The Best Child Welfare Policies Address Problems Before They Need Fixing

Kelley Griffin | NCSL.org

After more than four decades working in the child welfare system, Jerry Milner has a mantra for people trying to help kids and families: Look upstream. 

It’s something the late Archbishop Desmond Tutu advised. “There comes a point where we need to stop just pulling people out of the river,” he said. “We need to go upstream and find out why they’re falling in.”

Milner, who recently served as associate commissioner of the Children’s Bureau in the Department of Health and Human Services and now consults on state policies with the firm Public Knowledge, says most families come to the attention of child welfare services when they are deeply in trouble.

“That’s too late. The family is already in distress,” he told a session at NCSL’s Legislative Summit. “We’re not out there looking for families that might need some help. We wait until the call comes into the child abuse hotline. We are not there to prevent but to fix.” 

We’re not out there looking for families that might need some help. We wait until the call comes into the child abuse hotline. We are not there to prevent but to fix. —Jerry Milner, Public Knowledge

Often the fix is separating children from their families into foster care, Milner says. But he thinks that is the wrong choice for many children and their families due to the psychological strain of separation and the maltreatment children have received in foster care. 

“I’m willing to bet upwards of two-thirds of children in foster care would be able to remain at home with their families if we provided them with the support they need to live together safely,” Milner said. 

He says the child welfare system needs to make more room for simply helping people who are struggling instead of treating every report as potential abuse and neglect. 

Milner says kinship care may often be a better choice for children than foster care, and some states, including Washington, now make it a priority to place children with relatives. But that option is often overlooked because relatives may not have all the resources they need, and he says states spend most of their child protection budgets on removal rather than helping support kinship care. 

Milner also notes that Black children are twice as likely to come into the child welfare system.

“I don’t believe that’s because Black families don’t care,” he said. “I believe it’s because they are over-surveilled and there are incredible disparities in other aspects of our society that lead to that.”

Help Is Critical at an Early Age

Research shows children under 5 make up more than 30% of reported maltreatment cases; half of those are under 1.

And this at a time when these young brains are still developing critical functions.

“The first three years of life are the most sensitive and rapid development” of the brain, says Cynthia Osborne, founder and executive director of the Prenatal-to-3 Policy Impact Center at Vanderbilt University. “Our brains are the only organ in our body which at birth is not fully formed.”

Osborne says policies to help children in their earliest years can have a high impact.

“It’s the environment we create in the first years of life that hard-wire that supercomputer and lead it on a path of healthy development,” she says. “When children experience adversity, chronic trauma, abuse, severe neglect, that actually has neurological, psychological and biological consequences that will last a lifetime.”

Osborne has reviewed extensive research on child welfare policies and identified the five most effective approaches for states:

• Refundable state earned income tax credit, at least 10% of the federal level.

• Reduced administrative burden for food assistance through the Supplemental Nutrition Assistance Program.

• Paid family leave of at least six weeks.

• State hourly minimum wage of $10 or greater.

• Expanded eligibility for health insurance.

Small Changes, Big Results

Osborne says relatively small shifts in the financial burden can make a significant difference for struggling families. 

One study showed “a $1 increase in the state minimum wage reduced child neglect reports by 9.6% overall and by 10% for children younger than 5,” she said. 

Osborne and Milner both say investing “upstream” isn’t just good for families—it’s good for communities overall.

“A real goal of care is that we reduce the stressors on the family so we can increase their capacity,” Osborne said. 

Milner urges lawmakers and staff to talk to families. “Identify parents who have experience the child welfare system first hand,” he said. “Sit down with young adults who spent their first years in the child welfare system, find out what would make their life better, what they got that worked and did not work.”

He says policies should aim beyond merely keeping families off child welfare’s radar.

“We need to give our families a chance to thrive—so their children can thrive and their children’s children can thrive,” he said. “So we can begin to break the cycle of problems that plague our families generation after generation.”