Why this maintenance failure is making headlines

The recent headline in the Los Angeles Times said it all: “Plight of 2 toddlers puts spotlight on L.A. County family program.” The lead identified toddlers found wandering the busy streets of South LA, hungry, dirty and neglected, mom oblivious to their absence, and the subject of the Department of Children and Family Services’ efforts to help maintain her family. How could this be?

There is a philosophical approach in child welfare practice that, all things being equal, values family unity.  As a result, there is an emphasis to assist families where there may be evidence of abuse or neglect to address their dysfunction and rebuild a stable home. In many instances the interventions employed to achieve this worthy goal are less traumatic for the child and family, leverage the good will and intention of the parents and larger family unit, and lead to a long-term stable environment. One such program is DCFS’ Family Maintenance, which the mother of the toddlers was enrolled in.  However, while this approach may be less intrusive and relatively inexpensive than removing a child and securing him or her in a foster or group home, it is nevertheless a very labor-intensive approach.  It requires expertly trained social workers and other professionals who need to make the successful restoration of a family their exclusive focus.

Assuming the accuracy of the Los Angeles Times article, clearly this mom was not a good candidate for this program. Given her struggles, she needed support beyond what was available. Somehow, insufficient assessments led to a poor judgment about the kind of care required to keep her children safe. As a result these impressionable toddlers have been traumatized and their safety jeopardized. Disaster was averted not by an expert social worker, a veteran social service administrator, or a gargantuan child welfare system but because of an observant bystander who could not walk away from the plight of these two toddlers in need.

As DCFS Director Philip Browning is quoted as saying in the Los Angeles Times, “Something didn’t work here.”  Given the DCFS fact sheet states there are more than 13,800 children in this program, the chances are that there are a number of other cases like this one where, no matter the good intentions of the County, the end result is that children are being neglected, the risk of abuse is significant, and children’s long-term well-being is being sacrificed.  What is being done to assure that the other children in this program are not subjected to the same trauma?

Immediate action is called for. Without knowing how DCFS has responded to this outcry, a number of strategies should be engaged: 

• All cases in the Family Maintenance program should be reviewed, and a rigorous assessment made as to the family’s appropriateness for this particular service. 
• Social workers involved in this program should be engaged to identify the supports and structures needed to effectively render services to children and families in this program. 
• A heightened sense of vigilance and urgency should prevail until all these cases are reviewed and appropriate treatment determined. 
• Additional resources may need to be employed to conduct this review in a timely fashion.

This process should be conducted in a transparent way, providing the public assurances that these tragedies will be avoided.

In 30 years working in the child welfare system I have rarely met a parent or family who cannot be engaged to assure the well-being of their child. That being said, we must not be naïve.  The challenges faced by these families are great and the efforts of those who serve them and their children are significant. For all parties involved, this must be an exclusive commitment driven by a desire and hope to see children thrive and be successful. However, the effort is well worth it. At Hillsides, our staff joins with families to accompany them through a difficult journey characterized not only by challenges and heartbreak but also by breakthroughs and achievement. It requires constant attention, diligent, consistent care, and an overall belief that hope can be restored.

We eagerly await not only whatever actions DCFS will introduce to address the failure of the Family Maintenance program but also the findings of the Blue Ribbon Commission appointed by the County Supervisors to review the county child welfare system. Regardless of the findings, I suggest that the remedy to DCFS’ woes has mostly to do with the lack of resources needed to implement the well-intended programs.  More than anything else there is no substitute for well-prepared, experienced workers who have the resources necessary to effectively intervene in the lives of the most vulnerable members of our community like the two toddlers found wandering the street.

It was the night before Christmas…

A long time ago I learned that the best thing for me to do at this time of year was to step aside from the fray and let the “professionals” do their thing, leaving me with the task of being the chief glad hander and merry maker while everyone else tends to the details. It leaves me the freedom to wander the campus, visit with our residents and staff, and wish them the season’s best.

As I make my rounds during the holiday, I am reminded that the true miracle of the season is that a large empty room at Hillsides becomes filled to the rafters with toys and gifts that help fulfill the hopes and dreams of all the children and families we serve. The call went out early in the season and it has been a steady convoy of cars and individuals bearing gifts. The chief elf this year was a rather unlikely character, large for an elf standing at better than six feet, wearing a bell around his neck in order to be detected in the stacked maze of toys and gift items. An elf’s day is long and requires great stamina but in spite of the holiday weariness each and every visitor to Santa’s workshop was greeted with a smile, a jingle of the bell, and a heartfelt thank you.

Since Hillsides is so special, Santa comes a few days early to visit our residents and so a walk around campus on Christmas Eve provides encounters with happy and grateful kids who continue to be awed by an all knowing Santa who clearly had rewarded them for how nice they have been this past year. Skateboards abound on our signature hills, basketballs are being broken in on the basketball court, and the familiar sounds of electronic games echo everywhere. New outfits are donned for a family visit or some of the many holiday festivities planned.

All in all it is a magical time of year when disappointments and hurts are put aside to spend time with people who love and care about one another. They are precious days that help to reset relationships and hope for a better new year.

To all our many volunteers and donors who so generously help us to create memories for all we serve, thank you. Without your support we would be unable to fulfill the hopes and dreams that are so important to the children and families in our care. May you and your family have a wonderful holiday and enjoy the comfort of knowing that your kindness this holiday season has made a wonderful difference for all those we serve at Hillsides.

Happy Holidays and Merry Christmas!

She is fabulous

Joining Susanne Crummey (Bottom row, third from left) is Susan Pinsky, Hillsides Board Member (left of Susanne)

If you ever have the opportunity to visit Susanne Crummey's office you feel like you have entered Santa’s workshop. In the corners of the office are stacks of toys and other kinds of prized treasures for children. I’ve always found it curious, but never felt the need to delve into why there was so much “stuff” in her office. Then one day it became clear to me why all those items had been kept in her office.

As I stopped by to catch up with her on a couple of issues, Susanne was busy preparing a “welcome bag.” The welcome bag provides new residents with an array of items to help them settle into their rooms and feel welcomed at Hillsides. The bags are huge, the size of a large duffle bag and filled with stuffed animals, games, electronics, music discs, and some clothing. Each is individually prepared to meet the specific needs and interests of the new resident and personally prepared by Susanne. Needless to say, this is not listed as one of her many responsibilities as the associate executive director, but clearly is one of those activities that she relishes and links her to the children we serve.

Susanne has general oversight over all clinical aspects of the agency. She does a marvelous job and has provided extraordinary leadership on any number of critical issues for the organization. But satisfying these responsibilities does not adequately define who Susanne is. More than anything else, Susanne is the touchstone that keeps all of us rooted in Hillsides mission to create lasting change for all those we serve. We are so fortunate to benefit from her exemplary leadership.

This past week she was honored by THE Magazine as one of Pasadena’s 50 fabulous women. It was great that the community at large was able to celebrate what we all have known for some time--Susanne is indeed fabulous and a great example of the extraordinary staff that we have at Hillsides.

What sets Hillsides apart is not just the quality services that we offer to vulnerable children and their families, but in a particular way it is our extraordinary staff who embrace a “can do” approach to being an essential resource for all those we serve. It is not sufficient to encourage our staff to take up this approach. This really needs to be modeled so that in concrete terms, staff come to understand what it is to be focused and dedicated to the children, youth, and families in our care. Susanne serves as such a model and indeed does a fabulous job at it.

Along with her were two other fabulous women who were honored and are also associated with Hillsides: Susan Pinsky, a long time Board member and Leah Mason, the wife of Board member Brent Mason and member of our support network H100.To Susanne, Susan, Leah and all the Fabulous 50, congratulations! 

Celebrities Step Up for Kids in Foster Care

May is Foster Care Awareness Month and it is important for us to make note of the more than 500,000 children nationally and 35,000 locally who are served through the foster care system and receive child welfare services. These numbers are especially overwhelming when you consider how difficult it is for a child to be separated from family and those things that are most familiar. A day for a child can seem like an eternity, let alone weeks, months, and years apart from family.

The decision to separate a family is a difficult one to make, but there are circumstances that warrant such a drastic action. For the children impacted by these decisions, we must provide safe, caring alternatives that are responsive to their needs and dedicated to their best interest. The foster care system at its best does just this and serves as an indispensable resource for both child and family to get through a challenging time.

The foster care system is often the focus of negative press. Inevitably the failure of an individual foster parent or an organization serving foster children can skew the community’s perspective of how effective foster care is. The truth, however, is that the vast majority of children and families served through the child welfare system appreciate how essential these services are in order to assure safety, well-being, and ultimately a stable future.

There is never enough we can do for these children, youth, and families, and as a result what we offer must be the best. No one organization can take on the responsibility of being such a resource without the extraordinary support of a generous community.

Once again during this month of celebrating foster care awareness, Hillsides is promoting a unique and fun way of generating much-needed support for the services we offer to children, youth, and families. This fundraiser, the Fifth Annual Hillsides Foster Soles, is an online auction of celebrity autographed items. The auction was launched on Wednesday, May 22, with a cocktail reception at Bar Celona in Pasadena. Co-chairing this event is Dr. Drew and Susan Pinsky, who have been supporting us for years and stepped right up to garner celebrity support for the auction.

Celebrity items can be viewed on eBay. The auction will last through the first week of June as we are continuing to list celebrity items throughout the weekend. To learn more about the auction, visit our website, www.hillsides.org. I encourage you to share this event with your family and friends. It’s an easy way to support what we do, bid on a few items you may want or give a gift to someone.

Child Welfare vs. Child Well-being

While recently attending the quarterly meeting of CWLA’s Board of Directors, there was a presentation on an initiative to establish an overarching set of principles to govern the standards of excellence in child welfare. The genesis of the initiative is an effort to demonstrate the impact of child welfare on the well-being of children and families. As I reflected on the discussion it occurred to me that perhaps we might want to no longer refer to these efforts to care for vulnerable children and youth as child welfare, but rather as child well-being. After all, is that not the goal?

Welfare has become a word to avoid in our politically charged divisive environment. No longer does the word welfare refer to the efforts of a noble society caring for those less fortunate.  Welfare now connotes a system of well intentioned, but failed, expensive entitlements that create dependence and a threat to true "freedom." As unbelievable as this may seem, it never-the-less reflects the philosophical divide that grips our nation in political grid lock.

Therefore, rather than constantly running the risk of alienating those for whom welfare has become a "dirty" word, I suggest we replace it with well-being, because at the end of the day that is indeed what is accomplished in all we do for the  children, youth, and families we serve.

Whether it is the support we provide children and their family when their homes have been disrupted, to the mental health services we offer to those experiencing trauma or the outreach we offer youth who are transitioning from the foster care system to independence, all these efforts contribute to their well-being. The end result is a marked improvement in functioning, stronger and healthier families as well as an ability to pursue a full, independent life.

Using the word well-being rather than welfare is not some semantic hat trick, but rather an attempt in a skeptical environment to express the impact achieved when services are rendered to a vulnerable population. Over the last few years we have seen 85% of children in our care successfully restored to their home and communities. The amount of time that families have been separated has been significantly reduced, and the hope for leading successful lives has been established.

If the word welfare is a stumbling block, then I suggest we get rid of it. More than ever we can not afford to allow anything to get in the way of the support we need to achieve lasting change for all we serve.

Fulfilling the Promise

I've mentioned before that Hillsides is in the process of seeking an accreditation with a national organization, the Council on Accreditation. This week a few staff members, including myself, attended the Triennial Conference of the Council on Accreditation in New York City. Organizations like Hillsides gathered to discuss best practices in child welfare and behavioral health care. As useful as many workshops were, what I found most worthwhile was coming together with so many who are clearly committed to providing the best care possible for some of the most vulnerable.

We provide excellent care to those we serve; the challenge lies with being able to demonstrate that excellence measured against nationally held standards of practice. Currently, Hillsides is accredited by a state wide provider's association. The standards of the Council of Accreditation exceed those of our current accrediting body and really insist on the development of an organizational culture that is not only driven by a commitment to provide fine services, but is also rigorous in sustaining a constant process of improvement. This important accreditation that we seek will validate our fine work, advance our stated mission to create lasting change, and position us within the provider community as having achieved excellence.

The conference opened with a quote from an unnamed sage, "if you want to know the past, touch a rock; if you want to know the present, touch a flower; but if you want to know the future, touch a child!" How absolutely true and it is for this reason that we strive for excellence because the opportunity to influence the future by caring for our children now is so precious that it must not be squandered. In a particular way for such vulnerable children and youth, whose needs are so great, every effort must be made to keep them safe, improve their well-being, and offer them permanency.

Accreditation is not a panacea, but it is an indicator of our commitment and resolve to provide the best care possible for all we serve.

Visit this blog for updates on our progress toward accreditation. As we prepare for the final submission of documentation in anticipation of an on-site review by an accreditation panel in early November, we continue to be hopeful that our efforts will advance our goal to be always an extraordinary resource for the children, youth and families we serve.

Access to Mental Health is Diverted

This past week I attended the annual meeting of the National Council of Community Behavioral Healthcare. Promoting effective and quality care, the conference gathered an extraordinary array of providers and consumers of mental health services from around the country.

As is often the case, I leave these conferences invigorated and resolved to be evermore committed to the care we offer to all we serve. Almost 60 percent of the revenues of Hillsides' annual operating budget is derived from mental health reimbursable services. The provision of mental health services is the greatest common denominator of care within all our programs and so it is essential to stay current with practice and trends in the delivery of care.

Because perhaps I take for granted the availability of mental health services, I was surprised to learn that only one-third of children in need of mental health care are ever treated. This kind of care denied during childhood and adolescence results in the need for mental health treatment of 50 percent of adults in care!

How is it that only one-third of children in need are treated? More likely than not, it is the result of poor diagnosis or the temptation to minimize any disorder hoping the child will "out grow it." Even when symptoms persist, the stigma associated with mental illness is also a deterrent.

In addition to our predisposition to tolerate, ignore or minimize mental health issues of children, care is also costly, providing yet another reason to avoid treatment. This is a very dangerous combination that results in creating considerable risks for our children. Often it is early intervention and treatment that are most effective in helping children and their families to successfully address the challenges presented because of mental illness.

Beginning in July, the burden of providing mental health services for children in California shifts from the responsibility of the local Mental Health Departments to the local public school systems. Most of these school systems are poorly equipped to take on this responsibility and are lacking the funds necessary to provide the services. At least 15 of our residents will have funding curtailed because of this shift, placing in jeopardy their need for ongoing treatment. Although we may identify some resources to prolong their care for a while longer, the chances of providing needed mental health services for children who may surface in the near future is pretty grim.

When you take all this into account, is it any wonder that only one-third of children in need of treatment receive it?

School systems are inadequately funded to provide these services and are in desperate need of our support. Resources are necessary to help them meet their responsibilities to their students. Although the solution goes beyond just additional funding, every effort must be made to adequately provide our schools with the resources needed to provide the care that our children require. Failure to address our children's mental health needs today only increases the likelihood of their suffering serious disorders as adults.

Inspired by Foster Care Voices

On Saturday, February 25, I attended   Town Hall meeting that was conducted by the Congressional Caucus on Foster Care, in Los Angles. The meeting was chaired by Congresswoman Karen Bass, who in her short tenure in Congress is recognized as a strong advocate for foster children. More than anything else, the forum was an opportunity for advocates and foster youth to voice their concerns and address critical issues challenging the foster care system. As always, this was an opportunity for the public to comment on policy affecting services and the need for adequate funding. 

Many eloquent presenters addressed the policy issues, but more importantly there were several articulate young adults, graduates of the foster care system who related, better than anyone else, the challenges and triumphs of life in foster care. The one young man that captured my attention approached the microphone and succinctly stated that three years ago he had stood at the bottom of a driveway wondering where he could go to get drugs and that today, thanks to the care he received while in foster care, he was clean and was headed to the University of San Francisco on a full scholarship. He ended by encouraging the legislators to maintain their support and thanked them for what they do.

There is an awful lot wrong with the foster care system; it is well-intended, but never-the-less can be harmful to its beneficiaries, separating families without plans for reunification, demonizing struggling parents and stigmatizing children. More often than not, it is inadequately funded and, therefore, ironically increasing the risk that it attempts to mitigate in the first place. In the midst of this quagmire, how refreshing it was to hear this young man’s testimony, pointing to the opportunities that do exist within the current system in spite of its flaws.

This event was a great prelude to several days spent in LA and Washington, DC advocating for those we serve in the child welfare system. That Saturday evening I had the pleasure of greeting Congresswoman Judy Chu who attended the Hillsides annual benefit as a pledge of her support for our mission. Sunday I flew to Washington to attend the national conference of the Child Welfare League of America. The conference began with a truly inspirational presentation by a young man, Lucas Boyce, who shared his story of being a foster child. Having lost his birth mother to addiction he was introduced to foster care in the home of a single  mom who welcomed him as  her own. Lucas’ foster mom provided him with a strong foundation that helped him complete his college education, at one point after college serve in the White House and now he is employed as the Director of Community Relations for the Orlando Magic.

Together with the many compelling stories of the children, youth and families we serve, I felt that I was well prepared to advocate on their behalf while meeting during my stay in Washington with the staffs of Congressmembers Roybal-Allard, Issa, Schiff, Bass and Senator Feinstein.

Knowing that these young people never gave up and battled the odds to be successful is truly inspirational; giving us reason to be hopeful and ever committed in our advocacy.

Referrals Indicate We are a Provider of Choice

Recently at a Child Welfare League of America Board meeting, a colleague approached me concerning a niece he has and the family’s attempts to secure appropriate treatment for this adolescent girl in Los Angeles. He hoped that we might be of assistance. After an initial assessment, a visit to the campus and authorization by DCFS, a referral for placement in our residentialtreatment program has been made for this young girl, the only glitch is that there is no room.

Whether in our residential program or in our community-based services, we continue to receive more referrals than we can handle. This, of course, is a good indicator that we continue to be a provider of choice, but it is a significant dilemma for children and families that can not really wait for a bed to open up or an available appointment. As we always do in situations like this we attempt to refer these cases to other agencies.

Over the last few months, Hillsides has conducted a planning process and although it is an on-going process, we have agreed upon an organizational strategy for the agency: to maintain and further develop our position as a preferred provider of education and behavioral health services to vulnerable children, youth and their families. In a sense this organizational strategy is an affirmation of what historically Hillsides has attempted to be, a place or, better yet, a resource for all we serve to see their lives improved, hope restored and success assured. Building on this, our strategy is to be clearly identified as a premier organization, sought after by referral agents and families alike to address the needs of very vulnerable children and youth.

Publically stating this strategy helps us to organize our programs, services and indeed all operations to achieve this goal. It is also a way to direct the efforts of our committed staff, Board and volunteers around achievement of this goal. Being bold enough to state our intention to become the area’s premier provider of services  for vulnerable children and youth also invites the kind of scrutiny that will hold us accountable to indeed provide the services that would allow us to claim this statement!

Nothing is good enough for those we serve, they deserve and require only the best and it is our job to do just that for them and, in the process, continue to be sought after as a preferred provider of such desperately needed services.

Wish List for 2012

 The start of 2012 feels more like ground hog day than the beginning of a great new year. As 2011 came to an end, word came from Sacramento that a short fall in state revenues will require $1 billion in budget cuts in 2012! And where will these cuts come from? Schools, libraries, prisons and services for the disabled, leaving me to think that the Mayan prediction of the world ending in 2012 just might be true!

All joking aside, this news is a sad start to the year for our great state and as Gov. Brown has said the solution lies not just with cuts, but indeed raising the much-needed revenues that would allow us as a community to fulfill our many responsibilities to the State’s most vulnerable.

Some would argue at this time of political impasse at both the national and sate level that there is little that can be done. I argue that it is precisely at this moment that our voices must be raised loud to be heard over all the political vitriol to advocate for the children, youth and families we serve.

So I offer the following wish list as a point of reference for all that we hope to accomplish this year in spite of considerable odds.

1. Keep all we serve safe and healthy, free of harm and hopeful for a better life
2. Provide our dedicated staff with a supportive work environment, honoring their commitment and dedication
3. Continue to cultivate our network of dedicated volunteers
4. Secure adequate public funding for all our services, but especially the education programs
5. Encourage a commitment on the part of our public policy and elected officials to address the needs of children, youth and families we serve
6. Develop a clear and compelling plan to bring Hillsides into a new century of service as we anticipate our centennial anniversary in 2013
7. Strengthen Hillsides’ recognition in our community and in this field
8. Develop a Master Plan for the revitalization of the campus
9. Introduce new donors to the Hillsides mission and successfully raise $2.5 million in private funds
10. Identify opportunities to further fulfill our historic mission

 The one thing we can not afford is to lose our resolve to make 2012 better than 2011 for all those we serve. Join me in making our many wishes for 2012 come true.

Teacher Peddles Around the World to Help Foster Care Kids

As a substitute teacher, Christine “Chris” Farrugia always rode her bike to her school site. At age 56, she has decided to peddle just a little farther to raise awareness of the needs of vulnerable children. Beginning December 1, Chris will kick off her one-year ride around the world in front of Hillsides.

I met Chris when she came to tour Hillsides and explain to us what she wanted to do. Chris explained that after her parents and brother died in a car accident, she felt alone and was left with a desire to do something to make a difference. She thought about how foster children or orphans must feel when they are no longer with family, which is how she decided to raise money for organizations that offer services to children in need.  Through Chris’ family tragedy, she believed that ordinary people do extraordinary things every day even after they have walked through situations or ride through storms. Unfortunate events test our human spirit.

So many of the vulnerable children and families we serve have experienced trauma, in one form or another. Their human spirit is tested and sometimes feel they are alone. They don’t know what steps to take and don’t know who to turn to. When they come to Hillsides or we reach out to families, our staff provides the quality care, expertise and talent to strengthen their spirit. Volunteers take their time and talents to give generously through hands-on activities, mentoring or funds to help us restore hope in their lives.

It’s a simple message from Chris: If you have a passion or a talent, no matter the circumstance, you could do something to make a difference. Just get out there and do it. Keep putting one foot in front of the other. And that’s exactly what she’s doing and I have seen our staff, volunteers and donor community put one foot in front of the other.

Although the journey can appear daunting, Chris’ positive energy, enthusiasm and commitment are infectious. I am excited to have been chosen as the charity in America to join Chris on her journey. She is funding the world cycling tour with her inheritance and welcomes sponsors to host her campground stays, weather permitted, or hotel accommodations. Eighty-five percent of the proceeds from the ride will raise funds for Hillsides and Good Shepherd Centre Orphanage in Zimbabwe, Africa, the other charity she has chosen.

On her recent visit to Hillsides, Chris explained the mission of Project Miracle Co, the charity she established to raise funds for other deserving children’s charities. “I wanted to help the wheels that were already in motion.” While touring our campus, Chris said, “I feel this is the right place to do this—like I’m home.”

Like Chris, I believe Hillsides is the right place to volunteer, do something, and help the most vulnerable in our community.

A Culture of Quality Care

I’ve mentioned in the blog before that Hillsides is seeking a national accreditation with the Council on Accreditation in New York. Although we are currently accredited by the California Alliance of Child and Family Services, a decision was made last year to pursue a national accreditation to better position Hillsides in an increasingly competitive and demanding environment. Although we have been preparing for the accreditation for several months, we have now begun a yearlong process that hopefully with culminate with our accreditation, just in time for our centennial celebration.

As part of the accreditation process, our efforts to continuously address improving the quality of care has been strengthened. A specific committee has been charged with reviewing all our efforts to assure quality services. A  Board committee will review these efforts, which engages not only all levels of staff, but will also solicit input from our many beneficiaries. More than anything else, what we want to reinforce is a culture that values the finest care for the most vulnerable.

In a previous era, it was satisfactory to talk about the good that was being done and point anecdotally to the impact that was made. Today, that is just not good enough--not good enough for those we serve and not good enough for us as an organization if we strive to be a provider of choice.

Hillsides has every reason to be proud of the quality of care it provides the children, youth and families we serve. But like any other organization, it is easy to be satisfied with what we have done or what we are doing without necessarily taking a critical look at how services are delivered and what the true impact is as a result of the care that has been received.

Some argue that it is difficult to measure the impact; there are too many variables out of our control that influence the outcome. Although that may be the case, it is still not an excuse for us to maintain a critical eye on what we do to assure that all we do is the best. Providing quality care is the greatest tool we have to counter those unforeseen variables that impact the lives of those we serve. In doing so, we can influence the outcome.

As I often say, we can never do enough for those we serve. So it is with that desire that we embark on this process with every hope that it will strengthen us as an organization. Further, cultivating this culture of quality care will enable us to fulfill much more effectively our mission of providing a safe “place” for all we serve.