Tuesday, August 18, 2009

Taking a Hard Look at Fixing the Budget

My friend, Charlie, said that he does not think we should give the government more money to solve the budget crisis. He sees raising taxes or throwing money at the problem is the easy solution. I was in an intense discussion with him about what California’s leadership was doing, pointing out that the politicians did not want to raise taxes on those who could best afford it, but instead they “taxed” those who could least afford it by cutting back on the safety net of children, the elderly, the poor, the disabled.

Taxing those vulnerable and who are least able to resist is also “the easy solution.” These individuals are less likely to make the difference in an election and certainly in no position to gather signatures or congregate in protest because they are working too hard to live day to day.

The harder solution would be to look realistically at how much we are being taxed. What is the corporations, businesses and citizens contribution to our tax base? Is it fair, reasonable and equitable? After all, don’t they benefit from the services provided by the state and local government? Is it really out of proportion to the rest of the country? Are we really over taxed for what we get?

What about the waste within our government? I recently wrote about the cost of L.A. County to audit Hillsides’ contract estimated at $200,000 to $250,000 to recoup $37,000 (which we believe is in error). Is there a better, more efficient way to audit? I think so.

How about the number of audits we get from different departments (many times a duplication of what another entity has done), by the state and local governments? We have approximately two audits a month. What about the amount of time and staff it takes to submit an invoice to Los Angeles County?

A business would never stand for this. If I can identify waste in my little corner of business with the County, multiply it by the thousands who do business with the state and local governments. Let’s start at the State and then move to local entities. Do we need all the commissions that we have? Do the legislators need all the staff they have? Are there procedures that could be streamlined or eliminated? I am sure that, taking an honest look, we could preserve the level of services for those vulnerable and still cut costs.

An example of this is our local school district’s new Superintendent reorganized the infrastructure of the district and saved millions of dollars. We should do the same thing across the State and Counties.

But no, the sad thing is our government would rather raise taxes or cut services to those who need them without ever looking at the real culprit.

Thursday, June 4, 2009

DCFS Chooses Procedures over Substance

Recently the Department of Children and Family Services has been working on a pilot program to demonstrate that children will fair better if the residential treatment program includes parents in all phases of the child’s experience while in residence. In addition, the residential treatment program will follow the child’s return to the parents. It makes sense: the residential treatment program that knows the child in residence is better equipped to help the parents when the child returns home.

So I was hopeful that when Hillsides wraparound program was referred a child from another residential treatment center that DCFS would be open to and refer this child back to that residential treatment program for the follow up wraparound service. This was in line with this new movement of “the program that has the child in residence is the program that follows him home.”

I was wrong to assume that DCFS would follow sound substance over procedures.

It turned out that DCFS was not used to an agency turning down business in favor of another agency doing it. There was no clear cut procedure, so my attempt to refer the child back to the original agency was bungled and DCFS reaffirmed their decision to have Hillsides do the wraparound service.

Further attempts to get DCFS to “act in the best interest of the child” were ignored, in favor of following the proper procedures. This back and forth took four weeks of negotiations. Hillsides reluctantly opened the case when DCFS refused to reconsider, even though some of their administrators believed that it probably was in the best interest of the child for the other program to provide the wraparound services.

A few months ago, I praised DCFS for doing a study on the re-entry rate of children placed into the community from foster homes, kinship homes and group homes. It was an honest look at their practices and it came out of their concern that their re-entry rate rose from 4% to10% over a three year period. One of the major findings was that “there is a lack of after-care services to provide ongoing formal and informal support.”

What is most troubling about this situation is that, on the heals of releasing this report, the Department is unable to bend over backwards, jump through hoops, do what ever it takes to do what is clearly “in the best interest” of one of their clients.

Monday, March 16, 2009

The Final Story in a Series of Seven Stories

T.C. had been neglected from infancy. Lacking in self-esteem, she had no hygiene or self-care abilities, and reacted with angry resistance to all efforts aimed at parenting her. Through patience, kindness and structure, her cottage staff achieved remarkable results and T. developed not only age-appropriate social skills, but a sense of her self-worth.

Admitted 3/27/03 and discharged 5/17/05; readmitted 11/02/05 and discharged 7/21/06; readmitted 11/19/07 and discharged 6/27/08. Hillsides staff was not in favor of any of these discharges. T is very unstable. She was discharged the first two times to a previous foster mother who was very uncooperative and was not amenable to services either before or after discharge.

During the third stay at Hillsides, a P3 worker located relatives of her mother in Pennsylvania. T had never met these people. DCFS sent her for a visit on Spring Break in 2008, and by 6/08, had cleared the home as an acceptable placement. Our request to keep her bed open was denied. In less than 2 weeks, the relatives called child services in Pennsylvania and they removed her from the home. Shortly thereafter, she was returned to California and is currently living in a foster home in Los Angeles County. The Los Angeles County Department of Children and Family Services child social worker made it clear upon our inquiry that Hillsides was not an option for placement again. We have no reason to think she will be any more successful in this home than in the others.

1. Back in 2003, LA DCFS should have conducted a TDM that would address her needs and the support services she would need in transitioning to a new placement. (A TDM meeting is an opportunity for all interested parties in the life of the foster care child to convene and address his discharge and treatment plan for a successful replacement.)
2. The County should never place a child with a foster home that will not be open to supportive services.
3. When considering a new placement out of state have some graduated visits which get longer each time to determine the suitability of the fit. Note, this might be expensive, but would cut down on the trauma of the child involved.

Supervisors comment:
This was a very unstable plan. I am worried about the outcome. This mother has a history of serious problems, and she had very little in the way of pre-placement services. She is also extremely resistant and suspicious, making it difficult for her to make use of the services that were offered.

1. Family involvement in the treatment process is a key factor.
2. A plan for discharge agreed by all parties, Hillsides, LA DCFS, the child and the family is necessary for a successful transition. (A plan is not going to work if the child or the receiving party is saying they are not ready.)
3. We should consider mandatory supportive services in the home.
4. Once a plan has been agreed upon, there should be some benchmarks set to determine the move-in date.
5. As a general rule, the residential treatment agency should provide Wraparound services to the receiving family where ever possible, since they are the ones who know the child and the family. (This would entail an exception to the Service Provider Areas (SPA) specific structure of the Wraparound program, since most residential treatment centers do not have Wraparound programs in all the SPAs.)