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* UPDATED x1 - DCFS responds * Failing our most vulnerable

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Children in the state’s welfare system are being warehoused in psychiatric hospitals and emergency shelters hundreds of days longer than they should be in many cases because the agency does not have a place for them, a new report found.

The highly critical review of Illinois’ Department of Children and Family Services came from the state auditor general’s office, even though DCFS did not track and could not provide most of the information the auditors sought, according to the report released Thursday. The data DCFS did provide were not ideal, as auditors questioned their accuracy and completeness.

The inspectors found that the delays stemmed in large part from a lack of available placements, scheduling and wait lists. One state ward remained in an emergency shelter 357 days last year, which is a staggering 10 times longer than the court-ordered 30 days, according to the report. Last year 380 children stayed in a shelter beyond 30 days, an improvement from 451 children in 2014, the audit found.

During that same period, the number of children who languished in psychiatric hospitals beyond medical necessity more than doubled to 168 in 2015. The average length of stay for those youths went up to 40 days in 2015, though the report found that one child remained at a psychiatric hospital 184 days after being cleared for discharge.

“Meanwhile, the children are suffering,” said Benjamin Wolf, legal director of the American Civil Liberties Union of Illinois. “I talked to a child who was trapped in a psychiatric hospital, and he was just weeping because he felt abandoned by everybody. What can you say? He has been abandoned. Like a shelter, it’s a miserable place to spend a big chunk of your childhood.”

Go read the whole thing.

* The full audit is here. A sampling from the summary…

• The number of children who remained psychiatrically hospitalized beyond medical necessity was 75 in 2014 and 168 in 2015. The average length of stay beyond medical necessity was 28 days in 2014 and 40 days in 2015.

• The number of children who remained in emergency shelters beyond 30 days was 451 in 2014 and 380 in 2015. The average length of stay for these children, from the date of admission was 72 days in 2014 and 80 days in 2015.

• The number of children who remained in a detention facility solely because the Department could not locate a placement was not available from the Department.

* Just as bad, though, is the fact that DCFS doesn’t seem to be tracking children very well. For instance…

• Psychiatric Hospitals – The Department does not specifically track in its computer systems the date a child is declared “beyond medical necessity.” Because this date is not captured in its systems, we could not obtain a download of children who stayed at a psychiatric hospital beyond medical necessity for calendar years 2014 and 2015. Instead, the Department maintained a list of children, including the beyond medical necessity date, in a spreadsheet that was separate from its computer systems. However, we had no way of verifying the completeness of this information.

• Emergency Shelters – The Department provided data for all children who had been in an emergency shelter in 2014 and 2015; however, we encountered issues that made reporting the number beyond 30 days difficult. The data required manual editing by auditors to determine the number of children in emergency shelters beyond 30 days. This was due to disruptions in stays, such as the child going on the run from the shelter. There is no statutory requirement that DCFS place children within 30 days of entering a shelter. The 30 day standard is outlined in the B.H. Consent Decree. (88 C 5599 (N.D. Ill.))

• Detention Facilities – DCFS was unable to provide this data because it does not track scheduled release dates for youths in detention. Without knowing a scheduled release date, we could not determine if a youth was held beyond that time. (pages 19-22)

Ugh.

*** UPDATE *** From DCFS…

Statement from Director George Sheldon regarding the Auditor General report:

This is one of the most intractable issues we have been dealing with. These are very challenging categories of youth.

To reduce the number of kids in emergency shelters, we have created emergency foster homes. Every child being removed from their own home needs to go to a home setting in their community, not to a shelter. That’s our goal. In June of 2014 we had 136 children and youth in emergency shelters. A year ago it was 91. Today we are at 43.

With respect to youth in detention, we now have two new contracts to provide placements with the supports these young people need, and two additional programs are being developed.

The children and youth in psychiatric hospitals beyond medical necessity are really very challenging cases. There are two categories here. For children already in our care, we are developing a pilot program to have very sophisticated and knowledgeable experts work with our case managers for these cases to get the kids reunited with their families with appropriate services and supports or stabilized in community placements.

Then there are children who are at risk of coming into our care because their families can no longer handle the cost of care on their own. Those are referred to as lockouts, but this is desperation for many families. Our ultimate goal is to provide families the support they need so parents don’t have to lock children out. We are working with the Department of Health Finance (HFS) and Human Services to develop a program and funding to make it possible for these children to stay in their homes.
Four times as many children and youth beyond medical necessity were discharged from the hospitals during the fiscal year just ended than in the year earlier.
We are developing a therapeutic foster care system, with trained professionals as fulltime foster parents, to work with young people who have severe medical or behavioral health needs. Again, it takes time to build this system, but we have three substantial pilot programs in place.

We have more data tools in place now, and our placement staff is tracking each and every child or youth in these categories.

BMN Youth in hospital

We had 16 discharged last week
2 will be discharged this week
Today, we have 21 BMN youth in hospital.
We have 127 total youth in psychiatric hospitals today. We usually have under 150 youth at any one time.

Right now, there are 10 youth in the hospital that are BMN and have pending lock-out investigations, meaning their families do not wish to have them back in their homes.
They are other children who are in hospital Beyond Medical Necessity who may have a pending abuse or neglect allegation so we have to wait to do our due diligence to determine whether they will enter care.

This is actually a growing problem, because families are struggling to cope with the cost and logistics in these cases. We have an Interagency Agreement signed to help address the challenge of lock-outs by parents who need our help, it will address the issue of children being locked-out of psychiatric hospitals by parents.

This is a historical snapshot of BMN

7/1/14 to 6/30/15 75 discharges
7/1/15 to 6/30/16 302 discharges
7/1/16 to date 59 discharges

posted by Rich Miller
Friday, Sep 9, 16 @ 9:57 am

Comments

Hang in there, kids.

Once the Turnaround Agenda is passed, those dozens of corporations the governor claims he has lined up will rush to the state and it will rain silver dollars.

Until then, all the basic responsibilities of the state will just have to suffer.

Comment by Anonymous Friday, Sep 9, 16 @ 10:12 am
“In Illinois there’s been a long-time history of what I would call social service, social justice, a bigger role for government in the safety net than in many other states. I think we can drive a wedge issue in the Democratic Party on that topic.” — Bruce Rauner, September 18, 2012.

This is the Rauner plan.

This is the ONLY Rauner plan.

This has ALWAYS been the only Rauner plan.

– MrJM

Comment by @MisterJayEm Friday, Sep 9, 16 @ 10:14 am
These issues predate current Administration. It has been and continues to be a broken, dysfunctional and unmanageable system.

Comment by to the point Friday, Sep 9, 16 @ 10:17 am
As I recall, Rauner made Quinn’s leadership of DCFS a campaign issue. He has done some good things there, but his deliberate destruction of the social services system overshadows all.

Comment by Earnest Friday, Sep 9, 16 @ 10:25 am
===It has been and continues to be a broken, dysfunctional and unmanageable system===

It has had problems in the past, many of which are on-going, not the least of which is the sheer volume of children needing protection from abuse and in need of counseling and mental health care. That costs money. A lot of money.

I seem to recall Jom Edgar doing some pretty amazing work to turn things around at DCFS. It helped that a court-ordered plan for improvements led to increased state investment in how we protect children.

These children deserve better. This is not the place to cut. This is the place to scour the planet to find the best practices that work and bring them here. We will be judged by how we care for our most vulnerable and we all need to take some ownership of this.

Comment by 47th Ward Friday, Sep 9, 16 @ 10:26 am
This is what happens when you go after very important DCFS workers. They are really critically short staffed. I’ve got a lot of those folks in my local. Their issues are tremendous. I hold those caseworkers and investigators as true Illinois heroes. Man, I don’t complain about my day when I hear theirs. Management needs to understand they can’t do more with less. This study is a prime example.

Comment by Honeybear Friday, Sep 9, 16 @ 10:38 am
It is encouraging that there are four recommendations included in the audit that dcfs has agreed to, with some nice detail listed.

One of the opening paragraphs states,
“The Department had 38 computer systems and applications in its case management portfolio. While some systems interface with each other, many do not. The number of different systems and the separation of applications made it difficult to collect and analyze data for different aspects of a child’s case.”

Anybody who has worked for or with the State of Illinois and survived the ridiculous computer systems, sub-contractor analysts, etc., can understand that paragraph.

Maybe the era of GIGO is winding to a close. Let’s hope so for these fragile youngsters.

Comment by cdog Friday, Sep 9, 16 @ 10:42 am
“These issues predate current Administration. It has been and continues to be a broken, dysfunctional and unmanageable system.”

My mistake.

For a moment I thought these children were the victims. But of course, the true victim is poor, helpless Bruce.

As always.

– MrJM

Comment by @MisterJayEm Friday, Sep 9, 16 @ 10:43 am
Bus them to the governor’s mansion.

Comment by VanillaMan Friday, Sep 9, 16 @ 10:44 am
{to the point}

Um, NO.

The number of youth being held unnecessarily in psych hospitals jumped from 75 under Quinn to 168 under Rauner.

That is more than a 100% increase.

You are playing the false equivalency game.

Sheldon’s point about building an alternative system would be fair, except that he apparently doesn’t realize that you don’t launch a new system unless you have a data collection system in place to figure out if it’s working.

Unless of course, all of these pilot projects are just theatre.

Time to audit everything, Senator Morrison.

#winning

Comment by Juvenal Friday, Sep 9, 16 @ 10:46 am
They need to computerize *everything*. Did you know that if DCFS has a child that has special needs, there’s no foster parent database they can search to see which homes could accommodate them?

Instead they call around to various private agencies (which are now short-staffed and even more overworked) and hope that someone will get back to them.

This is a big part of the problem — the kids don’t have anywhere to go, and the caseworkers are waiting and hoping that someone will get back to them. They don’t know what agencies to target, so they waste resources on a shotgun approach and hope something hits.

Comment by Stuff Happens Friday, Sep 9, 16 @ 10:48 am
>I hold those caseworkers and investigators as true Illinois heroes.

I want to second Honeybear’s shout-out. If you think the rest of us are frustrated seeing children not getting what they need, think how the people who actually meet these kids and go into their homes feel. They have to go into some horrific and heartbreaking situations.

Comment by Earnest Friday, Sep 9, 16 @ 11:10 am
SACWIS, DCFS’s main child tracking system, is the poster child of a failed IT outsourced project. It was only half finished when that contract ended due to cost overruns. The design for most of it is at least 15 years out of date and nearly impossible to maintain or improve.

Maybe Bhat, can do something with his DOIT. But I doubt it. They need to attract some serious IT talent to get that system replaced, but as long as they want to pay state IT employees below market wages and call them over paid, they won’t attract the people they need to modernize some of these systems.

Comment by A Jack Friday, Sep 9, 16 @ 11:15 am
A Jack, it’s not a software system or IT fix as I understand it. It’s a “boots on the ground” problem. You need more people telling the legacy or new computer system what to do and record. It’s a staffing problem. The investigators that I know are consummate professionals. They fight like a demon to protect our states children every day. You’ve got to recruit and train more of these Spartiate, not less, and overwork them to boot. Even the diehards are starting to singe. If Rauner forces us out on strike, even though they are “essential” I believe, they will crack. Rauner needs to “pivot” fast towards the social services and get them some help pronto.

Comment by Honeybear Friday, Sep 9, 16 @ 11:43 am
===These issues predate current Administration. It has been and continues to be a broken, dysfunctional and unmanageable system.===

Maybe so but you don’t shut off life support while figuring out how to treat the disease.

Comment by Cubs in '16 Friday, Sep 9, 16 @ 12:15 pm
Honeybear, DCFS has always been understaffed as far as front line workers go, and has had a number of court orders because of it. And likely will continue to be understaffed because you will have even less qualified people graduating with MSW’s as our universities are underfunded. And besides who is going to want to take those jobs in the current poisoned climate. If you look at the state’s job website you will see numerous postings for front line workers that will likely remain unfilled.
However, even those limited staff they do have need something more than pencil and paper to track the children in their system. If you don’t have the staff, you have to make the staff you do have more efficient to make up for the lack of personnel. The best way to improve efficiency is through computerization.

Comment by A Jack Friday, Sep 9, 16 @ 12:18 pm
By the way, anyone that thinks a National Guard member can fill in during a strike should take a look at the minimum requirements for a Child Protection Specialist.

Comment by A Jack Friday, Sep 9, 16 @ 12:25 pm
Interesting response from DCFS.

Let’s hope the “reforms” are worthy of the souls affected.

One pint really caught my eye,
“Then there are children who are at risk of coming into our care because their families can no longer handle the cost of care on their own. Those are referred to as lockouts, but this is desperation for many families.”

Made me wonder if any of those families’ providers worked at O’hare. /zerosnark.

Comment by cdog Friday, Sep 9, 16 @ 12:41 pm
@11:15 A Jack ===They need to attract some serious IT talent to get that system replaced, but as long as they want to pay state IT employees below market wages and call them over paid, they won’t attract the people they need to modernize some of these systems.==

Munger should loan DCFS some of her IT group. They finished doing difficult custom upgrades to some of her computer programs, maybe they could improve the effectiveness of the DCFS computer systems. That won’t do much to solve the other problems at DCFS, but it might help a little bit.

Comment by DuPage Friday, Sep 9, 16 @ 12:47 pm
The Comptroller is planning on replacing their outdated data warehouse and will probably need their limited IT resources for that project.

Comment by A Jack Friday, Sep 9, 16 @ 1:07 pm
A Jack, you’re right about the open positions. There are a ton of them on the website. In general I agree about the efficiency however sometimes the “fix” is worse than the problem. At DHS we’re about to go live with IES our new system. As they say in my office, “Girrrrrrlllll, you don’t know”. We are going to fly straight into the mountain side. Hot mess of the decade. Hopefully we’ll figure it out before the Feds start to impose sanctions. Again it comes back to properly trained and supported professional employees. I get a lot of folks in front of me who have MSW’s who are totally interested in working for the state “once the nonsense with the Governor is over”. But regardless thanks for responding to me.

Comment by Honeybear Friday, Sep 9, 16 @ 1:14 pm
–because their families can no longer handle the cost of care on their own.–

This is totally true. I get folks in here adding and removing children all the time. Mostly it is Grandma adding the grandkids on for food stamps. Folks we ARE failing fast. I know from many of your vantage points that you don’t see it. Please trust me. Illinois is a failed state.

Comment by Honeybear Friday, Sep 9, 16 @ 1:17 pm
== With respect to youth in detention, we now have two new contracts to provide placements with the supports these young people need, and two additional programs are being developed. ==

“We don’t need to tell you how big this problem is or whether we fixed it. We signed more paper.”

Comment by crazybleedingheart Friday, Sep 9, 16 @ 2:21 pm
Honeybear,
I don’t know about IES, but I have heard that many DHS systems have been outsourced. When you outsource an IT project, you get a cookie cutter solution to a unique problem. And the solution just doesn’t fit. DHS is unique, not only in its human services mission, but it is also unique from any other state’s DHS because of its Department rules promulgated over the years. So hopefully whoever designed IES worked with DHS front line people to find out their unique needs.

Sadly though state IT is often outsourced to those that don’t understand what the users need. There is a perceived notion by some of the upper echelon that the project will be done more quickly or for less money than if they do the project in house. And it is true that the project may be finished more quickly, but it won’t fill the needs of the users. Often the project is outsourced because the users need it but there isn’t staff to get it done quickly.

The IT department is almost always understaffed which is why they created that DOIT. But when someone skilled in programming can find a job in St. Louis, paying 50% more and without being told they are overpaid and underworked, it’s a fairly easy decision.

Comment by A Jack Friday, Sep 9, 16 @ 2:56 pm
A Jack- The IES system is actually well designed for the most part. My job will be tough because I’ll have someone sitting across from me patiently or impatiently waiting for me to figure out how to get to the next page! The problem with IES is that service coordination is a huge complex mystery most of the time. Why didn’t the stamps go on, did the customer do something or did we. It’s just super complex work. People need food and medical YESTERDAY! It’s going to be a rough year and a half.

Comment by Honeybear Friday, Sep 9, 16 @ 3:10 pm
Hasn’t DCFS been relatively unaffected by the state’s budget crisis, as it is or was under a consent decree.

And Director Sheldon, a Democrat, I believe, with significant prior child welfare executive experience, was a good pick by Rauner.

And yes, the problems described are long-standing, as Wolf well knows, as the ACLU has been monitoring the DCFS for several decades.

Whatever the solution, I don’t think we can blame this one on the evil mogul.

Comment by Cassandra Friday, Sep 9, 16 @ 3:34 pm