Women and prescription on opioids is focus of this research paper. The author examines the history of prescription opioids and their affect on women in the United States. The author also discusses that state of the prescription opioids epidemic as well as the policies and regulations trying to address it.

1. Running Head: Policy Analysis Paper
Policy Analysis Paper
Latagia Copeland-Tyronce [latagia.copeland@wayne.edu]
Wayne State University School of Social Work
Advanced Social Welfare Policy: SW: 8770
June 12, 2017

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INTRODUCTION
The American Child Welfare system has experienced many changes over the last fifty
years. Public opinion, and the opinions of those in Washington, has shifted dramatically; and
thus, so has child welfare policy. The dramatic shift from family preservation to child safety and
permanency is by far one of the main and most important aspects of our current child welfare
system. It was during the 1970s that a number of efforts to reduce children’s time in foster care
and expedite paths to permanency; this culminated in the creation of the1997 Adoption and Safe
Families Act (or ASFA) (P.L. 105-89), which was signed into law by then President Bill
Clinton.1 Before ASFA was signed into law, there had been no comprehensive congressional
attention to child welfare since the Adoption Assistance and Child Welfare Act of 1980 (or
AACWA) (P.L. 96-272).
AACWA was influenced by the theory that disruption of the parent-child relationship
caused a great deal of emotional damage; and thus, provided financial incentives for states to
change child welfare policies and attempt to move children out of foster care and encourage
permanent placement through reunification and adoption. Moreover, AACWA emphasized
family preservation and actively encouraged permanent placement with a family, either
biological or adoptive, as opposed to the child becoming “trapped in the system” and spending a
long period of time in foster care. AACWA also made kinship foster care a viable option to the
child welfare system and in 1979, the Supreme Court in the case Miller v. Youakim established
kinship foster care as a means to deal with the increasing foster care population.2
1
Concept and History of Permanency in U.S. Child Welfare. (n.d.). Retrieved June 09, 2017, from
https://www.childwelfare.gov/topics/permanency/overview/history/
2
White, C. (2006). Federally Mandated Destruction of the Black Family: The Adoption and Safe Families, 1 Nw. J.
L. & Soc. Pol'y. 303. http://scholarlycommons.law.northwestern.edu/njlsp/vol1/iss1/12

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In contrast, ASFA marked the first time in child welfare history that issues related to
specially to permanency were explicitly stated in legislation; this of course, fundamentally
changed the landscape of the child welfare system and how it operates. At the time that ASFA
was passed, there were 516,000 children in foster care, up from 262,000 in 1982 (U.S.
Department of Health and Human Services). ASFA was established as a means of accomplishing
four main goals. (1) to promote the safety of children first and foremost; (2) to decrease the time
it takes to achieve permanency for children “a child’s sense of time”; (3) to promote adoption
and other permanency options; and (4) to enhance state capacity and accountability for both
safety and permanency.3 Due of the enormous effect that this one policy has had on child welfare
system, and the thousands of families that encounter it, ASFA is the focus of this policy analysis
paper.
DEFINITION OF THE SOCIAL PROBLEM/ISSUE
While, I believe that the law makers that created and signed into law ASFA had good
intentions; there have been some devastating consequences as a result. Moreover, there is one
group and/or vulnerable population that have been negatively impacted and effected more than
any other. African Americans have long been subjected to marginalization, discrimination, and
institutional racism; these very real facts were not taken into account when establishing ASFA
back in 1997. Indeed, ASFA is a major contributor to the gross over representation and
disproportionality of African American children within the child welfare and/or foster care
system. According to the U.S. Government Accountability Office (GAO), African Americans
make up 34 percent of the foster-care population, but only 15 percent of the general child
3 Notkin, S., Weber, K., Golden, O., & Macomber, J. (2009, December). Intentions and Results A Look Back at the
Adoption and Safe Families Act. Retrieved June 09, 2017, from http://affcny.org/wp-
content/uploads/IntentionsandResults.pdf

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population and are more than twice as likely to enter foster care compared with white children in
2004.4
Moreover, it has become blatantly and undeniably apparent that racial disparities are
evident at every critical decision point within the child welfare system.5 And while race plays an
undeniable role in the disparities that exist within the system so too does socioeconomic status.
According to University of Pennsylvania law professor Dorothy Roberts, poverty is the leading
cause of children landing in foster care.6 In fact, one study concluded that poor families are up to
22 times more likely to be involved in the child-welfare system than wealthier families; and
since African Americans are more likely to be poor they are affected disparately.7 This wasn’t
always so, there was a time in child welfare history when it was, for all intents and purposes, a
Whites only intuition and African American children were completely ignored as result of the
racist backlash after the Civil War, false claims of African American inferiority and Jim Crow
laws.
It wasn’t until the late twentieth century that the child welfare system allowed African
Americans to participate in services that had long been reserved for the White community. Prior
to that, African Americans were forced to rely primarily on other resources such as extended
family networks and churches to take care of children whose parents were unable to meet their
4 United States., Government Accountability Office. (2007). African American children in foster care additional
HHS assistance needed to help statesreduce the proportion in care: Report to the Chairman, Committee on Ways
and Means, House of Representatives.Washington,D.C.: U.S. Govt. Accountability Office.
5 Race Matters: Unequal Opportunity within the Child Welfare System - The Annie E. Casey Foundation. (2006,
January 01). Retrieved June 09, 2017, from http://www.aecf.org/resources/race-matters-unequal-opportunity-within-
the-child-welfare-system/
6 Roberts, D. E. (2002). Shattered bonds:The color of child welfare. New York: Basic Books.
7 Burroughs, G. (2008). Ms.Magazine | Too Poor to Parent? | spring 2008. Retrieved June 09, 2017, from
http://www.msmagazine.com/spring2008/tooPoorToParent.asp

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needs. However, once African American, and other minority, children entered the child welfare
system, issues started to appear such as high removal rates and lack of quality services. And
unlike AACWA, which favored achieving permanency through “reasonable efforts” towards
reunification and maintaining the familial structure; ASFA, effectively eliminated the
“reasonable efforts” requirement and steadfastly focusing on adoption (through speedy
termination of parental rights) as the best possible permanency solution for children in foster
care.8
It has long been established in this country that, “All families have a constitutional right
to be together, free from the unwarranted interference of third parties, particularly the state. This
is an intrinsic human right that encompasses the right of parents to the “custody, care and nurture
of [their] child[ren],” and the parallel right of children to be raised by and live with their
parents.9 This fundamental right, however, doesn’t apply to African American parents and
families equally and ASFA only exacerbates the problem by incentivizing states to remove and
adopt out [African American] children.
Furthermore, child welfare practitioners and members of the public still continue to turn a
blind eye to the existence of racism and its tangible effects in the child welfare system. When
confronted with the issue, many practitioners and public officials simply state (and believe) that
the over-representation of African American families living in poverty is the reason for the racial
disparities in the system.10 Others, wrongly and unjustifiably, state that the reason there are more
8 Adoption and Safe Families Act of 1997, Pub. L. No. 105-89, 111 Stat. 2115 (1997)(codified in scattered sections
of 42 U.S.C.)
9 Stanley v. Illinois, 405 U.S. 645, 651 (1972) (quoting Prince v. Massachusetts,321 U.S. 158, 166 (1944)); see also
Troxel v. Granville, 530 U.S. 57, 66 (2000).
10 Thomas D. Morton, The Increasing Colorization of America’s Child Welfare System: The Overrepresentation of
African-American Children, POL’Y & PRAC. PUB. HUM. SERV., Dec. 1999, 23, 24; Daniel Heimpel, The Future
of Foster Care: Are We Too Cheap to Keep Children Safe?, HUFFINGTON POST: THE BLOG (Feb. 11, 2011,

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African American children in foster care is because African American parents have “worse”
parenting skills than White parents, and more frequently mistreat their children.11 Several studies
have concluded that African American parents do not abuse and/or neglect their children at
higher rates than Whites do; and in fact, the exact opposite is true. Of the all substantiated cases
of child abuse and neglect reported nationally in 2013, White parents constituted the majority of
perpetrators, at 44 percent; with Hispanics being second, at 22.4 percent; and African Americans
coming in last, at 21.2 percent.12
In summation, ASFA has increased the number of African American children in foster
care and created a fast track (15 of 22 months) to adoption without acknowledging how easily
African American children enter foster care in the first place. Moreover, ASFA ensures that
African American children are more often permanently severed from their families. Under
ASFA, familial bonds between African American parents and their children are devalued; and
African American parents entrapped in the system tend to have their parental rights systemically
and disproportionately terminated.13 Termination of parental rights is considered to be the civil
death penalty; this is especially true for the thousands of African American families targeted by
our current child welfare system.
12:34 PM), http://www.huffingtonpost.com/daniel-heimpel/future-of-foster-care_b_821682.html
[https://perma.cc/T8ML-9GBU]
11 See Heimpel, supra note 7; see also Elizabeth Bartholet, Differential Response:A Dangerous Experiment in Child
Welfare, 42 FLA. ST. U. L. REV. 573, 584-85 (2015) [hereinafter Bartholet 2015]; Elizabeth Bartholet, Thoughts
on the Liberal Dilemma in Child Welfare Reform, 24 WM. & MARY BILL RTS. J. 725, 728-29 (2016) [hereinafter
Bartholet 2016].
12 Child Welfare Outcomes 2010–2013: Report to Congress ... (2013). Retrieved June 12, 2017, from
https://www.bing.com/cr?IG=10F2C77C3F544114B67D667A7E967CE9&CID=1357F08A39ED69D4352EFA1538
EB6843&rd=1&h=QXlrL9VbwccV57IRbmtlWzRM4UiSQYewBoaWBxpTYDs&v=1&r=https%3a%2f%2fwww.a
cf.hhs.gov%2fcb%2fresource%2fcwo-10-13&p=DevEx,5067.1
13 Cloud, E., Oyama, R. & Teichner, L. (2016) Family Defense in the Age of Black Lives Matter, 20 CUNY L. Rev.
Available at: http://academicworks.cuny.edu/clr/vol20/iss1/14

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RESEARCH/STATS
The following national statistics is the most recent publicly available data and is from
2015. On September 30, 2015, there were an estimated 427,910 children in foster care. 269,509
children entered foster care. 243,060 children exited foster care. The number of children in foster
care on September 30, 2015, (427,910) remains lower than those in care on the same day in 2006
(510,000). However, 2015 saw an increase in these numbers as compared to 2014 (415,129).14
Of the estimated 427,910 children in foster care on September 30, 2015, were in the
following types of placements: 45 percent were in nonrelative foster family homes; 30 percent
were in relative foster family homes; 8 percent were in institutions; 6 percent were in group
homes; 5 percent were on trial home visits (situations in which the State retains supervision of a
child, the child returns home on a trial basis for an unspecified period of time, and after 6 months
the child is considered discharged from foster care); 4 percent were in pre-adoptive homes; 1
percent had run away; and 1 percent were in supervised independent living. Percentages for
placement settings on September 30 changed slightly between 2006 and 2015, with a notable
increase in the use of placements with relatives and a decrease in placements in group homes.
The estimated 427,910 children in foster care on September 30, 2015, had the following
case plan goals: 55 percent had a goal of reunification with parent(s) or principal caretaker(s); 25
percent had a goal of adoption; 6 percent had not yet had a case plan goal established; 4 percent
had a goal of emancipation; 3 percent had a goal of long-term foster care; 3 percent had a goal of
guardianship; and 3 percent had a goal of living with other relative(s). From 2006 to 2015, the
14 Child Welfare Information Gateway. (2017). Foster care statistics 2015. Washington,DC: U.S. Department of
Health and Human Services, Children’s Bureau.

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percentage of children with case plans of reunification experienced the largest increase, while the
largest decrease was in the percentage of children with case plans of long-term foster care.
Of the estimated 243,060 children who exited foster care during 2015 the following was
the outcome: 51 percent were reunited with parent(s) or primary caretaker(s); 22 percent were
adopted; 9 percent were emancipated; 9 percent went to live with a guardian; 6 percent went to
live with another relative; and 2 percent had other outcomes. From 2006 to 2015, there were
increases in the percentages of children who left the system for adoption and guardianship. There
were decreases in the percentages of children who left the system to reunite with their parents or
primary caregivers or live with other relatives or who left with other outcomes. Of the estimated
243,060 children who exited foster care during 2015, the median amount of time spent in care
was 13.5 months.15
The following are the races and ethnicities of the estimated 427,910 children in foster
care on September 30, 2015: 43 percent were White; 24 percent were Black or African-
American; 21 percent were Hispanic (of any race); 10 percent were other races or multiracial;
and 2 percent were unknown or unable to be determined. The following are the races and
ethnicities of the estimated 269,509 children who entered foster care during 2015: 45 percent
were White; 23 percent were Black or African-American; 20 percent were Hispanic; 10 percent
were other races or multiracial; and 2 percent were unknown or unable to be determined. From
2006 to 2015, the percentages of Black children entering foster care, as well as for those whose
race or ethnicity was unknown or unable to be determined, decreased, while the percentages of
15 Child Welfare Information Gateway. (2017). Foster care statistics 2015. Washington,DC: U.S. Department of
Health and Human Services, Children’s Bureau.

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Hispanic children and children of other races or multiracial children entering foster care
increased.
The following are the races and ethnicities of the estimated 243,060 children who exited
foster care during 2015: 45 percent were White; 23 percent were Black or African-American; 21
percent were Hispanic (of any race); 9 percent were other races or multiracial; and 2 percent
were unknown or unable to be determined. From 2006 to 2015, the percentages of White
children, Black children, and children of unknown race or whose race was unable to be
determined who exited foster care decreased, while the percentages of Hispanic children and
children of other races or multiracial children exiting foster care increased.16
POLICY ANALYSIS
Intended Effects of ASFA: As of 2015, there were 427,910 children in foster care, which
shows a 17.7 percent decrease from 1996 figures. As of 2015, the median length of stay has
continued to decrease from a median of 19.8 months in 2000 to 13.5 months in 2015. As of 2015,
children eligible for adoption waited approximately 25.2 months to achieve permanency, which
marks significant decrease from 2000 statistics. Unintended Effects of ASFA: Racial
disproportionality was not addressed; and as of 2015 African American children are still grossly
over-represented in the foster care system, at 24 percent.17
16 Child Welfare Information Gateway. (2017). Foster care statistics 2015. Washington,DC: U.S. Department of
Health and Human Services, Children’s Bureau.
17 Karnes, L. J. (2015, May). The Adoption and Safe Families Act of 1997: A Policy Analysis.Retrieved June 12,
2017, from
https://www.bing.com/cr?IG=14012BA6FD0545D58C5645D85229DE1E&CID=1433663C8DD469EC16B56CA38
CD26834&rd=1&h=l8ksV2MRTGbSs2qaEGOvz3Gd5YdrCLrVRkmIX9EZLHg&v=1&r=https%3a%2f%2fweb.cs
ulb.edu%2fcolleges%2fchhs%2fdepartments%2fsocial-
work%2fdocuments%2fePoster_Karnes.Lesley_ASFAanalysis.pdf&p=DevEx,5060.1

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ASFA has indeed increased exits from the foster care system through adoption and
guardianship, yet many youth exit foster care through emancipation and many without
connections to a family. ASFA acknowledged the need to support birth families to prevent
removal if possible and to reunify quickly and safely with their children, but did not fully address
what must happen to make this a reality for the vast majority of children. ASFA recognized, but
did not sufficiently support, relative placement options. ASFA laid bare the need for improved
collaboration, supports, and services from other public systems such as mental health, housing,
income support, and criminal justice systems.18
POLICY RECOMMENDATIONS
1. Significantly expand the timeframe of 15 out of the last 22 months.
2. Permit parents whose rights have been terminated to have those rights reinstated, if
deemed appropriate, within a certain time period (if the child has not otherwise
achieved permanency).
3. Create federal legislation, similar to the Indian Child Welfare Act (or ICWA), for
Africans Americans (the African American Child Welfare Act.) that would address
the overrepresentation of African Americans within the child welfare system and
improve outcomes and support at every critical decision point.19
4. Promote placements with caring relatives through adoption or subsidized
guardianship; ensure timely provision, by the state, of the services necessary for the
safe return of the child to the family.
18 Notkin, S., Weber, K., Golden, O., & Macomber, J. (2009, December). Intentions and Results A Look Back at the
Adoption and Safe Families Act. Retrieved June 09, 2017, from http://affcny.org/wp-
content/uploads/IntentionsandResults.pdf
19 Weaver, J. D. (n.d.). The African-American Child Welfare Act: A Legal Redress for African-American
Disproportionality in Child Protection Cases. SSRN Electronic Journal SSRN Journal.

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5. Provide funding for new “Family Connection Grants” that will allow states, localities,
and nonprofits to invest in Kinship Navigator programs, family group decision
making, intensive family-finding efforts, comprehensive family-based substance
abuse treatment.
6. Amend ASFA to create an exception to the 15/22 mandate for incarcerated parents
and their children.
CONCLUSION
This analysis has demonstrated that evolution of child welfare policy and how these
policies have impacted African Americans disproportionately. Moreover, this analysis has
provided a picture of ASFA; its goals, its flaws, and how it has been implemented in the real
world through the practices of child welfare professionals. While it is clear that ASFA has indeed
accomplished many of its stated goals; there has been much damage done in the process. ASFA
has created thousands and thousands of “legal orphans,” (overwhelmingly African American)
many of whom, have loving and caring families that would gladly take them if only given the
chance. In fact, there are those who have stated that ASFA is the legal devastation of the Black
family. Advocates, judges, and even child welfare professionals themselves, have started stating
their concerns about ASFA and are demanding change. Twenty years is long enough, it’s time to
address this pressing issue with new federal legislation.
SPECIAL THANKS TO
Professor Tonya Fleming-Fuller