Friday, July 6, 2001 | 5:01 a.m.
Teresa Becker is often frustrated by the frequency with which foster children are assigned new case workers.
The president of the Foster Parent Association of Southern Nevada once had a foster child who was assigned five state case workers in three years.
"If you pay case workers better and give them a lower case load, hopefully they will stay longer and won't burn out so quickly," Becker said. "The children don't trust the system when you keep on handing them to someone else who is in charge of their life."
Becker hopes foster children won't have to endure as many new case workers when Clark County Family & Youth Services takes charge of the entire local child welfare system.
In perhaps its most important decision affecting children this year, the Nevada Legislature passed a bill requiring the state Division of Child and Family Services to transfer control of foster care to Clark and Washoe counties. Clark County alone has about 2,000 foster children.
Known initially as Assembly Bill 343 and later as Assembly Bill 1 when the legislators met in special session, the transfer of authority signed by Gov. Kenny Guinn should be completed by 2004. Clark and Washoe currently take abused and neglected children out of homes and transfer them to the state. That system is unusual as these counties are the only two political jurisdictions in the nation with such an arrangement.
The state runs the entire system in the 15 rural counties. In the other 49 states, child welfare is run entirely by the state or by the county. UNLV professor Thom Reilly, a former deputy administrator of the state Child and Family Services division who becomes Clark County manager July 27, said the split system in Clark and Washoe needed to be eliminated because of inefficiency.
"Every study that was done by the federal government and child welfare groups had always questioned the effectiveness of the system," Reilly said. "There is a duplication of services and a duplication of effort.
"In a bifurcated system you actually need more case workers. You also have to change the child's therapists because the county does not have to use Medicaid providers whereas the state does. The multiple hands in the pot have a devastating effect on children and families."
The Las Vegas Sun exposed problems with the current system in a six-part series in 1997 that examined child protective services in Clark County. Two years later a special legislative committee was created, and its efforts led to this year's legislation.
The county now takes abused or neglected children out of their homes and provides temporary shelter, usually for up to two months. On average, the county starts about 800 new investigations each month, averaging 1.7 children per case. Children deemed eligible for long-term care by Clark County District Court are transferred to the state's foster care system. This transfer of authority has been far from seamless, however.
Although county and state case workers are supposed to meet when a child is transferred to state custody, the Sun reported four years ago that this happened only 60 percent to 70 percent of the time because of scheduling conflicts. A large number of cases fall through the cracks.
Although the county and state have done as much as possible to bridge those communication gaps, no one involved in local child welfare likes the current setup. Mark Fitzgerald, a county child protective services supervisor, said having Clark run the entire system should eliminate gaps in foster child care because all case workers will be under one agency.
"You always get improved communication when people are sited together," Fitzgerald said. "There will be a smooth transition of the cases. It will help in the courts, too. Judges will only have to deal with one agency rather than two."
Because two levels of government are involved in the same child welfare system, records on many children are not as complete as they should be. Becker said it once took her two years to obtain a copy of a birth certificate for one child.
There have been gaps in a child's recorded medical history, so much so that foster parents are sometimes unaware that a youngster suffers from a particular malady. A county case worker might know details about a child's personality or relationship with a relative that somehow does not get passed on to the state.
It has also been difficult for the local child welfare system to comply with the 1997 Adoption and Safe Families Act. The federal act requires that authorities develop a permanent plan within a year regarding a child's removal from a home. This can include adoption, legal guardianship, long-term foster care or return to the child's family.
Under the split system, plans for permanency typically have been delayed by at least six months per case.
"You cannot afford to have an inefficient handoff from the county to the state," said Adrienne Cox, assistant director of the county's Family & Youth Services. "If we don't comply with the law, we stand to lose federal reimbursement that amounts to about $20 million a year in Nevada."
How Clark's system evolved goes back decades, even before child abuse was on the nation's radar. The state initially handled foster care and neglect cases. But local judges, unhappy with the state's performance in neglect cases, ordered their transfer to the county. The state then took on abuse investigations.
In the late 1980s the county also inherited abuse cases. In return, the state assumed the county's mental health care duties while continuing to run foster care. The result was a child welfare system run by two levels of government.
The 1999 Legislature formed a committee led by Assemblywoman Barbara Buckley, D-Las Vegas, to develop a plan to dismantle the current system.
"The bifurcated system was an antiquated, poorly designed way to serve children," Buckley said. "This is the most important piece of legislation enacted by the Legislature this year. As I look back, this is the legislation we can be most proud of."
To help Clark and Washoe develop their own systems, the new law will make a one-time allocation of $5.16 million to be shared by the counties. They will also share $1 million in fiscal 2002 and $5.6 million in fiscal 2003 for ongoing costs related to the transfer of authority.
This funding will help Clark absorb 144 state workers who will become county employees. Many make considerably less than equivalent county workers and will be in line for hefty pay raises. It is partly because of the higher pay that Becker said she believes case workers will stay on the job longer.
The law also established mental health consortia for Clark and Washoe that include representatives of child welfare, health care financing, school districts, juvenile probation, business, foster parents and parents of emotionally disturbed children. The consortia will develop mental health recommendations that will be forwarded to a newly created interim legislative committee on children, youth and families.
The importance of mental health cannot be overstated. Nevada, which has one of the most poorly funded mental health systems in the nation, has been particularly woeful in providing such services to foster children. Lawmakers were told that 36 percent of all foster children suffer from severe emotional distress, but about one-third of those youngsters were not receiving counseling or therapeutic services in Clark County.
"We increased funding for the therapy that these children need, but we still haven't done enough," Buckley said. "We pay a lot for institutionalization. If we took care of these children at home, we could take care of more children for less money."
Becker, who has been a foster parent to 12 girls over the past seven years, said it is not uncommon for foster children to endure long waits for counseling. Behavioral problems that go unchecked are a primary reason many foster children bounce from home to home.
"The kids go through episodes when they get upset, but to get help there's a three-month wait for counseling, and a lot of the counseling that is available is horrid," Becker said. "Children that have been pulled from their family need grief or loss counseling, and foster parents are not trained in that area. These kids need someone to talk to."
State case workers, meanwhile, have been so underfunded that their heavy case loads -- about 40 to 45 foster children each in Southern Nevada -- doesn't permit them to spend much time on any child. Coupled with relatively low pay, the result is often job burnout. It is common for foster children to go through multiple case workers each year.
The new law's funding is intended to help Clark County achieve case loads of as few as 28 foster children per case worker by 2004.
The state Child and Family Services will oversee child welfare from a regulatory standpoint, but is preparing to assist Clark County in the transition. Christa Peterson, deputy administrator in Las Vegas, said state workers had questions about their future responsibilities as county employees, but she added that "we'll be working hard with the county to reduce disruption in services."
"The intent of the legislation was not to transfer an under-resourced system to the county, but to enhance it," Peterson said.
A key player in the transition will be Cox, who will help oversee the child welfare system merger for the county. Before the county tackles foster care it will have to merge county and state records on each child. Space will also have to be found for the former state workers, although one potential solution is for the county to assume leases of buildings used by the state.
"It's a lot of people to bring over at one time," Fitzgerald said. "It's going to be a culture shock for them and a culture shock for us."
Cox sees the unification as only the beginning of improvements she hopes will be made to the system. She said she would also like to see increased funding for mental health care and for front-end services such as transportation and housecleaning instruction to enable families to keep their children rather than lose them through neglect.
Cox also intends to improve recruitment of foster and adoptive families. The foster parent end of the equation got a lift this year in separate legislation that boosted the state's daily reimbursement from $13.28 to $19.50 for foster children who are younger than 13 and from $16.33 to $22.50 for teenagers. Buckley said Nevada went from the bottom third in the nation to the top third with those increases.
"It is our hope that when we unify the system it will be seamless for the children and the families," Cox said. "The number of things you've got to do is phenomenal when you're taking on this kind of program."