Profitable Investing In Foster Care & Age Out Before They Die

Before you delve into the latest Watergate2 video of the day, I am going to set up this as a conundrum wrapped in an enigma.

So, if there is a significant spike in the deaths of youth in the U.S. over the few years, and we know there is a direct link to poverty, opioids and child trafficking, then that would mean the current national policy climate ain't doin' too swell.

So, instead of investigating why youth who age out of foster care end up homeless, selling themselves to eat for the day, becoming victims of the opioid industry, these Faith Based Initiative Funding groups partner with another NGO to come up with another layered fraud scheme to "follow the data".

Yes, this is just another money making predictive modeling hustle, brought to you by privatization.

Child Trends for the Children’s Home Society of Virginia and Better Housing Coalition addresses absolutely nothing about the failures of the entire concept of foster care and adoption, yet does an extremely weighted bias of holding its slimey fingers on the scales of justice for youth and the future of humans by pumping up its predictive modeling hustles it will eventually diffuse across the nation and, eventually, across the globe, in its ventures privatization and social impact bonds, of which they do in the name of the tax exempt God.

Just another Faith Based Funding Initiative child welfare operation of human trafficking.

Supporting Young People Transitioning from Foster Care: Virginia Findings from a National Survey and Policy... by Beverly Tran on Scribd

The acquisition of children in predictive modeling developed in parallel tangent with child welfare fraud schemes to fund political campaigns to elect public officials who are bereft of any economic acumen when it comes to the well being of anyone execpt themselves.

But the age out foster care population is ripe for the targeting, as witnessed in this Jim Casey Youth Opportunities Initiative 2013 Report, of which we know the benefactors want a profitable return on their social impact bond investments.

They are selling humans right under the noses of the public, and the neither has the FBI nor DOJ have done a damn thing about it.

ISSUE BRIEF: COST AVOIDANCE The Business Case for Investing In Youth Aging Out of Foster Care May 2013 by Beverly Tran on Scribd

It is time to end the propaganda and the fraud.

Stop snatching kids and you might find you will not have youth aging out of foster care.

Better yet, dismantle the entire child welfare system and if you ask the same, inane question of "What are they going to do with all those abused and neglected children", I am going to refer you to the answers provided when the same questioned was posed in the argument against the Emancipation Proclamation - "What are they going to do with all those ex-slaves?"

No one should ever have to experience such horrors in life, let alone a child, for the purposes of maximing revenue in Medicaid fraud and asset seizures, because when these youth die, guess who the beneficiaries are to the life insurance policies and trust funds?

It ain't the youth.

Virginia life outcomes for age out foster youth 2015, it is even worse, 2018.

Virginia has high percentage of youth aging out of foster care

 Dominique Bryant became homeless when she was 17.

Now 23, Bryant was placed in foster care in New York immediately after she was born. She was adopted when she was 10 and moved to Charlottesville with her adoptive mother. But when Bryant was 17, the mother terminated her parental rights.

Bryant went to a foster family and then to a psychiatric clinic to be treated for depression. After that, she said, the foster family didn’t want to take her back.

“Because I was right on the cusp of 18, there weren’t many options for me,” Bryant said. “I was placed in a sobriety house, even though I wasn’t an alcoholic.”

Residency in the home was contingent on attending regular meetings. Bryant missed one, because she couldn’t get transportation. She lost her place and spent four months homeless in the Charlottesville area. The outcome that Bryant faced as a result of aging out of foster care without achieving permanency — being adopted or finding a permanent foster placement — is common.

According to the results of a national survey conducted by Child Trends for the Children’s Home Society of Virginia and Better Housing Coalition, 20 percent of the people who age out of foster care are homeless within two years. Twenty-five percent are incarcerated, 42 percent drop out of school and 71 percent of the women are pregnant by age 21.

The report estimates that if this population graduated from high school at the same rate as the general population, they would earn $1.8 billion more over their working lifetimes and contribute $430 million in additional taxes.

The results of the survey, released Nov. 14, also show that Virginia has one of the highest percentages of youth exiting foster care due to aging out — 20 percent compared to 9 percent nationally.

YOUNG AND HOMELESS

Meghann Cotter, executive director of Micah Ecumenical Ministries, a faith-based nonprofit that supports the Fredericksburg area’s homeless population, said she has seen the number of homeless youth increase in the 10 years she’s worked at Micah.

“When I started, the faces of those we were seeing were drastically older and sicker — more what you think of when you think of ‘homeless on the street,’ ” she said. “But in the last three or four years, the faces have become drastically younger.”

Between July 1, 2015, and July 1, 2016, the homeless services system in Planning District 16, which includes Fredericksburg and Stafford, Spotsylvania, Caroline and King George counties, served 162 clients between the ages of 18 and 24 — 12 percent of the total population served.

“They bounce around with friends or whatever, and they’re OK for a while,” she said.

But she said research shows that 85 percent of former foster-care youth have experienced some kind of trauma.

“So not only are they lacking the life skills that all 18-year-olds lack, but they’re also dealing with a lessened amount of coping skills as a result of trauma experience, and they have no social support system to wrestle with that,” Cotter said.

Though 18 is the age of legal adulthood, research quoted in the CHS report shows that the brain continues to develop through age 25. Today’s young people tend to rely on their parents for emotional and financial support well into their 20s. When kids don’t have a built-in support system, bridging the gap between adolescence and adulthood is that much harder.

“For a lot of kids, the first year of college is tough,” said Gail Crooks, director of the Spotsylvania Department of Social Services. “But you bounce back to mom and dad. When you don’t have a safe place where you can go to come back from tough spots, they just have a cumulative effect.”

In 2016, 464 foster-care youth aged out of the system in Virginia. Those figures have the potential to grow, as the number of children in foster care nationally grew by 8 percent between 2011 and 2015, possibly due to the opioid epidemic — which was declared a national public health emergency in October.

Bruin Richardson, chief advancement officer at Children’s Home Society, said there are a number of reasons why Virginia has higher numbers of youth leaving foster care without being adopted.

“One is that we’re a county-administered system, and that creates some barriers that make it more difficult to get kids adopted,” he said in a phone interview. “Also, kids tend to be older when they come into the system in Virginia than the national average. What that results in is they may have more significant trauma and then they really are teenagers before they become eligible to be adopted.

And its harder to place those kids.”

In 2014, the proportion of older children — ages 16 to 20 — in Virginia’s foster care system was larger than it was for the nation as a whole, the CHS report shows.

Crooks said that, anecdotally, kids tend to be 10 or 11 years old when they come into foster care in Spotsylvania.

“In Virginia, we try very hard to maintain children in their home,” she said. “We try to support the family to stabilize it. So when we do come in, we’ve exhausted a whole lot of options, and kids are coming in with higher levels of need.”

“We try to prepare our kids, because we know there might be challenges to permanency,” she added.

EXTENDING HELP

Virginia is one of 36 states that elected to extend foster care services beyond the age of 18. Last year, the state introduced a new program, Fostering Futures, which went into effect July 1, 2016, for people who turned 18 on or after that date. It uses federal Title IV-E funds to extend care past the age of 18, so youth in successful foster home placements can stay there. They can stay in contact with their case managers or receive stipends for rent and groceries.

However, Fostering Futures is an opt-in program, and young people often don’t choose to opt in, leaving the system before the mandated cut-off age.

Richardson said this was one of the most surprising findings of the CHS report.

“Maybe it shouldn’t have been a surprise to us, but even in states where there are programs for youth through the age of 21, in the vast majority of those states, the majority of youth are opting out of those programs at 18 or 19,” he said. “And that was eye-opening.”

Crooks said that many kids who have been in the foster care system for years choose emancipation as soon as they are able because they just don’t want to be connected to social services anymore.

“Sometimes, all they want is distance,” she said.

She thinks it would help those kids to hear from their peers.

“They need to hear from someone else the value of it,” she said. “They need someone to help them see down the road and see how staying associated with us can help them get to their tomorrow.”

Crooks said she would love to set up a body of mentors from the local community to act as cool, caring aunts or uncles to older foster care kids.

“It would be like Big Brothers/Big Sisters, for anyone who wants to sign up to be a mentor or who has something these kids respect,” she said. “Like the mom of your best friend that you can talk to when you can’t talk to your mom.”

Another way to fight the problem of youth aging out of foster care is to find more families willing to foster or adopt teenagers, and adequately supporting those who do.

Cotter said she’s seen kids at Micah’s cold-weather homeless shelter who were dropped there by their adoptive parents.

“The parents are just done, for whatever reason,” she said.

Crooks said it is very difficult to place teenagers in adoptive homes, especially when the teens have years of traumatic experiences behind them.

“So that’s building block number one — beefing up resources for families willing to take older kids,” she said.

Richardson said another crucial step is improving access to affordable housing.

“It’s very difficult to take advantage of those programs that may exist if you’re trying to figure out where your next meal is coming from and whether you will have a roof over your head tomorrow night,” he said. “These are young people who have almost uniformly been victims of trauma. They’re already in survival mode, and then when we don’t do things that will help provide housing, they lack the stability to get beyond that.”

TAPPING POTENTIAL

Taylor Landrie, director of the Great Expectations program at Germanna Community College — a statewide, grant-funded program that helps current and former foster youth transition into college — said supporting former foster care kids can be as simple as giving them lots of pep talks.

“These kids are just the most resilient, intelligent, tough individuals I’ve ever met,” Landrie said. “They have this huge amount of potential to be incredibly successful. They already have the life skills, they already have the grit and tenacity that they need to be successful in college, but in some cases, no one has ever told them that they’re smart or ever told them they were college material or that they can do anything they want to.

“When we support these students, they’re able to reach their own academic goals and support themselves and their families,” she continued.

Tiffani Beissel, 21, is one student who benefited from Great Expectations. She was placed in foster care at age 14 in her birth state of Missouri, and though she was adopted by a friend’s family when she was 15, that situation didn’t work out, she said. She moved in with a boyfriend, but he was abusive, and she moved to Virginia to get away from him.

“There have been so many times when I wanted to give up,” Beissel said. “When you don’t have anybody to love or care for you, it’s easy to just give up.”

But Beissel knew the statistics about former foster youth and didn’t want to become one of them. She said her resilience saw her through. She now lives with her aunt and uncle in Caroline County and will graduate from Germanna in May with an associate degree and a specialization in psychology.

Bryant also has benefited from Great Expectations. She’s now pursuing an associate degree in early childhood education and has found a stable home in Locust Grove with a member of her church.

CHS has put together a task force made up of experts in affordable housing, foster care, child welfare and education, as well as Virginia delegates and senators and aged-out foster youth, to make policy recommendations for improving access and services to youth aging out of foster care.

The task force aims to complete its work in mid-2018.

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Congressional Candidate Shaun Brown Indicted For Child Welfare Fraud

Having previously recognized the bottom up pattern of investigation, I recalled a previous post on the targets of child welfare smaller programs by the FBI.

FBI Begins To Take Down Child Welfare Fraud Programs In Collaborative Conjugations 

I have been pontificating on the use of child welfare funding going into political campaigns for the tenure of my blog.

As always, I had to analyze the original documents.

The FEC issued a letter calling for disavowment of using funds from a third party to fund a politcal campaign.

She probably charged food for campaign events to the USDA program.

Looking at her campaign committee funding for the 2016 cycle, below, she did not raise very much money, but did nake an odd contribution herself, in the FEC filing, below.

I will bet anything she was what I like to call a prop candidate.

The DNC is notarious for this type of surrogate action.

They pick someone out the blue who they know will be fully complicit to whatever the party tells them to do because they will be elevated to the ranks of a community queen, finally achieving being chosen to go to the promised land of a better financial lifestyle.

In order to be recognized and blessed by the party, you must first demonstrate that you can raise money.

I call it distraction of the pretty shiney trinkets because all I found was a facebook page for the campaign, making this a low budget hustle.

This woman did not have the financial acumen to raise money.

She was used as a patsy.

Then, as she is busy studying her DNC talking points, like a good little girl, the operatives come out the cyber woodwork and set up money laundering operations because they know the FEC is ill-equipped to do very much.

I wonder how much they raised behind her back and not even report.

All I am saying is that there is more to this story than just ripping off sandwiches from the kids.

Come to Detroit.

Congressional candidate Brown indicted for fraud, theft

Shaun Brown, Democratic Candidate for the U.S. House
of Representatives, Virginia, District 2, 2012 

A federal grand jury has indicted Democratic congressional candidate Shaun Brown on charges of fraud and theft of government property.

The indictment alleges that Brown and others with JOBS Community Outreach Development Corp. filed fraudulent claims with the Summer Food Service Program in 2012, the U.S. Attorney’s Office for the Eastern District of Virginia said.

Brown, meanwhile, has gone to court herself, accusing the U.S. Department of Agriculture, the state Department of Health and several officials of discriminating against her and the organization she co-founded with her mother, Jenever Brown, which ran the summer feeding program for children.

“This is about making sure there are no hungry children in Hampton Roads,” she said.

Brown ran for Congress in 2016, losing to Rep. Scott Taylor, R-Virginia Beach, by nearly 23 percentage points.

She is again seeking the Democratic nomination for the 2018 race.

The indictment says that Brown directed JOBS staff to inflate the number of children actually fed and to falsify documents in order to obtain additional money, according to the U.S. Attorney’s Office.

She has been charged with wire fraud and theft of government property, and faces a maximum penalty of 20 years in prison if convicted.

“We will vigorously defend. She maintains her innocence,” said her attorney, Jimmy Ellenson.

He said there’s been “a longstanding dispute between her and the feds about this whole thing,” adding that the timing of the criminal complaint seems unusual, given Brown’s own recent lawsuit.

“And why would they do this right before Christmas?” he asked.

In the lawsuit, which she filed without a lawyer, Brown says she and her mother filed a civil rights complaint against USDA alleging the agency’s summer food program discriminated against them.

The lawsuit says the USDA, state health department and five officials unlawfully delayed payments, and falsified reimbursements and claims for reimbursements.

Brown alleged that USDA officials in 2016 derailed JOBS’ efforts to secure financing to “satisfy its prior financial commitments for 2012, outstanding bills from the summer of 2012 and $625,000 to purchase” a restaurant that the company hoped to use as a central kitchen for its summer feeding programs. Her lawsuit says that calls from state health officials to a funding group and to her supplier upset agreements JOBS hoped to arrange. It adds that the state’s designation of JOBS as a “high risk auditee” after 2012 cut it out of the summer program. The lawsuit says the state has falsely claimed JOBS was involved in fraud.

The suit seeks $10 million in damages.

Brown asked the U.S. District Court in Alexandria to appoint an attorney for her, but Judge Liam O’Grady denied the request, saying that the exceptional circumstances that allow judges to do so in civil lawsuits did not exist in her case.

Her campaign finance reports with the Federal Election Commission show she’s raised $713,491 as of the end of October, all but $2,750 of which came from her. She said most of that was in the form of stock in her company. The FEC report shows she has no cash on hand in her campaign account.

Democratic Candidate for U.S. House of Representatives, Virginia, District 2, 2012 Shaun Brown, FEC Disavow... by Beverly Tran on Scribd

BROWN, SHAUN DENISE

Candidate Details

From: 03/01/2016  To: 12/31/2016

CANDIDATE INFORMATION BROWN, SHAUN DENISE Office: HOUSE Party: DEMOCRATIC PARTY Election: 2016 State: VIRGINIA District: 02 FINANCIAL SUMMARY From: 03/01/2016   To: 12/31/2016 I. RECEIPTS Itemized Individual Contributions $16,052 Unitemized Individual Contributions $12,261 Party Committees Contributions $0 Other Committees Contributions $1,750 Candidate Contributions $102 TOTAL CONTRIBUTIONS $30,166 Transfers from Authorized Committees $0 Candidate Loans $2,480 Other Loans $0 TOTAL LOANS $2,480 Operating Expenditure Offsets $0 Other Receipts $0 TOTAL RECEIPTS $32,646 II. DISBURSEMENTS Operating Expenditures $23,428 Transfers to other Authorized Committees $0 Candidate Loan Repayments $2,480 Other Loan Repayments $0 TOTAL LOAN REPAYMENTS $2,480 Individual Refunds $2,674 Political Party Refunds $0 Other Committee Refunds $0 TOTAL CONTRIBUTION REFUNDS $2,674 Other Disbursements $5,266 TOTAL DISBURSEMENTS $33,849 III. CASH SUMMARY Ending Cash On Hand $4 Net Contributions $27,491 Net Operating Expenditures $23,428 Debts Owed By $3,050 Debts Owed To $0

Shaun Brown For Congress 2017 FEC Itemized Contribution $674,157.50 by Beverly Tran on Scribd

Voting is beautiful, be beautiful ~ vote.©

Bringing Them To Heel: The Residuals Of The Peculiar Institution

This is a work by the artist known as Chill EB.

Instead of whips and chains, we now use chemical constraints, which are billed to Medicaid, whether needed or not.

The industry of child welfare is a perfect example of what happens when there is no regulation.

Sure, there are a few, minuscule unenforceable rules on the books to make it look legitimate, but, in essence, child welfare functions with certain immunities.

I am quite sure there are only a handful of individuals who have witnessed an honor roll child being drugged to the point of palliative care, where, if one complains of the beatings and rapes which ensued, parental rights would be terminated and the child would linger in the state of care until the age out, to live a life on the streets.

If there is be a better way, first and foremost, define better.

 

Psycho/pharma spends billions of dollars a year marketing mental 'disorders' & drugs for kids- proper terminology is child abuse propaganda -- yet these drugs are documented by international drug regulatory agencies to cause mania, psychosis, hallucinations, suicide, violence, homicidal ideation, heart attack, stroke and death. What's more, they are being prescribed for psychiatric disorders that are simply a checklist of behaviors. Get the facts here http://www.cchrint.org/psychiatric-disorders/

Voting is beautiful, be beautiful ~ vote.©

The Privatization Of Child Welfare: The Democratic Ticket

This is a snapshot of things to come under a Clinton presidency:  Child Welfare 2.0.

The current discussions to change child welfare funding #HackFosterCare is pushing for predictive models.

How can you predict behavior.  You cannot.  But you can make it lucrative enough that people do not question.

Child poverty is a crime on the books as the "failure to provide for the necessary needs of the child".

This is Tim Kaine's wife who works in child welfare:

Meet Tim Kaine’s wife, a longtime child welfare advocate and Virginia’s secretary of education

This is why child welfare has been excluded from the DNC platform:  they already have a plan and thy name is privatization.

Kaine's crime-busting past may hurt Clinton's outreach to blacks

Democrat Hillary Clinton's pick of Tim Kaine as her vice presidential running mate could hamper her efforts to reach out to African-American voters because of Kaine's past embrace of crime-fighting strategies that have driven up the U.S. prison population and are unpopular in the black community.

The now-defunct Project Exile that Kaine backed was so unusual it was championed by Republicans and Democrats alike and by both the top U.S. gun lobby group and gun-control advocates. But the federal program launched in 1997 in Richmond, Virginia, was also criticized at the time as a racially biased initiative that condemned young black men to lengthy prison terms.

Clinton has come under fire herself from black activists for her past support for tough-on-crime policies of the 1990s now blamed for a surge in U.S. prison population and heightened tensions between law enforcement and black communities.

One of her fundraisers got disrupted earlier this year by activists who asked her to “apologize for mass incarceration.”

Clinton named Kaine as her running mate late on Friday, making what is considered a safe choice for her battle against Republican presidential rival Donald Trump.

As Richmond mayor from 1998 to 2001, Kaine, 58, was a vocal supporter of Project Exile, crediting it with reducing the city's murder rate.

Its goal was to literally live up to its name by making illegal gun possession a federal, not a state, crime, which allowed prosecutors to send convicted felons, most of them black, to a distant federal penitentiary for at least five years.

Sam Sinyangwe, co-founder of Campaign Zero, a group focused on curtailing police violence, said Kaine's choice could exacerbate Clinton's problems rallying support of African-Americans, particularly younger people.

"To select somebody like (Kaine) is not a sign of good leadership potential in a president," Sinyangwe said.

Nicole Lee, a civil-rights lawyer and activist in Washington, D.C. who is African-American, also expressed concern.

“Project Exile broke black families," she said. "This is not a benign thing to be for. These measures were not used against white kids in the suburbs with guns, they were used against black kids in the cities.”

DRAMATIC TIMES

To defeat Trump in the Nov. 8 presidential election, Clinton needs high turnout among blacks and other minority voters to offset Trump's popularity among white voters.

During the 1990s, she supported tough-on-crime initiatives backed by her husband, former President Bill Clinton, but now vows to "end the era of mass incarceration."

Her campaign is trying to walk a political tightrope after the killings of two black men by police and the shooting deaths of police officers in Texas and Louisiana. She has offered support for the Black Lives Matter movement, while also strongly condemning the killings of police officers.

Officials who were in Richmond during Kaine's mayoral tenure believe the community, ravaged by the crack-cocaine epidemic and an escalating murder rate, had to take dramatic steps. Amy Dudley, a spokeswoman in Kaine's Senate office, said the senator stood by the program, believing that it reduced gun violence.

Jerry Oliver, the police chief at the time and an African-American, said the program focused on black communities out of necessity. “We had to be where the problems were,” he said.

The National Rifle Association, the nation’s biggest gun lobby, was an early proponent of Project Exile as was the gun-control advocacy group Brady Campaign to Prevent Gun Violence.

As Richmond's first white mayor in more than a decade, Kaine was widely credited for helping to bridge racial divisions in the city, but Project Exile drew fire from defense lawyers and community advocates who argued that the program unfairly targeted African-Americans.

Kevin Ring, vice president of Families Against Mandatory Minimums, a Washington advocacy group lobbying against federal sentencing minimums, said that Kaine, like Clinton, will have to demonstrate to black voters that he has "evolved" on the issue.

"There are some that will be bothered. There will be questions," Ring said.

Kaine supports legislation that would roll back some mandatory minimum federal sentences and give judges more discretion, although his office says he still supports firm sentences for illegal gun possession. Kaine's backing of Project Exile also makes him odd bedfellows with Trump, who has made law and order a central theme of his candidacy. Trump has called for the program's revival and his campaign website said it was "tremendous."

Voting is beautiful, be beautiful ~ vote.©

Defensive Medicine in Child Welfare Found To Be Fraud Scheme

With the continuous lack of oversight and enforcement in children's health care programs funded through Medicaid, children suffer as privatized contractors reap the financial benefits of false claims.

On of the largest areas for Medicaid fraud, waste and abuse is in Targeted Case Management, particularly under the foster care programs.

Reimbursements are submitted by phantom and ineffective children's programming to provide non-existent health care services and/or extremely poor quality services, by persons who are not qualified, to justify the billing of more extreme and unnecessary evasive medical procedures, more readily recognized as defensive medicine.

As there is little or no redress or recourse for children under the auspices of the state who have been harmed by the relevant aforementioned Medicaid fraud scheme,  the pattern of practice continues, as does the false claims.

There is no medical malpractice liability in child welfare.

U.S. House Judicial Committee recently addressed the issues of the practices of defensive medicine in regards to Medical Malpractice Liability.  Unfortunately, nothing was mentioned regarding States Child Welfare Medicaid Programs.



Stay tuned...

Medicaid pays more, kids get less, audits show

Turning in-home and in-school treatment of some of Virginia's most troubled kids over to private providers has resulted in ballooning Medicaid costs, overbilling and treatment by unqualified staff.

Many of the hundreds of firms that jumped into the business also treated children who weren't really eligible for service, according to state records, obtained after repeated Freedom of Information Act requests to the Department of Medical Assistance Services.

Many children were not properly assessed. Providers didn't prepare formal treatment plans and didn't keep progress notes. Providers commonly claimed to provide service in improbable circumstances, including lengthy sessions of up to five hours for young children, as well as treatment after 11 p.m. and on holidays, the records show.

"It's very clear some families and children didn't get the services they needed," said Lester Saltzberg, director of licensing at the Department of Behavioral Health and Developmental Services.

It wasn't for a lack of spending by Medicaid — the joint state and federal health care program for the poor and disabled that's been struggling for years with limited funds.

Medicaid's expenditures on the in-home service has grown 250 percent since 2006, to reach $176.5 million, according to data compiled by the House of Delegates' Appropriation Committee. Just last year, as the state began auditing providers, spending rose 20 percent, according to Medicaid's own data.

Spending on the day-treatment service, generally delivered in schools when children are not in mainstream classes, rose by 418 percent, to $144.9 million. Even after auditing started last year, this spending rose 28.5 percent.

An outside auditor's review of 70 providers' 2008 operations identified $14.9 million of questionable payments. The state attorney general's office prosecuted three cases involving more than $4.6 million of fraud.

"Given the number of new providers and the focus on providing services to children in the community, increasing expenditures were expected," said Medicaid spokesman Craig Markva.

He also said the services were overused as some providers misinterpreted who was eligible and what exactly was required of them.

In July, Medicaid started using a firm to check whether particular children actually need the service for authorizing payment. It strengthened requirements for staff qualifications in September, Markva said.

The two services used to be offered through community services boards, the state's local mental health agencies, usually with staff who held master's degrees or had several years of experience.

In a bid to expand the service, the state opened the service up to private firms three years ago — but didn't update regulations, which meant the private firms could legally send people with only high school diplomas to do clinical tasks in homes and schools, said Saltzberg, at the behavioral health department.

At the $70 an hour Medicaid was paying for the two services, the boards were breaking even on the services provided by their professionals.

But the $70 rate looked like a business opportunity in the private sector. Hundreds of firms signed up for the work — 401, up by nearly 200 in the past two years — and many hired staff with minimal qualifications.

And with nobody in state government checking who the companies were serving, the number of children and families in the system rose too — many were children who were more appropriately served with other kinds of outpatient services, for which Medicaid pays public and private providers $46 an hour, Saltzberg said. It's been tough to keep those programs going, financially.

In one case, Denise McCreary, a suburban Richmond provider billed Medicaid for:

Services the city's Behavioral Health Authority actually provided one child.

Services for three boys, telling Medicaid they were seriously disturbed while telling their guardian she was providing them a Big Brother program. One of the boys was an honor roll student; none had been diagnosed with a mental health issue or been found to be at-risk youth.

Therapy provided a 6-year-old and a 7-year-old, which turned out to be one trip to a Chuck E. Cheese restaurant and another to a city park. Their guardian thought McCreary was providing a Big Brother/Big Sister program; neither of the two were considered at-risk children.

A federal judge last fall convicted her of defrauding Medicaid of $601,580 over a 10 month period.

"The aim was to expand access," Saltzberg said. "But if you expand access without looking at how you regulate, there can be unintended consequences."

Virginia Medicaid Program Costs and Trends 2010

Most Medicaid Children in Nine States Are Not Receiving All Required Preventive Screening 2010