Making strides

If not for the courage and devotion of his aunt, a 4-year-old boy born to a drug-addicted and incarcerated mother might be lost in a child welfare

system in which American Indian children like him are disproportionately represented. But earlier this month, Lorenzo Gaines-Fuentes was adopted by a Spokane woman of Cree Indian and Hispanic heritage who fought for her sister’s son against cultural biases that nearly resulted in him being taken away from his Native culture and family forever.

Tracy Fuentes’ struggle for Lorenzo was documented by The Spokesman-Review in one of a series of stories in April 2007 that explored solutions to child abuse and neglect as part of an unprecedented community partnership with social service agencies, public officials, business leaders and media professionals called Our Kids: Our Business.

Today, as The Spokesman- Review begins a second, monthlong look at the state of our children’s welfare, Lorenzo again appears on the front page and with every hope for a future rooted in his family and culture.

But his outcome is far too uncommon.

Just this month, 6-month-old Nevaeh Alana Miller was killed, allegedly at the hands of her mother’s live-in boyfriend, a familiar scenario. Child abusers are most often someone the victim knows.

In fact, nearly 85 percent of abused children are the victims of a parent, whether the parent is acting alone or with another person, the newspaper has reported, citing the federal Child Welfare Information Gateway.

Last year, the Washington Children’s Administration received 5,587 referrals in its Spokane office from people worried that children were being abused. Of these, 2,555 referrals, involving 3,690 children, were accepted for investigation.

The Idaho Department of Health and Welfare reported 716 referrals in the five northern counties last year. Of those, 19 percent were substantiated and 72 percent were unsubstantiated or classified as “unable to determine.” The rest were classified as invalid.

The community’s efforts on behalf of its children did not go unrewarded in the past year.

“Spokane police assigned two detectives to work exclusively on child abuse cases. “The Spokane County Jail has begun Engaging Fatherhood classes for incarcerated dads, the first time the state Community Corrections Department has taught the curriculum in a jail setting. The first class of eight men graduated earlier this month.

“The Spokane Regional Health District was one of three communities in the nation to win federal funding for a Nurse-Family Partnership program, which matches new mothers with public health nurses.

“Beginning in April, children at risk of abuse will find at least 75 Safe Places to turn to in an emergency, including every Spokane fire station and many businesses. A similar program has been protecting children in Coeur d’Alene since 1999.

“A Racial Disparity Advisory Committee, mandated by an act of the 2007 Washington Legislature, will make recommendations by 2009 on how to remedy the disproportionate representation of minorities and their disparate treatment in the child welfare system.

“The 2008 Washington Legislature strengthened the child death review system, requiring the Office of the Family and Children’s Ombudsman to report annually on how the state Department of Social and Health Services is implementing recommendations of independent child fatality review panels.

During last year’s Our Kids: Our Business campaign, Washington Gov. Chris Gregoire pledged to increase child safety, and her office’s Government Management Accountability and Performance (GMAP) staff has been tracking progress.

There have been dramatic improvements in two key areas, according to Cheri Keller, a GMAP analyst: Caseworkers respond within 24 hours to urgent calls alleging abuse of children 94 percent of the time, compared with 60 percent four years ago.

In addition, 80 percent of children who are receiving state services but who remain in their homes are visited by caseworkers every 30 days now, compared with 56 percent in 2006.

But much work remains.

In its most recent annual report, released late last year, the ombudsman’s office found shortcomings in three areas: compliance with the federal Indian Child Welfare Act; long-term treatment for children with mental illnesses; and reducing the workload of caseworkers and supervisors in the Washington Children’s Administration.

In the year ending Aug. 31, 2006, the ombudsman’s office, which is charged with overseeing child protection and child welfare services, investigated a record 477 complaints. Most of these complaints fell under two categories, “failure to protect” and “unnecessary removal” of children, reflecting the tightrope the Children’s Administration walks in performing its duties.

That year, the administration received 95,800 requests for services – 78,700 of which involved allegations of abuse or neglect.

Though DSHS Region 4, encompassing King County, generated the most complaints to the ombudsman’s office – 117 compared with 96 in Eastern Washington’s Region 1 – 58 complaints were about the Spokane office, the most of any office in the state.

Children’s Administration workload

Since recommending a reduction in caseloads in 2005, the ombudsman’s office has conducted periodic random reviews of the Children’s Administration, consistently finding much higher caseloads in both Child Protective Services and Child Welfare Services units than recommended by the national Council on Accreditation.

Mary Meinig, director of the Office of Family and Children’s Ombudsman, said these high caseloads are responsible for the “severity of morale in the agency and a sense of its staff being overwhelmed and afraid.”

Meinig’s concerns were confirmed in a study contracted by DSHS that was completed late last year by Walter R. McDonald and Associates in collaboration with the American Humane Association.

The study concluded the Children’s Administration would need an additional 1,540.5 full-time equivalent employees statewide to adequately do its job to the standards required by law.

“If you close the gap with only workers, that’s the number. But there are a number of ways you can close the gap,” said Cheryl Stephani, who heads the Children’s Administration.

Stephani pointed to efficiencies that will reduce workload, including an integrated computer management system, soon to come on line “that will bring qualitative difference in the work of documentation.”

She also said that by May, the administration will have employed 460 new social workers and their direct support staff.

“But with all of those things, there will still be a gap between who we have to do the work and the work that needs to get done,” Stephani said. “So in the next budget cycle we will be looking at what combination of staff we could propose to the Legislature to close that gap.”

Special needs children

In its report, the ombudsman’s office also recommended that the state Division of Children and Family Services, the Division of Developmental Disabilities and the Mental Health Division come together to help families with children who can no longer be managed at home.

Authors of the report were referring to families – biological, foster or adoptive – of children who are developmentally delayed or who have mental health problems or both. There may come a time in the lives of these families when a child could present a significant risk to themselves or other family members.

“Exacerbating these issues, the ombudsman finds that a culture has developed within the agency that frequently shames families who cannot manage special needs children at home,” the report stated.

In response to the report, DSHS Secretary Robin Arnold-Williams wrote the ombudsman’s office that the department was aware of the lack of publicly funded Children’s Long-term Inpatient Programs, known as CLIP, and was seeking appropriations for additional beds, as well as more alternatives to inpatient placement, such as “wraparound” services.

Wraparound services are “individually tailored services to the child and family using a team-based planning process.” A team may include counselors, educators, primary health-care providers or anyone interested in helping the family of a child with mental health issues.

In March 2006, the state Department of Health’s Office of Maternal and Child Health completed a mental health assessment begun two years earlier. It concluded that 8 percent of children in Washington needed mental health services and that nearly 43 percent of these children did not receive needed services. There simply are not enough mental health services in general and not enough inpatient beds in particular.

According to the ombudsman’s report, there are four inpatient treatment facilities statewide providing 91 publicly funded beds. In Eastern Washington, there is only one such facility, Spokane’s Tamarack Center, with 13 CLIP beds.

According to Richard Kellogg, Mental Health Division director of Health Recovery Services Administration for DSHS, the average waiting time for inpatient beds among children 13 to 17 years old is 45 days. The average wait time for children 6 to 12 years old is 90 days.

Because there are so few beds available in Spokane, and none for developmentally delayed children, those in need of inpatient treatment often must be sent to the west side of the state.

Since youths in the child welfare system may already have severe detachment disorders, removing them and treating them across the state is probably not the best course, said Kevin Heid, a psychologist at Sacred Heart Children’s Hospital.

“We have great outpatient services available here in Spokane, but there are times when they are not enough,” Heid said. “Maybe not all of these children need to be removed from their homes, but without other alternatives, that may be all they’re left with.”

The priority of the Children’s Administration is to avoid inpatient treatment if possible.

“Our first approach is to try to help them in home, respite care or wraparound services,” said Stephani, of the Children’s Administration.

But such services also are few and far between.

“Generally speaking, wraparound services have not been funded through the public mental health system as a systemic service that is available throughout the state,” Kellogg said.

In 2007, the Legislature approved funding for a pilot wraparound program in three Western Washington counties to serve 90 children per month. Kellogg hopes the 2009 Legislature will fund this model statewide.

Indian child welfare

There is a reason that American Indian and Alaskan Native children have been singled out for protection by the 1978 Indian Child Welfare Act. Having seen their numbers diminished, Native Americans cannot afford to lose their young through assimilation in a child welfare system that ignores their heritage.

Yet Native children are disproportionately represented in the child welfare system, according to the National Indian Child Welfare Association.

Though Native Americans comprise just 1.7 percent of Washington state’s population, they represent 11.9 percent of children in out-of-home placement; 14.5 percent of unexpected deaths among children who have had contact with the Children’s Administration within a year; and 9 percent of complaints to the ombudsman’s office.

Besides requiring DSHS to convene a task force on disproportionality, the 2007 Legislature allocated $1.8 million to tribes and urban Indian social service agencies to address child welfare issues.

“It isn’t a whole lot of money for all of our children in the state of Washington, whether they are in tribal jurisdiction or state jurisdiction,” said Nancy Dufraine, Indian Child Welfare manager for the Children’s Administration. “However, the appropriation comes from the state Legislature.”

Dufraine said it was the first time in 12 years that she had seen a budget increase for Indian child welfare.

The ombudsman’s office made several recommendations to identify Native Americans entering the child welfare system, notify tribes that children have entered the system, recruit Native foster homes and avoid placement of Native children in non-Native foster homes.

In Spokane County, where Native peoples represent 1.5 percent of the population, more than 10 percent of the children in state custody are American Indian or Alaska Native.

“Yet there are few culturally appropriate rehabilitative services,” according to Tara Dowd, children and youth services coordinator for the NATIVE Project, who was herself raised in foster care. “And there is no coordinated ‘active efforts’ to reunite families,” as mandated by federal law.

Dufraine said the Spokane area has more services available to Native peoples “than most areas of the state put together,” citing the NATIVE Project, the American Indian Community Center, the Kalispel Tribe’s Camas Institute and the Spokane Tribe’s TANF program.

She also said the state contracts with the National Indian Child Welfare Association to provide cultural competency training for Children’s Administration staff.

Also last year, Dufraine said, the Children’s Administration began a comprehensive Indian Child Welfare Case Review for each region in the state

But a look at the review for Region 1 shows the administration has a long way to go to reach full compliance with Indian child welfare law.

In the key category of whether inquiries were made to tribes or the federal Bureau of Indian Affairs to determine a child’s Indian status, the state fully complied 41 percent of the time.

In the category of ongoing “active efforts” to provide social services to the Native family to maintain the child in the parental home, the state fully complied 69 percent of the time.

“It does look dismal,” Dufraine said, “but we have a starting point that is very distinct.”