Texas foster deaths hit grim record

SAN ANTONIO — In the past fiscal year, eight children died from abuse or neglect while in foster care in Texas, an all-time high and a fourfold increase over the previous year.

The alarming trend shows the Texas Department of Family and Protective Services, which oversees about 350 private agencies that are supposed to take care of children removed from their dangerous parents, likewise is failing at the job, some child welfare experts contend.

In the midst of the upswing in deaths, department officials are trying to change the foster care system, just as a group outside Texas has mounted a legal attack on the state agency.

DFPS began rolling out a reorganization of foster care this summer in one region of the state, a plan that the department says will keep foster kids closer to their home communities, improve safety and create incentives to provide better care.

But whether the redesign truly will fix what's wrong with foster care is up for debate, with some critics saying it doesn't go far enough and introduces another layer of contractors in a system that's largely privatized.

Meanwhile, in August, a judge opened the door for a class-action lawsuit filed by New York-based Children's Rights on behalf of 12,000 children in long-term state care.

The suit cites myriad deficiencies — children are placed in unsafe care; they stay in care too long; oversight is woefully inadequate.

Case in point: The separate unit within the department that licenses, inspects and investigates allegations of maltreatment in more than 10,000 foster homes and facilities has a staff of just 124 caseworkers, the suit notes.

The suit further alleges that children in foster care are moved around repeatedly, their welfare in the hands of overburdened caseworkers, and an untold number receive substandard care from poorly screened and loosely monitored private contractors.

Two recent deaths seem to underscore points made in the suit:

In October, 11-month-old Orien Hamilton died in the Cedar Park home of her step-aunt, who was her foster mother, while in the care of a man with a violent history. State investigators said Lutheran Social Services of the South, the placement contractor overseeing Orien, didn't adequately screen the man, the father of the aunt's three children, to find that he was living at the house.

Orien's father said he also had warned Child Protective Services, which is supposed to regularly monitor foster children, that the man was staying in the home with Orien.

Jacob Salas is accused of crushing the child's head between his knee and the floor.

In July, 2-year-old Alexandria Hill died in Rockdale, an hour northeast of Austin, after her foster mother allegedly slammed her head on the floor. The foster mother, Sherill Small, who later was charged with capital murder, reportedly told police she lost her temper. The state determined Texas Mentor, a for-profit placement contractor, didn't conduct adequate background checks on people who visited the home and violated other state standards.

After Orien's death, state officials announced new safety measures, including an increase in unannounced visits to foster homes and tighter background checks for visitors.

Retired Judge John Specia, head of the department that regulates foster care, has since traveled the state, holding forums with private foster care agencies to try to improve the system ahead of the redesign, which will take years to fully implement.

For Marcia Robinson Lowry, head of Children's Rights, which has filed lawsuits nationwide since the 1980s as a way to force reform, these efforts come too late and aren't enough.

“The trouble is it takes a dead child for (Specia) to be concerned about the foster care system he runs,” Lowry said.

Speaking at a forum earlier this month in San Antonio, Specia told an auditorium full of social workers and others that “the vast majority of children in foster care in Texas are safe.”

“We're good at catching the red flags,” he said. “But we have to get better at catching the purple flags.”

A privatized system

In 2012, almost 28,000 children lived in state care in Texas, distributed among foster homes, relatives, residential treatment centers and other housing.

The state began relying on private contractors, some of which are owned by for-profit corporations, to recruit and train foster care providers about a decade ago.

These child-placement agencies, or CPAs, oversee the foster homes and facilities in which they place children, although Child Protective Services caseworkers are required to check on the children, usually once a month.

Today, 90 percent of children in foster care are placed and overseen by a patchwork of more than 350 CPAs, which each year receive hundreds of millions of dollars in state money.

Critics said some of these CPAs fail at their jobs, sometimes with fatal results, and that the state — ultimately responsible for children in foster care — doesn't sufficiently monitor them.

Texas Mentor, the agency that placed Alexandria Hill in the home of foster parents Sherill and Clemons Small, is owned by a national corporation and received $10 million a year in state money. After Alexandria died, the state suspended child placements at Texas Mentor branches in San Antonio, Arlington and Houston, citing serious safety concerns, such as caregivers who used corporal punishment and withheld food.

The company says it has a good record as a long-time contractor with the state.

Earlier this month, the state also suspended Austin-area foster homes monitored by Lutheran Social Services after Orien died. LSS officials have disputed some of state's findings.

When the state suspends placements, it doesn't remove foster children still living in the homes, said Patrick Crimmins, a department spokesman.

As far as CPS' actions in Orien's case, the inspector general initially closed its investigation, saying policy was followed. But the case was recently reopened to address questions the first investigation skipped.

“That aunt did a good job lying to us,” Specia said in a recent interview. “Mistakes can be made evaluating foster parents, but I don't think you can indict a whole system for one mistake, an incredibly tragic mistake.”

To Mike Foster, a program specialist for a Texas child-placing agency who has worked in foster care for decades, the problem of duplicitous foster care parents is compounded by “front line workers who are inexperienced.”

“Another problem are agencies that take shortcuts when they screen and license providers,” he said.

Filing suit

The Children's Rights lawsuit states Texas violates the rights of children in permanent foster care by not providing adequate oversight, specifically because it fails to employ enough caseworkers to ensure their safety and well-being.

High caseloads mean worker burn-out, which leads to high turnover, critics say. In Region 8, which includes San Antonio, the average daily workload for a CPS substitute care worker in 2012 was 40.5 cases; statewide, it was 33.7.

The Child Welfare League recommends no more than 12 to 15 cases per worker.

Texas children often are placed in group homes with up to 12 children — “essentially places that more closely resemble poorly supervised dormitories,” the suit contends.

The state also fails to address problems at foster homes and facilities — some 10,000 across the state — in a timely or effective manner, it claims.

In 2011, the state found “deficiencies” in care, such as the use of corporal punishment or failure to conduct background checks, in about 30 percent of investigations it conducted at licensed agencies and facilities. Of 812 findings, it initiated only 16 corrective actions, the lawsuit states.

The story of Michael, 18, who is not specifically named as a plaintiff in the lawsuit, illustrates the pitfalls of the foster system.

Born in San Antonio to a drug-addict mother who whipped her children with “anything she had,” Michael was removed from his home when he was 6 and his older brother was 7.

He was placed in Boysville, a residential facility, while his brother was sent to a psychiatric hospital.

A year later, Michael moved to a treatment center in Victoria.

“I was scared most of the time,” said Michael, who doesn't want his last name used for privacy reasons. “There were these crazy adults living there too. You had to keep your distance. They tried to hurt kids.”

He was then transferred to St. PJ's Children's Home in San Antonio, where he started to address the lingering wounds of his mother's abuse. He started playing football.

“I felt good about myself for once,” he said.

At 15, he was placed in a foster home in Kerrville, where six other foster boys lived. The foster parents wanted to adopt him, he said, but he still struggled with anger issues and ran away several times.

Four months later, he was placed in another foster home in San Antonio, where the foster mother screamed profanities and fed him and the other children only sandwiches or ramen noodles.

After two foster placements, he lived briefly with his great-grandmother, his brother and, for a time, his biological mother.

“She came at me with glass bottle and a metal pipe,” he said.

Several months ago, Michael returned to St. PJ's. Foster youths can stay in care until they reach 21, as long as they have a job, attend school or volunteer. Michael, who volunteers at a pet store, wants to go to law school one day and will start community college next month.

He has only one thing to say about his experience with foster care in Texas: “Some people are in it just for the money.”

Foster care redesign

Specia declined to comment on the pending lawsuit, but said he doubted it would help Texas children.

“I don't think we benefit from an organization in New York City trying to run Texas' CPS system,” he said. “You ought to look at other states that have entered into consent decrees after settlements, to see if their systems are running better.”

Children's Rights has filed lawsuits in 19 states. Of those, 15 have resulted in settlements or judgments against the state, according to its website. Some states have complied with the court-ordered requirements for reform; others still are being monitored and enforced, the group's spokeswoman said.

In Texas, the state-initiated changes to the foster-care system, which have been years in the making, aim to address a paucity of foster care in swaths of the state, especially rural areas, where finding enough providers has been a struggle. As a result, foster kids often are placed sometimes hundreds of miles away from their home communities, severing them from extended family, schools and therapists.

A central feature of the changes: The department picks one sole contractor to be responsible for recruiting providers in its specific region of the state. Most will partner with existing CPAs to do this and to monitor the welfare of children.

CPS caseworkers will continue to check on foster children once a month, and serve as the link between them and the court system.

The addition of a sole contractor creates “a whole other layer of oversight, another set of eyes and ears” on foster children, Specia said. It will drum up more foster homes because sole contractors — unlike individual CPAs — are specifically tasked to create providers throughout an entire region, he said.

Not everyone is on board.

Rayman Kinman, head of a child-placing agency in Corpus Christi, said the redesign “just adds redundancy and a new layer of bureaucracy.”

“These (sole contractors) are going to wave their magic wands and find more providers?” he said. “What this does is pull money away from people who are already on the ground, trying to find homes closer to kids.”

Kinman said some CPAs are worried the new model eventually will force them out of business, as sole contractors work to keep all the state money for themselves.

The redesign also changes the way foster care providers are paid — and that has critics, too.

The current system links the amount of money the state pays the foster care provider to four levels related to a child's needs, which can range from basic, $23.10 a day, to intense, $92.43 a day. The more behavioral, medical or emotional issues a child has, the more money the provider gets.

Some argue this creates a “perverse incentive” — caregivers aren't motivated to see children in their care improve because it means they will get less money or lose a placement.

A new “blended” flat rate pays the sole contractor about $65 per child per day, although the amount may vary by region.

The sole contractor will be financially rewarded when it shows children in its care have improved or have moved more quickly out of the system, either back with parents or placed in kin or adoptive homes. It's penalized when those things don't occur.

The goal is to weed out bad providers, Specia and others said.

“There are so many great people who do this work, but there are some who aren't in it for the right reasons,” said Diana Martinez with TexProtects, an Austin child advocacy group.

Some worry the payment change will mean less money to care for kids.

The state pays the blended rate to the sole contractor, which then can pay foster providers whatever it deems appropriate, as long as it doesn't fall below $23 a day, the basic rate.

“It's in the (sole contractors') best interest to keep the payments as low as possible,” said Foster, the long-time foster care executive. “There's a lot of financial uncertainty. At same time, providers are given less resources, they're being asked to do more. That's scary.”

The new incentive structure could create its own problems, some fear, with kids being sent back home or placed in adoptive homes too quickly, just so the sole contractor can report progress. Still others are concerned certain contractors will be more interested in making money than saving children.

They point out that the first contractor selected by the state — Providence Service Corp., based in Arizona that will oversee foster care in a 60-county region that includes Abilene, Midland and Odessa — is a for-profit company.

So far, the company has received more than $700,000 to place about 500 children, which includes those who have just entered foster care, have changed placements or are now simply counted under the new sole contractor.

The state paid more than $27 million for foster care services in the region in 2011.

“My concern is, what is the bottom line?” said state Rep. Elliott Naishtat, D-Travis, a member of the Human Services Committee. “Will these agencies be all about taking care of investors and stockholders, or will it be taking care of these kids?”

For her part, Lowry of Children's Rights says the redesign doesn't go far enough.

“It's doesn't even purport to deal with some very significant problems,” she said, “such as high caseloads or lack of accountability and oversight.”

Specia said moving foster care children out of the system more quickly will reduce caseloads over time, making things easier on caseworkers, which will in turn improve worker retention.

The new model will eliminate the balkanization of foster care in the state, he said, and ameliorate a host of other problems.

“The whole system is designed to increase safety, permanency and well-being,” Specia said.Some advocates said the problem starts at the top: lawmakers who refuse to adequately fund the foster care system in Texas, which in 2012 received $382 million.

“We don't need to reinvent the wheel; we just need to fund the one we have,” said Ashley Harris of Texans Care for Children.

Most people have taken a wait-and-see attitude toward the changes.

“I hope and pray this works, because if it doesn't, I don't know what the next good alternative is,” said Irene Clemmons, president of the National Foster Parent Association.

Martinez with TexProtects said the real solution is to put more money into child abuse prevention, which gets a miniscule portion of the department's $2.4 billion biannual budget.

“We've got to work on our (birth) families, because at the end of the day the state is not a good substitute parent for these children,” she said.