Monday, February 6, 2017

Foster Care Redesign Is Not Working In Texas

I have had several people asking me about my testimony last week at the Senate Health and Human Services Committee. I ended up discarding my planned testimony to address the misinformation that had already been spoken in the hearing. I simply spoke to the Committee about my experience and the reality of the system for children. However, the Committee did receive this written testimony.

The hearing was actually over Senate Bill 11 which has Foster Care Redesign moving forward across the state, but even more alarming is that it wants to privatize even more rolls of CPS! If you know someone who works for CPS, you need to make sure they are aware of this Bill.  It would do away with their job with DFPS. This Bill is very alarming! I will be posting bullet points tomorrow that I would ask everyone to call their Senator and Representative to voice the concerns and challenge the misinformation being given.

This is what I presented to the Committee:


To:                   House Health and Human Services Committee Members

Background/Perspective:
I am a former foster parent, mother to 9 children (6 of whom are adopted), and executive director of an adopt only child placing agency. I have managed a contract with DFPS for adoption services for the past three and a half years. I attempted to secure a contract with Providence, and currently have a contract with OCOK. I have been a part of the adoption community for the past 15 years. I have a passion to empty the Texas foster system of children who are legally free for adoption, but remain in foster homes because of a lack of adoptive homes. I have a passion for recruiting, training, and supporting adoptive homes to ensure successful, life-long outcomes for our children who cannot return to their biological families.

Problems with Senate Bill 11
First, let me thank the committee for seeing the current state of our child welfare system and desiring a change. I commend you for that. However, upon reading the majority of Senate Bill 11, I am left with a sense of dread as it is clear that the issues with our system have been misdiagnosed. The issues that plague our current system and result in poor outcomes for children cannot be fixed with the continued roll out of Foster Care Redesign or the privatization of more case management services.
My concerns over privatization of any aspect of case management for our children as well as the continued roll out of redesign across the state come not from theory or unsubstantiated fear. My concerns come from my actual experience with redesign and the current philosophy that the competition of the free market will ensure better outcomes for children.

My first experience with redesign was in 2014 when Providence, the SSCC in the catchment area for regions 2 and 9 refused to discuss a contract with me as an adoption only provider. During my first phone call to Providence I was told “We would never stand in the way of children finding a home.” That changed over the course of my 6 week battle for a sibling group of 4 to be placed in one of my licensed adoptive homes. I had a contract with DFPS. I met all of their requirements. My licensed home was located in the same catchment area, but because the SSCC would lose money by placing the children in my licensed home the placement was denied. That is a decision that was driven completely by profit margin. The outcome for those four children was a sentence to languish in foster care for three more years. One child remains in CPS custody still today. The siblings who would have remained a unit, are no longer able to live in the same home. Did redesign fix the system for those children?

Providence withdrew their contract in the midst of my conversations with the HHSC as well as Kaysie Reinhardt the DFPS Foster Care Redesign Director. As I continued to work in Region 9, my agencies home region, to place waiting children in licensed adoptive homes through my DFPS contract, I would have to wait 6 months for a case file for a little girl and her brother so that one of my families could move forward with adopting them. When I inquired time and again why we were having to wait, it was stated that the overwhelming task of transferring cases back to CPS from Providence had left the department paralyzed. What we would learn later is that every Sunday of that 6 months, that little girl went up to the alter at her church and prayed for an adoptive family. She had an amazing foster family who did a wonderful job of beginning her healing process and preparing her for a forever family. However, week after week, the little girl expressed her feelings of rejection that no one wanted her as their forever daughter. The heart ache of trauma of this little girl was extended by 6 months because of the failed privatized system of foster care redesign. I am happy to report that once redesign was out of the way, the little girl’s prayers were answered. She and her brother are thriving in their adoptive home and have far exceeded anyone’s expectations of progress in the time they have been in their adoptive home. Redesign did not fix the system for these children. And the case turn over when Providence withdrew leaves the question, what will we do with massive case turnovers when a SSCC does not renew their contract if we continue the move to privatization. There is not a good answer. It is an inevitable occurrence that will once again leave Texas children vulnerable and unaccounted for.  We are simply exchanging the cancer that currently plagues our system for another.

This was not an isolated occurrence with Providence. In the January of 2016 I was contacted by CPS and asked if I had an adoptive home for the twin sister of a 16 year old I had placed a few months prior. The sister was now ready to be adopted, and her amazing CPS worker was attempting to find a home geographically close to her twin sister to facilitate regular contact between the twins. Again foster care redesign threatened to stop the placement of a 16 year old girl simply because of financial reasons. I have black and white emails where the SSCC worker was willing to let her remain in an RTC instead of working to place her in an adoptive home that was ready to take placement – and could have moved forward without any hesitancy in the legacy system. Thankfully the potential adoptive parents along with the adoptive parents of the twin sister already placed advocated for their daughters. With the help of Representative Brooks Landgraff and Matt Krause, we were able to secure a contract with OCOK in order to place this young lady in a home where she is currently thriving – maintaining regular contact with her twin sister. For this young lady, redesign was a huge step backwards. She has a bright future despite redesign.

I hear many sing the praises of foster care redesign. There are many goals of redesign that I support 100%. However, as a person working on the ground, I do not see those goals being obtained for the children of Texas. I hear reports that are given by the people with a vested interest – either an interest in financial gain or an interest in saving face that redesign is worth the tax payer dollars it has used. This leads me to one of the biggest concerns of child advocates with privatization. How do we ensure quality outcomes when profit margin is the driving force? I am perplexed when I speak to those at DFPS as well as some who serve on the PPP for redesign. They all state there are amazing outcomes from redesign. It leaves me wondering where is the disconnect between the theory of what should be happening in this privatized system and the reality of what is actually happening for our children in care. For example, everyone I speak to about my concerns with adoptions under redesign refers to the increased number of adoptions occurring in catchment area 3b.  Yet, I have a conversation with the CASA office in Johnson County telling me that they have not had any of their children placed in adoptive homes in months and are wondering why that would be. I personally have experienced an increased delay in the process of selecting children for adoptive homes under redesign. If I am working with a CPS worker directly in the selection process, it takes a matter of weeks. Twice I have had to enlist the assistance of Governor Abbott’s office to simply get a phone call or email returned to by OCOK letting me know if children are still available for adoption or if my family was selected. Yet the numbers say adoptions are increasing. When I asked Ms. Reinhardt to see the numbers for actual adoptive placements of children who are legally free for adoption and placed into matched adoptive homes, I was told that data was unavailable. The adoption numbers being reported include those where children were adopted by their foster family as well as kinship placements. These are amazing and highly desired outcomes for those children. However, the reporting of those numbers as “adoptive homes” gives an inaccurate representation of the outcomes for our harder to place children who are remaining in foster homes when they should be in permanent, adoptive homes. 
I would encourage those on the HHSC committee to talk to the people on the ground. Ask foster families and CPS workers if they see an improvement in our system under redesign. I have yet to speak to any CPS case manager or foster family who feels redesign is a good model. At a town hall meeting in catchment area 3b, foster family after foster family expressed concerns over lack of support and poor outcomes for children. One foster family stated that they had a bed available in their home that was 20 miles from a CPS office where an infant was having to stay at the office due to no “available” bed. This foster mother was a 3b home and was therefore not allowed to take placement of this baby sleeping in a CPS office. So while redesign may show that fewer children are sleeping in offices, what do the numbers of the regions around redesign say? Is anyone looking at the entire picture to see what creating a competitive market for children’s cases does overall to Texas children? I have a string of emails I will be happy to share that show a region 3b family reaching out to a CPS worker in another region about adopting a Texas child because she has had no movement on her case in months. The CPS worker has a child she would like to consider placing in their home after visiting with the family. However, the placement is not allowed to occur because the family is told that her agency will not release her home study for a placement of any child outside of 3b. This young man’s only other family being considered was in New York. I believe this is an unintended outcome of implementation of redesign. But is anyone looking at these unintended outcomes? Or are we just looking at the numbers in the catchment area and ignoring the negative outcomes for all other Texas children?

Based on my experience, I would have to say the latter. CPS workers have been told they cannot speak out against redesign, or they will lose their jobs. My initial contract with OCOK had a silencing clause in it. Had I signed the contract as it was originally sent to me, I would not be able to sit before you today exercising my right to speak up for children without the threat of legal action against me. This begs the question, if redesign is all the numbers say it is, why do we have to silence the people who know the actual outcomes for children?

I understand the concept of free-market supply and demand. In a consumer driven market, consumer choice drives the demand for quality. I am told that is what will maintain the quality of care for children under privatized systems like redesign. Yet, I know providers who are being paid less under their contracts with OCOK than they were under contracts with DFPS. When asked why that is, service providers are told that OCOK must recoup some of it’s cost somewhere. How is paying a middle man, in this case an SSCC, making the best use of the funds available to in fact provide quality service to our children? That fact alone defies the entire philosophy of creating a privatized system that will ensure quality care of our Texas children.  We already have a vast shortage of agencies willing to license families for adoption only due to the drastic profit loss when an agency moves a child from a foster placement to an adoptive placement. That shows that outcomes for children will in fact be affected by a system based on monetary incentives. How will we ensure biological families are protected, and every child who could be returned home will be when an organization would profit from the child remaining in care? You cannot afford to give large enough incentives to reunify a child compared to what an organization would earn for keeping the child in care.

We need not look to Florida or any other state to see if privatization of DFPS case management works. The private sector in Texas, of which my organization is part, has proven is does not have the capacity to manage the vast needs of our children in care. This is why Providence failed and why we have seen no other redesign roll outs despite deadlines that have come and gone for the next SSCC to take over.

Suggested Solution:
I believe if someone brings a complaint to the table, they should have a proposed solution as well. The sections of Senate Bill 11 suggesting we continue the roll out of foster care redesign as it is as well as begin to create privatization of other case management currently under the supervision of DFPS are simply exchanging one crisis for another.

I work with amazing people with DFPS who have a heart for children. They have a desire to do their job well so children have positive outcomes. However, they simply cannot do their jobs because of caseloads and supervisor turnover. We need to funnel all of our available funds into strengthening salary scales, and hiring more workers to make caseloads manageable. We need to have accountability on the local level and empower our regional offices to engage the community and take ownership of their outcomes for children. Harris County is giving us an amazing example of how this can work. Let us learn from their success and stop redesign roll out. We cannot simply exchange one cancer for another. We need real, proven, successful outcomes for our children. We must look at the facts of redesign as they apply to all Texas children and understand it has not truly created the outcomes it was in theory able to create. We cannot allow competition for outcomes and profits in one area of Texas by an individual organization keep children from another area of Texas from receiving quality care of permanence. We must not be divided in our efforts to help children, but come together united for all Texas children.


The question I leave with you is: if you want to continue the roll out of privatization of any case management of children where demand drives quality, what is the price tag for ensuring our children have the safety and future they deserve? I am quite certain it is a price you cannot afford. 


***After hearing some amazing people who have a heart of the children of Texas speak against Senate Bill 11 and all it's challenges, it became clear that there should be a pilot program that would fully fund one region of CPS from investigations all the way through post adopt programs. Lets fund the current CPS program with the money they are using to fund redesign and see if by chance what we have now will actually work when it is fully funded! Our children do not have time for us to get this wrong....and Foster Care Redesign is too costly and has already failed in one of two attempts! Our children cannot survive under those odds! 

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