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Wed August 21, 2013
Keeping Families Together
The last person a struggling parent wants to see at his or her door is a worker from the state Department of Children and Families. Years of adversarial relationships with families have contributed to the troubled agency's reputation. In the last year, DCF has adopted a reform that turns the old way of doing things on its head.
Amy DeRosa is a 36 year old mom with two children. She's a pretty positive person despite life handing her one challenge after another.
"My husband passed away two years ago unexpectedly from triple pneumonia. Three days later I found out we were pregnant." DeRosa went on to deliver a healthy baby girl, a bright light that kept her mind off the grief of losing her partner of twelve years. But 2011 also brought bad news. She was diagnosed with a rare soft tissue cancer that led to the amputation of part of her left arm. Taking care of a newborn tires out any parent but pair that with cancer treatments and DeRosa spent much of her time on the couch while her mother cared for the baby. And then there was her 6-year-old son to think about. "He's had behavioral problems since my husband passed away so he knows that I can die from this."
One of her visiting nurses knew DeRosa was struggling and felt someone needed to step in. That's when her nurse called DCF. "You know many communities and neighborhoods have not had positive experiences with DCF." Lamond Daniels is a project coordinator for Wellmore Behavioral Health. DCF uses the community provider as a contractor. And while Wellmore's workers aren't DCF employees, Daniels says offering help to families is not an easy sell.
"When we make those initial home visits, there's often resistance, there's fear, there's anxiety."
Fear of DCF came out of the way the department handled its cases for years and that was to launch investigations for every complaint, treating a minor neglect case the same as a case involving severe abuse. The department has taken a different tack under Commissioner Joette Katz who was hired in 2011.
In the last year, DCF has implemented a child welfare reform called differential response. That means DCF divides low risk cases like DeRosa's from high risk cases like severe neglect and abuse.Differential response still means a visit from a DCF worker but she called DeRosa first, there was no surprise visit.
Even so, DeRosa was anxious. "I was petrified. I cried. You know, I had my family come and clean my house so it looked like, you know a museum." After the visit, DCF decides whether the case can go on the low risk track. If so, then it's referred to a contractor like Wellmore. Once that happens DCF closes its case and the family works directly with the community provider to connect them with services. DeRosa met her Wellmore case worker six months ago, her name is Candra.
On one recent visit, they laugh together like old friends as DeRosa jokes about her amputation. "You know the other day I actually reached for something with my left hand? I was like, ‘you dumbass’. I do it all the time, it's been almost a year!"
Wellmore has helped DeRosa connect with her brother who lives out of state. He's now the legal guardian of her children in case her health declines. The provider also has connected her son with grief therapy.Most importantly, DeRosa and her children still live together as a family. DCF Commissioner Katz says that's the goal of differential response.
"So if we do our job well and then providers like Wellmore do their jobs well the transition is pretty seamless."
This year thirty-eight percent or more than fifty-seven hundred reports to DCF were accepted as low risk and they were handed off to a community provider. One thing to note, family participation is voluntary in the low risk track. They don't have to accept help but that's been the case less than five percent of the time according to DCF. Overall, the way that state has implemented differential response is being noticed especially by one of DCF's toughest critics.
"So far, it looks like Connecticut is quite a good example nationally of how this is being done." Ira Lustbader is the Associate Director of Children's Rights, a national advocacy group. It's the same group that sued DCF in 1989 for negligence in serving the children in state custody. He says the state has implemented differential response correctly.
"I have actually referred to Connecticut as appearing to be rolling that out with the kind of careful planning that one would like to see."
Still Lustbader stresses differential response is a good system only if there's ongoing oversight. He says that's not always the case in states that adopt reform only to save money. Differential response is among several initiatives launched by Commissioner Katz. Yet, DCF still has more work to do before the agency can get out from under a court order that tracks how it cares for children in its custody. The latest report shows the department failing to provide timely delivery of mental health services and case management to all the children and families in its care.