What Oregon Can Learn From Tennessee's Child Welfare Approach

This series was funded in part thanks to a grant from the Solutions Journalism Network.

The Oregon child welfare system is in crisis — and has been for years.

Related: Oregon Sending Foster Children To Facilities Accused Of Abuse

A scathing audit in 2018 detailed how the state is failing its most vulnerable children. The agency has paid millions of dollars in settlements over the years after children were harmed while in its care. Meanwhile, children are being placed in hotels, sent to out-of-state facilities, staying in retrofitted jails or languishing in emergency room departments because there is no place for them in Oregon.

Children who do manage to land with foster parents often bounce around to dozens of different placements within a few years.

The problems are entrenched and decades in the making. But now, there is some optimism among child welfare officials that a shift in mentality — and resources — could help alleviate some of the state’s troubles. It’s a mindset that other states have embraced with some success.

The idea is rather simple on its face: try to keep children out of the state system entirely.

Oregon’s Challenges

It’s easy to dismiss the child welfare horror stories that grab headlines as rare outliers.

But the truth is, even the stories that don’t make the news, the ones closer to the everyday reality for the thousands of Oregon’s foster care kids, aren’t much more uplifting.

Brittany Hope entered state custody when she was 15. She was placed in so many different foster homes, she can’t remember the final tally off the top of her head.

A few placements stand out, however: Like the fancy home in the Portland suburbs where she was confined to the basement with two other foster children. There was an alarm on the basement door ensuring the foster children couldn’t come upstairs — couldn’t access the kitchen, for example.

She had foster care parents who were petty drug dealers; strangers wandered in and out of the house. There was never any food in the kitchen. Hope was afraid to leave any of her belongings out of fear they would be stolen.

She didn’t fare much better when it came to state caseworkers. In a two-year span, she had five different people assigned to her. Once, when she met a caseworker she had been working with for several months, he didn’t recognize her, let alone known her case history, or as she put it, her “values, goals or the events transpiring in (her) life.”

Now 21, and a college student, Hope is hoping for a massive transformation in the state’s child welfare system.

Richard Wexler, the director of the National Coalition for Child Protection Reform, points out that even in the best scenarios foster care is an inherently traumatic experience for children and removing too many children stresses the entire system.

There are, of course, times when children need to be taken from their homes, such as when their safety is threatened. But in Oregon, the number of children in foster care is nearly twice the national average.

“You overload your system with all those kids that don’t need to be there, and the workers have to endure all that stress, they don’t have time to investigate property and they overlook children in real danger,” he said. “So wrongful removal drives everything else.”

The Best Parents

In Oregon, nine out of every 1,000 children are in foster care. In Tennessee, the rate is nearly half that.

Related: How A Landmark Audit Could Change Oregon's Child Welfare Department

More than a decade ago, an advocacy group for foster children sued Tennessee’s child welfare system. The class action lawsuit claimed the state was failing to take care of its foster children and said vulnerable children were being kept in large shelters, akin to orphanages. As in Oregon today, the state did not have appropriate placements for foster children that met their needs.

It took about 16 years for Tennessee to implement long list of requirements mandated by a judge to improve its system. They managed to satisfy the requirements and made headway ensuring more foster children were in family-like settings rather than institutions and that caseworkers had fewer cases.

One nonprofit in particular, Youth Villages, and a program known as Intercept, helped.

For years, the prevailing belief in child welfare circles was removing children from their homes was the most productive way to improve their lives. The belief was the parents were part of the problem, not the solution, and placing the children in a group-home setting would be a more efficient way to get them back on track.

But now, many people believe that was misguided.

It took years for Patrick Lawler, the CEO of Youth Villages, to come to that realization. Youth Villages is a national nonprofit that aims to help foster care children. They offer in-home services, adoption assistance, residential care and have a program to help those children who have aged out of the system.

When Lawler started following up on foster children who left Youth Villages’ residential treatment facilities, the outcomes weren’t good.

After the foster youth left their congregate care programs, a high percentage ended up in jail, unemployed or homeless.

Over time, Lawler and his crew realized outcomes were a lot better when children were able to stay in their home and the entire family was given support.

The state of Tennessee finally realized, Lawler said, that it wasn’t the best parent for kids.

“The best parents for kids … is their own families,” he said.

They also recognized there were thousands of children coming into care unnecessarily. Often their families were in the midst of a crisis. Sometimes what they needed was some short-term help to stabilize life and sometimes, they found, a removal could be avoided.

Lawler’s group started a program offering intensive in-home family treatment programs targeting the entire families and kids who are at risk of being removed from their home.

Rather than removing a child, the goal was to see if up-front preventative help could stabilize the family.

“Because once a kid is in the system, it’s hard to get out,” Lawler said.

There are, of course, times when a child needs to be removed, such as when their safety is threatened. But in Oregon — as in many states — the primary reason children are removed from their families is neglect, not abuse.

And in some instances, neglect is easier to overcome. If the family is struggling to find stable housing, for example, finding them housing vouchers could solve the problem. Or if the parents are wrestling with addiction, case workers might have more success providing the appropriate treatment and resources to manage addiction than taking a child away.

Tennessee's Solution

Consider the example of Malik Murphy.

The 9-year-old from Memphis, Tennessee, has struggled since kindergarten. He’s run away from school. He’s had meltdowns that last for hours. His behavior was so bad, his teachers have had to call a crisis center for backup. And he’s spent weeks in a mental health residential behavioral treatment facility.

In October, he was on the verge of being suspended. Again. And it looked like he might wind back up in residential care.

But then someone from the residential treatment facility told Malik’s mom about Youth Villages’ Intercept program.

The goal of Intercept is to help children and their families overcome behavioral and emotional challenges and keep families together. The state of Tennessee contracts with Youth Villages.

Lawler said it costs about $100 a day to provide intensive in home services. So, if a person from Lawler’s nonprofit visits a family three times a week for six months, the entire tally is about $7,800.

Compare those costs to a psychiatric treatment facility, Lawler said, and it seems pretty small. Plus, when a person enters a facility, there’s a good chance they stay for an extended period of time, leave and wind back up there.

For comparison’s sake, the state of Oregon is spending about $10,000 per kid for one month of treatment in an out-of-state facility.

Specialist Cayla Beard started visiting Malik Murphy and his family three times a week. She spoke to Malik’s teachers, a guidance counselor, the principal. And together with his mom, Shaketa Murphy, they identified Malik’s triggers and came up with a plan.

Some of the ideas were pretty simple, like giving Malik stress balls to use at school and creating feeling cards to help him express his emotions rather than lashing out.

Simple or not, they started to work. For the first time, Malik was able to articulate his feelings. He stopped running away from school, and the meltdowns became less common.

Beard’s mission is similar to a caseworker in a state child welfare system. She is there to spot any safety issues and offer support to the child and the family, to help them stabilize.

But caseworkers in Oregon have on average one hour and 20 minutes per month to spend on a child’s case. Beard, on the other hand, visits Malik’s family for several hours at least three times a week. She is on call 24 hours a day. She has time to get to know the family. She becomes part of the family.

“When Miss Cayla came in, she developed a relationship with Malik. And I think he liked that one-on-one attention,” Shaketa Murphy said.

Malik was probably not at risk for being put into foster care, since the problem was largely his behavior and not the environment he was in. But he was on the cusp of being put into a state residential treatment facility.

And the approach Intercept counselors take is the same for any child at risk of being removed from their home. The idea is to give families and children up-front preventative support to keep kids with their families.

Before Beard entered the Murphy’s lives, Shaketa Murphy was getting calls from Malik’s school four or five times a day.

“I haven’t gotten one in about six weeks. So yeah, we on the road,” she said. “ We on the road, yes.”

Families First

There is a shift at the national level to focus more on prevention and move away from institutional care.

Last year, U.S. Sen. Ron Wyden pushed the Family First Prevention Services Act in an effort to give states more flexibility to use federal funds toward prevention and to reduce a reliance on group homes. Historically, states have only been able to spend the federal dollars on children once they were removed from their families. Wyden and advocates wanted to change that.

“I do believe there is a growing understanding that preventing children from being removed from their families is a better way, whenever possible,” said Andrew Grover, the CEO of Youth Villages in Oregon.

Plus, Grover added, when children exit foster care they often end back up with their biological relatives.

“The foster care system hasn’t been the best experience for them anyway, and now they are back to where they started, and the family hasn’t been strengthened,” Grover said.

This legislative session, Oregon lawmakers are trying to figure out how to meet the requirements of the Family First legislation. The other piece of the federal law is a requirement that if a group-home or congregate-care like settings are used, the providers have to meet certain standards and go through a federally-approved accreditation process.

Currently, that is not the case. And if states want to use prevention services, they must be able to show there is evidence proving the programs work.

Sen. Sara Gelser, D-Corvallis, sits on a task force with Grover overseeing the state’s implementation of the law. She said it’s exciting to think about opportunities the flexibility could bring.

For example, if a child’s parents end up in domestic violence courts, evidence has shown the children are often at risk for eventually being put in foster care.

“It gives us a chance to think more creatively to help families before they are in crisis, before there is abuse and neglect and before they are separated, because no one wants that,” Gelser said.

The state Legislature is also considering creating an advisory council that would be responsible for overseeing children as they bounce from one state agency to the next.

Children in the state welfare system also often interact with Oregon Youth Authority and the Oregon Health Authority.

“The kids are crossing all these silos all the time and we don’t have a single entity that says, ‘I’m responsible for the kids, not just child welfare, or the mental health issues, but the kids,” Grover said.

There are efforts this session to improve training for caseworkers and push the state’s Department of Human Services to ensure there are a sufficient number of caseworkers, in an effort to keep the caseloads lower. Persistent turnover, low morale and a high number of cases plague the state caseworkers.

There’s also a push to expand the “independent living program,” which helps foster care children who are aging out of the system and living on their own. It’s a program that offers help with personal finance or looking for an apartment.

Gelser said the other main priority this legislative session is determining how to find the appropriate placements for children. The state currently doesn't have oversight over the county-level facilities, such as a former jail in Roseburg, where foster children are being housed, and she wants to see that change.

She also said it's time to bring all the children who are at out-of-state facilities are home.

It’s time, Gelser said, for the state to figure out how to find the appropriate place for the state’s most vulnerable children. And for some insight, it’s possible Oregon will look to the south.

Editor's note: This story has been updated to reflect that Oregon has  at a rate higher than the national average of children in foster care.