[Congressional Record Volume 148, Number 98 (Thursday, July 18, 2002)]
[Extensions of Remarks]
[Pages E1304-E1305]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                    CONTINUING CRISIS IN FOSTER CARE

                                 ______
                                 

                           HON. GEORGE MILLER

                             of california

                    in the house of representatives

                        Thursday, July 18, 2002

  Mr. GEORGE MILLER of California. Mr. Speaker, today the ACLU and 
several child advocacy groups brought a suit requesting the court to 
hold accountable those county and state officials responsible for 
oversight of California's foster care system. Plaintiffs charged that 
negligence, mismanagement, and abuse and neglect of children are 
routinely committed by the very state agency charged with protecting 
children and ensuring their safety and well-being.
  In the following article in today's Los Angeles Times, one of the 
plaintiffs reports that the suit will demand all appropriate mental 
health services; multidisciplinary assessments of the needs of each 
child; case plans; and providers to ensure that no child will be 
neglected. Judging from recent news reports, this same lawsuit could be 
brought against most state child welfare agencies.
  The federal child welfare law that I authored in 1980 requires States 
to comply with a number of core requirements intended to protect 
children placed in foster care as a condition of receiving Federal 
foster care funds. Yet twenty years after enactment of P.L. 96-272, 
many of the same shortcomings as prompted the passage of the law are 
affecting hundreds of thousands of children in foster care placements, 
raising serious questions about the diligence of the states and the 
federal government in enforcing the law and protecting the children.
  The situation described in the Times article is not unique to 
California, which has had a very troubled history in foster care for 
decades. In Florida, in the District of Columbia, in New York, and in 
many other jurisdictions, allegations about inappropriate services, 
improper placements, inadequate staff training and compensation coupled 
with massive caseloads and staff turnover are commonplace. And yet the 
Congress has not taken a broad look at how best to assist in the 
improvement of accountability and services in the nation's foster care 
system.
  The time has come for a broad review that brings together experts and 
practitioners and advocates to help shape a thoughtful critique of 
current practice and make recommendations for the federal, state and 
local governments. This is not only a family crisis and a children's 
crisis; it is a fiscal crisis, because we are spending billions of 
dollars a year on a system that, despite efforts at reform, continues 
to fail the children in its custody. The article follows:

              [From the Los Angeles Times, July 18, 2002]

                A Foster-Care Tragedy Worthy of Dickens

                            (By Lew Hollman)

       Los Angeles has a foster-care system driven by what is 
     available, not what is needed. Children receive too few 
     services too late. Thousands are shuttled to ineffective and 
     expensive institutional care. They are poorly monitored, with 
     no consistent, individualized care. Not surprisingly, many 
     deteriorate in county care, populating our jails, homeless 
     shelters and mental wards after they ``age out'' of a failed 
     system. Many never overcome the effects of the abuse or 
     neglect they have suffered.
       At a time when funds for children's services are ever more 
     scarce, we are paying more for less in terms of healthy 
     outcomes. Millions of federal dollars are at risk because of 
     our inability to meet reasonable guidelines for stable 
     placements--through family reunification, adoption or long-
     term foster care. More important, the children whom the 
     system is intended to protect are being irreparably harmed.
       This is not a problem that can be solved simply by changing 
     the person at the top, as L.A. County has done twice in 
     recent years. It requires a philosophical change at all 
     levels--from a system based on what services are available to 
     a system based on earlier intervention and individualized 
     needs.
       A suit will be filed today on behalf of foster children put 
     at risk by a failed system. It will demand a wider array of 
     mental health services available under Medi-Cal; 
     multidisciplinary assessments of the needs of each child 
     based on all relevant information; continuity in services and 
     plans for each child; and the development of services and 
     providers to ensure that no child will be rejected.
       MacLaren Children's Center in El Monte, the county's 
     emergency shelter for abused and neglected children, is an 
     apt symbol of our failed system. Designated a short-term 
     shelter, it has become instead the county's warehouse for the 
     unwanted. Once a home for wayward girls, it retains its 
     foreboding atmosphere. Such control as exists--in many 
     instances, poor management has led to children being abused, 
     often by other residents--is prison-like.
       Some MacLaren residents languish for months beyond the 
     ostensible 30-day limit. Many more are constantly 
     ``recycled'' as foster homes reject them, adding to the 
     trauma that brought the children to the county's care. One 
     plaintiff, removed from her home as a result of sexual and 
     physical abuse by her stepfather, was moved by the county 28 
     times between the ages of 9 and 13. Another is in a locked 
     facility because of the healthy impulse to find a better life 
     elsewhere. In less than three years, she was moved 25 times.
       When Dickensian stories like these are related to the 
     uninformed, they are greeted with incredulity. It is often 
     assumed that lack of resources must be the problem. Of 
     course, no one desires these rootless sojourns through 
     impersonal care. And our society could, no doubt, better 
     invest in the needs of its children. But lack of money is not 
     at the root of these problems.
       Inertia and lack of accountability are the culprits. The 
     county has become increasingly defensive about releasing cost 
     estimates.
       According to a recently released Los Angeles Grand Jury 
     report, however, costs during the 2001-2002 fiscal year at 
     MacLaren approximated $757 per day for each child--more than 
     $276,000 per year. Group-care facilities, recognized as 
     contrary to the interests of most children, were estimated to 
     cost about $33,000 annually per child five years ago. By 
     contrast, children at risk who can be assisted without 
     removal from the home costs less than $5,000 a year, and 
     foster home and kinship placements less than $10,000 a year.
       Medi-Cal, through the early and periodic screening, 
     diagnosis and treatment program and other federal programs, 
     can pay for many of the intensive services that children 
     need. True case management would ensure

[[Page E1305]]

     the effective use of such services to enable children to 
     remain in--or quickly return to--their homes, be freed for 
     adoption or settled in long-term foster care.
       The county recognizes the penny-wise, pound-foolish nature 
     of the system. In addition to grand jury reports, state 
     audits, independent evaluations and testimony before the 
     Board of Supervisors, it brought its own expert in to 
     evaluate and make recommendations in 1998.
       Dr. Robert F. Cole, an independent expert nationally 
     recognized for his work with disturbed children, centered his 
     recommendations on an ``integrated delivery system,'' such as 
     ``wrap-around'' care, that would coordinate services and 
     deliver them in a family-like environment, or the child's 
     home, whenever possible.
       A successfully tested method, the wrap-around concept is 
     used in other counties in California and in other states, 
     where it has reduced costs and improved the outcomes of 
     children in foster care. The goal is for caseworkers, 
     therapists, health providers and schools to work together to 
     ensure children prompt and stable placements and the early 
     development of a long-term plan to see children reunited with 
     their families, adopted or placed in long-term foster care.
       Two years after his initial report, Cole praised the county 
     for being poised to implement coordinated services for foster 
     children. But in that time, the county had contracted with 
     only two providers for wrap-around care, serving two children 
     each. Although additional foster care providers have been 
     found since 2000, wrap-around care and other types of 
     intensive care are virtually unavailable in a system 
     providing services to more than 50,000 children year, with 
     slightly less than 38,000 in county custody. Half of those in 
     custody are estimated to have serious emotional problems. 
     Those problems will become increasingly difficult and 
     expensive to treat if effective care is not provided.
       The U.S. Supreme Court has held that due process under the 
     Constitution requires the government to protect from harm any 
     child it takes into its custody.
       The Constitution is violated when children deteriorated in 
     county care or are subjected to policies--such as 25 
     different placements in less than three years--that no 
     disinterested professional would countenance. Federal 
     Medicaid laws are broken when needed medical services for 
     children are not provided.
       The lawsuit to be filed today will ask the court to cut the 
     knot of inertia and hold accountable the county and the state 
     officials responsible for oversight.