Thursday, October 1, 2009

The frontline rebellion that saved kinship care in Michigan

So apparently it was quite a love fest between the group that so arrogantly calls itself "Children's Rights" (CR) and the Michigan Department of Human Services (DHS) in federal court yesterday. Not surprising. When a group that doesn't care about keeping families together sues an agency that doesn't care about keeping families together, and they wind up with a settlement that boosts funds for foster care and institutions at the expense of prevention and family preservation - what's not to love, right?

But if the judge really believes the progress is "truly laudatory and exceptional" I have to believe – or at least hope – she hasn't actually read the report of the court monitor overseeing the decree.

In yesterday's post to this Blog, I noted the biggest revelation in the report: the fact that DHS Director Ismael Ahmed's budget cuts in prevention and family preservation may be illegal.

But there are other revelations buried in the 95-page document. Among them is one concerning how CR and DHS were stopped from crippling kinship care in Michigan.

I'll discuss that at the end of this post. First, NCCPR's take on the key points raised in the report.

Though there are exceptions, in general, the monitor's report reveals largely pathetic compliance with a largely pathetic consent decree.


The rebellion that saved kinship care is one indication that the people on the frontlines are outthinking both CR and DHS. But there are others:

--Despite the pressure to "take the child and run" entries into foster care declined during the monitoring period – a period that happens to coincide with the height of NCCPR's activity in Michigan. I am proud of the role NCCPR played in dampening pressure for needless removal and reinforcing the best instincts of the state's best frontline workers.

--As noted in yesterday's post to this Blog, DHS is ahead of schedule in reunifying families where children have been trapped in foster care more than a year (even as private agencies, paid for every day they hold these children in foster care, fall behind.) But also, as noted previously, the budget cuts jeopardize the success of the reunifications.

--In contrast, DHS is behind in helping another group – legal orphans created by the state's mad rush to terminate parental rights. In part that's because it appears DHS and CR are pushing only one answer for these children: Adoption. Since it is likely that, in many of these cases, parental rights never should have been terminated, and since it is common for these children, once they reach 18 and are free of the system, to head right back to their birth parents, DHS instead should be focusing on seeing whether there are more cases in which parental rights should be restored and efforts at reunification revived.

--Another key barrier to adoption is institutionalization. Almost all foster children are adopted by their extended family or foster parents. Institutionalizing children denies them their best shot at adoption. Since Ismael Ahmed is apparently in love with institutional care, it's no wonder getting children adopted remains a problem.


The progress on reunification is one of the very few areas of substantive progress noted in the monitor's report. Most of the areas in which goals were achieved were bureaucratic.

If the requirement involved shifting job titles and moving around boxes on a table of organization, DHS generally succeeded. When it involved actually improving outcomes for children, DHS generally failed. In other words, DHS is good at rearranging the deck chairs, bad at bailing out the boat.

So, for example, DHS managed to reorganize itself and create that separate child welfare division that CR craves, even though there is no evidence that agencies that have such divisions work better - or worse – than agencies that don't.

But DHS failed to keep much more important commitments.

--DHS failed to make sure that foster children are covered by Medicaid.

--DHS failed to make sure that children aging out of foster care have health insurance.

--DHS failed to keep its promise to spend more on mental health services for foster children.

--DHS failed to refer all children aging out of foster care for housing assistance.

And perhaps most tragic:

--DHS failed to make sure children who are not delinquent are not placed in juvenile detention. As the monitor's report noted, there is widespread consensus that "a single day in jail or detention changes a child's life forever" – and not for the better.

When it comes to other provisions of the consent decree that really might do some good – DHS failed to meet its deadline and CR obligingly extended that deadline:

--Limits on institutionalizing children: Delayed. (No surprise that the always institution-friendly Ismael Ahmed isn't going to rush to put limits on warehousing children in institutions run by the state's powerful private agencies.)

--Development of treatment foster homes (a key alternative to institutionalization): Delayed.

--Performance-based contracting, in which private agencies actually would be held accountable for helping children, instead of just raking in per diems by keeping them in foster care as long as possible: Delayed.

--Reviewing policies concerning the use of potent psychiatric medications on foster children: Delayed.

--Limits on out-of-county placements: Delayed


--As it began to come to terms with its dreadful data gathering capacity and started actually learning about the children it's supposed to care for, DHS found far more children in particularly vulnerable groups – such as children remaining in foster homes where abuse was alleged and children languishing in institutions – than the agency expected.

That, in turn, is delaying efforts to give these cases special review, which means, of course, these children will be warehoused in institutions or trapped in potentially abusive foster homes even longer.

--There are some potentially disturbing data concerning deaths in foster care. I have long cautioned about drawing inferences about overall system performance based on fatalities, but since they remain the measure of choice for media, the information in the report about such deaths deserves further scrutiny.

The data show that from March 31, 2005 through March 31 2009, 88 Michigan children died in foster care. In many cases, the deaths may be due to illness or other factors for which the system is not at fault. But in 51 cases, there were suspicions of abuse or neglect in connection with these deaths. In ten cases the suspicions were substantiated. But abuse in foster care always is underestimated when the state is, in effect, investigating itself, and the monitor's report found that some of the investigations were disturbingly superficial. And there is no systematic process for investigating these deaths.


The original consent decree had an idiotic clause requiring all kinship care homes to be formally licensed, including homes where grandparents and other relatives had been safely and lovingly caring for children for years. Unless a grandparent either could obtain a hard-to-get waiver or comply with ten single-spaced pages of requirements, many of them unrelated to health and safety, their grandchildren would be expelled from their homes. As I noted at the time, the home in which President Obama was raised by his grandmother could not have qualified for licensure under these regulations.

Intense pressure by NCCPR and other advocates ultimately forced DHS and CR to back down. But the monitor's report reveals something else that was going on as well – what amounts to a rebellion by dedicated frontline workers who either were too appalled by the policy to enforce it, or simply couldn't believe DHS and CR really wanted them to do something so stupid.

According to the monitor's report, the rebellion began after DHS issued a memo, called an "L-Letter," instituting the draconian new policy called for by the consent decree. The letter ordered all homes to be licensed and ordered the removal of children from homes that could not or would not be licensed. According to the monitor's report:

The reaction was immediate. Concerned judges, advocates, and field staff thought this new L-Letter presaged a retreat from the State's longstanding commitment to relative care. Judges also saw a handful of examples of families who were being told children long in their care would be removed if the families did not cooperate with licensure. The majority of staff in the field waited and held off on moving children, asking for clarification about the policy. Staff continued to place children coming into care with kin… [emphasis added.]

The waiting paid off. In March, 2009, in the wake of pressure from NCCPR and others, DHS issued a revised L-Letter backing off from the mandatory licensure policy. As the monitor reports:

After the issuance of the revised L‐Letter and outreach by [DHS child welfare division] leadership, word spread quickly that mandatory removal of children was not DHS’ policy, and managers and judges were able to reinforce that it was not necessary to remove children from safe relative homes because of licensing challenges.

Thanks to the efforts of NCCPR and other outside advocates, and the dedication of so many frontline staff, there was no reduction in the proportion of children placed with relatives.

But the monitor appears to feel the steps taken so far are not enough to ensure that this record continues. He goes on to send his own message to the frontlines, explaining to caseworkers that they don't have to limit the number of waivers from licensing requirements to ten percent.

The monitor's report also makes clear that the original attempt to force all kinship care parents into licensure had little if anything to do with safety – it was, and is, strictly about money. Even a CR press release admits as much.

The licensing requirement was designed to allow DHS to get federal aid for the placements and then use that aid to provide grandparents with payments equal to those paid to strangers (which is, in fact required by federal law, if relatives are licensed).

That's a commendable goal. But the fact that it didn't occur to CR that impoverished grandparents might not be able to meet ten pages of hypertechnical licensing requirements – or simply might be too suspicious of DHS to want to go through the process – illustrates perfectly the bureaucratic mindset that dominates CR; the notion that real human beings are like boxes on an organization table, to be moved around and manipulated at will in order to create the best looking human flow chart imaginable.

In CR's hyper-bureaucratic mind, anything that looks good on paper must work in real life. It's a perfect example of why the people at CR are like the people you least want to see when you finally make it to the front of the line at the DMV.