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!

A Response Regarding Responsibility

I was corresponding with one of our local Community Based Care (CBC) representatives yesterday about the responsibilities the CBCs have in placement decisions. I was particularly upset by one line of one of the emails I received that stated that "The decision to move a child as well as place a child does not always fall on the CBC's decision makers."

The more I thought about that line, the more upset I got. You see, I think it is a common practice for those of us working in dependency to throw our hands up in the air and declare that something is not our fault because the system is too big and there are so many players that we cannot control everything. I strongly disagree with that idea and think that we each have a responsibility to uphold the intent of the system to make life better for the kids in our care by holding every single player to an extremely high standard - including ourselves. I was so upset by this that I ultimately didn't sleep very well again because I kept dreaming about the issue. So when my teething one year old woke me up for the third time at 2 AM, I never really fell back into a sound sleep. So at 4 AM I composed the following response:

The more I thought about your response last night the more it got me thinking. I wanted to say something that's been on my mind for a few years now as I've worked on a lot of these types of issues both at out local level and statewide (and if you want to get truly technical, even at the interstate level).

You said in your email that the decision to move a child as well as place a child does not always fall on the CBC's decision makers, but I think that it actually does. The decisions themselves may not, but the responsibility to ensure that they are done according to best practices and in the best interests of the children does. That means that while the decision makers are not the people manning the placement phone lines and doing the day to day work of moving and placing children, they are the ones who are working on the policy practices, manning the contract management of the various partner agencies working under the auspices of the CBC's contract, and following up with the quality assurance plans that should show compliance with the state's requirements for the adequate treatment of the children and the families who care for them.

We all know that there are five thousand working parts to dependency and that the system is incredibly fluid. As a result, many times there are no true "textbook" cases, but there are human considerations for which to account. The two most recent cases I've brought to your attention do have some similarities to each other despite their being polar opposite examples - the similarities are that the consideration of the impacts to the kids and the families caring for them of actions on the part of placement and/or case management were not adequately addressed. This means that the families who were caring for children were treated with little respect. Because care giving families are not automatons who are simply paid babysitters we should afford them the respect they deserve - even in times of turmoil and quickly changing priorities. If the system wants to be able to treat families without that kind of respect, then my recommendation would be to scrap the foster home model completely and hire part-time babysitter providers who would be available at the drop of a hat, would not work as advocates for the children, and wouldn't mind being treated as "less than" - though I would caution that the expenses associated with that model would be incredibly high - both monetarily and otherwise. No one is advocating for that type of model to be put into place because everyone realizes that a home setting is truly the best setting for kids who come into care - but to keep the current model working at optimal efficiency, we need to make sure that we're being sensitive to the needs of the families in whom we place such trust. It's spelled out very clearly in the Partnership Plan. It's touted at every conference and every QPI call. We need to do everything we can to live what we preach.

My hope is that by providing the examples of cases where the system was not working optimally, we can ferret out the places for improvement and take ownership of the improvement processes. My goal is to help every single family we bring into the system, whether it's a biological family, foster family, relative or non-relative family experience the very best parts of the system without re-traumatizing them any further through poorly implemented or inadequately thought out processes.

I hope you can see where I believe that the CBC's decision makes do have the responsibility to ensure that placement decisions are done properly and with the interests of the folks directly involved (ie the children AND the families) are taken into account - not just the convenience of the transporters and case managers.

Thanks, and I'll chat with you soon, I'm sure!

I haven't gotten a reply yet - but I'm quite certain I've managed to irritate at least one person today (even though that was not my intent - honest!)!

Working towards fixing a broken system of care...

I am copying a letter I wrote today to a couple of folks at our local Community Based Care partner to attempt to resolve some persistent issues in one region of our state. This is an issue I've had first hand experience with from this particular county and have actually worked with the individuals I sent my letter to before trying to address some of the things we thought needed tweaking to help better serve the kids who come into care. This is the kind of action I think all foster parents should be prepared to take when it comes to the kids they're entrusted with.

Dear So-and-So,

I'm writing to you because I have gotten another series of questions this week from three different foster families who have kids placed with them from Bay, and I'm not really sure how to advise these parents going forward. The theme of the last few days has been:

I have kids from Bay county and I'm not getting copies of JRs or Case Plans or any other documents that should be included with the kids' files. When I've asked for them I've been told I'm not allowed to have any of this information.

I've had kids placed with me from Bay who have been with me for over two years and the DCM still is not willing to work towards filing TPR even though the parents have not been compliant with any of their case plan tasks. (This particular statement came from two different families - one of which even said the magistrate gave the department 45 days to file a TPR which he said should have been filed months ago)

When my kids go for visitation, they often come back saying they have not gotten very much to eat during their visit. (this sounds eerily like what another foster family and I expressed two years ago about our kids going for visitation - so this one really concerns me greatly)

I hear several recurrent themes from families when dealing with Bay county quite frequently - and they come from multiple families which leads me to think that the experience is common and not limited to one or two case managers. Most of my conversations with other families usually end with the family saying they are unwilling to accept children from that county ever again and this really concerns me for several reasons I will outline below.

I'm concerned anytime a foster parent shares stories about case managers or other system employees who do not listen to the parent's concerns regarding the children in their care - but I'm more concerned with this when it comes from multiple families over long periods of time. With the Bay County issues, I've been first party to what happens over there, but I am now two full years removed from any first hand experience. I see where Life Management has posted that they have a critical foster home shortage over there and that we are not doing a good job retaining or recruiting families there. And when less than two days later I've gotten emails or phone calls from three different families dealing with similar issues as what I dealt with two years ago, I'm starting to understand why there may be a critical shortage of homes.

I'm not naive enough to think that there aren't other mitigating circumstances that affect the practices of that county - I get that it has a highly mobile population with a very low median income. I get that homelessness and drug use is more prevalent and that there's also a military base to deal with. But I also wonder if there are practice issues at the case management level and legal level that are affecting the support that foster and bio families are receiving which are making supporting the children in care more difficult? I am afraid that kids who are removed form Bay homes are going to be shipped to farther areas of the state as more families become unwilling to work with the county - I want to help combat that because like you guys, I truly do believe that kids need to stay as close to home as possible.

So with all of that in mind, what can I do to help? What answers or tips or suggestions can I give families when they come to me with questions, concerns or complaints? What is the right combination of people to put them in contact with and what steps can they take to have their issues handled?

I know with the first bullet I offered, they are entitled to the documents they are requesting as they are supposed to be a part of the resource record and the language including foster parents as appropriate participants to be included is specific in the statute and rule -- yet legal continues two years later to refuse documents to families. Who do we escalate this one to? And maybe the second bullet would be appropriately addressed to the same party?

The third bullet falls under the issues that stem from transportation, handing off to case management/visitation center, and the biological parents - so I know this one will certainly have to have a multiple party approach - but I think this one may actually be more pressing than the first two as it really bothers me that children are saying their basic needs are not being met during visitation/travel time.

Let me know what steps you think we need to take as a community to find workable solutions to these issues. I want us to get to the point to where all families are willing to take all children regardless from which county or circuit they originate.

I hope that they will take my letter seriously and that we can work to get some relief for both the families who are caring for the kids and also for the kids themselves. Wouldn't it be fantastic if we could ever reach that wonderful goal of having three homes available for every child who comes into care - because that would mean we've either figured out a way to safely keep kids with their biological families or we've figured out an amazing way to recruit and retain amazing foster and adoptive homes!