Many fos­ter kids get care far from home

State of­fi­cial seeks to change prac­tice as part of sys­tem over­haul

Austin American-Statesman - - FRONT PAGE - By Corrie MacLag­gan AMER­I­CAN-STATE­MENT STAFF

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It’s one of the prac­tices she wants to change as her depart­ment seeks to re­vamp a fos­ter care sys­tem she says is out of date.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.

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