Moderated by Rick Badie
A legislative plan is afoot that would enlist private organizations to help fix our troubled child protection system. The Division of Family and Children Services would be required to contract out primary functions such as adoption, foster care and case management to faith- and community-based organizations. Is this what’s best for nearly 7,000 of our most vulnerable children? Read the views of today’s guest writers, along with a writer who defends the health care of veterans.
Privatized care may be a great start
By Mark A. Washington
Georgia has seen its share of struggles and successes in its foster care system. Citizens may find it difficult to discern what is real and how prevalent are the issues. The complexities and varying geographies complicate a process of quick-and-easy solutions.
Expectations of citizens and stakeholders are not the problem. Everyone desires a state where children are safe, where families provide the love and support they need to be successful, and where every child has lifelong connections to other adults. The pathway to finding better results seems elusive from the outside looking in. These widely held expectations drive the few involved — paid and pro bono — to improve the system one family at a time.
While some are led to volunteer, foster or adopt, many more are needed to meet expectations. Many individuals are disconnected and distant from a system that has moving parts, players and intersections. More than ever, people in every community are needed to lend time and talent into a stretched, under-resourced system.
The concerns of the past year involving DFCS have led our elected officials to take notice. Gov. Nathan Deal and a group of legislators have initiated a two-pronged response. Deal has reversed the draconian budget cuts of the last six years by replacing 10 percent of the $74 million lost from DFCS and adding staff. While new money is laudable, this step alone will not be enough.
Last week, the Georgia Senate introduced legislation that would privatize the foster care system, effectively placing all services sans investigations with private nonprofits. The bill provides for more localized involvement in buying the services families need, and proposes an atmosphere where communities have a greater voice in the care of children.
Stakeholders, providers and adults who work to support the system are asking questions. They’re curious about how these changes will affect them and the services they provide. They wonder if new service opportunities will be created. They’re frustrated that the accelerated pace of legislation has left them without a voice.
It’s notable that young people who have experienced the foster care system have slightly different concerns. They want to know if this change will help them, their families and their futures. They want to find permanent, loving homes quickly. They’re desperate to stay connected to their families and communities.
These latter questions are the ones that truly matter. We must answer these questions well and with integrity, accepting the system’s complexity and clarifying our collective expectations by investing the energy and money necessary to meet these expectations.
While this legislation is not a panacea to cure all that ails, if a pay-for-performance approach brings about more local involvement and increased funding for protective services and foster care — and if it is put into operation with planning — it may be the start of a better tomorrow.
Mark A. Washington is managing partner of The Washington Group, an Atlanta-based child welfare and behavioral health consulting group.
Screen children in danger
By Melody T. McCloud
Eric Forbes. Markea Berry. Just two of more than 152 dead children who were under the watch of Georgia’s Department of Family and Children Services.
Gov. Nathan Deal promises $27 million during the next three years to hire more case workers, while legislators tout privatization of foster care placements. Privatization has been adopted in some states, but rejected or later reversed by others due to the expense and unsafe placements.
The push for privatization puts the cart before the horse. The main problem with DFCS hasn’t been dangerous foster care placements. Eric Forbes and others aren’t dead because of that; they didn’t get that far. We need places to put endangered children, but first we must identify those children who need to be placed.
Since October, I’ve called for a “mandatory referral” of children to non-agency pediatricians. Upon a third call to DFCS about a child, that child must be referred to an independent pediatrician for examination as well as to counselor-investigators for emotional evaluation.
In a Nov. 6 Channel 2 Action News report, state Rep. Mary Margaret Oliver was asked if she thought mandatory referral was a good idea. Her reply: “Absolutely. Independent medical reviews will be an excellent new source for screening of children in danger.”
Too often, repeat calls were made to DFCS about children suspected of being abused, yet nothing was done — or done correctly — and now, children are dead. Eric Forbes is Exhibit A.
In less than a year, there were 10 calls to DFCS from teachers suspecting Eric was being physically abused. When the father called 911 on Oct. 11, saying the boy had accidentally drowned, police found he had been beaten to death and had signs of longstanding physical abuse. Among other injuries, Eric’s skull was cracked. There were multiple human bite marks all over his body and bruises in different stages of healing.
If Eric had been examined, his injuries would have been detected early, and he could be alive today. As could others.
Legislators should first review current employees’ education, experience and outcomes, have an independent review of DFCS’ case log, and remedy DFCS’ most glaring defect: case management.
I ask the Legislature to summon Sen. Renee Unterman, other members of the Health and Human Services Committee and other legislators; officials at the Georgia Department of Health, Children’s Healthcare of Atlanta and Stephanie Blank’s Center for Safe Children, and community pediatricians and counselors to flesh out a “mandatory referral” law for repeat calls to DFCS about a child.
Florida spends $17 million on its successful system. With wise allocation of funds, Georgia can and should do the same. First things first.
Melody T. McCloud is an ob-gyn and founder/medical director of Atlanta Women’s Health Care.
Veterans deserve care and benefits
By Tommy Sowers
America’s veterans deserve the very best this nation can offer to honor their service and sacrifice. Employees of the Department of Veterans Affairs — nearly one-third of whom, like me, are veterans themselves — care deeply for every veteran we are privileged to serve.
What veterans do not deserve is misinformation and distortions that may cause them to avoid seeking earned services and benefits. They deserve facts.
VA operates the largest health care system in the country, with 1,700 sites. It’s consistently recognized for excellence by independent reviews and organizations. From the Annals of Internal Medicine to the Joint Commission and the RAND Corporation, VA health care outperforms the private sector in care quality, treating acute and chronic illnesses and delivering preventive care. We do this with unprecedented transparency, down to posting public data about each hospital’s performance.
Each day, VA provides veterans and eligible family members more than 236,000 appointments. That’s like seeing almost every active-duty member of the Marines and Coast Guard every day. In surveys, veterans consistently give VA health care high marks, comparable to private sector ratings.
Yet no health care system of this size and complexity can be free of error, some tragic. When an incident occurs, we do what we learned in the military: Acknowledge it. Learn from it. Then, work to fix it.
Misinformation about VA care comes at a cost, discouraging those who might seek help. For instance, suicide is a national tragedy made worse by the fact that the vast majority of veterans who take their lives are not enrolled in VA health care. We estimate more than a million uninsured veterans could qualify for VA health care, but because they don’t know or are told misinformation, they may forego a lifetime of earned care and benefits.
Since 2009, Secretary Eric Shinseki has led an unprecedented expansion of access to VA care and benefits. More than 2 million new veterans have enrolled in VA health care. More than 1 million veterans and their families have benefited from the Post-9/11 GI Bill. In 2013, VA guaranteed a record number of home loans and provided $53.6 billion in disability compensation to 3.6 million.
Our nation has pledged to honor the service of these brave men and women. Those of us charged with providing those care and benefits will continue to serve and continue to improve. Veterans deserve no less.
Tommy Sowers is assistant secretary for public and intergovernmental affairs at the Department of Veterans Affairs.