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No Family, No Future
Greater Investment in Family Caregiver Recruitment & Support is Essential to Improve Outcomes for California's Foster Children
A Policy Report by:
County Welfare Directors Association of California (CWDA) Legal Advocates for Permanent Parenting (LAPP)
May 2007
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Introduction
California has the largest child welfare system in the nation with nearly 80,000 children in the state's foster care system. In 2001, the state passed ground-breaking legislation that established the Child Welfare Services Outcomes and Accountability System to improve the outcomes faced by children and families touched by the child welfare system. Implemented in January 2004, California's system is an enhanced version of the federal oversight system mandated by Congress and used to monitor states' performance. Over the last three years, California has made significant progress in improving outcomes for children. The most recent data available from the UC Berkeley Child Welfare Performance Indicators Project the statewide entity that tracks all California child welfare data shows that counties are improving on most measures, with significant improvement in some measures and more modest improvements in others. While this early tide of improvement is promising, a serious, statewide shortage of families who are able to care for foster children threatens continued progress. The pace of improvements in state performance outcomes such as placement stability, sibling placement, placement in institutional and group care, and time to reunification and adoption will very likely be slowed. Although the impact on children is of primary concern, slowing progress in achieving outcomes also brings the threat of federal sanctions as steep as $74 million for the state. Key barriers to recruiting and retaining family caregivers include foster care rates that have been frozen for over six years and issues surrounding the level of support that families need from agencies to help care for foster youth. Foster care rates are roughly 23 percent lower than they were in 2000 when adjusted for inflation. A critical first step in addressing this crisis is to enact legislation that includes: 1) a basic rate increase that keeps up with inflation; and 2) further investments in family caregiver supports.
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Shortage of Family Caregivers Affects Outcomes for Children
Foster children do better with families.
For children who must be removed from their homes due to abuse and neglect, county child welfare agencies have the discretion to place in one of four settings: (1) kinship care, (2) a licensed foster family home (FFH), (3) a certified foster family agency (FFA) home, or (4) a group home. County child welfare agencies strive to place children and youth in the least restrictive, most family-like setting possible. Initially, every effort is made to place with kin or another individual with whom the child has a relationship (e.g., nonrelated extended family members). When kinship placement is not available, OUT-OF-HOME CARE SETTINGS licensed foster family and adoptive homes are the next best and most preferred placements Kinship Care: Kin are adults who are relatives by blood, adoption or other close relationship. for children. Certified foster family agencies and group homes are intended to be the placements of last resort as both are intended for children and youth who need a higher level of therapeutic service. These types of placements are significantly more costly than licensed foster family homes (see cost information on page 4).
Preferential treatment is given to a grandparent, aunt, uncle or sibling.
Licensed Foster Family Homes: Family homes are licensed by the California Department of Social Services to provide services to no more than six children. Children placed in these settings have the fewest needs for services and supports. Foster Family Agencies: These nonprofit organizations recruit, certify, train and support family homes that are intended to provide "intensive treatment" to youth who might have otherwise been placed in a group home. Group Homes: These placements vary from small, family-like homes to larger institutional facilities and generally serve children with greater emotional or behavioral problems who require a more restrictive environment.
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California faces a serious shortage of licensed families who are able to care for foster children.
On any given day, less than 50 percent of the nearly 80,000 children in the foster care system in California are living in the most preferred types of placements--37 percent with relatives and only 10 percent with licensed foster families.1 Of the remainder, the majority are placed either with foster family agencies or in group homes. While some children and youth in foster care require therapeutic settings, most do not. Too often children and youth are unnecessarily placed in these higher-level settings due to a serious shortage of licensed foster family homes. This is a statewide crisis affecting children in nearly every county. A recent survey of California counties shows that of the 21 counties surveyed, representing 85.6 percent of the foster care population in the state, 77 percent reported a loss in licensed foster family homes in the last decade (see Appendix A).2 In those counties that track and could provide data to complete the survey, the supply of licensed homes had declined an average of 30 percent. In several counties--Sacramento, Santa Clara, San Mateo and Sonoma--losses were as high as 45 to 50 percent. San Bernardino reported a decline of 61 percent. The overall decline reported by the counties translates into a loss of at least 3,059 homes statewide and 18,354 potential placements, since each home can be licensed for up to six children. SUPPLY OF LICENSED FOSTER FAMILY The counties surveyed cited low reimbursement rates as a primary reason HOMES DECLINING they are unable to recruit and retain foster family homes. Inadequate board and care Counties have experienced an average rates are a significant barrier in the Bay Area and other high cost regions of the decline of 30 percent in licensed foster state. San Mateo and Santa Clara Counties, for example, have experienced pronounced family homes. Sacramento, Santa Clara, losses of foster family homes as the cost of housing has increased. Other frequently San Mateo and Sonoma report losses as reported reasons for the loss of foster family homes were that families decided to high as 45 to 50 percent. San Bernardino adopt or re-locate. The majority of counties also noted the increasing County reports a decline of 61 percent. difficultly in competing with foster family agencies (FFA) due to the higher rates and the supports provided to families by FFAs. This trend is affecting local placement practices. For example, Riverside County, which has experienced a 33 percent decline in foster family homes in the past five years, indicates that placements into foster family homes have decreased by 49 percent, while placements into foster family agencies have increased by 53 percent.
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While licensed family homes decline, more costly foster family agency and group home placements expand.
The number of foster family home placements statewide has decreased roughly 30 percent since 1999 and an additional .8 percent decrease is expected for the coming year (see Figure 1).3 Despite the decline in licensed family home placements and a decrease in the overall foster care caseload, the numbers of children placed in foster family agency and group homes has increased consistently over the same time period--nearly 19 percent for foster family agencies and a little more than five percent for group homes. (see Figures 2 and 3).4 These settings are far more costly than foster family homes. While licensed family foster homes cost $425 to $597 monthly, depending on the age of the children, a FFA treatment home costs $1,589 to $1,865 monthly and a group home costs $1,454 to $6,371 monthly.
Figure 1:
Foster Children Placed with Licensed Foster Famlies in California (1996-2007)
64000 62000 60000 58000 56000 Number of Children 54000 52000 50000 48000 46000 44000 42000 40000 38000 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 Year The number of placements with licensed foster famlies has decreased roughly 30% since 1999.
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Figure 2:
Foster Children Placed w ith Foster Fam ily Agencies and Group Hom es in California (1996-2007) 21000 20000 19000 18000 17000 Number of Children 16000 15000 14000 13000 12000 11000 10000 9000 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 Year The num ber of placem ents in group hom es has increased a little m ore than 5% since 1999. The num ber of placem ents in FFAs has increased roughly 19% since 1999.
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Inadequate rates and support are key barriers to attracting and retaining quality, licensed foster family homes.
Support for licensed foster and adoptive parents in California is woefully inadequate. The gap between the cost of caring for foster children and the reimbursement and supports that are provided has reached a crisis point. While many families truly want to care for and commit to children and youth in foster care, they are simply unable to with the support currently offered. The reimbursement rates for foster family homes are well below the true costs of care. California has not increased reimbursement rates in over six years. The minimal costs to raise a child, based on more specific California-data where available, now exceeds the foster care board and care rate by over 43 percent (see Figure 3 and Table 1)*.
Figure 3:
Cost to Raise a Child in California versus Reimbursement for Foster Care
$800 Amount (Monthly) $709 $600 $400 $200 $535
43.3% difference
Rate Paid for Foster Child (Age 9-11)*
$494
Average Cost to Care for a Child in CA**
2001 to 2005
Table 1:
Cost Type Monthly Cost Per Child 2001 $215.90 $57.75 $185.00
10 6
Monthly Cost Per Child 5 2005 $334.20 $66.60 $205.60
9
Difference ($) $118.30 $8.85 $20.60 $26.20 $173.95
Difference (%) 54.8% 15.3% 11.1% 34.1% 32.5%
Monthly Rate Paid for Child Age 9-11
Difference from 2005 and Current FC Rate ($ & %)
Housing & Utilities Transportation Food Misc,
7 8
$76.80
11
$103.00 $709.40
TOTAL
$535.45
$494
$214.40 (43.3%)
The base licensed foster family home rate varies by the age of the child. The rate paid for foster children age 9-11 was used to calculate the differential because it represents the middle of the payment range.
*
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The board and care rate to cover just the basic expenses of caring for a foster child--housing, food, utilities and basic transportation--has not kept up with inflation. California's cost of living has increased steadily while reimbursement for basic board and care has moved in the opposite direction. Lost purchasing power is estimated to be roughly 23 percent by July 2008 (see Table 2).
Table 2:
State Fiscal Year
2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 5.31% 3.74% 3.46% 2.75% 4.07% 3.75% 3.70%
CNI
Child Age 9-11 Basic Foster Care Rate
$494.00 $494.00 $494.00 $494.00 $494.00 $494.00 $494.00 $494.00
Rate if COLA was Provided
Loss of Purchasing Power Since 01/02
$521 $541 $559 $575 $598 $620 $643
5.04% 8.47% 11.53% 13.89% 17.26% 20.25% 23.10%
MORE FOR DOGS THAN FOSTER CHILDREN The State pays less to care for a foster child than the average kennel charges to board and feed a dog. Kennels charge an average of $620 per month to care for a dog, compared to the average cost of $494 per month for basic board and care for a foster child.*
State statute provides for a discretionary cost-of-living adjustment (COLA) for AFDC-Foster Care rates based on the California Necessities Index (CNI). The CNI is based on the change from December to December of five components of the federal consumer price index (CPI). By statute, the five components are food, rent, fuel/utilities, apparel, and transportation. From December 2005 to December 2006, the weighted average of the costs for these components increased by 3.7 percent, based on actual data available in January 2007. * Based on a CWDA telephone survey of county kenneling costs, January 2006
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Needed supports for foster family homes are still lacking. In addition to increased reimbursement rates, numerous surveys and studies of foster families show that solid supports are key to retention. Foster families need access to a support network of experienced foster/adoptive parents, caseworkers, and professionals when challenges and crises occur. They also need regular planned respite opportunities and mentoring. More funding is needed to bolster local foster family and kinship placement support efforts. Family caregivers also need more support after adoption. The need for support doesn't end with adoption. Improving adoption outcomes, and specifically improving timeliness to adoptions, is both a federal and state performance goal. California has done relatively well in this area; however, more can be done to ensure that adoptive families remain intact after the adoption is finalized. Additional supports needed include educational supports, speech or other physical therapies, access to counseling and other psychological and psychiatric therapies, and support groups for children and parents.
The consequences of too few and inadequately supported family caregivers can be dire for child outcomes.
Too few and inadequately supported family caregivers will slow the pace of, and potentially reverse, California's improvement on state and federal performance outcomes--threatening not only children's welfare but inviting federal sanctions of up to $74 million. Children's placement stability, connection with siblings and other relatives, and ultimately, their length of time in care and opportunity to find a lifelong, permanent family will be affected. Placement stability--Without needed supports, family caregivers struggle to provide the stable placements that children in foster care so desperately need. Having already suffered the trauma of being separated from their birth families, too many foster children still experience multiple placement moves while in care. While the state's performance has been improving over the past several years, roughly one-third of foster children who first entered care from October 1, 2004 to September 30, 2005 had moved three or more times 12 months after entering care.12 Children and youth with multiple placements are more likely to exhibit behavioral and attachment issues that can interfere with their ability to achieve lifelong connections with caring adults.13 Research shows that children with multiple placements are more likely to incur higher mental health costs related to greater child hostility and behavioral problems.14 Moreover, children in less stable placements are more likely to have higher medical costs in general.15 Placement with siblings--Too many children and youth in foster care are still unable to live with their siblings. As of October 1, 2006, only 47.4 percent of the children in care who had other siblings in care had been placed in homes with all of their siblings.16 The sibling bond is critical to child development and, whenever possible and appropriate, siblings should be placed together. Studies show that siblings placed
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together help reduce the sense of loss, provide support to one another and fare better with emotional and behavioral problems.17 But California counties report particular difficulty recruiting families for sibling groups, especially larger sibling groups. The cost of care and inadequate supports combined with the greater supervision demands makes caring for larger groups very challenging. Without a sufficient supply of quality foster family homes, too many siblings will continue to be placed apart. Length of time in care--Children and youth placed in higher-level care and institutional settings stay in care longer. Of the children and youth who entered care for the first time from January 1, 2001 to December 31, 2003, those who were placed in foster family agencies stayed nearly one-and-half-times longer and those in group homes about 11 percent longer than those placed in licensed foster family homes.18 So not only are these placements significantly more costly than foster family care, but children are remaining in them longer. While significantly longer stays in foster family agencies might be justified due to the more intensive needs of the children served, research shows that few differences exist between children placed in foster family agencies and those placed in foster family homes.19 Research also shows that children and youth in group homes are less likely to be connected to family; more likely to transition out of foster care alone, without the support of a lifelong family; and more likely to experience poorer outcomes as adults.20
Enacting AB 324 (Beall) is a Critical First Step in Addressing the Crisis
The available research indicates that foster and adoptive parent retention is positively affected by a combination of sufficient reimbursement rates and solid supports.21 AB 324 will accomplish gains that are critically needed to halt the decline in family caregivers and to begin to reverse this trend. Increase the basic rates paid to foster parents. AB 324 provides a 5 percent rate increase effective January 1, 2008, and bases future increases on percentage changes in the state cost-of-living based on the California Necessities Index. "You don't do it for the money, but you can't do it without the money."
Create a Foster and Adoptive Parent -California Foster Parent Recruitment, Retention and Support Program to enhance statewide and local efforts to support foster and adoptive parents. This $25 million fund could be used to establish a respite care program for family caregivers to reduce stress or to retain family caregiver advocates to support and work on their behalf. Other possible uses for this fund might include covering the cost of liability insurance or costs for onetime expenses such as purchasing an extra bed. The fund could also be used for locallyPage 9 May 2007
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driven media campaigns, with an emphasis on recruiting foster parents from the same communities as foster children to minimize disruptions from school and other supports. _____________________________
For questions or additional information, contact Frank Mecca or Cathy Senderling, CWDA at (916) 443-1749 or Regina Deihl or Lois Raap, LAPP at (650) 712-1442.
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Appendix A: County Declines in Licensed Foster Family Homes
County
Kern Kings Los Angeles Orange Riverside Sacramento San Bernardino San Diego San Joaquin San Mateo Santa Clara Sonoma Stanislaus Tulare
Tracking Period
2005-2007 2003-2007 2000-2006 2003-2007 2003-2007 1999-2006 2001-2007 2002-2007 2001-2007 1995-2007 1991-2005 2001-2007 2001-2007 1993-2007
Difference (#/%)
17/ 4% 1 / 2% 670/ 21% 104 / 17.4% 86 / 33% 353 / 45% 425 / 61% 115 / 7% 22 / 11% 68 / 45% 380 / 48% 80 / 50% 32 / 21% 143 / 45%
These 14 counties represent 77 percent of the foster care caseload in California.
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Endnotes
Needell, B., Webster, D., Armijo, M., Lee, S., Cuccaro-Alamin, S., Shaw, T., Dawson, W., Piccus, W., Magruder, J., Exel, M., Smith, J. , Dunn, A., Frerer, K., Putnam Hornstein, E., Ataie, Y., Atkinson, L., & Lee, S.H. (2007). Child Welfare Services Reports for California. Retrieved [month day, year], from University of California at Berkeley Center for Social Services Research website. URL:
1
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PR Newswire story, "For Foster Children, Unstable Placements are Linked to Higher Healthcare Costs" (available at http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=109&STORY=/www/story/05-032004/0002165410&EDATE"). 16 Needell, B., Webster, D., Armijo, M., Lee, S., Cuccaro-Alamin, S., Shaw, T., Dawson, W., Piccus, W., Magruder, J., Exel, M., Smith, J. , Dunn, A., Frerer, K., Putnam Hornstein, E., Ataie, Y., Atkinson, L., & Lee, S.H. (2007). Child Welfare Services Reports for California. Retrieved [month day, year], from University of California at Berkeley Center for Social Services Research website. URL:
15
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