Lexie Gruber and her sister couldn’t live at home anymore, but her uncle was ready and willing to welcome both girls with open arms. The State of Connecticut deemed his house unfit because it did not have enough bedrooms.
That singular triumph of lazy bureaucracy over common sense set Gruber on a path that would lead her through foster homes, homeless shelters and even a hospitalization during her teenage years. One of her final stops before college was a group home, an experience she related to members of the Senate Finance Committee at a hearing yesterday.
If anyone who listened to her testimony wasn’t affected by what they heard, someone should check their pulse. Gruber’s story pretty much sums up why the notion of limitations on group care have gained more consensus than any other finance reform idea on Capitol Hill.
Walls at her group home were adorned with information and bulletins. The staff, who Gruber said were instructed not to form an attachment with the kids, posted the nightly dinner menu on the office door.
Normalcy? Not a hint of it. The cabinets and fridge were padlocked. Upon arrival at the home, perfect behavior earned you the “privilege” of 30 minutes on the computer and a phone call. Over a longer period of time, you could even have an hour walk by yourself.
“I felt like I was a wrongly accused offender locked away for someone else’s crime,” Gruber told the committee. “Privileges were the only thing that kept me sane,” but “I could not understand why I had to act perfectly” to get them. “Why was I being penalized for having been removed from an abusive home?”
All the while, psychiatrists plied her with “myriad medications” at weekly meetings with a psychiatrist.
“If I was moody during our visit, he would give me a new prescription and claim my behavior was due to mental illness rather than seeing moodiness as a normal teenage response.”
The price for skipping those meetings? Loss of privileges, said Gruber.
Gruber has just graduated magna cum laude from college, a result attributable mostly to her own relentless pursuit of an education during her time in foster care. Several of her housemates from the group home were trafficked by pimps then and continue to work the streets now as adults. Others she shared her teenage years with are dead.
The question of if congregate care should be limited is no longer at issue, at least for Senate leadership on child welfare. They all agree that it should.
But in YSI’s opinion, there are two factors here that will determine whether anyone acts on this.
Line-drawing vs Oversight
The easier question to answer in child welfare policy matters is: “Should we?” It’s not easy, but many times the need for change is abundantly clear.
The real doozy is answering: “How do we?” And that is what will need to be hashed out here.
In 2013, the Annie E. Casey Foundation proposed an elimination of federal IV-E support for group care for those under 13, and a one-year limit on group care for teens. Senator Orrin Hatch (R-Utah) proposed a 15-day limit of IV-E support for group care for children under 13.
Both proposals amount to drawing a line in the sand at certain ages and for certain amounts of time, which is essentially saying to states: “You can leave kids in group homes for months or years, but we aren’t paying you to do it.”
Leading the argument against that mode of thinking is the Alliance for Strong Families and Communities, in particular its CEO Susan Dreyfus. In a column posted on the Alliance website yesterday, she says that residential care “should not be micromanaged by artificially controlled time or age limits or made bureaucratically difficult through artificial procedural barriers.”
Her counter-proposal is to require validated capacity plans by state, based on utilization, population trends, and projections, “so we know how many residential beds the children’s behavioral health system needs, where they are needed, and by what type and quality.”
One could see that as the first step in a group-care limitation model based on oversight instead of drawn lines. Hatch proposed oversight processes as a solution for teens in-group care; the Obama administration did the same.
Both ways have virtues and vices. Time limits create pressure to act, but any line in the sand is inherently arbitrary when you are talking about the development and needs of kids.
Oversight and tighter protocols can mean better scrutiny and decision-making in all cases, but create an illusion of improvement if nobody takes the changes seriously. Ask juvenile justice advocates how much progress has been made since addressing disproportionate minority contact became a federal requirement in 2002.
Single Issue vs Single Piece
The lead Republicans on child welfare in the Senate, Hatch and Charles Grassley (Iowa) might be content to move a bill that just limits the use of congregate care. We’ve heard they might also have some interest in addressing psychotropic drugs.
For Democrats and most of the interested advocacy groups, this is one piece of a bigger puzzle.
The Annie E. Casey Foundation’s 2013 proposal called for limits on congregate care, but in the context of a shift that would also put a three-year clock on foster care. And that proposal also called for savings from those limits to be reinvested in a number of things, including better training of foster parents and caseworkers.
Senator Ron Wyden (D-Ore.), ranking member on Senate Finance, voiced support for the notion of less residential care, but like Dreyfus and the Alliance, he might not support a bill that put time limits on it.
Wyden’s notion is to spend more on prevention, preservation and reunification services – way, way more – in an effort to lower the number of kids who would even be candidates for group care.
He circulated a draft bill last week that would, for the first, time, permit states to use the entitlement for anything other than foster care. It would also take the smaller IV-B allotment going to states, increase it by at least $1 billion, and make that more flexible as well.
Joo Yeun Chang, who leads the Children’s Bureau at the Department of Health and Human Services, praised Wyden’s bill at yesterday’s hearing. But it has about as good a chance of gaining the requisite Republican support as Hillary Clinton does of getting Ted Cruz’s vote in 2016.
It seems likely to YSI that Hatch will again seek a law to curb group care, but won’t have bipartisan support unless he’s willing to couple that with some new investments in other, community-based services.
This doesn’t even cover the intentions of House child welfare leaders, by the way, who have their own ideas about residential care and lots of other child welfare finance reforms. If the Senators agree on some single-issue bill or package to move, they’d still need to get buy-in from House Ways and Means.
If it gets to that point, and the Senate is looking for a liaison to help both chambers communicate, here’s a suggestion: ask Lexie Gruber. The Senators were clearly moved by her testimony; she has already been a staffer for child welfare leader Rep. Jim McDermott (D-Wash.); and she’s about to join the staff at First Focus.
Youth Services Insider is mostly written by Chronicle Editor John Kelly.