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Reunification Services and Federal Funding

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Reunification Services and Federal Funding

 The Adoption and Foster Care Analysis and Reporting System (AFCARS) provide annual data on the number of
children in foster care and some of the characteristics and outcomes for these
children and youth.  The most recent data
for federal fiscal year 2009 indicates that 423,773 children were in a foster
care setting on September 30, 2009.
During the course of FY 2009, 700,000 children spent at least some time
in foster care.  255,418 entered care
while an additional 276,266 left or exited foster care.  Of the 276,266 children that left foster
care, 140,061 or 51 percent were reunified with a parent or primary caretaker.

According the Child Welfare
Information Gateway site though the Department of Health and Human Services:

 “When
children must be removed from their birth families for their protection, the
first goal is to achieve reunification as safely as possible. Child welfare
agencies implement multifaceted strategies that build on strengths and address
concerns.  Returning children home often
requires intensive, family-centered services to support a safe and stable
family.”

The National Resource Center for Foster Care and
Permanency Planning (NRCFCPP) has examined some programs and approaches to
strengthen the reunification process in a way that is both safe and
lasting.  While pointing out that there
is limited research in this area they do highlight key elements or practices
that appear to be important factors in successful reunification outcomes:

  • placement
    decision-making
  • parent-child
    visiting
  • intensive
    services
  • resource
    parent/birth parent collaboration
  • aftercare
    services

Child
welfare agencies depend on a variety of federal funding streams. Along with
state and local dollars, these funds are used to support children, provides
services, hire staff and purchase services. Each revenue source has its own
rules, regulations and policies.

Based
on a series of state surveys, the sixth and most recent conducted by Child
Trends and funded by Annie E. Casey and Casey Family Programs in 2007, states
relied on five major federal funding sources: Title IV-E (Foster Care,
Subsidized Guardianship and Adoption Assistance) and Title IV-B parts 1 and 2, (Child
Welfare Services/Promoting Safe and Stable Families) with both Titles dedicated
to children and families that come into contact with child welfare.  In addition three other sources with a
broader population are also critical to funding: Temporary Assistance for Needy
Families (TANF), Social Services Block Grant (SSBG) and Medicaid.

Of these five federal funding sources (all found under
the Social Security Act), the only funding dedicated to reunification of foster
children with their families is found under the Promoting Safe and Stable
Families (PSSF) program
That
funding source however is one of the smallest
and it is designed to
address four services:  reunification,
adoption services, family preservation and family support.  States are directed to spend at least 20
percent of their funding on each of the four services.

A specific description of the five federal funding
sources follows:

Title IV-B Part 1, Child Welfare
Services (CWS
)

Title IV-B of the Social Security Act was first
established as part of the original law when it was enacted in 1935.  States submit a five year “Child Welfare
Services Plan” that requires several assurances and commitments by the
state.  Funds received may be spent on a
wide variety of child welfare related services and are considered very flexible.

Reunification services could be drawn from this funding
but this is one of the few federal child welfare funding sources that could
also be used for prevention initiatives. Based on what states originally used
the funding for in 1979, some states are allowed to use some of these funds on
foster care maintenance payments, adoption assistance payments, and child care
necessary for employment based.

Congress is authorized to appropriate $325 million
annually and in FY 2011 approximately $291 million was approved.  It requires states to provide a 25 percent
match in state dollars.  Each state share
is based on the state’s population under age 21 as compared to other
states.  Although Congress can
appropriate up to $325 million, the highest level of funding was reached in
1994 when just under $295 million was provided.

Title IV-B part 2, Promoting Safe and
Stable Families

Promoting Safe and Stable Families (PSSF) is funded at a
total of $428 million in combined mandatory and annually appropriated
(discretionary) funding.  The funding has
been divided into four broad categories over the last several
reauthorizations.  Of the total $428
million in FY 2011: $368 million is for the core purposes of the program:
family preservation, family support, family reunification and adoption services.  The remaining funds are designated for
competitive court-child welfare programs; competitive grants to address
substance abuse; and funding to states for workforce development.  Tribal governments also receive a set-aside
of funds.

As a general rule, at least 20 percent of the money for
the $368 million base grant must be spent in each of four categories: 1) family
preservation, 2) community-based family support services, 3) time limited
family reunification services and 4) adoption promotion and support
services.  A description of how these
funds are to be expended must be included in the state’s five year Child
Welfare Services Plan.  Just like Child
Welfare Services there is a 25 percent state match required.

Title IV-E Foster Care Maintenance Payments

As an entitlement, IV-E
foster care funding is determined by the level of need and claims filed by
states for reimbursement by the federal government.  For the federal fiscal year 2011, the
Administration projects that Title IV-E foster care maintenance and
administrative costs will be at $4.5 billion.
The funding will cover an estimated 168,200 children in foster care
which will likely represent less than 40 percent of the children in care in FY
2011[i].  For federal fiscal 2009, 423,000[ii]
children were in out-of-home (foster care). Foster children not eligible for
federal funds are covered by state and local dollars.

If a child is eligible for
federal funding, state spending is matched at the Medicaid matching rate or
Federal Medical Assistance Percentage (FMAP) ranging from 50 percent to
approximately 80 percent.  States are
also reimbursed at a fifty percent matching rate for Administrative Costs for
an eligible child.  Prior to the
Fostering Connections to Success and Increasing Adoptions Act of 2008 (Fostering Connections, PL 110-351), only
children up to age 18 were eligible.  Now
states have the option to extend the age of foster are to age 19, 20 or
21.  As a result of that law, states can
also use these funds for subsidized/kinship care placements under the same
financial eligibility standards.

Foster care maintenance
payments are for the cost of
providing food, clothing, shelter, daily supervision, school supplies, a
child’s personal incidentals, reasonable travel to the child’s home for visitation,
and reasonable travel for the child to remain in the school in which the child
is enrolled at the time of placement.  In
the case of institutional care it includes the reasonable costs of
administration and operation of the institution in providing these same
needs.

When Congress converted AFDC
into the TANF block grant in 1996, the eligibility remained tied to AFDC.  States are required to determine eligibility
by determining whether or not a child had been removed from a family that would
have been eligible for AFDC as it existed in that state on July 16, 1996.  This was done because some advocates believed
tying foster care funding to the new TANF program would make more children
ineligible for federal funding.

 

 

Title IV-E Adoption Assistance
Payments

As an entitlement IV-E
Adoption Assistance funding is determined by the level of need and claims filed
by states for reimbursement by the federal government.  For the federal fiscal year 2011, the
projected cost for Title IV-E Adoption Assistance payments and Administrative
costs are projected to be $2.4 billion.
An estimated 453,900[iii]
children will be helped by adoption assistance federal funding.  As is the case with foster care, if a child
is eligible for federal funding, state spending is matched at the Medicaid
matching rate or FMAP.  States are also
reimbursed at a fifty percent matching rate for Administrative costs for an
eligible child.  States have the option to
extend the age of coverage for special needs adoptions to age 21 under certain
conditions.

Adoption assistance payments
are designed to assist families that may need additional financial support in
the adoption of a special needs child.
The amount of the payment is determined through an agreement between the
adoptive parents and the state (agency).
It is to take into consideration the circumstances of the adopting
parents and the needs of the child being adopted, and may be readjusted
periodically, with the concurrence of the adopting parents.

Fostering Connections created
a gradual delink of Adoption Assistance eligibility from the AFDC
eligibility.  Starting in fiscal year
2010, special needs children 16 and older who are newly adopted from the foster
care system are covered by federal funds.
The age or delink of eligibility continues to decrease by two years each
fiscal year until all special needs adoptions are covered in 2018.

Independent Living and Adoption
Incentives

Two additional funding sources are also found under
Title IV-E for specific issues.  The
Chafee Independent Living program is targeted to assisting youth who leave
foster care due to their age and not as a result of being placed in a permanent
home setting.  It is a fixed block grant
of mandatory funding of $140 million with states required to provide a 20
percent match in funds.  States may
assist youth previously in foster care up to age 21 and are required to have
detailed plans and the definition of eligible services.  States where also given the option to extend
Medicaid coverage up to 21 for youth formerly in foster care, approximately half
the states have done so.  The 2010 Patient Protection and Affordable Care Act (P.L.
111-148) will extend Medicaid coverage up to age 26 for all youth formerly in
foster care starting in 2014.  A young person leaving foster care after age
16 for either adoption or kinship care may continue to be eligible for Chafee
services.

 

Adoption incentives were enacted to encourage and
expedite appropriate placement of children from foster care into adoptive
families.  If states increased the number
of children adopted from foster care over a previous year’s high mark, they are
awarded an incentive.  In the last two
reauthorizations, (the latest being in the 2008 Fostering Connections Act)
Congress provided an increase bonus of $8000 for the placement of an “older”
child.  Older children are defined as a
child 9 years of age or older.  In
addition, a $4000 incentive is provided for an increase in the number of
special needs adoptions and $2000 is provided for an overall increase in
adoptions.  In the 2008 action, Congress
also allowed a $1000 incentive if a state increased its adoption rate
(regardless of actual numbers of placements).
In 2010, just under $35 million was awarded to 38 states.

 

Non-Child Welfare

Title IV-A, Temporary Assistance for
Needy Families (TANF), Social Security Act

A state entitlement program,
TANF is funded at $16.8 billion.  Based
on previous surveys of state child welfare spending, states will spend
approximately $2.4 billion[iv]
on a range of child welfare services from kinship care to other out of home
services and prevention and intervention services.

In 1996 the Temporary
Assistance for Needy Families (TANF) Act, PL 104-193 converted AFDC from an
individual entitlement to a block grant.
States are required to spend over $12 billion a year in
Maintenance-of-Effort (MOE) funds to qualify for their share of the $16.8
billion. In addition to the many changes the law made to eligibility
requirements for individuals and states, including time-limits on assistance
and work requirements and work targets for both individuals and states, it also
created great flexibility in how states spend their federal funds.  TANF represents a significant source of
federal funding, representing approximately 19 percent of all federal funds
spent on child welfare;[v]
ranking second only to Title IV-E funding with the $2.4 billion in TANF spent
on child welfare services.

Title XX, The Social Services Block
Grant (SSBG), Social Security Act

The Social Services Block
Grant (SSBG) is a federal block grant that is considered an entitlement to the
states.  It was funded at $1.7 billion in
federal fiscal year 2011 and states can and do spend these funds on a range of
services for children, the elderly, individuals with disabilities and several
other populations.  SSBG is generally the
biggest federal source of funds of Child Protective Services (CPS), with
approximately 41 states allocating approximately $250 million in funds each
year on what are described CPS services[vi].  Almost all of the states will spend some
potion of SSBG on at least of the following: protective services, foster care
services, adoption services, services for displaced youth and other child
welfare related services each year, although it can vary from year to year[vii].  According to SSBG annual reports funding for
a range of child welfare related programs totals more from $810 million in 2000
to a low of $660 million in 2004.  A
significant portion of these SSBG dollars are TANF funds states have
transferred into SSBG.  According to the
Child Trends Survey, states spent $1.6 billion through SSBG on child welfare
services.  This represents 12 percent of
total federal funds spent on child welfare.[viii]

 

 

Title IXX,
Medicaid, Social Security Act

Medicaid is considered the nation’s health insurance
program for the poor.  Created in 1965
along with Medicare, it is an open-ended entitlement program that provides
medical services to Medicaid eligible poor adults, the frail elderly and
children under certain conditions.  In 2010
Medicaid is expected to spend approximately $280 billion in federal funds,
although this figure will be affected by the economy and some temporary
increases in funding due to the recession.
The FMAP, which is established at the beginning of each federal fiscal
year, is based primarily on the state’s per capita income and ranges between 50
percent and 83 percent.

Surveys on child welfare spending have consistently
shown that Medicaid contributes approximately 13 percent of total child welfare
spending, which amounted to $1.4 billion in 2006[ix].  In these surveys, the Medicaid spending
measured includes child welfare related services and does not count basic
health care – it includes services such as Targeted Case Management (TCM), rehabilitative services and health related
transportation services.

States vary greatly in which services they select under
the optional category.  Title IV-E
eligible foster care and all special needs adoption children have categorical
eligibility for Medicaid, meaning a state must cover them.  In addition, states cover non Title IV-E
eligible foster children and children from low income families under the
“medically needy option.”  In those states,
almost all foster children are Medicaid eligible.

Targeted Case Management, TCM, allows the state to
provide case management to a “targeted” group such as child welfare, foster
care, adoption or mental health.  The
state Medicaid plan must address: “target group, areas of the state in which
services will be provided, comparability of services, definition of services,
qualifications of providers, free choice of providers and assurance that
payment for case management services under the plan does not duplicate payments
made to public agencies or private entities under other program authorities for
this same purpose.”

The federal definition of rehabilitation service
includes any medical or remedial services recommended by a physician or other
licensed practitioner of the healing arts within the scope of his practice
under the state law, for maximum reduction for physical or mental disability or
restoration of a recipient to his best possible functional level.  This very broad definition provides many
opportunities for children served in the public and private child welfare
system. Examples of Medicaid reimbursable rehabilitation services that relate
to child welfare currently being funded in one or more states include:
residential treatment centers, therapeutic family foster care and intensive
in-home services.  The use of these two
services have been limited in some states by CMS and efforts have been on-going
before, during and after the health care debate to clarify and strengthen the
use of these services as they apply to child welfare families and children.

Footnotes


[i] Department of Health and Human Services. (2010). Budget in Brief, (page 82).Washington DC

[ii] U.S. Department of Health
and Human Services, Administration on Children, Youth, and Families. (2010). The
AFCARS Report 2008.
Retrieved July 15, 2010, from
http://www.acf.hhs.gov/programs/cb/stats_research/afcars/tar/report16.htm.

[iii] Department of Health and Human
Services. (2010). Budget in Brief, (page
83).Washington DC

[iv] DeVooght,
K., Allen, T., and Geen, R. (2008). Federal, state, and local spending to
address child abuse in SFY 2006.
Retrieved November 24, 2009, from
http://www.childtrends.org/Files//Child_Trends-2009_02_17_FR_CWFinancePaper.pdf.
Washington, DC: Child Trends.

[v] Ibid.

[vi] Child Welfare League of America.
(2008) Legislative Agenda, the Social
Services Block Grant (SSBG).
Retrieved from
http://cwla.org/advocacy/2008legagenda11.htm.

[vii] Child Welfare League of America.
(2008–2001) Legislative Agendas, the
Social Services Block Grant (SSBG).
Retrieved from http://cwla.org/advocacy/2010legagenda.htm.

[viii] DeVooght,
K., Allen, T., and Geen, R. (2008). Federal, state, and local spending to
address child abuse in SFY 2006.
Retrieved November 24, 2009, from http://www.childtrends.org/Files//Child_Trends-2009_02_17_FR_CWFinancePaper.pdf.
Washington, DC: Child Trends.

[ix] DeVooght,
K., Allen, T., and Geen, R. (2008). Federal, state, and local spending to
address child abuse in SFY 2006.
Retrieved November 24, 2009, from http://www.childtrends.org/Files//Child_Trends-2009_02_17_FR_CWFinancePaper.pdf.
Washington, DC: Child Trends.

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Written by dawneworswick

July 6, 2011 at 7:24 pm

Posted in Uncategorized

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