Child advocate columns, Dec. 21, 2009

3312 Northside Drive Suite D-250 Macon, Georgia 31210
478-757-2661 478-757-2666 (fax) www.oca.georgia.gov

Office of the Child Advocate
Tom C. Rawlings, Child Advocate

55 Park Place, NE Suite 410
Atlanta, Georgia 30303
404-656-4200 404-656-5200 (fax) www.gacfr.oca.georgia.gov

"Where Are You Going?"
by Tom C. Rawlings
Quo Vadis? "Where are you going?" is a question I've had a lot in the past few days, as I make plans to transition out of my position as Director of the Office of Child Advocate at the end of this month. It's also a good question to be asked of our state's child welfare leaders as Georgia faces tremendous budget pressures and ongoing public scrutiny of our child protection, mental health, and social services systems.
Since the more important question is where Georgia is going, let's start by suggesting some answers to that one. Over the past two and a half years, our team at the Office of the Child Advocate has worked to map out good paths for our child welfare system to take, and here is some of the advice we hope policymakers will consider.
1. Go straight. First, it's important to note that in the area of foster care, Georgia has been going in the right direction. We have successfully reduced the number of children in foster care after we took a hard swerve in 2004 and saw our foster care population shoot up to almost 15,000. The influx of children into foster care overwhelmed the system and was likely unnecessary, and leadership's efforts to reduce those numbers safely are commendable. Recent numbers suggest we are doing well on keeping children safe in foster care and are making progress toward moving them to safe, permanent homes in a timely manner. Our foster care population is now just below 9,000, and that seems to be a manageable and appropriate number in line with our resources and population. With more resources freed up, our Division of Family and Children Services (DFCS) can better ensure we are meeting the needs of children in foster care. The agency and the state juvenile courts are now in a better position to hone in on ways to find permanent homes for those children who have been "stuck" in the system for long periods of time.
2. Get a good compass. We've all heard the stories of folks who were lost in the woods and ended up walking in a circle, ending where they began. They all thought they were going straight ahead! In a similar vein, our state's DFCS must make sure we are not veering off to one side or the other, neither using foster care unnecessarily nor leaving children in unsafe situations. Much of the policy work the Office of Child Advocate has done over the past year has attempted to focus DFCS' attention on measuring the quality of its involvement with troubled families. At www.oca.ga.gov, you can read some of our latest reports recommending better "guideposts" for assessing child safety and conducting thorough investigations.
What we all want to avoid is wandering off without a clear sense of direction and ending up where we were in 2004. How might that happen? We all know that government policy tends to swing like the pendulum of a clock. It will swing in one direction and, by its own inertia, will continue to swing until it hits the extreme, at which point the laws of physics send it hurtling the other way. In the area of child welfare, the two extremes can be labeled "child safety" and "keeping families together." One extreme leads to every child being placed in foster care, which overwhelms the system and inflicts unnecessary trauma and disruption on children and their families. The other extreme leads to increased risk that, at its worst, leads to tragic and unnecessary child abuse and deaths that infuriate the public and send the pendulum swinging in the other direction. With good guidance that keeps our attention focused on both child safety and family preservation, we can keep that pendulum somewhere in the middle.
3. Update your map. It's hard to know your path when the roads are constantly changing, and in the area of child welfare the road builders are often the federal government. Over the next year, for example, our state will be working to comply with a new federal law that appropriately mandates a wider range of services for adolescents in foster care. The Fostering Connections to Success and Increasing Adoptions Act represents the most significant change in U.S. child welfare law in a decade, and implementing it well will require some major changes in our policy and practice. Everyone at DFCS, from management to front-line workers, must be willing to embrace these new policies.

"Where Are You Going?" Page 2
Another significant change should come in the area of how we pay for residential treatment services for children in care who have mental health or behavioral issues. A few years ago, the federal Centers for Medicare and Medicaid Services (CMS) decided the state could no longer "bundle" residential treatment and behavioral care into one payment for providers. CMS targeted two states Georgia and Colorado and made us create an entirely new compensation system. The practical result was millions in expenses to our therapeutic foster care providers and the destruction of numerous providers who couldn't make the change.
Now, under a new federal administration, CMS has reversed those rules. Having seen the effects of "unbundling" on our provider network, we at OCA are very encouraged by the rollback1. But despite the changes, Georgia has yet to react and is still operating under the wrong system. Over the next year, we should move quickly to reinstitute a bundled therapeutic approach to supporting our most troubled foster children.
4. Ask directions from the locals. No one knows how child welfare policy works in practice better than the front line workers, the foster parents, and the private providers who care for our abused and neglected children every day. Yet in government and business, as Mark Twain once said, an "expert" is "an ordinary man from another town." Too often we institute policies that have been designed without input from those who best know Georgia's children, and the result is often far from ideal. Rather than being the man who drives around lost for hours because he refuses to ask directions, our child welfare leadership must treat providers and foster parents as integral partners.
Throughout the next year, the Office of the Child Advocate will continue in its mission to provide guidance and direction to our child welfare system. As I leave, Melissa D. Carter will continue as Acting Director and will bring her policy expertise, advocacy experience, and calm demeanor to OCA's child welfare analysis and child fatality review work. She has served as my Deputy Director from the start, and the agency will continue in good hands.
My new position will allow me to continue working to assist abused children and their families and will also allow my children to be exposed to a very different culture and language. While I am looking forward to the challenges we'll face, I will miss working with the many DFCS leaders, case managers, child advocates, legislators, foster parents, CASAs, judges, and policymakers whose commitment to Georgia's families and children has been a source of inspiration to me these past few years. I'll also miss working with our dedicated staff at OCA, but leave knowing they'll continue to provide the balanced, independent child welfare policy and practice advice for which OCA strives.
Perhaps the most satisfying accomplishment of my time here has been the opportunity to develop a solid relationship between the Governor's Office and the Office of the Child Advocate. It's not always easy being the designated, independent "internal critic" for the child welfare system, but the Governor and his advisors have always been supportive, gracious, and open to our advice, and willing to listen. And that support has made the work worthwhile.
Merry Christmas and Happy Holidays to you all!
1 Read all about these changes at http://www.alliance1.org/Public_Policy/Health/Bush_era.pdf