There is every reason to believe the COVID-19 pandemic will have a long-felt impact on child welfare systems around the country. The list of concerns starts with mortality, and whether children lose one or both of their parents. More pernicious over the longer term is the economic impact the virus is having, and the strain those changes induce in already fragile families.
Child abuse and neglect rates will likely rise, with a follow-on shift upward in the number of children in out-of-home care. It needn’t happen this way, but it’s best if we prepare for what might be called COVID-19’s secondary contagions, lest we find ourselves ill-prepared.
Of course, one has to ask how we prepare ourselves for a sudden and protracted shift in the demand for child welfare services. First, it is important to acknowledge that rapid growth in child welfare caseloads is possible – what scientists call exponential growth. Exponential growth starts slowly, almost invisibly, until it explodes. A quick look at the charts showing new COVID-19 cases in the U.S. illustrates the point.
Over the last 40 years, at least three states have experienced what is best described as exponential growth in their foster care caseloads. New York, between 1986 and 1989, saw the number of admissions to foster care grow from 13,000 per year to 24,000 per year. In Illinois, the number of admissions stood at 7,400 in 1990 and 13,600 in 1994. More recently, Arizona had to withstand an increase in the number of admissions of about 50 percent overall between 2011 to 2015, from 6,400 to 9,800.
In all three states, simultaneous changes in how long children stayed in care pushed caseloads up even faster. Put simply, more admissions and slower rates of exit – the twin engines of exponential growth – took hold of these systems in a relatively short timeframe.
The reasons why the caseloads increased in those states ties back to an unusual combination of policy choices and social calamities (i.e., crack cocaine and the Great Recession). Even so, it is difficult to draw out a single lesson. But that isn’t the point at this moment in time. The fact remains caseloads in the child welfare system can and do rise exponentially when the conditions are, shall we say, ripe.
Importantly, in the case of New York, Illinois and Arizona, the state child welfare agencies did manage to flatten the curve. But doing so required considerable public expenditure to prevent young people from coming into care unnecessarily. There was also the cost of carrying a large foster care population long into the future. For example, in the wake of New York’s exponential growth, the foster care population did not return to pre-growth levels for another 10 years after reaching the peak.
Although these are useful examples when one wants to highlight what is possible, these examples offer little guidance when it comes to the current situation and judgments we need to make regarding what is likely to happen and what should be done about the emerging situation. Our lack of understanding is mostly because the science behind how social epidemics impact the child welfare system is underdeveloped.
For example, we know that economic hardship, maltreatment and foster care are correlated with poverty, but we know very little about the ways in which changes in financial well-being affect the probability a family will have contact with the child welfare system. It’s a far more complicated question than it sounds. Even so, it’s knowable, and we don’t have a firm grasp on an answer. It means that if poverty climbs above current levels for any of the reasons it might, we don’t have a reliable estimate of how that change will ripple through the child welfare system.
That said, using the language of pandemics we’ve all learned in the past few weeks, we have the tools we need for a simple thought experiment.
If we think of caseworkers as doctors and nurses, then we will recognize immediately that a sharp increase in demand will increase stress in the workforce. If we think of preventive services slots as hospital beds with respirators attached, we can see demand outstripping supply. It leaves workers with hard decisions about who gets a service and who doesn’t. If workers are uncomfortable with those decisions, and they will be, the burnout that afflicts the field will grow, worker retention rates will collapse, and recruitment of new workers will dry up.
Fewer workers will give way to ever-more difficult decisions, and before long, you have a chain reaction the likes of which gives rise to exponential growth in foster care. Without an increase in preventative services, workers will be caught between the decision to leave a family alone or remove the child. No one wants to be in that position.
But, all of this is manageable, if not outright preventable, provided we accept the possibilities. First, we have to acknowledge two realities. Anecdotally, the number of reports to the child protection system are down, at least in some places. That’s likely because out-of-school children are not in front of mandated reporters as they normally are. If so, then there is, at this moment, pent-up demand. Then, there is new demand attributable to growing economic stress.
Should these sources come together at some point in the future, then we have to adjust the supply of what we need to manage the influx. That is primarily caseworkers and frontline staff, who are needed to do the investigations and make service referrals. We also have to acknowledge that workers will likely be faced with service demands for which there are no services, just as doctors face the possibility that their patients who need them will not have respirators.
To be ready, we need decision-making guidelines that workers can use to make what may well be life and death decisions. If I turn a family away because I have no services to offer them, then I do so knowing that my decision might lead to an otherwise preventable child death. Or, I have to use more foster care. Our workforce needs guidelines for making those decisions, not to mention their own first aid. We have the analytic capability to inform those guidelines, but the work has to start now before we are forced to rush our judgments.
Finally, we need to increase our collective capacity for forgiveness. The increase in demand for child welfare services is not inevitable. But, should demand strain capacity such that we are withholding services because we must ration what we have more than we do already, the unthinkable will happen. If and when it does, we will need to draw on our reserves of forgiveness. To do otherwise will only extend the lingering emotional effects of COVID-19 on those who serve on the frontlines of child protective services.
Fred Wulczyn is a senior research fellow at Chapin Hall and the director of its Center for State Child Welfare Data.