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Does Privatized Foster Care Put Kids at Risk?
The number of kids in foster care is climbing, and so are public costs. In search of efficiencies, many states have at least partially privatized their systems.
In 2012, when Alexandria Hill was a year old, Texas’s child welfare agency found her parents unfit to care for her. The baby’s biological mother was prone to seizures, officials said, and both parents were using marijuana. So the state authorized a for-profit company, The MENTOR Network, to locate foster parents.
The first family MENTOR placed Alexandria with neglected her; when her biological parents complained after finding her filthy at a supervised visit, the company moved her to another home—that of a 53-year-old woman named Sherill Small. Less than a year later, Small killed Alexandria. She told police she’d been frustrated with the girl and swung her until her head crashed into the floor.
Buzzfeed’s harrowing 2015 investigation into MENTOR exposed the grim repercussions of privatized foster care, detailing Alexandria’s and others’ tragic cases that likely resulted from shortcuts made in the pursuit of profit. Piling too many cases on social workers, for instance, can result in abuse when foster parents aren’t properly vetted or monitored. Among the omissions in Alexandria’s case: MENTOR failed to interview Small’s sisters, who said they would have warned the company about her. (MENTOR denied that it cuts corners to make money.)
The lessons of such an investigation are perhaps even more important today, as more children are entering foster care because of the impact of the widening opioid crisis. According to the U.S. Department of Health and Human Services’ Administration on Children and Families, the number of children in foster care rose almost 7 percentfrom 2013 to 2015, nearing 430,000. In 32 percent of all foster placements parental substance abuse was cited as a factor—an increase of 10 percent compared to 2005.
When a state privatizes foster care, it uses federal, state, and local funds to contract out services, such as locating and monitoring foster parents, to private agencies. In most cases, public agencies still manage children’s long-term outcomes, such as reunification or adoption—but more jurisdictions are shifting even that responsibility to the private sector.
These private agencies are usually nonprofit, making MENTOR, as a for-profit corporation, an extreme example of privatization. Yet nonprofits can subcontract their work to for-profit companies; in states that forbid for-profit entities from administering foster care, MENTOR used this loophole as a workaround. And even in more straightforward nonprofit arrangements, privatization has negatively impacted children.
Over the past three decades, many states have privatized at least part of their foster care systems; some, like Kansas and Florida, have privatized theirs completely. Despite high-profile cases like Alexandria’s—which helped prompt a 2015 Senate Finance Committee investigation that resulted in proposed legislation to strengthen government oversight of foster care—some states and officials continue to see privatization as an antidote to a bloated and inefficient public sector.
Kentucky, for instance, recently pledged to investigate whether it should fully privatize its foster care system; private agencies currently provide services for around half of the children in the state’s care. In Texas, a pilot program that privatizes the monitoring of homes identified as at risk for child abuse or neglect is moving forward, despite some lawmakers’ concerns.
Proponents of privatization often claim that private entities are more efficient than government agencies, and calls for the privatization of foster care have been no different. Yet Tracey Feild, director of the Child Welfare Strategy Group at the Annie E. Casey Foundation, questions that idea. Private agencies, she said, have “certainly not done the work for a lower cost.”
Feild, whose Child Welfare Strategy Group provides consulting to child welfare agencies, said that the private sector has in fact brought more resources to the foster care system through, for example, successfully lobbying politicians for funds. Though this might be a positive development, she said the argument can also be made that if those additional resources had gone to the public sector to begin with, it could have solved the problems that spurred calls for privatization. For instance, new resources could be used for services such as more and better substance abuse treatment to keep families intact rather than rely on foster care.
And while public agencies still conduct the initial investigations into abuse or neglect, once a system is privatized legislators often assume they no longer need to give them money. This leaves the public agencies chronically underfunded, making it difficult to monitor their private contractors. “A public agency can be handing out tens of millions of dollars to private providers with very little oversight,” said Feild.
Private agencies can be effective in providing foster care services, Feild says. But they often face a steep learning curve. “If you’ve got the patience and good providers, you can make a go of privatization,” she said. “But it’s not going to take two to three years to improve outcomes. It’s more like 10 years.” Kansas’ privatized system, for example, is quite strong, she noted, as it’s been in operation for over 20 years. (Still, the state is struggling to keep up with cases due to the opioid epidemic and funding cuts.)
In less established systems, the private agencies can get overwhelmed with their new responsibilities—and kids can suffer, languishing in foster care or shelters. “Child welfare workers get crisis focused; they’re worried about getting a child a bed for that night,” said Feild. “So the initial priority for the new privatization provider isn’t the child who may be able to return to his family because the provider has been doing work with the parents. It’s who is coming through the provider’s front door, which results in kids staying longer than necessary.”
Jessalyn Schwartz, a Boston attorney focusing on child welfare and mental health law, added that in these circumstances children are usually placed in what is available rather than what is needed. “And they often don’t get much say in where they end up or how often they move,” she said. “Though privatized foster care is often labeled as a corrective, it’s imperative to better understand it before declaring it as such.”
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