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Getting to Baltimore's at-risk kids before it's too late

Here's what Molly McGrath Tierney, director of social services in Baltimore, has been thinking about: tearing down the foster care system, as we know it, and building something new that, among other things, might make ours a less violent city in the years to come.

In McGrath Tierney's own words: "We intend to be the first urban child welfare system with no children placed in foster care. We believe it is possible to have a child welfare system change the nature of its work and keep children safe at home with their own families."

If that sounds radical or revolutionary, it is. McGrath Tierney's idea is completely outside the box of traditional thinking about child welfare, which generally views aggressive intervention — such as foster care — as necessary to repair the lives of abused or neglected children. But that system, McGrath Tierney says, isn't working; the outcomes are not good, she says.

"There are 50 state child welfare agencies in the United States and funds to underwrite them are in the billions [and] not a one among them is reputed to be working well," McGrath wrote in an application to a think tank for help with a new strategy. "Terrible things happen to children in foster care. Their short-term outcomes are abysmal. Their long-term outcomes are worse. Those who grow up in foster care are overwhelmingly destined for the penitentiary, the morgue or the child welfare system when their own children are taken into foster care."

In addition to the government's child welfare apparatus, millions of dollars are spent every year on what McGrath Tierney calls "an industry of lawyers, foundations and consultants" focused on reforming the system. All that money, she argues, would be better spent on intervening early in the lives of children and their families to keep them whole and make them healthy.

In a way, this revolution already has started. Since 2007, when McGrath Tierney took over Baltimore's troubled department, the staff at social services has reduced the number of children in foster care by 55 percent, placing them in permanent homes through reunification with their families, adoption or legal guardianship.

But McGrath Tierney isn't satisfied with that. She's impatient for better outcomes for the few thousand city children who grow up in dysfunctional homes, miss a lot of school, and move from one foster home to another on their way to age 18.

The experience of being removed from a home can be an "insurmountable trauma," she says. Ideally, children should grow up with their real families.

I agree. However, given some of the horror stories we've heard over the years, that's not always the best idea. That's why McGrath Tierney's department, with hundreds of employees, exists.

"I'll never leave kids in an unsafe setting, let me make that clear," McGrath Tierney says. "But we've got to stop looking at foster care as the primary intervention. The intervention of taking people's kids is too late and it's catastrophic. When it happens, it should be rare and it should be brief. ... We need to intervene significantly earlier with children and families."

Doing otherwise, she says, greatly increases the chances of more problems as children grow into adolescence and adulthood.

McGrath Tierney's agency receives government money for each child it places in foster care. "What if," she asks, "instead of paying me to take someone's kid away, you pay me to keep them in their home?

"What if we go to the school system, and we identify kids in pre-K who are chronically absent, and then go to their homes and knock on the door and see what's up there? What if we do that in the 12 city neighborhoods we worry about the most?

"What if we work with [United Way's] 211 call center and work with every family with small children that called in for help getting food?"

The idea is to help mothers — and fathers, if they're around — take care of their kids, get them fed and get them to school. It's a holistic approach to intervention, with removing children from their homes as a last resort.

In the new system, McGrath Tierney says, her agency won't always be reacting to problems, arriving when it's too late to change the trajectory of a child's life — after they've been arrested, for instance, or after they've turned up homeless.

The 12-year-old who gets picked up for holding drugs for dealers? Might not happen at all, in the new system. "I would have known him from the time he stole his first candy bar," McGrath Tierney says, suggesting that early intervention might have kept the boy from turning to the streets. Do that enough, with enough children and families, and it might start to make a real difference for everyone in the city.

That's what Molly McGrath Tierney has been thinking about — that it's time to try something else, to help kids and their families before it's too late. And to avoid being too late, you've got to get through the front door as early as possible.

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