Preventing and Treating Causes of Child Abuse and Neglect – Not Foster Care Placement – May Improve Safety and Wellbeing, New Brookings-Princeton Paper Finds

May 05 2015
Source The Future of Children
Each year, an estimated 680,000 children are reported as victims of parental abuse and neglect in the U.S. The current child welfare system, which gives states an incentive to remove children from their homes, should be reformed so that we help prevent and treat the causes of child abuse and neglect, which ultimately is better for the children, according to a policy brief published with the spring 2015 issue of the Princeton University-Brookings Institution Future of Children journal, “Policies to Promote Child Health,” released today. 
In the policy brief, “Can States Improve Children’s Health by Preventing Abuse and Neglect?” Ron Haskins, senior fellow in economic studies and co-director of the Brookings Center on Children and Families; Janet Currie, Ph.D. ’88, the Henry Putnam Professor of Economics and Public Affairs at the Woodrow Wilson School of Public and International Affairs, chair of Princeton's Department of Economics and director of Princeton University’s Center for Health and Wellbeing; and Lawrence Berger, professor at the University of Wisconsin-Madison, write that revising the grant programs that help states and localities run their child welfare programs could improve the welfare of children who are at risk of abuse or neglect. The authors point to research showing that many prevention and treatment programs reduce the need for out-of-home placement. But the current system is structured so that “funds available for foster care on the back end exceed those for front-end services by a huge amount … [giving] states … financial incentives to remove children from their homes” instead of preventing the causes of abuse and neglect or providing early treatment for the family.
The authors point out that two grant programs in the Social Security Act, authorized under Titles IV-B and IV-E, are exacerbating the problem of yanking kids out of their homes. Title IV-B, the smaller of the two programs, gives states $650 million in fixed funding each year to cover the cost of front end services that can be used to treat or prevent the root causes of child maltreatment  interventions to reduce substance abuse, violence in the home, and mental health problems, for example. Title IV-E, by contrast, provides states with more than 10 times as much money, or $7 billion, in open-ended funds that must be used primarily after the child has been removed from the family and placed in another setting, usually foster care. Several previous attempts in Congress to increase the flexibility of the funds and support more front end services have failed to pass, including attempts in 1996 and 2004.
However, a dramatic decline in the foster care caseload  which has fallen almost 30 percent, from 567,000 in 1999 to 402,000 in 2013  may present a rare opportunity for the most fundamental shift in federal child welfare policy in decades. States are now realizing that if they had accepted a flexible grant containing all the foster care placement, administrative, and training costs in Title IV-E , they actually would have received more money than they did under the existing IV-E program. In fact, the Congressional Research Service estimates that states would have received more than $12 billion more  nearly $65 billion from 2005 to 2014, compared to just the $52.8 billion they received under current law. 
A problem with allowing states more flexibility in using IV-E funds is that the funds would have to be fixed at a level equal to the amount states would spend under current law as estimated by the Congressional Budget Office. Thus, states would lose the open-ended funding for out-of-home placements that is guaranteed under the current IV-E, a feature that would come in handy if states experienced a sudden increase in their foster care caseload as has happened in the past. Loss of open-ended funding in exchange for more flexibility is a major reason many child advocates and members of congress are opposed to the change in IV-E.
“Following the mandate of federal and state law that the holy grail of child welfare is safety, permanence, and child wellbeing, states have shown that they can increase adoptions and reduce foster care placements. Further, research increasingly shows that many programs for children, families, and communities can effectively reduce mental health problems, addiction, and other troubles that afflict families and children so that safety, permanence, and wellbeing can increase. The annual statistics on confirmed cases of abuse, neglect, and child deaths show that the nation still has a long way to go. The prevention and treatment programs that have been shown to effectively promote child welfare, usually without removing children from their families, are expensive, though they can save money in the long run,” the authors conclude.
Read the policy brief.
Read the full journal.
The Future of Children is a collaboration of the Wilson School and the Brookings Center on Children and Families.