Texas is privatizing its child welfare system (Texas Monthly, 3/6/19). It’s a change that makes many child advocates uneasy.
As readers will remember, the Texas system has for years been a shambles. It’s been found by a federal judge to violate children’s civil rights and by an independent auditor to be chronically understaffed, overburdened and underfunded. Caseworker turnover approached the astonishing rate of 30% per year. And then there was the steady drumbeat of anecdotal evidence of children killed and injured, children known to be at risk by CPS. The most famous of those involved the 2016 death of a little girl in the Dallas - Fort Worth area. Her caseworker was swamped with 70 cases – five times the industry standard.
One “therapeutic camp,” licensed in Texas for 22 years and receiving about $1.3 million annually, housed boys in primitive open shelters; the boys cooked their own dinner with water they heated themselves on a fire, and their outhouses discharged sewage all over the surrounding area.So Texas started budgeting money to change the system. That of course is what it should have done ages ago. Even a casual glance at the agency’s problems encouraged the conclusion that more money would keep more caseworkers on the job, reduce caseloads and provide better service. But Texas is a low-tax/low-spend state and even when it came to children, couldn’t be persuaded to loosen the purse strings.
But the devastating findings of federal Judge Janice Jack of Corpus Christi turned the tide. The legislature began taking the problem seriously and budgeting large increases for CPS.
But now it’s decided that privatization is the way to go. That’s true despite the fact that the two states (Kansas and Florida) that privatized their child welfare systems haven’t seen an improvement in services. Indeed,
Florida, which transitioned more slowly, spent $27.5 million on five pilot programs—four of which failed—and still received mixed results.
Those results haven’t improved. In January 2017, the U.S. Department of Health and Human Services’ Children’s Bureau rated Florida as needing improvement in 11 of 14 categories and gave the state 90 days to come up with a plan to improve care.So privatization per se has scarcely proven itself to be the magic bullet everyone so desires. And Texas’ rollout looks to have serious problems before it’s even close to fully implemented.
For starters, the state intends to turn over all aspects of children’s welfare to private employers. Now, all states include private providers in their mix of services. So if a parent needs parenting help, it’s likely that a private entity will provide the training. The same is true for substance abuse, educational help for kids, etc. Texas of course has long done the same. But now it’s turning over case management to those private entities. That is, there will be no state employees visiting kids in their homes. Of course a caseworker employed by a private provider can do as good a job as one provided by the state. But without state eyes on kids, the ability of the state – that’s legally the child’s conservator or guardian - to know what’s going on with kids is entirely subject to the transparency of the private provider. The state overseers may find themselves as much in the dark as the rest of us have always been. The private provider will be the gatekeeper of information.
Plus, the new system is clearly burdened with a conflict of interest. Private providers may be given a financial incentive to take children from their homes. After all, they don’t get paid for kids for whom they don’t provide services. The CEO of one private provider, Wayne Carson, attempts to refute that notion.
“What people don’t understand is, this contract evolves to [a stage that] would actually incentivize us to send kids home earlier because we get paid kind of the same amount; it doesn’t matter how long they’re in care,” he said.In other words, his company, ACH, gets a particular amount every year from the state, so it pays not to take more kids or keep them in care longer, but to send them home ASAP. The problems with that gloss are all too clear.
First, not taking kids into foster care can be as dangerous as the opposite. Financially incentivizing caseworkers to leave kids in homes may well result in the same horror stories we’ve been hearing for years. Why would it not?
And the amounts paid to ACH by the state are in fact determined by the number of kids they think, at the beginning of the budgeting session, will end up in foster care.
The pilot contract ran January 2014 to August 2017 for between $35 million and $45 million. (The number was flexible and dependent on how many kids would be taken into foster care.)So the state is offering an incentive to keep those numbers up. The more kids served, the more money budgeted for ACH.
In short, Texas appears to simply be rearranging the deck chairs on the Titanic. Will privatization cost less than the public system? I don’t see how it can. Will it provide better outcomes for kids? That of course is the acid test and one we won’t know the result of for years to come. And with all the vital information in the hands of the providers, we may not know even then.