[ Are our kids better off than four years ago? Not hardly ]

Are our kids better off than four years ago? Not hardly

By KATHERINE KENT

Special to The Capital-Journal

As a former child welfare worker who has spent 35 years as a mental health practitioner with children and families, and many years as a trainer and consultant to therapists and child serving agencies, I have always been concerned about the limited resources available to serve the children in our child welfare system. However, until four years ago I took some comfort in knowing that there were safeguards in the system that guaranteed some quality of life for them. The changes in the Kansas child welfare system since 1996 have significantly weakened that safety net .

When Gov. Graves took office in 1995, he asked SRS to move with expediency to privatize child welfare. Both locally and nationally, professionals were stunned by the speed and vigor with which the state of Kansas made these changes. Without the benefit of pilot projects and against the recommendations of several study groups working on child welfare reform, the state began signing contracts with private agencies by July of 1996.

Current issues of concern for children in the Kansas child welfare system include the following:

1. Instability and fragmentation, which destabilize the lives of children. Privatization began with the state issuing a request for proposals (RFP) to private agencies. Some of those contracts were not given to the agencies with the most experience and/or expertise in that area of practice. In effect, the children were sold to the lowest bidder.

In 1999 the state negotiated new contracts, with significant changes in its choice of private contractors. This bidding strategy has meant that children suffer repeated losses --- of homes, foster parents, friends, teachers, neighborhoods and therapists --- as they move from one contractor and funding plan to another. If there is one assumption that is supposed to guide excellent child welfare practice, it is that children's placements and relationships should remain stable.

2. Serious debt to contractors and subcontractors --- even agency closure --- as a result of privatization. In 1996 Kansas had many excellent foster and group homes which offered a continuum of services so that children could be placed according to individual need at the most appropriate level of care. Since 1996, respected agencies have been closing at an alarming rate. Others have incurred serious debt that threatens the future of their programs.

A common perception is that contractors are not held accountable for their costs and are not sharing money equitably with the subcontractors who care for many of the children. I hear constantly that neither the state nor contractor Kansas Children's Service League cares if other agencies close because they agree that KCSL will simply keep expanding with the intent of placing as many children as possible in the least expensive level of care --- foster homes --- and allowing other options such as group homes to close.

Recently, KCSL has claimed that research indicates children in foster homes fare better. From my perspective, enhanced recently by many hours studying research in this area, most experts agree that children vary in their needs and require a range of options if their individual needs are to be met. Group homes cost more than foster homes because they provide more services for children who need them. If the contractors succeed in making one size fit all by trying to place virtually all children in foster homes, the financial advantage to the agency is obvious.

I hope the trend in Kansas child welfare is not in the direction of forcing respected agencies, perhaps all group homes, out of business to end up with a monopoly and a mandate by the state for substandard services for our children by offering only one option for their care.

3. The loss of critical services to children in care. Services to children such as hospitalization, psychotherapy, tutoring and respite care have diminished rapidly. Since privatization the children are no longer allowed to use their medical cards for mental health treatment. Instead, the contractors require that 80 percent of the cost of psychotherapy as well as all other services come out of the daily rate so the agencies are able to provide less and less.

4. Difficulty obtaining full and accurate information due to public relations campaigns and questionable "outcome research." Child welfare administrators at the state level have clearly had a strategy from the beginning to present privatization in a positive light and to dismiss or discredit anyone questioning the changes. This effort included a national conference only five months after completing the transition to privatized foster care which showcased the plan to a national audience.

Levered Kahn, a leading authority on child welfare, noted last August that in the early days of privatization, "Kansas was everybody's poster child for managed care" but he also went on to say: "And they have nothing to show for it yet that anyone should copy."

Copyright 2001
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