Georgia considers privatizing foster care

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Fascinating debate occurring in Georgia that has life-altering impacts on children. Have you studied the research on privatization of foster care and/or other child welfare services? If so, please share what you’ve learned? Has your state had experience with partial or full privatization? Any lessons to share with Georgia and the rest of the country from that?

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Privatizing foster care blogs.ajc.com

Moderated by Tom Sabulis The General Assembly is considering legislation that will put foster care largely in the hands of private agencies, even with regard

Comments

  • Jake

    Jake Terpstra

    —

    Privatization has been done in 5 states. none resulted in better service at lower cost as promised.

    FL was first. They first pilot tested it in 5 counties, 4 were failures but 1 was successful, so they did it. A friend of mine, a CASA administrator, said services deteriorated.

    KS did it and in a few years the administering agency went broke and they started with a new contracting agency.

    NE did it and a newspaper in MI described it as “horrible”.

    MS did it with friend of the court services and reverted back when it failed.

    TX did it. When the contracting agency went broke they found a new contractor but the state had to make up a $3 million shortfall.

    Now the MI legislator is pushing it with the assumption of better services with lower cost. Their preliminary plan has platitudes but NOTHING that indicates improved services and NO cost comparisons.

    Privatization is a politically conservative move to enhance private enterprise, but has no evident concern about what it does to children.

    Jeanine L., Amy R. and 1 other like this

  • Susan

    Susan McPherson

    Consultant

    Public vs private provision of services to foster care children are secondary to the overall accountability of successful outcomes. There are many non caring workers in private agencies as there are many in public agencies. Private agencies have a NEED to maintain a census in order to thrive. As long as each child has a “rate” and caretaker/agency/foster parent have a dependency on such rates, the very thin line between commodity and human service can unnoticeably dissipate in the process of “welfaring” the child…..as has been magnified within the negatively plagued image of social services and foster care.

    The incentives for successful outcomes are deficient. Keeping in mind that it is most important to understand or clearly define “successful” outcomes. Current ideal outcomes, resultant of best practice formulas, are really just standard and basic. Adoption, reunification and the lowest level of care objective of placing a child with a family has become the measure of outcome satisfaction. The longevity of permanency should really be the actual outcome and measures of success.

    Successful placement into a family can not be deemed “permanent” for quite some time and often much longer than six month trial periods. Marriages between fully grown adults who may have known each other years before marrying often require more than six months to adjust to a new and “permanent” life.

    Until “successful outcomes” can be effectively defined to include the complexity, longevity and fiscal responsibility of building permanent relationships, systems, whether public or private will continue to NEED new models.

    And so child WELFARE will continue to be just that.

    Jeanine L., Diane L. D. and 1 other like this

  • Jake

    Jake Terpstra

    —

    Susan your comment is right on.

    A definition of permanency planning we had in the Children’s Bureau was, “,,,,,,,the process of helping child to live in a home that offers the hope of establishing lifetime family relationships”. A you pointed out it then still takes time to be permanent. A bigger concern of mine is the large number of kids who age out with no family connections. Agencies often don’t even try to adopt older teens. 80% of the people in prison have been in foster care. I would like to know that percentage of them aged out and how many were connected with families. We need research on that.

  • david

    david roby

    I/ Executive Director at Kids Country Club

    I am a director of the Ontario wide (ORCA) association with both private and public paid care providers. There is no doubt that private operators can save the government money. First there are no fixed costs. Private operators maintain the supply of homes and the government only pays a per-diem. The concern we have here is that the governments agencies (F&CS or CAS) remain as guardian and thus they carry some liability. Private operators here are long standing, excellent reputations, provide better training and better supervision of the homes.

  • Susan

    Susan McPherson

    Consultant

    Jake, I really like that definition of permanency planning.

    As for youth aging out of foster care, when considering the abundance of research on this issue, I am amazed that there is not closer oversight and accountability to services that can better prepare them. Child welfare inadvertently teaches and programs its children to be dependent via all of the mandates in caring for them. There is hardly any leverage to teach them independence. Then….they reach an age out birthday and whallah….there is no turning back. What they have learned with little doubt and based on their “live” experience (not hearsay or a book or course study but real experience) is that systems provide for your needs. So, lacking realistic alternatives, next available system that is quick, instant and NON-REJECTING is prison.

    Realizing that older teens are harder to connect to new families, I believe, requires much more attention on alternatives. If there are some who are willing to be adopted, that’s fantastic! However, most systems/agencies know the potential of their older youth long before he/she ages out and still there is very little accountability to preparing them efficiently. The lack of exposure to future opportunities is seldomly considered essential to youth in foster care. And sadly, additional funding such as the Chafee grants can provide for such exposure. But, where is it mandated that foster children should travel on vacations outside of their “native neighborhood or fosterhood”, or where is college exploration mandated, or what about trips that explore the interests of foster children….where is that mandated? How many foster care agencies require teens to learn how to swim…which could prepare them to become lifeguards once they age out? Or expose them to activities such as diving? Or fishing…which could also result in a career? Or at minimum, experience flying in a plane? Are they NOT WORTHY of these types of activities? Keep in mind that action speaks louder than words…especially to older teens. These activities all have the potential to be incentives for futures. And btw: most importantly, what is the incentive for completing ones education while growing up in foster care. How many youth age 18 have exercised their voting rights? Disconnected youth are the product of all of the disconnected adults that have a role in their lives.

    As you may see, I am very passionate about this because the bottom line is that outcomes clearly identifies the incomes. Who is held accountable for rearing a youth who has spent the majority of his/her life in a system and that youth ages out without a high school education, homeless, unemployed and possibly unemployable. For a system designed to protect children, this is nothing short of child neglect!

    I’m sorry…I may have swayed from the original discussion topic….let’s see….what initiated this discussion…Oh..I remember…”life-altering impact on children in foster care”.

    Researching how many youth aged INTO prisons would undoubtedly be helpful in advocating for further policies and/or legislation to improve services. However, as mentioned previously, there is such an abundance of research on youth aging out and we have yet to determine what to do to effectively address that issue.

    Diane L. D., Jake Terpstra and 2 others like this

  • Jake

    Jake Terpstra

    —

    Dear Susan,

    You hit a lot of nails right on the head. With our own kids we help them to develop interests and skills as they go along e.g. music lessons, vacation trips, drivers training, sport activities, bank accounts, part time jobs. It is endless but goes on as they develop. Don’t use trash bags to keep their things in either.

    I believe nearly all kids long for a family of their own, but may be reluctant to admit it because they have been hurt and rejected by families. Caseworkers need to deal with all of that. They need training to develop such skills and time to do it. Many studies indicate that they spend over half their time on paperwork. Child welfare now is driven by courts and has become a legalistic process.

    The term Independent Living is a misnomer. We want them to learn how to live interdependently, not independently. Hermits do that. Some agencies provide mentoring as they age out, that can help but doesn’t last. Who will go to their weddings, birthday parties, and be grandparents to their kids? My point is that connection with families should be Plan A. When that doesn’t work, of course we try to help with independent living services, but that’s Plan B and should not be recorded as success.

    I think you would appreciate a book I wrote and was just published, “Because Kids Are Worth It”. It’s a small book about child welfare services, how they got to be what they are, with suggestions about improving them. It’s available at Amazon and Barnes & Noble.

    Look forward to more of your comments.

    Diane L. D. likes this

  • Susan

    Susan McPherson

    Consultant

    Thank You Jake. You are so accurate. Will definitely get the book.

    Considering the national concerns surrounding youth aging out of foster care, I wonder if there could be a system process that offered agency incentives on certain outcomes, ie: # youth graduating from HS, # youth attending colleges, # youth employed for one full year, etc. I know that some systems track this information but I’ve never heard of incentives resulting from the info. There could be a range of desired positive outcomes. Agencies with highest scoring could be distinguished and/or compensated. At one time there were financial incentives for each adoption and clearly adoption rates skyrocketed.

    Also, New York has a program “Bridges To Health” (known as B2H). This program came with a very interesting twist in services because the foster child and family were allowed to choose the agency that they wanted to service them. At any given time, the foster child/family could ask to change agencies and of course, what ever agency was selected would be paid via Medicaid. Quite interesting was the fact that it forced a competitive component amongst agencies which meant that the quality of services had to be prioritized in order to keep the clients and receive payment for services. I was so intrigued by this program. Services were no longer “no choice” but instead “pro choice”,

    LOL… services with a smile and “how can we be of best service to you”.

    Very interesting change for child welfare especially when considering the pros and cons of public vs private.

  • Carol MartinCarol

    Carol Martin

    Director- Court Appointed Special Advocates (CASA)

    I am excited about both these ideas. Clearly what we have now is not working.
    Re: Idea #1
    I am a CASA director in Lucas County (Toledo) Ohio. We have a child welfare agency that has a good Independent Living department, but the results remain bleak. Incentives are certainly worth a try, but would have to be carefully structured so all kids in care have a chance for success and progress. I had my own case with a teen. He was bright enough (IQ over 110), but at age 16, I discovered he did not know his times tables. He was embarrassed to go to group tutoring (the Agency would not pay for individual), he was ADD and on the fetal alcohol spectrum. His particular challenges needed to be addressed so he had a shot at success. Any incentive program would have to be able to consider the wide range of cognitive, social, emotion and mental health issues many of these children have. But, it could be done!
    Re: #2
    I love it. Too often our foster kids get second (or third) rate services. Too many have multiple service providers within one agency- obviously a high turnover rate negates progress in counseling. In addition, many of the counselors are new to the field and asked to handle these very complicated cases with multiple and complex issues. I believe that giving the child, the foster parents and the GAL a say in who will provide service would be a huge step forward. I like the competitive component; those agencies that are not producing results would have to examine themselves or go under. It’s time the kids have a real shot at healing.

  • Susan PunnettSusan

    Susan Punnett

    Executive Director at Family and Youth Initiative

    I think the question of how to make services individualized while also meeting an appropriately high standard is key. The case management steps are so much easier to track (visits held, case plans updated/filed) so that’s what gets measured and where the focus is. But it’s not how children need to be parented – what they need is someone to recognize and encourage their interests and abilities and give them opportunities. The system as a system can’t do that (or do it well). It has to be an individual who has taken the time to get to know that child or teen.

    Maybe it’s possibly that a case worker or CASA or other individual can fulfill that role. My bias is that it’s best an adult outside the formal system.

    How to define who that person is or how we know they’re both working in the best interest of the child and succeeding (which may often mean pushing back against system decisions which we know those in formal case management roles don’t handle well).

    We’ve clearly not solved the question for our APPLA youth of how to measure/identify adults who are really going to stay in the life of a youth aging out (rather than just checking that box because someone has put forward the name of some adult).

    I believe that there are many more teens who still want families if only we worked with them differently – giving them more of a voice and time to get to know adults before we require them to say yes or not to adoption. That’s what we do and we know it works – including for some whose goals were not adoption; one of whom consistently said no to adoption until he was told it was his mentor who wanted to adopted. Immediate change to his response once the conversation changed from the unknown to a very well know adult. Also increases the pool of adoptive families when adults get to know these teens first.

    So long as we continue to treat older children as unadoptable and take them at their word when they say they don’t want to be adopted (despite no one having done the hard work with them first to tease out why they’re saying that and making sure they understand what it means to age out), systems won’t put the time or money into changing practice enough to increase the number of older children who are adopted (and/or connected to adults who really will be there for them even if they ultimately decide they don’t want adoption).

  • Jake

    Jake Terpstra

    —

    Susan, you make some very good points. Probably most teens long for a family of their own, but having been mistreated and possibly rejected by a family(s) they don’t want more of the same—unless it is someone they trust. Caseworkers need to be trained to deal with that, and have time for it. Studies show that they spend over half their time on paperwork.

    To my knowledge, agencies do not have criteria for success. If only connections with lifetime families were considered success, and counted, agency practices would be quite different.

    Normally I would like to see that special role carried by the caseworker, rather than an “outside” person. But that begs a few questions. Only 37% of child welfare staff have had social work training. In addition very few universities have child welfare courses. And as I mentioned, so many other “duties” have been added that they don’t have much time for it. The system itself is upside down. I just wrote a book about the system; let me know if you are interested in getting it.

    Jake

    Sandra Seaman likes this

  • Jeanine LivingstonJeanine

    Jeanine Livingston

    Contracting Compliance Manager at Washington Federation of State Employees

    Karen, an attempt was made in Washington state in 2009 to do this. I work for the labor union that represents the state workers in our Children’s Administration. I worked extensively with our members, academics and national experts in this area to understand a) what is this about; b) is this a good thing or a bad thing and c) what is our position/argument. Not wanting to take the standard labor position, it was important to our members that we do what’s best for kids & families.

    Through that process (and it was a LONG 4+year process) we learned that there really is no benefit to the system in adding another layer of bureaucracy to the child welfare system. The costs of doing so are extensive; look to Nebraska, Milwaukee and even Florida where the first tests were done. HUGE costs to set up the infrastructure that resulted in no improvement to outcomes.

    In response to claims that the jurisdictions doing this saw improved outcomes it was often said by the academics & experts I encountered that “with the amount of money invested in the system, someone would have to have been trying really hard to not improve outcomes”. What I learned is that there really isn’t any objective research that isolates and quantifies the contributing factors to improved outcomes. The jurisdictions that implemented privatization did so in conjunction with a variety of other initiatives so it’s very difficult (I would assert impossible) to say that privatizing was the answer.

    In 2012, near the end of the push to try this, I was invited to attend a Casey learning exchange in Phoenix. Representatives from both private and public sectors from several jurisdictions were there for panel discussions. Jurisdictions considering such a move got to ask jurisdictions that had implemented about their experiences. When asked about whether the movement to privatize alone contributed to improved outcomes each of the panelists very honestly replied that wasn’t a factor. It was the investment into services, largely attributable to getting a IV-E waiver that allowed flexibility in spending, that was the most significant in improving outcomes – however you define them. In fact, at one point, one of the panelists of a jurisdiction that had already implemented declared that it appeared we were having a “watershed moment” where we were all wondering why we would invest in additional layers of bureaucracy rather than directly into services.

    Since then, in Washington state, we received a IV-E waiver to implement a Differential Response (we call it Family Assessment Response) model. Our members fully support this. About 11 years ago we implemented Family Voluntary Services (an adaptation of DR) that was highly successful.

    Today we are looking at Social Impact Bonds as a mechanism to better fund and expand needed services. Again, our members fully support this. We have gone from a highly adversarial iniative that would divert sorely needed dollars for services for families and children into greater bureacracy to a very collaborative movement to more wisely invest scarce dollars to where they can do the most good.

    There is a substantial amount of data on what’s happened here. I’m happy to help direct you to those resources if you like.

    Best of luck to you!!

    Connie Hayek, Jody S. like this

  • Jake

    Jake Terpstra

    —

    Jeanine,

    Your experience is consistent with what I heard about privatization. (not purchase of services from private agencies) None of those five states reported improved services or lower cost, as promised. The contracting agency went broke in two of the states, because they underestimated the cost.

  • Susan PunnettSusan

    Susan Punnett

    Executive Director at Family and Youth Initiative

    Jeanine, what a thoughtful process in Washington State; very interesting to read that description. Hope other states learn from what you collectively did – and that one day there is “objective research that isolates and quantifies the contributing factors to improved outcomes;”that is much needed.

    Jake, One of the things that has stayed with me since my introduction to the thinking of some social workers was the idea that some teens were too damaged to have a family – but if they don’t learn to be part of a family (however defined) now, what does that mean for their adult lives, since being connected to other people is part of what all of us want and need? I think case workers should be the person who makes sure a child’s individual needs are met while he or she is in care but even if that were happening would still believe that there needs to be an “outside” person whose commitment to the child is personal and will continue long after that child leaves care (whether that means a parent the child will return to/be placed with or someone who will serve in a parental type role if the child is going to stay in care until aging out). Found your book on Amazon and looking forward to reading it.

  • Jake

    Jake Terpstra

    —

    Susan, That’s a complex set of questions. But real.

    It s true that some kids are considered to be too damaged for family care, though that may depend partly on foster homes available. I ran a treatment facility, and often had a tough time keeping kids out who I thought could be cared for in a family. but there were some. I considered our program a family support service rather than a child care service.. We did what we could to keep family ties intact.. And considered our mission to prepare kids for family living, if not their own, then some other ones, relatives , foster care or adoptive.. It usually worked.

    We accepted children only if the referring agency agreed to work with the family, and then we worked as a team. That’s effective.

    But one of the most valuable, and also under-used, resources is specialized ((treatment/therapeutic) foster care.. They can help most kids that would otherwise go to group care programs, with better outcomes and at about a 4th the cost. Some programs have a problem though—-kids staying in those hones for adoption. That’s the agency’s problem not the kid’s. If anything in CW is my pet, it’s SFFC.

    You’re right that the caseworker should stay in the picture with adoptive families of older, or at least be available. Post adoptive services are in short supply generally, as are reunification services. And they probably have more payoff economically than any other services.

    On of my favorite stories is about Karen Jorgenson, who was the director of NFPA for about 10 years. She had a girl in foster care who eventually left and I believe lost contact. But when this girl was married, had kids and in her 40s, she called Karen ands asked her if she would adopt her. She needed the security of that tie. And she did. That’s permanence!!

    Hope you like the book.

  • Adoree BlairAdoree

    Adoree Blair

    Co-Owner at Integrated Family Services

    Top Contributor

    What a great story. And what a great foster family – I remember Karen as NFPA President. We lose far too many of these dedicated foster families by not ensuring the child they love has a good outcome. People are complex.

    I worked hard during the late 1990’s to bring people to the table to discuss privatizing foster care in our state. We did not get there, but about 50% of our placements are in private (non profit) foster care. What I saw from the front lines, as a foster parent, is that the ability to have a cushion of support from the agency when a foster parent was advocating a different outcome than the public agency advocated, was invaluable for preserving the best foster families. Families certified by the government agencies faced more retaliation and helplessness when they advocated in a way that made the county/state uncomfortable. It made sense to me to ensure that all foster care thus be privatized in order to ensure that all people who cared about the child came to the table without retaliation.

    The issue that remained, of course, is that we don’t do a good job of measuring why people enter foster care. Those who do so out of a ‘calling’ or a love for children are the ones the children need. We have too many who foster for the money, which is frightening when one considers there is just not money there (we always paid more out of pocket than we were ever reimbursed, which is common among those who foster for child-centered reasons.)

    Until we can measure and put standards on the foster parents upfront (enough financial and other stability, enough resources within their own family to remain stable with the added burden of dysfunction foster care brings) and then keep those families by treating them as partners, we will always have less-than-adequate foster homes. If privatizing solved this issue, it would be great, but a lot of other standards would have to be built into the privatization.

    Sandra Seaman likes this

  • Jake

    Jake Terpstra

    —

    Adoree,

    I’m not sure we are talking about the same thing re: privatization. In Kent Co MI the Co Dept purchases 95% of its services Some legislators think that increasing it to 100% would be privatization. That simply would increase purchase of services. With privatization the county dept staff would be forced to leave and a private contractor would take over. It could be compared with farming. If a farmer hires work done, that’s purchase of services. If he sells the farm that’s like privatization.

    In our licensing experiences in MI we concluded that the best services were in private agencies and also the worst. It depends on the management more than the auspices. It sounds as though you working in a very good agency. I worked in both public and private agencies and wouldn’t rate private higher. I worked on the foster care review board here for 3 years, and noticed that practices of the private agencies don’t come close to the public image they have and work hard on.

    In the Children’s Bureau I sometimes was asked what is better, public or private agencies. I said that either can be excellent or deplorable. It depends on the management not auspices. I also recommended that they try to make it about 50 50 because no one should have a monopoly and clients need choices.

    But there is something that we sure agree on—that case decisions should not be changed for kids in foster care without involvement of foster parents. They should be invited to ALL court hearings about their kids. and asked their opinions. I’m sure court decisions would be much better. Same for case planning in agencies. If there were active fos parent associations in each jurisdiction it would make a huge difference.

    On of the issues that you (or I) didn’t mention is that 2/3rds of the caseworkers have NO social work training. It’s supposed to be a social service but mostly it is done without social workers.

    The whole system needs overhaul.

  • Hedy

    Hedy Clothier

    Supervisor at Broome County Social Services

    I am a supervisor in a Social Service agency in upstate New York. About 4 years ago we contracted out foster care services. The intital transistion began when the unit responsible for finding and maintaining foster/adoptive homes was contracted out to a private agency.Then over the next 4 years 98% of the cases have been transfered to private agencies for foster care services. It has been a rough transisition and there are still issues to be resolved.

    The local agency still oversees all cases thru casemangement. The casemamagers are responsible for writing the reports to the court, approving the 6 months assessments, making sure that the voluntary agency comply with regulations regarding contact wth the families and youth and also making sure that diligent efforts are documented in with in the case notes/casefile. This asures that dilligent efforts are undertaken to reunite children with there parents. If that is not possible it is the casemanagers and the local districts DSS file the petitions to free children for adoption.

    I believe that if the staff had been more involved in the actually process and were allowed to develop a plan for the transition if could have been much smoother. People became angry and feared for their jobs and instead of assisting the voluntary agency out and provide guidance they developed and attitude of “let them figure it out” In fact, there has not been one job cut and we recently were granted 2 new caseworker positions by the county legislature. Workers have found out that there is more then enough work to go around.

    An Interagency protocol was developed to assist workers in determing their role in a case. Workers meet with the volunary agency staff on a monthly basis’s to dicuss changes in visitation, and review progress or lack of progress with the family.

    Some days it is still a struggle to have staff not do the work that the voluntary agencies is supposed to do. This is still a work in progress but it continues to improve.

    Most of the voluntary agencies have social workers on staff and have easier access to psychiatrists and psychologists. We have greatly reduce our youth in residential placements. A large number of children that would have previously been placed in a residential setting are now being maintain in thereputic foster home. A handful of the local district’s staff are MSW’s but the majority are not.

    From a cost point of view I do not know that it is any more cost effective. However, it allows district staff more time to provide preventive services and more timely Child Protective investigation.

  • Jake

    Jake Terpstra

    —

    Hedy, the encouraging part of your message is that you are sharply reducing residential group care of kids. In addition you are doing it in the best possible way, using therapeutic foster homes.Congratulations.

    Are you still under a class action suit by CRI?

  • Adoree BlairAdoree

    Adoree Blair

    Co-Owner at Integrated Family Services

    Top Contributor

    I agree also, Hedy and Jake – it is good, too, to share forward steps! Jake, I agree with what you said about private/public foster care agencies. I must have not made the point well enough. It is a shame that foster children face a ‘roll of the dice’ about what type of social worker, foster home, services, etc., that they get. We really need to keep the best homes with the extra effort and stop certifying those who aren’t clearly doing the work due to their heartstrings caring about children.

  • Chiloquin SheltonChiloquin

    Chiloquin Shelton

    Experienced HR Specialist, Customer Service Advisor, Administrative Specialist, Business Graduate, Entry Level Marketer

    I live in Austin, Texas where there are many private foster care agencies particularly churches and non profit organizations. Whether it is private or public there is still a problem in the end for those particularly who age out of foster care. Many organizations such as CASA.org are trying to do what they can to help with guidance, resources and mentorship. But in the end, it is those who have lived most of their lives in foster care and age out that we should be concerned with the most. A program needs to be created for those who have lived in the system and are close to aging out that can allow more adults to mentor and may even consider adopting older children as a way of preparing them for adulthood…companies, colleges, financial institutions, any business that is interested in helping these young teens and young adults have the opportunity to be successful…

  • Adoree BlairAdoree

    Adoree Blair

    Co-Owner at Integrated Family Services

    Top Contributor

    Amen, Chiloquin, to (also) needing to support those aging out. There have been many innovative programs designed to provide that support, but no real victories. I grew up in Oregon, where there was a small town about 100 miles from my birth town, in the Southeast of Oregon, named Chiloquin, In fact, that was the town where my mother grew up. Were you aware of this? I have never heard this as a name – it’s lovely.

    Chiloquin S. likes this

  • Chiloquin SheltonChiloquin

    Chiloquin Shelton

    Experienced HR Specialist, Customer Service Advisor, Administrative Specialist, Business Graduate, Entry Level Marketer

    I have Adoree and one day plan to visit this small town…I asked my mother why she named me this and it has to do with our Native American heritage (Although our heritage originates from NC…lol) I am proud of the name regardless and thank you for the compliment:)

  • Rose JordanRose

    Rose Jordan

    Pursuing opportunities as LCSWA

    Mark Kroner (Lighthouse Services, Ohio) provides an excellent alternative living housing program with supportive services for ready to age-out and aged-out foster youth.

  • david

    david roby

    I/ Executive Director at Kids Country Club

    David Roby
    Scanning all of the comments makes me realize that across North America there are a lot of good people (many on this panel) who care about our children. This applies regardless of private or direct government services. Karen we have gone through the identical questioning around privatization and I can tell you (unfortunately) that the end result is that nothing really changes. First there are a lot of adult interests at play. More CAS organizations are unionized than private firms and unions will fight privatization to the death. Current staff in the social services like their jobs and intend to keep them. Private organizations have the need to balance books and yes the government ‘expects’ them to do the same work for less. Why? Because the whole idea is to find a way to save money and please the taxpayer. ‘Notice,’ thus far I have said absolutely nothing about what is ‘best for the children.’ But, until we all come to the table as equals, nothing positive will come from privatization. Karen, sorry to sound like a bitter old man (despite the fact that I have been in the ‘business’ for more than 40 years) but reality is, Kids are not the problem…..we are. And unless you are prepared to confront these vying adult positions Georgia will end up with a lot of money spent on surveys and plans and the taxpayer will be expected to pay for the stale-mate.
    PS: An old foster child of mine called the home last week. He is now 42 years of age, married with children, and still calls me Dad. He said “I want you to know that the day you sat on the floor, held me and we cried together was the day that changed my life.”

    Pamela W. B., Jeanine L. like this

  • Jodi DoaneJodi

    Jodi Doane

    Director at HIAS Chicago

    Susan, I also enjoyed your comments. IL is roughly 88% privatized, and made the move in the early 90s. We’ve had much opportunity to get it right and get it wrong. To Jake’s point, IL did hope that the cost of care would be less expensive; that more youth and families would be served with less dollars. Unfortunately not the case. But as also mentioned, there are workers that make a lifelong impact on youth- to the positive and negative- in both private and public agencies. As a state-administered state, we have only one DCFS to answer to, to negotiate with, to showcase successes of youth and families as a result of our services. I believe the challenge lies in how far beyond the agency equivalent of “minimum parenting standards” an agency is willing to go- and if they are, it usually means fundraising to cover the gap. This isn’t bad, and I don’t know many state legislatures that expect the state portion of funds to cover all services to a youth or family; but if the agency doesn’t have strong programs with verifiable outcomes and some innovation in service thrown in, privatization vs. non doesn’t matter: our young people still won’t have the same level of opportunity or knowledge that young people growing up in healthy natural families have.

    Adoree Blair likes this

  • Adoree BlairAdoree

    Adoree Blair

    Co-Owner at Integrated Family Services

    Top Contributor

    Bless you David Roby. I remember the kitchen floor and a heart-broken boy rocking in my Kao wailing while I rocked him and cried too. All foster children deserve the kind of empathy. What a privilege it is to be a foster parent. How I miss it.

  • Jake

    Jake Terpstra

    —

    David, we sometimes forget that relationships (worker with kids and families), is the heart or essence of child welfare—not keeping all the Ts crossed and Is doted. Your experience with that boy is the real heart of CW. But the role of caseworkers and the time they have available for clients now makes it difficult. Even if they are inclined.

    Results of privatization in 5 states that I am aware of were mediocre at best, and one described in a local paper, ‘horrible”. In two states the contracting agencies underestimated the cost and were unable to continue. In one instances the state had to make up a $3 million shortfall. The assumption that private agencies can do it better and cheaper, may be true in isolated instances, but there is no basis for believing that generally. That is stereotypical thinking. ll the proposals assumed it. None claimed it afterward.

    You’re right, kids’ interests do not seem to enter the picture, a least not clearly. It reminds me of an African proverb, “When elephants fight it is the grass that suffers”.

  • Adoree BlairAdoree

    Adoree Blair

    Co-Owner at Integrated Family Services

    Top Contributor

    What a great proverb, Jake – that tells it like it sometimes is. We can do so much better.

  • Beverly

    Beverly Jones

    Vice President – Chief Program Officer at Lutheran Child and Family Services of Illinois

    I have worked in both the public and private sectors. Given this, there is no magic answer to having a child and family serving system that works well for children and families. I have seen the best and the worst regardless of the provider. It seems to me the conversation needs to be about what do we want the system to achieve and not who does it. We need to move past the number of visits, caseload size, and the like and ask the more important question – What is the outcome and impact that we need to achieve when families are served in the system?

  • Jeanine LivingstonJeanine

    Jeanine Livingston

    Contracting Compliance Manager at Washington Federation of State Employees

    Beverly that is probably the biggest issue: “What is the desired outcome?” not who does the case management – frankly it’s the same people doing the boots-on-the-ground work. The desired outcome, particularly in the movement to “Performance-Based Contracting” is where the danger lies; unintended consequences. In MIlwaukee they saw a huge increase in quick, “permanent” placements with kin. It was fast, easy and cheap. Unfortunately, this was achieved by inadequate screening and sharp increase in re-abuse. The administrator of the system was sharply criticized and quit the job before being fired. Regrettably, we ended up with her here in Washington. Thankfully, we were able to prevent a similar experience.

    The same is true in Nebraska (you don’t have to look to a different state to learn how horrible it was, the local news and legislature in NE say plenty), Florida, Illinois and Kansas. They all had to remodel from the original initiative.

    My best advice: Investigate fully not only the initiative but the people and money behind it. Many have very bruised reputations seeking redemption, others are well funded and wish to retain the funding streams. All are well intentioned but many got lost along the way. Be careful. Very very careful when selecting outcomes.

  • Adoree BlairAdoree

    Adoree Blair

    Co-Owner at Integrated Family Services

    Top Contributor

    Jeanine – this is not the first time I heard about this sharp increase in re-abuse due to kin placements. Of course, we also know that often, kin are the best place for a child. But careful consideration is needed. Also, in the 1990’s, in Minnesota, the state decided that all foster children should be placed with same-race families. It was considered bold and cutting edge, and there was a great deal of hope surrounding such placements. (I recall being there for my daughter’s college with my African American foster baby in tow, and being told “you are not supposed to have him.”) There followed a horrible expose’ in the Star Tribune about how many children had been abused AND killed in the same-race homes. The issue was not that any one race is more abusive, but in order to certify enough same-race homes, standards had become lower. It was horrific to read about. Somewhere in my files, I have the articles regarding this.

  • Jeanine LivingstonJeanine

    Jeanine Livingston

    Contracting Compliance Manager at Washington Federation of State Employees

    You are very correct Adoree, very often Kin placements are the best and I didn’t meant to take away from that in this discussion. The problem I researched was in setting a performance outcome of quick permanency. If the choice is adoption, reunification or kin placement and the incentives for permancy are equal regardless of which is chosen, Kin placement will be chosen as the most preferred. Why? It’s faster and it’s cheaper.

    Termination of Parental Rights (TPR) for adoption is a long and expensive process through the legal system and finding an adoptive home is also long and expensive with home studies, background checks and due diligence requirements.

    Typically, kinship placements are faster to get through the background checks and legal process. The parents/biological families tend to be more aggreeable and there is less of a legal process. Home studies are not as arduous. So this is where the children go regardless of the best possible outcome.

    We found that when implementing Performance Based Contracting, whether for case management or service delivery, starting with process outcomes is the best place to phase-in and increase to actual safety, permanence and well-being outcomes more gradually.

  • Jake

    Jake Terpstra

    —

    Many studies show that outcomes are better when kids are placed with relatives, but many of those are adoptions. .

  • Adoree BlairAdoree

    Adoree Blair

    Co-Owner at Integrated Family Services

    Top Contributor

    Interesting points, Jeanine Livingston –

  • Connie HayekConnie

    Connie Hayek

    Child Welfare Consultant

    My observation has been that the states that are considering or have implemented privatization initiatives tend to be those that have problems and are seeking to ‘fix’ those problems by privatizing. This is absolutely the WRONG reason to pursue it, IMO. Bringing in another layer of management, bureaucracy, and accountability will not ‘fix’ a system that is experiencing challenges. Those internal issues must be addressed in order to successfully shift to a new model of service provision.

    Similarly, looking to privatization as a cost-savings measure is not realistic. As many have mentioned, cost-savings have not been realized by those jurisdictions that have privatized. Adding more management layers will not save money in the short-term and probably not in the long-term.

    With privatization, there is an additional challenge of data collection and reporting. In the past, the Children’s Bureau has not been receptive to allowing private agency staff to input directly into SACWIS systems. This means that the public agency must continue to perform the data entry function, which tends to exacerbate the problem of caseworker turnover and job/career dissatisfaction. This in turn weakens the oversight and accountability factors.

    In spite of all of this, I believe there is potential for something LIKE privatization to successfully improve outcomes. I’m thinking of performance-based contracting or Social Impact Bonds (SIB). There have been some exciting outcomes identified with SIBs in juvenile justice, early childhood, and corrections. I’d like to see more (healthy) jurisdictions pursue and evaluate these approaches.

  • Jake

    Jake Terpstra

    —

    I understand that privatization hit a snag in the GA legislature Lets hope it is permanent. Privatization plans always promises better service as less cost, but never delivers. It’s not about kids it’s about politics.

  • Gaven LudlowGaven

    Gaven Ludlow

    Vice President of Kansas Foster Care and Adoption Services, TFI Family Services

    I have been part of the state system in KS that ‘privatized’ (truly a private/public partnership) almost 20 years ago. While many of the comments about cost and service are true, this must be viewed in the context of the times, politics and goals originally set out. I believe and have seen the system for children in KS improve. Multiple outcomes from lengths of stay in foster care, success in reintegration, time to adoption, reduction of residential placements, other child focused outcomes have been better. Did it reduce cost? No, but was it realistic to expect cost reduction in a system that needed major improvements and was at the time failing under a federal lawsuit? Again No. Did it objectively (if not fully knowingly) start to establish criteria for improving services to families and kids. Yes, and with successive years it continues to learn and grow.
    Did the original structure of the partnership cause agencies to struggle and some fail, Yes, government lead, sped and focused initiatives often fly before they actually have the wings to stay aloft. However multiple programs in the system of ‘privatizing’ services can work and I believe some states are slowly learning these lessons.

    So let’s not throw out the idea of privatization as bad and hope it does not start in other states. Instead, let’s ensure we are demanding that the methods of structuring it, setting goals for it and monitoring it fit with solid child welfare practice. A simple case in point is still my own state of Kansas. Each contract for services is only engaged for 4 years with an agency. As agencies develop and mature, costs also continue to rise. Those costs are not always about the agency but often simple workforce economics. If you do a good job of hiring and retaining employees, your staff costs increase each year along with other benefits and expenses. So based on a open bid system for limited contracts, an agency will often price themselves out within 1 to 2 contract cycles. If they don’t it is likely they are extracting those savings from staff or services.

    So in Kansas we do end up with contract provider changes more frequently than would be beneficial to the services. It forces staff to restart with a new agency, children/families to endure a transition period, and a contract losing agency to rebuild. There are better and more lasting contract methods that do fit for these services.

    Again, I say with pun intended, don’t throw out the baby with the bath water.

  • Karen WorthingtonKaren

    Karen Worthington

    Versatile writer ♦ consultant ♦ lawyer ♦ editor providing strategic communications and subject-matter expertise.

    Thank you for all the helpful information on the effects of privatization in states that have tried it and the insights of those who have looked at this issue.

    Quick update on Georgia’s pending privatization bill: as of today, Georgia has three days left in the legislative session. The House provided a substitute to SB350 (the privatization bill) that would introduce a two-year pilot in a few areas in the state. The original provisions of SB350 have been added into HB990, a Medicaid bill that passed the House and is now moving through the Senate.

    Today Governor Deal announced the creation of the Child Welfare Reform Council to complete a comprehensive review of the Division of Family and Children Services and advise the governor on possible executive agency reforms and legislative fixes if necessary. (http://gov.georgia.gov/press-releases/2014-03-13/deal-council-will-work-reform-child-welfare-system)

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Author: Mike Tikkanen