Wednesday, December 17, 2008

The Second in a Series of Seven Stories

A .K. was first admitted to Hillsides on 4/05/06 and was discharged on 6/5/07. When A.K. entered Hillsides, he was morbidly obese, weighing more than 148 pounds. When he was discharged a year later, he had dropped to 122 pounds through a combination of diet and intensive exercise supervised by the nursing and recreation departments. While still overweight, his general health had improved dramatically. Upon his re-entry into Hillsides’ residential program in July of this year, after having been removed, he weighed 226 pounds.

At the time of discharge, A.K. was still not stabilized, although he had been doing better. Hillsides’ advocates were opposed to the discharge both for his fragility, and also because his mother had barely been released from jail and had not received services to help her deal with this boy. The Los Angeles County’s Department of Children and Family Services made the decision to move him with no input from Hillsides. It wasn’t until Hillsides’ intervention that the County agreed to a post-discharge Team Decision Making meeting (TDM). (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.)

At that point, Wraparound Services were initiated and provided by Hillsides’ team. A.K. did not do well at home, and his mother was not effective. (Wraparound is a program where the process of creating safe places for a child includes wrapping support services around the child and the entire family to increase the possibility of successful outcomes). He was readmitted to Hillsides on 7/22/08.

REFLECTION
1. Have a TDM that would include the mother in the planning process
2. Set up a plan that would insure that she was established back into the community with a job that could support A.K. (the mother and son were homeless when he returned to Hillsides).
3. Provide Wraparound services well in advance of his returning home

CONCLUSION
1. Family involvement in the treatment process is a key factor.
2. A plan for discharge agreed by all parties, Hillsides, 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.)

Friday, December 12, 2008

Where is the Bailout for Charities Serving Children and Families?

Teresa De Crescenzo, Executive Director of GLASS Youth and Family Services, wrote an excellent opinion article for the Los Angeles Times where she asks “Where’s the bailout for non-profits?” She continues, “The stock market is in free fall, financial organizations are being bailed out and the Detroit automakers may yet get financial help from Washington. But what about those of us in the non-profit world? Where’s our bailout?” I salute Ms. De Crescenzo for expressing what many of us who devote our lives to helping others feel.

The State of California is enmeshed in their own fiscal meltdown it appears that it will not be in a position to help non-profits for many years. In fact, the exact opposite has been and is occurring. As the Executive Director of a major residential treatment center for children in foster care and families, my Board and I struggle to give abused, neglected and abandoned children the treatment that they need and deserve. Despite the fact that the State has failed for years to cover the costs of these comprehensive services, we continue to treat thousands of children and their families each year with a system of funding that has only given Hillsides an increase of 5% after more than five years of flat funding---not even an annual cost of living increase.

In effect, charities like Hillsides and the clients we serve have been burdened almost to the breaking point while we as a society are willing to bailout corporations who are now experiencing the aftermath of their own mismanagement and greed. Where is the equity for those children who are unfairly being accused of depleting state funds due to an increase in demand for the free lunch programs, as reported in the Pasadena Star-News on December 4? Where is the fairness for those children who are suffering due to the cuts in educational support or whose families have had their child care subsidies slashed?

If I sound angry and frustrated, I am. Everyday, I see firsthand the suffering and challenges people face—particularly the children in foster care who have no voice. Out of a commitment to create safe places for children and families living in Los Angeles County, the Board of Hillsides continues to take the position that rather than cut vital services, our charity is using our limited financial reserves to manage this downturn in the economy. Our reserves are not an endless source of revenue and, frankly, I do not know how much longer we will be able to continue doing this. A non-profit’s only alternative when funding is not available is to turn desperate people away, as we have no bailout to fall back on.

If the choice is between sitting on the sidelines willing to maintain status quo or letting children continue to suffer the ravages of child abuse or go without breakfast and lunch or providing assistance to charities, the answer seems simple to me. While many of you might not like the idea of tax increases, I believe this is the only option left open to the State of California. We’ve tried budget cuts with disastrous human consequences, now it is time to consider “Whoever does this on the least of thee does it to me.”

Monday, December 8, 2008

The First in a Series of Seven Stories

THE FIRST IN A SERIES OF SEVEN STORIES: M. R.
This child was admitted to Hillsides on 4/4/06 and discharged on 4/18/07. Prior to coming to Hillsides, this client had experienced multiple failures in school. In addition to poor academic progress, he had behavioral problems, and was a chronic truant as well. At Hillsides Education Center, he achieved stability in both school attendance and performance, developing a particular interest in the industrial arts program. He reduced his aggressive behavior and truancy.
Upon discharge, he went to a group home in San Bernardino to be closer to his grandfather. M.R. was a street-savvy kid who was not a good fit for Hillsides. His grandfather came in regularly for family treatment, but as he lived almost two hours away, it was difficult for him. Although we were not optimistic about M’s prospects for success, his grandfather very much wanted him to be closer to home. We didn’t oppose this plan.

A DCFS Team Decision Meeting was arranged, but because he moved to another group home, aftercare services was not recommended. He left the group home after two or three weeks (he was considered on status AWOL, Absent Without Leave) and lived on the streets for a while. He apparently was placed in several group homes following his sojourn on the streets.

REFLECTION
The plan to move the client closer to his grandfather was a good one. Things DCFS might have done: 1) Explore the suitability of the receiving group home for this client, and 2) Had a Wraparound provider involved with the transition with a goal of placing him with the grandfather. (Wraparound is a program where the process of creating safe places for a child includes wrapping support services around the child and the entire family to increase the possibility of successful outcomes).

CONCLUSION
1. Family involvement in the treatment process is a key factor.
2. A plan for discharge agreed by all parties, Hillsides, 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.)

ACTION
See below to find out what you can do to help a child and youth in foster care.