Cost of Care and Redirection of Resources

Developing a high quality alternative care system requires adequate funding and resources. In countries that are working to reform their care systems, efforts are needed to redirect financing from residential care options towards new initiatives that support parents, prevent family separation, and provide children with a range of family and community based care alternatives.

Cost-benefit studies of different forms of alternative care demonstrate that it makes good economic sense for governments to invest in family based alternatives rather than residential care. While costs may increase for a temporary period as countries make the shift to family-based care – for example to fund training of social workers, develop social welfare services and establish tracing and foster programmes – in the long run it costs less than keeping children in institutions where funds are required to pay salaries for staff, maintain buildings and provide food and other services. The bottom line is that for the cost of keeping one child in residential care, many more girls and boys can be supported within families.

Funding for care reform involves allocating (or redirecting) resources from institutional care towards a range of family-based care services, investing in the development of a competent social welfare workforce, supporting carers, and providing financial and practical support to children leaving care. It also means investing in programmes that tackle the factors that lead to family separation and children being placed in alternative care – such as poverty, unemployment, disability, health and conflict. This could include promoting access to basic health, education and housing services, developing social protection and financial assistance initiatives, and working to strengthen families through parenting education or counselling.

Governments also need to make a commitment to putting in place licensing and regulation mechanisms to ensure that funding of care is motivated by children’s best interest rather than the financial benefit of the provider – and that resources are directed towards families rather than institutions. Unfortunately in many countries, there are vested interests in admitting or keeping children within formal care (particularly residential facilities) for profit-making, and large numbers of private care facilities operate outside the control of authorities.

The literature in this section focuses on budget and cost analysis pertaining to children’s care, including preventive services to support family based care and the provision of a range of alternative care options.

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Mapping U.S. Support for Orphanages Abroad: Key Findings & Strategic Recommendations

Better Care Network and ReThink Orphanages, 01 Apr 2020

This report lays out the results of a preliminary mapping exercise to document the ways in which the United States supports and perpetuates overseas orphanages. It is based on: an analysis of existing data; a literature review of U.S government publications and investments; a review of non-profit organizations and foundation activities; an analysis of key supply chains and stakeholders; and the identification of existing data gaps.

High cost child welfare cases: Child characteristics and child welfare services

Svetlana Yampolskaya, John Robst, Mary I. Armstrong - Children and Youth Services Review, 12 Feb 2020

The purpose of this paper is to examine child characteristics and child welfare services associated with high welfare costs in the US, defined as the top decile of child welfare costs.

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The Scottish Independent Care Review: The Money

Katherine Trebeck - The Independent Care Review, 05 Feb 2020

This paper was written by Dr Katherine Trebeck and is her reflections on what was found as a result of the work done to Follow the Money, the report of the Independent Care Review that produced the financial argument needed to challenge the way Scotland invests in its ‘care system’.

The Scottish Independent Care Review: Follow the Money

The Independent Care Review, 05 Feb 2020

One of several reports produced as part of the Scottish Independent Care Review, this report explains how Scotland can invest better in its children and families.

State Investments in Head Start to Support At-Risk Children and Families: More Important Than Ever

National Head Start Association, 2020

This brief from Head Start provides an overview of state funding for Head Start, a collection of comprehensive birth to five programs in the U.S. specifically designed to strengthen families, promote school readiness, and improve child health.

Public Budgeting for Children’s Rights in the Philippines: A Resource Book

Child Rights Coalition Asia, through support of UNICEF Philippines, Plan International and Save the Children, 2020

This resource book simplifies and unpacks budget processes with key guidance on specific policies and steps for those who seek to be champions for child-centered public finance in the Philippines context.

Children’s Budget 2020

First Focus on Children, 2020

This report from First Focus on Children presents analysis of the U.S. spending on children and children's services, including child welfare, in 2020.

Lumos’ response to the European Commission’s Evaluation of the support to promoting social inclusion, combatting poverty and any discrimination by the European Social Fund

Lumos, 01 Dec 2019

This brief from Lumos reviews the the transition from institutional to family and community-based care under the European Social Fund (ESF) funding period 2014-2018, including promising deinstitutionalisation practices, and outlines key recommendations to the European Union for the completion and implementation of the ESF+ 2021- 2027 funding period.

Pulling Back the Curtain: What Do Non-Funders Think Are the Key Challenges, Needs, Gaps and Opportunities in Supporting Children and Young People Facing Adversity?

Elevate Children Funders Group (ECFG), 01 Dec 2019

This report is an analysis of the feedback that the Elevate Children Funders Group (ECFG) received from a six-question survey with over 70 non-funder stakeholders.

Costs for physical and mental health hospitalizations in the first 13 years of life among children engaged with Child Protection Services

Amanda L. Neil, et al - Child Abuse & Neglect, 26 Nov 2019

The purpose of this study was to estimate the costs of hospitalization for physical and mental health conditions by child protection status, including out-of-home-care (OOHC) placement, from birth until 13-years, and to assess the excess costs associated with child protection contact over this period.

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