On Tuesday, May 19, the Senate Finance Committee held a hearing on the use of congregate care. The hearing was titled, “No Place to Grow Up: How to Safely Reduce Reliance on Foster Care Group Homes.” The hearing focused on the desire to make sure that children do not grow up or stay in what is generally referred to as “congregate” care. Title IV-E Foster Care describes residential care as a “child care institution which accommodates no more than twenty-five children…..but does not include detention facilities, forestry camps, training schools, or any other facility operated primarily for the detention of children who are determined to be delinquent.” The annual AFCARS report includes two categories: group homes and institutional settings. A child in foster care in “congregate care” could be in a residential treatment facility, maternity home for pregnant or parenting child/youth, temporary shelters, group homes and other placement settings depending on the state and service intended.
In an opening statement by Senator Orin Hatch (R-UT) (who was on the Senate floor managing the trade debate) the chair said:
“Groups home, sometimes referred to as “congregate care,” are literally breeding grounds for the sexual exploitation of children and youth. As the committee heard during a hearing on domestic sex trafficking of children and youth in foster care, traffickers know where these group homes are and target the children placed in them for exploitation.
While the provisions included in my bill 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 groups homes is ultimately just as destructive… Additionally, we will attempt to address policies and practices that, as detailed in a BuzzFeed Media series, led to a number of horrific cases of severe abuse, neglect, and the tragic death of a little three year girl.” In order in inform the committee’s work on how to address the policies and practices that contributed these horrific outcomes, Ranking Member Wyden and I wrote a letter to all 50 Governors requesting responses to a series of questions related to the oversight of private child welfare service providers.” Witnesses before the panel included Ms. Lexie Grüber, Former Foster Youth, CT, Dr. Jeremy Christopher Kohomban, President, The Children’s Village, NY, Mr. Matthew Reynell, Adoptive Father, NY, and JooYeun Chang, Associate Commissioner, Children’s Bureau, HHS. Lexi Gruber recounted her personal experience being placed into foster care as a teen and the multiple placements in a variety of settings and the negative impact the removal and settings had on her. Dr Kohomban discussed the Children’s Village transformation from a residential services provider to providing a continuum of child welfare services. Mr Reynell discussed how he came to adopt his son who was in residential care. He praised the facility and the support the treatment professionals provided and he urged that all facilities have similar care aligned with support parents and caretakers as part of the treatment plan. Commissioner Chang indicated that a recent analysis by the Children’s Bureau found that children in congregate care made up 18 percent of the foster care population in 2004 and 14 percent in 2013. She emphasized that while trends suggest that child welfare practice is moving toward more limited use of congregate care, the improvement is not across all fifty states, and in some states the use of congregate care has increased. She highlighted a proposal in the Administration’s FY ’16 budget that would increase monitoring of congregate care use and supporting family-based care as an alternative to congregate care. The proposal would amend title IV-E to promote specialized family-based care as an alternative to congregate care for children with behavioral and mental health needs, and provide oversight when congregate care placements are used. The proposal would: Require an initial justification of appropriateness and If a child must be placed in a facility, the child welfare agency would be required to justify congregate care as the least restrictive foster care placement setting appropriate to meet the child’s needs. States would be required to request a judicial determination at six months and every six months thereafter that the placement in the congregate facility is the best option for meeting the child’s needs and that the child is progressing towards readiness for a more family-like setting. Child welfare agencies would be reimbursed with 60 percent match in federal funds for specialized casework (instead of the 50% match) and an 80 percent match for specialized caseworker training. Senators were in and out of the hearing since it was directly competing with a Senate floor debate on trade policy but opening remarks reflected senators’ desires to reduce the use of residential placements. Of significance Senator Debbie Stabenow (D-MI) used the hearing as an opportunity to press for passage of the Family-Based Foster Care Services Act: HR.835/S.429, legislation she is cosponsoring to encourage the use of therapeutic foster care through Medicaid. Ranking Member Senator Ron Wyden (D-OR) talked about his proposed legislation that is still in draft format but would encourage more services that could prevent foster care placements and could strengthen families that are reunified. Senator Wyden is still seeking input on his discussion draft bill. The discussion draft would build on the Administration’s FY 2016 budget request that seeks to expand the use of the foster care “candidacy” category as a methodology to provide home and community based services for children who have not yet been placed into foster care. The proposal and legislation would also use this tool to provide services to those children and families that have been reunified. Senator Wyden is circulating the draft to solicit input before it is introduced as legislation. The responses will be reviewed and, if appropriate, be incorporated into legislation that Wyden plans to introduce in the coming months. Please email comments on the proposal to childwelfaredraft@finance.senate.gov by June 12, 2015. Key input is being sought on how to define the expanded services that would now be allowed under Title IV-E foster care, how to evaluate those services (evidence based, evidence informed, etc.) and how to establish accountability on states that draw the expanded funding for services to prevent foster care placement and services to support children once they are placed or reunited with a family. To watch a video of the hearing go here. .
