Tag Archives: Foster Care Review Board

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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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).

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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.

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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.

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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.”

State of emergency: Shortage of foster homes leads to separated siblings, moving far from home

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GA Foster Care

Georgia is in a “state of emergency” when it comes to foster care, and Floyd County was ranked the fifth highest county per capita for children removed from their homes, according to DFCS officials and a report from Georgia Child Welfare Measures.

Some 244 children from Floyd County were sent into foster care from April 2014 through March 2015, according to the statistics.

That state rate over that time period was 31.2 children per 10,000. Floyd County’s rate was 104.5 per 10,000.

Why is the rate so high? There are several reasons, according to local officials.

“It comes down to the fact that we are looking more,” said Floyd County Juvenile Court Judge Greg Price. “We have two hospitals and many medical professionals who are required to report suspicious things. We have a high number of teachers and law enforcement as well.”

These individuals are trained to notice signs of trouble, he added.

“When you’re a mechanic trained to fix problems on VWs, when you drive down the road, you’re going to see the VWs first,” explained Price.

Another issue is cyclical abuse and neglect, according to Price and Lindsey Howerton, director of the Floyd County Division of Family and Children Services.

“We have many families who repeat the cycle of abuse and neglect,” she said. “They stay here. Their children have children, and it keeps going and no one breaks the pattern.”

The reasons for the removal of children from their homes covers a wide range, with 120 removed for neglect, 80 removed because their parents were abusing drugs or alcohol, 52 removed because parents were unable to cope, 88 removed for inadequate housing, 30 were abandoned and 32 were victims of physical abuse. Other reasons include sexual abuse, domestic violence or because parents are incarcerated.

Howerton said the specific reasons stated can be misleading.

“Many times, when we investigate further, we may find signs of physical or sexual abuse when the child was originally removed for neglect or drug abuse,” she said. “This is especially true for a younger child who is not in school. If that child is only going to the doctor once a year, it is much harder to catch.”

A major crisis situation arises after these children are removed, because Floyd County only has 16 DFCS foster homes.

“This often results in our children being placed out of county, which causes all kinds of problems,” she said. “The children have a harder time coming back for court dates and for visits with their families. Also, you have the added trauma for the child, which is just increased by them having to completely relocate and have nothing familiar around them.”

DFCS always tries to help the families, she added, and this is made more difficult when the child is miles away.

“Our main goal when a child is removed from a home is to work with the parents to help them change behaviors if possible and bring their child home,” Howerton said. “Having to place that child in a home in Macon just makes it that much harder on everyone.”

So, the first thing DFCS does is try to find a qualified family member or family friend who can take the child. This is the best option, but sometimes is impossible because they might not live in the area or may be unsuitable.

Issues also often arise because of siblings, she said.

“We have a lot of multiple-child families, and the ideal would be to have those siblings together or at least close to each other,” she said. “This becomes hard because many foster families can’t handle that many children at once.”

Floyd does have 23 homes that work with child placing agencies, such as Faith Bridge, Howerton added. However, these homes can have children who are not from Floyd County placed in them. Winshape Homes is its own entity and does work with DFCS as much as possible, she said.

“We have two large sibling groups placed with Winshape currently,” she said.

The Open Door Home is a group home and children are only placed there if they are 13 or older.

“We are always hoping that if people know there is a need, they will be willing to serve as foster families,” she said.

Potential foster families attend classes, she said. Families are taught about the process from start to finish about policies and how a child might behave.

“For instance, a child who has suffered neglect may hoard food,” she said. “I’ve had children who don’t understand or know about the bath routine and a child who had never seen a toothbrush.”

Those who want to foster are also given a home study session in which a DFCS agent comes into the home and observes the environment and the family’s interaction.

“Most understand the reasons behind this,” Howerton said. “It is all about the safety and well-being of the child. The home studies are usually completed within two or three sessions.”

Foster parents also have to undergo fingerprinting, background checks and financial checks.

“We have to make sure they can handle the extra expense,” Howerton said. “We do not so much pay as reimburse. A foster family has to be stable enough to handle extra costs like clothing, diapers and glasses, and then be reimbursed.”

Once approved, foster parents are often immediately needed.

“I’ve had families receive a child the day they were approved,” Howerton said.

About 75 percent of the 422 Floyd County children in foster care are placed outside of Floyd County, Howerton said. Of the 25 percent here, the majority are placed with family members.

These numbers frustrate Howerton, she said.

“I would love to put myself out of a job,” she said. “We are trying to build strong families in a strong community. When it comes to foster care in this county and this state, we are in a state of emergency.”

A Bill would ease foster placements

Foster Care Kids Need Love Too

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Jill Johnson of Omaha agreed last fall to take a state ward into her home — a 12-year-old boy she had known since he was a preschooler.

Nebraska Families Collaborative in Omaha sought her out, knowing she had worked with him professionally in the past to resolve his behavioral issues.

When he had to leave his previous foster home because of behavioral issues — it wasn’t safe for him or the family he lived with — Johnson and her husband said the boy could come and live with them.

It was then that the Johnsons found out they had to go through a rigorous licensing process that would delay bringing him into their home by months.

By the time they are approved, at least five months will have gone by, Johnson said.

A state law that went into effect in July has been causing concern among agencies that find foster homes for kids. It has slowed the process for placements of children with families in which at least one adult knows them.

In the 2012 session, senators passed a bill that required licensing of all foster parents who were not related to a child by blood, marriage or adoption.

 

This year, Lincoln Sen. Colby Coash has introduced a bill (LB265) that would allow foster children to access kinship and relative foster care more easily.

The hearing on that bill is scheduled for Thursday at 1:30 p.m. in front of the Health and Human Services Committee.

It exempts kinship and relative homes from the requirement to be licensed, or from certain other requirements. It defines kinship homes as those in which the caretaker has lived with the child or has had significant contact with the child.

“It would really allow us more flexibility with placing kids with people that they know,” said Jewel Schifferns, kinship care services manager with Nebraska Families Collaborative.

At a time when there is a shortage of foster homes in the state, the agency has seen a significant decline in kinship placements since July.

On July 1, the agency had 115 foster homes with kids who knew the caretaker before placement, she said. Since then, 26 of the homes have been licensed, 17 are ineligible and 14 still are working on licensing.

The remaining are no longer caring for foster children.

As a result, Nebraska Families Collaborative has been placing more kids with foster parents the children don’t know, she said.

Dave Newell, president and CEO of Nebraska Families Collaborative, said licensing takes a lot of time.

When children are removed from their parents, it is the least traumatic if they can go stay with someone they know.

“That’s far less scary for them than going to somebody that they don’t know,” Newell said. “And we really lost that flexibility when the law changed.”

The intent of the law, to raise the quality of foster homes, was good, Newell said, and Nebraska Families Collaborative supports licensing homes.

But there have been some problems with it.

With licensing, there is somewhat of a built-in bias against low-income families who must have a certain amount of square footage per person in the home, for example.

There also have been cases in which four siblings, for example, two of whom have one father and two have another, cannot all be placed with a paternal relative. That forces the agency to place all four together in “stranger care” or split up the siblings, Schifferns said.

The rules could be more flexible on things that don’t affect the safety of the child, Newell said.

With Coash’s LB265, homes still would have to be approved by HHS, with a background check and a home study.

The homes could pursue licensing and would have the assistance of HHS to do so.

For relative homes pursuing licensure, requirements that don’t affect the safety of the child may be waived.

New Law Aims to Help Students in Foster Care

Foster Care Kids Need Love Too

 

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COLUMBUS — A law signed last week by President Obama is expected to help clear some educational roadblocks for foster children, whose school records often remained closed to child-welfare workers.

The Uninterrupted Scholars Act gives the agencies access to the records by making an exception for child-welfare workers in the Federal Educational Rights and Privacy Act of 1974, known as FERPA.

That means child-welfare workers won’t necessarily have to obtain parental consent or wait for court orders to act on school matters. Parents don’t automatically lose their educational rights when an agency has temporary custody of their child.

Local advocates say the change in FERPA should reduce or eliminate some of the snags, delays, and missed days that occur when children come into custody or change schools.

“It was a well-intentioned law, but it had some unintended consequences for foster children who are moving around from school district to school district and often fall behind,” said Scott Britton, assistant director of the Public Children Services Association of Ohio.

Missed school days are a problem for foster parents too, he said, because many can’t miss work while transfers are pending.

“It’s become a real deterrent for foster families in some cases,” he said. “Days would turn into weeks.”

In some cases, Mr. Britton said, Ohio foster children’s school records and report cards were “held hostage” by the former school district if certain fees had not been paid. Waiting for court action and county-issued checks took more time.

Many child-welfare agencies have developed educational-stability programs for foster children.

According to studies of adults in the Midwest who had been in foster care, more than one-third changed schools at least five times as children, and most read at a seventh-grade level after completing 10th or 11th grade.

Among Ohio foster children in the ninth grade, one-fourth passed the math and science proficiency tests and half passed the reading test. Foster children drop out of school at higher rates and are about half as likely to graduate from high school, advocates said.

A Child Transitioning Out The Supervision of The State

Foster Care Kids Need Love Too

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Good morning Foster Care Kids Need Love Too Family! I have a very special message from a foster child that transition out of the supervision of the state. She wanted to share your passage in and be a advocate for foster care children in need. Her name is Katlynn in i will share her story. It took bravery for her to share her story so this is for us as a family to understand that we have a voice of opinion here at Foster Care Kids Need Love Too. This is her story: My name is katlynn. I’m 15 & this is my story , My mom had me at a really young age and i went into foster care and I was called names for it. Or they would say no body wants you not even your mom. And that Hurt so bad, and the people around me thought I would turn out to be a foster kid that has nothing good and I started to believe it and gave up, but one day a guy told me show them your better then what they say you are. After that I got everything back together and now I’m adopted and loved by my family and have people who support me and don’t make jokes about being a foster care kid or an adopted kid. It’s not easy to be in the system.Thank god that I had the foster parents I did. And I thank god for giving me a family.

Volunteers needed for Foster Care Review Board

Forward In Faith

Montgomery County, TN – The Foster Care Review Board is seeking volunteers to serve on its boards. Board members make recommendations to the Juvenile Court Judge or Magistrate that is overseeing each child custody case.

Board members are asked to attend one board meeting per month. The boards usually meet on the 1st and 2nd Tuesdays and the 4th Monday of each month.

Foster Care Review Boards are set up by law to review the cases of children who are in the custody of the Tennessee Department of Children Services.

For more information or to volunteer to serve on the Foster Care Review Board, contact Howard Johnson at 931.648.7686.