The Honorable Willie L. Brown Jr.
Speaker of the Assembly
     and Members of the Assembly

The Honorable Bill Jones
Assembly Republican Floor Leader

TABLE OF CONTENTS

INTRODUCTION

FINDINGS AND RECOMMENDATIONS

FAMILY PRESERVATION

FOSTER PARENTS

ETHNIC PLACEMENTS

STATE OVERSIGHT

COORDINATED SERVICES

CONCLUSIONS

APPENDICES

ENDNOTES

TABLE OF ILLUSTRATIONS

Figure 1 - Reason for Removing Children from Their Homes, Calendar Year 1991

Figure 2 - Number of Children Placed in Out-of-Home Care, Fiscal Years 1988-89 through 1991-92

Figure 3 - Out-of-Home Placement Costs, Fiscal Years 1988-89 through 1992-93

Table 1 - Percent of Children Leaving Foster Care That Stayed Longer Than 18 months, Fiscal Years 1988-89 through 1992-93

Figure 4 - Annual Costs of Placing Children in Group homes, Fiscal Years 1988-89 through 1992-93

Figure 5 - Annual Cost Per Child Residing in Out-of-Home Placement

Figure 6 - Average Monthly Cost Per Child for Child Welfare Services, Fiscal Year 1989-90

Figure 7 - Number of Children in Foster Care, by Reason for Removal

Table 2 - Outcomes for Drug-Exposed Infants, Fiscal Year 1988-89

Table 3 -Amount of Foster Parent Training Required by Counties

Figure 8 - Types of Placements Made by County Welfare Departments, Calendar Year 1991

Table 4 -Statewide Basic Rates for Foster Care, Effective Since July 1990

Figure 9 -Ethnicity of Foster Children, Calendar Year 1991

Figure 10 -Proportion of Ethnic Minority Children in Foster Care, Fiscal Years 1988-89 through 1991-92

Figure 11 -Comparison of Ethnicity of Foster Care Children and General Population, Fiscal Year 1991-92

Table 5 - Percentage of Foster Children Placed With Relatives, Calendar 1991

Currently, more than 81,000 children are in the foster care system, having been removed from their homes and their natural families. These children are living in settings such as foster family homes, group homes and specialized care homes. The costs of placing and maintaining the children in these homes and of providing county services to the children amount to approximately $1.4 billion per year. In response to widespread criticisms of the foster care system, the federal government enacted the Federal Adoption Assistance and Child Welfare Act of 1980 (Public Law 96-272), which required states to enact specific reforms in order to continue receiving federal funds related to foster care.In 1982, California incorporated the required federal changes into state law through the enactment of Chapter 978 (SB 14, Presley), which had the major goals of:

• providing treatment services to families to reduce unnecessary placement in foster care:

• safely reuniting more foster care children with their families;

• increasing the stability of foster care placements; and

• placing more adoptable foster care children into adoptions.

In July 1991, the Commission initiated this study of child welfare services to follow up on the foster care portions of its 1987 report and to identify and review any recent issues related to foster care.As a result, the Commission developed the following findings and related recommendations.

Family Preservation

The State's foster care system runs contrary to the preservation of families. Generally, it is best for children to remain with their natural families and, thus, it is most appropriate for government to invest in "front-end" services that work at removing the problems from dysfunctional families rather than removing the children.Such an investment could save more than three dollars for every dollar spent. Moreover, given the fact that only 20 percent of foster children are removed from their homes because of physical or sexual abuse, the remaining children are good candidates for family preservation services.To date, however, California has not provided a sufficient investment in such services and, instead, has continued to rely on out-of-home placements. As a result, the numbers of children removed from their homes and the associated costs have spiraled upward.Further, children are staying in the system longer once they are removed from their homes; the percent of children remaining longer than 18 months has increased from 27.5 percent in fiscal year 1988-89 to an estimated 30.8 percent in fiscal year 1991-92.Finally, the future of graduates of the foster care system is bleak:45 percent of runaway youths have been in foster care and many foster children grow up poorly educated, in poverty, suffering from drug and alcohol abuse, and in trouble with the law.

Recommendations

1. The Governor and the Legislature should enact legislation that would ensure that greater emphasis is focused on placement prevention programs and associated family preservation services for those families whose problems do not stem from physical or sexual abuse.

2. The Legislature should enact a resolution stating California's support for federal legislation that would provide additional federal funding for family preservation services.

3. The Governor and the Legislature should continue to re-examine and monitor the effects of state-county realignment and enact any legislation necessary to ensure the realization of realignment's intended effect of encouraging counties to invest in family preservation programs and place children out of their homes only when warranted.

Family Foster Parents

Training, support services, screening and rates of reimbursement are woefully inadequate for the State's foster parents.Individuals who elect to be foster parents have a critical need for comprehensive training to develop the skills necessary to cope with today's troubled foster children.These children are extremely "damaged," largely due to the adverse effects of drug and alcohol abuse on their families.Nevertheless, there is no statewide mandated training for foster parents, and the training required by most counties is minimal.Further, support services necessary to assist foster parents in coping with the children is deficient. In addition, the State lacks a policy to screen prospective foster parents for their suitability to parent abused and neglected children. Furthermore, although foster parents should be adequately compensated for the responsibility of parenting these children, they are not even reimbursed enough to cover the basic costs of raising children.As a result, foster children are exposed to potentially abusive situations and are not provided the help needed to overcome their disadvantaged circumstances.Moreover, there exists a shortage of qualified foster parents in the State and a consequent reliance on more costly types of placement facilities.

Recommendations

4. The Governor and the Legislature should enact legislation that makes training and a psychological evaluation a prerequisite to the licensure of foster parents.

5. The State Department of Social Services should provide the leadership necessary to encourage counties to maximize the use of federal Title IV-E funds for the purposes of training foster parents.

6. The Governor and the Legislature should provide additional funding for the Foster Parent Training Program administered through the California Community Colleges.

7. To the extent that reliance on more costly types of out-of-home placements can be reduced, the Governor and the Legislature should enact legislation that increases the statewide basic foster care rates of reimbursement to adequately cover the costs of raising foster children in foster family homes.

8. The Governor and the Legislature should aggressively lobby Congress and the President to enact legislation that would make all foster children federally eligible for AFDC-Foster Care.

Ethnic Placements

More attention needs to be paid to the needs of ethnic minority children in foster care. Although state law requires that foster children be placed with relatives or families of the same racial or ethnic background to preserve the children's cultural identities, the disproportionate share of some ethnic minority children in foster care outnumbers the available "culturally competent" homes.For example, approximately 40 percent of foster children are African-American (compared to 6.3 percent of all children in California), but indications are that there is not a commensurate availability of African-American foster family homes or group homes. The possible causes for this situation include racism and insufficient recruitment.In addition, ethnic minority children who are placed with relatives may be adversely affected because of an inequitable reimbursement rate structure that does not generally allow relatives to receive as much reimbursement as non-relative foster parents.This situation affects a great many ethnic minority children because they are place with relatives at a much higher rate than are white children.

Recommendations

9. The State Department of Social Services should reinstate funding for its Minority Home Recruitment Program and concentrate its recruitment efforts on ethnic minority foster parents.

10. The State Department of Social Services should monitor counties' administration of the foster care program to ensure the counties are making placements in accordance with the law.

The State's foster care system suffers from inadequate monitoring and oversight. Because of problems inherent in the foster care system, there is a potential that children could languish in intolerable situations when counties do not take appropriate action against inadequate homes.These problems include the counties' conflict of interest in performing both the licensing and placement functions, and the lack of an independent reporting mechanism for complaints regarding the system. Further, the State may not establish performance standards in accordance with timelines set by law, and there has been no bona fide longitudinal study of the foster care system and its clients.These circumstances render the State's decision makers uninformed regarding the effectiveness of the foster care program.

Recommendations

11. The Governor and the Legislature should enact legislation establishing a statewide foster care ombudsman program.

12. The Governor and the Legislature should enact legislation eliminating the ability of the State Department of Social Services to contract with counties to perform the licensing functions in the foster care system, thus making the Department solely responsible for those functions.

13. The State Department of Social Services should complete the foster care performance standards in accordance with Chapter 1294, Statutes of 1989.Once the standards are developed, the Department should monitor counties' adherence to the standards, while allowing counties discretion in how to meet those standards.

14. The Governor and the Legislature should enact legislation requiring a bona fide longitudinal study of California's foster care system and its clients to determine the long-range effectiveness of the system.

Counties lack sufficient interagency screening of children coming into the foster care system. Despite the foster care system's goal to protect abused and neglected children, a "re-abuse" of these children occurs when counties lack sufficient interagency coordination to protect the children from the trauma of being shuffled from agency to agency for multiple screenings. Counties that promote such coordination have more success in mitigating further trauma to the children and reducing duplication of effort.Further, there currently exists an ideal opportunity to create the vehicle through which State leadership could be provided in the area of interagency coordination:State legislation (SB 479, Morgan) is pending that would establish the Child Development and Education Agency, which would transcend departmental boundaries to most effectively encourage interagency coordination at both the state and county government levels.

Recommendations

15. The Governor and the Legislature should enact legislation to establish the Child Development and Education Agency.

16. The Governor and the Legislature should enact legislation providing start-up funds for counties to establish systems that institute interagency coordination.

When government intervenes and takes over the responsibility of parenting children, it should be held to the same standards as the children's parents.Unfortunately, California's foster care system cannot even ensure the immediate safety and well-being of the children in the system, much less guarantee that these children will grow and develop into productive, well-adjusted adult members of society.Without true reform, the State's system will continue to remove children from their homes unnecessarily, encourage unstable placements, and perpetuate uncertainty regarding the safety and best interests of children.

In this study, the Little Hoover Commission focuses on some of the key issues surrounding out-of-home placement for children in California.

Background

The state, federal and county costs of maintaining foster children in out-of-home care facilities such as foster family homes, group homes and special homes for seriously emotionally disturbed youths, are budgeted to run more than $900 million in fiscal year 1992-93.5 The budgeted cost of counties' provision of child welfare services is an additional $500 million, bringing total annual costs for the Child Welfare Services Program to more than $1.4 billion for fiscal year 1992-93.6

The present Child Welfare Services Program reflects federal and state changes enacted in the late 1970s and early 1980s.These changes were sparked by widespread criticism from child welfare professionals (social workers, attorneys and academicians) of the services that were provided to abused and neglected children and children in foster care.7 Some of the specific criticisms:

• Too many children were removed from their parents' care, with little or no effort to keep the families intact.

• Children in foster care received few, if any, ervices to facilitate reunification with their families.

• Children in foster care were allowed to "drift" from one placement to another, with no long-term plan for their future and little likelihood that they would ever enjoy a stable, family-like placement.

• Too many children remained in long-term foster care who should have been permanently placed through adoptions.8

• provide treatment services to families to reduce unnecessary placement in foster care;

• safely reunite more foster care children with their families;

• increase the stability of foster care placements; and

• place more adoptable foster care children in permanent homes.11

When counties do remove children from their homes, they have an array of possible placement facilities from which to select, depending on the children's needs, including:

• Foster family homes licensed by the State or, as is the case in 46 of the 58 counties,¹² by the county through a contract with the State - The majority of children are placed in this type of home, which comes as close as possible to a "regular" family's home. These homes, run by foster parents, can take up to six children and are not provided professional support. Further, the foster parents may or may not be relatives and/or guardians of the children placed in the homes.

• Foster family homes certified by State-licensed foster family agencies - These homes are similar to foster family homes licensed by the county or State except that the foster family agencies -- which are private, not-for-profit organizations or individuals --provide an additional layer of administration. The agencies are responsible for recruiting, certifying, training and providing professional support to foster parents in whose homes foster children are placed.

• Group homes - These homes, which are licensed by the State and classified as residential care facilities, can take seven or more children depending on each home's capacity specified by its licenses. Further, the homes can be operated by organizations or individuals either on a profit or not-for-profit basis, are staffed 24 hours a day, and provide some form of treatment and support services. The licensee resides outside the group home.

• Small family homes - These homes also are licensed by the State and classified as residential care facilities for children. The licensee provides 24-hour care for six or fewer children who are mentally disordered, developmentally disabled or physically handicapped and who require special care and supervision as a result of such disabilities. Care is provided in the licensee's family residence.

• County shelters or receiving homes - These facilities generally are used only for emergency shelter care, but sometimes are used for longer periods when suitable, alternate placement facilities cannot be found.

• Medical facilities - These facilities are used when a child's medical needs are so severe they cannot be met in alternate facilities, or when other facilities are not available.

It should also be noted that children who are placed in foster family homes or licensed small family homes, and who require additional care because of a health and/or behavior problem, are eligible for specialized care to be provided by a qualified care giver.

There has been recent and intense focus on Child Welfare Services in general and foster care in particular. But the topic is not a new one for the Little Hoover Commission. In 1987, the Commission completed a wide-ranging report on the delivery of children's services in the State of California.¹³ The report topics included child care, runaway/homeless youths and abused/neglected children, and the report's primary general recommendation was for the State to establish a Children's Czar or a Commission on Children and Youth to provide better coordination of all services to children. Under the topic of abused/neglected children, the report included an analysis of foster care and the State's Child Welfare Services Program, and contained six related findings and 11 related recommendations:

Findings:

1. Increased number of reports of child abuse and neglect have contributed to workload problems.

2. Current approaches for abuse and neglect may prove damaging to families and children.

3. There is a lack of comprehensive training for child welfare professionals, foster parents and mandated reporters.

4. The court system is experiencing difficulties in dealing with cases of abuse and neglect.

5. Lack of emphasis on prevention of abuse and neglect is resulting in long-term problems for children and increased cost to the State.

6. There is a shortage of services and placement resources for abused and neglected children and their families.

The realignment package is aimed at: reversing a pattern of yearly cutbacks in state funding for health, mental health and social services; providing a source of funding expected to grow yearly by seven or eight percent; and increasing county flexibility, discretion and effectiveness. The State's role in the realigned programs is supposed to be one of oversight and assessment.¹⁸

Scope and
Methodology

In addition to the public hearings, Commission staff conducted extensive fieldwork by reviewing literature, publications and statistics related to children's services in general and foster care in particular. In addition, the Commission and its staff toured county facilities, foster family homes and group homes in San Francisco, and interviewed numerous individuals throughout the State.

Report Format

Finding #1

Generally, It Is
Best for Children
to Remain with
Their Families

As an example, consider the effect such a break-up had on a 17-year-old girl who testified at the Commission's November public hearing. The girl told of how she and her 11-year-old sister were removed from her alcoholic mother's care only to drift from one foster home to another and be serviced by five different social workers. The girl said she received nothing but discouragement from the social workers and counselors she came in contact with and, despite her and her sister's pleas to have her family reunited, she was told she could not go home because no services were available to treat her mother. Prior to being removed from her home, the girl was an honors student in school and had a 3. 8 grade point average; since being placed in foster care her grade point average has plummeted to 2.0. The girl also spoke of now living in shame because she felt that, without knowing where she might be moved to next, she could not even give out her address.²¹

An alternative to removing children from their homes is to remove the problems from the homes. Placement prevention programs provide such an alternative through family preservation services to children and their families. Through intensive support and supervision, such services help many troubled families whose children are at imminent risk of removal to remain safely together in their homes. Beginning in 1988, California has seen a total of 13 counties that have implemented, or have specific plans to implement, family preservation programs.²²

Across the nation, as well as in California, the programs share some basic service characteristics in addition to the fundamental goal of protecting children while preventing their removal from home. Most often, specialized staff provide services to the family as a unit, generally in the home. Programs frequently have social workers on-call 24 hours a day. Funds are generally available for the purchase of marketed goods and services, like a housing deposit, the purchase of a playpen, or car repair. Services are intensive and time-limited. Small caseloads allow staff to devote many hours a week to help families make the changes necessary to avoid out-of-home placement. Linkage to community resources is provided to help when the short-term service delivery period ends.²³

Some case examples further help to illustrate the mechanics of the programs:

• A Solano County woman's two daughters, ages six and eight, were placed in foster care after the woman, an alcoholic, came to pick up her oldest daughter at school smelling of alcohol. The girl explained the situation to school authorities, who then called the police.

  After the incident, "I went home and just started drinking. That's how I dealt with all my problems," said the woman."I was in denial for a long time. I blamed all my problems on everybody else. I wasn't willing to take responsibility for myself."

  The first priority of the social worker from Solano County's family-preservation unit was to get the woman to stop drinking. At first the woman did not think too highly of the worker. "I thought she was being too hard on me, that she wanted me to do all this stuff by myself, and I wanted her to do it for me," said the woman. But she acknowledged that the social worker focused on her strengths, showing her that she could take control of her life."I talked to that lady (social worker) on the phone almost every day for the last nine months. She has been my support."Now the woman has her children back, and the future looks considerably brighter.

• The Birthing Project, a community-based volunteer organization that has established itself as a community resource for African-American maternal and child health in Sacramento, operates a 12-month child abuse prevention program (called "IMANI," which is Swahili for "faith") for pregnant women (including teens) who are at risk of abusing or neglecting their children. The risk exists not because the women are classical "child abusers," but because: they do not have the basic resources necessary to maintain a safe and nurturing home for their children; they may be substance abusers; or they may, themselves, be in an abusive family situation.

  Through IMANI, a counselor works with each woman to identify and appropriate immediate services such as housing, financial assistance, drug counseling and medical services. Other services include: development of long-term (one year) plans, including education and employment goals and support services necessary to maintain them; enrollment in parenting and personal growth and development classes; and provision of emotional and practical support, direction and advocacy. Moreover, the IMANI counselor identifies and coordinates services using a group of community agencies and resources that has been convened by the Birthing Project.

  Success cases of the program include a mother of a minor in foster care who was allowed by the court to reside as a boarder in the foster home. Also, in a precedent-setting decision, the court allowed one young mother to maintain supervised custody of her infant on the condition that she "volunteer" at the IMANI office and receive on-the-job parenting instruction and supervision from IMANI's staff.²⁴

• A woman in Detroit, the mother of ten and grandmother of five, was perilously close to having her children removed. The living conditions in the overcrowded home were squalid: Everything in the house (including the walls) was black and grimy from years of dirt, fleas and flies were everywhere, and plates of rotting food and piles of dirty laundry covered the floors. The family's pets, a menagerie of cats and dogs, relieved themselves wherever they wished, adding to the fetid atmosphere. In addition, the mother was dangerously overweight and plagued by medical problems.

  The social worker assigned to the case had the family prioritize their goals, the first of which was to find a new place to live. Within days, the social worker found an appropriate house four blocks away, arranged a lease and put down a security deposit. Next, the family gave up all but one of their pets to friends and relatives. Then the kids were taken shopping to purchase desperately needed clothes and new bunk beds, and the mother bought a stove and a washing machine. The state and Families First, the family preservation agency involved in the case, paid all the bills. Finally, the social worker helped the family devise a chore chart and encouraged the mother to enforce the rules.

  In total, the social worker spent four weeks with the family, making herself available to them day and night, whenever they had a problem. Both the mother and the social worker now feel the family will succeed in staying together.

  Further, although the cash expenditures may seem extravagant, the program does save money in the long run. The average Families First intervention, which lasts four to six weeks, costs about $4,500 per family; traditional family foster care placement in Michigan typically runs between $10,000 and $14,000 per year per child.²⁵

By investing in the "up-front services" of a placement prevention program, the government accomplishes two important goals. First, by providing in-home services as an alternative to out-of-home placement, children can avoid the traumatic experience of being separated from their families and their homes.²⁶ An early round of studies conducted by the founders of Tacoma, Washington's Homebuilders, the nation's first family preservation program, showed remarkable success rates: 94 percent of the children had avoided foster placement three months after receiving the family preservation services, and 88 percent had avoided placement at the end of a year. Programs using different models had similar outcomes. Maryland's Intensive Family Services claims that 95 percent of families it served avoided placement 90 days after services were provided, and that 90 percent had still avoided placement after two years.²⁷ According to Contra Costa County officials, that county's program has kept 83 percent of families together for at least one year.²⁸ Other programs boast that between 61 percent and 97 percent of placements were avoided one year after the programs began.²⁹

Critics of these studies claim that they were conducted without control groups to provide an accurate comparison to families not receiving family preservation services and that such high rates are inflated. Some feel that a more accurate percentage of placement avoidance is closer to 10 percent. Studies that did contain control groups, however, showed clear advantages of family preservation services. (Please see Appendix C for a brief discussion of the results of such studies. )

A second goal that can be accomplished through placement prevention programs is the reduction of the growing cost of out-of-home care by helping many troubled families whose children are at imminent risk of removal remain together safely in their homes.³⁰ A 1990 evaluation of the initial three family preservation projects in California concluded that, after only the first pilot year of the projects, the projects resulted in savings of more than $1 million in direct costs of placing children out of their homes.³¹ In Contra Costa County, officials estimate that for every $1,000 spent on a child in the family preservation program, it would cost $3,000 to keep the child in a foster home for the same amount of time and as much as $5,000 to put the child in a juvenile camp, which has very close supervision.³² Another 1990 study projected that an investment of $106 million in placement prevention programs in California over four years would reduce the direct costs of placing children out of their homes by $347 million over that same period.³³ It should be noted that these studies did not contain control groups.

Family
Preservation Is
Not Always
Appropriate

Meanwhile, the reasons for removal that are most directly related to parental substance abuse -- specifically, endangerment due to parental neglect, incapacity or absence -- have increased.³⁷ The fallout of substance abuse as felt by the foster care system is discussed more fully in Finding #2.

Out-of-Home
Placements &
Associated Costs
Are Increasing

In 1991, the California Legislative Analyst compared California's placement rate with two other large industrial states -- New York and Michigan -- and with the nation as a whole. The comparison showed that, once population increases were accounted for, the rate was higher in California than the rates in New York and Michigan and almost double the national average.⁴⁰ Another 1991 study had similar findings: Not only did foster care placement rates increase in more than three-quarters of California's counties, but of the 46 counties large enough to rank, 30 counties have rates higher than the national average and 4 counties have rates double the national average.⁴¹

As one might expect, the costs associated with out-of-home placements have increased likewise. Figure 3 presents out-of-home placement costs for a five-year period.

Figure 3

As described in Figure 3, the cost of placing children in out-of-home care has increased nearly $400 million (72.3 percent) over the five-year period, increasing from approximately $553 million in fiscal year 1988-89 to a budgeted $952 million in fiscal year 1992-93.⁴²

An even more striking view of the increase in placement costs is achieved when one considers that such costs amounted to only $150 million in 1981-82, the last fiscal year before the Child Welfare Services Program was restructured.⁴³ In the 11 years since that time, the cost of placing children out of their homes has increased more than $800 million, or approximately 535 percent.

It is important to recognize that the cost figures discussed above represent only the costs directly associated with placing children out of their homes and in facilities such as foster family homes, group homes and special homes for seriously emotionally disturbed children; these costs primarily are made up of basic caseload costs and grants to maintain the children in the homes. The other portion of the Child Welfare Services Program -- counties' provision of child welfare services -- are not included, but have increased as well. In fact, child welfare services costs have increased from nearly $392 million in fiscal year 1988-89 to a budgeted $512 million in fiscal year 1992-93, an increase of about $120 million (30.6 percent).⁴⁴ The substantial growth rate of child welfare services costs is magnified when one considers that such costs have nearly quadrupled since fiscal year 1981-82.⁴⁵

In projecting caseload and placement costs to the future, the 1990 study, "10 Reasons to Invest in the Families of California," concluded that, "[i]n the absence of an investment in strategies which keep families safely together and prevent the need for out-of-home care, by 1994 California's foster care caseload will grow to 90,000 children and costs will double to $1. 8 billion."^{46SUP> It is interesting to note, however, that these projections, which were made in 1990, included caseload estimates that were lower than actual figures. For example, the report's projection for caseload in fiscal year 1990-91 was 62,800;47 actual caseload for that year was 81,064.48 Thus, the report's projections actually may be understated and the future costs of out-of-home placements could be even higher than previously thought.}

Children Are
Staying Longer
in Foster Care

More recent statistics also indicate an increase in the length of stay for children in foster care. A review of the children who have left the foster care system revealed that the percentage of children in foster care 18 months or longer increased between fiscal years 1988-89 and 1991-92. Table 1 shows the length of stay for children exiting the foster care system.

Percent of Children Leaving Foster Care
That Stayed Longer Than 18 Months -
Fiscal Years 1988-89 through 1991-92

* Note: Figure for fiscal year 1991-92 is estimated based on data for 12 months ending December 1991.
Source:Foster Care Information System, State Department of Social Services

The Permanent Placement caseload statistics and foster care length of stay statistics are deeply troubling. They reveal that fewer children are returning to their natural homes despite the efforts of county social service agencies. As fewer children return home there is substantial pressure on the system to find permanent alternative homes. As a consequence, child welfare resources are increasingly needed at the "back-end" of the system for both the social work staff who locate alternative homes for children as well as the costs of adoption assistance and long-term foster care payments. A growing use of resources at the back-end of the system indicates that service strategies in California are not adequately proactive. They do not focus on the needs of children after they cannot return to their natural homes.

Tragically, the absence of a serious, proactive investment in "front-end" placement prevention and family preservation strategies has led to the increase in Permanent Placement and foster care caseloads. Until a serious investment in these front-end services is made, out-of-home care caseloads will continue to grow and more and more children will be denied the opportunity to grow within their natural families.⁵⁶

Bleak Future for
Foster Care
Graduates

In addition, a recent study of foster care graduates in California shows that many are poorly educated and cannot afford adequate housing. They suffer from chronic illnesses and drug and alcohol abuse, and are more likely to run afoul of the law. Other studies confirm that disproportionate numbers of children who stumble through foster care tend to end up on the streets or in prison.⁵⁸

Reasons for
Increase in Out-of-Home
Placements and
Associated Costs

The same can be said of funding patterns in California. For example, in fiscal year 1988-89, the State spent nearly $10 on out-of-home placement and related casework costs for every $1 spent on services to keep children and their families together.⁶¹ With the advent of family preservation programs in additional counties, more funds are being directed to keeping children in their homes; but, as shown earlier, funding of out-of-home placements continue to increase at startling rates.

While the overall costs of out-of-home placement have continued to increase, it is the cost of group homes that stands out. On the following page, Figure 4 displays the annual costs of placing children in group homes for fiscal year 1988-89 through 1992-93.

Figure 4

As exhibited in Figure 4, the cost of out-of-home placement in group homes has escalated from $323,141 in fiscal year 1988-89 to a budgeted $522,685 in fiscal year 1992-93, an increase of $199,544 (61.8 percent).⁶² (The decrease in costs in fiscal year 1991-92 is due to a freeze in group home rates. )

During this same period, the cost of placing children in foster family homes rose only $128,926 (from $220,649 to $349,575), a 58.4 percent increase.⁶³ However, the cost of group homes represents nearly 60 percent of basic caseload and grants costs for all out-of-home placements. Therefore, the increase in the cost of group homes is a major factor in the increase in the cost of placements.⁶⁴

Another way to view the high cost of group homes is to compare it against the cost of other types of out-of-home placements. On the next page, Figure 5 shows such a comparison in terms of the annual cost per child residing in out-of-home placement.

Figure 5

Note:Figures represent most recent information available from various sources and may not necessarily be reflective of the same period. For example, the costs of foster family homes and group homes are for calendar year 1991; the other facilities are for fiscal year 1991-92.
Source:State Department of Social Services, State Department of Finance, Probation Business Manager's Association, Legislative Analyst's Office, and Los Angeles County Department of Children's Services

As Figure 5 shows, the least expensive placement is in a foster family home where, on average, it costs approximately $6,500 per year per child. By contrast, the average cost of placing a child in a group home is nearly $33,000.⁶⁵ Only the county-run MacLaren Children's Center in Los Angeles has a higher per-child placement cost than group homes, and that facility is used as a placement of last resort for children who have severe behavioral problems, who are developmentally delayed, or who were not able to function well in group homes.⁶⁶

Concern over the high cost of group homes is not to say that group homes do not have a position in the continuum of placement facilities available to counties. In fact, group homes really are the only logical choice for some children and youths that require higher levels of care. For example, the Commission received testimony from one county's chief probation officer who stated, "In Alameda County, few of the minors referred to us are able to tolerate the closeness of a normal family setting and because of the severity of their delinquency, few can be maintained in a minimally structured, community setting."⁶⁷

The chief probation officer went on to point out:

The State's resources for serving delinquent children have been directed to the most expensive types of care -- out-of-home placement in group homes and the California Youth Authority.

Between 1985 and 1989, out-of-home placement of court wards increased 11% in group homes, 15 percent in California Youth Authority institutions and 9 percent in county camps. While these three out-of-home care settings had comparable monthly costs in 1985, by 1989 this picture had changed substantially:

• California Youth Authority monthly cost per child increased 15 percent despite the fact that increased overcrowding at Youth Authority institutions offset cost increases. In 1989, total California Youth Authority placement costs for children under the age of 18 was $59 million.

• The average monthly group home placement cost increased over 43 percent. In 1989, total placement costs for court wards in group homes was $140 million.

• County camps, which are funded entirely by county funds showed less than a 2 percent increase in monthly costs per child. Total county camp expenditures in 1989 amounted to $76 million.

Now, let me give you a case in point of how the continual erosion of probation dollars is costing the taxpayer more in the long run. I just told you that county camps are funded entirely by county funds. We all know counties have been hurting since 1978 when Proposition 13 passed. So it shouldn't surprise many that from 1985 to 1989, monthly costs per child only rose 2 percent. As a result, group homes in 1989 cost 50 percent more per month than camps.

Now, can you guess what I had to do three months ago because of reductions in my budget?I had to close a less-costly 94-bed camp so that now, in order to meet out-of-home placement needs, I must use a more-costly group home or California Youth Authority.

Prior to committing a youth to the California Youth Authority, the juvenile court is required by law to exhaust less restrictive treatment options. If state law makes this demand, shouldn't the State be doing more to promote alternatives to group home and California Youth Authority placements for court wards?⁶⁸

Another cause for reliance on out-of-home placement is the State's lack of an adequate system of support services for foster children and their families. This complaint is not a new one; in response to a survey conducted by the Legislative Analyst's Office in September 1989, most social workers indicated that treatment or support services were often not available. For example, 42 percent of the social workers surveyed indicated that they had, on at least one occasion, placed a child in foster care because they were unable to find appropriate services that would have allowed the child to remain in the home.⁶⁹ This is particularly distressing in light of the fact that these services are an essential tool in achieving one of the primary goals of the Child Welfare Services Program: minimizing the use of foster care.

Further, 64 percent of the workers surveyed cited a need for additional services in the Emergency Response, Family Maintenance, or Family Reunification Programs. Workers in all three programs believed that additional services were needed most in the areas of in-home services, mental health counseling, parenting classes, and substance abuse treatment and counseling.⁷⁰ Obviously, if some of these additional services were provided, the need for out-of-home placement could be mitigated.

The data regarding the supply of services support the social workers' perceptions that there is an overall lack of services available to families served by the Child Welfare Services Program. For example, the Legislative Analyst reported that of the $439 million counties spent on child welfare services in fiscal year 1989-90, $392 million was used for staff and overhead costs, and $46 million was used for "direct costs."⁷¹ On average, the counties spent $289 monthly for each child welfare services case in 1989-90. On the following page, Figure 6 shows a breakdown of the average monthly costs per child.

Figure 6

As shown in Figure 6, only $11 (3.9 percent) of the $289 in average monthly costs per child supported the purchase of treatment and support services.⁷² The majority of the money is spent on staff salary and overhead costs.

In the absence of services being rendered through external providers, the social workers themselves provide some of the services, usually through their case management activities and face-to-face contacts with families. These contacts alone, however, probably are not sufficient to ensure the effective provision of services. First, the contacts are too infrequent. Most workers indicate that they make face-to-face contact with families at about the minimum frequency allowed by law: emergency response workers about once every two weeks, and family maintenance workers about once every 25 days.

A second reason why face-to-face contacts are not sufficient for effectively providing services is that the primary purpose of the contacts is to accomplish tasks such as ensuring that the child is safe, making referrals to treatment and support services providers, and assisting the parent(s) in understanding court orders. Once these types of case management tasks are completed, there is not sufficient time remaining for the social worker to effectively provide treatment services to the child or the family.⁷³

As indicated earlier, mental health services were among the services cited as lacking by social workers. According to at least one study, the lack of an adequate mental health system has forced placement in the most intensive and expensive foster care group homes - psychological and psychiatric programs. The study's report, "10 Reasons to Invest in the Families of California," stated that the "average" group home placement in fiscal year 1989-90 was a psychological/psychiatric placement at a cost of $31,100 per year.⁷⁴ This trend appears to have continued given that, as shown earlier in Figure 5, the average group home placement in calendar year 1991 cost $32,653. Further, the upward spiral of group home costs, as discussed earlier also, suggests that such costly placements continue to be made.

The report also indicated that the State's foster care grants to group homes do not reflect the total cost of services to all children in group homes. It stated that county mental health departments report that approximately seven percent of the children in group homes received a supplemental payment, a "treatment patch," for mental health services in 1989 and approximately 10 percent of all children in out-of-home care received services by a local mental health department.⁷⁵

Yet one more reason for the State's unwillingness to provide extra funding for family preservation programs is the perennial problem of scarce resources. This condition is particularly true given the current budget difficulties the State is experiencing. There is a glimmer of hope on the horizon, however. Pending federal legislation, the Child Welfare and Preventive Services Act (S. 4, Bentsen) and the Family Preservation Act of 1991 (H. R. 2571, Downey), would make significant programmatic and funding improvements for children, youths and families in the child welfare system, including an emphasis on family preservation. The legislation promises a much-needed infusion of $3 billion to $6 billion in federal spending for child welfare over the next five years. With the new funds, it may be possible to begin to rebuild the present foster care system, as well as develop and expand a range of workable alternatives to the system.

Another possible source of improvements in the foster care system is the state-county "realignment" package of bills enacted as part of the 1991-92 budget. In addition to the revenue enhancing features of realignment already outlined in the introduction section of this report, specific realignment provisions relating to social services include:

• increasing the county share of non-federal costs of foster care from 5 percent to 60 percent.

• increasing the county share of non-federal costs of the Child Welfare Services Program to 30 percent; previously, the county share was fixed at 1982-83 levels plus specified cost-of-living adjustments.

• authorizing the counties to supplement, at county expense, the rates paid to foster parents and foster family agencies within the county, as well as supplements for specialized care, clothing allowances, and infant supplements.

• expanding the family preservation program to allow all counties, upon approval of the State Department of Social Services, to operate family preservation programs.

• until January 1, 1997, requiring specified data to be reported annually by the Health and Welfare Agency and the Youth and Correctional Agency; the data are intended to monitor counties' maintenance of effort in child welfare, mental health and probation programs, and to avoid inappropriate reliance on institutional care.

• requiring the California Youth Authority to convene a task force to identify ways to better coordinate the continuum of services for youthful offenders, including innovative local alternatives to placement in the Youth Authority.

• Requires counties that reduce the capacity of their county juvenile homes, ranches or camps in 1991-92 to pay the State for the cost of increased Youth Authority commitments over the current fiscal year.⁷⁶

Whether realignment will have its intended effect, however, is subject to conjecture. The Commission received information from numerous witnesses and interviewees who speculated as to the possible effects of realignment. Some indicated that realignment will, in fact, offer more flexibility to counties and will encourage more investment in family preservation services because of the increase in the counties' share of costs; others suggested that realignment will do nothing to truly reform the system and, instead, will continue to perpetuate existing problems. All, however, agreed that it was too early to tell exactly what the final effects of realignment will be.

Summary

ecommendations

1. The Governor and the Legislature should enact legislation that would ensure that greater emphasis is focused on placement prevention programs and associated family preservation services for those families whose problems do not stem from sexual or physical abuse. Such programs and services must focus on ensuring the safety and well-being of the child, however, and not mindlessly concentrate on preserving families at any cost.

   Legislation should include, but not be limited to, increased funding for home- and community-based family preservation and placement prevention services so that local agencies have the ability to address the problems of families without having to resort to out-of-home placement.

   Funding in addition to current levels could be made available only to the extent that savings are expected to be realized through a decrease in out-of-home placements, and only with a commensurate decrease in funding for those placements.

2. The Legislature should enact a resolution stating California's support for federal legislation that would provide additional federal funding for family preservation services.

3. The Governor and the Legislature should continue to re-examine and monitor the effects of state-county realignment and enact any legislation necessary to ensure the realization of realignment's intended effect of encouraging counties to invest in family preservation programs and place children out of their homes only when warranted.

Finding #2

Training, support services, screening and rates of reimbursement are woefully inadequate for the State's foster parents.

Today's Troubled
Foster Children
Require Skilled
Foster Parents

[T]he needs of infants, children, and youths in foster care have become more complex and perplexing. Historically, children in care were classified in two groups: those who were primarily dependent and neglected, and those with special emotional, behavioral, and medical needs. Today, family foster care must respond to the developmental needs of youngsters who have been traumatized by poverty and homelessness, emotional maltreatment, physical and sexual abuse, alcohol and other drug exposure, HIV infection, and -- the worst fear of all children-- the inability of their parents to take care of them. Today, most infants, children, and youths needing family foster care have some kind of special needs; the remainder have what can only be termed extraordinary needs. These children and youths need a level of service that traditional foster care and child welfare services were not designed to address.⁷⁹

Drugs Are A
Major Factor in
Troubled
Families

The State's statistics on the reasons for removing children from their homes corroborate the concern that substance abuse has become an increasing problem. Endangerment resulting from parental neglect, incapacity or absence are the principal findings used by the juvenile court to place children in foster care when a parent with a drug problem cannot provide appropriate care and supervision.⁸² For the foster children supervised by county welfare departments, (rather than county probation departments, which would not be reflective of substance abuse problems with families), these types of endangerment also are the primary reasons the children have been removed from their homes. Below, Figure 7 provides a comparison of the numbers of welfare department-supervised children, by specific reason for removal, for the fiscal years 1984-84, 1988-89 and 1991-92.

Figure 7

Note: Figures represent average monthly number of children in foster care.
Source: Foster Care Information System, State Department of Social Services.

As Figure 7 shows, in each of the fiscal years, more children were removed from their homes because of endangerment due to parental neglect, incapacity or absence than for sexual or physical abuse. Further analysis of Figure 7 reveals that, for fiscal year 1991-92, the estimated number of welfare department-supervised children who will have entered foster care for endangerment reasons closely tied to parental substance abuse (55,000) was 3.4 times as large as the combined number of these children entering the system because of sexual and physical abuse (16,100).⁸³

In addition to the increases in absolute numbers, the proportion of these children has been growing in the foster care system. Consider that in fiscal year 1984-85, children (supervised by county welfare departments) who were in foster care because of endangerment due to parental neglect, incapacity or absence constituted 60 percent of all children in foster care; by fiscal year 1988-89 that percentage increased to 70 percent. And for fiscal year 1991-92, those children will have accounted for an estimated 72.7 percent of all welfare department-supervised children in foster care.⁸⁴

In perhaps the saddest statistical corroboration of the drug problem, California is witnessing an increase in the number of infants being placed in foster care as a result of parental drug abuse. A 1990 California Senate Office of Research survey regarding drug-exposed infants documents the linkage of substance abuse by a parent and child welfare interventions.⁸⁵ Thirty-five counties (accounting for approximately 80 percent of live births in California) responding to the survey reported that 6,358 drug-exposed newborns were referred to county child welfare services during fiscal year 1988-89. This figure translates into 7,920 referrals for all 58 counties.⁸⁶ Thirty-four of the 35 counties provided detailed information on 5,219 cases that were referred. The outcomes of these referrals are illustrated in Table 2.

Outcomes for Drug-Exposed Infants - Fiscal Year 1988-89

Note: Only 34 counties reported detail on referrals, only 29 counties reported on juvenile court actions, and only 26 counties reported on placement outcomes (for 2,783 cases).
Source: Senate Office of Research

• As part of running a crack house, a three-year-old girl negotiated a street sale with undercover police at the direction of her mother and grandmother under detailed instructions from the mother's imprisoned husband. When police went to arrest the offending adults later that evening, they found the little girl alone in the house with three younger siblings, including an infant less than a month old. The living conditions of the crack house were wretched; no running water, human waste in every room, the toilet backed up and overflowing, the infant lying on a urine-soaked bed, an infestation of roaches, and rotten food everywhere.⁹⁰

• Three little girls -- ages 2, 4 and 6 -- were found living amid garbage and filth in a low income residence. Thirty-three marijuana plants were growing in the backyard and, inside the house, a machine used to cook marijuana plants into hash oil and a marijuana pipe also were found. When discovered living in the squalor, the girls were dirty with matted hair and could not communicate except by grunting and pointing. The girls' mother had lost two sons to adoption in the early 1980s because the boys nearly starved to death under her care; she was later convicted on charges of neglect similar to those she faces now.⁹¹

• An 11-year-old boy, who had been under the guardianship of his older sister since his mother died of a drug overdose, waved down a passing patrol car to say that his 23-year-old uncle had forced him to sell crack cocaine from the bathroom window of his home. The police were skeptical until the boy said, "I got drugs on me" and showed them a plastic bottle containing 16 rocks of crack. The youth told child abuse investigators that his uncle had taught him to load several weapons, including shotguns and handguns, and how to sell crack. The boy said he was forced to wait up all night and sell crack to anyone who came up and said, "Milt sent me."The boy further said that his night work caused him to miss a lot of school, and that his uncle beat him with electrical cords, switches and fists and threatened to shoot him if he did not sell the drugs.⁹²

To Gain Skills,
Foster Parents
Need Training

California must commit itself to providing the very best specialized training for care providers. Currently, the Community Colleges Foster Care Education and Independent Living Programs offer excellent instruction to foster parents. But these programs are underfunded and are plagued with the risk of reduced funding or elimination altogether. Many counties are recognizing the need for ongoing, in-service training for foster parents. And while counties are contemplating requiring foster parents to participate in ongoing instruction, funds for those programs have not kept up with the increasing demand but have remained constant, and have even been reduced in some cases.⁹⁷

Training Is
Not Mandated

Amount of Foster Parent Training Required by Counties

Note: Figures are subject to consistency and accuracy of data reported by counties.
Source: Unpublished document provided by Independent Living Program, California Community Colleges

Thus, based on the lack of statewide training mandates and the relatively few hours of training, if any, required by the vast majority of counties, it is fair to say that foster parent training has not received a high priority in California. This conclusion is drawn despite the obvious need for such training.

Need for
Screening of
Foster Parents
Exists

Instead, as some children's advocates say, "the state pays too much attention to the physical conditions of the homes, and not enough on whether the parents are emotionally capable of raising children who often have psychological problems."¹⁰² "They are not looking at what the foster parents know and what kind of people they are," said the executive director of the Association of Children's Services Agencies. "They look at, `Do we have an extra bed?' and that kind of thing."¹⁰³

Although
Necessary,
Support Services
Are Lacking

Maintaining the ties of children with their families through placement in a relative's home should be pursued as part of a broader effort to promote extended-family preservation. Like non-related foster parents, extended families that care for related children play an important role in the family reunification effort and they need training and agency support services to assist them with that role.¹¹¹ But training and support services are even more scarce when it comes to relative foster parents. Often, the limited services that are extended to non-relative foster parents are not available at all to relative foster parents.

Reasons for Lack
of Training and
Support Services

Regardless of the cause for inadequate training and support services for foster parents, the need for the training and services is so great that the consequences of "doing without" are enormous.

High Price to
Pay for Lack of
Training,
Screening and
Support Services

Some would argue that such horror stories occur in only a minority of cases which command significant publicity. In fact, a State Department of Social Services official testified at the Commission's November public hearing that problems occur only in an estimated 10 percent of the State-licensed facilities in California and speculated that a similar percentage of foster family homes have problems.¹²² Even if 10 percent strikes some as being rather low, the lives and well-being of the children and youths in those "problem homes" dictate that any percentage greater than zero is far too material to be ignored.

Better
Reimbursement Is
Needed for
Foster Parents

Statewide Basic Rates for Foster Care Effective Since July 1990

Source:Foster Care Program Bureau, State Department of Social Services