What's Best for the Child is Secondary to More Federal Money

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[sSRI-Research] What's Best for the Child is Secondary to

More Federal Money

 

 

What's Best for the Child is Secondary to More Federal Money

 

http://www.massnews.com/2002_editions/01_Jan/0102dss6.htm

 

DSS 'Follows The Money;' Makes An Extra $90 Million Per Year

What's 'Best For The Child' Is Secondary To 'More Federal Money'

 

Massachusetts News

By Edward G. Oliver

 

December 1 [2003]--The Department of Social Services is using financial

consultants who specialize in advising the state how to aggressively

" maximize federal revenue. " This means that the decision as to whether to

remove a child from his parents is often a factor of whether the DSS

can get

more federal money, according to many experts. It is reported that the

Department is making an extra $90 million a year by this method. The

practice of hiring private consulting firms to advise and manage child

welfare (and other agencies) is one that is used nationwide by state

governments, sometimes on a no-risk, contingency basis. This means

that the

federal money that is supposed to be helping chil-dren is being

siphoned off

by consulting firms and the children are paying the price. And

Massachusetts

is a leader in the practice. The task force of accountants that

arrive from

the consultants re-engineer how the agencies are run, right down to

training, policy, forms, and other areas to serve the overriding

purpose of

obtaining more money from the federal government.

 

When asked by Massachusetts News if she knew that DSS was using one of the

revenue maximization firms, State Rep. Marie Parente, Chair of the

Legislative Committee on Foster Care replied: " Yes, Andersen

Consulting. In

fact that was one of my big com-plaints. I thought it should have been

looked into. " When I was on the Governor's 'Blue Ribbon Commission' in

1993,

Andersen Consulting volunteered their services and they kept saying it was

management and maximizing revenue and they could do it; they're in the

business. In the end they got a three million dollar contract and I think

they still hold it today. I objected. I thought it was unethical and I

thought there were state workers at the time doing that work and we never

needed Andersen. We have a fine revenue collec-tion department in DSS.

Andersen carved out a niche for themselves and I think they still

have the

contract. "

 

A spokesman from Andersen Consulting, Meg Travis, tells Massachusetts News

that at one point they had three contracts with DSS and the last one ended

in December of 1997. DSS spokesman David Van Dam confirms they used

Andersen

until late 1997; and when asked, he said DSS now uses another consulting

firm called PCG (Public Consulting Group) but when asked what services

they

perform, he did not specify what they do. He says the work Andersen

did that

was related to the Commission was completed by An-dersen. Attempts to get

further information from PCG in time for this article were unsuc-cessful.

 

 

DSS Follows Recommendations For Money

 

When asked if the recommendations for reform from the Blue Ribbon

Commission

were acted on, Rep. Parente answered that DSS implemented those parts

of the

Commission " Report " that Andersen liked which increased the federal

revenue.

She said, " What they did was the parts that Andersen liked, you know, the

money part, the federal reimburse-ment. But my special committee filed a

minority report because I thought they focused on the wrong thing. "

 

A look into the Committee's " Final Report " reveals the " money part "

Parente

speaks about where it states: " DSS should undertake an immediate revenue

maximization ef-fort. " And it continued that DSS should be sure that the

money stays in its hands and does not go to the state. " A retained revenue

account should be established to ensure that funds brought in through the

revenue maximization effort are retained and used by DSS. " An-dersen

reported to the Commission that enhanced revenues held the potential of

claiming up to $40 to $70 million extra dollars per year. The " Final

Report " also reveals that DSS was sticking its toe into the " revenue

maximization waters " nineteen months prior, when DSS conducted an analysis

on the " potential for enhancing federal reimbursements from Medicaid and

other entitlement programs " even as it had " enhanced its federal

reim-bursements significantly over the last few years through the use of a

consultant on a con-tingent contract. "

 

This concept of maximizing federal revenue is beginning to cause

trouble in

many other states as well. In California, plaintiffs sued Health and Human

Services and Contra Costa County for allowing children classified as

disabled to languish for years in foster care while the county seized and

misappropriated their personal SSI and other federal benefits.

 

 

Texas Is Imitating Massachusetts

 

An illuminating report by the Texas Comptroller of Public Accounts,

titled

" Maximize Federal Revenues for Health and Human Services, " is a case study

in the thought proc-esses and cost shifting schemes associated with

maximizing federal revenue. While some of it is sound management

techniques,

it is a short leap from creatively squeezing federal dollars from active

cases to directly targeting children for removal from the home based on

certain demographics and categories - especially if consultants are

paid on

a contin-gency basis. Some examples of children who would bring federal

money with them would be those who are eligible to receive Medicaid (which

would be given to the state if they become foster children) and special

needs children who receive Social Security money.

 

Incredibly, the Texas report frankly admits, " States typically obtain more

revenue from the federal foster care program by increasing the number of

cases that are eligible for federal reimbursement. " Another admission from

the same office is a report titled, " Maximize Federal Funding for Child

Welfare Programs, " which reveals that financial consultants indeed train

agency staff directly to maximize federal funding. " Some states, " says the

report, " that have hired Title IV-E expert consultants have increased

their

federal reimbursements by as much as $20 million or more per year. These

consultants work with child welfare program staff to improve policies,

forms, training and other program elements to generate additional federal

reimbursements. "

 

The Texas Comptroller's Report uses - who else but - Massachusetts as a

shining example of how revenue maximization should be done by confirming

that Andersen's recommen-dations were put into effect. " For example " says

the Texas Report, " Massachusetts raised its percentage of children's

eligible cases for reimbursement from 23 percent of all chil-dren

receiving

services in 1993 to nearly 65 percent in 1996. Massachusetts also changed

how it accounts for its essential program costs so that the state could

claim full instead of partial reimbursement. Massachusetts received $58

million more in federal funds in the first year, $64 million in the

second,

and expects net additional revenues in the third year to reach from $88

million to $90 million.

 

Massachusetts also considers clients who are eligible for Medicaid and are

either abused and neglected, or at risk of being abused and neglected,

to be

eligible for Medicaid ser-vices through the child protective services

agency. "

 

 

Money Influences Workers

 

The big question that arises out of the quest to maximize federal

dollars

is, are financial consultants hired to advise and train DSS workers in

determining who gets taken out of the home? Do they design risk assessment

models for caseworkers to use on home visits which serve to provide

interesting details that perhaps raise a flag to supervisors about a

child's

potential federal funding eligibility status? For example, a minority

child

is auto-matically considered " special needs " and therefore eligible for

Medicaid. Broadly defined " disabled " children are also very

profitable. The

foster child population is in fact heavily weighted in those

categories now

and those parents are least able to fight their removal.

 

An innocent notation of these " trip wires " by a caseworker may have

serious

implications for the child. If, as DSS claims, a caseworker's notes are

reviewed by supervisors, do revenue maximization considerations enter the

equation when deciding who gets pulled from the home? Perhaps seemingly

irrational decisions by caseworkers to pull a child can be explained

better

in this light rather than a case of widespread incompetence. Perhaps

incompetence comes into play only in the fact that a more educated worker

may question the guidelines, while less trained field personnel dutifully

act without questioning.

 

Virginia based researcher Emerich Thoma, who uses foster care and child

welfare data from many states, mentions that, " Two Massachusetts studies

serve to demonstrate the inextricable link between poverty and child

removal. " He says that in a study of abused and neglected children

entering

a hospital emergency room it was found that if a physical injury was

severe,

it was less likely that the child would be removed. " Specifically, the

researchers found that the highest predictor of removal was not the extent

of a given physical injury, but rather whether or not the family was

Medicaid-eligible.

 

In a follow-up study of 805 children, researchers found that the degree of

physical injury to a child only became statistically significant in the

reporting of child abuse when the family's income was excluded from the

analysis. " Both studies involved Boston-based Dr. Eli H. Newberger who

also

served on the Governor's Blue Ribbon Commission on Foster Care.

 

Attempts to reach Dr. Newberger in time for comment were unsuccessful.

Speaking to Massachusetts News, Thoma quotes the Texas Comptroller of

Public

Accounts, John Sharp, as saying that before a social service agency is

considered to be well managed, there must be at least 50% of its children

who are eligible for Social Security. The Texas Comptroller said,

" There is

a little known formula employed by child welfare agencies, this formula is

called the " penetration rate. " What that means is before a system is

con-sidered fiscally well managed, it has to have a minimum ratio of

50% of

its children as eligible for SSI. "

 

Thoma says the Comptroller " received that information from a

communication

with one of the big consulting firms, I believe it was Maximus. Federal

Grand Juries have looked at this problem in California and what they have

found is that these agencies are dipping into Medicaid, SSI, Title

IV-E, and

virtually everything else they can get their hands on. You end up with six

or eight times the amount of money that is needed for that foster

placement,

and many states bill the parents on top of it. As the Santa Clara County

Grand Jury put it: 'Agencies benefit financially from foster care

placements.' "

 

 

" Cooking the Books "

 

Thoma provides numerous examples of creative, some call fraudulent

techniques, which consulting firms perform for state agencies. He cites a

recent study issued by the Office of the Inspector General of Health and

Human Services. That study, " Review of Rising Costs in the Emergency

Assistance Program, " laments that we are cooking the books to claim

federal

funds by " lengthening eligibility periods, defining emergencies

broadly, and

setting high income limits for determining eligibility, thereby maximizing

federal revenue. The Emergency Assistance expenditures are escalating at a

rapid pace due mainly to three types of costs, juvenile justice, foster

care, and child welfare services. "

 

The prospectus from the consulting firm Maximus, Inc. warns investors, " To

avoid ex-periencing higher than anticipated demands for federal funds,

federal government offi-cials on occasion advise state and local

authorities

not to engage private consultants to advise on maximizing revenues. "

Thoma uses Massachusetts as an example. " Conna Craig, a Boston-based

children's ad-vocate points out that in her own home state of

Massachusetts,

child welfare agencies are known to defer requests for termination of

parental rights until children reach the age of seven, as at that age

children are deemed to have 'special needs' for which child welfare

agencies

may claim additional federal reimbursements. " Massachusetts News has been

unable to reach Craig for comment.

 

 

Ten Thousand Children Every Year

 

Approximately 10,000 children per year are taken from families in

Massachusetts and placed into foster care, according to DSS spokesman

David

Van Dam. Rep. Parente de-scribes for Massachusetts News the important role

federal dollars play in decision-making about those children at DSS. " I

remember Congresswoman Schroeder, " recalls Parente. " She said her greatest

fear about federal funding for DSS is that every time they decided to put

more money into a different facet of DSS, then DSS focused the

attention on

that. It is that way across the country. If they thought that children

should stay with families and that was their big thing that year, all kids

stayed with their families because then the state would get a lot of

money.

If the focus of the federal government and funds change to adoption, then

everybody would get adopted. "

 

Is it really possible that decisions affecting the well-being of children

who cross paths with the Department of Social Services are being made with

emphasis on what will bring in the greatest amount of federal revenue,

rather than what's best for the child? There are indeed monetary

inducements

for DSS to take children from their parents. Federal fund-ing, such as

Title

IV-E of the Social Security Act, reward the placement of children into the

foster care system. Services that focus on family preservation - cases

where

no child is placed into the system - are not as lucrative.

As Conna Craig of the Boston-based " Institute for Children " wrote in 1995,

" The prob-lem with foster care is not the level of government spending, it

is the structure of that spending. As more children enter the system, so

does the tax money to support them in substitute care. As one foster child

put it: 'Everywhere I go, somebody gets money to keep me from having a mom

and dad.' "

 

 

" Foster Children " Changes With New Laws

 

The number of foster children in the mid to late seventies numbered

a half

million in the United States. In 1982, a low of 262,000 was recorded, a

reduction by almost half. Thoma credits a short-lived requirement

passed by

Congress with helping to reduce those numbers so dramatically. " In

1980, " Thoma writes, " Congress passed the Adoption Assis-tance and Child

Welfare Act, or Public Law 96-272. The Act included a provision that

" reasonable efforts " be made to prevent placement in foster care. The

reasonable effort requirement was implemented, in part, because the

Congress

determined that a large number of children were being unnecessarily

removed

from their homes. " The " reason-able efforts " requirement however, lacked

enforcement from the Dept. of Health and Human Services. State

agencies soon

saw it as a paper tiger and returned to routine foster placements

which shot

past the half million mark, where it hovers today.

 

Still, in order for DSS to get paid for the foster child, a judge is

supposed to be convinced that reasonable efforts were made to keep the

child

at home. Critics, such as the Cape Cod-based, parent support group

" Justice

for Families, " charge that this legal proceeding takes place in a secret,

rubber stamp session with nobody else present " to rebut, object, or verify

the truth " except a DSS attorney and a judge. The group claims the judge

routinely signs off on a little known federal form called a 29-c which is

the ticket for federal funds. They charge DSS is guilty of defrauding the

federal government - not to mention trauma-tizing children and their

families. Signed 29-c forms obtained by the parents' rights advo-cates

appear to provide evidence that children are placed into foster care no

matter what the form says when the judge signs off on it. At times it is

blank.

 

In a report issued by the parents' group Cape Cod-based, parent support

group " Justice for Families titled " Findings and Suggestions on DSS

Reform, "

they charge, " By seizing children illegally, in violation of Title IV-E

requirements via the filing of false and fraudulent documents in secrecy

through the courts to obtain federal funding, DSS is de-frauding the

federal

government with deliberate intent. "

 

This was foreseen by the Finance Committee of Congress in 1980 when it

stated: " The Committee is aware of allegations that the judicial

determination requirement can be-come a mere pro forma exercise in paper

shuffling to obtain federal funding. While this could occur in some

instances, the Committee is unwilling to accept as a general proposi-tion

that judiciaries of the States would so lightly treat a responsibility

placed upon them by federal statute for the protection of children. "

 

Now, a new bonus is promised to states who can put kids into the

adoption

phase in a year or so. Like circus lions leaping to the crack of a whip,

states are reordering their pri-orities by passing adoption laws that will

bring them into compliance with federal re-quirements.

 

Massachusetts passed their adoption law in March of this year.

 

As Thoma observes, " The Congress failed to ask one crucial question

when it

passed the legislation; Why are so many children in the foster care system

to begin with? "

 

(Thanks to Charlie for forwarding this!)

 

Charlie Wittman, Director,

Advocates for Children and Families, theacf

PO Box 10, Los Gatos, CA 95031

Main ACF WWW site:: http://www.theacf.org

CRIN: http:: //www.crin.org/organisations/viewOrg.asp?ID=1774

AFRA:: http://www.familyrightsassociation.com/

www.adhdfraud.com

http://www.antidepressantsfacts.com