We Should Do No Harm in Pursuit of a Child Welfare Reform

Well-being, children, families, congregate care, residential treatment, group home, US Senate Finance Committee, Group Home Reform, Los Angeles, Pasadena, trauma, legislationJust this week on Tuesday, the US Senate Finance Committee held a hearing on what is called Group Home Reform. A number of advocates including a youth, who was formerly in foster care, were at the hearing on hand to address this issue. The youth, who lived in a group home while in foster care, talked about her experience, how she resented having been removed from her family, and how her family was not seriously considered as a viable alternative to being placed in a group home. Understandably, this young woman provided a poignant testimony to the limitations of congregate care or the group home environment. In spite of her frustration, she spoke of the kind people that cared for her at the group home and advocated for them to be better compensated. Senator Charles Grassley (R-Iowa), chair of the committee, reacted with outrage that the viable option to remain with her family had not been considered despite the young woman’s plea, then a minor. Others present were able to mitigate the senator’s reaction by pointing to the diverse requirements of children in the child welfare system and the need to have a full continuum of care to effectively address the challenges confronted by these children and their families.

Not all youth formerly in foster care have the same reaction as this young woman. At a recent volunteer recognition event, Briana Elliott, a former resident at Hillsides, expressed that while being in a chaotic child welfare system, her stay at Hillsides brought a sense of stability and calm. Hillsides staff allowed her to deal with traumatic experiences and eventually return to her family. Today she is an active member of the Hillsides Volunteer Network and gives back to the current residents for the great care she received while living at Hillsides.

The draft legislation, entitled “No Place to Grow Up,” captures the sentiments of advocates whose preference is to serve these children while living with their families. However, for the children whose families have fallen apart, whose safety is at risk, and who continue to be overwhelmed by any number of serious issues, staying in the home may not be a viable option.

Advocates at the Senate hearing suggested a balanced approach. Hillsides joins other advocates to support the funding of a full continuum of services for children served by the child welfare system. Preference should be given to help families stay together and to fund early intervention and prevention. Extended family members may be the best resource if a child must be removed from their parents’ home. In addition, distinctions need to be made between the various forms of congregate care offered in the foster care system. The contribution of residential treatment centers like Hillsides must not be confused with a less structured or clinically intensive group home. Foster homes also have a place within this continuum and funding is required to allow these typically exemplary families to have the resources necessary to adequately serve the children in their care. Time-delineated services minimally provide a regular point of review to keep children from being lost in the system. Yet, arbitrary time constraints may not adequately reflect the treatment period required to be successful.

The separation of a child from his or her family is traumatizing and this trauma is not easily overcome. Our former resident Briana said as much to the volunteers this past week. Which ever system established to address the needs of these children and families must above all else ease the trauma and be a resource that brings about the restoration of not only the family but the well-being to all involved. The medical oath taken by those in the healthcare profession applies here as well. All our efforts must be directed to “do no harm” and bring about healing. As this reform debate heats up in a political environment desperate not to be reduced to partisan posturing, those setting public policy should be reminded of the oath “to do no harm.”

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