Tag: system failure

abuse, child death, child welfare reform, foster care abuse, cps, death
When CPS workers accept lies, children can die
By ROBERT T. GARRETT
Austin Bureau
rtgarrett@dallasnews.com
Published: 14 December 2013 11:13 PM
Updated: 14 December 2013 11:41 PM

(source: Dallas Morning News)

Emma Thompson
Emma Thompson died from injuries that included a fractured skull after workers were lied to about her case

 

 

 

 

 

 

 

Alexandria Hill, 2, died of head injuries last July. Her foster mother has been charged with her murder.
Orien Hamilton, an 11-month-old, died in October from fatal head injuries in a suburban Austin home.
Foster mother Sherill Small, 54, faces trial on a capital murder charge in a toddler’s death
Gregory Guajardo has been charged in the death of his son

 

 

AUSTIN — When Child Protective Services workers accept lies at face value and stop pressing for the truth, children can die.

Being gullible about relationships, living situations or even abuse can be fatal, as illustrated by the recent beating deaths of at least four young Texas children — Orien Hamilton, Alexandria Hill, Giovanni Guajardo and Emma Thompson.

In each instance, adults who had something to hide or who needed to be strong-willed protectors misled CPS workers. Had the workers known the truth, they might have removed the children from harm’s way.

State protective services chief John Specia said he wants to better train his people to ferret out deception.

“We’ve got to be able to connect dots,” said Specia, a veteran San Antonio family court judge. Gov. Rick Perry selected him last year to run CPS’ parent agency, the Department of Family and Protective Services. “It’s really a matter of being able to have … that little red light go off that somebody isn’t telling you the whole story.”

While Specia has ordered some policy changes in response to two recent deaths, The Dallas Morning News found gaps and loopholes in the department’s current rules and procedures.

The newspaper found, for instance, that CPS workers aren’t necessarily required to interview neighbors when they investigate tips about birth parents’ being abusive. Nor do CPS workers or employees of the state’s foster-care contractors have to knock on neighbors’ doors when they examine people stepping up to care for the children.

Such a check is done only if the people agreeing to tend to the youngster submit neighbors as references, said department spokesman Patrick Crimmins.

And state rules don’t require prospective foster parents to supply any references at all.

Several large contractors who perform such checks ask for references in applications, and industry veterans say it’s standard practice. But, Crimmins said, there’s an anomaly in the rules: Relatives who volunteer to take in children must supply names of people who can vouch for their character, but total strangers serving as foster parents do not.

“We can find no current … or prior standard that requires references,” he said Friday. Asked if the department would move to require them, Crimmins said: “We’re looking at everything” after a rash of child deaths.

It’s another crisis for an agency that has been through several rounds of legislative overhauls over the last decade. And in trying to improve investigations, it faces familiar problems: employee turnover fueled by low pay, too-heavy caseloads, inexperienced workers and supervisors who are almost as green as their subordinates.

In late October, 11-month-old Orien Hamilton suffered fatal head injuries in a suburban Austin home. A month earlier, CPS whiffed in checking out a tip from her birth father. He’d warned that a man with violent tendencies was helping to care for her.

Although CPS had seen the man in the home in April and knew he’d been involved in a domestic-violence episode there the following month, its worker who checked out the tip bought a step-aunt’s lie that he’d moved to Colorado.

That revelation rocked the department, reviving painful memories of a 2009 Houston case. CPS left 4-year-old Emma Thompson, who’d contracted herpes, in her mother’s care. A CPS worker accepted the mother’s misleading claims.

Fifteen days later, the mother’s live-in boyfriend sexually abused and killed Emma.

“Women who are abused are really good liars. I’ve dealt with that as a judge,” said Specia, who said CPS workers need more training on domestic-violence victims’ tendency to protect abusers.

Earlier this year, lawmakers heeded Specia’s plea and gave him money to hire 800 more front-line workers, supervisors and clerical staff. But Texas CPS still faces significant morale problems.

Each year, more than one third of the lowest-seniority caseworkers quit. A recent CPS salary study said the reasons remain unchanged — stress, safety concerns, poor supervision, low pay. Investigators still juggle more than 20 cases each. As of last week, seven urban counties — none in North Texas — had more than one-third of their newly referred investigations still waiting for a boots-on-the-ground look-see after two months.

Experts consider that a bad practice. They also don’t recommend having “conservatorship workers,” who visit foster children and youngsters handed off to relatives, responsible for 32 cases apiece. But Texas tolerates that, several child welfare experts said in interviews.

The experts warned that any drive to detect more deception will crash against two stubborn facts: Most CPS workers are overworked and most are young, recent college graduates who have not reared a family and are in their first job.

Expecting them to cut through deceptions as well as someone in her 40s might is foolish, said former McKinney police Sgt. Ida Wei Cover. She spent seven years as a CPS worker and then switched to law enforcement.

“They just don’t have the life experiences,” Cover said. Given their age and caseloads, no one should be surprised when tragedies occur, she added. “Realistically, it is unmanageable to have a good finger on the pulse on all of their cases.”

Susan Etheridge, who was a CPS program administrator in Dallas County until 2004, said her old employer competes for college graduates with companies and school systems that pay more. When CPS fails to give rookies top-notch training and place them under the wing of savvy, experienced supervisors, it invites disaster, she said.

“Come on, you can’t run McDonald’s with the kind of turnover they’ve got,” said Etheridge, who now runs Court Appointed Special Advocates of Collin County, which recruits volunteers to guide and help abused children as they’re taken from birth families. “The really good [CPS workers] will say to you as they’re leaving, ‘It is unethical because I can’t meet all of these requirements. And I can’t stand it anymore.’”

Recent child deaths

Etheridge and other longtime leaders of child-welfare organizations suggested possible improvements after reviewing the clues that CPS missed and the opportunities for more rigorous investigation it didn’t seize in several child deaths:

Emma Thompson: In June 2009, doctors at a Houston hospital confirmed the 4-year-old had herpes and unusual bruises around her waist. Interviewed at the hospital, Emma denied she’d been touched inappropriately.

According to the Houston Chronicle, birth mother Abigail Young told a CPS worker that no other adults were living in her household. Young said Emma might have come into contact with someone with herpes at a local YMCA. While in rare cases herpes can be transmitted in a nonsexual way, Young also had the disease.

She also lied about her live-in boyfriend, Lucas Coe, who served as a part-time baby-sitter. He had a lengthy criminal record. CPS had investigated him three times on accusations he abused a former girlfriend’s young boy.

Had CPS known Coe was there, it probably would have removed Emma and her two sisters. Instead, she stayed with Young, a nurse. Fifteen days later, Emma died from injuries that included a fractured skull, severed pancreas, vaginal tearing and more than 80 bruises. Coe is serving a sentence of life without parole in connection with her death. Young received a prison term of 20 years for failing to protect the child.

The case triggered a policy change — CPS has to interview neighbors if a child has a sexually transmitted disease. The Legislature also passed a law tightening such investigations so that the presumption is the disease-ridden child will be removed.

Alexandria Hill: The 2-year-old died of head injuries last July at a Temple hospital. In January, Texas Mentor, a for-profit foster-care contractor, had placed her in a newly licensed foster home in Rockdale, an hour northeast of Austin. Just over a year ago, CPS removed Alex from her birth parents in Austin, citing concerns about their parenting skills and drug use.

Foster mother Sherill Small, 54, faces trial on a capital murder charge in the toddler’s death. Small told police she was swinging Alex by the legs through the air when she accidentally lost her grip, smashing the child’s head against the floor. Milam County authorities recently announced they’re seeking a sentence of life without parole.

Experts say CPS and Texas Mentor overlooked too many warning signs about Small and her husband, including her own history as an abused foster child and his past drug addiction and scrapes with the law, and baby-sitting relief she later was learned to have received from one of her adult daughters. In 2002, the daughter had been convicted of robbery and kidnapping.

Specia was apparently upset that neither CPS nor Texas Mentor properly vetted the adult daughter. He has ordered that in the future, all grown offspring of foster parents will be interviewed before any placements occur.

Orien Hamilton: The 11-month-old, born in San Antonio with methamphetamines in her body, died in October from fatal head injuries. They occurred in the suburban Austin home of a step-aunt, Heather Hamilton. Only days earlier, Lutheran Social Services, the state’s largest private child placing agency, had licensed the aunt as a foster parent.

Officials have acknowledged that CPS and Lutheran conducted such inadequate checks that they didn’t know Jacob Salas was Heather Hamilton’s live-in boyfriend and eight-year partner. Salas, 32, was well-known to police for violence. In May, he flew into a rage and put his fist through a car’s tail light, according to police and CPS reports. He’d also listed Heather Hamilton’s previous address on a 2004 driver’s license application and her current Cedar Park address on several more recent public records.

Giovanni Guajardo: The 6-month-old, born in Dallas in September 2012 with amphetamines in his system, suffered fatal head injuries in a Balch Springs home last March.

Giovanni’s parents, Shawnna Gonzalez and Gregory Guajardo, also have two daughters. The oldest, now 3, tested positive at birth for cocaine, according to CPS records. After Giovanni’s birth, “both parents admitted to illegal drug use,” said a terse child fatality report by CPS.

CPS farmed out Giovanni to one relative and the girls to another.

Dallas Juvenile Court Judge William Mazur put those relative caregivers under strict orders not to allow unsupervised visits by the birth parents, records show. But for several days in March, all three youngsters were left in the care of their birth parents and grandmother.

The grandmother “also was aware that they were not supposed to have unsupervised visits with the parents,” said CPS spokeswoman Marissa Gonzales. “She knew that it was happening.”

Gregory Guajardo, 31, who has a lengthy criminal record, has been charged with capital murder in connection with Giovanni’s death. CPS says it never got an explanation of what happened.

“The autopsy photographs on that child were horrible,” Balch Springs Deputy Police Chief Jonathan Haber recounted.

Trusting intuition

Mike Foster of Austin, who has 40 years of experience running a residential treatment center and a family services agency for abused children, said that in child safety investigations, if adults are uncooperative, CPS or private companies should escalate their aggressiveness.

They should randomly interview neighbors and demand to look into closets — say, to see if a man’s clothes are present, indicating he lives in the home.

“You should always take it to the next step,” Foster said. “You almost always regret not trusting your intuition. If you feel like something’s up, you better chase that down.”

Crimmins, the CPS spokesman, said workers may ask to look into closets. But if rebuffed, they are encouraged to confer with a supervisor, he said. The agency then can consider further action “to compel a complete inspection,” he said.

Retired child-placing agency executive Irene Clements of Austin, now president of the National Foster Parent Association, said assessments of adults who fill in for birth parents are too sketchy.

“You can learn a lot by asking for more information,” she said. Clements said long ago, the state required prospective foster parents to write autobiographies and essays on their marriages and child-rearing techniques.

“You could compare his answer to hers, and you can catch stuff,” Clements said.

Cover, the former McKinney police child-abuse investigator, said CPS should pair all rookie workers with a veteran worker in a mentorship. Ideally, it should include opportunities to work cases alongside police detectives.

Having CPS workers take certain law enforcement courses about interrogation techniques would also help, she said.

“Attempt to build an alliance with that individual, saying, ‘I’m helping you to get this placement. I’m helping you to keep your granddaughter in your home,’” she said. “Make the agency the bad guy. … Build the trust.”

Specia has said he wants to “beef up” training about domestic-violence victims for CPS’ 1,400 conservatorship workers, though he has offered no details.

Crimmins said the training has yet to be enhanced. But a three-month, basic-training course gives CPS rookies two reading assignments about domestic violence and covers the subject in about three hours over three separate days of classroom instruction and in a simulation of mock cases.

A special unit in San Antonio is trying to come up with new guidelines for handling households afflicted by domestic violence.

Cover said fewer CPS recruits had college majors, such as social work and psychology, than in years past. That helped them for the drug- and violence-wracked households they’re about to enter.

“These workers absolutely need additional training in the dynamics of family violence and spouse abuse and how it impacts the children, as well as alcoholism and drug abuse,” she said.

Follow Robert T. Garrett on Twitter at @RobertTGarrett.

AT A GLANCE:

Vetting caregivers

Is Texas’ checklist for vetting adult caregivers of abused children adequate? Before children may be placed in a foster home or with a relative, Child Protective Services requires the following information or checks:

• Addresses for the past 10 years

• Basic information on all members of the household

• Family income

• Criminal history background check

• A check of any past investigations by CPS

CPS requires these questions about domestic violence:

• For foster parents, screeners must check for any domestic violence-related calls to law enforcement in the past 12 months.

• For relative caregivers, screeners simply must inquire about family violence.

Possible holes in vetting by CPS and its contractors:

• Workers for CPS or private child-placing agencies don’t have to demand references from prospective foster parents. However, some agencies do, and the state requires five from relatives who’ve volunteered to take in abused kids.

• Workers don’t have to randomly interview neighbors, even during initial investigations of suspected child maltreatment.

• Workers don’t have to examine closets of single adults who want to be caregivers, to see if they’ve omitted mention of an adult partner spending significant time in the home.

• For foster parents, CPS requires interviews of all members of the household and adult children living elsewhere. However, for relative caregivers, guidelines don’t specifically say all household members must be interviewed. Guidelines do call for contacting adult children.

SOURCES: Texas Department of Family and Protective Services; Texas Administrative Code; child-placing agencies’ websites; Dallas Morning News research

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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
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
Names of top politicians, royal aides and a famous pop star on list seized by police investigating child paedophile ring at suburban B&B

Names of top politicians, royal aides and a famous pop star on list seized by police investigating child paedophile ring at suburban B&B

  • List found among documents after raid at the home of former child protection worker

By DAILY MAIL REPORTER

PUBLISHED: 07:57 EST, 20 January 2013 | UPDATED: 08:05 EST, 20 January 2013

MP Tom Watson sparked the police investigation into child abuse at a guest house after a speech into the CommonsMP Tom Watson sparked the police investigation into child abuse at a guest house after a speech into the Commons

Police investigating allegations of a child paedophile network have seized a list naming  top politicians, members of the royal household and a world-renowned pop star, it was reported today.

They were allegedly visitors to a bed and breakfast guest house which operated as a brothel where youngsters were abused at gay sex parties.

The names were recorded on a handwritten note found by police at the North London home of child protection worker Mary Moss during a raid.

She had initially declined to co-operate with the investigation. Documents and a laptop were seized and Ms Moss later handed over other 19 files she had put in a neighbor’s shed.

The papers include a list of men who went to sex parties in the 80’s at the Elm Guest House, in Barnes, south west London.

Among them were two former Conservative Cabinet ministers, four other senior Tories, a Labour MP, a prominent Irish republican and a leading National Front member, according to the Sunday People.

The note also allegedly names two members of the royal household – one a former Buckingham Palace employee – plus the owner of a multinational company and two pop stars.

One of those is a best-selling musician, but like some others on the list he is not suspected of being involved in any child abuse.

Linked to a sex ring: MP Sir Cyril Smith
Linked to a sex ring scandal Anthony Blunt

Linked to child sex scandals: Liberal MP Sir Cyril Smith and disgraced traitor Anthony Blunt

The list emerged at meetings in 1988 between child protection officials and the guest house’s manager Carole Kasir, who died aged 47, two years later from a suspected overdose.

The paper said that 16 boys from nearby Grafton Close council home were allegedly trafficked to the guest house and abused.

Now detectives are to check social services records from Richmond, Wandsworth, Hammersmith and Fulham, and Hounslow.

Officers will also be examining copies of cash receipts and ­the guest house’s visitor records.

Famous names linked to child sex rings include Liberal MP Cyril Smith in Rochdale and disgraced traitor Anthony Blunt, the former Keeper of the Queen’s Pictures.

A complaint by Labour MP Tom Watson during a speech in the House of Commons sparked Operation Fernbridge. He claimed a paedophile ring used high-level connections to escape justice.

Ms Moss told the People: ‘They [police] were friendly enough but I thought it was heavy handed and a complete violation of my ­privacy..

The Met confirmed their statement to the Mail Online. ‘The investigation will be led by the Child Abuse Investigation Command.

‘The allegations under Operation Fernbridge were initially assessed under Operation Fairbank, which was from information passed to police by Mr Tom Watson.’

Read more: http://www.dailymail.co.uk/news/article-2265371/Names-politicians-royal-aides-famous-pop-star-list-seized-police-investigating-child-paedophile-ring-suburban-B-amp-B-guest-house.html#ixzz2J0byL19R

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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”

cover

Carol Strayhorn on Texas Foster Care System in 2004

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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”

cover

Carol Strayhorn on Texas Foster Care System in 2004

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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

 Graffiti

accountability, Collin County, Texas, corruption, crime, lawsuits, RICO, system failure children
RICO Lawsuit Against County & District Clerks Association of Texas

FOTP Editor Files RICO Lawsuit Against County & District Clerks Association of Texas

federal Racketeering Influenced and Corrupt Organizations (RICO) lawsuit in Sherman last week. Fussell is our editor for the six Collin County newspapers FOTP Group has planned. This lawsuit, filed in the Southern District of the federal district in Texas, includes several plaintiffs — including Fussell’s sister, who lives in Midlothian — who allege the County & District Clerks Association of Texas of committing fraud, racketeering, money laundering and a mountain-full of other crimes. The petition (see documents below) is intense reading material. It’s been redacted of plaintiffs names (seven in all) for publication, but it is public record in the court file system.
 Some excerpts:

 (emphasis added)

“…create a criminal enterprise under the misrepresentation of a Government Office, for the express intent to reclassify Plaintiffs as offenders, or abusers to meet a condition precedent for CDCAT to fraudulently qualify Plaintiffs’ family and children for CDCAT Multiple Employer Welfare Benefit Plan and Trust.”

“…entered into various Rule 11 agreements absent Plaintiffs’ consent, discussion, or agreement.  Plaintiffs are still unable to obtain a record or accounting of such Rule 11 agreements.  Said actions constitute a serious Breach of Fiduciary Duty, and Plaintiffs request this court to issue relief as allowed by law.”

“20.       Various District County Courts issued a “General Order, which is described as a standing order to protect property and children pending litigation of a divorce or child custody order. .. Included in the standing order is the following:

“No party to this lawsuit requested this order.  Rather, this order is a   standing order of the Collin County District Courts that applies in every divorce suit and every suit affecting the parent-child relationship filed in  Collin County.  The District Courts of Collin County have adopted this order because the parties and their children should be protected and their  property preserved with the lawsuit is pending before the court.”

21.       Defendants created the standing order which has the same effect as a Protective Order under Texas Family Code Section 85. The rules of procedure are significantly different for processing cases in which the parties are parties to a Protective Order verses processing a court case when the parties are free from such.

Readers and researchers will see one phrase used repeatedly, and the context of this is crucial to understanding  the entire case. Lisa Fussell is not just any editor of mine. Her father is the architect of an investment vehicle Collin County’s government implemented for themselves: a Multiple Employer Benefit Plan

“Said order, reduced to writing, will also include multiple clauses and contractual terms as necessary for Defendants to process the Divorce Decree as a contract which purports the parties agree to participate in Defendants’ Multiple Employer Benefit Plan. “

This is pretty powerful verbage too, as this gets to how the judiciary in Collin County (and probably all over the country) is basically one gigantic corporation:

Certain Plaintiffs represented themselves through the duration of their cases.  A significant amount of Defendants success depends on misrepresentation by association attorneys.  Absent this advantage, Defendants resort to wholly falsifying court documents or tampering with government documents.  Plaintiff, [redacted by publisher], had previously divorced in Collin and Grayson Counties.

Through the course of [redacted by publisher]’s present involvement with Defendants, CDCAT completely rewrote Plaintiffs previous Divorce Decrees, which were entered by the presiding judge after her ex-husband signed a 2002 waiver under the waiver provision.

Defendants fraudulently rewrote the orders as Agreed Orders moreover adding provisions into the order that enrolled [redacted by publisher]’s children so as to receive benefits from the Multiple Employer Benefit Plan.  Defendants not only added and rewrote the previous orders, but moreover forged [redacted by publisher]’s signatures, backdated clerk stamps and substituted Official Notary Statements.

So, what happens when one goes up against the “Corporation?”

“The Honorable Judge John Roach Jr. forewarned her of his intended retaliation a month before the DA filed the charges.”

“[Another plaintiff] was falsely imprisoned on a court order that was never set for hearing.”

“[Another] Plaintiff was indicted on a court order that was vaguely rendered that does not exist.”

A list of the generalities that are being alleged that the County & District Clerks Association of Texas committed:

  1. Abuse of Process
  2. Statutory Fraud
  3. Fraud of Nondisclosure
  4. Bad faith
  5. Defamation
  6. Malicious Prosecution
  7. Mail obstruction and unlawful mail opening
  8. Negligent Misrepresentation, and
  9. Conspiracy

 The plaintiffs filed suit against the County & District Clerks Association of Texas (CDCAT), which is “under the authority of the International Association of Clerks, Recorders, Election Officials and Treasurers (IACREAOT),” specifically alleging the following:

[Emphasis by The Ellis County Observer publisher]

–> Plaintiffs recently discovered check dispersing of substantial sums of money from the court Registry of certain court cases in which Plaintiffs’ children are designated in the Odyssey System as “Secured Parties”

–> Defendants further retaliated against Plaintiffs who unsuccessfully inquired about the registry checks utilizing various forms of intimidation which included abuse of power.  Plaintiff, contacted the presiding officer of the commissioner’s court, Keith Self, about the Registry disbursements in collin county that where discovered in the family law case. (See exhibit B).

Within five days, said Plaintiff was brought before the court in a disposition for the family law case, however,  the disposition was a unexplainable thrust on plaintiff mere days after his inquiry to Judge Self.  The family law councilor questioning him focused the “deposition”  to the subject of the inquiry to Commissioner Self.  A few examples are “have you been harmed in some way because of any money transferred in the Registry”, and “what do you think the checks you saw written in the Register mean to you?”

 Documents:
[Word Document | Click Here to Read, Download or Print | Federal Lawsuit vs. CDCAT]

[PDF | Click Here to Read, Download or Print | CDCAT Bylaws]

 See Also: Freedom of the Press Group Collin County https://www.facebook.com/pages/Freedom-of-the-Press-Group-Collin-County/187102218005916

See Also: FOTP Group Editor Re-Indicted http://www.elliscountyobserver.com/2011/06/09/1-of-my-editors-has-been-re-indicted-in-collin-county/

See Also: Brooke Muncie-Weltzer Bogus Kidnapping Arrest; McKinney Cops Cover-Up
http://www.elliscountyobserver.com/2011/05/09/collin-county-brooke-muncie-weltzer-didnt-kidnap-her-son/

See Also: ARC of Texas Process in Texas Courts System:
http://www.elliscountyobserver.com/2011/05/27/chart-arc-process-in-texas-court-system-does-ellis-county-work-this-way-too/

ARC Chart Below:

Program

1. Academy of Special Needs Planners

2. ARC (Non-Profit Corporation)

3. Municipal District

4. Court System

Players

1. Title IV-D (Attorney General)

2. DFPS

3. Judges

4. Bank of America and JP Morgan Bank

5. Psychologists / Home Study Experts

6. Special Needs Attorneys

7. Abusive Parent

8. Our Children

9. Protective Parent

10. Law Enforcement

 Process

1. The Court orders Alternate Dispute Resolution (ADR)

2. The Special Needs Attorney determines the wealth of the family

3.  One of the parent becomes the target of the courts, DFPS, and law enforcement

4. To obtain evidence the Court orders a psychological exam and a home study

5. The Court utilizes the evidence to build an adverse case against one parent

6. The build a stronger case DFPS testifies in Court about the TI’s drugs, abuse, mental instability

7. Judge removes conservatorship rights

8. Special Needs Attorney assumes temporary guardianship using the temporary guardianship form

9. Working in cooperation with DFPS and the ARC program – the children are labelled with special needs

10. A trust fund is established by the Special Needs Attorney vis-a-via the ARC

11. Bank of America and JP Morgan Bank then invests the money or borrow against assets

12. The trust fund is overseen by the municpal districts and the Title IV-D Office

Outcome $$

1. Pooled Trusts

2. Liens

2. Domestic and international 501C corporations

3. Retirement Funds

cps
This is M.D. one of the children not forgotten…
Source of Stories: PLAINTIFFS’ ORIGINAL COMPLAINT FOR INJUNCTIVE AND DECLARATORY RELIEF AND REQUEST FOR CLASS ACTION in the recent lawsuit filed on behalf of 12000 foster children in the State of Texas against Governor Rick Perry, Thomas Suehs, Executive Commissioner of the Health and Human Services Commission of the State of Texas and Anne Heiligenstein, Commissioner of the Department of Family and Protective Services of the State of Texas.

There are several “named plaintiffs” suing the Texas system. They are children who have had to live in foster care on a long-term basis and they represent a “class action” suit on behalf of over 12000 other foster children.

Usually a foster care stay is approximately 12 to 18 months if all goes well, but for the not so fortunate, the stay in foster care may last for years. Many children never find a permanent home, and “age out” of foster care as a young adult who has not learned how to find a sense of security or how to trust people.
These children have become a product of their environment, harmed by the failure of a government system that needs not just an overhaul, but a miracle to fix. Whether an oversight created some problems or a lack of financial funding for a private foster family or residential facility occurred because of some bureaucratic red tape – the effects trickle down and the leftover mess is cleaned up by the ones that matter the most – the children – and when I say cleaned up, I mean dealt with.

Most of the time, the higher ups will never put a face to the name – or number these innocent children have become. Most of the time, these are not accidents, or unforeseen circumstances, but completely preventable and avoidable situations that leave these children paying the ultimate price by living in an unimaginably painful world. Negligence, abuse, misconduct, untrained workers, caregivers with backgrounds that should keep them from working in any environment ‘designed’ to protect children….are some of the causes for the damage done to these children. Caseworkers carry too high a workload with too little incentive or not enough pay for long hard overtime work hours so the turnover rate is high. The need to hire more workers often means they are not always experienced or even properly trained to deal with the depths of the situations they will encounter in their job. The real life situations of a child that they must protect if at all possible, realizing their decisions may change the course of many lives forever. That is not a light responsibility to be taken, and when the workers are hired and fired or quit so often that motivation to do the job right is low, lives can be ruined. Destroyed. By one choice made, or one decision.

I can barely touch the issues our system must address in order to affect a noticeably positive change that those families named in the lawsuit as well as those who are not. will benefit from. One thing is clear, anyone involved in the system will become someone new before its over with. The lawsuit outlines what the issues are that the children see in their daily lives when living in foster care. The lawsuit places the failures on the table for all to see now, not just the children, but anyone else who has not, until now, taken a look.

Its Almost Tuesday is thrilled that legal action has been sought to find justice for these children and families. Meanwhile we await the outcome of the battle ahead that the lawyers must face, and we can only cross our fingers that the outcome we can anticipate will be in favor of the children. We can only hope it will not only be in favor of the children, but also begin the road to remedy the harmful effects they have suffered. Somehow. Having said that it only seems appropriate now, to take the time to get to know these children, starting with M.D. the first named child plaintiff in the lawsuit.

M.D. is the first of many stories we will share. Remember, these stories are real. These experiences have been lives of children not unlike yours or mine — they have been caught up in an unfortunate trap set by a system out of control.

Child Welfare. Child Protection. How much do we see in these stories? Have these children been protected?

If they had been we would not watch as lawsuits are filed. If they were protected, I would not be writing this blog; or introducing you to these children. Although we will only learn their initials and not their full names, we will hopefully learn something about who they are – and not forget them.

Its Almost Tuesday commends all the survivors of the foster care system, applauds them for their courage when living in a world they never should have known…

This is the story of M.D.

M.D. is a fourteen-year-old girl from Corpus Christi, in Nueces County. M.D. was originally brought into state custody at age eight, placed with relatives, and then again brought back into state custody at age ten. Over the four years that M.D. has most recently been in the care of the state, DFPS has repeatedly failed in its obligation to provide for her safety and wellbeing. Instead of providing her with services and therapy to address the maltreatment that caused her removal from her parents and the abuse she suffered while living in a DFPS-selected placement, DFPS has compounded that trauma by placing her for years in inappropriate institutions; failing to provide her with critically-needed mental health evaluations and services; over-medicating her with powerful psychotropic medications; failing to seek and secure an appropriate permanent home for her; and subjecting her to numerous and frequent placement moves that have prevented her from establishing lasting relationships with caregivers, therapists, or even other children.

When M.D. was eight years old, DFPS removed her from her parents due to neglect by her mother and abandonment by her father. After nine months in the state’s custody, DFPS placed M.D. in conservatorship with her aunt and uncle. However, when M.D. was ten years old, DFPS removed her from this home, because her cousin sexually assaulted her while she was
under the aunt and uncle’s conservatorship.

After removing M.D. from her relatives’ home, DFPS moved the ten-year-old child through three foster placements over the next six months. Eventually, DFPS placed M.D. in a foster home in Dallas, over 400 miles from her home community.

Toward the end of 2007, DFPS moved M.D., still only ten years old, to an institution, an RTC in Victoria. After three months in this facility, M.D. became suicidal. She stayed there for almost two and a half years, steadily deteriorating both emotionally and psychologically. During this time, DFPS assumed PMC of the child.

From the RTC, DFPS sent M.D. to an acute care facility just outside of Houston, without making any permanent plans for her. After two months, DFPS moved M.D. 300 miles away to yet another RTC in Denton.

While at that RTC, M.D. and another young child left the facility and walked to a nearby retail establishment where M.D. was raped. After the rape, DFPS did not provide M.D. with any special counseling, even though M.D. was so traumatized that she had started cutting herself.
Instead, RTC staff chastised M.D. for leaving the facility. In the midst of the emotional turmoil resulting from the assault, DFPS sent M.D. to a juvenile detention center after a disturbance at the RTC.

During the four years that M.D. has been in foster care, DFPS has moved her through at least seven different foster placements, as well as hospitalizations. For much of this time, this young child has been kept in institutions of one kind or another – RTCs, psychiatric centers, and detention facilities. With such an existence, M.D. has been unable to form any lasting relationships.

M.D. is currently placed in an austere, restrictive short-term therapeutic placement in San Antonio. M.D. has no privileges of any kind. She has no visitors. She cannot have any toiletries. She is warehoused and alone. Her DFPS caseworker has said that M.D. will be transitioning from this facility to another RTC.

As M.D. has moved through the foster care system, she has been given numerous psychotropic medications. These drugs have been used as a chemical substitute for the care, counseling, and permanent placement in a family that DFPS is obligated to seek and secure for her. M.D. is now diagnosed with bipolar disorder and depression.

While M.D. is nominally in the eighth grade, she has been placed in a number of schools attached to the institutions where she was placed. In those schools, she has been advanced from one grade to the next based on her age. Her true academic progress has been constantly interrupted by her placement in a series of far-flung facilities.

Although DFPS knew early on that M.D.’s parents were not capable of parenting her, and in fact had removed her from their care in 2005, it was not until July 2010, more than three years after she was brought into foster care for the second time, that M.D. was freed for adoption.

Despite the fact that M.D. has consistently asked to be adopted, DFPS has continually failed to seek and secure a permanent family for this lonely child. At the age of fourteen, M.D. faces the prospect that she will age out of care after four more years of being shuffled around the state from institution to institution.

Defendants have violated M.D.’s constitutional rights by failing to protect from her from harm while in their care; failing to provide adequate supervision over her foster care placements; subjecting her to frequent moves across the state far from her home community; failing to arrange for adequate therapy to address the trauma she has suffered both before and while in DFPS custody; subjecting her to unnecessary psychotropic medications; keeping her for long periods in institutions; and failing for years to identify or plan for an appropriate permanent placement.