A State-Wide Trauma-Informed Care Approach: Implementation of Stricter Guidelines for Discretion in Child Welfare Cases and a Shift Towards Family Services in the Early Stages

I. Current Landscape

            The good news is that California as a state recognizes the importance of implementing a trauma informed approach to child welfare cases. Assembly Bill 2083 was approved by Governor Brown at the end of 2018. The bill provides a continuum of care provision, which means that foster children will no longer be aged out of the system, and provisions for counties to ensure that foster care placements are actually equipped with training to deal with children who have trauma. The legislation is focused on creating case plans or placements that are tailored to the specific needs of each child, since we know that children entering the system have been through life events that create long-lasting trauma.

            In my view, AB 2083 establishes the threshold for a state-wide approach to child dependency. Assemblyman Ken Cooley, who introduced this legislation, asserts that the bill does the following:

  1. Sets the expectation for coordinated services at the local level for youth who require services from multiple agencies through formalized Memorandums of Understanding.
  2. Requires the Secretary of Health and Human Services and Superintendent of Public Instruction to establish a joint inter-agency resolution team at the State level with certain responsibilities, including but not limited to, providing technical assistance to county agencies to establish local MOUs, and link youth to needed services.
  3. Requires the interagency team to review the availability of appropriate placements (from family homes to congregate care) that are trained and/or supported to provide trauma-informed care to foster youth and make recommendations to the Legislature for improvements in this area.
  4. Requires the interagency team to consult with stakeholders, including practitioners, to develop a plan to increase the availability of trauma-informed services to youth in care.

All of these things are great and a step in the right direction, but what if there were state-wide Memoranda of Understanding that each county agreed upon that addressed the needs of families before children are removed and placed in foster care? Why are there not interagency teams established by the Secretary of Health and Human Services to link parents to drug treatment programs, housing opportunities, child care and job training so that families have the tools to create healthy environments for themselves and their children?

Continue reading “A State-Wide Trauma-Informed Care Approach: Implementation of Stricter Guidelines for Discretion in Child Welfare Cases and a Shift Towards Family Services in the Early Stages”

Sense of Community: Basic Challenges Facing Transgender and Gender Nonconforming Youth in Foster Care

Dr. Ryan T. Anderson of The Heritage Foundation has made a career of late arguing that transgender people are merely making a choice regarding their identity and not affirming openly a fact that their gender identity fundamentally differs from their sex at birth. People like Dr. Anderson, PhD,  know, or believe they know, or think they know, what it means to be  transgender/gender nonconforming (TGNC). They believe it to be fundamentally an act of choice: to reject one sex and elect to be part of another.  They are partially correct; in some manner, there is a choice. But the choice isn’t between genders, or sexes, or sexuality, but rather a choice of whether to live life as one’s authentic self or to keep hidden from the world a basic internal truth of who one is as an individual.

Gender Identity [PDF Pg. 4], as defined by the American Psychological Association, is “[a] person’s deeply-felt-, inherent sense of being a boy, a man, or male; a girl, a woman, or female; or an alternative gender (e.g., genderqueer, gender nonconforming, gender neutral) that may or may not correspond to a person’s sex assigned at birth or to a persons’ primary or secondary sex characteristics. Since gender identity is internal, a person’s gender identity is not necessarily visible to others.” The same APA definition goes on to state that one’s “affirmed gender identity [. . . ] refers to a person’s gender identity after coming out as TGNC or undergoing social and//or medical transition process.”

In this post, I will discuss the issue of visibility and community for TGNC youth, I will talk about how TGNC foster youth have exceptionally bad outcomes even when compared to non-TGNC youth in foster care, and finally, I will briefly touch on the existing Foster Youth Bill of Rights in the California Welfare and Institutions Code. Continue reading “Sense of Community: Basic Challenges Facing Transgender and Gender Nonconforming Youth in Foster Care”

A Consolidated Court System gives Dually Involved Youth a Better Chance for Positive Outcomes

Dually-involved youth (DIY) in jurisdictions without a consolidated system in place, could have two separate cases, before two separate judges, each with different goals. If this wasn’t confusing enough, the two court systems might not have coordination, cooperation, or communication. The child could be represented by two different lawyers and would be assigned a probation officer and a social worker, which could have very different case plans that include contradictory orders and services that interfere with one another. Each of these stakeholders plays an important role in making decisions that can affect DIY for the rest of their lives.

Because DIY present more complex issues than single-jurisdiction youth, they tend to drain already scarce resources from child welfare agencies, probation departments, and the courts. This can happen when agencies duplicate case management efforts. Additionally, because there are multiple parties involved, usually with differing goals and means of achieving them, costs can add up and their plans can be less effective than if there was a consolidated effort to provide a unified plan administered by cooperating agencies. I will not be addressing financial costs in this post; in the next post I will discuss financial costs and how having a unified system of courts and service programming will benefit all of us as a society. In this post I will focus instead on some of the challenges raised by having DIY report to multiple agencies and/or courts and show the advantages for DIY in jurisdictions using an integrated systems approach.

Continue reading “A Consolidated Court System gives Dually Involved Youth a Better Chance for Positive Outcomes”

White Saviors are Not Saving Children

While many of us would like to believe we live in a post racial era, where everyone is seen and treated as an equal, unfortunately, that just isn’t so. In many of our systems, even those designed to do good and help others, race matters a great deal. One such system is the child welfare/ foster care system. It’s no secret that children of color are overrepresented in this system. This has been acknowledged for many years. In this series of posts, I aim to address why race matters in this system, how the race and culture of a child should be considered in his/her foster care placement, and the ways in which we can work to make the system better for children and families of color.

Before we dive into talking about racial disparities, implicit biases, and sifting through whether or not the child welfare system is racist and what that really means, there’s something that I think is important to acknowledge and understand: discussing race often makes people uncomfortable, defensive, and sometimes angry. I believe it is critical to establish the lens through which I am viewing and discussing this issue.

Continue reading “White Saviors are Not Saving Children”

Unpacking Adverse Childhood Experiences and the Impact on Foster Care Youth

In the past 20 years, doctors and public healthcare professionals have uncovered a clear link between poor adult health and adverse childhood experiences (ACEs). According to the Substance Abuse and Mental Health Services Administration, adverse childhood experiences (ACEs) are “stressful or traumatic events, including abuse and neglect. They may also include household dysfunction such as witnessing domestic violence or growing up with family members who have substance abuse disorders.” ACEs not only lead to early morbidity, but they also have been found to promote participation in maladaptive, “high-risk,” behaviors. 

In the United States, adults who have experienced 6 or more ACEs during their childhood are 24.36 times more likely to attempt suicide than a person without ACEs. According to the 2017 article from the International Journal of Child Abuse and Neglect, not only are adults with high ACE scores likely to attempt suicide, but they are also 3.73 times more likely to use illegal drugs, 2.84 times more likely to engage in heavy alcohol use, and 2.73 times more likely to suffer from depression. 

Unfortunately, adults who suffer from drug addictions and alcohol abuse are not less likely to have children than their peers. Instead, they become families with adult caregivers who suffer from drug and alcohol addictions. At a certain point, when the substance abuse is unmanageable, law enforcement and Child Protective Services will intervene in the best interest of the child. If the parent is unable to cure their addiction, their child will join nearly 52,000 other youth who are in California’s Foster Care System.

Continue reading “Unpacking Adverse Childhood Experiences and the Impact on Foster Care Youth”

Notice, Courts, and Culture: ICWA in the Modern Era

Although the history of discrimination against Native American children and families is apparent to most, the decision to keep ICWA in practice today remains controversial. In October of 2018, a federal judge in Texas struck down ICWA as unconstitutional in Brackeen v. Zinke (2018). The Fifth Circuit has heard oral arguments and will issue a decision later this year, but dissatisfaction with ICWA has been festering for years. The Brackeens—the family who are the plaintiffs in this case—are merely the face of families and political actors that have been dissatisfied with the way ICWA has played out within the foster care system.

The Notice Requirement and ICWA

You may recall from my first long post that when a child is made a dependent of the court, any and all biological parents are told to notify the court as to whether they have Native American heritage. The burden of finding out the extent of that heritage, which tribe the heritage is from, and notifying the tribe(s) that could possibly be involved with the case lies with the court and county counsel. If either or both parents do not know if they have Native American heritage, the court and county counsel must notify all federally recognized tribes.

ICWA’s notice requirements are incredibly strict. These requirements are set in order for the tribe to be able to make a determination of which child may or may not qualify for membership within that tribe; and therefore, the notice must be “complete, timely, and accurate.”

The California Court’s ICWA Notice Information Checklist details the requirements that the law sets out for county counsel and the court in order to comply with federal guidelines. The notice must contain information about the child’s relatives “as far back as great-grandparents,” at minimum, which includes a duty to interview all extended relatives that are available to provide the names of these ancestors to the tribe. The most detailed list of requirements is found in the form that county counsel must fill out to provide notice; the information, at its most complete, would have:

All names known of the Indian child’s biological parents, grandparents, and great-grandparents, or Indian custodians, including maiden, married and former names or aliases, as well as their current and former addresses, birthdates, places of birth and death, tribal enrollment numbers, and any other identifying information, if known.

That, of course, is an incredible amount of information, and it may be difficult for even the average person—without any Native American heritage—to provide similar information about their ancestors. But, in the past, cases have been overturned on appeal because of “missing middle names, misspellings,” and “reasonably” available information.

But perhaps the most difficult requirement that is currently in California and federal law is that the “court and child welfare department have an affirmative and continuing duty to seek to obtain th[e information above] throughout the life of the case where they know of or have reason to know that the child is or may be an Indian child.” (emphasis added). This means that the adoptive parents of a child who could have Native American heritage—even if the parents themselves have terminated their parental rights—could still be subject to ICWA law, and tribal jurisdiction could still trump their adoptive rights that could be found at any time in the child’s case. While this is an example of California law (see Cal. Welf. and Inst. Code §224.3), similar laws exist in many states throughout the United States or just comply uniformly with ICWA’s exact wording. (For another specific example, see Colorado’s Title 19, Children’s Code §19-1-126; for rote compliance with ICWA, see New Mexico’s §32A-1-14 (2016).

Brackeen v Zinke (2018) and Current Controversy

But what does notice have to do with Brackeen?

Continue reading “Notice, Courts, and Culture: ICWA in the Modern Era”

Trauma Systems Therapy Training: What Social Services Needs to be Utilizing, But Isn’t

Children in foster care are exposed to many adverse experiences and are heavily impacted by their trauma. As discussed in my previous posts, trauma affects kids, leads to behavioral problems, and can result both in school discipline and in parents failing to understand the source of misbehavior- which results in placement instability. A foster care system that incorporates policy and training meant to deal with the effects of trauma can better support youth and improve their life outcomes.

In an attempt to reduce placement instability and promote the child’s well-being researchers and people involved in foster care have begun to move toward an approach of trauma-informed care. In this post, I will explain why California should use the Annie E. Casey Foundation (AEC) Trauma Systems Therapy for Foster Care curriculum to implement a standardized system of trauma training throughout the child welfare system. I will do this by examining recent actions by the California legislature and demonstrating why using the AEC materials is the best approach we currently have available.

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Stage 3 of 4: Barriers That Prevent Schools from Addressing the Needs of Youth with Trauma

My first paper introduced the strong impact that trauma has on kids’ ability to learn in school. I then explored the disheartening educational data surrounding our youth in foster care in my second paper. So, if we know that trauma affects learning, and youth in foster care are exposed to various levels of trauma and are therefore not performing well in traditional public schools, what are the barriers that prevent teachers and other school staff from being able to effectively teach youth with trauma? 

Continue reading “Stage 3 of 4: Barriers That Prevent Schools from Addressing the Needs of Youth with Trauma”

Who’s Watching the Watchers? – How Overrides Undercut Well-Measured Assessment Tools

In my last post we personified the real-life implications of discretion in the child welfare systems and how it can create inconsistency. We will now review current statutes, California’s most widely used policy manual, (the structured decision-making tool (SDM)), and culture of the agencies involved to uncover exactly why and how discretion can create inconsistencies that inflict further unnecessary trauma. The problem is not that child welfare agencies have discretion – every unique family deserves a response that best suits them – the problem is that this discretion is unfettered. There are clear steps and guidelines; however, a social worker can use something called an “override” (p.5) to change the course of a child welfare case based on their personal judgment. In this post I will illuminate unchecked discretion can have negative consequences for families.  

            It is important to have an overview of the juvenile dependency process before we go into the issues. First, a report of neglect or abuse is made to the child welfare service. These reports can be made by a law enforcement agent, officials at the child’s schools, family members, etc. Once a report is made, an official at the child welfare agency will determine whether and how quickly a response is warranted. Once a social worker responds, they have to make assessments about the risks of the child’s situation to determine what the best course of action will be (ie: open a case and work with the family, close the case, or remove the child). A social worker is to make those decisions, with or without the approval of a supervisor, using the SDM. These determinations will not be reviewed by a judge until the child welfare agency has a detention hearing, which can take days or weeks. 

I. Evaluation of Relevant Statutes

            California Welfare and Institution Code § 300 defines state law on the issue of removal. The subsection relevant to substance use related neglect is as follows:

(b)  (1)  The child has suffered, or there is a substantial risk that the child will suffer, serious physical harm or illness, as a result of the failure or inability of his or her parent or guardian to adequately supervise or protect the child, or the willful or negligent failure of the child’s parent or guardian to adequately supervise or protect the child from the conduct of the custodian with whom the child has been left, or by the willful or negligent failure of the parent or guardian to provide the child with adequate food, clothing, shelter, or medical treatment, or by the inability of the parent or guardian to provide regular care for the child due to the parent’s or guardian’s mental illness, developmental disability, or substance abuse. A child shall not be found to be a person described by this subdivision solely due to the lack of an emergency shelter for the family. 

If a report comes in and gets substantiated, a social worker can launch an investigation. If, during the course of investigation, it is determined that there is substantial risk of the child suffering then WIC § 300 is the controlling statute for removal. Although there are different potential causes for removal according to the statute, I would like to focus on substance use related neglect since this issue is at the heart of the overwhelming majority of child welfare cases.

            I would like to break down this statute to identify where the law grants discretion which creates opportunities for agents of the state to subjectively evaluate conditions. First, what constitutes “substantial risk?”  The statute lists substance abuse as a cause for willful or neglectful failure to care, but it does not state that that substance abuse automatically creates a substantial risk that the parent will willfully or negligently fail to care for the child.

            The determination of whether or not a child is at “substantial risk” is subjective and these crucial decisions are largely made by a case worker, with approval of a supervisor if there are issues that require overrides. Overrides are when a social worker uses their clinical experience to make judgment calls outside of the guidelines in the SDM. (pp. 8-9) This type of discretion is subject to implicit biases that social workers might carry, especially when it comes to substance use disorders.

            In many cases, substance use disorders can constitute grounds for removal; however, there is evidence that removal is typically not the best one for the child or parent involved. A child being yanked out of their home by strangers is extremely traumatic and is likely to cause long term suffering and issues; however, in some situations that might be in the best interest of both the parent and the child. Removal can have a positive impact on some parents by giving them a reason to begin to make serious life changes, but it can also drive a parent further down the rabbit hole of addiction by taking away the only thing that gave them hope to keep fighting to make those changes. Issues with removal are very complex and need to be tailored to individual situations, that is absolutely a fact. That fact is also the reason why these decisions should not be completely susceptible to the judgment of one social worker (and possibly a supervisor) without any safeguards or protection. Of course, discretion can also be used in ways that have a positive impact on families. However, this statute leaves a lot of room for subjectivity without any safeguards when making such a crucial decision about the trajectory of a child’s life.

            Next, California Welfare and Institutions Code § 309(a) governs the responsibilities of the child welfare agency to keep a child with their parent or at least, place the child with a family member. The law regarding placement is as follows:

309 (a) Upon delivery to the social worker of a child who has been taken into temporary custody under this article, the social worker shall immediately investigate the circumstances of the child and the facts surrounding the child’s being taken into custody and attempt to maintain the child with the child’s family through the provision of services. The social worker shall immediately release the child to the custody of the child’s parent, guardian, Indian custodian, or relative, regardless of the parent’s, guardian’s, Indian custodian’s, or relative’s immigration status, unless one or more of the following conditions exist:

(1) The child has no parent, guardian, Indian custodian, or relative willing to provide care for the child.

(2) Continued detention of the child is a matter of immediate and urgent necessity for the protection of the child and there are no reasonable means by which the child can be protected in his or her home or the home of a relative.

According to this statute, the child welfare agency “shall… attempt to maintain the child with the child’s family through the provision of services.” The agency is not mandated to maintain the child with the child’s family through the provision of services. However, the agency is also not allowed to fail to exert any effort to maintain the child. This leaves the standard regarding continued detention – which states that it should only be used if there is immediate and urgent necessity for the protection of the child and there are “no reasonable means” that could protect child in their home or the home of a relative – subject to human judgement once again. Do “reasonable means” look the same in every case?

            Lastly, California Welfare and Institutions Code § 361.4 governs the emergency placement of children who have been declared dependents of the state and is as follows:

 (3) Notwithstanding paragraph (2), a child may be placed on an emergency basis if the CLETS information obtained pursuant to paragraph (2) of subdivision (a) indicates that the person has been convicted of an offense not described in subclause (II) of clause (i) of subparagraph (B) of paragraph (2) of subdivision (g) of Section 1522 of the Health and Safety Code, pending a criminal records exemption decision based on live scan fingerprint results if all of the following conditions are met:

(A) The conviction does not involve an offense against a child.

(B) The deputy director or director of the county welfare department, or his or her designee, determines that the placement is in the best interests of the child.

(C) No party to the case objects to the placement.

WIC § 361. 4 outlines the standards for clearing potential emergency placements in regard to criminal records. The statute indicates that placements can be approved even if the person who is intending to take temporary custody of the child has a criminal record, so long as the other conditions are met. One of these conditions is that “the deputy director or director of the county welfare department, or his or her designee, determines that the placement is in the best interest of the child.” This means that determining whether or not a family member is the best option for placement of a child despite a criminal conviction is ultimately left up to the judgment of a human with their own subjective beliefs. I would be interested to know how the agency would determine what was in the best interest of the child.

            As you can see, all of the statutes discussed above have discretion built into them. Like mentioned above, discretion can be used for positive outcomes like keeping families together, placing children with relatives who might have criminal records, or promptly removing kids out of dangerous situations when the SDM might not call for those actions. However, in light of the entire process and the lack of guidance or oversight until after these decisions have been made, and the fact that these decisions can have traumatic consequences that cannot be undone it should not be so easy to use discretion to circumvent a well-established tool.

II. The Role of Risk Assessment

            Every county in California utilizes the structured decision-making tool to inform their decisions regarding child dependency. Levels of risk determine the decisions made by the child welfare agency involved about a particular case. The section regarding substance abuse of a caregiver states,

The caregiver is diagnosed with chemical dependency or abuse AND is currently using. Current use does not require that caregiver be under the influence at the moment of the call, but that the caregiver has used within the past two weeks and has not entered into a formal or informal program to achieve abstinence; OR The caregiver is using illegal drugs; OR The caregiver’s alcohol use suggests a probability that dependency or abuse exists, such as blackouts, secrecy, negative effects on job or relationships, identified drinking patterns, etc. (p.28)

I thought it was interesting that a person with a substance use disorder (not alcohol) can be classified as neglectful even if they haven’t used in two weeks, yet a person with an alcohol dependency is afforded a more thorough evaluation of how their drinking affects their ability to care for the child.

            The structured decision-making tool is intended to assist child welfare agents make risk assessments throughout the process described earlier. However, not every decision will be dictated by the SDM because each and every step recommends a certain action but also gives an easy “check this box and explain” override option that can be used retroactively.

            This seems like a major problem. Let’s look closer at the override options to uncover how “checking a box” to avert the recommended course of action can be problematic. The first step in the SDM is determining whether or not the report requires a response and this step has an “override” option. (p.5) This is when the agency has received a report of neglect and is determining the next course of action.

Continue reading “Who’s Watching the Watchers? – How Overrides Undercut Well-Measured Assessment Tools”

The Impact of Receiving Disparate Public Services: A Comparison of Youth in Foster Care and Youth in the Juvenile Justice System

I. Introduction

            This blog post will focus on the different public services, mostly education, available to children in the foster care system and children in the juvenile justice system. Children and youth are a segment of the population that most individuals would view as needing protection, support, and guidance. This is even more true for children and youth that are in either the foster care system or the juvenile justice system. Both systems aim not to punish, but to rehabilitate and/or help children. However, foster youth generally receive more public services compared to youth in the criminal justice system even though they both experience similar social circumstances and traumas. In providing these services, governments seek to protect and provide for the most vulnerable members of our society and improve the quality of life after traumas. Additionally, there are children that exist in both systems referred to as dually involved youth. Dually-involved youth…[are] youth who are concurrently known to both the child welfare and juvenile justice systems at some level. However, children who are involved in both systems will not be the focus of this post. My research will focus on the disparity between the services provided to foster youth and youth in the criminal justice system. In terms of public services available to deal with trauma, displacement, and instability, foster youths generally receive more services. This is a problem because even though justice-involved youth are experiencing similar trauma (housing insecurity, poverty, etc.) they are not getting the services that might be able to help them.

Continue reading “The Impact of Receiving Disparate Public Services: A Comparison of Youth in Foster Care and Youth in the Juvenile Justice System”