Foster-care in a state of disrepair
See also:
- This is Child Protection?
- "My baby will be taken from me the moment it's born"
- Gay couple left free to abuse boys - because social workers feared being branded homophobic
- DCFS Adoptions
- Investigators: Grandparents passed over in favor of foster care
- Foster children in polygamist enclave raising concerns
- Child protection facing criticism
- A Critical Look At The Child Welfare System
- Foster care payments used to feed pokies
- Advocates question whether foster kids should be placed close to home
Wow.
I found this outstanding website that focuses on the failures of Child Protective Services. For those who think adoption is all about saving orphaned babies, please read between the lies Adoption Web-sites are selling people. Read what's really happening:
from: fightcps.com/
Washington: Foster Parent Arrested For Abusing A Foster Child For Ten Years; CPS Caseworkers Ignored 15 Reports of Child Abuse!
CPS caseworkers in Washington apparently failed to follow up on fifteen reports of child abuse, but when a neighbor told police a teenage foster child was locked in the closet, the girl was finally rescued from what appears to be a horrific foster care abuse situation. Detectives said the first fifteen complaints weren’t acted on because the foster parent moved from apartment to apartment, and they couldn’t find her, yet at the same time this woman collected foster parent benefits for housing the young girl.
My theory is different. I believe that cases of child abuse in foster homes are ignored because CPS doesn’t get any money for taking children from one foster home and putting them in another. They only get an increase in funding when they take a child from their natural families, then place them in a foster home. Therefore foster child abuse isn’t a priority for busy CPS caseworkers.
Fight CPS hopes to shed light on the problem of abuse in foster homes. Statistics have shown that child abuse of all types is about ten times more likely to happen in a foster home than in a natural family home.
The child, who is now sixteen, lived with foster parent Chornice Lewis, 33, for ten years. Acquaintances said Lewis was very polite and made a good impression on them.
Police allege that if the foster child caused any problems, Lewis put the child’s hand on a hot stove. And if she didn’t listen she had to stand next to her foster parent’s bed all night long. If she slept, a 10-lb weight was dropped on her feet. And once, when she wasn’t packing properly, an insulin needle was plunged into her eye, so the girl is now blind in one eye.
According to a KOMOTV.Com article, Cheryl Stephani, an employee of the Washington Department of Social and Health Services, DSHS, said “We missed it. . . . As a child welfare system. It’s all of us, the courts, the department, the children’s administration. We should hold each other accountable; we need to hold each other accountable.”
Holding CPS caseworkers accountable = Good Idea. When?
Source: Mother accused of abusing foster daughter for years by Bryan Johnson, for KOMOTV.Com, published June 26, 2007.
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social-services suck
from: www.cwla.org
A Snapshot of Children in the Child Welfare System
Mental Health Needs Of Abused And Neglected Children
Children who are victims of physical and/or sexual abuse and neglect are likely to be in foster care for safety reasons and require treatment for mental/behavioral health conditions related to their victimization.
Importance of Medicaid for Abused and Neglected Children
Medicaid alone provides health care protection for more than 51 million people in the United States. That total includes 25 million children, including children in the child welfare system. While Medicaid does address some of the health care needs of children in the child welfare system, its services extend much further.
Medicaid also supports the treatment needs of abused and neglected children, whether or not those children qualify for federal foster care and adoption support through the Title IV-E program. Children in foster care who receive federal Title IV-E foster care and adoption assistance are automatically eligible for Medicaid. However, due to outdated income eligibility standards, less than 50% of all abused and neglected children in this country who are in foster care receive federal support. State and local funds support the other 50% of all foster care placements. All states do however; utilize their option to provide Medicaid assistance for every abused and neglected child in their care who is in need of treatment
Medicaid is used to provide many important services to children in the child welfare system. Almost three-quarters of all Medicaid spending on foster children was used to provide seven (of the 29 total) allowable services.
Importance of Targeted Case Management Services for Children in Foster Care
TCM provides case management as defined in regulation as services that "assist eligible individuals gain access to needed medical, social, educational and other services", such as those children in the child welfare system.
The new Urban Institute report demonstrates that children in the child welfare system who receive Medicaid TCM services have greater access to a variety of services that support a child's well-being. The report documents that through the use of Medicaid TCM foster children are much more likely to receive physician's services, prescription drugs, dental services, therapy, and rehabilitative services than children not receiving TCM services.
The Medicaid data on the use of TCM may reflect recent attempts by the Center for Medicare & Medicaid Services (CMS) to restrict, deny, and prevent states from using these funds to provide foster children with these needed services. In FY 2001, only 38 states funded TCM services for foster children with Medicaid funds.
Medicaid TCM funds are not used to substitute for Title IV-E Foster Care assistance. Title IV-E funds serve a different purpose. Title IV-E assistance funds can only be used to pay for the room and board costs for children in foster care. Title IV-E administrative funds are used to address what is needed to achieve the goal of a permanent living arrangement for a child. These services may include such items as time spent in court, preparation, family meetings, and other social services.
Importance of Rehabilitative Services for Children in Foster Care
Rehabilitative services are defined in regulation as "services that may include any medical or remedial services recommended by a physician or other licensed practitioner of the healing arts, within the scope of his practice under State law, for maximum reduction of physical or mental disability and restoration of a recipient to this best possible functional level." Each state has the option to provide rehabilitative services. A state electing this option designs its program within the parameters set by its state plan. Each state defines its conditions of participation, conditions of eligibility, and the scope of service.
For many states, Title IV-E and Medicaid are each significant federal funding sources for the care and treatment of children in the state's custody. By law, Title IV-E Foster Care and Adoption Assistance is available for the care and support of eligible children. This "care and support" includes room, board, school supplies, supervision, and transportation. It does not include treatment of a child's medical condition or the provision of social services.
Medicaid covered services are designed to treat a recipient's medical condition, with "medical" encompassing both physical and mental health conditions. Medicaid may pay for treatment, but not food, clothing, and shelter. Nursing facilities and accredited psychiatric residential treatment facilities are an exception of this rule. Medicaid does not provide supports to meet the child's needs that are paid for with Title IV-E funds. Title IV-E funds are used to provide food, clothing, and shelter for children in foster care.
While some states claim Medicaid reimbursement for both TCM and rehabilitative services, each program is discrete. States may have either or both programs. TCM is defined as assisting eligible recipients to access needed medical, social, educational, or other services. While rehabilitative services provide medical or remedial services to reduce a physical or mental disability and restore the individual to the best possible functional level.
CWLA's Concerns with White House Proposals to Restrict the Use of Medicaid for Abused and Neglected Children
On August 5, U. S. Department of Health and Human Services Secretary Michael Leavitt sent the White House Medicaid legislative proposals to Congress. Initially introduced in the President's FY 2006 Budget, these proposals specifically call for ways to reduce federal Medicaid support for children in foster care or otherwise involved in the child welfare system.
Members of Congress are currently considering these proposals as they put together budget reconciliation legislation by September 16th that reduces federal spending for entitlement programs by $35 billion over five years. Of that amount, $10 billion is expected to come from Medicaid.
The Administration's proposal reduces federal spending for Medicaid by restricting the use of Medicaid services and by reinforcing that Medicaid is the payer of last resort. The Administration proposal includes options that would:
CWLA Concern: While some of these services currently funded under Medicaid may be allowable uses of other funding sources such as Temporary Assistance for Needy Families, Social Services Block Grant, Title IV-B Child Welfare Services, Title IV-B Promoting Safe and Stable Families program, and to a much more limited extent Title IV-E Foster Care and Adoption Assistance administrative funds and other mental health and juvenile justice funding sources, it is not likely that states would be able to use these other funding sources. These funds are used to provide services for many other allowable populations and are also used to provide other types of services to children in the child welfare system such as child abuse prevention.
CWLA Concern: States do not charge non-Medicaid recipients for case management services. These services are provided to non-Medicaid recipients with state funds. If a state began charging non-Medicaid recipients for these services, it would raise the question whether parents of children in the child welfare system also have to be charged. This requirement would mean that fewer abused and neglected children would receive needed services.
CWLA Concern: It is a common practice for therapeutic programs for children to use a milieu model of treatment. In these programs, treatment is woven throughout the entire fabric of daily activities of the child and it is the child's participation in that program for the day that constitutes treatment. Because of that, one day of service in these programs equals one unit of service and all the costs of providing treatment are bundled into a single rate. Would a bundled rate be interpreted as meeting the requirement of a "fee schedule"? If not, then stand alone services with unit intervals, such as 15 minutes of life skills, 30 minutes of individual therapy; 30 minutes of group counseling would have to be billed instead of one day of service. Enlisting an itemized billing schedule fails to meet the complex and multi-layered approach to services that foster children receive.
CWLA Concern: It is difficult to measure outcomes for TCM since TCM services link children to needed services rather than projecting what the outcomes of those services should be. While it may be difficult to measure TCM services, the services that TCM links recipients to are measurable. The new report from the Urban Institute found that TCM recipients were more likely than non-TCM recipients to receive physician services, prescription drug services, dental, rehabilitative, inpatient, clinic, inpatient psychiatric, and home health care services.
CWLA Concern: FMAP reimbursement rates currently range from 50% up to 83%. Currently over half of the states are operating with FMAP rates that exceed 60%. Altering this reimbursement rate would add an immediate and severe financial burden on states since the proposal calls for an effective date of October 1, 2005.
CWLA Concern: The State's administrative activities are not likely to lessen which means that states will receive less federal support for these activities.
Impact of the White House Proposals
Restricting the use or reducing the federal support for TCM and rehabilitative services for children in foster care would cause states to have to make choices.
Studies also demonstrate that children in foster care have variable access to necessary services. 11 For instance, children in foster care often receive psychological evaluations only after displaying highly disruptive behavior, such as suicidal ideation. 12 When children in foster care receive mental health evaluations, clinical problems are not always addressed properly. According to one study, only 48% of children with psychiatric diagnoses indicating a need for psychotropic medication received any such medication. 13
CWLA Recommendations
The Child Welfare League of America urges you to reject the White House Medicaid changes that would limit services to abused and neglected children. Instead, we urge this Committee to seek ways to improve and strengthen coordination between the Medicaid and child welfare programs at the state level so that all children in the child welfare system have better access to Medicaid and the treatment and services they need.
With the needs of children placed into foster care ever increasing, it is crucial that local and state providers maintain federal Medicaid supports. While some of these services are "optional", meaning that a state has the choice whether or not to provide them, we encourage you not to lose sight of how critically important they are to the well-being of these vulnerable children.
As Congress is considering legislative changes to Medicaid as part of budget reconciliation, CMS is continuing to arbitrarily scrutinize, and in some cases prohibit, state's uses of TCM and rehabilitative services for children in the child welfare system. CWLA opposes these administrative actions that restrict the ability of individual state to meet the needs of abused and neglected children.
Conclusion
While much of the recent reform discussion on Medicaid is cast in terms of how to cut costs and restrict federal spending, the reality is a much larger challenge. This challenge is how to provide comprehensive health care for all children regardless of income boundaries, especially those children in the child welfare system. This reform must provide complete and integrated access to mental health services, behavioral health services and long-term care. The absence of addressing these demands cripples any reforms enacted through a reconciliation package and may only serve to delay an inevitable crisis for children in the child welfare system.
Do they take better care of their kids over there?
from: www.scotland.gov.uk
Children and Young People's Mental Health: A Framework for Promotion, Prevention and Care
7.1 Evidence suggests that some groups of children and young people are at greater risk of developing mental health problems than their peers. There is also evidence to suggest that some groups are likely to find more difficulty accessing the support and help that they need. Among these children and young people are those:
7.2 Additional or specific action is required to ensure that these children and young people are able to access support for their emotional and mental health and wellbeing across promotion, prevention and care.
7.3 The Children (Scotland) Act 199550 sets out the duties of and powers available to public authorities to support children and their families in the interests of a child's welfare. The Act is centred on the needs of children and their families and includes duties of assessment for "children in need" and their carers. The Additional Support for Learning (Scotland) Act 2004 provides a further legislative framework for assessing and meeting the needs of children and young people, whatever those needs might be. The Children (Scotland) Act includes specific provisions to support and protect the interests of looked after and accommodated children and young people, and those who have been in public care. This Framework fits within this overarching legislative context.
Overarching philosophy & culture
7.4 Although there are many factors which are well established as increasing children's vulnerability to mental health problems, there are also many protective factors which need to be considered and supported. These include an individual child's attributes, their relationship with a range of others including their families and their peers, and the availability of support networks. Any assessment of a child's needs, whether formal or informal, should therefore focus on their strengths and skills as well as their difficulties.