WBEZ | Illinois DCFS

Layoffs may be avoided at DCFS

Fri, 12 Oct 2012 17:26:00 -0500

A few hundred Illinois state employees who work with at-risk youth may not lose their jobs as expected. The Illinois Department of Children and Family Services had its budget cut earlier this year by $90 million. Now, it’s expected to get half of that money back, which means the scheduled layoffs of 375 workers across the state may not happen.

The department works directly with families on cases involving child abuse and finds foster care or adoptive services for youth who need it.

A spokesman for DCFS, Dave Clarkin, said some of the 375 employees were middle managers and will have new jobs working with families more directly.

"What that will allow us to do is to clear cases more quickly to figure out if children are at risk and get them the help they need or find them a safe place," Clarkin said.

The head of the department, Richard Calica, announced the cancellation of the layoffs in a memo. He called the shift in job descriptions a "reorganization."

Meantime, a spokesman for the union that represents DCFS workers, the American Federation of State, County and Municipal Employees, said in a statement that there are concerns about the reorganization plan, but that members are "relieved" efforts are being made to find funding for these positions.

Legislators in Springfield still need to reallocate the money to prevent the layoffs, which could happen in the upcoming veto session. Although State Representative Sara Feigenholtz said it’s not clear how the department will find the funding needed to keep the jobs.

"There have been a lot of ongoing discussions about where we will find the sources to pay for some of these restorations and the answer to that remains unanswered," said Feigenholtz, who is the chairwoman of the Appropriations - Human Services committee.

She said DCFS has avoided budget cuts in the past because consent decrees had mandated a certain level of service from the department. Feigenholtz said legislators need to be diligent in finding out how the department would spend the money before a check is written.

Report: DCFS investigator caseloads too high

Mon, 05 Mar 2012 15:49:00 -0600

A new media analysis finds caseloads for Illinois Department of Children and Family Services investigators are too high.

The Chicago Tribune reports Sunday that the biggest trouble spots are in Cook County, the counties around Chicago and in southern Illinois. The newspaper says its analysis found the department is violating a 1991 federal consent decree that aimed to set monthly limits on new cases for investigators.

Investigators should handle about two dozen cases at a time, but the newspaper's survey found they often have 40 or more cases.

DCFS spokesman Kendall Marlowe says it would be a mistake to attribute the recent deaths of two Chicago-area children to worker caseloads. Marlowe says hiring more investigators would solve the problem if that were the case, "and it won't."

The tricky transition to adulthood

Thu, 27 Oct 2011 11:00:00 -0500

People between the ages of 18 and 25 are the most likely of any age group to experience mental illness. They’re also the least likely age group to get adequate services, and often have difficulty navigating the complex transformation into adulthood known as “the transition cliff.”

Ana lives in one of those unassuming buildings peppered throughout Chicago that don’t quite look like the homes and apartments surrounding them. These are assisted living facilities. She’s been living here with her cat, Snowball, and a handful of other adults with mental illness for a few years.

ANA: I turned 21 on a Sunday, and that Friday I was emancipated from DCFS. I had no guardian; I was my own guardian. I knew I wasn’t going to have anymore help. I was scared when I was put into my own apartment because thought I was going to end up doing something really bad to myself.

Ana’s diagnosis is borderline personality disorder, depression, chronic PTSD and schizoaffective disorder. Since she was 13, she’s bounced between dozens of hospitals and nursing homes. Ana has family in Chicago, but none she could turn to for help.

ANA: Unfortunately my dad doesn’t believe in mental illness so it’s kind of hard to talk to him. He doesn’t believe I need medication. He has a thing about throwing my pills in the garbage and I have to go scavenge hunting after them. It’s hard to make him comprehend I can’t help it – he thinks I do it on purpose.

Ana says her dad didn’t believe her mom’s mental illness was legitimate, either. Her mom is schizophrenic.

ANA: Unfortunately she jumped off 7th floor building, and crushed her leg. She’s permanently in a wheelchair. I just learned this last year. My family kept that from me. Before that I thought my mom was dead.

Her mother is now living in an assisted care facility in Texas. Ana arrived at her facility with the help of Thresholds. Her supplemental security income – or SSI – pays the rent. She’s been doing well here, even holding down part time jobs at Radio Shack and Target. But she wants more.

ANA: I don’t want to be here such a long time, you know? There are people here who’ve been here 10 years, 13 years, you know? And I don’t want to do that. I don’t want to be here the rest of my life.

Mark Fagan is the associate director of youth programs at Thresholds. The non-profit mental health agency provides treatment and housing.

FAGAN: With our state in Illinois, we know that it’s increasingly very seriously difficult to get any kind of mental health services if you don’t have really good insurance or if you don’t have Medicaid.

He says even though the law says adulthood starts at 18, insurance and Medicaid coverage don’t necessary follow that marker. So Fagan says that young adults experiencing a mental health condition tend not to qualify for those services at exactly when they need it the most.

Adding to that problem is the fact that the mental healthcare system is designed for independent adults or for dependent children. There’s not much out there for those who fall in between.

Vanessa Vorhies is a researcher who works with young adults at Thresholds. She says that research shows that true adulthood actually starts around 30 years old.

VORHIES: You know if we think about any other developmental phase across a lifespan - this one is what I find is most interesting - is the amount of change. The young people tend to move a lot, they tend to be under a lot of stress because they have to pick college or a career or something. And you can become a parent. Also young people are most likely to get or develop serious mental health conditions during this time.

Because hormonal changes affect brain development, many disorders don’t physiologically show up until these in between ages. By the time these symptoms are identified, Fagan says the services that match with them don’t follow along, and that’s where we get into what we call a “transition cliff.”

COREY: Being honest you know, independence is hard.

Corey is 21 years old. He suffers from schizophrenia and lives with his family in Roscoe Village.

COREY: My family thought that it was like a phase or a funk - that it would go away eventually. But unfortunately it didn't happen and they decided I needed professional help.

Corey is lucky to have parents that recognized his illness and who still want him to keep living with them. Because many parents, after years of incredible difficulty raising a child with illness, are overwhelmed to the point of saying, “You know what? You’re 18 – you’re on your own.”

COREY: One of my pills was $400. Another was $200. Two of them were over $100. Pills are very expensive, that's why people need health insurance.

While his family offers emotional support, he says they’re not in a position to fully support him financially. Corey’s monthly cost of medication comes to nearly $1,000. And like so many navigating insurance beaurocracy, he had a lapse in services.

COREY: We have Medicaid, and then they sent me a notice in the mail that at 19 they cut me off my insurance, but they never gave me a chance to apply for my own medical card. I didn’t have insurance for a month and a half. I had to pay for my medications completely and medications are so expensive. I completely broke the bank, I had no money in my account whatsoever.

Shannon Garrison is a therapist working with Corey and many other young adults at C4 Chicago. She says she sees gaps in services like his all the time.

GARRISON: I’m still trying to figure out how this process works because there doesn't seem to be rhyme or reason. I have quite a few clients that have the same mental health diagnosis, the same kind of delays or deficits in functioning and one has gotten approved for a medical card, and has gotten approved for SSI, but a kid in a similar situation can't get either one.

With this lack of medication and therapy, Garrison says young adults end up back in the hospital, or worse.

GARRISON: So it actually ends up costing more without these services because you're going to see a lot higher rates in psychiatric institutions and in unfortunately the criminal justice system.

Garrison’s program, just like the other rare programs like it across the state, lost a $100,000 dollar grant to fund their young adult services. They had been teaching scores of struggling youth everything from balancing a checkbook to job readiness. And it’s dealing with some of that daily grind that makes life so hard for people like Corey.

COREY: Ever since my mental disorder, when I’m stressed out, I get under pressure I do have little breakdowns. I get angry, I cry. I just feel like if I still went back to school I’m afraid I couldn’t finish because to this day I still crack down under pressure.

Both Corey and Ana have had it rough. But in a way, they’re fortunate – because they found help. Studies show that about one out of every five youth has a diagnosable mental health disorder. And of those – 70 percent never get treatment. Consider this: If one in five Chicago public school students had an undiagnosed mental disorder, there would be more than 57,000 ill children without mental health care in this city alone.

Corey and Ana’s lives illustrate just a few ways in which this phase of life is treacherous. Despite advances in medicine and therapy, the immense social stigma of mental health conditions remain immune to science. In considering everything, it’s easy to feel hopeless. But Mark Fagan, who we heard from a while back, says the very instability of this period is actually where there’s hope, too.

FAGAN: Young adulthood is also a time where we’re able to have some pretty serious influence. You know often times their brains are not fully developed and that’s what’s great. Because we still have that opportunity to provide some influence in terms of both their biological structure as well as their social and emotional structure. So even though it’s an incredibly difficult time, it also provides us with a lot of opportunity for hope and support and for the ability to create healthy transitions along their lifetime.

What are your hopes for the future?

ANA: I want to become a social worker or therapist. I want to be someone that helps other people.

COREY: I don't want to throw my life away - I have dreams for myself.

State guardianship's role in caring for mentally ill kids

Wed, 26 Oct 2011 15:01:00 -0500

Some wards of the state end up in psychiatric hospitals like Chicago Lakeshore Hospital. Over the years, the Illinois Department of Children and Family Services has made great strides in finding homes for abandoned, neglected and traumatized kids. Some families, like the one profiled in Rehman Tungekar's piece, choose to give up custody of their adopted children because they can't afford treatment for mental illness; but DCFS has little power of supervision once children leave the agency. When the University of Illinois at Chicago issued reports that were highly critical of some of the region’s private psychiatric hospitals this year, DCFS was limited in what actions it could take. To learn more about the challenges facing the agency and its charges, Eight Forty-Eight was joined by the deputy director for the Division of Clinical Services at DCFS, Cynthia Tate.

Adopting the fight: A family's effort to provide for their mentally ill child turns into a custody battle

Tue, 25 Oct 2011 15:35:00 -0500

From their modest home in Ingleside, Ill., Toni and Jim Hoy draft a letter to their son, Dan. He last lived with them three and a half years ago.

Dan and his brother Christian are adopted. They joined the Hoys and their two biological children 15 years ago.

The adoption decision had been risky, especially given the children's troubled history.

"It was very chaotic," Toni explained, citing the boys' young birth mother. "There was prenatal substance abuse: alcohol and drugs. And there was post-natal physical abuse. Severe neglect where the children did not have food to eat. The neglect was probably worse than the abuse."

It didn't take long for Toni and Jim to see the childhood abuse manifest in the kids' actions. "Soon after, we realized, probably after two years of having them in our homes, even being untrained, these were not normal kid issues," recalled Jim. "But we had already brought them in our homes, and we made a promise to them that as long as they wanted to be here, they would always be a part of our family. And I've tried to always honor that promise to those children."

Christian had manic rages and was diagnosed with bipolar disorder at the age of nine. Medications helped stabilize him.

But Dan was getting worse. Around the time he reached the fifth grade, he exploded.

"There were times where I would pick him up from school, he would wait to get in the car where he thought no one could see him, and he would basically attack me, where he knew he could get away with stuff," Jim remembers. "He'd throw stuff at the drivers, he'd grab the steering wheel and direct us into oncoming traffic, and he thought it was funny."

Dan was diagnosed with post traumatic stress disorder. The Hoys tried all sorts of therapies to treat Dan's condition, including psychiatry and medications. But, according to Toni, "none of that worked either."

The Hoys tried between 20 and 30 different medications, but Dan's behavior became more unstable. His therapist recommended he be placed in a residential treatment center--a home with intensive therapy and specialized care.

But residential treatment is expensive. Despite looking everywhere, they were denied the family funding.

Treatment would cost over $10,000 a month. Their insurance wouldn't cover it, and neither would the Medicaid Dan received as part of his adoption package.

The Hoys scrambled to buy time while they looked for funding. But it all came to a head when Dan was 14.

Violent behavior takes hold

Jim described the situation in detail. "By that time, we had to have Danny residentially placed because he was trying to hurt the other kids--threatened to stab them, tried to push one of his siblings down the stairs."

They brought Dan to a nearby hospital for one of what would become countless psychiatric evaluations. By this time, hospital visits were becoming more frequent.

According to Toni, the situation was dire. "He was in the hospital, the hospital was wanting to discharge him. We were trying to stall, and we were asking if they'd hold him for just a couple of days. And they refused and told us that if we didn't pick him up they were going to call the [Department of Children and Family Services] child abuse hotline and report us for child abandonment, and yet DCFS told us if we brought him home they were going to try us for child endangerment for failing to protect the other children."

It was a lose-lose situation. "I thought at that time we were at our worst point, and it kept getting worse and worse and worse," recalls Jim.

Out of the Shadows will explore the fractures in mental health care for children in Illinois and illuminate how it affects our youth.

The problems encountered by the Hoys are not typical. According to a report from DCFS, 95% of adoptions remain stable after five years. DCFS also offers a variety of post-adoption support services for families in need, but that offered little comfort to Toni.

"Ultimately, you know, it really came down to safety. When you really think about a vision of one of your children holding a knife to the other one's throat knowing that he's going to kill him, you know, can we go on living like that?"

Neglect charges and state red tape

Taking the advice of a therapist, the Hoys decided to leave Dan at the hospital.

"I went there and told Danny that I wasn't going to pick him up. I mean it was the hardest thing I ever had to do in my life," Jim remembers through tears. "For the first time since I had made that promise to Danny and to Christian that we would always be there, I wasn't sure I was going to be able to fulfill it. It's very, very tough."

Toni and Jim relinquished custody of Dan and were charged with neglect. They later had the finding amended to no-fault dependency, which meant while legally they were still Dan's parents, the state of Illinois had guardianship rights over him. As such, he was able to access residential treatment at the expense of DCFS.

But not everyone was pleased with the decision.

Kendall Marlowe is a spokesperson for DCFS. "Adopted children are not returnable, like an ill-fitting garment," Marlowe says. "There's a reason they call it permanency."

Marlowe says that families seeking treatment like the Hoys place an undue burden on a department that was never designed to handle such requests.

"There have been academic studies that show that a high percentage of children who enter child welfare systems throughout this country, are, at the root cause of it, entering those systems because of unmet mental health care needs. And that's just not the best way to get help to children and families," says Marlowe.

Marlowe thinks families should be more vigilant about getting early preventative treatment through health service systems. "Broadly speaking, we will be more effective at delivering mental health services when it comes from the health service system. And that is not something that state will be able to conquer on their own. It will need a federal role to truly be effective."

But it was too late for the Hoys to seek preventative treatment at the time of the relinquishment. Over the next two years, Dan would live in two different residential centers. Toni and Jim ultimately regained custody of Dan, but he's in juvenile detention after an incident at his last residential center.

His future remains uncertain as the Hoys work towards obtaining funding for his treatment.

"You know, hope is like the air we breathe. I mean, to me I will never be out of hope for Danny. But at the same time, we gotta be somewhat...have reality and focus too," Jim says. "Right now, if anything, Danny is worse than when he went into the residential system. That being said, my family was made complete when Danny and Christian came into our lives. Like we said, from day one when they came, if they wanted us to be mom and dad forever, we would be. And we're here."

Scandal allegations rock DCFS

Tue, 18 Oct 2011 14:31:00 -0500

A businessman who was paid millions of dollars by the state of Illinois to help children, addicts and other needy people actually did little or no work for the money, investigators said Monday, and he got away with it partly because of his close relationship with "Mac" — Erwin McEwen — the recently departed head of the state's child-welfare agency.

State inspectors report that George E. Smith billed several government agencies for work done by non-existent employees, submitted fake papers, forged people's signatures, turned in fraudulent expense accounts and falsely claimed he was a psychiatrist. They also found that he administered psychotropic drugs to children without permission and without determining the proper dosages.

The report by the state's executive inspector general found that George E. Smith and his various organizations collected $18 million in state grants from 2008 through 2011. Smith often rebuffed questions from employees at the Department of Children and Family Services by saying he only answered to "Mac."

"Director McEwen created a situation that was ripe for a vendor such as Dr. Smith to enrich himself and inflate costs by billing for 'ghost' positions and billing various agencies for the same services," said the report, a result of an investigation by the DCFS inspector and the state's executive inspector general.

McEwen, who described Smith as his "personal friend and mentor," stopped cooperating with investigators in May, the report said, although state employees are required to aid such probes. He announced his resignation in August and left DCFS at the end of September.

Gov. Pat Quinn said Monday that McEwen "was given the opportunity to resign and he took that opportunity." Quinn, appearing at an unrelated news conference, did not take any other questions on the issue and did not explain why he didn't publicly disclose the reason for McEwen's departure.

Brooke Anderson, a spokeswoman for the Democrat, said the law barred Quinn from disclosing the misconduct. However, that law applies to early release of "investigatory files and reports" from the inspector general; it does not prohibit a governor from saying he believes a member of his Cabinet is mismanaging an agency.

Anderson said all contracts and grants to Smith were halted and that DCFS is taking steps to make sure nothing like this happens again. She could not describe the steps that are being taken.

McEwen and Smith did not return messages seeking their comment on the allegations.

Inspectors recommended the state seek criminal prosecution of Smith and take him to court in an effort to recover the grant money.

The misconduct went beyond DCFS, investigators said. Chicago State University, the Department of Human Services and the State Board of Education all "paid Dr. Smith grant funds with little or no effort to determine whether services were actually provided."

The investigators concluded that Smith:

— submitted the same documents as proof that he had done work on two different grants for two different agencies.

— claimed payment for therapists and consultants who apparently did not exist.

— described himself as a psychiatrist in official forms, even though he is not a medical doctor or psychologist.

— overstated expenses and collected reimbursement for improper expenses like liquor and cable TV.

"Dr. Smith's fraud continued for so long, in part, due to lack of DCFS oversight. At least one annual $450,000 DCFS grant awarded to him went completely unmonitored for years," investigators reported.

DCFS spokesman Kendall Marlowe said the agency has begun a review to determine how such a problem can be prevented in the future. He said the lax oversight found by investigators is "unacceptable."

Marlowe said DCFS will "take whatever measures are available to make the taxpayers whole." He said he could not comment on whether criminal charges are being discussed.

Marlowe also said he did not know yet what disciplinary steps would be taken against three DCFS employees, not including the former director, who were cited for misconduct in the report.