One NC legislative victory: support for well-being of foster children

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While there may be much to lament about what the General Assembly could have accomplished but didn’t, there are some bright spots concerning the most vulnerable members of our society: children in foster care.

Each year about 9,000 children in North Carolina and about 400,000 across the country are in foster care. Far more children, over 100,000 each year in North Carolina and 2.7 million nationally, are investigated for child abuse or neglect.

For decades, researchers, policymakers, child welfare professionals and advocates have focused on the three-legged stool of foster care: safety, permanency and well-being. However, the emphasis on the immediate needs of children in foster care has often left well-being as an afterthought in policy and practice. We know from longitudinal research, brain science and the experiences of children in foster care that well-being – the social and emotional health of children – matters tremendously

Lack of well-being keeps children in foster care from thriving physically, mentally, emotionally and socially. While safety and stability are critical, children’s mental and emotional health problems do not just go away with time. They must be identified and treated effectively.

Here’s why we should be encouraged: Recent federal and state legislation has focused on ensuring that children and youth in foster care have enhanced opportunities to become healthy, educated, productive adults.

Last month, Sen. Ron Wyden (D-Oregon) introduced the Family Stability and Kinship Care Act of 2015. This act would allow states to use current federal funding for foster care in more flexible ways to pay for prevention services and interventions aimed at keeping kids out of foster care. This summer, the General Assembly unanimously passed the Foster Care Family Act, which eliminates barriers to obtaining a driver’s license, attending out-of-state field trips and enjoying sleepovers with friends – opportunities that most children take for granted, but not children in foster care.

These legislative changes begin to address the “wicked problem” of foster care, as Dr. Mark Testa, UNC professor and child welfare expert, called it in his keynote address at the 2015 Family Impact Seminar convened by the Duke Center for Child and Family Policy. The seminar, “Helping Kids in Foster Care Succeed: Strategies for N.C. to Strengthen Families and Save Money,” highlighted nonpartisan, cost-effective strategies to ensure that children and families in foster care are healthy, educated and self-sufficient. In addition, the seminar encouraged policymakers to consider the family impact of legislation just as they consider economic or environmental impact.

The seminar speakers and materials highlighted well-documented foster care realities and options for policymakers.There were some clear takeaways:

▪ Focus on evidence-based programs and paying for what works.

▪ Use standardized assessments to identify trauma and other concerns early and refer to services.

▪ Develop a full array of services including intensive care coordination, in-home services, psychiatric interventions and residential options that more closely resemble family environments.

▪ Provide post-permanency services to support families after children come home or to provide ongoing assistance to guardians and adoptive families.

▪ Address the special needs of youth who “age out” of foster care and extend the age of foster care to 19 or beyond to give these youth a headstart into adulthood.

Fostering Success (SB 424), sponsored by Sen. Tamara Barringer (R-Wake) and passed this year, will increase the voluntary age of foster care to 21, allowing many young adults additional opportunities to get on their feet – finish high school, start college, get a job and find stable housing before they age out of the system.

The average behavioral health expenditures for children in foster care are double the cost of their peers with Medicaid, a statistic we see replicated in preliminary studies in North Carolina. Explanations for the high costs include overreliance on intensive residential treatment services and psychiatric medication, and underuse of evidence-based interventions to address trauma and well-being. For many children in foster care, earlier interventions could have improved their life trajectory.

The economic impact of child abuse and neglect is both immediate and long-lasting with studies showing that the lifetime cost ranges from $30,000 to $200,000 per child. These costs are borne by the health care and human services systems, schools, juvenile and criminal justice systems, and employers.

Another bright spot of this long legislative session is that N.C. legislators heard from the Pew-MacArthur Results First Initiative, which works with states to implement an innovative cost-benefit analysis approach that helps them invest in policies and programs that are proven to work.

Foster care is a perfect candidate for evidence-based policy, investment and intervention, and promoting well-being for children in foster care has the potential to benefit all of us.

Jenni Owen is director of policy initiatives at the Duke Center for Child and Family Policy. Susan Foosness is a consultant at Public Consulting Group.