The Doris Duke Charitable Foundation Stands Up an Initiative to Transform the Child Welfare System

The child welfare system’s goal is to protect children, but it too often shatters families and relegates children to foster care in ways that disproportionately impact families of color and people living in poverty. Many in the field envision an overhaul of the system that leads with prevention and works to strengthen families and communities. The Doris Duke Foundation (DDF) hopes that its new program, Opportunities for Prevention & Transformation Initiative, or OPT-In for Families, will help pave the way.

The ambitious, three-year, $33 million initiative seeks to spearhead an alternative to the child welfare system — one that, according to the foundation, “moves from a punitive system focused on assessing whether children should be removed from their homes to a prevention-oriented wellbeing system that leads to better outcomes across a child's life.”

To launch the initiative, the Doris Duke Foundation selected four sites around the country where child welfare leaders have already introduced prevention-oriented approaches. The sites — in Kentucky, Oregon, South Carolina and Washington, D.C. — will each receive $9 million to build and scale their programs. In addition to DDF, the Duke Endowment and the Aviv Foundation are also providing support.

The Doris Duke Foundation was built on the vast fortune of Doris Duke, the only child of James Buchanan Duke, founder of the American Tobacco and Duke Energy Companies. DDF supports a wide array of causes including the performing arts, medical research, the environment, building bridges between diverse communities and child wellbeing. These focus areas are guided by the interests Doris Duke laid out in her will, including "the prevention of cruelty to children," according to the foundation. Duke passed away in 1993.

“We feel like this is exactly the kind of activity that honors [Doris Duke’s] legacy,” said JooYeun Chang, DDF program director for child wellbeing. “Just because this is the child welfare system we have today doesn’t mean it is the only system we have to be willing to support. We think it honors her spirit of innovation to support those who are doing the work already and need a helping hand.”

As DDF president and CEO Sam Gill said when OPT-In for Families was announced, “This effort is intended to demonstrate the potential gains from redesigning a system to ask a new question: What do children and families need to thrive?”

Filling gaps and backing preventative approaches

In many cases, families who are facing challenges but are not yet in crisis are overlooked by an overburdened child welfare system that prioritizes acute cases where child safety is at risk. In fact, 50% of families referred to child protective services are screened out if neglect or abuse is not detected. These families may be struggling, but if they are screened out, they often receive no assistance at all, even though they are at high risk of being referred again.

OPT-In for Families seeks to provide support for those families before a difficult situation escalates into crisis. It recognizes that poverty is often the underlying reason families are referred to child welfare — they are struggling because they are having trouble meeting basic needs. They may not have enough money to afford groceries, for example, or their car has broken down so parents can’t get to work. For these families, poverty is a barrier to accessing available services.

“If a mom doesn't know how she's going to feed her kids that night, no matter how great the parenting program that you offer her is, she's not going to be in the space or have the capacity to take that in,” Chang said. “So we thought, OK, families’ concrete needs are a barrier to getting services. How do we address that? We realized that is one of the policy gaps in the system and we need to build some information and evidence to bring back to policymakers. We believe that is the role of philanthropy: to see where the gaps are and use our investments in risky experimentation — risky because we don't know the answers yet.”

Chang hopes OPT-In for Families and its demonstration partners will provide some of those answers. She has been working to improve the child welfare system for much of her professional life, most recently at the U.S. Department of Health and Human Services, where she led the Biden administration's efforts to implement child welfare policy. She also headed Michigan’s Children’s Services Agency, and before that, worked on child welfare for Casey Family Programs.

Chang has long advocated a prevention-oriented approach to child welfare and appreciates that DDF, where she has worked for close to two years, does, too. “There are a lot of organizations that try to make foster care better, or to take care of certain special populations in the existing system,” she said. “But there aren't that many who focus exclusively on prevention. It's an area that's always been really close to my heart.”

For Chang and others who support a preventive approach to child welfare, the Family First Prevention Services Act, passed in 2018, initially inspired hope, but to date, has proven to be a disappointment. “The Family First Prevention Act provided an open-ended entitlement to pay for protection services for families at risk,” Chang said. “And yet, five years after passage of that legislation, we really don't see that systems have changed. They're still primarily funding investigations that lead to family separation, and then all of the really expensive costs that are associated with foster care. And so we asked ourselves, why is it that we fought so hard to get policy changed, thinking that could unlock transformational work, and yet it hasn't happened?”

Cash in hand, technical assistance, deep dives and warm lines

In the course of asking that question, Chang and her team have zeroed in on examples of transformational work already taking place on the state and local levels.

Oregon, one of the four OPT-In for Families demonstration sites, began working on a vision for transforming child welfare in 2020. Since that time, the Oregon Department of Human Services (ODHS) has developed more responsive preventive services, connecting families to community resources and providing one-on-one coaching to meet families’ needs.

Chang believes Oregon’s approach is effective in part because it relies on local community institutions, including tribal governments when appropriate, to approach families. “One of the really painful things we've learned along the way is that families who are eligible for services are often afraid to ask for help because they think institutions are not there to be of service to them, but rather to judge them, and — worse case scenario — take their children,” she said. “ODHS takes the approach that we're not [Child Protective Services], we're not here to do an investigation, we're here to help. They’ve had the foresight to engage those with lived experience to engage families in these services, to spend time getting to know them and help them navigate these very complex systems.”

Aprille Flint-Gerner, the director of ODHS’ Child Welfare Division, said that the support from OPT-In For Families will let the department build on its current efforts and provide direct financial help to families when needed.

“The data points to the benefits of cash in hand, that it can change a family's trajectory,” she said. As an example, she described a family who lacked the money to fix their badly damaged roof. “This is a hazard in the home that is impacting child safety. The family needs their roof fixed, and there isn’t a way to get it with state resources. Well, here's this grant that's going to cover the cost. Philanthropy has a flexibility that we just don't have in state government, so we think these kinds of co-investment partnerships are key. We're not saying we're backing away from our role — we're saying we can't do it alone.”

She also pointed to the technical assistance and research component of OPT-In for Families, which will help demonstration sites build out, evaluate and scale their programs to see what’s working and what is not.

“They’re going to deep-dive in ways we never have the ability to do,” Flint-Gerner said. “We are working hard and fast and furious to do what we can, day to day. But those deep dives are so important to help us understand where we’re headed.”

Another OPT-In demonstration site, Washington D.C., introduced a “211 warmline” last fall to field calls about families who are reported to D.C’s Child and Family Services Agency but do not meet the criteria for an investigation of child abuse or neglect. Families connected to the warmline are referred to social service resources. The program launched last October and received more than 2,000 calls in its first three months, according to the Washington Post, which reported that “requests ranged from assistance for housing and utilities to food and health.”

Chang said the four demonstration sites will provide important information for other states and the nation as a whole. “We believe that there is a crisis of imagination and a meta crisis of technical knowledge,” she said. “We want to inspire people that it can, in fact, be done — that is part of our goal. And we'll also provide explicit lessons about how these jurisdictions do it — they're all different: rural and urban, West Coast and East Coast and the Midwest. Because we want to encourage people that this can be done, to help them understand exactly how these folks do it so they can replicate it. It's not just the practitioners that we hope to inspire, but policymakers, as well.”

Honoring a legacy

A number of other prominent funders support child welfare and children in foster care, among them the Conrad N. Hilton Foundation, the Anthony and Jeanne Pritzker Family Foundation and philanthropies funding collaboratively through The Audacious Project, as IP has reported.

The Annie E. Casey Foundation has provided what may be the deepest and most consistent support over the years. Annie E. Casey conducts research and develops policy; its comprehensive child welfare program works closely with welfare agencies, policymakers and advocates.

For the Doris Duke Foundation, this funding area is particularly relevant because it honors the legacy of the founder. According to her obituary in the New York Times, Doris Duke’s wealth complicated her relationships; it also brought her notoriety she didn’t seek, including hate mail and constant pleas for money. But she was happy to give her money away for causes she believed in. During her lifetime, she gave away “the equivalent of more than $400 million in today’s dollars — often anonymously,” according to the foundation.

Chang believes Doris Duke would approve of the foundation’s efforts to transform the child welfare system. “One of the things that made her a leader is that she looked at those populations and areas of need that others weren't willing to finance,” she said. “Families in this country are considered invisible by so many of our systems. We tend to deal with them when they're in a real crisis, and we know that that's just not the best approach. So we think this honors the letter of what [Duke] asked us to do and the spirit with which she approached the work — one of curiosity and embracing innovation and risk.”

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