The Brookings Institution was the setting this past Tuesday, May 5 for a discussion “Can States Improve Children’s Health by Preventing Abuse and Neglect“. As part of discussion there was a new release of The Future of Children from Princeton and the Brookings Institution: Policies to Promote Child Health. Although the focus of the discussion was on prevention some of the comments focused on financing of the child welfare system.

Janet Curry, Princeton University, gave an overview of child health and some of the progress and some of the challenges that still exist when examining the past several decades. Ron Haskins, Senior Fellow and moderator of the panels, the Brookings Institution, had some opening remarks on financing. Much of his discussion focused on state child welfare financing. Mr Haskins argued that states would have benefited from a child welfare block grant proposed in Congress in the late 1990s. He proposed that greater state flexibility and funding would have benefited child welfare and children. That point of view was disputed by Patrick McCarthy, President/CEO, Annie E Casey Foundation, who argued that state flexibility already exists in the current funding structure and that the issue is much more complex than simply restructuring funding. He also focused some of his comments on the challenges of the workforce with many caseworkers facing conditions that include understaffed work forces, lack of adequate supervision for those caseworkers, little data tools and fewer resources to really deal with and make the informed choices on very critical life altering decisions that change the lives of families and children. . The second panel focused more on Capitol Hill and potential policy changes. Panelists included Brenda Donald, Washington DC, who discussed the continuum of care Washington DC has been putting into place over the past several years. They have tried to structure services from early childhood services such as home visiting all the way to focusing on youth in the system who need assistance transitioning to adulthood.

Kenneth Dodge, Duke University, focused on what they are attempting to do in the Raleigh Durham area through their “Durham Connects.” He spoke for the need to have two systems in place: one system to fund the current services that are vital to the children who are dependent on those services; and a second more structured toward prevention services. He compared the strategy to a waterfall with children at the top of that waterfall needing preventive supports. He argued you cannot build that protection at the top by taking services and funding from children lower down on the waterfall who are also in need of services. He also supported a universal system of prevention that does not select out certain families and described an approach in Durham County whereby nearly every baby born in the county is assessed in their homes. Also on the panel was Christine Calpin, Casey Family Programs, who focused comments on the use of waivers by states to experiment with changed funding strategies. She highlighted Florida and some of the other states that have received permission to reallocate Title IV-E funds in different ways. A key discussion point were comments by Becky Shipp, Republican staffer, Senate Finance Committee, who offered her perspectives of congregate care in foster care and her concerns regarding its use as a placement. She also weighed in with concerns over the use of block grants and their shortfalls in addressing child welfare. There was a consensus by much of the panel that major child welfare finance reform will not happen this year but it is possible to have smaller pieces of legislation that addresses specific areas. There was also consensus that there was no way that a block grant of child welfare services could get through Congress at this point. In addition there was some disagreement and opposition on the idea that what is really needed is state flexibility or more state flexibility.