Lessons from AZ - July 2024
* Coaching One Another Through Trends and Consequences
Greg McKay, former Director, Department of Child Safety, Arizona
- McKay, former Director of Arizona’s Department of Child Safety (2015-2020), led Arizona’s transformation from America’s worst-to-first in numerous federal measures. Most notably, he eliminated a backlog of over 16,000 cases, safely reduced foster care by over one-third, cut caseloads by over 80%, and provided leadership that reduced staff turnover by 30%. He accomplished these goals all the while defending an aggressive class action lawsuit. McKay’s rise to prominence in the field of child welfare led Casey Family Programs to present an award for his leadership. However, his long held views caused him to become unpopular among certain intolerant industry representatives.
Lives Cut Short - July 2024
* Lives Cut Short
Naomi Riley, American Enterprise Institute
Sarah Font, Associate Professor of Sociology and Public, Penn State
- Every year, at least 2,000 children die of maltreatment. Many of the adults responsible for their deaths were known to child welfare services or law enforcement before the fatal incident occurred. Unfortunately, state governments fail to count many of these deaths or release information that would help determine their causes. Why is this? How can we prevent these deaths? Our presenters have created a new data set.
Texas Lawfare - July 2024
* Federal Court Activity in State System: the Texas Lawsuit
Katie Olse, Senior Director, Child & Family Wellbeing, Sellers Dorsey
Audrey Carmical, VP for Regulatory Affairs, TACFS
- Texas has been the defendant in a class action lawsuit regarding foster care since 2011, with final orders being implemented and overseen as of July, 2019. This discussion will look at some of the impacts of this case to the state system and private providers, such as:
- Regular status hearings plus relatively frequent emergency hearings
- Extensive monitoring
- Outlay of state resources
- Contempt findings
- In addition to the above, the lawsuit commands intense focus from media, non-practitioner stakeholders, and the public. It drives decisions and actions of direct impact to private providers and responses from the full system, in addition to potentially being relevant to other states.
New HHS Rule on Foster Care Providers - July 2024
* HHS Foster Care Rule: Designated Placement Requirements Under Titles IV-E and IV-B for LGBTQI+ Children
Natalie Dodson, Policy Analyst and Scholar, HHS Accountability Project, Ethics and Public Policy Center
- The HHS proposed rule, “Safe and Appropriate Foster Care Placement Requirements for Titles IV-E and IV-B,” would require foster care providers to “affirm” a child’s “LGBTQI+ identity.” The final rule will have been published by our conference date
- Of course, all children in foster care should receive “safe and proper” care, including children who identify as “LGBTQI+.” This rule, however, proposes special considerations for “LGBTQI+ children” premised on two incorrect and harmful assumptions:
- (1) that not “affirming” a child’s self-proclaimed “LGBTQI+ identity” is unsafe and abusive; and
- (2) that foster care providers who hold traditional beliefs (religious or otherwise) about marriage, sexuality, and gender are unable to provide “LGBTQI+ children” with safe and loving homes.
- These premises are not only false but are harmful to children in foster care and will undermine religious freedom and parental rights far beyond the foster care context.
State Performance on Time to Permanency - December 2023
* Timely Permanency Report Cards
Sarah Font, Associate Professor of Sociology and Public Policy, Penn State
* How does Utah Achieve Permanency?
Kevin Jackson, Utah Child Welfare Assistant Director
Anti-Adoption Movement - December 2023
* The Battle for Permanency: The Anti-Adoption Movement in the US
Thea Ramirez, Founder of Adoption-Share
- Adoption, a longstanding practice in America, has seen an unprecedented impact on individuals today compared to any other era in U.S. history. Despite the majority of Americans holding a positive view of adoption, a growing anti-adoption narrative in contemporary United States poses a threat to alter the prevailing cultural sentiment. This narrative characterizes adoption as potentially detrimental to adoptees and their biological families. What was once considered a radical perspective is now gaining momentum, permeating both cultural attitudes and policy discussions. Without intervention to counter this negative narrative, there is a risk that public perception of adoption will undergo a significant shift, potentially leading to further changes in public policy that could undermine adoption as a means for children to attain permanency.
- In this brief presentation, Thea will speak to the anti-adoption rhetoric in the public square, its impact on public policy, what's driving this perspective, and what leaders can do to ensure adoption remains a viable opportunity for children who have a goal of adoption but have no family identified to adopt them.
Residential Care - December 2023
* Purpose Not Placement: Setting the Stage for the Future of Residential Care
Lisette Burton, Chief Policy & Practice Advisor, Association of Children's Residential and Community Services
- In 2021, a diverse coalition of over 600 national, state, and local organizations signed a joint letter urging Congress to exempt Qualified Residential Treatment Programs (QRTPs) from the Institutions for Mental Diseases (IMD) exclusion. Members of Congress introduced The Ensuring Medicaid Continuity for Children in Foster Care Act of 2021, a bipartisan, bicameral legislation to ensure that children in foster care with assessed behavioral and mental health needs would not be at risk of losing their federal Medicaid coverage if placed in a QRTP over 16 beds. Unfortunately this bill was not passed into law. California, in an effort to comply with the IMD 16-bed limitation, has lost over 1000 QRTP beds in the last 18 months. At least 18 states are currently not implementing QRTPs. There is bipartisan, bicameral movement on the effort to address the QRTP-IMD issue this Congress (HR 4056/ S. 3196).
- This issue has been routinely raised by SIG members. Joining us for a discussion of this issue is Marie Cohen of the Child Welfare Monitor
and Lisette Burton of the Association of Children’s Residential and Community Services ARPA.
- 2023 QRTP-IMD Overview and Support Letter
Drug Testing and Reporting of Substance Exposed Infants - December 2023
* Prenatal Substance Exposure and Child Protection: Trends in Policy and Practice
Sarah Font, Penn State
* Lessons in Failure from New Mexico
Maralyn Beck, Founder & Director, New Mexico Child First Network
- Penn State’s Sarah Font reports that federal and state policies are moving toward fully deidentified “notifications” for most children exposed to drugs in-utero, thus inhibiting any child protection response. These policies rely on the dubious assumption that parents with active substance use problems will seek and accept treatment as long as child protection agencies are kept away from them. This policy has been in full flower in New Mexico and Maralyn Beck of the Child First Network will report on the consequences to newborns of such a policy of “hear no evil, see no evil”.
Foster Care Aging Out - July 2023
* Promoting Readiness of Minors in Supplemental Security Income (PROMISE): Five-year Impacts and Other Findings
Ankita Patnaik, Ph.D., Principal Researcher, Mathematica
* Wisconsin PROMISE: Building Lessons Learned into Wisconsin Workforce Programs and Partnerships
Ellie Hartman, Ellie Hartman, Workforce Data Integration System Chief Evaluation Officer, Wisconsin Department of Workforce Development
- PROMISE (Promoting Readiness of Minors in SSI) was a national random control demonstration ending in 2019 intended to improve the transition of SSI youth to adult employment and self-reliance. This demonstration offers lessons to child welfare agencies managing the problem of foster care aging out. The services provided to parents and children enrolled in SSI included intensive case management and employment services to families who volunteered. All sites experienced good short-term impacts but only WI and NYC had large impacts sustained over five years. What did WI and NYC do differently? We will have the program evaluator and the state operations manager from WI explain.
How Missouri side-tracked a certain ticking time bomb in child welfare. - July 2023
* Knowing Where to Focus
Kristen Cox, Founder & CEO, Epiphany Associates / Jonathon Coneby, Director of Client Engagement, Epiphany Associates
- When Steve Corsi, former SIG member and past Secretary in WY and MO, arrived at his new job in Jefferson City, he learned that there was a backlog of 7583 child welfare alerts and reports for which no worker had been to visit. Alarmed, he called in the staff and immediately introduced a certain process reform he had used in WY and that at least four other SIG states have adopted to good effect (and have reported their results back to SIG). The process reform is called the Theory of Constraints (TOC). After eight months of initiating TOC for the backlog, Corsi had reduced it to 400 and two months after that to zero.
What are the characteristics of state programs most effective at moving children to permanency? - July 2023
* How Long Do States Let Children in Foster Care Wait for Permanent Families? Timely Permanency Report Cards: July 2023
Naomi Schaefer Riley, Senior Fellow, AEI
Federal laws that guide states emphasize timely permanency, but states exercise substantial discretion in implementation. A recent report by
AEI ranks state on several metrics using an interactive map. It measures performance on four permanency measures—overall, by the child’s age at entry, and by race or ethnicity. Performance across measures is summarized by an overall ranking, from 1 to 51. The analysis demonstrates that children’s chances of permanency, especially through adoption, depend largely on where they live. Best state performance in exits to permanency of those age 0 – 14 at entry: rank order of top ten - - SC, WY, UT, CO, AR, LA, OH, KY, AL, ID
Minnesota Safe Passage for Children - July 2023
* Safe Passage for Children of Minnesota: Child Fatalities Report
Rich Gehrman, Founder and Executive Director, Safe Passage for Children of Minnesota
No room for child advocates: Why I was kicked off DC’s Child Fatality Review Committee fare? - July 2023
* No Room for Child Advocates: Why I was Kicked off of DC’s Child Fatality Review Committee
Marie Cohen, Child Welfare Monitor
- “Until recently, I was one of three “community representatives” on the District of Columbia’s Child Fatality Review Committee. Community
representatives are the only members who are not paid to sit on this panel; the rest are agency representatives who sit on it as part of their
jobs. My service on the panel was an important aspect of my advocacy for abused and neglected children in the District of Columbia. But this
work ended abruptly for me in March of this year when I was told that my service was over. I have some ideas about why the panel decided to
dismiss perhaps its most engaged, passionate, and productive member.”
Child Welfare Meeting November 2022
Abuse and neglect are two separate standards. Don’t co-mingle them! - November 2022
* Child Maltreatment, Poverty, and Other Social Problems
Doug Besharov and Doug Call, University of Maryland
- Besharov was the very first director of the National Center for Child Abuse and Neglect under President Nixon (subsequently merged into
the Children’s Bureau at HHS), and the author of Recognizing Child Abuse.
- Besharov will argue that, although child protective agencies play a vital role, they often intervene too aggressively in the lives of families. The most recent examples are efforts to deny parents a role in their children’s “gender affirming” treatment, but the problem is long standing and broader. He points out that efforts to abolish parental rights to reasonable corporal punishment, which is a feature more common in Black families, can be considered unjustified. In addition, less than adequate child rearing within low-functioning families is often labeled “child neglect”—when the personal factors that impede parents from becoming self-sufficient are also related to those that can make them less than satisfactory parents (but not necessarily physically dangerous). In many instances he asks, would not the children and families be better off if we kept them out of the quasi-law enforcement, child protective system?
Texas uses data matching to improve service capacity sooner and divert families from substantiated findings
* Prevention in Texas
Sasha Rasco, Chief Prevention and Community Well-Being Officer, Texas Dept. of Family and Protective Services
- Using several federal funding streams and a healthy investment of state funding, Texas serves almost 60,000 families and youth per year
separate and independent of the child welfare system. With a network of community-selected and evidence-informed programming, Texas
matches children and families against child protection and juvenile justice data during the period they are receiving services, and annually up to three years post service. The resulting rate of diversion from child abuse and neglect substantiation is 97% and from juvenile adjudication is 99%. But beyond the programs and the direct impact to those served, it is the service capacity and mindset shift at the community level toward supporting parents sooner that has been equally valuable to the agency. Sasha Rasco has been leading the prevention efforts in Texas since 2013 and will share lessons learned as well as the challenge of scaling to a more impactful level.
What is there to do about the “legal orphans” for whom there are no prospective adoptive parents? - November 2022
* Leveraging Technology to Create Families
Thea Ramirez, Founder and CEO, Adoption-Share
- For nearly two decades, AFCARS data shows the number of children with the goal of adoption who get adopted each year has hovered
around 50%. Most of the children reflected in the 50% success rate are being adopted by a relative or current foster parents. But what about the children who are post-termination of parental rights (TPR) and have no family identified to adopt them? Although these children constitute a smaller population relative to all children with a goal of adoption, the resources and tools deployed to find adoptive families for these children have not changed in over 150 years. A technology program, Family-Match, offers child welfare practitioners a new way to solve an old problem. It is an intentional inversion of the matching process, and its use of research informed compatibility models show significant promise. Yet barriers remain at the state and federal level which constrain its wider use.
Should Maternal Illicit Drug Use During Pregnancy Be Considered Child Abuse? - November 2022
* Should Illicit Drug Use During Pregnancy Be Considered Child Abuse?
Nancy Young, Children and Family Futures & Project Director, National Center on Substance Abuse and Child Welfare
- The prevalence rate of drug use by pregnant women in the United States has been shown to range from 7.5 percent to 11 percent [NIH]. Fifteen states have laws requiring health care workers to report to authorities if they suspect a woman is abusing drugs during pregnancy and eighteen states have laws that say drug use during pregnancy is child abuse. At the same time other jurisdictions are making detection more difficult, e.g. prohibitions against drug testing of mothers with newborns. Estimates vary, but in NYC approximately 75% of founded child abuse determinations are related to parental drug abuse. How can we make sense of all this cacophony of practices? Our presenter Nancy Young works on state policy and practice related to substance use during and after pregnancy for a national organization contracted with SAMSHA.
Are juvenile justice placements taking over child welfare? - November 2022
* Dangerous Merging: Foster Care Offramp for Dysfunctional Juvenile Justice Systems
Greg McKay, former AZ commissioner
- For some time treatment and custody of minors as between child welfare and juvenile justice programs has been shifted in favor of child welfare, partly for state budgetary reasons. Beyond that. former AZ State human services secretary Greg McKay writes:
In the current political environment, the juvenile justice system has become another off-ramp to divert young criminals from punishment. Perhaps even worse than plans to defund the police, eliminate cash bail, and promote “reparative justice” over incarceration, sending juvenile defendants into the foster-care system puts them into close contact with our most vulnerable populations. And the system lacks any kind of rehabilitative services that juvenile delinquents are supposed to receive to prevent escalating criminal behaviors.
Birth Match precautions save new infants from harm from known abusers - November 2022
* Learning from the Past: Using Child Welfare Data to Protect Infants through Birth Match Programs
Marie Cohen, Child Welfare Monitor
- When a new baby is born to parents who had their rights terminated to a previous child due to severe abuse or neglect, or who killed or
severely harmed another child, the child welfare agency should be notified, and a professional should make contact with the family to ensure the child is safe and offer the parents any assistance needed. It is such a commonsense idea that it's hard to imagine anyone would oppose it. Nevertheless, only five states have adopted such a program, and the four states with programs that have been in effect for more than a year have displayed what appears to be little interest in assessing or improving their implementation. On the contrary, there seems to be some interest in eliminating Birth Match programs among administrators and legislators in some states. The current ideological climate in child welfare may be largely responsible for this failure to use this simple tool to protect children.
Will the Indian Child Welfare Act be struck down? - November 2022
* Brackeen v. Haaland and ICWA
Tim Sandefur, VP for Legal Affairs, Goldwater Institute
- On November 9th the Supreme Court will hear oral arguments about the constitutionality of the Indian Child Welfare Act. Originally it was intended to redress wrongful actions by state and federal agencies that often took Native children away from their families without good reason. However the ICWA today often stands in the way of Native parents and of state child welfare agencies that are trying to protect Native youth from abuse and neglect. And because ICWA applies to “Indian children”—which it defines based on biology—it violates constitutional rules that prohibit the government from discriminating based on race. Will the upcoming Supreme Court decision be a precursor to a prohibition against race-based remedies in Harvard v. Students for Fair Admissions? Our presenter Tim Sandefur helped write the friend of the court briefs submitted by Goldwater, CATO and state of Texas. Director Kim Guay Alaska will describe the situation in the Frontier state.
Enforcing Time Frames and Moving Cases - June 2022
* Enforcing Time Frames and Moving Cases
Darcy Olsen, CEO, Gen Justice
Tim Keller, SVP and Legal Director, Gen Justice
- Family court judges are notorious for postponing and delaying decisions about children to their detriment. Judges often ignore the requirements of ASFA’s fifteen of twenty- two months provision and in general tend to delay permanent placements or terminations. Arizona just unanimously passed a bill which prohibits court continuances over 30 days absent extraordinary circumstances. Are legislative mandates a positive way forward?
Parental Drug Use and its Consequences - June 2022
* SIG Child Welfare Day
Sarah Font, Pennsylvania State University
* Parental Drug Use
Nancy Young, Children and Family Futures
- Drugs have been estimated to be the primary or contributing factor in three quarters of child welfare cases in New York City and other urban areas, and informal estimates are even higher. Child welfare directors are reporting that the severity and effects of parental drug use are increasing. Family drug courts can help motivate parents to recover, but they should be paired with known principles of treatment. State child welfare agencies should be at the forefront of testimony about the effects of drugs on families and from their informed positions should be advocates in efforts to reduce the spread of legalization of soft and hard drugs.
Foster Care Recruitment and Kinship Care - June 2022
* Foster Care Recruitment and Kinship Care
Darcy Olsen, CEO, Gen Justice
Tim Keller, SVP and Legal Director, Gen Justice
- The Call is an Arkansas church- based support group which helps recruit foster families from among its congregations in 51 counties. What other solutions can help with this severe shortage, especially the lack of families who will take older or disturbed children?
Emphasizing Prevention-- And is there such a thing as prevention? - June 2022
* Prevention: From Upstream to Downstream
Marie Cohen, Child Welfare Monitor
- The world of children and parents within their family relationships is for the most part private. What do we know about how to peer inside a family before neglect or abuse becomes evident so as to provide interventions and services that might help? Nurse home visiting programs and Family Connects show evidence of positive impacts but they are voluntary and therefore limited in reach. What else do we know and can Big Data point to families in need of preventative services?
Family First Act - June 2022
* The Family First Prevention Services Act
Marie Cohen, Child Welfare Monitor
- The provision allowing IV-E to be used for prevention will have only modest impact, while the restrictions on congregate care placements have put agencies in a vice. Some highly troubled and traumatized children need the supervision and psychological help they can only get through temporary institutional care.
Secretaries’ Roundtable Child Welfare - November 2021
* Revisiting Common Claims About Child Welfare
Sarah Font, Pennsylvania State University
* The CALL
Laurie Currier, The Call
- Secretaries discuss all current issues in the child welfare system - -
- • Foster care and adoption
• State policies related to child removal from home
• How cultural trends are affecting the business of state child welfare operations
• Placement options and Family First and CAPTA
- Joining our discussion is Dr. Cassie Bevan who worked in the U.S. House of Representatives for twenty years as a professional Republican staffer and later staff director on the Ways and Means Committee. During her tenure on Capitol Hill, Dr. Bevan was the principal staffer on many domestic and international bills including: the Adoption Tax Credit of 1996; the Adoption and Safe Families Act of 1997; the Foster Care Independence Act of 1999 and others. John Mattingly introduced many child welfare innovations during his tenure under Mayor Bloomberg including ChildStat. He introduced training and cooperation in child welfare investigations with retired detectives from NYPD. Sarah Font is the author of many books and articles including the recent It’s not “Just poverty”: Educational, social, and economic functioning among young adults exposed to childhood neglect, abuse, and poverty. Lauri Currier is the director of The Call, a Christian church-based foster care non profit in Arkansas that helps recruit foster parents from the parishes. They operate in 56 counties.
A Critique of the Evolving Biden Philosophy and Political Practice - August 2021
* The New, Unconditional Child [Tax] Credit
Doug Besharov, University of Maryland
* Total Economic and Social Resources - Poor Families with Children Poor Families - 2018
Robert Rector, Senior Research Fellow, Heritage Foundation
- Secretaries and their governors act as agents in the national political conversation and SIG Secretaries and Directors allocate over $200 billion annually that can be put to use promoting our objectives of work, healthy families and economic self-sufficiency. This morning session with our best and most senior Washington thinkers is dedicated to understanding the philosophical and research basis for our own conservative views. We will review each of the important Biden initiatives on spending and policy to shed light on their deeper long -term consequences. How will the retreat from the idea of mutual obligation, e.g. work in exchange for benefits, affect individuals making life choices and the body politic? How will the explosion of new entitlements in all areas of the welfare state affect the responsibility of Americans to act as productive economic units and supportive family members? Our six panelists will each describe a topic followed by commentary and discussion among all the panel and our members. We will discuss what we can do as agency heads on our own with or without federal guidance.
Child Welfare New Developments - August 2021
* FFPSA and the IMD Issue
Sean Hughes, Managing Partner of Governmental Relations at Social Change Partners
- Naomi Riley is AEI’s child welfare expert and has been critical of aspects of Family First as enacted. Sean Hughes helped write and pass the Fostering Connections to Success and Increasing Adoptions Act of 2008, and served as director of Congressional Affairs at the Child Welfare League of America.
Recruiting Foster Care Families - November 2020
* The Church and the Foster Care Crisis
Bob J. Bruder-Mattson, President and CEO, FaithBridge Foster Care
Child Welfare - November 2018
* Family First Prevention Services Act: Implementation Considerations
Judge Jim Payne, PCG
- This is a follow on session to our July half day on the Family First Preservation Act. In addition to discussions about federal implementation, we will discuss how the regional offices are working with local jurisdictions, state and county to respond to questions and provide advice regarding Children’s Bureau directions.
Child Welfare and New Family First Legislation - June 2018
* Organizational Structure and the Family First Act of 2018
Jim Payne, former Director, Indiana Department of Child Welfare and former Presiding Judge, Marion Superior Court Juvenile Division
* Family First Prevention Services Act Opportunities
Heather Baker, Public Consulting Group
- The passage of the Family First Prevention Services Act is the most consequential change to IV-E in more than a decade, and restructures how the state must provide services. Funds are newly available for prevention, limits are placed on congregate care, new options are made available related to substance abuse treatment, and changes to foster care licensing are some. We will discuss the opportunities and challenges for agencies who are just now learning of the implications of these changes.
Child welfare and Theory of Constraints - June 2018
* Getting Big Results in Social Services
Kristen Cox, Executive Director, Utah Office of Management and Budget
A year ago, Utah’s Kristen Cox described for SIG members how the strategic application of a management intervention, Theory of Constraints, is used across Utah to increase the supply and effectiveness of citizen services at a lower cost. Since she made this presentation she has worked to improve child welfare with these remarkable results:
Caseworker direct engagement with families up 30%
Case resolution 19% earlier and 11% more consistently
Capacity up 20% so that point-in-time cases carried by workers are 20% fewer
Surveyed worker morale up
Child Support - December 2017
* Recent Trends in Child Support Enforcement
Robert Doar, American Enterprise Institute
- Various priorities among states such as child welfare and opioids seem to be contributing to less agency emphasis on child support. Beyond that, there is a debate about the right balance between enforcement of collections and encouraging work among parents delinquent in their obligations. What are some of the options?
Developing a SIG Child Welfare Proposal for State Flexibility - July 2017
* Child Welfare Financing
Don Winstead, SIG Consultant
- During his service as FL Deputy Secretary for Children and Families, Don Winstead led the negotiation for the statewide IV-E child welfare waiver. Between 2001 and 2005 he served as the HHS deputy assistant secretary for policy and evaluation in human services. In that capacity he helped develop the Bush Administration’s legislative 2004 proposal which would have allowed states to move to an alternative system for foster care, receiving funds in the form of flexible grants so as to create innovative child welfare plans an emphasis on prevention and family support.
- Don will describe current state of affairs and lead a discussion of an alternative which would allow SIG states more flexibility and control.
Child Welfare - November 2016
* Presentation: Doug Besharov
Doug Besharov, University of Maryland School of Public Policy; and first director of the U.S. National Center on Child Abuse and Neglect
* The Allegheny County Experience
Marc Cherna, Director, Dept. Human Services, Allegheny County
* Rethinking Consent Decrees
John Bursch, Partner, Warner Norcross and Judd
- Jim Payne will discuss the current state of affairs. Marc Cherna, the nationally recognized child welfare innovator from Allegheny County PA will discuss specific operational challenges and solutions. Supreme Court litigant John Bursch will discuss proposed legislation which would curtail consent decrees which remain active for years and decades.
* Advanced Analytics to Improve Child Welfare Practice and Outcomes
Will Jones, Child Well Being Industry Consultant, SAS State and Local Government Practice
- Rapid Safety Feedback uses predictive analytics to prioritize calls of suspected child abuse. Predictive analytics in child protective services means assigning suspected abuse cases to different risk levels based on characteristics that have been found to be linked with child abuse. These risk levels can automatically revise as administrative data is updated. Administrative data may be as simple as school reports or could delve deeper into other information that the state holds: the parents’ welfare checks, new criminal offenses or changing marital status.
Marriage and Child Support - November 2016
* Are We Still Married? Family Structure and Family Policy in the Emerging Age of the Unformed Family
David Blankenhorn, President, Institute for American Values; and author of Fatherless America and The Future of Marriage
- From troubled family structures to the emerging age of the unformed family - - Ten trends that are influencing how public policy and human services programs must respond.