The Administration’s budget includes several proposed appropriations increases or changes in law to expand child welfare services, particularly for children and families involved with foster care. It is in fact a change for a budget area that rarely experiences any requested increases beyond what happens under the entitlement programs. Whether any action takes place will depend on Congress but in recent years Congress has been reluctant to invest heavily beyond the increases under Title IV-E foster care and adoption assistance.
The Administration is requesting funding for a joint project by the Administration for Children and Families (ACF) and the Centers for Medicare & Medicaid Services (CMS) to address the over use of psychotropic medications by promoting evidenced-based interventions targeting children in the foster care system. Similar to last year the Administration requests $50 million a year through ACF matched by $100 million a year through Medicaid. Funding would be used for competitive demonstration projects.
States would receive performance-based Medicaid incentive payments to improve care coordination paired with ACF funding to states that support state efforts to build provider and systems capacity. The capacity building through ACF would include: Enhancing child welfare workforce; Providing reliable screening and assessment tools; Coordination between child welfare and Medicaid especially Early and Periodic, Screening, Diagnosis, and Treatment (EPSDT); Training for foster parents, adoptive parents, guardians, and judges; implementing an evaluation and providing data.
Also consistent with a proposal included in several past budgets is a request for reforms to the child support program that would designate that child support payments, collected by the states from some parents of children in foster care (as mandated by law) be used on behalf of children, especially youth in foster care. Currently such funding is returned to the states and the federal government based on their share of foster care costs.
A new and potentially significant proposal would spend $586 million over ten years through Title IV-E for prevention and post-permanency services. The prevention piece is broadly framed as services and efforts to prevent a child from entering or re-entering foster care. The proposal, which like many budget items needs to be fleshed out into legislative language, would expand the category of services that can be provided to children considered “candidates for foster care.” Currently states use such classifications and services provided on a very limited basis under federal restrictions and guidance. This might also be a tool for post-placements services. Currently the only designated funding for family reunification is approximately 20 percent of funding provided under the Promoting Safe and Stable Families (PSSF) program but those services are time-limited to when the child first enters foster care and the funding amounts to less than $75 million a year.
An additional new budget initiative would attempt to reduce the use of congregate care by placing greater justification for such placements by the child welfare agency with increased oversight by the courts including a re-determination after six months. The proposal envisions a $78 million cost in year one with overall savings in foster care placements of $69 million over ten years. The expanded coverage along with the increased oversight would provide support for specialized case management using smaller caseloads and specialized training for caseworkers to focus on “family-based care specialized casework.” The proposal also includes specialized training and salaries for foster parents who provide a therapeutic environment for a child in foster care.
The Administration proposes an additional $30 million in discretionary funding under PSSF. Of this total $20 million would be designated to assist tribes in capacity building for various child welfare services such as family support and preservation. $7 million will be designated for rural areas to build their capacity and the remaining $3 million would be designated for research, evaluation and technical assistance. The increased funding for tribes is part of several budget items to assist tribes that are under resourced especially in terms of wrap-around and family support services.
Finally under CAPTA, the Administration seeks a total of $20 million of discretionary funding that would be designated in part ($15 million) for competitive grants to design programs that can prevent children from being lured into illegal activities including but not limited to sex trafficking. The remaining $5 million would be for improved casework through the child protection system—a proposal that is likely linked to the current work of the Commission to Eliminate Child Abuse and Neglect Fatalities.
As part of the CAPTA reauthorization the administration is seeking a re-design of the Abandoned Infants program. The program gets reauthorized with CAPTA. The program has been funded at $11 million for more than a decade and addresses instances when an infant may be abandoned in safe places such as hospitals. Originally (in the late 1980s) numbers had been driven by the crack epidemic and the spread of AIDS. Citing reduced numbers of abandoned infants, the Administration is requesting a re-direction in the program’s mission. The reauthorization request updates to the program including re-naming it to Protecting Abandoned and At Risk Infants and Toddlers in order to modify the program so that it can better address the current needs of at-risk families with infants and toddlers. Citing the fact that infants and toddlers are one of the fastest growing groups being served by child welfare and child protective services the Administration is attempting to use the reauthorization as a way to focus greater attention on this population. In recent years this population has not always been the focus of congressional attention when it comes to the child protective services and foster care systems.