Recently, I sat down with Patrick Lawler, Founder and CEO of Youth Villages, to discuss, in great depth, the evolution and promise of social innovation in the foster care system, and what needs to be done systematically to advance the field. Patrick Lawler has been working in foster care space since 1973. In 2006, Lawler was recognized as one of “America’s Best Leaders” by U.S. News & World Report in conjunction with the Center for Public Leadership at Harvard University’s John F. Kennedy School of Government. Harvard Business School also produced a case study highlighting Youth Villages’ innovative treatment program in 2009. Below is an excerpt from our interview.
Marquis Cabrera: First, I appreciate your taking this interview. Let’s jump right in! Pat: Can you explain to me what Youth Village does?
Pat Lawler: [Youth Villages] provides residential treatment, therapeutic foster care, intensive in-home services, adoption, crisis services, and transitional living services. We obviously also try to have some great outcomes: we track all of our kids for two years post discharge. We also do research. We know [University of Maryland Dean] Rick Barth very well and have collaborated with him on several research papers. But our focus is on strengthening and restoring families. We have the philosophy that children are really raised best by their families. And we do everything possible to keep young people with their relatives and in the community. If they do have to be removed, we think they should go to the least restrictive environment for the shortest period of time.
We want to help raise all boats. We want to provide great services to kids, but we want to work with policy makers and advocates and people that are really the brightest and the best in our field. We want to support them to help change policies and funding mechanisms and create Medicaid codes and those kinds of things that really allow for the necessary support to be given to organizations that produce favorable results and have strong performances.
Marquis Cabrera: I like the idea of the system’s perspective and really working with researchers and working with policy makers to help a child beat the odds. And – what are your thoughts on the current state of the foster care system?
Pat Lawler: We believe that the system is terribly broken: Over 400,000 children in the foster care system live outside of their home everyday. And there are really few processes and significant programs across the country and funding streams to prevent young people from ever being removed from their families in the first place. There’s not good funding streams. Some states have been able to work with Medicaid to fund preventative services with federal dollars, but most states do not have that available.
Marquis Cabrera: What must be done to improve the foster care and child welfare systems?
Pat Lawler: We think there first has to be a common set of beliefs that everyone shares at the state and national level and creative systems put in place and processes to support these beliefs. Then of course the necessary funding must be available and programs to reinforce all of this. And a plan to execute this strategy to reinforce the beliefs.
Permanence is key. Kids should not just languish 8-10-12 years in the foster care system and being placed in 10-15-20 foster homes-and that is not uncommon. I am sure you have heard these stories before. We must recognize that families are important, that families are the key to the solutions for young people. It might not be the birth family. It could be an adoptive one. But these children need to be living with a permanent family in a community.
There are some pockets of success and areas in the country where we are making progress, but overall it is a terribly broken system. The sad part is that there are very few people at the highest level of leadership that really have taken an interest in the child welfare system. I think that until we find a bold leader and a champion at a high-level in Washington and in each of our states, [the child welfare system] will not change. Often people will tell you that they don ‘ t see anything working for these kids and families, but there are things that are working.
I do think that every state is so different and most every state, and the country of ours, is in reform process, but so often these reforms are not based on evidence or other reforms that have really worked… so often reform stalls with transitions in leadership, commissioners, governors. One of the biggest challenges is the constantly changing leadership in states. Transformations sometimes aren’t given time to really take effect and then someone comes in and changes things again. It’s a problem.
Marquis Cabrera: Wow! Can you share with me some best practices from the state that you are currently headquartered?
Pat Lawler: Tennessee is one of the states that we work in that has made by far the most progress. There’s four components that Tennessee has-there’s four systems:
1. Crisis Services: Often kids come into the system because of a behavioral crisis. Tennessee has a fantastic crisis response program, which we are responsible for. We work hard to make sure children receive effective help on the very front end, when a crisis happens versus removing a child and trying to put them in a psychiatric hospital or some other out-of-home placement. And that is the first system that has to be in place in every state. And those systems have to be monitored and measured. I mean regularly to determine if they are effective.
2. Prevention Services: Through its TennCare waiver – the way the state does Medicaid – Tennessee uses federal dollars to provide intensive in-home services for every child who is in danger of going into custody or psychiatric hospital or goes to a treatment placement. They have good funding streams, standards and good outcomes.
3. Performance-based contracts: Providers that offer child welfare services through the Department of Children’s Services in Tennessee work under performance-based contracts. Outcomes are measured with clear metrics that were developed with the help of Chapin Hall at The University of Chicago. Everything from how long a child is in care; what happens at discharge, whether they return to care is tracked and measured. There are a lot of processes in place to measure how an organization is doing working with young people.
4. Tennessee has the only comprehensive transitional living program provided to every young person who ages out of state custody without family support in the country. This is not a drop-in center, where a foster kid can go clean up their resume, it’s not someone helping him or her learn how to do an interview, this is all comprehensive, intensive support that allows young people to set their own goals and get help to achieve them. This is a full-time staff person working with a small caseload of 7-9 young people committed to helping them resolve their problems. We’re available 24/7 to do whatever it takes to help them, which is much more comprehensive than most aging-out services.
We help them with their drivers’ licenses, healthcare, and transportation and just working on their own crises and problems they have. Some of the young people have children of their own, some have mental health challenges or other disabilities. The program is really helping young people be successful. We are available 24/7, and we will do whatever it takes to help them. It’s much more comprehensive then other programs you hear about where there may be a hot line number that they can call or a drop-in center where they can get a change of clothes and help with a resume. I don’t know about you, but I bet you had a mentor or a champion in your corner during difficult times… That’s what our specialists are for the young people in our transitional living program.
Marquis Cabrera: My question to you – and I don’t want to keep you for much longer but – Pat this has been an awesome interview by the way. The things that you’re highlighting are things that I feel personally about the system and to hear someone saying it and articulating it in a way and have such a background and passion for this is just incredible to hear, especially over the long term in your experience. I’ve only been doing this for four years and I mean you’ve beat me by decades so this is just amazing to get an inside view of your mind and what you’re thinking. So this has been awesome. My final question is: If you just had like one recommendation, it could be pertaining to Youth Villages, it could be a policy initiative, a gambit of things. But if you had something you wanted to try, or something that may work, this could help or this has been proven to help….what would it be and why?
Pat Lawler: First of all I’m not sure there’s any one program. Let me think. You know part of me says start all over. I think people have to recognize this, every one of these young people have a tragic story, but every one of these young people, given the right opportunities, can have a bright future. We have got to quit treating young people like they are chess pieces on a chessboard; I mean we have got to quit doing this. We are so far removed as a society from these young people. People don’t understand who they are or why they have problems or why they can’t just straighten themselves up or why their families don’t care about them. I really think we have got to make this a significant priority in our country. These are kids that are filling up the prisons, that are filling up the psychiatric hospitals, that are homeless, that are on government funded programs for the rest of their lives, and I think there’s just got to be change.
I wish there was one answer. I think one answer is to take child welfare seriously and to give it the same level of attention and oversight supports you would give the bank industry or investment markets or the way they manufacture cars and monitor safety and monitor quality. We need to have all those same measures and processes and support systems in place to help children be successful. I’m not comparing kids to products, I’m just saying in so many other areas of our country there’s so much more attention given, but foster kids and child welfare just doesn’t get attention until there’s a crisis on the front pages of the newspaper.