The budget proposed by President Donald J. Trump threatens critical health, scientific research and education programs that contribute to the social safety net for millions of Americans, according to the American Psychological Association.
“This budget, if enacted, would jeopardize our nation’s educational, scientific and health enterprises and limit access to critically needed mental and behavioral health services,” said APA President Antonio E. Puente, PhD. “These cuts would disproportionately affect people living in poverty, people with serious mental illness and other disabilities, women, children, people living with HIV/AIDS, older adults, ethnic and racial minorities, immigrants, and members of the LGBTQ community.”
“While every administration must make difficult budget decisions, any attempts to balance the federal budget should increase, not decrease, the number of Americans who have access to high-quality education, health care and social support,” said APA CEO Arthur C. Evans Jr., PhD. “APA calls on Congress to reject this budget proposal and replace it with one that protects and increases access to services and care for all Americans.”
Among the cuts denounced by APA:
• $7.2 billion from the National Institutes of Health, approximately a 21 percent decrease from the FY 2017 level, which would result in 1,946 fewer grants. The National Science Foundation would receive a cut of approximately $820 million compared to FY 2017, a decrease of 11 percent.
• More than $600 billion in reductions over the next decade from the Medicaid program, which could eliminate Medicaid benefits for about 7.5 million people. The proposal also includes the option for states to choose between a per capita cap or a block grant beginning in FY 2020. Medicaid is the single largest payer for behavioral health services in the United States, accounting for over 25 percent of behavioral health spending.
• Elimination of the Graduate Psychology Education Program, the Behavioral Health Workforce Education and Training Program, and the Geriatric Workforce Enhancement Program, which together would reduce mental health workforce training by nearly $100 million.
• Almost $400 million from the Substance Abuse and Mental Health Services Administration, including a roughly 22 percent reduction from the Community Mental Health Services Block Grant.
• 14 percent ($9.2 billion) from the U.S. Department of Education, eliminating investments in educational equity and quality, including slashing other key programs that support gifted students, effective teaching and professional development.
• Elimination of the Public Service Loan Forgiveness program and programmatic changes that would prolong repayment periods for students with graduate school loans.
• 13.2 percent cut from the U.S. Department of Housing and Urban Development, including elimination of the Community Development Block Grant.
• $200 million reduction for the Special Supplemental Nutrition Program for Women, Infants and Children.
• Elimination of 75 employees from the Office of Justice Programs, including a cut of over 30 percent, reducing the office’s budget from $1.8 billion to $1.3 billion. The agency administers critical juvenile and criminal justice grants and houses the Bureau of Justice Statistics, Bureau of Justice Assistance and National Institute of Justice.
“A strong educational system is the foundation of a globally competitive workforce that fosters innovation, discovery and research,” Puente said. “As other countries continue to invest in education as part of their economic and workforce development strategies, the need for increased federal investment in American education has never been more important to our nation’s economic stability, national security and public health.”
“APA looks forward to working with Congress to ensure a more balanced approach to addressing our nation’s fiscal 2018 budget priorities, including making progress on increasing access to mental health care and addressing the opioid epidemic, investing in the scientific enterprise and expanding access to higher education for all Americans,” Evans added.
Head Start May Protect Against Foster Care Placement
Participating in Head Start may help prevent young children from being placed in foster care, finds a national study led by a Michigan State University researcher.
Kids up to age 5 in the federal government’s preschool program were 93 percent less likely to end up in foster care than kids in the child welfare system who had no type of early care and education, said Sacha Klein, MSU assistant professor of social work.
Klein and colleagues examined multiple forms of early care and education – from daycare with a family member to more structured programs – and found Head Start was the only one to guard against foster care placement.
“The findings seem to add to what we already know about the benefits of Head Start,” Klein said. “This new evidence suggests Head Start not only helps kids develop and allows parents to go to work, but it may also help at-risk kids from ending up in the foster care system.”
Klein and colleagues studied the national survey data of nearly 2,000 families in which a child had entered the child welfare system for suspicion of abuse or neglect. Those children were either pulled from the home or were being overseen by a caseworker.
Klein said Head Start may protect against foster care because of its focus on the entire family. Services go beyond providing preschool education to include supporting parental goals such as housing stability, continued education and financial security.
There are more than 400,000 children in foster care in the United States, about a third of them under the age of 5, according to the most recent report from the U.S. Department of Health and Human Services. All children in foster care automatically qualify for free Head Start services, regardless of income level.
Klein said the findings suggest policymakers should consider making all children in the child welfare system, including those living at home, automatically eligible for Head Start. That could help prevent more kids from ending up in foster care.
While foster care can be a vital resource for protecting children from abusive and neglectful parents, it is rarely a panacea for young kids, the study notes.
“Indeed, young children who are placed in foster care often have compromised socio-emotional, language and cognitive development and poor early academic and health outcomes,” the authors write. “Trauma and deprivation experienced before removal may largely drive these developmental deficits, but foster care often fails to alleviate them and sometimes can worsen them.”
Klein’s co-authors are Lauren Fries of MSU and Mary Emmons of Children’s Institute Inc. in Los Angeles.
To Counter Child Abuse, Administrators and Case Workers Need Support to Implement Evidence-Based Improvements
In 2015, more than 425,000 children were placed in foster care due to incidents of abuse and neglect. But many unsubstantiated cases under investigation divert time and resources from handling cases that warrant close monitoring and attention. According to recent statistics, more than two million reports of child abuse and neglect were accepted for investigation in 2015 – with more than 700,000 of them eventually substantiated as cases of child abuse or neglect.
Imperfect Responses to Harmful Abuse and Neglect
Caseworkers often report that negotiating the multiple demands of their jobs puts them under constant stress. The sheer volume of Child Protective Services reports and investigations, the number of youth in foster care that need to be looked after, and the piles of paperwork that must be filled out to track decision-making – all of these burdens are overwhelming under the best of circumstances.
Faced with such workloads, agencies and caseworkers are ill-equipped to deliver services based on evidence of what works for youth and parents in the foster care system. The current standard of practice, however, leads agencies and caseworkers to engage in practices not supported by research-based evidence. Poorly conceived and delivered services cause considerable harm by failing to limit the incidence and after-effects of abuse and neglect.
Victims of child abuse and neglect are nine times more likely to become involved in crime and 25% more likely to experience teen pregnancy. Such victims also face increased risks of smoking, early-age drinking, suicidal ideation, inter-personal violence, and sexual risk-taking. The sad results become obvious in later years. Two-thirds of adults under treatment for drug abuse report that they were maltreated as children. And similar reports of childhood abuse come from 14% of men in prison along with 36% of incarcerated women. Four-fifths of 21-year-olds who were abused as children show evidence of at least one mental health disorder. And saddest of all, about 30% of child abuse victims will later abuse their own kids.
What Could be Done?
Several steps can be taken to improve responses to child abuse and neglect:
- Improved, ongoing training and job support for caseworkers and supervisors could ensure that they know the characteristics of the populations they serve and are aware of effective anti-abuse practices and know how to deliver them or help clients find others in the community who can provide optimal help. Front-line workers also need training to monitor client progress and detect when a case warrants more intensive intervention.
- Enhanced preventive efforts could save lives and money. Research shows that the total cost of new U.S. cases of fatal and nonfatal child maltreatment was approximately $124 billion in 2008. The estimated cost per victim of nonfatal child maltreatment was $210,012 in 2010, including the costs for health care, productivity losses, child welfare services, criminal justice procedures, and special education. In fatal cases, the figure rises to an astonishing $1,272, 900 per death.
- Resources should be reallocated to areas of greatest need. In addition to redistributing available funding to hire more staff to manage high caseloads, innovative and effective programs and services must be delivered to prevent child maltreatment and fatalities. States should take advantage of funds offered by the federal government to expand evidence-based child welfare interventions that may have previously been underfunded.
Lessons from Philadelphia
A promising model comes from the state of Pennsylvania, which has participated in a federally funded project that allows child welfare agencies to use Title IV-E funds for evidence-based reforms. Philadelphia’s child welfare system has been at the forefront of adopting three evidence-based treatments for children and families that the city was previously unable to implement due to lack of funding. Waiver funds have made it possible to enhance preparation for child welfare caseworkers, develop databases to track outcomes for children and families, and train staff to identify and implement further improvements.
With flexible authority over spending, two child welfare agencies in Philadelphia decided to implement the Positive Parenting Program, an evidence-based approach to preventing child abuse. Although some reallocated resources have been used to train staff, additional funding is needed to discover barriers to effective program implementation and to implement additional steps known to be cost-effective – such as holding weekly consultations and boosting training for current and replacement leaders and caseworkers involved in the new program.
Research could pinpoint which approaches do best at giving various parents and youth access to the positive parenting program. And as parents and their offspring complete the program, further research would ideally track results in areas such as safety, reductions in abuse incidents, and improved parent-child relationships.
The Title IV-E Waiver Demonstration Project was a provision in the U.S. Child and Family Services Improvement and Innovation Act, which Congress reauthorized for five years in 2011. Now that the act is again up for reauthorization, Congress has the ability to implement changes to the way child welfare federal funds are allocated. Advocates for children have an opportunity to contact representatives and senators in Congress to propose that this program should expand to give more states the chance to reallocate funds and improve child safety.
Much remains to be learned about what it takes to carry out evidence-based interventions in the child welfare system, which provides vital help to many endangered children, youth, and families, disproportionately minorities. The federal Waiver Project provides a unique opportunity to observe what happens when system leaders, community partners, and providers mobilize to prevent childhood trauma. Lessons learned will help provide ongoing guidance to federal and state administrators and welfare leaders as they look for the most effective, empirically proven ways to protect children and families under their supervision.
Connected Commonwealth: Programs for Kentucky Youth Aging Out
In May 2016, Anna Shobe-Wallace, program manager for Louisville Metro Community Services said, “Each year, more than 500 young people between the ages of 18-21 age out of Kentucky’s foster care system.” Many youth ‘aging out’ are disconnected from larger society and face barriers to success such as: low socioeconomic status, low educational achievement, unplanned pregnancy, racial segregation, and mental and physical challenges.
A recent study assessed the plight of disconnected youth who are teenagers and young adults between the ages of 16 and 24, and these youths are neither employed, enrolled in or attending school. The study focused on disconnected youth in the following categories: by state, county, congressional district, gender, and by race and ethnicity. Currently, there is approximately 5,527,000 disconnected youth in the United States or 13.8% of young adults.
- Kentucky ranks 36th in youth disconnection rates with 15.2% of youth in this group for a total of 81,850.
- Cincinnati, OH–KY–IN ranks 44th in youth disconnection among the most densely inhabited areas. The percentage of disconnected youth in this area is 12.8% or 38,312 total. The racial breakdown for this group is 20.6% Black and 11.8% White.
- Louisville/Jefferson County, KY–IN ranks 56th in youth disconnection. The percentage of disconnected youth in this area is 14.0% with a total of 21,750 disconnected youth. The racial breakdown for this group is 18.5% Black and 13.3% White. This Kentucky county has the lowest percentage of disconnected youth.
- Kentucky counties with the largest percentage of disconnected youth are as follows: Martin County, Kentucky ranks 2,020th with 47.8% disconnected youth; Union County, Kentucky ranks 2012 with 43.7% disconnected youth; Bracken County, Kentucky ranks 1,998th with 41.4% disconnected youth; Lee County, Kentucky ranks 1,994th with 40.9% disconnected youth; McCreary County, Kentucky ranks 1,992nd with 40.4% disconnected youth; Morgan County, Kentucky ranks 1,985th with 38.7% disconnected youth; and Wolfe County, Kentucky ranks 1,972nd with 37.5% disconnected youth
Researchers from this study concluded that larger urban communities had increased numbers of disconnected youth due to the following indicators: a historical pattern of disconnection, decreased neighborhood well-being rates, low SES, increased unemployment, a lack of academic achievement, and racism.
These alarming statistics clearly indicated systemic issues that impact disconnected youth. Experts from this study proposed that, “Disconnection is not a spontaneously occurring phenomenon; it is an outcome year in the making.” With this thought in mind, the study recommended these steps moving forward:
- An estimated $26.8 billion dollars was involved with supporting the nation’s 5.5 million disconnected youth— comprising Supplemental Security Income payments, Medicaid, public assistance, incarceration, in 2013. Proposing more beneficial ways to invest in this population would be advantageous to society as a whole.
- Designing preventive measures to address disconnection by sustaining at-risk parents and investing in quality preschool programs. It is usually more cost effective and compassionate to implement prevention strategies than crisis responses.
- Re-joining youth and young adults who are secluded from higher education and the job market is more expensive than pre-emptive methods that address disconnection at the outset. However, these young people need another opportunity—considering many came from challenging backgrounds.
- At the community level, an evident positive correlation was seen between adult employment status and youth’s relationship to education and employment. The amount of education adults had greatly projected the likelihood of young people ages 16 to 24 years old to attend school.
- Significant headway involves individuals and organizations cooperating to institute specific measurable attainable realistic timely (SMART) goals for decreasing youth disconnection.
Amy Swann, author of “Failure to Launch”, notes that for 2013, the study data indicates that the Louisville Metropolitan Area (which consists of bordering counties) has 14.0 percent of youth ages 16-24 disengaged from employment and education. The study’s emphasis on cities resulted in reporting by Louisville news outlets at the Courier-Journal and WFPL. Media exposure of the status of disconnected youth in Kentuckiana has led to remarkable new efforts that focus on this population.
In light of this compelling evidence: social workers, legislators, and other helping professionals in the state of Kentucky have amassed their efforts to cultivate community partnerships and programs to support disconnected youth on their journey into emerging adulthood.
According to their website, here is a description of each program, and how it addresses the needs of disconnected youth and youth ‘aging out’.
Family Scholar House plans to open its fifth Louisville campus at the Riverport Landings development in southwest Jefferson County. The project goal is to equip families and youth to excel in education and to obtain independence. The new facility is expected to be ready by 2017 and will accommodate low-income families, single-parent families, and young adults formerly in foster care.
Fostering Success is a summer employment program developed by Gov. Matt Bevin that began June 1, 2016. The program provides job training via the Kentucky Department for Community Based Services for youth ages 18 to 23 years old. The program will run for 10 weeks and culminate with meetings with college and career counselors to prepare participants for future education and employment goals. Approximately 100 youth will be employed full-time at a rate of $10.00 dollars per hour. Fostering Success is one of the seminal programs in the state to target youth aging out.
Project LIFE serves 60 kids across Kentucky, including 25 in Louisville and offers an empowering environment to prepare them for success. Youth are given a housing voucher, along with social supports to improve access to education, employment, and income management skills.
Coalition Supporting Young Adults (CYSA) is an initiative created to address the barriers faced by Louisville’s disconnected young people. The mission is to develop: a standard agenda that meets the needs of Louisville’s vulnerable youth and young adults; common measurement tools that define collective goals and strategies; mutually supportive activities that create new partnerships and execute thoughtful programs; effective communication that creates a viable structure; foundational support that stimulates growth, responsibility, and dependability.
Transition Age Youth Launching Realized Dreams (TAYLRD) is an effort to create a unique program for young people born out of the federal government’s proposal called “Now is the Time” Healthy Transitions Grant Program. The Department of Behavioral Health (DBH) in Kentucky requested and received funding and Seven Counties was chosen as a venue to open drop-in centers where young people can foster relationships and access support /services to achieve their future goals. Youth Peer Support Specialists (YPSS) and Youth Coordinators work together with clients to define what concerns are most important, and then appropriate services/supports are brought into the drop-in centers. Some of the supports/services offered include: case management, life skills development, employment services, academic support, legal support, and therapy.
True Up founded by foster care alum Frank Harshaw, is a nurturing group of foster care alumni who have overcome obstacles to employment, pursuing education, gaining independence and solidifying healthy relationships. They have chosen to pay it forward through mentorship. True Up empowers foster youth through academic and hands-on learning in the following areas: Mobility & Transportation, Career Mapping, Financial Management, Relationship Building Skills, and Educational Achievement.
These are just a few of the innovative programs and resources available in the state of Kentucky. As helping professionals and the broader community create data driven programs for disconnected youth and youth aging out, expected outcomes will be much more positive in the near future.
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