It is time to shift the child-as-client paradigm

President and CEO Dr. William C. Bell addressed Fordham University’s Graduate School of Social Sciences.


Good afternoon.

It is my deepest honor to be asked to speak to you on this occasion – the re-launching of the Dr. James R. Dumpson Chair in Child Welfare Studies.

On April 5th we will celebrate the 100th anniversary of the birth of a pioneer and a legend in the field of child and family welfare. Someone who has had an incalculable impact on not only the way we think and the way we act in response to the needs of children and their families, but also an equally as incalculable impact the lives of many of the individuals who have practiced in this field, including many of us who are in this room today.

I am grateful to have been asked to participate in the re-launching of the Dr. James R. Dumpson Chair, to be involved in an effort to continue that great legacy that has been afforded us through the work of this great man. His legacy is one of seeing possibilities rather than seeing what can’t be done. His legacy is one of putting children and their families first and one of continuously seeking to find ways to improve how we serve children, families, and communities.

The theme “From Child Welfare to Family Well Being: Expanding the Paradigm” suggests that we, like Dr. Dumpson, must challenge all of the assumptions that underlie the techniques, methods and practice models that drive our current system of responses to meet the needs of those in need.

Frederick Douglass wasn’t a social worker. He wasn’t even trained or educated in the ways of children and families. Some would say that he wasn’t formally trained in any capacities in the way that we think about it today. But he was self-taught and common sense man who was a keen observer and was well aware of the impacts that slavery and the impending freedom, without the proper supports, would have on the fragile structure of the African American family and the communities in which they would live.

It was Frederick Douglass who once said, “it’s easier to build strong children than to repair broken men.” He knew preparation during one’s developing years was one of the keys to a successful adulthood and a thriving African American community that could become a true and equal partner in the country’s future.

Much like Frederick Douglass was concerned in his time about the implications of not providing the necessary tools and properly preparing a vulnerable population for mainstream living, self-sufficiency and the future; we must also be concerned about the implications of not adequately providing for half a million vulnerable children in foster care, and the untold many others who are at risk of entering foster care.

It is in this context that I would like to spend the time afforded to me today to describe a Concept that I believe is central to any effort designed to move our social welfare system from a focus on child welfare to a focus on family welfare. That’s not to suggest that the welfare of children is not an important focus. But it is to suggest that children should be seen in a larger context. I will discuss some of the functional changes needed to implement this concept as well as some of the challenges that may impede making those changes. And finally I will close with some discussion of the implications if we do not make this transition.

If we were to take an intense look at the current construct of our social welfare response system developed to meet the needs of vulnerable children in our society, it would be hard to over look the connections that still remain to a day when our response paradigm was one based on a concept of child rescue. Even as we have entered the 21st century, we have a system that still far too frequently sees lengthy separations between children and their parents who are too often struggling with the impact of poverty and substance use as being the desired intervention. We still have a system that raises the standard for family reunification far beyond the threshold for family separation and thereby seeing many children who enter foster never to return to their homes. We have a system that continues to design its social response strategies based on the ages of individuals (child welfare, aging services) or based on particular actions or needs such as substance abuse or juvenile justice.

As we all can attest, there are a number of children, youth, and seniors who have been helped by our social service systems. Therefore I do not suggest that a focus on some of the unique needs of each of these categories is unnecessary, I am however pointing to the fact that we as human beings do not live our lives in categories or isolated from the members of our families because of certain needs or actions. When our elders age, they still remain very strong members of our family. When our elders age, they still remain very strong members of the decision making process that keeps our families together. When young men enter into the juvenile justice system, that does not detach them from their role and their status in their family, nor does it detach them from the love and the hearts of those that they’ve left behind.

The various aspects of our lives are integrated and interwoven to form the totality of our existence. Just as we do not live our lives in silos or categories, we cannot adequately intervene to resolve human suffering through categorical funding or silo based intervention strategies. If we are to find any measure of success in moving from a child welfare paradigm to a family well-being paradigm we must be willing to replace our categorical, individual client response paradigm with and integrated response paradigm.

Our current response paradigm allows us to see an individual child as our client outside of the context of that child being a member of a family. Our current response paradigm allows us to seek to address the needs of poor families without taking any actions to address the needs of the poor communities in which they are trying to exist. If we are going to be successful in moving from a child welfare paradigm to a family well being paradigm we must be willing to always see children in the context of a family, to see families in the context of their community, and to see any intervention in the context of a family and community support network.

An integrated response paradigm requires us to acknowledge the interconnectedness of children, families, and their communities and to design our strategies of intervention with an understanding that if we fail to identify and address causative factors across each of these three spectrums of need then we will fail at our attempt to truly change the human condition of those we seek to help.

Throughout the history of our social welfare system there have been a number of forces that have influenced our strategies for intervention:

  1. the requirements connected to funding streams,
  2. the limitations placed on what should be included as services options, and
  3. our larger societal tolerance levels for truly helping those in need. These factors have too often driven service responses more than a comprehensive assessment of the human condition followed by a comprehensive treatment plan.

Some examples include funding for homeless services that allow for significant payments to house families in hotels or shelters, but prohibit the use of these same funds to help families pay for permanent housing; or the walls of separation that will not allow preventive funds from the corrections system to be used to help improve life outcomes for youth aging out of the foster care system. Several studies have estimated that between 12% and 25% of current United States prison population has spent time in the foster care system and that approximately 30% of the homeless population in America has spent time in foster care.

We cannot continue with business as usual. We cannot continue to spend more than $20 billion a year on foster care, but use so little of those dollars to support vulnerable families before children are placed in foster care. We cannot continue to speak with pride about how successful we are with raising our own children to be successful productive adults, but suggests that effective strategies for raising the 500,000 children in foster care are somehow beyond the scope of our knowledge.

What are the changes that must occur if we are to transition from our current paradigm of child welfare? If we are to expand our social welfare response system to one that truly seeks to achieve child well being in the context of family and community well being, we must be willing to challenge all of our assumptions that underpin our perspective on what is required to keep children safe and to improve their outcomes. We must be willing to honestly take on the task of designing a system that requires us to fully and completely engage families in decision making at every level including diagnosis, treatment plan design, administration, and research. We must be driven by the belief that if communities are not well, then it will be much harder for the families that live in those communities to be well, and even harder for the children in those families to be well. This will require us to reframe our perspective of client or consumer to an integrated perspective.

Finally we must encourage philanthropy to adopt an integrated response paradigm as it pertains to their trends of supporting change and improving outcomes for vulnerable children and families.

The need for this in philanthropy, I think, it becomes very evident when we think about the response to Hurricane Katrina. It wouldn’t be hard right now if we were to search websites or print material to find out how many foundations have poured millions of dollars into rebuilding and relief efforts in New Orleans.

Yet after 5 years, people are still spread across this country as a result of the devastation of Katrina, while Greensburg, Kansas is almost completely rebuilt as a model green city. The devastation in Greensburg occurred from a tornado that came after Katrina.

What I am suggesting is that New Orleans could be rebuilt as well if we truly sought to do it. Imagine the difference that would have resulted if the heads of all of those foundations had come together and said to leadership in New Orleans, leadership in the State of Louisiana, and FEMA, “we want to sit down with you”.

We have “X” million dollars for education. We have “X” million dollars for rebuilding. We have “X” million dollars for child welfare. We have “X” million dollars for whatever the dollars for other needs as identified by the community. How can we use these combined resources to help you move your plan forward for rebuilding the city? How can we make sure that the lives that have been devastated by this natural disaster are improved? How can we make sure that they are not taken back to the level of poverty that they existed in before the disaster, but that we intentionally build a response system that says we value their lives just as we value our own, and that we want to see improved life outcomes as a result of this rebuilding effort .

Imagine the results. Imagine the possibility if that were the paradigm from which we approached this world. You know, I keep going back to this is complicated. I don’t want to just stand here because I know I am heading back to Seattle tomorrow and speak as though this is easy. I know that this is complicated, but it can be done.

There are a number of challenges that complicate any effort to change to a family well-being paradigm. One significant challenge is the level of political will needed to support such a change. If law makers are unable to grasp the benefits of such a shift, this shift is not likely to occur. Increasing political will, will require data. We must engage in research and demonstration efforts supported by philanthropy to document the cost benefits of such a shift as well as the benefits to vulnerable children, families and communities.

Another significant challenge that we will have to face in making this a reality is that we need to design and facilitate the continuous use of ego alternatives. We all desire to get a profound sense of gratification from what we do. But this model will require more sharing than we probably have been comfortable with doing. It will require sharing visions.

It will require shared leadership, and it will require shared ownership for the results. If we are going to succeed at making the shift from a system of child welfare to a system focused on family well being we will have to address the challenge of changing public policy. At every level, those with an interest in supporting the move to a family well being response system must seek every opportunity to work collectively to advocate for federal, state, and local public policy agendas that seek to build and support stronger families and communities. The new administration in Washington DC has arrived with a sense of hope and a deep sense of personal responsibility and commitment to change aimed at creating a better America. That change will not happen unless we work together during this window of opportunity to ensure that it occurs. It has been said that power concedes nothing without a demand. We can either sit and wait for the stimulus to somehow reach the families that we care about, or we can engage families, children and affected communities in elevating their voices so that their needs are heard just as those of the banking and the automotive industries.

The recently passed federal legislation, Fostering Connections to Success Act (P.L. 110-351), is the most significant federal child welfare legislation passed since ASFA in 1997. This legislation contains a number of improvements for the foster care system. Provisions include:

  1. federal participation in kinship guardianship payments in all 50 states for kinship foster parents;
  2. requiring states to notify all relatives within 30 days of children being placed in foster care;
  3. allowing states to waive non-safety related licensure requirements for kinship foster homes;
  4. allows all states to extend foster care to age 21;
  5. requires better coordination between foster care and education systems to ensure school stability;
  6. requires that transition plans are developed at least 90 days in advance for all youth aging out of foster care;
  7. gives direct access to title IV-E funding for federally recognized tribes.

While these are significant and laudable enhancements to the child welfare system, the new law made no provisions for improving family functioning to prevent foster care placements or to expedite discharge. There is still much work to do.

Public policy can set the stage or platform upon which we can build a social welfare system that incorporates an integrated response paradigm, a paradigm that has family well being as a central tenet. This will require engaged and continuous communication with elected officials. This will require the academic community to use its voice, such as the Dr. James R. Dumpson Chair, to keep the dialogue going, to keep challenging the assumptions that for too often still do not see this population of being worthy of our help.

We desperately need to change the conversation at the national level. We need to have courageous conversations with lawmakers that will inform them and lead to well thought out policies – policies that pave the way for developing a better system of care across this nation. Policies that serve to align our work from the national level to the state, community and family or direct service levels.

As the new administration begins its work, we have to demand and push our leaders to put families first. If this nation puts families first, then families would be in a better position for success; a better position to withstand and work through the hardships and stresses that put them in crisis and at risk. If we, in this country, value families and are willing to provide vulnerable families with the tools and means to strengthen and lift themselves beyond their current conditions, then the need for foster care would be drastically curtailed.

Even in this time of unprecedented spending to stimulate change in our economy, the question of cost will undoubtedly arise in the context of developing an integrated response paradigm. There will be those who will declare that this will cost too much. My question and my concern is what it will cost if we don’t. What will it cost us if we continue to do exactly what we’re doing today?

If we do nothing, then we will continue to have 12 to 25 percent of former foster youth who are in prison. The lower estimate on this range is that of the 2.2 million adult inmates, 270,000 of them came out of foster care. At an average cost of $40,000 a year per inmate we’re now spending over $10 billion a year to house adults who were formerly in our foster care system. That’s more than half of what we currently spend for 500,000 children in foster care.

If we don’t change by the year 2020, another 11 million of our children will be confirmed as victims of child abuse and neglect in this country. If we don’t change by the year 2020, another seven million of our children will experience foster care. What’s even more startling and sad, if we don’t change by the year 2020, almost 17,000 more of our children will die in the result of child abuse or neglect?

The choice is ours. We can choose to continue with the things that keep us busy every single day. Trust me, I know how busy all of you are every single day trying to make a difference in this great city. But if we don’t change, if we don’t choose to change, then we have to accept the responsibility for the outcomes associated with our inaction.

Dr. Dumpson, it’s a tremendous privilege to honor you for your life services. I encourage this Chair to keep the conversation going, to keep challenging people to think differently, to keep challenging people to put aside limitations, to put aside agendas, and come together to create a world where there is one standard for all of our children. And that one standard has to be, if it is not good enough for our own children, then it is not good enough for any child in America.

There is much work to be done, but we can figure this one out. Repairing broken adults is so costly in so many ways that it can not continue to be the prevailing option in our social welfare system. Building strong children by strengthening families – by expanding the paradigm to include families – deserves further development. It’s a solution that will work for everyone – children, families, the community, the larger society.

Thank you and God bless.