* Heidi Dalenberg, Director of the Institutional Reform Project, ACLU of Illinois…

“A cursory examination of the capacity of DCFS reveals that the agency does not have adequate resources to fulfill their core mission - assuring the safety and permanency for youth in their care. Consider the reality: DCFS does not have enough workers to investigate allegations of abuse and neglect, does not have enough caseworkers to help children return to their families or find a permanent home with other loving adults, does not have enough community-based services to help children with significant mental or behavioral health problems, and does not have enough doctors or enough residential facilities to safely care for those same youth.

None of these problems are addressed in the budget adopted for the new fiscal year. Instead, the budget appears to believe that DCFS is about to enjoy a series of miracles, starting with a reversal of the years-long trend of adding thousands more children to the total youth in DCFS care. We would love to live in the world where miracles are possible. The children in DCFS care live in the real world. Every day, DCFS underserves children to such a gross degree that its mistreatment exceeds the ‘offenses’ that DCFS labeled as abuse or neglect when taking the children from their families.

DCFS cannot fulfill its obligation to the children in its care with the budget it requested. We can only hope that if the miracles DCFS is counting on do not materialize, the Department comes to the Legislature for supplemental funding.”

* I asked for some specifics…

Trend of system growth:

According to DCFS’ prepared numbers, the system has been growing as follows, measured at the end of the FY:

FY 2018 closed with 17,463 youth in care
FY 2019 closed with 18,568
FY 2020 closed with 21,099
FY 2021 ESTIMATE is that we will be at 23,238
FY 2022 PROJECTION is 23,544 – essentially flat growth, with no significant change in DCFS practices in place.

Inadequate care of youth in DCFS custody – most extreme example is youth with significant mental / behavioral health needs who are not getting the treatment they need. We have approximately 10 youth per month, since the YouthCare MCO rollout, who have had what we consider “unaddressed” mental health crises. What that looks like is that a call is made for a provider to come out and do an emergency assessment of a youth whose behavior is out of control. The youth either needs stabilization services – and does not get them – or needs a psych hospitalization – and does not get it. The result is that the youth is taken to a hospital emergency room and may sit there for 2 days, 3 days, 5 days, or even longer. The youth eventually gets sent home from the emergency room without receiving appropriate treatment, and has been re-traumatized by this latest experience.

Inadequate placement capacity - Illinois has made little, if any, progress in building community-based supports for youth so that they can be “placed” in family settings rather than in residential facilities. But at the same time, the residential facilities are bleeding staff – they are unable to recruit and retain. By the end of the year we expect that more than 70 congregate care beds will have closed, in large part because providers cannot responsibly keep them open due to staff shortages. Two agencies are shutting down their foster care programs. Provider capacity for Intact family services is shrinking as well in some areas of the state. I believe ICOY has issued a statement about the newly passed budget that contains these figures and has more detail.

What does that look like for children? When a youth is entering care or disrupting from an existing placement, and has significant behavioral or mental health issues, Illinois has nowhere for the child to go. The Department is resorting to use of “unoccupied” bed space at residential facilities – where there is no program in place for the child, no education, no counseling, and no services during the child’s stay – and has one-on-one supervision of the child that is provided by the child’s caseworker. This can go on for weeks.

Inadequate staff of workers to investigate abuse and neglect allegations.
The most recent report we have received regarding the personnel available to conduct investigations shows that the Department is more than 100 workers short of its estimated headcount need. The pattern of vacancies is not consistent across the state – some areas are sufficiently staffed, but other offices are facing critical shortages that push the workers’ caseloads far above BH limits. The worst of the offices are understaffed by 40% or more. DCFS is putting in place emergency measures to support the hardest hit offices, but the shortage of workers continues to be a serious and dangerous problem.

*** UPDATE 1 *** Governor’s office…

Since taking office, Governor Pritzker has increased DCFS’ budget by $340 million. Most of the year over year budget increases funded increased staffing, caseload growth, rate adjustments and IT improvements for the agency’s case management system. DCFS is also making tremendous strides in hiring staff after prior administrations oversaw the hollowing out of the agency.

*** UPDATE 2 *** Andrea Durbin at the Illinois Collaboration on Youth…

Hi Rich,

Thanks for sharing the information from the ACLU. It is true that current staffing shortages within the child welfare system have created potentially dangerous conditions for the children and youth in the system. One aspect of the child welfare system that is frequently misunderstood is that it is not DCFS alone. Illinois has given full case management responsibility for approximately 85% of children in care to community-based organizations, as well as the case management responsibility for most of the families served through intact family services. While DCFS itself has been making strides in addressing the workforce challenges in the public sector, the workforce shortages plaguing community-based organizations have been persistent and dramatic, placing children at risk.

For example, providers are reporting foster care caseload ratios at 21 or 22:1, which is significantly higher than the 15:1 maximum imposed by the Federal consent decree in BH v Smith. These ratios persist even when supervisors and other eligible staff, including program leadership, are forced to carry direct service cases to ensure the safety of children in their care.

Residential treatment programs report staffing at between 63%-68% of capacity, resulting in program closures and long waiting lists at a time when children are living in hospital emergency rooms for days at a time and stuck in psychiatric hospitals for months beyond medical necessity due to a lack of adequate care options for them.

Over the past five years the number of children and families in care has steadily grown. At a time when we should be expanding capacity within the child welfare system, instead we are seeing system contraction. A recent survey of child welfare providers revealed that:

57% of respondents had voluntarily put their agencies on intake hold during the past 18 months
More than 70 congregate care beds have been closed or are closing by the end of this year, on top of the more than 500 beds that were closed during the past 5 years
At least two agencies are shutting down their foster care programs – one in the Chicago/Cook County region and another in six counties in Central Illinois. Some intact family services are also being closed in those same counties.

This workforce crisis is built into the contracts that community-based providers get from DCFS. For example, community-based contracts are structured around paying an intact family caseworker $32,000/year, or just slightly above the $15/hr minimum wage. That same position advertised on the state’s CMS website starts above $55,000/year. Providers are forced to offer wages comparable to fast food and retail jobs for positions that require bachelor’s degrees in human services and special trainings and certifications. In this tight labor market, it is no surprise that they struggle to recruit qualified staff for these essential jobs.

This is not a problem that has happened overnight and it is not going to be fixed overnight. We were heartened to see the letter from Acting Director Smith today assuring providers that there will be a 3% rate increase in FY22 to community-based contracts as well as the establishment of a rate methodology workgroup to address long-term sustainability of these essential services. We look forward to working in partnership with Acting Director Smith and the Governor’s office to address these urgent concerns. The children and youth in our care are counting on us.

Thanks,
Andi

A letter from Director Smith is here.