Is it a good idea to make foster parenting a salaried profession? It’s not a new question (see Should ‘Foster Parent’ Be A Salaried Position?) but a recent article provided an interesting update (see Foster Parenting Is A Salaried Profession In Some States) with a profile on the Milwaukee, Wisconsin county-run Professional Foster Parent Program (see Milwaukee County Professional Foster Parent Services and Understanding Wraparound Professional Foster Parent Program). Milwaukee County is not alone. An Illinois pilot program with professional foster parents launched in 2016 and Texas introduced a professional foster parent program in 2017. The advantages of professional foster parents cited include an increased ability to serve individuals with a broader range of physical and behavioral disorders and increasing the number of foster parents.
This issue has received more attention in the last couple of years for two reasons. First, there are more children in the child welfare system than before, which some attribute to rising opioid addiction (see Number Of West Virginia Children Entering Foster Care Due To Parental Addiction Rose 124% Between 2006 & 2016 and Number Of Youth In Foster Care Up 1.5% In A Year; 36% Of New Entries Due To Parental Drug Use). The other is that there is new competition for foster families. With a push from consumers and payers for non-institutional living arrangements, we’re seeing increased need for adult foster care—also known as host homes—for people with disabilities (see State Coverage Of Host Homes For Adults With I/DD: An OPEN MINDS Market Intelligence Report). One example: The Veterans Administration is turning to a medical foster home model to prevent institutionalization of veterans with disabilities (see What Is A Medical Foster Home? and VA Turns To Foster Care For Veterans Over Nursing Homes). I asked our team about the evolution of professional foster parents, and what they saw as opportunities and potential pitfalls.
The opportunities/the upside
Ken Anderson, OPEN MINDS senior associate believes the salaried profession idea is a good one that might allow families that need two incomes to consider foster parenting but stressed the need for standards and oversight. “Screening, training, standards, support, and oversight seem like the overarching issues in terms of protecting the child and ensuring success for all involved,” he said.
Sean Klutinoty, MBA, OPEN MINDS senior associate, agrees that it’s a good idea if it brings standards and measures to foster parenting. “There are tremendous foster parents who do a great job with the children in their care,” he said. “On the other side, some children require special training, education, and learned skills for a foster family to be appropriate. I have seen numerous foster kids come into residential and hospital services due to a lack of education and training of the foster parents attempting to work with special needs. Not every foster family needs to be professional but, in some cases, it would produce a better outcome.”
Citing the Family First Prevention Services Act (see Opportunities & Challenges: The Family First Prevention Services Act), Mr. Klutinoty described a push to keep kids out of foster care and go with family first (see Do New Foster Care Rules Move The Needle?). As this gains ground, it might result in the “type” of kids in foster care being more challenging, due to special needs, and create more need for specialized foster homes. “Professionalizing these homes would ensure foster parents are equipped to manage the special needs and circumstances” he added (see Meeting The Health Needs Of Foster Kids).
The potential problems
“We have a crisis in foster care today, but to me it is more related to the kind of respect, support, and overall expectations we have for these folks more than whether they are salaried or not,” said Paul Neitman, LMSW, MSW, OPEN MINDS senior associate (see Complex Needs=Complex Care Management For Children In Foster Care). “I think it’s a mistake to call them professional foster parents.” One reason: The challenge to operating a dual system of foster parents who are salaried and those who are traditionally reimbursed. While clear expectations between the two groups would help, “Expectations for ‘professional’ foster parents described in the article are what I would expect of traditional foster parents, including the necessity of having one parent in the home 24/7 to serve some youth,” he explained.
Lori Schmidt, J.D., OPEN MINDS senior associate, cited positive attributes to the idea, such as such as making foster parenting more affordable, enabling children with complex needs to live in a family home instead of in an institution, and a few negatives: The risk of people going into foster parenting for the money and the fear that paid families would get priority over a child’s family members. “Overall, I have concerns. There are foster parents who are good and some who are bad. Some are doing it for the stipend even though it is small. This job would be no different,” she said. “It would require monitoring to ensure hired parents are the best providers. In fact, it may improve foster parenting if the supervision of employees is managed to ensure great fostering. I believe this is a viable alternative, at least for now. The negatives can be addressed and prevented while the positives only improve the system.”
Recommendations for state/counties
While the issue of paying foster parents salaries is taking center stage, OPEN MINDS experts say the most important issues for success are resources and support, a sentiment backed up by data that shows that 30% to 50% of foster parents quit within the first 18 months after being licensed (see Foster Parent Retention Revisited). From professional counseling to crisis management supports, respite, and financial resources, OPEN MINDS senior associates urge state agencies to employ better screening and training to ensure that foster parents can care for a growing number of children in need (see Increasing Integration—Foster Care & Health Services and The AFCARS Report).
Mr. Anderson referenced a similar discussion from the early ‘80s when additional payment was proposed for special needs children (i.e., those with behavioral health issues), and foster parents would be required to participate in specific training. In comparison, recent articles focus on salaries that would allow at least one foster parent to stay at home. “Increasingly we see that children in foster care have significant behavioral health issues, have suffered multiple childhood traumas, and must endure significant upset during any sort of family reconciliation process,” he added (see The Child Mental Health Gap—More Prevalence, Less Treatment, More Opportunity). “That is a lot for families to take on.”
Steve Remillard, OPEN MINDS senior associate, advocates for updating the economic model for foster care, which has not kept up with cost-of-living increases and notes that reimbursement rates are simply too low to allow a foster parent to stay at home. “The idea that ‘it shouldn’t be about the money’ is ridiculous. One can make money and still have a passion for their work. In my time at the state, county administrators were adamant that the level of acuity of many of these kids had far surpassed what they had seen in the past, particularly in light of opioid addictions and severity of sexual abuse/trafficking.
As debates continue about making foster parenting a salaried position, OPEN MINDS experts agree that nothing will change until there is adequate reimbursement, better screening and training, increased support from caseworkers and more appropriate resources to support youth including medical support, professional counseling, crisis management supports, and respite for foster parents. We will continue to follow this issue, and recommend the following resources from the OPEN MINDS Circle Library:
- Should ‘Foster Parent’ Be A Salaried Position?
- Opportunities & Challenges: The Family First Prevention Services Act
- Increasing Integration—Foster Care & Health Services
- Number Of Youth In Foster Care Up 1.5% In A Year; 36% Of New Entries Due To Parental Drug Use
- Do New Foster Care Rules Move The Needle?
- Complex Needs=Complex Care Management For Children In Foster Care
- More Children, Less Money—The State Of Child Welfare Budgets
- The Child Mental Health Gap—More Prevalence, Less Treatment, More Opportunity
- 2018 Children & Youth Services Market Update
- Specialized Health Exams Recommended For Adopted Children
And join us for the OPEN MINDS Children’s Services Executive Summit: The Future Of Medical Homes June 4 during The 2020 OPEN MINDS Strategy & Innovation Institute in New Orleans.