Child Welfare in the 21st Century

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Posts Tagged ‘children’

We must invest in kids.

Posted by lboyd544 on February 24, 2015

This morning I received an article from which I will paste this sentence: Between 2006 and 2011, the number of children’s hospitalizations in the United States for suicide attempts, suicidal ideation, and self-injury increased by 104% among children under age 18.

Sad and scary, but there is much we can do.

We must fight against budget cuts in our states and at the federal level that will harm mental health and behavioral health services. We must join the ranks of performance based contracting for mental health outcomes. We must stand up for quality of our service providers/provisions.  Good discussion:

We must demand that Congress reauthorize CHIP (national Children’s Health Insurance Program) promptly and fully. Check this out

We must encourage those states who have declined to expand Medicaid via ACA, to do so through their own state plans or waivers.

We can make a difference!


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Lessons from Adrian Peterson

Posted by lboyd544 on November 19, 2014

It is 6am. I feel embarrassed, sad, and powerless this morning.

Adrian Peterson, purportedly the best running back in the country,…and undisputed the best running back in the country if you are from Oklahoma….is suspended from pro football for the remainder of this season.

Yes. Sad because his little boy was injured by his Dad’s disciplinary actions with a switch. Sad trying to imagine the impact of this national attention and the suspension on the lifelong relationship between Dad and son. Sad that Adrian really didn’t see the severity of his actions against the boy….maybe because he was raised the same way.

Embarrassed. Embarrassed that I feel sad, because I really like Adrian and everything else I know about him, and I won’t get to watch his amazing athletic prowess this season. Embarrassed that the country and multi-million dollar sponsors of Adrian are outraged about this incident, yet not equally outraged or invested financially in the hundreds of thousands of incidents annually when other children are abused at the hands of a parent or other adult, …too many to the point of their deaths.

Powerless. Powerless to know how to move people’s hearts to reach out to educate those caring for children and help them be healthier caretakers. Powerless to tap the hearts of couples and parents who could provide foster care and/or respite for children (and their parents) when a child’s needs for safety and permanency cannot be met at home. Powerless to find the words for large businesses and successful companies who could do so much more to feed hungry families, to hire fathers and mothers who need a decent job or a second and third chance, to support before and after school programs and community youth organizations, or to mentor just one child not in their own bloodline!

I am grateful for all those who do care: who pray, who legislate, who open their wallets and their homes, and who follow the Bible’s instructions to care for the poor, the widow and the orphan, however those terms fit this 21st Century world.

Yet today, whether outraged at Adrian Peterson and his actions or at the NFL and its decision, there is a truth we must hear and acknowledge: there is much more to be done and much more each of us can do.

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As the World Turns….

Posted by lboyd544 on November 7, 2014

Yesterday was a tough day.

News outlets reporting terrible voter turnout on Tuesday. Regardless of whether you are thrilled or devastated about specific races, a 30-40% voter turn out nationally is alarming and shameful.
Speculation now swirls that with the shift in some states from Democratic Governor to Republican Governor, expansion of Medicaid for those making 133-400% of poverty may be at risk of repeal.

AND I received calls from three sets of desperate parents looking for a placement for their teenagers (two are boys, one is a girl) sons who are shortly to be dismissed from three different inpatient facilities and who cannot return to their biological homes due to fear of danger toward family members via anger, depression, or sexual acting out. None of these youth are in the custody of the state. These families cannot meet the needs of their children, although none will give up and each wants to participate in therapy with their youth….hopefully while the teen is in a therapeutic foster home. If you are in this field in child welfare, you know as you read this that available placements in therapeutic foster homes are a premium. I have 100 state custody youth on a waiting list in Oklahoma!

I am flummoxed. I am depressed. I am worried.

As a citizenry, have we become so deflated or so complacent that we do not acknowledge the freedom, privilege and responsibility of representative democracy? Can’t we handle a little rain and get out to vote?
Do people only run for office as a next job or next stepping stone forward versus desiring to truly lead, offer policy and change ideas, and commit to the fabric of this country? Are they willing to risk election or defeat only when they can reasonable predict the outcome ahead of time: incumbency, open-seat, money, “party machine”?
Do we not accept mental illness as we would any illness, so that families struggling with children’s need can reach out and find services and supports before the entire family pays an unaffordable price?
Why do we only have passion for our own kids and not open our homes to those youth needing the interest and investment (if not the ‘love’) of healthy, caring adults through temporary foster care?
How is that we have become so litigious that public child welfare goes far beyond ‘best interests of the child’ in accepting foster families and creates more barriers than pathways through background checks, references, home studies, and training approaching a job application to the FBI!

I am basically a “Pollyanna”. I am an optimist. However, yesterday (and perhaps today) was a tough day.

But not nearly so tough as the day(s) these families and youth are facing!

We must hear these pleas. It has to bother us. They have to matter. We are America, aren’t we?

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Courts and other legal partners: An essential collaboration for child welfare public and private

Posted by lboyd544 on October 29, 2014

Last week I had the privilege of presenting a workshop entitled: Therapeutic Foster Care – Exceptional Care for Complex, Trauma-Impacted Youth in Foster Care, to an annual Judicial Conference held in Oklahoma City, OK. This conclave of 250 was sponsored by the Administrative Office of the Supreme Court of Oklahoma. Attendees included Judges, District Attorney’s, private client attorneys (for the youth in care), state child welfare workers, and CASA volunteers. The presentation and discussion created an energetic, informative exchange that both provided questions and answers for services in communities for these youth and also a clear recognition of our overlapping responsibilities, if we are to serve such youth and their families.

I want to reflect on just a few highlights:

1- I hope other states annually have such conferences and opportunities for training in cross-disciplines so that we best meet the needs of vulnerable youth and families. The respect for each other and the willingness to ask and learn permeated the large meeting room for these judges and public servants.

2- Therapeutic foster care (TFC) is a community-based treatment, provided in specially trained foster homes for youth who would otherwise be in group homes or other congregate caring, including an in patient facility. TFC is a medically necessary service, the clinical components of which are paid by Medicaid. It was surprising and most informative for Judges to learn that a youth cannot simply be ‘ordered’ to therapeutic foster care. Instead, a child must be ‘approved’ as meeting medical necessity criteria by the state’s Medicaid authority if reimbursement for services is to occur.

3- Public child welfare workers and court personnel were surprised and pleased to know that kinship and relative placements for youth with child welfare involvement can, and should, be approved for training and services as TFC homes, if the child meets such behavioral and mental health conditions as enumerated in Medicaid criteria. Likewise, TFC agencies can provide services for in-home stabilization in order to divert an out-of-home placement.

4- With the signing on September 29, 2014, of the federal Preventing Sex Trafficking and Strengthening Families Act, states must begin to screen, identify, track and serve minor victims of sex trafficking. Therapeutic Foster Care and specialize congregate care are the only two appropriate treatment resources for this population. We must work quickly and closely with one another to provide specialized responses for trafficked youth.
States vary in their definitions of both “medical necessity” and their understanding of therapeutic foster care. The national

Foster Family-based Treatment Association is hard at work with Congress to create uniform, national definitions and standards for TFC services and professionals. As that effort moves forward, I hope all states will develop or continue the multi-discipline sharing such as provided by the Oklahoma Supreme Court Administrator. Check into what is happening in your state and ask to be involved!

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Coming Soon to an Agency near you!

Posted by lboyd544 on October 21, 2014

Performance Based-Contracting

Performance Based Contracting has long been implemented in sales, manufacturing, and other business environments. Over the past few years, health care and hospitals have joined this path in defining desired outcomes for patient care and in rewarding the meeting of these goals.

PBC, short for Performance Based Contracting, has spread out into the fields of human services, behavioral health care, and foster care as well.

All members of the Oklahoma Therapeutic Foster Care Association are fully engaged with the Oklahoma Department of Human Services to define organization and service goals for the foster care population we serve, for our foster families, and for our agencies. We are in the midst of identifying : goals for recruitment, outcomes for TFC implementation and services, strengths of TFC providers, and system barriers to achieving desired outcomes.

OTFCA specifically is committed to being the best TFC service delivery group in the US! We know we are well on our way. All agencies of the Association are trained in trauma-informed services for families and youth. All agencies are nationally accredited in behavior health. All agencies utilize evidence-based programming, such as Together Facing the Challenge. We know of no other state association where all agencies meet these criteria.

Proud of you OTFCA!

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New Study from Annie E. Casey Kids Count Shows Long Term Risks for Children in Poverty:

Posted by lboyd544 on June 24, 2013

Newspapers across various states will be publishing this week details of the annual Kids Count Data Book and reflecting on improvements and declines concerning the well-being of their youngest citizens.

Oklahoma moved ‘up’ this year to 36th in child well-being (from 40th last year). Yet there is much to be alarmed about in terms of a child’s future. It is known that children’s brains develop most rapidly from birth to the age of entering school. Brains continue to mature and form through teen years; yet, with each skipped-step or missed-opportunity, optimum brain development, ie. optimum futures, is impacted.

According to Kids Count, in Oklahoma children living in poverty remains at 23%!   No improvement and basically, at the national average. Mind you, this is in a state that boasts accurately a strong economic base for future development and a recent past of sustaining minimal job loss due to the recent recession.

Oklahoma figures that worsened this year include 30% of children whose parents lack secure employment, 36 % of children living in single parent homes, and 59% of children not attending early childhood education. 73% of eight graders at not “at-level” in math. How many of today’s underperforming eight graders would have also shown up in those other groups of statistics 5 and 10 years prior?

These stats are just for Oklahoma. All states should be proud of any improvements; some states rightly boast of major strides forward. In Maryland, for example, there was a 10 percent decline in high school dropouts and a 16 percent decline in the teen birth rate between 2005 and 2010. However, 179,000 Maryland children, or 14 percent, were living in poverty in 2011, an increase of 27 percent since 2005. This is a huge increase in poverty of children in Maryland and yet their rate is still only 14%. Oklahoma’s, as noted above, is 23%.

How can our country tolerate any of these statistics? In one of the few, thriving, industrialized countries of the world, almost one-quarter of our most vulnerable citizens live in poverty! And there is no guaranteed access to basic health care for all our children! Let’s not even look at the awful statistics for dental health availability.
Oops, and might these factors impact mental health? Of course, they do!

This is my ‘moan’. And as you hear ‘moaning’ about less government, Obamacare, needed tax cuts, etc., please listen carefully. Who is talking and about whom are they talking? What is their plan for protecting tomorrow’s future? Are they willing to tackle the ‘shame’ of children’s conditions today?  

I don’t know of any political perspective or government (or private!) program that cannot be improved. I believe in conversation, sharing and working together. But I do know that boasting, refusal to listen and engage, and “putting one’s foot down” based on political ideology from whatever spectrum will not feed our children’s bodies or minds today and will not raise our nation to its potential in years to come.

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Changing the conversation about what is important.

Posted by lboyd544 on April 24, 2013

To quote a good friend and true champion of children, Bruce Lesley, CEO of First Focus, “In America, a child’s ability should determine his or her future, not the circumstances of his or her birth.”

Democrats and Republicans surely agree with that statement. However,  our responsibilities as citizens, leaders, advocates, family members, voters, and stewards of our democracy and our earth  begin with that statement. Sadly, policy makers too often respond to this truism as permission to ignore investing in vulnerable children and families.

We know that access to early childhood teaching, to books and other learning experiences,  and to healthy nutrition and medical care are essential for brain development and lifelong potential. Yet the consequences of sequester have cut Headstart programs for vulnerable youth. Poor families are under attack in accessing SNAP (food stamps) in a variety of federal and state proposals from cuts to the SNAP program funding across the country to new work requirements for parents to be eligible for food stamps to the unresponsiveness of state workers to calls and applications from local citizens.

We know that children access necessary medical care more readily when their parents also have access to medical care. Yet too many states are refusing to expand Medicaid in spite of federal assurances that 100% of expansion costs will be covered for the first three years.  (Why not at least try expansion to see if it works/is affordable? States with questions and concerns can drop out of the expansion at any time!)  At the Congressional level, elected officials are doing their best to stop implementation of the Affordable Care Act without reasonable alternatives for the very popular aspects of ACA that families overwhelmingly welcome:  ending of preexisting conditions, equalization of insurance rates for women and men, extension of young people being able to remain on their parents’ insurance policies until age 26…

We know that children need caring and healthy adults in order to have physical and emotional stability. Yet the gap between rich and poor widens daily while the ‘middle class’ evaporates. Congress argues tax policy that protects the “have’s” and gives little leadership to equalizing economic and tax reform for the majority of our nation’s working class. As parents struggle with joblessness and underemployment, depression and domestic violence are on the rise. Child abuse and neglect rates are increasing. Families are fractured emotionally, geographically, and legally.

Sixty percent of children nationally who are subject of maltreatment reports in any given year receive no mental health services . 

What happens to the dreams, the ambitions, and the potential of children whose lives are too chaotic for their abilities to survive the circumstances of their birth? What are the dreams of a child living in poverty or living in a home of violence?  Are those dreams career? Philanthropy? Home ownership? College?  …hardly.

This nation can continue to be a nation of opportunity. But will it/we – for the immigrant family, the family in poverty, the child or adult suffering from mental or physical illness, the veteran with PTSD?

We must implore our federally and state elected officials to act on these matters crucial to families and children: quality affordable and accessible health care,  opportunities for mental health care, jobs that offer a salary which can support a stable home and shelter, access to educational opportunities from early Headstart to college, and an adequately paid workforce of educators and law enforcement officers to keep all our communities growing and safe.

I’ve had enough of the chest-pounding and fist-pumping of politicians who think only of their next election and cutting spending. It is only with input from citizens that we can inform them of what truly matters in our communities and for their constituents. Tell them what is important to you. Eventually, I do believe we can get their attention; but it will take a citizen army of voices.

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Posted by lboyd544 on December 16, 2012

The looming “fiscal cliff” will result in automatic tax increases and spending cuts unless a deal is reached before year’s end. To not come to some resolution will do profound harm to Oklahoma’s children.

Nearly one-quarter of Oklahoma’s children live in poverty.  About two-thirds relied on either Medicaid or food stamps during 2011. The Earned Income Tax Credit, the Child Tax Credit, Unemployment Insurance and food stamps prevented thousands more Oklahoma families from falling further into poverty last year. Yet the automatic budget cuts scheduled to go into effect on January 1 would devastate these programs.

A single mother raising two kids in Oklahoma on a full-time minimum wage salary currently gets a $7,000 tax credit check thanks to the Earned Income and Child tax credit.  That check could disappear.  The additional burden would be equivalent to a $3.50 per hour pay cut.

Republican Congressman Tom Cole recently strayed from the position of House leadership when he said in a private meeting that we should lock in tax cuts for the middle class now and postpone fighting over tax increases for higher-income earners until later. Representative Cole should be applauded for being part of a serious discussion about a critical issue.

As important as it is to avoid the fiscal cliff, we must also make sure that any deal doesn’t ultimately do as much damage as the automatic cuts. The solution is a balanced approach that includes new revenue and spending cuts – as has been endorsed by at least two bipartisan deficit reduction commissions.

Several core principles should be reflected in any deal to avoid the fiscal cliff.  First, it must not exacerbate either poverty or income inequality.

Any deal must also eliminate the Bush tax cuts for wealthy Americans.  According to the non-partisan Congressional Budget Office, extending the Bush tax cuts for the wealthiest Americans would account for nearly half the projected growth in the nation’s debt for the foreseeable future.

There should be no harmful changes to the Medicaid and food stamp programs that are the safety net preventing even more Oklahoma children from living in poverty.

Congress should also be careful not to simply shift burdens to the states. Additional cuts should take into account the $1.5 trillion in reductions to non-defense discretionary spending that have already been made.

The fiscal cliff represents a monumental challenge for our nation, and spending cuts must be part of the solution.  But we must avoid cuts that will save a little now only to cost us far more in social, public safety, corrections, and education costs later.  We must be even more careful not to solve our fiscal problems on the backs of defenseless children who did nothing to cause the problems we confront today. We will need them healthy and well-educated to lead our country for many years to come and confront the long lingering challenges of getting the federal budget under control.

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Election Day is upon us!

Posted by lboyd544 on October 31, 2012

Yesterday I attended a fascinating Forum sponsored by and for members of Leadership Oklahoma. The guest presenter for the afternoon was journalist Bill Bishop, author of the best selling book the Big Sort. In his book, Mr. Bishop uses demographic data from across the country to show how Americans have been sorting ourselves into extremely homogeneous communities in the past 30 years. Most disconcerting, he demonstrates how dangerous to the basic tenets of our country and to democracy this sorting is. We ‘sort’ on the basis of education, income, and lifestyle. We choose who and what we will believe, and we have become so ideologically inbred and polarized that we don’t understand or communicate with others who may live only blocks away, much less with those who are of different ethnic, religious, political, educational, or experiential backgrounds.

While we may think of the ‘world at our fingertips’ due to the advances of technology and the easy access to the web, smart phones, and TV channels, our worlds individually have actually shrunk to a few like-minded neighbors or civic groups who think like we do, choose like we do, and live like we do. As a result, extremism in ideology and politics has grown; tolerance of differences has diminished.

The most scary result of this sorting, which we see on any day of the year, is our inability as a nation to act collectively to tackle and resolve urgent challenges: budget, spending, health care, Social Security, Medicaid, Medicare, and so on. The data supports this premise from Mr. Bishop that politics is no longer about solving the nation’s problems; it is about showing ideological commitment to a political party.

There is a crucial election next week. Will you vote on ideology? Will you educate yourself on the candidates thoroughly from various objective references, not your ‘favorites’? Will you study state questions that might be on your ballot?

Or will you vote, as we seem to be doing way too much, on innuendo, prejudice, emotion, party….fear….anger?

America is the land of opportunity. At least it was once. Yet if we are now ‘sorted’ and intolerant, and I believe we are, we must cast our votes for President and all candidates from a lens of who will listen to various voices, who will keep in mind those who seem to have no voice (the children, the poor…), and who will work from the center and reach out to all sides for discussion and consideration?

Sadly, being a ‘moderate’, i.e. governing from the middle, is rarely successful any more in elections. Ideology gets the money and the votes.

We need courageous and informed voters to secure our country’s future and to return us to a country welcoming differences as richness, not imposition. Please ‘go carefully into this dark night’.

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Make Your Vote Count

Posted by lboyd544 on October 12, 2012


On November 6, 2012, Oklahoma voters will select a U.S. president and five representatives to the U.S. Congress. This election will affect Oklahoma children. But since they can’t vote, they need you to make their voices heard.

Why? Because children in Oklahoma face serious challenges.

According to the most recent published data reports:

  • 23% of Oklahoma’s children live in poverty
  • 11% of Oklahoma’s children have no health insurance
  • 7248 Oklahoma children (SFY 2010) were confirmed victims of abuse and neglect, and
  • 36% of Oklahoma’s fourth graders score below Basic Reading levels

It’s more important than ever for all of us to know where the candidates stand when it comes to our children and the programs that support their growth and development. Ask questions and cast your ballots wisely. Your vote can make a difference to you, your child, and to all America’s children. After all, when we invest in kids, we invest in America.

So what can you do?

Ask questions. Get the facts.

What will candidates do to:

  • ensure children are protected from violence in their homes, schools, and communities?
  • make sure every child has access to the best available medical and dental care?
  • make sure children have a home and get enough to eat?
  • help children get high-quality early care and education?
  • see that school-age children are safe, supervised, and learning after school?

Register to vote. Encourage others to register.

Learn more about the Issues affecting children and families.

Talk to the candidates, your friends, relatives, co-workers, and child service providers.

Vote on or before November 6, 2012.                 

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