October 30, 2017 Practice Points

Youth in Privatized Foster Care: What You as an Advocate Need to Know

By Jessalyn Schwartz

Following a two-year investigation into state foster care practices and their partnerships with private service entities, the Senate Finance Committee released an extensive report outlining the myriad problems discovered through this effort. The bipartisan group analyzed information provided by 33 states following a 50-state inquiry, specifically focusing on the privatization of foster care occurring nationwide as more children, especially those with special needs, are pulled into the system. The conclusions of this report spurned lawmakers to propose the Child Welfare Oversight and Accountability Act of 2017.

The investigation found that children in the care of private companies, such as the MENTOR Network, based in Massachusetts and operating in approximately 26 states, are plagued by shortcuts taken by these companies to increase profit. Inadequate screening of foster parents and others in their homes, increasing workloads for social workers, high social worker turnover, filling beds using a quota system, and hiring unlicensed workers are a few of the root causes leading to rampant abuse and neglect of youth in privatized care. At the same time, public funding is being funneled into these private agencies at high rates, found to range between $18 and $50 million. States and contracted private agencies are failing to meet standards on action plans, treatment plans, and mental health assessments, especially for children in need of therapeutic foster care (TFC). There are further failures to identify and respond to risks to children in foster care, while programs and foster parents continue to be highly rated despite potential safety concerns in the homes or facilities. There is inadequate follow-up on fatalities and inadequate monitoring of placements due to social worker turnover.

The investigation also found that there is much inconsistency in reporting from state to state, making effective oversight and assessment nearly impossible. There is no consistent, national language or definition of abuse and neglect, as well as other terms of art in child welfare, which makes state-to-state comparisons incredibly difficult. Many states do not even track maltreatment in foster care, and in a large number of situations, the reported numbers come straight from the states or their agencies, which brings about questions of accuracy. The study found that there were typos, inconsistencies, errors, inaccuracies, and missing information in the bulk of incident reporting from privately contracted agencies, as well as states.

Mortality reports were found to be misleading, as different calculations were used to minimize the death rates. For example, the investigation found that privatized foster care placements had a 42 percent higher death rate than the national average for youth in care. Additionally, not all states use electronic data, relegating important information to inaccessible paper files, and there is a large discrepancy on the tracking of TFC, with some states only tracking numbers in relation to TFC, and others lumping all of the data together. Many states and private agencies are also not following oversight guidelines, using exceptions and waivers for foster placements and their supervision, and overlooking violations.

The investigation report contains specific recommendations for States and Tribes, the Department of Health and Human Services (HHS), and Congress. Improving support and services in the recruitment of foster parents, better outcome tracking for youth, transparent data reporting, clarification of service delivery and definitions of therapeutic foster care, abuse, and neglect, with the provision of guidance, are all suggestions within the report. A brief summary of the report with a complete list of the recommendations at each level can be found here. The full report contains specific data from individual states and a number of appendices that delve deeper into the report’s methodology.

Jessalyn Schwartz is an attorney in Boston focusing on child welfare and mental health law.


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