DOH Again Faces Tough Questions about Children’s Health

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Standing before a panel of senators from the Senate Health and Human Services Appropriations Subcommittee, Department of Health (DOH) Chief Operating Officer Jennifer Tschetter faced probing questions about the agency’s treatment of special-needs and medically needy children.

Thousands of children have been screened out of Children’s Medical Services Network (CMS Network), the state’s collection of programs for children with the most severe medical issues, into less expensive (for the state) Medicaid managed care. At the hearing, Tschetter was unable to answer exactly how many children had been screened out of the program, although the DOH presentation to the committee made it appear the number was close to 9,000.

Eligibility screening was completed with a tool that an administrative law judge ruled was adopted without proper rule making procedure. That ruling came down on September 22nd and since then not one additional child has been added to the CMS Network. Committee Chairman Renee Garcia (R – Hialeah) expressed surprise that DOH had stopped enrolling children pending the rules challenge.

The rule-making hearing is scheduled for October 16th.

Questions were also raised about the influx of money provided by last year’s legislature for Early Steps, after the program’s administrative staff was reduced from 23 to 5. According to the data provided by DOH at the hearing, in FY 2014-15 nearly 48,000 were referred to Early Steps while only 27,500 (57%) received some level of service. In FY2013-2014, the number of children receiving Early Steps service was almost equal to those receiving services in 2014-15 even though fewer than 44,000 children were referred.


Angry Words and Drama, Oh My!

Those that follow the legislature closely must have felt the disorienting sensation of deja vu last week, as a measure that would have changed background screenings and a clear understanding of standards and oversight of afterschool programs once again stalled in its first committee of reference.

Last year, a similar bill stalled twice before it passed the Senate Children, Family, and Elder Affairs Committee and then failed to be scheduled in its next committee of reference.

Some of the same policy makers who voted last year to expand background checks were in attendance at Senate Community Affairs and prepared to ask questions. The discussion with bill sponsor Senator Smith (D-Broward) covered background checks (which would be reduced under the legislation), and the transfer of oversight from the Department of Children and Families to the Department of Education.

Sen Bradley (R-Fleming Island) focused on the Boys and Girls Clubs who brought forward the proposal and the funding that has been invested by the legislature because of their good work, stating, “whether some of those millions should be used to make sure some of the people who are roaming around the halls are not predators — that doesn’t bother me too much if we’re checking all the boxes to make sure everybody’s safe.”

On the House side, Committee leadership told the media that the companion bill is unlikely to be scheduled in “its current form” or if it involves moving away from background checks.

The bill has created drama both before the legislature and behind the scenes. One lobbyist even wrote to advocates that critical comments were “actionable” when questions were raised about the safety of children should the legislation pass. It is just the tip of the iceberg regarding the divisiveness being caused by the proposal in its current form. Hopefully, future dialogue will be more collegial and constructive.

An in-depth review of the components of the bill by The Children’s Campaign revealed more questions than answers about the oversight and enforcement of compliance with the basic standards outlined in the bill. Specific requirements for health and safety are not outlined and its construction leaves questions about rulemaking power to address this deficit. Senator Smith conceded already there was a lack of definition about those who would be exempt from background checks. The Children’s Campaign also has questions about the membership of a proposed study group.

In Other News…

Child Welfare Reforms under Scrutiny

Florida Department of Children and Families (DCF) presented to Florida lawmakers during presentations in both the Senate and the House last week.

Presentations focused on the progress of reforms begun with SB 1666.

In an effort to gather data and examine Florida’s child welfare system, DCF began the mandated deployment of Critical Incident Rapid Response teams (CIRRT) at the beginning of 2015. The purpose was to investigate child fatalities, learn from mistakes, and make recommendations for system improvement.

CIRRT teams are deployed after a child dies who had abuse or neglect verified by DCF within 12 months preceding the death. In a report to lawmakers, DCF stated that it has trained 200 people from across the state to aid in this process. This includes Child Protective Investigators (CPI), medical professionals, hotline staff, mental health experts, drug abuse experts, and many more. It was reported that the model is moving away from focusing on singular incidents and towards examining family history (drug abuse, mental illness, etc.) and underlying factors.

During the presentation Representative Clarke-Reed (D-Pompano Beach) asked if there were any correlations found from the CIRRT reports so far. DCF Assistant Secretary Janice Thomas responded that most of the children and their families have extensive history with the child welfare system, and that there is a high number of incidents resulting from unsafe sleep. What wasn’t made clear is the frequency of unsafe sleep incidents that also involved alcohol and drug use.

Speaking to members of the Senate Children, Families, and Elder Affairs Committee last Thursday, DCF Secretary Mike Carroll said that he is disappointed in the state’s child death numbers— for which the agency has come under intense scrutiny in 2014. A total of 369 child deaths have been called in to the state abuse hotline so far in 2015. That means Florida is on track to have roughly as many child deaths this year as it did before passing a sweeping child welfare reform law in 2014. For the upcoming legislative session, Carroll said he’ll be looking to put some rules in place to reduce those numbers.

He also reported that he is still in the process of reforming DCF, and that it’s going to take a lot of work.


Child Dies in Lord of the Flies Style Beating at Juvenile Facility

At the end of September, Carol Marbin Miller, a celebrated investigative journalist with the Miami-Herald, broke a story about the death of 17-year-old Elord Revolte at a Miami-Dade juvenile facility.

The official cause of death was the beating Elrod received at the hands of roughly 20 other juveniles. What Miller reported is that there is more to the story than kids beating other kids in detention.

According to multiple people close to the case, including Elrod’s foster mother and a public defender, guards in the Miami-Dade facility are allegedly using “bounties” of coveted food items to incentivize juveniles beating other juveniles.

Chief Assistant Miami-Dade Public Defender Marie Osborne told the Miami-Herald that the “bounties” allow guards to “get around Abuse Hotline charges in an unorthodox way and maintain order and control in a situation where they are seriously outnumbered.”
The problem does not seem to be unique to Miami-Dade. Detainees from around the state have reportedly shared similar stories of contraband food used to incentivize child on child violence. It also does not appear to be a new problem. The Herald reports that complaints about food bribes go back nearly two decades.


Settlement in the Bell Tragedy

Photo Credits: Cox Media Group

Photo Credits: Cox Media Group

A poignant and tragic example of why measures such as the CIRRT reports are so vital is the Bell tragedy.

In September of 2014, 40 miles west of Gainesville, Don Spirit, 51, murdered his daughter, Sarah, and her six children — who ranged in age from 2 months old to 11 years old — before committing suicide.

DCF along with two private companies have agreed to pay $750,000 to settle legal claims resulting from allegations that the Department and private providers could have done more to protect the children.

Under the terms of the settlement, DCF is responsible for 60% of the total amount.

According to the Department, the family had been involved in 18 child protective investigations from February 2006 to Sept. 18, 2014. Don Spirit was involved in six of the investigations and was alleged to have been the perpetrator in three, including a 2008 incident in which he was arrested for physically abusing his then-pregnant daughter.

In response to the deaths, DCF Secretary Mike Carroll ordered the retraining of staff in the department’s nearby Chiefland office and a review of all open investigations involving children 3 years old and younger in Gilchrist and Dixie counties.

 

Photo Credits: Miami Herald

Photo Credits: Miami Herald


In Memoriam – Judge William Gladstone

Last week Judge William Gladstone, a Miami-Dade circuit court judge and lifelong child advocate passed away at the age of 85.

An inspiration to other child advocates across the state and nation, including president and founder of The Children’s Campaign Roy Miller, Gladstone’s positive impact on the lives of Florida’s children and the future generations of child advocates are his public legacy.

Throughout his career, including 20 years of sitting on the bench, Gladstone pressed for new laws and programs to help juveniles under supervision of the child welfare and justice systems. He fought for funding to treat mentally and emotionally scarred children, proper pay for social workers, and overall better treatment of children in the system.

He frequently referred to himself as “a social worker with a judge’s title”. His many accomplishments across Florida and the nation are testaments to that description.

Gladstone was a special juvenile justice adviser to U.S. Sen. Bob Graham and helped design Youth Environment Service, a federal program that allocates land for children’s programs. He worked with Juvenile Dependency Judge Cindy Lederman to expand the Miami Safe Start Initiative, which provides support for babies and mothers in the dependency court system. He created the Last Chance Ranch, a rehabilitation facility for youths charged with violent crimes. Gladstone’s other accomplishments include the Swamp Camp at Big Cypress National Preserves and Everglades, the Gladstone Center for Girls, and the Dade County Guardian Ad Litem program.

According to Seymour Gelber, who finished serving six months ago as a senior judge at 96, “virtually every juvenile program created in Miami-Dade was founded by him, he was the main force and the main factor in developing today’s juvenile court.”

He will be deeply missed by his family, friends, and the network of advocates he helped form across the state and beyond. The Children’s Campaign praises him for his many years of service and the work he has done for children everywhere. We send our deepest condolences to his family, colleagues and friends.

 

This Legislative Connection is brought to you by Amanda Ostrander, Meghan Cottrell, Karen Bonsignori and Roy Miller

Amanda Ostrander        Meghan Cottrell        Karen Bonsignori        Roy

 

With online support from Tiffany McGlinchey

Tiffany

 

 

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DOH Again Faces Tough Questions about Children’s Health