Troubled kids mired in shelters, jail cells
Wednesday, May 31, 2006
by Ofelia Casillas
Dozens of troubled youths are stuck in hospital rooms, jail cells and shelters as officials struggle to find them appropriate homes, reflecting an acute shortage detected as the state's child welfare system evolves.
The child welfare system is the smallest it has been since the late 1980s, with roughly 17,000 children in state care, most in foster homes.
But among those who remain is a core of children with serious mental, behavioral and emotional needs, with few facilities suited to house them.
"The system has come to a standstill," said Cook County Public Guardian Robert Harris, whose office identified the problem in a recent study.
That analysis found that at least 120 youths were waiting for spots in residential facilities, group homes and supervised apartments last September and October. Their waits lasted weeks and sometimes months.
Years ago, children became state wards without the Illinois Department of Children and Family Services making a sophisticated evaluation of their mental health needs. Some children shuffled among foster homes before making it to a residential facility, and others never got more than outpatient help.
After 2002, when DCFS stopped sending youths to Maryville Academy in Des Plaines--once the largest residential facility for children in the state--experts from two universities found the state did not have the right mix of facilities for its troubled population. They also found DCFS did not fully understand the needs of its children.
So the department launched two new programs last year to better evaluate its population. It also raised its standards, trying to limit the placement of challenged youths to the facilities that could handle them.
As a result, some less-equipped institutions closed down. Demand for the few institutions that had the expertise and resources to handle the most troubled children soared, creating waiting lists at more than 30 facilities, from Lake Villa to Onarga.
"The shortages of placements for kids with special needs are very serious, and new evaluation systems have not solved it. If anything they have highlighted how bad it is," said Benjamin Wolf, an American Civil Liberties Union attorney who oversees a 15-year-old federal consent decree with DCFS.
"When DCFS set up the new assessments, the agency agreed to an enforceable plan where they would, over time, create the capacity to meet the needs of the children. We've seen very little movement in that direction, and we are very concerned about it."
Of the 120 youths studied in September and October, the guardian's office identified 30 waiting in emergency shelters who needed special supervision.
Eight stayed beyond medical necessity at psychiatric hospitals, and another eight stayed longer than necessary at correctional facilities as they waited for spots in residential and group homes.
The rest were waiting in homes of foster parents or relatives or at other facilities that were not able to meet all of their special needs.
DCFS Director Bryan Samuels said the system can hospitalize children or move them to the top of a waiting list if they are in crisis. He cautioned that moving a child to a facility doesn't always end troublesome behavior, such as running away or committing crimes.
In addition to the new demands the department is making on providers, Samuels said his agency is competing against other state agencies and families also trying to find a home for children with severe mental health needs.
"I don't know that DCFS alone can eliminate a waiting list," he said.
Samuels said he expects DCFS children to get what they need sooner once the child welfare system has adjusted to keep up with changing conditions while trying to maintain the highest level of care.
To that end, Samuels said his agency estimates it will spend more money this year, per child at a facility, than ever before.
"We are moving in the right direction in terms of identifying their needs better, and I think the waiting-lists issue is one of us making adjustments and the private agencies making adjustments, based on real-time information," he said.
"I'm not sure how else at the macro level you can do it, and it will be unfortunate that there are a small number of kids who really need residential treatment and have to wait a short period of time before they can get it."
The case of a 17-year-old boy offers a glimpse at the difficulty of finding the right home.
The boy came into state custody in 1993 and was placed in the home of his great aunt on the Far South Side. As he grew up, he began to fight, steal and try to set fires at school. He ran away, abused drugs and eventually was arrested for assault.
As early as December 2004, a DCFS worker said a residential facility should be considered, according to a state incident form.
"The minor has been completely wrapped with services and minor's behavior continues to worsen," the worker wrote, a finding echoed a few months later by another caseworker.
The boy's great aunt asked workers to find him a new home, and last spring they agreed, state documents show.
In August the boy stole a car, violating probation for an earlier robbery, and went to the Cook County Juvenile Temporary Detention Center. There, a therapist suggested one more time: "A therapeutic residential placement setting should be considered for him."
Cook County authorities said the boy waited weeks in detention for that opening. When it didn't occur, he returned to his great aunt.
Again, in November, a DCFS evaluation recommended "placement in a highly structured residential treatment center to address delinquency, mental health and substance abuse." That month the boy was arrested again on a weapons charge.
In December, a Cook County Juvenile Court judge ordered DCFS to find him a home. The boy had an interview scheduled at a facility in January, but it was too late--he was sentenced to a correctional facility instead.
It was in part to place children where they belonged sooner that DCFS launched the Integrated Assessment Program last year, to determine the clinical needs of children new to the system. That July, special teams were formed to assess whether children already in care were better off in special foster homes, facilities or supervised apartments.
As of March, there were 2,318 youths living in institutions--up from 2,220 in July, though still down from previous years, DCFS data show.
Spending on these programs has steadily risen, from about $30 million in 2000 to an estimated $50 million this year. Caring for each child will cost the state roughly $100,000 a year.
Some child-welfare experts expected the mismatch in available beds and the growing need.
"You can't turn a system on a dime," said Mark Courtney, director of the Chapin Hall Center for Children at the University of Chicago. "Residential-care beds don't grow on trees. It will take some time for the provider community to gear up to meet this demand."
To take some pressure off residential facilities, DCFS added 200 teen foster homes last year and next year plans to open supervised apartments for 215 older youths who may be living in residential facilities only because they have no alternative.
DCFS also has added capacity at programs that can handle the children's high-end needs.
"You amend existing contracts so that you can do more business with those private agencies," Samuels said.
Samuels said DCFS will start a new fiscal year in July armed with data from its evaluations, knowing exactly how many and what type of beds it needs. By then, private agencies will have had more time to meet demand.
"When we go to contract next year it will be for a different set of beds," Samuels said. "The private agencies will know that."
Meanwhile, however, some youths are not getting the care that they need, experts warn.
"We've got to make some radical changes to get the kinds of services that these kids need," Harris said. "In some cases we are as bad as the parents we have taken them from."