INdiana Systemic Thinking

February 9, 2008

Inside H.B. 1288: Certified Behavior Analysts

H.B. 1288 requires the state to establish the State Board of Behavior Analysts.  Behavior Analysis, as defined by the bill “means the design, implementation, and evaluation of instructional and environmental modifications to produce socially significant improvements in human behavior through skill acquisition and the reduction of problematic behavior”.  It allows for two levels of Analysts, one requires a Bachelor’s degree, while the other requires a Master’s degree, although the degree can be in any area.  Both certifications require a test and supervised hours.  The requirements mimic the requirements of the Behavior Analyst Certification Board, a non-profit Florida Corporation.

Background

This legislation was first requested at an Indiana Commission on Autism meeting.  Specifically, the commission was asked by Michelle Trivedi, “parent of an autistic child, for the commission to support legislation to be introduced in the 2008 session of the General Assembly that would require board certification for applied behavior analysts.”  The commission heard from Ms. Trivedi, but had many significant questions and did not recommend the legislation be pursued in it’s final report.  However, Rep. Vanessa Summers and Rep. Phil Hinkle, both commission members, introduced the legislation in the 2008 session.

Legislative Progress

Upon introduction, the legislation became very controversial for several reasons.  First, it did not exempt any professionals currently licensed to practice medicine, psychology, mental health counseling, social work, and marriage and family therapy.  Because the definition of what behavior analysis is, it would require all of those professions to become certified as behavior analysts to continue to practice with the licenses they already have.  Thankfully, the authors of the bill agreed to amend the bill to effectively state no-one could use the title Certified Behavior Analyst, unless they are certified.  With this amendment, the concerns of the already licensed professionals were satisfied and they did not oppose the bill in the house.  The bill passed the House last week and is now awaiting a hearing in the Senate Corrections, Criminal, and Civil Matters Committee.

Advertisements

January 21, 2008

10% Laid Off At Dunn MHC

Calling it a “temporary reduction in force”, Dunn Mental Health Center is saying goodbye to 29 employees, according to the Indianapolis Star.  This accounts for almost 10% of their workforce.  Not wanting to sound partisean, here is the whole story from the Star.  Remember, she said it, I didnt.

Twenty-nine employees of Dunn Center Mental Health in Richmond have been laid off, said CEO Kay Whittington on Sunday.Whittington called the “temporary reduction in force” a result of Gov. Mitch Daniels’ proposed cuts in Medicaid and a bill that could limit how much Medicaid communal health centers may offer.
Dunn Center is comprised of a staff of more than 300.”We have had a temporary reduction in staff across (the) seven counties that we provide services to,” Whittington said.The Dunn Center is a Medicaid provider, and the state government has “dramatically reduced what (the center) can do for Medicaid rehabilitation options,” Whittington said.Gov. Mitch Daniels said in early January a new budget forecast that shows state revenue falling below predictions could lead to some cuts “in some of the entitlement programs like Medicaid.””It all relates to that,” Whittington said.Five of the 29 positions laid off are part-time and the rest are full-time, and Whittington said many of the employees were offered a transfer into other positions.

Whittington said she knows of other communal health centers in the state that have laid off workers.

“We’re all faced with the same thing,” she said. “You can’t wait for the ship to sink.”

Whittington will be available for further details about the situation today, she said.

“We wanted to make sure our staff had the weekend to think about (transferring).”

January 12, 2008

Tajanay Bailey Court Hearing Recording Released

According to today’s Indianapolis Star, Marion County Juvenile Court officials released the recording of the last hearing in the Tajanay Bailey case.  A complete overview of the recording is provided by the Star.  However, of most importance is this part;

[Magistrate Scott] Stowers’ questions focused mostly on the process of the case. At the end, he approved the DCS plan to initiate unsupervised visits with approval from the counselor and the advocate.

Read that closely… “he approved the DCS plan to initiate unsupervised visits with the approval from the counselor and the advocate.”  In the Blogmeister’s experience, it is not unusual for a Judge, or Magistrate in this case, to approve certain things, pending approval of counselors and advocates.  The reason for this is these people often know the case the best, have a great deal of contact with the family, and, in the counselor’s case, have more training and expertise on family issues than anyone else involved.  So, no problem there (except, again in my experience, DCS hates this because they feel their paying for the case, so they should get to say).  However, his order was to initiate unsupervised visits pending approval, not initiate reunification. 

At the core of this case, and yet to be determined, if ever, is who made the decision to go beyond the Court’s mandate and reunify this family.  The Blogmeister’s guess…someone at DCS.  Why you ask?  They had the most to gain by reunifying the family.  They would save foster-care and treatment money and it would fit with their internal provisions to reunify the family within eighteen months.  It is also interesting the advocate and the counselor, remember the two people who the Judge pended his order for their approval, were seeking court intervention to get her back into foster care.  That hearing was scheduled for the day she died.

Now maybe DCS didn’t take it upon themselves to reunify this family.  Maybe it was a “team” decision, maybe aliens came and did it.  The fact is we don’t know.  Until we know who made this decision, can we expect any real changes at DCS?  Further, doesn’t the court now have standing to, on it’s own motion, conduct a hearing to find out how this family was reunified despite it’s own order to the contrary.  I’m no lawyer, but that sounds a lot like contempt of court to me.

December 7, 2007

Daniels Reacts to Bailey Case

In a story just published by the Indianapolis Star, Governor Mitch Daniels calls the TaJanay Bailey case a “tragic, human error of judgment”  and stated,  “the case ‘broke my heart.’ ”

Still, he continues to defend his reforms “to add caseworkers and training to DCS”.   Reporting the reforms have “made a difference, pointing out that there were eight visits to Tajanay’s home in the last three weeks of her life.”  Further, “This [the tragedy] was not from a lack of effort or attention, which used to be the case in Indiana…Children would go months without anyone looking in on them.”

“The system is dramatically better, provably better, recognized nationally now as better, but it still made a tragic mistake here.”

 The Blogmeister understands the need for the Governor to spin this in the best possible light, but look at the facts.  The 8 visits were by outside contractors, not DCS employees. Even after the contractors brought the living/coping conditions to the attention of DCS, the agency refused to remove TaJanay from the home. 

Home-based therapists have contracted with DCS since 1994, not just since the Daniels administration. 

While it is more than likely true children would go months without their caseworker looking in on them,  the Blogmeister did not see anything in the record indicating the caseworker looked in on TaJanay. 

Finally, the Blogmeister has already taken issue with the “recognition” the Governor’s program of reform has received in this prior post.

The Blogmeister continues to support the Governor’s reforms.  However, they do not go far enough and are superficial.  If the Governor wants to truly reform DCS, system wide and systematic changes need to take place in every area of the agency.  Whats that old saying about putting lipstick on a pig, it’s still a…well you get the idea.

TaJanay Bailey, Records Released

[ Updated 8:30 a.m. with information for the Indianapolis Star and Fort Wayne Journal Gazette]  TaJanay Bailey’s records were released today by Judge Marilyn Moores, despite objections by the defense team representing her mother, Charity Bailey.  The file is reported to be either 1600 to 2000 pages, depending on the news outlet. 

Background from the Star:

“DCS had taken the bruised and sickly girl from her mother’s care in May 2006 after a former foster mother took her to the emergency room. Unemployment, drug abuse and domestic abuse had given social workers involved in the case reason for pause during the next year.

By late summer 2007, the documents show that social workers all thought Bailey and Green were making inroads and trying to bond with the children. Green had completed a parenting course and was enrolled in drug education classes, and both had jobs.

They returned TaJanay and her brother, Lawrence Green Jr., home for a 30-day trial visit Oct. 31.

But after the children came home, the couple’s failure to hold jobs, lack of a family support network and a failed drug test by Charity Bailey triggered a rift among the social workers, according to the newly released records and interviews this week. 

The first sign of concern appears in a Nov. 9 e-mail in which case manager Tara Hayes documented a phone call the day before from guardian ad litem Carolyn Thurston, the court-appointed advocate for TaJanay. Thurston asked for a team meeting to discuss the children’s placement.

From what the Blogmeister is able to determine from what he has seen of the records;

On 11/9/07, members of the team working the case expressed frustration the DCS case manager did not inform them of the reunification of the family and “they [case managers] typically do not” inform the other members of the team.”  These emails appear to be between Thurston and home based therapist, Kelly Kochell regarding Hayes.

The Blogmeister can see how this would happen, based on his work with DCS  in the past.  As a contractual provider, it is not unusual to be frustrated with a lack of information from the DCS caseworkers.  There does not appear to be any rule or DCS policy stating providers be made aware of changes in a case.  If there is, it is not followed.  Much of the time, it depends on the working relationship and rapport one has with the caseworker, as to how much information the provider will receive.  This is a constant source of frustration with outside providers. 

Back to the documents:

In an undated email, the home-based therapist advised DCS of Lawrence Green and Charity Bailey’s “inability to provide for their [the family’s] most basic needs” and she recommended the children be removed “as soon as possible”.

In the Star article this morning it states;

In discussing the case Thursday, [DCS Director James W.] Payne said the e-mails did not convey an “imminent danger,” which would be necessary for DCS and police to remove the child without a court order. The normal course would be to raise those issues at the next court hearing, which was set for Nov. 27.

How a parent’s “inability to provide for their [the family’s] most basic needs” is not “imminent danger” is beyond the Blogmeister, but back to the records:

Casemanager  Hayes, on 11/19/07, writes, “I don’t think this is working having the kids in the home.  There are major concerns.” She also discusses how good the foster mother is and may be a good permanent placement for the children.

Again, on 11/19/07 casemanager Hayes, emailed the team working on the case and stated, “DCS has decided not to put in an affidavit for the courts to remove the children as of yet.”  She appears aware of the concerns from other members of the team as she states, “Please know your concerns have been noted and are discussed in the court notes for the upcoming hearing”.  She further states, “thank you for being so patient with me.”  In a response about 40 minutes later, someone, probably Thurston, the Guardian ad litem, emails back and states, “I predict if DCS does not step forward with removal our agency will petition the court to order DCS to do such.”

From the Blogmeister’s knowledge of the system, outside providers can only make recommendations to DCS about what they think should happen in a case.  It is solely up to DCS and the courts to remove a child.  If one reads between the lines, the home-based therapist was screaming for this child to be removed.  In addition,  to tell the case manager another agency will petition the courts for an order to have DCS remove the child is VERY SERIOUS.  It implies DCS is either negligently not doing their job, or there is something else going on inhibiting DCS from doing their job.   The person who wrote that was VERY brave, putting their personal reputation on the line, and was doing the right thing.

Further, the case manager worded her email on 11/19/07 very carefully when she stated, “DCS has decided not to put in an affidavit for the courts to remove the children as of yet.”  Notice, she did not use the word “I”, nor did she identify a person.  It appears she took this to her supervisor who told her the children would not be removed.  It also appears she had some sympathy for other members of the team when she stated, “Please know your concerns have been noted and are discussed in the court notes for the upcoming hearing”.  This gives the case manager an out if the courts decide to remove the child at the hearing, without the case worker getting blamed by her superiors.  One may wonder why the case manger had to ask her superiors if she could remove the child.  Actually, this is standard procedure because if a child is removed, DCS needs to find a place for them.  Again, why is this a problem?  DCS had a foster parent waiting in the wings who, by all accounts, wanted TaJanay.  The reason is all foster parents are paid.  By who you ask?  Well, DCS.  The case manager had to ask to remove the child because it would involve expense to DCS.

Again, back to the records;

On 11/21/07 the home-based therapist attended a meeting with the members of the team and the parents to discuss the case.  The therapist notes the parents did not bring the children, “because she was afraid they would be taken away” from them.  Additionally, she reports, “The DCS supervisor tended to minimize my concerns” and the DCS Supervisor stated “there was no reason to hold the case from closing”.

From the Star:

Cynthia Booth, executive director of Child Advocates, which employs Thurston, said that until mid-November, “the case had been a wonderful example of teaming and collaboration.”

But as differences of opinion came into play that month, she said, the old mentality that DCS knows best and should make all of the decisions seemed to trump the new approach.

“I am a supporter of this reform, and I want it to work,” Booth said. “But it has to be implemented in the spirit of inclusion.

“In this case, I don’t think that was the situation — and the worst thing that could have happened did.”

The next note from the home-based therapist describes getting a telephone call from Charity Bailey informing her of TaJanay’s death.

In a final email, The home-based therapist writes to Hayes and states she did not know there were domestic disturbance calls to the police in the two weeks prior to Tajanay’s death, until she learned of them from the media.  She asks in an email, “why did we not know about that…?” and if she had known, she would have “insisted the children [be] removed”.

 This is the first time anyone has heard DCS was pushing to close the case.  This is VERY interesting.  It also speaks to why someone wanted the family reunited quickly.  If the family was not reunited, either DCS would have to terminate the mother’s rights, and/or continue to work with her and provide services.  Both of those cost money.  In addition, this case had drug on for approximately 17 months, by the time TaJanay died.  It has been the Blogmeister’s experience that DCS wants their cases resolved in approximately 18 months.  In fact, under Indiana Law, a child must be in foster care for 15 months of the last 22 months to initiate a termination of parental rights hearing in the courts.  So,  the logical question is, if DCS has that, why not just terminate the mother’s rights?  In addition to the costs mentioned above, DCS, again in the Blogmeister’s opinion, sees a permanent removal as a failure for their statistics.  When one adds this to the cost and the time-line, one can see why DCS was pushing for a termination to the case. 

To some, this will seem like a pretty superficial reason to chance a child dying.  However, the general public has no idea the pressure caseworkers and supervisors are put under to “make the numbers”.  It is not out of the realm of the Blogmeister’s experience that the above scenario could very well happen.  Still, please remember the conclusions drawn are based on the Blogmeister’s experience and what he is reading in the released documents. 

 Comments by Payne appear to confirm this.  In the Star story he states, ”

“I will defend my staff in their judgment, because it’s our job then to figure out how we can improve that judgment,” Payne said. “My review of this case does not cause me to conclude that there was either malfeasance or misfeasance, nor was there neglect.”  Of course he is going to say this, becasue if the Supervisor was following the 18th month guideline, and feeling pressure to do so, it is a system problem and he cannot blame her for an error in judgment.  Think about it.  If one works for a company and makes an error in judgement and someone dies, they’re fired, as they should be.  If they are following policy and someone dies, well, they can hardly be blamed by that system.

Of paramount importance to this case will be why DCS wanted this case closed so quickly.  A resolution to that question will lead to answers about why DCS did not remove the child as the home-based therapist recommended.

You may review the available released documents here.

The Blogmeister will continue to review and revise this post as more news becomes available today.

Create a free website or blog at WordPress.com.