Case-by-case struggles for Child and Family Services

Tuesday, Dec. 2, 1997 | 10:14 a.m.

Try squeezing 37 new foster kids a month into an average 30 vacancies.

Try telling caseworkers to do a thorough job when they are serving nearly twice as many kids as the recommended national standard.

These are two of the major challenges facing the Nevada Division of Child and Family Services.

Over the past six years there has been little fluctuation in the number of children under the state's protective custody in Clark County. But the number of kids referred to the state by the county doubled to 39 from January 1996 through June 1997, forcing the state to close cases faster.

A recent study by former division administrator John Sarb concluded the state has been left with "a higher concentration of very difficult cases."

This makes the state's job tougher because of the chronic shortage of foster homes in the county. Not only are there more kids per home than the state would like, they have more behavioral problems.

"We've always had a shortage of foster homes," says Stuart Fredlund, deputy administrator of the state Division of Child and Family Services. "Because of that it's difficult to find sufficient resources to place children. I think we should double the number of homes."

In addition to regular foster care, there's a need for more therapeutic homes that match special-needs children with specially trained foster parents. The need is especially lacking for children under 12, Fredlund says. Homes for large sibling groups also are in short supply.

"Usually you can find a home for two siblings. When you get to three siblings and over it starts to get difficult," Fredlund says.

Children often are bounced around the system because of a lack of appropriate homes.

"A lot of times a child will move into a therapeutic foster home or a group home because there are no alternatives," Fredlund says.

Even though foster parents can house as many as six children without having a group home designation, overcrowding a family places the household at risk, he adds.

Fredlund thinks the state has trouble recruiting and retaining foster parents because they don't have sufficient resources. The state's own mental health services remain so underfunded that foster children sometimes must wait six months for behavioral counseling.

Foster children can go to private counselors through Medicaid, but Christa Peterson, deputy administrator of the Division of Child and Family Services, says there aren't enough outpatient providers.

There's a waiting list for state mental health services primarily because of the large number of Nevadans who are uninsured, she says. The state has one of the nation's highest per-capita levels of uninsured residents.

"The waiting list is not going to change because we're not getting new resources," Peterson says. "There needs to be better coordination of (community) services. There are duplications in services but there are more gaps than overlaps. Child mental health is a very under-served group."

There's also too little contact between foster parents and the state because caseworkers are overburdened.

Another reason it's hard to recruit and keep foster parents is money.

Years ago, many women stayed at home. But "in today's economy a lot of women are working outside the home so that pool has shrunk," Fredlund says.

The county's round-the-clock work shifts may be a hindrance because you "don't want kids running around while a parent is sleeping," he adds.

Aside from foster care, the state has four options for children. They can be reunited with their parents, placed with a guardian such as a relative, put in privately run group homes or be adopted.

In contrast to foster homes, the state contracts with a glut of private group homes in the county covering five levels of treatment. They range from Level I care for children with developmental, behavioral or emotional problems, to Level V crisis intervention.

The cost of group home care to taxpayers is $33 to $420 a day, compared to about $15 a day for standard foster care.

Cost was the reason the state Legislature last session decided to close the Southern Nevada Children's Home in Boulder City after 28 years of operation. Fredlund says the decision was a mistake.

"I always valued the children's home as a resource for sibling groups who had limited potential of going back home or being adopted," he says. "It was a place where they could reside in a stable environment until they left the system. There is some talk of reopening the home on a private basis."

Foster parents are encouraged more than in the past to adopt their foster children. Fredlund estimates that foster parents account for three-fourths of the adoptions of kids 5 and older.

"It always seems to be easier to place a child with a physical disability," he says. "When children have severe emotional problems it's difficult to find families willing to parent these children. Families want to adopt younger children because they want to mold a child their way. Teenagers are not as amenable to a strong family unit."

Although the state has been able to keep an increasing number of children with their families through expanded parent counseling and neighborhood resources, the rapid increase in children entering the system has exacerbated the foster home shortage.

"We don't really know why," Peterson says. "We're glad there's increased awareness (about child neglect and abuse) but that means we need increased resources on the front end."

Because tougher kids are entering the system, they're getting bounced around foster homes more often. When this happens, the state temporarily returns the youth to the county's Child Haven shelter as a "courtesy hold."

To relieve overcrowding at the county facility, the state plans to use one of its newest private contractors, the 20-bed Olive Crest group home, to house children caught between foster families.

Foster children are getting harder to deal with because of increased substance abuse among parents. At least 70 percent of the children placed in protective custody come from homes where the mother or father abused drugs or alcohol. Children who have fetal alcohol syndrome, for instance, may develop a multitude of physical, behavioral and mental problems.

"A lot of parents are referred to drug and alcohol treatment programs but the follow-through is dismal," Fredlund says. "A lot of parents aren't receptive to treatment. The cases that end up getting transferred to our custody are cases where the parents have rejected all offers of drug treatment."

More problematic children require more attention from caseworkers. But with an average caseload of 47 children, state workers are at nearly twice the recommended national standard of 25 to 1.

"We've had national experts come in and look at our caseload and they gasp," Fredlund says.

The state has attempted to achieve the modest goal of 35 children per caseworker, which is still 40 percent higher than the national standard. Through last summer, the Las Vegas district office was about 12 caseworkers short of meeting that goal.

The caseworker staff increased from 50 to 54 this fall and will climb to 59 next year. Fredlund estimates he needs 62 caseworkers for a caseload ratio of 35 to 1. But given the steady increase of new cases, that would necessitate even further staff increases.

"The primary problem is the caseworkers don't have sufficient time to give kids proper attention," Fredlund says. "They can't make visits on a regular basis to see how they (the children) are doing in the foster home."

The minimum state requirement is a home visit every other month and another face-to-face contact in the month in between. But that doesn't always happen, according to foster parents and court-appointed special advocates.

Caseworkers could take a more proactive role in working with families if they had lighter caseloads, Peterson says.

"Right now they have little time to plan," she says. "It's more of a crisis-management approach."

A typical home visit takes a minimum of two hours. Then there's the preparation of case plans for the natural parents to follow, Family Court appearances and mounds of paperwork.

"They have so many problems to deal with they don't have time to focus on cases that can be moved out of the system," Fredlund says. "So kids in all probability are sitting in foster care because the caseworker doesn't have the time to do all the necessary work to move the case out as quickly as possible.

"I have personally spent an entire day finding a placement for a difficult child no one was willing to take. That detracts from the quality of work you should be giving the rest of your caseload."

In addition to being overworked, caseworkers are also relatively underpaid. Peterson says salaries are $33,481 to $45,457 a year, which is less than other social service agencies.

"Our morale is a bit better because we got more resources from the Legislature, and will address issues in our (ongoing) reorganization plan," she says.

Despite being understaffed, the division actually did quite well the last legislative session, Peterson says. Its budget was increased by 12 percent over the next biennium, and its overall staff of 740 will be increased by 138.

More money also was provided for foster parent training and a new juvenile residential treatment facility in Las Vegas. For Southern Nevada, the state has budgeted $4.4 million this fiscal year for family foster care, $8.9 million for group care and $6.8 million for foster medical coverage.

The state also increased reimbursements for standard foster children by 20 percent and hiked their clothing allowance. The reimbursement rate is now $365 a month for children under 13, and $438 a month for teenagers.

Those rates were increased in part after groups such as Foster Parents of Southern Nevada Inc. complained that Nevada ranked 36th in the nation in reimbursements. Even with the increase, the state remains well below U.S. Department of Agriculture recommended guidelines of $599 a month for children up to age 4, $616 for ages 5 to 11, and $694 for older kids.

The groups argue that Nevada's reimbursement rates were one of the main reasons the state's overall supply of foster homes declined from 586 in 1993 to 554 in 1995. Peterson says she believes the drop has leveled off.

"Our goal is to have as few placement disruptions as possible," Peterson says. "When a child comes into our care we try to know the most about their needs, and as they become stable we transition them into a family foster home."

She says physicians, therapists, teachers, natural parents and foster parents help formulate case plans.

Though the division operates various programs in at least 10 sites in the county, consumers find they can't get everything they need at one location. For instance, mental health services are on West Charleston Boulevard while other child welfare services are cross-town on Belrose Street.

"We're trying to move our services out to more neighborhoods so people can work closer together," Peterson says.

The division hopes to open an office in Henderson next year that will house caseworkers, therapists and other foster care services.

Peterson also hopes to recruit foster parents from the children's neighborhoods, an approach she says has has been successful elsewhere in the country.

archive