Colorado, like many states, is working to overhaul its antiquated child welfare system that, despite important successes, is expensive, reactionary rather than proactive, activates too late, and regularly leaves children, families and wrongly maligned human services staff unsatisfied.
This overhaul is overdue as Colorado, like the rest of the country, grapples with the cascading effects of childhood trauma. Colorado’s child welfare referrals have increased 46 percent over the past 10 years, while our state’s child abuse and neglect hotline (1-844-CO-4-KIDS) ended 2017 with a staggering 211,554 calls.
Removals of children from unsafe homes have been increasing nationwide since 2012, primarily because of parental substance abuse.
While the child welfare sector is straining under this influx, it is simultaneously rewiring to overcome sector outcomes that can’t continue.
We know that adults with un/under-processed childhood trauma combined with ineffective journeys through child welfare are disproportionately homeless, unemployed, at far greater risk of suicide and addiction, have PTSD rates six times that of the general U.S. population and are under-educated and incarcerated at alarming rates.
Child abuse and neglect cost the United States a staggering $220 million a day.
Enter the Family First Prevention Services Act (FFPSA) passed by Congress earlier this year. FFPSA brings new possibility to a sector crying out for change.
The cornerstone objective of the law is to shift resources and effort away from costly, too-frequently used out-of-home placements toward prevention and early interventions.
Simply put, the goal is to reinvent the sector by encouraging early and comprehensive investments and interventions so that families experiencing trauma can instead thrive together in their homes and communities. And if a child needs to be removed from an unsafe home, the intent is to do so in a way that minimalizes the time they spend outside of a permanent, safe home setting.
As such, child welfare in Colorado is likely to look much different in a few years. Thankfully.
The sector will more comprehensively tackle multi-generational trauma so that parents can transform, not transmit, their pain. New allies who have always been on the front line of healing will emerge more prominently, such as Boys & Girls Clubs, Boy Scouts, and communities of faith activating around families.
Expect newly empowered nurses and schools to identify opportunities to support families earlier, and watch as service providers like the Tennyson Center for Children morph for greater impact.
Moreover, Coloradans will be asked to rethink how we consciously and subconsciously isolate families experiencing trauma. Traumatized families often unravel as they lose jobs to care for kids, struggle financially and emotionally and are stigmatized for raising “bad kids” when nothing could be further from the truth.
Finally, Colorado can lead nationally on FFPSA implementation by tackling a handful of weaknesses in the new law that will undermine success.
First, Colorado should courageously attack the funding models that perpetuate late-stage interventions. Sector funding is largely locked into narrow medical billing codes that mistakenly miss opportunities for early interventions that are more impactful, save money and are focused on supporting family unity, but are hard to finance.
Leaders need to reimagine funding models and move beyond current “medical necessity” and “imminent risk” categories that only apply once families-in-need reach a crisis point.
Second, we need to eliminate the notion that youth have to “fail” at lower levels of care to qualify for higher levels. Need should be assessed individually, based on current circumstances and not on a medical model where youth must essentially “fail” in order to receive the support they actually need.
Delaying support often leads to more severe needs, more complex trauma, and an increase in risk factors that often outweigh protective factors.
Third, and linked to the above, is the mistake made by legislators in our nation’s capital in pushing “evidence-based (therapeutic) practices” over outcomes.
Agencies are scrambling to figure out which evidence-based practices will be eligible for funding when in fact what should be center stage is holding agencies accountable for outcomes that change the narrative of kids’ and families’ journeys through child welfare.
Healing journeys are complex, not easily boxed into the practices under consideration, and certainly not only contingent on therapy.
Instead, agencies like Tennyson should demonstrate that they can stabilize children and families experiencing trauma, help them heal and build strategies to sustain that healing over time while successfully reintegrating kids and families into their community without the need for ongoing child welfare involvement.
Better outcomes only come from a mix of therapies, healthy relationships, schooling and other interventions (such as but not limited to art, music, substance abuse treatment, parent support groups and membership in organizations like the Boys & Girls Clubs) that transcend the FFPSA’s evidence-based practice requirement.
Finally, we need to integrate Colorado’s Child Maltreatment Prevention Framework for Action and FFPSA. The maltreatment framework is outcome-focused, embraces early interventions and understands the critical flag of “neglect” that sadly will never rise to the visibility of “medical necessity.”
Our best opportunity to intervene in ways that limit child welfare engagement is to elevate “neglect” as a true intervention point.
Ultimately, we envision a world where abuse and neglect dramatically decline and trauma is addressed in radically new ways, unshackling victims from the pain of their past and positively unleashing them into the opportunities of their future.
FFPSA sets the table, and Colorado has a chance to lead the nation in designing the particular menu that truly changes the game.
Edward D. Breslin (Ned) is the president and CEO of the Tennyson Center for Children. Brandon Young is Tennyson’s chief advancement officer.
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