After strategizing for months, DHS officials have a plan to address Arkansas's foster care crisis.
Start with an undeniable fact: The state of Arkansas is taking children away from their families at an unprecedented rate.
From January 2015 to November 2016, the number of kids removed from their homes and placed in foster care by the Division of Children and Family Services — the child welfare division of the Arkansas Department of Human Services — has grown by 37 percent. There were 3,811 children in foster care on Dec. 31, 2014. In July 2015, when then-DCFS Director Cecile Blucker told the Arkansas Times the system was "just maxed" and identified the situation as a "crisis," there were more than 4,400. Sixteen months later, as of Nov. 21, there are 5,218 children in the care of the state.
To determine why, DCFS in March turned to its independent consultant, Hornby Zeller Associates Inc., a New York-based firm that researches child welfare issues. In June, after analyzing 400 sample cases, HZA delivered its findings to DCFS. The report said the increase in foster children did not seem to be driven by an increase in child maltreatment cases, since the percentage of investigations into child abuse or neglect that were found "true" from January 2015 to March 2016 did not rise dramatically. Instead, it declared, "the increase in foster care is due largely to two factors: DCFS removing more children [from their homes] immediately upon investigation and the courts ordering removals against the recommendations of the agency."
HZA concluded that 22 percent of Arkansas children who were placed in foster care in 2015 and early 2016 should have potentially been left with their families, representing a nearly 30 percent increase in "questionable removals" by the state's child protection authorities. (That increase translates to at least 300 additional children.)
"In most of these cases, there were family supports clearly available which could have prevented the removal or the allegations were simply not sufficiently serious to warrant removal; and in rare instances, the investigative work was incomplete or there was nothing in the record to indicate any safety concern," HZA wrote. The consultant included a list of recommendations to address the problem.
When this newspaper obtained a copy of the document last month under a Freedom of Information Act request, DCFS Director Mischa Martin said in an attached letter that she had "concerns" about the "conclusions drawn and recommendations made," although she also agreed with "many of HZA's findings." At the time, DHS spokesperson Amy Webb said the agency was working on a broader plan of its own that would better address the surge in foster care numbers.
On Nov. 14, DCFS released that plan, "Moving Beyond Crisis," which outlines the first phase of an effort to stabilize the child welfare system. Although the report does not address some key issues identified by HZA, it is nonetheless ambitious and substantial. The agency plans to place more children with their relatives, rather than with strangers in the broader foster care system. By putting more resources into "in-home services," DCFS wants to decrease unnecessary removals of children from their families. It plans to add 228 new employees statewide and address its chronic staff turnover problem. It intends to streamline the foster parent application process. It also aims to help foster children stuck in residential psychiatric or behavioral health institutions.
Coupled with Governor Hutchinson's recent announcement of a proposed $39 million boost in DCFS funding over the next two years — among the largest proposed increases in the governor's fiscally conservative budget — the DHS plan represents a concerted, sustained effort to improve child welfare outcomes in Arkansas. Many of the proposals in the DCFS plan address problems highlighted by the Arkansas Times in our coverage of the state's foster care crisis over the past year and a half.
Jennifer Ferguson, deputy director of Arkansas Advocates for Children and Families, described the report as a "well laid-out plan to address longstanding issues within the division." The spike in foster care numbers has created a budget crisis for DCFS, she said. "The biggest problem is more kids staying in the system. They enter, but they're not able to exit. [DCFS] is operating on a budget that's not built for that many kids." That has created a child welfare workforce "operating in crisis mode" and in dire need of more staff, Ferguson said.
Perhaps surprisingly, the plan was also praised by one of the state's fiercest critics of DCFS: State Sen. Alan Clark (R-Lonsdale), a self-described "far-right conservative" who has led an aggressive legislative investigation into what he sees as abuses of power by DCFS, the courts and other pieces of the child welfare system.
"The problem is so comprehensive, and it requires a comprehensive solution, and that's going to take a while. You can only have so many balls in the air," Clark said. "I really think they're dealing with about as much at one time as you can deal with. Long term, I think they will have to do more, but I think for now, we really couldn't have asked for them to do any more. ... I'm still a skeptic, but I truly believe with [DHS Director] Cindy Gillespie at the top and Mischa [Martin] over DCFS that they're on the right track."
Both Gillespie and Martin took over their positions from agency veterans. Martin, a DCFS attorney, was named interim director of the division in April when Blucker departed after seven years on the job. (Martin's appointment became permanent in July.) Gillespie, a former D.C.-based health care consultant and adviser to Mitt Romney, assumed control of DHS in March. Her predecessor, John Selig, had held the agency director post for a decade.
Since May, Gillespie and Martin have been holding what they call "war room" sessions intended to figure out what is going wrong in the state's child welfare system and how it can be stabilized. The meetings have included DCFS administrators, officials from other DHS divisions and partners with local and national nonprofits.
"There are so many factors and so many issues going on, and they feed on each other," Gillespie told reporters at a press conference accompanying the plan's release. "What we're focused on right now is breaking that cycle."
Here are some of the most significant proposals.
1. Placing more children with relatives, rather than strangers.
The need to increase "relative placements" was a primary focus of a report on DCFS authored by consultant Paul Vincent in July 2015. That study was commissioned by Hutchinson in the wake of an Arkansas Times story about the "rehoming" of two adopted children by a state legislator, Rep. Justin Harris (R-West Fork), and their subsequent sexual abuse. At the time, Vincent noted that only 14 percent of the children DCFS removed from their homes were placed in the care of a family member. The national average for such placements is 29 percent.
"Increasing the use of relative placements is the simplest and most promising next step" toward improving foster care, Vincent wrote. Child welfare experts have long said children fare better with relatives than with strangers, yet many judges (and some DCFS staff) are mistrustful of extended family members who want to care for children removed from their parents.
Last October, the Times wrote about Kimberlee Herring, a Cabot resident whose three grandchildren (ages 3, 4 and 5) were removed from their unstable parents and adopted by a foster family. They were then physically abused in their adoptive home. (The adoptive mother was convicted of second-degree domestic battery in 2015, but is still fighting the conviction on appeal.) Before the adoption, Herring and six other households on both sides of the family attempted at length to obtain custody of the children, but none could gain the approval of DCFS, often due to seemingly minor issues with background checks. Their story is not unusual: Many grandparents, aunts, uncles or other relatives have described being shut out of the foster care or adoption process after a child is removed from his or her parents, despite being willing and able to provide a good home.
Arkansas has already improved its record on relative placements significantly. Since this summer, DCFS has attempted to address bureaucratic hurdles by decentralizing some approval processes, working with local law enforcement to run background checks and having workers on call to approve homes after hours. The number of children placed in the care of a family member or "fictive kin" has now risen to more than 25 percent, and the agency aims to reach or exceed the national average by next August.
2. Removing fewer children from their homes.
In recognition of the fact that children generally fare better and are less traumatized by remaining at home, the DCFS report focused heavily on ways to preserve and strengthen families. At the end of fiscal year 2016, more than 6,000 children were being monitored through what DCFS calls "in-home cases." But high caseloads and an overburdened DCFS field staff means that caseworkers are unable to keep up with the demand to visit homes and provide support services.
This could partly be addressed through a new "prevention and reintegration unit," if Hutchinson's $26.7 million proposed budget increase for fiscal year 2018 wins legislative approval. DCFS proposes partnering with nonprofit and religious partners to expand an existing program called "Nurturing Families of Arkansas," which provides four months of intensive, hands-on parenting education.
Ferguson, of Arkansas Advocates, described the initiative as "a really good evidence-based program ... but it takes funding to do."
DCFS also wants to use federal Medicaid dollars to create a supplemental home visiting program to provide oversight for families with children under 8 who have had substantiated reports of neglect, failure to thrive, Garrett's law (children born with illegal drugs in their system), medical neglect or Munchausen Syndrome. The new program would coach families on basic parenting, home and financial issues and provide guidance and practical support, such as transportation assistance, to help parents manage their children's medical care.
At present, Gillespie said, the agency lacks the means of effectively helping keep children at home in situations where it may be safe to do so. "You've got to get the family ready to take a child back," she said. "That's why ... strengthening families, this prevention and reintegration unit is an incredibly important part of what we're doing. We haven't got the resources right now, in- or out-of-house, to focus on a family that might be getting into trouble."
"The research is really strong on how traumatic it is to remove a child from the home," Ferguson said. She said she couldn't comment on whether the child welfare system in Arkansas removes children too readily, since Arkansas Advocates is "not on the ground," but added, "if you can keep a kid at home safely, that's what you should do."
Clearly, removal is sometimes necessary. It would be difficult to think of a better argument for an aggressively interventionist child welfare system than the case of Isaiah Torres, the 6-year-old boy in Bella Vista who was killed in March 2015 after sustaining years of abuse from his parents. His father, Mauricio Torres, was sentenced Nov. 15 to death for the capital murder of his son; the child's mother, Cathy Torres, is awaiting trial for capital murder as well (see Arkansas Reporter, this issue).
However, the fact is that foster care sometimes holds its own perils. Last month, the Department of Justice announced that a former foster parent from Van Buren, Clarence Garretson, had pleaded guilty to five counts of interstate transportation of a child with intention to engage in criminal sexual activity. FBI agents gathered testimony from multiple victims who said Garretson, a long-haul truck driver, raped them while on cross-country trips. Garretson and his wife operated a DCFS foster home from 1998 to 2004, during which at least 35 minors were placed in the residence.
There are advocates on both sides of the political spectrum who believe child protective services are too quick to take children away from their parents. Richard Wexler, the executive director of the National Coalition for Child Protection Reform, believes that is the case. After reviewing both the DCFS plan and the Hornby Zeller Associates report, Wexler said the DCFS plan "may lead to marginal improvement," but also criticized the agency for not addressing the central point made by its consultant, HZA: that the rise in foster care in Arkansas is due largely to "questionable removals."
"It completely ignores the Hornby Zeller findings — and those findings are the key to real reform," Wexler told the Times. "The only way to fix foster care is to have less of it. ... The DCFS generals are ignoring the message from their frontline troops. What's needed more than another new unit and a bunch of new caseworkers is a fundamental change in the take-the-child-and-run culture that permeates both DCFS and the Arkansas courts."
Among other things, the HZA report ascribes the rise in removals partly to specialized "investigative units" established by DCFS that operate separately from every day family service workers. The consultant said these investigators sometimes see "themselves as law enforcement officials rather than social workers" and adopt an adversarial role with the families they're investigating. This leads to a greater number of children being removed, HZA said. Regular caseworkers told HZA that investigative units had a "low threshold" for removing children whose parents might have been dealt with instead by monitoring them in their homes with protection plans. On the other hand, investigators expressed mistrust of caseworkers' abilities to effectively monitor children left in homes. DCFS officials were not available to explain why the agency report did not address HZA's concerns on that point.
Sen. Clark said DCFS should create an ombudsman position outside the agency's typical chain of command that could handle complaints about overly aggressive action from DCFS staff. "They're going to have lots and lots of complaints that aren't valid," he said. "You know, I get calls every day from people who are guilty. You have to sift through those. But what they're also going to get are the real complaints, the real problems, and when you get that repeatedly — on a certain person, in a certain area — then you deal with it."
3. Hiring and retaining more staff at DCFS.
The staff at DCFS is chronically, mercilessly overworked — another fact the Times has reported on before. Despite the sharp rise in children in the foster care system, DCFS' total staff numbers have not increased accordingly (in fact, there were employee reductions in 2010). The result is that Arkansas family service workers handle, on average, nearly twice as many cases as the national standard, leading to an average of 240 annual overtime hours per employee. Agency-wide, in fiscal year 2016, the agency paid $3.1 million for almost 208,000 overtime hours.
Predictably, the burnout rate is high. Most of the agency's geographic service areas have a 32 percent turnover rate for family service workers, leading to a dearth of experienced staff and too many inexperienced workers making decisions about cases.
While everyone knows turnover rates in the agency are high, DHS Director Gillespie said, "The reports we get are that every month the experience [level] of our staff is going down. ... A big piece of focusing on this area is not just 'let's add more bodies,' but how do we address retention? What is making them leave us?"
For staff working such a huge amount of overtime, Gillespie continued, their lives effectively belong to their jobs. "We hear from our workers that they'd be willing to take a cut in overtime to be able to not have burnout," said Martin. "At some point you can't function when you're working 24/7 all the time."
Governor Hutchinson's request for funding would create 228 new DCFS jobs, including 150 new family service workers, 18 supervisors and 60 program assistants. Among that number would be five employees who make up a "mobile crisis unit," which could deploy to areas that have lost staff to fill in the gap until new workers are hired. DCFS is also hopeful that a new pay plan for agency staff could further help with recruitment and retention.
Clark said he supports the increased funding. "I'm a fiscal conservative. I'm not for throwing money at anything. But I'm also a businessman, and if you've got problems to solve, you need to solve the problems," he said. "They're down to 13 months [average tenure] ... . That is such a major problem. Just imagine what a short time some people have been with the agency, and that they should be prepared to make these decisions?" Clark said that he's visited with caseworkers who are doing "a great job," and that DCFS desperately needs to recruit and retain such people. He expressed hope that "once we fix some of these things, you really should be able to decrease this budget. ... It's kind of like the surge in Iraq: Sometimes you have to do what you have to do to control the problem, and then once the problem's controlled, it'll take less resources."
But Wexler, of the National Coalition for Child Protection Reform, was not impressed. He again pointed out a disconnect between the HZA report's criticism of "questionable removals" of kids and the solutions proposed by DCFS.
"I am a tax-and-spend liberal and proud of it," Wexler said. "I'm glad to throw money at problems, and no problem is more deserving of money than child welfare. But HZA didn't say that children are being needlessly removed because there is not enough counseling and parent education. HZA said children are being needlessly removed, period. They concluded that even with the resources currently available, many children are being taken needlessly from everyone they know and love and consigned to the chaos of foster care."
4. Recruiting and retaining foster parents.
Last September, the Times reported on a backlog of applications from would-be foster parents that appeared to be languishing within DCFS. The process to open a foster home necessarily requires extensive background checks, home visits and other safeguards. But the system also seems at times to bind applicants in red tape for little reason.
Carolyn Edwards of Pine Bluff was one such parent. It took her two years to successfully adopt her niece's daughter after the girl was born with drugs and alcohol in her system — a delay that was largely due to two nonviolent criminal charges on her husband's record, both from over 20 years ago. Lost paperwork, caseworker turnover and sometimes counterintuitive rules made the application process arduous, some foster parents said. In fact, many good foster parents close their homes due to frustrations with DCFS.
The DCFS plan acknowledges these complaints, quoting one foster parent who told the agency in a survey that "it's very frustrating to have to communicate with someone who seems to not want to trust you when you are attempting to help — help that has been heavily solicited. You stop feeling like volunteers and begin to feel more like a resented staff member."
DCFS says it is working to streamline the application process more generally, to take a more customer service-based approach to interactions with families, to create a senior-level position responsible for foster parent support, and to modernize its methods of communication. For example, it is initiating a text messaging system for caseworkers seeking placement options for new foster children. (Caseworkers often tell of hours spent calling one foster family after another to find an available home when a child is in immediate need.) The agency is also piloting a "Rapid Response" program, created by the Casey Family Foundation, in Sebastian County — which has long exemplified the state's foster care crisis, with reports last year of children having to sleep in DCFS offices for lack of open beds in foster homes — that could fast track permanency plans for children whose adoption or family reunification plans have stalled.
DCFS also described steps it would take to increase recruitment of foster homes that can handle older children, groups of siblings and children with developmental disabilities or "complex behavioral health needs."
5. Reducing reliance on behavioral health institutions.
The Times wrote last summer about Ivy Brake, who entered the foster system in 2007 at age 10 and spent the next eight years bouncing to over a dozen placements, including behavioral and mental health facilities. It's unclear whether she ever qualified for behavioral or mental health admission, but during her time in such institutions she accumulated a string of psychiatric diagnoses for which she was prescribed a variety of medications. The Times also spoke to former DCFS workers who confirmed that foster kids are often "sent to behavioral" after they cycle through too many foster homes.
Sometimes residential treatment is necessary for foster children with behavioral or mental health needs. But the DCFS plan acknowledges that a number of foster children have lingered in such facilities beyond any medical necessity, simply because the agency lacks the means to reintegrate them into the community. That creates worse scenarios for children, along with great expense to the system (institutionalization is much more expensive than outpatient treatments).
The report found that "89 youths were 'stuck' in an institution on July 1 for more than 30 days even though it was no longer medically necessary because ... a lack of supportive services prevents them from transitioning to a less restrictive setting." Since the agency's "war room" meetings began, it's made addressing this problem a priority; by October, 28 of those 89 youth had been moved out of long-term residential treatment.
DCFS says it is moving immediately to help children exit unnecessary psychiatric care and has "requested federal approval to create and implement a short-term Medicaid-funded initiative that will build out transitional services for youth leaving psychiatric residential treatment." The $2.5 million program will pay for a "mobile assessment and crisis mobilization unit" that could be operational as soon as this month, as well as family and support services from by a behavioral health provider. The agency also has a longer-term plan to improve the behavioral health system in general — which is managed by a separate division of DHS — and limit children's time in institutions. It is aiming to implement that plan by next July.
Funding for this reporting was provided by readers who donated to a crowdfunding campaign on ioby.com and the Arkansas Public Policy Panel.