Safety of group homes hard to check

Why wasn't CPS called in on this situation? Why are these "homes" allowed to take children if they are abusing them? Why aren't they more closely monitored (even for the adults) when many of these patients can not defend themselves? Why....? Why..? Why???
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By JULIE MURPHY, Staff writer
August 28, 2011 12:30 AM

GLENWOOD -- Chris Nicoles sits and draws at the kitchen table while Louise Harwin watches television in the family room.

It's a familiar scenario in homes everywhere, except that Nicoles and Harwin live in a group home for adults with disabilities.

"These houses are supposed to look like any other house in the neighborhood," said Ed DeBardeleben, area administrator for the state Agency for Persons with Disabilities. "These (group homes) are their homes."

Outside of making frequent personal visits, there's little parents or guardians can do to ensure the safety and well-being of loved ones who live in such group homes. Most are left to trust that the system and its safeguards are working.

But are they?

Reviews and violations found on a state website for 57 licensed group homes in Volusia and Flagler counties, as well as for other group homes statewide, are often outdated, with the most recent reports in many cases being more than 3 years old. State inspection reports are often vague, providing few, if any, details about a particular home's overall condition or employees' qualifications.

A recent case of criminal abuse of a disabled Palm Coast teen living in a Palatka group home run by O'Carroll Homes illustrates that sometimes problems slip through cracks.

O'Carroll Homes, which runs several facilities in Palatka and one in Hastings, had its Medicaid waiver agreements pulled by the state after four workers and a former employee accused of burning the 17-year-old girl with a clothes iron were arrested and charged in January.

One of the workers was sentenced to four years in prison earlier this month for his role in the abuse case. Four others have September court dates, according to the State Attorney's Office.

NO EASY FIXES

Many group home providers are paid through Medicaid waiver agreements, according to Agency for Persons with Disabilities spokeswoman Melanie Etters. The waivers pay for care and supplies for adults diagnosed with certain disabilities before the age of 18.

While pulling Medicaid waivers doesn't technically close a home, its residents or their families would have to pay for their care privately. Costs vary widely based on behavioral issues, daily living and medical needs, but can run between $35,000 and $150,000 per year, Etters said.

"In general, APD typically closes about two group homes a month statewide," Etters said. "Generally, there are two main reasons why this occurs. First would be some major incident occurs at the group home endangering the health and safety of one or more individuals. Second would be when a home is continually cited for issues during monthly monitoring and has not corrected any of the issues within a reasonable amount of time, and the agency is concerned for the health and safety of the people living in the home."

After her daughter was burned in January, Jeanette Roscoe moved her to another group home in North Florida and thought she had found an ideal site -- just as she had when she took her daughter to the O'Carroll Homes facility in Palatka 11 years ago.

"The first time I did research, (O'Carroll Homes) were long-standing and had all the credentials," Roscoe said. "I looked at the cleanliness, that she'd have her own room and the ratio of staff to patients."

Roscoe also closely inspected the North Florida facility where she decided to move her daughter, who she said has the mind of a 2- or 3-year-old. Again, Roscoe studied employee folders and resumes, scrutinizing who administered medications and where they were kept.

But again, her daughter suffered serious injuries. This time, she jumped through a window at 5:30 a.m. Aug. 10 and wound up needing more than 100 stitches and staples to close her wounds, Roscoe said.

"It was a 5- to 6-foot drop out the window," Roscoe wrote in an email to The News-Journal that included images of her daughter's injuries. "I thought she had one-on-one supervision, but she didn't. At least she didn't then."

LONG WAIT FOR CARE

The group homes overseen by DeBardeleben's office, which covers Volusia and Flagler counties, include small family-run operations as well as homes owned by large businesses such as Duvall Home, LifeShare, Sunrise Community and National Mentor.

Group home workers are expected to undergo criminal background checks through the FBI, Florida Department of Law Enforcement and local agencies. They must also sign an affidavit that they are of good moral character, DeBardeleben said. "Zero tolerance" training is also required and employees are instructed to treat residents with dignity and respect, as well as to look for signs of abuse or neglect and to report it to law enforcement.

But researching group homes is complicated, said Jim King, executive director for The Arc of Volusia, which provides programs to increase independence and quality of life for adults with developmental disabilities.

"It's not an easy situation," King said. "There (is) a waiting list of people not getting any services. Funding has always been limited and it keeps getting cut. These are all independent businesses -- some big, some small."

DeBardeleben said more than 20,000 people are on the waiting list for Medicaid waivers statewide.

Martin Favis, president of the Duvall Home -- among the largest care providers for the developmentally disabled in the country -- said the challenge is to provide a homey setting for its 160 residents who live in 10 group homes and one larger congregate-living facility. Some pay privately while others have Medicaid waivers.

"Not every individual has a vested parent or guardian," Favis said as he walked through the home where Nicoles and Harwin live. "We want to have compatible homes where people have things in common. This is their home and it should feel that way."

Favis admits things weren't picture-perfect at Duvall before his arrival three years ago.

"We've come a long way in three years," he said. "APD (Agency for Persons with Disabilities) wasn't happy with us. There were funding cuts and financial problems. We had to really mend our relationship."

Group homes are monitored monthly, typically by a two-person team from the Agency for Persons with Disabilities. The exception is "respite homes," those that only take people who need temporary care -- for instance, if a family goes on vacation. They are not inspected if they have no residents during a given month.

"Group homes have their own niche," DeBardeleben said. "We want clients to have a choice so they integrate into the community, and different clients have different needs."

FINDING A NICHE

Some homes have nurses on staff. Others are "intensive behavioral residential habitation group homes," which handle patients who may be a danger to themselves or others.

One Duvall Home niche is that it is an adult-only facility.

"I'm hoping to get (my daughter) placed in Duvall," Roscoe said. "She turns 18 on Sept. 9 and hopefully we'll be able to transfer her that day."

Roscoe, her daughter, her daughter's case manager -- officially referred to as a waiver support coordinator -- and other officials from the Agency for Persons with Disabilities, as well as Favis, are working together to help Roscoe's daughter make the transition.

"I'm waiting for this to all settle down," Roscoe said before breaking into tears.

Roscoe believes her daughter should have been reassessed in January after she was burned. A reassessment is usually done once every three years, with exceptions made for crises.

"That was a crisis," Roscoe said. "I think she was in shock immediately afterward, but I can only guess that because of her limited verbal communication. She wets the bed now and has been self-mutilating. It's post-traumatic stress. And I'm tired. I'm trying to protect her. I'm trying to protect her from other people. I'm trying to protect other people."

Source

http://www.news-journalonline.com/news/local/flagler/2011/08/28/safety-of-group-homes-hard-to-check.html

I-Team: Troubled Foster Kids Exposed to Powerful Drugs

Posted: Aug 10, 2011 3:16 PM CDT
Updated: Aug 11, 2011 9:24 AM CDT
By Colleen McCarty, Investigative Reporter
By Kyle Zuelke, Photojournalist
By Alex Brauer, Photojournalist

Click here to watch a video that goes with this article.

LAS VEGAS -- The use of powerful mood-altering drugs for mental health treatment is on the rise among kids in the care of Nevada's child welfare system. It's a trend the I-Team first examined back in 2009.

Despite assurances from both state and local officials progress has been painfully and perhaps dangerously slow. The data the I-Team received from both the state and the county is such a mess it's hard to say exactly how much the use of psychotropic medications among kids in care has increased.

Numbers from the state and the county -- regarding the same children -- doesn't match. In addition, figures provided to the I-Team in 2009 are somehow different today.

What is clear is that nearly 30 percent of kids in the system are taking at least one of these medications and the state confirms an increase last year. At the same time both agencies were supposed to be fixing the problem.

"These are the very first kids that were place were placed with us," said Jill Fox, a former foster mom who has taken in some 50 children. While most returned to their birth parents, five did not. Eleven-year-old Brooklyn, 9-year-old Sondra, 6–year-old Jenna, 3-year-old Jackson, and 2-year-old Cooper stayed with Fox.

"With children who've been through the trauma, whether it's neglect or abuse or the trauma of instability in their lives, or the drug and alcohol exposure in utero, things go well for a while and then it goes downhill for a while but we always seem to make it back up the hill," said Fox.

It's a climb that -- for some children in foster care -- involves the use of psychotropic medications. These are powerful mood-altering drugs that can come with severe side effects. The drugs are prescribed to kids as young as three-years old.

"Legitimately there are children whose behaviors are such that we need to medicate to get control of the behaviors, to get some stability, so that they can digest the counseling, they can digest the love and the support, but at what point is somebody going to start taking them off?" Fox said.

According to state Medicaid statistics, nearly 30 percent of kids in the child welfare and juvenile justice systems are on at least one psychotropic medication. That's up from two years ago. Despite both Clark County policy and state law drafted at the same time to reduce the numbers.

"Am I disappointed by the slow roll out on this policy? Yes," said Mike Willden who is the head of the Nevada Department of Health and Human Services which oversees the state's child welfare system.

"What is the real issue is that children are being overmedicated. Their health is at risk, those kinds of issues. That's the real issue, not whether or not we have the right form or we don't have the right form or something like that. You want to ensure that prescribers are accurately addressing a child's welfare needs," said Willden.

Willden tells the I-Team, despite the two-year delay, both Reno and the rurals have implemented state policy requiring a child's parent or legal guardian, or in their absence, a court consent, to the use of psychotropic medications.

Clark County however -- to Willden's frustration -- has yet to comply.

"I could make excuses for them, I'm not going to. It should've been straightened out a long time ago, even at the state level, we should've moved quicker," he said.

The county declined the I-Team's request for an interview yet earlier this year Tom Morton, the former Director of Clark County Family Services offered this explanation to lawmakers.

"We have been unable to implement our version of the policy because we don't have funds for a psychiatric consultant who can review the medication prescribed by the prescribing psychiatrist or physician."

In a written statement, the county insists it is now working to meet the requirements mandated by both the 2009 and 2011 legislatures to improve the management of psychotropic medications.

Read Clark County's Statement

Until then, moms like Fox, will worry about the little kids on big drugs who depend on the system to keep them safe.

"It needs to be a front burner issue," said Fox.

Clark County has submitted an implementation plan. Director Willden tells the I-Team he's given the county 90 days to come into compliance.

If there is a silver lining, psychotropic drug use among kids age 5 and under is on the decline due in part to additional oversight from Medicaid. Willden says that same oversight will apply to all age groups in the near future.

Source Article http://www.8newsnow.com/story/15245079/i-team

52% of foster kids are prescribed psych drugs—One of them is fighting back

By CCHR Int - Original Article 06-23-2011

At just 6 years of age, still grieving over the death of the only mother he’d ever known, his foster mother, Giovan Bazan received the first of many psychiatric “diagnoses” and drugs that would plague him for the next twelve years of his life. Moved from foster home to foster home, orphanages and other modes of state care, Giovan was stigmatized with a plethora of psychiatric diagnoses and drugs until the age of 18, when he could finally make his own medical decisions and quit. Now a child advocate working part time at the Division of Family and Children Services (DFCS) in Georgia, Giovan is on a mission: To get a full-time job with DFCS and help enact laws to combat the wholesale labeling and drugging of foster children. In the video below, Giovan tells his story and why he decided to fight back against the abuse of kids in foster care.


Foster kids—often removed from family homes because of abuse—are further abused when they are prescribed psychotropic drugs under state care. Many of these children are on cocktails of prescribed drugs, including antipsychotics and antidepressants with documented side effects of diabetes, stroke, mania, psychosis, tumors, coma, suicide and death.

Yet, the rates with which these children are being given drugs has been increasing. The antipsychotic use rate among foster kids increased by 5.6% between 2004 and 2007 (from 11.7 percent to 12.4 percent). Another study in Pediatrics, revealed that youth in foster care covered by Medicaid insurance receive psychotropic medication at a rate more than 3 times that of Medicaid-insured youth who qualify by low family income.

Only half of state child welfare systems have a policy to review usage of these drugs, and those are weak policies at that.

The psychiatric drugging of foster kids has caused so much concern nationally that in July 2010, the Government Accountability Office (GAO) started an investigation into the use of these drugs in foster care, as they are widely used in dangerous combinations, and for so-called “off-label” uses to treat symptoms for which they have not been medically approved. The GAO is looking into the estimated hundreds of millions of dollars of fraud arising from this and is collecting and analyzing data from Florida, Maryland, Massachusetts, Minnesota, Oregon and Texas.

The Medication Of Foster Children

Jan. 7, 2011

A recent 16-state study from Rutgers University on the use of antipsychotics in children and adolescents covered by Medicaid found that foster children received antipsychotic medications at a rate almost nine times that of other children covered by Medicaid.

Here is a PBS video about children in foster care being drugged.

Watch the full episode. See more Need To Know.