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.)
Showing posts with label pasadena. Show all posts
Showing posts with label pasadena. Show all posts
Tuesday, January 27, 2009
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.)
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.”
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.”
Friday, November 14, 2008
Requiring Foster Family Certification for Adoptions May Close Some Family Doors
Just when I think that the administration of the Los Angeles County Department of Children and Family Services (DCFS) is on right path with initiatives to keep families intact with supportive services, to move children in out-of-home care back into their families, extended families or adoptions, they come up with a policy that flies in the face of good practice.
The Department of Child and Family Services and its Director, Trish Phloehn, are insisting that they will not contract with foster family agencies (FFA) who do not certify their foster families for adoption. For those unfamiliar with the process, this direction means the foster family will be required to go through a process for certification that is similar to the process they already go through to be certified foster families. The major difference is that they must be willing to declare that they are interested in adoptions.
At first blush, this would seem to be an improvement in service delivery because it would cut down the time that it takes for a foster home to become an adoptive home. In fact, DCFS is citing this as a reason for wanting it in the contract. They are also saying that an adoptive home study is a higher standard than a foster home study even though FFAs report that they are just as exacting for their foster homes as the adoptive homes. And finally, DCFS is saying they do not want a foster family who wants to adopt to fail the certification and approval process to adopt a child even though DCFS can not cite, nor can the FFAs cite, an instance where this has happened.
What they fail to take into consideration is that foster care homes for some children are temporary homes used to care for the child until reunification or permanency can be worked out. A number of foster care homes would like to assist children in this transition period of their lives, but do not have a desire to adopt. A number of foster care families who entered the foster care system with the idea they did not want to adopt have changed their minds after being foster parents to a child or children. In other words, they fell in love with the child or children and decided to adopt. Demanding that they be certified to adopt prior to accepting foster care children may have stopped these families from being foster parents. The Department could have closed the door of opportunity for adoption at a later date.
Couples like my wife and I who are over 65 who might have the time to do foster care would be eliminated because we are too old to be certified, or because we are not interested in adopting at this stage in our lives. Some wonderful older couples, who take in babies and toddlers while reunification is being worked through, would be eliminated from the pool of potential foster care homes. If, in fact, a foster home does want to adopt, and an infant or toddler is in their care while the biological mother is getting clean and sober, it puts the foster parent in competition with the mother. This unintended competition is not supportive to the reunification process.
Hillsides does not have a foster family agency, however, at one time Hillsides did take in infants and toddlers whose mothers were addicted to drugs and alcohol and worked with them to help them regain their babies. This was one of the most successful programs we operated, because these mothers did not want to be addicted, wanted to get clean and sober, and wanted to regain their babies. Most of the mothers were able to get their children back within 12 months. One of the things we had to do with our own child care staff is to remind them that they were to be role models to these mothers, they were not to put up barriers to helping the mothers bond with their children. Even though they also loved these children, their job was to help the mother regain custody. This would be a difficult task for a foster care mother who wanted to adopt the child she was caring for.
The Department needs both kinds of foster care homes. The Department will have children who will not be able to return to their families and need a permanent home where adoption would be the outcome. Several types of foster care homes exist: those very much interested in adopting children, those that may grow into that frame of mind as the child has lived with them, or those that may have gotten into foster care with the expressed intention of wanting to adopt.
Unfortunately, the Director of DCFS has persuaded the Los Angeles County Board of Supervisors to buy into this policy without hearing some of the strong arguments against doing this. We now have a situation where the Board of Supervisors has publicly supported its DCFS Director, and it is difficult for them to reverse their decision.
The direction taken should not be either or, but a thoughtful discussion on solutions that will meet the needs of all parties involved.
The Department of Child and Family Services and its Director, Trish Phloehn, are insisting that they will not contract with foster family agencies (FFA) who do not certify their foster families for adoption. For those unfamiliar with the process, this direction means the foster family will be required to go through a process for certification that is similar to the process they already go through to be certified foster families. The major difference is that they must be willing to declare that they are interested in adoptions.
At first blush, this would seem to be an improvement in service delivery because it would cut down the time that it takes for a foster home to become an adoptive home. In fact, DCFS is citing this as a reason for wanting it in the contract. They are also saying that an adoptive home study is a higher standard than a foster home study even though FFAs report that they are just as exacting for their foster homes as the adoptive homes. And finally, DCFS is saying they do not want a foster family who wants to adopt to fail the certification and approval process to adopt a child even though DCFS can not cite, nor can the FFAs cite, an instance where this has happened.
What they fail to take into consideration is that foster care homes for some children are temporary homes used to care for the child until reunification or permanency can be worked out. A number of foster care homes would like to assist children in this transition period of their lives, but do not have a desire to adopt. A number of foster care families who entered the foster care system with the idea they did not want to adopt have changed their minds after being foster parents to a child or children. In other words, they fell in love with the child or children and decided to adopt. Demanding that they be certified to adopt prior to accepting foster care children may have stopped these families from being foster parents. The Department could have closed the door of opportunity for adoption at a later date.
Couples like my wife and I who are over 65 who might have the time to do foster care would be eliminated because we are too old to be certified, or because we are not interested in adopting at this stage in our lives. Some wonderful older couples, who take in babies and toddlers while reunification is being worked through, would be eliminated from the pool of potential foster care homes. If, in fact, a foster home does want to adopt, and an infant or toddler is in their care while the biological mother is getting clean and sober, it puts the foster parent in competition with the mother. This unintended competition is not supportive to the reunification process.
Hillsides does not have a foster family agency, however, at one time Hillsides did take in infants and toddlers whose mothers were addicted to drugs and alcohol and worked with them to help them regain their babies. This was one of the most successful programs we operated, because these mothers did not want to be addicted, wanted to get clean and sober, and wanted to regain their babies. Most of the mothers were able to get their children back within 12 months. One of the things we had to do with our own child care staff is to remind them that they were to be role models to these mothers, they were not to put up barriers to helping the mothers bond with their children. Even though they also loved these children, their job was to help the mother regain custody. This would be a difficult task for a foster care mother who wanted to adopt the child she was caring for.
The Department needs both kinds of foster care homes. The Department will have children who will not be able to return to their families and need a permanent home where adoption would be the outcome. Several types of foster care homes exist: those very much interested in adopting children, those that may grow into that frame of mind as the child has lived with them, or those that may have gotten into foster care with the expressed intention of wanting to adopt.
Unfortunately, the Director of DCFS has persuaded the Los Angeles County Board of Supervisors to buy into this policy without hearing some of the strong arguments against doing this. We now have a situation where the Board of Supervisors has publicly supported its DCFS Director, and it is difficult for them to reverse their decision.
The direction taken should not be either or, but a thoughtful discussion on solutions that will meet the needs of all parties involved.
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