Sunday, May 18, 2014

Foster care: US moves to phase out group care for foster kids

For those who are unaware, this is addressing billions in Medicaid funding and its failed, costly, archaic philosophy of chattel ranching (my term for state warehousing of poor children, a.k.a. "foster care").

There have been extensive federal discussions to address the failures of the child welfare system.  Unfortunately, a progressive change in how, we, as a society deal with child poverty, will generate financial ire inside the historic, status quo institutions which generate substantial financial benefits, albeit profit, whether proper or improper, off the economic ills of society.

Multiple states are making strides to cut down the use of residential facilities for foster care youth. There has been significant progress in finding placements for foster care youth with extended families. Can the US end the use of group homes entirely?

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Angel B., 15, sits under a board displaying past and present residents of Williams Cottage at the Children's Village foster care facility campus in Dobbs Ferry, N.Y. on April 24.

In many ways, Children's Village resembles an idyllic college campus, with its abundant open spaces, handsome buildings, brand-new activities center and Olympic-size pool.
Yet the child-welfare professionals who run the 180-acre complex in Dobbs Ferry, N.Y., a New York City suburb, are committed to a seemingly paradoxical goal: They want fewer foster children settling in to make the residential cottages their home.
"The longer kids stay in institutions, the less capable they are of reintegrating into society," said Children's Village CEO Jeremy Kohomban. "We need to use the residential system as a short-term emergency room, then get kids back to the community."
At the forefront of a nationwide effort to improve the foster care system, Kohomban and his team have steadily shifted the focus of Children's Village, which was founded in 1851. The Dobbs Ferry campus now has fewer than 100 beds set aside for foster children, down from 275 in 2004.
Over the same period, the charity's caseload of children receiving community-based services – in their own neighborhoods throughout greater New York – has risen from 1,367 to more than 4,400. These services range from in-home therapy for some troubled kids to parenting classes for their mothers and fathers.
That shift of mission reflects a growing consensus within the child-welfare field that institutional settings for foster children – while sometimes necessary – should be used sparingly. With varying success, most states have tried to move in that direction, and Sen. Orrin Hatch (R-Utah), recently proposed a bill that would cut off federal funding for long-term placements in group homes.
Hatch says youths in group homes are often targeted by sex traffickers and pimps. Other problems include abuse by staff, youth-on-youth sex abuse, overuse of psychotropic medication, and restrictive rules that prompt many youths to run away.

Even an acclaimed facility like Children's Village has disadvantages.
"We can help kids who were traumatized - we can stabilize you, treat you," said Mr. Kohomban. "But we can't teach you to be a brother, a sister... The best place is always with your family or extended family."
According to the latest national statistics, there were 397,000 children in foster care as of September 2012, including 58,000 – or 15 percent – in some form of institutional setting. There are two main forms of group care – residential treatment centers like Children's Village which accommodate children with serious emotional or behavioral problems, and group homes housing other children for whom no foster family can be found.
As recently as 1999, there were more than 100,000 children in group care, about 18 percent of that year's foster care population of 567,000. In the ensuing 15 years, most states have shortened stays in foster care, expedited adoptions and expanded preventive support for troubled families so more children avoid being removed from home in the first place.
While pleased that group-care numbers have fallen, many child-welfare activists and members of Congress want the trend to accelerate. They accept the need for some residential treatment centers but they would like to phase out the use of other group homes.
"In congregate care, children are cut off," said Celeste Bodner, who advocates for foster youth as head of a nonprofit called Foster Club. "They deserve to continue their childhood in as normal a setting as possible, instead of pulling them out and sticking them in a bubble separated from the people they know and love."
To lower their group-care numbers, states have two main options: providing more preventive support for fragile families and recruiting more people – including relatives of the affected children – to serve as foster parents. It's generally the older children – adolescents and teens – who are the hardest to place with families, and thus the most likely to be placed in group homes.
"There's not enough work done on developing foster families for teens, so group homes become the default option," said Tracey Feild, a child-welfare specialist with the Annie E. Casey Foundation. She said 57 percent of all teens in foster care spend some time in group settings, where they often are deprived of normal activities such as organized sports or learning to drive.
"What happens in a group home is all youths are treated exactly the same – you get points for behaving well, or demerits," Ms. Feild said. "There's not a lot of room for individual development."
Jacque Mata-Lemons, now a 22-year-old college student, spent six years in a group home in Lubbock, Texas. She excelled at her school work and was able to earn a few privileges denied to the other youths, yet she chafed at the extensive restrictions.
Use of telephones, TV, and the Internet was limited, as were extracurricular activities at school and visits to the homes of friends who lived elsewhere in the city, Ms. Mata-Lemons said. When her mother – a drug addict who served several stints in jail – died seven years ago, Mata-Lemons said the group home staff wouldn't let her go the funeral because of lack of transportation.
"A lot of the kids compared it to a prison," she said.
Yet Mata-Lemons, who aspires to be a college math instructor, expressed doubt that Texas could recruit and screen enough qualified foster parents to contemplate phasing out group homes.
"They should have group homes, but they need to have laws to make sure the kids can feel like normal kids," she said. "Then there wouldn't be such a problem with kids running away, getting mixed up with sex traffickers."
At the Children's Village campus in Dobbs Ferry, the young residents are governed by various rules, including mandatory chores, but they also have their own school – which competes in basketball, softball, and track – as well as the state-of-the art activities center and a popular program teaching how to train service dogs.
Yet despite the amenities, Children's Village has taken numerous steps to shift away from long-term residential care, with a goal of limiting most stays to less than six months.
For children who do need to be removed from their own home, the charity has intensified efforts to find relatives or neighbors to provide a foster home nearby. Vincent Madera, who oversees these efforts, says his team conducts searches on the Internet and has even hired a private investigator in its quest for suitable foster parents. In 2012, the program reported reunifying 101 children with a parent or relative and finalizing adoptions for 36 others.
The charity also has expanded its support programs for the children – and their families – after they return from the campus to their communities, offering up to five years of services.
Anthony Robinson, now 18, came to Children's Village four years ago, bristling with anger at a time when his mother was unable to care for him. Over a two-year-stay, he blossomed into a successful athlete and student, but finally, at age 16, was pressured by the staff to move to a group home in New York City in order to develop more self-reliance.
"It was hard to transition out," Robinson said. "But it's taught me that life is not always going to be like the campus, where everything was given to me."
Nonetheless, Robinson has insisted on completing his high school education at the Dobbs Ferry facility, a two-hour commute each way from his group home. He plans to enroll this fall at Nazareth College near Rochester in upstate New York, and expects to stay in touch, from long distance, with his Children's Village mentors.
"They are always there with their support system," he said.
Several advocacy groups are pushing for an overhaul of the federal funding system for child welfare, with a goal of shifting funding from institutional settings to alternatives such as family placements. One proposal by the Annie E. Casey Foundation and one of its partners, the Jim Casey Youth Opportunities Initiative, says federal reimbursement should be eliminated for shelters and group care for children under 13 and allowed for older children's group care only for short periods when necessary for psychiatric treatment or other specialized care.
Many youths placed in group settings "have been ripped away from families, ripped away from communities," said Kohomban. "They are really mad at all of us and incredibly scared and afraid for their future, and so they exhibit symptoms that we then label as mentally ill."
According to the Casey Foundation's latest figures, Kansas has one of the lowest percentages of foster children in congregate care – 5 percent.
KVC Health Systems, a private company hired to provide child-welfare services in eastern Kansas, has moved even further, reporting that only 3 percent of the 3,100 children it oversees are in group settings, primarily for short-term psychiatric treatment, while virtually all the others are placed with foster families. That's a huge change from 1997, when 30 percent of KVC's children were in congregate care.
"Change is hard," said Erin Stucky, KVC's executive vice president. "When a system is looking at making a significant reduction, there's often resistance among providers of residential services who are concerned about their business."
Several states with above-average percentages of foster children in congregate care say they are striving to reduce those numbers.
Connecticut, for example, had 1,965 foster children – 29 percent of the total – housed in group settings in 2004. As of March, the number had dropped to 847 – bout 21 percent of the total.
Joette Katz, appointed in 2011 as commissioner of Connecticut's Department of Children and Families, wants to go below 10 percent. One of her goals, she said, is changing the mindset of department employees who feel it's less risky for their job security to place a child in a group home than with relatives.
Colorado has had one of the highest proportions of children in congregate care, though the Office of Children, Youth and Families says the rate has dropped from 25 percent in 2012 to about 22 percent this year.
"We do think we can do better," said the office's director, Julie Krow, as she described "aggressive efforts" to place more foster children in family settings.
One of the challenges is to boost financial support for families who do provide foster homes for traumatized adolescents.
"A lot of people are paranoid of taking them because they fear no one will support them," said Skip Barber of the Colorado Association of Family and Children's Agencies.
Rhode Island has about 24 percent of its foster children in congregate care, according to the Department of Children, Youth and Families. Critics say efforts to lower the number have been hampered by budget cuts.
"We could do a much better job keeping kids from coming into the system in the first place with a strong enough prevention system that supports their families," said David Caprio of the nonprofit group Children's Friend. "Our state has not invested in that. We're paying the price. The kids are paying the price."
Preventive services can include counseling, parenting classes and substance abuse treatment.
The New York-based advocacy group Children's Rights has filed several lawsuits against state child-protection agencies alleging, among other complaints, that foster children are inappropriately placed in restrictive institutional settings.
The Texas Department of Family and Protective Services – the target of one such lawsuit – declined to comment on the pending case, but outlined efforts to reduce the number of children in group care.
The lawsuit cites several media accounts, including an Associated Press story detailing how one group home in East Texas was a collection of mobile homes and how the state repeatedly ruled out allegations that girls living there were sexually abused by their foster father until he was arrested on such charges.
The executive director of Children's Rights, Marcia Robinson Lowry, says group care should be limited to "only those extraordinary situations when it is absolutely needed."
She believes more pressure could be put on the states – via new funding criteria – to recruit, train, and support qualified foster families.
"Notwithstanding this huge infusion of federal money, the government is not holding states accountable," she said. "The states are left on their own to do it well or poorly and abusively. It's the luck of the draw for the kids."


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