November 3, 2006
Last week several significant changes were made in the leadership of the Philadelphia Department of Human Services and a related State oversight agency. This occurred in response to a series of tragic deaths of Philadelphia children in the child welfare system. The changes must have been very difficult: the professionals that were asked to resign, or were fired or reassigned, are all good people who have devoted lengthy careers to children’s services. Despite good people trying hard, the results – at risk children not being protected – are not acceptable.
This is not only a Philadelphia problem. Florida, New Jersey, and many other states have also had children “lost” in the system and suffering, resulting in firings, law suits, and reorganizations. Responses in these other states have often included increased staffing and increased resources (laptops, vehicles, information systems) which are both helpful, but do not address the most fundamental problem. Decisions about when to remove a child from his or her family and how to move that child as quickly as possible to the best permanent placement are extremely difficult. It is very challenging for any bureaucracy – public or private – to support good case management in these situations.
Effective case management in child welfare must be very aggressive and proactive: not aggressive in removing a child from a family, but aggressive in following up on warning signs. Methamphetamine addiction is a child welfare crisis. Any hint of it must be followed up, not trusting that everything seems alright. Bureaucracies have a tendency to be reactive rather than aggressive and proactive. “The squeaky wheel gets the grease.” In fact, sometimes current laws do not allow agencies to intervene before actual abuse or neglect has occurred. Unfortunately, being reactive is often too late in child welfare.
Devereux has been a leading provider in several states that are wrestling with these issues. The best resolution we have seen so far is in Florida. The form of the change there was a significant privatization of most of the child welfare services in each district in the state. However, I do not think privatization itself was the reason for significantly improved results. Through privatization, some of the contractors developed much stronger case management models and increased their focus on prevention. These stronger case management models and emphasis on specific, proven prevention models can be implemented within an agency, as well as through privatization.
Of course, I believe that Devereux has developed by far the best case management and prevention models in our Florida operations. Fortunately, that opinion is supported by data and a series of accolades for our programs.
I hope we have an opportunity to share our experience with the City of Philadelphia. We must do better for all our children.
November 8, 2006 at 2:08 pm
As a pediatric critical care nurse practitioner I have always had mixed emotions and experiences with the child welfare system. I have been in many states and served on many child protection teams in major hospitals, It seems to me good case management is dependent on good, responsible, thorough people with good, honest, responsible and able supervisors. Perhaps if our society and in specific our current leaders valued the life of the children already born and spent less time protecting the money of the very rich and protecting the unborn child only during the nine months of pregnancy we could move forward.
I was thrilled to read that Florida is making progress. I can unequivocably state as an adoptive Mom of an African American infant who qualifies for an adoption subsidy based on her prenatal life that it was next to impossible to secure an adoption subsidy from Florida. Her finalization was delayed until she was a year old (came to me at 4 days of age) because no one knew who was responsible for what if anything in the privatized, decentralized enviroment. There are no simple answers.
November 8, 2006 at 2:23 pm
I am fully aware of the crisis regarding children needing help and there not being enough of it or at least not enough time. I do think that there should be some changes made to how things are done or restaffing certain areas, but my husband and I were recently part of an investigation into us regarding something that our 9 year old son(8 at the time) said to his therapist while at an in-patient treatment center. He had corrected himself a day later but the damage had been done and our child services agence here in Houston decided that we might be unfit parents even though we are doing everything that we can to help our bipolar, adhd asperger syndrome, and cerbral dysrhythmia impaired son. They actually took the investigation too far and were threatening to take away our daughter and son, we were consulting attorneys at that time to help deal with the issues.now because of the stress and the money we had put into all of it, we are now behind on our mortgage payments and have a week to come up with 5000.00 or they take our house. so there are some case managers that take things too far and get a little over zealous about protecting children and don’t take into consideration the reasons for a child being placed in a treatment center.
Thank you
November 9, 2006 at 1:18 pm
The state of Florida has the opportunity to seize the day. We just elected a new bi-partisan leaning Governor this week. In June the Florida House passed a Child Welfare bill that among other important goals, requires that the Governor designate an Office of child abuse prevention. It lays out specific mental health recommendations. Devereux has Case Management Organizations (CMO) in three counties in addition to being the largest mental health provider in Florida. We pride ourselves on our goal of individualized care for each client and helping families. In my combined years of almost 10 years of working in foster care in two different states, and my training in education and behavioral analysis, I have worked with countless children and families in crisis. In joining Devereux over 2 1/2 years ago, I have had the opportunity to learn from other professionals and provide treatment for children with developmental delays. I hope that Devereux will grasp the opportunity to help take an active role in needed changes for the individuals in our state. It takes a large vision using prevention and proven methods, not reaction to tragedy, and MANY decidated multi-disciplinary professionals to solve the great problems facing families that cause child abuse.