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.

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.

The Fifth in a Series of Seven Stories

S. A. was first admitted to Hillsides on 2/07/06 and was discharged to his grandmother and legal guardian 8/27/08. S. came to Hillsides after multiple suicide attempts resulting in numerous psychiatric hospitalizations. While living here, program staff had to intervene repeatedly to prevent self-harm. Over time, these crisis contacts developed into healthy, secure relationships, and the self-injurious behavior gradually disappeared.

They received family therapy during his entire stay, Therapeutic Behavior Services from Hillsides upon discharge and Wraparound from another agency. (Therapeutic Behavior Services offer intensive one-on-one services to children whose needs go beyond a weekly therapy session. Trained therapeutic behavior specialists work with a child in school, in the community, and in the home, devising an attainable behavioral goal, and then meeting with the child to assist him or her in developing the skills to reach that goal. ) In spite of everything, he was readmitted 12/24/08. We have reinstituted family therapy with a new focus.

REFLECTION
This was a case in which Hillsides and the County agreed on the plan. The one thing that “may” have made a difference would have been if Hillsides provided the Wraparound services since we had the relationship with the client and the family. (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, 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.)

Working Together to Resolve Foster Care Concerns

Some good news has developed as a result of sharing the stories of the children in foster care who have re-entered the system after leaving Hillsides. While I have been concerned and writing about the need for the Los Angeles County Department of Children and Family Services (LA DCFS) to take up the issue of children who are moved into homes and then re-enter the system within six to 12 months, another advocate has been looking at the issue. It turns out that one of the Commissioners from the Los Angeles Commission for Children and Families, Helen Kleinberg, has been concerned about the same issue.

She and selected LA DCFS staff have been involved in taking a sample of some of these re-entering clients, studying the issues and listing the causes (not unlike what I have been doing with the children that we have in our program). They have a laundry list of issues that should be addressed. However, two important conclusions they highlighted was the need for a better discharge planning process to be developed and the need for a better way of engaging support services to the families receiving these children be introduced. These are some of the same issues that I identified in the stories of the children who re-entered the system after leaving Hillsides.

Commissioner Kleinberg and the LA DCFS staff working on this study invited a limited group of providers to look at what had been identified and the areas that we thought they should address. It was a most meaningful discussion and, for the most part, their findings reflected our experience. All participants agreed we needed to address a better process for transitioning the children from foster care and group care into the “family homes.” The meeting ended with suggestions of a few more avenues for collecting data and then a commitment to work on developing systems to increase the probability of a successful transition.

I look forward to future meetings of working together with the Department of Children and Family Services in developing those systems.

The Third in a Series of Seven Stories

M.F. was admitted to Hillsides on 4/11/05 and discharged on 7/18/07. M had severe and sometimes violent tantrums at home and in school which led to this youngster’s placement at Hillsides. Intensive use of Therapeutic Behavioral Services helped him develop a number of substitute behaviors as an alternative to having tantrums, which led to experiencing more success in school and on home visits. He also became an avid swimmer, participating in aquatics activities at the Rose Bowl.

The Hillsides therapist worked intensively with his grandparents and his mother although she felt that the DCFS Social Worker’s plan to send him to live with the grandparents was not feasible. The mother was an active substance abuser and clearly unable to provide a home for M. The court concurred that sending M to his grandparents was not advisable, but an aunt living in another county showed up and petitioned the court to let her take him.

The court agreed in spite of his very vocal opposition. As M was very unstable at the time, we recommended that a little more time was necessary to help prepare him. The court discharged him immediately into the aunt’s care. She was opposed to any outside services to help her with him. Within a month, he was back into the system and, as far as we know, is doing well in a foster home.

REFLECTION
1. Outside County and Court should have allowed Hillsides to spend time with County’s social worker in planning M’s movement out of Hillsides.
2. Listen to M’s objections about living with his aunt (after all he has control on how cooperative he is going to be in the placement).
3. See if there are things that would make this aunt more acceptable to M.
4. If there are no alternatives to the aunt’s acceptability of M, explore alternative permanent placements.

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.)

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.)

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.”

In American history women have played a significant role in making our country what it is today. In particular, women addressed a plethora of unmet needs in communities and founded countless nonprofits. Most specifically in Los Angeles County, Deaconess Evelyn Wile envisioned a world where children were safe and nurtured in their homes.

During National Women’s History Month, I wanted to bring attention to Wile’s vision, which has rescued over 35,000 children in 95 years. Founder of Hillsides, formerly the Church Home for Children, a Pasadena foster care children’s charity, Wile saw the devastating affects of death, divorce, desertion, and disease had on children left behind.

Serving children at risk and their families in Los Angeles County, Hillsides follows in the footsteps of its founder who believed in creating safe places for children. Unlike the traditional orphanages of the early 1900s, Hillsides created a cottage concept, an open space home environment where children would experience a normal childhood, share a room with no more than three children, and be cared for by house parents.

Reminiscing, Wile described what was apparent, “I knew there was no money, land or house for such an undertaking--nothing but five hens which a friend had promised me…” With blessings from the Bishop of the Episcopal Diocese of Los Angeles, Wile set forth and purchased the first home in Highland Park in 1913, and in just four years relocated Hillsides to what many children refer to as their safe haven--17 acres in the San Rafael Hills of Pasadena.

Wile continued, “Through the kindness of friends who loaned their cars, we were able to take the children out to the new homesite and allow each of them to turn a little of the sod and thus be in ‘at the beginning.’ We hoped that the lesson of the bare hillside would impress itself upon the children’s hearts and minds, in comparison with what is ‘to come’ through the generous gifts which have been made.”

Today, children continue to turn a little of the sod, tend to the weeds, and discover new life in plants and flowers. In their gardens, they find a peaceful, restful place they can visit to get their minds off of the things that may be weighing on their hearts and minds.

Children living at Hillsides because of their foster care placement or severe emotional disturbances find comfort, security, and trust with our staff. Given intensive treatment combined with recreational therapeutic activities, children begin to thrive and establish connections with adults.

In addition to the residential program Wile founded, Hillsides has expanded its programs and services to serve families in crisis who need support in redirecting their lives to create safe places for their children. We also provide special education and a transitional living and housing program, as well as advocate for children’s rights.

When a man was directed to the home during Wile’s day, he was surprised to hear what Hillsides really was, and said he had “‘supposed those were two real homes--perhaps a father and son were building.’ And that’s exactly what we want them to be--real homes!” Wile recalled.

Wile truly created a real home for children traumatized by their early circumstances. After 95 years, eight homes, and an apartment building, Hillsides remains a true home to 66 children and 20 former foster care youth.

Society Diminishes Value of Children, Especially Foster Care Kids

Over 510,000 children are in foster care nationwide and of those children, about 81,000 are in California. In Los Angeles County, we have more than 37,000 children living in out-of-home placements. For years, Americans have said children are our most valuable resource, our future. Based on recent events that demonstrate the value in which we hold our children, the impact of America’s future is bleak.

A lawsuit was filed in the State of California, on behalf of foster children, because of the poor reimbursement given to foster parents to care for them. Children continue to be the largest segment of our population that lives in poverty. In addition, President George W. Bush vetoed a bill that would make health care available to all children living in America.

Foster parents have been under-funded. In particular, California’s reimbursement rates to foster parents are embarrassing and fall far short in providing the financial resources necessary to give foster parents the ability to provide adequately for our children’s needs. According to a recent report released by Children’s Rights, the National Foster Parent Association, and the University of Maryland School of Social Work, California’s current foster care rates must be increased by up to 61 percent in order to cover the real costs of providing care for children.

As the executive director of Hillsides, a Pasadena-based foster care children’s charity that provides care to children at risk and their families, I have seen families struggle to meet the financial obligations to care for their own children. What agencies are beginning to see now is a decrease in the number of foster parents willing to open their doors to children who have been abused, abandoned, and neglected.

Inadequate foster care rates negatively affect foster parent recruitment and retention, potentially increasing the likelihood that children will be placed in institutions or shuttled from one foster placement to another—and decreasing their chance of finding permanent homes. At Hillsides and in other similar residential treatment centers, we see the devastating affects that multiple foster care placements have on children.

As a society, we are challenged to solve children’s issues and make sound policy. Too often we talk about the problems, but never quite find positive solutions. Or the pen never makes it on the paper to sign sound legislation into law. Or policies are never put into practice. When will we begin to hold elected officials, government administrators, and government agencies responsible for bettering the future of America’s children?

Keeping silent perpetuates this cycle of political ping pong and furthers the abuse these children must endure. In one way or another, society’s silence fosters this atmosphere which greatly devalues our children. I see a society that has misplaced its priorities of caring for our children and is no longer a focus.

Most schools, particularly in the large urban areas, are under-funded and failing to provide educators with adequate tools to teach students. Teachers, caretakers, and childcare workers are poorly paid and not given the tools they need to be successful with their charges. We have not wanted to pay higher taxes to improve children’s situations. We have argued for years about the cost of universal healthcare without considering what the denial of such a program does to the children and families in need of it. We protect the gun lobbyists, while our children are shooting each other on the streets. We ignore the devastating affect of drugs and alcohol on children and families without making rehabilitative programs available to all that need it.

The fact remains that child protective services started in New York at the turn of the 20th century using Humane Society regulations designed to prevent cruelty to animals. Even today, kennels receive more money to board pets than foster families who care for children, according to reports citing the lawsuit filed in California. As a society, we have not come very far in the last one hundred years.

When will we say, “It’s time to consider what is in the best interest of all children living in America and let’s do what it takes to accomplish that?” As a society, we can put a stop to political ping pong. We can vote for Presidential and Congressional candidates who talk the talk and walk the walk when making policy that is in the best interest of American children. We can communicate to our elected officials and hold them responsible for placing children first. If we do this, we will begin to see hope in the future of our children.

Los Angeles Children’s Court Should Support Foster Care Policies

As the executive director of Hillsides, I have seen far too many children in the “system” who should never have been there. Fortunately, the Department of Children and Family Services has halved their out-of-home placements in the last seven years. The Department’s two major goals are to transition children back to their homes more efficiently and to reduce its reliance on out-of-home care.

Several strategies have been effective in reaching these two goals. Structured Decision Making helps an investigative worker assess a child’s risk of further abuse in the home. If the child is not in immediate danger but his family is in crisis, the worker can refer them to a community provider that can help them and so keep the family together while eliminating the risk of further abuse.

Point of Engagement has also contributed to reducing removals, providing much-needed help to these families, and reducing the risk of abuse. This strategy recognizes that families want what is best for their children and are willing to make changes. It brings the social service agencies and family together at the “point of engagement” with the Department so that the service agency immediately begins working with the family.

Team Decision Making (TDM) incorporates all available people involved with the child or family to discuss a plan to move the child into permanency. This particularly important strategy helps a child return to his family or relatives because the assembled group not only determines the steps but also what individuals and agencies will be involved in the plan’s success.

Although these strategies are in place, staff do not always support the Department’s policy, and in the case of one child at Hillsides, neither did a judge. The Department must ensure that these critical strategies, all of which are in the best interest of the clients they serve, are incorporated by the line staff and supported by the courts.

View the full story…

Foster Care Legislation Introduced

US Senator Barbara Boxer introduced the Foster Care Continuing Opportunities Act that would provide federal funding to States to continue providing essential foster care services such as food, housing, and legal services to youth over the age of 18.

Boxer is quoted as saying “This legislation would help improve the services for foster care youth so they can better transition from childhood to adulthood. The future for foster youth, once emancipated, is often bleak. In my state of California, about 65 percent of emancipated youth are homeless, less than three percent go to college, and 51 percent are unemployed. We must do more for these youth adults who deserve much better, and there is no better time to do it than during Foster Care Month.”

As someone who has worked in the foster care system for over 45 years, this is a bill that is long overdue. However, it is only the beginning, our system for helping foster youth is sorely lacking. Hillsides recently implemented Youth Moving On, an emancipation program to assist foster youth in the transition from foster homes to independent living. We were shocked on how ill-prepared these foster youth were to make this move. Many of the foster youth entering our program had never worked, had their own bank account, knew how to shop and prepare meals. They were ill-prepared to be living alone.

Even though independent living classes for foster you in California is part of the program that all foster youth 14 years and older take, it does not seem to be doing the job. We need to look again at what we are doing in preparing these youth to leave the foster homes they reside in. We need to make sure that any legislation that extends the states’ rights to access federal funds for foster youth up to age 21 includes services that will give the youth support during this critical time in their lives.

Reflecting on Foster Care Awareness Month

As I reflect during Foster Care Awareness Month, I realize in my 45 years of working with children in foster care I have never been as optimistic as I am now about the public policy being enacted to address the issues of abused children and their families. I have learned over the years that most parents want the best for their children and will do almost anything to see that they are successful. Situations of abuse usually arise out of the problems of adults; drug and alcohol abuse leads the way with dysfunctional relationships taking up a close second. Being out of work, stress, homelessness and poor parenting skills all lead to situations where children are being hurt.

For many years protective services solved the problem of abuse by removing the child from the home which, in far too many instances, only prolonged the abuse. Families were ordered to change their ways with no real guidance or help to do so. Children drifted through the system hoping that something would change so they could go home.

Over the past five years public policy, particularly in Los Angeles, has changed. There is recognition that families need immediate help and if given that help, their children can remain with them safely. In instances where children were formerly removed, it is possible to get them involved with a variety of services that help them stay out of the system, resolve the issues and allow the children to remain at home.