You are on page 1of 21

THE CRISIS IN FOSTER CARE REPORT NO.

7

A Report by the 1991-92 San Diego County Grand Jury June 29, 1992

THE CRISIS IN FOSTER CARE

INTRODUCTION This special report by the 1991-1992 Grand Jury amplifies earlier reports on the foster parent process in San Diego County. The 1988-1989 "Children in Crisis" report of the Grand Jury spoke to the looming crisis in foster care. The 1989-1990 Grand Jury made eleven recommendations regarding foster care. These recommendations were unheeded and few improvements were made. Foster parents play an integral role in the juvenile dependency system. The commitment to children of the majority of these parents is extraordinary. This report is not, and should not be interpreted as critical of the services provided by selfless individuals and families who have opened their homes and hearts to children in need of protection. The 1991-1992 Grand Jury in its report "Families in Crisis" made findings that some foster parents are not effective checks in the dependency process because they are co-opted by the Department of Social Services; that good foster parents are lost because of the treatment they receive at the hands of some caseworkers at the Department of Social Services; and, that the Department must discourage foster parents from viewing foster care as a first step in an adoption plan, especially where babies and toddlers are concerned. The statewide Little Hoover Commission report on foster care and its consequences to children was released in April, 1992 as a follow-up of to its l987 study. The findings of that report are significant and deserving of careful study. The Commission found that every $1 spent on family preservation saved $3 in long term costs. It estimated that between 35% and 70% of foster children should never have been removed from their parental homes. It strongly recommended a reassessment of front end diversion funding to avoid pulling children who can be safely kept at home. The Commission found a disturbingly disproportionate number of ethnic minority children in foster placement. For example 40% of all California foster children are African-American (compared to a 6.3% overall African-American population) with an inadequate availability of African-American foster family homes or group homes. Causes for this were attributed to include racism and insufficient recruitment. In addition, ethnic minority children who are placed with relatives may be adversely affected because of an inequitable financial support rate

structure that does not generally allow relatives to receive as much financial support as non-relative foster parents. This situation affects a great many ethnic minority children because they are placed with relatives at a much higher rate than are white children. The study further found that the future of those in the foster care system is bleak. Forty-five percent of runaway youths have been in foster care and many foster children grow up poorly educated, in poverty, suffering from drug and alcohol abuse, and in trouble with the law. While recognizing that those children coming into foster care are already a troubled class, these statistics remain disturbing indicators that foster care generally is not breaking the cycle many of these children are locked in. These children need the very best society has to offer and are being shortchanged by a system which does not provide sufficient training, support services, screening, and reimbursement to foster parents.1 An additional serious problem which requires consideration is the provision of foster care to teenagers. Many of these children have difficulties adjusting to foster care and as a result may suffer multiple unsuccessful placements. The AWOL problem in this age group is significant. Many of the children run away from placement only to run to the receiving home. There is some evidence that this group of children could be better served in cottage style residential facilities in the community or close by in rural settings. While this concept brings with it a host of other problems, it may meet the needs of those children who can not adjust to a foster family situation or ever to being returned to their natural family. A lack of societal commitment has led to children in general being more troubled; foster care children generally suffer from multiple problems which contribute to ever greater adjustment problems. Foster care funding is primarily from federal grants. Last year San Diego County spent over 70 million dollars on foster care. Almost all of that was reimbursed by federal and state funds. As of a few months ago the County is now expected to contribute 60% of the portion paid by the state. It is expected that this additional cost to the County will cause a closer look at placement decisions. The intentions of open-ended foster care funding was to ensure that all children would receive the level of care they needed. This has had the unfortunate result of encouraging out of home placement and higher levels of care than may be needed. It is hoped that the increase in the level of County responsibility will not discourage expenditure of funds when needed. 1 Mending our Broken Children: Restructuring Foster Care in California, Little Hoover Commission, April, l992.

The cost of foster care has escalated dramatically in the past several years. Unfortunately, this open-ended funding stream may have been partially responsible for excessive placement of children in foster care. Foster care has evolved into a highly developed "cottage industry" with a strong political voice. While the majority of foster parents are well motivated, it is important to remember that there can be a strong element of self-interest in the foster care provider positions on dependency issues. This report on foster care is intended to share with the community, general and specific, findings on problems in foster care. The problems are many and solutions will be difficult. Only by acknowledging the existence of these problems can curative steps begin. The Grand Jury has divided the range of problems into three categories: Foster Placement Problems, Problems of Training and Status, and Problems of the System. Our recommendations for change make up the final portion of this report. FOSTER PLACEMENT PROBLEMS The Grand Jury has identified five problems caused by some foster parents. Although many foster parents are truly dedicated contributors to child welfare, too many are in the business of making money by renting their homes to the dependency system. These problem foster parents cheat the system and short-change the foster children. Foster placement as a precursor to adoption. The Grand Jury interviewed attorneys, physicians, specialists in child development, caseworkers2 and investigators, all of whom work with foster children, in an effort to discover foster care problems and to arrive at solutions. While these experts routinely praised the many excellent foster parents who are motivated by love for mistreated or neglected children, they acknowledged that many foster parents are motivated by money, supplementing, and at times being the entire family budget, by "taking in" foster children . However, by all accounts, the most troublesome problem for the system is foster parents 2In earlier reports the Grand Jury has used the term "social worker" to describe employees of the Department of Social Services. However, the term "social worker" denotes a person who has achieved the Masters Degree status in the social work curriculum or who is licensed as a social worker. Many departmental employees who work on cases are not "social workers" by this definition. (See San Diego County Juvenile Justice Commission Case Review Report, p.1.). In this report the Grand Jury uses the word case worker to denote that general class of departmental employees who perform case work.

screening children for the "right" one to adopt. Those foster parents who hope to adopt may "sift" through a number of children until they find the one they want. An example of this type is the case of Baby Girl R. Baby Girl R.'s counsel informed the Jury that the foster mother admitted that she was holding her foster care license only until the family found a "baby sister." This mother takes emergency care (short term, up to 45 days) placement, only, so that the family can "check out" a number of children. The Hispanic natural mother of Baby Girl G. who was placed in this home has tried to visit her baby in the foster home, but the foster mother frustrates the visitation efforts and instructs the caseworker not to transport the mother to the foster home. (The birth mother does not have transportation of her own.) The result is predictable and recurrent. The child, "who looks white" according to the foster mother, will bond to the foster parents without knowing her real mother. The natural mother will fail at her reunification plan because she does not fulfill the visitation requirement. The child will be "freed" for adoption, and the family will have its "baby sister." In another strikingly similar situation with a bizarre twist, the foster parents believed the foster child is "too white to be Hispanic", and have therefore changed the baby's name to an English one, as part of the process of making this child a permanent part of the family. Many children need to be adopted because their parents have abandoned them, or because the parents have forfeited their parental rights through neglect or abuse and failure to comply with the requirement for reunification during an 18-month reunification period. These children should be adopted. However, these children tend to be beyond infant years, the age when children are the most attractive for adoption. The process that the Grand Jury finds unacceptable is the placement of infants or small children whose parents are still attempting to reunite with foster parents hoping to adopt. This creates an irreconcilable conflict. These foster parents frustrate visitation and lie to the caseworker about the parents' behavior, hoping that the caseworker will promote the foster parent's view to the court, hastening the day when the court frees the child for adoption. Many natural parents in this situation have difficulty communicating their plight to others because of language barriers or because they are afraid to complain about "official" conduct until it is too late. AB 243 was written into the Welfare & Institutions Code short clock for reunification. Bureaucracies respond slowly to complaints as this clock keeps ticking.

Only vigorous advocacy by the attorneys for the natural parents, and more careful screening to discover the genuine intentions of foster parent applicants can solve this problem. Certainly the Department must immediately cease promoting foster parenting as a precursor to adoption.

Treatment of the foster child as compared to treatment of the biologic or adopted child. Foster parents are expected to create an atmosphere as nurturing as possible for foster children. Although foster children older than infants or toddlers know that they are not in their own home, they need to believe that they are being treated fairly. Because they miss their parents and their real home, they must adjust to their new surroundings, especially to the new children with whom they live___the biologic or adopted children of the foster family. That adaptation is impossible if they are treated differently from the other children in the home. Many caseworkers and investigators report that some foster families treat foster children differently than the other children in the home. The Grand Jury was given some of the following examples by minor's counsel and caseworkers: foster children given different (cheaper) food than the other children;
o o

foster children given access to only limited areas of

the home; foster children given only very cheap clothing, or poor condition hand-me-down clothing from the other children;
o

no photos, schoolwork, awards or other mementos of the foster children are permitted to be displayed in the home, even in long-term placements;
o

physical discipline of foster children by foster parents in spite of such discipline being forbidden by Department of Social Services rules;
o

foster children being forbidden to watch television with the rest of the family or being forbidden to open the refrigerator;
o

foster children being excluded from vacations with the rest of the family.
o

This disparate treatment can only single-out, mark, and even destroy the foster child. Caseworkers report that they fear raising the issue of these abuses to higher levels in the department because of the constant shortage of foster homes. Therefore, complaints other than of the most serious kind are discouraged. This fear is widespread and recurs in discussion of problem foster homes: A poor quality foster home is better than the risk of no foster home. The Grand Jury decries this attitude. Poor quality foster homes have no place in the system. Fortunately, the current leadership of the Department and Child Protective Services is in full agreement with the Jury's concern. Improper attempts to obtain higher rates. Foster parents are paid monthly rates to care for foster children. As an example, a foster family currently receives $354.00 per month for a child up to four years of age and $484.00 per month for a child from 5 to 18 years old. Clothing allowances are in addition to these amounts.3 These amounts are not taxable income. If a foster child requires special care, then special care rates of up to $1,000 per month (including the basic rate) are available at the discretion of the caseworker and his or her supervisor. The Jury has several concerns with the funding of foster care. First, many of the children in foster care are there because of poverty. Their natural parents are unable to take care of them on AFDC. The amount received on AFDC is little more than half that received by foster parents. Foster parents are not supposed to be making a profit from fostering and so it is assumed that the amount received by a foster parent is what the state reasonably expects it to cost to have a child in the home. This is logically inconsistent. Why should it cost a foster parent almost twice what it costs a natural parent? Nonetheless, the Little Hoover Commission and Grand Jury testimony indicate that it would save money in the long run to increase the amount paid to foster parents and to obtain a higher quality professional cadre of foster parents. The state pays approximately $6500 to support a child in a foster family compared to more than $32,500 to place him in a group home. Children who are placed in bad, abusive, ar inadequate foster homes are more likely to need eventual placement in the higherpriced group home. The Grand Jury has received reports that some foster 3Children's Services Special Notice, #67-90, p. 2.

parents improperly claim that a child needs special care in order to increase the amount of money coming into the home. The Department of Social Services considers behavioral or medical problems and "minor and/or temporary conditions"4 as potentially justifying the payment of extra funds to the foster family. Caseworkers, investigators and attorneys believe that some foster parents routinely complain of behavioral problems, insist that those behavioral problems require mental health therapy and then seek additional funds for regular transportation to the therapist and special care needs. These claimed behavioral problems are subjective and are not capable of being confirmed by objective tests. In fact, Department of Social Services policy authorizes the payment of special care rates for "children exhibiting behavior problems" for which documentation has not yet been provided.5 The Grand Jury suggests that foster parent claims of behavioral problems in foster children not previously identified as having the problems should be carefully investigated. Improper use of controlling medications. Treatment for some behavioral and allied medical problems is through the use of medications which control the child's nervous system and mental processes. These medications range from mild depressants and hypnotics to strong psychotropic drugs. In the mental health, social service and foster care communities these nostrums are referred to by the apparently innocuous name "meds." When obtained and used inappropriately, meds become a way of making a child quiet, withdrawn, and apparently trouble-free. Meds are often the physician's way of treating behavioral problems. However, if the physician receives incorrect information about a child's behavior, it is possible that medications could be prescribed for a child who does not need them. As will be noted in a later section on medical care of foster children, the lack of money for medical treatment, the financial pressures on medical providers and a generalized lack of medical records for foster children all contribute to make it possible for unscrupulous foster parents to obtain medication (and special care payments) for children who do not need to be medicated. The Grand Jury recommends that the Department of Social 4Children's Services Special Notice, #1-89, p. 2. 5Children's Services Special Notice, #1-89, p. 2.

Services set up a system to record and inspect the kind of care by foster family (including medical requests) so that abuses can be substantiated. Thereby, inappropriate foster families can be removed from the opportunity to further harm these unfortunate children. The Grand Jury further recommends that parents be kept fully informed of all medical treatment received by dependent children. The Grand Jury further recommends that parents be kept fully informed of all medical treatment received by dependent children. Sabotage of reunification efforts. An intent to adopt by the foster parent is not the only problem which occurs with reunification plans. Caseworkers, investigators and attorneys who contributed their experiences to the Jury told of foster parents who interfere with reunification for a variety of other reasons. Some foster parents find the conduct of the natural parent so unacceptable that the foster parent pronounces a personal judgment that prevents the natural parent from ever being able to reunify with the child. This kind of attitude, although understandable, limits the court's ability to promote reunification, and also acts against the birth parents' right to learn from mistakes and to change their conduct.
o

Some foster parents become antagonistic to the birth parents because of controversies that arise during foster care. Often, parents of dependent children are from other cultures, or have communication difficulties, or are so nervous and upset over losing their children that they act inappropriately. An angry foster parent can exaggerate the negatives and forget to describe the positives when reporting to the caseworker. The caseworker then becomes a reporter of inaccurate information which creates a biased record to the court.
o

Some foster parents are not sympathetic to the philosophy that parents have a right to reunify. These foster parents may put roadblocks in the way of natural parent contact with their children. When contact and visits do not take place, caseworkers and judges are less likely to approve reunification.
o

Many foster parents are economically far better off than the natural parents. The natural parents may feel embarrassed and inadequate faced with this disparity. This may impact the ability of the parents to visit at the home of the foster parents.
o

The existence of these problems makes it especially important that recruitment of foster parents, their training, and all of their caseworker contact stress the professional aspect of

foster parenting. Foster parents must have a measured, rational, and sympathetic approach to parents. They must understand that reunification, not separation, is the goal of the dependency system. PROBLEMS OF TRAINING AND STATUS By the accounts of witnesses who addressed these topics, foster parents do not receive sufficient training, and their good work in the system is not appreciated. This has led to a failure to keep many good foster parents. Although there are many reasons, mostly historic and financial, for this state of affairs, it must be changed. The alternative will be further suffering by foster children and their natural families, and a continuation of the difficult task of finding and keeping good foster parents. Insufficient training especially in the area of child development. The Department of Social Services attempts to train foster parents in their role as temporary, substitute parents. That training needs to be expanded in both breadth and content. When faced with this proposition, caseworkers respond that the system cannot put too many demands on the foster parents or it will lose them. The Grand Jury sympathizes with the difficulties in recruiting good foster parents but believes that appropriate training and psychological screening will attract, not put off, the best foster parents. With this training and screening should follow increased status and respect within the system. A physician who specializes in child developmental medical problems in San Diego County, and who treats foster children as a major part of her practice is astonished at the lack of knowledge displayed by foster parents in dealing with problems of child development. Child development is a branch of medical science which has found that unrecognized and untreated developmental problems will have lifelong affects for that child. Since foster parents, by definition, raise foster children who are the most unfortunate of society's charges, foster parents must receive intensive training in child development. The Grand Jury suggests that the Department of Social Services must unite with child developmental medical experts in this county to design a training program that will teach foster parents how to recognize developmental problems and to arm those foster parents as advocates to demand appropriate diagnosis and treatment for children with such problems.

Failure to co-opt foster parents. In an ideal system, the foster parent would become the eyes and ears of the caseworker, providing constant up-dates on the status of the child and the child's interaction with the natural family. However, because of the unfortunate inability to attract only the best foster parents, because so many foster parents are motivated by money, and because some foster parents are not trained sufficiently in their role, many caseworkers do not view foster parents as reliable informants, devoted to the welfare of the children. As a result, this minority of inappropriate foster parents have poisoned the well for the majority of foster parents who seek to do a good job. These good foster parents are further hampered by non-communicative caseworkers who have formed a bad impression of all foster parents based on the poor performance of the few. In spite of the bad experiences, caseworkers ought to be encouraged to expect the best from foster parents and to report those foster parents who perform in a sub-standard fashion. In short, discouraged social workers have low expectations of, and little respect for, many foster parents. Such an expectation is self-fulfilling, causing foster parents to lose hope of real cooperation. The self-defeating spiral must be stopped. As an institution, only the Department of Social Services can stop it. The following observations suggest how severe this problem has become. Neglect and abuse of foster parents. Investigators and attorneys have provided many examples of foster parents who tried to give crucial information to caseworkers but were met with disbelief and inaction. An example involved Louis R. whose mother is in prison. When Louis was six, he was placed with his long-term foster mother. After two years in foster care Louis had worsening behavior problems, was running away, and was causing serious problems in the foster home. Louis had five caseworkers in two years, and the last of them, newly assigned to the case, would not honor the foster mother's requests for "a break." Instead of providing respite care, the caseworker removed Louis from the foster home, wasting two years of hard work by the foster mother in building a relationship with Louis. Louis has to adjust to a new foster home, missed long-term foster mother, and the system

lost an effective foster parent.

A number of caseworkers act inappropriately toward foster parents. The effect of the inappropriate behavior is to destroy the self-image of foster parents, and to cause foster parents to resign. Bobby J.'s foster mother had noticed recent behavior changes by Bobby's parents. Over the preceding six months the parents had increased their visits with Bobby, had called him almost daily, and were improving their financial circumstances. Bobby was responding strongly to this increased attention. The foster mother reported these changes which she called "dramatic" to the caseworker. In response, the caseworker spoke disparagingly of the birth parents. The foster mother began to believe that the social worker had "written off" the natural parents. The foster mother asked the caseworker if the foster mother could report directly to the court. The caseworker responded that "foster parents have no part in the decision making process." Absolutely frustrated, the foster mother planned to resign her license, but sought help from an outside agency that found a way to communicate the foster mother's beliefs to the court which, in turn told the Department of Social Services of the changed circumstances. This case ended well for the natural mother and child because of the foster mother's perseverance in spite of the Department. Foster parents report that they receive a new foster child in this way: a caseworker calls and says that (s)he is bringing Johnny over. Johnny arrives with a small bag. He is frightened and upset. The caseworker handles the introduction and then takes the foster parent aside for a ten-minute presentation of Johnny's status. The foster parent asks for medical and educational records, but they are not available, yet. The caseworker leaves. Caseworkers are reluctant to share much information with the foster parents for fear of frightening the foster parents, sharing confidential information, or poisoning the foster parents' conception of the natural parents. These are valid concerns.

However, the foster parent received none of the information needed to help Johnny adjust and to spot behavioral clues that Johnny is having problems of a particular kind. Many foster parents report that they obtain insufficient

information. Often, caseworkers are afraid to share information with foster parents for fear of making inappropriate disclosures. There is a distinct need to convene a task force of psychologists, attorneys, caseworkers, natural parents, foster parents and educators to devise a protocol for the appropriate sharing of information with foster parents. PROBLEMS OF THE SYSTEM The following problems in foster care are systemic. They involve funding, cultural identity issues, agency organization, interaction with other bureaucracies, the despair of the medical profession, and the system's orientation toward emergencies as a guiding and limiting force. These problems run deep and wide, and they share a common denominator: inadequacies in funding. The Jury describes these systemic problems, even with the knowledge that solutions are difficult and that budgets are strained to the breaking point. Foster care funding in conflict with reunification goals. The Jury has several concerns with the funding of foster care. First, many of the children in foster care are there because of poverty. Their natural parents are unable to take care of them on AFDC. The amount received on AFDC is considerably less than that received by the foster parents. Foster parents are not supposed to be making a profit from foster parenting and so it is assumed that the amount received by a foster parent is what the state reasonably expects it to cost to have a child in the home. However, is it logical for the government to pay more for foster care than it pays to support children in the home of the natural parents? The Little Hoover Commission found, and Grand Jury testimony indicates, that it would save money in the long run to increase the amount paid to foster parents to obtain a higher quality professional cadre of foster parents. The state pays approximately $6500 to support a child in a foster family compared to more than $32,500 to place a child in a group home. Children who are placed in abusive or inadequate foster homes are much more likely to need eventual placement in the higher priced group home. Inadequate foster care homes. The dependency system in San Diego County needs to place approximately 180 children per month.6 Some of these placements 6In May, 1992, Juvenile Court received new petitions on 188 children. Most of these children required at least temporary placement. There are thousands of children in out-of-home placement at all times. Children come into placement at a faster rate than others leave.

can be made with relatives. Some of the children can be placed, on a monitored basis, with their own families. The rest must be placed in foster care. The struggle to find new foster homes is constant. In addition to new cases, placements changes further burden the system. Foster families have emergencies, so respite care or other foster homes must be found for the foster family's foster children. A foster family may no longer be able to cope with a particularly troubled child, so a new placement must be found. For many reasons children from cultures other than the dominant culture are placed outside their homes at a rate far in excess of their population.7 "Families in Crisis" made suggestions to help reduce this problem by establishing cultural competency as a mandate of the Department. This is currently happening and hopefully will result in a reduction in the overall percentages of minorities in foster care. In other words there are too few foster homes in general, and there are critically too few foster homes for children from diverse cultures. The recruitment of foster homes which match the dependent child's culture of origin has become a high priority of the Department. Professionals who gave information to the Grand Jury believe that there has been an insufficient effort by the Department of Social Services to recruit foster parents from diverse cultures. This failing is seen as specially pronounced in the failure to recruit Hispanic foster homes. At least one member of the departmental unit assigned to recruit Hispanic foster homes is a person who is a monolingual English speaker. The lack of foster homes and arbitrary rules separate siblings. The Department of Social Services uses a system which categorizes foster homes to meet specific needs which commonly recur: ESCU (Emergency Shelter Care Unit) homes take children on a short term basis for up to 45 days.
o

Short term foster homes take children who will probably be in placement for more than 45 days, but less than long term foster care.
o

7Twenty-three percent of the children placed out of home by the Department of Social Services are African-American while only seven percent of all children in San Diego County are of African-American. Report of the Placement and Evaluation Committee, San Diego County Commission on Children and Youth, April, 1992.

Long term foster care homes expect to have the foster child for an extended period of time. (Long term foster care is an alternative for children who cannot be reunited with their birth family, and for whom an adoption is not a possibility.
o

Medically-fragile homes are homes where the parents have specialized experience or training that makes them capable of caring for children with special medical problems.8
o

Using this category chart it is easy to see that if children in the same birth family have different needs, they will be placed in different foster homes, thereby separating the siblings. But the problem is even more complicated. Some foster homes (and foster homes' licenses) have limitations on the number of children they can take. Some foster homes take only children of one gender. Some foster homes take only children of certain ages. In many cases these specifications may be appropriate. However when there is insufficient flexibility in foster home opportunities, siblings are separated because of (1) special needs of some children in the family, (2) age differences between the children, (3) gender differences, or (4) the number of children in the family needing placement. Once siblings are separated, the child has lost the last vestiges of his or her natural family. The only hope for that child to remain in contact with this family is through regular visitation. The lack of foster homes and the same arbitrary rules are "terrible for kids and pernicious for infants". Physicians who provided information to the Grand Jury are motivated to help these most unfortunate children in spite of slim financial rewards. They are appalled by the effect that foster care has on their young patients. Reporting physicians see the constant shifts from emergency shelter care to short term care to long term care as destructive to their patients' mental and physical health. A pediatrician cited a common experience in her practice. A child has health problems and is placed in a medically fragile home. After a period of adjustment caused by the change in placement, the child begins to respond to the love and care provided by the foster parent. The child's medical condition improves. The child begins to bond to the foster parent. The 8Medically fragile homes should not be confused with "F.F.A. Homes." F.F.A. homes are foster homes which are selected and supervised by Community Based Organizations which contract with the County to provide certain types of specialized foster care. F.F.A. homes are not covered in this report.

child is cured, or the condition stabilizes. The caseworker must then move the child to another foster home because this child no longer needs specialized care and another child does. The first child must now deal with yet another rejection and the loss of a loved one. Physicians see these changes in placement as doubly hard for infants. Whereas some older children may be able to adjust to constant changes of homes, infants cannot. Nothing in their experience prepares them for losing their mother and being shifted from one stranger to another. A physician treating foster children stated, "these constant placement changes are terrible for kids and pernicious for infants." The crisis in visitation. One of the worst features of the separation of families into foster homes are the difficulties with visitation. In calling this particular problem a crisis, the Grand Jury considered these facts: Most dependent families are very poor and do not have transportation of their own.
o

With some exceptions, travelling throughout San Diego County by public transportation is problematic, at best.
o

Foster families have very difficult schedules, added to normal family activities are the special needs and time demands created by caring for the foster children.
o

The Department of Social Services has very few case aides available to assist with transportation.
o

The parceling of multiple children to different foster homes geometrically increases the problems with visitation for both parents and siblings.
o

One of the prime indicators in favor of family reunification is the frequency of visits. The rule is: "Families that visit often get reunified; families that don't visit lose their children."
o o

Some foster parents try to keep visits from happening.

Some caseworkers are not helpful in arranging visitation.
o

Foster homes are often not located in the same part of the County as the parents' home.
o

San Diego County is as large as the states of Connecticut and Vermont, combined.
o

The solution to part of this problem is clear and is presently being addressed by leadership in the Department and by Task Forces studying this problem; it lies in a change of priorities by the Department of Social Services in selecting foster homes. The highest priority in the dependency system must be the reunification of families so long as reunification can be accomplished with safety for the children. Departmental priorities must reflect this mission. Top priorities one and two in the selection of foster homes must be: Selecting a foster home that will allow the children in the dependent family to live together; and
o

Select a foster home which is located as closely as possible to the home of the parents of the foster children.
o

Educational problems resulting from foster-care placement. While children are in foster care their education often suffers enormously. Part of this educational setback is caused by the child's need to adjust to a new school. Given the frequency of foster home changes in a typical case, it is not unusual for a dependent child to change schools two or three times per year. Schools can be slow to transfer records. Sometimes a child in foster care is changed to a third school before the records from the first school arrive at the second school. This problem is magnified for the children who need special educational services. A child who is in Special Education in his original school may not be identified as having special needs for some time after placement in a second school. While the child's Individualized Education Plan (I.E.P.) should travel with the child, professional testimony indicates this is not the norm. Experts in the area of Special Education testified that special needs children are far more likely to have multiple changes in placement. "Families in Crisis" made specific recommendations in this area. It is an unfortunate fact that many dependent children need special educational services because of conditions attending the child's birth, because of injuries resulting from abuse, and because of the twin emotional traumas caused by the conditions of dependency and the constant changing of homes and schools. If an I.E.P. testing is arranged at one school and the child is moved before the procedure is completed, the child must start the process again at the new school. Even if testing is completed and an individualized plan is adopted, a change in

schools will mean that the provision of special education services called for by the plan is delayed. According to information received from an advocate for special educational services, these services are difficult to obtain if the student remains in the same school system at all times. If a student moves frequently between school systems, these services are almost impossible to provide. The Grand Jury suggests that the Juvenile Justice Commission address the problems of transfer of records and the provision of special educational services where dependent children are involved. Health care threats. As in all of our society, the reliable and affordable provision of medical services to dependent children is becoming more problematic. Fewer medical service providers accept payment at the level which the Department of Social Services subsidizes. Most physicians and psychologists no longer accept cases which pay at the Medi-Cal rate.9 For example, only one medical clinic in the North County area takes Medi-Cal patients. This economic dilemma forces foster parents to fight to have their foster children seen at clinics. Once the foster parent is able to have the foster child seen by a physician, the assessment process is slowed by the lack of medical records. Some foster children new to the system do not have medical records because their natural family either did not obtain treatment, or the records were lost. Some foster children who have been in the system do not have medical records because those records did not transfer when the child changed from one foster home to another. The Medical Passport is an attempt to rectify this problem and, properly implemented, would help. However, as reported in "Families in Crisis", the Passport to be effective must be kept up to date with accurate information. The Department of Social Services reports that it is constantly improving this transfer of documents. Physicians continue to report that, whatever the reason, they do not receive medical records for many/most foster children. This dual situation of a declining number of medical providers and missing medical records is one of the most troubling parts of the dependency system and should be monitored on an ongoing basis by the Juvenile Justice Commission. 9Medi-Cal pays the physician $12.00 for a complete assessment. At that rate, even a charitable physician in a non-clinic setting can afford to do no more than one assessment per week in the opinion of the physicians who informed the Grand Jury.

Inadequate preparation for transition between homes. Child development experts informed the Grand Jury that one of the most destructive aspects of the foster care system is the failure of caseworkers adequately to prepare the foster child who is about to be moved to a new foster home. Incremental damage is done by any change in homes, but the failure to prepare the child compounds the damage. Caseworkers respond that they do not have time enough to prepare children. They cite high caseloads and the emergency nature of many changes of placement. The Grand Jury believes that the "emergency excuse" has permeated the Department of Social Services and that caseworkers are not expected to make adequate provision for change of placement. The Grand Jury calls for the formation of a task force made up of child psychologists, child advocates, caseworkers and their supervisors who will establish minimum standards for the child's preparation for change of placement in every instance. Failure to close bad foster homes. One feature of the foster care system was cited by all of the physicians, psychologists, attorneys and investigators who supplied information to the Grand Jury: the Department of Social Services mechanism to close sub-standard foster homes is inadequate. Physicians, especially, cited examples of foster parents who failed to feed foster children, who made the children wear shabby and dirty clothing, and who constantly missed medical appointments. The foster children were pulled from the home, but new children would be sent with the same result. These physicians stated that they had difficulty finding a person willing to take their complaints and that these homes continued to house foster children. Attorneys and investigators also reported difficulty in having the Department deal systematically and quickly with complaints about foster homes. CONCLUSIONS Foster care will always be an essential part of the juvenile dependency system. Most foster-care parents fulfill their roles with selfless commitment to children as their primary motivation. Some foster parents are motivated by

financial gain; others are using foster parenting as a path to obtaining a child for adoption. Family preservation is the goal of the juvenile dependency system. In some cases children will never be able to reunify with their natural families. However, placement of the child during dependency intervention must not become a part of the problem in reunification. General societal problems have impacted the provision of educational and medical services to all poor children. Children in foster care are further impacted by frequent changes in placement. A disproportionate number of minority children are in foster-care placement. There has been an inadequate identification of minority foster-care providers. Relativeplacement reimbursement is less than is provided to unrelated foster-care providers. This impacts the ability of some relatives to provide foster care. In San Diego County this situation is receiving priority attention. RECOMMENDATIONS The Grand Jury recommends that the Department of Social Services: #92/133: Insure that foster care is not used as a path to adoption. #92/134: Explore use of an assessment predictor to screen prospective foster parents which will identify those who are seeking to adopt infantS or toddlerS. Develop a psychological screening procedure for prospective foster parents. #92/135: Explore legislation to professionalize foster parents with higher pay and better training. #92/136: Develop a system to report differential treatment of foster children in relation to families' biological or adopted children. #92/137: Monitor requests for special care payments and for behavior controlling drugs on a foster home by foster home basis. Supervisory monitoring of these requests should be tightened and requests approved only when there is medical evidence establishing the condition. #92/138: Enhance training of foster parents with more time given to teaching the rights and difficulties of natural parents and the facilitation of reunification.

#92/139: Recruit assistance from the San Diego County Commission on Children and Youth Child Development Competency Task Force to assist in the creation of a training program in the recognition of developmental problems and in the advocacy of diagnosis and treatment. Request that this Committee provide a protocol for the minimum standards required to prepare children to deal with changes in placement. #92/140: Provide necessary training to all caseworker staff on the importance of implementing and reinforcing adherence to existing protocol for the sharing of appropriate case-specific information with foster parents. #92/141: Convene a task force or identify a suitable existing body of foster parents, community leaders, caseworkers, reunified parents, and representatives of all of San Diego's many cultures to develop strategies to attract foster homes within the diverse community in numbers proportional to the children from each culture who are in out-of-home placement. #92/142: Adjust priorities in the selection of foster homes. These priorities should include selection of homes which allow siblings to remain together, selection of homes within close physical proximity to the homes of the parents of disabled children, and selection of ethnically, culturally, and linguistically consistent foster home. #92/143: Request that the San Diego Commission on Children and Youth establish a task force made up of representatives of the school systems, foster parents, special education advocates, specialized psychologists, and departmental representatives to forge a protocol on the transfer of the educational records of dependent children and on testing for and provision of special educational services for dependent children. #92/144: Provide a second "hotline" to be available to service providers, attorneys and investigators specifically for complaints about foster homes. Those complaints should be passed immediately to the internal collection and investigation system which should be set up in response to Recommendation #137.

SI-HSS2