Tag Archives: CASA

This IS Our Problem: Fixing Foster Care in America, My Part (And Yours)

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Last night it was bitterly cold. The heat in our office building hadn’t been working so the staff and I worked most of the day with our coats and hats on. We thought the conditions were impossible, brutal, unbearable. We complained to management. We complained to each other. And then, just as I was about to head home to a delicious meal with my family, my cell phone rang and I was suddenly reminded that even the worst conditions I have ever faced are the best conditions some children can imagine.

It was a social service worker, a friend of mine, calling to ask if I could wait a bit longer for a group of caseworkers to come to our facility. They had just abruptly removed 4 children from deplorable conditions. Their mother was nowhere to be found. The kids needed pretty much everything; from clothing to shoes to comfort items. Of course, I agreed to wait.

In situations like these, it’s the waiting that is sometimes the hardest part. I wonder what I’m about to see. I wonder how bad it will be. I wonder if these children will be crying. I wonder if they will be scared. I wonder if I will be able to hold it together so I don’t make them feel even worse.

I opened the door twenty minutes later to three caseworkers. One was carrying a baby. One was carrying a toddler who was not wearing any shoes or socks. The other 2 children walked in on their own; 5 and 7 years old. Immediately, the 7 year old made eye contact with me and I could see she had been crying. She looked up at me and almost began to cry again.

I knelt down and took her hand and told her my name. Then I asked hers and she whispered it softly. Then I asked her if she would like to go look at some toys. Immediately, her face changed. She smiled a bit. “Yes!”

Over the next hour and half the caseworkers and I split our time between walking the children through our toy closet, helping them choose their favorites, and attempting to find enough clothing in the right sizes to get the children prepared for their first night away from home.

Beneath her dirty clothing, the baby was covered in feces. It took two workers to clean her up. One of the men came out and sat down, head in his hands, and said “How can people do this?” For me it’s always so hard to see that type of raw, vulnerable emotion, especially from a big, strong, tough-looking guy. I didn’t know what to say to him.

When the group was ready to leave, the 7 year-old girl turned back and gave me a hug. I held her as tightly as I could. I wanted to take her home.

It was then I started to think about my own kids; 7 and 8 years old. Their biggest worry of the day was doing homework. They were waiting at home for me with their amazing, attentive, super supportive dad. They were playing games in their playroom. I didn’t feel guilty for this joyful loving home I have. But I did feel like I wanted to get back to sharing it.

So I will. I am hopeful that in the coming months my home will be reopened to accept foster children like the four amazing kids I met last night. That is the part I want to play in this solution.

But that may not be your reaction and that is totally OK! There are dozens of ways that you can also do something super amazing to ensure these beautiful, innocent children get the love and support and hope they need. Because they need all of us in on this.

To be honest, I don’t even care why you decide to help. Just do something other than read this, feel bad and go on with your day. Do it to be a good example for your kids. Do it to better your community. Do it because you can…because you had a loving family, or you didn’t have a family at all, but you are here and healthy and able. Do it because if you don’t, who will?

Let’s just all come together and loudly and proudly make a commitment that we will be one part of the very big village we know it takes to raise a healthy, happy child.

Below are some of my favorite ways to get involved but I want to hear more. Join me in using #MyPartOurVillage and tag @OneSimpleWish on Twitter.

Here are 5 ways to get started in doing YOUR part:

1. Grant a wish!
It’s a simple, direct and beautiful way to share some joy with a child impacted by foster care and abuse and neglect.
2. Consider becoming a CASA.
Court Appointed Special Advocates are amazingly dedicated volunteers who act as a voice for a child in court and are a stable source of support for kids who need it.
3. Read Foster Focus Magazine
Learn more about what is going on with foster care in America and the inspiring kids and adults who are working hard to fix it.
4. Consider becoming a Foster Parent.
All you need to know is here. And you can email me too!
5. Tweet about other foster care or children’s rights organizations that you support. Tell us what you do and how to do it. Don’t forget to use #MyPartOurVillage and tag@OneSimpleWish so we can share your ideas!

Please remember that whatever you choose to do, one way or the other, it will matter.

Follow Foster Care Kids Need Love Too on Twitter: https://twitter.com/FosterLoveToo

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Church hopes to match kids with foster families

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church outreach

WAYNESBORO — Sonya Payne remembers her best birthday ever.

It was in 2010, the day she legally adopted her foster daughter Ariel Simone Payne, 16.

Ariel wasn’t the first child that Payne has fostered. In fact, Payne estimates that she’s legally fostered 40 children since 1993, and taken in over 70, even if only temporarily.

“That’s why we call her superwoman,” said Ariel’s adoptive sister Taimonique Payne, 15 and a half years old.

Payne decided to become a foster parent while working with battered women, and seeing the effect it had on both the women and children.

“It was too much,” Payne said. “I told my husband, we have to do something to help these kids.”

She read about her first foster child in the newspaper in 1993 and the rest is history.

Even with families like the Paynes, there are still local children in the foster care system that do not currently have homes and are at risk of aging out of the system, which severely affects their chances of success once they become adults, said Jennifer Eccles, foster parent and member of the mission team at First Baptist Church in Waynesboro. There are 163 kids in foster homes locally, but 14 that don’t have somewhere to call home.

That’s why the church decided to hold a summit about foster care, with a panel of foster care workers, parents and adopted teenagers, to inform the community about the need for more participation in the foster care system.

The summit was Sunday afternoon and about 25 people attended, Eccles said.

“The church feels very strongly that we have a calling to help these kids in our community,” said the mom of six. “They need families.”

One of the main focuses of the summit was on the need for care for older children and children with siblings, specifically, Eccles said. Removing the stigma that older children come with more problems is key.

“This is not about bad behavior,” Eccles said of why children end up in the foster care system. “It’s because of abuse or neglect.”

Both Ariel and Taimonique spoke about being adopted and what they would tell other foster parents if they could.

“Never give up on your adopted kids,” Taimonique said. They may have difficult behavior and difficulty adjusting, but never to give up.

For more information about foster parenting call Jennifer Edson or Heather Hudnall at Shenandoah Valley Social Services at 540-245-5800.

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#URGENT AAP Care Recommendations for Foster Care Children

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foster kids

Despite having resources available to provide for their healthcare needs, a vast number of children in foster care are not receiving adequate medical care.

Given that children in foster care are prone to physical, mental health, developmental, and psychosocial impairment, it is critical that pediatricians claim their role as advocate for this population, according to a new report from the American Academy of Pediatrics (AAP).

Recommended: Teaching kids to cope with stress

According to the updated position paper from the AAP on healthcare issues for children in foster care, 641,000 entered into foster care for some period of time in 2013—a figure that peaked at more than 814,000 children in 2002—and those children have a wide range of needs.

“The majority of children entering foster care have lived in deprived and chaotic environments for a significant period of time until removal for imminent safety concerns secondary to maltreatment,” states lead author Moira A Szilagyi, MD, PhD, a professor of pediatrics at the University of California at Los Angeles. “More than 70%
of children in foster care have
a documented history of child abuse and/or neglect, and more than 80% have been exposed to significant levels of violence, including domestic violence. In addition, even before entering foster care, many children have experienced multiple caregivers, limiting their ability to form a stable attachment to a nurturing caregiver. Removal is emotionally traumatizing for almost all children, although for some, it is the first time they may feel safe.”

Pediatricians are uniquely qualified in these situations to offer medical assessment and intervention for the child; mental and psychosocial counseling; education for caregivers; and to advocate for the best interests of the patient. The child in foster care will enter a pediatrician’s practice with a host of unmet healthcare needs precipitated in traumatic histories and inadequate access to care, Szilagyi says. The problem is so extensive that AAP has begun to classify children in foster care as a population with special healthcare needs, she adds.

“Overall, 30% to 80% of children come into foster care with at least 1 medical problem, and one-third have a chronic medical condition. It is common for such problems to have gone undiagnosed and untreated before these children enter foster care,” she says. “Up to 80% of children and adolescents enter with a significant mental health need, and almost 40% have significant oral health issues. Approximately 60% of children aged younger than 5 years have developmental health issues, and more than 40% of school-aged children have educational difficulties.”

More: Cutaenous clues of child abuse

Szilagyi also pointed out in the study that foster children are 3 times more likely to drop out of high school compared to other low-income children, and slightly more than 50% graduate high school—most often with an equivalency diploma. Beyond schooling, Szilagyi says data suggests that children who were in foster care during their adolescence grow up to experience higher rates of mental health problems, homelessness, posttraumatic stress disorder, and low educational achievement.

Despite the clear need for intervention, however, data suggests that only a fraction of children in foster care are receiving the help they need before, during, and after entering the foster care system.

According to a 2013 report by the Council of Family and Child Caring Agencies and the New York State Health Foundation, children in foster care are receiving minimal care in many cases, and outcomes are generally unavailable for those that do receive care. National data on healthcare frequency in foster children is lacking, but the New York report provides a snapshot.

According to the New York report, a mere 15.7% of children had a preventive care visit with a physician in the 12 months prior to their entry into foster care. Statewide, the number rose to 31.9%. Once children were placed into foster care, the frequency of visits appeared to increase, but not by much. According to the report, preventive visits for children increased while in foster care in New York City from 15.7% to 25.2%, and from 31.9% to 36.5% across the entire state. After exiting foster care, however, the frequency of preventive visits dropped down further than before—to 11.9% in New York City and 25.4% statewide in the year after exit from foster care.

Where visits were higher were in emergency visits—42.8% of children in New York City and 40.4% statewide had at last 1 visit to an emergency department (ED) in the year before entering foster care. Those visits dropped by 38.8% and 30.9%, respectively in the year the children were in foster care, but dropped further in the year after exit from foster care, with 22.3% visiting EDs in New York City and 27.6% statewide.

For infants, the most common reason for an ED visit was childbirth, indicating a high number of deliveries occurred through the ED.

More: Docs often overlook chuld sex trafficking victims

In terms of inpatient stays, a top reason children in foster care are admitted to hospitals is for treatment of mental health conditions. Attention Deficit Hyperactivity Disorder was the top diagnosis for children aged 1 to 5 years, followed by bipolar disorder. For children aged 6 years and older, bipolar and depressive disorders are top admitting diagnoses. Infants also were frequently admitted for respiratory problems, while toddlers and preschool-aged children were commonly hospitalized for injuries and asthma.

The most recent national data on healthcare compliance among children in foster care is from the 1990s, Szilagyi says, when the Government Accountability Office released a “scathing” report on the state of healthcare compliance in foster care.

At the time of the report, the number of children in foster care more than doubled over the previous 5 years but was still half of what it is today. The review at the time found that, despite resources being made available to provide healthcare services for children in foster care, roughly 12% of young children in foster care received no routine health care; 34% were not immunized; at least 32% had unmet healthcare needs; and an estimated 78% were at risk for human immunodeficiency virus but only 9% had been screened for infection. Another 62% of children in foster care were estimated to be at risk for health problems related to prenatal drug use, the report states.

Pediatricians play a big role in providing caregivers—who come to foster care with a wide range of experiences and skills—with education and support to connect them with the services they need and to emphasize the importance or regular, timely healthcare intervention.

To address these healthcare needs, and the special circumstances involving children in foster care, AAP’s updated statement places greater emphasis on early childhood trauma and its impacts on all aspects of health, including physical and mental wellness, developmental health, and how trauma becomes predictive of poor outcomes, Szilagyi says.

More: Is telemedicine good for the long haul?

If caught early while the brain is still malleable, pediatricians, through good care and good experiences, can help shift the trajectory for these children in a better direction, Szilagyi says.

“The pediatrician has both a responsibility and an opportunity to really improve outcomes for these children. It really does require some work across systems to implement everything and it requires a lot of time they might not be reimbursed for,” Szilagyi says. “However I think it’s just a really big opportunity to make a big difference in a child’s life. I really view foster care as an opportunity for healing. It’s an opportunity to make sure all their needs are assessed and they have all the services they need.”

Even in cases when children don’t require medical or psychological support upon entry to foster care, things can change quickly, Szilagyi says. Birth parents may be struggling to comply with visitation and mental health care, and noncompliance during the foster care period may negatively impact the child.

“It’s really incumbent on pediatricians to reassess them periodically,” Szilagyi says. “It’s a great thing about having a periodicity schedule in pediatrics. There is an argument for seeing these kids more frequently because they have a lot of stresses and things that can go wrong in their lives.”

By staying attuned to the needs of the children in foster care, as well as their caregivers, pediatricians can provide valuable support at the personal and population level.

Ideally, the AAP guidance recommends that all children receive a full mental health evaluation, including a trauma assessment, shortly after entering foster care. Assessing for suicide risk and acute mental health needs is a priority, but the full evaluation is probably best conducted after the child has had some time to adjust to their new living situation, Szilagyi says. Social workers and foster caregivers may not have adequate experience in caring for a child’s mental health needs, and the pediatrician can offer support and guidance. In instances where psychotropic medications are needed or have already been prescribed to a child, pediatricians must weigh the benefits of the regimen.

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“It can be challenging to discern the appropriateness of psychotropic medication for those children with multiple mental health diagnoses. The use of psychotropic medication to manage the behavioral and mental health problems of children in foster care has come under scrutiny in recent years, as data suggest that children in foster care are prescribed psychotropic medications at a rate 3 times that of other children enrolled in Medicaid and have higher rates of polypharmacy,” according to the AAP statement. “Some children clearly benefit from psychotropic medications when appropriately prescribed, but concern exists that some children are not receiving appropriate mental health and trauma assessments before treatment and that medications are sometimes prescribed in lieu of evidence-based trauma care and other mental health interventions. …In addition, there are concerns about the effects of psychotropic medications on the developing brain as well as the adverse effects of some of these medications.”

When the use of psychotropic medications is warranted, they should be initiated at low doses and titrated slowly, with close monitoring, and no patient should receive more than one psychotropic medication from any given class, Szilagyi says.

In physical assessments, pediatricians should assess upon entry to foster care any evidence of abuse or developmental delay. Follow-up assessments should be performed within 60 to 90 days after placement and include screenings for abuse, poor weight gain, compliance with healthcare recommendations, and bonding between children and their foster caregivers.

In terms of frequency, it is recommended that children in foster care be seen monthly within the first 6 months of life, every 3 months from 6 months to 24 months of age, and then every 6 months thereafter to monitor the wide range of physical and emotional stressors the children can face within the foster care system.

Next: 5 steps to a trauma-informed practice

Pediatricians should allow additional time for assessing children in foster care due to the complex nature of their situations, and also develop an office system for communicating with caseworkers and foster caregivers following each encounter.

Even with the best efforts, however, many barriers exist to providing adequate healthcare to children in foster care, Szilagyi says. Care coordination is particularly difficult given the transient nature and diffuse authority of the foster care system. Pediatricians may also be faced with incomplete medical records, inadequate resources, and difficulty in identifying an authority to consent to health care services for the child.

“See them early, see them often, and continue to see them to monitor their progress and be an advocate when needed,” Szilagyi says. “We’re often the first real child professional that families encounter so we really have an amazing opportunity to either prevent adversity or ameliorate the impact of adversary. Sometimes that just starts with recognizing that bad things have happened and for both children and parents it can begin the healing.”

Legislature Approves Foster Care Overhaul

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The California foster care system would be overhauled under a bill passed by the state Legislature. The measure changes the focus of the foster care system in the state..

Democratic Assemblyman Mark Stone authored the bill.

“What this bill does is move the care away from congregate care, group homes, and into more individualized care,” he says.

Stone says children may still be placed in group facilities for short periods of time. But he says they would receive intensive treatment while there. A greater effort will also be made to return children to their families or find them new permanent homes.

Foster parents will also receive more training and support.

The bill includes recommendations from a 2015 Department of Social Services report on reforming the foster care system.

It is awaiting action from the governor.

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More Maine families opening homes to foster children

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The Department of Health and Human Services said hundreds of people are taking steps to become foster parents after putting out a plea from the department’s commissioner.

Eric and David Stearns said their lives have changed since they opened their doors and their heart to 15-year-old Ethan.

“Ethan is full of life. It’s a lot more vibrant. It’s busy,” Eric Stearns said.

Ethan is a foster child who spent nearly a decade of his life in state custody living in a residential program in Cornville.

“Ethan was a much different child. Very scripted, considered not verbal, high behavioral, high need. We had talked about adoption, and we said we would rather help a child that needs it,” Eric Stearns said.

Nationwide, up to 35 percent of kids in state care are placed in group or institutional settings.

Maine has reduced that rate to five percent.

“If you look at the state of Maine over the past decade we have made incredible strides in the right direction,” said Director of Child and Family Services Jim Martin.

Maine is a leader when it comes to utilizing kinship families.

In 2000, nine percent of children in state custody where in the care of a relative. As of this year, that number had increased to 35 percent.

A 2012 study by the Foundation for Government Accountability found that Maine ranks in the bottom 10 states when it comes to re-unifying families, and 25th for it’s foster care system as a whole.

“We certainly want to reduce the amount of time that children spend in the states care. Children need to be in families,” said Department of Health and Human Services Commissioner Mary Mayhew.

Mayhew said she hopes to achieve the goal of reducing the time children spend instate care with increasing immediate support and assistance for children and families.

“We want to make sure that we are doing everything possible to improve their outcomes. At the end of the day how do we define success on behalf of these children?” Mayhew said.

Foster children with special needs add another layer to the process, which can seem daunting.

Eric and David Stearns are therapeutic foster parents. They have had extra training with Spurwink Services to learn how to manage Ethan’s autism.

“When families are feeling at the point where they really need something they have people they can call. We have 24/7 on call for families,” Spurwink resource coordinator Rana O’Connor said.

After six months, Ethan is thriving with his foster family.

The Stearns’ dedication to providing Ethan with a routine, exposing him to the outdoors and introducing him to pets is paying off.

“We feel like a real family. It really does work day in and day out,” David Stearns said.

The Stearns hope their success can be beneficial for other potential foster parents.

“I think anybody can do it with any level of commitment. To want to provide a safe environment for any child, I think that’s the No. 1 priority, and they support you with anything that they can,” David Stearns said.

Mayhew said she plants to roll out changes over the next year that she hopes will provide similar support and assistance for all foster families, not just those with special needs.

Ohio bill would extend foster care services to wards age 21

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Foster Care Kids Need Love Too

COLUMBUS, Ohio (AP) – A state bill would extend the age that younger residents can get foster care services while requiring that court-appointed guardians receive a guide developed by the state’s attorney general.

The legislation would increase to 21 the age that foster youths could get services, provided they meet certain education and work requirements. It would create a bill of rights for those under guardianship care that would include being treated with dignity and respect, having personal information kept confidential, and safe, sanitary and humane living conditions.

State Rep. Dorothy Pelanda, one of the bill’s sponsors, said the proposal is designed to protect two of the state’s most vulnerable populations: people under the care of guardians and foster children approaching adulthood.

“As a family lawyer for more than 30 years, and having been appointed a guardian or attorney for a foster child, I have witnessed firsthand the heartbreaking circumstances of these situations and the confines and frailties of the law as it relates to these individuals,” Pelanda said in a written statement.

Advocates for those in foster care say more than 1,000 youths age out of the system at 18 each year, increasing their risk of homelessness, unemployment and dependence on public assistance.

Under the proposal, participation in the extended foster program would be voluntary.

The bill’s sponsors say their measure also is aimed at raising awareness of issues associated with caring for the more than 67,000 juvenile and elderly wards in Ohio.

The state costs associated with the bill include $300,000 in 2016 and $1.7 million in 2017.

Volunteers needed to represent foster children in court

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There are almost 1,000 children living in foster care in Atlantic and Cape May Counties. CASA, or Court Appointed Special Advocates, currently has about 200 volunteers to represent 350 of them, making sure they get the services and help they need during foster care, and as a permanent placement.

“Because of the shortage of volunteers, we usually get only the most complex cases right now,” said Karen DeRosa, director of comm-unity development for CASA for Children of Atlantic and Cape May Counties. “But we would like every child to have an advocate.”

The CASAs are appointed by a judge and help supplement the work of case workers. The volunteers can visit the foster home, the biological parents or even the child’s school.

“I worked with a school system for a child who was having problems,” said Carole Phillips, of Egg Harbor Township, who has been a volunteer for about three years. She originally thought about becoming a foster parent, but decided that might be more than she could handle.

“I always had a heart for helping children,” she said. “This is something I can do.”

Court Appointed Special Advocates Carole Phillips, of Egg Harbor Township, left, Lisa Weiss, of Somers Point, Daryl Shall, of Ventnor and Lauren Uher, of Ventnor, attended a recent meeting of CASA for Children of Atlantic and Cape May Counties.
Court Appointed Special Advocates Carole Phillips, of Egg Harbor Township, left, Lisa Weiss, of Somers Point, Daryl Shall, of Ventnor and Lauren Uher, of Ventnor, attended a recent meeting of CASA for Children of Atlantic and Cape May Counties.

Husband and wife, Lauren Uher and Daryl Shall, of Ventnor, became volunteers after retirement. They typically work together with families that have multiple children in foster care and are often placed with different foster families.

“We had been looking to do something that really had meaning,” said Shall. “There is so much enthusiasm and commitment for the mission.”

Uher said volunteers should love children, be good at asking questions and communicating to the court. Some cases take more time than others, and volunteers do make an emotional investment in the child’s well-being.

She said because they are impartial, and are assigned to do what is best for the child they represent, judges respect their recommendations.

“Our mission is the child,” Shall said. “You read their files and there are so many horrible things, families that just can’t function. Then you go meet the kids and they are so sweet and you just have to help them.”

While many volunteers are retired, Lisa Weiss, of Somers Point, said she works and still finds time to serve. She said case workers juggle so many cases that they are happy to have the CASA volunteers help out. She typically spends about 12 to 15 hours per month on her case.

“We are just one more resource to make sure the children get safe homes,” Uher said.

Contact Diane D’Amico:

609-272-7241

DDamico@pressofac.com

Become a

CASA volunteer

To learn about CASA for Children of Atlantic and Cape May Counties, call 609-601-7800. Information is also online at atlanticapecasa.org also send donations at https://www.wepay.com/donations/fostercarekidsneedlovetoo

CASA of Cumberland, Gloucester and Salem Counties can be reached at 856-521-0734, or email

susanna.casaofcgs@gmail.org

CASA of Ocean County can be reached at 732-797-0590.