Privatizing Texas Social Services

"Thank heavens for Arkansas!" has long been a sarcastic statement and ugly acknowledgment both in and out of Texas government. Texas consistently ranks among the lowest states in terms of providing funding for programs such as social services and education. Currently Texas ranks 47^th nationally for its funding to child protective services and is close to $2 billion dollars below the national average. (Mann) Multiple high profile cases have tarnished the image of Texas social services, especially in cases where children died at the hands of their caregivers. Reform efforts in the past several years have yielded some improvements through increased funding. However, funding remains a contentious topic in state government, particularly when resources are scarce. A proposed element of reform is privatizing certain services currently offered through government social services agencies, such as foster care placements and adoptions. Privatization is seen as a solution that costs the citizens nothing.

When government services are minimal or unavailable, the private sector often steps in to take its place. While this is not an inherently good or evil act, privatization comes with a price that is sometimes more than just monetary. Privatization raises serious ethical concerns, especially when the services impacted are ones that deal directly with public safety and welfare. One of the greatest problems with privatization of government services is the issue of accountability and regulation. The public is used to being able to hold their elected and appointed bodies to a certain standard and to know that ultimately these bodies are accountable to the people by virtue of taxes paid and votes given. However, when public services are contracted out to private providers such accountability can become unclear and potentially disastrous.

While privatization can be economical and in the best interest of citizens, it is a process that must be handled with careful planning and strict oversight. To date, privatization efforts in Texas have suffered from poor planning, insufficient oversight and unreliable contractors. One significant example is the 2006 privatization attempt with Accenture, LLC. The state hired Accenture to manage centralized call centers to handle enrollment in benefit programs such as food stamps and Medicaid. (MacLaggan)

After the pilot program suffered substantial setbacks and thousands of citizens were unable to access their benefits, the state canceled the contract. However the Health and Human Services Commission was unable to resume efficient service and now has more difficulties than prior to the privatization pilot program. The agency suffered internal chaos and a large amount of employee turnover between the announcement of the pilot program and the canceling of Accenture's contract.

As plans to privatize foster care and services for abused and neglected children move forward, they will face similar challenges and new ones.

The reform legislation of 2005, Senate Bill 6, was primarily aimed at improving casework and investigation services. "After the passage of SB 6, CPS hired more than 3,200 new investigative caseworkers, supervisors and clerical workers and strengthened investigations by improving CPS caseworker training and fostering cooperation with law enforcement agencies." (Ryan 4) Instead of just rushing to handle case after case on already overburdened workloads, new emphasis was placed on family planning and positive outcomes from investigations. Additional influence was placed on "family preservation" strategies to allow children to remain in their homes. Thousands of new caseworkers and aides were hired to facilitate additional family services

Foster care is not the sole option for children removed from their homes. During a five year period between 2001 and 2006, Texas dramatically increased the number of kinship placements for children. Kinship placements put children in the homes of relatives who must pass a criminal background check. The Texas Department of Family and Protective Services implemented a specific background check unit, accessible to caseworkers twenty four hours a day. Close to 70% of children are placed in kinship placement. (Roper 3) However this increase has been largely subsumed by the rising number of children removed from homes due to abuse and neglect. While kinship placements are an important alternative for social service workers, they are not enough on their own.

Senate Bill 6 proposed to bridge the gap between funding and demand for services by mandating privatization of all of the foster care services currently administered by the Texas Department of Family and Protective Services. Private agencies provided 80% of foster care placements. (Ryan 5) The bill called for privatization of the remaining 20%, which were foster homes recruited through Child Protective Services. This plan was to take place over a period of five years and be completed by 2011.

Due to improvements in investigative services, the number of children entering the foster care system rose significantly and the system suffered unintended side effects. Because most of the new funds went to the investigative side, there were not enough resources to assist the foster care system in absorbing the influx of children. Caseworkers who oversaw children in state custody were suddenly overwhelmed by rapidly increasing workloads. It created a situation not too dissimilar from the one that plagued investigations prior to reform efforts.

Legislators were shocked in 2007 to learn that children were sleeping in government offices, often for more than one night. In May 2007, 160 children spent at least one night in a state office building. (Ryan 4) As a result Texas has adopted a number of different strategies to reduce the number of children going into foster care as well as to prevent future incidents where children must sleep in state offices. The number of available beds has not kept pace with the demand. While the number of children with no place to go but a caseworker's office has dramatically decreased due to mandates against the practice, the underlying problems that lead to the situation have yet to be resolved.

One of the most concerning aspects of SB6 was privatizing caseworkers and representation for the children as they moved through foster care and adoption processes, while still maintaining the state's legal responsibility for these children. SB6 reforms called for making all oversight casework the responsibility of private providers. Despite now being solely in the custody of private providers, Child Protective Services would retain legal responsibility for the children in foster care. The main difference would be that the child's advocate through the process of placement, any court proceedings and adoption would now be handled by workers from private agencies instead of caseworkers from the state.

The majority of foster homes in Texas are run through private Child Placing Agencies (CPA) that receive licensing through the Department of Family and Protective Services. Many of these agencies are non-profit and religious organizations, such as Lutheran Social Services. Agencies must adhere to minimum standards and follow guidelines from state law and the Texas Family Code. Additionally, Child Protective Services (CPS) maintains specialized units that recruit and train individuals to become foster parents. It should be noted that CPS foster home workers are not state employees, but private individuals.

Bexar County was chosen to be the pilot program to implement the new regulations because of its large population and continuous demand for foster care placements and services. After Bexar's initial testing of the new system, the program would then be rolled out statewide. The state began soliciting bids for contracting foster care services, and preparing agency workers to begin transitioning their responsibilities to private caseworkers. However the program was abruptly put on an indefinite hold and has yet to resume.

During late 2006, several child deaths became high profile media cases because the children died while in the care of private foster placement agencies. Mesa Family Services was responsible for administering the homes where three children suffered abuse and death at the hands of caregivers. In one situation, two young siblings were moved five times between January 27^th and September 4^th 2006 but the agency only notified the Department of Family and Protective Services about two of the moves. One of the children, a 16 month old boy, died of severe head injuries while in the care of a foster mother already caring for three other children under the age of five. (Garrett)

A review of Mesa Family Services found numerous violations of various standards and little corrective action or oversight by the state licensing agency. Mesa had failed to properly monitor foster families, and had failed to screen out foster placements that were not up to minimum standards. The agency received more than 100 citations for various safety violations but still received renewal of its contract with the state. (Mann) Public outcry and condemnation by state legislators was swift. Mesa's contract was canceled and proceedings were initiated to revoke their license.

While the legislation of 2005 called for increased monitoring, new legislation passed in 2007 to require even further regulation of private agencies contracting to provide services. Child Care Licensing (CCL) workers from the Department of Family and Protective services increased the number of inspections they perform and meetings with providers. "CCL has also promulgated new minimum standards for residential treatment centers, child-placing agencies, and emergency shelters for the first time in nearly two decades." (Roper 7) The change has not been without friction, as many foster parents and agencies feel the new regulations are too stringent. There are concerns that tighter standards without any increase in funding will result in even more foster parents leaving the system and more children left without any placement other than the sofa in a state office.

Not every agency is lax in following regulations or providing services. Many agencies provide exceptional service that goes unremarked in the public eye. A problem facing these providers is the ability to develop the much needed capacity to absorb the growing influx of children. Simply, there are not enough beds for every child who needs one.

"From 2001 to 2006, the number of children entering foster care increased by 45.3%. During the same time period, the number of foster homes-both CPS and CPAs-grew only 26.4%." (Roper 2) These figures do not factor in the relatively tiny number of emergency shelters and residential treatment centers, which overwhelmingly run by private agencies.

Due to the demanding and emotional nature of the work, social service agencies both in the private and government sectors see large amounts of turnover among their workers and contractors. This does not promote a stable system, and can increase the number of times a child will have to move while in foster care. Frequent moves can increase stress, anxiety and other emotional issues for children, as well as lead to poor bonding with foster caregivers. It is believed this can also increase the likelihood that a child in the foster care system will experience abuse or neglect.

While the Legislature approved more funding for salaries of social service workers, these efforts were not significant enough to make much of a difference. Workers saw raises of approximately 3% on their salaries which translated to an extra $50 to $80 per month, before taxes. Foster care providers receive minimal payments as well to compensate them for care provided to children. Often these payments are not enough to cover the child's needs, especially in cases of children with severe physical and mental health problems.

There is no one perfect solution, or one solution that will provide an end to concerns about foster care. Without millions or even billions of dollars, state government is unable to provide enough services for citizens. To obtain that revenue, citizens would undoubtedly face substantial tax increases or new taxes. Private agencies alone face concerns about oversight, regulation and quality of services to an extremely vulnerable population. Neither side can bear the entire burden of reforming the system. The answer lies somewhere in the middle ground.

Partnerships between private agencies and government can work. Kansas has shown that holding contractors to strict standards and providing careful oversight can ensure high quality services to citizens. In 1996 and 1997, Kansas privatized adoptions, foster care and group care. (Johnson) Contractors received strict performance based incentives to encourage these agencies to facilitate adoptions and provide safe services for vulnerable children. These incentives are credited with the success of the agencies in providing safe services, reducing the number of times a child is placed and maintaining community and sibling relationships.

Texas needs to adopt a similar system to provide services. There are several challenges, such as education, funding, oversight and the ability to create the needed capacity for the system. None of the challenges are insurmountable. Merely they will require dedication and perseverance.

Currently private agencies contracting for foster care are able to refuse to take a child and are not obligated to place a child in an open bed. Most often this occurs when a child has mental health problems, a history of running away or juvenile delinquency. "The cost of caring for difficult children, and the financial risk entailed, should be fairly spread among providers." (Roper 6-7) Contracts could require agencies to provide care for a certain percentage or number of difficult to place children, thus both limiting the ability to reject difficult placements and making certain no one agency bears too much of the burden of more costly care and services. Financial incentives for providing specialized care for mentally ill or medically fragile children should be considered under strict guidelines and regulation.

Financial compensation, training, support and oversight are all issues that must be resolved at the state government level. Even with increases in spending from the 2005 and 2007 legislative sessions, Texas still has one of the lowest funded social service agencies in the nation. While the goal of privatization is to minimize cost to citizens, efforts at reform along with privatization may mean shifting budget priorities in the coming years. With private agencies bearing more of the financial burden of care costs, state and matching government funds could be reallocated to more efficiently and better serve needs in this area.

The Department of Family and Protective Services "spends approximately .08% to .09% percent of the available federal dollars for recruitment and retention efforts." (Roper 7) More effort should be made to provide ongoing training and support to foster and adoptive parents. They face unique challenges in working with and caring for children removed from situations of abuse and neglect. This will help to reduce turnover among foster providers, which will also reduce stress and trauma for the children in their placements. With cooperation between the Department of Family and Protective Services and private contractors, both higher quality of care and higher capacity for children could be achieved at the same time.

One of the most important obstacles to an effective relationship between government agencies and private contractors is the difficulty of establishing trust and a working relationship. The same can be said for the relationship between private contractors and citizens. Education in regards to the various responsibilities and expectations will be extremely important, both at the beginning and continuing through development phases. Government social service workers and private social workers may have conflicting or different expectations of each other. Citizens will likely have questions and concerns about the privatization process, most especially those who have children or relatives in the foster care system.

Public relations will be critical to establishing the presence and impression of these new partnerships, as well as providing education. A special effort should be made to reach out to communities and families around the state. Texas has a substantial Spanish speaking population, as well as large immigrant communities from Vietnam and Nigeria. Particular attention should be paid to making sure billboards, pamphlets, media spots and other outreach materials are made available in other languages. Private agencies will need to make attempts to have some workers on staff who can provide interpretation services in case state social workers or law enforcement are unable to provide assistance.

The process of integrating private agencies with state agencies will not happen overnight. The temptation to find a "quick fix" to the problems faced with foster care must be avoided. Both government and private providers must be committed to the steady progress of creating a new, functional system to better serve the needs of Texas children.

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