Many foster kids get care far from home
State official seeks to change practice as part of system overhaul
The most emotionally disturbed children in the Texas foster care system are too often shipped across the state to residential treatment centers in Houston, far from their siblings, schools and the adults who care about them, a state official told lawmakers at a Capitol hearing Wednesday.
“That is not a good situation for children,” said Anne Heiligenstein, commissioner of the Texas Department of Family and Protective Services, during a meeting of the House Committee on Human Services.
It’s one of the practices she wants to change as her department seeks to revamp a foster care system she says is out of date. She expects to submit a plan to the Legislature by the end of the year, just before lawmakers convene in January.
Of the 66 residential treatment centers in Texas that serve foster children, half are in Houston. And of every 10 children placed in Houston-area centers, six are from other parts of the state.
“The odds of that child getting well and being able to go home go down when we take children away from their home community,” Heiligenstein told lawmakers.
Nearly 1,600 foster care children — 9.5 percent of children in paid foster care — are in residential treatment centers, she said. They have the most intense needs of any foster children,
often traumatized and ill from abuse and neglect and other underlying issues, she said.
For example, one such child is a 17-year-old girl who is a sex offender with bipolar disorder, fetal alcohol syndrome and a history of aggression and running away, Heiligenstein said. The girl has had more than 42 placements, including psychiatric hospitals, residential treatment centers and emergency shelters.
The state has struggled for years to place such children. In 2007, state workers kept children overnight in state offices when they had nowhere else to take them. During the peak of such placements, well over 100 children a month spent the night in state offices, said Heiligenstein, who took the helm at the department in December 2008.
She said the need for treatment centers is especially acute in Dallas, El Paso and the Rio Grande Valley. In Dallas, strict zoning and neighborhood opposition have contributed to the low number of centers, she said.
The Austin area has 13 such facilities, including those run by Helping Hand Home for Children and the Settlement Home for Children. Still, Austin children are routinely sent to Houston, said Patrick Crimmins, a department spokesman.
Not all residential treatment centers have contracts with the state to take CPS children. The others — which are also licensed by the state — may take children who are on juvenile probation, private-pay clients or children from other states, Crimmins said.
The state typically pays residential treatment centers between $96 and $243 a day to care for each foster child, depending on a child’s needs. Some centers are paid up to $374 a day for an intensive psychiatric program.
Heiligenstein said treatment centers report that the state rates are about 79 percent of what it costs to care for the children. She said she plans to ask the Legislature to increase rates for the centers.
She says she’ll attempt to make most reforms without asking for additional funds. The foster care system could certainly use more money, she said, but she’s realistic about the state’s tight budget, so she’ll seek flexibility to use the money the department receives in a smarter way.
For example, she wants to revamp the way caregivers are paid.
“Right now, we have a perverse financial reimbursement system in which the sicker the child is, the more we pay the caregiver,” she said, explaining that the situation means caregivers have no financial incentive to help the child get better.
And one of her priorities is ensuring that foster children are kept with their siblings.
“To separate siblings is an- other wound to children besides taking them from their own home that they really don’t get over,” she told lawmakers.
In addition, she said she’s concerned about whether children are prepared for a productive adulthood when they exit foster care.
“If there’s something that, besides just basic safety, that I worry about at night … (it) is what have we done to these kids education-wise?” Heiligenstein said.
At the hearing, state Reps. Elliott Naishtat of Austin and Patrick Rose of Dripping Springs, both Democrats, demanded to know why lawmakers weren’t informed about a 2008 fight at a residential treatment center in the Houston area. Employees of Daystar Residential Inc. in Manvel provoked a fight among seven female foster children with developmental disabilities, the Texas Tribune and Houston Chronicle reported in June.
Heiligenstein, who was not commissioner at the time of the fight, agreed lawmakers should have been told. “There was never any conscious decision to keep this from anyone — by no means the Legislature,” she said.