presently defined, since these children cannot be brought to even a minimum level of functioning, with known methods of treatment, by the time they reach adulthood."

One of my concerns is that our focus on children may be lost in all the discussion of welfare reform. Without question our system of providing income support to families must be reformed. But the services now needed by children and families cannot wait another 3 years while we debate changes in the welfare system.

FUNDING ISSUES

The most immediate issue, that of overriding importance, is the existing system of funding for foster care.

Currently, foster care is funded through a number of different provisions of the Social Security Act. Under Section 408 of the Social Security Act, Federal Financial Participation (FFP) is available only for maintenance, which is defined as the provision of shelter and board. The eligibility criteria is the same as that for Aid for Dependent Chillren (AFDC) with an additional requirement that there be a judicial determination to the effect that continuation in his own home would be against the child's best interests.

The eligibility requirements for AFDC are cumbersome and restrictive. By limiting federal reimbursement to those who are AFDC eligible, states are, in fact, penalized for providing foster care to intact families who might have to avail themselves of this service.

I think it should be noted that foster care services are not mandated by federal law. What money is available for services falls under Title XX of the Social Security Act. Although the states have been given latitude in how they can spend their money, the reality is that there is no money for new programs. Most of the Title XX funds have been earmarked for services that had previously been funded under Title IV A of the Social Security Act. (In New York over 60% of Title XX funds are expended for day care services)

In addition, the formula for Title XX funds works to the detriment of the larger urban areas. New York State's share of funds under Title XX has decreased every year of the existence of this program.

Title IV-B of the Social Security Act, which I will discuss more fully later on in my testimony, provides some federal monies for both foster care maintenance and services. The appropriations for IV-B, however, have been too small to make any appreciable impact.

The funding system for foster care is fragmented, cumbersome and costs a great deal of money. When one considers the time and effort that is expended in meeting requirements first for FFP under Section 408 and then for Title XX, and then consider medicaid eligibility and the requirements under the parent locator provisions of the Social Security Act (Section IV-D), you can see that a great deal of our time is spent on paperwork and not on providing the necessary services to children and their families.

Furthermore, as every child in foster care is eligible for medicaid, the real cost of these services are far greater than just the Section 408 and Title XX expenditures. In New York City, we are spending almost $250,000,000 to care for an average of 28,000 children.

RECOMMENDATIONS

I would like to offer some recommendations for changes in the child welfare syste that I strongly hope this subcommittee will consider:

(1) Need to provide preventive services-As I stated previously, our ultimate objective should be providing services to children and their families in order to prevent foster care. These programs, while more desirable from a services objective, are also cost-effective. In New York State we recently concluded a number of preventive services demonstration programs. The results showed that extensive services to both children and their families prevented nearly 70% of the children from entering care. The cost of providing these preventive services was about $2.000 per child per year. This is remarkable when you consider that in New York, depending upon the type of facility, foster care can cost anywhere from $5.00 to $20.000 per year.

(2) Adoption subisidies-Adoption is one method of attaining permanency for a child and one method of aiding in adoptions is to provide a subsidy to

prospective adoptive parents who would not otherwise be able to financially provide for a child. Adoption subsidy is a program that 43 states now employ. We in New York can attest to the fact that providing subsidies has greatly assisted in getting children adopted. Here again it should be noted that this program is cost-effective as the subsidy payment is far below the average cost of foster care. For example, in New York City it costs an average of $4,900 per year to keep a child in foster care. The same child adopted with subsidy cost us only $2,250.

Currently, no federal money is available for adoption subsidies. One of my recommendations is that money be made available to provide subsidies to adoptive parents through open-ended maintenance funds now available in Section 408.

(3) Fully fund Title IV-B-There is in existence a method to help fund the necessary child welfare services. Title IV-B of the Social Security Act is specifically designated for child welfare services. However, while Title IV-B has an authorization of $266 million, no more than $50 million has been appropriated.

I strongly urge full funding for Title IV-B. Because of the importance of providing services both to prevent children from coming into care and to return them to a stable permanent home once in care, I would recommend that new IV-B funding be limited to non-maintenance activities such as preventive services, family reconstruction services, adoption subsidy and state and local administrative and systems improvements. What we do not need is any more research and demonstration programs. States should also be required at least to maintain their present efforts in the areas of prevention, etc. even if federal funding is increased.

In addition, as an added incentive to states to fund these needed services, I would recommend that the complicated matching formula now required under Title IV-B be eliminated. This would not cost the government anything and would, in fact, provide a cost savings as there would be a reduction in maintenance costs which are currently funded, open-endedly, under Section 408 of the Social Security Act.

If we are really serious about full funding of IV-B, Congress should make it an entitlement, instead of a source of funds that is so hard to get that we have had to come this present long, laborious route.

While my talk is focused on changes in the service delivery system, I would also like to make two other recommendation concerning foster care.

(1) Eliminate the requirement in Section 408 for a judicial determination as a condition for AFDC-FC-On account of the desire to receive federal maintenance dollars, states are being forced to send their AFDC-FC income eligible voluntary placements through the courts. This process is an unnecessary charade as the court merely rubber stamps what has already been agreed to (In New York City, nearly half the placements are voluntary and the court approves over 95% of them).

Courts that should be dealing with adoptions, case reviews, abuse and neglect and juvenile delinquents are unnecessarily bogged down with voluntary placements and social workers, who should be out working with families to prevent placement or limit its duration are forced to spend time in court to attest to a voluntary placement that, by definition, would have happened without the court's involvement. The wasted cost to the court is significant in real dollars as well as time that could be better spent. Even more striking is the cost in caseworkers time. We did a time and motion study and found that our workers are spending 40% of their time in court. 25% on eligibility determination and only 35% in direct service delivery. Of this 35%, almost 1/3 is spent in preparing reports. 1/3 on travel time to visit clients, leaving 1/3 of their time for actual counseling and services.

(2) Amend Section 408 to allow for federal reimbursement for foster care maintenance in public institutions such as group homes and residential treatment centers-This current prohibition prevents states and localities from developing the needed resources to handle the children now entering foster care. I am not saying that public agencies should open up large institutions for the warehousing of children. On the contrary, nearly everyone in the child welfare field agrees on the need for group homes and residential treatment facilities, smaller congregate care facilities with the capability of providing a structured service setting.

Last year Congress, in its amendments to the SSI program, allowed for federal financial participation for recipients in public facilities of 16 beds or less. I strongly urge that this provision be extended to the foster care program. I would urge, however, that FFP be available. for public institutions of the group home nature of up to 25 beds as the per capita costs in a program with anything less than 25 beds are prohibitive in urban areas.

Members of the Sub-Committee, I have tried to explain some of the problems in the child welfare system as I see them. Congress has had a long and respected tradition of concern for our most precious resource, our children. I strongly believe that reforms are necessary and I ask for your assistance in assuring that the children of our country receive the best of all opportunities to develop their potential. Thank you very much.

STATEMENT OF BARBARA J. SABOL

Ms. SABOL. I am Barbara Sabol, director, division of children and youth, Kansas Department of Social and Rehabilitation Services. I am pleased to have this opportunity to talk to you about some of the problems that we have in Kansas as it relates to children. I think oftentimes it is very easy to say these things can happen in New York, but do they happen in other places? I would like to describe for you some things that are happening to children in Kansas:

One: In fiscal year 1976 there were 6,113 cases of reported suspected child abuse and neglect.

Two: To date in fiscal year 1977 there have been 7,004 cases of reported suspected child abuse and neglect.

Three: In fiscal year 1976 there were 207 cases of reported suspected sexual abuse, 96 of which were confirmed.

Four: To date February 28, 1977-in fiscal year 1977, 226 cases of reported suspected sexual abuse have been received, 90 of which were confirmed.

Five: In fiscal year 1976 there were 17 child deaths as a direct result of abuse and neglect.

Six: To date February 28, 1977-in fiscal year 1977, there have been seven child deaths as a direct result of abuse and neglect.

Seven: In 1970 there were 7,682 reported juvenile arrests for major crimes; in 1974, 9,444-an increase of 32 percent.

Eight: There were 6,197 children in out-of-home care as of January 1, 1977; 2,106 of these were in family foster care.

Nine: In 1975 there were 92 pregnancies in the 10-14 age group; 75 of the 92 were unwed pregnancies. In 1975 there were 6,368 pregnancies in the 15-19 age group.

Ten: 1970 data indicates that there are 90,646 Kansas women with children under 6 years of age in the labor force, and 165,088 Kansas women in the labor force with children 6-17 years of age.

Eleven : There were 12,561 divorces and annulments in Kansas in 1975. This is an increase of 1,077 of 9.4 percent from 1974.

These are not just the problems of minority and poor families. These are problems in practically all our communities and are not limited to any racial or socioeconomic strata. Of the 105 Kansas counties there are only two in which there has not been a reported case of suspected child abuse/neglect.

We recently had studies of 117 cases of children and youth who were receiving out-of-home care. Here are some interesting findings from that sample:

One: In 53 percent of the cases, one parent was caring for the child prior to placement.

Two: Fifty-two percent of the sample were living in suburban/ urban settings prior to placement; 48 percent in rural areas or small

towns.

Three: Thirty-two percent had previous police contacts ranging in severity from status offenses to attempted murder.

Four: The number of children having police contacts during initial placement were considerably less than those having police contacts prior to placement-13 percent versus 32 percent.

The problems associated with out-of-home care deserve special attention.

In Kansas, title IV-B funding has been almost exclusively utilized for foster care services. The removal of a child from his/her own family and home should be a last resort. Too often we are faced with the utilization of foster care as a first step rather than as a last resort. This is primarily a function of funding pattern and available

resources.

A recent analysis of closure of foster care cases other than parental rights severed-indicates that 50 percent of the cases are closed within 1 year. This indicates to us that if there had been adequate in-home services available, probably one-third of the children removed from the home could have remained in the home. Our desire is to have children removed from the home only when there is no possibility of protecting the child in the home.

Title IV-B Federal funds distributed to States above the current allotment should require no match and should be distributed to the States on an entitlement basis. This means then that the State can develop a comprehensive plan for child welfare services based on knowledge of the resources available and the needs of children, families and communities. If this program were funded to its full authorization, we could move from the two-step of evaluate and place or place and evaluate to the development and implementation of a system of preventive and rehabilitative services making available to children and families:

One: Education for parenthood as a preventive and rehabilitative service.

Two: Improved staff-client ratios.

Three: Intensive casework services which can help parents bond with children and provide a relationship and person who can stand by and stand with a parent in meeting the parent dependency needs in such a way that the parent can move to independence and support of the children.

Four: Homemaker services.

Five: Crisis nurseries.

Six: Emergency care workers and emergency shelters.

Seven: Aftercare services to children leaving institutional settings. Eight: Family therapy services.

Nine: Safe houses for mothers/wives and children who are being abused.

Ten: Improved services to unmarried parents to assist them in gaining skills and knowledge of child rearing, use of community resources, et cetera.

Eleven: Increase adoption subsidy.

The ability of the Kansas Department of Social and Rehabilitation Services, Division of Services to Children and Youth, to provide adoptive homes for children with special needs is enhanced by the Adoption Support Act. The adoption support program has increased adoption opportunities for children with special needs by providing continued financial help to families who will adopt the child in their care; sibling groups but the selected family cannot afford the additional expenses of receiving two or more children at one time; children with chronic medical problems; children who need special help such as speech, psychiatric or physical therapy; children with learning problems and development disabilities; or children or other racial or minority groups but the family income would ordinarily preclude the addition of a child by adoption. In addition to the obvious benefits which permanent adoptive homes provide for these special children, the average cost of maintaining a child in an adoptive home during fiscal year 1976 was approximately $126 per month compared to an average of $260 per month for a child in foster care. Forty-two children were approved for adoption support in fiscal year 1976 and a total of 153 children have been approved for adoption support since implementation of the program in 1973. Because of its potential to facilitate permanent homes for children, adoption subsidy should be included as an authorized expenditure until title IV-B.

This is not an exhaustive list to be sure, but simply indicates some of the alternatives to the trauma of removing children from their homes and families.

In Kansas the expenditure for homemaker services for children in fiscal year 1976 was approximately $110,000 and the foster care expenditure was $11,704,345. There is no discussion of child welfare services and prevention of child abuse and neglect and treatment of failing families that does not include homemaker services. It is less costly as well as preventing separation of children from their family. Given the service resources to provide services to families to assist them in remaining intact, I would expect to see an impact on the turnover rate in social service staff. Imagine the frustration of reviewing a well done evaluation and making a proper casework plan only to find that your only alternative is removing the child from his family-foster care. Case finding and evaluation may assist agencies in justifying their existence but it has little impact on the child or the family unless we can offer and give services and assess impact of those services.

Full funding increases the possibility of addressing community development and community education, training, facilitating collaborative prevention and treatment activities between various disciplines and agencies. Unfortunately, preventive activity, or even rehabilitative activity does not "score" quickly. The interventions that "score" quickly are often those that are most destructive to the integrity of the family, that is, foster care.

This is not to say that foster care services should be eliminated. There are children who will need to be removed from their own home, however, we must assure that there is recruitment and proper