CSWE CHILD WELFARE SYMPOSIUM A View from DC JOAN LEVY ZLOTNIK, PHD, ACSW November 3, 2016 joanzlotnik@gmail.com

Social Work & Child Welfare: A Long History Children’s Bureau’s social work leadership Commitment to train social workers from the beginning of federal foster care. Lenroot report - 1939http://www.mchlibrary.info/history/chbu/20688.PDF https://cb100.acf.hhs.gov/Cb_ebrochure Federal discretionary grant funding for child welfare training Federal reports identifying workforce (manpower) gaps as social services expand (1959 and 1965). The States, therefore, were encouraged to include in their plans for child-welfare services one or more of the following procedures: 1. Granting educational leave to qualified persons for attendance at recognized schools of social work. 2. Improving quality of service through providing more adequate supervision of workers. 3. Using specially staffed local units for orientation of new workers; for periods of intensive supervision of workers brought into the unit from other counties; and in some instances, for a limited number of students of schools of social work, usually those regarded as potential child- welfare workers in the particular State. The amount of money set up for educational leave in the 35 States and Hawaii for the fiscal year is $92,735-out of a total of $1,701,786.22included in the budgets for child-welfare services for these States and Hawaii. Focus on preparing for rural work and taking off more than 2 quarters at a time. Students’ responses to their experiences A longer period of educational leave. 2. Better facilities for field work and more competent supervisors of field work. 3. Closer integration of classroom work with field work. 4. More realism in the content of lecture material. 5. Instead of specialized courses in rural work, rural as well as Urban 6. Less time devoted to historical material in lecture courses. 7. Opportunity for advisory services regarding selection of courses prior to student's registration. 8. Better adaptation of courses on community organization on to situations in rural communities. 9. Smaller classes. 10. Emphasis on the importance of interpreting the program to the community. In the light of these suggestions an interpretation of case-work principles in all courses offered. [Jnder the Social Security Act Title V, Part 3 Development of Program, 1936-38 Bureau Publication No. 257

Federal Legislation Supporting the Child Welfare Workforce Title IV-B – Discretionary training opportunities Stipends traditionally NCWWI – since 2003 Usually social work focused, especially since ’92 Title IV-E – Entitlement Funding Part of 96-272 (1980) Based on Title IV-A Foster Care Regs.

Promoting Professional Social Work Practice in Public Child Welfare NASW Presidential Initiative – 1985-1987 Lack of focus on child welfare in SW ed. Deprofessionalization of CW agencies High caseloads; complex cases; recruitment and retention problems. Collaborate with other national organizations and social work education programs Develop an agenda & plan implementation Create publications Engage key stakeholders

Title IV-E Training to Support Social Work Education Since late 1980s, increasing use by Schools of SW to support BSW & MSW students – LONG TERM TRAINING. Variations in regions. Unclear regulations. Not for ‘clinical’ training. Tied to 1996 AFDC eligibility rates. Cost allocation of training across child welfare services.

Use of Title IV-E to support BSW & MSW Education 1992 – 24 programs accessed Tit1e IV-E 1996 – 68 programs (91% began after ’91) Early 2000s – estimated IV-E use in 40 states CSWE’s 2011 statistics report – 35 states CSWE’s 2013 statistics report – 33 states CSWE’s 2015 statistics report – 33 states (156 BSW/105MSW) NASW Social Work Policy Institute (SWPI) 2012 survey (Zlotnik & Pryce) (93 programs reporting) 2/3 operating for over 15 years 70% remained the same size or decreased over past 3 years

Using Title IV-E to Support SW Education

Key Issues Interpretations of Title IV-E training policy in some jurisdictions appears to restrict use The application of stringent rules and outdated regulations does not support the essential development of a skilled workforce. Impacted by: Changes in the leadership and administration of public child welfare agencies and ACF Regional Offices Conflicting opinions and Departmental Appeals Board decisions regarding cost allocation of training expenses across federal programs Privatization of child welfare services Narrow interpretation of what topics can be covered by Title IV-E (see Child Welfare Policy Manual).

The Child Welfare Workforce No specific information on education and training (NSCAW analysis <40% with a BSW or MSW degree) – varies across states from <10% to 60%. High rates of turnover – varies by agency & by county even in state administered systems. High workload (recent reports from VT, CO, SC, GA, MA). Insufficient clinical training & assessment skills (i.e., substance abuse, maternal depression, risk and protective factors, evidence-based interventions). No specific and complete information on education and training of the workforce exists. Different states and different agencies use different methods to deploy workers and small agencies may have one worker providing multiple services while large agencies may have many specialized units. In terms of the background of the workers while the public and policy makers might assume a highly professionalized workforce, in actuality an NSCAW analysis found that less than 40% of child welfare workers have a social work degree – and that varies greatly across states, of those with social work degrees, more have a BSW or MSW degree) – and in some states the % of social workers is less than <10% to 60% Since the quality and competency of the workforce is so important, the 2010 reauthorization of the Child Abuse Prevention and Treatment Act (P.L. 111-320) includes a provision (Sec. 106(d) “to include data on numbers of CPS personnel, average caseloads, education and training requirements, demographic information, and workload requirements.” However this information is not yet available and it is unclear if states are even reporting this info the Federal government, . High rates of worker turnover is also of great concern – varies by agency & by county even in state administered systems - with rates as high as 50 %. High workload is an on-going issue (Just in the last few months there have been new reports requested by legislatures or governors from VT, CO, SC, GA, MA with these findings) Based on workload study - -Colorado needed 574 additional FTE Caseworker positions. 49% increase in case worker hours. High workload has been a concern for the past 30 years. Some states might address it as follow up to a child death and efforts at reform, or in response to a lawsuit – but it seems such reforms are not sustainable and the workload creeps back up. Insufficient clinical training & assessment skills (i.e., substance abuse, maternal depression, risk and protective factors, evidence-based interventions). Ironically the largest federal source of training funds for child welfare workers, according to the Children’s Bureau’s own policy manual – state that the funds cannot be used for clinical training or to training on CPS investigation – so states are left to try to find other sources, play a semantics game in describing training content, or might find that the training expenses are disallowed.

Well-Being: Parallel Process Child Welfare Worker SUPPORTIVE & EDUCATIONAL SUPERVISION QUALITY ORGANIZATIONAL CULTURE & CLIMATE SKILLS , KNOWLEDGE & RESOURCES TO IMPLEMENT EVIDENCE-BASED INTERVENTIONS REASONABLE WORKLOADS Child SUPPORTIVE NURTURING CAREGIVERS MENTAL HEALTH PHYSICAL & SAFE & SECURE LIVING ARRANGE-MENTS ECONOMIC SECURITY

Promoting Workforce Well-being Promote Hiring and Retention of Competent Staff BETTER CHILD WELFARE OUTCOMES Apply Evidence-Informed Retention Strategies Promote Policies that Fund Social Work Education & Professional Dev. Create and Sustain University-Agency Partnerships Build Healthy Organizational Culture and Climate Support High Quality & Supportive Supervision Apply Clinical & Evidence-Based Knowledge to Engage with Families and Promote Strengths

Components of an Effective Child Welfare Workforce Our intent in developing a framework for an effective child welfare workforce was to dispel the myth, partciualry at the policy level, that training and caseloads were the only workforce concerns. The group recognized from their broad experience that staff needed supports to accurately assess and provide what children and families need. They also needed the resources to support their work with children and families. And they need to be able to connect to the children and families they serve. In assessing and providing what children and families need – strong and consistent leadership is key as are the boxes in organe – quality staff preparation, supervions and traning and professional development. Strong and consistent leadership is again key in ensuring that the workforce has what it needs to support its work. Along with those other components in red , yellow and green – the supportive organizational environment, manageable caseloads and workloads, effective oversight and accountability, timely and accurate data and information, practice enhancing research and evaluation, and then useful technological resources, safe and suitable working conditions, and equitable employment incentives. Interesting enough in much of the research salary is not at the top of the list and many of these other facts are more relevant in recruitment and retention. Then a set of components that often get left off which help to connect staff to children, families and communities – authentic cultural competence and sensitivity and engaging families, children and other community is the work being done. Children's Defense Fund & Children's Rights 12 8/5/2008 12

Workforce Issues Impact Child Outcomes Impacting Child Outcomes More workers a child has, increases likelihood of more foster care placements (Milwaukee County). Worker turnover impacts return to care (FL)(predictive analytics). Workers with social work degrees: Quicker to achieve permanency outcomes. Greater sense of competency - self-efficacy Greater frequency of child visits Better use of community resources. Services more specific to level of severity of risk for further abuse & neglect. Self-Efficacy – Sense of Competence and Human Caring

Worker Outcomes Factors relating to retention: Personal factors: Workers commitment to child welfare, sense of self- efficacy, low levels of emotional exhaustion. Organizational factors: Supervision, co-worker support, job satisfaction, sense of fairness, salary & benefits. Workers expected to use clinical judgment and assessment tools – they need: Critical thinking skills. Knowledge/skills – specific to child welfare. Adherence to ethical practice. Strong assessment skills. Sense of self-efficacy. Continuous learning. Supportive supervision and coaching. Factors relating to retention: Personal factors: Workers commitment to child welfare, sense of self-efficacy, low levels of emotional exhaustion. Organizational factors: Supervision, co-worker support, job satisfaction, sense of fairness, salary & benefits. Workers expected to use clinical judgment and assessment tools – they need: Critical thinking skills. Knowledge/skills – specific to child welfare.(risk and protective factors, understanding substance abuse, depression, domestic violence, poverty Adherence to ethical practice. Strong assessment skills. Sense of self-efficacy. Continuous learning. Supportive supervision and coaching. Quality Supervision is consistently a factor related to worker retention, Attributes of supervisors Skills in mentoring High level of practice knowledge Workers that stay attach to supervisors With high rates of turnover – run the risk of supervisors with out necessary competencies related to supervisory role or practice excellence. Fatalities are low incidence and high impact – workers need to have core knowledge and skills and agencies need a practice model and expectations of ethical practice by workers engaged in optimizing child and family outcomes. And support for professional judgments.

Workforce Issues Impact Agency Outcomes Worker turnover is costly to agencies Recruitment, hiring, retraining – estimates of at least ½ of the CPS worker salary Worker turnover is costly to other workers Increased workload Problematic organizational culture and climate Absence of peer support Work-family imbalance Emotional exhaustion Supervisors providing direct services

An Unanswered Questions Why are workforce changes not sustained across years – decades of reports say the same Workload is too great Hire more workers Provide better training Hire people better prepared for the work Increase retention.

Opportunities President’s 2017 Budget Proposal. CDC Essentials for Childhood. Institute of Medicine Consensus Committee – New Directions in Child Abuse and Neglect Research. Commission to Eliminate Child Abuse and Neglect Fatalities Report and HHS Report to Cngress. National Child Welfare Workforce Institute. New Quality Improvement Center – University of Nebraska.

President’s 2017 Budget Proposal Workforce Critical in Child Welfare Outcomes Supports the need for more BSWs and MSWs\ Incentives to states to hire and retain Would not require cost allocation across child welfare programs (enhanced federal match). http://www.socialworkblog.org/advocacy/2016/02/president- obamas-budget-offers-opportunities-for-social-workers-in-child- welfare-behaviorial-health-early-childhood-home-visiting/ http://www.socialworkblog.org/featured-articles/2016/09/workforce- proves-critical-in-child-welfare-outcomes/

President’s 2017 Budget re: Child Welfare Improve permanency services so children are less likely to need foster care placement in the future, Strengthen tribal child welfare programs, Promote family‐based care for children with behavioral and mental health needs to reduce the use of congregate care, Foster successful transitions from foster care to adulthood, and Improve the quality of child welfare services provided to children through better trained staff Stronger information technology systems.

Title IV-E Recommendations Specifically related to Title IV-E training, President Obama is proposing to directly charge the cost of BSW and MSW education to Title IV-E, eliminating the cumbersome process of cost allocating the expenses based on the percent of a worker’s caseload that is Title IV-E eligible.

NASW/CWLA Child Welfare Workforce Briefing “Given the research the agency has seen, Wood said, child welfare workers with BSW and MSW training serve as “a foundation and a bedrock to meet the needs of youth and families immediately upon hiring.” “We know enhancing the amount that we pay for BSW and MSW training is one way to help improve our federal workforce,” Jenny Wood, Special Advisor, ACF/HHS. June 28, 2016 Other speakers – Helen Cahalane, Barry Chafkin, Brandi Stocksdale

Incentives to States for BSW/MSW Staff To incentivize States to exercise this option, this proposal would offer an enhanced match rate for case planning and management for children in foster care, as well as for administrative activities related to children who are candidates for care, when these activities are significantly performed by caseworkers with either degree.

Status of Family First Prevention Services Act Passed the House HR 5456, Report 114-628 No final Senate action Will there be action in December lame duck? Who wins the election How to pay for it – offsets Reauthorize IV-B needed Compromise between supporters and states and advocates who oppose some provisions? http://www.cwla.org/families-first-act-now-what/

2017 Challenges What direction will the new administration take? How does a public health approach to child welfare help strengthen social workers’ roles in child welfare service delivery? How can we marshall the lessons learned to create sustainable support for social workers in child welfare service delivery? Do we have data on the 20 year use of IV-E in social work education? Is there evidence on impact on child welfare outcomes? Are we teaching the right content?