Patrick McCarthy, Remarks at the IFPS 40th Anniversary, July 18, 2014

patrick-mccarthyI have to start with a disclaimer. Not only am I not the most qualified person in this room, by a long shot, to do a summary of everything that’s happening over the child welfare horizon, I’m not even the best person in the room from the Annie E. Casey Foundation to do this. Tracey Feild directs our Child Welfare Strategy Group and she knows an awful lot about this. I tried to give her wrong directions about how to get here so she wouldn’t have to sit through this, but she’s doing it anyway. So here I am and, in the next few minutes, I’m hoping to touch on some of the important developments I see going forward. I’ll stay at the tops-of-the-trees level and I’ll start with front-line practice.

As we’ve been discussing, there seems to be a reignited interest in intensive family-based services. Along with this I see a veritable explosion of interest in evidence-based interventions and in the related issues of fidelity and implementation science. I think this trend is worth encouraging if we get it right.

These evidence-based interventions are taking advantage of what we’re learning about brain development, about trauma, and about toxic stress and applying these science-based insights to child welfare practice. That is awfully important.   I also think we’re starting to see more recognition of the importance of training and other supports to ensure fidelity in implementation of skills that all or most evidence-based practices are calling upon.

What I mean here is that, if you look across the many specific, brand-name models and their dedicated manuals tied to discrete interventions, you see common themes. For me the best example is family engagement because it is core to just about everything else and so many evidence-based interventions, appropriately, put a lot of emphasis on getting that right. So what people are starting to figure out is how to train staff in those skills so that when a child or a family walks in with a particular problem that may not be exactly what one or another specific evidence-based intervention deals with, staff have the skills to help that are based on well-tested and well-developed approaches.

Team decision-making, which in its early days I think we would have talked about more as an administrative approach than a front-line practice, is now becoming much more focused on the practice skills to do it well. So it’s no longer just a check-the-box, we had a team decision-making meeting kind of thing, but it is coming increasingly under the heading of an important part of front-line practice and more attention is being paid to the actual quality of the practice.

We’ve been talking today about the increased focus on child well-being and along with that I’m seeing a reignited interest in measuring child well-being. If done properly, and we’re experimenting with this at Annie E. Casey, we can do a better job of matching both services and service provider to particular kinds of presenting issues and tracking who does what well. It would take a whole other conference to go deep enough on this, but I think we’re getting much closer than we were before to looking at which children ought to be in which kind of service for what kind of purpose.

An often neglected yet critically important element in good practice—and we haven’t talked much about it here—is ensuring that families have quality legal representation. Legal representation is an intervention that, all by itself, can change the game in terms of family and family voice.

The field has focused increasingly on kinship care, but in recent years I think we’re recognizing the need to go much deeper on what it takes to do it right. Instead of just placing a child in a kinship setting and then saying “OK, let us know if there’s a problem,” I see more thinking about what it takes to really support kin so they can be successful.

I see a whole range of practices emerging around older youth. As you know well, the experience of older youth in the system is very, very different than the experience of young children. Most of the data that we look at show that the older youth are coming in with a different set of problems, and I think we’re starting to understand what it takes to work with these older youth and their families.

Related to that, and this is a big, big, big issue for Annie E. Casey, is reducing reliance on congregate care. Use of it varies from under 5% of all the children in care in some states to over 30%, and I just can’t believe that the children in State X are that much different from the children in State Y. So that’s another big initiative for us.

Somewhat related to this, there is a whole range of financing issues that we are working on and advocating for. We think there are federal financing strategies that, if adopted, could actually drive down congregate care and deal with some of the length-of-stay issues.

One of the things that family preservation helped us do was to pay attention to the concrete and material needs of families. I think that is part of the reason that today we are seeing new models in supportive housing. Since housing and poverty drive so much of placement, if you can have a more effective supportive housing system in place, you can prevent lots of placements and get better outcomes for children.

This next one is a bit weird in some ways but hear me out. We’ve developed a family-based information system and I know we don’t often think of that as part of the equation. But a bad system trumps a good program any day of the week and if you don’t have good data and the data is not family-based, you won’t be thinking about families in the same way. So we’ve developed a Facebook-type information system that Indiana—and they are here—is the first state to use statewide in its child welfare system

I’m going to end by raising an issue that goes well beyond child welfare. One of the things that I think Peter [Forsythe] and others really did in launching the family preservation movement was to change the narrative, to change how we think about families who are at very high risk of coming to the attention of Child Welfare. I think the next frontier is actually an even more ambitious change in the narrative.

Back then, there was this tendency – and I think it still lingers – to see families as being in trouble because of what the rest of us saw as bad choices or bad character or bad parents, etc. What has happened in the intervening 25 years is that the economy has been really, really tough on working families. It has been so tough on working families that the group of families that are at risk of coming to the attention of child welfare has expanded exponentially. Now, as many as 45% of the children in our country are at risk because their families are facing circumstances that undermine even the best efforts to meet their children’s needs.

I grew up in a neighborhood where everyone was working class and no one had gone to college but pretty much everybody did okay. The reality would be far different in that same neighborhood today. Because of the erosion in earning power and undermining of financial security for lower income families, both of my parents and all my friends’ parents would be working multiple jobs. We would see an increase in family stress and a decrease in the bandwidth parents have for their children. We would see erosion in neighborhood ties. I would be growing up much poorer, more isolated, less likely to benefit from social supports beyond my family. This is the reality for as many as 45% of our nation’s children. I think we have to challenge ourselves to recognize how many families who come to the attention of the child welfare or other public systems find themselves in trouble not because of bad choices or flawed characters, but because we have failed to provide the supports many families now need to make it.

That’s my quick summary tour.