Complete Fiscal Year 2024 data now on the Dashboard of the District of Columbia’s Child and Family Services Agency (CFSA) reveal significant changes over the previous fiscal year. Most striking is a large jump in the number of incomplete investigations and a concomitant decline in “substantiated” and “unfounded” reports. The number of children entering foster care increased for the first time in over ten years. There was a drop in in-home case openings but a similar increase in foster care placements during the year. The agency did not respond to this writer’s questions about the meaning of these trends.
Referrals
Total referrals (or calls to the CFSA hotline) have increased for the second year in a row. After falling in 2020 and remaining below 2019 levels in 2021 and 2022, the number of referrals jumped from 16,899 in FY2022 to 20,246 in FY2023 and then rose more modestly to 20,978 in 2024–an increase of 3.6 percent. Prominent child welfare scholars like Emily Putnam-Hornstein have concluded that referrals are the best available indicator of actual maltreatment due to the strong correlation between referrals and future reports (regardless of the outcome of any associated investigation) and also evidence of the difficulty of correctly determining whether maltreatment has occurred. Thus, the increase in referrals may well be a sign of increasing maltreatment. Contributing factors might be the end of COVID-19 assistance programs and the growing mental health, substance abuse, and housing crises in the District.
Childcare and school personnel continued to make more than half of the referrals to CFSA, with another 13 percent coming from law enforcement and 11 percent from friends and neighbors. All three of these groups made more referrals in FY2023 than FY2024, while counselors, therapists, social workers and medical professionals made fewer, suggesting that children may be seeing fewer of these professionals with the disappearance of virtual options spawned by the pandemic.
Looking at CFSA’s response to the referrals, the largest portion, or 73 percent, were screened out. That compares to only 19 percent that were accepted for investigation. The remaining referrals were either linked to an existing investigation (three percent) or classified as an information and referral that does not involve an allegation of abuse or neglect. These percentages are quite similar to those of the previous year.
Investigations
An investigation can have five different dispositions. According to the definitions provided in the Dashboard, unfounded means that there is not enough evidence to conclude that the child has been maltreated or at risk of being maltreated. “Substantiated” means that there is enough evidence to conclude that the child has been maltreated or is at risk of maltreatment. “Inconclusive,” means that “there is insufficient evidence to substantiate the report but there still exists some conflicting information that indicate the abuse or neglect may have occurred.” “Incomplete” means that the investigation could not be completed due to barriers like inability to locate the family, a family’s refusal of access to the home, or finding out that the family lived out of state.
There was a big jump in the number of investigations categorized as incomplete, from 525 in FY2023 to 1,442 in FY2024. That was an increase from 15% of all investigations to 38% of all investigations. As a consequence of the increase in incomplete investigations, the number and percentage of investigations that were unfounded and substantiated dropped drastically. The number of investigations that were substantiated fell from 799 (21 percent of investigations) in FY2023 to 606 (or 16 percent of investigations) in FY2024. Unfounded remained the most common disposition in FY2024, but the proportion of cases that were unfounded dropped from 58 percent to 41 percent.
CFSA’s communications director did not respond to several emails asking for an explanation of the the jump in incomplete investigations. But it seems likely that this trend stems from the workforce crisis that is affecting CFSA and other child welfare and human services agencies around the country. A spreadsheet that the agency provided to the DC Kincare Alliance shows 27 out of the 36 social workers performing investigations as of August 2024 were carrying more than the 12 to 15 cases that CFSA uses as an indicator of satisfactory performance. This included 19 social workers carrying 20 or more cases and five social workers carrying more than 30 cases. Even more concerning is that the number of social workers doing investigations fell from 42 in January 2024 to 36 in August 2024, according to the spreadsheet. More concerning still, in its FY2024 Performance Oversight Responses, CFSA documented the caseloads of 90 social workers.
If social workers are not able to complete the required interviews and collect needed information timely, endangered children may suffer further harm. It is possible that most of the incomplete investigations have been essentially concluded with a determination of findings, leaving only the completion of needed documentation and forms undone as workers hurried to start new investigations. Such a scenario might be somewhat less alarming but would still raise concerns that overburdened social workers are not able to thoroughly investigate allegations, thereby endangering vulnerable children.
In-Home Case Openings and Foster Care Placements
The table below shows the number of in-home case openings and children entering foster care by year. These two numbers cannot be added together because because in-home entries are reported at the case level (with multiple children in many cases) and foster care entries are reported at the child level. However the trends over time can be compared, showing that the number of in-home cases opened dropped between FY2023 and FY2024 while the number of children entering foster care increased. This was the first time the number of children entering foster care increased since FY2021, after the drop in foster care placement due to COVID-19.
The total number of children served in home and in foster care on the last day of every quarter are available on the CFSA Dashboard and can be added to yield the total number of children served on that date. The chart below shows that the total number of children served on the last day of the fiscal year (September 30) stayed basically the same between FY2023 and FY2024. But the number of children being served in their homes decreased by 50 while the number in foster care increased by 49. FY2024 reverses a trend of annual decreases in the number of children in foster care going back at least as far as 2011.
The increase in the number of children in foster care between September 30, 2023 to September 30, 2024 reflects an excess of entries to foster care over exits from care during FY2024. Specifically, the number of children in foster care at the end of the fiscal year should reflect the number of children in foster care at the end of FY2023, plus the number of entries to foster care during the year, minus the number of exits from foster care. While there is a discrepancy of two between the results of this calculation and the foster care caseload reported by CFSA, the numbers confirm that there were about 50 more entries than exits, so the caseload increased. A similar calculation cannot be performed for children served in their homes, as the entry data are based on cases, not children.
2023 FC Caseload
2024 FC Entries
2024 FC Exits
2024 FC Caseload
496
243
196
545
It may be reassuring that the number of children served by CFSA changed so little in FY2023. One can hope that despite the high percentage of incomplete investigations, CPS workers are doing what is necessary to find the children that need help and simply leaving some of the paperwork for later. However, such a situation is not sustainable without endangering children. And the 3.6 percent increase in the number of referrals between FY2023 and FY2024 was not met with an increase in the number of children served, which may be a result of the incomplete cases.
It is not possible to understand the FY2024 data without further information from CFSA. How alarming the increase in incomplete investigations may be depends on whether these investigations are truly incomplete or basically finished except for forms and documentation. More concerning still, CFSA caseload data indicates that there are fewer than half the number of social workers doing this work now than in previous years. It is good that the total number of children being served has not dropped precipitously along with the drop in completed investigations. But the public needs to know more about how CFSA is functioning and what it is doing to alleviate the workforce crisis
This post summarizes the results of my analysis of CFSA’s FY2023 data, compared to the data from FY2022 and previous years. Except when otherwise noted, the data is drawn from the Public Dashboard of the District of Columbia’s Child and Family Services Agency (CFSA), which provides data, updated quarterly, on the agency’s essential functions. My analysis showed a large increase in hotline calls in the last year, but a decrease in the number of investigations and substantiated claims of abuse or neglect. The foster care and in-home caseloads continued to fall, with a precipitous drop in the opening of in-home cases in particular. An important finding was the decline since 2019 in the number of in-home and foster case opened as a proportion of substantiated investigations. Taken together, the data suggest an agency that is withdrawing its core mission of responding to abuse and neglect in favor of new initiatives that are more in accord with the current ideological climate in child welfare.
There were 20,246 calls to the CFSA hotline (called “referrals” by the agency) in FY 2023. About 51 percent of the referrals came from school and daycare personnel; that share has increased to more than its pre-pandemic level of 42.9 percent in 2019. Nationally, teachers, made only 20.7 percent of referrals in FY2022. The District’s very different reporting pattern may reflect its educational neglect law, which requires teachers to make a report when a child has more than ten unexcused absences in a year.
Figure 1 shows the precipitous drop in referrals during the pandemic year of 2020, followed by an increase in FY2021, and a slight dip in FY2022. The total of 20,246 calls to the hotline in FY2023 was 20 percent above the total of 16,899 in FY2022 and even eclipsed that of the year before the pandemic. Most sources increased their reporting in FY2023, but much of the increase came from school and childcare personnel, who made 10,329 reports in FY2023 compared to 8,389 in FY2022. It is not clear why referrals increased so much in FY2023.
CFSA responded to the increase in referrals by screening out a larger percentage of these calls and accepting a smaller percentage for investigation. Out of the 20,246 referrals received in FY2023, CFSA hotline staff screened out 11,540 or 73.7 percent, compared to the 68.3 percent of referrals they screened out the year before, as shown in Figure 3. And they accepted only 19.3 percent, as compared to the 26.2 percent they accepted the year before. (Referrals not screened out or accepted were linked to an existing investigation or redirected to another agency). Hotline staff actually accepted significantly fewer referrals for investigation in FY2023 than in FY2022 despite the increase in referrals–a total of 3,902 accepted referrals in FY2023 compared to 4,429 the previous year, as FIgure 2 shows.
With fewer referrals accepted for investigation, there were naturally fewer investigations, as the height of the bars in Figure 4 shows.* The number of investigations that was substantiated (meaning the allegation of maltreatment was supported by the investigation) decreased from 861 in FY 2022 to 799 in FY2023, which was a drop of 7.2 percent. But the percentage of investigations that were substantiated did not change, remaining at about 21.5 percent of all investigations. So the decline in substantiations reflects the decline in the number of investigations initiated rather than a decreasing tendency to substantiate allegations.
Substantiated investigations can result in several outcomes, depending on the level of danger and risk to the child or children as estimated by Child Protective Services (CPS). if the child or children are deemed to be at low-or moderate risk, policy dictates that the family be referred to one of the Healthy Families/Thriving Communities collaboratives, nonprofits that are funded by CFSA to provide case management and other services. If the risk is deemed to be high or “intensive,” CFSA opens an in-home case. And if the child or children are assessed to be in imminent danger, the child is placed in foster care or an informal placement with kin or a family friend.**
Table 1 shows the number of substantiated investigations, in-home cases opened, and foster cases opened between FY 2019 and FY 2023. The table shows that the number of substantiated investigations has been falling since 2020. In-home case openings fell moderately from FY2020 to FY2022 and dramatically from 463 in FY2022 to 363 in FY2023, a drop of 21.6 percent. Foster care entries, which had fallen rapidly between FY2019 and FY2022, fell less dramatically in FY2023, perhaps beginning a leveling trend after years of rapid decline. The total of in-home cases opened plus foster care entries (in other words, the total number of cases opened) fell from 886 in FY2019 to 542 in FY2023, a drop of 38.8 percent. From FY2022 to FY2023, total cases opened dropped by 18.4 percent. The number of In-home and foster care cases opened as a percent of substantiated investigations over the five-year period has dropped considerably since 2019, from 88.2 percent in FY2019 to 67.8 percent in FY2023, indicating a reduced likelihood of opening a case when an allegation has been substantiated.
Table One: Substantiations, In-Home Cases Opened and Foster Care Entries, FY2019 – FY2023
Fiscal Year
2019
2020
2021
2022
2023
Substantiated investigations
1004
1035
920
861
799
In-Home Cases Opened
499
500
442
463
363
Foster Care Entries
387
217
251
201
179
Cases opened (In-Home Cases Opened Plus Foster Care Entries)
886
717
693
664
542
Cases opened as a percent of substantiated investigations
For a longer-term view, Figure 5 shows the number of children served in-home and in foster care on the last day of the fiscal year (September 30), using historical data from CFSA’s most recent Annual Needs Assessment.*** In 2010, about as many children were served in foster care as in their homes, but since that time the proportion of children served in their homes has risen, standing at 66.0 percent in September 2023. The foster care caseload has decreased every year and shows signs of starting to level off. The in-home population has also declined over time, though less steadily. The number of children served in their homes, though still much larger than the foster care population, has fallen much faster than the latter in recent years, dropping from 1,290 on September 30, 2021 to 962 on September 30, 2023. The total number of children served in home and in foster care has fallen from 4,194 in FY2010 to 1,458 in FY2023, a drop of 65 percent. And it dropped by a precipitous 33.6 percent between FY 2019 and FY2023. The “footprint” of CFSA, in terms of essential services, has shrunk dramatically.
CFSA is pushing back against any impression that it is serving fewer families and children, as shown in the graphic displayed below from the latest Annual Needs Assessment. To the foster care and in-home populations (the same numbers shown in Figure 5) they add two more populations starting in FY 2019 — children and families they categorize as “Front Porch” and “Front Yard.” The agency defines “Front Yard” as families not yet involved with CFSA “but facing challenges that could put them at risk of coming to the agency’s attention.” It defines “Front Porch” as “families known to CFSA, both with and without an open case.”**** These “Front Yard” and “Front Porch Families” are being served by the Healthy Families/Thriving Communities Collaboratives using CFSA funds, rather than directly by CFSA.
Adding the “Front Porch” and “Front Yard” children to the children served in their homes and in foster care gives the impression that the number of children and families served has not fallen but in fact has increased in recent years. That may be technically true, but there are serious problems with that assertion. First, the total number of children served by the Collaboratives began declining in FY2021, and it is not clear what the future holds. Second, the services provided by the Collaboratives are typically much less intensive (and therefore cheaper) than CFSA’s in-home services. Collaborative case managers are generally not licensed Masters-level social workers and have much higher caseloads than CFSA in-home workers. Therefore, they often do not have the time or the skills to to provide the same level of services. Collaborative services have had a dubious reputation over the years; one of the first things I heard as a social worker at a private District agency managing CFSA foster care cases is how one could not expect any meaningful services from a collaborative. As a matter of fact, CFSA tried to end its contracts with the Collaboratives in FY2018 under the previous director, Brenda Donald. But the outcry from Collaborative staff and community members (perhaps recruited by the Collaboratives themselves) led her to renew the non-competitive contract for the collaboratives.
Third, it is not obviously sensible to divert CFSA funds to families in the “Front Porch,” and especially the “Front Yard,” when the agency is clearly not doing enough for the families currently receiving in-home services. The latest needs assessment focuses on in-home services and is sobering reading. In-home caseworkers responding to a survey reported that the most common barriers that caregivers display (daily parenting behavior, substance abuse, and mental health) barely change between the opening and closing of an in-home case. Only a quarter of the in-home cases reviewed by CFSA’s internal reviewers demonstrated “good progress.” CFSA concluded that the lack of progress in the other three-quarters of cases was due to the lack of parental engagement in services. CFSA’s responses to oversight questions from the Committee on Facilities and Family Services show that of the 503 in-home cases closed in FY 2023 and the first quarter of FY 2024, 214 (or 40 percent) of the families have already been the subject of a hotline call after the case was closed. My study of deaths of children known to CFSA between 2019 and 2021 showed that four of the deaths occurred while an in-home case was open for the family. Three other families had had one or more in-home cases that closed before the children died.
The data analyzed here show that from FY2010 to FY2023, CFSA has been serving fewer families with in-home services and foster care. In the last year, the decline continued even as calls to the hotline increased. During that last year, it is the rejection of a higher number of referrals and the reduced likelihood of opening a case when a referral is substantiated that account for the decrease in families served. But what is the actual cause of these trends?
There is more than one possible explanation for the rejection of more referrals and the opening of fewer cases for each substantiated referral. Like other child welfare agencies, CFSA is struggling with a staffing shortage. Perhaps the lack of staff in all units is constraining the ability to conduct investigations and staff the number of cases that are needed. That could result in hotline workers accepting fewer referrals and CPS workers referring more families to the collaboratives instead of to in-home services.
Another factor that is clearly at play is a changing perception of the agency’s purpose. CFSA’s leadership seems unenthusiastic about its primary mission of responding to child abuse and neglect. Agency management craves a less reactive role, adding the prevention of child maltreatment to the agency’s other responsibilities. As Director Robert Matthews likes to say, and repeated in his oversight testimony, he wants to transform CFSA “from a child welfare agency to a child and family well-being system.” That’s why the agency has gone even further beyond its core mission in its Families First DC initiative, attempting to reach even beyond the front yard to work with any family living in one of the disadvantaged communities where they have funded Family Success Centers that provide a wide variety of services and activities. But the agency seems to disregard the fact that these programs are likely to attract the families that are the least at risk of child maltreatment.
CFSA’s approach is in tune with the messages that are coming from the federal government and the powerful foundations and nonprofits that heavily influence the national child welfare agenda. These organizations disparage the “family policing” functions of child welfare and recommend, if not abolition, a drastic reduction in its traditional functions of investigations, in-home services, and foster care. By being in tune with the Zeitgeist, CFSA puts itself in the pipeline for grants, awards, and positive attention from the federal government and private funders. Moreover, CFSA leaders also appear believe passionately in the currently dominant orientation.
The allergy to “reactive” services is telling. Many agencies have reactive missions–police, firefighters, emergency rooms–and one could argue these are the most important services of all because they save lives and prevent serious injuries. The analogy with the police cannot be ignored. Police react to allegations of crime just as child welfare agencies react to allegations of child abuse and neglect. To prevent crime, we must not rely on the police, who are overburdened already and not trained and equipped to provide the services needed. Instead we must turn to a whole host of agencies dealing with education, public health, mental health, housing, income security and more–the same agencies that we must mobilize if we want to prevent child abuse and neglect.
It is still interesting to speculate on how the rejection of more hotline reports by hotline workers and the reduced number of referrals to in-home services by CPS workers has been (and is being) accomplished in practice. Both the acceptance of referrals and the assignment of a risk level are governed by actuarial assessment instruments. But as a former social worker in the system, I know that these instruments can be completed so as to obtain the desired response. Perhaps that is the answer or perhaps the instruments have been changed. I wish the Council’s oversight committee for CFSA would ask the agency this question.
CFSA’s data for FY2023 provide new evidence that the agency is withdrawing from its primary mission of protecting children who have already been abused or neglected in favor of reaching out to families that have not been reported to the agency. This is particularly evident from the decrease in referrals accepted for investigation, the decreasing proportion of open cases as a percentage of substantiations, and the increased emphasis on serving, through the collaboratives and the family success centers, families that are not currently involved with CFSA. With total budgetary resources decreasing, there is reason to fear that abused and neglected children are less protected every year as CFSA spreads its resources more and more thinly.
Notes
*While the number of referrals accepted for investigation was 3,902 in FY2023 according to the Dashboard’s Hotline Calls by Referral Type graphic, the total number of investigations displayed in the Investigations by Disposition graphic was 3,704. The reason for the difference is unclear. According to the Dashboard, “accepted for investigation” means that “the hotline call resulted in a new investigation being opened on the family.” So the two numbers should be the same.
**Such an informal placement may occur before substantiation as well.
***These data do not exactly agree with numbers that I have collected from the CFSA dashboard over the years. I have also noticed that Dashboard data for the same period, particularly in-home case data, has changed over time.
**** It appears that those with an open CFSA case qualify as Front Porch families if they are receiving collaborative services as well as in-home services from CFSA, but this is confusing and suggests the agency may be double-counting families by counting them in both the “in-home” and “front porch” populations. The agency cites a different definition of Front Porch families in its 2023 Annual Public Report, saying that the term refers to “families that have already been the subject of a CPS investigation but did not present with safety or risk levels that warranted opening a child welfare case.
Good morning! Thank you for the opportunity to testify today. My name is Marie Cohen and I write the blogs Child Welfare Monitor and Child Welfare Monitor DC. After my first career as a policy analyst and researcher, I became a social worker and served in the District’s child welfare system until 2015. Soon after leaving that job, I began writing these blogs to share some of the insights I had gained from my time in the field, and I’ve been amazed to see both of my blogs acquiring readers and influence beyond my wildest dreams. I take a child-centered approach, placing the safety and wellbeing of the child above all other considerations. I also take a particular interest in translating academic research for a lay audience and exposing misinterpretations of research by those trying to support their point of view. In my testimony today, I’ll start by talking about CFSA’s performance in child protective services, then continue with in-home services and then foster care. In conclusion, I’ll explain why I fear that CFSA is losing interest in these core services in its desire to become a “child and family well-being agency” and why I hope that the Council will encourage a renewed focus on CFSA’s primary mission.
My testimony draws from several sources. First, I have used recent CFSA reports including the FY 2021 Needs Assessmentand the performance oversight responses recently submitted to the Committee, as well as the CFSA Data Dashboard. I also share some insights from my service on the Child Fatality Review Committee and as a mentor through BEST Kids for almost seven years. Finally, I draw from the national research and policy trends I that I review for my blog.
CFSA has had some successes in the past year. The agency has returned to a mostly normal service posture after the pandemic-induced transition to virtual services. It has found a creative way to claim federal funds for case management and improved one service for families with substance abuse by bringing it in-house. The agency is increasing the number of professional foster parents, though not by enough so far, and the menu of therapeutic services available to foster youths and their parents through a contract with MBI. It has used federal funds to add four new staff members to work with schools and families to reduce school absences due to educational neglect. But CFSA is still falling short on meeting its primary missions of keeping District children safe and providing a physically and emotionally safe haven for those children who must be removed from their homes.
Child Protective Services: CFSA’s primary mission of protecting children has suffered as the agency has continued to emphasize narrowing the front door.
CFSA often boasts about the drop in the foster care rolls, which have fallen from over 1500 on September 30, 2012 to only 614 on September 30, 2021, crediting its policy pillar of “Narrowing the Front Door.” But a drop in foster care numbers is not in itself a positive outcome unless it has been achieved without compromising the safety of children. The choice of “Narrowing the Front Door” rather than “Keeping Children Safe” as the first pillar is not accidental: the goal has become reducing foster care regardless of the impact on child safety. Moreover, CFSA is no longer serving more children in their homes as they place fewer children in foster care; the number of children receiving in-home services has also fallen since 2019, with the total number of children served decreasing from 1994 at the end of FY 2020 to 1904 at the end of FY 2021.
My service on the Child Fatality Review Committee (on which I am thankful to have been joined by Chairperson Nadeau), has revealed many occasions in which CFSA missed chances to protect some of our most at-risk children. I have reviewed death after death of children from families that were the subject of multiple reports to the CFSA hotline dating back many years. Yet these allegations were repeatedly screened out or not substantiated by the agency. CFSA needs to assess the operations of its hotline and investigations, which have both been criticized by the Court Monitor in the past, to make sure that its desire to narrow the front door is not outweighing the concern for child safety. But there is also something the Council can do. I have noticed that many children who later died were at some point assessed to be at high risk but were left after an investigation with no support or monitoring by CFSA. When I ask why, I am reminded that CFSA cannot open a case if abuse or neglect was not substantiated, no matter how risky the situation appears to be. So whether we can protect a child depends on whether harm has already occurred, not whether it is likely to occur. But not all jurisdictions require substantiation in order to open a case for in-home services or foster care. In Washington State, an allegation does not need to be substantiated for an agency to file a neglect petition in court; the purpose of filing a petition is to “prevent harm” and there is no need to prove that harm already occurred. In Michigan and Minnesota, a case can be opened or a child removed because of “threatened harm,” which can be substantiated as a type of maltreatment. I hope the Council will consider changing DC law to make it possible for CFSA to protect at-risk children before it is too late, even without a substantiated allegation.
In-home services: Services provided through CFSA’s Prevention Services Plan are reaching few people and wasting funds, at the same time as CFSA is failing to provide families with needed behavioral health and other services.
The Family First Prevention Services Act allows CFSA to spend Title IV-E funds for evidence-based family preservation or reunification services to prevent entry or re-entry to foster care. However, only evidence-based practices (EBP) that are approved by the Children’s Bureau’s Prevention Services Clearinghouse can receive federal reimbursement. Currently, the only services receiving Title IV-E funding from HHS are Motivational Interviewing, which is part of CFSA’s case management model, and a home visiting program called Parents as Teachers (PAT) that is run by the Health Department. The other services included in CFSA’s Prevention Plan are funded by Medicaid or other local sources.
CFSA deserves credit for realizing that one practice that is reimbursable under Family First, motivational interviewing, could be incorporated into case management, thus allowing CFSA to collect matching funds for case management for all families receiving services in their homes. This was a creative way to claiming federal funds despite the flaws of the Family First Act, under which has not brought about the promised bonanza of federal resources for family preservation services. I also applaud the agency for improving the performance of Project Connect since they brought the program in-house. Project Connect provides intensive home-based services to families with an in-home case who are addressing substance abuse. When provided by a contractor, Project Connect struggled to enroll families, but now that it is operated by CFSA, the agency reports that the program has been at capacity since January 2020. The agency reports 46 families served, and 26 cases closed, with 9 families having disengaged and 17 having completed the program in FY 2021. Of course the longer-term outcomes of the program in terms of sobriety and child maltreatment remain to be seen and I hope CFSA will be reporting on them.
But the other services provided in CFSA’s Prevention Services Plan are reaching few people. According to the FY 2021 Needs Assessment, only 8% of the families referred to DBH received services. Similarly, only 8% of clients referred to the Department of Health home visiting programs, Parents as Teachers and Healthy Families America (HFA, the other DOH-run home-visiting program,) received services. Most of these referrals were either rejected as not appropriate or withdrawn because the family did not engage. According to CFSA’s oversight responses, CFSA referred 159 families to Mary’s Center for home visiting services through the HFA and PAT models in FY 2021, but only 26 of these families were served. CFSA paid over $160,000 to Mary’s Center to provide PAT in 2021; we don’t know how many of the 26 families received PAT or completed the program, since data on PAT and HFA are combined. Several other programs included in the prevention plan served between 0 and 4 families, according to the oversight responses.
At the same time as CFSA was paying $160,000 to enroll 26 families in PAT, parents and children who wanted basic behavioral health services such as cognitive-behavioral therapy and medication management could not get them because of the crisis in the District’s mental health system that affects all residents who must rely on Medicaid to access services. I hope the Council addresses this crisis. But regardless, there is no gain in accessing federal money to serve no-one. CFSA might as well spend this money on services families need, whether or not they are approved for Title IV-E funding.
Another set of services that is sorely needed for CFSA families are services to address domestic violence. According to CFSA’s 2021 Needs Assessment, of 123 child welfare professionals, the largest percentage (64%) ranked domestic violence (DV) as a prevalent risk factor among their clients. It is encouraging that the 2021 Quality Services Reviewers found three-quarters of the families with DV in in-home cases were receiving services. But some of these services were provided by the CFSA social worker themselves, presumably because services were not available. Moreover, the reviewers found that accessing the agency’s one DV specialist for consultation was a challenge for social workers and that case managers for only six of the 16 families reviewed were able to obtain such a consultation. I hope that the Committee will choose to add funding for at least one more DV specialist to make sure that caseworkers can benefit from a real expert to determine what their clients need and link them with services. The Needs Assessment also indicates that there is a general shortage of DV services in the District, which I hope the Council will address.
Early care and education is one service which has great potential to prevent maltreatment recurrence among families with in-home cases, but has been largely ignored by CFSA. Guaranteeing a slot in a high-quality preschool like Educare in Ward 7 for every preschool-aged child involved in an in-home case might do more to prevent child abuse and neglect than any other single strategy. We know that high-quality early care and education prevents child abuse and neglect by multiple pathways: easing parental stress, providing family support and parenting education, increasing monitoring by mandatory reporters (at Educare children are checked for abuse daily), and simply reducing the amount of time a child is alone with caregivers and vulnerable to abuse. And indeed, multiple studies link early care and education with reductions in child maltreatment. I hope the Committee will work with CFSA, the Mayor and OSSE to ensure that all children with in-home cases receive high-quality early care and education.
Foster care is not yet a truly safe haven where youth in CFSA custody can heal from past trauma and address educational deficits.
When CFSA takes the drastic step of removing a child from their home, it has the obligation to make sure the child is placed together with siblings, in the home of either a known relative or family friend if possible, and with all the necessary supports, including mental health services, the best healthcare (including covid-19 vaccines) and educational and vocational supports. And whenever reunification is not possible, CFSA should stop at nothing to support permanency with real or fictive kin. But CFSA is falling short in these areas. Often agency leaders seem to lack the creativity, passion, and outside-the-box thinking that is necessary to make foster care the safe haven that CFSA advertises.
Foster care: CFSA continues to lack appropriate placements for older youth and those with significant behavioral health needs.
The lack of suitable placements for older youth and those with more serious behavioral health needs continues to be a crisis leading to placement disruptions, abscondence, and further deterioration in the mental health of our most vulnerable youth. This issue has been covered in depth the Children’s Law Center in their written testimony. In general, I agree with their findings and recommendations on building an adequate placement array but I would add that CFSA may have to consider adding one or more therapeutic group homes as well as increasing its supply of professional foster parents. There are simply not many potential foster parents who are dedicated and gifted enough to take on these very challenging young people.
Too few foster youth are receiving the behavioral health services they need.
Only 18 children were receiving therapy at CFSA in the first quarter of FY 2022, out of the 600+ children in foster care, according to CFSA’s oversight responses. That means CFSA’s four in-house therapists are being paid to provide therapy to only 18 children, so that each therapist is seeing fewer than five children a week. CFSA did not report on the number of children receiving therapy outside of the agency, but the low number receiving in-house therapy is concerning. Moreover, according to the 2021 Needs Assessment, the percentage of children recommended for therapy who received it went down from 69% in FY 2020 to 40% in the first half of FY 2021. I understand there is a citywide crisis in mental health services, with a catastrophic shortage of providers, not to mention quality, cultural competence and turnover, as the Children’s Law Center explains in its written testimony. I join the CLC in urging that this Committee work with the Committee on Health and the rest of the Council to fix the District’s behavioral health system. However, until this reform can take place, CFSA must not waste the resources it has allocated for behavioral health for its foster care youth.
I do appreciate, however, that CFSA has added two popular evidence-based therapeutic modalities – Dialectical Behavior Therapy (DBT) and Eye Movement Rapid Desensitization Therapy (EMDR) – through its contract with MBI Health. And I’m also happy that CFSA has included parents of children in foster care in its contract with MBI. However, I’m disappointed that MBI served only 16 of the 28 children and parents referred during FY 2020.
CFSA needs to find creative housing solutions to keep siblings together in foster care and to enable children to be placed with kin in foster care, guardianship or adoption.
According to the 2021 Needs Assessment, the Agency has only 50 licensed providers to care for three or more children in foster care. However, there are 194 foster children in a family of three or more siblings, which indicates the need for more foster parents with the capacity and willingness to take groups of three or more siblings. CFSA should look for creative, out-of-the box ideas tor increasing placements for sibling groups. For example, CFSA could seek a public-private partnership to create a community of homes for foster parents who take in large sibling groups, in the mode of SOS Children’s Villages in Illinois and Florida. Perhaps this could be included as part of a development plan for a parcel owned by the city.
CFSA also needs to be more creative and proactive in finding housing for relatives who want to take in children who have been removed from their families, temporarily or permanently. CFSA’s oversight responses state what we already know: “For DC-based kin, the ongoing lack of affordable housing in the District continues to impact the families’ ability and/or willingness to provide licensed kinship care.” And it’s not just kinship care but also permanency. I recently heard of a teenager being pressured to accept guardianship with a foster parent with whom she is not bonded, even though a relative is willing and available but has been unable to find suitable housing. This is unacceptable. As it did with Wayne Place for youths leaving foster care, CFSA should work with the private sector to create housing for relatives who are providing a home for children in foster care – housing like Plaza West, a building for grandparents raising children that was created without CFSA involvement. It is not acceptable to force children into guardianship with unrelated foster parents because relatives cannot find housing.
CFSA is not making sufficient efforts to ensure educational success for foster youth.
Education outcomes for District foster youth are truly horrendous. Foster youth aged 15-21 for whom Grade Point Average (GPA) information was available had a median GPA of 1.98 in the last academic year, according to the oversight responses. And only 68% of the foster youth who were eligible to graduate high school in June 2021 graduated or got a GED by that date. The blame for this abysmal school performance should not be placed entirely on CFSA: most of these children were probably struggling academically when they were removed from home. After all, many of these children came into foster care with a history of chronic absenteeism and school transfers. But if CFSA is going to remove children, it needs to take responsibility for improving their educational performance regardless of what it was before.
There are some things CFSA can do to improve educational performance among foster youth that have drawn little attention. For one, CFSA needs to make sure that foster parents are involved with the schools that the children in their custody attend. It is well-known that home-school communication is critical to school success. But when I was a social worker at a private agency working with Maryland foster parents of CFSA youth, many foster parents I worked with had never even been to the children’s schools, especially when these schools were in the District. They certainly did not attend Back to School Nights and parent-teacher conferences. Foster parents should be told that attendance at these events and regular communication with the schools is required. Secondly, CFSA needs to end the practice of pulling kids out of school for a whole day in order to attend one medical, dental, or court appointment. When I was working in the system, I found that family support workers usually made appointments during school hours because they were busy after school taking youths to family visits or therapy. For the same reason, they usually made these appointments in the middle of the day, ensuring the maximum loss of school time. Requiring foster parents to take children to these appointments might help solve this problem; it should clearly be their job anyway. These two steps, requiring foster parent involvement and stopping system-caused school absenteeism, would be a good place to start in improving foster children’s school performance. Monitoring the performance of the tutoring provider is another; I’ve heard too much over the years about incompetent tutors.
OYE Vocational specialists must be replaced.
The 2022 Needs Assessment states “CFSA has identified a gap for career preparation and available employment supports for youths.” That’s putting it mildly! In FY 2019 CFSA eliminated OYE’s Career Pathways unit and replaced it with the LifeSet program, which is not dedicated to career preparation or staffed with vocational specialists. There are no vocational training specialists at CFSA, only college specialists. As a result, there are NO youth currently enrolled in vocational training programs, according to the 2022 oversight responses. Around the country and here In the District there is a growing recognition that college is not for everyone, especially for those who are not likely to complete it. Many jobs requiring vocational training or apprenticeships provide a path into the middle class and a much better option than college for youths with poor academic skills. At this time of unprecedented labor shortages, it is a shame that the agency is not taking advantage of this opportunity to get our young people into good jobs. In the Needs Assessment CFSA indicates it is working with the Department of Employment Services to address this gap; the Committee should encourage the agency to address it with the urgency and intensity it deserves.
CFSA has neglected its responsibility get foster youth vaccinated
As I have written, CFSA seems to be prioritizing parental consent, even when not required by law, over the health of foster children and containment of Covid-19 in the District of Columbia. Moreover, it appears that the agency been reluctant to educate older foster youth about the benefits of vaccines. They don’t even know how many foster children have been vaccinated. And they have not reported how many have gotten Covid-19. This is not acceptable.
Conclusion: CFSA appears to have lost interest in its primary mission of protecting abused and neglect children.
In conclusion, CFSA continues to struggle to carry out its primary mandates of investigating allegations of abuse and neglect and responding appropriately with in-home supervision and support and foster care when necessary. Yet, despite these struggles, CFSA is eager to add more responsibilities to its plate. As the agency explains in its oversight responses, it wants to “transform from a child welfare system to a child and family well-being system.” This sounds great on first hearing but does not bear closer scrutiny. Child and family well-being are dependent on all the health, education and human services agencies in the District of Columbia. CFSA is having enough trouble accessing the services of these agencies for its current clients. Why not concentrate on performing its core duties rather than expanding them? I must acknowledge that CFSA is being encouraged on this misguided path by the federal Children’s Bureau, which has included the agency in its partnership to do exactly what CFSA is proposing. But just because it is being promulgated by the feds does not make it a wise policy.
The expansion into primary prevention through creation of the Family Success Centers is a prime example of this desire to broaden CFSA’s mission when the agency struggles to perform its core responsibilities adequately. Prevention of child maltreatment is not in the original mandate of child welfare agencies, and for good reason. If anything, child maltreatment prevention is normally conceptualized as a public health function, which is why home visiting programs are generally provided by health departments. More and more jurisdictions, including our neighbors in Maryland and specifically Baltimore, are investing in Family Connects, which provides a hospital visit from a nurse to every newborn to assess risk and refer to appropriate services. Family Connects has been shown by randomized controlled trials to reduce emergency room visits and hospital stays by 50% in the first year of life and CPS investigations by 44% in the first two years of life. The jurisdictions that have adopted Family Connects understand that neighborhood family support centers will never reach the most at-risk children, whose parents are too mentally ill, impaired by drugs, or overwhelmed to recognize that they need help.
I have some ideas about why CFSA (and the Children’s Bureau for that matter) appears to have lost interest in its core mandate of protecting children and providing a safe haven for those who must be removed from their homes. But until we figure out how to prevent child maltreatment, and even after we do, there will still be maltreated children who need to be protected. CFSA may have lost interest in these duties, but it is up to the Committee and the entire Council to remember our most vulnerable children and make sure the agency performs its core mandates.
The Child and Family Services Agency (CFSA) has updated its Data Dashboard for the fourth quarter of the District of Columbia’s Fiscal Year (FY) 2021, which included July through September of 2021. As usual, hotline calls dropped with the closure of schools for the summer, and then rose again when school started in September. However there was no dramatic onslaught of referrals when students returned to in-person school compared to what happens in a typical September after summer vacation. Hotline workers screened out a smaller percentage of referrals in the fourth quarter than they did in the previous quarter, investigating a larger percentage of them but substantiating a somewhat smaller percentage of those they investigated. CFSA served a fairly constant number of children and families in their homes throughout the year. However, the foster care caseload has been dropping fast – with an 11.5 percent decrease from in the Fiscal Year ending September 30, 2021.
Referrals
Many experts have predicted that hotline calls (known as “referrals”) would skyrocket after children returned to school in person, and indeed this has happened in other jurisdictions around the country. In the District, referrals did begin increasing in the third quarter of FY 2020 and continued to increase in the two succeeding quarters, as shown in Table One, even though most children were still learning virtually. By the third quarter, there were 5,880 referrals, almost as many as the 6,058 referrals that came in the corresponding pre-pandemic quarter of 2019. The quarterly number of referrals fell drastically to only 2,997 in the fourth quarter (July through December 2021), which is a return to the seasonal pattern in which referrals drop in the summer, when school is out of session. The total number of referrals for the third quarter of 2021 (2,997) did not reach the level of the third quarter of FY 2019 (3,274), the last fiscal year before the pandemic. But fourth-quarter data hides the difference between summer vacation and school, which started on August 30 for DC Public Schools students.
As shown in Table One, referrals did rise in September 2021 to 1,148 from only 759 in August. That is considerably more than the 942 referrals in September 2020, but considerably less than the 1,377 calls in September 2019. The absolute difference in referrals between August and September of FY 2021 was smaller than in FY 2019 but the percentage difference was slightly greater. (FY 2020 showed less of an increase between August and September referrals in both number and percentage, showing the effects of the pandemic and virtual schooling.) But there was no dramatic onslaught of referrals in the wake of schools opening in person in September 2021, compared to a normal September. However, based on FY 2019 data, October brings more referrals than September, so we will see what the next quarter’s data show.
Table One
Referrals in August and September, FY 2019-FY 2020
Referrals
FY 2019
FY 2020
2021
August
946
718
759
September
1377
942
1148
Difference
431
224
389
Percent Change
31%
24%
34%
Source: CFSA Data Dashboard, and Child Welfare Monitor, previous posts
Figure Two shows the number of referrals made by each reporting source in Fiscal Years 2019, 2020 and 2021. This number, which had dropped from 17,960 in FY 2019 to 14,046 in 2020 with the onset of the pandemic, bounced back to 17,422 in FY 2021, almost the same number as in FY 2019. School and daycare personnel are traditionally the largest referral source, and they actually made substantially more reports in FY2021 than they did in the pre-pandemic fiscal year, 2019 – 8,482 compared to 7,704. They also made a higher percentage of all reports–48.7% compared to 42.9 percent in FY 2019. This increase in teacher reporting relative to FY 2019 may reflect teachers’ increased concerns about children missing too many days of online schooling last spring, as well as concerns raised by seeing children in the fall for the first time in 18 months.
Once a call comes into the hotline, it can be accepted as an “information and referral” to be referred to another agency; accepted for investigation; linked to an existing open investigation; or screened out as not requiring any response. Figures Three and Four show how as the number of referrals increased in the first three quarters of FY 2021, CFSA reduced the proportion it accepted. In an earlier post we suggested this might reflect the impact of CFSA’s belief that teachers make too many referrals for “compliance” purposes only. This belief led the agency to institute a new policy of rejecting educational neglect referrals for a family with whom the school or CFSA had been in contact within the previous 10 days of school. But in the fourth quarter, as referrals dropped after schools closed, CFSA screened out a smaller percentage of referrals. The agency screened out only 56.6 percent of referrals compared to the 75.0 percent screened out in the previous quarter. So the number of referrals accepted dropped much less than the total number of referrals received from 1124 in Quarter 3 to 1081 in Quarter 4.
Figure Five shows the large drop in the number of investigations in the first four pandemic quarters compared to four preceding quarters. In the fourth quarter of FY 2021, the number of investigations was closer to pre-pandemic levels but still lower – 1030 in FY 21 versus 1176 in FY 2019. Notably, the number of investigations hardly dropped in quarter 4 over quarter 3 even though the number of referrals (shown above) dropped greatly. This lack of a summer drop in investigations reflects the increased percentage of referrals accepted, as discussed above. It’s as if the agency was trying to keep the number of investigations constant by rejecting more referrals when they received more of them, but this may just reflect the lower credence given to referrals from schools.
An investigation can have several possible results. It can result in a finding of “inconclusive,” meaning the evidence is insufficient to prove maltreatment despite some indications it occurred; “unfounded,” which means “there was not sufficient evidence to conclude or suspect child maltreatment has occurred” “substantiated,” indicating that the evidence supports the allegation of maltreatment; “incomplete” (as defined in the CFSA Data Dashboard), or “child fatality,” which is defined as a “suspicious death of a child that may be due to abuse or neglect.” About 23 percent of investigations were substantiated in the most recent quarter, as shown in Figure Six. That was slightly lower than the 26 percent substantiated in the previous quarter. Figure Seven shows that number of substantiations fell in the summer quarter in accord with the smaller number of investigations and the lower substantiation rate.
When an abuse or neglect allegation is substantiated, several things may happen, depending on the assessed level of risk to the child or children in the home. The agency may take no action, refer the family to a community-based collaborative, open an in-home case, or place the child or children in foster care.
In-Home Services
When a CFSA investigator considers children in a family to be at high risk of maltreatment, but not in imminent danger, the policy is to open an in-home case for monitoring and services. Figure Eight shows the number of in-home cases opened by quarter, starting in the first quarter of FY 2020.* There were slightly fewer case openings in the summer quarter than the prior quarter, reflecting the decline in the number of substantiations. Figure Nine shows that the number of in-home case closures rebounded in Quarter 4 following a decline in the previous quarter. These may be random fluctuations or they may reflect unknown factors.
Table One shows that the total number of children being served in their homes was 1,290 on September 30, 2021, very slightly down from 1299 on September 30, 2020. That is not surprising, since the difference between entries to (119) and exits from in-home services (134) was very small as well.**
Table One
\Total Number of Children Served at Home and in Foster Care, FY 2020 and FY 2021
In-Home
In Foster Care
Total
Sept. 30, 2020
1299
694
1993
Sept. 30, 2021
1290
614
1904
Source: CFSA Data Dashboard, cfsadashboard.dc.gov
Foster Care
The number of children entering foster care decreased in the last quarter of FY 2021, after rebounding from a large pandemic-induced drop in the fall and winter quarters and then decreasing in the spring quarter. Fifty-nine children entered foster care in the last quarter of FY 2021, as shown in Figure Ten. Figure Eleven shows that exits from foster care decreased in Quarter 4 but were still more numerous than entries. There were 64 exits from foster care compared to 59 children entering care.
Figure Twelve shows the number and percentage of children exiting foster care for different reasons in FY 2020 and FY 2021. There were no big changes between the two years. In both years, reunification was the main reason for exits from foster care, though the percentage exiting through reunification decreased slightly from 41 percent to 39 percent, at the same time as the percentage exiting through adoption increased from 31 percent to 34 percent. CFSA does not post these data for earlier years, but perhaps this was due to a pandemic-induced suppression of adoptions in FY 2020. Smaller but still significant percentages left the system for guardianship (13 percent in 2020 and 12 percent in FY 2021) and emancipation (14 percent in FY 2020, declining to 12 percent in FY 2021), with very small numbers having died or entered the custody of another agency.
Figure Twelve
Children Exiting Foster Care by Reason for Exit, FY 2020 and FY 2021
Looking at the data for Fiscal Year 2021 in total, there were 251 entries into foster care and 327 exits in the four quarters ending on October 30, 2021. With exits eclipsing entries, the number of children in foster care should have fallen by approximately 76 children. And indeed, Table One above shows that the total number of children in foster care fell by 80 from 694 in September 2020 to 614 in September 2021.** This was a decrease of 11.5 percent, somewhat less than the 13.0 percent decrease between FY 2019 and FY 2020. The foster care rolls have been falling annually for years, but the decrease accelerated in Fiscal Year 2020, as shown in Figure Thirteen,*** and only slightly decelerated in FY 2021. When asked about the drop in the foster care rolls a year ago, CFSA responded that it reflects the agency’s continued commitment to keep families together without formal child welfare involvement when it is safe to do so.
The total number of children served in their homes and in foster care decreased from 1993 to 1904, a decrease of 4.47 percent from FY 2020 to FY 2021, as shown in Table One above. Data from earlier years is available from the Center for the Study of Social Policy for the calendar year only. Figure Fourteen shows the number of children served both in foster care and in their homes in the calendar years from 2010 to 2019 and in September of 2021. That total has been decreasing for the last two fiscal years.
In conclusion, the fourth quarter showed the normal drop in referrals with the closure of school for the summer. There was an increase in hotline calls when schools reopened in person last September, but not the overwhelming influx of calls that some had predicted with the re-opening of school buildings. The number of children and families with in-home cases stayed stable, but the foster care population continued to drop–resulting in a small decline in the number of children served by CFSA from September 2020 to September 2021. CFSA has attributed its declining foster care numbers to its continued commitment to keep families together without formal child welfare involvement when it is safe to do so. We can only hope that CFSA is fulfilling this commitment without jeopardizing child safety.
*These numbers include all in-home cases opened as a result of CPS investigations. It does not include a small number of cases opened as a result of case transfers from foster care or adoption units or in-home cases that are the result of reunifications and are managed by the foster care units.
**There is a small difference between the number of exits (134) minus entries (119) from in-home care and the year-to-year difference in the number of children in in-home care (9) and a similar small difference between the number of exits minus entries to foster care (76) and the year-to-year difference in the foster care caseload (80). The small anomalies reflects standard data entry delays when there is a change in a child’s status.
***The accelerated decrease in the foster care rolls did not seem to be related to the pandemic. When we compared data from March to September of 2019 and 2020, we found that 74 fewer children entered foster care and 68 fewer children exited it, suggesting that the pandemic had little effect on the total foster care caseload.
The COVID-19 vaccine has been approved for all children aged 12 and older and has been proven safe and effective. The Mayor has strongly encouraged all eligible youths to be vaccinated, organized special vaccination clinics in schools, and announced a variety of incentives for youth vaccinations. Children in foster care are wards of the District, and one might think that the agency would act as the Mayor has encouraged parents to do, and make vaccinating its wards the top priority. However, it appears that that for CFSA, vaccinating its youth falls somewhere below other priorities, such as protecting parents’ rights to refuse vaccinations for their children.
In the District of Columbia, all children aged eleven and up are allowed to consent to their own vaccinations under a new law, the Minor Consent for Vaccinations Amendment Act of 2020. However, in a new Administrative Issuance (AI) released on on July 22, CFSA takes pains to clarify that it has chosen not to take full advantage of this opportunity to get foster youth vaccinated. In the AI, titled “How to Obtain Informed Consent for COVID-19 Vaccination for Children Served in Out-of-Home Care,” CFSA states that “This law does not negate the Agency’s ability to first seek parental consent, rather, it provides an avenue for consent when a parent or caregiver does not consent.” The agency goes on to state that it has decided to continue obtaining parental consent for vaccination for youth 11-17 unless parental rights have been terminated. Youths aged 18-21, who are “developmentally capable,” are allowed to consent to their own vaccine.
Given that CFSA has decided to request consent from all parents of children under 18, the agency could have required social workers to ask all parents of children in their caseloads to consent to the COVID-19 vaccine for their eligible children by a certain date. But they did not do so. Instead, the AI states that “Social workers will ensure that parents receive the share (sic) “Fact Sheet for Recipients and Caregivers” before obtaining their consent to ensure they are making an informed decision about their child receiving the COVID-19 vaccine.” Thus, the focus is on ensuring that social workers share the fact sheet if they request consent, rather than requiring that they ask all parents to consent to the vaccination for their children. Moreover, there is no requirements that these conversations be documented so that the agency can determine how many parents have been asked and how many have agreed; documentation is required only when parents “refuse or are unable to provide consent.”
We do not know how proactive the agency is being in requesting parental consent for children aged 12-17 to receive the COVID-19 vaccination. According to Kera Tyler, CFSA’s Communications Director, “our social workers are actively encouraging parental consent for the vaccine for children in care over the age of 11. By sharing relevant educational materials along with District incentives, our Parent Engagement Education and Resource (PEER), family support workers, and social workers are facilitating conversations with both birth and resource parents to support vaccination for youth 12 and older.” The emphasis on educating parents and using peer support workers is laudable. But with no record of how many parents are being reached with such communication and what the results were, there is no way to know how successful these efforts have been.
The AI does provide a procedure for a child aged 17 or under who wants to get vaccinated to consent to the vaccine if the agency has not obtained parental consent for whatever reason. In such a case, “CFSA will ensure that the child meets with their primary care provider,” according to the AI. The social worker must “ensure that age and developmentally appropriate information about the COVID-19 vaccine is provided to the child by the primary care provider…The primary care provider must confirm that the child understands that they are making an informed decision about their consent to receive the vaccine.” And If the child does consent to the vaccine, “the primary care provider will be responsible for arranging and administering, recommending, or prescribing the vaccine.”
This is a rather cumbersome procedure. The extra step of seeing the primary care provider is not required of other District children consenting to their own vaccinations. Arranging and carrying out this visit is a burden for already taxed social workers. It is not even clear that primary care providers are willing to schedule such appointments. In any case, following this procedure is sure to delay vaccination. Perhaps most importantly, this provision makes it harder for young people in foster care than for their peers who are not in foster care to consent to their own vaccinations. One has to wonder if any children have been vaccinated under this provision, but CFSA has not been collecting vaccination data, as discussed below.
The situation is different for foster youth aged 18 to 21. According to the AI, these young people can consent to vaccinations unless they have a mental disability. The AI states that “Social workers will ensure that youth receive the share (sic) “Fact Sheet for Recipients and Caregivers” before obtaining their consent to ensure they are making an informed decision about receiving the COVID-19 vaccine.” Again, the instructions are more about ensuring that social workers share the fact sheet if they do request consent, rather than requiring that they make this request of all youth in this age category. And without a documentation requirement, we have no idea about how often these conversations are being held and what the results have been.
As with parents, CFSA cannot document how proactive it is being in requesting consent for vaccination from older youth in foster care. According to Tyler, “For our older youth, CFSA social workers have distributed educational materials to youth on their caseloads, coordinated appointments, arranged transportation to and from vaccination sites, and promoted the District’s incentives as applicable.” I mentor a nineteen-year-old in foster care who was eligible early for the vaccine early based on medical status, and it was I who provided information about the vaccine, helped her obtain her appointments and drove her to both. She reported that her social worker “mentioned” the vaccine, but there was no offer of assistance in getting vaccinated.
Given the procedures restricting vaccine uptake among CFSA children aged 12 to 17 and the lack of guidance about vaccine among older youth, it is important to know how many youths in CFSA care have been vaccinated. Unfortunately, the agency is not collecting this information. This makes it impossible to know how successful their attempts at obtaining consent have been. CFSA is collecting reports of children who receive a positive diagnosis of COVID-19 but given that these diagnoses are medical data, Tyler states that CFSA is developing some quality control standards before making those figures public.
It is perhaps not surprising that CFSA is sensitive to the beliefs of parents and older youths about COVID vaccines. Most foster youths are Black and vaccine hesitancy is high in the Black community. This hesitancy and the misinformation on which it is based is indeed the biggest barrier to getting older youths vaccinated, according to the Chairperson of the Board of Directors of FAPAC, an organization representing foster parents in DC. It makes sense to focus on sharing educational materials along with incentives to encourage vaccination among foster youth.
But the health of our foster youth, foster parents, and the District of Columbia population overall should be the top priority during this critical time, and CFSA should spare no effort in ensuring that all youth get the necessary information, and that all who are ready to be vaccinated can get the vaccine without delay. We know that foster youths have more health problems than their peers who are not in foster care, some of which put them at high risk if they develop COVID-19. Children’s National Medical Center has reported a “dramatic increase” in pediatric COVID-19 cases over the summer, fueled by the Delta variant. Nationally, cases in children have reached the highest level since the start of the pandemic–more than a quarter of all new weekly cases.
There were 624 children in foster care in the District of Columbia as of June 30, 2021. More than half of these are 12 and older.* This is a small number relative to the total number of children in the District, but these children are under the District’s direct care. The Mayor has made vaccinations a priority for all eligible groups. One might hope that the District would set an example by making vaccination of its wards a top priority.
*According to the CFSA Data Dashboard, 47 percent of CFSA youth were aged 13 to 21 in the third quarter ending June 30; therefore it is likely that at least half of these youth were aged 12 to 21.
The Child and Family Services Agency (CFSA) has updated its Data Dashboard for April through June 2021, which is the third quarter of the District of Columbia’s Fiscal Year (FY) 2021 and the fifth quarter of the COVID-19 pandemic. The new data show that calls to the CFSA hotline have almost returned to pre-pandemic levels as school and childcare staff have increased their hotline calls. However, instead of increasing its investigations to pre-pandemic levels, the agency has been screening out more of these calls every quarter, resulting in a number of investigations that is only 70 percent of its pre-pandemic level for the equivalent quarter. CFSA has maintained a fairly constant number of children and families with in-home cases over the past 12 months. However, the foster care caseload has been dropping fast–with a 14.5 percent decrease from June 2020 to June 2021.
Referrals
Figure One below shows the quarterly number of calls to the CFSA hotline, known as “referrals,” starting in the quarter beginning in January 2019 to enable comparison with pre-pandemic levels. The FY 2019 data represents seasonal variation in referrals in a normal year, with referrals falling in the summer quarter when schools are closed, then rising again in the fall, winter and spring quarters. The pattern changed with the large drop in referrals in the first pandemic quarter of April through June 2020. After remaining low in the summer, referrals rose each quarter starting with October through December 2020. By the most recent quarter, April through June 2021, there were 5,880 referrals, almost as many as the 6058 referrals that came in the corresponding pre-pandemic quarter of 2019.
Figure Two shows the number of hotline calls made by each reporting source, which are available only on an annual basis from CFSA. School and daycare personnel are traditionally the largest referral source, having made 7,704 calls, or 42.9 percent of calls to the hotline, in FY 2019. But they made only 5,006 calls, or 35 percent of calls, in the pandemic fiscal year that ended in September 2020. This is not surprising. While childcare centers resumed operations during the first two quarters of the pandemic, most public and charter schools were operating virtually during that time. Moreover, many children were struggling to log into class, and teachers may have been unwilling to make CPS referrals for students who were not participating due to connectivity problems. But in the first nine months of FY 2021, starting in October 2020, school and childcare staff made 7,610 calls – almost as many as the 7,704 they made in the entire 12 months of FY 2019. In other words, school and childcare providers were reporting at a higher rate and are on track to make more reports in FY 2021 than in the pre-pandemic FY 2019. The percentage of calls that were from schools and childcare centers increased to 47.7 percent in the current fiscal year to date–which is higher than the pre-pandemic share of 42.9 percent in FY 2019. This rebound in referrals from schools and childcare centers could reflect teachers’ concerns about children that returned to classrooms; it could also reflect concerns about those who did not return and teachers’ increased willingness to make reports about children who have been attending sporadically throughout the school year.
Once a call comes into the hotline, it can be accepted as an “information and referral” to be referred to another agency, accepted for investigation, linked to an existing open investigation, or screened out as not requiring any response. As shown in Figure Three, as the number of referrals increased in each quarter, CFSA has reduced the proportion it accepts, thus avoiding a large increase in the number of investigations. The number of referrals more than doubled from 2,396 in the quarter ending September 30, 2020 to 5,880 in the quarter that ended on June 30, 2021. But the number of referrals accepted for investigation increased by only about 17 percent, from 957 to 1124, during the same period. Instead of accepting these new referrals, CFSA was screening them out. In fact, CFSA has been screening out a higher proportion of referrals in each quarter as the number of referrals has increased. The proportion of referrals that were screened out increased from 51.3 percent of referrals in the quarter ending September 30, 2020 to 75 percent of referrals in the quarter ending June 30, 2021, as shown in Figure Four.
In a recent post, I reported that CFSA sent a message to DC Public Schools (DCPS) and the Public Charter School Board early in March 2021 describing a new practice in screening referrals for educational neglect “due to the influx of reports for potential educational neglect and furthermore the city-wide attendance issues caused by the COVID-19 pandemic.” Under the new procedure, CFSA would reject any educational neglect referral for a family with whom the school or CFSA had been in contact within the previous 10 days of school, with some exceptions. It is not clear when CFSA implemented this procedure. It was already screening out 72 percent of referrals in the quarter ending March 30; this increased slightly to 75.2 percent in the quarter ending June 30, 2021, although the number screened out increased from 3,541 to 4,423 in the spring quarter. Of course, these numbers and percentages include all referrals and not just those for educational neglect: Child Welfare Monitor has requested data on educational neglect referrals from CFSA.
Investigations
Figure Five shows the large drop in the number of investigation in the first four pandemic quarters compared to the analogous pre-pandemic quarters. The fifth pandemic quarter continues the pattern. CFSA reported only 1,092 investigations, or only 70 percent of the 1549 investigations in the spring quarter of FY 2019. We have seen that the number of hotline calls had almost reached pre-pandemic levels in that quarter – but the number of investigations did not follow suit, because so many referrals were screened out as described above.
An investigation can have several possible results. It can result in a finding of “inconclusive,” meaning the evidence is insufficient to prove maltreatment despite some indications it occurred; “unfounded,” which means “there was not sufficient evidence to conclude or suspect child maltreatment has occurred” “substantiated,” indicating that the evidence supports the allegation of maltreatment; “incomplete” (as defined in the CFSA Data Dashboard), or “child fatality,” which is defined as a “suspicious death of a child that may be due to abuse or neglect.”
The percentage of investigations that resulted in a substantiation (shown in red) has not changed greatly during the pandemic. It has varied between 21 percent and 26 percent per quarter since the Spring quarter of FY 2019, as shown in Figure Six. Figure Seven shows that the number of substantiations increased from 206 in the quarter ending September 2020 to 279 in the most recent quarter, but is still considerably lower than the 379 substantiated investigations in the same quarter of FY 2019, before the pandemic. The failure of substantiations to rebound to Spring 2019 levels reflects CFSA’s screening out an increased proportion of referrals as the number of referrals increased.
When an abuse or neglect allegation is substantiated, several things may happen, depending on the perceived level of risk to the child or children in the home. The agency may take no action, refer the family to a community-based collaborative, open an in-home case, or place the child or children in foster care. CFSA’s Data Dashboard provides data on how many cases are opened for in-home services and foster care.
In-Home Services
When a CFSA investigator considers children in a family to be at high risk of maltreatment, but not in imminent danger, the policy is to open an in-home case for monitoring and services. Figure Eight shows the number of in-home cases opened by quarter, starting in the first quarter of FY 2020.** The figure shows a large drop in the number in-home case openings in the third quarter of FY 2020, following the onset of the pandemic. This undoubtedly reflects the decline in referrals, investigations, and substantiated reports during that period. Case openings were even lower in the summer quarter, then rebounded somewhat to a total of 131 case openings in the third quarter of FY 2021.
Like in-home case openings, in-home case closures also fell immediately following the pandemic shutdowns, as Figure Nine illustrates. This is not surprising in light of the effects of the pandemic. In-person visits to families with in-home cases became virtual, and there may have been some disruption as new protocols were put into place and online connections were established. Many parents with in-home cases rely on services from other agencies, such as mental health and treatment, to complete their case plans, and these services were presumably disrupted as well. These disruptions doubtless made it difficult for parents to complete required services and thus resulted in a postponement of case closures. Presumably, virtual home visits and services were put into place and bolstered in the following quarters. In-home case closures rebounded in three quarters after April through June 2020, though they fell again to 87 in the Spring quarter of 2021, for unknown reasons. But these are small numbers and random fluctuations can occur.
There were 477 in-home cases opened and a very similar 457 closed in the four quarters ending June 30, 2021, which suggests that the number of open cases changed little over the period. The number of families with in-home cases indeed changed little from June 30 2020 to June 30 2021–from 1,429 to 1,398, as shown in Table One. The total number of children being served in their homes was 1,398 as of June 30, 2021, a very slight decrease from the year before.
Table One
Total Children Served in their Homes, June 2019, 2020, and 2021.
As I have described in earlier posts, there was a big drop in foster care entries before the pandemic, with a surprising increase in entries in the first full pandemic quarter; quarterly entries have remained between 60 and 70 for the last three quarters. Sixty-two children entered foster care in the Spring quarter of 2021, similar to the 64 who entered foster care in the same quarter of FY 2020, as shown in Figure Ten. Figure Eleven shows that while the pandemic seemed to delay foster care exits in its initial stages, that effect seems to have dissipated as the agency and courts adapted to virtual operations. The number of children exiting foster care increased slightly in the Spring quarter of 2021. There were 86 exits from foster care, compared to 62 entries in the March-June quarter resulting in a decrease in the foster care population from 648 children on March 30, 2021 to 624 on June 30.
Looking at the data for the most recent four quarters, there were 234 entries into foster care and 340 exits in the four quarters ending on June 30, 2021. With exits eclipsing entries, the number of children in foster care had to fall. And indeed, Table Two shows that the total number of children in foster care fell from 740 in June 2020 to 624 in June 2021, a decrease of 14.5 percent, very similar to the 14 percent decrease the year before. The foster care rolls have been falling annually for years, but the decrease accelerated in Fiscal Year 2020, as I described in recent testimony. It looks like FY 2021 will show the same trend when the year is complete. When I asked about this trend a year ago, CFSA responded that it reflects CFSA’s continued commitment to keep families together without formal child welfare involvement when it is safe to do so.
Table Two
Total Children Served in Foster Care as of June 30
In conclusion, the third quarter of FY 2021 saw the number of referrals (calls to the CFSA hotline) recover almost to pre-pandemic levels. CFSA responded by screening out more of these referrals and increasing the number of investigations only slightly. CFSA reported only 1,092 investigations, compared to 1549 in the spring quarter of FY 2019. The number of children and families with in-home cases stayed stable, but the foster care population continued to drop–by an annual rate of about 14.5 percent. CFSA has attributed its declining foster care numbers to its continued commitment to keep families together without formal child welfare involvement when it is safe to do so. Whether CFSA is fulfilling this commitment without jeopardizing child safety remains to be seen.
*DCPS buildings closed in March 2020 and remained closed for all students for the remainder of the academic year. Only a few students were welcomed into school buildings in the fall of 2020. Schools reopened in person in February 2021 to some students, but still only about 20 percent of DCPS students and most only part-time.
**These numbers include all in-home cases opened as a result of CPS investigations. It does not include a small number of cases opened as a result of case transfers from foster care or adoption units or in-home cases that are the result of reunifications and are managed by the foster care units.
Good afternoon! Thank you for the opportunity to testify before the Committee today. My name is Marie Cohen, and I write the blog, Child Welfare Monitor DC, as well as Child Welfare Monitor, which focuses on national issues. I am also a former social worker in CFSA’s foster care system. My testimony is based on the data that CFSA has been sharing on its new data dashboard, as well as their performance oversight responses and published reports. The most recent dashboard data were uploaded last week and pertain to the quarter that ended in December. I’ll also be making some remarks about CFSA’s efforts around in-home services and prevention, leaving my friends at FAPAC and Children’s Law Center to talk about foster care..
My testimony makes a few major points.
There was a drastic drop in calls to the CFSA hotline starting last March following the closure of schools and the imposition of a stay-at-home order by the Mayor. Total calls were 25 percent lower in March through December 2020 than in the same months of 2019. The number of calls gradually returned to almost normal by December, after CFSA provided training to schools in how to detect abuse and neglect in a virtual environment. The number of investigations, and the number of findings of abuse or neglect, followed the pattern of hotline calls.
CFSA does not currently have valid data on the number of in-home cases opened each month so we cannot tell if that has been affected by the pandemic. But point-in-time data shows the number of children being served in their homes dropped about six percent from 1,333 on December 31, 2019 to 1,250 on that date in 2020.
Foster care entries displayed a surprising trend during 2020. There was a big decrease in foster care entries before the pandemic, and since then quarterly entries have bounced up and down.
Foster care exits declined by 24 percent between March and December, perhaps reflecting court and service delays due to the pandemic, but the gap seems to be closing, with exits actually eclipsing the previous year in October and December.
The total number of children in foster care declined from 771 on December 31, 2019 to 662 on December 31, 2020, for a decrease of 14 percent. The fiscal year decrease of 13 percent is larger than for any other year since FY 2014. We do not know the extent to which this accelerated decline in the foster care rolls reflects policy and practice changes, demographic changes in the city, or other factors, but it does not appear to reflect the loss of hotline reports due to COVID-19. Such a big decrease in foster care caseloads raises concerns about whether children’s safety is being compromised.
The total number of children served in foster care and in their homes declined by nine percent between December 2019 and December 2020. This is a decrease of almost 10 percent in one year in the total number of children served by CFSA.
About 65 percent of children served by CFSA are being served in their homes rather than in foster care, but we know too little about the services they and their parents are receiving. The oversight responses show a large dropoff between referral and receipt of services, and nothing about completion. Moreover, CFSA does not report on how many parents receive basic psychiatric, therapy, drug treatment and domestic violence services provided by DBH and other agencies. We know that quality and availability are both issues for these services.
CFSA has invested in Family Success Centers as its strategy for the prevention of child abuse and neglect before they occur. These centers seem to be off to a good start and are offering a large menu of services geared at strengthening families. But these centers make no special effort to engage those who need them most, who are traditionally hardest to engage.
Several policy recommendations are suggested by these findings. These include: training alternative reporters for child maltreatment; collecting and sharing data on children diverted to kinship care and their outcomes over time; reviewing CFSA policies and practices to make sure they are not compromising child safety; recognizing the critical role of DBH services for CFSA clients, including parents and those with in-home cases; adding a prevention program that is targeted to the children most at risk of being maltreated, and ensuring speedy implementation of the Children’s Ombudsperson Act.
My observations are discussed in more detail below.
Hotline: There was a drastic drop in hotline calls after pandemic closures, with calls gradually approaching normal levels by December 2020
Almost as soon as the pandemic took hold and stay-at-home orders were issued, child advocates around the country began to express fears that abuse and neglect would increase due to parental stress and economic hardship. Research has suggested that family violence spikes during natural and economic disasters. At the same time, school closures raised fear that child abuse and neglect would go undetected as children stayed home away from the eyes of teachers and others who might report suspicions of abuse or neglect. And indeed, in the District as around the country, calls to the child abuse hotline dropped drastically relative to last year, especially in April and May, just after the shutdown of school and the imposition of a stay-at-home order. School closures were likely the main cause for this drop, as school and childcare personnel made 43 percent of the calls in FY 2019–and only 36 percent of calls in FY 2020. But the summer, when teachers are not seeing students anyway and reports go down, looked more like a normal year. It is as if summer started in April and did not end until August. There is usually an uptick in reports in September and especially October after children return to school and teachers get to know them. This occurred in FY 2020 but was smaller than in FY 2019. But reports began to approach their normal level in November and December. CFSA credits the guidance they developed (in the form of a webinar and a participant guide) to be used to train teachers teaching virtually about how to spot abuse and neglect in a virtual environment. In total, the number of hotline calls dropped from 15,456 between March and December 2019 to 11,579 in the same months in 2019–a difference of 25 percent.
Figure One
Some commentators around the country have wondered if the loss of some reports from teachers might be a good thing because some of these reports were trivial and should not have been made. If only the frivolous reports were being suppressed, the number of reports accepted for investigation would remain similar across the two years. This was not the case. The pattern of hotline calls accepted for investigation followed closely the pattern of all calls to the hotline.
Figure Two
The number of investigations that was substantiated followed a similar pattern to that of reports and accepted investigations. The total number of investigations that was substantiated decreased from 1,053 in March to December 2019 to 808 in March to December 2020, a decrease of 23.2 percent, similar to the percentage decrease in hotline calls.
Figure Three
We do not know how many in-home cases were opened in 2020 but we do know that the in-home caseload declined significantly between CY 2019 and CY 2020.
When child maltreatment is substantiated, CFSA can place the child in foster care (opening an out-of-home case), open an in-home case, or not open a case at all and refer the family to a collaborative. One might expect fewer cases of both types to open during the pandemic due to the decline in hotline calls. CFSA does not currently have valid data on in-home case openings, so we do not know the effects of pandemic on this indicator. (Data on in-home case openings posted earlier has been removed due to technical problems). Point-in-time data shows that the number of children served in their homes dropped about six percent from 1333 on December 31, 2019 to 1250 on that date in 2020. And the number of families served in their homes dropped about seven percent from 510 to 473.
Table One: Number of Children and Families Served In-Home
December 31, 2019
December 31, 2020
Children
1,333
1,250
Families
510
473
Foster care entries decreased before the start of the pandemic; not so much afterwards.
It is not surprising that hotline calls, investigations, substantiations and in-home case openings all declined in the wake of the pandemic and associated closures. The big surprise is that foster care entries did not display the same pattern. Entries into foster care started out low in January, dropped in February and actually rose in March, April and May of 2020 before dropping sharply in June and a bit more in September. The total number of children placed in foster care declined from 261 in March through December of 2019 to 181 in March through December of 2020.
Figure Four
Looking at quarterly data over time shows that the big decrease in foster care entries appears to have occurred before the onset of the pandemic. It took place during the last two quarters of FY 2019. Foster care entries bounced up and down for the last five quarters, actually increasing last spring when the pandemic began.The data suggest that there was a renewed push to “narrow the front door” of foster care starting in the third quarter of Fiscal Year 2019. And indeed, CFSA’s Communications Director stated that the fall in foster care entries reflected CFSA’s “continued commitment to keep children out of foster care by supporting families in their homes.” Could an increased use of kinship diversion have contributed to these numbers? We won’t know until CFSA starts reporting data on the use of this practice.
Figure Five
It appears that there were some delays in the achievement of permanency for foster youths in the first few months after the pandemic, as evidenced by declining foster care exits, but the agency appeared to be closing the gap in the first quarter of FY 2021.
There has been widespread concern around the country that covid-19 would create delays in the achievement of permanency for foster youth. Family reunifications could be delayed by court closures, cancellation of in-person parent-child visits and increased difficulty facing parents needing to complete services in order to reunify with their children. Court delays could also hamper exits from foster care due to adoption and guardianship. And indeed fewer children did exit foster care every month from March to September, especially in May and June, than in the same months in 2019. However, the difference between the two years declined in July and August and almost disappeared by September, and the pattern reversed in October and December, so perhaps the agency and court were able to clear the backlog. The total number of children exiting foster care declined from 357 during the period from March through December 2019 to 272 in the same months of 2020.
Figure Six
A large (14 percent) decline in the number of children in foster care occurred in 2020.
The total number of children in foster care on the last day of Calendar Year 2019 was 798. It declined to 694 by December 30, 2020, for a decrease of 14 percent. This does not seem to be a consequence of the pandemic, as entries and exits decreased by a similar amount in March to December 2020 relative to 2019. The number of children in foster care on the last day of the fiscal year has declined every year since FY 2012. However, the percentage drop in the foster care rolls (13 percent) was greater than in any other year since FY 2014. Such an accelerated decline always raises questions about whether child safety is receiving adequate consideration.
Figure Seven
The total number of children served both in-home and in foster care declined from 2,104 on December 31, 2019 to 1,912 on December 31, 2020, a decrease of 9 percent. Out of these 1912 children, 662 (34.6 percent) were being served in foster care and 1,250 (65.4 percent) were being served in their homes. It is important to note that this is a decrease of almost 10 percent in one year in the total number of children served by CFSA, rather than a shift in the percentage being served from foster care to in-home. The reason for this drop is not totally clear but may reflect pre-pandemic policy and practice changes for foster care and pandemic induced reporting declines for in-home services.
Table Two: Children Served in Foster Care and In-Home
Date
Foster Care
In-Home
Total (% Difference from Previous year)
December 31, 2019
771 (36.6%)
1333 (63.4%)
2,104 (1.7%)
December 31, 2020
662 (34.6%)
1250 (65.4%)
1,912 (9.1%)
We know too little about the services received by the parents, as well as children served in their homes.
I have talked a lot about numbers but not at all about the content and quality of services, and I’ll focus on in-home services here. CFSA’s oversight responses provide a list of services provided to families with an open investigation, in-home case, and out of home case combined, not separately for each group. The responses indicated that 910 families were referred to these various services but only 544 were served in FY 2020. We have no idea how many people completed these services, but it is probably a lot less. Moreover, CFSA did not report at all on how many parents received basic psychiatric, therapeutic and drug treatment services, or domestic violence services. CFSA depends on DBH for mental health and drug treatment services and nonprofits for domestic violence services. The DBH services are often of poor quality and all of these services are often in short supply with long waits. CLC discussed the unmet behavioral health needs of children in foster care; the same applies to children in in-home care and especially their parents, who need these services in order to reunify safely with their children.
The big worry is that if the services provided to parents are not effective, cases will be closed without parents having made the changes necessary to be able to keep their children safe. Therefore, we are likely to see these families in the system again, with more harm done to their children. However, there is encouraging news from the latest Quality Service Review (QSR) Report about the In-Home Administration’s improved performance on providing supports and services to families.
CFSA seems to have made a good start in implementing the Family Success Centers but needs to do more to engage the families that are most at-risk and hardest to engage.
The Family Success Centers appear to be off to a good start in offering a diverse menu of family strengthening services close at hand for parents in Wards 7 and 8. However, it is not likely that they are going to reach the families that need them most. Families at higher risk are traditionally difficult to engage and reach with services. If CFSA really wants to make a serious effort toward prevention, it will need to target families that are identified as at high risk of child maltreatment.
One example of such a program is Hello Baby, which was pioneered in Allegheny County Pennsylvania, home of Pittsburgh and the visionary child welfare leader Marc Cherna, who has since retired. Allegheny already had Family Success Centers, and they already know that they do not reach the families that need them most. Allegheny County decided to offer a universal support program to all parents of newborns. The program has three tiers, with the least at-risk families being offered services such as a “warmline,” texting services, and website. The middle tier is connected with Allegheny’s equivalent of the Family Success Centers. And the most at-risk group receives a peer mentor and a benefits navigator or case manager who work together to ensure the family receives the services they need. To assign parents to tiers, Allegheny County uses a predictive algorithm based on a highly advanced “data warehouse” that integrates data across multiple county agencies.
Policy Suggestions
The information outlined above points to several recommendations for CFSA and the Council
Although calls to the CFSA hotline seemed to approach normal levels in December, the total hotline calls between March and December dropped by 25 percent between 2019 and 2020 . Moreover, a nearly 10 percent drop in the total number of children served by CFSA may reflect in part the loss of these reports. CFSA should consider training alternative reporters outside schools: These might include postal and delivery workers and animal control officers, because child maltreatment often coincides with maltreatment of pets. This strategy is recommended by the family violence researcher Andrew Campbell, who has spoken at more than one event under the auspices of Children’s National Medical Center.
The CFSA dashboard provides no information on kinship diversion–not surprising because CFSA has so far not collected this data. This is an omission that needs to be corrected. The new CFSA policy requires the collection of some data on each diversion and the circumstances surrounding it. These data need to be available on the CFSA dashboard, but we also urge CFSA to make it a matter of policy to track these children regularly and provide regular updates via the dashboard or a public report.
CFSA should review its policies, practices and data to make sure that it is not compromising child safety in the rush to reduce the foster care rolls through kinship diversion or changed CPS practices.
The Council must recognize that CFSA relies on DBH for some of the most important services to parents and children and must be willing to allocate funding to improve the services offered by DBH in general. They also need to inform the council about the adequacy of current Domestic Violence services to meet the need among their clients. CFSA must start collecting data on the number of clients receiving these services and the amount of services they receive.
CFSA should consider adding a more targeted prevention program that reaches out to parents at risk of abuse and neglect but are not yet known to CFSA. This would probably involve developing a predictive model based on data from CFSA as well as other agencies.
The Council is to be congratulated for authorizing the creation of an Ombudsperson office for children. The implementation of this office should not be delayed as it will be very helpful in ensuring that CFSA continues to improve its performance even in the absence of the Court Monitor after the LaShawn case is closed. Moreover, I hope that with the resources provided the Ombudsperson can do a better job than I can in analyzing the data shared by CFSA.
Thank you for the opportunity to testify. I hope this testimony is helpful in your important work.
This testimony was modified on February 26, 2021 to reflect a CFSA’s clarification to hotline data included in the agency’s oversight responses.It was modified again on June 2, 2021 to clarify the foster care caseload data.
In August, I wrote about the drastic decline in reports to CFSA’s hotline, investigations, and substantiated abuse and neglect allegations in the wake of the Covid-19 emergency, which closed schools and resulted in increased social isolation for children. CFSA has released data from June through October 2020, and the same trends are continuing. Reports, investigations, substantiations, and in-home case openings are down drastically. Foster care entries have decreased as well, but that drop seems to have occurred mainly before the pandemic. With plans for reopening schools up in the air, it is long past time to worry about the children who are not being seen in school or child care and to find alternative ways to reach them until schools and childcare centers are fully open. Moreover, these frightening data lend support to those calling for schools to reopen soon–especially for children of elementary-school age or younger, who are incapable or less capable of seeking help.
In the District, Mayor Muriel Bowser declared a public health emergency on March 11, 2020 and schools closed for in-person classes on March 13. After a two-week spring break, online learning began on March 24 and the stay-at-home order went into effect on April 1. Online learning ended on May 29, nearly a month early, and the same day that the District entered Phase One of reopening. Schools started on a virtual basis again on August 31. In its public-facing Dashboard, CFSA posts data for each quarter 45 days after the quarter ended. The data for the July through September quarter were posted on November 13, 2020. Using this data, we compared the numbers of reports, investigations, dispositions, in-home case openings and foster care placements since the pandemic with the numbers during the same months of 2019.
Reports to the Hotline
Hotline calls are generally a family’s first contact with CFSA and thus the earliest indicator of the effects of the pandemic. Figure 1 shows the number of hotline reports per month in FY 2019 and 2020. In FY 2019, the number of reports increased every month until May, dropped to a much lower level in July and August when schools were closed, and then bounced up in September with the opening of schools. The pandemic year of 2020 looked very different. The number of calls fell from February to March with the closure of schools, followed by a much larger drop in April, with the number of calls staying fairly flat until a modest rise in September with the opening of school. It’s as if summer vacation started in March, with a slight increase of reports when school started again.
Comparing the months across years shows that in January and February 2020, before the pandemic shutdown began, there were actually more hotline calls than there were in the same months of 2019, suggesting that the year would have seen increased reports if not for the pandemic. But in every month of the pandemic, the number of hotline calls in 2020 was considerably less than its counterpart in 2019. (The actual numbers are provided in Table 2 at the bottom of this post.) The biggest year-to-year differences were in April and May 2020, after the pandemic emergency began, when calls were down by 64 percent and 67 percent respectively over the same months in the previous year. In July and August, the differences between 2019 and 2020 were less drastic, which is to be expected because schools are normally closed during the summer months. But still reports were down by nearly a quarter in both July and August 2020 from the previous year. The total number of hotline calls received between March and September (roughly the period affected by covid-19) fell from 14,245 in 2019 to 9,780 in FY 2020, a decrease of 31 percent.
It is likely that the school closures were a major reason for the drop in hotline reports. Many schools, especially in the poorest areas, struggled to engage many of their students in distance learning last spring; some students were missing for the entire quarter. In addition, signs of maltreatment may be harder for teachers to observe online, although a virtual platform does allow them to observe incidents in the home that might otherwise go unreported. Moreover, DCPS closed several weeks early, offering not even virtual education in June. The lower level of reports even in the summer months may be due to families being more isolated due to the pandemic, spending less time with friends, neighbors, and extended family members who might report suspected abuse or neglect, as well as putting off visits to doctors, another common reporting source.
While monthly data on reporting source are not available, annual data shown in Table 1 support the hypothesis that a decline in reports from school personnel was a major factor behind the fall in reports overall. In 2019, presumably a fairly “normal” year, school and childcare personnel made 42.9 percent of all reports to the hotline. This is larger than the national percentage of 21 percent for these groups in FY 2018, probably because the District requires schools to report to the hotline all students who have more than 10 unexcused absences during a school year. These data show that these groups made a smaller share of reports in the recently completed Fiscal Year 2020 (in which more than half of the school year was virtual) than in FY 2019. In FY 2019, childcare and school personnel made 7,704 reports, which was 43 percent of all reports to the hotline. But in 2020 they made only 5,006 reports, which was only 36 percent of all reports. Counselors, therapists and social workers also made fewer reports in FY 2020, probably reflecting services that were suspended and or transitioned to a virtual platform. Their reports dropped from 2,342 to 1,702, or 13 percent of reports, which was not a large percentage change. On the other hand, law enforcement and medical personnel made an increased number and share of reports. Law enforcement personnel made 1,938 reports in 2020, a slight increase over the 1,891 reports they made in FY 2019. Their share of total reports increased from about 11 percent to 14 percent of all reports. Medical personnel made 965 reports in FY 2020, a big increase from the 866 reports they made the previous year, and their share of reports increased from five to seven percent. Friends and neighbors made fewer reports, but these reports were a slightly higher fraction–about 14 percent) of those received. Clearly no group could make up for the missing reports from teachers, so the total number of reports for the year was 14,046, down from 17,960 in 2019. The increasing number and share of reports due to law enforcement and medical personnel reflects their status as essential workers who have continued to see District residents in person. There have been anecdotal reports from many areas that maltreatment cases that do come to the attention of child welfare tend to be more severe; this may reflect the increased role of these reporters, who are more likely to see children who are seriously injured, and the reduced role of teachers, who are often said to report concerns that do not rise to the level of abuse or neglect.
Table 1: Hotline Reports by Source, 2019 and 2020
Reports accepted for investigation
A hotline call can be screened out as not meeting the requirements for an investigation, referred to another agency, or accepted for investigation. The number and percentage of reports accepted for investigation is shown below in Table 2. The percentage of hotline calls accepted was higher each month during the pandemic period (especially in May and June) than in that same month of the previous year. This pattern suggests that the reports made during the lockdown tended to be more serious, with the less serious reports less likely to be made. Such a trend has been observed in other jurisdictions where data have been analyzed in more depth, as reported in my national blog, Child Welfare Monitor. As mentioned above, some commentators have suggested that teachers in particular make many reports that do not merit investigation. Virtual schooling may have screened out some of this “noise.” CFSA data provide evidence for a small winnowing effect but one that was far from enough to make up for the drastic drop in the number of reports.
Table 2: Hotline Calls Accepted for Investigation
Completed and Substantiated Investigations
In addition to the number of calls accepted for investigation each month, CFSA also reports on the number of investigations completed each month. This is a different number because investigations can take a month or sometimes even longer to complete. So we can expect a time lag in observing the effects of the pandemic on the number of investigations completed. Also there is a small number of investigations that are not completed, as explained on the dashboard. These of course are included as part of total, but not completed, investigations.
Figure 2 shows a similar pattern of differences in completed investigations as shown in Figure 1 for reports, with the time lag delaying the effect by a month. In 2019, completed investigations mostly increased from January through June and then fell through September. In the pandemic year of 2020, the number of completed investigations fell precipitously in April and May, with the onset of the pandemic, drifted slightly upward through August, and fell slightly in September.
Turning to the numbers, in the pre–pandemic months of January and February 2020, the number of investigations was 24 percent and 36 percent higher than it was in January and February 2019. (Table 2 below the text shows the numbers and percentage changes.) It appears that the agency was on track to have more reports and investigations in 2020 than in 2019, if not for the pandemic. Completed investigations fell in April but it is not until May that the number of investigations completed in FY 2020 dropped below that of FY 2019. Once the number of investigations began to fall, however, it dropped like a stone. In May, only 230 investigations were completed compared to 565 in 2019–a drop of 59 percent. There were 56 percent fewer investigations completed in June 2020 than in June 2019. The gap between FY 2019 and FY 2020 lessened in July but was still large at 39 percent, reflecting the fact that many of these investigations would have begun in the first half of June, when school was still in session in 2019 but not 2020. It was only in August and September that the year-to-year difference declined to 21 percent and 18 percent respectively, reflecting the time lag between reports and completed investigations. It is worth noting that the year-to-year difference was still significant even in those months. This presumably reflects the continuing suppression of hotline reports during the summer of the pandemic. The total number of investigations completed between April and September (roughly the period affected by covid-19) fell from 2,716 in 2019 to 1,787 in FY 2020. That was a decrease of 25 percent–somewhat less than the difference in reports, reflecting the fact that a higher fraction of reports was investigated in 2020.
An investigation can have several possible results. It can result in a finding of “inconclusive,” meaning the evidence is insufficient to prove maltreatment despite some indications it occurred; “unfounded,” which means “there was not sufficient evidence to conclude or suspect child maltreatment has occurred,” or “substantiated,” indicating that the evidence supports the allegation of maltreatment. (See the CFSA Data Dashboard for the full definitions of these terms as well as of “incomplete investigations.”) As shown in Figure 3, the monthly trends and yearly differences were very similar to those for investigations in general.The total number of substantiated investigations for April through September dropped from 643 in FY 2019 to 420 in FY 2020, a decrease of 35 percent. The percentage of investigations that was substantiated during that period stayed almost exactly the same from year to year at approximately 24 percent.
In-home cases opened
When an abuse or neglect allegation is substantiated, several things may happen, depending on the perceived level of risk to the child or children in the home. The agency may take no action, refer the family to a community-based collaborative, open an in-home case, or place the child or children in foster care. As Figure 4 shows, there was a drastic drop in in-home cases opened between March and April, coinciding with the closing of schools and the pandemic emergency. Case openings dropped 48 percent in April, 54 percent in May and 74 percent in June compared with the previous fiscal year.[2] Data were not available for the quarter ending September 30, 2020. Presumably the trend in new case openings reflects in large part the trend in substantiated allegations; the patterns appear similar but not identical in the two measures. The total number of in-home cases opened in the pandemic months of March to June dropped from 533 in March-June 2019 to 267 in the same months of 2020–a decrease of 50.0 percent.
It is not surprising that hotline calls, investigations, and substantiations all declined in the wake of the pandemic and associated closures. The big surprise is that foster care entries do not display the same pattern. There was a big drop in foster care entries in February 2020–before the pandemic closures hit. Foster care entries actually rose in March, April and May of 2020 before dropping sharply in June and a bit more in September. True, monthly entries into foster care were always lower in 2020 than in 2019, though only by one child during the month of July. The total number of children placed in foster care declined from 193 in March through September of 2019 to 119 in March through September of 2020.
But the big decrease in foster care entries appears to have occurred before the onset of the pandemic, as Figure 6 shows. The number of entries into foster care was falling throughout FY 2019, aside from slight rises in May and August. There was actually somewhat of a rebound in the spring pandemic quarter, while the summer quarter entries fell back to the January-March levels.
The downward trend in foster care placements that began before the pandemic may have been due to policy or practice changes. As we mentioned in an earlier post, the data suggest that there was a renewed push to “narrow the front door” of foster care starting in the third quarter of Fiscal Year 2019. As we reported then, CFSA’s Communications Director indicated that the fall in foster care entries reflected CFSA’s “continued commitment to keep children out of foster care by supporting families in their homes.” Of course, we do not know if placements would have been higher in the absence of the pandemic; perhaps the school closures and pandemic orders did suppress foster care entries somewhat. But clearly, the pandemic has had a more obvious effect on the opening of in-home cases, resulting in a big decrease in in-home case openings. This makes sense if we assume that CFSA had become more likely before the pandemic to open in-home cases in lieu of foster care cases.
Exits from Foster Care
Commentators around the country have expressed concern that covid-19 would create delays in the achievement of permanency for foster youth. Family reunifications could be delayed by court closures, cancellation of in-person parent-child visits and increased difficulty facing parents needing to complete services in order to reunify with their children. Court delays could also hamper exits from foster care due to adoption and guardianship. The monthly data in Figure 7 show that fewer children did exit foster care every month from March to September, especially in May and June, than in the same months in 2019. The difference between years declined in July and August and almost disappeared by September, so perhaps the agency and court were able to clear the backlog. The total number of children exiting foster care declined from 261 during the period from March through September 2019 to 178 in the same months of 2020, a difference of 83 children or 32 percent. A small part of the reduction is due to the City Council’s decision to allow older youth to stay in foster care instead of aging out during pandemic. There were 27 exits by emancipation in the third and fourth quarters of FY 2019 and only 10 in the second half of FY 2020. But this difference does not account for most of the drop in foster care exits during the pandemic period.
Figure 8 shows the trends in total foster care caseload over time, which reflects both entries and exits. The total number of children in foster care on the last day of Fiscal Year 2020 was 695, compared to 798 on September 30, 2019, for a decrease of 13 percent. This reflects a total of 217 entries and 321 exits during the year. [1] (The percentage declines are listed in Table 7 at the bottom of this post). Combining Dashboard data with previously published data shows that the number of children in foster care on the last day of the fiscal year has declined every year since FY 2012. However, the 13 percent fall during 2020 was greater than in any other year since FY 2014. It appears that this decline happened mostly before the pandemic. Comparing data from March to September of 2019 and 2020 shows that 74 fewer children entered foster care and 68 fewer children exited it, suggesting that the pandemic had little effect on the total foster care caseload.
Conclusion
The release of fourth-quarter FY 2020 data on CFSA’s data dashboard shows a continuation of the trends that were displayed in the second-quarter data released in August. The pandemic and its associated closures had the expected downward effect on calls to the child abuse hotline, investigations, substantiated maltreatment reports, and in-home case openings. What was not expected was that although foster care entries fell in FY 2020, most of that fall occurred before the pandemic and appeared to be due to other factors, such as policy and practice changes. It appears that by suppressing reports and investigations, the pandemic probably suppressed the opening of in-home cases more than it reduced removals into foster care. But in any case, it resulted in a loss of protective services for children. Child Welfare Monitor DC has long been urging CFSA to do more to reach the children who may be suffering behind closed doors through means like working with schools to track down no-shows, launching a public awareness campaign about child abuse and neglect, educating non traditional reporters to spot signs of abuse and neglect, and reaching out to at-risk families known to the system. These ideas are discussed in my national blog, Child Welfare Monitor. With no clear plan for reopening schools, it is hoped that CFSA will now make this their top priority. Moreover, the data are sobering enough to support a return to school soon for children of elementary school age or younger as soon as possible because school is such a crucial safety net for abused and neglected children.
[1] The total is 694 rather than 695, which presumably reflects a small inconsistency in counting of entries and exits.
[2] There was an anomaly in the in-home case data that casts some doubt on the accuracy of the case opening numbers. We are awaiting clarification from CFSA.
Additional Tables
Table 2: CFSA Hotline Reports by Month, FY 2019 and FY 2020
Table 3: Investigations by Month, FY 2019 and FY 2020
Table 4: In-Home Cases Opened by Month
Note: Data not available for July-September 2020
Table 5: Foster Care Entries by Month
Table 6: Foster Care Exits by Month, FY 2019 and FY 2020
Figure 7: Children in Foster Care on Last Day of Fiscal Year
The annual oversight hearing on the Child and Family Services Agency took place on February 12, 2020. The hearing lasted over six hours and covered a wide variety of topics and perspectives. The testimony painted a mixed picture of considerable progress along with continuing concern about major issues including the availability of placements meeting the needs of some of the more difficult-to-serve clients. Much of the testimony centered around CFSA’s responses to the committee’s oversight questions that were submitted in advance. These are a very useful resource that can be compared from year to year. Readers can watch the hearing here.
Widespread Praise for CFSA: The last to testify, CFSA director Brenda Donald heralded a year of accomplishment, including planning and getting approval for a five-year Title IV-E Prevention Plan under the new Family First Prevention Services Act, creating the local Families First DC program, reducing the scope of monitoring under the LaShawn class action lawsuit, settling its new arrangement for delivering foster care, fully implementing its in-house mental health unit, and gearing up for new child welfare information system. As she pointed out, CFSA is currently considered to be a national leader in child welfare. Many other witnesses also praised CFSA for these accomplishments or others.
Foster Care Numbers: Contrary to national trends, the number of youth in foster care continued to fall in the District since a year ago. Director Donald testified that there were only 796 children in care at the end of 2019 and 1357 were being served in their homes. Reunifications increased from 197 in 2018 to 227 in FY 2019 and the number of children aging out of care fell from 63 to 53. CFSA expects further declines because of the emphasis on front-end prevention, according to Director Donald, as well the agency’s continuing efforts to reduce the length of stay in foster care. Donald did not mention the movement of low-income families into Maryland due to rising rents in the District, which may be an even more important factor behind the continued declines at a time when the national foster care total has been rising.
LaShawn Exit Plan: Court Monitor Judy Meltzer of the Center for the Study of Social Policy reported that CFSA and CSSP have agreed on a revised exit plan in the 30-year-old LaShawn vs. Bowser class action lawsuit. The new plan removes 56 of the exit standards; 23 remain to be achieved. As part of the revised plan, CFSA committed to adding several types of placements and it has already satisfied most of these commitments, as described below.
Lack of appropriate placements: CFSA continues to struggle with a lack of placements for the young people with the most serious disabilities and behavioral problems, as described in testimony from CSSP’s Meltzer and witnesses from the Children’s Law Center (CLC). As a result, 31 children spent a total of 60 nights at the agency between April and November 2019. The number of children staying overnight more than doubled between FY 2018 and 2019, as Aubrey Edwards-Luce of the Children’s Law Center pointed out in her valuable written testimony. The number of children staying at the Sasha Bruce emergency shelter also more than doubled. About 100, or one in every eight children, had stayed in an emergency shelter or respite home in FY 2019. Moreover, about 22% of children in care had three or more placements, the same number as the previous year, which suggests a lack of appropriate placements for some children.
Additions to Placement Array: CFSA has made some progress in expanding the array of placements that can accommodate children with more severe problems. The agency has contracted with Children’s Choice for 36 therapeutic foster homes for youth with intensive needs; added two “Stabilization Observation Assessment Respite (SOAR) professional foster homes, with a total of four beds, to serve high-needs children; secured six congregate care placements for children with autistic spectrum disorders, and added six additional behavioral therapeutic congregate care placements.
Foster Parent Retention and Supports: Judith Sandalow of the Children’s Law Center urged CFSA to focus on retention as well as recruitment of foster families by improving its support for foster parents. Margie Chalofsky of the Foster and Adoptive Parent Advocacy Center (FAPAC) suggested several improvements to foster parent supports, including on-call and timely crisis support, which has not been consistently available through the current resources; more therapy for foster youth; and a mechanism for foster parents to evaluate social workers. Interestingly, Cheryl Brissett Chapman of the National Center for Children and Families gave a dissenting position on retention, arguing that foster parents need to take a break after two therapeutic youths. She also reminded listeners that many foster homes are lost when foster parents adopt the youths in their care and that should not be considered a problem.
Education and Employment: Data on education and employment outcomes cited by Aubrey Edwards-Luce from CFSA’s oversight responses continues to be very concerning, although the high school graduation rate among CFSA foster youth actually increased from 67% in FY 2018 to 73% in FY 2019, based on corrected data submitted later by CFSA. The Grade Point Average (GPA) of the 84 (out of 186) high-school aged children in care for whom this figure was available was only 1.69. Nearly 10% of high school students in CFSA care dropped out in FY 2019. And nine of the 40 foster youth who enrolled in college in FY 2019 dropped out, based on corrected data from CFSA. Moreover, less than half the young people enrolled in vocational programs completed them.
Youth aging out: Edwards-Luce pointed out that CFSA’s data on living arrangements of youth aging out of care are deceptive. CFSA reported that only four of the 49 youths who aged out of foster care in FY 2019 exited to unstable housing situations, which it defines being homeless, in a shelter, or incarcerated. However, CLC believes that “the agency improperly defines transitional housing, college dorms, staying with friends, and DDS placements as “stable living arrangements.” If those arrangements are considered unstable, 32 out of the 49 youths who aged out were in unstable housing.
Office of Youth Empowerment: CFSA touted its status as the first public agency to be awarded a three-year $10 million grant fromYouth Villages to implement the evidence-based and much-praised YV LifeSet program. But CLC’s Edwards-Bruce expressed concern about the elimination of OYE’s Career Pathways program, which served 113 youths in FY 2019, and its replacement by the LIfeSet Program, which served only 49 youths in the firsts quarter of FY 2020. According to CFSA’s Annual Progress and Services Report, YV Lifeset requires participant buy-in, and youths who do not wish to participate will receive similar services to those provided under Career Pathways. Moreover, there is some reason for concern that the LifeSet funding may be supplanting rather than supplementing local funds, as discussed below.
Aftercare: In her very enlightening oral and written testimony, Marcia Huff of the Young Women’s Project described her experience running CFSA’s aftercare program in a contract that lasted from 2017 to 2019. In a nutshell, Huff found that “the vast majority of the youth we worked with were unprepared to succeed when they emancipated from care at age 21.” Among the depressing data she cited about the young people entering her program: 51% were unemployed; 9% were employed 15 hours or less; and only 20% were employed full-time; 31 out of 75 were homeless or couch surfing; 32% were in temporary housing, and only 9% were in permanent housing with a long-term voucher or rent that was sustainable based on employment; 56% had one or more children; 27% needed help managing marijuana or other drugs; 58% had unresolved mental health issues that interfered with progress in employment and housing; 17% had no GED or high school diploma; and 36% had no bank or deposit account of any kind. Lack of housing was a major obstacle to engagement with the program and progress toward goals and kept many participants in a state of crisis. Lack of child care was a huge obstacle for parenting youth. Huff’s testimony, which should be essential reading for anyone who cares about foster youth, recommended first and foremost that the agency needs to “start young and go deep” to prepare youth for life after care because “by the time they are 20 it is nearly too late and it is extremely hard to turn things around.”
Youth Services Reprogramming: Human Services Committee Chair Brianne Nadeau asked about the reprogramming of $449,782 allocated for teen youth services to support for the court monitor in LaShawn, which was not included in the FY 2019 budget. Donald testified that this money was saved by bringing youth aftercare in-house, without any loss of service capacity. If true, this would point to an appalling inflation of the contract price, which seems unlikely. This writer cannot help wondering whether this money may have instead been replaced by the grant to implement YVLifeSet and hopes Chairwoman Nadeau will look into that possibility.
Kinship Care: Several witnesses celebrated the new Close Relative Caregiver Subsidy, including Donte Massey, whose testimony last yea sparked the creation of this program. Massey reported that the program is helping him raise his younger siblings. Stephanie McClellan of the DC Kincare Alliance asked the Council to remove the requirement that a caregiver must wait six month to receive the subsidy. This results in an actual eight-month rate which is a hardship for cash-strapped caregivers. She also asked the Council to consider emergency funding to eliminate the current waiting list. The longstanding Grandparent Caregiver Subsidy also received praise from caregiver Vernita Grimes, who credited program staff with providing emotional and moral, as well as financial, support .
Social Worker Support: Wayne Enoch, president of the union local representing 400 workers at CFSA, expressed his members’ concern about worker safety from attacks by clients, even in the office. The union is seeking for a “viable health and safety committee” to work with management on a long-term solution to this problem. Worker turnover is a concern for CFSA. Social workers complain about work-life balance, support from supervisors, and micromanagement rather than pay and promotions. Despite the problems, Enoch hailed Brenda Donald for her commitment to workers’ well-being and to working with the union through the Labor Management Partnership Council. He noted that CFSA has appointed a Wellness Coordinator to boost well-being among its workers. He said that other agencies should follow CFSA’s example of labor-management cooperation.
Latino Families: Isabelle Suero-Stackl of the Latin American Youth Center (LAYC) argued that CFSA is not meeting the needs of the Latin American community. Although LAYC has a contract to deliver foster care including case management to Latino families, all of these families are initially managed by CFSA, and most are served directly by CFSA. Moreover, in-home services to all families are provided by CFSA, which may be a problem for a family that does not speak English. Instead, Suero-Stackl recommended that CFSA should assign all Latino families to LAYC as soon as they come into in-home or out-of-home care.
Changing nature of foster youth: Both Director Donald and Dr. Cheryl Brissett Chapman of the National Center of Children and Families (NCCF) cited changes in foster youth. They are seeing more young children with aggressive behaviors than in the past. Dr Chapman of NCCF, which manages all of the Maryland foster homes that house about half of the District’s foster youth. had some interesting observations from a long career in child welfare. Unlike the “parentified” children seen in the crack epidemic, who acted as parents to their own parents and their siblings, many of today’s children coming into care are accustomed to be treated by their parents as peers. When they come into foster care, they are not ready to treat foster parents respectfully as adults, and many older, veteran foster parents cannot cope with disrespectful behavior. Surprisingly, placement disruptions are most frequent for children aged 9 through 12, and it is this disrespect that is causing many of the disruptions.
CFSA Mental Health Unit: the new mental health unit to provide initial services to youth coming into care seems to have be achieving its goals of allowing CFSA to screen and evaluate children more quickly and get them into therapy sooner. This unit works with children for six to nine months. Donald testified that CFSA has issued a contract for ongoing mental health services for some children with specialized needs and to serve some parents.
Child Protective Services: The number of substantiated investigations went up slightly in FY 2019, as did the number of removals, which Deputy CFSA Director Robert Matthews suggested might be due to the elimination of Family Assessment as an alternative response to investigation. He also mentioned that the quality of investigations is improving as indicated by the agency’s Quality Service reviews. However, one representative of a charter school raised concerns about the quality of CFSA responses to reports alleging child abuse and neglect. In his written testimony, Christopher Nace of the DC International School mentioned two families that were the subject of repeated and serious reports to CFSA, none of which resulted in actions that protected the children. In the case of the first child, staff reported concerns ranging from sexualized language and behaviors, physical abuse, educational neglect and sex trafficking. none of which resulted in any change in the child’s situation. In the other case, school personnel reported concerns about a family 11 times between 2016 and 2020 on issues including domestic violence witnessed by school staff, children being left alone all night, alcohol and drug abuse in the home, children being driven to school by intoxicated parents, concerns about drug distribution, physical abuse that left bruises; and fights in which weapons were drawn and students were kicked out of the house. Nace recommended that CPS investigations should take into account past allegations as well as the present one and that CFSA should collaborate more extensively with schools and other agencies involved in the lives of children and consider adding regular “check-ins.”
Families First DC: The Committee heard from many of the organizations that have received grants to start Family Success Centers under Families First DC, CFSA’s new primary prevention initiative. The grantees have been chosen and given money for a year of planning. The centers are to launch early in Fiscal Year 2021.All of the grantees praised the support of CFSA and the provision of a year to plan their programs with input from community residents. Grantees expressed their excitement about this program.
Transparency and Responsiveness: After last year’s hearing, where representatives of several organizations lamented a decline in transparency and community involvement by CFSA, both the Children’s Law Center and the Foster and Adoptive Parent Advisory Council (FAPAC) noted that CFSA had become more open and responsive to feedback from advocates and foster parents in the last year.
Ombudsman Proposal: Several witnesses, including Aubrey-Luce of CLC, reiterate the need to move forward the proposal of establishing an independent Ombudsperson for CFSA in order to spur the needed improvements.
This year’s oversight testimony highlighted agency’s ability under the leadership of Brenda Donald to accomplish major initiatives. Of more doubt to this writer is how many of these initiatives actually improve children’s lives. Some of the most important testimony highlighted the major problems that still plague the District’s foster care system, especially the lack of appropriate placements for the hardest to serve children and the lack of effective approaches to enhancing education and employment outcomes for foster youth. As I have written before, CFSA’s vaunted success in getting the first Family First plan approved is of limited utility given the extreme limitations on services available for funding. However, CFSA responded in an email to this writer that “CFSA’s implementation of Family First//// is not designed to produce immediate results. ” Instead, “Family First has created the momentum for the District to look at our referral pipelines, assess the systems we have in place to ensure referral connections are made timely and, have targeted conversations to determine if we have the right services available to meet children and their families’ needs.”
The abysmal outcomes for older foster youth and those who have aged out (while consistent with those around the country) indicate that there is much room for improvement. And the transfer of $450,000 in services to older youth in order to pay for the court monitor’s oversight is particularly concerning considering the great needs of these youth. However, some of the new initiatives, such as the addition of new placements for children with greater needs, the creation of in-house mental health services, and the establishment of Family Success Centers are likely to make life better for children in CFSA care and in the community.
Director Donald’s concluded by expressing her gratitude to the Mayor for supporting CFSA in its request for funding for its new initiatives. She did not however, point out that parents and youths involved with CFSA rely on other systems, like behavioral health and child care, in order to achieve their goals. Many parents rely on mental health and drug treatment services provided by the Department of Behavioral Health (DBH) to get their children back or keep their children at home–and these services are characterized by waiting lists, high turnover, and insufficient capacity. CFSA has attempted to compensate for DBH deficiencies by creating its own mental health unit for children in care, and is expanding that unit to serve their parents as well, but parents and children with in-home cases will still be relying on services funded by DBH. Youth who have aged out need these services as well, including help in managing their use of marijuana and other drugs, as mentioned in testimony by the Young Women’s Project. Parents with in-home and out-of-home cases, as well as parenting youth in foster care and aging out, all struggle to find and pay for child care. In order to ensure that CFSA can achieve its goals, the generosity of the Mayor must extend to other systems as well.
This post was updated on February 25, 2020 to incorporate corrections and comments from CFSA.
On October 29, 2019, the Child and Family Services Agency (CFSA) became the first child welfare agency to have its Title IV-E Prevention Plan approved by the federal Administration on Children and Families (ACF). This plan, called Putting Families First in DC, describes how CFSA plans to implement the Family First Prevention Services Act (“Family First”). .While it is encouraging that the District was successful in gaining federal support for its plan, it is disheartening that there will be very little expansion of services under this new legislation, and that Family First will have no impact on the shortage of critically needed mental health services for parents.
Family First widened the population of children and families that can be served under Title IV-E of the Social Security Act from children in foster care to children who are “candidates for foster care” and their families. A “candidate for foster care” is defined as a child who is identified in the jurisdiction’s prevention plan is being at “imminent risk of entering foster care” but who can remain safely at home or in a kinship placement if services are provided. Each state sets its own definition of a candidate for foster care in its Title IV-E plan. CFSA has chosen a fairly broad definition, which includes many types of families that have been investigated by CFSA after an allegation of child abuse or neglect
Most interestingly, CFSA has chosen to include as “candidates for foster care” children of pregnant or parenting youth who are in foster care or have left foster care within five years. The inclusion of these families is particularly significant because it allows services to families in which abuse or neglect has not taken place. Rather than preventing the recurrence of abuse or neglect (known as “tertiary prevention”) this extends the use of Title IV-E funds to preventing the first occurrence to a high-risk population (known as “secondary prevention”). This represents a more “upstream” approach, which many experts and child welfare leaders have long been arguing deserves more support.
However, the effects of this expansion of the eligible population are drastically constrained by the severe limitation on what services can be provided under Family First. The Family First Act extends the use of Title IV-E funds to services designed to prevent placement of children in foster care. Three categories of services are allowed: “in-home parent skill-based services,” mental health services, and drug treatment. (“Navigation” services to kin who are caring for children are also covered). So far, so good. But when specific services are considered, things become complicated.
As I described in earlier posts, the decision of Congress to make Medicaid the payer of last resort rules out using Title IV-E to fund many mental health and drug treatment programs that are crucial to keeping families together safely. And Congress’ decision to limit reimbursement to programs that are included in a Title IV-E Prevention Services Clearinghouse rule out support for many promising and supported programs that jurisdictions are already using or might want to use to support their struggling families.
Through a Program Instruction, ACF recently gave states an option to claim “transitional payments” for services that have not yet been approved by the clearinghouse, by conducting an “independent systematic review” of such services. But the funding will be cut off if the Clearinghouse decides not to approve the service, and it is not clear if any states will use this option. The District of Columbia has elected not to do so. As a result, after all the hoopla, the District is claiming only one evidence-based prevention service for funding under Family First! That is the Parents as Teachers (PAT) home visiting program, which is already being provided by the DC Department of Health using federal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) funds. CFSA will be using local dollars, matched by federal Title IV-E funds, to add slots to this program to meet the needs of its foster care candidates and their parents.
It is worth noting that the evidence on PAT’s potential to prevent child maltreatment or its recurrence not very compelling. The California Clearinghouse for Evidence Based Practices in Child Welfare (CEBC, the leading organization of its kind) rates it as only “promising” (not “supported” or “well supported”) on primary prevention and does not even rate it on prevention of maltreatment reduction. Since the CEBC rated the program, a new study was released testing the potential of PAT to reduce maltreatment among parents who already have been found neglectful or abusive. The study found no overall effect, though they did find that there was a reduction in maltreatment reports for parents who were not depressed and did not have a significant history with Child Protective Services–in other words, the easiest-to -treat minority of the population of parents involved with CPS.
It is also strange that CFSA has not adopted the home visiting program that has shown the strongest evidence by far of preventing child abuse and neglect. That is the Nurse Family Partnership (NFP) , which is the only program to have been given a rating of 1 (“Well Supported by Research Evidence”) by the CEBC for the prevention of child abuse and neglect. NFP is designed for first time teenage mothers only; it would be a natural for teen parents in foster care and other teen parents citywide. It is a shame that DC’s Department of Health has not chosen to invest in this program and that CFSA has followed suit.
It is likely that CFSA will eventually receive Title IV-E support for a second service. Motivational Interviewing (MI) was approved by the Title IVE Prevention Services Clearinghouse after CFSA had already submitted its plan. MI is a method of counseling to facilitate behavior change, especially regarding substance abuse. It is typically delivered over one to three sessions. However, CFSA has included Motivational Interviewing in its plan as a “cross-cutting” program rather than a program addressing substance abuse. The agency states that it intends to use MI as a “core component” of its case management model, rather than a two-or-three-session freestanding program. Brenda Donald, CFSA’s director, told the Chronicle of Social Change that she expected to be able to claim IV-E reimbursement for case management once it was added to the clearinghouse. Other jurisdictions are moving in the same direction, according to the Chronicle.
CFSA included in its Family First Plan other programs eligible for Title IV-E funding but is not planning to claim federal funds for these programs because they are already supported by federal funds. Also included are several services that have not yet been approved for Family First funding and are supported by Medicaid or local dollars. It’s a large array of programs, none of which will be supported by Title IV-E funds except PAT and perhaps MI.
So under Family First, Title IV-E dollars are being used to expand one home visiting program in the District and perhaps can be used to match funds spent on case management if CFSA succeeds in making the case that the use of the MI approach makes case management reimbursable. In the meantime, District parents with children at risk of foster care placement are desperately seeking needed services, especially mental health services to treat their mental disorders, such as depression and Post Traumatic Stress Syndrome (PTSD) that contribute to child abuse and neglect. As recently reported by the District of Columbia’s Citizen Review Panel (CRP), there is such a shortage of basic mental health services for parents that social workers are doing therapy themselves and also trying to substitute alternative services that may not be as effective, such as telemedicine or yoga. Lack of appropriate mental health services and long waiting lists were major themes of CFSA’s 2019 Quality Service Review, as reported by the CRP. Poor quality of Medicaid-funded services and rapid turnover of providers are also problems that plague CFSA-involved parents and their social workers.
What a difference Family First could have made if its funds could be used to augment the supply of Medicaid-funded basic mental health services such as medication management, individual and group therapy! How many families could be strengthened if the Clearinghouse had included, or was considering, newer and exciting evidence-based mental health services like EMDR and Mindfulness Based Stress Reduction that may not be covered by Medicaid! Without federal help through Family First, parents involved with CFSA continue to wait for services they need to parent their children safely.
Another problem for CFSA lurks down the road. As CFSA describes in its plan, the law requires that 50% of IV-E spending be for practices that are “well-supported” as defined by the Act. But most of the “well-supported” practices that CFSA is using are funded by Medicaid in the District. If the Medicaid-funded programs cannot be counted as part of CFSA’s total Family First expenditures (which ACF has suggested will be the case), CFSA will not be able to show that it is spending 50% on “well-supported” practices. Congress has already passed the Family First Transition Act, which delays implementation of this requirement to 2024, with a requirement that by 2022 states have to show 50% of practices as “supported” or “well supported.” But what will happen then? The Chronicle voices the hope that more practices would have made it to the well-supported list by that time. We shall see.
With all the fanfare around Family First and CFSA’s large investment of time in developing this plan, it seems clear that the agency is gaining few resources in return for the large burden of showing compliance with Family First. It’s ironic that CFSA must provide extensive documentation to ACF regarding services that are getting no funds under the act. CFSA and other jurisdictions should press for amendments that make Family First more likely to achieve its objective of supporting parents to improve their parenting and keep their children safely at home.
The annual oversight hearing on the Child and Family Services Agency took place on February 12, 2020. The hearing lasted over six hours and covered a wide variety of topics and perspectives. The testimony painted a mixed picture of considerable progress along with continuing concern about major issues including the availability of placements meeting the needs of some of the more difficult-to-serve clients. Much of the testimony centered around CFSA’s 
On October 29, 2019, the Child and Family Services Agency (CFSA) became the first child welfare agency to have its Title IV-E Prevention Plan approved by the federal Administration on Children and Families (ACF). This plan, called 
Child Welfare Monitor DC 