Saturday, June 7, 2008

CPS in Tucson: Too many cases

Tucson Citizen
Editor's Note: This is the first in an occasional series examining Child Protective Services and the state's child welfare system.
Poverty and drug addiction along with intergenerational abuse and neglect are common to Tucson families who end up in court in child dependency cases.
Add to that an overworked child welfare agency and waiting lists for mental health and addiction treatment, and the challenges facing the state's child welfare system become clear.
Child Protective Services has come under fire recently because the organization had been involved with the families of three children who were killed this year: Brandon Williams, 5; Ariana Payne, 4; and her brother Tyler, 5.
CPS workers in Pima County struggle daily to keep up with their caseloads and always go home knowing more must be done in a case, said Cheryl Russell, a CPS unit supervisor in Tucson.
Russell called it a stressful but rewarding job.
Caseworkers here routinely are assigned more cases than the recommended national standard.
Most CPS workers in Pima County carry 14 or 15 cases at a time while the national standard is 13 cases, said Russell, who has a master's degree in social work. She's been with CPS in Tucson for 6 1/2 years.
Russell has oversight of seven caseworkers and an aide who handle 92 cases involving 172 children. Her CPS office is one of several in Tucson.
CPS receives dozens of calls a week from residents, police, schools and others about the welfare of a child. The agency follows a complicated screening process to review each call and determine which need investigating.
Once a file is opened, any number of outcomes are possible. Most cases are resolved with the children remaining in the home, and the parents required to follow a case plan that often involves drug and alcohol counseling, parenting classes or mental health treatment. But some cases result in the child taken from the parents and either placed with relatives or in the state's foster care system.
A large network of nonprofit social service agencies supports CPS. But Russell said the lack of access to addiction treatment and other services hinders the agency's ability to accomplish its mission.
"That's the toughest, most difficult thing I struggle with, trying to get appropriate services for families," she said.
Russell said it's difficult to get outpatient treatment for parents who don't qualify for AHCCCS, the state's version of Medicaid.
It is also hard to get individual psychotherapy - as opposed to group therapy - for clients who need it, she said.
"A lot of times we come up against brick walls with the mental health system," Russell said. "There's waiting lists. Sometimes they don't qualify for individual therapy" and end up in group therapy, which may not work well for clients in some cases.
"The mental health system has standards for individual therapy, which don't always match up with ours," she said.
Russell said she sees intergenerational patterns of abuse, drug use and "incivility" in CPS clients.
"We do have a lot of domestic violence, people in poverty and dependent teenagers who get into the drug thing just like their parents, and then we have to remove their children."
Russell said the overriding goal of caseworkers is to keep children at home whenever possible and "engage the family in services." That is what is best for children, she said.
"Historically, we've moved kids around too often. It deters their bonding, their developmental growth and wreaks havoc on their schooling when they are moved from place to place."
Children who must be removed because they aren't safe at home are moved when possible to a "willing, capable relative's home instead of to a foster home or group home," Russell said.
Taking kids from their home and placing them with a stranger is always tough on children, she said.
"When you remove them, you're taking them from everything that is familiar and putting them with strangers," Russell said.
Judge Stephen M. Rubin, a Pima County Juvenile Court judge who hears child welfare cases, also sees widespread illegal substance abuse in his caseload.
Rubin said about 70 percent of cases involve some type of substance abuse or addiction.
Most of the cases involve neglect of children, not abuse, said Judge Patricia Escher, Pima County's presiding Juvenile Court judge.
The parents are preoccupied with their drug use and children aren't fed, bathed and attended to as they should be, she said.
Rubin is immediate past president of the National Council of Juvenile and Family Court Judges, which sets voluntary national standards for child welfare proceedings.
Rubin has been helping to direct reforms of the child welfare system here, based on those standards, through the Juvenile Court's Model Court program, one of about a dozen nationwide.
Rubin said that for nearly 11 years, the court has been working to improve the child welfare system, but some problems persist that make it difficult for families to repair themselves.
"If you sit in our courthouse on any given day and you watch the cases that come in and you look at the financial affidavits of the parents involved, many of them are unemployed, they have a history of unemployment, they have no transportation and they have no resources."
These factors contribute to children being abused and neglected, he said.
"When people are under stress, they do bad things, and it's very unusual to find someone who is not under stress on the end of a child abuse and neglect petition.
"It's very emotional work," Rubin said of his work overseeing these cases. "You can't do this job and not become involved in the lives of these families.
"It's our job to make sure families are provided the services they need and given the opportunity to reunify (with their children) when appropriate," Rubin said.
What the community needs to help families with substance abuse problems is more neighborhood-based treatment facilities, he said.
"We need to provide it in a way they can actually access it.
"It doesn't make a lot of sense if somebody lives at Mission and Ajo (roads) to send them to a therapist at Kolb (Road) and Broadway when they don't have a car."
Rubin said the state's child welfare agency, the Department of Economic Security's Division of Children, Youth and Families, and the publicly funded behavioral health system "have worked very hard together to utilize the assets that they have in the most effective way possible to provide treatment.
"Certainly they are operating on very limited budgets," he said.
"We know that prevention works, yet funds for prevention programs don't come in to the level that we need them."
Even without more funding from the state and federal government for treatment, Juvenile Court judges here remain committed to working with families who are "disadvantaged socioeconomically and educationally," he said.
Escher said difficult child welfare cases reflect generations of individuals who "have not been parented," who do not know what to do with a baby or even how to structure their time.
With little formal education and limited job skills, some parents who end up in court in a dependency case need help simply to learn how to be better parents, she said.
Rubin said CPS workers here have a tough task.
"The attempt to nurture and educate people who have not been nurtured and educated is an enormous job," he said.
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