Saturday, July 4, 2015

Michigan Billed Medicaid in the Murder of Ricky Holland


Ricky Holland was murdered in Michigan foster care.

The same people who were in charge then, are still in charge now.

This is why nothing has changed and this is why Michigan should continue being under federal court monitoring.


Michigan foster care 'a persistent and dire problem'

10 years after Ricky Holland, state improves but still fails kids

LANSING – A girl was injured during an unsupervised visit with the parents she'd been taken away from. Kids with a history of inappropriate sexual behavior were placed in homes with younger children. A child ran away and police weren't notified for days.

A decade ago, the death of Williamston 7-year-old Ricky Holland at the hands of his adoptive parents revealed fatal flaws in the state's safeguards for foster kids. Seven years ago, a class-action lawsuit in federal court mandated improvements.

Still, Michigan continues to fail hundreds of kids a year, court-appointed monitors say.

State officials and private providers said Michigan has taken big steps to protect kids — improving training, investigations and the way abuse is reported — but bad things will continue to happen because child welfare is a large, complex system full of large, complex problems.

"I would never contend that we could prevent all risk to children; that would be a mistake,"

said Maura Corrigan, who headed the state's human services agency from 2011 through the end of last year. "But Michigan is doing a lot to aggressively investigate these incidents."

Still, inspections of both state and private foster care agencies reveal case workers continue to make some of the same mistakes that preceded Holland's death in July 2005.
Records are poorly kept. Case workers remain overtasked. Investigations happen too slowly. Warning signs go unheeded, allowing kids to be placed in dangerous situations.

Michigan's "failure to achieve the minimum safety standards for children in foster care is a persistent and dire problem," monitors in the lawsuit wrote in their most recent report in April. Available data shows Michigan has fallen short of federal standards by 1,240 children who suffered repeat maltreatment and 434 abused or neglected in foster care since a modified settlement was signed in 2011.

Seven foster children died between January 1 and April 24, 2014, the monitors reported.
State employees and private providers describe numerous ongoing challenges: A year-old, $61 million computer database is still plagued with problems, leaving caseworkers with incomplete or incorrect information. Funding is strained for services that might prevent abuse. Tips on suspected abuse are still handled inconsistently. In response tofederal oversight, the state Department of Health & Human Services issues a blizzard of bureaucratic paperwork, taking up time better spent working with families.

But Patty Babcock, director of the Florida Institute for Child Welfare, said one of the biggest problems — in Michigan or anywhere else — is that society has accepted failure.






Patty Babcock
"If this were medicine or aviation, we would never tolerate the number of errors that are made," she said. "We would never tolerate this many bad drugs going out or planes going down."

'A messy business'
Child Protective Services visited Ricky Holland's home four times in the years before he was killed. Seventeen months after his death, the state conceded, among other failures, that "additional investigative steps should have been taken."

Licensing investigators still uncover similar problems statewide. Dozens of violations have been found, for example, at public and private agencies in Ingham and Kent counties, where DHHS is testing new reforms meant to prevent maltreatment.
Among the more serious findings:

A February 2014 investigation found state workers waited days after a child went missing before making the proper notifications.

A March 2012 investigation revealed a 4-year-old was injured after he leaped out of his foster mother's moving vehicle. The foster family repeatedly told Catholic Charities of West Michigan they struggled to meet the boy's "extensive mental health needs."

A February 2010 investigation revealed a young girl was found with a dislocated elbow after a Bethany Christian Services caseworker left the girl alone with her father, in violation of a court order.
The chief reason problems persist is that foster care "is still, and always will be, a system of very vulnerable families and therefore unpredictable and chaotic situations," said David Gehm, president and CEO of the Flint-based Wellspring Lutheran Services. "We're getting better results, but it'll always be a messy business."

Ricky Holland

Look back: The search for Ricky, the arrests and trial
The foster care system, 10 years later: Michigan foster care ‘a persistent and dire problem’

"You can't anticipate everything, but when we identify situations, we deal with them aggressively," saidSteve Yager, executive director of DHHS' Children's Services Agency. "If we had a crystal ball, that would be ideal."

Even Children's Rights, the New York-based group that sued Michigan partly in response to Holland's death, credits DHHS with building the infrastructure to improve "a system that was very sick," said Sara Bartosz, the group's lead counsel.

"But it's not just about building structures, but knowing how to work within those structures and implement them properly," she said. "There's something going on in Michigan that is unsound that's allowing the kind of safety numbers we're seeing."

'The grand design'
Yager contends Michigan's numbers remain high partly because the state is doing a better job finding and documenting abuse.

And he said the state hopes to continually improve. In Ingham County, for example, DHHS is piloting predictive analytics, looking for factors common in past abuse cases so they can intervene early in families showing those factors now.

Michigan is trying to learn from Florida, a few steps ahead in its own reforms followinga string of child deaths. Babcock, whose Institute for Child Welfare was created to make Florida reforms research-based, told the State Journal one the biggest hurdles to success is the lack of a systemic response. Agencies "work in silos and the money doesn't follow the child," she said.
Michigan's answer is Kent County.

Currently, DHHS pays private agencies based on the amount of time kids spend in foster care. In Kent County, the state will experiment with payments based on results, such as getting kids into safe homes more quickly.

The five private agencies in the pilot are developing a broader, more collaborative way of serving kids, a model they've likened to a shopping mall. The agencies are the anchor stores but "kiosk" groups readily offer mental health, substance abuse treatment, homelessness prevention or other services.

"The idea that we have to do a better job at prevention to control costs is also good for children," said Jim Paparella, president and CEO of the Grand Rapids-based D.A. Blodgett–St. John's, one of the agencies in the pilot. "That's kind of the grand design."

State Rep. Earl Poleski, R-Jackson, who chairs the House human services spending committee, said the state must ask more of local communities because "ultimately, government cannot be mother and father to everyone, and adults have to take responsibility."

By the numbers






141: Number of children in foster care who were abused or neglected between April 1, 2013 and March 31, 2014. That's down from 230 kids mistreated in the October 2009-September 2010 reporting period, but higher than 111 reported between October 2007 and September 2008.

99.35%: The share of Michigan foster kids who were safe from harm in the 2013-2014 period, shy of the federal standard of 99.68%. But 99.62% of foster kids were safe in the 2007-2008 period.
74: Number of foster parents who were perpetrators of abuse or neglect in 2014. Nearly 22,000 biological parents perpetrated abuse that year.

14.9: The rate per 1,000 of all Michigan kids up to age 17 who were confirmed victims of abuse or neglect in 2013, up from 12.9 in 2009. The national rate fell in that time.

Sources: Michigan Department of Health & Human Services, Annie E. Casey Foundation Kids Count Data Center

A timeline of reform





Halving caseloads, thereby doubling the amount of time foster care workers can spend with children, has been one of the most affective reforms to keeping Michigan foster kids safer, state and private agency officials said. But that's one of many reforms implemented over the past decade:

2005: Mandated reporter hotline created for streamlined reporting of suspected abuse or neglect.

2009: Maltreatment in Care Unit created within Child Protective Services for specialized
investigations of abuse or neglect in foster care. Also created was the Children's Services' Data Management Unit, to gather and analyze data in a more timely and accurate manner.

2011: Implementation of MiTEAM, a new case practice model for child safety. Following a review in 2013, the model was enhanced and continues to expand.

2012: A centralized intake hotline for reporting abuse and neglect was created. Also, a policy prohibiting corporal punishment in foster care implemented.

2013: Work begins on a pilot in Kent County for performance-based foster care funding.

2014: A pilot Safety Planning Practice Initiative launched in Ingham County, testing the use of "predictive analytics" for early intervention in maltreatment cases. New training for safety assessments and planning was implemented. And a new quality assurance process was implemented to gauge quality of services provided to children and families.

Source: Michigan Department of Health & Human Services

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