Caring for Our Caregivers

I can’t sleep. My stomach is churning, my head pounding. I am livid about a phone call I received at Foster Kinship, a “kinship navigator” program I direct to help connect relative caregivers with critical supports.

The 73-year-old grandmother told me that she recently received a call from child protective services in California: her daughter was being investigated for abuse, and two of her grandchildren were about to enter foster care. Panicked, the grandmother verbally agreed to care for her children, and the next evening her grandchildren arrived unaccompanied by overnight bus. She welcomed them into her studio apartment in a subsidized senior living complex.

The children had nothing when they arrived in the middle of the night. No clothing, custody paperwork, or identifying documents. What they did have was trauma - a lot of it.

Grandma loved her grandchildren and wanted to know how to get licensed as a foster parent, a process that would provide her financial help and training on how to care for children with trauma.

As I listened to her story, I learned the sending state had closed the case, a common but debated practice known as diversion. Because the child welfare system diverted the children, the training and financial support provided by licensing would not be accessible to their grandmother. Even more disturbing in this case, there would be no child welfare oversight of the children’s safety.

As I lie awake, I fear for this family.

Sadly, I hear these stories daily: children harmed by bad child welfare policy and inadequate social work practice. Bringing attention to these children means challenging established systems and threatening the status quo. I have gotten used to hearing, “Who do you think you are?”

But making people uncomfortable is part of advocating for systems change, and I feel a strong sense of urgency because we are facing a crisis. Five percent of children in the U.S. live in households where neither parent resides, according to the U.S. Census Bureau. The overwhelming majority of these children live in kinship care. Most kinship homes receive no help at all, which is unacceptable. Because when it comes to changing the outcomes for children, kinship families tell me: love is not enough to overcome trauma.

Adverse childhood experiences predict a range of negative outcomes over a lifespan. Compared to children who live in homes with both parents, children living with neither are 332 times more likely to experience four or more of them, according to recent data from the National Survey of Children’s Health. Experts acknowledge that childhood trauma is a public health crisis, but we have yet to address this crisis in the population of children in kinship care receiving no support or services.

Child welfare systems must improve outcomes for children by adopting best practices in supporting kinship families. Here are, in my view, the three most important changes needed.

Tracking Diversion: When child welfare agencies remove children from parents, federal law instructs them to search for a suitable biological family. But too often child welfare agencies divert children who come to the attention of their system by finding a relative and closing out the investigation, the problem “solved” on their end.

Diversion can harm children because once diverted, kinship families cannot access critical support needed to raise healthy children. Jurisdictions who rely on diversion practices can often be identified by their lower-than-national average percentage of children in the foster care system. Diverted children should be tracked to ensure safe outcomes and encourage greater accountability.

Increasing Formal Kinship Placement Rates: I applaud states who have a high percentage of kinship placements in foster care. Kinship caregivers of children in foster care receive safety oversight and have access to support and training they could not get outside the child welfare system.

Clark County, where 75 percent of the population of Nevada resides, has a higher-than-average placement rate with relatives - around 41 percent. In fact, more children are in kinship homes than traditional foster homes, a positive statistic. But to get a clear understanding of how these families fare, a look at the licensing rate of kinship families completes the story.

Increasing the Kinship Licensing Rate: The critical metric for Nevada and other states with high kinship placement rates is to dig deeper and understand how those caregivers are supported. In many states with high kinship placement rates, there is not a requirement that kin caregivers become licensed. Licensure provides kinship families with needed training and access to support they would not otherwise receive.

National trends over the past decade show an increase of children in the child welfare system who live with kin. But this increase is mainly in the use of unlicensed care. An increase in the use of unlicensed care means more children in the child welfare system are in homes which are unpaid and untrained.

In Clark County, an estimated 43 percent of children in kinship foster careare in licensed homes. Continued community partnership and improved policy and practice should keep the licensure rate on an upward trend.

Diversion rate, kinship placement rate, and kinship licensing rate are three statistics that provide meaningful data about kinship support. Child welfare systems can then use this data to track efforts to improve support to address the public health crisis of childhood trauma.

Consider the grandmother whose story kept me up at night. It turns out my fears were founded. She faced eviction from her low-income senior housing unit within a month. Without birth certificates for children, she could not establish guardianship. The children end up separated, one in traditional foster care in Nevada and one in a group home in California. These children experienced unnecessary additional trauma due to multiple child welfare systems failing to support kin properly. Had anyone tracked this grandmother’s situation, and worked to surround her with training and support, they could have helped the children safely stay with their grandmother.

For that grandmother, and all who come after, I will continue to advocate until I stop receiving desperate calls for help. And that means I will probably keep hearing, “who do you think you are?” for decades to come.

Dr. Ali Caliendo is the executive director of Foster Kinship, a  nonprofit organization devoted to the support of kinship families in  Nevada. Caliendo focuses her academic work on policy implications for children in nonparental care in the United States.

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