N.J. alters its therapy for troubled children
Program reform means cutback in home visits
Friday, November 02, 2007
BY SUSAN K. LIVIO
Star-Ledger Staff
http://www.nj.com/printer/printer.ssf?/base/news-12/1193982745128580.xml&coll=1
The Department of Children and Families is making sweeping changes to a
home therapy program that some parents and professionals have called an
expensive, poorly supervised "baby-sitting" service for troubled children.
The reforms will reduce the level of services for about 10,000 children
a year while maintaining the current help for some 7,000 others who need
it most. Other changes will toughen job qualifications for several
thousand therapists and aides who have been providing support to
children in their homes, said Nadia Robinson, the acting director of the
department's division of Child Behavioral Health Services.
Separately, the Division of Consumer Affairs is cracking down on
therapists who have been working in these homes even though they are
unlicensed or have failed to meet other employment requirements.
Robinson said the changes by her department address "resounding concerns
and questions" raised by families, many professionals and the department
about the program, Intensive In-Home Community and Behavioral
Assistance: "When is this good for kids? Are we sure this is okay? How
do we know kids are getting better?"
"We are in a reform process, but we are not going to do it in one fell
swoop because it wouldn't be good for kids and families," Robinson added.
State officials have spent the last year rethinking the home-based
program, a cornerstone of New Jersey's mental health system for kids.
The program cost $100 million over the last five years and raised
repeated questions about how well it works.
A Star-Ledger analysis on Aug. 26, based on state records and interviews
with more than 50 people involved with the program, found the in-home
program grew too quickly with virtually no oversight, few training
requirements and minimal hiring standards.
Some 140 complaints filed with the state since 2004 have accused
therapists and "behavioral assistants" of cutting visits short or
skipping them entirely. Other complaints allege that what was billed as
therapy actually consisted of trips to the mall, a bowling alley or on
personal errands. A few parents alleged emotional abuse; one said her
child had been abandoned at a miniature golf course.
20-HOUR CUTBACK
State officials defend home therapy services, saying they can quickly
dispatch a professional to the home of a troubled family and try to
prevent a child from landing in a jail, psychiatric hospital or foster
care. In a state of crisis, Robinson said, getting a family to an
outpatient clinic "can be an insurmountable challenge."
However, a committee of professionals assembled by Robinson last year to
recommended improvements suggested targeting home therapy for the most
troubled kids, she said.
The department's changes, effectively immediately, cut the number of
hours a private therapist spends with the children who have the fewest
behavioral problems. Therapists will now spend 16 hours, instead of 36
hours, with these children over a 60-day period.
In addition, none of the kids with fewer problems would see a behavioral
assistant at all except under exceptional circumstances, according to a
letter Robinson sent Tuesday to private mental health agencies.
Officials said yesterday about a third of the 30,000 low-risk children
served by the mental health system received home services last year.
Seven thousand other children had severe problems, and they will get the
same level of care.
LICENSED TO HEAL
Robinson said she's also proposing that private, nonprofit mental health
agencies be required to hire only licensed therapists. Nonprofits
account for about half of the more than 250 mental health providers
contracted by the state.
Since 1993, the state has required the other providers -- the for-profit
companies -- to use licensed therapists. But in recent years that rule
wasn't tightly enforced. The Division of Consumer Affairs began a
crackdown in September.
Since then, the state Board of Marriage and Family Therapists has fined
five therapists $250 and another $500 for working without a license at
for-profit companies, acting Consumer Affairs Director Larry DeMarzo said.
"Informally, they said they didn't know" about the rule, DeMarzo said.
"The statutes are clear."
The rule also surprised officials at the children's mental health
agency. Robinson said her office is overseeing the transfer of about
2,000 children to licensed therapists or professionals working for a
nonprofit agency. In a couple of instances, she said, there have been
complaints "from families who've said, 'This person has worked so well,
why do I have to lose this person?'"
Robinson's proposed changes also would require behavioral assistants to
have a college degree and three years of experience in mental health
work -- a big jump from current requirements of a high school diploma,
driver's license and one year working with kids. The proposed rules
require approval next year by the Office of Administrative Law.
WAITING LIST
Many professionals worry how the reforms at the Department of Children
and Families will be implemented.
Richard Mingoia, president of Youth Consultation Services, one of the
largest providers of family mental health services in New Jersey, has
been a critic of the in-home services program. He said the state should
improve all of its mental health services.
"I definitely feel that there is a place for in-home services as a part
of the continuum of care that some youngsters need, but it should not be
provided at the expense of other treatments which may have just as much
value," he said.
Mingoia's staff manages the mental health care of 180 seriously
disturbed kids in Hudson County, many of whom receive home-based care.
He said there is a monthlong waiting list for outpatient care. He
questioned why the state would cut the number of hours that therapists
can spend at a child's home.
"I'm not sure that the cutback is a reversal of the state's
long-standing position on the value of these services, or is just an
expedient excuse to further reduce services and save money," he said.
The state pays a mental health agency $39 every time one of its
behavioral assistants visits a family, compared with $26 when a child
sees a licensed psychologist or social worker in an office. Robinson
said the state plans next spring to use some of the money spent on home
therapy to raise the reimbursement for community clinics and
office-based therapists.
One mental health care manager feared that demanding higher
qualifications for therapists and their aides will make it tougher to
fill jobs that generally don't pay well.
"I'm really worried there aren't going to be enough people out there to
fill the needs we have," said Richard Horowitz, executive director of
the Tri-County Care Management Organization, which oversees the mental
health care for 180 kids in Hunterdon, Somerset and Warren counties.
CURRENTLY CHILD PROTECTIVE SERVICES VIOLATES MORE CIVIL RIGHTS ON A
DAILY BASIS THEN ALL OTHER AGENCIES COMBINED INCLUDING THE NSA / CIA
WIRETAPPING PROGRAM....
CPS Does not protect children...
It is sickening how many children are subject to abuse, neglect and even
killed at the hands of Child Protective Services.
every parent should read this .pdf from
connecticut dcf watch...
http://www.connecticutdcfwatch.com/8x11.pdf
http://www.connecticutdcfwatch.com
Number of Cases per 100,000 children in the US
These numbers come from The National Center on
Child Abuse and Neglect in Washington. (NCCAN)
Recent numbers have increased significantly for CPS
*Perpetrators of Maltreatment*
Physical Abuse CPS 160, Parents 59
Sexual Abuse CPS 112, Parents 13
Neglect CPS 410, Parents 241
Medical Neglect CPS 14 Parents 12
Fatalities CPS 6.4, Parents 1.5
Imagine that, 6.4 children die at the hands of the very agencies that
are supposed to protect them and only 1.5 at the hands of parents per
100,000 children. CPS perpetrates more abuse, neglect, and sexual abuse
and kills more children then parents in the United States. If the
citizens of this country hold CPS to the same standards that they hold
parents too. No judge should ever put another child in the hands of ANY
government agency because CPS nationwide is guilty of more harm and
death than any human being combined. CPS nationwide is guilty of more
human rights violations and deaths of children then the homes from which
they were removed. When are the judges going to wake up and see that
they are sending children to their death and a life of abuse when
children are removed from safe homes based on the mere opinion of a
bunch of social workers.
CHILD PROTECTIVE SERVICES, HAPPILY DESTROYING THOUSANDS OF INNOCENT
FAMILIES YEARLY NATIONWIDE AND COMING TO YOU'RE HOME SOON...
BE SURE TO FIND OUT WHERE YOUR CANDIDATES STANDS ON THE ISSUE OF
REFORMING OR ABOLISHING CHILD PROTECTIVE SERVICES ("MAKE YOUR CANDIDATES
TAKE A STAND ON THIS ISSUE.") THEN REMEMBER TO VOTE ACCORDINGLY IF THEY
ARE "FAMILY UNFRIENDLY" IN THE NEXT ELECTION...
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