Tag: foster care

cps
Former Case Worker: Texas Foster Care Crisis Is Getting Worse

 Grace Reader, 21 hrs ago

Read original article here.

AUSTIN (KXAN) — As the pandemic continues to drag on, a former case worker says the already widely publicized foster care crisis in Texas is only getting worse.

“We have so many children in care, it might be due to the pandemic, there’s a lot of stress on families,” Mayra Butler, a former case worker in District 7, which houses Austin, said. Butler is now the chief executive officer for Homes in Harmony . “We have seen a rise in which there’s more drug usage on the biological parents.”

In July, national officials announced that overdose deaths went up in 2020 by roughly 30%. A record 93,000 people died of an overdose in the United States last year.

Butler also says they’ve seen a spike of kids coming into the foster care system as schools have reopened over the past couple of months.

In the state of Texas, as is the case in almost all states, teachers and school employees are considered mandatory reporters, which means they are legally required to report suspicions of abuse and neglect . They can be charged for not doing so.

“Now that the children are coming back and reporting to teachers of things that might have happened to them of abuse, neglect…so now they’re starting to share with teachers and so that’s where the rise comes in and there’s an overload of children in the DFPS offices,” Butler said.

Mandatory reporters

Even though DFPS says the total number of reports of abuse or neglect have not been significantly higher this year than they have previously around this time, there has been a shift in who is making those reports.

In 2018, more than 66,100 reports of neglect or abuse were made by schools in Texas , that was followed by more than 56,600 made by law enforcement. The numbers were similar in 2019.

In 2020, though, reports made by law enforcement outpaced reports made by schools. There were roughly 20,000 less reports made statewide by school officials.

Foster care failures in Texas, the latest

According to a report released last month by a group of independent court monitors overseeing a federal lawsuit against the state, 501 children spent at least one night in an unlicensed placement in the first half of this year alone.

Some children spent more than 100 consecutive nights without a “proper” placement. The report found that 86% of these children were teenagers, and many of them require intense or specialized care, due to serious mental health needs or past trauma, that they likely weren’t receiving.

The report also noted Texas has lost more than 1,600 foster beds since January 2020. DFPS officials have continually pointed to this loss of foster beds and treatment center closures as their reason for lacking placements for high-needs children.

“There is a dire need for a lot of foster homes, all over the state of Texas,” Butler said.

‘We do need our community to be more involved’

Seeing the desperate need for foster families in Texas, Butler, and a foster family that Butler knows from case work, opened their own foster and adoption agency out of Laredo. It also serves District 7, which houses Austin. They were officially contracted with the state in April of this year.

What they really need right now, Butler says, is for people to step up and open their homes to these kids.

“There is a great need. We do have constant emergency placements needed and children that are waiting in the office to be placed, especially teenagers,” Butler said.

A catastrophe’: More than 200 kids sleeping in CPS offices as need for foster care intensifies

“If you can provide a home that is safe, if you can provide love that is genuine, and just want to help a child in need, you’re highly qualified,” Butler said.

You can find the foster parent application for Homes in Harmony here .

aging out, cps
California is the First State to Approve Guaranteed Income For Foster Youth

Aging out of foster care has to be one of the most difficult and scary times for foster teens. This is a time that sees many whose fear leads them to attempt or commit suicide before they age out.

I’m extremely happy to see an initiative to address those going through this delicate process. I’m interested in seeing how those who receive the help fare as time passes. Of course money is only one of many complex needs these teens face in their transition into becoming an adult.

Please comment with your thoughts.

Thank you and Godspeed.

Many thanks to ELIZABETH AMON for this article.

In a historic move to support young adults raised by the government, a monthly check of up to $1,000 — with no restrictions and no strings attached — will be sent to thousands of California foster youth once they leave the state’s custody, guaranteeing them the first statewide universal basic income.

Veronica Vieyra benefited from the UBI program Santa Clara County has in place for former foster youth.

California’s state Senate and Assembly unanimously passed the $35 million program on Thursday, which was then approved by Gov. Gavin Newsom on Friday.

Responding to the news in a text message, Vieyra, 25, celebrated the state leaders’ decision. 

She said the benefit “has now become the one helping hand youths are in search of when feeling lost or alone after exiting the foster care system.” 

Legislative analysts estimate that the taxpayer-funded program will serve between 2,400 to 2,500 young people like Vieyra who exit the foster care system each year.

“It’s not a nice-to-have, it’s a need-to-have for these young people,” said Priya Mistry, the director of community initiatives at the San Jose-based nonprofit Pivotal, which supports foster youth with education and employment support. Mistry said the money will make a profound difference, allowing young people to “actually have a place to live, pay rent, bills, and money for a cell phone — which is critical.”

The amount former foster youth receive will be determined by local governments and organizations, but will likely be $1,000 a month, aiding these young adults who struggle far more than others their age with homelessness, educational delays and incarceration.

In May 2020, the Santa Clara County Board of Supervisors approved a universal basic income pilot plan, with no-strings-attached payments to help keep former foster youth’s lives stable in turbulent times.

The plan provided a lucky group of former foster youth, ages 21 to 24, with $1,000 monthly payments for up to a year. It was the first time the nascent idea of universal basic income has been granted specifically to foster youth.

“We’re already doing it, and it’s been successful so far,” said Sparky Harlan, the CEO of the Bill Wilson Center, which provides services to more than 5,000 children, youth, young adults and families in Santa Clara County.

The local government decision came in the middle of the COVID-19 pandemic, as unemployment rates in California approached a devastating 24%.

The Santa Clara County supervisor who spearheaded the effort, Dave Cortese, later became a state senator and this year, introduced Senate Bill 739, which was combined with the governor’s universal basic income proposal.

Gov. Newsom announced in May a statewide universal basic income program, building off of efforts in Stockton, Oakland, and other cities. These programs have been gaining momentum with plans previously announced in New Orleans, Louisiana; Los Angeles and Oakland, California; Tacoma, Washington; and Gainesville, Florida; according to the Associated Press.

Sen. Dave Cortese announcing the Santa Clara County foster youth UBI program. Photo courtesy of the office of Dave Cortese.

Under California’s state law, local governments and organizations will determine the size of the monthly payments, which can range from $500 to $1,000 per person each month. Pregnant people will also be prioritized for benefits, as well as other low-income Californians, according to the most recent state budget summary.

Former foster youth April Barcus told The Imprint in March that even before the pandemic wrecked low-income people’s finances, California’s housing costs kept many of her peers from building savings and a sense of security. 

“Even if you work a minimum wage job full-time, it’s not enough,” Barcus said. “You’re always working, and you’re always behind.”

Barcus is among the thousands of young people emerging from foster care who will soon be able to rely on a steady income.

The law had bipartisan support and passed 36-0 in the Senate and 64-0 in the Assembly, according to the AP. However, Vince Fong, a Republican Assembly member from Bakersfield, told the news service that guaranteed income programs “undermine incentives to work and increase dependence on government.”

“We should be pushing policies that encourage the value of work,” said Fong, who abstained from Thursday’s vote. “Guaranteed income doesn’t provide the job training and skills needed for upward mobility.”

But many of these young people are working, and the money provides “a cushion, so they aren’t on the edge of homelessness,” director Harlan said. And given the added burdens of the pandemic, many people need that help to pay for car insurance or repairs, as well as upgrading technology so they can join Zoom meetings or participate in online learning.

The concept of a UBI payment for former foster youth recently received the strong endorsement of University of Chicago social work professor Mark Courtney, a leading researcher on young people aging out of the child welfare system. In a Feb. 5 opinion piece published by the nonprofit news outlet The Appeal, Courtney advocated for guaranteed direct cash assistance to help young adults “bridge the gap” from foster care to independence.

Courtney makes this case after spending decades surveying thousands of young adults across the country on the hardships they face after leaving the system.

“The government functions as their parent,” wrote Courtney and co-author Shanta Trivedi, a fellow at Georgetown University Law Center, “and then swiftly extinguishes financial support, depriving foster kids of the safety net that so many of their peers increasingly find necessary.” 

cps, foster care
Missing Children in Foster Care -Remembering the Forgotten

i can think of only one event more traffic than being falsely accused and having your child taken into foster care and a result- and that is being falsely accused and your child being taken into foster care, wrongly, and then finding out your child is missing!!

What a horrific thought. It happens. It shouldn’t happen but it does.. A child who goes missing and isn’t found if one of the worst tragedies. Lack of closure can haunt a parent of a missing child for the rest of their life.

Tens of thousands of children the foster system has lost –

Remembering the forgotten children.

More than 60,000 kids across the country are unaccounted for by the child welfare system that is supposed to protect them.

Original article by Rene Denfeld| The Washington Post

12:39 PM on Jun 19, 2018 CDT

The public has exploded in outrage at American immigration authorities’ treatment of children in recent months, but meanwhile there are tens of thousands of other children who are unaccounted for in this country: the more than 60,000 foster children who have gone missing.

A review of federal records by investigative reporters Eric Rasmussen and Erin Smith revealed in May that child welfare agencies throughout the country have closed the cases of at least 61,000 foster children listed as “missing” since 2000. An additional 53,000 were listed as “runaway.” Their investigation aligns with other reports of children missing from various states — 80 currently missing in Kansas, hundreds lost in Florida. Against the scandal of migrant children unaccounted for is another scandal: that our nation has lost track of so many of its own.

Just how did 60,000 of these children disappear? Blame a lack of federal oversight, underfunded agencies straining under almost half a million children, high caseworker turnover — in some jurisdictions, staff turnover is as high as 90 percent a year — and a chilling indifference to the plight of foster children.

In Arizona and other states, children who are missing for six months are dropped from the foster care rolls. A “missing” foster child is not necessarily on the streets; some are safe with a foster family or relative, and even though the state has lost track of them, they aren’t being harmed. But the point is that the state has no idea. In one case in Illinois, workers closed the case of a 9-year-old child who had disappeared. It took investigators a year to locate her, but she was alive. In Florida, a 4-year-old girl was missing for 15 months before anyone from the Department of Children and Families noticed. Her foster parent is in prison in her killing.

Lara B. Sharp, a successful writer who grew up in foster care, says that of the foster children she knew, “all went either missing or they died, mostly before age 18.” Sharp told me of three different times workers misplaced her. This happened when she was moved from one home to another, and no one updated her file. Had she been kidnapped or run away during these times, no one would have known. She would have fallen through cracks in the system so wide they are canyons.

The outcome for this negligence can be deadly. Sharp recalls a girl she lived with named Jennifer, who had lost her parent in a car accident. When she was 15, Jennifer went missing. She ended up sex trafficked and murdered. “She was a lovely, kind, clever, sheltered little girl,” Sharp says. “She loved the Bronte sisters and The Brady Bunch. I will never forget her.”

But our government has forgotten thousands of children like Jennifer. No one seems to know where these children are or how they vanished. In many cases, they are assumed to be runaways. In Texas last year, 1,700 foster children were declared runaways. Of these, 245 are currently missing. And they are at profound risk.

“Most of the children who are being bought and sold for sex in our nation are foster care children,” human rights attorney Malika Saada Saar writes. “Our very broken foster care system has become a supply chain to traffickers.” In one of many examples, a national FBI raid to recover child sex-trafficking victims found that 60 percent of the children came from foster care.

I asked human rights worker Quintan Wikswo why the recent case of missing immigrant children sparked outrage, but thousands of vanished foster children have not.

“It’s easier for partisan politics to use the immigrant children disappearances as fuel for whatever case they want to make,” Wikswo says. “But it is far more unpopular for folks to look into their own communities, to get involved in their own local judicial and law enforcement elections, and ask for documentation that their representatives are prioritizing the foster network.”

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cps, parental alienation syndrome
Heartbroken Parents of Alienated Children Never Stop Trying To Reach Out To Their Children

source:

Alienated parents share unanswered texts to their kids and it’s crushing

by:Alexandra Carlton

Being prevented from seeing or communicating with your child is a special kind of hell – but a parent’s love never dies.

Imagine if you were unable to see or speak to your own young child.

You may know where they live. You may have a phone number or email address or social media handle for them.

But because they live with a hostile parent who controls their contact – your efforts to communicate disappear into a black hole of despair.

Alienated parents, also known as ‘targeted parents’ are distinct from estranged parents, who have a rift in their relationship with a child for a legitimate reason such as abuse, neglect or infidelity.

Alienated children have been caught in high-conflict separations where they have been forced to choose a side, and are aligned, both physically and emotionally, with one parent, rejecting the other.

Reaching out to an alienated child: ‘Never give up’

For loving parents, yearning for child who is alive but cut off from them is a special kind of agony – a pain some have described as “a living death”.

Almost all targeted parents continue to reach out to their children by whatever means available, as a way to let their children know that they haven’t given up. Amanda Sillars, who runs alienated support group The Eeny Meeny Miney Mo Foundation, calls these communication attempts “breadcrumbs of love”.

I asked a dozen alienated parents to share some of these “breadcrumbs of love” – messages of unbreakable love that went unanswered.

The responses are beyond heartbreaking:

This mum sent thousands of unanswered messages to her sons over the years before discovering their phone had been cut off. Source: Alex Carlton

Parents never give up – no matter what. Source: Alex Carlton

What does parental alienation look like?

Never assume that a parent who doesn’t see their child has done something wrong.

In some cases there may be court orders that mandate that the child must see both parents, but the alienating parent defies them with impunity.

Sometimes there may be no court orders but the alienating parent has successfully ‘turned’ a child against their mother or father, resulting in the child taking one parents’ side in an effort to reduce the conflict between the parents.

In almost all cases, the alienated child had a loving, normal and secure relationship with the parent they no longer see before the alienation happened – even if their demeanour towards the targeted parent has become hostile.

What does the research say?

There is little Australian data available about parental alienation but according to a study from published in the Children and Youth Services Review, at least 22 million American parents may be a victim of this terrible form of abuse.

It’s thought to affect both mothers and father equally. It can be a difficult concept to understand, even for professionals. Research about it is minimal and there is little consensus about appropriate remedies.

It is recognised in courts in the US, Canada and the UK – and increasingly in Australia – but more research is needed to find out why it happens, what the effects are on children and parents and the what the legal and therapeutic communities can do to help those it affects. The Australian Institute of Family Studies has some information here.

If you are a parent who is alienated from their child or a child who is alienated from a parent, The Eenie Meenie Miney Mo Foundation has some excellent resources that may help.

Most of all, stay strong. And never give up.

How to reach out to your alienated child

Amanda Sillars urges targeted parents to keep trying to contact their children, even if they receive no response, as they may one day be the ‘breadcrumbs’ that their children can follow to reconnect and reunite with the parent they love and terribly miss.

“Often the children read the messages but they don’t want to be caught responding,” she explains. “You might not see the positive outcomes for months or years – but your kids may one day have an opportunity, away from the house or on holidays, to try and reach out. Don’t give up.”

She offers some excellent tips for parents trying to communicate with their alienated child here.

Tips for reaching out to an alienated child

  • Speak with love and kindness
  • Always stay calm and never react
  • Focus forward
  • Don’t bombard them with communications even though you may be excited to get a break through
  • Expect crumbs in communication – anything more is a bonus
  • No response is not always a bad thing
  • Be the best version of you
  • Avoid dark and heavy conversations
  • Show your children that you are interested in them
  • Ask them about school, activities or hobbies they may be involved in, friendships they have and so on
  • Avoid talking about the situation
  • Remember: actions speak louder than words
  • Don’t make promises you cannot fulfil
cps
Removing Children from their homes IS a big deal…

by 14thdaymom

child-abuse-foster-care-300x300

My last post about the BREAKING NEWS in Houston where a judge made an unprecedented move when ordering CPS to have NO CONTACT with children it removed from their natural home.

At the end of the video a statement is made that I think needs to be reiterated, and that’s how big a deal it is to take a child from their parents.

IT IS A HUGE DEAL.

download

It is against the constitutional rights of the parents and the kids!

How big a deal is it? Its been 14 years since my son was taken from me. We have since been reunited now that he’s an adult, but not without scars. As I tried to share in my posts about ambiguous loss, parents often learn the hard way, as I did, how hard it will be when they meet back up with their kids one day.

The expectations of what will happen when they reunify and what actually happens are not the same. It blindsides them when what they’ve built up in their minds are expectations almost impossible to meet. Kids who were separated from their families grow into dysfunctional adults, and the parents never heal.

images

The family in Houston lost their children for three days. That’s horrible and it’s awesome to know it was acknowledged as wrong. I lost TEN YEARS with my son. The judge showed justice in their case, but there’s countless other families who did not get that justice. It is a big deal to take children from their families. It’s such a big deal that it NEVER GOES AWAY.

No matter what. It is a lifelong curse. The kids become a case number to the social worker but the social worker becomes the person that changed that kids life path entirely. A decision like that will affect them for the rest of their lives.

There is nothing that can make that right. There would be no amount of money that could fix the damage done to my relationship with my son. There is no telling how our lives would have fared if he had not been taken from me. NOTHING can mend that pain that I still feel EVERY DAY, even 14 years later. Some days are better than others. Some days I might almost go without thinking about it, but something will always remind me. Some days I can’t escape it. I can’t go back in time, and I can’t erase the memories. I still feel the anger and have to stuff it inside. I still carry guilt just comes with the questions … the could’ve been, should’ve been torture.

Its been 14 years and still it is a big deal. Fortunately I have the support and understanding of two people very close to me. My husband who was put in a boys home 30 years ago but recalls it like it was yesterday. My best friend sadly understands as well since she lost her kids too many years ago. She still has not reunited with hers. They are adults now too, after 9 years since they were separated. She suffers the grief so deeply. It truly haunts her.

I can talk to her or my husband any time I need to. i know it’s been 14 years and sometimes I catch myself feeling like I’m just repeating myself over and over again. I know that they’ve both heard my story and thoughts a thousand times over.

They know that they’ve heard my story before. Still, they listen to me with understanding and compassion like it’s the first time I’ve told them.

That’s because they understand how big a deal it was when my kid was taken from me.

If only the CPS workers had understood what a big deal it was when they took him from me.

cps, post traumatic stress disorder
Sudden, lasting separation from parent can permanently alter brain

GettyImages_500414662.0

I feel badly for the children who are taken from their families at the border because they are the innocents.

I find it difficult to feel badly for the parents because they are not the innocents.

The adults know ahead of time that what they are doing is illegal, and they are doing it anyway. They are putting the innocents at risk of being taken.

There are ways to come into this country LEGALLY. If they enter the U.S. LEGALLY (albeit it may take longer or require more effort) but that would not place the children at risk of being taken.

That being said, I cant help but to point out that all the outrage is making me sick.

These children and their fate is being used and exploited politically and the outrage I believe, is being media driven.

If you are truly outraged over this issue, then you should have been outraged a long time ago.

Just like parents who commit a crime, do drugs, or abuse their children, know they might have their children taken away if they get caught, these immigrants know if they cross the border illegally and get caught, they may lose their children.

This atrocity has been happening in the United States to OUR CHILDREN, U.S. CITIZENS, with the foster care system EVERYDAY… FOR YEARS.

Many times the parents who lose their children to foster care did NOTHING wrong.

These families are separated from each other in their very own home in their very own country… keep that in mind…

Foster-Care-v2.png

Are we saying foreign children matter more than our U.S. children?

I hope not.

The protests and outrage is long overdue.

Read the original article here

June 22 (UPI) — At birth, the brain is the most underdeveloped organ in our body. It takes up until our mid-20s for our brains to fully mature. Any serious and prolonged adversity, such as a sudden, unexpected and lasting separation from a caretaker, changes the structure of the developing brain. It damages a child’s ability to process emotion and leaves scars that are profound and lifelong.

That’s bad news because, although President Donald Trump has ended his “zero-tolerance” immigration policy of separating parents and children at the border, there are some 2,300 childrenwhose reunification with parents remains uncertain.

In my psychiatric and therapeutic practice, I work with children and adults who as children experienced unexpected and lasting separation from their parents. Some fare better than others. Some struggle with major psychiatric disorders, whereas others have no psychiatric diagnosis. Yet, their feeling of safety and trust in others is compromised. The impact of separation trauma is everlasting.

Born to be nurtured

Altricial species, such as humans, are dependent upon parental care for survival and development after birth. The parent is necessary to regulate the offspring’s temperature and to provide food and protection against environment threats. This is accomplished through parent bonding with the offspring that nurtures a deep attachment. The newly born learn quickly that signs of parental presence, such as an image, voice, touch or smell, signal safety.

Studies in mammals show that infants naturally conform to parental emotions. The presence of a calm and caring parent produces the feeling of safety in a child. On the contrary, parental distress and fear activate the infant’s brain circuits that are responsible for processing stress, pain and threat. The ability of a caretaker to regulate the offspring’s emotions is an adaptive function encoded in our genes. Before people have our own independent experiences, we start learning what is safe and what is dangerous in the surrounding environment through observing and interacting with our parents. This increases our chances of survival and success in the world.

Numerous studies show that parental presence is more important than the surrounding environment for the emotional well-being of an infant or a very young child. As long as the parent is present and remains calm and caring, the child is able to endure many threats and adversities. Metaphorically speaking, the caretaker is the world for the young child.

Separation alters the brain’s structure

The parents’ presence is also necessary for a person’s harmonious growth and development. That includes the development of our psychological and social functions, such as our ability to respond to stress and self-regulate our emotions or our ability to trust others and function in a group.

Any serious and prolonged disruption of parental care, especially in infants and very young children, alters how the young brain develops. Very young children, younger than 5 years old, separated from their parents cannot rely on their presence and care anymore, which causes their stress levels to spike. As stress hormones like cortisol, epinephrine and norepineprhine rise, they alter physiological functions of our bodies to better prepare us to cope with threat. However, prolonged increases in the levels of stress hormones disrupt physiological functions and induce inflammation and epigenetic changes — chemical alterations that disrupt the activity of our genes. Turning genes on or off at the wrong time alters the developmental trajectory of the brain, changing how neural networks are formed and how brain regions communicate.

Studies of children who were separated from their parents or neglected by their parents, and experimental research on animals, consistently show that the disruption of parental presence and care causes a precocious and rapid maturation of brain circuits responsible for processing stress and threat. This fast-track development alters the brain’s wiring and changes the way how emotions are processed.

Short, sharp separation quickly causes harm

Laboratory studies show that it doesn’t take long for separation to hurt these infants and children.

In laboratory rodents these changes in brain wiring are triggered when a pup is separated from its mother for a mere two to three hours a day for a several consecutive days. We know the stress to the pups is caused by the mother’s absence, not by other changes in the environment, because the researchers continued to feed the pups and maintain their body temperature during the experiment.

Premature maturation of stress and threat processing networks in the brains of children separated from parents stunts the child’s development and leads to loss of flexibility in responding to danger. For example, most of us are able to “unlearn” what we may have initially considered threatening or scary. If something or someone is not dangerous anymore, our defense responses adapt, extinguishing our fear. This ability to unlearn threat is compromised in maternally separated animals.

The subsequent reunification with a parent, or the replacement with a new caretaker, may not reverse the changes caused by this early separation stress.

Pictures of the brain reveal altered brain structures

Brain imaging studies demonstrate structural and functional changes in the brains of children separated from their parents. Specifically, the stress of separation increases the size of the amygdala, a key structure in threat processing and emotion, and alters amygdala connections with other brain areas. On the molecular level, separation alters the expression of receptors on the brain cell’s surface involved in stress response and emotion regulation. Without the right number of receptors, the communication between neurons is disrupted.

The trauma of either permanent or temporary separation poses general health risks and affects academic performance, success in career and personal life. In particular, the loss or separation from parents increases the likelihood of various psychiatric disorders, including post-traumatic stress, anxiety, mood, psychotic or substance use disorders.

The Conversation

The feeling of safety and the associated ability to bond with others, the ability to detect and respond to threat, as well as the ability to regulate one’s own emotions and stress are vital. Early reprogramming of neural circuits underlying these functions can directly or indirectly alter the child’s physical, emotional and cognitive development and causes lifelong changes.

Jacek Debiec is an assistant professor in the Department of Psychiatry and an assistant research professor in the Molecular & Behavioral Neuroscience Institute at the University of Michigan.

This article was originally published onThe Conversation. Read the original article.

cps
Trump has passed a new federal law aimed at keeping at-risk families together during treatment

This new federal law will change foster care as we know it
BY TERESA WILTZ
Stateline.org
May 03, 2018 01:00 AM

WASHINGTON

A new federal law, propelled by the belief that children in difficult homes nearly always fare best with their parents, effectively blows up the nation’s troubled foster care system.

Few outside child welfare circles paid any mind to the law, which was tucked inside a massive spending bill President Donald Trump signed in February. But it will force states to overhaul their foster care systems by changing the rules for how they can spend their annual $8 billion in federal funds for child abuse prevention.

The law, called the Family First Prevention Services Act, prioritizes keeping families together and puts more money toward at-home parenting classes, mental health counseling and substance abuse treatment – and puts limits on placing children in institutional settings such as group homes. It’s the most extensive overhaul of foster care in nearly four decades.

“It’s a really significant reform for families,” said Hope Cooper, founding partner of True North Group, a Washington, D.C.-based public policy consultancy that advised child welfare agencies on the new law. “The emphasis is really on helping kids stay safe with families, and helping vulnerable families get help earlier.”

Most child welfare advocates have hailed the changes, but some states that rely heavily on group homes fear that now they won’t have enough money to pay for them.

The federal government won’t release compliance guidelines until October, so states are still figuring out how the changes might affect their often-beleaguered systems. Most expect the impact will be dramatic, particularly states such as Colorado that have a lot of group foster homes.

For the first time, the Family First Act caps federal funding for group homes, also known as “congregate care.” Previously, there were no limits, Cooper said. The federal government won’t pay for a child to stay in a group home longer than two weeks, with some exceptions, such as teens who are pregnant or parenting.

But even in states that are moving in the direction envisioned by the federal law, officials are worried about certain aspects of it.

In New York, state officials are concerned that the limits on group homes will cost counties too much. Under the new caps, New York counties will have to chip in as much as 50 percent more for certain children, said Sheila Poole, acting commissioner for New York’s Office of Children and Family Services. That would be a significant hit for smaller counties with scant resources, she said.

In California, city, county and state officials and child welfare advocates worry the law will place a burden on extended family members who are raising grandchildren, nieces and nephews outside of foster care. That’s because “kinship caregivers” won’t be eligible for foster care payments under the new law.

This practice isn’t new, but it is likely to expand under Family First, said Sean Hughes, a California-based child welfare consultant and former Democratic congressional staffer who opposes parts of the law.

The new law, Hughes said, “closes the front door to a lot of safety nets that we’ve developed for kids in foster care.”

Child protective services investigates alleged abuse or neglect in as many as 37 percent of all children under 18 in the United States, according to a 2017 report in the American Journal of Public Health. African-American children are almost twice as likely as white children to have their well-being investigated by child protective services. (The report only looked at reports of child abuse and neglect, not placement in foster care.)

A March report by the U.S. Department of Health and Human Services found the foster care population increased by more than 10 percent between 2012 and 2016, the last year for which data is available. The agency linked the increase in child welfare caseloads to the nation’s opioid epidemic, which is ravaging families.

In six states – Alaska, Georgia, Minnesota, Indiana, Montana and New Hampshire – the foster care population increased by more than half.

To help reverse the trend, the new law places a greater emphasis on prevention.

The federal government underfunded prevention services for years, said Karen Howard, vice president of early childhood policy for First Focus, a Washington, D.C.-based child advocacy group that worked on the legislation. Before the enactment of Family First, states got reimbursed for foster care through funding provided by Title IV-E of the Social Security Act – and that money could be used only for foster care, adoption or family reunification. The money could not routinely be used for prevention that might keep families from sending their children to foster care in the first place.

Now, for the first time, evidence-based prevention services will be funded as an entitlement, like Medicaid.

That means that prevention services will be guaranteed by the federal government for the families of children who are deemed “foster care candidates”: usually kids determined to be victims of abuse or neglect who haven’t been removed from their home.

Under the new law, states may use matching federal funding to provide at-risk families with up to 12 months of mental health services, substance abuse treatment and in-home parenting training to families. Eligible beneficiaries are the families of children identified as safe staying at home; teen parents in foster care; and other parents who need preventive help so their kids don’t end up in the system. States must also come up with a plan to keep the child safe while remaining with parents.

Some child welfare advocates, such as Hughes, worry that 12 months of preventive care isn’t enough for parents struggling with opioid addiction. People with opioid addictions often relapse multiple times on the road to recovery.

Many preventive services, such as home visiting, clinical services, transportation assistance and job training aren’t eligible for Family First funding, Poole said.

The law provides competitive grants for states to recruit foster families; establishes licensing requirements for foster families who are related to the child; and requires states to come up with a plan to prevent children dying from abuse and neglect.

In another first, the law also removes the requirement that states only use prevention services for extremely poor families. Because the income standards hadn’t been adjusted in 20 years, fewer and fewer families qualified for the services, advocates say. Now, states don’t have to prove that an at-risk family meets those circa 1996 income standards.

“That’s significant,” said Howard of First Focus. “Because abuse happens in rich homes, middle-class homes, poor homes. This is a game changer, because states can really go to town” to provide innovative prevention services to troubled families, Howard said.

Under the new law, the federal government will cap the amount of time a child can spend in group homes. It will do so by reimbursing states for only two weeks of a child’s stay in congregate care – with some exceptions, such as for children in residential treatment programs offering round-the-clock nursing care.

The new restrictions begin in 2019. States can ask for a two-year delay to implement the group home provisions of the law, but if they do, they can’t get any federal funding for preventive services.

The group home provision comes after the U.S. Department of Health and Human Services issued a 2015 report showing that 40 percent of teens in foster care group homes had no clinical reason, such as a mental health diagnosis, for being there rather than in a family setting. Child welfare experts saw this as more evidence that group homes were being overused. Children’s average stay in a group home is eight months, the report found.

Some states rely more on group homes than others, with the amount of children in congregate care ranging from 4 to 35 percent of foster care children, according to a 2015 report by the Casey Foundation. Colorado, Rhode Island, West Virginia and Wyoming have the greatest percentage of children living in group homes, though the report also found that over the previous 10 years, the group home population had decreased by about a third.

Those who oppose the group home restrictions say they are too narrow in scope.

The law’s additional requirements for congregate care “reduce a state’s flexibility to determine the most appropriate placement for a child and would negatively impact the likelihood of receiving sufficient federal funding,” said Poole, the acting child welfare commissioner in New York. She said the state is weighing whether it will ask for a two-year delay.

It makes sense to not place foster youth in group homes unless absolutely necessary, said Hughes, the California consultant. But sometimes it is necessary. The vast majority of foster youth in group homes are there because staying in a foster home or with a relative didn’t work out, Hughes said. For kids who’ve been through trauma, particularly older kids, a traditional foster home isn’t equipped to give them the care they need, he said.

“The idea that kids are placed in group homes because the system is lazy and doesn’t have any regard for their well-being is unfounded,” Hughes said.

aging out, cps
Dallas County Foster Kids Age Out to Troubled Lives…
 Its Almost Tuesday wants us all to remember, stories like these are about the children who live to age-out.  Many do not. Many commit suicide just prior to their 18th birthday. Those are the ones that the system needs to focus on, how that sort of tragedy could have been prevented.
Maybe listening to the ones that live to age-out can give us the answer to saving the next suicide victim-to-be.

After aging out of foster system, some teens’ troubles are just beginning

|by Source of article: JANET ST. JAMES,  WFAA 

Posted on September 5, 2013 at 10:31 PM                                                    Updated Friday, Sep 6 at 4:55 PM

DALLAS — When many high school students are fighting for Independence, Seth Miller seemingly has it all.

He wears what he wants, eats when he wants to, has complete Independence, and an apartment of his own.

But Seth would trade it in a second for one thing.

“One family,” he said. “Even if I had to live in a box — family.”

When Seth was a baby, he was adopted into a large family. The adoption lasted until he was seven, when abuse allegations split up the children.

He remembers what his adoptive mother told him on his last afternoon at home.

“‘You’re just going to spend the night, but you’ll be back tomorrow,'” Seth recalled. “Sometimes I question why she didn’t tell me the truth.”

In the coming years, Seth would live with five other foster families, never feeling part of any of them. Neglect was part of his foster life, he says. Distrust of people and anger at the world grew.

“You were just a number,” Seth said stoically.

At 18, Seth became a legal adult and aged out of the foster care system. He left his last foster family in an attempt to find happiness.

About 1,500 Texas teens age out of the foster care system annually, with few resources to help them survive the adult world. Many struggle with unemployment and crime. Nearly half, according to some research, become homeless.

A few weeks ago, Seth was living in his car.

“I remember one night, I did fall asleep and woke up the next morning and I was like this,” Seth said, leaning on his steering wheel, “and my neck kind of hurt. I never imagined living like that.”

“He called and told me he was homeless,” said Virginia Barrett, a Court Appointed Special Advocate, or CASA.

Unlike state case workers, CASA’s are volunteers charged with protecting the best interests of a single child. There are not enough CASA volunteers for every foster child in North Texas.

Barrett has been Seth’s CASA since he was seven. When the state assistance stopped, this volunteer has kept helping the angry, abandoned young man.

She gathered donations and helped Seth rent an apartment so he could finish his senior year of high school.

“My goal is to make it better,” Barrett said. “That’s what we’re working on.”

She’s trying to get Seth into a supervised independent living program to help him meet his monthly financial needs so he can concentrate on graduating.

Seth has biological siblings he has never met, and never knew existed until a few months ago. For now, Virginia is his only family.

Seth also works full-time at McDonalds. He is determined he will not fail himself.

He believes the system, overloaded with too many foster children, too many unqualified foster families, and too few case workers, let him down.

“I know I’m tough because I went through a lot,” he said. “And I’m going to make it. Because I have to. That’s all I have. That’s the only choice I have.”

Seth would like people to take notice of what he calls a broken system, to protect other vulnerable children who grow up in foster care.

He hopes other foster teens will see him now and know they are a number.

Number one.

E-mail jstjames@wfaa.com

WFAA Reader Comments:

cps
Forgotten Children

I saw filthy living conditions

"Pee wall" next to sleeping quarters at therapeutic foster camp.
“Pee wall” next to sleeping quarters at therapeutic foster camp.

make-shift outhouses

4a (Large)
“playhouse” at a therapeutic foster camp

unsanitary food storage in so-called outdoor camps

Sleeping facilities outside at therapeutic foster camp.
Sleeping facilities outside at therapeutic foster camp.

 

where children must sleep in sleeping bags – no walls, no fans, no heat – for months and months and in many cases, year after year.

Water hole where children at therapeutic foster camp are forced to shower year round.
Water hole where children at therapeutic foster camp are forced to shower year round.

That’s not care.

Isolation area to punish foster children in attic with lock on outside of door.
Isolation area to punish foster children in attic with lock on outside of door.

That’s cruelty.

image_71290
Worker at therapeutic foster camp demonstrating a technique in restraint of foster child.

That’s not educating.

Foster Child in Army Fatigues
Are foster children being forced to wear army clothes? Why?

That’s endangering”

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Carol Strayhorn on Texas Foster Care System in 2004

cps
The Comptroller’s Health Care Claims Study – Drugging Foster Children

(CLICK HERE TO DOWNLOAD & LISTEN TO A FOSTER CHILD DESCRIBE, TO HIS MOTHER, THE EFFECTS OF PSYCHOTROPIC MEDICATIONS HE WAS GIVEN IN FOSTER CARE BY MISTAKE IN COLLIN COUNTY TEXAS.)

Its Almost Tuesday is determined to keep thE  PROBLEM OF CPS DRUGGING FOSTER CHILDREN alive AND TALKED ABOUT!

IN THAT REGARD, please READ & share THE IMPORTANT INFORMATION  IN THIS ARTICLE with others & demand accountability FROM OUR GOVERNMENT OFFICIALS!

cover2
Special Report of Foster Children has revealed many failures and tragedies – by connecting the dots between the state’s foster children and their Medicaid medical and prescription drug claims. The picture is bleak, and rooted in profound human suffering. It represents nothing less than a failure of the entire Texas foster care system.

Voluntary medication parameters and guidelines have been created and the Health and Human Services Commission (HHSC) and its allied agencies have issued a request for proposals (RFP) “to contract with a single Managed Care Organization (MCO) to develop a statewide Comprehensive Health Care Model for Foster Care.” But much more needs to be done. (See Appendix I for a history of psychotropic medications and foster children and Appendix III for a comparison of fiscal 2004 and 2005 foster care psychotropic prescriptions.)

The complex nature of the foster care system generates many opportunities for fi ngerpointing, but ultimately the responsibility must lie at the top, with the government agencies that allowed this situation to develop.

While not all foster care providers provide optimum care and treatment, HHSC and the Department of Family and Protective Services (DFPS) must be held accountable. They place the children and monitor them—or fail to—and they pay the medical bills.

One of the biggest differences between foster children and other children is that foster children often do not have an active and engaged guardian or caregiver in their lives like other children.

While DFPS has a policy that requires foster care caseworkers to visit children on their caseloads at least once a month and visit them at their places of residence at least every three months – in reality this does not always happen. Caseworkers rely on foster care providers or foster parents to ensure that children in their daily care are doing well and following their treatment regiment. In many cases this system works well and foster children receive the service they need.

However, because the foster care population moves from place to place with frequency there is often no single person on a daily basis that watches out for the well being of the child. In addition, many foster children have very complex emotional and physical needs.

Foster children are often prescribed numerous psychotropic medications.

These powerful medications sometimes carry warnings from the U. S. Food and Drug Administration regarding their adverse effects that can be serious or even life threatening. Some foster children receive combinations of psychotropic medications, which can then create other side effects. Foster parents often do not have the training or expertise to be able to monitor these children.

Most children have biological parents or guardians, who know exactly what types of medical treatments, prescriptions, etc. their children have had. In fact, most biological parents or guardians know who their children’s doctors are and how to reach them. However, in many instances foster care providers do not know a child’s medical history or physician because they have not received any of the child’s medical records.

In addition, foster care providers don’t normally know right away what to expect from a foster child, and in many cases do not have a chance to care for children for prolonged periods of time because they are moved so frequently. (As documented in the Comptroller’s Forgotten Children report.)

To analyze the extensive amount of Medicaid prescription data, the Comptroller called on two internationally recognized and extensively published experts: Julie Magno Zito, Ph.D., a professor of pharmacy at the University of Maryland School of Pharmacy; and Dr. Daniel J. Safer, a psychiatrist and professor at Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences.

These authorities guided the review team in examining and understanding these records, and in making recommendations for improved care.

This external review produced a number of key findings:

Key Points of The Zito/Safer External Review include:

• Most prescribed psychotropic medications for foster children are “off-label”, which means they are not FDA approved for this population or for a particular indication. Consequently, pertinent safety and efficacy information on medications is very limited for this age group.

Increasing the number of concomitant medications increases the risks of adverse drug events.

Random assignment, evidence-based, controlled, clinical trial data on psychotropic medications prescribed concomitantly for youth are essentially non-existent.

MEDICAL CONCERNS

This report reveals a number of significant medical concerns within the state’s foster care system.

LACK OF MEDICAL HISTORIES

DFPS still does not provide its foster children with a “medical passport” explaining their medical history, including diagnoses and prescriptions although the passport is required by law.

Instead, foster children often move from one placement to another, seeing new physicians or counselors who have little or no knowledge of their past medical histories. A medical passport would help provide more consistent care for these children.

In September 2006, DFPS stated that it “is working with HHSC on the development of the health passport, scheduled to be implemented September 2007”— more than three years after the Comptroller’s first published recommendation. Psychiatric Hospitalizations DFPS has no rules, guidelines or monitoring procedures concerning the psychiatric hospitalization of foster children.

In fiscal 2004, 1,663 Texas foster children were hospitalized for psychiatric care for a total of 33,712 days, at a cost of $16 million based on daily rates of more than $500 per day.

DFPS has no rules, guidelines or monitoring procedures concerning the psychiatric hospitalization of foster children.

More than 400 foster children spent than a month each in psychiatric facilities in fiscal 2004.

Some of these foster children were “dumped” into psychiatric hospitals, by foster parents who decided that they could not deal with the child’s behavior.

DFPS caseworkers often left foster children in such facilities long after they were authorized for release.

Medically Fragile Children

The Comptroller’s office estimates that about 1,600 “medically fragile” children were in Texas foster care in fiscal 2004. These children have serious and continuing medical conditions requiring specialized care and treatment. About 49 percent of them were four years old or younger.

Many of these children were in “basic” service-level homes, because DFPS places more emphasis on behavioral conditions than on physical conditions and needs.

HIV and AIDS

DFPS has been particularly negligent in caring for foster children with fatal and incurable human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS). These children are not receiving consistent care and counseling.

Some have been enrolled in clinical trials and did not have advocates appointed for them.

  • At least one foster facility that cared primarily for children with HIV and AIDS was closed due to poor living conditions and substandard care.
  • Twenty-six Texas foster children received at least one HIV medication and had at least one outpatient HIV procedure in fiscal 2004.
  • More than 15 had at least one outpatient procedure with an HIV-related diagnosis code, but did not receive any HIV medications—a peculiar and disturbing pattern.

Many of these children were categorized at the lowest, basic service level.

In fiscal 2004, 63 foster children were raped while in care; of these, only 16 received HIV tests.

Meaning that 75 percent of those raped were not tested for HIV following the rape, as required by law.

One foster child with HIV who was also medically fragile had more than 600 outpatient claims and more than 200 prescription drug claims in fiscal 2004.

This child lived in rural Texas, in a 1,300 square-foot mobile home with four other foster children, one of whom also was medically fragile. A review of the DFPS records indicated that this small home was not licensed to care for more than four children.

Sexually Transmitted Diseases

Some Texas foster children are suffering from sexually transmitted diseases (STDs).

Many are sexually active or were sexually abused while in care, while others come into care with the disease. In fiscal 2004, more than 200 foster children were diagnosed with STDs.

Most of them were teenagers between the ages of 15 and 19. DFPS should recognize this problem and actively address it through education, testing and appropriate treatment.

The review team found irregularities in prescribing practices and counseling delivered to foster children with STDs; females in foster care were six times more likely to be diagnosed with a STD than males.

Pregnant Foster Children

In fiscal 2004, 142 foster children delivered babies.

The DFPS guidelines regarding birth control, pregnancy and abortion are vague and are not given to providers and foster parents.

Some pregnant foster teens received powerful psychotropic medications that are not recommended for use in pregnant women.

And many were moved repeatedly throughout their pregnancies, because many residential treatment centers and foster homes will not take them.

Texas has few specialty maternity homes that can offer services to these teens. Foster teens and their new babies, moreover, often were not placed in the same home in a timely manner following their discharge from the hospital.

Contraceptives and Foster Children

In fiscal 2004, Medicaid spent $176,814 on more than 4,300 birth control prescriptions for more than a thousand Texas foster children.

Medical claims for these children suggest that not all sexually active foster children receiving these medications were given their recommended yearly gynecology examinations.

A 15-year-old mentally retarded foster child received eight different prescriptions for birth control pills in fiscal 2004, but had no claims for a gynecological examination.

And, a 17-year-old foster child received six different prescriptions for birth control patches in fiscal 2004, but had no claims for a pap smear or gynecological exam. This child was diagnosed with a sexually transmitted disease early in fiscal 2004.

Injuries and Deaths

In fiscal 2004, 46 Texas foster children died while in care.

DFPS determined that five of these deaths resulted from abuse and neglect, but 15 cases were left “open” and abuse and neglect were not ruled out.

HOW MANY DEATHS OCCURRED THAT SAME YEAR BY ABUSE AND NEGLECT FROM NATURAL PARENTS IN TEXAS? JUST CURIOUS – IF ANYONE HAS THAT DATA?

Many other foster children were taken to emergency rooms or hospitals with very severe injuries and medical conditions.

Medicinal Poisonings

More than 150 foster children were poisoned by medication in fiscal 2004, and not all of these cases were investigated by DFPS.

Some foster children remained in the same foster homes after they survived the poisoning.

DFPS and HHSC should ensure that every poisoning from medication is investigated.

The DFPS hotline received a report that a nine-year-old child was being overmedicated, but the agency did not investigate the case.

Foster Children and Clinical Trials.

It was revealed in May 2005 that HIV positive Texas foster children had been enrolled in experimental clinical drug trials.

This news sparked nationwide coverage of the topic, since the children were being exposed to potentially serious and even lethal side effects of the trial drugs.

Because of the confidential nature of clinical trials, it is not possible to find out details regarding Texas foster children enrolled in such studies, but some questionable indicators were uncovered – such as medications were billed with no record of medication payment and foster children that are HIV positive with no Medicaid billings for medications.

Section 6544 of the DFPS Handbook states:

…no HIV infected child in DFPS conservatorship may participate in any experimental drug therapy… unless the child or child’s caregiver first secures the written approval of the child’s physician or program director of the child’s conservatorship unit.

The review team asked DFPS:

How many foster children participated in any experimental drug therapy or clinical trials from fiscal 2004 to 2006, and how such participation is reported or tracked and if there is detail by disease or condition?

The agency responded as follows:

There are currently no clinical trials for HIV, so no children in foster care were enrolled in this type of trial between FY 2004 and FY 2006. A few children in foster care may be enrolled in other clinical trials.

This response is vague and it is clear DFPS either does not know how many foster children are in clinical trials—or chooses not to tell.

(NOTE: THEY CHOOSE NOT TO TELL.)

According to the U.S. National Institutes of Health website in September 2006, there were 1,928 clinical trials under way in Texas, including several related to HIV.

Executive Summary &

Systemic Recommendations

More than 150 foster children were poisoned by medication in fiscal 2004, and not all of these cases were investigated by DFPS.

The Medications

In fiscal 2004, Texas Medicaid spent $30 million for powerful, expensive psychotropic prescriptions for Texas foster children. Many of these children received multiple medications. Psychotropic medications can have very serious side-effects and their use should be strictly monitored; a large number of them are not approved for use in children or adolescents.

The review team found that Texas foster children receive more psychotropic medications than their counterparts in mid- Atlantic and Midwestern states.

DSHS has set voluntary parameters for the use of psychotropics by foster children. These guidelines were released in February 2005 and were supposed to be revised annually. A committee met in August 2006 to discuss the revision; the first revised parameters were scheduled for release in October 2006.

Key concerns identified by this review include:

  • Costly Psychotropic Medications In fiscal 2004, psychotropic drugs accounted for more than 76 percent of the cost of all medications prescribed to foster children, which totaled $39 million for all medications.
  • All other drug categories, including a wide variety of drugs from antibiotics to cancer medications, accounted for just over 23 percent of the total or $9.2 million.
  • Of all drugs prescribed to children in foster care, three psychotropic drug classes, antidepressants, antipsychotics and stimulants— were the most frequently prescribed.
  • In fiscal 2004, Texas Medicaid spent more money on antipsychotic drugs for foster children, more than $14.9 million or 38 percent of the total, than on any other class of drugs.
  • The average cost per prescription for psychotropic drugs was $114.69. The average for all other drugs, by contrast, was $52.17 per prescription.
  • Antipsychotics: In fiscal 2004, Texas Medicaid spent nearly $15 million on 65,469 anti-psychotic prescriptions for Texas foster children.

NOTE: BIG PROFIT FOR DRUG COMPANIES

CPS takes children from homes, usually on unsubstantiated referrals of abuse or neglect.  They drug the children, test drugs that are not FDA approved, bill the state-funded (tax payers) Medicaid Program, offer kickbacks to pharmaceutical companies & doctors, and funnel the funds amongst themselves at the expense of families and children. – MILLION AND MILLIONS OF DOLLARS.  

WHEN THE OFFICIALS GET CAUGHT FOR MEDICAID FRAUD, the Texas Government  REFUNDS THE MONEY BACK TO MEDICAID

– but cannot prosecute anyone for the Medicaid Fraud because of a COMPUTER GLITCH THAT DESTROYED THE EVIDENCE NECESSARY TO PROSECUTE ANYONE!

What about the foster children who were drugged? What about the trauma induced in the parents who saw their children drugged at visits?

What has been done for these children? NOTHING.

Can Governor Rick Perry tell the children and their parents what will be done to compensate them for their ruined lives?

These very powerful and expensive medications were prescribed despite a lack of studies demonstrating their safety and efficacy in children.

There are questions regarding the long-term safety of these medications; documented serious side-effects include menstrual irregularities, gynecomastia, galactorrhea, possible pituitary tumors, hyperglycemia, type 2 diabetes and liver function abnormalities.

Close monitoring of these medications by physicians is essential; Texas foster children are not receiving this attention.

In addition, more than 400 foster children were prescribed antidyskinetics drugs to control side effects from antipsychotics.

Side effects from antipsychotics include tremors, tics, dystonia, dyskinesia and tardive dyskinesia.

Stimulant Prescription Drugs:

  • In fiscal 2004, Texas Medicaid spent $4.5 million on 45,318 stimulant prescriptions for more than 6,500 Texas foster children.

Nearly all of these medications are Schedule II controlled substances, due to their high potential for abuse and severe psychological or physical dependence.

More than a quarter of all male foster children and nearly 15 percent of female foster children received prescriptions for stimulants in fiscal 2004; nearly 200 of these children were aged four or younger.

In addition, some foster children received many questionable high-cost, high-dose prescriptions.

One prescription for a foster child was written for 360 pills of the stimulant Adderall XR 30mg—for a 30-day supply. (note : that’s 12 pills a day!!!)   Adderall XR is an extended-release medication meant to be taken only once daily. 

NOTE: WAS ANYONE ARRESTED FOR MEDICAL NEGLECT?

WHO WAS HELD ACCOUNTABLE FOR POISONING THAT CHILD?? 

WHAT KIND OF DOCTOR OR FOSTER PARENT WOULD DISPENSE A DOSE LIKE THAT TO A CHILD?

DID THEY DISPENSE IT TO THE CHILD?

DID THEY ONLY DISPENSE THIS MEDICATION ON PAPER FOR THE PROFIT?

DID THIS CHILD OVERDOSE!!!????

 Its Almost Tuesday would like to know.

Anticonvulsants (Mood Stabilizers): accounted for more than 76 percent of the cost of all medications prescribed to foster children, which totaled $39 million for all medications. 􀃍

In fiscal 2004, Texas Medicaid spent nearly $4.8 million on nearly 43,000 mood stabilizer prescriptions for about 4,500 Texas foster children.

This included 133 children aged four and younger.

These medications are used to treat bipolar disorder, anxiety and depression; some also are also used to treat seizures and epilepsy.

NOTE: FOR A FOUR YEAR OLD OR YOUNGER???

HOW MANY FOUR YEAR OLD CHILDREN ARE BI-POLAR WITH ANXIETY DISORDERS?   

Trileptal and Topamax, which together accounted for about 38 percent of all mood stabilizer prescriptions, have no established efficacy for psychotropic use in either children or adults.

Antidepressants: In fiscal 2004, Texas foster children received more than 66,000 prescriptions for antidepressant medications, making this drug class the most commonly prescribed medication.

Antidepressant medications ranked fourth in the total cost of prescriptions for fiscal 2004, at $3.8 million.

In June 2003, the U.S. Food and Drug Administration (FDA) began to investigate the use of antidepressants to treat children and adolescents.

NOTE:  BEGAN TO INVESTIGATE??

PRESCRIBED MORE THAN 66,000 ANTIDEPRESSANTS BY THE NEXT FISCAL YEAR? AND THEY CLAIM THEY WERE NOT DOING CLINICAL TRIAL STUDIES?

THEY ARE USING FOSTER CHILDREN AS GUINEA PIGS!

In October 2004, the FDA ordered drug manufacturers to place a “black box” warning on all classes of antidepressants stating that they may increase the risk of suicidal behavior in children and adolescents.

NOTE: I WOULD LIKE TO KNOW HOW MANY CHILDREN IN FOSTER CARE COMMITTED OR ATTEMPTED SUICIDE AND WERE ON ANTI-DEPRESSANTS?

Anxiolytics (Anti-anxiety): In fiscal 2004, 688 foster children received 3,113 anti-anxiety prescriptions.

The largest subclass of these drugs, and the most widely prescribed, are the benzodiazepines.

NOTE: ONE OF THE LEGALLY PRESCRIBED DRUGS I WAS TAKING AND THE SAME CPS USED AS ONE OF THE REASONS FOR REMOVING MY CHILD INTO FOSTER CARE – WHERE THEY THEN PRESCRIBE THE SAME MEDICATIONS…?

These drugs have been used with success to treat anxiety, but their use is limited because they have sedating side effects and may be habit-forming when taken for a long time or in high doses.

Anxiolytics are regulated under Schedule IV, by the U.S. Drug Enforcement Administration (DEA).

Hypnotic/Sedatives: In fiscal 2004, Medicaid spent more than $72,000 on nearly 2,500 hypnotic/sedative prescriptions for about 1,000 Texas foster children, including 232 children aged four and younger.

These medications are used to treat anxiety or sleep disorders. They can cause dependency in just a few days and tolerance in a few weeks.

Psychotropic Use by the Very Young

In fiscal 2004, 686 foster children aged four and under received more than 4,500 prescriptions for psychotropic medications,

NOTE: THATS AN AVERAGE OF 7 PRESCRIPTIONS PER CHILD UNDER THE AGE OF FOUR the majority of which are not approved by the FDA for use in children.

A two year-old foster child with no diagnoses indicating psychosis received seven prescriptions for Risperdal, a powerful antipsychotic, totaling more than $700.

NOTE: TWO YEARS OLD –  AND THESE PEOPLE ARE NOT JAILED, ARRESTED, OR HUNG ON A STAKE???

A TWO YEAR OLD BABY!!!???

Controlled Substances

In fiscal 2004, Medicaid spent $4.6 million on more than 53,000 prescriptions for controlled substances for more than 9,600 Texas foster children.  

NOTE: HOW MANY OF THESE VERY SAME FOSTER CHILDREN WERE REMOVED FROM THEIR HOMES FOR PARENTS HAVING SUBSTANCE ABUSE ISSUES? 

FURTHER – HOW MANY OF THOSE CHILDREN REMOVED FOR PARENTS HAVING SUBSTANCE ABUSE ISSUES DID NOT INCUR INJURIES OR ABUSE BUT WERE MERELY REMOVED DUE TO THE S.A.  ISSUES?

HOW MANY OF THOSE CHILDREN WERE THEN GIVEN CONTROLLED SUBSTANCES IN FOSTER CARE?

HOW MANY OF THOSE FOSTER CHILDREN WILL BECOME DRUG ADDICTS THEMSELVES AS A RESULT OF CPS FOSTER CARE DRUGGING THEM?

The U.S. Drug Enforcement Administration (DEA) has placed these substances on the controlled substances list because of their high potential for abuse.

More than 2,300 Texas foster children, including 871 children age four and younger, received more than 3,200 prescriptions for addictive narcotic syrups.

A total of 177 foster children received more than 1,100 prescriptions for phenobarbital.

NOTE: READ ABOUT PHENOBARBITAL ON WIKIPEDIA HERE

Long-term Risks and Polypharmacy

The Zito & Safer External Review notes that the widespread use of antipsychotics in children and adolescents raises particular concerns regarding long-term safety.

Serious questions exist regarding this issue, which involves documented, side effects.

Little is known about the long-term effects of early and prolonged exposure to psychotropic medications on the development of children’s brains.

These findings underline the importance of further research to determine the safety and efficacy of pediatric psychotropic drugs and polypharmacy.

The use of psychotropics in the Texas Medicaid population of children and adolescents tripled from 1996 to 2000.

A 2004 Texas study by the HHSC’s Office of the Inspector General revealed that foster children receive more psychotropic drugs on average than other Texas Medicaid children.

Psychotropic use by Texas pre-school-aged foster children was three times higher than among similar foster children in the Mid-Atlantic states. Instances of “polypharmacy,” the prescription of two or more psychotropics for one person—has increased rapidly as well.

Complex psychotropic drug therapy tends to result in ever-increasing combinations that tend to increase in continuously enrolled populations and present risks for long-term safety in developing youth.

Off -label Usage

Most psychotropic medications have not been studied extensively for efficacy and safety in children.

The National Institutes of Mental Health notes that about 80 percent of psychotropic drugs are not approved for use in children or adolescents.

Their use in this population is described as “off-label.” Yet the off-label use of these drugs in children is common.

Efficacy Questions

Many medications prescribed to Texas foster children have been shown to have no or minimal efficacy. Among antidepressants, for instance, FDA findings from clinical trials showed little or no efficacy from the use of escitaloram (Lexapro), paroxetine (Paxil) and venlafaxine (Effexor).

Yet prescription patterns among foster children appears to ignore such findings from clinical trials that show a lack of or minimal efficacy.

In fiscal 2004, Texas foster children received the following:

escitaloram (Lexapro): nearly 12,000 prescriptions totaling $763,000.

paroxetine (Paxil): more than 550 prescriptions totaling almost $50,000.

[youtube=http://youtu.be/AWr1GK7w1uE]

venlafaxine (Effexor): about 3,000 prescriptions totaling more than $300,000.

NOTE: EFFEXOR.COM STATES: 

Suicidality and Antidepressant Drugs Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, teens, and young adults.

Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide.

Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. 

EFFEXOR XR®(venlafaxine HCl) is not approved for use in children and teens.

Many anticonvulsant drugs are being used as mood stabilizers for Texas foster children, including oxcarbazepine and topirimate.

These drugs have been found to be ineffective for psychiatric purposes.

Nevertheless, they were widely prescribed to Texas foster children in fi scal 2004:

oxcarbazepine (Trileptal): nearly 13,000 prescriptions totaling $1.98 million.

topiramate (Topamax): more than 3,300 prescriptions totaling more than $500,000. Compound Drugs In fiscal 2004, 572 foster children received nearly 2,000 prescriptions for compound drugs.

The FDA is concerned that such drugs carry a risk of contamination and the efficacy and potency can be effected. Fraud and abuse can also be a factor in compound drug prescriptions.

Recommendations to improve the Texas Foster Care system that should be implemented immediately:

1. The Health and Human Services Commission, Office of Inspector General should fully investigate areas of concern and cases of interest identifi ed in this report.

2. DFPS should hire a full-time physician to serve as its medical director, to oversee the care, treatment and medications provided to Texas foster children. The medical director should evaluate medical care provided to foster children and report the results to the DSHS and HHSC annually. The medical director should establish an analysis team to assist with the evaluation. The team should consist of psychopharmacologists and child and adolescent psychiatrists from medical schools.

3. The newly created DFPS medical director should be responsible for ensuring that all foster care parents and facilities receive “medical passport” information within 48 hours of the foster child’s placement. The “passport” should be updated consistently and should document all medical treatments, prescriptions, psychological diagnoses and counseling to provide continuity of care.

4. DSHS should review this report and begin implementing its recommendations as soon as possible, including those from the external review by Zito/Safer.

5. DFPS, in coordination with DSHS and HHSC, should examine the best practices of successful foster care providers to develop and implement means to reduce the system’s reliance on psychotropic medications to treat foster children.

6. DFPS should establish strict rules regarding participation by foster children in any type of clinical trial. In addition, DFPS should track and monitor all foster children who are enrolled in clinical trials. All foster parents and providers should be made aware of the rules and the potential risks of clinical trials. Additional recommendations more specific to each problem are made in later chapters in this report.

Counseling

Some foster children receive counseling services, but not all do, and others do not receive consistent counseling.

According to the American Counseling Association, “Professional counselors help clients identify goals and potential solutions to problems which cause emotional turmoil; seek to improve communication and coping skills; strengthen self-esteem; and promote behavior change and optimal mental health. Counseling is a technique that can be used by individuals coping with a mental illness, recovering from a trauma, managing stress, or dealing with family issues.”

While some foster children suffer from severe mental illness, others have milder problems. The various options described below may help to reduce the number of psychotropic prescriptions prescribed to Texas foster children. Innovative Therapeutic Provider One Texas therapeutic foster care provider consciously uses a different approach to treat very troubled foster children, most of whom are classified by service level as specialized.

This facility employs intensive therapeutic intervention that focuses on teaching children appropriate ways to problem-solve and make healthy and positive choices in their lives.

In an interview regarding the usage of psychotropic medications, a staff member stated that children at this facility are held accountable for their actions and are taught to manage their behavior with as few psychotropic medications as possible.

HE (A STAFF MEMBER) ALSO SAID THAT SOME CHILDREN COME INTO THEIR PROGRAM SO HEAVILY MEDICATED THAT THEY ARE “DROOLING.’

An innovative therapeutic foster care provider has been successful in lowering the number of psychotropic medications given to foster children in its care.

Not all foster children who need counseling are receiving it on a regular basis. •

DFPS is not doing all it can to promote mentor-ship for foster children.

Since publication of the Comptroller’s Forgotten Children report in April 2004, the Department of Family and Protective Services (DFPS), the Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS) have been addressing psychotropic medication use by foster children.

DSHS has established medication parameters to help monitor and reduce the number of prescriptions.

Yet many psychotropic medications still are being prescribed to all ages of foster children. While medication may be beneficial in treating mental disorders, a “pill” cannot solve all of the emotional issues and problems foster children face while in care.

The Zito/Safer External Review states,

“poverty, social deprivation and unsafe environments do not necessarily require complex drug regimes.”

Often when foster children experience emotional problems they undergo psychiatric evaluations and are then taken to a physician, frequently a psychiatrist (but not always) who then prescribes one or more medications to help treat the problem.

While medication may be beneficial in treating mental disorders, a “pill” cannot solve all of the emotional issues and problems foster children face while in care.

A check of this provider’s Medicaid claims for foster children in its care showed that their usage of psychotropic medications decreased.

It is also important to analyze underlying causes that can affect mental health. Britain’s Mental Health Foundation has observed that,

“An integrated approach, recognizing the interplay of biological, psychological, social and environmental factors, is key to challenging the growing burden of mental ill-health in western nations.”2

Researchers are discovering how aspects of environment and social class can be associated with children’s poor health and behavior.3

Britain’s National Health Service has found that mental health problems are more common among people in poor living conditions, members of certain minority groups and the disabled.4

In Forgotten Children and its subsequent studies, the Comptroller’s office has found that Texas foster children often come from unhealthy living environments, and some remain in unstable and unsafe living conditions while in the foster care system. These include medically fragile children living in very small homes with many children, in mobile homes and in remote, isolated areas of the state.

Administrators at psychiatric hospitals told the review team that some children they treat have refused to return to their previous placements because they were so unhappy there.

Medical records revealed about 200 claims for scabies and multiple claims for the treatment of parasites in fiscal 2004, involving about 1,500 prescriptions at a cost of $80,000.

Scabies often is found among people living in crowded and unsanitary conditions. An unhealthy living environment can affect the mental health of already emotionally fragile children.

Alternatives to Psychotropic Medications – Psychotherapy

Psychotherapy is a common treatment that can help children understand and resolve their problems and modify their behavior. It can come in many forms, including individual, family and group therapy, play therapy and cognitive behavioral therapy.5

Many foster children need therapy because they have been removed from their homes, which can be very stressful.

The Comptroller’s office has found that Texas foster children often come from unhealthy living environments, and some remain in unstable and unsafe living conditions while in the foster care system.

ITS ALMOST TUESDAY WELCOMES AND ENCOURAGES READERS’ COMMENTS ON  THE TOPIC OF THIS OUTRAGEOUS ACT OF DRUGGING FOSTER CHILDREN, DISREGARDING THEIR RIGHTS AS HUMAN BEINGS 

THE LIVES OF FOSTER CHILDREN ARE NOT DISPOSABLE

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