Posts tagged with Citizen Journalism Academy

No Safe Haven for Nebraska Teens Is Kansas next?

You may have read "No more teens: Neb. safe haven law to be changed" (LJWorld, 10/21/2008). Nebraska got caught by language that was too broad in its law to provide a safe haven for parents (usually young mothers) to abandon their infants at hospitals without being prosecuted for abuse or neglect. The language is going to be changed from 'child' to infants up to 3 days old. So don't think about driving to Lincoln and dropping off your difficult teen. In Kansas the Department of Social and Rehabilitation Services in response to the request of Governor Sebelius (6/27/2008 news release) to reduce budgets by 1% - 2% is proposing to cut back on services to teens (http://www.srskansas.org/admin/Budget/SRS%20Budget.htm). One proposal is to no longer place youth 16 years of age and older into state custody except for maltreatment. They expect to save $3 million with this proposal. I like the idea. I think that child welfare foster care should be reserved for children who are victims of abuse or neglect who cannot be safely kept at home. I am concerned about how these families will get the help that they are looking for. These teens will still exhibit out-of-control behavior, truancy and running away that overwhelms parents. SRS proposes to add $254,998 to Family Services and $239,432 to Family Preservation to assist these families. Is it enough? Can $494,000 serve these teens as well in family preservation as $3 million did in foster care? I hope so. If it can, why didn't SRS do this a long time ago? Someone once told me that they thought that the usual community response to difficult teens was like the bubble under the rug. You try to smooth out the rug and the bubble simply moves someplace else. In this context this means that when child welfare tightens up and stops serving a group of kids they don't get better they simply move on to mental health or juvenile justice. Let's hope that this is not true this time.If this proposal is implemented, I call on the legislature to require SRS to report on the results for the children and families involved.

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You’re not a victim of domestic violence, are you?

This is the title of an article in the Annals of Internal Medicine about screening for domestic violence in emergency rooms. Unfortunately the title tells much of the story. Since October is domestic violence awareness month I thought it would be good to visit this problem that plagues all of our communities. Many victims visit emergency rooms as a result of domestic violence injuries. This study that took place in emergency rooms in two large hospitals, one urban and one suburban, demonstrated that the question that a health care professional asks makes a big difference. The researchers audio taped emergency room interviews of women who were not medically emergencies and consented to the audio taping. Missed opportunities: This research found that screening for domestic violence only occurred for 34% of women who could be interviewed. Domestic violence is a problem: When there was a domestic violence inquiry 26% (n=77) of women disclosed either a current or past problem. It is possible that 150 additional cases of domestic violence would have been revealed if the other 66% of the women would have been screened.More missed opportunities: The study found that medical staff inquires were "often perfunctory," did not usually include follow-up questions or opportunities to talk. Only 31% were documented in the medical record and only 25% were referred for counseling.So what about Lawrence? The emergency room at Lawrence Memorial Hospital does better. According to Belinda Rehmer who is the LMH communications coordinator personnel use a computer generated list of questions when someone is comes to the emergency room. The domestic violence question is: Do you feel safe at home? If the answer is no an automatic referral is made to a hospital social worker. The study was conducted only with women. Women are victims of abuse much more than men. But some men are victims. I was once in a hospital recovery room (in another community) after an outpatient procedure and a nurse asked me a question about domestic violence. After I recovered from my surprise I was pleased that my hospital cared enough to ask.If you use a different hospital other than Lawrence Memorial and share my concern for domestic violence, ask them how their emergency room staff asks patients about the problem. Rhodes, K.V., Frankel, R.M., Levinthal, N., Prenoveau, E., Baily, J., & Levinson, W. (2007). "You're not a victim of domestic violence, are you? Provider communication about domestic violence."Annals of Internal Medicine, (147), pp. 620-627.

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Nebraska’s parenting problem: Is it happening here?

You may have read or heard that Nebraska has a little problem with its safe haven law. Safe haven laws were designed to solve the problem of pregnant women, mostly young, leaving babies in trash cans and bathrooms. These laws provide that women who leave their babies in places like hospitals will not be prosecuted for child abuse or neglect. Never mind that most women at the time of giving birth are not rationally determining how they will dispose of a baby.The Nebraska legislature in its wisdom broadened its safe haven law to protect any child not just newborns. Well a family that included five boys and four girls took up the offer. The children are now in state custody. This is an extreme but not unique incident. Other smaller families are also accepting the offer.Could this happen here or is it already happening?The Department of Social and Rehabilitation Services (SRS) reports that last year they investigated 9,344 calls to their child abuse hot lines with concerns that were not abuse or neglect. These are typically concerns about child behaviors that are difficult to manage. These seem to be the first cries for help by someone in the community.One response to these situations is out of home placement. That is where the Nebraska children went. SRS reports that of 3,610 children placed into foster care during the last fiscal year, the primary reason for placement was something other than child abuse or neglect for 1,376. Here is the breakdown for these placements.¢child behavior problems - 322 children¢caretakers inability to care for the child 282 children¢truancy 170 children¢'other' - 602 children.The rather large 'other' category includes the child's alcohol or drug abuse, child's disability, death of parent, failure to thrive, inadequate housing, incarceration of parents, parent-child conflict, relinquishment and runaway. Mostly family problems unrelated to abuse or neglect.So between 22% and 29% of out of home placements were because of something other than abuse or neglect. Were these families giving up?We are all familiar with behaviors of children that are difficult to manage. Those who haven't been parents can think back on their own difficult behaviors when they were children. For most children and parents growing up can be difficult at times but manageable. However some children have extreme behaviors that are difficult for anyone to manage and parents vary widely in their ability to cope. These families need help.Many community agencies as well as SRS also work with these families. However with about 25% of out of home placements being primarily for reasons other than abuse or neglect apparently these services are not sufficiently effective. Kansas may not have the same problem as Nebraska but we clearly have a similar problem with many families not getting the help they need.

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Feria Hispana - recycling?

http://worldonline.media.clients.ellingtoncms.com/img/blogs/entry_img/2008/Sep/29/recycling.jpgThe photo says it all. People want to recycle. At yesterday's Feria Hispana people put their aluminum cans on top of the trash can so that they could be recycled. But note the plastic bottle inside. There were others further down. Every year there is an article in the Journal World about Lawrence being above average in the rate of recycling. Yet if you go to a public event in South Park you can't recycle unless you pack it somewhere else. Last November I traveled in Paraguay (our partner in Latin America). Paraguay is not nearly as developed as the USA. In several public places there were 3 trash cans with 2 set aside for recycling. Clearly Lawrence can do as well.

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Parents helping parents

Being a parent of a child in foster care is difficult. This family crisis is accompanied by feelings of anger, guilt, shame or failure. Then there is the stigma. Many people paint these parents with a broad brush. They must all be sadistic abusers. Who wants to say that the reason that their child is not living at home is because he/she is in the custody of SRS? Of course some parents are just mean and don't think that there is a problem. Then there are those with uncontrolled mental illness or substance abuse that prevents them from being adequate parents. Some parents have children with mental illness that exhibit behavior that is virtually unmanageable. Poverty, domestic violence and homelessness are just a few additional family problems. There are a host of reasons that children are placed in foster care.The problems resulting in children being placed out of home are not resolved quickly. The Department of Social and Rehabilitation Services (SRS) reports that last year 2337 children were reunified with their families but only 57% of children in foster care were returned within one year. With the stigma, lengthy involvement with SRS, the court and other service providers there are still a group of Kansas parents who have 'been there' and are reaching out to try to help other parents experiencing the same difficulties. They are even helping SRS and other service providers to be as responsive as possible.The Kansas Family Advisory Network (KFAN) is such a group. Their vision is to have a statewide network of family members who are partners in child welfare (www.kfan.org). One example of their work is the Family Navigator Program. Parents who have had children in foster care become partners to parents newly experiencing this stressful situation. The partner helps by explaining what to expect because they have been in the same situation. Currently KFAN only has resources to provide this service in Cherokee and Reno counties.Another project is the Family Planner. This is a three ring notebook of all the paperwork regarding a family's case. It includes a list of everyone involved with the case along with phone numbers. With the involvement of SRS, court, schools, mental health centers and social service providers this can be quite a list. The Planner also includes court orders and meeting dates with actions taken. An important feature is a space for parents to record their own thoughts about meetings, hearings and other events. The Planner may seem like a small thing but one frequently forgotten in stressful times. The ability to easily retrieve this information to recall what has been written or said is a powerful tool since those inside the system don't always share this same information effectively. This tool can help parents hold key actors accountable.KFAN also works on the statewide level to help improve Kansas child welfare. I have the pleasure of serving on a statewide SRS committee with Ruth Heitsman who is one of the founders of KFAN. Ruth is a passionate child welfare advocate who speaks forcefully for parents. At the same time she pushes for better services and outcomes for foster children. KFAN is a new organization struggling to obtain resources to expand. Hopefully their vision of being a statewide leader in child welfare will be realized soon.

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Evolving dialogue

God: Charles?Charles: What?God: Thank you Charles.Charles: What?God: Thank you.Charles: For what?God: For the book.Charles: What book?God: "The origin of the species."Charles: Oh that one. Actually the title is "On The origin of the species." It initially had a longer title but we shortened it. Thanks. I think that there is an idea there but I don't think I did very well explaining it. I worked on the idea for some time but I didn't understand enough myself. I needed more data.God: You did better than I did. Charles: What do you mean?God: Well I came up with that simple idea of the world being created in 7 days. Well 6 actually. I put in a rest day on the 7th. I had to keep it simple. Man's mental abilities were pretty primitive in those days. I couldn't make it too complicated. Actually I made up different stories for different groups or visa-versa but that is the one that seemed to stick.Charles: Wait! Who am I talking to?God: God.Charles: No way. There is no God. I must be dreaming.God: Whatever.Charles: If you are God, why did you make so many mistakes?God: What mistakes are you talking about?Charles: There are lots of them How about the appendix or prostate? That one is really causing problems for me these days.God: Sorry about your prostate. I never claimed to get it right all of the time. Maybe all powerful, but not perfect. You do need more data.Charles: So your claim is that you set things going but then it was up to chance?God: Well, not totally chance. There are some rules. Your metaphor doesn't rely solely on chance does it?Charles: Chance plays a part but survival is not based on chance alone.God: Exactly. Charles: If you like my ideas, what about all of those people saying that your 7 day thing should be taught instead of my ideas.God: I like your metaphor but it is a bit simplistic as well. It is better than my story and as you collect more data other ways of helping people understand what the world is all about will evolve. Be patient with the folks that hold on to old ways of understanding. Not everyone gets it right away. But they do need to leave me out of science classes. I have my own realm.Charles: So how did you do it? Assuming that you did it. God: I'll ignore the second sentence. I set up a few rules. Charles: What rules?God: If I told you, all of the fun would be gone.Charles: So how about a hint? Is quantum physics on the right track?God: You deny that I exist but you want me to reveal my secrets? Quantum physics is an interesting metaphor. Charles: The jury is still out on you. I studied you for a long time but when I went out in the real world you just didn't make sense. What do you mean that quantum physics is an interesting metaphor?God: Maybe you needed more data. I like quantum physics. It has all of those far out ideas. All of those dimensions, uncertainty and things exploring all states at the same time. Didn't I do a good job with the brain? Charles: The brain is amazing. It is capable of making up some really weird ideas. After all it created you.God: Watch it.

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Kansas versus Iowa

As we begin football season that morphs into basketball season I recall that last year the pigskin Jayhawks beat Iowa State by a score of 54 to 17 and that Self's guys beat them here and there. But Iowa is beating Kansas in the race to provide health insurance to low income children.The latest census report on poverty and health insurance includes information on the percentage of uninsured children by state. I was amazed to find that 20 states have a lower percentage of uninsured low income children than Kansas. Then I saw that our sister state of Iowa beat us with only 2.9% of their children living in households at or below 200% of poverty not having health insurance while the rate in Kansas was 5.2%. These may not seem like large percentages but this represents 39,000 uninsured low income children in Kansas while Iowa had only 21,000. I am focusing on Iowa because it is the state that is most like Kansas. The census report shows Iowa as having a population of 743,000 children under 19 while Kansas has 747,000. That is really close. So what accounts for the difference?First, the Iowa legislature passed a declaration of intent stating the goal that all children in the state have health care coverage which meets certain standards of quality and affordability. Second, Iowa disregards 20% of earned income before they calculate income eligibility. This means that a family of four with an earned income up to $53,000 is eligible for state subsidized health insurance for its children while in Kansas the limit is $41,300 (200% of the poverty). In addition, an Iowa family of 4 with an income less than $35,750 pays no premium while in Kansas the limit is $30,975. Above that a modest monthly premium applies in both states. Third, and perhaps most important, Iowa has an outreach program to get children enrolled. There is a person in each county designated as the outreach coordinator whose job is to get children enrolled. You can go to a state map and click on a county and find the name, email address and phone number of the person responsible for outreach (http://www.hawk-i.org/en_US/outreach.html). Kansas does not have such a program. Imagine how many more Kansas children could have health insurance coverage if we had an outreach program. This is not just a children's health issue. Imagine the financial help to our community. Each year Health Care Access, Heartland Medical Clinic and the hospital emergency room provide medical care to the uninsured. What a help it would be to have more children insured.Certainly Kansas can beat Iowa in providing health insurance to low income children.

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Reasons to Celebrate in Paraguay and Kansas

Today Paraguayans are celebrating the end of the 61 year rule of the Colorado Party. It has the distinction of having been the longest ruling party in the world. Not a good thing in this case.Paraguay has been working on developing democracy since the removal of Alfredo Stroessner the dictator who ruled from 1954 until he was deposed in 1989. In 1993 Paraguay had their first free election since 1928. However, this year's election was the first time a non-Colorado candidate won. It is a hallmark of democracy when ruling parties change through free and fair elections. Fernando Lugo is the new president and is more personality than party. He was a Catholic Bishop who resigned his clerical position to run for president. The Vatican still does not recognize his resignation. He is considered a leftist but what that means is yet to be determined.What does this have to do with Lawrence? Well in addition to being interested in the peaceful spread of democracy, the Lawrence League of Women Voters had a small role in the development of democracy in Paraguay. After the 1993 election several Paraguayan women's groups were eager to have contact with the League of Women Voters in the U.S. The women presented their proposal to the Kansas-Paraguay Partners and Partners of the Americas. They were put in contact with the League of Women Voters of Kansas and Mary Miller a member of both Kansas-Paraguay Partners and the Lawrence League was the lead Kansas person in this project.In 1995 Mary traveled to Paraguay to become acquainted with the women's groups and their needs. In 1997 five Paraguayan women came to Kansas to spend two weeks hosted by five of the local Leagues. Their purpose was to see government in action and the participation of women in governmental and non-governmental organizations. Their project on returning home was to carry out a series of surveys in five public markets in and around Asuncion to determine and prioritize the concerns of thousands of women who work in the markets. Forums were held and the market women gained confidence in their ability to voice their grievances. The final forum was held before the municipal elections of November 1996, and was attended by a League member from Kansas. The candidates for mayor were invited and heard the women's complaints. The candidates then signed contracts to better conditions. Now that is democracy at work.By the way it is also the birthday of Asunción the capital of Paraguay. Asunción was founded on August 15, 1541 and is one of the oldest cities in the Americas.

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How did we do raising our 9,187 children last year

Last year we took part in raising 9,187 children. That is the total number of Children in Need of Care who were in out of home placements during the last fiscal year. Since the state produces data on a fiscal year basis our year runs from July 1 through June 30. Children in Need of Care are those who are awarded that designation by a juvenile judge. The Secretary of the Department of Social and Rehabilitation Services (SRS) is given custody and most are then placed in foster care. The Secretary is acting on our behalf. The goal for these children is to keep them safe, find a safe and permanent home for them as quickly as possible and maintain their well-being.Safety Children in our custody are reported as being safe. 99.91% of children in out of home placement last year were reported as safe; 98.6% of children were safe after leaving foster care. Nationwide child welfare systems have shown that they do keep children safe. This is generally measured by counting the confirmed or substantiated incidents of abuse or neglect. Kansas has a rather high level of proof needed to substantiate a case resulting in only 8% of all investigations of abuse or neglect being substantiated. This low rate suggests that the safety measure may not be the best indicator of safety. Permanency This is child welfare jargon for children returning to a safe home, being adopted or having someone else assume guardianship of the child. SRS has set a standard that 76.2% of children entering foster care will return home within 12 months. Last year they missed the mark. Only 57.3% of children returned home in that time period.If children are returned home too quickly they frequently return to foster care in a short period of time. In Kansas only 6% of children returned to care within 12 months of going home. This is a low rate and a good outcome. This probably can be attributed to the child welfare contractors having to assume the cost of foster care when a child returns to foster care within 12 months. This has been an effective provision of the contracts encouraging the contractors to provide support and services to families after reunification. SRS reports that last year 712 or 727 (both numbers appear in their data) children found new families through adoption. This compares with 715 the year before. SRS has a standard that 32% of children adopted will achieve this within 24 months of entering foster care. Last year the rate was 30.7%. With 871 children awaiting adoption one wonders if these numbers couldn't be improved.Someone, usually an extended family member, assuming the guardianship of a child is another way that children achieve a safe and permanent home. Last year 330 children left SRS custody through guardianship. This has become a well accepted way for children to achieve a safe and permanent home. Research has shown that these arrangements have many benefits because the people assuming guardianship are usually grandparents or aunts or uncles who are well known to the children.Well-being Many experts suggest that education, health and mental health are what ought to be considered as child well-being. As a parent I know that these were important considerations in raising my children. How are they doing in school? How is there physical health? How is their mental health?Unfortunately we know nothing about the well-being of children in SRS custody or those leaving. This is disturbing. Imagine a parent not knowing how their children are doing in school. Isn't that neglect? In general we know that children entering foster care are not doing well educationally. That is even more reason to make reporting educational status as a priority. Youth leaving care because they reach the age of majority is another group for which well-being is important. These are youth who did not return home, were not adopted and did not have someone assume guardianship. SRS reports that 433 youth fit this description last year. Nationally, research on these youth has shown that they do not do well as adults. They enter foster care with many problems and leave with few resources and few prospects. In recent years these youth have more opportunities to attend college and maintain their health care after leaving care. Yet, we don't know how many are leaving care with a high school education, work experience or a medical card. You can look at the date yourself at http://www.srskansas.org/CFS/datareports08.html

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Douglas County: Below normal?

If you want to get into interesting conversations start comparing Lawrence and Douglas County to other places in Kansas or places with Big 12 universities or places in the US or : It goes on and on. I guess that most people want the place where they live to be the best. Although I know a lot of people who pine for some other real or imagined place. Recent data on children removed from their homes show that, on average, 2 children per 1,000 in Douglas County were placed into foster care. This is below the 5 per 1,000 that is the median for Kansas Counties. You may recall the recent flap in Wichita. There was an assertion that more children were removed from their homes in Sedgwick County than Los Angeles or New York. Well, in Kansas, Sedgwick is entirely normal removing 5 children per 1,000. These figures come from recent end of fiscal year data from the Department of Social and Rehabilitation (SRS). Since the number of children removed from their homes can vary quite a bit from year to year I used the average number of children removed from their homes over the last 3 years. In counties with small number of children the year to year variation can be very large. For example, Greeley and Wallace counties have the smallest number of children (less than 400). One family having problems requiring 3 children to be placed into foster care in one year would really change the placement rate. The 3 year average accommodates for this type of variation. At the low end, no children from Hodgeman and Stanton Counties were placed into foster care during the last 3 years. Hodgeman and Stanton each have less than 700 children. Scott County has about as many children as Norton and Rooks Counties but has fewer removed from their homes. Scott County averaged 0 children placed although they did have one child removed for the home two years ago. Norton is in the middle of Kansas counties with an average of 5 children per 1,000 removed. Rooks County is below that at 3 children per 1,000. I wonder what is different about Scott County. I also wonder what is different about Barton County. With an average of 14 children per 1,000 removed from their homes Barton has the highest placement rate of any county in Kansas. This is almost 3 times higher than the state median. Bourbon, Labette, Crawford and Allen are not far behind Barton in terms of the removal rate. What is a reasonable rate for removal of children from their homes? We don't know the rate at which children need to be removed from their homes. Traditionally foster care is used to provide a safe place for children who are suffering abuse or neglect. SRS reports that during the last fiscal year there were 53,888 reports concerning the welfare of children. A little over half of these were assigned for an investigation. Two-thirds of these were for reasons of abuse or neglect. However in Kansas a child can be identified as a Child in Need of Care (CINC) for a variety of reasons other than abuse or neglect. One-third of the reports investigated were for non abuse or neglect reasons. What to make of all this? Since there is no absolute standard against which we can judge these rates, it is worth looking at counties at the extremes (Scott and Barton) to see what we can learn from their experiences. And by the way, in Kansas, Sedgwick County has a normal foster care placement rate and Douglas is below normal.

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