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Children's Voice Article, May/June, 2005

Executive Directions

In a recent meeting with CEOs from some of our member agencies, I heard firsthand that the financial belt tightening we've all endured in recent years is wearing dangerously thin. These members conveyed their frustration at having to dip deeper into their own agency pockets to find funding for their work. They are also very concerned that shortfalls could eventually threaten their ability to perform their work in a manner that ensures the quality outcomes they seek for the children and families they serve.

A tenuous balancing act is at play here. Private, not-for-profit child welfare agencies find that the contracts that support their work often don't cover the actual costs of carrying out that work. Once they've spent funding allocated to them through these state and county contracts, little is left over at the end of the day to pay for all that each child in their care needs.

To fill the gap, agencies are relying increasingly on other funds raised privately through their organizations. Unfortunately, at the same time they are raising money to cover those shortfalls, they are dipping into endowments and leveraging themselves financially in a way that is placing them at risk.

These providers are well aware of the actual costs of providing care when they sit down to plan their budgets, and they are communicating to their county and state leaders about these costs as they engage in local and state advocacy-an increasingly important role for CWLA as well. Indeed, child welfare agencies are laying all their cards on the table when seeking county and state funds. In an ideal world, they should be able to rely on these governmental agencies to come much closer to fully covering their costs of caring for these children. Unfortunately, this is not the world we live in.

In fact, Congress is considering legislation that could reduce per diem rates states pay to private providers. If enacted, this legislation would cap federal funding for foster care and adoption assistance, leaving states with a fixed amount of federal funding to care for all children in out-of-home care. If federal funding is capped and states cannot draw on greater federal funding when needed, states may decrease the per diem paid to private providers caring for these children.

The federal Child and Family Service Reviews (CFSRs) conducted over the last few years provide clear evidence that increased funding is needed to deliver the quality care and results we all desire. States cannot fully implement the positive changes outlined in their improvement plans without both enhanced performance and additional investment.

For example, under the CFSRs, only six states achieved substantial conformity-the highest rating possible-to the outcome of protecting children from abuse and neglect. In the area of children receiving services to meet their physical and mental needs, 20 states received a rating of "strength" in meeting children's physical health needs, and four states achieved "strength" in meeting children's mental health needs. No states, however, achieved substantial conformity to this outcome.

States coming up short in providing sufficient care for children with mental health needs is particularly alarming, considering the sheer number of children in the child welfare system tackling mental illness. The pervasiveness of this problem is documented in the article "Unlocking Mental Health Services for Youth in Care," reprinted with permission from the National Court Appointed Special Advocate Association in this issue of the Voice.

Steve Hornberger, CWLA's Director of Behavioral Health, is quoted throughout the article. "Anywhere from 40% to 85% of kids in foster care have mental health disorders, depending on which report you read," he says. And, as the CFSRs uncover, most of our states are not sufficiently treating these disorders. In fact, 35 states participating in the CFSRs in FYs 2002-2004 were found to have insufficient mental health assessment and treatment services to meet the needs of children in the child welfare system.

CWLA is committed to helping agencies make improvements in future federal reviews. CWLA members, at our Biennial Leadership Summit in South Carolina last October, identified the goal of aligning funding with the needs of children as a top priority. Following the summit, a Membership Advisory Committee formed and began working to develop a messaging strategy to build the public and political will necessary to improve the lives of children and families through smarter, more substantial investments.

At CWLA, we understand the value of these efforts. In an under-resourced child welfare system, a child with an undiagnosed mental disorder risks not only suffering further from the disorder, but also falling behind in school and eventually dropping out or landing in the juvenile justice system. A family failing to receive necessary care may never reunify, or may reunify in less than ideal circumstances. Children placed in adoptive homes may not receive the postadoption supports necessary to ensure a successful outcome. Further compounding these failures will be the potential loss of agencies and workers committed to the child welfare field who may find it impossible to continue their essential work without sufficient support.

If we don't act to provide the resources to properly attend to children's needs, society ultimately will pay the true costs. The challenge of providing the full cost of care, therefore, demands that we consider the price we pay when we fail to do so.

Shay Bilchik

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