Policy & Practice | Spring 2025

The Magazine of the American Public Human Services

Association Spring 2025

Pathways and Solutions to Support Thriving Communities Stronger Families, Better Futures

TODAY’S EXPERTISE FOR TOMORROW’S SOLUTIONS

www.aphsa.org

contents

Vol. 83, No. 1 Spring 2025

features

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Child and Family Well-Being Designing a Multifaceted Approach to Child Welfare Prevention

Navigating Workforce Challenges How Technology and Process Design Can Help Government Agencies Do More with Less, and Provide an Even Better User Experience

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Improving Community Outcomes How Population Insights, Data, and Advanced Analytics Can Support Increased Efficiency and Better Mission Outcomes

Beyond the System Building a People-First Approach to Tech Adoption in Child Welfare

departments

3 From Our President and CEO APHSA’s 2030 Next Gen Strategy

6 From Our Partners

10 Technology Speaks

Transforming Reentry Services: The Role of CMS 1115 Waivers in Supporting Health and Community Reintegration 8 The Human in Human Services Foster Kinship and Grandparents as Parents Partner to Expand Kinship Navigator Support in Alabama

When Code Meets Compassion: Empowering Child Welfare for Thriving Communities

5 From Our Partners

Integrated Services for Stronger Families and Thriving Communities

29 Staff Spotlights

Chase Story, Budget Manager Lesley Jackson, Child Welfare Compact Associate

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Spring 2025 Policy & Practice

APHSA Executive Governing Board

Chair Grace Hou, Secretary, Illinois Department of Human Services Vice Chair Rodney Adams, Principal/CEO, R Adams & Associates Treasurer Kathy Park, CEO, Evident Change Leadership Council Chair Kelly Kennedy Garcia, Director, Iowa Department of Health and Human Services Local Council Chair Dan Makelky, Director, Arapahoe County (CO) Department of Human Services Affinity Group Representative Karen Godnick Barber, General Counsel, Vermont Department of Mental Health Elected Director Derrik Anderson, Executive Director, Race Matters for Juvenile Justice Elected Director Vannessa Dorantes, Managing Director, Casey Family Programs

Elected Director Christine Norbut Beyer, Commissioner, New Jersey Department of Children and Families Elected Director Kristi Putnam, Secretary, Arkansas Department of Human Services Elected Director Sherron Rogers , Vice President & CFO, Johns Hopkins All Children’s Hospital Elected Director Jennifer Sullivan , Enterprise Senior Vice President, Strategic Operations, Atrium Health Elected Director Eboni Washington , Director, Government and Community Relations, Action for Child Protection Immediate Past Chair Dannette Smith, Commissioner, Behavioral Health Administration President & CEO Reggie Bicha, President & CEO, APHSA

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Policy & Practice Spring 2025

from our president and ceo By Reggie Bicha

H ello members, partners, and friends! From our start in the 1930s—yes, more than 90 years ago—we have been a member association focused on advancing well-being and building thriving communities across the nation. There is no doubt that the American Public Human Services Association (APHSA) has had to repeatedly refocus and reprioritize to remain relevant to the political environment, the realities of the human services sector, and most importantly, the needs of our members and partners. During my first year as President and CEO, I was determined to listen and engage with our members, partners, and staff in as many ways as possible to ensure we continue to stay true to our collective mission. At last year’s APHSA National Human Services Summit, we conducted focus groups with members and launched a national survey. Thanks to the responses to the focus groups and survey, as well as the many other engage ment opportunities throughout the year—what I liked to call my listening tour—I am both hopeful and confident you will continue to see your needs better met as we implement our 2030 Next Gen Strategy. One of the first messages I received during my planning process for this next phase was, “Don’t change what’s working.” Ninety-five percent of our 2024 survey respondents shared that they could take what they learn from APHSA and use it immediately on the job. This is inspiring feedback and a huge indicator of practical relevance! As we implement APHSA’s 2030 Next Gen Strategy, we want to keep this momentum going while also reaching new heights. I want to quickly share just a few of its priorities that may be of interest to you: 1. Accelerate and broaden national policy and state and local implementation approaches that achieve results for APHSA members, the communities they serve, and the taxpayers funding these programs. This includes increasing bipartisan influence with federal officials and policymakers, strengthening coalition advocacy and member influence,

2. Expand, retain, and engage membership through clear value propositions, strategic engage ment efforts, and improved member experiences. This includes enhancing our conference and event experiences, delivering a consistent, high-quality journey for all members and strategic partners from onboarding to transition, and strengthening and growing APHSA Affinity Group offerings. You can hear more about my key 2024 takeaways and our future together with Next Gen during my remarks at the upcoming APHSA National Human Services Summit, June 1–4 in Philadelphia. And if you happen to be reading this while already at the Summit, please, let’s connect!

and broadening our own capacity and expertise in human services programs to ensure we can be responsive to all your needs, big or small.

Photo illustration by Chris Campbell

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Spring 2025 Policy & Practice

Policy & Practice™ (ISSN 1942-6828) is published four times a year by the American Public Human Services Association, 1300 N. 17th Street, Suite 340, Arlington, VA 22209. For subscription information, contact APHSA at (202) 682-0100 or visit the website at www.aphsa.org. Copyright © 2025. All rights reserved. This magazine may not be reproduced in whole or in part without written permission from the publisher. The viewpoints expressed in contributors’ materials are the authors’ own and do not necessarily reflect the policies or views of APHSA. Postmaster: Send address changes to Policy & Practice 1300 N. 17th Street, Suite 340, Arlington, VA 22209

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APHSA’s blog, The Catalyst , encourages the exchange of creative ideas and promising initiatives to strengthen the human services sector and accelerate our collective impact. Featuring content from members, partners, and staff, our blog posts focus on what it takes to build well-being from the ground up. Organized around areas of impact as well as a variety of special series, our goal is to spark new ideas and accelerate the spread of promising approaches that help realize our shared vision for thriving communities built on human potential.

Read the Latest Post, Visit https://aphsa.org/the-catalyst/

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Policy & Practice Spring 2025

from our partners

By Meshia Henderson

Integrated Services for Stronger Families and Thriving Communities

S tate and local governments play a critical role in helping to shape the future of their communities. In particular, a wide range of human services programs at state and local levels are vital to ensuring the well being of children—the embodiment of any community’s future. These programs include child support, finan cial support like Temporary Assistance for Needy Families (TANF), and food assistance like the Supplemental Nutrition Assistance Program (SNAP). The impact of each program is felt within families and across communi ties. However, their collective impact is strengthened when they integrate additional support designed to foster stable family relationships and economic security for both custodial and noncustodial parents of children. As state and local governments deter mine how best to address the needs of entire family units, they recognize the efficiencies of integrated services and the opportunities for blended funding. Some are integrating employment and training services to boost noncustodial parents’ earnings potential; others are focusing on fathers specifically. Providing Greater Support for Noncustodial Parents In late 2024, a new rule 1 expanded funding options for employment and training services for noncustodial parents. The rule allows the use of IV-D federal funds for job search assistance, job readiness training, job development, placement and retention services, skills assessments and training, work support, and

occupational training. Some child support agencies may use this ability to braid federal and state funds to imple ment new employment and training services or expand the reach of existing offerings for noncustodial parents. Addressing the Economic and Social Needs of Fathers The latest estimate from the U.S. Census Bureau found that mothers lead roughly 80 percent of one-parent families. 2 Research shows that children growing up without an actively present father are significantly more likely to experience poverty. It also indicates that higher levels of family instability often lead to increased rates of health and behavioral problems. 3 Financial instability can intensify children’s challenges, making it more difficult for them to thrive.

That’s why integrated economic empowerment and fatherhood programs serve as a pathway to help fathers achieve stability and success while contributing to their com munities. These programs include employment and training services to address unemployment and underem ployment, and services that address other key barriers fathers face, such as strained co-parenting relationships. Three Considerations for Economic Empowerment and Fatherhood Programs First, identify and address all the obstacles. Programs should address the specific challenges that fathers who are economically disadvantaged often face. Chronic unemployment or

See Integrated Services on page 28

Illustration by Chris Campbell

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Spring 2025 Policy & Practice

from our partners

By Julia Kessler, Christine Newhall, Katie Thomas, and Shannon Weaver

Transforming Reentry Services: The Role of CMS 1115 Waivers in Supporting Health and Community Reintegration

T he United States leads the world in its proportion of incarcerated individuals, with a prison population of more than 1.2 million 1 individuals. Many of these individuals face immense barriers when transitioning back into society, particularly in accessing health care. Historically, individuals in carceral settings were excluded from Medicaid benefits. This exclusion, known as the Medicaid Inmate Exclusion Policy, leads to gaps in care and creates additional obstacles for individuals reentering their communities. In 2023, the Centers for Medicare and Medicaid Services (CMS) released groundbreaking guidance 2 to allow states to design and implement 1115 demonstration waivers aimed at improving health care access for individ uals involved in the justice system, often referred to as reentry waivers. These waivers present an opportunity for states to test new approaches for health care coverage, to reduce recidivism, and improve health outcomes for individuals transitioning from incarceration. Why Reentry Waivers Matter Pre-release services are one crucial way for states to address the staggering health disparities faced by individuals involved in the justice system. There are strong correlations between incar ceration and premature death, as well as higher rates of physical, behavioral, and mental health conditions. n 44% of people who are incarcerated in jails have a history of mental illness 3

also mental health and substance use disorders. Reentry waivers are one solution, enabling states to receive Medicaid funding for critical health and social services provided to incarcerated individuals leading up to their release. Services commonly provided include: n Medication-assisted treatment for substance use disorders n Case management and peer support n Housing support and community health worker services n Preventive care and chronic disease management Providing health care through these waivers can play a key role in improving health, as well as

n 33% of sentenced jail inmates meet the criteria for drug dependence 4 n 80% of people who are returning to the community after incarceration have a chronic medical, psychiatric, or substance use disorder 5 The time immediately following release is particularly high-risk. Individuals reentering society are up to 129 times 6 more likely to die from an overdose than the general public. Individuals returning to their com munities also face barriers and stigmas that make reintegration difficult, and that make risk for re-engagement with the justice system high. These statistics underscore the need for services that address not only physical health, but

Illustration by Chris Campbell

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socioeconomic outcomes. The cor relation between untreated mental health and substance use disorders and involvement in the criminal justice system is well documented. 7 Treatment and support services during the reentry process help individuals address the root causes of their involvement with the justice system. Housing support, case management, and peer-support programs can help individuals find stable housing, secure employment, and engage in community activi ties. By involving behavioral health agencies, housing providers, and social services organizations in the reentry process, the waivers ensure there is a coordinated approach to helping these individuals thrive in their communities. Implementation Challenges and Considerations While the potential benefits of 1115 reentry waivers are clear, implementing these programs comes with significant challenges. Public Consulting Group (PCG) has supported California, the first state in the nation to implement a reentry waiver, to develop and test pre-release services. States that have implemented reentry waivers early can provide valuable insights into the com plexities of scaling such initiatives. People Challenges n States, carceral facilities, and justice system partners need new skills, knowledge, and staffing capacity, as jail and prison health care are being treated as part of the larger health care ecosystem for the first time through these initiatives. n There are needs for new relation ships between entities such as Health-Related Social Needs pro viders, managed care plans (MCPs), and carceral facilities. n There are challenges with change management, including willingness and readiness to change. Opportunities n Work with stakeholders to develop avenues for feedback, proactive engagement, and collaboration on an ongoing basis to ensure issues are identified early and solutions are informed by practitioners.

n Provide technical assistance and funding support to stakeholders as they work through the implementa tion process, build capacity, and address new staffing needs. Process Challenges n Prison health providers do not have the infrastructure or business pro cesses to bill Medicaid and facilitate wraparound service delivery. n Implementation timelines can be a challenge for carceral facilities. The rapid changes necessary to meet reentry waiver requirements can be difficult for agencies starting at dif ferent readiness levels. Opportunities n Design reentry programs with an iterative approach, starting with a few pilot agencies to identify and address process pain points. Build in reflection and review points to ensure modifications and adapta tions are made proactively. n Encourage phased implementation, ensuring agencies gain familiarity with foundational Medicaid pro cesses and establish appropriate workflows before launching services. n Develop practitioner-focused imple mentation tools that break down requirements, key decisions, and process needs at various phases of service roll-out. n Complex technology systems that require identification, implementa tion, and training are necessary for the carceral facilities to participate in screening, service delivery, and referral processes. n There is a need for bi-directional data exchange, data sharing, and billing and referral systems between carceral Opportunities n Support justice system partners in identifying standard data col lection, reporting, and program evaluation needs, and the tech nology required to support the new services being implemented. Technology Challenges facilities, justice system partners, MCPs, and Medicaid agencies.

n Provide funding to support devel opment, enhancement of data exchanges, or both. n Set up learning collaboratives specifi cally focused on technology, sharing solutions to build strong partnerships between health care providers, justice system partners, carceral facilities, and community organizations. Looking Ahead As more states implement 1115 reentry waivers, the potential for these programs to improve the lives of indi viduals involved in the justice system grows. With a focus on continuity of care and promoting community rein tegration, reentry waivers represent a transformative opportunity to address health care disparities and support individuals during one of the most challenging transitions of their lives. For states looking to implement these waivers, success will depend on thoughtful planning, collabora tive partnerships, and an unwavering commitment to improving the health and well-being of these community members. With the right support and resources, reentry waivers can help build a more effective and just health care system for all. Reference Notes 1. https://bjs.ojp.gov/library/publications/ prisoners-2022-statistical-tables 2, 3. https://www.medicaid.gov/federal-policy guidance/downloads/smd23003.pdf 4, 5. https://aspe.hhs.gov/sites/ default/files/documents/ d48e8a9fdd499029542f0a30aa78bfd1/ health-care-reentry-transitions.pdf 6. https://www.vera.org/publications/ overdose-deaths-and-jail-incarceration/ national-trends-and-racial-disparities 7. https://www.sciencedirect.com/science/ article/pii/S074054721400083X

Julia Kessler is a Senior Consultant at Public Consulting Group.

Christine Newhall is an Associate Manager at Public Consulting Group.

Katie Thomas is a Senior Consultant at Public Consulting Group.

Shannon Weaver is a Senior Consultant at Public Consulting Group.

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the human in human services

By Keith Lowhorne and Ali Caliendo

Foster Kinship and Grandparents as Parents Partner to Expand Kinship Navigator Support in Alabama

I n December 2013, my wife Edie and I rushed to the hospital for the birth of our fourth grandchild, Kyren—a moment that marked the beginning of a long, painful journey. Kyren faced serious medical challenges at birth and was diagnosed with Neonatal Abstinence Syndrome. Over the next few years, Kyren suffered neglect and abuse at home, but despite our reports and appeals to authorities, nothing changed. In 2016, when another grand child, Harper, was born under similar conditions, the situation shifted—tem porary custody was granted to us, and eventually, we adopted both children. It was a difficult road marked by love, loss, and resilience, but in the end, we became the permanent guardians of two children we already considered our own. I retired after 43 years in broadcast news, expecting to travel the world with Edie. Instead, we are raising two young children. We had no support, no guidance, and we knew others must be struggling too. Then, the pandemic hit. Our phones started ringing—it was grandparents raising grandchildren, desperate for food. I reached out to many of the contacts I had made in my long career. A nonprofit stepped up, allowing us to distribute food. It started small, in our driveway—25 families, then more. Complaints came in, but the president of the homeowners’ association, raised by his grandparents, stood by us. Over time, Grandparents as Parents (GAP) has distributed more than 130 tons of food, clothing, school supplies,

miracle. I took notes, asked questions before, during, and after each session. A friendship was quickly formed. We returned to Alabama, determined to replicate the Foster Kinship model— but it was an uphill battle. I spoke at churches, parent–teacher association meetings, and community events. Hands always went up when asked if they knew someone raising a relative’s child. We formed an official nonprofit—Grandparents as Parents (GAP)—with a board of directors, including foster and kinship care givers, along with others not usually in this space, but who bring great value and perspective. We continued moving forward with our mission supporting grandparents raising grandchildren. We tapped national partners like

and more. GAP launched “Christmas for Kin,” fulfilling more than 1,200 children’s wish lists. Edie would get Christmas lists from the grandparents, then find donors who agreed to buy exactly what’s on the list. Waking up on Christmas morning with kids finding exactly what they wanted proved that Christmas miracles do happen—grandparents can be heroes. In 2018, Edie and I attended a con ference, leaving our grandchildren for the first time. There, I met Dr. Ali Caliendo, the Executive Director of Foster Kinship. The nonprofit’s “one stop-shop” model for kinship care in Nevada was the answer our com munity needed to grow and sustain support for grandparents raising grandchildren. To me, it was another

Illustration by Chris Campbell

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Kinship caregivers are the backbone of child welfare, stepping up for children when no one else can. Yet, too often, their voices are missing from policy and funding decisions. This partnership is a step toward shifting that reality, proving that care giver-led organizations are not only essential, but capable of transforming the system from the ground up. Today, GAP distributes food weekly from the driveway, with the garage and storage units overflowing. Our board members continue meeting with state officials, but GAP grows with grassroots and nonprofit partner support regardless. Together, Foster Kinship and GAP are working toward a future where all children in kinship care have access to the resources, sta bility, and support they deserve, no matter where they live.

leading to improved long-term outcomes for children in kinship care. Foster Kinship’s work began as a grassroots movement in 2011, driven by kinship caregivers who saw first hand the gaps in resources, services, and legal support. Over the years, Foster Kinship has built a model that is effective and rooted in caregivers’ lived experiences and includes kinship families in the decision making. Foster Kinship believes that community-led organizations like GAP are the heart of kinship care advocacy, as they bring cultural knowledge, trust, and direct experience to their work. By sharing the Kinship Navigator model, Foster Kinship leadership hopes to equip GAP with the tools needed to engage with Alabama’s child welfare system, demonstrating the critical role grassroots organizations play in stabilizing families. With the right structure in place, kinship organiza tions can position themselves for sustainable partnerships with the state, ensuring access to federal Family First Prevention Services Act (FFPSA) Title IV-E funds, which are largely untapped for kinship families across the country.

Generations United for support, as well as led a state-wide charge under Alabama Lt. Governor Will Ainsworth to surface challenges and supports for grandparents raising grandchildren. In October 2024, the board of direc tors of GAP visited Foster Kinship’s campus to learn firsthand how their exemplary model works. This col laboration, offered pro bono, aimed to strengthen GAP’s capacity and position it for potential partnerships with the state, with a goal of ulti mately unlocking Title IV-E funding to sustain and expand critical kinship support services. Foster Kinship’s Kinship Navigator Model has been rigorously evaluated and proven to improve family stability, prevent entry into the foster care system, and connect kinship caregivers to essential services. The model begins with intake and assessment, ensuring caregivers receive accurate, customized guidance. Families are then supported through case management, providing peer–professional assistance until they reach their goals. The program focuses on legal capacity, financial stability, par enting support, and child well-being,

Keith Lowhorne is the Founder and President of Grandparents as Parents (GAP)—Alabama.

Ali Caliendo, PhD, is the Founder and Executive Director of Foster Kinship.

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Spring 2025 Policy & Practice

technology speaks

By Molly Tierney

When Code Meets Compassion: Empowering Child Welfare for Thriving Communities

O ver recent years, child welfare agencies across the country have embarked with zeal on a journey to the micro-chip millennium. The Comprehensive Child Welfare Information System (CCWIS) rules, and the funding that came with them, meant the human services sector could finally have the technology we desperately need to get our work done. Technology could be the enabler for a myriad of excellent practice models and help us realize our mutual belief that child welfare could contribute to stronger families and a better future in thriving com munities across the country. It’s no secret that, in many places, the CCWIS journey has not gone as

of child welfare. By design they are to put their heads together and co-design a new solution that will work for child welfare. It’s an elegant model that has worked wonders in other sectors. Except in child welfare somehow it hasn’t. Team One, they populate them with technologists who have experience from other human services projects— which makes good sense. Except, remember that since child welfare has not updated its technology in 25 years, the people from whom they select—while very smart, expert pro fessionals—have built their careers designing solutions for child support I have a hypothesis about why. First of all, when vendors staff

well as we had all hoped. In some places it has stalled altogether. Like many of you, I’ve devoted my entire career to child welfare, so this turn of events has left me dismayed and frustrated. After picking myself up and dusting myself off, I decided to do some thinking on the matter. I asked myself: Really, what is going awry between kick-off and go-live in CCWIS deliveries? CCWIS deliveries begin with a process called Discovery. This is basi cally a room in which two teams of people gather. Let’s call them “Team One” and “Team Two.” Team One is a vendor team comprised of tech nologists. Team Two is comprised of professionals who know the business

Image via Accenture

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understand child welfare. Both Teams end up feeling the other Team simply does not get it. The real problem is we got it wrong in design. We get it wrong when vendors don’t put people on Team One who have worked in child welfare. We get this wrong when we write off Team Two as resistant to change and fail to under stand the urgency of the matter at hand. We can get it right if we get Team One and Team Two into the same conversation in Discovery. Doing that would mean vendors would always build teams that included members who had years of experience in public child welfare systems. It would also mean listening, really listening, to what child welfare professionals are telling us their technology needs them to do.

one is the kicker—is “parent.” They are the parent for the child they are serving. They know they are the end of the line for that kid and, furthermore, that no one else is coming. For them, filling out the form is how they become the “parent.” They stand on that line and protect the very life of the kid they are serving. So, you see, for Team Two, this is not about a tech system or about a field or function. It’s about a life. And it’s their job to save it. We get this wrong when Team One and Team Two gather in Discovery and think they are in the same meeting but actually end up in very different conversations. Team One is trying to burn through a list of finite decisions that they think are more or less binary in nature. Team Two is explaining how it does not work that way. Team One then ends up with the experience that Team Two is resistant and only wants to rebuild their old solution on a new platform. Team Two feels alarmed that Team One does not

or Medicaid or SNAP. These are wildly different projects. They are largely scientific equations. Child welfare, in comparison, is art. It is a counter-intu itive, complex set of assessments and associations. This means that Team One walks in the door to Discovery underestimating the complexity of the magnitude of the task at hand. Next, you have Team Two. Public agencies staff those teams with seasoned professionals who know the ins-and-outs of every inch of their process. These are people who take great pride in their jobs and they get their identity from their role at work. Like most of us, they derive their identity not at the level of title, but at the level of task. For them, there are two tasks that matter for the purposes of this discussion. Their first task has been to fill out the “form”—whatever “form” it was. They know how to fill out every field in that proverbial form to complete a child welfare process accurately. Their second task—and this

Molly Tierney is a Managing Director at Accenture LLP where she leads the firm’s Child Welfare Practice.

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WELL-BEING Child & Family

Designing a Multifaceted Approach to Child Welfare Prevention

This article is a reprint from APHSA’s series, Courageous Imperatives for Human Services , which provides recommendations to the current Administration and Congress to help develop strategies that unlock the potential of human services. To learn more about this series, visit our Election Transition Recommendations at: https://aphsa.org/election-transition-recommendations/.

Outcomes 1. Prevent unnecessary child protection service involvement and foster care placements by addressing poverty-related factors that lead to child protection interventions, ensuring families receive support to prevent unwarranted separations. 2. Reduce foster care entries through the implementation of prevention services and Alternative or Differential Response that allow children to remain safely with their families while addressing abuse or neglect risks. 1 3. Promote family stability by strengthening family support systems and advancing child and family outcomes through holistic, well-being–centered initiatives. Courageous Imperative: Promote family stability and reduce the need for child welfare system involvement by advancing proven, whole-family solutions. By empowering local communities to support families in need and addressing economic challenges, we can keep families together and ensure better outcomes for children and families.

H

Better OutcomesThrough Prevention Services Evidence strongly supports that some children will benefit more from receiving prevention services and maintaining connections with family members rather than if they are removed from their families and networks and enter foster care. In December 2024, Congress passed

a bipartisan reauthorization of Title IV-B of the Social Security Act with overwhelming support. Titled Supporting America’s Children and Families Act , the reauthorization introduces reforms to modernize the Title IV-B program while saving taxpayer dollars. By emphasizing early intervention, the updates aim to help families remain united and strengthen prevention services. We

istorically, the American child welfare system has responded to crises of abuse and neglect by inter

vening only after abuse or neglect has occurred. By prioritizing proven pre vention initiatives and implementing whole-family approaches, agencies can strengthen and stabilize families with children at risk of abuse or neglect and reduce unnecessary and often trau matic foster care entries for children. Using preventive policies to address systemic barriers—like housing instability, lack of child care, medical costs, and low wages—will reduce child welfare involvement and ensure greater family stability. According to the Child Maltreatment 2023 report from the U.S. Department of Health and Human Services, Child Protective Services (CPS) agencies received 4.3 million referrals alleging maltreatment involving 7.5 million children. Of these reports, CPS “screened-in” 2.1 million referrals (representing 3.1 million children), meaning they met agency criteria for an investigation or alternative response. Investigations confirmed that 415,000 children suffered abuse and/or neglect, with 74 percent expe riencing neglect, 17 percent physical abuse, 11 percent sexual abuse, and 0.2 percent sex trafficking.

4,276,000 referrals alleging maltreatment involving 7,530,000 children

CPS “screened-in” 2,119,706 referrals (representing 3,096,101 children)

558,899 children suffered abuse and/or neglect

0.2% 10.6%

17%

Children experiencing neglect

Children experiencing physical abuse

Children experiencing sexual abuse

74.3%

Children experiencing sex trafficking

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crises occur reduces the number of children from marginalized com munities entering the system. 2 Innovating and Building from Family First Prevention Strategies The Family First Prevention Services Act (Family First), signed into law by President Trump on February 9, 2018, transformed the child welfare system by allowing federal Title IV-E funds to be used for evidence-based prevention services, such as mental health support, substance abuse treatment, kinship navigators, and in-home parenting programs. This opened the path for many jurisdictions to begin implementing alternatives to removing children and separating families. The law made some of these preventive services available

share in the vision and commitment that this bipartisan legislation highlights to invest in prevention efforts and supporting families nationwide. We call on the Trump Administration and Congress to do even more if we are to achieve the fol lowing vital goals: n Reduction in Maltreatment: Prevention services reduce the incidence of child maltreatment by addressing risk factors such as parental substance abuse, mental health issues, and economic instability. 2,3 n Improved Family Stability: Programs that strengthen family relationships and support parents

n Better Long-Term Outcomes: Children who stay with their families and receive appropriate support achieve better long-term outcomes in mental health, edu cational achievement, and social relationships. Stability and conti nuity within the family contribute to these positive outcomes. 3,5 n Cost-Effectiveness: Investing in prevention services proves more cost-effective than the expenses associated with foster care and other child welfare interventions. Reducing the number of children

entering the system allows for more efficient resource allocation. 4,5

help prevent the need for child removal, maintaining family unity and reducing the trauma of separation. 2,4

n Reducing Racial Disparities: Prevention services mitigate the disproportionate impact of the child welfare system on families of color. Providing support before

Increase the Availability of Prevention Services

Key Issues: n The Family First Act currently funds a set of services, including in-home parenting programs, mental health services, substance abuse prevention and treatment, and kinship navigator services. These services address many prominent issues that may cause children to be at risk of abuse and neglect. However, additional covered services could enhance the system’s ability to prevent foster care entry due to neglect. As noted above, conditions of poverty have a strong correlation to determinations of neglect. n The IV-E Clearinghouse requires prevention services to demonstrate evidence of effectiveness through randomized control trials or quasi-experimental designs to qualify for funding, which has been instrumental in advancing evidence-based practices. However, this standard poses challenges for innovative programs developed in rural communities or tailored for specific populations that often lack access to academic researchers, institutions, or funding. Despite their proven success within smaller populations, these programs may be ineligible for support. Many well-designed and impactful initiatives struggle to meet the Clearinghouse’s rigorous academic standards due to limited resources, potentially excluding effective solutions from broader adoption and funding opportunities. n Child welfare services and economic assistance programs are implemented by different agencies or offices at the federal level, making coordinated and aligned service delivery to families at the state and local levels difficult. n Complex federal financing rules across Medicaid, child welfare, public health, and behavioral health make it difficult to contract with, reimburse, and monitor service providers.

Key Opportunities: n Establish a cross-agency task force to identify barriers and develop solutions for integrating prevention strategies into housing, Medicaid, and public health systems and specifically delink factors associated with poverty from the child protection system. n Extend Family First’s allowable services to explicitly include economic supports and other evidence-based services that demonstrate success in preventing children from entering foster care. n Amend the IV-E Clearinghouse rating criteria so that effective cultural-, location-, or population-specific programs and services are eligible as IV-E prevention services without having to meet the randomized controlled trial, quasi-experimental design, sample size, or replicability criteria. n Align the IV-E Clearinghouse with existing best practices in substance abuse and mental health so that best practices funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) and Medicaid are available in the Clearinghouse or otherwise made allowable for reimbursement under Family First.

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Policy & Practice Spring 2025

Better Engage Family Members to Support At-Risk Children and Those in Foster Care

Key Issues: n Only 34 percent of children in foster care are placed with family members or fictive kin. n Unlicensed kinship caregivers typically receive support limited to child-only benefits through the Temporary Assistance for Needy Families (TANF) program, which generally amounts to less than half of the financial assistance provided to licensed foster parents. States need additional funding and technical assistance to meet the intent of the Kinship Licensing Rules, which allow states to reimburse kinship caregivers at the same rate as licensed foster parents.

Key Opportunities: n Create a set of best practices, model policies, innovative use of technologies, and technical assistance to enhance family finding and engagement activities through federal guidance and technical assistance. n Address funding gaps that limit kinship caregivers from being reimbursed at the same rates as licensed foster parents.

Address the Intersection of Poverty, Neglect, and Unnecessary Foster Care Entries

Key Issues: n Children are often reported to the child protection system for conditions related to poverty. n Work is needed to advance and evaluate community-based alternatives to child protective service involvement that could help children in low-income situations and ameliorate harmful conditions of poverty.

Key Opportunities: n Introduce a federal demonstration project on diversion programs that supports state pilots to test diversion programs for neglect-only cases that focus on prevention and service provision without formal child welfare involvement. n Evaluate outcomes and scale successful models through federal funding mechanisms.

and enter foster care by advancing executive actions and policy changes that continue to shift the child welfare system from reactive interventions to proactive prevention services. By revising the scope and scale of effec tive prevention services, removing barriers that hinder family connec tions, and creating opportunities for cross-system collaboration and coordi nation between child welfare services and other systems that increase economic security, policymakers can create a more effective, coordinated system. This modernized approach would not only strengthen the child welfare system’s ability to protect children and strengthen families, but generate measurable, long-term outcomes that reflect both fiscal responsibility and social impact. Conclusion APHSA and our members are com mitted to working with the Trump Administration to strengthen the

nation’s human services system so it continues to provide foundational support to families across the country. Through leadership, innovation, and executive action, human services programs can become an instru mental tool to attain our national priorities of health, well-being, and prosperity for all. To discuss our recommendations, please reach out to policy@aphsa.org .

to families with children at risk of entering foster care, which may have unintentionally excluded families who could benefit from earlier, more comprehensive support, potentially creating gaps in the child welfare system’s effectiveness. The law should be strengthened by: n Revising the eligibility require ments determining which families can receive services to include those facing significant economic hard ships (such as housing or child care). n Supporting innovations and proof of concepts to cover services that demon strate reduction of children entering foster care and stronger families. n Creating flexibility for states to implement approaches that work best in their jurisdictions. Taking Action: Opportunities for Impact Federal policymakers can signifi cantly reduce the number of children who experience abuse and neglect

Reference Notes 1. https://www.childwelfare.gov/ topics/casework-practice/ differential-response/?top=81 2. https://www.ncfr.org/system/

files/2021-04/Transforming_Child_ Welfare_Full_Brief_0421.pdf 3. https://www.acf.hhs.gov/sites/default/ files/documents/cb/evaluating_ prevention_child_welfare.pdf 4. https://www.rand.org/pubs/research_ briefs/RB9949-1.html 5. https://www.rand.org/pubs/ articles/2018/how-the-child-welfare system-could-protect-more-kids.html

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Spring 2025 Policy & Practice

NAVIGATING Workforce Challenges

How Technology and Process Design Can Help Government Agencies Do More with Less, and Provide an Even Better User Experience

The Growing Impact of Workforce Challenges in Human Services

BY

Marina Pascali

Mary Alice Hunt

The workforce pressures facing gov ernment agencies have been severe and are expected to increase. Staffing cuts, employee turnover, shrinking budgets, and increasing caseloads are further overburdening caseworkers and impeding access for those who need services the most. Mary Alice’s experience is not unique. Research by Boston Consulting Group reveals that 60–70 percent of people encounter issues when engaging with government services. 1 From struggling to access benefits to lengthy response times for appoint ments, people face hurdles created by resource limitations and outdated processes. Amid current budget uncertainty, states are likely to face additional program changes with steady or growing demand. Training employees across programs is on the rise in an attempt to increase staffing flexibility but is not sufficient unless coupled with innovative approaches in people, processes, and technology. Let’s take a look at how community resources and self-service options can streamline processes and reduce case worker workloads.

NAME GAME

Recently, I had to correct an error with my name, “Mary Alice,” in a government system, where it had been incorrectly split into two fields during a system data migration. What initially seemed like a simple fix turned out to be more complex than I expected. The online portal only supported legal name changes, requiring me to call, spend hours on hold, and schedule an in-office appointment weeks later, in an office that was an hour away from my home. When I arrived, the lobby was overflowing with clients using a check-in process that was confusing and dependent on a self-service kiosk with no staff member available to assist. It was clear that technology and workforce limitations were creating barriers for the many people there to access essential services, especially an elderly woman I encountered. This experience highlighted an opportunity to improve the integration of technology and human support in service delivery. It was an eye-opening encounter with the challenges human services agencies face today. Reduced workforces, outdated processes, and over-reliance on technology without human support are collectively impacting individuals in need of services and increasing pressure on already stretched teams. For human services leaders, these challenges create an urgent question: How can agencies do more with less while still prioritizing human-centered services? —Mary Alice Hunt is a Director at Cúram

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Spring 2025 Policy & Practice

Seeing Uncertainty as a Catalyst for Innovation

Rather than focusing on workforce challenges as obstacles, there is an opportunity to use this moment of uncertainty as a catalyst for cre ativity. Technology and collaboration, when applied thoughtfully, can help agencies optimize their resources. By focusing on automation, accessibility, and seamless processes, states can reshape how services are delivered— even in the face of reduced staffing. Here are three considerations for human services leaders in addressing these challenges while delivering better outcomes for individuals. 1. Leveraging Technology for Automation and Efficiency Automation isn’t about replacing human workers—it’s about empow ering them to focus on high-impact tasks that require their expertise while technology handles mundane, repeti tive processes. Common applications and integrated eligibility workflows are examples of how smart automa tion can transform operations. These approaches allow caseworkers to cen trally manage clients across multiple

Automation

Seamless

Efficient Accessible

Centralized

Person-Centered

programs, and common processes such as intake and renewals through “light touch” and “no-touch” workflows. Seamless integration with external systems, combined with verification process automation, is another way to reduce demand on caseworkers. For example, your residency can automati cally be verified via integrations with trusted sources such as postal services or vehicle registration agencies. This reduces the need for data entry and worker oversight, streamlining the entire process. Following the unwinding of the COVID-19 public health emergency, Minnesota faced the daunting task of processing hundreds of thousands of Medicaid renewals with fewer staff. 2 By automating renewals, the state increased its auto-renewal rate, eased caseworker workloads, and ensured eligible residents could retain their benefits. n Hamburg, Germany: To better Real-World Successes: n Minnesota:

Automation also extends to self- service technology. Tools for appoint ment management, screening, and benefit applications save time for both clients and caseworkers. Beyond increasing efficiency, they create a resilient system capable of adapting to fluctuating demand. 2. Designing Accessible, Person-Centered Systems While automation is key, technology alone isn’t a universal solution, and Mary Alice’s story highlights the reason why. Even though she didn’t personally struggle with technology, she saw first-hand how poorly designed self-service platforms left many feeling overwhelmed, especially groups like the elderly or those with specific needs. These are often the very people who rely on these services the most. This demonstrates the need for incorpo rating community-based organizations (CBOs) and assistants to bridge the gaps. They play a critical role in sup porting those who cannot self-serve, ensuring no one is left behind. For technology to truly benefit users, it must also be accessible and user-friendly for everyone, including those with limited tech literacy or accessibility needs. Person-centered design plays a crucial role in creating systems that prioritize accessibility for both end users and staff, delivering better outcomes and inclusive solu tions. Intuitive interfaces that follow global standards like Web Content Accessibility Guidelines are essential, especially with government agencies required to meet these standards by April 2026. Accessibility is about more than compliance—it’s about removing

Marina Pascali is a Senior Director at Cúram.

serve abused and neglected youth, Hamburg deployed an outcomes based solution that

Mary Alice Hunt is a Director at Cúram.

automated client intake and case management. 3 The results? A 60 percent increase in cases processed over five years and more than 20,000 monthly transactions to support child welfare—a testament to using technology for better outcomes.

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Policy & Practice Spring 2025