Changing children’s lives for almost half a century

Arlene Goldsmith for 43 years has led New Alternatives for Children as its executive director. Now, she has transitioned into the role of Founder, after working alongside a new ED, David Goldstein. 

Goldsmith, a trained social worker at her core, has worked with children neglected by the system, finding them homes, providing life-changing services, and sending them off to college.   

New Alternatives for Children started in 1982, provides family supportive services for children with medical complexities and disabilities. The organization works to bring children home from hospitals, or helps to find them homes.  More than 400 staff members work for the nonprofit, including social workers, pediatricians, nurses, psychologists, psychiatrists, education specialists and more. Goldsmith helped grow the organization from its very beginnings to serve 3,500 children and families across New York City.

New York Nonprofit Media spoke with Goldsmith about her decades as executive director, what’s changed in the organization and the child welfare landscape, and what’s up next for her.

This interview has been edited for length and clarity.

How did New Alternatives for Children get its start?

I went around to different places to see different hospitals and see what was going on, and these children were living beyond their medical needs. There were children that were addicted to crack as the big crack cocaine epidemic happened in 1981. I was hired that year and we began to look at how we were going to start an agency with very little money, we couldn't even get a bank account. And suddenly I began to work with Blythedale Children’s Hospital, where women who were volunteers at Blythedale came and joined our board. So that's how we got our start. We had a whole group of people who knew that these children were living in hospitals and what we could do about it, and I kept going to the state to get contracts, and that took almost a year. We got incorporated and we started off with preventive services. At that time, prevention was a very small piece of the puzzle that the city was doing.

How has the organization transformed over the years?

Right now, we have probably the hardest caseload in the City of New York because we have very vulnerable children. We've had children that have had heart transplants, kidney transplants, lung situations. So a lot of agencies are not able to handle the kind of special needs that we have. We have a renowned pediatrician and full-time psychiatrists. We have a mental health clinic and work as a team so that families get certain dosages of services. We have about 50 programs that we've developed over the course of 43 years to help when we see something that a family needs. We also go ahead and try to develop a program for those children and those families with disabilities who are Black and brown and who have been through terrible abuse or neglect in their own lives and need a specialized program. If you want to go to a health care clinic with a child with a disability, you might have to wait for hours. You can't get mental health in New York City. We have a full time psychiatrist, a whole mental health team. They get everything in one place, which avoids the fragmentation of services that children with special medical needs face every day. Over the course of the years, we have built this agency from this little tiny thing, which was like a little gem, to an agency now that is serving these 3,500 children and families annually and with the services that they require.

What do you think is the secret to keeping a successful nonprofit alive and well?

You need to have professional staff. You need to have an interdisciplinary staff. And when you bring that together, it means that we can have a case conference, where there are 13 or 14 people talking, so we have very good outcomes for kids and families. And when you have good outcomes, you can draw on getting money from foundations and the government. We've gotten federal grants. It's a lot of work to get that extra money. We were able to buy all the kids computers because, frankly, the computers from the city did not really work well. Our doctor, for example, made about 50 home visits. He brought a scale to the homes during the pandemic, a blood pressure machine and a little baby scale to weigh the babies. One of the things that made us not fold up is that we raised money and we served our families in a way that was different from other agencies. We had 500 people read books online, including authors, videotaping them and then showing it to the kids so that when they were home they had somebody reading them a book. We had other online videos showing kids how to play baseball. We did so much during the pandemic. We have a lot of kids who use wheelchairs.If you're a mother in the depths of Brooklyn and there's no food store near you, the only way you used to go is to take the child with you. It's very, very difficult for our kids, or our families, to take something home to carry. It wasn't easy. So we sent the vans out to help. Our vans work every single day. That was what we did during the pandemic and we raised money to help to do all of that. And I think why we didn't fold is that we have a very, very strong board of directors who helped us.

How do you think child welfare policies have transformed over the years in New York City? Do you think it has gotten better or has it gotten worse?

Twenty-five years ago, most of the children in the New York City child welfare system were placed in foster care, which involves removal of a child from their birth family. Today, the vast majority remain at home in prevention programs, which provide court-mandated services to keep at-risk families safely together. Keeping families together through prevention when safe and feasible is considered a best practice for the children. There are now four times as many children in prevention (33,000) as in foster care (7,600). Both programs have the same goal - to protect and promote the safety, permanency and well-being of children who have experienced or are at risk of abuse and neglect.

The families in prevention have endured extensive trauma and live below the poverty line, which is often passed on from generation to generation. Children in prevention have experienced or are at substantial risk of abuse, including physical or emotional abuse, and/or neglect, including educational or medical neglect.

Over the years, New Alternatives for Children has added program after program to become the one-stop operation our families need. Today, our organization has 54 different programs and services for our families from attachment and bonding therapy to job and housing placement support and everything in-between. We started by adding a medical clinic and then a mental health clinic. These supports have grown overtime to include a team of nurses who work primarily in the field and a range of therapies including music and art therapy, pet-assisted therapy, play therapy, and most recently an intensive in-home based multi-systemic therapy.

Our families typically live in some of the most-under-resourced communities in New York City. As such, we’ve built one of if not the largest education advocacy teams of any child welfare agency. Many of our children have early intervention needs and individualized education Programs and therefore our education staff have become vital to making sure our families are getting the services they deserve. Likewise, homelessness prevention and benefits management assistance were not things we could refer out to others and to simply hope for the best, we need to provide these services directly to our families under the same roof as everything else we provide. By adding an external relationship team, we have built lasting partnerships with outside companies and organizations to receive in kind donations and access to special opportunities that we can pass on to our families and open up parts of the city that haven’t always been available. There is so much more that we do. We encourage our staff to be innovative and to try new things, especially if they will help our families.

Over time, it became clear that providing wrap-around support to our families was the reason they could find a way out of child welfare, which is or should ultimately be the goal for everyone involved in child welfare. Variations of these supports, however, need to remain in place after families have left the child welfare system. Without continued support we see clearly what happens, which is that families enter, leave, and re-enter the child welfare system at consistently high rates and at great cost to the city. Seeing this and knowing there had to be a better way, we started post-child welfare programs: Partners in Parenting in 1998 and the Post Legal Adoption Network in 1995. The period after discharge from the child welfare system can be very challenging for families, especially those caring for children with profound disability or illness. As such, the need for the safety net of aftercare is greater than ever. If aftercare were widely available as needed it would provide a cost-effective alternative to children languishing in and aging out of foster care. This is not something the Administration for Children’s Services or Office of Children and Family Services have focused on.

Our aftercare programs support families as they leave the child welfare system by offering ongoing case management, counseling, parent support groups, and use of our medical, mental health, educational, vocational and recreational services. These programs have been extremely successful and have prevented children from being in the child welfare system. Child welfare reinvolvement is at a rate somewhere at more than 12% for the general population, but individuals in our aftercare programs for children with special needs experience around a 1% - 2% recurring child welfare involvement. 

Another important program worth mentioning is our Healthy@Home, which we started in March 2015 and is in many ways a program that echoes the original mission of New Alternatives for Children, which is to keep children out of hospitals and long-term institutionalized settings. Sadly, this still happens today for too many children. Health@Home is an initiative that seeks to improve the health and well-being of two groups of children with complex chronic conditions who, with their families, face staggering challenges. These are children living in long-term care facilities beyond medical need, and children living at home who could be at risk of institutionalization due to inadequate medical care and social support. The intent of the program is to enable both groups of children to be adequately cared for at home. The program provides intensive services to engage families requiring early intervention, expanded medical and behavioral healthcare services, coordinated care management, and community-based support and services to address their unique and complex needs. Since 2015, Healthy@Home has served 550 children from nearly 225 families and has successfully taken 30 of those children out of long-term hospitalization, some living in hospitals for upwards of nine years.

A lot has changed in the child welfare landscape since we started. Things continue to change all the time. Importantly, New Alternatives for Children has always been focused on creativity and ideas, we have never been afraid to push back when necessary, to join in when it’s right to do so, and to always be innovative in ways that others can follow. We will continue to do this for as long as there are people in need.

What’s next for you?

When you're a founder, it's always difficult because you want to ensure that your agency continues with the innovation and the work that we've done. And so I hired a COO six and a half years ago, David Goldstein. And so we've worked together for those six-and-a-half years and I am totally sure that agency will continue in the way that it is. So that makes me very, very pleased and happy that he's taking over this role. He is very well respected. He's had over 35 years in child welfare. He worked at another child welfare agency for 30 years and more than six years at this agency. So that is a good thing for me to know that it was going to continue to grow and, and continue to bring in the innovative work that we do. Making sure that salaries for staff remain  high and competitive, which is very difficult. 

I'd like to do a documentary, particularly with the young people that started with me all those years ago and are still here and still call me. I would like to do this documentary. or maybe write a book. So those are the two possibilities. I don't know if I can ever do that. The idea of the book would be good because I tell stories every time. I think stories are the most important thing you can sell because it really shows – it demonstrates the effectiveness of New Alternatives for Children. 

Maybe I'll rest a little bit because I've worked since I was 16 years-old. My first job was at a cerebral palsy day camp with kids. I taught a boy, that I now know is autistic, how to tie his shoelaces. He was 12-years-old. At the end of camp, the mother said, “Oh my god, you can tie your shoes!” and she hugged me. I don't think she wanted to let go of me. If you work hard enough you can do anything and I hope that I've instilled that with my own kids. I have four granddaughters. They're pretty old now, but the idea that nothing is impossible, that's the kind of thing that I think we try to help our children with.