President-Elect Donald J. Trump’s administration and its likely policies pose many more questions than answers. What does a Trump presidency mean for those in the child welfare field? What impact will Dr. Tom Price, the designee for Secretary of Health and Human Services (HHS), and his team have on the Administration on Children, Youth and Families (ACYF)?
Unlike previous incoming administrations, a review of the Trump transition team provides very little insight into what a Trump/Price child welfare agenda might be.
Guess number one: very little will change at ACYF and the Children’s Bureau. ACYF is pretty far down the HHS food chain. The focus on repealing or replacing Obamacare should suck most of the policy oxygen out of HHS and its staff. The ACYF and federal child welfare budget is pretty much a rounding error for most high-profile government agencies.
One major issue for the child welfare field will be funding for home-visitation programs like the Nurse-Family Partnership that is included in the Affordable Care Act (ACA). The ACA included an authorization of $1.4 billion under the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) to establish home-visiting programs across the nation. An outright repeal of the ACA would eliminate funding for the Nurse Family Partnership, an evidence-based and cost-effective program. But a more nuanced revision of the ACA might well save the home visiting program; the program was originally included in ACA as cost neutral — no new monies in the federal budget were committed to fund nurse-home visiting.
The biggest piece of the child welfare budget continues to be Title IV-E of the Social Security Act of 1935. Title IV-E remains an open-ended entitlement program, which might catch the eye of administrative and Congressional budget-cutters.
Pardon the phrase, but last year’s unsuccessful Family First Prevention Services Act bill may trump (sorry, I could not resist) administrative efforts to modify Title IV-E. The Family First legislation had broad support in both the House and Senate and nearly was passed in September. An effort to include Families First in the 21st Century Cures Act failed when Senator Richard Burr (R-North Carolina) put a hold on the bill in the Senate.
The bipartisan support for the Family First Act suggests that the bill, with some changes and refinements, is likely to be re-submitted in the 115th Congress. While some legislators, such as Senator Burr and senators from Texas and California, may seek significant changes in the bill, there is little to suggest significant input should be expected from the White House and HHS.
The unexpected election results probably mean that there is not a large cast of “usual suspects” waiting for presidential appointments to key HHS child welfare positions. Further, some individuals who might be expected to be prime candidates for such positions may hesitate to be included in a Trump Administration. (Although I suspect few would actually turn down an invitation to be appointed should that call come.) In conversations with HHS administrators who will stay in their positions (as they are civil service and not presidential appointees), many of them suggest that former ACYF staffers from the two Bush administrations will be tasked with examining AYCF and the Children’s Bureau. Thus, the likelihood of radical policy and funding changes at AYCF seems low.
For those who are truly fearful of possible radical changes and funding cuts in the child welfare field, it is best to remember that the first major piece of federal legislation enacted in the child welfare field, the Child Abuse Prevention and Treatment Act (CAPTA) of 1974 , was signed by Richard Nixon — the absolute bête noire of most liberals in the 1960s.
Prior to signing CAPTA, Nixon had vetoed the Comprehensive Child Development Bill in 1972. Sen. Walter Mondale (D-Minnesota) responded to Nixon’s veto by introducing CAPTA. Mondale was later quoted as saying, “Not even Richard Nixon is in favor of child abuse.”
So, you never know.
Richard J. Gelles, Ph.D., is the Joanne and Raymond Welsh Chair of Child Welfare and Family Violence in the School of Social Policy and Practice at the University of Pennsylvania. His book, Out of Harm’s Way: Creating and Effective Child Welfare System (Oxford University Press), will be published March 3, 2017.