JUDGE JOETTE KATZ
Governor-Elect Malloy's November 30, 2010 appointment.
The CT Department of
Children and Families:
A priority for the
Malloy Administration
"Mission and Guiding Principles: The mission of the
Department of Children and Families is to protect
children, improve child and family well-being and support and preserve
families. These efforts are accomplished by respecting and working
within individual cultures and communities in Connecticut, and in
partnership with others."
Contents of this page:
News;
How many children with what types of
disabilities in CT total under DCF jurisdiction?
Under the control of a Federal watchdog.
Larger issue?
Subsidized housing: Should homeless children get to jump to the front
of the wait list?
Jacqueline Rabe Thomas, CT MIRROR
February 21, 2012
One way of looking at the business of state government -- especially
human services -- is through numbers.
The state's population of about 3.5 million breaks down into about 1.3
million households, according to the U.S. Census. Of those, more
than 190,000 households last year claimed the federal EITC -- earned
income tax credit -- a good indicator of families living on the
financial edge. But Friday afternoon, in a room in the state
Legislative Office Building, a single, small number seemed to stand out
and tell its own story.
The number was 83, and it referred to the number of children who are in
state custody for only one reason: their families have no
home. Of
the children who "could go home if there was a home to go to," the
Department of Children and Families said, more than half were living
with strangers as foster children. Others were living in large group
homes or in shelters. And 24 of those 83 were living with other family
members.
"So to me that translates to: we have children for no other reason than
poverty," DCF Commissioner Joette Katztold lawmakers on the
Appropriations Committee Friday.
State law forbids DCF from removing children from their homes because
of poverty. But the agency has no alternative because there is limited
space in subsidized housing. The agency reports that each month
it refers 100 families with children to the state's subsidized housing
program. About 800 families referred by DCF are on the waiting list for
the Connections program. Sen. Toni N. Harp, D-New Haven, and
co-chairwoman of the Appropriations Committee, wants to allow homeless
families with children to cut to the front of the long line of people
vying for public housing.
"Since resources are limited, we've got to make decisions about who
gets it first. I think the people you serve should get it first," Harp
told Katz. "This is an awful reason to lose your children."
Gov. Dannel P. Malloy's proposed budget preserves the $6.3 million this
housing program received last year. He also recommends adding 150 new
subsidized housing units to be offered to the elderly, disabled and
those families at-risk of losing their children to DCF. Without a
line-jumping change in policy or huge influx in funding, a backlog of
children deemed eligible to go home will inevitably remain in DCF
custody.
Evelyn Torres was one of the lucky parents that landed an apartment
through DCF.
"My daughter was in care of DCF because I was homeless. After this
program we reunified again," the mother of four from Waterbury told the
Appropriations Committee. "Without support[ive] housing, I don't know
where I would have gone."
Management consternation
When parents enter DCF's housing program to avoid having their child
taken away, their dealings with the agency doesn't end there.
Members of the Appropriations Committee were told the agency follows up
to make sure these children are safe. Additionally, the program aims to
get parents out of poverty so their children are not at risk of being
removed for other poverty-related incidents, such as lack of food or
health care.
So when Malloy proposed having the state's economic development agency
run the program, legislators were stunned.
"That has really caused some uncomfortableness among us," said Rep.
Toni E. Walker, D-New Haven, and the other chairwoman of the
Appropriations Committtee.
The move could also put the state at risk of not qualifying for federal
reimbursements for the Connections housing program, said Ruth White
with the National Center for Housing and Child Welfare.
"It will make it difficult if not impossible" to qualify, she said.
"Disrupting this risks destroying the very nature of that nationally
renown program," she said.
The intent of moving the program to the Department of Economic and
Community Development was an effort to move all the state's housing
programs under one roof, a spokesman said.
"Consolidating the state's housing fuctions into one centralized office
located within DECD will streamline, facilitate and strengthen a
coordination of these needs for those who need it most throughout the
state," David Bednarz said.
DCF one year under new management: much work remains
Jacqueline Rabe Thomas, CT MIRROR
January 6, 2012
A year into new management at the troubled Department of
Children and Families, a report card issued by the court-ordered
monitor outlines the "significant challenges" that remain before he is
convinced abused and neglected children are in good hands with the
state.
But, "This report demonstrates considerable progress as well as
identifying significant challenges," Raymond Mancuso, the court
monitor, said in his report card, issued Friday.
Joette Katz, who stepped down as a state Supreme Court justice to lead
the agency, gave herself a goal of one year to turn around the agency
enough to shed federal court supervision.
Thursday marked her one-year anniversary of running the $894 million
agency responsible for the care of 4,700 children on any given day.
But according to the court monitor's report and the lead attorney in
the "Juan F" class-action lawsuit that resulted in court oversight,
Katz still has miles to go before claiming victory in turning the
agency around.
DCF has been under federal court supervision for more than 20 years.
Eight commissioners before Katz failed in reforming the vast, troubled
agency.
One of the largest challenges is finding and retaining the foster
families to sustain the "critical system reform[s]" the agency has
begun. The department has promised to reduce the use of large group
homes, or congregate placements, and bring most children living
out-of-state home.
"The diversion from congregate care utilization is hampered by the lack
of appropriate foster care resources," the court monitor's report
reads, noting that the agency lost 35 foster homes over the past three
months. "The lack of sufficient foster/adoptive resources remains the
most significant barrier... Additional foster care and adoptive
resources remain an essential component required to address the needs
of children."
This loss of foster homes comes even after two recent attempted
strategies, one under Katz's direction. DCF has had three years to add
850 foster placements; during this time, the agency has actually lost
placements. Reports and surveys have indicated that many foster
families have dropped out of the program because they feel disrespected
and say they don't get the necessary services for their children from
DCF.
In response to the report card, Katz wrote there are numerous "positive
indicators of the changes we have put in place." But, she agrees that
numerous challenges remain.
In comments at the end of the monitor's report, Katz wrote that to
tackle the foster care dilemma, her focus on placing more children with
family members will help alleviate some of the shortfall in
traditional, stranger-placement foster homes. When Katz took office,
the department had one of the worst rates in the country in placing
children with family members. She's moved that rate from 15.3 percent
of the 4,784 children being placed with family to 19 percent.
Ira Lustbader, the lead attorney for the plaintiffs, said the "sweeping
and impressive" changes Katz has thus far implemented have helped.
"She has recognized and owned the problems," he said. "These are really
impressive initiatives so far, but a tremendous amount of work remains."
His proof: the needs of four out of 10 children in DCF custody are not
being met, according to the court monitor's report.
"The numbers are creeping in the right direction now, which is good,
but it's not enough to meet their needs," he said.
Katz makes no excuses.
"We must work together over the coming year to ensure these children
transition to a safe, appropriate and stable placement that meets their
needs," Katz wrote.
And Katz will have to work a little harder to maintain the progress, as
she has agreed to a major shift in how the court monitor grades her.
Previously, the agency was given several days' notice of which
children's cases the monitor would be inspecting. That is no longer the
case -- "a take-home test vs. a blind sample," as Lustbader calls it.
"It was giving them the opportunity to clean up their files," he said.
Katz may have estimated it would take her one year, but Lustbader is
optimistic that the end of court oversight could be in sight if the
agency continues to head in the same direction.
"The eventual exit from this longstanding lawsuit is in her hands. It
certainly could be during her tenure if she continues with this
approach," he said.
Homelessness, income disparity and housing costs rise
Caitlin Emma, CT MIRROR
October 24, 2011
Family homelessness, income disparity and the number of households
burdened by housing costs increased in the last year as Connecticut
remains one of the most expensive states in which to own or rent a
home, according to a report issued by the Partnership for Strong
Communities Monday.
The partnership used data compiled by a number of agencies in forming
the report, including the U.S. Census Bureau, the Connecticut Coalition
to End Homelessness (CCEH), the Connecticut Housing Coalition, the
National Low Income Housing Coalition and the U.S. Department of
Commerce's Bureau of Economic Analysis.
Christy Rubenstein, a senior policy analyst for the Partnership, said
the homelessness data was one of the most striking issues.
"There's been a change in the demographic of homelessness," she said.
"There are more families attending shelters and a lot of adults pointed
out that it was their first experience being homeless. I think it shows
how the economic downturn is affecting everyone."
CCEH found the number of homeless families, or unsheltered adults with
children, rose 15 percent between 2010 and 2011. CCEH measured
homelessness in the state on one night in January 2011, called its
"Point in Time Count." The PIT count showed a total of 4,451 homeless
people in one night, an overall 8 percent increase since 2009.
Rubenstein said homelessness proves a multifaceted issue and with more
families seeking help, shelters need to meet different needs.
"Consider a 68-year-old homeless man who's been homeless for 20 years
and compare it to a homeless family with three children," she said.
"They have different needs."
The Homeless Management Information System (HMIS), administered by
CCEH, showed Connecticut's homeless shelters operating at full capacity
in 2010. The partnership also used data from the United Way of
Connecticut's 2-1-1 Infoline and its requests received for housing
services, from homeless shelters to rent payment assistance. Requests
rose to 90,074 in 2010 from 72,251 in 2009 and based on requests
received through August, United Way of Connecticut predicts a higher
number for 2011.
Rubenstein said a complete number of homeless people proves hard to
quantify because PIT, HMIS and United Way of Connecticut only count the
numbers attending shelters.
"These numbers don't count the people who we call 'bubbled up,' or
living with friends and family," she said. "Consider also the homeless
youth who are couch surfing and avoiding being placed in the system by
DCF [Department of Children and Families]. We consider these people
homeless, too."
She said chronic homelessness, or repeated homelessness over a number
of years, also increased by 26 percent among single adults since 2009.
"Some of this could be attributed to more families using the shelters,"
she said. "If more families use the shelters, more single adults get
pushed out."
Income disparity also widened in 2010, providing no relief for those
teetering on the edge homelessness and living in unaffordable housing.
The lowest household income for 20 percent of state residents in 2010
fell to $13,696 from $14,525 in 2009. The highest paid 20 percent of
state residents made an average of $233,617 in 2010, down from $238,354
in 2009.
"Connecticut has some of the highest incomes per capita and still one
of the greatest records of income disparity in the nation," Rubenstein
said. "When that happens, all kinds of weird things will come out of
the housing market."
The report showed more people looking to rent, driving up rental
prices, while median incomes and housing prices declined. Even though
housing prices dropped, a lower median income still makes owning a home
unaffordable in many cases, driving people to rent property.
Fifty-one percent of Connecticut renters and 37 percent of home owners
spent 30 percent of their income on housing, the report showed. The
Partnership's current report and a report put out in August deem 112 of
169 communities "unaffordable" for families earning the state's medium
income and paying for a median-priced home. About 27 percent of
households proved severely burdened by renting costs, spending almost
50 percent of their income on rent.
Rubenstein said the current administration earned the partnership's
approval by spending $130 million on developing more affordable housing.
"The current administration has been great with this," she said.
She said the state still needs to continue investing in the state's
Rental Assistance Program offered by the Department of Social Services,
while investing in new affordable housing initiatives. The report
cautioned that a shifting housing market could mean much of
Connecticut's current stock of affordable housing may not meet future
needs.
"I'm doing what legislators and
advocates have asked..."
Goal Of DCF's Katz: Get
Troubled Children Back Home, Back Into Community
The Hartford Courant
By JOSH KOVNER, jkovner@courant.com
7:50 PM EDT, August 6, 2011
The state Department of Children and Families, long under pressure to
improve its treatment system for young people, announced last week that
it wants to get many of the 1,400 children now in residential
facilities back to their families or into foster care.
Commissioner Joette Katz said the effort, which includes stopping the
flow of troubled children to out-of-state facilities and developing
in-home and neighborhood-based services, will cause some pain during
the transition and require a radical shift in the way the agency has
operated in the past 20 years.
For example, she said, a some counseling services, psychiatric
treatment and other programs now at residential centers would be moved
to in-home settings, or to walk-in family clinics. The DCF also might
have foster families, instead of private agencies, run group homes with
five or six children — at a third of the current rate of $500-per day
per-child.
Of the 1,400 children in institutional settings, 200 are 12 years old
and under. Katz issued a directive last month saying that children in
that age range will no longer be sent to residential centers. She said
the goal is to have the 200 children out of those institutions and in
foster care or back at home by early next year. Counseling, training
and a range of other support services — crucial to the success of the
transition away from residential care — would be provided to the
families.
Of the remaining 1,200 teenagers in residential care, some of them are
nearing 18, the age at which they will leave the centers and go into
other programs, or leave DCF care.
"That leaves a core of 700 or 800 kids in residential care, half in
state, half out-of-state, that we need to address. That's
challenging,'' Katz said.
She said parents, children, social workers, juvenile-court judges,
treatment providers and the DCF all have to cooperate for this cultural
sea-change to stick.
"It's going to take a lot more than me at the table,'' said Katz.
"We're working with treatment providers. They've acknowledged we're
paying a lot of money and not always getting all we need from them.''
As for the DCF, it must improve support services to foster families
dramatically, and recruit many more families, including relatives of
the children, to serve as foster parents, Katz said. She
acknowledged that, in a few cases, the children themselves have
experienced the pain of this transitional period. She said that when
she recently blocked the out-of-state placement of 15-year-old Jeffrey
M., a youth with no prior criminal record who was charged as an
accomplice in an unarmed robbery attempt, she found herself "between a
rock and a hard place.''
Her action meant that the youth has spent weeks in detention while the
state Appellate Court hears Katz's argument that only the DCF
commissioner, not Superior Court judges, has the authority to send
troubled children out of state. Katz, the former state Supreme
Court justice who took over at DCF in January, said a ruling affirming
the commissioner's authority is key to the agency's efforts to keep
troubled kids closer to home and cultivate an effective treatment
network in Connecticut.
"I'm pretty confident in the legal determination that I've made,'' Katz
said in an interview Thursday. "I hope the Appellate Court agrees and
the juvenile-court judges will take notice. Then we can stopping
wasting time.''
She stressed that she's considering requests for out-of-state
placements on a case-by-case basis. Of the last 17 requests to send
children to outside facilities, Katz has rejected eight and approved
nine — the latter after confirming that there was no adequate place for
those children in Connecticut. But for some parents, lawyers and
other advocates, Katz is moving too fast, blocking outside placements
before the in-state system is ready.
Michael and Patty Alquist of West Hartford, whose child's placement at
a facility for autistic children in Framingham, Mass., was blocked last
week by the DCF, say they wonder what goes into Katz's decisions.
The DCF has said that their son should go instead to the Children's
Home of Cromwell, which, under director Garrell Mullaney, has begun
programs to treat children in the autism spectrum. Experts at the
University of Massachusetts are developing the program for the
Children's Home and training the staff.
The Alquist family qualifies for state services because the boy's
issues — he can be highly aggressive when he is agitated — are
overwhelming. The family wants the boy to go to the New England Center
for Children, which established its school for autistic children in
1975. The child has been living at home, with services provided to the
Alquists. Patty Alquist said she had serious concerns about the
Children's Home when she and her husband visited, including that
children with criminal histories or psychiatric problems mingled in the
cafeteria and hallways with the autistic children. She said she was
also dismayed by the physical condition of some of the buildings, and
thought the therapeutic program had gaps and shortcomings.
"I love him. I want him to be in state," Patty Alquist said. "I
understand what DCF is trying to do. But our son is a complex kid. He's
the exception. He needs to go out of state.''
Katz said DCF is working closely with the Children's Home to develop a
top-tier program.
Jeffrey M.'s lawyer, Aaron Romano of Bloomfield, said Katz's action
unraveled a court-approved arrangement to send the youth to the Glen
Mills school in Pennsylvania, where 11 other Connecticut children
already live, with the most recent placement coming in June.
The judge in the case, William Wollenberg, commented that after the DCF
became involved, "the wheels came off.'' Katz countered that she has to
start somewhere to turn around an out-of-state exodus that diverts tens
of millions of dollars a year that could be used to bolster Connecticut
programs. Children who are sent out of state spend appreciably longer
periods at those facilities than they do if they stay in Connecticut,
records show.
Romano and associate Naomi Fetterman brought to light the case of a
another teenager who they said is languishing at the Connecticut
Juvenile Training School — the state's juvenile jail — after the DCF
blocked his transfer to an Iowa program. The youth needs sex-offender
treatment and Connecticut doesn't have an established program, Romano
said. Katz said the DCF is now sending a therapist into the
training school to provide extra treatment to the youth — an
arrangement that could continue when the youth goes home or into foster
care.
Romano said the amount of weekly therapy is inadequate.
"The legislature wants these kids home," Katz said. "Am I going fast?
Am I drawing a line in the sand? I'm doing what legislators and
advocates have asked of me and have historically asked of DCF."
DCF to investigate how it handled abducted girl's case
Greenwich TIME
Ken Dixon, Staff Writer
Published: 12:20 p.m., Wednesday, February 2, 2011
The state Department of Children and Families is conducting a special
investigation into how it handled the case of Carlina White, who was
allegedly abducted as a baby from a New York hospital in 1987 and
raised in Bridgeport.
Joette Katz, the recently named DCF commissioner, said Tuesday there is
no evidence that DCF mishandled the case, but the in-house probe will
focus on whether it could have helped the child further when it first
had contact with her in 2005. The goal is to make sure cases
similar to the White case, which made national news, can be avoided in
the future, she said.
"I want to know everything about the case," Katz said in a Tuesday
interview. "What we did for her. What the information we had about her
was. But clearly, what more we could have done for her."
She expects the internal review to take about a month.
"My guess is that, frankly, we'll be able to do this in an expeditious
manner," Katz said. "A lot of the changes will take place internally. I
have already spoken to the (DCF) Training Academy. My hope would be
whatever we decide to do and whatever we decide is the best practice,
we must make sure something of this nature never happens again. To me,
how we approach kids and their needs should be holistic."
Social workers will be interviewed and DCF reports on White dating back
six years will be inspected. Katz said she did not know what
triggered the first contact DCF had with White. Asked whether the
agency took custody of her and placed her in foster care, Katz said "We
provided housing and we also got her through school."
Katz said she did not know whether another child of Pettway's,
13-year-old Trevon Teele, has been involved with the DCF. She
said that federal law enforcement officials from the Southern District
of New York, where Pettway is facing a kidnapping charge, recently
requested a release of documents on White and Pettway. The agency
provided those records, she said.
Katz could not say whether the DCF helped obtain a Social Security
number for White, who was raised in Bridgeport under the name Nejdra
Nance. Katz said she has not yet discussed the issue with Gov. Dannel
P. Malloy, who asked Katz to leave the state Supreme Court to head the
agency. Pettway admitted to the FBI last month that she took the
child from Harlem Hospital in August 1987, out of fear she could no
longer bear children, according to court records. She is being held
without bail.
White has since been reunited with her biological parents.
Last December, after questioning the validity of a poorly forged birth
certificate, White contacted the National Center for Missing and
Exploited Children, which found that her history possibly matched the
1987 hospital kidnapping. Katz, during a news conference earlier
Tuesday in the Capitol complex, announced members of her leadership
team that will guide an agency often in controversy and under pressure
from settlements in federal court on child-welfare issues, called
consent decrees.
She named Janice Gruendel, former co-chairwoman of Connecticut Voices
for Children, and Elizabeth Graham, an early advocate of gender-based
community diversion programs, as deputy commissioners. Fernando
Muniz, a DCF program director, will be promoted to chief of quality and
planning. Michael C. Williams, the former director of the DCF Hartford
Area Office, will round out Katz's leadership team.
Behavioral Health Partnership gets children 'unstuck' from in-patient
psychiatric care
Arielle Levin Becker, CT MIRROR
January 17, 2011
The support group Amber Robinson leads is supposed to run from 6 to
7:30 p.m., but it often lasts hours beyond that.
"Parents are talking," she said. "They got a lot of stuff to say, to
get out. They just want to talk and talk."
Like the parents in her group, Robinson knows the frustrations of
trying to find services for a child with mental health needs in a
system that is often overwhelmed and unresponsive. Her 8-year-old son,
Dante, has been hospitalized multiple times since he was 4. His
intermittent explosive disorder causes tantrums so severe that at times
he must be restrained, and since last year, he has lived in a
residential treatment center.
But Robinson considers her family fortunate in at least one respect.
Because he is covered by the HUSKY health plan, her son is part of the
state's Behavioral Health Partnership, a program that has made
significant strides in ensuring that some of the most vulnerable
children in the state get the care they need. Some observers say it now
provides better access to mental health services than the private
sector.
That was not always the case. The partnership began at a time when
children were stuck in psychiatric units longer than necessary because
there was nowhere to send them. Other children struggled to get any
mental health services until they ended up in emergency rooms in
crisis. When it began in 2006, there were skeptics about the new
model's ability to meet its goals of improving access to care and
getting more young people cared for in less intense--and less
costly--settings.
But from the program's first to second year, the number of children
receiving outpatient services increased by 5.5 percent and the number
of children admitted to inpatient care dropped. The trends have
continued, and the program is now being expanded to including more
Medicaid-covered groups, including people with disabilities and
low-income adults.
People who have followed the partnership say it is far from perfect,
but an improvement over what it replaced and, in some ways, a model for
other programs.
"It's not that it's all fixed and we can all go home and say
everything's perfect," said Sharon Langer, a senior policy fellow at Connecticut Voices for Children
and a member of the partnership's oversight council. "But there has
been real movement toward unsticking the children, so to speak, and
also expanding the availability of community-based services."
It has worked in part by giving officials enough data to keep close
tabs on where efforts are, and aren't, working, and the ability to
intervene. Behavioral health providers get financial incentives to
ensure that patients get appointments or that children don't spend
unnecessary time in hospitals. The company that administers the
program, ValueOptions, has a portion of its pay withheld unless it
meets certain performance targets, and cannot earn more money by
denying services.
"The reason that it works so well is because everyone is pulling in the
right direction," said Dr. Andrew Lustbader, a child psychiatrist who
led a group of pediatricians and child psychiatrists that recommended,
among other things, using the partnership as a model for the private
sector.
Making progress has also taken money. About $180 million was budgeted
for the program this year, and some, like Jeff Walter, co-chair of the
program's oversight council, worry how it will fare through the
upcoming budget process.
Leaders also see the down economy as a challenge as more people rely on
the state for help.
"I just think the sheer volume of people that are going to come
knocking at the door seeking services in these hard times is going to
be a real challenge," said Karen Andersson, the partnership director
for the Department of Children and Families, which jointly administers
it with the Department of Social Services. "Without dollars to jump
start start-ups, new programs, existing systems can only take so much
on at a time with the existing infrastructure. That's going to catch up
to us very quickly."
A Surgical Approach
The partnership replaced a fragmented system that was often hard for
families to navigate. Some services were paid for by DCF, while DSS
covered others. In HUSKY, coverage was divided among multiple managed
care companies, and children and families often struggled to get any
services covered.
The partnership developed as a way to create one system for children
and adults in HUSKY and children involved with DCF.
The effort to improve access to care was helped along by increasing
rates paid to providers. But the providers didn't just get more money;
they had to meet certain standards to get it.
For outpatient providers, that included giving people appointments in a
reasonable amount of time, offering an appointment within two weeks to
95 percent of the people who seek one, with faster times for more
urgent cases.
Early measures showed that meeting the "timely access" standard would
be a major improvement for many providers; some were giving timely
appointments to as few as 50 percent of new patients. Many hired staff
to reach the targets.
While some young people had struggled to get into outpatient services,
others were stuck in hospitals because they could not get into the
right community-based services.
"They would stay for a very, very long time," said Mark Schaefer, DSS'
director of medical care administration. "It wasn't good for the kids,
was very expensive for the state."
To reduce the number of "discharge delays," the partnership developed a
performance incentive program. Hospitals could compete for a pool of
money--close to $500,000--that was distributed based on their ability
to reduce unnecessary days spent in inpatient care. ValueOptions was
given a similar incentive, geared toward making sure that children
weren't being discharged before they were ready.
Each year between 2007 and 2009, patients served by the partnership
spent about 10,000 fewer days in inpatient care.
It was possible, in part, because of an expansion of the state's
community-based services, like therapeutic group homes and extended-day
treatment, in the early 2000s, which allowed people to receive clinical
and therapeutic services without having to live in institutions.
But the drop in time kids spent in hospitals also occurred because
program leaders had a better handle on when they were placed there, and
why.
In the old, fragmented system, it was hard for the departments to
measure and track the scope of the problems or what worked in improving
them.
The system developed under the partnership was designed to gather
significantly better data. The partnership can now track whether
children in one area of the state are having trouble accessing a
particular type of care, and what interventions could improve things.
They can see if one treatment center is keeping kids significantly
longer than others, then address it.
"We're able to take a real surgical approach," said Lori Szczygiel, CEO
of ValueOptions Connecticut. "If we know one provider's struggling, why
have one intervention for every provider when we can just focus the
resources that we have for one provider? It allows us to be more
thoughtful."
And being able to see where problems occurred, and having a small
number of people or organizations who were accountable, created a sense
of urgency, Schaefer said.
"It just sort of made things move much more quickly," he said. "And
while you could argue it should happen anyway, there's always calls you
can put off til the next day. There's always other kids whose needs and
families' needs you can focus on."
For the hospitals, reducing the time children spent in inpatient care
meant a drop in their income. But again, the data helped. Walter said
it put the hospitals "under the microscope," making them subject to
non-financial pressures to improve.
"Everybody wants to look good," said Walter, who is CEO of Rushford, a
provider of mental health and addiction treatment for teens and adults.
"And when everybody's looking at something, even if your short-term
financial goal is in jeopardy, long-term you're better off playing ball
because nobody wants to feel like, 'oh gee, everybody's pointing the
finger at me.' And it works."
Oversight, Accountability, Support
There are other, less tangible reasons that people who have followed
the program say it has worked. Many cite the wide range of groups
represented on the oversight council, and the tone set by Walter,
Szczygiel and the state department officials. In contrast to the
often-contentious medical side of Medicaid, the program's oversight
council has a collegial atmosphere.
"I think there's an example of what good leadership is all about,"
state Child Advocate Jeanne Milstein said. "There's good leadership,
there's good oversight, there's clear expectations, there is good
support...and there's accountability."
For Amber Robinson, the partnership has provided a support system as
she tries to find the best care for her son. A peer specialist from the
partnership goes with Robinson to meetings, helps her find programs and
activities for him, and listens when she needs to talk. Robinson
describes her as "another voice" when dealing with her son's treatment.
"It makes you feel a lot more comfortable when you feel like you have
somebody on your side," she said.
At her peer specialist's suggestion, Robinson, who lives in Hamden,
attended training programs to help her advocate for her son, learning
how to make sure his providers are all on the same page, how to better
understand his rights in school, and leadership skills. She now tries
to spread the knowledge through the support group.
"They've made a big impact on me," she said. "And I'm making through
them a big impact on families."
Robinson would prefer that Dante could live at home, but has come to
recognize that it's not always possible.
"Your job as a parent, and especially if you want the best for your
child, is to protect your child, and you want to make sure everybody
that's around them understands that," she said. "A lot of times, the
typical person out there that hasn't gone through it really doesn't
understand why you may be trying to keep him in the home."
Agency sends more troubled youngsters out of Connecticut
DAY
Article published Jan 17, 2011
Hartford (AP) - Connecticut's child protection officials are sending
more troubled children out of state for treatment, raising costs and
concerns about what happens when youngsters are cut off from guardians
and siblings.
The children are in residential treatment longer - an average 189 days
more - than children in Connecticut programs. The practice has
continued despite the availability of empty beds at local programs.
Peter Mendelson, head of behavioral health at the Department of
Children and Families, told state lawmakers recently that the children
are sent away only when an appropriate in-state placement cannot be
found.
A review by The Hartford Courant has found that although there is room
for children in Connecticut, the agency has rejected requests for help
crafting programs needed to keep children in state.
In the last year, the number of children sent to outside agencies has
increased to 367 from about 280 as some treatment centers in
Connecticut with room to accept children have closed facilities or
programs because the Department of Children and Families are sending
fewer children to the in-state centers.
Children's advocates say the agency is less able to monitor the
treatment of out-of-state children.
Of the 367 children living in out-of-state programs as of December, 285
were in New England. Among the other states with children from
Connecticut are Alabama, Florida, Georgia, Michigan, New Jersey, New
York, Illinois, Iowa, Ohio and Pennsylvania.
DCF Sending More Children Out Of State For
Treatment: Officials Sending More Kids To Facilities Outside
Connecticut
The Hartford Courant
By JOSH KOVNER, jkovner@courant.com
January 16, 2011
State child protection officials are sending an increasing number of
troubled children to out-of-state treatment facilities, racking up high
costs and raising concerns among advocates about the emotional
consequences of cutting kids off from guardians and siblings.
Once they go away, the children spend far longer in residential
treatment — an additional 189 days, on average — than children in
Connecticut programs. The practice has continued unabated despite the
availability of empty beds at local programs.
The Department of Children and Families, a $900 million-a-year agency
that has toiled under federal oversight for more than 20 years, has
struggled with an over-reliance on out-of-state placements for at least
a decade.
A Courant review has found that although there is room to keep children
in Connecticut, the department has frustrated private treatment
providers by failing to heed requests for help in fashioning the very
programs needed to keep children in state.
DCF also has fallen far short of its mandate from the federal court to
recruit hundreds more foster families. The result has been a system in
gridlock, with children being sent out of state "by default,''
advocates say.
Time and again, in public testimony and reports to the legislature, top
DCF officials have maintained that they send troubled children to
out-of-state treatment centers only as a last resort, and only after
the children have been rejected by local providers.
The instinct is to believe them. After all, the downsides are glaringly
obvious: The cost to keep the current roster of 367 children in
out-of-state facilities is about $35 million a year. It's also widely
acknowledged, inside and outside of DCF, that contact between the
children and their biological or foster parents and siblings decreases
sharply when they go away, and that the loneliness can be traumatizing.
Case workers must visit the children personally every two months, which
adds about a $1 million a year in travel expenses to the overall cost,
according to a state report.
Peter Mendelson, the DCF's head of behavioral health, told the
legislature's appropriations committee at a recent public hearing that
the children are sent away only when an appropriate in-state placement
cannot be found. He said that the agency looks hard for those local
placements, and that "providers have to re-tool and be willing to treat
these kinds of kids,'' which he said include increasingly troubled
children with histories of fire-setting, sexually aggressive behavior
or multiple substance-abuse and psychiatric problems.
"And we're just getting around now," asked state Rep. Marie Lopez
Kirkley-Bey, D-Hartford, "to telling residential providers what they
should be doing'' to keep children in the state?
"We've been doing it for years but this is a more difficult, more
challenging'' group of children, Mendelson responded.
But that is not the whole story. Private treatment providers in
Connecticut say they want to create new programs and have reached out
repeatedly to the DCF for detailed information on the children who get
sent out of state. They said the department often is inexplicably
unwilling to share its "needs projections'' — which include profiles of
the children and their treatment needs.
And the department has not always acted aggressively to attack the
problem of sending too many kids out of state, as lawmakers and
advocates have demanded.
The legislature passed a law requiring the DCF, by July 2009, to put in
place a "master plan'' on how it would stop out-of-state placements and
maximize Connecticut programs. The agency told the legislature in 2009
that its goal was to stop the outside placements by the summer of 2011.
But in correspondence obtained by The Courant, dated in mid-July 2009,
after the agency was to begin implementing its plan, Mendelson wrote
that no action was taken because the legislature didn't give DCF
additional money.
The agency now says it made a plan and informed the legislature that
doing anything else was contingent on getting extra money.
DCF did not make Mendelson available for an interview with The Courant.
In a written statement, the agency said reducing out-of-state
placements of children is a "top priority'' of new DCF Commissioner
Joette Katz, the former state Supreme Court justice. Katz intends to
resume talks with local providers about expanding services, the
statement says.
"In talking to staff in her first days as commissioner, she has clearly
expressed the view that the best way to treat children with behavioral
health needs is to provide services to the child in his or her home. If
this is not possible, the child should be treated in a setting that is
as close to his or her community as possible and in Connecticut," the
statement reads.
"Commissioner Katz is committed to exploring ways to build in-state
capacity to treat children with acute needs so that the department does
not have to resort to sending them out of state, and the commissioner
is scheduling meetings with providers to determine a path to do just
that,'' the statement says.
Within the last year, the number of children sent to outside agencies
has jumped from around 280 to 367, even as some treatment centers in
Connecticut with room to accept children have closed wings or programs
because of a reluctance on DCF's part to send children to them — the
very children being sent out of state. The $35 million overall cost of
out-of-state placement is based on DCF figures of an average rate of
$292 per day per child for care, plus $4,453 per child for a 10-month
school program, plus travel expenses.
And the stakes are high for each out-of-state referral. Advocates for
children note that DCF is less able to monitor whether Connecticut
children are being injured, getting involved with the police or being
physically restrained by staff when the children are not in Connecticut.
DCF protocol requires that the outside programs call the DCF hotline
immediately if a Connecticut child is injured, arrested, or restrained.
But the outside placements hamper DCF's ability to head off problems at
the private treatment centers, as the agency would be expected to do in
Connecticut.
During 2007, seven children were injured while being restrained by
staff at a KidsPeace treatment center in Orefield, Pa. It wasn't until
the state of Pennsylvania downgraded the center's licenses and froze
admissions that DCF stopped sending children to KidsPeace in September
2007. The Courant could not determine if any of the injured children
were from Connecticut.
The Pennsylvania investigation prompted the resignation of the center's
CEO. The licenses at KidsPeace have since been restored, and the total
number of children at the center has been reduced from 500 to 303.
Records show that DCF officials last inspected KidsPeace in February
2009. As of late last year, about 15 Connecticut children were living
there.
A Courant review of DCF records and correspondence shows a deep
disagreement between DCF and the treatment community over just how
"unwilling'' the local providers are to take DCF referrals.
In fact, directors of treatment centers and heads of trade groups that
represent them pointed out in interviews last week that facilities need
referrals from the DCF to stay in business. The providers say that they
are willing to work with DCF to modify their programs, if necessary, to
take children with more serious and complex problems — but that the
process is hindered by DCF's reluctance to share detailed information
on the specific needs of the children.
The providers also say DCF has been unwilling to divert, for use by
Connecticut providers, some of the tens of millions of dollars it
spends sending children out of state.
For example, here is the opening paragraph of a "program alert'' from
DCF asking for a residential program for adolescent boys with sexual
behavior problems: "DCF is seeking providers (for) congregate care
treatment on a fee-for-service basis. Start-up funds will not be
available. Similarly, the Department will not fund capital expenses. …
No guarantee of usage, either specific or implied, is made here in.''
Jon Clemens, of the Connecticut Association of Non-Profits, said it
would be difficult for treatment centers to commit to such a program
without up-front money and with no promise of referrals.
Meanwhile, of the 318 children who were living in out-of-state
residential programs at one point last year, 40 were classified as
having sexual behavior problems. The state would have paid more than $4
million to the outside programs to care, treat, educate, and visit
those 40 children for the year.
Martha Stone, a children's lawyer and advocate, said there has been a
good bit of finger-pointing between the providers and DCF.
"So kids are ending up out of state by default, not because they need
that level of care — and it's just wrong,'' said Stone, who has won
several emergency court orders to get children out of outside treatment
centers and back to Connecticut.
The irony is that whenever Stone, her colleague Sarah Eagan, or other
children's lawyers get the state Superior Court involved, a treatment
slot in Connecticut seems to pop up within a few months. And that's
after DCF has represented that no openings for a specific child would
materialize "for the foreseeable future.''
Of the 367 children living in out-of-state programs as of December, 285
were in New England centers. Among the other states with Connecticut
children are Pennsylvania, Florida, New York, Illinois, Iowa, Alabama,
Georgia, Michigan, New Jersey and Ohio.
The Courant's review found that DCF sometimes tells the legislature one
thing and the treatment providers another. In a March 2009 report to
the legislature, the agency, explaining how it intends to reduce
out-of-state placements of children, says it "would continue a series
of meetings with individual providers to determine willingness to
modify their programs to treat specific populations of children.''
But in October 2009, Karl Kemper, the DCF's chief of staff, conveyed a
different sentiment in a letter to Alan J. Deckman, a lobbyist and
executive director of the trade group the Children's League of
Connecticut Inc. Kemper wrote: "At this point I do not believe that
further meetings with multiple providers and the department would
accomplish anything other than reinforcing what is already known.''
Kemper's letter to Deckman came after the Children's League and the
Connecticut Association of Non-Profits reached out to DCF in August
2009 in an attempt to increase in-state referrals and craft programs
that would meet DCF's immediate needs. The Kemper letter two months
later ended those meetings. They resumed this past February after
Clemens, of the Connecticut association, again wrote to then-DCF
Commissioner Susan Hamilton, asking for specific information on the
children who were at risk to go out of state and a "needs projection''
from DCF.
Hamilton responded that she would be "happy to make data available to
your members to assist with their planning and it appears that some
additional discussion is warranted to better define the scope of the
information that would be most valuable.''
Some of that discussion did take place and was productive, Clemens
said, but the meetings stopped and have not resumed, leaving the trade
groups and providers without the resolution they had sought 17 months
ago.
Some advocates believe DCF might be hesitant to work with local
providers because it has been criticized in the past for poor oversight
of the private treatment centers.
For example, Child Advocate Jeanne Milstein and Attorney General
Richard Blumenthal in 2007 documented longstanding, deeply rooted
problems in the quality of care at the former Lake Grove treatment
center and school in Durham, and questioned DCF's "role as licenser,
overseer, and consumer of Lake Grove's services.'' DCF immediately
flooded the program with behavioral-health experts and spent six weeks
trying to correct the problems. The effort failed and the school, with
47 DCF children, was closed.
"See, DCF doesn't have a plan,'' said Stone, executive director or the
Center for Children's Advocacy in Hartford. She has represented
children in DCF care for decades and was the lead lawyer in the "Juan
F." abuse and neglect case that triggered federal oversight of the
agency.
"Instead of dealing with the management problems, they precipitously
close these agencies. Our position is DCF should develop services to
keep the kids in Connecticut,'' she said.
DCF's written statement to The Courant implicates the local providers
as largely responsible for the increase in out-of-state placements.
"Regrettably, the number of children in an out of state residential
placement has risen since 2007. This reflects the fact that several
in-state programs have closed. In addition, a larger number of children
with acute needs require treatment services and in-state providers have
not had the capacity to serve children with these high levels of
need,'' the statement says.
Clemens, of the Connecticut Association of Non-Profits, said it's true
that some programs aren't equipped to take the most difficult, complex
cases, such as children who are fire-setters or sexually aggressive. He
acknowledged that programs have declined to accept some children
referred to them by DCF. It's also inevitable, he said, that some of
these businesses will close. But he said that most providers are
willing to do whatever it takes to serve kids and fill their treatment
slots. Clemens works with about 140 agencies in Connecticut that serve
children.
And there are proven, well-established programs in Connecticut that
have empty beds.
Jeffrey Walter is executive director of the Rushford Center, which runs
programs in Middletown, Meriden, Glastonbury and elsewhere. Rushford
now operates a 12-bed treatment center for children with substance
abuse problems, located in a single building on the grounds of the
former Lake Grove School in Durham.
In a report last year, DCF indicated that of the 318 children the
agency was sending out of state at the time, 25 were in the category of
substance abuser. The Courant asked Walter in an interview last week
why DCF doesn't license Rushford to accept more of the kids with drug
problems so fewer go out of state.
His response: "I'm not even filling my 12 beds. We're constantly
reaching out to the department because we're only paid for beds that
are filled. It's something I puzzle over as a provider.''
Asked why DCF would not make full use of a proven local program, Walter
said, "The answer I get is that the kids have other issues that make
them not appropriate for in-state treatment. But we try to be as
open-minded and creative with our admissions as possible.''
DCF said in its written statement that Rushford's 12 beds were filled
as of last Tuesday, with two kids waiting. Walter said Friday that it's
true that his program is sometimes filled.
"We have discharges. The point is that over time, we are not full on a
consistent basis,'' Walter said.
At the Children's Home of Cromwell, executive director Garrell Mullaney
has had similar issues. In 2008, DCF stopped placing boys under 12 in
residential treatment centers.
Advocates like Stone say that children in DCF care should be in the
least restrictive setting as possible. Group homes, for example, are
preferred over residential centers, and foster homes are preferred over
group homes.
DCF shares that philosophy, and so do providers like Mullaney. The
problem, Mullaney said, was that DCF never replaced those young boys
with another population of children from among the children who were
being sent to out-of-state residential centers. That left the
Children's Home, as well as other Connecticut centers, with empty beds
and a crippling hole in its budget.
"I lost 14 beds. I have no idea why they didn't say, 'Hey, listen you
guys, we have this other population of kids. Let's do this.' And I
don't know why they didn't take the money they were paying for those
young boys and try to place that different population,'' said Mullaney,
who came to the Children's Home in 2007 after serving as the chief
executive of Connecticut Valley Hospital.
The removal of the young boys from residential care and the need of the
centers to replace those kids with other children "doesn't by itself
give in-state programs the capacity to serve children with acute
treatment needs,'' DCF said in its written statement.
Mullaney and Walter said that within the past year, DCF has improved
its method of notifying providers when specific services are needed.
For example, Mullaney responded to program alerts from DCF about a need
for treatment of DCF children with developmental disabilities and
children who fell into the autism spectrum. Mullaney said his board of
trustees agreed to take the gamble and spend the money to create those
programs, and said they are doing well.
But Deckman, the lobbyist and director of The Children's League, said
program alerts fall short of a formal bidding process that would allow
local centers to plan for and create new programs designed specifically
for the kids that are going out of state.
And Stone said there's no reason DCF can't request that treatment
programs be designed around the needs of individual children. Stone
also noted that DCF has lined up far fewer foster homes than required
by the "Juan F." consent decree and that the shortage has created
"gridlock'' in the entire Connecticut system.
Deckman added: "We're making investments in Maine, Pennsylvania and
Massachusetts when we should be investing in providers in Connecticut.
We should be reallocating the money that is going out of state. It's
too easy to say there are no programs here. What about the flipside?
How do we make it so we can keep the kids here? There are informal
discussions for months at a time between the department and providers.
But in the end, it goes nowhere.''
Martha Stone
DCF commissioner appointment a 'high
priority'
Jacqueline Rabe, CT MIRROR
November 22, 2010
For two decades, the state has failed to meet the mandates of a federal
court order to improve the way it cares for children in its custody,
making Gov.-elect Dan Malloy's choice to head the Department of
Children and Families a closely-watched decision.
"He has to get this right," said Martha Stone, one of the lawyers
behind the class-action lawsuit that led to federal oversight of DCF.
"Enough is enough. Let's finally fix this."
"This appointment is a very high-priority,' said Malloy's chief of
staff and transition team leader, Timothy F. Bannon. "Now that the
focus is no longer on filling the [budget director] job, we have
shifted to this."
The latest quarterly report by the court-appointed monitor overseeing
DCF cites both the state's continued lack of foster homes and the lack
of medical and mental health treatment for too many of the 4,000
children in DCF care. Overall, DCF adequately met the needs of children
in just over half the cases reviewed, the report said
"You can't change things overnight, but it shouldn't take 20 years to
fix things... Many children still aren't getting the care they
deserve," said Stone, who still represents plaintiffs in the lawsuit.
Among the problems resulting from the lack of foster homes, she said,
are the 300 children living in out-of-state facilities at any given
time and infants living in large group settings.
"When Malloy chooses who will run DCF, hopefully they will be able to
make progress pretty quickly," she said.
Malloy has said the problems at DCF stem from the lack of leadership
and the state's inability to recruit and retain enough foster care
parents.
"We just about need to change everything we've been doing... We have to
change directions," Malloy said during the campaign after a federal
judge rejected Gov. M. Jodi Rell's request to relieve DCF of federal
supervision. Malloy said he agreed with U.S. District Court Judge
Christopher F. Droney's ruling.
Three Connecticut governors have failed so far to reform the state's
child welfare agency enough to end federal supervision. Now it's up to
Malloy and whomever he appoints as the next commissioner to reshape the
$865 million bureaucracy.
Bannon said they have begun reaching out to potential candidates to
replace current-commissioner Susan Hamilton, who announced the day
before Malloy was elected she would resign at the beginning of the year.
"We have been focused on top-tier appointees who just haven't come out
of the process in the past. They have been unsuccessful," Bannon said.
"We are going to solve the problems at the root of that consent decree."
Stone said the constant turnover of leadership in DCF has been part of
the problem.
"It's a revolving door," Stone said, noting that no DCF commissioner
has lasted more than 3 years since federal oversight began. "We need
real leadership."
The state's child advocate, Jeanne Milstein, is confident Malloy
understands what needs to be done.
"He clearly understand the need for a new leadership team at DCF," she
said.