Substance Abuse Treatment for Persons With Child Abuse and Neglect Issues
Treatment Improvement Protocol (TIP) Series 36

Welfare Reform

Provisions of the Personal Responsibility and Work Opportunity Reconciliation Act (1996) will affect all parents receiving public assistance, including those in substance abuse treatment. However, because the law is fairly new and each State has some choice in the way it implements the law, it is difficult to forecast precisely who will be affected and how. With that caveat, here are a number of issues to keep in mind:

1. Mandatory work requirements: States must move increasing numbers of people from welfare to work or face a reduction in Federal funding. With few exceptions, recipients must work after 2 years of receiving public assistance. Parents in treatment who fail to comply with the work requirements will see their benefits reduced or eliminated. (States may not penalize single parents with a child under 6 who cannot find child care.) States may also cut Medicaid coverage to parents who do not comply with the work requirement (42 U.S.C. §607(e)).
2. Time limits: No family may receive assistance for more than 5 cumulative years (or a lesser period of time, at the State's option). Once a parent has been on public assistance the allotted time, he may be cut from the rolls, although certain hardship exceptions can be made (42 U.S.C. §608(a)(7)).
3. Drug testing: States may screen welfare recipients for substance use and sanction those who test positive by reducing or eliminating their benefits or mandating treatment.
4. Drug felony ban: Those applying for public assistance must disclose any substance-related conviction of any household member. States then can deny public assistance and food stamps to individuals whose substance felony convictions occurred after August 22, 1996. States must take an affirmative step to opt out of this ban (§115 of P.L. 104-193, as amended by §5516 of P.L. 105-33).
5. Probation/parole violation ban: Offenders who violate the terms of their probation or parole lose their public assistance and food stamps. In some States, offenders who have been mandated into treatment and who leave treatment may be subject to this provision (42 U.S.C. §608(a)(9)).
6. Restrictions on immigrants: A lawful immigrant may or may not be eligible for benefits, depending on a variety of factors, including the benefit he applies for (e.g., Medicaid, food stamps, or public assistance), when he arrived in this country, how long he has been here, his age, and other facts about his personal history.

Family Preservation and "Fast-Track" Adoption

The Federal government has established a series of programs to fund and support States' efforts to help children and their families in crisis. These programs include the following:

• Family Support Services, which are "community-based services to promote the safety and well-being of children and families designed to increase the strength and stability of families (including adoptive, foster, and extended families), to increase parents' confidence and competence in their parenting abilities, to afford children safe, stable, and supportive family environments, and otherwise to enhance child development" (42 U.S.C. §629a(2), as amended by §305 of the Adoption and Safe Families Act of 1997)
• Family Preservation Services, which include
  • Preplacement preventive services, such as intensive family preservation programs, to help children at risk of foster care placement remain safely with their families (42 U.S.C. §629a(a)(1), as amended by §305 of the Adoption and Safe Families Act of 1997)
  • "Time-limited family reunification services ... provided to a child who is removed from the ... home and placed in a foster family home or a child care institution and to the parents or primary caregiver of such a child, ... to facilitate the reunification of the child safely and appropriately" (42 U.S.C. §629a(a)7, as amended by §305 of the Adoption and Safe Families Act of 1997)
  • Programs to provide followup care to families when a child has been returned after a foster care placement (42 U.S.C. §629a(1), as amended by §305 of the Adoption and Safe Families Act of 1997)
• Foster Care Services, which assist States with foster care maintenance payments (42 U.S.C. §670)
• Adoption Promotion and Support Services to encourage more adoptions out of the foster care system, when such adoptions promote the best interests of children. These services include
  • Pre- and postadoptive services
  • Services to expedite the adoption process and support adoptive families
  • Adoption incentive payments (42 U.S.C. §673(a)(1)(A) and §673A, as amended by §201 of the Adoption and Safe Families Act of 1997)

These programs provide funding to States but also require States to adopt a number of important policies, timetables, and restrictions, including

• Greater emphasis on children's health and safety: Until recently, Federal law has placed primary emphasis on preservation of the family--that is, avoiding foster care placement whenever possible and encouraging the speedy return of children to their families. In line with that policy, since 1983, States have been required to maintain a federally approved plan that ensures that "reasonable efforts" will be made to prevent or eliminate the need for a child to be removed from the home and placed in foster care and to make it possible for the child to return to the home. The 1997 amendments to the Family Preservation and Support Services Act changed the emphasis from family preservation to child health and safety by adding the following:

  In determining reasonable efforts to be made with respect to a child ... and in making such reasonable efforts, the child's health and safety shall be the paramount concern (42 U.S.C. §671(a)(15), as amended by §101 of the Adoption and Safe Families Act of 1997).

• Greater emphasis on permanent placement: The 1997 Act requires each State's federally approved plan to promote the permanent placement of children:

  ... if continuation of reasonable efforts [to preserve or reunite the family] ... is ... inconsistent with the permanency plan for the child, reasonable efforts shall be made to place the child in a timely manner in accordance with the permanency plan, and to complete whatever steps are necessary to finalize the permanent placement of the child (42 U.S.C. §671(a)(15), as amended by §101 of the Adoption and Safe Families Act of 1997).

  Moreover, to reduce the numbers of children who remain in foster care for years and increase the number of children who are more promptly settled into a permanent living situation, the 1997 Act provides that States "shall not be required" to make reasonable efforts to preserve or reunify a family when
  • A parent has subjected the child to "aggravated circumstances" as defined by State law (including abandonment, torture, and sexual abuse)
  • A parent has committed murder or involuntary manslaughter against another of her children or felony assault resulting in serious bodily injury to the child or a sibling
  • Parental rights have been terminated with regard to a sibling (42 U.S.C. §671(a)(15), as amended by §101 of the Adoption and Safe Families Act of 1997)
• Prompt development and frequent review of service plans: Within 60 days of beginning services to families, the agency charged with responsibility must develop a case or service plan for each child. Each child's status must be reviewed at least once every 6 months by a court or administrative agency to decide whether placement continues to be necessary and appropriate (42 U.S.C. §675(5), as amended by §103 of the Adoption and Safe Families Act of 1997).
• Time limits on family reunification services: Family reunification services are now limited to 15 months after the child has been removed from the family and placed in foster care. This time limit applies to substance abuse treatment and mental health services; individual, group, or family counseling; and transportation to or from services (42 U.S.C. §675(5), as amended by §§103 and 305 of the Adoption and Safe Families Act of 1997).
• Speedier termination of parental rights: To reduce the number of children who remain in foster care for years and to increase the number of children who are more promptly settled into a permanent living situation, the State must
  • Hold a "permanency" hearing (formerly called a "dispositional" hearing) within 12 months of the child's placement to determine whether to return the child, initiate termination proceedings, or place the child in another permanent living arrangement (42 U.S.C. §675(5)(c)), as amended by §302 of the Adoption and Safe Families Act of 1997)
  • Begin the process of terminating parental rights, with certain exceptions, and finding permanent adoptive or legal guardianship homes for children who have been in foster care for 15 of the most recent 22 months (42 U.S.C. §675(5)(c)), as amended by §103 of the Adoption and Safe Families Act of 1997)
  • Commence termination proceedings within 30 days when a child is placed in foster care and the State declines to offer family preservation or reunification services because (1) the parent subjected the child to "aggravated circumstances" as defined by State law; (2) the parent committed murder or voluntary manslaughter against another of his children; (3) the parent committed felony assault resulting in serious bodily injury to the child or another of his children; or (4) parental rights have been terminated involuntarily with regard to a sibling (42 U.S.C. §671(a)(15), "the Family Preservation and Support Services Act," now called "Promoting Safe and Stable Families," as amended by §101 of the Adoption and Safe Families Act of 1997 and 42 U.S.C. §475(5), as amended by §103 of the Adoption and Safe Families Act of 1997)
  • Document in the case plan the steps being taken to secure a permanent home for the child when the permanency plan is adoption or placement in another kind of permanent home (42 U.S.C. §675(1), as amended by §107 of the Adoption and Safe Families Act of 1997)
• Adoption incentive payments: The Federal Adoption Assistance Program assists States in providing nonrecurring adoption expenses (such as adoption fees, court costs, and attorneys' fees) and ongoing assistance to families adopting children out of foster care. The Adoption and Safe Families Act of 1997 requires States to submit an annual report on performance in increasing adoptions from foster care and empowers the Secretary of Health and Human Services to provide incentive payments to States that increase adoptions from foster care (42 U.S.C. §473, as amended by §§201 and 402 of the Adoption and Safe Families Act of 1997).