Wednesday, August 26, 2015

Because telling me to shut up works so well... ask my husband!

So anyone who knows me knows a few things are just part of my genetic makeup. I’m a loudmouth. Highly opinionated. Passionate. I have a super strong sense of justice. I am more tenacious than a Jack Russell Terrier. I like to talk – a lot. I also have a massively bad case of ADHD so I either hyper focus or can’t focus at all. I believe in follow through and good customer service. I will praise you to the ends of the Earth if you do great things, but I will point out when systems or processes are failing (and usually even provide possible solutions). I’m usually happy. I love mornings and coffee and evenings and the occasional glass of wine. And kids… I love my kids. I’m not afraid to be a mama bear when I have to (for mine or others). And the one thing that really makes me crazy is administrators dismissing problems brought to them by consumers without considering that there may be issues with their businesses or processes.

So given this introduction to my personality and quirks, it likely wouldn’t surprise you that I get really frustrated with bad service, lack of compassion, poorly designed systems and processes, and administrators who refuse to see the problems in their service delivery models – or worse yet, see the problems but refuse to acknowledge them or work hard to fix them. If you add an extra layer to the story and know that I’m talking about the provision of services to vulnerable children and their families and the agencies charged with keeping kids safe you can probably predict that when I feel things are not being done adequately to protect kids or help the families charged with protecting them that I probably get a little worked up.

Last Monday I was called in to the “principal’s” office to discuss the “vision and expectations of our system.” Read: I posted a challenge to the local agencies on Facebook that I would demand no less than Gold Standard performance for the kids and families in the dependency system and got called in to discuss that I was being overly critical and emotional and not being the good cheerleader that a lead should be. I knew going in to that meeting that it would be what it was – and despite the fact that I am not a paid employee of the agency or the CBC but rather a volunteer who has only ever tried to help the agency perform its duties more effectively and efficiently – I went anyway to be a team player.

I came away from that meeting frustrated. I stewed and simmered for a week before writing any kind of response hoping that I could filter out my frustration before presenting any of the recent issues my families had brought to my attention for help. A week later I wrote up the most recent eleven service provision issues brought up in the last 32 days by multiple families. I sent the list to our local CBC leadership as well as the sub-agency leadership responsible for the delivery of the services. My original questions are numbered below – and then I provide the sub-agency responses and my responses back. I will say that I feel like most of the issues were dismissed as unimportant, and I believe this administrator does not want to admit that the performance of his agency is clearly lacking in many areas. I also feel that this is one of the reasons our area has such a critical shortage of homes and families willing to foster our kids. The short-sightedness of agency administrators who refuse to see the operational picture from the eyes of a different set of players only serves to exacerbate the problems that already exist. My hope is that we can work to alleviate these problems so that we can recruit more quality families willing to do the difficult work of fostering our most vulnerable kids!

1. Licensing has informed families that there are two months where none of the training they take can count towards relicensing so that Super Saturday hours and hours gained from the conference can't be used towards their licensing requirements. Is this true?

Sub-Agency Response: We have to submit a completed licensing packet 60 days prior to the license expiring to Big Bend CBC. That packet then needs to be submitted to DCF 30 days prior to the license expiring. However we can not start working on the packet prior to 90 days of the license expiring. Any training done from the time packet is submitted to Big Bend CBC and when the license expires can not be counted. In essence, our foster families have 10 months to actually do their training. I had a conversation with the DCF Regional Licensing Specialist today and she explained it this way. In order to submit a relicensing packet it must be totally complete. In other words we can not add to the packet once in has been submitted. Therefore if a packet is missing training hours it can not be submitted.

My response back: In speaking with another local agency dealing with licensing and training, it does appear that this is an issue for other agencies too, though they've been able to work around some of it with the timing of submission of packets. I have referred this to Carole Shauffer to work directly with DCF to develop a better solution to this issue, but in the meantime, wouldn't it be more ideal if we could allow the training hours to be used for the next renewal period even if they can't be used for the current renewal period? The reason I ask is we're pushing our families to attend Summit and other high level conferences for training, but anyone who has a renewal that falls in late July, August or early September cannot use those hours for training which defeats the purpose of encouraging our families to seek higher caliber training from direct sources like Super Saturdays, conferences and the Summit.

Sub-Agency Response back: We have also asked DCF to look into this issue. Training hours can not be “banked” and applied to future licensing periods. Hours are applied to the licensure period in which the hours were achieved, prior to the submission of the relicensure packet.

2. Omitted – handled (Original question which actually was handled through back channels was: Having no agency-issued IDs for transporters causes unreasonable risk to caregivers is there no way to make a temporary ID or to accelerate the process? Sub-Agency Response: We found resolution to our ID issue. All transporters should have ID’s when transporting. *SIDE NOTE: The initial Sub-Agency response to this item was there was no solution and this wasn’t a safety issue. By pushing back channels, a solution was found that solved the glaring safety issue.)

3. Is it in fact Big Bend's policy to discourage continued contact between children in foster families they have recently moved from? How is this reconciled with the DCF policy on transitions?

Sub-Agency Response: There is no policy to discourage continued contact between children and former caregivers. The decisions are made on a case by case basis depending on the circumstances.

My response back: I understand there is no policy to discourage contact, but there also appears to be no policy or direction to ENCOURAGE continued contact post-transition though the Partnership Plan specifically mentions it in item 9. There may be confusion about this issue with case management and supervisors as I was recently told by a supervisor that this is not promoted once a child leaves a caregiver's home. Maybe we should open this up to more dialog and additional training?

Sub-Agency Response back: As stated above, the decision to allow or not allow is assessed and determined on a case-by-case basis. I am very familiar with the supervisor’s comment to you and it was specific to that one case.

4. Trainers are currently providing misinformation to foster parents (Ex - babysitting requirements, photos of foster kids on social media, haircuts, etc.) I understand there are long term plans for additional training of trainers, but how is this being addressed in the short term to ensure that foster parents are getting accurate information?

Sub-Agency response: We are aware of the one class where there was an issue and it has been resolved. The trainers are now using the normalcy document provided by DCF as a part of the training. Further, Carol covered this issue in-depth at Super Saturday.

My response back: I appreciate that the trainers are now using the normalcy documents, but we've seen inexperienced trainers providing misinformation in a few other areas and in other classes than just that one you mention as well (ex - when independent living skills should begin and how they are delivered for one). I would like to know what the plan to supplement trainer knowledge is and what the timeline to implementation is so that we can be certain our trainers are delivering the best possible information to our new families. I know you specifically mentioned additional support in how to train, but system-specific knowledge also needs to be more thoroughly developed for individual trainers.

Sub-Agency response back: There will be one more QPT class provided this year which will afford our trainers additional time to come up to speed and resolve any outstanding deficits. This class will be facilitated by Carol Edwards.

5. Licensing counselors are giving inconsistent answers to families regarding requirements (Ex - some families being told drop side cribs with immobilizers are okay but other families are being told absolutely not; also some questions about relocation requirements when families move have been inconsistent).

Sub-Agency response: We addressed this issue with the licensing staff today. They all understand that drop side cribs with immobilizers are okay. What we are telling people is if they have a drop-side crib, go to the manufacturer and get an immobilizing kit. We haven’t told anyone that these cribs are not allowed even with immobilization.

My response back: Drop side cribs are only one example, and I can tell you that there is continued confusion about this one example between various licensing consultants as recently as the end of last week. There have been other instances where information about multiple policy areas has been inconsistent between consultants - maybe we could work on a clarification memo to all of the consultants about the drop side crib requirements (and copy me please) and possibly work on a series clarifying some of the bigger policy areas where changes have recently occurred?

Sub-Agency Response back: Thank you for the recommendations.

6. Omitted - BBCBC/DCF question (Original question was: Questions from families about the transition planning on kids who have PESS eligibility and were recently adopted. Is there a formal policy on how to handle these meetings? Sub-Agency response: I am not sure which meeting you are referring to, however Young adults that were adopted after the age of 16 from foster care or placed with a court-approved dependency guardian after spending at least 6 months in licensed care within the 12 months immediately preceding such placement or adoption met the eligibility requirements. *SIDE NOTE: this is actually not an issue the sub-agency deals with so I can give him a pass here.)

7. Several families are working through issues with school transport of kids who are out of their normal school zone but none of the case managers appear to be well (if at all) versed in helping with getting kids to the school of origin. Is there a policy on how to assist families in obtaining assistance through McKinney-Vento when they have kids in schools outside of their normal zone?

Sub-Agency Response: There have been several children who have been able to remain in their original school because the school system provides the transportation. In those situations the Case Management will have a conversation with Matt McKibbin who talks directly with the school system transportation department to resolve the issue.

My response back: Due to this being a sensitive issue currently with the recent start of the school year, maybe a communication to all of case management as well as all caregiver families would be ideal here to reinforce to everyone that there is a policy/procedure in place and that there is help with this issue available through BBCBC.

Sub-Agency response back: This topic was revisited with all Case Management staff this week.

8. Several families need post-adoption support but are not getting help with getting adoption decrees, birth certificates or information on switching insurance. Since there's a short window to change insurance plans and most people need help with getting kids re-registered for school, is there a current contact that can help speed up assistance?

Sub-Agency response: Adoption decrees, birth certificates and switching insurance should be discussed with the adoption worker.

My response back: There may be miscommunication in the adoptions unit given the number of families who have recently asked for help in this area. Having the adoption worker clarify this with families who have recently completed adoptions may help alleviate confusion? And having the adoptions unit identify families whose adoptions worker recently changed and proactively reach out to those families to see if they need assistance might go a long way in helping increase satisfaction with the families and ensure that the needs of the children are being adequately met.

Sub-Agency response back: Your feedback is noted and appreciated.

9. Many families in the process of adopting have said that they are having to wait several (more than four) weeks to have counselors assigned. Should it take more than four weeks to assign a new counselor for current cases? Who supports the families in the interim?

Sub-Agency response: I am not sure that I completely understand the question. Adoption workers are assigned as secondary workers at TPR if the goal is adoption.

My response back: I believe part of the issue here is the number of people who have recently changed positions. Several families who are in the process of a current adoption have had their worker changed but not had a new one assigned for several weeks. If an adoption worker changes and a new worker is not immediately assigned, who supports the needs of the families and children in the interim?

Sub-Agency response back: There is never a moment when a case is not assigned to a case manager. The thought that it takes several weeks to assign a worker is simply not accurate. Foster and adoptive parent support is a priority to our operations.

10. Parents are being told they absolutely CANNOT transport their kids to dental appointments now that the only people allowed to do this are the case managers or case manager supervisors. Is this true? I had a CHS supervisor email me that it was, but it seems contrary to what we train families to do.

Sub-Agency response: This is an old issue. We have worked extremely hard to ensure that children go to their dental appointments. Due to the extremely limited number of dentist seeing our children appointments are challenging to set. There have been children who have missed their appointment because the caregiver could not take them. We made a decision to ensure that all of the children make their appointment. That decision included staff taking children to the appointments. We certainly hoped that it would provide some level of relief for caregivers.

My response back: This is an issue I've taken to Carole to address specifically with DCF as this decision is in direct violation of the Partnership Plan. I recognize that there are a limited number of dental appointments available and that there has been difficulty in getting our kids to those appointments, but the decision to remove the caregiver from the solution is incredibly short sighted and in direct contradiction with item 14 of the Partnership Plan. Additionally, this change was not communicated to caregiver families when it was made, nor was input for a solution sought from the caregiver families (or the associations who serve them) when the issue was identified. Other areas of the state had similar issues and were able to solve them utilizing their partnerships with the caregiver families - I believe we can address this issue in a way that emphasizes the importance of the caregiver in alleviating anxiety the children may experience with a dental appointment while still allowing the agencies to meet their target goals for getting kids their dental care on time!

Sub-Agency response back: Thank you for your input on this issue. We have had several caregivers thank us for the assistance with transportation. We are certainly willing to revisit this issue.

11. Omitted - BBCBC/DCF issue specifically (Many, many, many families are still saying there are not enough medical providers (particularly specialists) who take the Sunshine plan. I know this is technically an AHCA issue, but since it affects our families we should be being proactive about it. Sub-Agency response back: I totally agree! We have even started taking children to walk-in clinics to meet their needs. *SIDE NOTE: This is a HUGE issue and still needs to be resolved, though the CBC and sub-agencies really have no control over it as it’s an AHCA issue.)

Clearly, there is more work to be done.

Clearly, I’m not going to shut up anytime soon!

Thursday, August 6, 2015

My Dear Daughter

My Dear Daughter,

I know you’ll be much older before you ever read this (if you ever read this), but I wanted to tell you the story of how you came to be my daughter. I wanted to tell you the story of how you changed me as a person. I wanted to tell you the story of how much you are loved. You see, you did not grow in my tummy, nor are you my permanent, legal daughter. Instead you came to me because placement called me very early one Friday morning – 1:27 AM to be exact – asking if I could take you and your brother on an emergency, over-night basis until they could find you and your brothers a permanent foster home the next morning. I remember thinking about how tired I was because the week had been a very long week already since daddy had been gone and wondering how I was going to fare at work the next day. It seemed like it took the investigator forever to arrive with you guys in tow, but when he pulled into the driveway at 4:32 AM, I was wide awake from having been thinking about you for the previous few hours. All I knew was your names and ages. I hadn’t really asked very many questions because I was not in the habit of taking placement calls anymore so all of my “good” foster parent skills were rusty from disuse.

When Mr. Byron opened the car and got you out I remember noting how little you seemed, but my goodness you were so brave for such a little munchkin. You came right over to me with your half-eaten happy meal in hand and jumped into my arms. I asked you if you were sleepy though I didn’t really need you to answer as you were already asleep before your head touched my shoulder. Mr. Bryon bought your brother inside; I carried you. Since all the other kids were asleep, we put you both on the couch in the living room, toes to toes, covered you up with warm blankets, and neither of you moved a muscle until I had to wake you for court a few hours later. You were both so exhausted.

I didn’t realize the significance of that morning at the time, my love. I had no idea that you would end up occupying more space in my heart and life than just the tiny fraction of the couch your sleeping form covered, and I had no idea how deeply I would end up loving you or how fiercely I would have to fight to be sure the people charged with your care would make wise decisions for your life. All I knew at that particular moment was that you and your brother needed to sleep and that we would all be heading in to court in less than four hours.

After the judge made it clear that you and your brothers would need to stay in care, the case manager began telling me that they would start looking for a home for you but that since there weren’t homes available locally that you and your brother would likely have to be moved to the central part of the state. I knew what that would ultimately mean for you so I got on the phone and started calling my foster family friends who might be able to help. We were able to find a family locally that could take your two youngest brothers, your other brother would stay with the family who initially took him that night and you would stay with us – I couldn’t keep your brother with you because you guys didn’t all fit into my van and the other family couldn’t take you because they didn’t have space either. I knew I was going to have to do a lot of explaining to daddy. I also knew I couldn’t just let them ship you guys all over the state willy nilly, and I figured this would only be for a few days until the placement team would be able to find a home that could take all four of you together. Even before I knew I loved you, I knew I needed to protect you.

What started out as me loudly nagging everyone on the case to see if a home had come available to accommodate all four of you eventually turned into the quiet questions during our monthly visit with the case manager. Daddy and I were both very clear with all the players that we were a temporary stop because you needed to be with your brothers longer term, but along the way, everyday life was happening. We signed you up for taekwondo (which you were lukewarm about at best), swimming lessons, a music class on occasion, and got you set up with our regular pediatrician and dentist. We worked on learning everyday skills like recognizing letters and colors and numbers, and we started learning your food preferences (I should tell you now that you were a McDonald’s junkie, sweet girl, and that you could smell a French fry a mile away). We figured out that you needed a nap in the middle of the day or you would fall asleep in the middle of taking a bite of dinner and that you absolutely loved the song “Drinking Class” because you would belt out every single word at the top of your lungs when it came on the radio. You eventually slipped out of calling me and daddy Miss Heather and Mr. Evan and started calling us mommy and daddy, though that seemed to happen quietly and before we really knew it, and I even heard you and Warren referring to each other as sissy and bubba a time or two when you weren’t too busy arguing with each other.

You and Warren would fight like cats and dogs one minute, but then two seconds later you were thick as thieves plotting some mission of mischief – do you remember the time the two of you locked the babysitter out of the house? Liam, who almost never uses anyone’s real name, would run around screaming “Naaaaana” because he couldn’t pronounce your whole name – but he couldn’t stand not being in the same room with you and would search all over until he found you. You guys would fight over the Leappad in the car but would gang up on Warren if he tried to intervene at all. You and Elie had a more tumultuous relationship because you shared a room and she would regularly steal your toys, but even so, you guys would sing together at night when it was time for bed, and I could hear you telling her bedtime stories long after we had told you guys lights out and good night.

I think we got so caught up in the swing of everyday life that the passage of time slipped quietly by until we were reminded that summer was coming to a close and you would be starting kindergarten soon. Somewhere in all the craziness of these last few months you took up permanent residence in mine and daddy’s hearts, and the conversations he and I were having about the time when you would have to leave us became almost unbearable for either of us. I think both of us had privately entertained the idea that you could be with us forever, but as selfish as both of us can be on occasion we also knew that you deserved to be with your brothers. We knew that the home and love you had with us would never be able to overcome that deep connection siblings share – no matter how much we loved you and no matter how much we tried to change that. We knew that all of us were going to hurt and that you were probably not going to understand things initially, but we also knew that if we didn’t push the system to try to get you back with your brothers now it would never happen. So to keep you from having to change schools and to give you a chance at getting your brothers back, my voice to the case manager and placement team grew loud again. Baby girl, if you know nothing else about any this, I want you to know that I have fought for your long term life with your brothers tooth and nail. I have pushed people to think about the consequences of their actions to the point of even doubting myself and my own motivations at times. My only regret is that I didn’t stay as loud as I should have the entire time – though I know that if I had I wouldn’t have had your sweet smile, infectious laughter and mischievous spirit with me as long as I did – so I am torn as to whether I did right by you or not.

Long story short, the system was not able to find a home with enough space or resources to take all four of you – though I pushed everyone really hard to carefully consider the long term implications for you and your brothers if we didn’t work hard enough now to try to keep you guys together. I tried very hard to make everyone understand how the loss of a sibling can hurt deeply – even decades later – though I know I was preaching to the choir most days. I was angry – and frustrated – that it didn’t seem like the folks making the big decisions understood what I was talking about on a personal level though. There were so many people all trying to look out for what was best for you and your brothers so I want you to know that none of the decisions about your life were ever taken lightly. Ultimately, we had to compromise and agree that being with one brother was better than being with no brothers at all – though I am really sad – no, angry – that we have to make choices like this.

Up to this point in my life, I’ve never had to make the kind of decisions that I’ve had to make in the last few months. Yes, we have had many children come through our home, but you were the only child we ever took in who was old enough to know what was happening. You were the only child I’ve ever had to have adult-level conversations with about things that would make most adults cringe and run away crying. Sweet pea, you have handled all of this chaos in your short life like a little champ and have shown so much strength and resilience that I know you’ll end up changing the world someday. You have amazed me continually with your ability to heal and grow and your capacity for love and wonder. My sweet child, I am not your permanent, legal, forever mommy, but you will forever be my permanent and forever daughter even without the legal paperwork. You grew love in my heart almost without me even realizing it, and you changed the way I view the world because you forced me to recognize the places in this world where things need to change. But because of you, I am a stronger person with a renewed sense of passion for fixing what’s wrong with the system that brought you into my life.

You came into my life in an unconventional manner for certain, but you’ll be in my heart and mind forever.