User:Astebbins/Foster care

Contribution plan description:

I will mention the connection between foster care and incarceration with a statistic to the last paragraph in the first section.

I will add a little historical information about the foster care system in the "United States" sub-section of the "By country" section. Specifically, I will mention the configuration of the foster care system: the government providing funding for NGOs who facilitate the foster care. I will mention some of the issues with this configuration, elaborating on the ethical and efficacy concerns surrounding the current foster care system. If a more current source provides statistics for this section I will update the numbers and sources listed.

There is an opportunity under the "Therapeutic intervention" section to add information about Multidimensional treatment foster care.

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Italics- my editing thoughts

Article Draft
(This following paragraph will be the third of the Lead in Foster care)

Scholars and activists are concerned about the efficacy of the foster care services provided by NGOs. Specifically, this pertains to poor retention rates of social workers. Poor retention rates are attributed to being overworked in an emotionally draining field that offers minimal monetary compensation. The lack of professionals pursuing a degree in social work coupled with poor retention rates in the field has led to a shortage of social workers and created large caseloads for those who choose to work and stay in the field. The efficacy of caseworker retention also affects the overall ability to care for clients. Low staffing leads to data limitations that infringe on caseworkers' ability to adequately serve clients and their families.

(This following paragraph will be inserted under the subheading of "Funding and system incentives" and this subheading will be renamed "Foster care structure" and it will moved directly below/after "Constitutional issues") renamed the original heading of "Funding and system incentives" to "Foster care structure" and moved it to be after "Constitutional issues"

Today, foster care in the United States is a complex structure of non-governmental organizations (NGOs) working together with state governments and the federal government to provide services to children deemed in need. The government's role remains to primarily provide funding to states that then decide how to allow the funds between the NGOs who offer foster care services. The methods enacted to provide foster care services create active discussions about the efficacy and ethics of the foster care system.

(These following paragraphs will be inserted under a new subheading "Critical debates", which will follow on the newly-named "Foster care structure")

Many worry that there is a monitoring problem within the foster care system. As of now, foster care services are left to independent organizations, leaving the market accountable for service delivery, policy and program development and implementation. “Institutionally, the acceleration in the breadth and depth of the private provision of child welfare services has given rise to the metaphor of the ‘hollow state’, in which command-and-control public bureaucracies are replaced by networks of public and private agencies that share service production and governance responsibilities”. On the one hand, the current structure of the child welfare system allows for greater functioning at a community level and allows for more organizational autonomy. Their inter-organizational networks enable access to “critical resources and expertise, thereby altering agency service technology and enhancing frontline service capacity”. On the other hand, the system may cause barriers to innovation due to a lack of communication between the government and the private agencies and between the agencies themselves. It is difficult for the government to determine the quality of foster care services provided by the various nonprofit agencies due to the individualized nature of service goals and a lack of meaningful performance measures which intern generates “an information asymmetry in which the government is unable to monitor the quality of services provided”.

Some scholars argue that foster care is inherently harmful and should be replaced by non-foster care kinship placement; in this view, foster care often fails at providing the basic needs of safety and stability, and that placing a child in foster care is as harmful as leaving the clients in their original situation. Yet, there is also scholarship arguing the opposite side: that there is either no effect or a positive effect on cognitive development and academic achievement with children involved in foster care. This view asserts that there are no viable and research-based alternatives, or that the research is difficult to do in kinship placement settings, nor do alternatives include what is considered the necessary government financial support, state-funded services, or court oversight and monitoring.

Ethical concern surrounds the standards for foster care selection and intervention. Currently, Structured Decision Making (SDM) tools are used to determine if a child is in immediate danger. The system is called into question on the basis of classification error due to the binary decision point to intervene. Advocates for a change in the decision-making process express that there is a need for less restrictive means to ensure child safety. The alternate view is that any detriment to child safety is too much. This debate is tightly linked to the issue of overrepresented demographics in the foster care system.

There is discussion around the ethical concern that the decision to use foster care is biased and racially skewed in the United States. “33% of children who reside in the foster care system are African American, while African American children account for only 15% of the total child population”. There is concern about racial biases based on the decision to use foster care as black and Indigenous children are overrepresented due to assumed differential treatment or discrimination. The counter is that it just so happens that black children are maltreated at higher rates. Maltreatment has a positive correlation with low-income families and these two demographics are more readily impoverished. Poverty, substance abuse, domestic violence, and parental incarceration are all major factors that affect the entry of children into foster care and are all found in higher frequencies within these racial demographics. However, it is imperative to acknowledge that poverty does not just happen to be prevalent in these populations, it is a result of the system that they are living in which contains vast amounts of structural inequality. There is a lack of preventative services and community-based services for families and communities of color compounded with service providers lacking cultural humility that exacerbates the demographic disparity within the foster care system.

(Here, you will add in the paragraphs from U.S. Academic Opposition to Foster Care" on the academic debate.)

U.S. Academic Opposition To Foster Care
'''Professor Daniel Hatcher of the University of Baltimore, author of "The Poverty Industry: The Exploitation of America's Most Vulnerable Citizens" has testified before Congress, the Maryland General Assembly, and in other governmental proceedings regarding several issues affecting children and low-income individuals and families. Hatcher's scholarship has addressed the conflicts between state agencies' revenue maximization strategies and the agencies' core missions to serve low-income children and families—including the practice of state foster care agencies converting foster children's Social Security benefits into state revenue, Medicaid maximization and diversion practices, welfare cost recovery policies in the TANF program, and foster care cost recovery through child support enforcement.'''

'''Professor Vivek Sankaran, University of Michigan, is author of "Rethinking Foster Care: Why Our Current Approach to Child Welfare Has Failed" and "A Cure Worse Than the Disease? The Impact of Removal on Children and Their Families." Sankaran advocates for the rights of children and parents involved in child welfare proceedings. His work focuses on improving outcomes for children in foster care by empowering their parents and strengthening decision-making processes in juvenile courts. In 2009, Professor Sankaran founded the Detroit Center for Family Advocacy, the first organization in the country to provide multidisciplinary legal assistance to families to prevent the unnecessary entry of children into foster care. In 2011, he was named Michigan's Parent Attorney of the Year.'''

Multidimensional Treatment Foster Care (MTFC), also referred to as Treatment Foster Care Oregon (TFCO) and Treatment Foster Care (TFC) is a community-based intervention that was created in 1983 by Dr. Patricia Chamberlain and her associated colleagues with the initial design intended to offer a replacement for group facilities. MTFC has differing approaches for different age groups. Preschoolers receive “a behavior-management approach and intensively trains, supervises, and supports foster caregivers to provide positive adult support and consistent limit setting” coupled with “coordinated interventions with the child’s biological parents.” MTFC for adolescence consists of individual placement with an intensely trained foster family providing “coordinated interventions in the home, with peers, [and] in educational settings.” MTFC has been shown to provide better results than group facilities and proves to be more cost effective. Reports show that Multidimensional treatment has effective results in reducing depression, arrest rates, deviant peer affiliations, placement disruption, and pregnancy rates while having positive replication trials. It is one method that attempts to incorporate trauma- and violence-informed care into its design.

Researchers have faced difficulty when it comes to accurately assessing what makes MTFC and other similar programs that involve multiple levels of intervention successful. It seems to remain in a "black box" scenario where it is unsure what aspect of the treatment plan is actually producing positive effects. Multiple peer-reviewed research articles on foster care programs point out a lack of research effectively evaluating the outcomes of specific foster care programs  , calling for more complete assessments to be conducted  in order to properly compare outcomes between treatment plans and evaluate what practices in MTFC are most effective. Ethical concerns have also been raised by Therese Åström and other associated researchers when conducting a systematic review on behalf of the Swedish Agency for Health Technology Assessment and Assessment of Social Services in 2018, noting that on the one hand MTFC is evaluated as effective, however, it tends to be implemented in a way that diminishes the child's agency.

(The above paragraphs will be placed Multidimensional treatment under the "Therapeutic intervention" section above the cross cultural adoption policies. These last two paragraphs account for my sector contribution)