Child Welfare in the 21st Century

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Posts Tagged ‘foster care’

Prayer for the New Year

Posted by lboyd544 on December 31, 2014

I think we all get a bit nostalgic today, Dec. 31st.  It doesn’t matter what year; it doesn’t seem to matter whether the past twelve months were ‘good’ or ‘difficult’ or whether the coming year holds specific promise and plans. Today is the one day we all are fully aware of the passage of time and of key moments in our lives.

I often write of the needs of vulnerable children. I frequently cajole those of you reading to action…again, more, quickly.

Yet I have been sensing a different perspective needed by all of us in the child welfare field and today I have found a clue in a prayer sent me by a friend. I do not know the author. Suffice it to say, I didn’t write it! But I will share.

“The vision is simple and clear. Let us leave as much as we can here, on this side of time, before we cross over to tomorrow. Let us come to the end of this year without regrets, worries, fear or anger. Let what needs to be left behind be released that our steps are as light as innocent hope, our hearts as free as first felt love.”

The message I need in this prayer is a message I fully believe in and try to present to those voiceless children and families we seek to serve: it is the message of ‘hope’. The different perspective is that we, who lead and have the opportunity to speak for our nation’s youth, also need ‘hope’ and innocent hope… unencumbered by prior failures or successes.

In 2015 we have hope for a new year, new energy, new opportunity, an expanding economy, a new Congress and Senate and state legislatures, new discoveries (even miracles) in health care, and new voices in our work to serve (and save?).

I feel light. I will release and leave behind the hardships of the past. And I look forward with hope and renewed spirit to our journey together in 2015.

Happy New Year.


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Courts and other legal partners: An essential collaboration for child welfare public and private

Posted by lboyd544 on October 29, 2014

Last week I had the privilege of presenting a workshop entitled: Therapeutic Foster Care – Exceptional Care for Complex, Trauma-Impacted Youth in Foster Care, to an annual Judicial Conference held in Oklahoma City, OK. This conclave of 250 was sponsored by the Administrative Office of the Supreme Court of Oklahoma. Attendees included Judges, District Attorney’s, private client attorneys (for the youth in care), state child welfare workers, and CASA volunteers. The presentation and discussion created an energetic, informative exchange that both provided questions and answers for services in communities for these youth and also a clear recognition of our overlapping responsibilities, if we are to serve such youth and their families.

I want to reflect on just a few highlights:

1- I hope other states annually have such conferences and opportunities for training in cross-disciplines so that we best meet the needs of vulnerable youth and families. The respect for each other and the willingness to ask and learn permeated the large meeting room for these judges and public servants.

2- Therapeutic foster care (TFC) is a community-based treatment, provided in specially trained foster homes for youth who would otherwise be in group homes or other congregate caring, including an in patient facility. TFC is a medically necessary service, the clinical components of which are paid by Medicaid. It was surprising and most informative for Judges to learn that a youth cannot simply be ‘ordered’ to therapeutic foster care. Instead, a child must be ‘approved’ as meeting medical necessity criteria by the state’s Medicaid authority if reimbursement for services is to occur.

3- Public child welfare workers and court personnel were surprised and pleased to know that kinship and relative placements for youth with child welfare involvement can, and should, be approved for training and services as TFC homes, if the child meets such behavioral and mental health conditions as enumerated in Medicaid criteria. Likewise, TFC agencies can provide services for in-home stabilization in order to divert an out-of-home placement.

4- With the signing on September 29, 2014, of the federal Preventing Sex Trafficking and Strengthening Families Act, states must begin to screen, identify, track and serve minor victims of sex trafficking. Therapeutic Foster Care and specialize congregate care are the only two appropriate treatment resources for this population. We must work quickly and closely with one another to provide specialized responses for trafficked youth.
States vary in their definitions of both “medical necessity” and their understanding of therapeutic foster care. The national

Foster Family-based Treatment Association is hard at work with Congress to create uniform, national definitions and standards for TFC services and professionals. As that effort moves forward, I hope all states will develop or continue the multi-discipline sharing such as provided by the Oklahoma Supreme Court Administrator. Check into what is happening in your state and ask to be involved!

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Coming Soon to an Agency near you!

Posted by lboyd544 on October 21, 2014

Performance Based-Contracting

Performance Based Contracting has long been implemented in sales, manufacturing, and other business environments. Over the past few years, health care and hospitals have joined this path in defining desired outcomes for patient care and in rewarding the meeting of these goals.

PBC, short for Performance Based Contracting, has spread out into the fields of human services, behavioral health care, and foster care as well.

All members of the Oklahoma Therapeutic Foster Care Association are fully engaged with the Oklahoma Department of Human Services to define organization and service goals for the foster care population we serve, for our foster families, and for our agencies. We are in the midst of identifying : goals for recruitment, outcomes for TFC implementation and services, strengths of TFC providers, and system barriers to achieving desired outcomes.

OTFCA specifically is committed to being the best TFC service delivery group in the US! We know we are well on our way. All agencies of the Association are trained in trauma-informed services for families and youth. All agencies are nationally accredited in behavior health. All agencies utilize evidence-based programming, such as Together Facing the Challenge. We know of no other state association where all agencies meet these criteria.

Proud of you OTFCA!

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National Foster Care Month

Posted by lboyd544 on May 24, 2014

There are many heroes in Congress when it comes to foster care: Sen. Grassley, Sen. Wyden, Sen. Carper, Sen. Baldwin, Sen. Stabenow, Sen. Portman, Landrieu….and others.  Also: Congresswoman Bass leads a Congressional Caucus on Foster Care of almost 200 members. These elected officials are each honoring foster families across the country this month, as they should. I also want to send a shout out to them and thank them for their tireless work!

And to you: the families and children…Thank You!

In the words of Sen. Grassley: “This month we take the opportunity to shed light on the foster care system and the thousands of children who have no permanent place to call home.

Every day, 691 new children find themselves entering foster care. There are more than 400,000 children and youth across the U.S. in the foster care system. More than 79,000 children will stay in foster care for more than three years. Of those, more than 23,400 will age out of foster care without ever finding an adoptive family or a permanent place to call home.

Society owes a debt of gratitude to the brigade of foster families, teachers, social workers, friends and neighbors who are caring for this vulnerable population and helping foster kids feel welcome and loved. These extraordinary citizens in our communities are making an extraordinary difference in the lives of foster kids.

In Congress, we are working to improve the lives of all those touched by the foster care system. 

We will continue working to keep the national spotlight on the challenges confronting foster youth — because every child deserves the stability and certainty that a loving, permanent home and family can provide.”


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Leadership!: Sen. Tammy Baldwin; Ms. Sylvia Burwell

Posted by lboyd544 on May 17, 2014

As you may know, Sylvia Burwell has been nominated by President Obama to replace Kathleen Sibelius as Secretary of HHS. Pleasantly, both Democrats and Republicans on the Senate Health, Education, Labor and Pensions committee appear to approve!

What you don’t know is that Sen. Tammy Baldwin, champion of the national effort to pass legislation creating a uniform definition of therapeutic foster care for children requiring intensive mental and behavioral health services while being served in special foster homes in their communities, continued her leadership and advocacy of this effort by addressing the issue at the public hearing.

Sen. Baldwin: “The President’s Budget proposes a new five-year collaborative Medicaid demonstration to encourage states to provide evidence-based psychosocial interventions to children and youth in the foster care system to reduce the over-prescription of psychotropic medications and to improve health outcomes. My bipartisan Quality Foster Care Services Act (S.1992) would improve access to the high-quality, evidence-based intervention therapeutic foster care (TFC) for children with special behavioral health needs and/or medical disabilities. My bill would improve access to these services by providing for a standard Medicaid definition for TFC. TFC works to keep particularly vulnerable youth out of costly and often ineffective institutional care. In addition, it provides needed clinical therapy options to youth in lieu of overmedication.

I am encouraged by the Department’s existing efforts through CMS, SAMHSA, and ACF to evaluate TFC and I look forward to the report on these findings. As Secretary, how would you continue the critical work to improve access to TFC and other evidence-based interventions for vulnerable youth? And how would you collaborate with state partners to clarify the availability of Medicaid financing for TFC for children with serious mental and emotional disorders?”

We will receive a written response from Ms. Burwell. I, for one, am thrilled. Will keep you posted.

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Removed! America’s shame!

Posted by lboyd544 on March 9, 2014

Prepare to be uncomfortable, impatient, angry, desiring to delete this blog message….BUT DON’T. 

Instead….read through, watch this 10 minute video link and change your life! And maybe the life of a child. Maybe several lives of other children and adults.

For those days when you wonder:
1- Why do “I”/”we” do this work?
2- What can I do to help?
3- “What’s wrong” with society?
4- Can the future be better/fixed?

Bring a tissue and give this 10 minutes.


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Let’s all work together on behalf of children to motivate the thousands of families in our communities to take action on the Adoption Tax Credit!

Posted by lboyd544 on February 18, 2014

We need your help! The Adoption Tax Credit Working Group (ATCWG) has set a goal of obtaining 30 Congressional Co-Sponsors on the Adoption Tax Credit (ATC) Refundability Bills: S. 1056 and H.R. 2144 in 100 days.

Why the urgency? Tax discussions are underway in the House and Senate and we need to keep the adoption tax credit top-of-mind with legislators and staff. The best way to do that is to demonstrate to legislators that their constituents care about this issue. Additionally, because refundability was not included in the bill that made the Credit permanent, many adoptive families are still not able to receive this critical support, a fact which some Members of Congress may not yet be aware.  

 Highlighted FAQ: What is “tax reform” and how does it relate to the adoption tax credit?

  • For the past several years, key Members of Congress have been calling for the U.S. tax code to be reformed and simplified. If tax reform occurs, ALL existing tax credits or policies, including the now permanent adoption tax credit, would be subject to review and there is always a chance that it could be changed or eliminated. The House Committee on Ways and Means and Senate Finance Committees (the two committees with jurisdiction over tax policy) have begun their review of the U.S. tax code and have signaled their interest in continuing to determine which of the existing credits should be eliminated. In order to ensure that the adoption tax credit not only remains a permanent part of the code but is amended to add back in refundability in order to serve the needs of all children in need of adoption, Members of Congress need to be educated about how this credit is affecting you and your family. To learn more about tax reform, go to www. or .

Call to Action: Get educated on the ATC by visiting the website link below, reading the FAQ section, and liking Facebook for frequent updates: Please also spread the word with your friends and family who would want to join in the fight to protect the adoption tax credit.

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New home? New parents? Foster and adopted youth have a right to mental health counseling!

Posted by lboyd544 on December 23, 2013

North Carolina state policy aims to make it easier for adopted children to get mental health treatment. But children in every state have the same right. 

Finally, a state has responded to a need that afflicts adoptive families in all states!

Ask any child welfare advocate/professional whether in the public or private sector and you will hear of struggle after struggle by adopted parents to gain access to needed mental health services for children whom they adopted from state care.

The need for mental health services for children who have experienced traumatic events is of no surprise any more thanks to advances in research, clinical practice, and policy. Clearly, many adopted youth experienced trauma prior to entering the state system, while in the state system, or after adoption, which if not adequately addressed, continue to interfere with their current functioning, well-being, and ability to form and maintain relationships.

We do not know how many adopted youth are struggling with unresolved trauma. But we do hear frequently about adoptive families who feel forced to relinquish a child in order for that child to be able to access needed mental and behavioral health services.  These situations are the most desperate; however, there are many other instances in which adoptive families struggle to find the behavioral health providers and services they need.  Just ask any professional in the fields of foster care or adoption.

The North Carolina Medicaid office, at the urging of advocates and providers, has created a new policy that makes it easier for adoptive parents to get mental health services for their children.  North Carolina has made it clear that wherever an adoptive family lives within the state, that family’s residence should be used for access to Medicaid treatment and provider payment of services.

For North Carolina families, this is important in two specific ways: 1- it restates that children who were on Medicaid at the time of their adoption continue to qualify for Medicaid services and reimbursement after adoption, and 2- for a state with a strong county administered services system, wherever that family lives is not relevant to being eligible for services.

All states should look to this example and adapt relevant practices for their adoptive families. Public agencies and private providers need to be reminded that federal law provides clear options for adopted youth. If the family chooses to seek services through their own insurance coverage, they may. However, federal law also states that the state Medicaid office “must allow an individual who would be eligible under more than one category to have his eligibility determined for the category he selects.”  This means that adoptive parents are entitled to seek mental and behavioral health services for their child through Medicaid if that is their desire.

No child should be relinquished because of denied access to services or inability of parents to pay providers.

Sadly, many public child welfare agencies and certainly adoptive families do not know of the right of these families to access services if their child was eligible for Medicaid at the time of adoption. (Keep in mind that all foster youth are categorically eligible for Medicaid once in state care.)

As leaders in the child welfare and children’s advocacy communities, we may need educate and remind other public and private systems within the states where we live and work of this protection. Better yet, let’s not wait until the next incident arises whether in the press or through a phone call. There is nothing to prevent us from contacting public child welfare agencies and Medicaid administrators to be sure they are aware of the federal protection….and the example of North Carolina in providing clarity for the families in that state. 

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Posted by lboyd544 on December 11, 2013

What does that word mean to you? Illness, sadness, depression, poverty, loneliness.

So many things can come to mind, especially during the holiday season when we Christians think of Christ’s birth and suffering for our sins…..when we think of those who have so much less than we or not enough of the basics that they need – food, shelter, friends….when we acknowledge our health and ‘riches’ – knowing others are frail and hurting….when we give more generously than usual to loved ones and to strangers.

“Suffering” is not a word I like. It is not a word I know how to ‘fix’. And I am a fixer (for better or worse).

There is one segment of humanity suffering about whom I want to heighten your awareness. Over the coming months, I will continue to address this specific group from time to time. That “group” is the women (97%) and men (3%) who are victims of sex trafficking. In particular, I will be addressing the plight of children and youth who are victims of Domestic Minor Sex Trafficking and victims of Commercial Sex Exploitation of Children.

All of us need to begin to at least recognize this activity and this population: DMST and CSEC. The United States is the hub of this crime! Nowhere else. 83% of these victims are American citizens. Not foreign nationals. Almost 50% of all victims are children. And somewhere between 65-90% of these child victims have been involved in the child welfare system.

I hope you see why I am focused on this specific segment and this specific victimization. I am ashamed and embarrassed. What is it about American males that they need and dominate this crime? (and maybe that the rest of us – women, too –  don’t speak up, don’t even know about this tragedy or neglect to get help for sex addicted people we do know?)

There are 5000+ animal shelters in the US. I contribute to one of those and one of my grown daughters has made volunteerism at that same shelter her life’s passion.

BUT there are only 226 treatment beds in the US for victims of sex trafficking! How can that be!

As I conclude this blog, it strikes me that at a time of joy and celebration that I am writing about this tragic condition. Knowledge is power, however. And I am not fearful. As a nation, we will address this suffering — it will take time, time the victims don’t have. (Statistics suggest that the average life span of a victim once they enter the trafficking trade is 7 years.)

We will a better nation this time next year. Your awareness…your concern will be a big part of that.

Season’s Blessings on us all! For Joy, Good Will and Peace.

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What if it were your child waiting?

Posted by lboyd544 on November 4, 2013

Each Thanksgiving, we gather together to give thanks for our families and count our blessings. For thousands of children in foster care, this cherished celebration is just a dream.

 In the United States, there are more than 100,000 children in foster care who need permanent, loving families, and many have been waiting years to get adopted. But there is hope. On Saturday, November 23, an unprecedented number of courts in 400 communities in all 50 states, the District of Columbia, Puerto Rico and Guam will open their doors to finalize the adoptions of thousands of children from foster care, and to celebrate all families who adopt. This year marks the 14th anniversary of National Adoption Day, a collective national effort to raise awareness of children waiting in foster care to find permanent homes and loving families.

For the last 13 years, National Adoption Day has made the dreams of more than 44,500 children come true by working with courts, judges, attorneys, adoption professionals, child welfare agencies and advocates to finalize adoptions and find homes for children in foster care.

But there is still much more to be done for the more than 100,000 children who are still waiting. They will spend at least three birthdays waiting for their forever families, and the longer children are in foster care, the more at risk they are of growing up in care and leaving without being adopted. In fact, each year, more than 26,000 children turn 18 and leave the system without families. 

Children enter foster care through no fault of their own because of abuse, neglect or abandonment they have suffered at the hands of the people who should have nurtured and protected them. Many foster youth move more than three times while in the system, and are separated from siblings.

In Oklahoma alone, 2916 children in foster care are waiting to find families they can call their own; and last year, 1226 children were adopted.

It is unacceptable that any child should not have the opportunity for a safe, loving and permanent home. I would like to encourage all of us to step forward to make a difference in the life of a child. Visit for more information.

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