Posts About Well-Being

Youth in foster care experience a number of challenges both while in care and upon emancipation. That’s why legislation that prioritizes normalcy standards, empowers youth in care and emphasizes family relationships is important to the overall well-being of these young people.

Earlier this week, the President signed into law, The Preventing Sex Trafficking and Strengthening Families Act (H.R. 4980). This legislation requires states to combat sex trafficking among youth in foster care and provide appropriate related services; collect data on instances of youth who were trafficked prior to, or while in foster care; promote normalcy for foster youth; empower youth in the development of their own transition case plan; and limits the use of Another Planned Permanent Living Arrangement (APPLA) as a permanency goal.

This legislation is an important step toward ensuring young people in foster care grow-up to be healthy, happy adults.  By mandating that youth be involved in their case plan and that foster parents use a “reasonable and prudent parent standard” for decisions related to caring for a child – including allowing young people to engage in extra-curricular, cultural and social activities, this legislation is well aligned with positive adolescent development. The bill also recognizes the importance of social connections, that young people should be connected to caring adults, by limiting the use of APPLA and requiring a judicial determination that APPLA is the best permanency plan at every permanency hearing. Child welfare agencies must continue to explore permanency options with family or non-relative resources.

In addition to the provisions outlined above, the legislation also reauthorizes the expansion of the adoption incentive program (Title II) and makes improvements to international child support recovery (Title III).

CSSP’s Youth Thrive initiative, is focused on supporting the healthy development and well-being of youth in foster care by focusing on the factors that mitigate risk and promote positive outcomes. These protective and promotive factors include youth resilience, social connections, knowledge of adolescent development, concrete support in times of need, and cognitive and social-emotional competence in youth. Policymakers at the state level interested in developing polices aimed at supporting healthy youth development should consider the impact of these factors.

For more information on H.R. 4980, please read a detailed summary created by the Children’s Defense Fund.

For more information on Youth Thrive, please visit CSSP’s website.

On May 15, U.S. Senator Bob Casey (D-PA) introduced a bill that calls for a consistent national standard for required reporting of suspected child abuse and neglect. Casey’s bill, the Speak Up to Protect Every Abused Kid Act (Speak Up Act),  mandates that all states require individuals with responsibility over children - such as medical professionals, teacher and coaches - to report suspected child abuse and neglect directly to state authorities. 

Initially developed and proposed in 2011 following Penn State’s Jerry Sandusky scandal, the bill addresses the state-to-state variance in “mandatory reporter” laws. Like with many child welfare laws, policy decisions regarding who has to report suspected child abuse and neglect are made at the state level. This flexibility allows policymakers to address the particular needs of children in their state and to adjust for local issues.

As of November 2013, a report by the Child Welfare Information Gateway found that 48 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico and the Virgin Islands already have some professional categories whose members are designated as mandatory reporters. In approximately 18 states and Puerto Rico - including New Jersey and Wyoming, the only two states not specifying by profession – any person who suspects child abuse or neglect is required to report. In every state, regardless of mandate, anyone who suspects abuse or neglect is permitted to report it. 

A major emphasis in the new bill is the mandate that all reports be made directly to state authorities. The Speak Up Act will close a loophole regarding “institutional reporting.” These are instances in which the mandated reporter is a staff member or volunteer at an institution, such as a school or hospital. Often in these cases, like with the Sandusky scandal, internal policies require the person who suspects abuse to notify the head of the institution who then reports it to the appropriate authorities. As of fall 2013, only 14 state laws make clear that regardless of internal policies the mandatory reporter is not relieved of his or her responsibility to report suspected child abuse or neglect to the local child protective service agency. The proposed mandate would extend this requirement to all states

The legislation would also tie states’ funding through the Child Abuse Prevention and Treatment Act (CAPTA) to successful implementation. In order to receive funds, the state would have to pass and enforce a law requiring adults with a professional responsibility to children to report instance of known or suspected child abuse or neglect.

In addition, the Speak Up Act will:

• Provide support for state-level educational campaigns and training about what constitutes child abuse and neglect, and promote greater responsibility
• Promote new approaches and techniques to improve reporting
• Evaluate states’ progress on mandatory reporting

The Speak Up Act currently has the support of more than 20 bipartisan child welfare advocate organizations and child welfare service providers from across the nation.

The over-prescription of psychotropic medication among children in foster care is an important issue with far-reaching consequences for the young people being prescribed these medications, their families, and communities. The research indicates that youth involved in the child welfare system are more vulnerable to behavioral and mental health disorders, and the use of psychotropic medication, which alters brain chemicals related to mood, behavior, and thinking, has been a popular form of treatment.

However, one of the problems with psychotropic medication is that it is commonly used to treat trauma as opposed to significant mental health problems, which is what it was originally intended for. According to the U.S. Department of Health and Human Services, 90 percent of children in foster care have some exposure to trauma, which is significantly higher than children not in care.  Confusing trauma with mental health problems can result in a mismatch of treatments and can hinder child well-being. Often times, trauma can be mitigated through therapy and other well-being services.  Successfully improving child well-being outcomes for children in care requires screening, functional assessment, and effective treatments. It is also necessary to work with children and their caregivers to understand what is triggering the behavior that might be considered necessary for medication. When children are not properly screened, assessed, or treated before being prescribed psychotropic medications, and trauma remains unaddressed, it can have adverse effects on child development – both now and in the future.

Bryan Samuels, the former head of the Administration on Children, Youth and Families, and current Executive Director of Chapin Hall, has stated his concern regarding the use of psychotropic medications, “The medications tend to be the stopgap measure. We are making significant investments in medication that have limited evidence of effectiveness and rarely address the issues of trauma."

The President’s Fiscal Year (FY) 2015 budget highlights the importance of reducing the reliance on psychotropic medications, disproportionately prescribed to foster children, by targeting improvements to the Medicaid program to increase access to mental health services and by establishing a new Medicaid demonstration project in partnership with the Administration for Children and Families to encourage States to provide evidence-based psychosocial interventions to children and youth in foster care, with the goal of improving outcomes for these young people.

For more resources on psychotropic medication, read our policy brief on Pregnant and Parenting Youth in Foster Care: The Complexities That Surround the Use of Psychotropic Medications.

A recent report released by the Children’s Defense Fund, The State of America’s Children 2014, examines a number of issues impacting the lives of children in America. These issues include child poverty, malnutrition, the economic success of families, inequality, the impact of government safety programs on children, gun violence, and education.

The report states that in 2012:

• For the first time the majority of children in America under the age of 2 were children of color.
• 1 in 5 or 16.1 million children were poor.
• Nearly 70 percent or 7.1 million children lived in extreme poverty— at less than half of the poverty level.
• Nearly 1 in 3 children of color were poor.
• African American children represented the poorest children of color at 39.6 percent, followed by American Indian/Native Alaskan children at 36.8 percent, and then Hispanic children at 33.7 percent—and nearly half of the states had a black child poverty rate of 40 percent or more.
• Children in families from the Southern states were more likely to be poor when compared to families around the nation.
• Children in single parent families were about four times more likely to be poor than children in married couple families.

The report goes on to state that there is a link between child poverty, child homelessness, and child malnutrition. In the 2011-2012 school year, nearly 1.2 million public school students were homeless, a rise of 73 percent since the recession. More than 1 in 9 children lacked access to adequate nutrition in 2012, a rise of 23 percent since the recession. And that employment does not guarantee an above poverty income for children and their families, more than two thirds of poor children lived in families where one or more family members worked. Moreover, Black and Hispanic families were more than twice as likely as white families to lack access to adequate nutrition in 2012. The average wealth of a white household in 2011 was 14 times more than that of a Hispanic household, and 17 times more than that of a Black household.

The report also states that nine million children were lifted out of poverty in 2012, because of income based government safety programs, more specifically 5.3 million children through Earned Income Tax Credit and Child Tax Credit and 2.2 million through SNAP benefits. And if it were not for government tax credits as well as food, housing, and energy benefits, child poverty would have been 57 percent higher than it was in 2012, and extreme child poverty would have been 240 percent higher.

The report also found that out of the 2.9 million poor infants and toddlers that were eligible for Early Head Start, funding only reached 4 percent of these children in FY 2012, and Head Start funding only served 41 percent of the 2 million eligible children. The report also found that while ninety-five percent of all children now have access to healthcare coverage, this does not mean that all ninety-five will be ensured. However the percent of uninsured children has decreased since 1997 thanks to the Medicaid and Children’s Health Insurance Program, which provided 44 million children with coverage in FY 2012.

The United States ranks 34^th out of the 35 top industrial nations surveyed on child poverty, now more than ever it is important that policymakers promote policies that support the holistic development of children and the families that raise them. These policies include policies that provide funding for programs like Early Head Start and Head Start, SNAP, WIC, and health insurance, as well as policies that provide housing and economic supports to children and their families.

For more policy strategies to support the early healthy development of children please click here.

For more policy strategies to support the economic success of children and their families, please click here.

Created by the Foundation for Child Development, the Child and Youth Well-Being Index Project (CWI) at Duke University measures trends over time in the quality of life of America’s children from birth to age 18. The CWI tracks changes in the well-being of children annually as compared to the 1975 base-year values. The purpose of the CWI is to observe the changes in child well-being, improvements or deterioration, and by which domains. The index is based on seven Quality-of-Life/Well-Being domains. The domains are: Family Economic Well-Being, Safe/Risky Behavior, Social Relationships, Emotional/Spiritual Well-Being, Community Engagement, Educational Attainment, and Health. A numerical value above 100 indicates an improvement in overall child and youth well-being, as compared to the 1975 base-year values.

Last week, The Foundation for Child Development released the most recent report on the CWI.  The event outlined the major trends in the 2013 update, Measuring 37 Year Trends: 1975-2012.  The report showed little change in the overall CWI for the years 2010-2012.When looking at the predominant long-term trend in the CWI there is also little overall improvement, as compared to the 1975 baseline.

• Key indicators, such as child poverty, decreases in secure parental employment, and median income, show that families with children under the age of 18 had a decade-long decline in the Family Economic Well-Being domain, which was further exacerbated by the 2008-2009 Great Recession. In 2011 and 2012, there were slight improvements; however, the values remained lower than those at the1975 baseline.
• The Safe/Risky Behavior domain continues to show improvement, as a result of large declines in key indicators, such as teenage birth rates, violent crime victimizations (which declined from 1991-2011), and violent crime offending (which declined from 1993-2010).
• There is a continued increase in the Community Engagement domain. The CWI measures whether children and youth are more connected to their community in social institutions by increases in college graduation rates, modest increases in high school graduation rates, higher increases in prekindergarten enrollment, rates of voting in presidential elections and the rate of youth not participating in school or work (the last two indicators either stayed the same as the baseline or decreased slightly).
• There has been a slight improvement in the Educational Attainment domain over the 37 years of study, measured by the combined index of reading and mathematics test scores from 100 in 1975 to 104.3 in 2012.
• The Social Relationships domain decreased from 1976 to 1997, primarily due to increases in the rate of children living in single-parent families.
• There was an increased trend in suicide rates for children and youth ages 10-19 during the late 1980s, and a decline in religious participation, which led to large declines in the Emotional/Spiritual Well-Being domain.
• Obesity rates contributed to the decline in the Health domain from 1975-2009. There have been modest improvements since 2009, but it is still considerably lower than the base line value.

Overall child well-being went down in 2012 at 99.7.  Since 1975, child well-being overall has been reduced with the high point of the index at 113 in 2000 and the low point at 89.9 in 1983. The index is an important tool in demonstrating the areas of improvements we have seen as well as the areas that require more attention, including support from policymakers. In order to achieve positive outcomes for children and families it is essential for policymakers to prioritize and invest in the domains that lead to child well-being.

For more information about the Child and Youth Well-Being Index, click here.

For complementary information on the importance of child well-being, please read Raising the Bar: Child Welfare’s Shift Toward Well-Being and our report on Supporting Early Healthy Development. 

1 in 10 children suffer from symptoms of childhood trauma. Studies have shown that exposure to trauma can have severe impacts on the development of a child’s brain. Exposure to childhood trauma also increases the likelihood that a child is labeled with a learning or behavior disorder, and can be a very strong predictor of academic failure. When left untreated, children who have been exposed to trauma are more like to experience negative outcomes like: behavioral problems, attention/concentration issues, separation anxiety, and extreme impulsivity. These symptoms, when manifested in children lead to high suspension and explosion rates in schools, and increased interaction with social service, law enforcement, and juvenile justice systems. In addition to the impact on child outcomes, the financial cost of untreated childhood trauma is high, estimated to be about 103.8 billion dollars by the Pew Charitable Trust.

The State Policy Advocacy and Reform Center (SPARC) and the ABA Center on Children and Law recently released a brief, Implementing Trauma-Informed Practices in Child Welfare. The brief states, “Children in care are more likely to experience trauma given the circumstances of abuse or neglect that led to their removal… and are subject to further stresses after entering the system, including separation from family, friends, and community, as well as the uncertainty of their future.”  The brief advocates for integrating trauma informed practices into child welfare systems to create better outcomes for children in care. Trauma informed care redirects attention from treating symptoms of trauma to treating the underlying causes and context of trauma. The brief outlines trauma informed, evidence-based interventions that emphasize a collaborative approach involving all major stakeholders (e.g. caseworkers, lawyers, judges, providers, educators, birth parents, foster parents, and kinship caregivers).

Trauma informed delivery systems can help states keep costs down and effectively treat childhood trauma before the child is involved in multiple systems. States like California and Maine have implemented this trauma informed approach into their education and child welfare system, and with good results. And 8 of the 15 active Child Welfare Waiver Demonstration Projects have indicated that increasing trauma informed services will be a priority in their attempts to create better outcomes for the children and families they serve.

This information has important implications for public policy. There are a number of federal funding sources that can be used to finance these programs and practices. Policymakers interested in addressing the comprehensive needs of children who have experienced trauma should consider ways to support the implementation of trauma informed care across systems.  

For more results-based policy strategies that support children and families, please visit policyforresults.org

Policy for Results has released our newest policy brief: Using the Affordable Care Act to Improve Well-Being Outcomes for Children and Families. CSSP believes that the health, happiness and success—or well-being—of children and youth depends on multiple elements, including physical and mental health, educational progress, social and emotional functioning, and healthy relationships.

The brief highlights the Affordable Care Act and the opportunities for states, beginning January 1, to improve access to health care for parents involved with the child welfare system by expanding coverage to provide health and mental health care access to working and non-working adults with incomes up to 133 percent of the Federal Poverty Level (FPL). Increasing access to treatment can have positive impacts and proven benefits by providing a broader array of supports and services for parents not previously covered.

Additionally, the brief includes recommendations for policymakers, state child welfare agencies, and advocates around promoting and implementing programs and policies that support parental and family well-being.

To read the brief, please click here.

For more policy briefs by Policy for Results, click here. 

Today, the Center for the Study of Social Policy released a new policy report, Supporting Early Healthy Development. The report discusses the developmental needs that are important to ensure healthy development for young children, which include having the benefit of the constant care and support of the adults in their lives as well as high-quality nutrition, medical and dental care, plentiful opportunities to learn and socialize, secure emotional attachment to a caregiver and safety and stability in their homes, schools and communities. When these crucial needs are met, young children thrive; however, when these needs are unattended children can face serious obstacles to their developmental health.

In the report, CSSP focuses on four primary policy areas for supporting early healthy development with detailed policy strategies included under each of the primary areas of focus.  The four areas of focus include detailed policy recommendations to support policymakers to:

1.)    Provide health coverage and access

2.)    Support early social, emotional, and behavioral health

3.)    Ensure school readiness by age 5

4.)    Support parents to ensure children thrive

CSSP’s Supporting Healthy Early Development report comes as a complementary piece to the new policy report by Kids Count, The First Eight Years: Giving Kids a Foundation for Lifetime Success. Together, Kids Count and CSSP believe in supporting children through the most crucial developmental stages and using policies to help accomplish this goal. In addition to the report, CSSP is excited to share this resource as an interactive tool to present data and trends. Through this tool Information is readily available to be viewed for all 50 states and the District of Columbia, concrete funding strategies are provided, as is useful background information related to the importance of supporting early healthy development.

For more detailed policy recommendations and connected analysis read our report in PDF version and click here. To visit the PolicyforResults web tool connected to this report and use the interactive data function click here. 

To read the Kids Count report on The First Eight Years, click here.

CSSP would like to thank ZERO TO THREE for adding their expertise – and reviewing this report! 

Recently New York added itself to the list of a handful of states that have passed legislation preventing employers from penalizing pregnant woman for requiring certain accommodations on the job. The Pregnant Workers Fairness Act requires employers to make the minor, reasonable job accommodations that will enable pregnant women to work more comfortably throughout their pregnancy. These accommodations include allowances for frequent bathroom breaks, assistance with heavy lifting and tasks that involve ladders, as well as providing stools for pregnant women who are in positions that require them to stand for long periods.

This law is important because it fills in the gap left between pregnancy discrimination laws and disability laws by requiring accommodations and providing the pregnant worker and her family an avenue to take legal action against her employer if her rights are not respected. Prior to the passage of this law, since pregnancy is not considered a disability, if an employer decided not to make the necessary adjustments for the pregnant worker, it was technically not discrimination if all other workers were subject to the same restrictions and/or expectations.

Two-thirds of first time mothers will work during their pregnancy, and 90 percent of these women will work well into their third trimester so the job protection and legally required adjustments provided in New York’s new law are monumental for pregnant woman, single mothers, and their families. It will allow for women to work longer into their pregnancies and to return sooner after giving birth.  This helps to ensure the economic security of their families. 

• Clare Anderson, Deputy Commissioner, Administration on Children, Youth and Families, U.S. Department of Health and Human Services;
• Amy Templeman, Well Being Supervisor, Office of Well-Being for the District of Columbia Child and Family Services Agency;
• Carla Perkins, Well Being Education Supervisor, Office of Well-Being for the District of Columbia Child and Family Services Agency;
• Aisha Hunter, Trauma Grant Specialist, Office of Well-Being for the District of Columbia Child and Family Services Agency;
• Julie Fliss, Supervisory Planning Advisor, Office of Well-Being for the District of Columbia Child and Family Services Agency;
• Dr. Cynthia Tate, Deputy Director, Office of Child Well Being, Illinois Department of Children & Family Services