Fostering Collaboration

Fostering Connections Roundtables Highlight Opportunities
to Improve Outcomes

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Last fall, in close partnership with Casey Family Programs, CWLA hosted a series of community roundtables around the United States focusing on effective implementation of the Fostering Connections to Success and Increasing Adoptions Act of 2008 (P.L. 110-351). Signed into law on October 7, 2008, Fostering Connections makes significant improvements in seven key areas: kinship care, youth in transition, tribal access to funds, workforce development, adoption, health care, and education access. "This is an historic moment for foster children and families," said CWLA President/CEO Christine James-Brown upon the law's enactment. "Not since the Adoption Assistance and Child Welfare Act of 1980 has this country had a bill that speaks directly to the needs of the more than 513,000 children in foster care."

Immediately after the bill was signed into law, CWLA held a series of regional conference calls to start educating CWLA members at the state level about the exciting opportunities it brings. While some provisions of the Fostering Connections Act took effect immediately, others will not take effect until this year or will be phased in over time. Some preliminary guidance has been issued by the overseeing federal departments and agencies, but much is yet to come. This delay has been due in part to the ongoing transition to the Obama Administration.

The Fostering Connections community forums this fall were a vital step in this process, to continue to educate the public and--even more importantly--to bring together public and private stakeholders to get a sense of how the law is being implemented, what steps have been taken to improve the lives of vulnerable children, youth, and families, and what obstacles states are facing through the implementation process. The community forums were held around the country in Chicago, Denver, Boston, Atlanta, Dallas, San Francisco, and New York. Each roundtable provided an overview of the law and then focused on specific provisions.

Kinship Guardianship

The Fostering Connections law grants states the option to use federal Title IV-E funds to support kinship and guardianship payments for children being raised by relative caregivers. This policy was long advocated for by CWLA and many other national, state, and local organizations. While the practice of kinship care is not new, it is becoming more common, partly because repeated studies and CWLA Best Practice Guidelines have demonstrated the value of placing children with relatives when appropriate. Of the 492,618 children in out-of-home care in 2007, 123,390 were living with relatives while in care. While these arrangements are often beneficial for children, the financial strain on relative caregivers and lack of direct federal assistance threatened the practice.

In 1997, the Adoption and Safe Families Act (P.L. 105-89) recognized placements with relatives or legal guardians as permanency options for children in foster care, but for years, the federal government failed to make funds available on a continuing basis to help those relatives care for the children. Before Fostering Connections finally offered states the kinship option, states working with private agencies had to rely on a variety of federal sources not focused on kinship care to fund subsidized guardianship placements for children, including Title IV-E child welfare waivers, Temporary Assistance for Needy Families (TANF), and the Social Services Block Grant. Other states had to exclusively use state and local funds.

More than 600 people attended the Fostering Connections roundtables last fall. Events were held in Atlanta (top), San Francisco (bottom), and five other cities around the United States.

This kinship provision became effective October 7, 2008. To take up the option, a state must amend its state plan, consult any child age 14 or older, indicate the steps taken to determine that reunification or adoption are not appropriate, and adhere to the same background check requirements, but the state may waive non-health and safety licensing on a case-by-case basis to eliminate barriers to placing children with relative caregivers. Children eligible under the kinship provision must also be eligible for federal foster care maintenance payments and must reside with the relative for at least six consecutive months. States must allow children who leave foster care for kinship guardianship to be eligible for independent living services and education and training vouchers. State agencies must also exhibit due diligence to identify and provide notice to all adult relatives of a child within 30 days after the child is removed from the custody of the parent(s). To assist these efforts, the law provides $15 million in new family connection grants, with $5 million of the authorized funding being reserved for kinship navigator programs and the remaining $10 million available for intensive family-finding efforts, family group decision-making meetings, and residential family substance abuse treatment programs.

At the Chicago roundtable, Erwin McEwen, Director of the Illinois Department of Children and Family Services, presented Illinois's positive experience with the use of kinship care and subsidized guardianships. Since 1997, McEwen reported, over 10,000 Illinois children have achieved permanence through guardianship. This success story began when Illinois started to operate under a Title IV-E waiver granted by the federal government, with the goal of eliminating long-term foster care placements and actively working to reduce the length of permanency planning and revitalizing relationships with private agencies. Throughout its restructuring and focus on kinship guardianship, Illinois learned many vital lessons--including the importance of postguardianship services to avoid displacement and dissolution of guardianship, equitable subsidies for kin families, comprehensive staff training, education to the families regarding the permanent nature of kinship/guardianship, and reliable and verifiable data to show results. Due to these efforts, Illinois has shown that of the children placed in adoptive and kinship homes, 98% were still in the permanent arrangements two years later and 92% were there 10 years later.

Sharon Pierce, President and CEO of The Villages of Indiana, attended the Chicago roundtable. "The collaboration demonstrated by CWLA and Casey Family Programs to provide thorough, accurate information to all of us working in the public and private sectors has really established a foundation of knowledge and practice for this exciting 'next generation' of child welfare law and policy," she said. "I think all of us who are privileged to work with abused and neglected children have been energized knowing that foster children, adoptive children, kinship caregivers, and our resilient older youth will have improved opportunities to have their voices heard and their needs met in a more timely and proactive manner."

At the Dallas roundtable, Ana Beltran, a special adviser to Generations United, reported that 10 states have enacted notification laws or amended prior notification laws that reflect the Fostering Connections requirements. Five states and the District of Columbia incorporated the new notification requirements into their relevant policy manuals or state policy bulletins. Penalty provisions, Beltran said, are rare.

Improving Outcomes for Children in Foster Care

Extension Beyond Age 18

Beginning next October, Fostering Connections will permit states to provide care and support to youth in foster care, adoption, or guardianship up to age 21 as long as the youth is completing high school or an equivalency program; enrolled in postsecondary or vocational school; participating in a program or activity designed to promote, or remove barriers to, employment; employed for at least 80 hours per month; or incapable of doing any of these activities due to a medical condition. Already in effect is a provision requiring states to develop a transition plan with all youth during the 90-day period immediately before they leave care.


Massachusetts is one of the states that has already extended foster care to age 21. At the Boston roundtable, the Massachusetts Department of Children and Families presented its successful experience, stressing the need for a wide range of services for this population and the importance of youth engagement. At the Atlanta roundtable, attendees heard directly from foster youth. Sheldon Marshal and Joshua Hudson, both part of the CHRIS Kids programs, explained that while the law requires youth to be actively engaged in planning their transition, that was not their experience. The youth stressed that caseworkers should be in more consistent contact with youth and that the youths' opinions need to be more highly valued. Michael Foust from Families First in Atlanta provided an overview of the somewhat bleak statistics of youth formerly in foster care. Since many do not have the consistent presence of family, Foust talked about the importance of connecting young people in foster care to supports within their communities.

Education

To promote educational stability of children in foster care, Fostering Connections requires state child welfare agencies to coordinate with local education agencies to ensure that children placed in foster care remain in the same school, unless contrary to the child's best interest. If remaining is not in the child's best interest, the state must ensure immediate enrollment in a new school. The cost of transportation from a child's foster home to that child's school can be calculated as part of the foster care payment.

Representatives from the American Bar Association (ABA) discussed the law's education provision at both the Chicago and Atlanta roundtables. The ABA houses a national technical assistance resource and information clearinghouse on legal and policy matters affecting the education of children and youth in out-of-home care. Kristin Kelly and Kathleen McNaught from the ABA Center on Children and the Law explained that the law's changes could not be realized without an equal responsibility and burden placed on the education system. Definitional questions were raised, such as how to determine proximity, appropriateness, and the best interest of the child when it comes to education. When school moves are necessary, the ABA recommended coordinating with the school to create a process with clearly identified responsibilities and working with schools to expedite obtaining necessary paperwork. The ABA reminded the audience that courts can be brought in to mediate and resolve remaining issues.

Health

To help meet health needs and improve overall health of children in care, Fostering Connections requires states to develop, in coordination and collaboration with the state Medicaid agency and in consultation with pediatricians and other experts, a plan for the ongoing oversight and coordination of health care services for any child in foster care. The health provision was effective starting October 7, 2008.

Jim Pawelski, director of the American Academy of Pediatrics' (AAP) division of state government affairs, presented at the Chicago roundtable and referred often to CWLA's Standards of Excellence for Health Care Services for Children in Out-of-Home Care when making suggestions for implementation. The standards recommend, for instance, that medical, developmental, and mental health screenings occur within 72 hours of entering the child welfare system and a comprehensive assessment occur within 30 days of entering the system. The AAP discussed the importance of a medical home, which is a patient-centered system of care in which one physician is responsible for coordinating the entire universe of care for a child. Pawelski stressed including specific steps in the child's health oversight and coordination plan for monitoring the prescription of medication, as studies have shown that children involved with the child welfare system are three to four times more likely than are non-child welfare Medicaid recipients to receive psychotropic medications.

In Dallas, staff from STAR Health, a managed care health program developed specifically for Texas foster children and designed to coordinate communication between medical consenters, caregivers, members, Department of Family and Protective Services staff, guardians at litem, attorneys at litem, judges, and law enforcement, spoke. Compared to more traditional care, the STAR Health representatives mentioned the benefits of immediate enrollment for children after they are removed from the home, health passports (a web-based health record), and 24-hour member hotlines to assist members. STAR Health screens certain children who have received treatment with a psychotropic medication for 60 days or more to ensure proper care of the child.

Tribal Foster Care and Adoption Access

Fostering Connections allows tribes direct access to Title IV-E funding. This is a historic change, as before this legislation, tribes could not access federal funds to administer their own foster care or adoption assistance programs but instead had to enter into agreements with their respective state governments to access IV-E funds--agreements that more than half of the federally recognized tribes did not have. This provision became effective last October.

An entire panel presented on tribal opportunities and challenges at both the Denver and Dallas roundtables, including individuals who work directly with tribal children and families. Representatives from the Association on American Indian Affairs and the National Congress of American Indians said that while many tribes will want to operate the program directly, they might have to contract with the state to perform certain functions if they do not have the capacity. The panelists stressed the importance of sharing information between tribes and states so that tribal children can maintain their eligibility for health and other services provided by federal and state programs. Critical challenges that will have to be overcome to properly implement the tribal provisions include identifying sufficient nonfederal match sources to meet Title IV-E requirements, developing a Title IV-E compliant automated data system, and managing unique tribal service delivery issues, such as determining eligibility of a tribal child when the tribal lands happen to be in more than one state. In San Francisco, participants heard from a new Children's Bureau resource center that will provide technical assistance to address these challenges. The National Resource Center for Tribes with the Tribal Law and Policy Institute is the lead organization that will work with the Bureau and other tribal nonprofit organizations to provide training and technical assistance.

Adoption Incentive Improvements

More than 133,818 children in the child welfare system are classified as "waiting to be adopted." Of the children waiting to be adopted from foster care, a disproportionate number are from minority populations. To promote the adoption of children from foster care, Fostering Connections reauthorizes the Adoptions Incentives Program until 2013 and enhances incentives from current law. Older child adoptions (defined as older than 9 years) are increased from $4,000 to $8,000 and special needs adoptions are increased from $2,000 to $4,000. In addition, the state will receive an additional payment of $1,000 per adoption if the state's adoption rate exceeds its highest recorded foster child adoption rate since 2002.

The law makes another important and long-awaited policy advancement. For far too long, a child's eligibility for Title IV-E adoption assistance was determined by an outdated standard. A child would only be eligible for federal assistance if the child was removed from a family that would have been eligible for the now nonexistent Aid to Families with Dependent Children (AFDC) cash assistance program as it existed on July 16, 1996. This translated to fewer and fewer children being eligible for federal assistance each year. While the child welfare field is still awaiting a de-link when it comes to foster care assistance, Fostering Connections slowly repeals the link to AFDC for special adoption assistance. Beginning last October, all special needs adoptions of children age 16 and older were de-linked from AFDC and each year, the age will be deceased by two years. In addition, all children who have spent at least five consecutive years in foster care will be eligible, as well as any siblings adopted into the same family.

A panel at the September 16 roundtable in Denver discussed the law's adoption provisions, including Susanne Dosch from the Adoption Exchange, Heidi Hendricks from Lutheran Family Services of Colorado, and Sharen Ford from the Department of Human Services. Panelists reported that the adoption provisions represent significant progress and opportunity and discussed the provisions' interplay with other advancements, including the kinship/guardianship and extending foster care to 21 provisions. The definition of kin, for example, will have an impact on how adoption is used by the state and where children can be placed in permanent, appropriate settings.

Moving Forward

On December 8, the last roundtable was held in New York City. Participants were able to engage in an important discussion about workforce development and how expanded access to Title IV-E training funds could assist both public and private agencies in strengthening the child welfare workforce. During the lunch, Carmen Nazario, newly approved assistant secretary for the Department of Health and Human Services and head of the Administration on Children and Families, gave one of her first addresses in her new position to CWLA members. Nazario discussed how important Fostering Connections is, her vision of what she hopes to accomplish, and her intention to address poverty in a more comprehensive way--extending beyond more traditional programs such as TANF. Nazario also expressed her desire to continue dialogue with roundtable attendees and other key partners to ensure that the new law is implemented in an effective way.

More than 600 CWLA members and nonmembers gathered at the seven roundtables that took place from early September to early December. The gatherings drew professionals from the public and private sectors, advocates, and officials from adoption, foster care, prevention, tribal, and youth service agencies. The discussions that took place left people enlightened, having provided some answers while also raising more questions. CWLA looks forward to building on the effort in 2010 so that more states, cities, and agencies can help use Fostering Connections as a tool to improve the lives of many of America's most vulnerable children and families.

Laura Weidner formerly served as CWLA's government affairs associate for health, focusing on Medicaid, CHIP, and mental health policy at the federal level. She also oversaw coordination and communication with state-level advocates.

To comment on this article, e-mail voice@cwla.org.

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