Senator Schumer are indeed significant. Assuming 11.000 children in care to be the optimal number – a generous supposition subject to some debate – that would mean that 34,000 too many children were in foster care in 1993. To apply some additional perspective, a press release from New York City’s Administration for Children’s Services dated February 3, 2005, states that the City’s foster care population had “decreased to 19,779 today from a high of 50,000 in 1991.” Assuming these figures to be accurate, that would translate to a reduction of approximately four-fifths the size of New York City’s foster care population relative to 1991. For detailed information about this initiative, see Administration for Children’s Services, “Protecting Children And Strengthening Families: A Plan To Realign New York City’s Child Welfare System,” February 2005. These gains notwithstanding, the sheer number of children and families impacted by child welfare agencies in New York City remains astounding. According to Sen Schumer, the most recent figures indicate that 10,000 children are removed from their homes for “protection” over the course of a year, while an estimated 200,000 families are “monitored” by agencies because their families are deemed to be at risk.
3. To this day, the overprescription of psychotropic medications to children and youth in care remains a seemingly intractable problem. For an analysis of a California-based legislative initiative that is continuing to make headway, see Rick Thoma, “California Legislators Take Aim at Psychotropics in Foster Care,” Lifting the Veil Blog, March 27, 2015; “‘Dr. Phil’ McGraw Testifies in Congress on Psychotropic Drugs in Foster Care,” June 6, 2014; “Reforming Foster Care Psychotropic Meds: A Cautionary Note,” Sept 3, 2012.
4. During her testimony, Ms. JooYeun Chang, Associate Commissioner of the Children’s Bureau, Administration for Children Youth and Families, United States Department of Health and Human Services, explained that, “Congregate care includes care in a group home or institution such as a child care institution, residential treatment facility, or maternity home.” The terms are used more or less interchangeably, with minor regional differences in usage as well as regional differences in the specific funding streams from which they may draw. The crucial point is that they are all forms of institutional care, as distinguished against a placement that provides a more family-like setting.
5. Michael Antonovich never ceases to amaze me with his canned answers. For decades, task forces had been created, even en as agency leaders have come and gone. All the while Antonovich pontificated that heads would continue to roll if something wasn’t done to “fix” child protective services. Yet, nothing ever seems to change.